Brent Arehart //
Every day, American viewers of television and streaming services alike are targeted by direct-to-consumer ads for pharmaceuticals. We are all too familiar with them. Chances are you already know something about Prozac, Lipitor, and myriads of other drugs even if you can’t recall off the top of your head what they are supposed to do. And then there are the wonder drugs—the Viagras and the hydroxychloroquines of the world—whose (in)famous effects are in the front of your mind. There’s no doubt that we live in an age of wonder drugs and hype. But as a historian of Greco-Roman medicine living in this age, I have wondered myself how these substances would have been hyped in earlier times. What might have been different, and what could remain the same?
For starters, there would be major differences in awareness and access. In antiquity, there was no social media to promote information about brands, no international conglomerates pumping cash into product development, and no meaningful distinction between over-the-counter and prescription drugs. (“Drugs,” or pharmaka in ancient Greek, could refer to any number of organic and inorganic substances ingested as food or drink, or even applied to the body externally, but also many things that would get labeled as “magic” today). Most information would have been passed on by word of mouth, or, for the literate, by reading pharmacological texts such as Dioscorides’ On Medical Materials. The raw ingredients—plants, animal products, minerals and the like rather than synthetic chemicals—would pass through a diffuse chain of suppliers and handlers en route to the consumer, if not readily accessible in the backyard. Doctors might give instructions on how to correctly prepare the ingredients, but their understanding of dosage was limited. They may have been more likely to do harm than good. And with little possibility of effective oversight, many substances could be passed off as something else entirely. Nevertheless, many of the same marketing principles would apply. People wanted drugs because they believed in their potential to solve problems. And anybody who stood to profit from enabling access to said drugs had a motive to influence the consumer’s decision-making process.
If we read the ancient evidence closely while exercising our sociological imagination, it may be possible to reconstruct some of the strategies used to promote wonder drugs. As it turns out, they may not have been so different from marketing techniques used nowadays. Let’s consider Viagra as our first example. Viagra may be a recent invention, but the idea of drug-induced erections goes back over a thousand years at least [1]. Called entatika in ancient Greek, these erectogenic drugs are often described with sensational language. Notice how the following recipe makes an appeal to personal experience:
An entatikon [sg. of entatika] that is unfailing from experience: after chopping up two unciae of arugula seed, one uncia of pepper, and a half uncia of celery seed, take one spoonful with seasoned wine mixed in hot water on an empty stomach after a bath for three days and you will be amazed [2].
It is unclear whether these words reflect the author’s own experience or that of an earlier source, but they manage all the same to cultivate an air of confidence in the product. In modern pharmaceutical ads, appeals to experience are extremely common and often take the form of actors assuring the viewers with heartfelt language that some drug worked for them personally. But this strategy can also be modified to target other aspects of the human experience, such as sexual appetite. For instance, several ancient papyri offer recipes that will enable you “to screw a lot,” “to have a lot of intercourse,” or “to get hard whenever you want” [3]. An example of the modern equivalent can be found in an ad for Viagra (@ 0:36-45), where a co-worker mentions that he was up late last night before the little blue pill appears over his mouth, censoring his obscenity-laced escapades.
Another strategy that resembles appeals to personal experience would be celebrity endorsement. The implication is that when a famous person sponsors a product, they approve of it because they have personally used it. So if it’s good enough for them, it should be good enough for you. Celebrity endorsement was used prominently in early Viagra ads featuring former US Senator Bob Dole and former NASCAR racer Mark Martin (@ 0:00-25). It remains a common marketing technique still, but what about in antiquity? Perhaps. Notice how the following recipe for an erectogenic drug claims to be the creation of the famous Roman emperor Trajan (reigned 98-117 AD):
Another [entatikon], from Emperor Trajan: one uncia of arugula seed, one uncia of root of panaces, one drachma of mustard, twenty grains of white pepper. You crush, separate, then make a handful of pills with water and administer one with wine on an empty stomach in the first hour. It also works for penile paralysis [4].
This is a somewhat rare example as far as erectogenic drugs go, but there are certainly other instances where the names of prominent individuals are attached to particular recipes. Mithridates VI, who was king of Pontus from 120-63 BC, had his own highly sought-after drug called mithridatium that many Romans scrambled to imitate [5]. The Roman emperor Marcus Aurelius (reigned 161-180 AD) was also in the daily habit of taking a type of antidotal drug known as theriac. It then became fashionable for the elite in Rome to take theriac too. As Galen once remarked, who had personal experience as Marcus Aurelius’ court physician: “It is astonishing how the wealthy emulate the actions of emperors, or at least want to appear to be emulating them. But since that emperor’s death, very few of them prepare this drug” [6].
Interestingly, Galen mentions elsewhere that theriac was not well-known before Marcus Aurelius popularized it [7]. One cannot help but compare theriac to the recent saga of hydroxychloroquine, which went from being a relatively obscure drug to a common household name after the former US president touted it as a new panacea for a pandemic he had previously dismissed as a hoax. GOP Senators and fringe members of the medical community were quick to praise hydroxychloroquine as a wonder drug, explaining away any lack of evidence with conspiracy theories involving deep state cover ups and reptilians running the government. This was a different, arguably more insidious version of celebrity endorsement in which the drug’s alleged efficacy was ancillary to its capacity to serve as a political symbol for the celebrity himself. They wanted to be seen emulating their emperor, but only time will tell how long they cherish his favorite drug.
In the end, while the mediums through which pharmaceuticals are advertised have changed significantly, it might be that the fundamentals of advertising have not. Or maybe the better question to ask is not how they are advertised, but why the advertising is effective. If advertisers have forced themselves to become more sophisticated, shouldn’t consumers do the same?
Notes
[1] Arehart, B. “Erectogenic Drugs in Greek Medicine.” Pharmacy in History 61.1&2 (2019): 15-25. Conceptually speaking, however, these drugs supposedly induce an erection directly whereas Viagra is a phosphodiesterase (PDE) 5 inhibitor that facilitates the process of erectogenesis. Viagra is not an “aphrodisiac,” in other words, although it has been advertised as the unofficial sponsor of Valentine’s Day before.
[2] Aelius Promotus, Dynameron 24.1.
[3] Respectively: SM 76 & 83; PGM 7.185-186.
[4] Latin Oribasius, Synopsis ad Eunapium 4.107 Aa (VI.616 Molinier). The word panaces can refer to multiple plants.
[5] Totelin, L. “Mithradates’ Antidote: A Pharmcological Ghost.” Early Science and Medicine 9.1 (2004): 1-19.
[6] Galen, De antidotiis XIV.24 K.
[7] Galen[?], Ad Pisonem de theriaca 2 (72 Leigh = XIV.216-217 K). The Galenic authorship of this work is disputed.
