Opium, Saffron and the Long Life of the Canon

Almost every medicine in Avicenna’s Canon of Medicine came straight out of nature. The roughly 800 “simple” drugs of Book 2 were plants, minerals and animal substances, and the 650 compound remedies of Book 5 were mixtures of them. Some of those natural sources — the opium poppy, mandrake, henbane, saffron, willow, turmeric and garlic — went on to become subjects of modern pharmacology, and a few of them lie behind drugs still used in hospitals today. Avicenna (Ibn Sīnā, about 980–1037), the Persian physician-philosopher who wrote mostly in Arabic, described them in the language of his own time: hot and cold, wet and dry, the four humours and the temperaments.

This page looks first at those natural sources: the opium entry and his description of opium as a poison, the sleep-inducing plants used around surgery, saffron and his separate Treatise on Cardiac Drugs, the pain remedies of his lists, and what modern laboratories have and have not examined. It then follows the book itself across six centuries — from a Latin translation made in twelfth-century Toledo, through the universities and the first printing presses, to a bonfire at Basel and the last lectures given on it in Padua and Spain. Every dose and recipe in the Canon is reported here as history only; no quantities or preparations are given, and nothing here is advice.

Table of Contents

  1. Plants, Minerals and Animal Drugs
  2. The Opium Entry
  3. Mandrake and Henbane in Surgery
  4. Saffron and the Treatise on Cardiac Drugs
  5. Willow, Turmeric and Garlic for Pain
  6. Testing Old Remedies with Modern Pharmacology
  7. Gerard of Cremona and the Latin Canon
  8. Montpellier, Paris and the Printing Press
  9. Bonfire at Basel and the Humanist Critics
  10. The Last Lectures: Padua, Salamanca and Beyond
  11. Key Research Papers
  12. Connections
  13. Featured Videos

1. Plants, Minerals and Animal Drugs

Book 2 of the Canon is a materia medica — a catalogue of single medicinal substances, arranged alphabetically after a first part on the general rules of drugs. According to the Encyclopaedia Iranica article on Avicenna’s medicine, it holds about 800 simple drugs, “mostly plants,” together with many animal and mineral substances. The plants range from kitchen spices and garden herbs to imported resins and powerful poisons; the minerals include metals, earths and salts; and the animal drugs include products such as honey, milk and parts of animals that had a place in the medicine of the time.

Avicenna did not invent this list. He inherited it. The Greek pharmacologist Dioscorides, writing in the first century, had described several hundred plants, minerals and animal products in his De materia medica, and Galen had built a theory of how drugs act around their qualities and their strength. Both had been translated into Arabic in ninth-century Baghdad. To that Greek inheritance the Arabic physicians added drugs from Persia, India and the wider trade routes of the Islamic world. Siddiqi devoted a long study to Avicenna’s materia medica in 1986, and the historian Danielle Jacquart has described how Arabic pharmacology between the ninth and thirteenth centuries built on Galen and Dioscorides while developing its own theories of drug strength.

How each Book 2 entry was laid out — its criteria of quality, its primary qualities, its actions and its substitutes — is explained on The Canon of Medicine: Five Books of Medieval Medicine. This page samples what was in the entries rather than how they were built. The sections below follow a handful of substances that modern historians and pharmacologists have singled out, because they connect the eleventh-century text with the drugs of the nineteenth and twentieth centuries.

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2. The Opium Entry

Opium is the dried latex of the unripe seed capsule of the opium poppy, Papaver somniferum. It had been used in medicine since antiquity, and the Arabic word Avicenna used for it, afyūn, comes from the Greek opion. In 2013 the researchers Heydari, Hashempur and Zargaran published a study of the Canon’s opium entry (“Afion”) and set its claims beside modern pharmacology.

What the entry describes

According to their study, Avicenna’s entry describes a wide range of effects. Opium relieved pain (an analgesic effect), brought on sleep (a hypnotic effect), quieted coughing (an antitussive effect), acted on the stomach and bowel, affected the mind and thinking, and depressed breathing. Heydari and colleagues report that most of these effects have been confirmed by modern research — the opium alkaloids are known to relieve pain, cause drowsiness, suppress the cough reflex, slow the gut, cloud the mind and, in overdose, stop breathing. A 2020 letter in The Lancet Neurology by Dadmehr and Bahrami returned to the same entry, under the title “Avicenna: effects of opium on sensation and pain.”

A poison as well as a medicine

The most striking feature of the entry, as Heydari and colleagues describe it, is that Avicenna named opium a potential poison. He placed it among the strongly “cold” drugs of humoral theory, and in that system an excess of cold could extinguish the body’s innate heat. The language was different from ours, but the danger was the same one modern medicine records: respiratory depression and death in overdose.

Eight centuries after the Canon, in the early 1800s, the German pharmacist’s assistant Friedrich Sertürner isolated morphine from opium — the first alkaloid to be isolated from a plant — and opened the era of alkaloid chemistry. Opium, morphine and their relatives are addictive substances and poisons in overdose; this page reports their history and pharmacology only. The long story of opium in pain medicine is told on Chronic Pain: History and Discovery.

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3. Mandrake and Henbane in Surgery

Surgery without anaesthesia was a terrifying ordeal, and physicians across the ancient and medieval worlds looked for plants that dulled pain or brought on a deep sleep. In 2000 Aziz, Nathan and McKeever reviewed “anesthetic and analgesic practices” in the Canon. They report that Avicenna described the use of mandrake (Mandragora), opium and henbane (Hyoscyamus) to induce sleep or relieve pain before surgical procedures.

The plants and their alkaloids

Mandrake and henbane both belong to the nightshade family, Solanaceae, the same family as deadly nightshade and thorn apple. Modern chemistry has identified their active substances as the tropane alkaloids — chiefly hyoscyamine (whose mixture with its mirror-image form is atropine) and hyoscine, also called scopolamine. These compounds block the nerve messenger acetylcholine at many sites in the body. In small amounts they dry secretions and cause drowsiness and forgetfulness; in larger amounts they cause a racing heart, high fever, delirium, hallucinations and death. That narrow gap between effect and poisoning is the reason the plants were feared as well as used, and the medieval literature records both sides.

Purified scopolamine and atropine went on to have long careers in twentieth-century medicine — atropine around anaesthesia and in eye examinations, scopolamine for motion sickness — as precisely measured pharmaceuticals rather than crude plant preparations. Mandrake and henbane themselves remain poisonous plants; poisoning from them is still reported, and this page describes their history only.

Airway procedures

Aziz and colleagues also point out that the Canon describes tracheotomy (opening the windpipe) and passing a tube through the mouth into the throat to keep the airway open — techniques that sit alongside the sleep-inducing drugs in the story of anaesthesia, since a sleeping patient’s breathing was itself one of the dangers.

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4. Saffron and the Treatise on Cardiac Drugs

Saffron, the dried red stigmas of the flower Crocus sativus, was one of the most prized drugs of Persian medicine, and Persia was one of its oldest growing regions. In a 2013 review in Phytotherapy Research, Hosseinzadeh and Nassiri-Asl compared Avicenna’s saffron monograph in Book 2 with modern pharmacology. Among the uses the Canon lists for saffron, they identify actions that would now be called antidepressant, hypnotic (sleep-inducing), anti-inflammatory, protective of the liver, and widening the airways (bronchodilator). The longer history of saffron as a medicine is told on Saffron: History and Traditional Use.

A separate book on the heart

Saffron also appears in a short work Avicenna wrote apart from the Canon: al-Adwiya al-qalbiyya, the Treatise on Cardiac Drugs. In Latin it became De viribus cordis (“On the powers of the heart”), translated by the physician Arnald of Villanova at Barcelona in 1306, according to the Encyclopaedia Iranica. In medieval thought the heart was the seat of the vital spirit, the source of the body’s life and warmth, so “heart drugs” were medicines that strengthened that vital centre as much as remedies for what we would now call heart disease.

A 2017 review by Sobhani and colleagues in Current Pharmaceutical Design counted about 50 plants in the treatise that Avicenna regarded as acting on the heart. When the authors looked for modern studies of those plants, they found the strongest body of research for saffron, cassia cinnamon, pomegranate, basil, cardamom, lemon balm and emblic (Indian gooseberry, or amla). Chamsi-Pasha and Chamsi-Pasha, writing on Avicenna’s contribution to cardiology in 2014, note that he discussed how drugs act on the heart and set out indications and contraindications for them. One named cardiac drug from his writings, zarnab, was the subject of a separate short paper by Tekol in 1989.

Several of these plants have their own pages on the site: Cinnamon, Cardamom, Pomegranate and Lemon Balm: History and Traditional Use, which also mentions Avicenna.

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5. Willow, Turmeric and Garlic for Pain

Opium was the strongest pain remedy Avicenna described, but it was far from the only one. In a 2015 review in the Avicenna Journal of Phytomedicine, Mahdizadeh, Khaleghi Ghadiri and Gorji gathered the analgesic (pain-relieving) and anti-inflammatory substances described in the Canon. Their review names, among many others, opium, willow, curcuma (turmeric) and garlic.

Willow

Willow bark and leaves had been used against pain and fever since antiquity — Dioscorides described them too. Their active substance, salicin, is converted in the body to salicylic acid. In the nineteenth century chemists extracted salicin from willow and then made salicylic acid in the laboratory, and in 1897 the chemist Felix Hoffmann prepared a purer, gentler form, acetylsalicylic acid, which was sold as aspirin. That story is told on Felix Hoffmann — Aspirin, Willow Bark and the Salicylate Story, and the plant itself on Willow Bark.

Turmeric

Turmeric, the yellow root of Curcuma longa, came to Persian medicine from India. Its best-studied constituent, curcumin, has been the subject of a very large modern research literature on inflammation, much of it in cell and animal studies. Its long history as a spice and medicine is told on Turmeric: History and Traditional Use.

Garlic

Garlic was one of the most widely used medicinal foods of the ancient world, from Egypt to China. Crushing a garlic clove releases sulphur compounds, chief among them allicin, which are responsible for its smell and much of its studied activity. Its history as a remedy is told on Garlic: History and Traditional Use.

Avicenna placed each of these remedies within humoral theory — he chose a drug for its “hot” or “cold” quality and its strength as much as for its effect on a symptom. Mahdizadeh and colleagues note that many of the substances he listed have since been examined in laboratory studies for effects on pain and inflammation; how far that work has gone for each plant is the subject of the next section.

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6. Testing Old Remedies with Modern Pharmacology

Over the last two decades a substantial literature has grown up, much of it from departments of traditional Persian medicine in Iran, that reads the Canon through the lens of modern pharmacology. The papers cited on this page belong to that literature. They are valuable for what they record about the text — which plants Avicenna listed, and for what — and for gathering the modern studies on each plant in one place. Their conclusions about whether a remedy works are the authors’ own, and they are reported here as information.

What the reviews report

Two systems of explanation

A caution runs through any comparison of this kind. Avicenna explained a drug’s action by its primary qualities and its effect on the humours; modern pharmacology explains it by a molecule binding to a receptor or enzyme. A match between an eleventh-century description and a modern finding shows that careful observers noticed real effects; it does not mean the humoral explanation was right, and a remedy that was valued for centuries can still turn out to do little in a controlled trial. The site’s individual herb pages report the modern evidence plant by plant.

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7. Gerard of Cremona and the Latin Canon

The Canon reached Europe through Spain. In 1085 the Christian kingdom of Castile took the city of Toledo, which held libraries of Arabic books, and over the following century scholars gathered there to translate Arabic science and philosophy into Latin. The most productive of them was Gerard of Cremona, an Italian who came to Toledo to find Ptolemy’s Almagest and stayed to translate scores of works. He died in 1187.

According to the Encyclopaedia Iranica article on Avicenna’s influence in the West, by the historian Ullrich Weisser, Gerard translated the Canon into Latin as the Canon medicinae in the second half of the twelfth century, adding a glossary of terms. (One modern writer has proposed that the translation was made by a second, later Gerard in the thirteenth century; the standard account credits Gerard of Cremona.) Arráez-Aybar, Bueno-López and Raio, writing on the Toledo translators in 2015, show that Gerard’s Latin Canon helped fix anatomical terms that are still used, such as diaphragm, orbit, pupil and sagittal.

The medical poem

Avicenna also wrote a medical poem, al-Urjūza fī al-ṭibb, a verse summary of the Canon in 1,326 verses. Abdel-Halim has traced the role of this poem in carrying medical knowledge to medieval Europe. Its Latin version, the Cantica, was made by Armengaud Blasius at Montpellier in 1294, according to the Iranica, which describes the attribution to Gerard of Cremona found in early printed editions as mistaken.

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8. Montpellier, Paris and the Printing Press

A translation is not the same as a textbook. The Canon became a textbook when universities put it into their syllabi. Weisser, in the Iranica, finds the earliest evidence at Montpellier, where a papal bull of 1309 lists it as an optional text for the medical mastership; by 1340 it was firmly established there. At Paris, lecture material on it is first mentioned in 1330, and the German universities followed the Paris model. The parts usually made compulsory were the first section (fen) of Book 1, on physiology, and the fevers of Book 4. Book 2, the materia medica, was read in some universities together with other Arabic pharmaceutical texts.

The commentators

Teaching produced commentary. The great Italian commentators on the Canon included Dino del Garbo (died 1327), Gentile da Foligno (died 1348), Ugo Benzi and Jacopo da Forlì, whose lectures and glosses grew into books of their own. In the Arabic world, as the historian Nahyan Fancy has shown, more than two dozen commentaries were written between the twelfth and fourteenth centuries. The German historian Michael Stolberg has argued that the Canon’s long popularity in Latin Europe may have owed as much to the scope it offered academic commentators — its doctrines, such as innate heat, invited debate — as to its systematic form.

From manuscript to print

The printing press multiplied the book. According to the Iranica, the first Latin printing came in 1472 and contained Book 3 only. About a dozen complete editions followed before 1500, including Venetian editions of 1490–95 with commentaries, and a Hebrew version was printed at Naples in 1491–92. Up to 1608 another fourteen complete Latin editions appeared. In 1593 the Medici press in Rome printed the Arabic text itself.

The Latin text also improved. Andrea Alpago (died 1522), who served for about thirty years as physician to the Venetian embassy at Damascus, corrected the Latin translation against Arabic manuscripts, and his revisions entered the printed editions.

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9. Bonfire at Basel and the Humanist Critics

The Renaissance brought a challenge. Humanist scholars wanted to return to the Greek originals of Hippocrates and Galen, now available in printed Greek and fresh Latin translations, and many regarded the Arabic medical books as corrupted second-hand versions. Weisser names the Italian physicians Niccolò Leoniceno and Giovanni Manardi, the Frenchman Symphorien Champier, and the Germans Janus Cornarius and Leonhart Fuchs among those who attacked the Arabic textbooks in favour of the Greeks.

Paracelsus and the fire

The most famous gesture came from the Swiss physician Paracelsus. In 1527, newly appointed in Basel, he threw a copy of the Canon into the Midsummer bonfire. Weisser describes this as a gesture against all written authorities, not only Avicenna, and stresses that it was “by no means typical of the age.” Paracelsus went on to champion chemical medicines and the idea that the dose determines whether a substance is a remedy or a poison — an idea Avicenna’s own opium entry had touched on centuries earlier.

A defence of Avicenna

The Canon also had defenders. In 1530 the physician Lorenz Fries published a Defense of Avicenna, addressed to the doctors of Germany. In 2024 Shoja, Tritsch and Tubbs published an English translation of Fries’s text with a study of the praise and condemnation the Canon drew in Renaissance Europe. The quarrel shows how central the book still was: no one burns or defends a book that no longer matters.

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10. The Last Lectures: Padua, Salamanca and Beyond

The decline was slow. In Weisser’s words, “In the second half of the sixteenth century, the Canon gradually fell out of the syllabus at most European universities.” Yet it did not disappear at once. Individual professors went on teaching from it — Werner Rolfinck at Jena was still doing so in 1670 — and scholars kept working on the text: Peter Kirsten at Breslau published an Arabic–Latin edition of Book 2 in 1609, and Plemp at Louvain published new Latin translations of Books 1, 2 and part of Book 4 in 1658.

In a few places the Canon remained obligatory into the eighteenth century: at the Spanish universities of Valladolid and Salamanca, and at Padua, then one of the leading medical schools in Europe. At Padua the anatomist Giovanni Battista Morgagni, a founder of modern pathology, lectured on Book 1 in 1712–15, as Santorio Santorio had done about a century earlier. The historian Nancy Siraisi’s study Avicenna in Renaissance Italy follows this Italian teaching in detail.

Verdicts

The Canadian physician William Osler, writing in The Evolution of Modern Medicine, called the Canon “the most famous medical textbook ever written” and said it had been “a medical bible for a longer time than any other work.” Moosavi, writing in 2009, goes further and describes medical teaching from the eleventh to the seventeenth centuries as turning “on the pivot of Avicenna medicine” — his own assessment. The Canon’s drugs are a mixed inheritance: some, like opium and the nightshade alkaloids, became modern medicines once chemists isolated their active compounds, while many others have never been tested in the way Avicenna’s own rules for testing drugs described. Those rules are explained on Avicenna’s Seven Rules for Testing Drugs, and the life of the man who wrote them on Avicenna: Life and Times.

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Key Research Papers

  1. Heydari M, Hashempur MH, Zargaran A. Medicinal aspects of opium as described in Avicenna's Canon of Medicine. Acta Med Hist Adriat. 2013;11(1):101-12. PubMed PMID: 23883087
  2. Dadmehr M, Bahrami M. Avicenna: effects of opium on sensation and pain. Lancet Neurol. 2020;19(9):724a-724. PubMed PMID: 32822632
  3. Aziz E, Nathan B, McKeever J. Anesthetic and analgesic practices in Avicenna's Canon of Medicine. Am J Chin Med. 2000;28(1):147-51. PubMed PMID: 10794127
  4. Hosseinzadeh H, Nassiri-Asl M. Avicenna's (Ibn Sina) the Canon of Medicine and saffron (Crocus sativus): a review. Phytother Res. 2013;27(4):475-83. PubMed PMID: 22815242
  5. Sobhani Z, Nami SR, Emami SA, Sahebkar A, Javadi B. Medicinal Plants Targeting Cardiovascular Diseases in View of Avicenna. Curr Pharm Des. 2017;23(17):2428-2443. PubMed PMID: 28215156
  6. Chamsi-Pasha MA, Chamsi-Pasha H. Avicenna's contribution to cardiology. Avicenna J Med. 2014;4(1):9-12. PubMed PMID: 24678465
  7. Tekol Y. Ibn Sina's cardiac drug zarnab. Hamdard Med. 1989;32(1):73-7. PubMed PMID: 11613995
  8. Mahdizadeh S, Khaleghi Ghadiri M, Gorji A. Avicenna's Canon of Medicine: a review of analgesics and anti-inflammatory substances. Avicenna J Phytomed. 2015;5(3):182-202. PubMed PMID: 26101752
  9. Nasiri E, Orimi JR, Hashemimehr M, Aghabeiglooei Z, Rezghi M, Amrollahi-Sharifabadi M. Avicenna's clinical toxicology approach and beneficial materia medica against oral poisoning. Arch Toxicol. 2023;97(4):981-989. PubMed PMID: 36862191
  10. Siddiqi T. Ibn Sīnā on materia medica. Indian J Hist Sci. 1986;21(4):326-57. PubMed PMID: 11621790
  11. Jacquart D. Islamic Pharmacology in the Middle Ages: Theories and Substances. European Review. 2008;16(2):219-227. DOI: 10.1017/S1062798708000215
  12. Arráez-Aybar LA, Bueno-López JL, Raio N. Toledo School of Translators and their influence on anatomical terminology. Ann Anat. 2015;198:21-33. PubMed PMID: 25667112
  13. Abdel-Halim RE. The role of Ibn Sina (Avicenna)'s medical poem in the transmission of medical knowledge to medieval Europe. Urol Ann. 2014;6(1):1-12. PubMed PMID: 24669114
  14. Stolberg M. [Teachings of "calor innatus" in the Latin Canon medicinae of Avicenna]. Sudhoffs Arch. 1993;77(1):33-53. PubMed PMID: 8333011
  15. Fancy N. Verification and Utility in the Arabic Commentaries on the Canon of Medicine: Examples from the Works of Fakhr al-Dīn al-Rāzī (d. 1210) and Ibn al-Nafīs (d. 1288). J Hist Med Allied Sci. 2020;75(4):361-382. PubMed PMID: 32974673
  16. Shoja MM, Tritsch T, Tubbs RS. Lorenz Fries on the defense of Avicenna, the prince of physicians: Addressed to the medics of Germany (1530). Clin Anat. 2024;37(6):649-660. PubMed PMID: 38630874
  17. Moosavi J. The place of avicenna in the history of medicine. Avicenna J Med Biotechnol. 2009;1(1):3-8. PubMed PMID: 23407771

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