Scribonio Largo


Scribonius Largus. Medico romano della prima metà del I secolo dC. Appartenente alla scuola empirica, autore di studi farmacologici, fu uno dei primi scrittori in latino di argomenti medici. Nella sua opera Compositiones medicamentorum raccolse ricette per molte malattie. A lui si deve la prima citazione del cosiddetto giuramento di Ippocrate, decalogo di antiche norme deontologiche per i medici.

In questa edizione del De re medica del 1529 Aulus Cornelius Celsus viene tramutato in Aurelius
Scribonio Largo fa compagnia a Celso col suo famoso De compositionibus medicamentorum

Scribonius Largus

Scribonius Largus was the court physician to the Roman emperor Claudius. About 47 AD, at the request of Gaius Julius Callistus, the emperor's freedman, he drew up a list of 271 prescriptions (Compositiones), most of them his own, although he acknowledged his indebtedness to his tutors, to friends and to the writings of eminent physicians. Certain traditional remedies are also included. The work has no pretensions to style, and contains many colloquialisms. The greater part of it was transferred without acknowledgment to the work of Marcellus Empiricus (c. 410), De Medicamentis Empiricis, Physicis, et Rationabilibus, which is of great value for the correction of the text of Largus.

See the edition of the Compositiones by S. Sconocchia (Teubner 1983), which replaced the well-outdated edition of G. Helmreich (Teubner 1887).

Scribonius Largus

A Roman physician, whose praenomen is unknown, and who sometimes bears the agnomen Designatianus. He lived at Rome in the first century after Christ, and is said to have been physician to the emperor Claudius, and to have accompanied him in his expedition to Britain. He himself mentions Messalina, the wife "Dei nostri Caesaris" (c. xi. § 60, p. 203). He was a pupil of Tryphon (c. xliv. § 175, p. 222) and Apuleius Celsus (c. xxii. § 94, p. 208, c. xlv. § 171, p. 221). He appears to have written several medical works in Latin (Praef. p. 188), of which only one remains, entitled "Compositiones Medicae," or " De Compositione Medicamentorum." It is dedicated to Caius Julius Callistus, at whose request it was written, at a time when Largus was away from home (perhaps in Britain), and deprived of the greater part of his library (Praef.). It consists of nearly three hundred medical formulae, several of which are quoted by Galen (De Compos. Medicam. Sec. Loc. vol. xii. pp. 683, 738, 764, vol. xiii. pp. 67, 280,284, &c.), and is interesting, as tending to illustrate the Materia Medica of the ancients, but in no other point of view. It has been supposed that the work was originally written in Greek, and translated into Latin by some later author, and that it is this version only that we now possess ; but there does not seem to be any sufficient reason for this conjecture. It was first published at Paris, 1529, fol. appended by J. Ruellius to his edition of Celsus. Another edition was published in the same year at Basel, 8vo. The best edition is that of J. Rhodius, Patav. 1655, 4to., containing an improved text, copious and learned notes, and a " Lexicon Scribonianum." The last edition is that by J. Mich. Bernholii, Argent. 1786, 8vo., containing the text of Rhodius, but omitting his notes and "Lexicon Scribon." The work of Scribonius Largus is also contained in the collections of medical authors published by Aldus, Venet. 1547, fol. and H. Stephens, Paris, 1567, fol. C. G. Kuhn published in 1825, 4to. Lips., a specimen of Otto Sperling's "Observationes in Scribonium," from a MS. at Copenhagen.

Dictionary of Greek and Roman biography and mythology
William Smith, Boston, 1867

Scribonius Largus

Claudius was accompanied on the British campaign of AD 43 by Scribonius Largus, a physician and pharmacologist, probably at the instigation of Caius Julius Callistus, an influential freedman who was the secretary in charge of petitions. He also commended his Latin medical writings to the emperor and, in appreciation for this patronage, Largus addressed and dedicated to him the Compositiones, a collection of drug compounds or recipes, written, as is related in the Preface, when he was abroad, with only a few books at his disposal.

Nothing is known of Largus beyond what can be inferred from the Compositiones. He may have been born in Sicily at the beginning of the first century and wrote in both Greek and Latin, given that he refers to his work in Latin being presented to the emperor and that Galen, a century and a half later, quotes prescriptions in Greek that are not in the surviving Latin text. Although Largus did treat members of the imperial household, he probably was not Claudius' personal physician. That role was held by Xenophon, who also had gone on the British expedition and later, as Tacitus relates in the Annals (XII), was induced by Agrippina (Claudius' fourth wife) to murder the emperor by means of a poisoned feather.

Most prescriptions in the Compositiones, if not all, seem to have been culled from teachers and connections at court. There is an antidote against poison favored by Augustus, a drug against colic prepared for Tiberius, an ointment used by Claudius' mother (Antonia) and grandmother (Livia), as well as dentifrices used by Augustus' sister (Octavia), Livia, and Messalina, Claudius' third wife. It is the mention of Messalina (LX), in fact, that allows the book to be dated sometime after Callistus succeeded to his post in late AD 47 and before the execution of Messalina for adultery late the next year.

Two hundred and seventy-one compounds are described, arranged from head to toe, according to the site of the disease; antidotes against poisons, bites, and stings; plasters, dressings, and salves; as well as references to aconite (CLXXXVIII) and to an early form of electroanalgesia, in which the shock of the torpedo ray was used to manage both headache (XI) and gout (CLXII), the latter when a freedman of Tiberius, standing on the shore, allowed the repeated shocks of a ray placed beneath his feet to numb the pain.

The word, itself, comes from torpere, "to be stiff or numb, torpid." Indeed, Meno, in speaking to Socrates in the dialogue of the same name, says "And if I may venture to make a jest upon you, you seem to me both in your appearance and in your power over others to be very like the flat torpedo fish, who torpifies those who come near him and touch him, as you have now torpified me, I think. For my soul and my tongue are really torpid, and I do not know how to answer you" [trans. Jowett]. As to the torpedo ray, itself, Oppian calls it the cramp-fish, saying that "in its loins it hath a piece of craft, its strength in weakness: even two rays planted in its sides, one on either hand. If one approach and touch these, straightway it quenches the strength of his body and his blood is frozen within him and his limbs can no longer carry him but he quietly pines away and his strength is drained by stupid torpor" [Halieutica, II.56ff]. Later, Oppian relates how, if caught, the shock runs through the line and rod to the hand of the fisherman, causing him to drop the tackle. "Such icy numbness straightway settles in his hand" [III.149ff].

Plasters also are recommended for the treatment of wounds suffered by gladiators (CI), but remedies against epilepsy (XVII) that involve drinking the blood of a gladiator or consuming a portion of the liver are condemned as falling outside the professio of medicine. (Celsus does promote such a cure, admitting that "Some have freed themselves from such a disease by drinking the hot blood from the cut throat of a gladiator: a miserable aid made tolerable by a malady still most miserable," III.23.7; also Pliny, XXVIII.4.

Here, professio means a public declaration by which the doctor imposes upon himself the duties and obligations of the profession and commitment to it. In the Preface, Largus expounds on what it means to be a physician, whose heart should be "full of mercy (misericordia) and humanity" (humanitas). There is a solemn obligation (sacramentum) to heal and show compassion for the patient; indeed, this beneficence is specific to the role of the physician and supercedes even civic duty. The doctor, for example, should know about poisons, if only to recognize and combat them, but never compound or use them, even on an enemy in war. Drugs are like "divine hands" and their effect like "divine intervention." To deny the efficacy of drugs because of ignorance is negligent; even worse, is not to use them when they are known to work.

The doctor's duty is to heal, not to harm and, in this admonition, Largus provides the earliest reference to the Hippocratic Oath, when he appeals to the provision that forbids a woman being given an abortive pessary. It is Hippocrates, "the founder of our profession" who "handed on to our discipline an oath by which it is sworn that no physician will either give or demonstrate to pregnant women any drug aborting a conceived child." Then "how much more abominable will those men judge it to do harm to a fully formed human being who consider it wicked to injure the uncertain hope of an unborn child" (trans. Hamilton).

Soranus, a Greek practicing in Rome in the early second century AD, refers to the Oath, as well, in the Gynecology. There, he sides with the opposing position of the controversy. Rather than prohibit all abortions, Soranus understands the Oath to prohibit only abortive suppositories and that abortion is permitted if the life of the mother is in danger.

"For one party banishes abortives, citing the testimony of Hippocrates who says: 'I will give to no one an abortive'; moreover, because it is the specific task of medicine to guard and preserve what has been engendered by nature. The other party prescribes abortions, but with discrimination, that is, they do not prescribe them when a person wishes to destroy the embryo because of adultery or out of consideration for youthful beauty; but only to prevent subsequent danger in parturition if the uterus is small and not capable of accommodating the complete development" (I.19.60).

A more suspicious view of the Oath (and Greeks in general) was held by Cato the Elder. "It was not only Greek philosophers that he hated, but he was also suspicious of Greeks who practised medicine at Rome. He had heard, it would seem, of Hippocrates' reply when the Great King of Persia consulted him, with the promise of a fee of many talents, namely, that he would never put his skill at the service of Barbarians who were enemies of Greece. He said all Greek physicians had taken a similar oath, and urged his son to beware of them all" (Plutarch, Life, XXIII.3-4).

Neither Largus, Soranus, nor Jerome quote the Oath exactly. Attributed to Hippocrates, who flourished in the fifth century BC, here is the second section, which concerns the obligations of the physician. The translation is by Edelstein.
"I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about. If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot."

Here is an example of one of Scribonius' potions (LXX) for inflammation of the tonsils, which was suffered by Antonia (Minor), the mother of Claudius.
"For Treatment of a Choking Quinsy: And the following has proven beneficial for many patients, and is certainly quite powerful and quite effective: 2 drachmas each of costus, celery seeds, anise seeds, oil of camel grass, and cinnamon-cassia, one-half drachma of cardamom, 2 drachmas of the wild rue (two-thirds of which is the seed), one-half ounce of fissile alum, 5 medium-sized ground-up oak galls, 2 drachmas of saffron, one-half drachma of the refined residue of the oil of saffron, one-half drachma of myrrh, 4 drachmas of Cretan birthwort, 3 drachmas of cinnamon, one ounce of the ashes of a young wild swallow, and one-half drachma of spikenard. All these ingredients are to be conjoined and either pounded or otherwise produced separately each having been skimmed in Attic honey. And whenever the compound is to be used, a sufficient amount of the same honey should be added to it. The Augusta always has this compound at hand" (trans. Scarborough).

The ingredients do have biologically active compounds and, insists Scarborough, comprise an effective analgesic.


Caius Julius Callistus

As for the "notoriously powerful" Callistus, a freedman who rose to a position of great influence under Gaius Caligula and Claudius, Pliny records having seen for himself thirty large onyx columns in his dining room (XXXVI.60). It is indeed a change of fortune for a slave once sold by his master as being of no use. Seneca relates the story.

"I have seen standing in the line, before the door of Callistus, the former master of Callistus; I have seen the master himself shut out while others were welcomed,--the master who once fastened the 'For Sale' ticket on Callistus and put him in the market along with the good-for-nothing slaves. But he has been paid off by that slave who was shuffled into the first lot of those on whom the crier practises his lungs; the slave, too, in his turn has cut his name from the list and in his turn has adjudged him unfit to enter his house. The master sold Callistus, but how much has Callistus made his master pay for!" (Epistles XLVII.9-10).

Josephus speaks of Callistus, as well, in the Antiquities of the Jews (XIX.1.10ff) as among those who conspired to assassinate Caligula. "And besides these, Callistus also, who was a freed-man of Caius, and was the only man that had arrived at the greatest degree of power under him, --such a power, indeed, as was in a manner equal to the power of the tyrant himself, by the dread that all men had of him, and by the great riches he had acquired; for he took bribes most plenteously, and committed injuries without bounds, and was more extravagant in the use of his power in unjust proceedings than any other." He goes on to relate how, fearful of losing his wealth, Callistus ingratiated himself with Claudius, although not so much that he felt obliged to inform the emperor of Messalina's infidelities, "remembering that prudent rather than vigorous counsels insure the maintenance of power" (Tacitus, Annals, XI.29.1ff; also Dio, LIX.29.1).

In the Life of Galba, Plutarch indicates that Caligula "while still a young man, had been intimate with the mother of Nymphidius, a woman of comely appearance and a daughter of Callistus, Caesar's freedman, by a hired sempstress. But this intimacy, as it would seem, was later than the birth of Nymphidius, and it was believed that he was a son of Martianus, the gladiator (with whom Nymphidia fell in love on account of his fame), and his resemblance to Martianus was thought to favour this connection" (IX).

The fragment above is from the Oxyrhynchus papyri (P.Oxy. 2547) and is in the Wellcome Library for the History & Understanding of Medicine (London). Dating from the third century AD, it contains a fragment of the Hippocratic Oath.


Scribonius Largus


ed. Georgius Helmreich, Scribonii Largi Conpositiones
Leipzig: Teubner, 1887

= libra

Scribonius Largus Callisto suo S.

Inter maximos quondam habitus medicos Herophilus, Cai Iuli Calliste, fertur dixisse medicamenta divinas manus esse, et id quidem non sine ratione, ut mea fert opinio: prorsus enim quod tactus divinus efficere potest, id praestant medicamenta usu experientiaque probata. Animadvertimus itaque saepe inter deliberationes contentionesque medicorum auctoritate praecellentium, dum quaereretur, quidnam faciendum aut qua ratione succurrendum esset aegro, quosdam humiles quidem et alioquin ignotos, usu vero peritiores, vel — quod fateri pudet — longe summotos a disciplina medicinae ac ne adfines quidem eius professioni, medicamento efficaci dato protinus velut praesenti numine omni dolore periculoque liberasse aegrum. Quamobrem spernendi sunt, qui medicinam spoliare temptant usu medicamentorum, non a medendo, sed a potentia effectuque medicamentorum ita appellatam, probandi autem, qui omni modo succurrere periclitantibus student. Ego certe aliquotiens magnum scientiae consecutus sum titulum ex usu prospere datorum medicamentorum multosque ex eadem causa non mediocrem gloriam tulisse memini. Est enim haec pars medicinae ut maxime necessaria, ita certe antiquissima et ob hoc primum celebrata atque inlustrata, siquidem verum est antiquos herbis ac radicibus earum corporis vitia curasse, quia timidum genus mortalium inter initia non facile se ferro <ignique> committebant. Quod etiam nunc plerique faciunt, ne dicam omnes, et nisi magna conpulsi necessitate speque ipsius salutis non patiuntur sibi fieri, quae sane vix sunt toleranda. Cur ergo aliqui excludant medicinam usu medicamentorum, non invenio, nisi ut detegant imprudentiam suam. Sive enim nullum experimentum eius generis remediorum habent, merito accusandi sunt, quod tam neglegentes in tam necessaria parte <artis> fuerint, sive experti quidem sunt eorum utilitatem, denegant autem usum, magis culpandi sunt, quia crimine invidentiae flagrant, quod malum cum omnibus animantibus invisum esse debet, tum praecipue medicis, in quibus nisi plenus misericordiae et humanitatis animus est secundum ipsius professionis voluntatem, omnibus diis et hominibus invisi esse debent. Idcirco ne hostibus quidem malum medicamentum dabit, qui sacramento medicinae legitime est obligatus; sed persequetur eos, cum res postulaverit, ut miles et civis bonus omni modo, quia medicina non fortuna neque personis homines aestimat, verum aequaliter omnibus implorantibus auxilia sua succursuram se pollicetur nullique umquam nocituram profitetur.

Hippocrates, conditor nostrae professionis, initia disciplinae ab iureiurando tradidit, in quo sanctum est, ne praegnati quidem medicamentum, quo conceptum excutitur, aut detur aut demonstretur a quoquam medico, longe praeformans animos discentium ad humanitatem. Qui enim nefas existimaverit spem dubiam hominis laedere, quanto scelestius perfecto iam nocere iudicabit? Magni ergo aestimavit nomen decusque medicinae conservare pio sanctoque animo quemque secundum ipsius propositum se gerentem: scientia enim sanandi, non nocendi est medicina. Quae nisi omni parte sua plene incumbat in auxilia laborantium, non praestat quam pollicetur hominibus misericordiam. Desinant ergo, qui prodesse adflictis aut nolunt aut non possunt, alios quoque deterrere negando aegris auxilia, quae per vim medicamentorum frequenter exhibentur. Etenim quasi per gradus quosdam medicina laborantibus succurrit. Nam primum cibis ratione aptoque tempore datis temptat prodesse languentibus; deinde si ad hos non responderit curatio, ad medicamentorum decurrit vim: potentiora enim haec et efficaciora quam cibi. Post ubi ne ad haec quidem cedunt difficultates adversae valetudinis, tunc coacta ad sectionem vel ultimo ad ustionem devenit. At Asclepiades, maximus auctor medicinae, negavit aegris danda medicamenta: quidam enim hoc mendacio etiam pro argumento utuntur. Poteram tamen, si verum id esset, dicere: Viderit Asclepiades, quid senserit; forsan non omnino in hanc partem animum intendit. Homo fuit, parum feliciter se in hoc negotio gessit. Non deterreor persona, cum rem tam manifeste prodesse videam. Nunc vero cum tam impudenter comminiscantur de eo, quid possum ultra dicere nisi genere quodam parricidium ac sacrilegium eos committere, qui haec dicunt? Ille enim febricitantibus vitiisque praecipitibus correptis, quae ὀξέα πάθη Graeci dicunt, negavit medicamenta danda, quia cibo vinoque apte interdum dato remediari tutius eos existimavit. Ceterum in libro, qui παρασκευῶν, id est praeparationum inscribitur, contendit ultimae sortis esse medicum, qui non ad singula quaeque vitia binas ternasve conpositiones expertas et protinus paratas habeat. Vides ergo, quam non placeat Asclepiadi usus medicamentorum, cui nisi plura quis ad quodque genus vitii medicamenta conposita habeat, non videtur dignus professione medicinae? Sed ista licentia nomine tantummodo medicorum propter quorundam neglegentiam latius processit. Raro enim aliquis priusquam se suosque tradat medico, diligenter de eo iudicat, cum interim nemo ne imaginem quidem suam committat pingendam nisi probato prius artifici per quaedam experimenta atque ita electo. Habeant itaque omnes pondera atque mensuras exactas, ne quid erroris in rebus non necessariis accidat: videlicet quia sunt quidam, qui pluris omnia quam se ipsos aestimant. Itaque sublata est studendi cuique necessitas et non solum antiquos auctores, per quos consummatur professio, quidam ignorant, sed etiam comminisci falsa de iis audent. Ubi enim delectus non est personarum, sed eodem numero malus bonusque habetur, <disciplinae ac sectae observatio perit> quodque sine labore potest contingere idemque dignitatis utilitatisque praestare videtur posse, unus quisque id magis sequitur. Sic ut quisque volet, faciet medicinam. Quosdam enim a perverso proposito nemo potest movere et sane omnibus permisit liberum arbitrium magnitudo professionis. Multos itaque animadvertimus unius partis sanandi scientia medici plenum nomen consecutos.

Nos vero ab initio rectam viam secuti nihil prius totius artis perceptione, qua homini permittitur, iudicavimus, quia ex hac omnia commoda nos consecuturos existimabamus, non medius fidius tam ducti pecuniae aut gloriae cupiditate quam ipsius artis scientia. Magnum enim et supra hominis naturam duximus posse aliquem tueri vel reciperare suam et unius cuiusque bonam valetudinem. Itaque ut ceteris partibus disciplinae, ita huic quoque, quae per medicamenta virtutem suam exhibet, curiose institimus, eo magis quod percipiebamus in dies ex usu profectus eius, quos interdum supra fidem atque opinionem plurimorum exhibebamus. Sed quid ultra opus est probare necessarium usum esse medicamentorum, praecipue tibi, qui quia percepisti utilitatem eorum, idcirco a me conpositiones quasdam petisti? Ego autem memor humanitatis tuae candorisque animi tui, quem omnibus quidem hominibus plene, mihi autem etiam peculiariter praestas, non solum quas desiderasti, verum etiam si quas alias expertas in praesenti habui, in hunc librum contuli. Cupio enim medius fidius, qua possum, tuae in me tam perseveranti benevolentiae respondere adiutus omni tempore a te, praecipue vero his diebus. Ut primum enim potuisti, non es passus cessare tuae erga me pietatis officium tradendo scripta mea latina medicinalia deo nostro Caesari, quorum potestatem tibi feceram, ut ipse prior legeres simpliciterque indicares mihi, quid sentires: plurimum enim iudicio tuo tribuo. Tu porro candidissimo animo et erga me benevolentissimo diligentiam meam sub tanti nominis editione non verbis, sed re probasti periculumque non minus tu iudicii quam ego stili propter me adisti, quo tempore divinis manibus laudando consecrasti. Fateor itaque libenter unicas me tibi gratias agere, quod et prius quam rogaveris consummasti amicissimo adfectu vota mea <et> quod contigit mihi favore plenissimo tuo maturiorem percipere studii huius mei fructum ac voluptatem. Ignosces autem, si paucae visae tibi fuerint conpositiones et non ad omnia vitia scriptae: sumus enim, ut scis, peregre nec sequitur nos nisi necessarius admodum numerus libellorum. Postea tamen, si et tibi videbitur, ad singula quaeque vitia plures conpositiones colligemus. Oportet enim copiam quoque earum selectam haberi, quoniam revera quaedam quibusdam magis et non omnes omnibus conveniunt propter differentiam scilicet corporum. Quarum initium a capite faciemus, summum enim et primum locum hoc obtinet, dantes operam, ut simplicia prima ponamus: interdum enim haec efficaciora sunt quam ex pluribus conposita medicamenta. Erit autem nota denarii pro Graeca drachma: aeque enim in libra denarii octoginta quattuor apud nos, quot drachmae apud Graecos incurrunt. Primum ergo ad quae vitia conpositiones exquisitae et aptae sint, subiecimus et numeris notavimus, quo facilius quod quaeretur inveniatur; deinde medicamentorum, quibus conpositiones constant, nomina et pondera vitiis subiunximus.

Scribonii Largi conpositiones.

1 Ad capitis dolorem etiam in febre primis diebus bene facit serpulli pondo quadrans, rosae aridae pondo quadrans. Haec incoquuntur duobus sextariis aceti acerrimi, donec ad dimidias perducantur. Inde sumitur cyathus et duobus rosae commiscetur frequenterque ex eo curatur caput: ubi enim concaluit quod infusum est, nisi aliud recens adiciatur, nocet.

2 Item prodest eodem modo ruta per se vel cum hederae bacis decocta. Polygonium quoque et menta multis profuit eadem ratione decocta et infusa capiti dolenti. <Item levat capitis dolorem> sphondylion et agni semen et platani pilulae similiter aceto incoctae rosaeque folia residuo aceto commixta.

3 Cum autem pluribus diebus permanserit dolor, tum omnium supra dictorum oportet uncias singulas sumere iisque admiscere lauri bacarum, castorei, nucum amararum, pulei, sampsuci foliorum, singulorum unciam et in aceti sextariis tribus decoquere ad dimidias <et> eodem modo rosa admixta, non tamen frequenter, caput curare.

4 Ad omnem capitis dolorem efficaciter prodest crocomagmatis pondo sextans, aluminis fissi vel gallae pondo uncia. Haec terere ex aceto et rosa vicibus adiecta oportet, usque dum mellis habeant spissitudinem, inde frontem et utraque tempora oblinere.

5 Ad capitis dolorem, cum inveteraverit, bene facit haec compositio: Murrhae p. I, croci p. II, amygdalorum amarorum p. II, rutae viridis p. III, sphondylii p. I, panacis p. I, laurus bacarum p. III, serpulli p. II, castorei p. I. Teruntur haec omnia aceto et fiunt pastilli; cum opus est, diluuntur aceto et rosa in mellis spissitudinem atque ita frons et tempora inlinuntur.

6 Oportet vero permanente capitis dolore materiam quoque detrahere ex eo per nares vel os. Quae res etiam auriculae vel dentibus dolentibus prodest nec minus quibus subitae vertigines obversantur, quos σκοτωματικοὺς Graeci dicunt; item comitiali morbo correptos et caligine inpeditos ex magna parte levat. Debent autem ii omnes pridie abstinere et superioribus diebus aquam potare.

7 Per nares ergo purgatur caput his rebus infusis per cornu, quod rhinenchytes vocatur: Hederae suco per se vel betae suco cum exiguo flore aeris vel cyclamini suco mixto lacte aut aqua pari mensura.

8 Bene detrahit e naribus liquorem et haec conpositio: Salis, nitri, mellis, aceti, olei veteris, singulorum p. binum, cyclamini suci, σταφίδος ἀγρίας, quam herbam pediculariam, quod pediculos necat, quidam appellant, singulorum p. I. Haec in unum mixta naribus per cornu infunduntur vel pinna longiore nares interius perfricantur. Cum satis visum fuerit fluxisse, ut reprimatur, aqua frigida nares diutius abluere pura oportet vel ea, in qua pridie crocum adiectum maceratum fuerit.

9 Sed si per os magis detrahere materiam visum fuerit, quia non sine tormento per nares ea deduceretur, suadebimus pyrethri radiculam commanducare atque subinde hiantem pati fluere salivam, vel uvam passam cum piperis albi granis totidem dabimus commanducandam et expuendam: aeque enim et haec deducunt pituitam. Bene facit et sinapi ex aceto tritum et non excastratum gargarizatum trium cyathorum mensura admixto mellis pondo quadrante: detrahit enim largiter pituitam.

10 Prodest, cum diu caput dolet, adtondere ad cutem et radere et diutius siccum ad relaxationem cutis fricare et aqua calida fovere pura vel laurum incoctam habente. Quo tempore etiam sternutamentum concitare non alienum erit medicamento, quod ex his rebus componitur: Veratri albi, castorei, struthii, quod est radix lanaria, piperis albi, singulorum p. I. Haec contusa tenuiter forato cribro transmittuntur; cum opus fuerit, per pinnam vel calamum scriptorium naribus insufflentur vel specillo tincto in aquam et excusso tacta naribus iniciantur. Proritat sternutamentum etiam per se contusum et eadem ratione iniectum veratrum album. Nigrum siccum et aridum sternutationem statim invitat.

11 Capitis dolorem quamvis veterem et intolerabilem protinus tollit et in perpetuum remediat torpedo nigra viva inposita eo loco, qui in dolore est, donec desinat dolor et obstupescat ea pars. Quod cum primum senserit, removeatur remedium, ne sensus auferatur eius partis. Plures autem parandae sunt eius generis torpedines, quia nonnumquam vix ad duas tresve respondet curatio, id est torpor, quod signum est remediationis.

12 Ad comitialem morbum, quem Graeci ἐπιληψίαν vocant, herbam, quam iidem πολύνευρον, nos nervalem appellamus, oportet ieiunum quam plurimam viridem comesse a prima luna ad tricesimam. Haec eadem herba ebrio data copiosa in crapula vinum discutit mentemque restituit.

13 Item hinnulei cervi coagulum intra novem dies exceptum bene facit ad morbum comitialem. Intellegitur autem dierum numerus ex eo, quod iacent aures hinnuleorum primis temporibus: a nono enim die subriguntur. Oportet ergo sumere tunc coagulum et arefacere, quo neque sol neque luna accedit, atque inde dare pueris viciae magnitudinis globulum ex aquae caldae cyathis duobus, maioribus vero natu fabae solidae magnitudine ex aquae caldae cyathis tribus per dies triginta. Dentur autem aquae purae supra medicamentum cyathi duo aut tres. Hoc remedium qui monstravit, dixit ad rem pertinere occidi hinnulum cultro, quo gladiator iugulatus sit.

14 Constat inter plures et crocodili testiculum pondere I aut victoriati per dies triginta ex aquae cyathis tribus sumptum multos remediasse.

15 Ad recentem comitialem morbum cito proficit, ad veterem tardius: Thymi albi p. III ex aceti cyathis tribus et mellis boni pondo uncia; ut dilutum ieiunus bibat per dies quadraginta quinque. Sed cum biberit, citatus ambulet milia passuum minime duo.

16 Scio Romae quandam honestam matronam aliquot comitiali morbo liberasse hoc medicamento: Eboreae scobis hemina, mellis Attici pondo libra, haec in unum miscentur; postea adicitur, si puer fuerit qui laborat, testudinis masculae, palumbi masculi, utrorumque ferorum, id est nuper captorum, sanguis, quantum fluxerit, dum viva utraque animalia dimittantur: sin autem puella fuerit, feminei generis animalia sint et eodem modo capta sanguine effuso emittantur. Oportet autem clavum Cyprii aeris acutum demittere in iugulum testudinis et palumbi venas, quae sub alis sunt, aere acuto incidere. Hoc medicamentum ligneo vase servatum reponitur. Cum opus fuerit, dantur ex eo luna decrescente per continuos dies triginta primum coclearia tria, deinde quinque, deinde septem, deinde novem, summum undecim, et rursus novem, deinde septem, deinde quinque, postea tria et iterum augetur minuiturque numerus cocleariorum, donec dies triginta ante dicti consumantur. Postea oportebit scobis eboreae heminam per duos menses consumere vitio correptum, accipientem ex ea terna coclearia in die ex aquae cyathis tribus. Hoc medicamento qui utitur, neque vinum neque suillam gustet; praeterea habeat in brachio verua eborea. Nam sunt et qui sanguinem ex vena sua missum bibant aut de calvaria defuncti terna coclearia sumant per dies triginta.

17 Item ex iecinore gladiatoris iugulati particulam aliquam novies datam consumant. <Hoc> quaeque eiusdem generis sunt, extra medicinae professionem cadunt, quamvis profuisse quibusdam visa sint.

18 Illud tamen non oportet ignorare sanari hoc vitium, cum cognitum est, aliquibus: viros facilius mulieribus remediari, pueros vel virgines liberari post complexum et devirginationem.

19 Ad conturbationes et epiphoras oculorum scio multa collyria, tametsi tarde, magnos tamen effectus habere; sed nulli collyriorum tantum tribuo, quantum lycio Indico vero per se. Hoc enim inter initia si quis ut collyrio inunguatur, protinus, id est eodem die, et dolore praesenti et futuro tumore liberabitur. Supervacuum est autem nunc laudes eius referre: in aliis enim expertus intelleges simplicis rei vix credendos effectus.

20 Oportet vero minime quater quinquiesve ex intervallo inunguere, deinde cum combiberint oculi ad singulas inunctiones, ex aqua quam poterint sustinere calidissima spongeis expressis vaporare eos diutius eodemque die in balineum ducere, ita ut cum cetero corpore caput quoque et facies calida inmergatur et foveatur, vinoque uti, ut quisque adsuetus est; postero die si qua vestigia epiphorae remanserint, inunguere collyrio aliquo acriore aquato sub vespere et rursus in balneum deducere et vinum dare eodem modo. Fere enim uno die tollit epiphoram et praecipue incipientem neque adhuc alio medicamento tactam. Sed si ea vis fuerit epiphorae, ut non cedat uno die, spectare oportebit, donec inpetus sedetur, et ita in balneum deducere ceteraque facere, quae praecepimus. Idem hoc medicamentum etiam supra perunctum tardius quidem, sed eosdem effectus praestat, maxime in teneris corporibus, ut mulierum et puerorum, quorum oculi nullius medicamenti vim sustinent. Triduo enim aut plerumque quadriduo tollit dolorem adiutum ovi infusione et aquae calidae vapore.

21 Item conpositorum collyriorum hoc maxime probo ad recentes epiphoras et conturbationes oculorum tumoresque et dolores: Aloes Indicae p. IIII, croci p. II, opii p. I, commis p. IIII, plantaginis suci cyathos tres. Terere oportet per se crocum diligenter, deinde cetera admiscere pridie macerata suci plantaginis cyatho atque ita reliquis duobus cyathis admixtis, cum spissata fuerint, fingere collyria. Utrumque autem genus medicamenti eximie prodesse iudico proprietate quidem quadam, sed praecipue quod nullam in se aspritudinem habet ut pleraque, quibus fere inunguntur homines. Nam quae ex cadmia aut aere usto eiusdemque generis pigmentis conponuntur, quamvis curiose terantur, naturam suam tamen amittere non possunt. Numquam enim ut sucus diluuntur, sed cum in summam subtilitatem deducta sunt perseverantia terentium, tamen corpora quasi pulverulenta necesse est maneant, quae oculorum partes velut configunt, certe exterius pungunt foramina primae tuniculae oculi atque <ab> initiis interdum non tam molestam futuram concitant epiphoram.

22 Quo nomine etiam quod dia glauciu dicitur probo in initiis. Nam et hoc genere quodam ex eadem materia constat nec ullam aspritudinem habet, quando sic conponitur: Croci p. V, sarcocollae p. X, glaucei suci p. XX, tragacanthi p. V, opi p. V. Hoc enim ego adicio et ita melius respondet. Sed opium et in hoc et in omni collyrio medicamentoque verum adicere oportet, quod ex lacte ipso silvatici papaveris capitum fit, non ex suco foliorum eius, ut pigmentarii institores eius rei conpendii causa faciunt. Illud enim cum magno labore exiguum conficitur, hoc sine molestia et abundanter. Teritur ante omnia crocum aqua pluviatili, deinde adicitur sarcocolla, glaucium, opium, tragacanthum, prius omnia seorsum macerata non multa eius generis aqua, ut quam primum, id est, si potest fieri, eodem die fingantur collyria: solet enim diu neglectum mortario inarescere. His utor primis diebus collyriis non <sine> ceteris auxiliis, prout res postulat, abstinendo dico, sanguinis detractione, meliusque eam ceteris proficere adfirmo.

23 Cum vero pluribus quis diebus vexatus fuerit epiphora cum perseverantia tumoris et pituita ipso calore oculorum glutinosior visa fuerit, quod fere sexto septimove die accidere solet, tum proderunt et ea, quorum genus superius inprobavimus, conposita ex rebus metallicis: facilius enim iam patiuntur oculi, si modo exulcerati non fuerint, iniuriam. Quorum praecipue hoc mihi placet, quod a colore φαιὸν dicitur; accipit autem haec: Aeris usti p. XII, cadmiae ustae p. XII, stibii cocti p. XII, acaciae chylismatis p. VI, aloes p. III, opi p. II, croci p. III, castorei victoriati pondus, murrae, lycii idem [scilicet] ponderis, commis p. XVIII. Aqua pluviatili quae sunt dura tam diu teruntur, donec levissima fiant, postea cetera alio mortario singula trita admiscentur; cum tollendum est, commi adicitur. Hoc quidam etiam in initiis utuntur cum ovi aquato liquore per se vel cum collyrio, quod a cinereo colore σποδιακὸν appellatur, conponitur autem ex his:

24 Cadmiae botryitidos ustae super testam, donec incandescat, et vino Falerno extinctae p. XL, cretae Samiae, quam vocant astera, p. LXXX, stibii cocti p. XX, opi p. X, commis Alexandrini p. XX. Teruntur haec omnia aqua pluviatili, commi ultimum adicitur; ante hoc cum cetera levia sunt facta, opium miscetur maceratum pridie aqua. Facit hoc per se etiam initio, cum tenuis abundansque fluit lacrima et pustulae molestae sunt, aut cum prima tunica oculi exesa est aliave exulcerata. Cum purum ulcus est, diluitur fere ovi albo, quod est tenuissimum.

25 Ad sordida ulcera oculorum crustasque habentia, quas ἐσχάρας vocant, item <ad> carbunculos, quos ἄνθρακας dicunt, facit bene et per se mel Atticum pyxide Cyprii aeris conditum et repositum mensibus duobus nec minus: quanto enim diutius remanet, efficacius fit.


Scribonius Largus

Scribonius Largus était le médecin personnel de l’empereur romain Claude. Vers 47, à la demande de Caius Julius Callistus, l’affranchi de l’empereur, il établit une liste de 271 prescriptions (Compositiones), pour la plupart de son invention, bien qu’il reconnût sa dette envers son maître, ses amis et les écrits d’éminents médecins. Cet ouvrage qui comporte aussi des remèdes traditionnels, est sans prétention quant au style et contient beaucoup d’éléments de la langue parlée de l’époque. Sa plus grande partie fut reprise sans être citée dans un travail de Marcellus Empiricus datant des environs de 410, De Medicamentis Empiricis, Physicis, et Rationabilibus, qui est d’une grande valeur pour la compréhension du texte de Largus. Les écrits de ce dernier ne furent découverts qu’au début du XVIe siècle et publiés en 1529.

Parmi les prescriptions Scribonius Largus, la plus célèbre est restée son traitement par l’électricité animale de la goutte et des maux de tête. Pour ces derniers, il plaçait un poisson torpille de Méditerranée, la raie électrique marbrée (Torpedo marmorata) sur le front du patient entre les sourcils et laissait le poisson se décharger jusqu’à ce que « les sens du malade soient engourdis », d'où le nom de "torpeur" pour désigner cet état. Pour la goutte, le poisson vivant était placé sous les pieds du patient.

Histoire de l'électrophysiologie

L'électrophysiologie est l'étude des phénomènes électriques chez les êtres vivants. L'histoire des connaissances en ce domaine remonte à l'Antiquité, mais ce n'est qu'au XVIIIe siècle, avec les travaux de Volta et Galvani que cette discipline scientifique commence à s'individualiser comme branche de la physiologie. Les applications de l'électrophysiologie à la médecine concernent d'une part certaines techniques utiles au diagnostic (électrodiagnostic), d'autre part des méthodes utilisées dans le traitement de certaines affections (électrothérapie).

La bioélectricité dans l'Antiquité

Les premiers phénomènes bioélectriques connus sont les décharges produites par l'organe électrique de certains poissons. Des bas-reliefs de l'Égypte antique représentent des poissons-chats, dont on sait qu'ils peuvent générer des impulsions électriques de plus de 350 V (bas-relief de la tombe de Ti à Saqqarah, datant de 2750 av. J.-C. environ par exemple). En Méditerranée, 5 espèces au moins de poissons électriques sont connues, comme Torpedo torpedo (torpille) dont il existe des représentations anciennes (mosaïque de Pompéi du Ier siècle. La torpille peut générer des impulsions de 45 V.

Bien que leur mécanisme fût inconnu, les décharges générées par ces poissons étaient utilisées d'une manière que l'on pourrait décrire comme de l'« électrothérapie ». Scribonius Largus, sous le règne de l'empereur Claude (41-54), décrit ainsi le traitement contre la migraine ou contre la goutte.

Débuts de l'électrophysiologie et découverte de l'électricité

Au cours du XVIIIe siècle on tenta de découvrir l'origine de ces décharges électriques en disséquant l'organe électrique de torpille. En 1776, John Walsh parvint à rendre visible la décharge électrique de l'organe électrique au moyen d'un flash lumineux. On peut dire qu'il s'agit de la "naissance" de l'électrophysiologie. À la fin du XVIIIe siècle Alessandro Volta et Luigi Galvani démontrent, avec des points de vue différents, que les phénomènes électriques ne sont pas restreints à l'organe électrique, mais de manière plus générale à l'activité des nerfs et des muscles.

En 1791, Galvani montra que les muscles de grenouille se contractent quand ils sont mis en contact avec un arc de métal. Il interprétera ce phénomène, en analogie à l'organe électrique qui est un muscle modifié, comme la décharge dans le métal de l'énergie électrique contenue dans le muscle.

Volta, quant à lui, pensait que l'utilisation de deux métaux produisait une différence de potentiel et, que l'électricité était transférée aux cellules musculaires. Cette interprétation le conduit à construire la pile électrique par l'empilement de disques. L'aspect de cette première pile ressemble beaucoup à la morphologie des colonnes de l'organe électrique.

Description du potentiel de membrane et du potentiel d'action

Dans les années 1840, le physicien italien Carlo Matteucci avait montré que dans un muscle coupé transversalement, un courant électrique s'établit entre surface de la tranche de section (l'intérieur de la cellule) et surface extérieure non endommagée (milieu extracellulaire).

Au milieu du XIXe siècle, Emil du Bois-Reymond (Berlin 1818-1896) mesura pour la première fois un courant d'action sur des muscles et des nerfs stimulés. En améliorant ses instruments de mesure, il observa en effet une diminution temporaire du courant précédemment découvert (alors appelé "courant de blessure", c'est-à-dire le potentiel de repos). Il nomma cette diminution de courant "fluctuation négative" (negative Schwankung). Cependant l'origine de cette "fluctuation négative" et de ce "courant de blessure" restait indéterminée.

Ludimar Hermann, un élève de du Bois-Reymond développa en 1898 la théorie du "noyau conducteur" (Kernleitertheorie). Il proposa que les muscles et les fibres nerveuses sont composés d'un noyau conducteur et d'une interface isolante (comme une "enveloppe"). Une excitation produirait un courant d'action qui polariserait l'enveloppe isolante, et, par induction, activerait les fibres voisines. L'origine locale de l'excitation serait une réaction chimique de type explosive dans le noyau: une altération brutale du métabolisme (Alterationstheorie).

Mais Julius Bernstein, un autre élève de du Bois-Reymond, montra en 1902 grâce à des mesure de dépendance à la température du potentiel de repos, que les phénomènes bioélectriques ne sont pas directement d'origine chimique. Ses expériences indiquaient au contraire qu'il y avait dans les fibres un électrolyte préexistant responsable du potentiel de repos et de la "fluctuation négative". Il profita pour aboutir à cette conclusion de deux avancées récentes:

Walther Nernst avait décrit le potentiel de diffusion entre deux solutions de concentration différente (1888/1889). Bernstein appliqua l'équation de Nernst au potentiel de repos qu'il mesurait.

Wilhelm Ostwald obtint presque simultanément (1890) un potentiel électrique de part et d'autre d'une membrane artificielle semi-perméable aux ions.

Bernstein pensa que l'enveloppe isolante décrite par Hermann est en fait une membrane semi-perméable. Il supposa alors que le courant observé entre la surface tranchée des muscles et la surface intacte est dû au différence de concentration ionique, à l'électrolyte préexistant. L'intérieur des fibres est riche en phosphate de potassium (K2HPO4), et la membrane perméable seulement au potassium. Il reprit sa "théorie membranaire" en 1912 dans sa monographie "Elektrobiologie". Il fonda ainsi un nouveau paradigme pour la compréhension de la bioélectricité qui resta inchangé pendant environ 40 ans, jusqu'à ce que l'amélioration des instruments de mesure permette de mieux préciser les différents mécanismes de la bioélectricité.


1791: Luigi Galvani décrit la bioélectricité des nerfs et muscle de grenouille

années 1840

Carlo Matteucci (Italie), « courant de blessure » (potentiel de repos)

Emil du Bois-Reymond (Allemagne), « fluctuation négative » (potentiel d'action)

années suivantes

1850: Hermann von Helmhotz mesure la vitesse de l'influx nerveux (40m/s)

1888/1889: Walther Hermann Nernst, base de l'électrochimie, il recevra le prix Nobel de chimie en 1920.

1902: Julius Bernstein applique l'équation de Nernst pour démontrer que l'origine du potentiel de repos est la sélectivité de la membrane au potassium, et le potentiel d'action la perte de sélectivité transitoire au potassium.

1939: K. C. Cole et H. J. Curtis travaillent sur le calamar.

années 1950

Alan L. Hodgkin et Andrew Huxley utilisent la technique de potentiel imposé (voltage clamp en anglais) sur l'axone géant de calmar, et postulent l'existence de deux conductances indépendantes et activées par le potentiel de membrane, une conductance sélective des ions sodium, et l'autre des ions potassium. Ils peuvent ainsi modéliser ces deux conductances (que l'on a par la suite identifiées à des canaux ioniques) et prédirent toutes les propriétés des potentiels d'action enregistrés. Ces résultats se sont révélés applicables à l'ensemble des neurones, et on valu à ces deux chercheurs le prix Nobel de physiologie ou médecine en 1963, partagé avec John Carew Eccles.


Erwin Neher et Bert Sakmann mettent au point le patch-clamp, pour lequel ils reçoivent le prix Nobel en physiologie ou médecine 1991.

Dictionnaire historique
de la médecine ancienne et moderne

par Nicolas François Joseph Eloy
Mons – 1778