Willow, Poppy, Mandrake and Aloe: The Remedies of Dioscorides

Pedanius Dioscorides, a Greek physician of the first century AD, described about 600 plants and around a thousand medicines in his De Materia Medica. Most of his entries are forgotten today, but a handful read like the opening chapters of modern pharmacology. He recorded willow for gout, the opium poppy as a “pain-easer” and “sleep-causer”, mandrake wine for people about to be cut or cauterised, aloe for wounds and for the bowels, and the autumn crocus as a poison to be recognised. Centuries later, chemists pulled salicylates, morphine, scopolamine, aloin and colchicine out of these same plants.

This page follows the best-known of those plants from his text to the laboratory. His words are quoted from T. A. Osbaldeston’s English translation (2000), which is based on John Goodyer’s translation of 1655, so every quotation is a translation of the Greek. Many of these plants are poisonous, and Dioscorides himself recorded that opium and mandrake “kill” when too much is taken; the hazards are reported here as findings, and the historical quantities in his entries are left out. How the book was organised, and how it survived, have their own pages in this wing.

Table of Contents

  1. Willow: Bark, Leaves and Gout
  2. From Willow to Salicylates
  3. The Opium Poppy
  4. Mandrake and the Word Anaesthesia
  5. Henbane, Nightshades and Tropane Alkaloids
  6. Aloe for Wounds and Bowels
  7. Autumn Crocus: A Poison Described
  8. Squill and the Diuretic Plants
  9. Spices and Kitchen Herbs in the Pharmacy
  10. Testing Dioscorides Against Modern Pharmacology
  11. Key Research Papers
  12. Connections
  13. Featured Videos

1. Willow: Bark, Leaves and Gout

Dioscorides placed the willow, which he called itea, in the first of his five books, among the trees. Botanists take it to be one or more species of Salix, the genus of the white willow and its relatives. His entry (numbered 1-136 in Osbaldeston’s edition) begins plainly: the willow is “a tree known to all whose fruit, leaves, bark and juice are astringent.” In the vocabulary of ancient medicine, “astringent” meant a substance that tightens, dries and binds tissue, the quality a physician looked for in a remedy for bleeding, discharges and swelling.

The line that later historians quote most often comes near the end of the entry. In Osbaldeston’s translation, “a decoction of them is an excellent warm pack for gout.” Goodyer’s older English wording, reproduced in Osbaldeston’s introduction, reads “a decoction of them is an excellent fomentation for ye gout.” A fomentation is a warm, moist application laid on the skin. In other words, Dioscorides described willow used on the outside of an inflamed, painful joint, not a willow drink taken to relieve pain throughout the body.

What the entry does and does not say

The willow entry is short, and it is easy to read more into it than is there. Dioscorides did not describe a fever remedy, isolate anything from the bark, or single out willow as a general painkiller. What makes the entry remarkable is that a plant he chose for an inflamed joint turned out, eighteen centuries later, to contain the chemical family behind one of the most widely used anti-inflammatory drugs in the world.

The site’s Willow Bark history page follows the tree’s traditional use in other cultures, and the Willow Bark page covers the modern research on the herb itself.

Back to Table of Contents

2. From Willow to Salicylates

Dioscorides was one link in a long chain. The pharmacologist John Vane, writing in 2000 about the history of anti-rheumatic drugs, noted that “Hippocrates, Celsus, Pliny the Elder, Dioscorides and Galen all recommended decoctions containing salicylate for rheumatic pain”, and that the willow-family remedies of antiquity “turned out to contain salicylates.” Osbaldeston put it more briefly: “In due course this knowledge led German scientists to aspirin.”

The road from a Roman fomentation to a tablet was neither short nor direct. Vane traces the modern story through the English clergyman Edward Stone, who in 1763 reported giving powdered willow bark to people with fevers, to the nineteenth-century chemists who isolated salicin from the bark and then made salicylic acid, and to Hermann Kolbe, who found a way to synthesise salicylic acid in 1860. The haematologists Desborough and Keeling describe the whole span, from willow-based remedies some 3,500 years ago to aspirin, as a single story “from willow to wonder drug.” Salicylic acid irritated the stomach, and at the end of the nineteenth century a chemically modified form, acetylsalicylic acid, became aspirin. That chapter belongs to the people who made it; the wing on John Vane explains how aspirin was finally understood.

How salicylates work

Willow bark itself contains salicin, a glycoside: a sugar molecule bonded to salicyl alcohol. In the gut and liver the body converts salicin to salicylic acid. Salicylates reduce the production of prostaglandins, the chemical messengers that drive inflammation, pain and fever, by acting on the cyclooxygenase (COX) enzymes. Vane’s own work in 1971 showed that aspirin blocks prostaglandin production, the discovery that made sense of a remedy used for millennia. Aspirin itself does something salicin does not: it permanently attaches an acetyl group to the COX enzyme, which is why its effect on blood platelets outlasts the drug in the bloodstream.

The hazards of salicylates are well documented. Research links aspirin and related drugs to stomach irritation, ulcers and bleeding; aspirin given to children with viral illnesses is associated with Reye’s syndrome; and large overdoses of salicylate cause a serious poisoning. Willow bark delivers a much smaller and slower dose of salicylate than aspirin, and its safety profile is studied separately.

Back to Table of Contents

3. The Opium Poppy

No entry in De Materia Medica carries more weight in the history of medicine than the opium poppy, mekon in Greek, Papaver somniferum in modern botany. Dioscorides placed it in his fourth book, among the powerful and dangerous herbs (entry 4-65). In Osbaldeston’s translation, opium is “a pain-easer, a sleep-causer, and a digester, helping coughs and abdominal cavity afflictions.” In the next breath he records the danger: “Taken as a drink too often it hurts (making men lethargic) and it kills.”

That sentence is one of the earliest clear statements in a medical text that the same substance relieves pain, suppresses cough, calms the bowel and, in excess, causes death. All four observations hold up. Opioid overdose remains a leading cause of accidental death in many countries.

Source, counterfeit and dispute

Dioscorides described the dried juice collected from the unripe seed head, and he distinguished it from meconium, a juice pressed from the whole plant, which he called “weaker than opium.” Osbaldeston notes that essentially the same method of collecting the juice from the capsule is still used today. Typically for Dioscorides, the entry also explains how opium was adulterated — with the juice of the horned poppy (glaucium), with gum, or with wild-lettuce juice — and how each fraud could be detected. He did not simply repeat earlier authorities: he dismissed claims made by Diagoras, Andreas and Mnesidemus as “false, disproved by experience.”

The chemistry that came later

The pain-relieving and sleep-inducing power Dioscorides described comes mainly from morphine, an alkaloid that makes up a substantial share of raw opium. Morphine was isolated from opium in the early nineteenth century, the first alkaloid ever purified from a plant, and codeine and other opium alkaloids followed. In the twentieth century researchers found that morphine works by binding to opioid receptors on nerve cells, and that the body makes its own opioid peptides, the endorphins and enkephalins, which act on the same receptors (Brownstein’s brief history traces this arc from opiates to receptors). The same receptors in the brainstem control breathing, which is why the lethal effect Dioscorides recorded is, in modern terms, respiratory depression.

The site’s Chronic Pain history page follows opium through later medicine. Opium and its derivatives are addictive and controlled substances; this page reports their history and pharmacology only.

Back to Table of Contents

4. Mandrake and the Word Anaesthesia

Mandrake, Mandragora officinarum, is a low plant of the nightshade family with a thick, often forked root that ancient writers compared to a human figure. It gathered more legends than almost any other plant of antiquity. Dioscorides’ entry (4-76) is largely free of them. He described the root boiled in wine and given to people “who cannot sleep, or are seriously injured, and whom they wish to anaesthetise to cut or cauterize.”

Mandrake wine, he wrote, was given to “those who shall be cut or cauterized … For they do not notice the pain because they are overcome with dead sleep.” Here, in the first century, is a description of a drug used to make surgery bearable. As with opium, the warning follows at once: “when too much is taken as a drink it kills,” and “Used too much they make men speechless.”

A word that came back

The Greek word anaisthesia already existed before Dioscorides, with a broad meaning of lack of feeling or perception. According to the Italian anaesthesia historian V. A. Peduto, who studied the mandrake passages and the Vienna manuscript of Dioscorides, Dioscorides was the first to use the word in the sense in which we use it today, as an absence of sensation produced for a medical purpose; Osbaldeston makes the same point.

From mandrake wine to the sleeping sponge

Anaesthesia historians describe mandrake as the true anaesthetic of the ancient world. Mion (2017) follows it from “Circe’s root” in Greek legend through Dioscorides to the medieval spongia soporifera, a sponge soaked in plant juices and held to the patient’s nose. Chidiac and colleagues (2012) describe how Roman surgeons used mandrake, how physicians of the Islamic world developed the soporific sponge further, and how versions of it remained in use in Europe until ether arrived. Carter (1996) notes that ancient and medieval surgeons combined opium with sedative plants of the nightshade family, and that the poppy head and the mandrake root still appear on the coat of arms of Britain’s Association of Anaesthetists.

The site’s Insomnia history page follows mandrake and opium as ancient sleep remedies.

Back to Table of Contents

5. Henbane, Nightshades and Tropane Alkaloids

Mandrake was not the only member of the nightshade family (Solanaceae) in Dioscorides’ pharmacy. He also described henbane (hyoscyamus), a sticky, foul-smelling plant whose name survives in the modern drug names hyoscyamine and hyoscine. Osbaldeston lists henbane among the drugs Dioscorides described that still appeared in some modern pharmacopoeias. Historians of ancient medicine find henbane, mandrake and the opium poppy used together across Greek and Roman texts: Laios and colleagues (2019) discuss them among the drugs ancient physicians used for mental illness, alongside hellebore, and Spielman (2026) finds henbane, mandrake and poppy among the remedies Greek and Roman writers, Dioscorides included, recorded for dental pain.

The tropane family

The active compounds in mandrake and henbane, and in their relatives deadly nightshade (Atropa belladonna) and thorn apple (Datura), belong to one chemical family, the tropane alkaloids. The best known are hyoscyamine, its mirror-image mixture atropine, and scopolamine (also called hyoscine). Osbaldeston notes that mandrake contains hyoscyamine, and Carter traces how the sedating principle of these plants was later identified as scopolamine.

All of these compounds block acetylcholine, a nerve-signalling chemical, at muscarinic receptors. That single action explains both the uses and the dangers. Blocking acetylcholine in the brain produces drowsiness, amnesia and, at higher levels, delirium and hallucinations; in the body it dries secretions, widens the pupils, speeds the heart and relaxes the gut. Modern medicine still uses atropine to treat a dangerously slow heartbeat and certain poisonings, and scopolamine against motion sickness.

The hazard

The margin between effect and poisoning is narrow. Toxicology describes anticholinergic poisoning from these plants with a classic picture of hot, dry, flushed skin, dilated pupils, a racing pulse, urinary retention, confusion and hallucination, and in severe cases seizures, coma and death. Accidental poisonings are still reported. Dioscorides’ own warning that mandrake “kills” in excess is consistent with everything known about tropane alkaloids today.

Back to Table of Contents

6. Aloe for Wounds and Bowels

Aloe appears in Dioscorides’ third book (entry 3-25). He reported that it grew abundantly in India, and also in Arabia, Asia and on the island of Andros. His uses fall into two groups that modern medicine still separates. Outside the body, the pounded leaf closes cuts and wounds, and the dried juice “Sprinkled on dry … heals wounds.” Inside the body, the juice “loosens the intestines” — it is a purgative.

As with opium, he explained how to choose good aloe and spot fakes. Counterfeit aloe, he wrote, was made “with gum — which is noticed by the taste, the bitterness, the strength of the smell.” In his preface he also took an earlier writer, Niger, to task for calling aloe “a mineral found in Judea”, an error he blamed on “erroneous gossip, not … personal experience.” (Osbaldeston’s translation includes the translator’s own modern glosses in square brackets; those notes are the translator’s, not Dioscorides’.)

Two products from one leaf

Modern pharmacognosy explains why aloe has two such different uses. The aloe leaf holds two distinct materials. The clear inner gel, made largely of water and complex sugars, is the part used on skin and burns. Just under the rind lies a bitter yellow latex rich in anthraquinone glycosides, chiefly aloin, which bacteria in the colon convert into compounds that stimulate the bowel wall and draw water into the gut. The dried latex is the “aloes” of the old pharmacopoeias, the bitter purgative Dioscorides described. Haller’s history of aloe (1990) is titled “A drug for all seasons” and follows the plant’s medical history from antiquity onward.

The two products carry different risks. Research and regulators have raised concerns about the latex as a laxative: in 2002 the US Food and Drug Administration removed aloe from the list of ingredients permitted in over-the-counter laxatives, because the safety data it had requested had not been supplied. Reported effects of stimulant laxatives include cramping, diarrhoea and loss of potassium with prolonged use. The site’s Aloe Vera history page and Aloe Vera page cover the plant in more depth.

Back to Table of Contents

7. Autumn Crocus: A Poison Described

One of the most revealing entries in De Materia Medica is not a remedy at all. The autumn crocus or meadow saffron, kolchikon (Colchicum autumnale), takes its name from Colchis on the Black Sea, the land of the poisoner Medea in Greek myth. Dioscorides described it (entry 4-84) as a poison and said so directly: “Eaten, it kills by choking, similar to mushrooms. We have described it so that it may not lie hidden and be eaten instead of bulbus.”

The last sentence explains why it is in the book. The corm of the autumn crocus looks like the edible bulbs ancient people ate, and Dioscorides wanted readers to recognise it. He did not present colchicum as a gout remedy.

The later gout story

The rheumatologists Nuki and Simkin, in their history of gout, note that colchicum was used as a purgative in ancient Greece, and that its first use as a specific treatment for gout is usually attributed to Alexander of Tralles, a Byzantine physician of the sixth century AD — some five hundred years after Dioscorides. Colchicum preparations passed in and out of favour for centuries. The active alkaloid, colchicine, was isolated by French chemists in 1820, and it is still prescribed for gout attacks and some other inflammatory conditions.

Colchicine works by binding to tubulin, the protein from which cells build their internal scaffolding of microtubules. Without working microtubules, white blood cells cannot move into a joint and mount the inflammatory reaction that uric acid crystals trigger. The same action in other dividing cells explains the toxicity. Colchicine has a narrow margin between a therapeutic and a toxic dose; poisoning, including from eating the plant by mistake, causes severe vomiting and diarrhoea, followed in serious cases by failure of the bone marrow and other organs. Dioscorides’ blunt line — “Eaten, it kills” — was accurate. The Gout history page follows colchicine and the disease it came to treat.

Back to Table of Contents

8. Squill and the Diuretic Plants

Squill, also called sea onion (Scilla or Urginea maritima, now often placed in Drimia), is a large Mediterranean bulb that grows on sandy coasts. Aliotta and colleagues (2004) traced its use as a diuretic, a drug that increases the flow of urine, “from Dioscorides to the end of the 18th century.” Osbaldeston lists squill among the drugs Dioscorides described that remained in some modern pharmacopoeias.

Squill turned out to share chemistry with foxglove. Its bulb contains cardiac glycosides (bufadienolides, such as scillaren), compounds that strengthen and slow the heartbeat. In heart failure, a stronger heartbeat improves blood flow to the kidneys, which then clear more fluid — one reason the old “diuretic” plants often eased dropsy, the swelling of heart failure. The same compounds are toxic to the heart in excess, and red squill was long used as a rat poison. The wing on William Withering tells how foxglove became the first of these heart drugs to be studied carefully.

Two hundred kidney remedies

Dioscorides gave the urinary tract a large share of his book. Touwaide and colleagues (1997) counted about 200 plants that he recommended for diseases of the urogenital tract. Comparing those entries with the kidney remedies of his contemporary Pliny the Elder, they concluded that the comparison does not support the idea of a close relationship between De Materia Medica and Pliny’s Natural History. In a later review, Touwaide, De Santo and Aliotta (2005) placed the book at the origin of Western herbal medicine for kidney disease and wrote that it had a deep influence on the following centuries, up to the birth of modern pharmaceutical chemistry.

Checking the claims

In 2019 Eric Yarnell and Alain Touwaide tested Dioscorides against modern research. Of 105 plants he described as diuretic, they found that 56 genera (53.3%) have been confirmed to increase urine flow in animal or human studies. Thirty-eight had never been studied, six gave mixed results, and five were shown not to be diuretic. Counting only the 67 genera that researchers have actually investigated, 56 — 83.6% — were confirmed.

Back to Table of Contents

9. Spices and Kitchen Herbs in the Pharmacy

Much of De Materia Medica would look familiar in a kitchen. The first book is devoted to aromatics — oils, ointments, resins and spices — and the second includes cereals, pot-herbs and sharp-tasting plants such as garlic, onion and mustard. Osbaldeston lists the minor drugs and flavourings Dioscorides described that later appeared in pharmacopoeias: anise, cardamom, cinnamon, coriander, dill, fennel, gentian, lavender, linseed, mastic, marshmallow, myrrh, olive oil, peppermint, psyllium, rhubarb, rosemary, saffron and thyme, among others, with wormwood, juniper, ginger and liquorice also in the book.

For a physician of the first century there was no sharp line between food, flavouring and medicine. Several of these plants have their own history pages on this site, each following its traditional use in more detail:

Seeds, roots and families

A modern statistical survey by Staub, Casu and Leonti (2016), working from a sixteenth-century edition of the text, counted 5,314 distinct therapeutic uses of 536 plant taxa and 924 herbal drugs. They found patterns that cut across the book: seeds of the pea family (Fabaceae) were often used for the skin, seeds of the carrot family (Apiaceae) as antidotes, and underground parts — roots, rhizomes and bulbs — were relied on heavily as drugs.

Kitchen herbs are not automatically safe in medicinal amounts. Research reports, for example, that large amounts of liquorice raise blood pressure and lower potassium, and that wormwood contains thujone, a compound toxic to the nervous system in high doses. These findings are covered on the herbs’ own pages.

Back to Table of Contents

10. Testing Dioscorides Against Modern Pharmacology

How good was Dioscorides? The honest answer is mixed, and the mix is itself informative. For the strongest drugs in his book, his observations line up closely with modern pharmacology. Opium did ease pain, suppress cough and calm the bowel, and it did kill in excess. Mandrake did produce a sleep deep enough for surgery, and it did kill in excess. The autumn crocus was a deadly poison. Aloe latex was a purgative. Willow, which he used for gouty joints, contains anti-inflammatory salicylates.

The systematic checks give numbers to that impression. Yarnell and Touwaide’s study of his diuretics found that more than half of the 105 plants he named, and more than four in five of those that have been studied, do increase urine flow. That is a remarkable record for a book written before chemistry, controlled trials or the microscope, and it reflects the method he described in his preface: personal observation, questioning of local people and rejection of claims “disproved by experience.”

Where he went wrong

The same book also contains amulets, remedies with no plausible mechanism and claims that later research has not supported, which are discussed on the page about the book and its method. A historical text is not evidence that a remedy works: of the diuretic plants alone, five were shown not to act as he said, and most of his other claims have never been tested at all. His ancient quantities and preparations are of historical interest only; the plants that worked best — opium, mandrake, henbane, colchicum — are precisely the ones with the most dangerous toxicity.

Why the ancient text still matters

For modern researchers, De Materia Medica works as a map. A plant that a careful observer used for the same purpose across many centuries is a reasonable candidate for laboratory study, and several of the most important drugs in medicine — morphine, atropine and scopolamine, colchicine, the salicylates and the cardiac glycosides — come from plants he described. Whether the book can still lead to new discoveries, and how deeply it shaped the folk medicine of the Mediterranean, are questions taken up in The Vienna Dioscorides and 1,500 Years of Legacy.

Back to Table of Contents

Key Research Papers

  1. Vane JR. The fight against rheumatism: from willow bark to COX-1 sparing drugs. J Physiol Pharmacol. 2000;51(4 Pt 1):573-86. PubMed PMID: 11192932
  2. Desborough MJR, Keeling DM. The aspirin story - from willow to wonder drug. Br J Haematol. 2017;177(5):674-683. PubMed PMID: 28106908
  3. Brownstein MJ. A brief history of opiates, opioid peptides, and opioid receptors. Proc Natl Acad Sci U S A. 1993;90(12):5391-3. PubMed PMID: 8390660
  4. Peduto VA. [The mandrake root and the Viennese Dioscorides]. Minerva Anestesiol. 2001;67(10):751-66. PubMed PMID: 11740424
  5. Mion M. From "Circe's Root" to "Spongia Soporifera": The Role of the Mandrake as True Anesthetic of Ancient Times. J Anesth Hist. 2017;3(4):128-133. PubMed PMID: 29275804
  6. Chidiac EJ, Kaddoum RN, Fuleihan SF. Special article: mandragora: anesthetic of the ancients. Anesth Analg. 2012;115(6):1437-41. PubMed PMID: 22584550
  7. Carter AJ. Narcosis and nightshade. BMJ. 1996;313(7072):1630-2. PubMed PMID: 8991015
  8. Laios K, Lytsikas-Sarlis P, Manes K, Kontaxaki MI, Karamanou M, Androutsos G. Drugs for mental illnesses in ancient greek medicine. Psychiatriki. 2019;30(1):58-65. PubMed PMID: 31115355
  9. Spielman AI. Managing Dental Pain in Ancient Greece and Rome. Part I. J Hist Dent. 2026;74(2):73-86. PubMed PMID: 42585149
  10. Haller JS Jr. A drug for all seasons. Medical and pharmacological history of aloe. Bull N Y Acad Med. 1990;66(6):647-59. PubMed PMID: 2282445
  11. Nuki G, Simkin PA. A concise history of gout and hyperuricemia and their treatment. Arthritis Res Ther. 2006;8 Suppl 1(Suppl 1):S1. PubMed PMID: 16820040
  12. Aliotta G, De Santo NG, Pollio A, Sepe J, Touwaide A. The diuretic use of Scilla from Dioscorides to the end of the 18th century. J Nephrol. 2004;17(2):342-7. PubMed PMID: 15293542
  13. Touwaide A, Pollio A, Aliotta G, Piomelli D, De Santo NG. Medicinal plants for the treatment of urogenital tract pathologies according to Dioscorides' De Materia Medica. Am J Nephrol. 1997;17(3-4):241-7. PubMed PMID: 9189241
  14. Touwaide A, De Santo NG, Aliotta G. The origins of Western herbal medicines for kidney diseases. Adv Chronic Kidney Dis. 2005;12(3):251-60. PubMed PMID: 16010640
  15. Yarnell E, Touwaide A. Accuracy of Dioscorides,' De materia medica (First Century C.E.), Regarding Diuretic Activity of Plants. J Altern Complement Med. 2019;25(1):107-120. PubMed PMID: 30403493
  16. Staub PO, Casu L, Leonti M. Back to the roots: A quantitative survey of herbal drugs in Dioscorides' De Materia Medica (ex Matthioli, 1568). Phytomedicine. 2016;23(10):1043-52. PubMed PMID: 27444350

PubMed Topic Searches

  1. Dioscorides and De Materia Medica
  2. Willow bark, salicin and history
  3. Mandrake and the history of anaesthesia
  4. Colchicine and the history of gout treatment
  5. Dioscorides and diuretic plants

Further Reading

Back to Table of Contents

Connections

Back to Table of Contents