by Lucy Inglis
There was often little distinction between diplomatic, religious and commercial missions to the steppes – a significant amount of the earliest Polo manuscripts are bound with Crusades treatises, for example – but the Polos were still opportunists of the first order and their ability to piggyback onto any useful party heading in the direction they wanted to go was remarkable. Marco was no different, and spent twenty-four years in the East, building a successful career for himself as ‘the Latin’ for Kublai Khan. He is frequently described as a provincial tax collector in later accounts, but it is more likely he ran some sort of salt monopoly and spent the majority of his time travelling to and from India on behalf of Kublai Khan. His descriptions of his time in service in China, though, are of less relevance to the history of opium than his journey through Central Asia, where he met a hundred-strong camel caravan carrying opium back to the West, and went on to relate the tale of the Old Man of the Mountain in the country of ‘Mulehet’, a story that he had heard from ‘several natives of that region’.
The Old Man had ‘caused a certain valley between two mountains to be enclosed, and had turned it into a garden, the largest and most beautiful that ever was seen . . . for the Old Man desired to make his people believe that this was actually Paradise’. In this garden ran milk, honey and water, and young maidens played musical instruments ‘for the delectation of its inmates’. At the entrance to this garden was a fortress, ‘strong enough to resist all the world’, and there the Old Man entertained ‘a number of the youths of the country, from twelve to twenty years of age, such as had a taste for soldiering, and to these he used to tell tales about Paradise, just as Mahommet had been wont to do’, but ‘no man was allowed to enter the Garden save those whom he intended to be his ASHISHIN’. Those chosen were given a ‘certain potion which cast them into a deep sleep, and then causing them to be lifted and carried in. So when they awoke, they found themselves in the Garden.’
As the Old Man had promised, life in the garden in the valley was very fine indeed, and all continued well until the Old Man needed an enemy dealt with, when ‘he would cause that potion whereof I spoke to be given to one of the youths in the garden, and then had him carried into his Palace. So when the young man awoke, he found himself in the Castle, and no longer in that Paradise; whereat he was not over well pleased’, which is understandable. The Old Man would then deliver the youth a promise: ‘Go thou and slay So and So; and when thou returnest my Angels shall bear thee into Paradise. And shouldst thou die, nevertheless even so will I send my Angels to carry thee back into Paradise.’ A ceremonial dagger was presented and the dutiful youth despatched to the target’s, and usually his own, death.62
The Old Man of the Mountain legend is an early mention of suicide-terrorism, and its inclusion in Marco Polo’s accounts of his travels meant that it spread rapidly far and wide, even before the age of print. Like almost all legends, Polo’s Old Man is a scrambled version of fact and fiction. Hassan al-Sabbāh, a religious fanatic of the Nizari Ismaili sect – a branch of the minority, Shia Islam – is believed to have been the Old Man of the story, and from 1090 onwards in Alamut Castle, around sixty miles from modern Tehran, he created a fertile, terraced garden within a defendable valley from which to attack the Abbasid Caliphs and the invading Seljuk Turks. Polo’s Mulehet was in Lebanon. Al-Sabbāh did indeed surround himself with young, male acolytes, a group of fedayeen willing to die for their beliefs at his order, but once inside the castle itself, there was little of paradise to be had. ‘Ashishin’, now taken to mean that the potion the youths drank to put them to sleep was made up from Cannabis indica, at the time often meant little more than lowlives.63 Cannabis was widespread throughout Egypt by the ninth century and the Arab world by the eleventh, much to the disgust and fury of stricter members of the faith.64 The transportation to paradise the youths felt is more akin to the opium experience than to that of cannabis, but a mixture of the two would have induced both visions and then a deep enough sleep to have allowed bodily transportation to some other place. It is strongly reminiscent of Jamšid’s ancient haoma. They were also drugged when they went on their missions: a mixture of cannabis steadied them and an ephedra element kept them alert.
Owing to the inclusion of such legends, and frequent missteps and confusion, there is a great deal of speculation about how far Marco Polo actually journeyed. Some believe he never made it further than the Black Sea, that his travels are a compendium of his father’s and uncle’s adventures, and certainly there are inconsistencies, exaggerations and downright fabrications in his Travels.65 Yet his description of Central Asia and the East is consistent both in terms of landscape and in what he met with there, and there are too many everyday details of life in the East for it to be a pack of lies. In particular, his detailed description of the paper money the Chinese used in larger trade transactions feels authentic, with his Venetian soul perturbed by such notions of trust and lack of coin.
His absence from extant Mongol texts may well mean he wasn’t quite as important as he made himself out to be, and his absence from Chinese records is attributed to the tendency to lump the Hsi-yu, Westerners, together. Among those who believe the travels were genuine, the theories that Polo spent his time in Badakhshan, then as now a poppy-growing centre, as an opium addict seem improbable. His account of the clean air on the Roof of the World – and how ‘men who dwell in the towns below, and in the valleys and plains’, upon suffering a fever would come into the mountains for two or three days, and ‘quite recover themselves through the excellence of that air’ – fits entirely with his own experience of feeling well ‘at once’ after suffering for a year with a weak strain of malaria picked up on the journey.66 It could also be that in an area already dominated by poppy-growing the local herbal medicines contained opium latex which stopped coughing immediately, thus effecting what seemed like a miraculous cure.
Most importantly, Marco Polo’s stories may have been lost entirely, had he not on his return to Venice in 1295 involved himself in Venice’s naval battle with Genoa a year later. Held prisoner until 1298, he is said to have formed a friendship with a fellow prisoner, the writer Rusticello, and after sending off to Venice for his travel notebooks, recounted the story of his, his father’s and his uncle’s travels. Upon his release, he married, had three daughters and died in 1324, a legendary adventurer in his own lifetime.
The Polo family’s journeys also demonstrate the extent to which it was possible to travel the world, even in the thirteenth century, by both land and sea. Despite many diversions caused by war or shifting political alliances, they still managed to roam Central and South-East Asia, as well as Egypt and Turkey, using reliable and well-known, if perilous, routes. In the next three centuries, these routes were expanded to include a continent of such riches even the Polos would not have believed, triggering a lift in global trade that truly did raise all ships, but there were many disasters to be overcome first – not least a scourging angel.
The Age of Discovery: Part One
Acre had fallen to the Muslims in 1291. The Crusades were over, and Europe stabilized quickly, allowing a new period of intellectual life to flourish. By the time Marco Polo died in 1324, Europe was looking forward to a period of prosperity. But the Silk Roads the Polo merchants had traded upon so successfully were harbouring something else that was eager to do business: plague.
The Black Death of 1346–53 killed anywhere between 30 per cent and 60 per cent of the European population, and estimates of the total deaths vary widely, from 75 million to 200 million people. Yersinia pestis came out of Central Asia in the early 1340s and swept west along the Silk Roads, and then covered almost all parts of western Europe by the mid 1350s.
The plague was devastating, but the sheer number of deaths had unexpected results. For many it raised wages and standards of living, and moved them off the land to towns and cities. The feudal system was challenged by the fact that suddenly it needed workers more than they needed it. The seeds of the middle classes
were already starting to grow, particularly in the northern Low Countries, where the merchants of Antwerp and Amsterdam were becoming increasingly powerful. London, which had been a backwater in terms of European trade, was coming to prominence thanks to its busy port.
Opium, in the form of theriac and mithridate, made a return as one of the prime treatments plague doctors used to try and both guard against plague and to treat wealthier patients. As previously seen with the complicated leprosy medicines, how frightening a disease was can be measured in some sense through the number of ingredients in the medicine used to treat it. One plague theriac lists over seventy rare and expensive items, including ‘viper’s flesh, ground coral, balsam, pepper, rose water, sage, cinnamon, saffron, ginger, parsley, gum arabic, nasturtium, centaurea, storax, myrrh, and anis seed’.67
Because plague was so vicious, and struck so fast, theriac – with its preventative properties against poisoning and other ailments – underwent a revival. Its opium constituent was also effective against three of the main symptoms of plague: pain of the buboes and joint pain, coughing and purging diarrhoea. The preoccupation with health that was spurred by the Black Death brought in a new wave of interest in pharmacology and the work of the apothecary. In the great medical school of Paris, trade was highly regulated, which in turn spread out across France. In Europe in general, opium was regulated as early as the thirteenth century, and a study of the few existing inventories of apothecary shops showed opium was dispensed from fourteen out of twenty-four shops in Provence, three out of five in Aragon and seven out of eighteen in Italy.68
Papaver somniferum had become a fixture of the medieval herbarium, and was grown, often in some quantity, in the gardens of religious and private houses. Merton Priory in south London grew opium poppies, as well as other medicinal drugs including henbane, black nightshade and hemlock.69 And in Oxford, the head of Merton College had a medicine garden by his house which grew opium poppies, and possibly also cannabis. Cannabis seeds, shattered as if to prepare them for use, were found when the site was excavated, along with greater celandine, hemlock, henbane and mint. The garden also contained a wide range of decorative shrubs and plants, reminiscent of the beautiful garden of the House of the Golden Bracelet in Pompeii. Opium poppy and hemp seeds were also found in the rubbish pit of the thirteenth-century house, showing that they had actually been used. The same plants, particularly the opium poppy, greater celandine, hemlock and henbane, were discovered in the garden of the nearby Dominican priory.70 Opium even formed part of the gardens of the Fleet Prison in London, along with cannabis.71
Plague also had the effect of increasing demand for doctors. There were some superb doctors working at the time of the plague, such as Frenchman Guy de Chauliac (1300–68), who studied in Bologna and practised in Lyons. Deeply influenced by the works of Galen and Avicenna, Chauliac was based in Avignon when the plague swept across western Europe. Unlike many other physicians, he chose to stay and attempted to treat the sick. His accounts of the plague ravaging the population divide it quite clearly into two different types: pneumonic ‘with continuous fever and spitting of blood; and death occurred within three days’; and bubonic, ‘with continuous fever, and with ulcers and boils in the extremities, principally under the arm-pits and in the groin; and death took place within five days’. Chauliac wrote that he had caught bubonic plague himself but recovered, ‘by the Grace of God’. He is also known for inducing unconsciousness in patients about to undergo surgery by compressing a nerve trunk in the neck. However, he was aware that this method wouldn’t work in all cases, and that if the surgery was so painful it would put the patient’s life at risk, then they should be medicated with opium first. A modern experiment to recreate Chauliac’s anaesthetic showed that if he were using Papaver somniferum latex of the same strength, his dose would have been 194 mg, which would have rendered the patient unconscious for some considerable time, and could easily have overwhelmed an unaccustomed user or a child.72 He did, however, have great success with anaesthesia, although his recipe for sore eyes – opium mixed with ‘womanis mylke’ – was perhaps less effective.73
Method of delivery was pivotal in early anaesthesia. The somniferous sponge required a delicate touch to avoid suffocating the patient with a mixture of drugs that would make them stop breathing, giving the anaesthetist’s role a prominence it retains today. English medical texts of the period, and up to the time of Shakespeare, refer to an anaesthetic drink ‘that men call dwale to make a man sleep whilst men cut him’.74 Dwale was a recipe that, unlike European sleeping draughts, remained remarkably consistent in terms of ingredients, which can be divided into two groups: harmless, and potentially dangerous. Pigs’ bile, bryony root, lettuce and vinegar added a herbal aspect and bitterness, while hemlock juice, opium poppy latex and henbane were the active ingredients. Small amounts of these potential killers were boiled up with half a gallon of wine and bottled until needed. The dwale recipe is of particular interest because of its inclusion of the large amount of wine that the patient drank, sitting next to a good fire until they fell asleep. The wine would have been rendered foul by the bile, bryony and vinegar, and most of the alcohol boiled off, so the effects were narcotic rather than alcoholic. The combination of hemlock with opium and henbane in half a gallon of wine would probably have proved fatal to patients on a regular basis, but the unpleasantness of the medicine, coupled with the rapid effects of hemlock and the more lasting effects of opium and henbane in the case of dwale, would have put them into a state of unconsciousness relatively quickly. Most importantly, the dwale was self-administered and the patient was controlling the dose. Probably for this reason, dwale was relied upon not only by physicians, but also as a folk remedy.
An almost exact contemporary of Chauliac, John of Arderne (1307 to after 1377) was an English physician who used a version of the dwale recipe to become one of the most influential surgeons of the age. England was lagging behind the rest of Europe in terms of medicine at this time, and relying heavily on the moralistic teachings of the early Christian church with regard to medicine. Ill health was caused by moral failings, and such nonsensical statements as ‘Every cure is brought about either by the use of contraries or by the use of similars’ were accompanied by ‘as a chilling disease is treated with heat, or a dry one with moisture, just as also it is impossible for pride to be cured except it be cured by humility’.75
Arderne, although very much a man of his time in terms of politely crediting God for his success, was a shrewd political and financial operator as well as a practical surgeon. His speciality was treating the anal fistula, an exceptionally painful and debilitating condition for anyone, especially for a society of businessmen and aristocrats who spent a lot of time in the saddle. The surgeries he describes in his masterwork Fistula in ano (1376) are painful to read, let alone undergo, but again show the importance these elective procedures had acquired. Arderne had spent time at the Siege of Algeciras against the Moors (1342–4), where gunpowder and cannon had been used against men for the first time, and the horrors that he saw there were still impressed upon his mind thirty years later as he collated his masterwork. Such wounds, as well as the day-to-day miseries of men on the march or in the saddle, inspired him to find effective methods of pain relief. His anaesthetic for surgery contained mandragora and Egyptian opium, when it was available, rendered down into pigs’ fat and then rubbed on the patient’s palms, temples, chest, armpits and soles of the feet. He lost around half of his patients during or after surgery, due to his ointment, shock or post-operative infection, but when he effected a cure he was so successful he was in great demand. His charges for surgery were on a sliding scale: for the wealthy, he charged £40, almost £30,000 in 2017, and for middling people, a hundred shillings, the equivalent of about £3,500.76 Arderne is most famous for anaesthesia and proctology, but along with his mandragora and opium recipe is a note for an insomnia cure, featuring pills made of opium and rosewater, ‘and he þat takeþ þem shal slepe for certayne�
�.77
The early part of the Renaissance, from 1300 onwards, brought men such as Arderne to the fore of medicine and a new, practical approach to medicine and pharmacology, as well as pain and surgery, had arrived. The old superstitions regarding the four humours still persisted, but the new bourgeois classes of Europe were increasingly looking for answers as to what ailed them, and medieval surgeons knew that if their profession was to make significant progress, they needed to study anatomy. Galen’s monkeys would no longer do. Secular dissection appears first in Italy and dates from 1286, when an outbreak of avian flu killed large numbers of hens and people in Cremona, Piacenza, Parma and Reggio, and the authorities wanted to know why. By 1300, the university at Bologna had added dissection to the curriculum, although private autopsies in the subject’s home were more common. The prevailing view has long been that people before the modern era had an overwhelming disgust and fear of having their bodies analysed post-mortem, but records from Italy indicate this isn’t necessarily true. In medieval Florence, Bartolomea Rinieri’s husband recorded that she had died in the morning aged ‘forty-two or thereabouts’, of a diseased womb, and had asked him ‘to have her autopsied so that our daughter or others could be treated’.78 Bartolomea’s request was not as unusual as might be imagined, and as long as funerary rites were respected, the body would be accepted for a church burial. The church was slowly having to relinquish its hold on medicine.
