French Observations of Disease

and Drug Use in

Late Eighteenth-Century Cairo
J. WORTH ESTES and LAVERNE KUHNKE

F R E N C H physician who spent many years in Egypt

during die early nineteenth century wondered about
die sources of Egyptian drug lore when he wrote:
It is worth remarking about the acquaintance the inhabi-
tants of Egypt have with a great quantity of drugs and with

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their empirically therapeutic usage. Docs this derive from
works translated from Galen and others, . . . or from a pharmaceutical codex
which exists in the hands of the imam of the maristan mosque [a hospital in
Cairo], or finally, from a remnant of traditional medical science, formerly so
much in honor among the Arabs?1
An unprecedented opportunity for Westerners to examine this drug
lore and, indeed, for systematic scientific observations of many kinds
was created in 1798 when General Napoleon Bonaparte launched an
invasion of Egypt, then a province of die Ottoman Empire. Successive
French governments had considered colonizing Egypt as early as 1777,
but not until February 1798 was Europe sufficiendy peaceful for the
five-man Directory then ruling France to implement the recommenda-
tion made twenty-one years before. The secretly and hastily organized
expedition was designed to tfireaten British holdings in India; it also
helped to divert attention from continental Europe, and gave Bona-
parte a coveted opportunity to expand his military skills. He managed
to assemble a fleet of about four hundred ships and an expeditionary
force of 55,000 soldiers and sailors in only ten weeks; haste was neces-

1. Charles Cuny, "Propositions dliygiene, de mctlcrine, et de chjrurgic, relative a l'Egypte,"

These pour le doctoral en mWccine presentee ct soutenue le 31 aout, 1853, in: Thisa de la Faadttie
mtdecint de Paris, Paris, Rignoux, 1853, 5,2a.
O 1984 BY THE JOURNAL OP THE HISTOIY OF MEDICINE AND ALLIED SCIENCES, INC.
ISSN OOU-5043 VOLUME 39 PACES [ I I TO I52
122 Journal of the History of Medicine : Vol. jg, April 1984
sary in order to complete the conquest before the annual Nile flood
began in July.2
The French landed at Alexandria on 1 July 1798 and defeated the
Egyptian forces defending Cairo three weeks later. However, while
the French were establishing dieir military government, theirfleetwas
destroyed by Admiral Horatio Nelson on August 1-2, thus cutting off
their supply lines from home. In early 1799 General Bonaparte failed in
his attempt to add Syria (the area now called Palestine) to his conquest,
but in July the French defeated a Turkish expeditionary force sent to
reclaim their lost province. Nevertheless, a month later Bonaparte
suddenly and stealdiily returned to France to exploit the disintegrating
political situation there. He left the military command in Egypt to
General Jean-Baptiste K16ber, but his assassination in June 1800, the
erratic and uncompromising actions of his successor, General Jacques
Abdallah Menou, and an Anglo-Turkish invasion in March 1801, all

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led to a French withdrawal in August of that year, diirty-seven months
after the capture of Cairo. France had gained nothing of economic
or political importance from Egypt, but Bonaparte had become First
Consul.
Although the French adventure in Egypt failed, it did have impor-
tant and lasting educational and scientific consequences. Accompany-
ing the expedition were 167 literary and linguistic scholars, scientists,
and technical specialists from a wide range of disciplines, specifically
appointed as a Commission to study die arts, history, and natural and
industrial sciences of Egypt. To serve as an elite professional associa-
tion for selected members of the Commission, and to advise the French
administration of Egypt, Bon?parte founded the Institute of Egypt and
charged its members to publish the results of their research. The mem-
bers of the Institute established laboratories for chemical and physical
experiments, in which local drugs and Nile water, among other things,
were analyzed; initiated archaeological studies and excavations; drew
topographical and other maps of the country; studied geological for-
mations and mineral deposits in die soil, oases, and lakes; and cata-
logued indigenous plant and animal life.3
Several of die physicians and surgeons with the French army pub-

2. We have followed the chronology outlined in J. Christopher Herold, Bonaparte in Egypt,

New York, Harper & Row. 1062.
3. Maurice Cropland, The Society o/Anueil: A View of French Science at the Time of Napoleon I,
Cambridge, Mass., Harvard University Press, 1067, pp. 6-16, 238-244.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 123
lished their own professional memoirs of the expedition, emphasizing
their medical experiences with the occupation troops in the major
Egyptian cities. In addition, Renf DesGenettes, the army's Physirian-
in-Chief, directed his staff to study and report on health-related en-
vironmental factors, indigenous diseases and their treatment, and sta-
tistical correlates of human life, as well as on Egyptian medical prac-
tice.4
In general, most eighteenth-century Western physicians agreed that
Egypt would be an extraordinarily healthy place to live, because of its
constant sunshine and dry climate, were it not for repeated epidemics
of frightening diseases like plague and small pox.3 The most dreaded
disease, plague, was considered endemic in Egypt at that time; in fart
the Nile Valley was held to be the cradle of plague.6 The French army
experienced one minor outbreak of plague during the occupation, and

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a major outbreak in 1800; about one diird of the 700 French servicemen
who were stricken recovered. DesGenettes recorded 2,937 deaths
among the city's roughly 250,000 inhabitants during the single month
of April although he did not know the number afflicted. He considered
plague to be a major cause of population stability in Cairo because, he
suggested, it helped to balance out the high birth rate.7
All observers agreed that the most prevalent endemic disease in
Egypt was ophthalmia, the first indigenous infection to afflict the
French occupation forces. Dominique Jean Larrey, the Surgeon-in-
Chief of the French Army of the Orient, wrote that ophthalmia had
caused panic among the soldiers after their landing on the coast by

4. R[en£] DesGencttes, Histoirt Medicate de I'Armee d'Orient, 3rd ed., Paris, firmin Didot
Freres, 1835, pp. 255-257.
5. DeChabrol de Volvie, "Essai sur les moeurs des habitants modemcs de l'Egypt," in Descrip-
tion de l'£gypte, ixat Modeme, 2, pt. 2, Paris, L'Imprimerie Imperiale, 1822, p. 371; M. le Baron
Larrey, "Memoires et observations sur plusieurs maladies qui ont affect* les troupes de 1'armee
Francaise pendant 1'expedition d'Egypte et de Syric ct qui sont endemiques dans ccs deux con trees,"
in Description de Vigypte, tiat Modeme, 1, Paris, L'Imprimerie Imperiale, 1809, pp. 431-509;
A[ntoine] M[arius] T[imoleon] Savaresi, Memorie ed Opuscoli Fisdci e Medici sull'Egitto, 1802,
trans, ed. Naples, Domenico Sangiacomo, 1808, p. 63; Thomas Grecnhill, NEKPOKHAEIA: or,
the Art of Embalming, London, for the author, 1705, pp. 165-166; Louis Frank, Collection d'Opu-
scules de MUednt-Pratiaue, Paris, Gabon, 1812, p. 2; Paul Triaire, Dominique Larrey et les Cam-
pagnesdclaRfvoluHonetdel'Empire, 1768-1842, Tours, Alfred Mame et Fils, 1902, pp. 187-188,
208; DesGenettes, (n. 4) Histoire mUicale, pp. 236-240, 287-292, 322; William Tumbull, The
Naval Surgeon, London, Richard Phillips, 1806, pp. 210-218.
6. LaVeme Kuhnke, "Resistance and response to modernization: preventive medicine and
social control in Egypt, 1825-1850," Ph.D. dissertation. University of Chicago, March, 1971,
see chapter 3, "Plague: die historical background," pp. 93-98.
7. DesGenettes, (n. 4) Histoire MUicale, pp. 206-207, 210, 214-215, 236-240.
 124 Journal of the History of Medicine : Vol. jg, April 1984
temporarily blinding many men.8 DesGenettes, too, noted the high
incidence of ophthalmia among the soldiers. He observed that the
majority of cases healed widiout treatment, aldiough Egyptians often
treated themselves with astringents applied directly to die eyes. One
visitor estimated that one in 130 "bad cases" became permanently blind
in one eye after repeated bouts of ophdialmia, and all observers agreed
that repeated attacks were responsible for most cases of blindness
throughout the country. Aldiough ophthalmia appeared to be a con-
tagious disease to many observers, their clinical descriptions are even
more consistent with sand and wind-induced conjunctivitis. Des-
Genettes and William Lempriere, a British surgeon who had travelled
in Morocco a few years earlier, attributed most cases of ophthalmia in
North Africa to die intensity of die sunlight and to heat.9
Perhaps as frequent as ophdialmia were the "dysenteries" diat afflic-

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ted the French troops and which were not identified as endemic infec-
tions but were diought to be, in DesGenettes' phrase, "inherent in
armies." He described the onset of numerous cases after the army
ended its march through die desert and rushed to quench dieir thirst in
the Nile at Cairo, and observed that "dysenteries" were among die
principal causes for hospitalizing troops diroughout die French occu-
pation. In his conclusions, DesGenettes reported diat 8,915 of die
30,000 men who reached Egypt had died in die hospital. However,
more dian 1,000 of that number had been victims of plague during die
expedition to Syria, and die salubrity of die Egyptian climate made the
number of sick in die French Army of die Orient proportionately less
than in any French Army in Europe. Table 1 summarizes French deadis

8. Larrey, (n. 5) "Mimoires." Many of the British troops who routed the French in 1801
developed ophthalmia, but few were blinded by it; William Fergusson, Notes and Recollections ofa
Professional Life, James Fergusson, ed., London, Longman, Brown, Green, and Longmans, 1846,
pp. I I O - I I I .
9. Thomas Trotter, Medicina Nautica, an Essay on the Diseases of Seamen, 3 vols., London, T.
Caddl and W. Davies, 1797-1803, 3, iii, 436-440; LaVerne Kuhrie, "Early nineteenth-century
ophthalmological dinics in Egypt," Clio Medial, 7: 209-214, 1972; DesGenettes, (n. 4) Histoire
Mfdicale, pp. 214, 217, 236, 259-266, 324, 341-349, 333; Dfominique] J[ean] Larrey, Relation
Historique et Chirurgicale de I'Expeajtion de I'Armee d'Orient en Egypu et en Syrie, Paris, Demon ville
et Soeurs, 1833, p. 19; William Lempriere, A Tour from Gibraltar. . . to Morocco, 3rdcd., London,
L. J. Higham, 1804, p. 29; Frank, (n. 5) Collection, pp. 99-190; Savaresi, (n. 5) Memorie, pp. 1 5, 63;
Greenhill, (n. 5) NEKPOKH&EIA, p. 163; Tumbull, (n. 5) Naval Surgeon, pp. 222-228. How-
ever, a European ophthalmologist who practiced in Egypt for many years and who did significant
historical research in Egyptian medicine, diought that "military" or "Egyptian" ophthalmia was
a mixture of trachoma, blennorrhea, and less harmful forms of conjunctivitis, probably due to
infection by die Koch-Weekj bacillus; see Max MeyerhorT, "A short history of ophdulmology in
Egypt during the 19th century," Bull. Ophthal. Soc. Egypt, 20: 33-52, April, 1927.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 125
during the occupation of all Egypt through June 1800. Just over one
half were attributed to battle wounds, and almost all the rest to plague
(in Syria, primarily) and other diseases. Scurvy had been a major prob-
lem to the French when they first arrived at Alexandria, but not after-
ward.10

TABLE 1
Percent of
Causes of Death Number All Deaths
Killed in combat 3614 40-51
Died of wounds suffered in combat 854 9.6 1 50"
Killed in accidents 290 3-3
Died of plague 1689 18.9
Died of ordinary illnesses 2468 27.7

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Losses among the 34,000-man French army in Egypt from July 1798 through June 1800.
The total 8915 deaths represent 26.3% of the entire army, probably an underestimate.
Source: R. DcsGcncttcs, (n.4) HistoirtMHicale, pp. 172-173.

Among the Egyptian population, in addition to ophthalmia and

dysentery which were universally noted, small pox was observed as
especially dangerous to young children; it occurred in adults only in
sporadic epidemics. Intermittent fevers (chiefly malarias) were found
in some cities but not in all; Cairo was relatively free of them. Accord-
ing to the French observers, catarrhal and more severe fevers, like
"nervous fever," were uncommon, although an epidemic of the latter
swept through Cairo during the last winter of the French occupation.
In general, the Egyptian population was reported to be relatively free
of pulmonary diseases, although DesGenettes was amazed at the inci-
dence of "asthma," which he attributed to the universal habit of smok-
ing tobacco in pipes. Other indigenous infectious diseases listed by
foreign visitors included leprosy, hepatitis, syphilis, impetigo, and
elephantiasis.11 However, of all the different diseases the Europeans
observed in Egyptians, it is likely that only some of the dysenteries and
fevers, especially those with predominantly respiratory symptoms,
were caused by micro-organisms not common in Europe. Thus, al-

10. DesGenettes, (n. 4) Histoirt Mfdtiale, pp. 12-15, 172-173, 236.

11. DesGenettes, (n. 4) HiaoireMUiaie, pp. 236, 276, 323-325, 375-376, 393; Savarcsi, (n. 5)
Memorie, pp. 15-20, 58-00, 63; Frank, (n. 5) Collection, pp. 2, 7, 9, 11; Tumbull, (n. 5) Naval
Surgeon, pp. 229-230; Greenhill, (n. 5) NEKPOKHAE1A, pp. 163-165.
 126 Journal oj the History of Medicine : Vol. 39, April 1984
though the French might note that Egyptian dysenteries and fevers
differed in frequency and severity from those familiar back home, they
could not, in 1800, have recognized different microbiological causes in
the two countries.
DesGenettes blamedricketsas the major contributor, besides plague,
to die stability of Cairo's population. He thought diat it afflicted mosdy
children between the ages ofone and three; he seldom saw it outside the
large dries. However, most observers reported that rickets was rare in
Egypt, and many of die apparently deformed children may actually
have suffered from severe malnutrition. Dr. Antonio Savaresi said that
he counted more than seventy hunchbacks but not one case of rickets.
DesGenettes was probably correct in reporting that infant mortality
was highest in the first six weeks of life. His colleagues attributed die
estimated 60% mortality rate among infants under direc years of age in
Cairo to their modiers' "constitutional weakness" which, in turn, the

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physirians thought was due to excessively frequent child-bearing and
to premature weaning. The French held the latter responsible for in-
fantile marasmus (protein defidency) and for infants' spedal vulnera-
bility to gastrointestinal disorders and small pox.12
In 1800 Cairo had a population estimated at 200,000 to 300,000;
several observers described the capital rity as inordinately crowded.13
Its density has been estimated at somediing like 50,000 persons per
square mile.14 The data compiled by DesGenettes and summarized in
Figure 1 probably represent a random thirty-mondi period in the mor-
tality statistics for late righteendi-century Cairo; no evidence from
French physirians suggests diat the occupation itself influenced the
dty's overall healdi. Of the 9845 deatfis tabulated by the French, 19.4%
were of men, 25.1% of women, and the remaining 55.5% of "infants"

12. DesGencttcs, (n. 4) Histoire Mfduaie, pp. 322-323; Savaresi, (n. 5) Memorie, p. 58; Frank,
(n. j) Collection, pp. 15-19. At that time it was not common to wean infants before the age of two
years, so the marasmus noted by the French was most likely associated with general under-
nourishment of mother and child. This was the familiar jyndrome of eighteenth-century urban
poverty, and probably matched die picture of child health among the poor of London and Paris at
the time.
13. Savaresi, (n. 5) Memorie, pp. 49, ji;DesGenettcs, (n. 4) HistoireMfdicale, pp. 313-314; M.
Jomard, "Description de la ville et de la citadelle du Kaire, accompagnce de l'cxpliarion des plans
de cette ville et de scs environs et de renseignments sur sa distribution, ses monuments, sa
population, son commerce ct son Industrie," in Description de l'£gypte, £lat Modcme, 2, pt. 2,
Paris, [mprimerie L'Impenale, 1822, p. 580; Francisque Minus Osscdat, Les Phamucienspendant
I'Expfdititm d'Egypte, Paris, CafEn, 1943, p. 61; Marcel Qerget, he Caire: ituie de Geographic
Urbaineet d'Histoire £conom'upu, 2 vols., Cairo, E. Si R. Schindler, 1934,1, 187.
14. Kuhnke, (n. 6), p. 46.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 127

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H O J F M A M J J A S O N D j F M A M J J A S O N O J F M A M
1791 1IOO 1S0I

Figure 1. Deaths among the civilian population of Cairo during the French occupation,
1798-1801. The squares (solid line) represent the total numbers dying each month; the
circles (dashed line) represent thefractionof all deaths who were "infants." The hiatus
in early 1800 coincides with the French expedition to Syria and elsewhere in the Near
East; presumably, the person to whom the figures were to be reported was absent
along with that detachment. Source: R. DesGenettes, (n. 4) Histoire mfdicale, p. 430.

(the age range was not specified).u Deaths rose among adults of both
sexes during the severe plague epidemic in the winter of 1800-01. The
proportion of children dying each month fluctuated between 37 and
76% of all deaths, corresponding to the minor epidemics in the sum-
mer of 1799, and the winter of early 1800, but fell to relatively low
levels in the summer of 1800.
The French military physicians estimated longevity among the
Egyptians at 70-80 years, as was true in contemporary Europe. They
saw more centenarians than at home in France or Italy, especially
among men, and even some men as old as 120 years (they said) who
could walk without canes. Women, who did not live as long as men,
tended to look aged by the time they reached 30, because, said the
French, they were subjected to hard work and poor nutrition.
I j . DesGenettes, (n. 4) Histoire Mfdicale, p. 430.
 128 Journal of the History ofMedicine : Vol. jg, April 1984
Men were commonly reported to be excessively libidinous, but im-
potent after age 40. Their wives were extraordinarily fecund, by Euro-
pean standards, and sterility was rarely observed.16
In order to find out what local (and imported) remedies might be
useful to the French—information of critical importance after their
supply lines had been cut by the British—DesGenettes urged his staff
to study native Egyptian medical practice carefully.17 He and other
Western physicians welcomed such opportunities to investigate the
medical practices of distant countries because they were inquisitive
explorers of the world around them, seeking new remedies for man's
illnesses. Physicians and surgeons in military or naval service contrib-
uted to the growing comparative medical literature as they applied
their talents in trained observations during extended travels. The Otto-
man Empire particularly excited their curiosity, for they were eager to
see what the eastern Mediterranean had preserved of the ancient medi-

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cal traditions which it shared with the West.
The French physicians and apothecaries viewed the practitioners in
Egypt with disdain, as a sorry remnant of what had been a prestigious
profession during the Middle Ages. The professional class of physi-
cians which had flourished then appears to have declined as the great
hospitals which had provided the institutional framework for its activi-
ties passed out of existence. Only one remained, the Maristan al-Man-
sur, in a wretched state of neglect when the French scholars surveyed
Egypt's institutions. The chief physician {Hakim Pasha) for Cairo, a
Turkish functionary appointed by the Ottoman court in Istanbul, re-
portedly was scorned by well-to-do Egyptians as well as by Euro-
peans. Observing the widespread reliance on self-medication among
the inhabitants of Cairo, the French observers concluded that Egyp-
tians had no confidence in their own medical practitioners, and that
many Egyptian remedies were merely superstitious. Expert medical
advice was easily available from the bazaar's drug dealers.18

16. Ibid., pp. 321-322. 373, 394; Greenhill, (n. s)NEKPOKHAEIA, p. 162.
17. DesGenettes, (n. 4) Histoirt Mt&caU, pp. 25J-2JT. Osscdat, (n. 13) Pharmacicns, pp. 28,49,
57-
18. [Pierre-Charles] Rouycr, "Notice sur les medicaments usuels des Egyptiens," in Descrip-
tion de 1't.gfple, txat Moderne, Paris, L'Imprimerie Impenale, 1809, I, 218; DesGenettes, (n. 4)
Histoirt Mfdiiale, pp. 256, 326, 376; Savaresi, (n. 5) Memorie, p. 63. Western physicians in the Age
of Enlightenment continued to exploit the humoral tradition they had inherited from the ancient
Greeks, while also incorporating newly emerging concepts of disease as disturbances in the
irritability of living tissues. Their therapeutic practice was self-confident, highly rational, and
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 129
Members of the French occupation observed some literate practi-
tioners, the Hakims, who still drew their learning from the works of
medieval Islamic medicine. Although a few practitioners in Istanbul
were reported to be familiar with works of Boerhaave or Sydenham, in
Egypt the healers' training consisted of copying and memorizing a few
standard texts like Ibn Sina's (Avicenna's) Canon. None of the healing
personnel seem to have been able to pursue that function full time and
exclusively; all had other more gainful occupations. Most physicians
were also pharmacists and sold drugs in the bazaar. Surgeons' (Jarrah)
and bonesetters' (Mujabbir) functions had fallen to the barbers (hallaq),
who, in addition to their most common service of shaving, also ban-
daged wounds, bled, scarified and cupped, extracted teeth, opened
abscesses, and couched cataracts; mey reduced dislocations and hernias,
performed circumcisions, and applied leeches. Amputations were al-

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most never performed because of the Egyptians' deep repugnance to-
ward mutilation, but barbers had on several occasions performed li-
thotomies successfully, according to French observers. 19
At the public baths barbers usually were joined by an attendant who
specialized in massage. Larrey remarked that local practitioners invoked
a wide range of "energetic" measures for treating external ailments,
and he suggested that perhaps Europeans unduly neglected oily and
dry massage, moxa, dry and wet cupping, and frequent steam baths.
Larrey also was favorably impressed by the Egyptians' recourse to

occasionally experimental; in general, their therapeutic results continued to reinforce their con-
cepts of pathophysiological processes. Charles E. Rosenberg, "The therapeutic revolution: med-
icine, meaning, and social change in nineteenth-century America," Ptrspec. Biol. Med., 20: 485-
506, 1977; J. Worth Estes, "Therapeutic practice in colonial New England," in Philip Cash, Eric
H. Christiaruon and J. Worth Estes, cds.. Medicine in Colonial Massachusetts, 1620— 1S20, Boston,
Colonial Society of Massachusetts, 1980, pp. 289-383;.!. Worth Estes, "Naval medicine in the
age of sail: the voyage of me New York, 1802-03," Bull. Hist. Med., jfr. 238-253, 1982.
19. In his definition of "Tibb" in the Encyclopedia of Islam, 4 vols., Leyden, E. J. Brill, and
London, Luzacand Co., 1913-1936, IV, 740-741, B. Carra de Vaux mentions diat Tibb generally
referred to a practicing physician, while the term Hakim, corresponding to Doctor, was applied
only to a scholar versed in the medical classics. Max Meyerhoff's article "Djarrah" in the Encyclo-
pedia of Islam, new ed., 4 vols. to date, Leyden, E.J. Brill, 1954- , II, 481-482, points out that the
bonesetter in medieval times was required to be familiar with Paul of Aeginus' writing on bone
fractures and sprains, while the surgeon had to know Galen's anatomy and therapy. Arab surgery
avoided every kind of destructive operation, like amputation, even apart from prohibitions of
scruples of a religious nature. Antoine Barthelme dot-Bey, Apercu dnfral sur IEgypte, 2 vols.,
Paris, Fortin, Masson et Cie., 1840, 2, 387-390; Sami K. Hamameh, "Medicine and pharmacy
under the Fatimids," Hamdard Median, 22: 33-69, July-September 1979. Cuny, (n. 1), p. 27,
reports successful lithotomies performed by barbers. For earlier centuries, see: Gary Leiser,
"Medical education in Islamic lands from the sevenm to me fourteenth century," J. Hist. Med.,
}S: 48-75. I983-
130 Journal oj the History of Medicine : Vol. 39, April 1984
rational prophylactic measures; they knew how to fend off "phleg-
masia" opportunely, he wrote, with "diet, rest, refreshing and acidu-
lated beverages, and light scarifications."20
Completing the spectrum of local practitioners, which matched that
in Europe at the time, was the daya, the Egyptian midwife, who was
invariably condemned by visiting European medical men. Fortunately
women in Egypt rarely required assistance during labor and the mid-
wives' scope for causing harm was limited. Their other practices, how-
ever—female circumcision, tatooing, and dispensing remedies for
sterility—provoked Western medical observers to polemics against
superstition and quackery.21
The most complete account of the drugs used by Egyptians at that
time was contributed to the multi-volume and monumental Description
de V&gyptt by a French army pharmacist, Pierre-Charles Rouyer. This
was published after the scholars had returned to France. Born at Ver-

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dun, France, on 12 May 1769, Rouyer studied pharmacy at a nearby
military hospital. Late in 1793 he was appointed Pharmacist Third
Class in the French army sent to attack Austria dirough Bavaria. After-
ward he was at the Val-de-Grace military hospital at Paris until, on 16
April 1798, he was named by the government to the Commission on
the Arts and Sciences which was to accompany General Bonaparte to
Egypt.22
As a member of the French military medical corps, Rouyer had
benefitted from the superior training of the best organized and most
advanced land forces in Europe. As an officer in a specialized support
service, he had had a highly practical education. Both pharmacists and
surgeons had by then attained a professional standing in France that
was comparable to that of the nation's physicians, so that in the mili-
tary services all three professional groups received commensurate
training, rank, and professional responsibilities.
Rouyer also represented the most advanced national pharmaceutical
profession in the world at that time. A royal declaration of 1777 had
replaced the fourteenth-century apothecaries' guild with a prestigious
20. Larrcy, (n. $), pp. 516-517.
21. Ibid., pp. 510-520; Savaresi,(n. 5) Memorie, pp. 59-60. Dr. Savaresi was delighted to leam
that abortion! could be induced by a "mineral body" or by a decoction of henna and onions,
without endangering the mother. See LaVerne Kuhnke, "The 'doctoress' on a donkey, women
health officer* in nineteenth-century Egypt," Clio Medial, 9: 193-205, 1974, for a description of
the social background in which midwives functioned.
22. Ossedat, (n. 13) Pharmaaens, pp. 172, 178.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 131
College of Pharmacy. By establishing the College of Pharmacy as an
administrative as well as an educational institution, France became the
first European country to bestow national and official recognition on
pharmacists, and to demarcate die occupational boundaries among
herbalists, spicers, chemists, and pharmacists. The 1777 declaration
also permitted die coming generation of pharmacists to be educated
without interference from the medical profession. During die Revolu-
tionary years, the College was replaced by die Free Society of Pharma-
cists of Paris; it established an official School of Pharmacy and pub-
lished the first French pharmaceutical journal.23
By die time Pierre-Charles Rouyer set off for Egypt, his profession
was becoming increasingly identified widi die exciting new discoveries
in medical chemistry being made by Lavoisier's disciples. When he
arrived in Egypt, Rouyer probably was aware of the great military and
professional traditions which he served, and could view die prepara-

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tion and prescription of Egyptian drugs widi die critical eye of a prac-
titioner conscious of his own superior scientific background. He was
placed in charge of all pharmaceutical supplies for die army during the
first days of the French occupation of Egypt. His comments on the
Egyptians' healdi reflect die conflicting opinions expressed by odier
members of the expedition who had observed different patterns of
disease incidence (albeit in several different cities and towns).
Rouyer criticized Egyptian medicine for having become oversimpli-
fied and therefore, in his view, degenerate, when compared with the
professional tradition he proudly represented. He judged that, "The
Egyptians, having become apathetic and indolent, have let a large
number of their medications fall into disuse." He also blamed alleged
Muslim fatalism for die Egyptians' reluctance to seek professional
medical assistance unless diey became very ill indeed.24
Rouyer observed diat the Egyptians recognized only diree funda-
mental humoral imbalances—excesses of bile, cold, and heat—which
led to their reliance chiefly on diree basic drug classes: cadiartics,
warming drugs, and cooling drugs. Dr. Savaresi also noted diat die
Egyptians preferred to have dieir illnesses clearly categorized in classi-

23. Charles Coulston Gillispie, Science and Polity m France at the End of the Old Regime, Prince-
ton, N.J., Princeton University Press, 1980, p. 87; Edward Kremen and George Urdang, Huwry
ofPharmacy, 4th ed., rev. by Glenn Sonnedecker, Philadelphia, W. B. Saunders, 1976, pp. 60-70,
76-77.81-83.
24. Rouyer, (n. 18), pp. 217-218.
 132 Journal of the History ofMedicine : Vol. 39, April 1984
cal humoral terms to facilitate their choices of remedies, and that each
customer purchased his own favorite drug that he thought suited him
best for each kind ofhumoral imbalance. Most of the drugs available in
apothecary shops were vegetable simples in the powdered forms that
Egyptian patients preferred to liquid preparations. If the patient wished
to take his drug mixed with sugar or honey he would make the prepa-
ration himself.M
The eighty-one plant drugs listed by Rouyer in his 1809 report are
tabulated in the Appendix, along with the clinical information he col-
lected for each. The discussions of individual diseases among the writ-
ings of the French army physicians and surgeons confirm Rouyer's
imputations of specific remedies for specific illnesses, although the
drugs used in Cairo, where Rouyer worked, differed in a few respects
from those preferred in the smaller cities of the Nile delta. He was quite
careful not to list drugs sold in three Cairene shops run by, and for,

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Europeans. Table 2 summarizes the eighty-one drugs most popular
among Egyptians by the pharmacological activities the Egyptians
ascribed to each. Rouyer classified diem in terms used in contemporary
Western medicine. He noted that Egyptians preferred the strongest
purges, especially colocyndi, camboge, aloes, euphorbia, and anti-
mony, and the strongest emetics, like scammony and jalap, even if the
Egyptians seldom used emetics because Muslims have an aversion to
vomiting. The violence of these drugs' actions is probably associated
with Rouyer's observation that "The more promptly a medicine acts,
the more the Egyptians believe it just right to heal their illness."26
Although European drugs had long been available to Egyptians (see
below), mercurial drugs were almost unknown to them, even for treat-
ing venereal diseases; instead, the Egyptians relied on cathartics, dia-
phoretics, and vapor baths for syphilis. Although most such treat-
ments were regarded as successful, refractory cases were treated with
even stronger purges for up to thirty days, while refrigerants and
astringents were standard treatments for gonorrhea.27
Rouyer found that a second major group of drugs was used to stimu-
late the mind. These drugs, which he labelled as cordials, tonics, stim-

25. Ibid., pp. 217-218; Savaresi, (n. 5) Mmorit, p. $7.

26. Rouyer, (n. 18), pp. 219-232; for an outline of the drug classes see Estes, (n. 18) "Thera-
peutic practice," pp. 364—366; for the importance of observable drug effects as indicators of
therapeutic response, see Rosenberg, (n. 18).
27. Rouyer, (n. 18), p. 219.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 13 3

TABLE 2

Percent Percent of Drug Class Members

of All Possibly Having Effects
Drug Class 81 Drugs like those Ascribed to Them*
Cathartics, Mild 19.8% 63%
Cathartics, Strong** 8.6 100
(All Cathartics) (26.4) (74)
Anti-Cathartics 1.2 0
Emetics*** 3-7 100
Anti-Emetics 2-5 0
Febrifuges and Diaphoretics 12.3 50

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Astringents 6.2 20
Carminatives 3-7 0
Cordials (i.e., mild stimulants) 12.3 10
Tonics 6.2 20
Stimulants 2-5 100
Antidepressants 2-5 100
(All stimulating drugs) (23-5) (24)
Sedatives and Narcotics 6.2 40
An rispasmodics 2-5 0

Aphrodisiacs i6!o •*•*

Anti-Aphrodisiacs 1.2 0
Fattening Agents 7-4 0
Breath Fresheners 3-7 100
Perfumes and Cosmetics 11.1 100
House Purifiers and Incenses 4-9 100

Summary of Egyptian drugs classified according to eighteenth-century concepts of their phar-

macological activities, as reported by Rouyer (n. 18) and compiled from the appendix. How-
ever, he did not assign all drugs to a class.
* As ascertained from modem texts.
** In his text he also mentioned one other cathartic, antimony.
*** In his text he also mentioned two other emetics, scammony and jalap.
About one third of these materials are known to be weak central nervous system stimu-
lants.
 134 Journal of the History of Medicine : Vol. jg, April 1984
ulants, and antidepressants, were in aggregate as popular as the cathar-
tics. Most were actually only aromatic or pungent, but the two drug
ingredients that Rouyer considered to be true stimulants, opium and
marijuana, were those to which he devoted more space dian any others
he found in Egyptian shops.28 Opium and marijuana preparations, like
cosmetics, were not used to treat illness, but only in periods of good
health. Opium was mixed with hellebore, marijuana, and various
aromatics to make substances known as dyasmouk, berch, and bemaouy,
among others, all designed to produce during sleep, "diverse pleasures
of the mind and die kind of dream one most desires." Rouyer reported
that the poorer classes used berch and bemaouy in the same way that their
counterparts in Europe relied on fermented liquors. These substances,
made exclusively by Coptic Christians and Jews, not Muslims, were
sold in all Egyptian towns at special shops, not by apothecaries. Rouyer
reported that the mixtures of hellebore and marijuana produced "gay

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and delicious" pleasures diat were long-lasting but sometimes dan-
gerous. Because growing numbers of French soldiers had been learn-
ing the joys of these stimulants, General Menou finally had to forbid
them from smoking marijuana.29
The usual opiates were philonium and theriac, two relatively weak
preparations that, in western prescriptions, contained only about 1-
6% as much raw opium as laudanum, the most potent (and most
popular) contemporary opiate. True Thebiac opium, the highest qual-
ity, no longer grew in Egyptian Thebes (modem Luxor); by 1798
Turkey had become the source of most of the world's raw opium. The
Egyptians thought that philonium was "appropriate for restoring
strength, for dissipating melancholy, for giving confidence and cour-
age," especially among the wealthier classes. Egyptian theriac was
highly regarded throughout the Muslim world. It was prepared in
ancient vessels in an elaborate annual ritual witnessed by leading medi-
cal and political authorities of Cairo, and dispensed through the Ma-
ristan, the one remaining national hospital which housed the insane,
the aged, and the sick poor and was supported by royalties from theriac

28. Rouyer also included opium among the antidepressants and sedatives, but not among the
narcotics. Hellebore was die other antidepressant, galbanum and water lily were the other seda-
tives, and henbane and onion were the two narcotics in his list (see the Appendix).
29. Rouyer, (n. 18), p. 220; DesGenettes, (n. 4) Histoire MMicalc, p. 172. The various marijuana
preparations seem to have been analogous to hashish in their use, but that more familiar term was
not mentioned by Rouyer, who used only die word dunvre.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 135
sales. Rouyer seems to have intended, but then forgotten, to include
the recipe for making theriac, he had obtained it with great difficulty
from its guardians. He did note that the recipe differed from the one
reported by Prospero Alpinus two centuries before, which had fifty-
eight ingredients. The simpler Egyptian version being made in Rou-
yer's time was, he thought, more like the ancient version originally
ascribed to Andromachus than the highly complex, and equally ritual-
ized, mixture then sold in Europe. However, he was quite sure that all
versions could claim a common ancestry.30
A third widely used group of drugs—again used only in health, and
chiefly by the wealthy—was die fattening agents (literally, those used
"with the intention of acquiring plumpness" or embonpoint). Women
were the chief consumers of these generally mucilaginous and starchy
substances, but men also used them after adding stimulants, apparently

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to stimulate the libido. Indeed, many French observers would have
agreed with Rouyer that Egyptian men were "insatiable of voluptu-
ousness." Savaresi reported that aphrodisiacs were used more often in
Egypt than anywhere else in the world. For this reason, Rouyer's list
includes thirteen materials that were popularly thought to be aphro-
disiacs; a few of them might actually have been mildly stimulating to
the senses. A number of cosmetics, perfumes, and incenses also con-
tributed substantially to the stocks of Cairo's apodiecaries.31
Table 3 summarizes die clinical indications for die drug therapies
reported by Rouyer. Cathartics were popular remedies for disorders
considered to be fevers, including the gastrointestinal and venereal
diseases, but, as noted earlier, opiates found no place in regular Egyp-
tian dierapeutics. Perhaps because of its unpredictability and its devas-
tating mortality when it appeared in epidemic form, plague had few
remedies in the Egyptian materia medica; only one drug, ladanum,
which had no noticeable physiologic effect, was specified as treatment
for that dread disease.
In his text, but not in his list of plant drugs, Rouyer alluded to the
wide variety of collyria (eye medications) used to treat the ever-present
ophthalmia. These materials were dessicating or astringent powders
made from inorganic salts applied dry or in cloths soaked in salt solu-
30. Rouyer, (n. 18), pp. 220-121; Prospero Alpinus, Medicina /tgyptuman, Leiden, Gerard
Potvliet, 1743, pp. 2OO-293;J. Worth Estex, "John Jones'J Mysteries of Opium Reveal'd (1701): key
to historical opiates,",/. Hist. Mcd., $4: 200-209, '979-
31. Rouycr, (n. 18), pp. 221-222; Savaresi, (n. 5) Mcmorit, p. 59.
136 Journal of'the History oj'Medicine : Vol. 39, April 1984

TABLE 3

Percent Percent of Indicated Drugs

ofAll with Probable
Clinical Indication 81 Drugs Cathartic Activity
Fevers, all 17-3% 29%
Fevers, Intermittent 3-7 0
Plague 1.2 0
Quinsy (tonsillitis) 1.2 0

Dysentery and Diarrhea 4-9 25

Colic 3-7 0
Jaundice 3-7 33
Worms 7-4 50

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Chest Diseases 4-9 0
Heart Palpitations 1.2 0

Venereal Diseases, all 16.0 38

Syphilis, especially 2-5 50
Gonorrhea, especially 6.2 20

Non-Venereal Skin Diseases 4-9 50

Ophthalmia* 4-9 0

Dropsy and Urine Retention 8.6 14

Headache 3-7 0
Rheumatism 1.2 0
Toothache 1.2 0

General antidote for poisons 2-5 0

Diseases of Women, all 11.1 22

Leukorrhea 2-5 0
Hysteria 1.2 0
Headache 1.2 0
Perinatal Routine Care 4-9 11

Wound Care 3-7 0

Care of Circumcised Male 2-5 0

Summary o f Egyptian drugs sold for use in particular diseases extracted from the appendix.
However, Rouyer did not specify the clinical indicationsforall 81 drugs in his list.
Drugs like opium and marijuana ire not included here, because they were not taken during
illness.
*Rouyer also noted that a variety of inorganic salts was used in collyria for preventing and/or
treating ophthalmia. '
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 137
TABLE 4

Area of Origin Percent ofAll 81 Drugs

Egypt alone 18
Ethiopia 10
North Africa 4
(All African continent) 32
Arabian peninsula 6
Turkey 5
Persia 1
Syria 6
(All Near and Middle East) 18
India 3O
China and elsewhere in Asia 5
(All Far East) 35

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South America 4
Europe* 13
Summary of geographic areas from which drugs were imported into
Egypt, extracted from the appendix. The likely origins of the three addi-
tional drugs which Rouyer mentioned but did not indude in his list of 81
are: Antimony, from Europe; scammony, from somewhere in the east-
ern Mediterranean littoral; and jalap, from Central or South America.
* Including two drugs imported from other continents via Europe.

dons and then allowed to dry. Rouyer further noted the black eye
makeup known as kohl which had been used as a cosmetic eye liner
since the pharaonic era; it was also thought to protect the eyes from
infection, perhaps as a dessicant. Pharmacist Rouyer did not mention
two treatments, scarification and fire (applied in a procedure some-
thing like Chinese moxibustion) which Savaresi claimed, as "feretfeu,"
were the most popular of all therapeutic measures.32
Rouyer's drug tabulation reveals a widespread commercial network
along which drugs travelled from throughout Africa, the Near and Far
East, and even South America, sometimes via Europe, to Egypt, as
indicated in Table 4. A century earlier, Dr. Greenhill had reported that
"To Cairo are brought, overland by the Caravan from Mecca, all sorts

32. Rouyer, (n. i8),p.219;Greenhill,{n. $)N£KPOKHdEIA, p.232; A . M . T . Savaresi,"Essai

sur la topographic physique et medicale de Damiettc, suivi d'observations sur l a maladies qui ont
regnf dans cette place pendant les premier semestre de l'an VU," in DcsGenettes, (n. 4) Histoirt
Mtdicolt, pp. 328-340; the quotation is on p. 334.
138 Journal of the History ofMedicine : Vol. 39, April 1984
of Perfumes, Aromatics, precious Stones and Gems, such as Olibanum,
Frankincense, Mastic, Myrrh, Amber, and Opobalsamum, also Indian stuffs,
Indico, and other rich and valuable Commodities." In those days it took
the typical caravan, consisting of over a thousand horses, mules, and
asses and over five hundred camels, about forty days to make the trip
between Cairo and Mecca which, in turn, was an important trade
terminal for goods coming from India and the East Indies.33 Pharma-
cist Rouyer thought that drugs imported to Egypt from Asia were of
much higher quality than those grown in Egypt itself, where they were
likely to be harvested without taking proper precautions for preserving
them; his best example was a comparison between the poor gum arabic
preparations from Egyptian sources and the best, which came from
Arabia.34
Perhaps Rouyer did not recognize the parallels between contempo-
rary French and Egyptian drug usage. The French had been importing

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drugs from Egypt, via Alexandria and Marseilles, for many years.33 Of
the drugs Rouyer found in Egyptian shops, 23% were regularly ex-
ported to France, according to contemporary French pharmacopoeias.
The proportions of drugs listed by Rouyer that were also mentioned in
official drug lists and medical lectures of the times are:
Codex Medicamentarius: 83%
Charas, Pharmacopie Royale: 35%
Cartheuser, Matiere Midicale. 67%
Lemery, Dictionnaire Universel: 72%
Billiard's lecture notes at
Montpellier: 84%
Only eight, or 10% of the Egyptian drugs appear in none of the French
pharmacopoeias, and of these we have not been able to identify six.36
For 78% of the drugs listed by Rouyer, at least one clinical indication
in eighteenth-century French usage corresponds to at least one Egyp-
tian indication. Three-quarters of the Egyptian drugs were also found
in the Edinburgh New Dispensatory then pervasive throughout the En-
glish-speaking world (although it regarded only 44% as effective ther-
apies), and almost half of the Egyptian drugs also appeared in the daily
33. Grecnhill, (n. QNEKPOKHAEIA, pp. 207-208.
34. Rouyer, (n. l8),p. 231. '"
35. Ouedat, (n. 13) Phatmadens, pp. 10-11, 16.
36. See the appendix for the full citations of these five French drug lists.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 13 9
practices of contemporary New England physicians (who regarded
only 36% as active drug ingredients). Because Western physicians, as
well as their Egyptian counterparts, aimed their remedies at their pa-
tients' humoral imbalances and symptoms, it is not surprising that
physicians on both sides of the Mediterranean tried to exploit similar
medicines. The spectrum of symptoms observable by both was simi-
lar, even if the causes—which physicians of all nations were unable to
detect—did differ.
In addition, medical practice seems to have shared a common origin
in the eastern Mediterranean lands. About a third, and perhaps as many
as 44% (depending on the accuracy of available translations of ancient
hieroglyphs) of eighteenth-century Egyptian drugs had been mentioned
in the medical papyri of the pharaonic period. The most prominent
among the drugs diat had remained in use along the banks of the Nile
for four millennia were the cathartics (it seems doubtful, but not yet

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absolutely impossible, that the ancient Egyptians used opium).37 Thus,
Rouyer's list seems to reflect several parallel developments in the medi-
cal therapeutics of several cultures that still relied heavily on the basic
concepts of the ancient humoral traditions. In fact, 67% of the drugs
Rouyer found in Egypt were also mentioned in a i960 British textbook
of pharmacognosy, and 43% of them were still said, even then, to
possess properties much like those Rouyer had reported.38
Rouyer and some of his colleagues in the French expeditionary force
judged the Egyptians' usage of drugs superstitious, or at least irra-
tional, because it did not conform to dieir European norms of utiliza-
tion. Their best example—the Egyptians' alleged failure to discover
and exploit the antidiarrheal action of opium—offers an interesting
insight into cultural differences in the two national groups. Tables 2
and 3, and the Appendix, indicate that cathartics were in greater de-
mand among the adult Egyptian population than antidiarrheal prepa-
rations, of which they had an abundant supply in gum arabic (or so the
French thought). Besides, opium was in much greater demand for its
tranquillizing, and euphoric effects. There is a bit of professional self-
righteousness in Rouyer's disapproval of the Egyptians' preferring

37. Laser, (n. 19); Chauncey D. Lake, The Old Egyptian Medical Papyri, Lawrence, Kans.,
University of Kansas Press, 1952; B. Ebbell, cram., TJiir Papyrus Ebers, Copenhagen, Levin Sc
Munksgaard, 1937; James Henry Breasted, The Edwin Smith Surgical Papyrus, 1 vols., Chicago,
University of Chicago Oriental Institute, 1930.
38. T. E. Wallis, Textbook ofPharmacognosy, 4th ed., London, J. & A. Churchill, i960, passim.
140 Journal of the History of Medicine : Vol. 39, April 1984
only a few simple remedies for illness, while resorting to a "prodigious
number" of preparations for pleasurable, aphrodisiac, fattening, and
cosmetic purposes. He deplored the use of drugs in Egypt as "degen-
erate" partly because he saw "people reduced to an incurable state [by]
being abused with diverse drugs," particularly narcotics. Also, the
Egyptians' general indifference to the impressive therapeutic arma-
mentarium which he and his colleagues were creating threatened to
subvert his conviction that he was a torch bearer of a superior art and
science.39 Rouyer exemplified the scholar and scientist of the Enlight-
enment. He was perceptive, enlightened, and zealous in investigating
the exotic, like his prototype and compatriot Voltaire. In holding up
the mirror of a strange culture to compare with his own, Rouyer,
unlike Voltaire, found no deficiencies in Europe, only excellences.
After the demobilization of the Army of the Orient, Rouyer was
assigned to the Hotel des Invalides in Paris. During the next few years

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he published five articles based on his observations in Egypt. In 1808 he
was summoned to Napoleon's court and appointed the third-ranking
royal pharmacist. After accompanying the successful 1808-09 cam-
paign in Spain, Rouyer was awarded a diploma and licensed to practice
by the College of Pharmacy of Paris. His article on the drugs of Egypt
appeared in 1809. A modem student of the French pharmacists in
Napoleonic Egypt has concluded that Pierre-Charles Rouyer's "gen-
eral knowledge, his technical expertise, his scientific curiosity give
[that] article genuine value."40 His Emperor rewarded his services by
making Rouyer first a Chevalier of die Legion of Honor and later a
Chevalier of the Order of the Reunion, honors awarded to very few
pharmacists. He went to war twice more, on Napoleon's unsuccessful
campaigns in Russia and Germany in 1812 and 1813. In 1823, after the
Bourbons regained the throne they had lost in 1792, Rouyer achieved
the rank of Pharmacist-Major at the Hotel des Invalides, in which post
he died on 31 May (or August) 1831. Through all the changes of
government in which he served, Rouyer was highly regarded by all his
supervisors for the "zeal" he consistently brought to his professional
work. Typical of his superiors' assessments of him is the untranslat-
able, but still understandable, evaluation by Gaspard Monge, a physi-
cist and mathematician member of the Commission on the Arts and

39. Rouyer, (n. 18), pp. 231-232.

40. F. M. Ossedat, (n. 13), p. 174.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 141
Sciences of Egypt, and one of Napoleon's most trusted confidants:
"Zele, plein d'intelligence et de lumiere, il en a fait preuve en Egypte—
moralite parfaite." In other words, Monge thought that Rouyer per-
fectly exemplified the scientist of the Enlightenment. And clearly
Rouyer's professional accomplishments overrode all the shifts in poli-
tical allegiance demanded of him by his times, as illustrated in his
detailed, and still useful, observations of medical therpeutics in Egypt
whose exotic past and present he tried to help popularize.41
Department of Pharmacology and Experimental Medicine
Boston University School of Medicine
Boston, Massachusetts 02118
Department of History
Northeastern University
Boston, Massachusetts 02115

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41. Paul Dorvcaux, "LCJ grand pharmacicnj. X. Les pharmaciens de Napoleon," Bull. Soc.
d'Hist. de la Pfutrmarie, r. 317-333, 1920-21; Maurice Bouvet, "Les sept pharmaciens militaires
decorcs de l'Ordre Imperial de la Reunion," Rev. d'Hist. de la Pharmaae, 14: 363-366, i960;
Ossedat, (n. 13) Pharmaciens, pp. 31-33, 172-178,248-251.

Acknowledgement*: We are graceful to Rosemary Angel of the Royal Botanic Gardens in Kew,
England, to Ida Hay at the Arnold Arboretum in Boston, and to Dr. FatimaM. Sa'ad, Director of
the Agricultural Research Center at Dokki, Cairo, for assistance in identifying die plants listed as
drug sources by Pierre-Charles Rouyer. Dr. Alex Berman of Cincinnati provided invaluable
assistance with the bibliography of French pharmacists, and Richard J. Wolfe of the Boston
Medical Library found many uncatalogued references for us. Jean Favier, Directeur General des
Archives de France, and N. F. Niched, Directeur Bibliodieque Interuniversitaire de Pharmacie,
provided information about Rouyer't life. Dr. Giuseppina d'Elia Raviola and Dr. Allan R.
Meyers, both of Boston University School of Medicine, helped, respectively with translating
Savaresi's book and with our understanding of North African ophthalmias.
142 Journal of the History ojMedicine : Vol. 39, April

APPENDIX
Drugs found in apothecary shops of Cairo
by Pierre-Charles Rouyer in 1798-1801 [Rouyer, (n. 18)]

The abbreviations for sources indicate the following areas or coun-

tries from which the drugs were brought to Cairo:
Ar Arabian peninsula Et Ethiopia NAf North Africa
As Asia Eu Europe Pe Persia (now Iran)
Ch China In India and/or East SA South America,

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Co Constantinople Indies and Indian West Indies
Eg Egypt Ocean littorals Sy Syria
Tu Turkey
The numerals under France indicate which of the following four
sources used by French physicians and pharmacists at the time of Rou-
yer's visit, and the medical school lecture notes cited, refer to each
drug:
1. Faculty de Medecine de Paris, Codex Medicamentarius, Paris,
Guillelmus Cavelier, 1748.
2. Moyse Charas, Pharmacopie Royale Galenique et Chymique, Lyon,
Freres Bruyset, 1753.
3. M. J. Fr. Cartheuser, Matiere Midicale, 4 vols., Paris, Briasson,
1755-
4. Nicholas Lemery, Dictionnaire Universel des Drogues Simples, 5th
ed., 2 vols., Paris, DeSaint & Saillant, Jean-Thomas Herissant,
Nyon, Savoye, D'Houry, Didot lejeune, 1763.
5. Gabriel Billiard, MS. notes "Matiere Medicale de M. Sfranne,
Prof, en Me\lecin a Montpellier, 1749," in Boston Medical Li-
brary, Boston, Massachusetts.
 Estes & Kuhnke : Disease and Drugs in 18th Century Cairo 143

SYMBOLS
France: * At least one French clinical usage resembles at least
one Egyptian usage.
# Drugs imported from Egypt to France in the late
eighteenth century, according to the references
cited just above and according to Ossedat, (n. 13)
Pharmaciens, p . 16.
0
Requisitioned from home by the French army

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physicians in Egypt in 1798-1801 because their
supplies were insufficient, also according to Os-
sedat, (n. 13) Pharmaciens, pp. 262—266.
Edinburgh: + drugs listed in the Edinburgh New Dispensatory, 4th
ed., Edinburgh, Bell & Bradfute, 1794. (+) drugs
the Dispensatory thought were of little clinical
value.
New England: + drugs used in late colonial New England listed by
Estes, (n. 18) "Therapeutic practice." (+) drug
materials used there only for flavoring, coloring,
or as vehicles.
Ancient Egypt: + drugs mentioned in the ancient Egyptian medical
papyri, especially the Hearst and Ebers papyri (n.
37).
Modern Source or Botanical Names, as given in standard modem
references and verified, when possible, in B. Daydon Jackson, ed.,
Index Kewensis, 4 vols. and 15 suppls., Oxford, Clarendon Press,
1893- •
 Drugs Listed by Pierre-Charles Rouyer in 1809
Mentioned in
COMMON NAME Sc Clinical Uses in Egypt, Edin- New Ancient Modem Source or Common
Liimean Name 1798 Source France burgh England Egypt Name (Botanical Name)
ABSINTHE, GRANDE Dropsy; specific for Eg 123451 Wormwood
Artemisia arborescens Worms; Intermittent Artemisia absinthum
fevers
ABSINTHE, PETITE Same as above, when Eg 1 45*# (?) Lesser Absinthe
Artemisia judaica * mixed with BOIS D'ALOES Absinthum ponticum (?)
and KAFAL; purify homes
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from illness
AECHE EL-NAUNE Dropsy; Urine retention; Sy Not yet identifiable
(none given) for washing hands
ALOES, esp. Cathartic for venereal and In I2345*# + + Aloe, Aloe barbadensis; (or
Socotrine skin diseases; in tonic perhaps A. perryi Baker)
Aloe perfoliata OPIUM mixtures
ALOES, BOIS D' Perfume; Tobacco In 1 34 * Aloe wood; Calambac
Excaecaria gallocha additive Aquilaria agallocha
AMBRE GRIS Aphrodisiac; added to In 12345* (+) + Ambergris, Spermaceti,
Ambra ambrosiaca2 OPIUM for smoking; from Sperm Whale,
Perfume Physeter catadon

1. This plant may have had some pharmacological effect; tee H. Abdel Hamid, A. A. El-Masry, A. Kandil, and S. M. Khafagy, "Judaicine: a new
anti-anginal drug," J. Egypt- Mtd. Assoc., 69:481-484, 1977.
2. Not until late in the nineteenth century was ambergris found to come from the sperm whale and not from pelagic plants.
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COMMON NAME & Clinical Uses in Egypt, Edin- New Ancient Modern Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

ANACARDE Fattening and warming Eu 1 45 Cashew nut

Anacardium occi- fruit Anacardium occidentale
dentale
AN1S VERTS Colic in infants; Post- Eg 12345* Anise
Pimpinella anisum partum routine in non- Pimpinella anisum
nursing women
ASSA-FETIDA Women, at menses and As 1 345*# Gum Assafetida
Ferula assa-joetida delivery Ferula assa-foetida
BADIANE Cordial; Aphrodisiac; in Ch 1 5* Star Anise
Illicium anisatum many electuaries Anisum stellatum
BAIES DE LAURIER In OPIUM mixtures Eu 123 5* ° Bay Laurel
Laurus nobilis Laurus nobilis
BAUME DE COPAHU Orally, after infant In 12345* ° Balsam of Capivi
Copaijera officinalis3
circumcision Copaijera officinalis
BAUME DE LA MEKKE Wound dressings; Ar 1 # Balm of Gilead
Amyris opobalsamum Cordial, in coffee Commiphora opobalsamum
BENJOIN Perfume, cosmetic In 5 See STORAX below
Croton benzoe*
BOL D'ARMENIE Astringent; Venereal and Co 1 3 5* Armenian Earth (not of
skin diseases; Antidote for botanical origin)
poisons; in OPIUM mixtures
3. Rouycr erred in stating that Copaijera came from the East Indies; it grows chiefly in tropical America.
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4. R o u y e r ' s species Croton benzoe did n o t exist; benzoin c a m e from Slyrax, according to the Edinburgh New Dispensatory, p. 113.
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COMMON NAME tc Clinical Uses in Egypt, Edin- Neu> AncietU Modem Source or Common
Linttean Name 1798 Source France burgh England Egypt Name (Botanical Name)

CACHOU Astringent; Gentle In 1 345* Catechu, Cutch

Mimosa catechu cathartic, Halitosis Acacia catechu
CAMOMILE Febrifuge; Gentle Eu 1 345* ° Chamomile
Anthemis nobilis cathartic, Antispasmodic Anthemis nobilis
CAMPHRE Tonic; Aphrodisiac; In 12345* ° Gum Camphor
Laurus camphora Incense Cinnamomum camphora
CANNELLE Antiemctic, Aphrodisiac; In 12345* ° Canella
Cordial; in theriac, Canella alba, or,
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Laurus cinnamomum incense, and berch sometimes, C. winteranda

Stimulant; Cordial In 12345* Cardamom
CARDAMOME Eletteria cardamomum
Amomum
cardamomum Obstinate fevers; SA 1 345* Cascarilla
CASCARILLE Dysentery; Perfume Croton eleutheria
Croton cascarilla
CASSB Laxative for labor; Eg 1 345*# Cassia
Cassiafistula Excipient for cathartics Cassiafistula
CASSIA UGNEA Diaphoretic; Febrifuge; In 1 345* probably, Cinnamon
Laurus cassia Tonic Cinnamomum zeylanicum
CENTAUREE, PETITE Specific for all fevers; Eg 1 345* Lesser Centaury
Gentian centaureum Colic; Heart palpitations Centaureum ramosissimum
CHANVRE Enervating and narcotic Eg 1 45* Marijuana
Cannabis sativa when smoked or in Cannabis sativa
bemaouy, dyasmouk, and
berch
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COMMON NAME & Clinical Uses in Egypt, Edin- New Ancient Modern Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

CLOUS DE GIROFLE Gentle cathartic; Cordial; In 12345* ° Cloves

Caryophyllus Aphrodisiac; on necklaces Eugenia aromatica
aromaticus
COLOQUINTE Cathartic; Worms; Eg 12345* Colocynth
Cucumis colocynthis Syphilis Citrullus colocynthus
CURCUMA Specific for jaundice; In 1 3 5*# Curcuma; Turmeric
Curcuma longa Tonic Curcuma longa
DJEBBEL-INDE Emetic In Gabal hindy (in Arabic)
(none given) Datisca cannabina
ECHAR Dysentery; to counteract In 5* probably, Giant Milk-
(none given) cathartics; Leukorrhca weed, Calotropis procera;
less likely, an Asclepias
sp. or Acchu, Morinda
citrifolia
ELLEBORE Antidcpressent; in berch Eu 12345* Black Hellebore
Helleborus niger and OPIUM mixtures Helleborus niger
EUPHORBE Cathartic for jaundice; NAf 1 345* Euphorbia
Euphorbia officinalis Venereal diseases Euphorbia officinalis
GAIAC Toothache; to strengthen SA, 12 45* ° Gum Guaiac
Guaiacum officinale gums via Guaiacum officinale
Eu
GALANGA Gentle cathartic; In 123 5* Galingale
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Maranta galanga Aphrodisiac ? Cyperus longus; s o m e -

times Alpinia officinarum
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COMMON NAME & Clinical Uses in Egypt, Edin- New Ancient Modern Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

GALBANUM Hysteria and headache Et 1 345 * Gum Galbanum

Bubon galbanum in women Ferula galbaniftua
GENTIANE Tonic; Febrifuge; Base for Eu 12345* ° Gentian
Cent tana lutea powders for many Gentiana lutea
diseases
GIGEMBRE Aphrodisiac; Cordial; in In 1 345* Ginger
Amomum zinziber berch and bemaouy Zinziber officinale
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GOMME ADRAGANTE Gonorrhea; Urinereten- Eu 1 345* ° Gum Tragacanth

Astragalus tion; Poison antidote; Astragalus gummifer
tragacantha Ophthalmia
GOMME Emmenagogue NAf I2345*# Gum Ammoniac
AMMONIAQUE Dorema ammoniacum
Cummi resina
GOMME ARABIQUE Diarrhea; Gonorrhea; Ar Gum Arabic
Mimosa nilotica Chest diseases; Acacia Senegal
Ophthalmia
GOMME GUTTE Cathartic, for venereal Pe 1 45 # Gamboge
Cambogia gutta diseases Garcinia hanburii
GRENADE Fever, Dysentery; Eg 13 5* Pomegranate
Punica granatum topically as antiseptic Punica granatum
HABBANIL Hydragogue cathartic Et Hab-en-Nil (in Arabic)
(none given) Ipomoea hederacea
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COMMON NAME & Clinical Uses in Egypt, Edin- New Ancient Modem Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

HABB EL-HAZIS Chest diseases; Fattening Eg 1 4 Nut-Sedge; Zulu Nut

Cyperus esculentus agent Cyperus esculentus, var.
sativa
HENN£ Red dye; Skin softener Eg Henna; Alkanet
Lausonia inermis Lawsonia inermis
HERMODACTE Cathartic; Fattening Sy 1 4 5*#° Hermodctyl
Iris tuberosa agent for women Iris tuberosa
JUSQUIAME Narcotic; to induce Eg 1 345* Henbane, probably
Hyoscyamus albus dizziness, with intoxicants Hyoscyamus muticus
KAFAL Perfume Ar probably Commiphora
Amyris kafal kataf
LABDANUM Perfume; Specific for Co 1 345* Ladanum
Cistus creticus plague Cistus creticus
LABEMOUR Astringent; Weak Sy 4 * Probably a Bryonia sp.;
(none given) cathartic; in "theriac of less likely an Arum sp.
the poor"
MAHALEB Carminative; General Eu 1 345* Mahaleb; Perfumed
Prunus mahaleb remedy for many diseases Cherry, Prunus mahaleb
MASTIC Halitosis; Tooth Co 12345* Gum Mastic
Pistachia lentiscus whitencr; House perfume Pistachia lentiscus
MOUATE Fattening agent; In Probably Moghat (in
Aphrodisiac Arabic), Giossostemom
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(none given)
brugiueri D C .
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COMMON NAME & Clinical Uses in Egypt, Edin- New Ancient Modem Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

MUSCADE Cordial; Aphrodisiac; in In 12345* Nutmeg and Mace

Myristica moschata many electuaries Myristicafragrans
MYROBOLANS Five species used in many In 1 451 Myrobolans
Phyllanthus emblica cathartic remedies Prunus cerasifera
MYRRHE Tonics; Wound dressings; Et Myrrh
(none given) Postpartum; Tooth Commiphora abyssinica
whitener
NAKD INDIEN Head disorders; Gentle In S* Nard; Spikenard
Andropogon nardus cathartic; in OPIUM Nardostachysjatamansi
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mixtures
NENUPHAR Tonsillitis; Sedative; Eu 1 345* Water lily
Nymphaea alba Malignant fever; Nymphaea spp.
Gonorrhea; Anti-
aphrodisiac for women
OGNON Seeds, as Cordial, Aphro- Onion
AUium cepa disiac, and in Narcotics AUium cepa
OLIBAN Astringent; Detergent; Ar 1 3 5*# Frankincense
<•,
Juniperus lycia Gonorrhea; Hemoptysis; Boswellia carterii
Leukorrhea
OPIUM Not used in illness; Taken Tu Opium
Papaver somnifemm in health as tranquillizer, (seeds Papaver somnifemm
to relieve boredom and only)
melancholy, for sleep, and
by soldiers for strength
and courage
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COMMON NAME * Clinical Uses in Egypt, Edin- New Ancient Modem Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

PISTACHE Fattening agent; Sy 1 345*# + + Pistachio

Pistachia vera Aphrodisiac Pistachia vera
POIVRE Seasoning; in OPIUM In 1 345* ° (+) (+) Pepper
Piper nigrum mixtures and aphrodisiacs Piper nigrum
POIVRE Seasoning; in berch Et 5 Probably Piper longum
D'ETHIOPIE imported from Ethiopia
Piper /Ethiopicum
POIVRE DE LA Cordial; in OPIUM In 1 345 (+) Pimento, from Pimento
JAMAlQUE mixtures and berch officinalis; Rouyer's per-
Myrtus pimento haps from Capsicum
annum (Piper indica was
the British source)
POIVRE LONG Cordial; in OPIUM mix- In 1 3 5* (+) Indian Long Pepper
Piper longum tures and berch; Seasoning Piper longum
RHUBARBE Gentle cathartic (only one Ch 12345* ° + + Rhubarb, medicinal
Rheum palmatum suitable for children); Rheum officinalis or
Worms; Astringent palmatum
RICIN Cathartic for fever, Eg 12 45* + + + Castor Bean/Oil
Ricinus communis dropsy, and gonorrhea Ricinus communis
RIT£ Jaundice; Urine retention In Probably Ritah (in Ara-
(none given) bic), Sapindus trifoliatus
SAFRAN Colic; Vomiting; Eu I2345*#° (+) (+) + Saffron
Crocus sativus Ophthalmia (topically) Crocus sativus
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COMMON NAME & Clinical Uses in Egypt, Edin- New Ancient Modem Source or Common
Linnean Name 1798 Source France burgh England Egypt Name (Botanical Name)

SALSEPAREIU.E Preferred treatment for Eu, 12345* ° (+) Sarsaparilla

Smilax salsaparilla syphilis and skin diseases NAf Smilax salsaparilla
SAMBR ESNOBAR To stop hemorrhage after Et Samgh el Senoubar (in
(none given) circumcision Arabic), Pinus spp.
SANTAL Rheumatism; Gout; In 1 345* (+) Sandalwood; Yellow
Santalum album Perfume Sanders, Santalum album
SASSAFRAS Venereal diseases Eu 12345*0 + + Sassafras
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Laurus sassafras Sassafras album

SCHISME Ophthalmia Et ? No common name
Cassia absus known, Cassia hispidula
SENE Common cathartic; Skin Eg, I2345*# + + + Senna, Cassia acutifolia or
Cassia senna diseases; Worms Et C. angustifolia
SESAME Fattening agent Eg 1 45 # Sesame
Sesamum orientate Sesamum indicum
SQUINE Incurable venereal Ch 1 345* ° + China root
Smilax china diseases Smilax china
STORAX Severe headache; Oppres- Sy 12345* ° (+) + + Benzoin, or Flowers of
Styrax officinale sion of chest; Perfume Styrax betizoin
TAMARIN Refrigerant Et, 1 345*# + + + Tamarind
Tamarindus indica Ar Tamarindus indica
ZEDOAIRE Gentle cathartic. In 1 345*# (+) Zedoary
Kaemferia rotunda Aphrodisiac Curcum zedoaria