Most of the antidotes treated of in this chapter are copied from Galen’s work ‘De Antidotis,’ but our author, in many instances, has used the liberty to introduce various alterations, either with the view of simplifying or improving upon the formulæ of Galen. Mesue also treats fully of antidotes in his work, ‘De Electariis,’ wherein he substitutes a considerable number of Arabic articles for those used by the Greeks. Serapion describes these compositions with extreme prolixity. (Tract. vii.) But what shall we say of Myrepsus, who gives prescriptions for 511 antidotes? Of these, and such like multifarious compositions, it would be idle to attempt any general analysis, and therefore we shall pass by all the articles treated of in this chapter unnoticed, with the exception of the Theriac, which was so celebrated in the records of ancient medicine, that we think ourselves called upon to give some further account of it. Galen devotes two distinct treatises to the consideration of the celebrated theriac from vipers, besides giving a general description of it in his work on antidotes. Our author’s account of it is merely an abridgment of his. Galen mentions that Mithridates, king of Pontus, had, by repeated experiments upon condemned malefactors, acquired a most thorough knowledge of the proper antidotes for almost every venomous reptile and poisonous substance, and hence he constructed the composition bearing his name, which was long esteemed as a general antidote to deleterious substances. From it Andromachus, the chief physician to the emperor Nero, formed his famous theriac, having added the flesh of vipers, and otherwise altered some of the ingredients in the theriac of Mithridates. The prescription for it was translated into verse by Damocrates, and the poem, consisting of 174 lines, is preserved in Galen’s work, ‘De Antidotis.’ As stated by Galen, it was composed of inspissated juices, liquid juices, barks, roots, flowers, seeds, and fleshes. Of the vegetable substances which entered into the composition of it, it is difficult to remark any one general character, although one can have no difficulty in perceiving that by far the greater number of them are hot, volatile stimulants, which, agreeably to the ancient views of practice, as explained by us in the [Fifth Book], were supposed to counteract the frigidity of poisons. It was, no doubt, with the same intention that Andromachus added the flesh of vipers, from which, as a modern author, Moses Charras, remarks, a volatile salt and oil are procured. In preparing the vipers, Galen directs us to cut off the head and tail to the extent of four fingers’ breadth, and then to take out their entrails and fat, and boil them until the backbone be separated from the flesh, when the latter is to be taken out and formed into trochisks, with crumb of bread. We need not occupy time with detailing all the other steps in the formation of this multifarious composition, as our author’s account is sufficiently ample and accurate. Galen expresses great confidence in it, especially as an antidote to poisons, and a remedy for inveterate diseases of the skin, such as leprosy and elephantiasis. It derives its name, he says, either from its being used as a remedy for the stings of venomous animals (θήρια), or because the flesh of such a reptile, namely, the viper, entered into the composition of it.
The Greek authorities subsequent to Galen repeat his directions for forming this celebrated medicine, and any alterations which they make in it are not very important. The Rheum barbarum instead of the Rhâ Ponticum appears in the prescription given by Myrepsus. Like his predecessors, he praises the theriac not only as an antidote to poisons, but as a preservative from pestilential diseases. Actuarius, who describes it very accurately, pronounces it to be the best of all the antidotes.
Averrhoes’s treatise on the theriac is interesting and worth consulting, although his views are upon the whole much in accordance with those of Galen. He seems to have referred its action as a medicine to its power in rousing the vital heat of the system; and hence he very properly forbids it to be administered in all cases of an inflammatory and bilious nature. He therefore condemns the use of it in pleurisy unless when the pain is dull and chronic. He says, it ought not to be given in cases of difficult parturition, unless when it is wished to rouse the expulsive faculty, or when the fœtus is dead. According to his account, the composition has not arrived at perfection, when it is four years old, and it retains its powers until after forty years.
Haly Abbas sums up the medicinal properties of the theriac with stating that it dries the natural humidity, strengthens the viscera, cleanses the organs of food and respiration, and expels superfluities from the brain. Hence he pronounces it to be a remedy for all the diseases which attack the human body. (Pract. x, 4.)
Serapion describes the following methods of trying whether the theriac be good: 1st. Give of it to the amount of a drachm to a person who has taken a powerful emetic or cathartic, such as white hellebore or scammony, and if it counteract the effect of the medicine that has been taken, we know that it is genuine. 2d. As Galen directs, having got a wild cock, allow it to be stung by a venomous reptile, and then give it a proper dose of the theriac. If the fowl escape unhurt we are sure that the medicine is good; but if he die we know that it is not to be depended upon. 3d. Give a poisonous substance, such as opium, to a cock or a dog, and then administer the theriac, the powers of which may be judged of from the result.
Moses Charras, who published ‘The Royal Pharmacopœia’ about the end of the seventeenth century, thus enumerates the medicinal uses of the theriac of Andromachus: “Treacle being composed of a great quantity of hot medicaments, ought to be very much esteemed for the cure of cold diseases, and of all those where the natural heat is feeble and languishing, especially, among the rest, of palsies, epilepsies, convulsions, and all cold diseases of the head. It is proper against all weaknesses and want of retention in the stomach and intestines; against the diarrhœa, dysentery, lientery, morbus cholera, and all sort of colics; against agues, and particularly the quartan; against the worms; against all sorts of poison, the pestilence, smallpox, the measles, and all epidemic diseases; against the biting of mad dogs and all sorts of venomous animals; against want of sleep, and griping pains in children; against hysteric passions, the jaundice, and an infinite sort of other diseases.” (P. i, c. 20.)
This famous medicine was expelled from the ‘British Pharmacopœia’ about the middle of the last century. When its rejection was proposed by Dr. Heberden, the College divided upon the question, and there were found to be 13 votes for retaining, and 14 for rejecting it. Its medicinal virtues had been previously questioned by Capivaccius, Trincavallius, and Julius Alexandrinus. It is still retained, however, in the ‘Codex Medicamentarius’ of Paris; and, we understand, is much used by the Greek physicians in Constantinople. A formula for a theriac is contained in the Greek Pharmacopœia of the present day. Although it still retains the name of “Theriaca Andromachi,” it consists of but a very small number of ingredients in comparison with the original preparation. Dr. Mead says of it, “The physicians in Italy and France very commonly prescribe the broth and jelly of viper’s flesh to invigorate and purify the mass of blood exhausted with diseases or tainted with some vicious and obstinate ferment.” (On Poisons.) Upon the virtues of viper’s flesh, Duemerbroeck expresses himself in the following terms: “Carnes viperinas ac serpentinas adversus multa venena eximiam antidotalem vim obtinere adeo notum est ut absolutè negari non possit, idque non tantum liquet ex Galeni testimoniis verum etiam ex quotidianâ experientiâ. Sic Hartmannus scribit se propriis oculis vidisse, a quodam experto medico tribus diebus continuis intra corpus gravissima quædam venena assumpta eademque paulo post sine ullâ noxâ, ab exhibito pulvere cum astantium admiratione iterum expulsa fuisse.” (De Peste, iii, 5.)
SECT. XII.—ON TROCHISKS, OR TROCHES.
Trochisks are so named from their form. There are three kinds of them. For some of them are to be swallowed, some injected, and some rubbed in. Of those which are swallowed, some are for restraining the belly, or a flow of blood, or any other discharge, by their cooling, astringent, obstruent, or desiccative qualities, such as that from Egyptian thorn, that from seeds, and the like. Some are anodyne, either by deadening the sensibility, such as the saffron, or by dispelling, like those from aromatic substances. Some act as deobstruents on the spleen, kidneys, and liver, such as that from bitter almonds. Of those which are injected, some are for blunting acrimony, as in dysentery, such as those from pompholyx, starch, and Samian earth, injected with the juice of ptisan, or the like. Some act as astringents upon the alvine discharges, or a flow of blood, as those from alum, acacia, and omphacium, such as that of Philip; or that consisting of Egyptian thorn, injected with the juice of roses or of plantain. Those that are caustic agree with spreading dysenteries, being composed of sandarach, arsenic, quicklime, and burnt pepper; but they are to be injected with the juice of lentils or of rice, the intestine being first washed out with salt water, and the patients having eaten and drunk beforehand, so that none of the powers of the medicine may be carried up to the stomach. Those trochisks which are injected prove serviceable principally in affections below the navel, for their power does not reach higher up. Those which are rubbed in are possessed of similar powers to those which are injected. But the astringent ones are applicable in herpes, exanthemata, intertrigo, hemorrhage, and ulcers attended with discharges, such as that of Andron and that of Polyides. Those possessed of blunting powers agree with carbuncle, and ill-conditioned ulcers, such as the white trochisks, and that from lotaria. Those which burn as those mentioned above, like the Faustian, are applicable in spreading ulcers in the pudenda and anus, and for pterygia and sarcomata.