Herbs in History: Ginger


Zingiber officinale


By Alain Touwaide & Emanuela Appetiti | January 2023

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From the Land of Spices

Zingiber officinale: the whole plant (Davor Lavincic/Getty Images)

Illustration 1: Zingiber officinale: the whole plant

Probably native to Malaysia and Indonesia and now encountered from the southern islands of Japan to New Guinea, the genus Zingiber (Ginger) in the family of the Zingiberaceae is made up of ca. 60 species. One of them, Z. officinale Roscoe (Illustration 1), made its way slowly into the therapeutic arsenal of the Mediterranean World despite a promising start.


A Bitter Aperitif?

Ginger does not appear in the medical literature of the Mediterranean World before the treatise De materia medica compiled by Dioscorides, in the 1st century CE, which is the largest encyclopedia on the natural products used for therapeutic purposes assembled in Antiquity. There it is identified as a substance coming from Arabia and the so-called Troglodytike region which possibly corresponds to East Africa. Through this distribution, ginger was a plant growing in the regions East and West of the Red Sea. As for its uses, ginger was principally a culinary substance, as an ingredient for aperitifs and as a condiment for boiled vegetables. It is also prescribed for the treatment of an ophthalmological condition and in the composition of antidotes.
The mention of aperitifs is particularly remarkable as it opens a new perspective on the history of the use of bitters and suggests that such use had already been discovered as early as the 1st century CE if not earlier. Also, such possible use evokes the culinary magnificence—with its excess—traditionally considered typical of the Roman Empire of the first centuries.
A closer scrutiny of the ginger text in De materia medica brings some anomalies to light. Whereas the entry appears at first sight to be built on the model of all the entries in De materia medica, its place in the work is out of order: it is inserted between two entries devoted to plants identified as species of pepper, breaking in that way the coherent group made of these two species. Truth is that ginger taste is defined as pepperish and its general therapeutic action is compared to that of pepper, two facts that might account for its introduction in the group, even though it breaks it. Nevertheless, such position is atypical. In addition, all the exotic substances in De materia medica are grouped at the very beginning of the treatise in a coherent series, the elements of which are characterized by both their geographical origin (the East), their environment (warm climates) and their major therapeutic property (warming). Finally, some terms in the ginger entry do not correspond to Dioscorides’ lexicon. One of them is, precisely, aperitif, of which we have here the only occurrence in the whole work.
These uses of ginger as per De materia medica, particularly the emphasis on food, hint at a great familiarity with the plant that does not seem compatible with the knowledge of the plant in Dioscorides’ time. We have indeed other medico-naturalistic treatises dating from the same period as Dioscorides: the medical encyclopedia by the Roman Celsus, the Compendium by his co-citizen Scribonius Largus, and the Naturalis Historia (Natural History) by another Roman contemporary of Dioscorides, Pliny. Whereas ginger is mentioned only once by Celsus and Scribonius Largus, it is specifically treated in Pliny, but in a very cursory way indicating a limited bookish knowledge:

Ginger is a small herb that grows in farms in Arabia and Troglodite. It decays rapidly in spite of its high bitterness. Its price is six denarii for a pound.

Interestingly, Pliny concurs with Dioscorides on the place of origin of ginger, revealing that both took their information from the same source, possibly a natural history report on the plants allegedly growing in the region of the Red Sea.
This sense of insufficient knowledge palpable in Pliny is confirmed by the treatise De simplicium medicamentorum facultatibus (On simple medicines properties) by the omniscient Galen (2nd/3rd century), which is an alphabetical list of the natural substances of all nature (plant, animal, mineral) used at that time in medicine and nutrition, with their analysis according to Galen’s original system. There, Galen identifies ginger as a useful root imported from the barbaric land, which generates a taste of heat in the mouth, but not immediately as pepper does, instead. Galen goes on with analytical considerations on the matter ginger is made of, without offering any relevant information on its therapeutic indications.

Returning to Dioscorides, the full text of his entry on ginger reads as follows:

Ginger is a distinct plant (from pepper) growing abundantly in Troglodyte and Arabia, the green parts of which are used for many purposes, as we do with rue, boiling it for aperitifs and mixing it with boiled foods.
It is a group of small roots, like those of turmeric, whitish, pepper-like in their taste and aromatic.
Choose those that are not eaten by worms.
It is pickled by some because it decays easily. It is traded to Italy in small clay jars. It is a useful food. It is consumed with the dry salted food.
It has a warming and digestive property, and also softens moderately the belly, being good for the stomach. It is efficacious to treat the shades in the pupil of the eye, it is mixed in the antidotes, and, generally, it resembles pepper for its properties.

Zingiber officinale: the rhizome (Takuya Aono/Getty Images)

Illustration 2: Zingiber officinale: the rhizome

There thus is a strong contrast between this presentation in De materia medica (particularly the exact description of the rhizome) (Illustration 2) and the scant information in the treatises by Celsus, Scribonius, Pliny, and Galen, all of which cover the period from the 1st to the early 3rd century CE.
Bearing in mind the atypical position of the ginger entry in Dioscorides, De materia medica, not among the exotic substances, but inserted between two elements of a coherent group (the two species of pepper) and also knowing how texts were transmitted through the centuries, we come to wonder whether this entry on ginger couldn’t be an addition introduced into the text of De materia medica as a note first written in the margin of a copy of the original text or on a fly leaf inserted between two pages in a copy. Later, this text was introduced into the text in a process that was not unusual in the past, as if this addition were an original part of the whole work.

From Spice to Medicine?

The first position of—and emphasis on—the culinary uses of ginger in De materia medica entry is infrequent in the treatise and directs the inquiry toward the ancient culinary literature. The most famous piece of antiquity in this genre is the so-called Apicius, a book of recipes attributed to the 1st-century Roman Marcus Gavius Apicius and entitled De re coquinaria (On the Matter of Cooking). A wealthy citizen living in the capital of the Empire, Apicius was also a gastronome and gourmet who became famous thanks to the extravagant meals he offered to the high society of his time. As the story goes, he spent all his fortune in these luxury dinners and, faced with the necessity to downscale his lifestyle, he preferred committing suicide. If he did write some recipes, he is not the author of the cookbook that circulated later under his name, which dates to the last decade of the 4th century or the first half of the 5th.
Ginger is markedly present as a spice in De re coquinaria. It was used in a great many recipes (some twenty), from appetizers to aromatized salts aimed to promote digestion, including spreads, main dishes of meat (an abundance of sausages, meatballs and the like, stuffed suckling pig, or roasted pieces of lamb, for example), poultry (stuffed chicken), or fish and seafood (octopus), sides, and mixed salads.
In the same culinary vein, though in a much more modest way, ginger can be found in the small dietary treatise De observatione ciborum (On the Examination of Foods) by the Byzantine Anthimus (6th cent.). The most salient characteristic of this work is that it was not written in the Byzantine World, but in the West as Anthimus served as physician to the Frankish King Theuderic (I (ca. 485-c. 533). Ginger appears there in only one recipe for the preparation of a young rabbit, with many other aromatic spices in addition to ginger.
In an apparently striking contradiction, in the following centuries ginger is found mostly in the West rather than in Byzantium. If ginger is indeed listed in a 6th-century imperial edict in Byzantium that fixed the maximal price of imported oriental substances, it is not markedly present in the medical literature of that time. In the West, instead, it enters in the composition of remedies listed in several Latin works: the medical treatises authored by the North-African Caelius Aurelianus (5th cent.) and the Gallic Marcellus (5th cent.), anonymous smaller works as the Latin Pseudo-Galenic Dynamidia (6th cent.) and the many antidotaria (books of antidotes) typical of Western medieval medicine from the 7th century onward, but especially in the 9th and 10th centuries, produced in Northern and Central Europe, in addition to the Latin translations of the Greek works by the Byzantine Oribasius (4th cent.) and Alexander of Tralles (6th cent.).  This strong presence in the West rather than in Byzantium is contradictory as Byzantium was closer to the ending points of the trade routes through which ginger reached the Mediterranean.
These recipes found in Western medical literature were for compound medicines in which ginger was just one among many other ingredients. Many such preparations can be qualified as broad-spectrum medicaments because they were not prepared for the treatment of any specific medical condition but were all-healing remedies. Some, however, targeted explicitly identified pathologies, organs, or more general medical conditions, all identified in a non-homogeneous way: cephalalgy, stomachache, pleurisy, liver and spleen, pulmonary affections, kidneys, gout, colic, intestines, arthritis, and also general bodily appearance. Some such recipes bore the name of the physician who created them, others the number of components they were made of, still others a term evoking their effect, and only a few the organ or medical condition they were supposed to treat. These recipes also included a toothpaste aromatized with ginger.
It seems significant that all the formulae for these medicines appear only in medieval receptaries and works.
Returning to Dioscorides after this survey of the uses of ginger from the 1st to the 10th century, it does not seem that ginger was already consumed in his time (the 1st century CE) as a bitter for aperitifs or in the preparation of vegetables. Even though ginger was traded in Rome and the Mediterranean World as early as the 1st century, it was not used as largely as it was later, with a noticeable transformation in its use from alimentation to medicine apparently towards the 5th century. This shift is exactly what we sense through the entry in De materia medica, where the culinary indications come first, and the therapeutic ones are limited to just one. It is highly probable thus that the entry on ginger in De materia medica is not an authentic piece of the original work, but a later introduction that reflected the expansion in course of the range of materia medica and the transformation in the use of ginger sometimes during the late 4th or 5th century. The use of ginger in aperitifs might not be a creation by either Apicius or any other 1st-century Roman individual trying to show off in Rome upper class (a cook, a wealthy citizen enjoying a luxury life or any other), or a more modest herbalist experimenting to better understand the benefits to be obtained from a plant newly introduced into the Mediterranean World, but possibly a Late-Antique creation whose author will remain anonymous.



Though frequently appearing in the formula of the compound medicines so typical of the medieval manuals of therapeutics, ginger is not credited with a specific indication or action, except in the entry of De materia medica relating its efficacy to treat shades on the pupil. The elucidation of ginger activity and uses came from the East.
Whereas De materia medica identified Arabia and Troglodytike as the origin of ginger, this is not the region where ginger grew. These two regions were in fact the arrival points of ginger from India to the entrance of the Red Sea, where the harbor of Berenike played a major role in the trade of oriental products to the Mediterranean. From there, these products were sailed up to the Mediterranean and they reached Constantinople where trading of ginger is confirmed from the 6th to the 10th century in legal documents fixing the maximal authorized price of spices. Further on, from Constantinople, they were shipped to Europe, most probably by sea, passing the strait of Gibraltar and sailing up to the north, reaching, among others, France and its harbors on the Atlantic. Pursuing up north they could arrive in the German countries and be further traded to North-Central Europe.
In the back of this commercial activity, the Eastern Mediterranean World, particularly the Arabic World from the 8th century onwards, acted as a broker. Trade went together with scientific study, and it is from the Arabic World that came the first complete medical analysis of ginger. It was compiled by the Arabic equivalent of the omniscient Galen, ibn Sina (980-1037), better known in the Middle Ages and Western historiography as Avicenna.
In the way of Galen, Avicenna characterized ginger in his Qanun (Canon) as a substance hot at the 3rd degree and dry at the 2nd. As for its therapeutic indications, he detailed them by organs or parts of the body:

It improves memory and eliminates the excess of liquid matter from the head and the throat.
It clears the darkness of eyesight due to excess of liquid when administered as either an eyeliner or a drink.
Digestive system
It is digestive and has a positive effect on a cold liver and stomach. It eliminates the excess of liquid in the stomach and the liquid resulting from the consumption of fruits.
Intestinal and reproductive systems
It is a laxative (even though some say it constipates) and is aphrodisiac.
Action against venoms
It counteracts insects’ venom.

This analysis became standard in the manuals of medical botany of the subsequent periods, particularly thanks to the translation into Latin of the Arabic scientific literature, including Avicenna’s Canon. The entry on ginger in the late medieval Tractatus de Herbis (Treatise on Medicinal Plants) is revealing. According to it, indeed, ginger, which is said to grow ultramarinibus partibus (literally overseas), treats throat sore and intellectual torpor, it alleviates stomachache and intestinal conditions (including tenesmus), it helps digestion, and it is useful in cases of syncope.

East and West, Gains and Losses

In its long journey from India to Norther Europe, from the 1st century to the 14th, ginger had a contrasted history, East and West, with gains and losses. Whereas it was already traded in the Roman World as early as the 1st century CE, it did not seem to have been much used until later, possibly the 4th century. Its history started in the culinary, rather than in the medical world in a way that should not be a surprise since food and medicine largely overlapped in the ancient world. Nevertheless, its consumption as an aperitif seems experimental and not rational; in any case, it contrasts sharply with its therapeutic administration in ophthalmology. And, pursuing with the paradoxes, intensive administration of ginger seems to have been more typical of the West (the Early Middle Ages) than of the East (Byzantium), even though some of the formulae in the medieval receptaries bear names of creators that are typically Greek. Trading of ginger had its center of gravity in the Eastern Mediterranean, indeed, on an axis from the Red Sea to Constantinople.
As for the therapeutic uses of ginger, there is a continuity from the entry in De materia medica (whatever its actual time and possible inclusion into Dioscorides’ authentic text) to the late medieval Tractatus, with a focus on the digestive system and the stimulation of digestion. The ophthalmic use attested in the Dioscoridean entry is repeated by Avicenna who clearly knew Dioscorides’ De materia medica, before disappearing in the following centuries. The typical use of ginger in the medieval formulae of compound medicines, which is not accounted for by any explicitly stated property but is probably justified by a general idea of ginger as a health promoting substance, is not maintained in the later literature.
Between East and West, gains and losses, ginger might be typical of the seduction of the substances from the land of spices, with attempts diversified according to the regions to explore the properties and optimize the uses of substances acquired at a high price on the international market.

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