Theriac: An ancient brand?

Nero’s improved formulation, Theriaca Andromachi, together with the original mithridatium, dominated the market for poison antidotes for nearly two millennia. Renowned physician Galen (130–210 CE) championed Theriaca Andromachi in particular, which ensured the popularity of these formulations for centuries, even though the original recipes were lost.

Their ancient ancestry certainly gave them an aura, as did the sheer volume of ingredients. In the first century CE, Aulus Cornelius Celsus suggested 38 ingredients, and Pliny the Elder suggested 54, commenting that “this is obvious ostentation of skill and prodigious exploitation of knowledge”. Galen’s own formulations seem to have stabilised the recipes, with around 52 ingredients for mithridatium and 60 for Theriac, including herbs, minerals and viper flesh. The presence of opium was also undoubtedly a key factor in their success. But medical historian Annette Bierman suggests that although the balsamic ingredients may have had a slight antiseptic action, any effect against poisoning would have been purely psychosomatic.

Over time theriac came to accommodate many variations; as Andromachus had adapted mithridatium to reflect European ingredients, so later apothecaries developed their own local versions. The Italian physician Pietro Mattioli (1501–77) created a super-antidote with 125 simple ingredients plus theriac, mithridatium, unicorn, red coral and pearls. Theriac of the Poor omitted viper’s flesh and contained only five inexpensive ingredients. In 1722, Theriac Edinensis appeared in the ‘Edinburgh Pharmacopoeia’ with only 11 ingredients. The term theriac was spread globally by missionaries, merchants and physicians, with evidence of recipes in Brazil, China and Japan from the 1700s. Forms of mithridatium appear in Islamic medical literature spanning seven centuries, probably derived from Galen and other Greek texts.

In Europe, a key promotional tool for both theriac and mithridatium was the pomp and circumstance surrounding its public compounding in city squares by leading apothecaries. The ceremonies provided an opportunity to legitimise the preparations and to perpetuate the theriac brand. Galen wrote that theriac reached its greatest potency six years after preparation and kept its virtues for 40 years. There was therefore a practical logic in preparing large amounts at one time. In 1712, 150 kg of theriac was prepared at one session in Maastricht in the Netherlands.

The English writer John Evelyn (1620–1706) purchased his ‘treacle’ after one such ceremony in Venice, confessing that “the making and extraordinary ceremony whereof I had been curious to observe, for it is extremely pompous and worth seeing”. These public events generally consisted of a display of ingredients to impress the citizens and allow officials to check their quality, followed by up to two days of preparing the ingredients, with constant inspections. Venice, like other cities, established supervisory committees and authenticated the highly expensive preparation with beautifully designed stamps, a precursor of the commercial power of the manufacturer’s brand logo. The last theriac ceremony happened in Paris in 1790. British apothecaries eschewed ceremonies, simply claiming that their preparations were superior to imported European theriacs.

Eventually theriacs began to lose their aura. Nicholas Culpeper’s description of theriacs as “terrible messes of altogether” was part of a wave of criticism from the 17th century onwards. French chemist Nicolas Lemery (1645–1715) criticised them as “monstrous descriptions, which only serve the purpose of throwing dust in one’s eyes, making the composition very expensive and difficult to prepare”. John Quincy (d. 1722) called them “the only relics of ancient superstition that now remain among us”.

The criticism crystallised in England with William Heberden’s ‘Antitheriaca: An essay on Mithridatium and Theriaca’ (1745). Heberden demanded that the random ingredients and potential toxicity be tested against rational theories and rigorous experiments. He also questioned how antique remedies would work against more recently discovered poisons. He claimed that greedy people had exploited the legends surrounding the remedies and people’s fear of poisons. His opposition may not have been entirely disinterested: his own variation of theriac, popularly known as Heberden’s Ink, remained in the ‘British Pharmacopoeia’ until 1890.

A surviving draft copy of the ‘Edinburgh Pharmacopoeia’ shows that mithridatium and theriac were struck out of the 1756 edition. They had disappeared from the ‘London Pharmacopoeia’ by 1788, but 39 theriacs appeared in a mid-18th-century ‘Lexicon for Apothecaries’ in the Netherlands. And theriacs continued to appear in pharmacopoeias in France, the Netherlands, Spain, Sardinia and Germany well into the 19th century.

A product called Andromachus Theriac was sold in Rome in the 1980s for insomnia, disorders of the nerves and digestive complaints. But 20th-century references to theriac in adverts and formulations seemed to refer to syrupy treacle rather than its complex ancestor, perhaps trading on the sense of mystery and longevity to mask a much more mundane product. The brand and its associated ceremony have finally passed into history.