Treating with minerals in the Middle Ages: the rare substance mūmiyāʾ (pitch-asphalt) and its medicinal uses in Byzantium

Abstract

Premodern medicine used a variety of mineral substances for therapeutic purposes. The present article deals with pitch-asphalt, and, in particular, a precious kind of it called mūmiyāʾ originating in Persia. It was first described in detail in the Arabic pharmacological tradition, and its fame spread throughout the medieval Mediterranean, including Byzantium. By editing and examining for the first time a previously unexplored medieval Greek text on mūmiyāʾ, this study offers new insights into the medicinal uses of this substance. It also significantly increases our understanding of the intense cross-cultural transfer of medical knowledge from the Islamicate world to Byzantium by showing that this was not merely based on the translation of a few Arabic medical works into Greek, but was a multifaceted phenomenon involving a complex nexus of sources that require further investigation.

Introduction

Various kinds of mineral substances played an important role in premodern therapeutics.¹ Some of these, such as the famous Lemnian earth or Armenian bole, were often mentioned as being extremely effective for infectious diseases, and modern research has recently suggested that they potentially had a strong antibacterial effect.² This article aims to cast light on a previously unknown episode in the long history of pitch-asphalt as a pharmacological ingredient by focusing on the reception of Islamicate pharmacological lore on this substance in Byzantium.³ It is divided into three parts. The first introduces pitch-asphalt as a mineral drug as evidenced in the works of ancient and medieval authors, with a particular emphasis on the variety of pitch-asphalt called mūmiyāʾ originating in Persia. The next part addresses the introduction and dissemination of medical knowledge about mūmiyāʾ in Byzantium, including evidence from several unpublished sources. The last section provides the first-ever edition and English translation of a medieval Greek opuscule on mūmiyāʾ, known as μουμιέ (moumie) or μώμιον (mōmion) in Greek.

Pitch-asphalt in premodern medicine

Different kinds of the mineral substance asphalt (Greek: ἄσφαλτος, Latin: bitumen) were mentioned by Pliny (AD 23/4–79) and Dioscorides (fl. first century AD), including those originating in Judaea, Sidon, Babylon, the Ionian island of Zakynthos, and Apollonia, a place near the ancient city of Epidamnus, now Durrës in Albania.⁴ Dioscorides informs us that the best variety is found in Judaea and Pliny specifies that it is manufactured on the right bank of the Dead Sea.⁵ Dioscorides also refers to two more kinds: one from Phoenicia and a liquid form from Sicily. He calls the one from Apollonia pitch-asphalt (πισσάσφαλτος) because this particular one smells like a mixture of pitch⁶ and asphalt. According to Dioscorides, asphalt has anti-inflammatory, agglutinative, dispersive, and emollient properties, and is beneficial for uterine suffocations. It could also be mixed with other substances and used, either in the form of a potion or a clyster, for a large variety of ailments, including chronic coughs, asthma, breathlessness, snake bites, pains in the hip joint and the side, bowel ailments, and dysentery. Interestingly, it was also used to glue the hair and when mixed with wax and soda was used in the form of plaster for those suffering from gout. Pliny adds a couple more uses, including skin affections, such as lepra and lichen-like eruptions, and quartan fever; asphalt can also heal sinews.

These uses were more or less followed by other ancient authors, including Galen (AD 129–216/17). The Pergamene physician pays particular attention to the use of asphalt in closing up bleeding wounds, both as a simple and as the active ingredient in a special group of plasters, the so-called ‘barbarian haemostatic [plasters] made of asphalt’ (δι᾽ ἀσφάλτου ἔναιμοι βάρβαροι).⁷ His references were adopted by late antique physicians, including, for example, Aetios of Amida (fl. first half of the sixth century AD) and Paul of Aegina (late sixth century–d. after AD 642). In addition to the use of asphalt as an agglutinative, the latter authors particularly emphasised its efficacy in cases of dysentery and hydrophobia.⁸

Classical knowledge about asphalt was transferred to the Islamicate world through translations of the works of Galen and Dioscorides, in which the translators seem to have been puzzled as to how to render the Greek πισσάσφαλτος, often transcribed as fīṭṭāsfalāṭūs or biṭṭasfalṭus. ⁹ Identification of Dioscorides’ ‘pitch-asphalt’ with mūmiyāʾ is attested for the first time in the ninth-century standard translation of Dioscorides’ work by Iṣṭifān ibn Basīl.¹⁰ An older translation discovered only a few years ago (vetus translatio) simply transcribed the Greek term and translated it literally as zift al-qufr (‘pitch of asphalt’)¹¹; the term mūmiyāʾī was applied in this text to Dioscorides’ ζώπισσα, thus adding another component to the import of ancient Greek knowledge on pitch-asphalt in the Islamicate medical tradition and showing a sort of uncertainty in correlating mūmiyāʾ with a particular Greek term.¹² The revised version of Iṣṭifān’s translation by Ibn Sīnā’s teacher al-Nātilī (fl. eleventh century) identified again πισσάσφαλτος with mūmiyāʾ; the author added the literal translation zift al-qufr. The translators of the twelfth century did not actually equate πισσάσφαλτος and mūmiyāʾ. For example, al-Malaṭī gives the literal equivalent of the Greek term, i.e. zift al-qufr, and Mihrān only explains the Greek name as a ‘variety of asphalt (qufr) from Apollonia’.¹³ However, al-Rāzī (d. c. 925) cited Dioscorides’ very short description in his Comprehensive Book on Medicine,¹⁴ where he omitted any medicinal uses. This shows that he indeed identified mūmiyāʾ with πισσάσφαλτος. After him, many authors writing in Arabic on pharmacognosy, such as Ibn Samajūn, Ibn Wāfid, al-Idrīsī, al-Ghāfiqī, and Ibn al-Bayṭār, followed his model and cited Dioscorides’ passage in their entries on pitch-asphalt.¹⁵ In what follows, we will show that despite the efforts to identify mūmiyāʾ with varieties of asphalt or bitumen mentioned in Dioscorides and Galen, the way the use of the term was further developed in both the Islamicate and Byzantine traditions widely differed from the scarce ancient accounts.

The etymology of the Arabic form mūmiyāʾ—other common spellings include mūmiyā (without the perhaps hypercorrect hamza) and mūmiyāʾī (coming close to the alleged original Persian form)—is not entirely clear. It certainly depends on mūm, the Persian word for ‘wax’. The most probable origin would be the Persian mūm-āʾīn (‘like wax’).¹⁶ According to some less likely interpretations reported by the Iranian polymath Abū l-Rayḥān al-Bīrūnī (d. 1048), it may be composed of mūm and the Persian āb (‘water’) or even the toponym Ābīn, a place near Dārābjird (now Darab in Iran’s Fars Province)¹⁷. According to reports by Arab geographers and pharmacologists, mūmiyāʾ was found in Persia and other places such as Syria, Yemen, near Cordova in Spain, and on the Atlantic coast of Northern Africa. The Persian variety was considered of highest quality. Quoting from an anonymous book on geography entitled Ashkāl al-aqālīm (The Shapes of the Climatic Zones), al-Bīrūnī informs us that it originated in a rock cave in Persia. The cave was unsealed only once a year when a small amount was collected under the supervision of high-ranking officials and then delivered to the Sultan of Dārābjird:¹⁸

The author of the Ashkāl al-Aqālim…writes: Momyāʾī is found in Dārā Bijard in a cave. It is reserved for the king and the mouth of the cave is guarded by sentries. At a specified time each year officials, despatchers of letters and the courtiers of the king gather together and unseal the mouth of the cave. Pissasphalt collects within the crevice of a stone in the lower portion in the size of a pomegranate. It is sealed in the presence of these dignitaries and all the officials of the government take a little of it. This is the real pissasphalt. All the other pissasphalt varieties are counterfeit. There is a village near the cave known as Ābīn. The name momyāʾī, is, therefore, an eponym, and is mom Ābīn (i.e. the Ābīn wax).¹⁹

In what follows, al-Bīrūnī gives a few variants of this story and informs us about other places of origin in Iran and neighbouring countries. The text also praises the effectiveness of this mineral when applied externally in gluing bones back together and repairing fractures.

The anecdote concerning the cave predates al-Bīrūnī and his source. Already in the ninth century, the geographer Ibn al-Faqīh had said the same about a cave near the now ruined city of Arrajān on the border between what are today the provinces of Khuzestan and Fars in Iran. In his Kitāb al-Buldān (Book on Countries), he wrote that in this cave there was a well, in which the water changed over time into white mūmiyāʾī. The iron door of the cave was opened just once a year in the presence of local dignitaries, who then sent the mūmiyāʾ to the Sultan. Ibn al-Faqīh also says that an amount equal to one lentil administered orally with water heals fractures and similar conditions.²⁰ The famous geographer Yāqūt al-Ḥamawī (1179–1229) repeats Ibn al-Faqīh’s information that the cave was in Arrajān; he also emphasises the use of mūmiyāʾ for bone fractures.²¹ It is an interesting fact that al-Bīrūnī and Ibn al-Faqīh relate almost the same story about two different towns, which makes one wonder whether this drug was actually that unique and if there was really such a monopoly. Centuries later, other authors locate the cave near Iṣṭakhr or Shīrāz in Fārs, and the German traveller Engelbert Kaempfer tells us the same story as late as in 1712.²² The tenth-century Syriac lexicographer Bar Bahlūl even stated that the real discoverer of the source of mūmiyāʾ was Daniel, the biblical prophet.²³ Several authors report mineral mūmiyāʾ found in the Islamicate West, either in the environs of Cordova, Lorca, or Meknes. According to others, a stone is found in Yemen containing such a liquid. Especially interesting is the report of Muḥammad ibn Aḥmad al-Tamīmī (d. c. 980). He tells us that the Fatimid caliph al-Muʿizz had sent a missionary of Ismāʿīlī Shiism to what is now Algeria. A black mound he found on the seashore turned out to be a kind of mūmiyāʾ, with which he successfully treated the broken bones of a building worker.²⁴

Arab authors of the early Middle Ages recommended mineral mūmiyāʾ for several purposes. Because of the vast number of entries dedicated to this substance in the Arabic medical literature, we focus here on the most important classical pharmacognostic texts, namely ʿAlī ibn Rabban al-Ṭabarī’s Firdaws al-ḥikma (Paradise of Wisdom, ninth century), al-Rāzī’s al-Ḥāwī (Comprehensive Book on Medicine, tenth century) and his al-Kitāb al-Manṣūrī (Book for al-Manṣūr),²⁵ al-Majūsī’s al-Kitāb al-Malakī (Royal Book, tenth century), Ibn Sīnā’s Qānūn fī l-ṭibb (Canon of Medicine, eleventh century), and Ibn al-Bayṭār’s al-Jāmiʿ li-mufradāt al-adwiya wa-l-aghdhiya (Collector of Simple Drugs and Foodstuffs, thirteenth century).²⁶ The main and most illustrious indication of natural mūmiyāʾ was the treatment of broken bones, and references to this can also regularly be found in the works by geographers and mineralogists mentioned above. It is worth noting that this use was never singled out so prominently in the earlier Greek tradition as far as pitch-asphalt is concerned. The second most important benefit was for coughing up blood. Other indications listed in these sources include headaches, migraine, facial paralysis, epilepsy, trembling and tetanus, earache and suppuration from the ears, angina, cough, hiccough, suffocation, conditions of the heart and spleen, incontinence, ulcers in the bladder and urethra, dropsy, jaundice, and pains in the nerves and joints. It was also recommended for poisons and scorpion stings. The drug was mostly administered orally and dissolved in diverse liquids. Furthermore, for some indications, it was dripped into the ears or the nostrils.

Over the next few centuries, there was a remarkable semantic expansion of the term mūmiyāʾ and its Latin counterpart mumia, which were also associated with the bituminous substance from embalmed mummies. For example, one of the most widespread works on simple drugs in Latin, the twelfth-century Salernitan treatise Circa instans, mentions mumia as a hot and dry substance, which is found in the tombs of people embalmed with spices. According to the text, the mumia is found near the brain and spine, is black, and has a bad smell; it is used as a haemostatic and also in composite drugs for dysentery, ailments of the intestines, and excessive bleeding in menstruation.²⁷ Mumia is also found in the vast Byzantine pharmacopoeia Dynameron by the so-called Nicholas Myrepsos, which was composed by the late thirteenth century, and it is particularly defined as ‘blood of a dead person, called moumia by the Italians’.²⁸

Arabic accounts of this ‘mūmiyāʾ from the graves’ (mūmiyāʾ qubūriyya) are actually rare.²⁹ Ibn al-Bayṭār (1197–1248), in his highly influential Jāmiʿ, reports four kinds of mūmiyāʾ: the pitch-asphalt of Dioscorides, the asphalt of Judaea (qufr al-Yahūd), the above-mentioned stone from Sanaa (Yemen), and the substance obtained from embalmed corpses.³⁰ According to Ibn al-Bayṭār, the latter was used by the Rūm (‘Romans, Greeks, or even Byzantines’) in ancient times. The Jewish philosopher Mūsā ibn Maymūn (a.k.a. Maimonides, d. 1204), who spent a significant part of his life in Egypt, mentioned in his entry on mūmiyāʾī only the variety from the graves.³¹ The oldest medical source describing this type of ‘mummy found in graves’ is actually Ibn al-Jazzār (d. c. 980) from Kairouan in his book on simple drugs.³² He apparently depends on his teacher Isḥāq ibn ʿImrān. Lastly, al-Tamīmī’s account is also highly interesting. He stated that the Pharaohs used to fill the corpses with the mineral ‘mummy from the West’ (mūmiyāʾ Maghribī), as he calls it.³³

The use of mūmiyāʾ from Egyptian mummies became extremely widespread all over the Mediterranean and beyond in the Middle Ages. There were apothecary jars full of it until at least the sixteenth and in some cases even into the nineteenth century. Various stories survive about the actual origin of this ingredient, especially after the fifteenth century, when there was a shortage of ancient Egyptian mummies and merchants quite often acquired the bodies of recently dead persons that had been prepared for this purpose by local experts.³⁴

Mūmiyāʾ in Byzantine texts

Having briefly sketched out the story of the mineral mūmiyāʾ and the closely related bituminous substance from mummies, we can now focus on the transmission of the knowledge of this ingredient in Byzantium. A letter that has survived from the ninth century provides us with a unique testimony to relations between the Byzantine and Islamicate courts and also concerning the role played by rare drugs as diplomatic gifts.³⁵ It also attests to the gradual introduction of Islamicate pharmacological knowledge to Byzantium, although not in the form of a translation of a single work from Arabic into Greek, as in the case of, for example, Ibn al-Jazzār’s (fl. tenth century) Zād al-Musāfir wa-qūt al-ḥāḍir (Provisions for the Traveller and Nourishment for the Sedentary) and al-Rāzī’s (d. c. 925) Kitāb fī l-Judarī wa-l-ḥaṣba (Treatise on Smallpox and Measles), which became available in Greek by the early twelfth century.³⁶ This letter is from the son of the Fatimid Caliph to Romanos (later Romanos II, sole r. 959–63), son of Byzantine Emperor Constantine VII (sole r. 945–59), and is connected with the frequent embassies between the two states in the late 950s.³⁷ The epistle was accompanied by a gift in the form of a precious substance, an invaluable sort of panacea drug, the rare mineral called μουμιέ (moumie) in Greek.

The text gives a lot of information about this mūmiyāʾ. It was given in a small silver vessel, is characterised as ‘priceless’ (ὑπέρτιμον) and ‘more precious than precious gems’ (τῶν τιμίων λίθων τιμιώτερον), and is indicated as most efficacious for the ‘treatment of the broken limbs of humans and birds’ (θεραπείαν συντριβῆς μελῶν ἀνθρώπων τε και πτηνῶν),³⁸ which is the most important use of the substance in both the Arabic and the Byzantine traditions. The letter informs us that this substance was only available to the Fatimid Caliph in Cairo and the Caliph of Baghdad, thus implying that it was not sold on the open market. It does not provide accurate details about the place of origin, apart from the fact that the substance originated in a guarded ‘rock which oozes droplets like tears’ (ἐπὶ πέτρᾳ καὶ στάζει ὡς δάκρυον), which is in line with the story about the rock cave in Persia that appears in the Arabic sources as early as the ninth century. Interestingly, the text states that the mineral is not found in any other places in East and West, and it reports that most recently they had only been able to collect two litres³⁹ (~640g) of mūmiyāʾ from the guarded ‘rock’ and that they had also found some quantity of this substance on the seashore; the latter, when drunk, was even more efficacious for broken legs, arms, and ribs.⁴⁰ This kind of information is not found in any currently available Arabic source.

Next come details about its use and dosage. According to the text, a quantity of one silver miliarision ⁴¹ should be dissolved in a little oil and swallowed.⁴² The text also includes a procedure for testing it. To be specific, it is recommended that a bird or an animal that has a broken limb should drink some of it, and the fracture should be bandaged for three or four days; after this period, the animal should walk normally once the bandage is untied.⁴³ As we will see below, similar forms of testing appear in Arabic sources as well. Mūmiyāʾ is also recommended for the treatment of catarrh, if the body becomes cold and full of humours (κατάρροιαν τὴν ἀπὸ ψύξεως γενομένην, καὶ εἰς τοὺς χυμούς), epilepsy (ἐπιληψίας), loss of sight (σκοτασμούς), speech impediment (μογιλάλον), cough (βῆχαν), sore throat (κυνάγχην), spleen affections (σπλῆνα), and scorpion bite (δηχθῇ τις ὑπὸ σκορπίου).⁴⁴ The references to epilepsy, spleen affections, and the scorpion bite clearly belong to the expansion of the use of pitch-asphalt in the Arabic tradition, as we saw above. The letter ends with a further emphasis on how unique and invaluable mūmiyāʾ is and mentions an adulterated version of mūmiyāʾ, viz. a mixture of pitch with other substances, which was often sold by merchants but, when tested, has been shown not to be as efficacious as true mūmiyāʾ. ⁴⁵

The absence of translations or adaptations of Arabic works on simple drugs in medieval Greek, apart from a work on purgative drugs ascribed to St. John of Damascus,⁴⁶ meant that mūmiyāʾ was not a particularly popular ingredient in Byzantine medical literature, and there are only a few mentions of it. The first reference is found in the Ephodia tou Apodēmountos, the Greek translation of the aforementioned Arabic treatise, Zād al-Musāfir wa-qūt al-ḥāḍir by Ibn al-Jazzār.⁴⁷ It appears as an ingredient in a composite drug for the treatment of bleeding from the ears. The earliest surviving witness of the text that retains this particular chapter, the twelfth-century Parisinus gr. 2311 (f. 59r, l. 28), reads μούμιεν,⁴⁸ which is very close to the term in the letter that we saw above and also to the original Arabic word. In fact, the Greek term has the diphthong ou for the Arabic letter wāw, while the combination of yāʾ and alif at the end have been rendered as ie with the use of the Greek letters iota and epsilon. The final nu in Greek here might point to the abovementioned Arabic variant mūm-āʾīn.

The next two references in Byzantine Greek retain the term mōmion, which is the same term as is used for the mineral substance in the anonymous Byzantine work that is edited below. Moreover, here we can see a distinct process of Greekification in the use of the ending -on, which makes the term neuter in gender, and the rendering of wāw with omega in the first syllable, making the entire word more euphonic in Greek. The first mention is found in an anonymous veterinary work on birds, which is dedicated to an emperor called Michael, most probably Michael VIII (r. 1282–1328), in which consumption of mōmion along with meat is recommended for fractures.⁴⁹ The second is in the unpublished recipe book of Benjamin the Jew, where mōmion is used as an ingredient in a composite drug, a plaster for testicular rupture.⁵⁰ The third reference comes from another unpublished recipe book by the otherwise unknown medical author called Andreiomenos. The text retains the term moumia; the substance is recommended as a simple drug, which should be swallowed in the form of a powder for the treatment of dysentery.⁵¹ It is not clear whether it refers to the mineral mūmiyāʾ or the bituminous substance from mummies. It is worth noting that Andreiomenos’s recipe book contains some recipes derived from Latin antidotaria, in which the term mumia is mainly used with reference to human mummies. The term moumia also appears, as we saw above, in the Dynameron, with reference to the blood of a dead person.

The most detailed treatment of mūmiyāʾ is found in an anonymous opuscule, which is edited and translated as part of this article. The text survives in two manuscripts, Vaticanus gr. 282 (=V), f. 444v, and Parisinus gr. 2194 (=P), f. 436r. It was first mentioned with reference to P by Charles du Cange in 1688, who also transcribed the first few sentences, without providing any other data about the term mōmion. ⁵² Since then, it has not been examined. Here mōmion clearly refers to the Persian variety of pitch-asphalt (mūmiyāʾ), which originates in rock caves (ll. 3–4) in line with the accounts in Arabic medical literature and the Fatimid letter discussed above. According to this text, the mineral is also found in other places, including Byzantium, but that sort is not of good quality (ll. 4–6); this probably refers to other kinds of asphalt, as we mentioned above in the cases of Pliny and Dioscorides.⁵³ It is also clearly specified in the text that ancient Greek authors were not aware of mūmiyāʾ (ll. 2–3). The best variety is the one that is neither soft nor too hard and is black in colour (ll. 6–7). There is a strong emphasis in the text on the use of the mineral substance for fractures, which was also emphasised in the Islamicate pharmacological tradition and the Fatimid letter.

A process is suggested for testing the efficacy of mūmiyāʾ when treating birds with a broken leg, which is very similar to the corresponding content in the Fatimid letter and alludes to reports in the oriental mineralogical and geographical literature. In this case, the text refers to a small chicken, which, as noted in the Fatimid letter, should walk normally again in three or four days if the mūmiyāʾ is genuine (ll. 7–9). Such a test, involving a chicken, was also mentioned by al-Bīrūnī.⁵⁴ In line with the Fatimid letter, it is recommended here that mūmiyāʾ should be taken as a sort of potion, not applied externally. In the Arabic tradition, we can see mentions of both internal and external application.⁵⁵ Interestingly, the opuscule referring to the treatment of limb fractures gives details about different dosages according to the age of the patient (infants, 5-year-old children, adults, old men) and the seasons of the year (winter, summer), something that is missing in the Arabic pharmacological texts. Mūmiyāʾ should be dissolved in warm unmixed wine or in breast milk for infants, rather than in oil as in the Fatimid letter (ll. 10–13).

Lastly, in this text, it is also used for swollen genitals ὀγκωθεῖεν τὰ αἰδοῖα caused by a kind of flatulence/gas (πνεῦμα) in both children and adults (ll. 13–14), an indication that is not mentioned explicitly in any other texts dealing with mūmiyāʾ. ⁵⁶ The only linguistic parallel (αἰδοῖα…ὀγκωθῆναι) in Greek is found in three miracles of St. Artemios that describe the miraculous treatment of patients.⁵⁷ In fact, this condition is very rare in medical texts. It alludes to the so-called pneumatocele (πνευματοκήλη) of Paul of Aegina, a sort of aneurysm of the testicular artery.⁵⁸ Paul warns that according to the first-century AD surgeon Leonides, an operation for pneumatocele could be fatal due to the risk of haemorrhage, but he nevertheless gives details about the procedure.⁵⁹ Interestingly, the same condition is also briefly described by Leo the Physician (ninth[?] century) in his Synopsis of Medicine where he emphasises that it mostly occurs in children and should be treated with drying medications, not with surgery.⁶⁰ He suggested two plasters, the so-called Athēna (Ἀθηνᾶ) and barbara (βαρβάρα), which, along with a large number of other ingredients, also include pitch,⁶¹ a substance similar in nature to mūmiyāʾ.

Conclusion

By focusing on the reception of the mineral mūmiyāʾ in Byzantium, this study has had some important outcomes. At a strictly textual level, it has been shown how critical it is to edit and make widely available even brief texts dealing with Byzantine medical material. In this case, evidence from a previously unexplored medieval Greek opuscule on mūmiyāʾ along with details coming from other unedited Byzantine sources has allowed us to outline the reception and dissemination of knowledge concerning this medicinal substance in the Byzantine world. The latter is particularly important for studying the impact of the significant transfer of medical knowledge from the Islamicate world to Byzantium and shows that scholars should move beyond studying the translations of single works from Arabic into Greek, of which in any case there were very few, and explore the actual diffusion of Islamicate medical lore in Byzantine medical works.

Another notable conclusion is that the Byzantines were keen on supplementing their medical cabinet with material on diseases and substances that did not exist in Greek. Mūmiyāʾ was often connected with various kinds of Dioscoridean pitch-asphalt in the Islamicate world, and although Byzantines were familiar with the Mediterranean pitch-asphalt that featured in earlier Greek and Byzantine accounts, they were eager to show awareness of the unique variety of mūmiyāʾ originating in Persia; they also used a newly coined term in Greek, first moumie and later the Greekified version mōmion. Thus, when looking at the reception of Islamicate medical lore in Byzantium, we must realise that the main intention of the Byzantines was to provide complementarity with those texts already available in ancient and medieval Greek.⁶² The latter is also suggested by the fact that this particular kind of mūmiyāʾ was recommended especially for fractures of bones, a use that was never emphasised in the earlier Greek and Byzantine medical accounts of pitch-asphalt.

Moreover, there is the medical and pharmacological context. Mūmiyāʾ, although rare, was a therapeutic agent with a reportedly high efficacy, which had defined pharmaceutical applications for particular ailments, especially broken limbs. The Byzantine sources give unique information about the quantity of the substance that could be collected every year, expand the reported uses of the substance for other ailments (e.g. swollen genitals), and provide detailed data on dosage for particular age groups, thus making the Byzantine evidence a unique witness to the history of mūmiyāʾ in the Middle Ages. The constant emphasis on the process of testing is consistent with the pharmacological experimentation that is reported throughout the corpus of late Byzantine pharmacological works, thus connecting theory with practice.⁶³

Lastly, we should mention the non-medical dimension, as evidenced in the letter to the son of the Byzantine emperor, which can provide an excellent way to explore how pharmacological knowledge had to be able to adapt to contexts outside medical practice. Drugs were often considered extremely prestigious from a cultural point of view and travelled long distances in the form of diplomatic gifts sent between rulers, thus giving another perspective on the study of the wider Mediterranean pharmacological tradition.