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The Significance of the Genizah's Medical Documents for the Study of MedievalMediterranean TradeAuthor(s): Zohar Amar and Efraim LevReviewed work(s):Source: Journal of the Economic and Social History of the Orient, Vol. 50, No. 4 (2007), pp.524-541Published by: BRILLStable URL: http://www.jstor.org/stable/25165209 .
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS FOR THE STUDY OF MEDIEVAL MEDITERRANEAN TRADE1
BY
ZOHAR AMAR* AND EFRAIM LEV*
Abstract
The medical texts in the Genizah have been analyzed mainly as part of other subjects, like the various professional classes within the Jewish community in Old Cairo. Until now few have studied these documents in their own right, despite the fact that they offer valuable
insights into the medieval economy of the Eastern Mediterranean and beyond. Focussing on
saffron and myrobalan, this article offers a tentative investigation of the significance of med ical drugs for the study of Mediterranean trade in the Middle Ages on the basis of practical
medical fragments found mainly at the Taylor-Schechter collection in Cambridge.
L'exploitation des textes medicaux de la Geniza a surtout servi aux sujets tels que les divers
groupes professionnels de la communaute juive du vieux Caire. Jusqu'a present de rares chercheurs ont etudies ces manuscrits pour leur valeur intrinseque. Pourtant, leur lecture permet
d'approcher d'autres aspects de l'economie medievale de la Mediterranee orientale et au-dela. Cette contribution, qui traite des drogues medicales, particulierement le safran et le
myrobalan, propose une premiere recherche sur 1'importance des drogues medicales dans l'etude du commerce mediterranean au Moyen-Age. Elle est fondee sur les manuscrits incom
plets traitant des pratiques medicales conserves principalement dans la collection Taylor-Schechter a Cambridge.
Keywords: Genizah, trade, Middle Ages, Eastern Mediterranean, medical drugs, saffron, myrobalan
* Dr. Zohar Amar, Department of Land of Israel Studies and Archeology, Bar-Ilan
University, Ramat-Gan, Israel, [email protected] * Dr. Efraim Lev, Department of Eretz Israel Studies and School of Public Health University of Haifa, Haifa University, [email protected]
1 The authors would like to express their deepest thanks to Dr. Leigh Chipman, Ben
Gurion University, Beer Sheba; Prof. David Jacoby, Hebrew University, and Prof. Yaakob
Lev, Bar Ilan University, Israel for their helpful remarks. Special thanks to our colleagues at the Taylor-Schechter Genizah Research Unit at Cambridge University Library, who shared
with us their enormous knowledge and experience and supported us with helpful remarks: Dr. Ben Outhwaite (head), and Prof. Stefan Reif. This research could not have taken place without the generous grant of St. John's College, Cambridge, which hosted Dr. Efraim Lev as an Overseas Visiting Scholar (2003-2004). The authors would like to thank the Syndicate of Cambridge University Library for permission to publish the Cairo Genizah fragments pre sented in this article.
? Koninklijke Brill NV, Leiden, 2007 JESHO 50,4 Also available online - www.brill.nl
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 525
Although the medical texts in the Genizah have received considerable schol
arly attention, they have predominantly been used as a contextual background for a focus on the Jewish experience in Old Cairo.2 We, however, would like to stress that these practical medical fragments contain a wealth of information and merit close study; they do not only provide information on the actual usage of drugs but also function as an important source for the reconstruction of the economic patterns in Egypt and its neighboring countries.
This article offers a tentative investigation of the significance of medical
drugs for the study of Mediterranean trade in the Middle Ages on the basis of Isaacs's catalogue of medical and para-medical manuscripts in the Cambridge
Genizah collection,3 as well as 200 fragments that have since been identified as
having a medical content.4 Furthermore, in the Taylor-Schechter collection in
Cambridge some 1,500 fragments of medical titles have been identified so far,
along with 50 notebooks, 140 prescriptions, 70 lists of drugs, and a few dozen letters and other documents.5
However, not all these medical fragments should be treated as a single group. Instead, we propose to distinguish different types of documents based on their
2 A number of scholars have dealt with this topic, e.g. S. D. Goitein, "The Medical
Profession in the Light of the Cairo Genizah Documents." Hebrew Union College Annual 34
(1963): 177-94; S. D. Goitein, A Mediterranean Society (Berkeley, Los Angeles, London: University of California Press, 1967-1988) vol. I: 267; C. F. Baker, "Islamic and Jewish Medicine in the Medieval Mediterranean World: The Genizah Evidence." Journal of the
Royal Society of Medicine 89 (1996): 577-80; P. Fenton, "The Importance of the Cairo Genizah for the History of Medicine." Medical History 24 (1980): 347-8; A. Dietrich, Zum Drogenhandl im Islamischen Agypten (Heidelberg: Carl Winter, 1954); M. R. Cohen, "The Burdensome Life of a Jewish Physician and Communal Leader: A Geniza Fragment from the Alliance Israelite Universelle Collection." Jerusalem Studies in Arabic and Islam 16 (1993): 125-36; E. Dvorjetsky, "The Contribution of the Geniza to the Study of the Medicinal Hot
Springs in Eretz-Israel." In Proceedings of the Twelfth World Congress of Jewish Studies, ed. Ron Margolin (Jerusalem: World Union of Jewish Studies, 1990) vol. II: 85-93; and espe cially D. H. Isaacs, "The Impact of Western Medicine on Muslim Physicians and their
Writing in the 17th Century." Bulletin of the British Association of Orientalists 11 (1979 1980): 52-7; D. H. Isaacs, "A Medieval Arab Medical Certificate." Medical History 35
(1991): 250-7. 3 D. H. Isaacs (with the assistance of Colin F. Baker), Medical and Para-Medical
Manuscript in the Cambridge Genizah Collection (Cambridge: Cambridge University Press,
1994). 4 E. Lev and L. Chipman, Isaacs's Catalogue "Medical and Para-Medical Manuscripts in
the Cambridge Genizah Collection"?New Edition (Cambridge: University Library/Oxford: Archeopress, forthcoming 2008).
5 The Taylor-Schechter Collections, which is held in the Cambridge University Library,
will hereafter be referred to as T-S.
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526 ZOHAR AMAR AND EFRAIM LEV
use. The principal distinction is between what we call "theoretical medical
knowledge," which mainly derived from books, and "practical knowledge," which is primarily reflected in prescriptions, list of drugs, letters, and notebooks.
The Genizah documents suggest that the work of the Jewish court physician in Cairo, Abu '1-Fadl Da'ud Ibn Abi '1-Bayan (born in 556/1161), entitled al
Dustur al-bimdristdni fVl-adwiya al-murakkaba, appears to have been popular
among the medical practitioners and drug sellers in the city. The same appears to be true for the Minhdj al-dukkdn by the Jewish druggist, Abu 31-Muna al
Kuhin ibn al-cAttar, who lived in Cairo around 658/1260.6 While these works
were evidently consulted by medical practitioners as well as patients them
selves, it is also interesting to examine which drugs were actually prescribed.
Being remnants of medical reality, the prescriptions offer interesting infor
mation which is not found in other sources. In most cases they are written in
Arabic (we have found 92 specimens) and Judaeo-Arabic (47 specimens), which
were the most widely used languages and dialects in the daily life of medieval
Cairo. Prescriptions also inform us about the prevailing diseases and the symp toms that members of the community actually suffered from. An analysis of
these texts and some of the notebooks shows that eye diseases were the most
prevalent ailments. The several dozen fragments from various medical books
relating to ophthalmology testify to this.7 Other common complaints included
skin diseases, headaches, fever, internal diseases (liver), intestinal problems, and
haemorrhoids, as well as urinary trouble, ulcers, swellings, coughs, and gynae
cological illnesses. Lists of drugs appear in various types of documents: inventories of pharma
cies compiled for establishing or dissolving partnerships, commercial orders for
drugs, texts concerning taxation, pharmacists' invoices, and order lists of sub
stances, especially those of wholesalers sent to retailers, or of pharmacists sent
to wholesalers. These are among the best sources for the reconstruction of the
range of "practical drugs"; S. D. Goitein, for example, points to two lists he
identifies as consignments, one consists of 54 items, the other of 34 (T-S Ar.30.274). The medicaments listed are also known from other sources, but in this case
were all carried at the same time by one retailer. The fragments also mention
weights and prices.8 Invoices to individuals are common, and they teach us
6 C. Brockelmann, Geschichte der Arabischen Literatur (Leiden: E. J. Brill, 1937-1949)
vol. I: 491, 492; L. Chipman and E. Lev, "Syrup from the Apothecary's Shop: A Genizah
Fragment Containing One of the Earliest Manuscripts of Minhaj al-dukkan." Journal of Semitic Studies 50 (2006): 137-67.
7 Isaacs, Medical and Para-Medical Manuscripts in the Cambridge Genizah Collection.
8 Goitein, A Mediterranean Society: vol. II: 268.
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 527
about transactions, payments, and the medicinal substances actually used. Some
of them note quantities and prices, while others only record prices (T-S
Ar.30.165). The 70 original lists found in the Genizah generally lack headings that might
explain their uses. However, since they are different from merchants' letters
dealing with trade in materia medica and give no instructions for the use or
preparation of formulas (as is usually found in prescriptions), they were
identified as lists of drugs. They were apparently used by pharmacists for pro fessional and business purposes as inventories of materia medica, records,
orders, or even receipts. Orders to the sharabi (sellers of potions) were also
found (T-S Ar.54.19). Some lists written in Arabic and Judaeo-Arabic mention
quantities in Arabic words (T-S AS 179.56) but some also include Hebrew
script (T-S Ar.43.315), and in a few cases Coptic numerals are used (T-S Ar.39.487).
The Most Commonly Used Drugs
Our substantial collection of prescriptions and lists of drugs allows, for the
first time, for the reconstruction of the range of medicaments actually used by the Jews of medieval Cairo. In total 278 substances were identified. The great
majority, 223 in number (80.2%), are of plant origin, while 31 (11.2%) are of
inorganic origin, and the remaining 24 (8.6%) are of animal origin.9 The occur
rence of non-indigenous drugs?for the practical use of which we have found
evidence?indicates that there must have been a trade in these substances; some
of these could otherwise not have found their way to the shelves of the phar macies in the lanes and alleys of the Jewish quarter of Cairo.
Table 1 lists the medicinal substances which were most frequently used by members of the Jewish community of old Cairo according to the Genizah frag ments. All these substances are of plant origin. The sugar cane may have been
of local, i.e. Egyptian origin, but others?the almonds, rose, and endive, for
example?were brought in from elsewhere in the Levant. Moreover, saffron and mastic were clearly imported from the western Mediterranean, while pepper,
myrobalan, and spikenard came to Egypt from Southeast Asia.
9 These numbers are the sum of those mentioned in our earlier articles, E. Lev and
Z. Amar, "Reconstruction of the Inventory of Materia Medica used by Members of the
Jewish Community of Medieval Cairo according to Prescriptions found in the Taylor Schechter Genizah Collection, Cambridge." Journal of Ethnopharmacology 108 (2006): 428-44, and E. Lev, "Drugs Held and Sold by Pharmacists of the Jewish Community of
Medieval (11th-14th Centuries) Cairo according to Lists of materia medica Found at the
Taylor-Schechter Genizah Collection, Cambridge." Journal of Ethnopharmacology 110
(2007): 275-93.
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528 ZOHAR AMAR AND EFRAIM LEV
Table 1: Ten medicinal substances most frequently used by members of the
Jewish community of old Cairo according to the Genizah fragments.
No. English Name Scientific Name Arabic name(s) No. of references
1. Myrobalan Terminalia sp. ihliladjdt 79
(Cherry plum) yellow myrobalan Terminalia citrina halaylaj asfar
black myrobalan Terminalia chebula halaylaj aswad
Indian myrobalan Retz Terminalia arjuna halaylaj hindi
Belleric myrobalan Terminalia belerica balaylaj
Emblic myrobalan Terminalia emblica amlaj
Chebulic myrobalan Terminalia chebula ahalaylaj,
halaylaj (ahalaylaj) kabdli]
2. Rose Rosa sp. ward 71
3. Almond Amygdalus communis lawz 41
4. Saffron Crocus sativus zacafran 34
5. Pepper Piper nigrum fulful; bahdr 34 6. Endive (Chicory) Cichorium intybus hindiba3; hundabd3 34 7. Spikenard (Sunbul, Nardostachys jatamansi ddr shishfdn 32
Nard) 8. Liquorice Glycyrrhiza glabra sus 32
9. Sugar cane Saccharum officinarum qasab al-sukkar
qasab al-mass
qasab hulw 31 10. Mastic Pistacia lentiscus mastaqd 31
So what do the medical texts in the Genizah tell us about the demand for these drugs, their financial importance, and trade trends at that time? In order to answer these questions, this article focuses on two substances with medical
uses, which were the subject of wide commercial activity and impressive cash
circulation: saffron and myrobalan.
The Geographical Origins of Medical Substances
The Genizah's medical documents do not inform us about the geographical
origins of the drugs, nor do they indicate along which trade routes they arrived in Cairo. However, we may overcome these problems by making a phytogeo
graphical (geo-botanical) analysis, on the basis of a comparison of the lists with other documents, such as merchants' letters, which occasionally include infor
mation about the origins of certain drugs. These letters thus shed a more gen
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 529
eral light on the routes and other aspects of the drug trade of the mediaeval era.
This is illustrated by Dietrich's book which?on the basis of one such fragment
(Heidelberger Inv. Ar.Pap.nr.912)?describes trade in medicinal substances between India and other countries in the Far East with Egypt.10 Furthermore, the mer
chants' letters and documents mention large amounts of various medicinal sub stances that were used by the Jewish community in Cairo as foodstuffs, spices, and condiments; but they also served industrial purposes in the tanning and dye ing business.
It seems that Egypt was one of the production centers of alum, cassia, flax, gum Arabic, purging cassia, and sugar, but these represent a minority within the range of drugs used. Ingredients for drugs were also exported from Egypt to North
Africa, Europe, and Southeast Asia, but in this article we will limit the discus sion to medicinal substances that were imported, traded, and used in Egypt.11
From the eastern Mediterranean the merchants in Cairo imported asphalt, almonds, roses, dried fruits, endive, gull nuts, scammony, olive oil, soap, sumac, and wax. Cheese and dodder of thyme were brought in from Crete, while Sicily supplied coral, lead, sulphur, and silk. From further west honey, saffron, mas
tic, copper, iron, lead, mercury, and silver were imported in Egypt. Other substances with medical applications came from the east. Frankincense and
myrrh arrived through the Arabian Peninsula, while Yemen supplied Cairo with alum, mineral mummy, screw pine (Pandanus odoratissimus), and wars
(Memecylon tinctorium; a dye-yielding plant). From India and Southeast Asia
10 Dietrich, Zum Drogenhandl im Islamischen Agypten. 11 The following (ingredients for) drugs were exported from Egypt: to Southeast Asia, dod
der of thyme and saffron; to North Africa, flax, and various spices; to Sicily, flax, indigo, pepper, cinnamon, clove, and sal ammoniac; to Europe, alum, pepper, cinnamon, clove, and
sugar; to other parts of the Levant, safflower, meadow saffron, henna, purging cassia,
mummy, salep, and aniseed. E. Ashtor, "Spice Prices in the Near East in the 15th Century." Journal of the Royal Asiatic Society 1 (1976): 26-41; E. Ashtor, "Europaischer Handel im
spatmittelalterlichen Palastina." In Das Heilige Land im Mittelalter Begegnungsraum zwis chen Orient und Okzident, eds. W. Fischer and J. Schneider (Neustadt: a.d. Aisch, 1982): 107-26; E. Ashtor, "II regno dei crociati e il commercio di Levant." In / Communi Italiani
nel Regno Crociato di Gerusalemme. Atti del Colloquio, eds. G. Airaldi and B. Z. Kedar
(Genoa: University of Genoa, 1986): 15-56; Menachem Ben-Sasson, The Jews of Sicily 825 1068 (Jerusalem: Magnes Press, 1991); M. Gil, Palestine during the First Muslim Period
(634-1099) (Tel Aviv: Tel Aviv University and the Ministry of Defense, 1983); Goiten, A Mediterranean Society; N. A. Stillman, "The Eleventh Century Merchant House of Ibn
'Awkal.'" Journal of the Economic and Social History of the Orient 16 (1973): 15-88; D. Jacoby, Trade, Commodities and Shipping in the Medieval Mediterranean (Brookfield: Variorum, 1997); D. Jacoby, Commercial Exchange across the Mediterranean: Byzantium, the Crusader Levant, Egypt and Italy (Aldershot, UK: Ashgate/Variorum, 2005).
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530 ZOHAR AMAR AND EFRAIM LEV
4 spain ( slc^\f\ ^ CI V. y\
j^^'~*m^ Tr^j ^Baghdad.__-*Kabul / AFRICA TUNISIA^^C:--_^C^DaiK/ /Damascu^ ^--^PERSlX J AhKlLA ^^^^^.X^^AlexandriaC^y / V^J\
'Isfahan
) ^\7"
~--^^Qj?? '/Jerusalem
Ba^raS^ (FustartlA/ \ \
EGYPT S\\ \Gul/\r \ INDIA J \\ ARABIA \.
^r 5 |\\* Mecca d ^/
Myrobalan <- f' J \ \ )
YEMEN^^ Arabian Sea \ J /\GhaydabVA\ ^ \ Saffron --* M XlA(^/~^__?_\
Map 1: Trade routes of saffron and myrobalan according to Genizah fragments
cinnamon, clove, galingale, indigo, pepper, myroblan, camphor, and spikenard were imported to Egypt, while cubeb came specifically from the island of Socotra.12
The Commercial Aspects of Two Medicinal Substances
This section focuses on the commercial aspects of two widespread practical drugs referred to in the Genizah. The first is saffron, which was well known and
widely used in the Mediterranean from ancient times. The second is myrobalan, a name which covers a group of fruits of the genus Terminalia. Our research
suggests that myrobalan had become one of the most frequently used drugs in
Cairo by the eleventh century.
Saffron
Saffron is a small herbaceous plant with lilac-colored flowers which are typ ical of irises, the larger group to which it belongs. The floral stigmas of saffron,
which are orange-hued, are of great value. Seventy varieties of saffron can be
found in the northern hemisphere. The medieval medical literature mentions a wide variety of applications for
this plant. For example, saffron was believed to release urine and cure women's
ailments, to inhibit urine, and to be beneficial for the kidneys.13 According to
12 Goitein, A Mediterranean Society: vol. I: 153-4, 209-24.
13 S. Muntner, "Assaph (Harofe) the Physician, 'Sefer Refuoth.'" Korot 4 (1967-1969): 397.
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 531
Maimonides, who died in al-Fustat in 1204, saffron could be used as a mild
purgative, a sexual stimulant, and as a cure for intestinal ailments.14 The Andalusian
scholar, Ibn al-Baytar (d. 1248), asserts that it also improves the general state
of mind and dispels headaches, while it can also be used for the treatment of
the liver, the throat, and the mouth, including the teeth and gums. He further notes the use of saffron for eye diseases and epilepsy.15 Zakariya3 b. Muhammad
al-Qazwini (d. 1283) wrote that the drug could be used as a diuretic, to accel erate childbirth, and to strengthen the heart, although high doses of it are poi sonous.16 The works of Ibn al-Baytar and the sixteenth-century physician, Da'ud
al-Antaki (d. 1599) also list that saffron sharpens the senses, prompts the
memory, slows the heartbeat, improves eyesight, relieves aches, stops haemor
rhages, strengthens the internal organs, cures inflammations, stimulates the appetite, and works as a contraceptive.17
By no means all these applications are mentioned in the Genizah texts, which
document saffron's use as an ingredient for medicines, perfumes, and as a dyestuflf.18 It figures in Genizah documents in 21 lists of drugs,19 and in 13 prescriptions for eye diseases, for a plaster, and for other uses.20
14 Moshe (Maimonides) Ben Maimon, Regimen Sanitatis: Letters on the Hygiene of the
Body and of the Soul (Hebrew Translation ofMoshe Ibn Tibbon, ed. SUssman Muntner (Jerusalem: Mosad Harav Kook, 1957): 3:2; Moshe (Maimonides) Ben Maimon, The Medical Aphorisms of Moses Maimonides, eds. F. Rosner and S. Muntner (New York: Yeshiva University Press,
1970): 9:46; 20:86; 21:76. 15 cAbd Allah b. Ahmad Ibn al-Baytar, Kitdb al-jdmic li-mufraddt al-adwiya wa-al-aghdiya
(Cairo: Bulaq Press, i874) vol. II: 162-3; Da'ud b. cUmar al-Antaki, Tadhkirat uli al-albdb
wa-l-jdmic li-al-ajdb al- cujdb (Cairo: Bulaq Press, 1935): 178-9; M. Levey, The Medical
Formulary of the Aqrdbddhin of al-Kindl (Madison: University of Wisconsin Press, 1966): 275; C. A. Wood, Benevenutus Grassus of Jerusalem, De Oculis, eorum egritudinibus et curis
(California: Stanford University Press, 1929): 37. 16
Zakariyya' b. Muhammad al-Qazwini, cAjd3ib al-makhluqdt wa-gard'ib al-mawjuddt (Beirut: Dar al-Sharq al-cArab"i, 1981): 250. On al-Qazwini, see Brockelmann, GAL: vol. I: 481.
17 Ibn al- Bay tar, Kitdb al-jdmic li-mufraddt al-adwiya wa-al-aghdiya: vol. II: 162-3;
al- Antaki, Tadhkirat uli al-albdb wa-l-jdmic li-al-ajdb al- cujdb: 178-9. Cf. E. Lev, "The Contribution of the Turkish Physician, Daud al-Antaki (16th Century) to the Research of Medieval
Medical Substances in al-Sham." Turkish Journal of Medical Ethics, Law and History (2005) 13: 74-80.
18 Goitein, A Mediterranean Society: vol. IV: 174-5.
19 T-S Ar.30.274; T-S Ar.30.291; T-S Ar.35.82; T-S Ar.35.229; T-S Ar.35.252; T-S Ar.35.326;
T-S Ar.39.136; Ar.39.139 [2]; T-S Ar.39.487; T-S Ar.43.317; T-S AS 153.51; T-S AS 176.151; T-S AS 176.22; T-S AS 177.139; T-S AS 179.132; T-S AS 182.3; T-S NS 306.106; T-S NS 306.117; T-S NS 321.49; T-S NS 325.127; T-S Ar.39.136.
20 T-S Ar.44.162, T-S NS 222.34, T-S Ar.30.227; T-S Ar.34.305; T-S Ar.41.81; T-S Ar.42.152;
T-S AS 177.40; T-S AS 177.39; T-S AS 181.127; T-S AS 214.96; T-S NS 151.52; T-S NS 297.17; T-S NS 306.134.
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532 ZOHAR AMAR AND EFRAIM LEV
According to medieval geographical sources, saffron was cultivated in
Muslim Spain,21 in Jadiya22 and Damascus,23 in Bilad al-Sham, in the region of
Isfahan and elsewhere in Iran,24 and in Afghanistan. Several Genizah fragments further indicate that it was also cultivated in Kermanshah, east of Baghdad,25 Tunisia,26 and probably also in Sicily.27 According to many eleventh-century Genizah fragments, saffron was brought from the countryside to major towns in
the cultivation areas and from there was transported along the trade routes to
other commercial centers of the medieval world. For example, in North Africa commerce was concentrated in the city of Qayrawan.28 The commodity was then
carried to al-Mahdiyya (in Tunesia) and shipped to Sicily, or to the Egyptian
ports of Alexandria, Rosetta, and Damietta, and from there to al-Fustat.29 A
merchant in mid-eleventh century al-Fustat, for example, wrote to his partner somewhere in North Africa that saffron was in great demand. In his letter he
asks him to send "as much as you can buy and as much as you can find in the
markets . . . and send it overland or by sea."30 Saffron was also imported in
Egypt from Italy, mainly from the region of San Gimignano, while during the
thirteenth and fourteenth centuries it was also brought into the eastern Mediterranean
region from other locations in southern Europe.31 Furthermore, "zafferano" is
listed among the products which residents of Italian cities traded in cAkka
(Acre), Beirut, and Ramlah,32 as well as in Aleppo and Alexandria.33
21 al-Idrisi, Opus Geographicum, eds. E. Cerulli et al. (Naples: Istituto Universitario
Orientale, 1974): 553, 569. 22
Yaqut, b. cAbd Allah al-Hamawi, Kitdb mu'jam al-bulddn, ed. F. Wustenfeld (Leipzig: F. A. Brockhaus, 1866-1873) vol. II: 5.
23 H. M. Said, ed. Al-Biruni's Book on Pharmacy and Materia Medica (Karachi: Hamdard,
1973) vol. I: 95. 24
al-Jahiz, Kitab al-Tabassur bi-al-Tajara (Cairo: Bulaq Press. 1935): 31; al-Idrisi, Opus Geographicum: 195, 675, 677.
25 M. Gil, In the Kingdom of Ishmael (Tel Aviv: Tel Aviv University and the Ministry of
Defense/Jerusalem: The Bialik Institute, 1997) vol. II: 42, No. 12. 26
Goitein, A Mediterranean Society: vol. IV: 173. 27
Ibid.: vol. I: 153. 28
Gil, In the Kingdom of Ishmael: vol. II: 302. 29
Gil, In the Kingdom of Ishmael: vol. II: 521; vol. Ill: 172, 901, 912, 940; vol. IV: 412; Ben-Sasson, The Jews of Sicily 825-1068: 197, 499; At that time saffron was exported from
Spain and Byzantium; Ben-Sasson, The Jews of Sicily 825-1068: 128; Stillman, "The
Eleventh Century Merchant House of Ibn 'Awkal'":72-3. 30
Gil, In the Kingdom of Ishmael: vol. IV: 628-9. 31 D. Abulafia, "Crocuses and Crusaders: San Gimignano, Pisa and Kingdom of
Jerusalem." In Outremer: Studies in the History of the Crusading Kingdom of Jerusalem Presented to Joshua Prawer, eds. B. Z. Kedar, H. E. Mayer, R. C. Smail (Jerusalem: Yad Yizhak Ben
Tsvi, 1982): 227-43. 32 Francesco Balducci Pegolotti, La Pratica Delia Mercatura, ed. A. Evans (Cambridge,
MA: The Mediaeval Academy of America, 1936): 64, 69, 90, 101; E. Ashtor, "The Crusader
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 533
Saffron was expensive, because for the production of one gram, no less than
150 stigmas had to be collected and dried. The gathering of the flowers and the
separation of the stigmas were manual labor, which required many skilled work ers. Saffron was therefore dispatched in boxes or special packages.34
A few Genizah documents mention the price of saffron, which generally appears to have been stable, with small fluctuations caused by international
events, the season, product quality, and supply and demand. According to one
Genizah document, the price of a gram of saffron was 3.5 dirham.35 Another
text mentions the purchase of saffron for home use at 9.5 dirhams for one
wiqiya (37.5 g.).36 Between 1050 and 1080 wholesalers usually used a weight unit called a mann, paying 2-2.3 dinars37 for one mann of saffron38 which they sold for 5-7 dinars.39 The price at which saffron was sold was thus two to three
times as high as the purchasing price, but this does not mean that the net profit was necessarily high, because the sale's price also covered expenditures like obtain
ing selling permits in the ports and bribes.40
It is sometimes difficult to assess the cost of saffron in the Genizah docu
ments, because they occasionally switch between measurements and prices (dinars and dirhams), both of which terms could refer to a coin and a mea
surement. For example, a document by Nathan Ben Solomon Ha-Kuhin, which
refers to saffron as medication, notes only its price of 1/4 dirham;41 however, in
order to make aromatic wine, various spices, including half a dirham [worth
of?] saffron, were used according to another document.42
Kingdom and Trade in the Levant." In The Crusaders in Their Kingdom, ed. B. Z. Kedar
(Jerusalem: Yad Yitshak Ben Zvi, 1978): 52; W. Heyd, Histoire du Commerce du Levant au
Moyen-Age (Leipzig: Otto Harrassowitz, 1936) vol. II: 668-9. 33
Abulafia/'Crocuses and Crusaders." 34
Gil, In the Kingdom of Ishmael: vol. Ill: 940; vol. IV: 600-1. 35
Gil, In the Kingdom of Ishmael: vol. II: 990. 36
Goitein, A Mediterranean Society: vol. II: 269. 37
The dinar was a gold coin weighing, according to the official exchange rate, 4.2 grams and the dirham a silver coin weighing 3.1 grams. Their value changed according to the polit ical, economical, or other circumstances. "In Egypt. . . some spices were weighed by the
mann, which was equal, according to the Arabic sources, to 260 dirhams, i.e. 803.348 g,
according to Pegolotti to 840 g, and according to other Merchants' Guides to 2 1/2 light Venetian pounds, i.e. 753 g." See E. Ashtor, "Makayil 1. In the Arabic, Persian and Turkish
Lands." In Encyclopaedia of Islam. New Edition, eds. C. E. Bosworth et al. (Leiden: E. J.
Brill, 2001) vol. VI: 119. 38
Ben-Sasson, The Jews of Sicily 825-1068: 264, 272. 39
Gil, In the Kingdom of Ishmael: vol. IV: 272, 412, 531; Ben-Sasson, The Jews of Sicily 825-1068: 421.
40 Gil, In the Kingdom of Ishmael: vol. Ill: 172.
41 Goitein, A Mediterranean Society: vol. IV: 232-3.
42 Goitein, A Mediterranean Society: vol. IV: 260.
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534 ZOHAR AMAR AND EFRAIM LEV
Considering the high price of saffron it is not surprising that attempts were
made to forge the product, and the sources record many such instances.43
Myrobalan (cherry plum)
The Terminalia genus has 200 species. The trees are tall and their fruit con
tains 30% tannin which is used for remedial and industrial purposes. The use
of the myrobalan fruit as a remedy had been well known in India and China
since early times, but Greek and Roman medical treatises neither allude to the
tree nor to its fruit.44 The Muslim conquests removed political borders and broke
down barriers, thus creating favorable conditions for the transfer and circulation
of traders, knowledge, and products from India to Spain. A. M. Watson, who
has named this process "agricultural innovation," mainly mentions domesticated
plants, such as sugar and lemon, which played an important part in medieval
pharmacology.45 This process was not restricted to agricultural crops and trees,
however, for it also included exotic spices and medicinal products and sub
stances. This development dramatically changed the distribution pattern of the
myrobalan, from the Far East to the Middle East, and later to the West.
In the Middle East the plant is mentioned from the early Islamic period in
connection with the medicinal use of its fruit. In Europe there is no information
about this plant until this time, when trade in its fruit began.46 Most myrobalan
species were imported in Egypt from tropical Asia and Africa where they were
cultivated, including India, Burma, and Madagascar.47 From Egypt the cherry
plum was then exported again to Europe.48 The Kabuli species was imported from Kabul in Afghanistan.49
Several species of Terminalia are mentioned in the medieval medical litera ture (see Table 1, above)?including the works of Maimonides, Ibn Slna, Ibn
al-Baytar, and al-Antakl?which prescribes them as a cathartic drug, which also
43 Z. Amar, The Book of Incense (Tel-Aviv, 2002) (in Hebrew): 115. 44
Levey, The Medical Formulary of the Aqrdbddhin of al-Kindi: 342. 45 A. M. Watson, Agricultural Innovation in the Early Islamic World: The Diffusion of
Crops and Farming Techniques, 700-1100 (Cambridge: Cambridge University Press, 1983); Z. Amar, Agricultural Produce in the Land of Israel in the Middle Ages (Jerusalem: Yad
Izhak Ben-Zvi, 2000): 334-6. 46 A. Dietrich, Die Ergdnzung Ibn Gulgul's zur Materia Medica des Dioskurides
(Gottingen: Vandenhoeck & Ruprecht, 1993): 7. 47 M. Zohary, The Plant World: Morphology, Taxonomy, Evolution, Biology (Jerusalem: ?Am Oved, 1978): 459; A. F. Hill, Economic Botany (New York: McGraw-Hill, 1952): 123-4.
48 F. R. Farag, "Why Europe Responded to the Muslims' Medical Achievements in the
Middle Age." Arabica 25 (1975): 292-309. 49
al-Idrisi, Opus Geographicum: 195.
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 535
cures ear diseases and throat pains, counteracts swellings in the mouth, and is an ingredient in an abortive medication. Furthermore, these works claim that
myrobalan prevents diarrhoea and strengthens the gums, teeth, and brain, while
it also improves breathing, stimulates coitus, hardens the penis, and increases
sperm production.50
Various kinds of myrobalan are recorded in 24 lists of drugs in Cairo
Genizah collections.51 It also appears in 55 prescriptions for eye diseases, hal
lucinations, problems with the stomach and digestion, weak eyesight and
migraine, and as an aphrodisiac.52 Several documents testify to the lively trade
in dried cherry plums in medieval Cairo.53 The Genizah documents also indicate
that myrobalan was imported through the trading routes of the Indian Ocean; from Aden it was transported to Egypt through the port of cAidhab.54
From Egypt cargoes of Indian and yellow myrobalan were exported to
Qayrawan55 and, through al-Mahdiyya,56 to Sicily.57 The product was also sent from
50 Levey, The Medical Formulary of the Aqrdbddhin of al-Kindi: nos. 68, 70-1, 75, 211;
al-Husayn b. ?Abd Allah Ibn Sina, al-Qanun fi 'l-tibb (Cairo: Bulaq, 1877): 270-1; Said, Al-Biruni's Book on Pharmacy and Materia Medica: vol. I: 76, vol. II: 80, 104; Ibn al
Baytar, Kitdb al-jdmic li-mufraddt al-adwiya wa-al-aghdiya: vol. IV: 190, 196-8; al-Antaki, Tadhkirat uli al-albdb wa-l-jdmic li-al-ajdb al- cujdb: 62; Moshe (Maimonides) Ben Maimon, Sexual Life: Hygiene and its Medical Treatment: Collection of Mediaeval Treatises, ed.
S. Muntner (Jerusalem: Mosad Harav Kook, 1965): 1:5; M. Meyerhof and P. G. Sobhy, (eds.
trans.) The Abridged Version of 'The Book of Simple Drugs" of Ahmad Ibn Muhammad Al-Ghafiqi by Gregorius Abul-Farag (Barhebraeus) (Cairo: El-Ettemad Printing Press, 1932
1940): no. 124; Ben Maimon, The Medical Aphorisms of Moses Maimonides: 21:73. 51 T-S Ar.30.274; T-S Ar.43.317; T-S AS 152.131; T-S AS 181.109; T-S Ar.35.328; T-S
Ar.39.450; T-S Ar.39.451; T-S Ar.39.487; T-S Ar.30.274; T-S Ar.39.450; T-S AS 182.73; T-S AS 184.234; T-S Ar.30.291; T-S Ar.39.307; T-S Ar.39.451; T-S Ar.43.317; T-S
Ar.51.53; T-S AS 179.80; T-S AS 181.109; T-S Ar.39.451; T-S Ar.39.487; T-S Ar.43.315; T-S Ar.43.317; T-S AS 184.34.
52 T-S AS 159.241; T-S 16.291; T-S AS 180.15; T-S Ar.30.286; T-S Ar.41.71; T-S
Ar.42.189; T-S NS 164.159; T-S AS 147.192), (T-S Ar.40.141; T-S Ar.39.184; T-S Ar.30.291; T-S Ar.30.65; T-S Ar.41.81; T-S AS 173.3; T-S NS 305.76(75); T-S NS
306.41; T-S 13J6.14; T-S Ar.30.291; T-S Ar.30.65; T-S Ar.41.81; T-S Ar.43.338; T-S AS
173.3; T-S 13J6.14; T-S K25.212; T-S Ar.30.291; T-S Ar.40.141; T-S Ar.41.81; T-S Ar.43.338; T-S Or.1081J.39; T-S AS 155.365; T-S AS 173.3; T-S AS 177.31; T-S NS
83.28; T-S NS 327.40; T-S NS 327.97; T-S 12.33; T-S NS J38; T-S 13J6.14; T-S Ar.40.141; T-S AS 177.31; T-S NS J38; T-S 12.33; T-S 13J6.14; T-S Ar.40.141; T-S Ar.41.81; T-S AS
177.40; T-S Ar.42.67. Cf. The letters between merchants based in al-Fustat and Alexandria
dealing with the trade in myrobalan in Gil, In the Kingdom of Ishmael: vol. Ill: 16. 53
Goitein, A Mediterranean Society: vol. Ill: 903, 912; Ben-Sasson, The Jews of Sicily 825-1068: 266, 273.
54 S. D. Goitein, The Yemenites (Jerusalem: Yad Izhak Ben-Zvi): 110. 55
Gil, In the Kingdom of Ishmael: vol. Ill: 170; vol. IV: 101. 56
Gil, In the Kingdom of Ishmael: vol. Ill: 276. 57
Gil, In the Kingdom of Ishmael: vol. II: 465, No. 158; Ben-Sasson, The Jews of Sicily 825-1068: 626.
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536 ZOHAR AMAR AND EFRAIM LEV
Egypt to other parts of the Levant, including the ports of cAsqalan (Ascalon),58 Sur (Tyre),59 and Tripoli in Lebanon,60 from where it was transported overland
into the interior. According to Genizah documents from the eleventh century,
myrobalan of Egyptian origin was sold in Jerusalem, where it had probably arrived via Ramlah. In a letter sent from Ramlah to Jerusalem, on which the
signature of cAmaram ha-Roffe was identified, the addressee was asked to send
some medicinal substances including kuhl (antimony sulphide) and myrobalan.61 In another letter, sent from Jerusalem to al-Fustat in 1053, Naharay Ben Nissim
is asked to send myrobalan for the treatment of the sender's wife.62
Some indication of prices can also be obtained from the documents. Yellow
myrobalan was the best kind and therefore the most expensive, the Indian
species were second best, while Chebulic was the least expensive variety.63 As
with other substances, the price of myrobalan varied according to market con
ditions. For example, in 1059 ten manns were sold in al-Fustat to a middleman
in Sicily for 3.3 dinars, whereas one qintar (463 g) of yellow myrobalan sold
for 1.25 dinars.64 In the summer of 1062 a merchant from Alexandria wrote in
a letter that "Chebulic myrobalan is not in demand."65 A document from al
Mahdiyya dated a year later indicates that the market was rising and the price of Chebulic myrobalan was 2.5 dinar per mann, while yellow myrobalan was
ten dirhams per qintar.66 In 1065 the price of yellow myrobalan in Alexandria was 5-6 dinars, the concentrate of fine Chebulic myrobalan fetching one dirham
per mann61
As with saffron, the difference between the price for which merchants bought myrobalan and the price it fetched in the marketplace was probably considerable.
58 Gil, Palestine during the First Muslim Period (634-1099): vol. Ill: 187-8.
59 Gil, Palestine during the First Muslim Period (634-1099): vol. Ill: 210.
60 Gil, Palestine during the First Muslim Period (634-1099): vol. Ill: 217.
61 Gil, Palestine during the First Muslim Period (634-1099): vol. II: 421.
62 Gil, Palestine during the First Muslim Period (634-1099): vol. Ill: 106, 108; The plant is also mentioned in a list of substances traded by the Crusaders in Acre during the 13th cen
tury; A. A. Beugnot, Les Assises de Jerusalem. Recueil des Historiens des Croisades. Lois
I-II (Paris: Imprimerie Royale; 1841-1843): 176. 63
Gil, In the Kingdom of Ishmael: vol. Ill: 905, No. 574; 912, No. 474; Ben-Sasson, The
Jews of Sicily 825-1068: 226, 273. 64
Ben-Sasson, The Jews of Sicily 825-1068: 159, 163. In Egypt the qintar used for
spices?known as rati fulfuli, the pepper rati?consisted of 150 dirhams, and weighed 463
g. Ashtor, "Makayil 1. In the Arabic, Persian and Turkish Lands": vol. VI: 118-9. 65
Gil, In the Kingdom of Ishmael: vol. IV: 447. 66 In both cases only small quantities were sold. Gil, In the Kingdom of Ishmael: vol. Ill:
252; Ben-Sasson, The Jews of Sicily 825-1068: 401. 67
Gil, In the Kingdom of Ishmael: vol. IV: 586, 589; Goitein, The Yemenites: 110.
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 537
CONCLUSION
Medical handbooks tell us a great deal about the materia medica of the
medieval Islamic world, but they do not inform us which drugs were actually
prescribed in practice. The Genizah documents form a unique source for the
study of what we propose to call "practical medicine," because they contain
lists of medicaments, as well as prescriptions by physicians, and evidence of
commercial transactions involving drugs. In the top-10 of most popular medicinal substances used among the Jews of
medieval Cairo we find saffron, a traditional spice which was well-known in the
ancient world for its various uses, was cultivated in the Mediterranean region and exported to the east. With 34 occurrences in the Genizah documents saf
fron shares the fourth place in our top-10 with pepper and endive. More sur
prisingly, at the top of the list is myrobalan, a drug which reached the Mediterranean
only after the Muslim conquests, arriving in Egypt along the trading routes from
Southeast Asia.
The Genizah documents show that saffron was cultivated in several locations in the Eastern Mediterranean and North Africa, but the substance was also
imported from Italy and Iraq. This suggests that the demand for saffron in Cairo was so high that it could not be met by regional production alone. The harvest
of saffron was a labor-intensive, and therefore costly process; the fact that it
also had to be imported from abroad?and packaged specially to preserve the
quality?further drove up the price, making it an expensive commodity. The cherry plum (myrobalan), which contains 30% tannin, was prescribed in
Cairo for a wide variety of ailments by the eleventh century. This medical sub
stance was unknown to the Greeks and Romans and was introduced in the
Mediterranean only after the spread of Islam. Myrobalan is thus an example of a medical substance which spread through what Watson has called "agricultural innovation"?which appears to have had a wider scope than he realized, includ
ing spices and drugs. The Genizah documents show that the cherry plum was
imported in Egypt from tropical Asia and Africa. Various kinds of myrobalan are recorded in no less than 24 lists of drugs in the Genizah collections, but the
commodity was not imported for the market of Cairo alone. On the contrary,
by the eleventh century Egypt exported myrobalan throughout the Eastern
Mediterranean, and to Europe, particularly through Sicily. Our evidence was produced by the Jewish community in Cairo between the
eleventh and thirteenth centuries. But these local sources offer valuable insights in the lively trans-regional trade in saffron, myrobalan, and other medical sub
stances in which Jews in medieval Cairo actively took part. Jewish merchants,
physicians, and pharmacists may have had an advantage over Muslims and
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538 ZOHAR AMAR AND EFRAIM LEV
Christians owing to the widespread diaspora of Jews all over the medieval
world. After all, many of the ports and cities that were important for the trade
in saffron and myrobalan?from Sicily to Syria and India?had thriving Jewish
communities during this period.
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THE SIGNIFICANCE OF THE GENIZAH'S MEDICAL DOCUMENTS 541
Illustration 1: Genizah fragment T-S-Ar 43 338v. Courtesy of the Taylor-Schechter Collection, ? Cambridge University Library.
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