'The Family That Couldn't Sleep: A Medical Mystery'

"Who is it that says there is a great difference between a good physician and a bad one; yet very little between a good one and none at all?" asked Arthur Young, the English agricultural journalist, in 1787, on a tour of the Continent. Still, faced with a sleepless, thrashing colleague, urged on by his terrified wife, the doctors would have taken action. In a case this grave, the best option was to prescribe the most powerful drug in their repertoire: triaca, or teriaca, or theriaca ex Galena. Or, in English, Venetian treacle. Triaca was a typical Venetian story. Galen himself was said to have concocted the original version of the drug, and the recipe had then followed the Roman armies into Europe. With the collapse of the empire, its formula had survived in the monasteries: for the next fourteen hundred years, it remained the wonder drug of Europe. Triaca was reputed to cure fever and even the plague, and to counteract all poisons. The exact recipe varied depending on the ingredients available in the region and the druggist's tastes.

The Venetians had begun manufacturing triaca in the Middle Ages, taking advantage of their window on the east to ?ll it with ingredients to which other European countries didn't have access. By law, members of the magistrato alla sanita, the department of public health, had to be present when the apothecary ground and mixed these ingredients. The public was sometimes invited to attend too, the apothecary's shop with its impressive jars on burnished wood shelves an appealing locale for a show. Once the health department had certified the treacle as authentic, the druggist was allowed to hang the Venetian stag, the lion of Saint Mark the Evangelist, outside to alert the world that a new batch of treacle was on sale. The hocus-pocus of government certification turned treacle into a patented brand that Venice could ship to the rest of Europe at a good profit.

Treacle's most important ingredient was viper's flesh -- "the base and foundation . . . without which you can absolutely not concoct it," as the great sixteenth-century Bolognese physician Aldrovandi wrote. The theory, enshrined in the work of Galen himself, was that it took a poison to counteract a poison. Since fever was a poison in the body, you needed an equally potent venom to stop it. The best (and most expensive) viper's flesh happened to come from the Euganean Hills near Padua, on Venetian territory.

The doctor's colleagues would have been able to negotiate a good price for the expensive drug because doctors licensed pharmacists in Venice. They would have carried the concoction back to their friend's house, where he now lay confined to his bed. They would have had to put the treacle paste directly on his tongue, bidding him to swallow it, or, if he was too weak to do so, they might have dissolved a small amount of the treacle in rose water to hide its bitter taste, and dripped it down his throat.

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