R E S E A RC H E S S A Y | A. R. Ruis, University of Wisconsin, Madison
Pomegranate and the Mediation
of Balance in Early ...
Literate physicians and clergy were educated in similar ways
in many cultures, and there was often considerable overlap
represent fertility but also to suggest fundamental connec-
tions between fecundity and barrenness, life and death. The
on the nonnaturals adapted from an earlier work by Ibn
Butlan, claimed that ingestion of sweet pomegranate promotes
vida/ por los granosde mimuerte, / que gotas desangre son) (Graf
2007: 114). The last of The Hunt of the Unicorn tapestrie...
regarded as the source of blood (V.9–10). Acid pomegranate
juice, when dripped into the eyes of a patient just having con-...
Perhaps the oldest and most common use of pomegranate
involved the expulsion of tapeworms. The Ebers Papyrus, com-
posed i...
being of Arabic origin, had no etymological relationship with
“pomegranate”). The Reconquista unified Spain politically
Pomegranate fruit, characterized by its bountiful seeds, lent
itself to religious and literary metaphors linking the one a...
metaphor of the Catholic Church, whose members were held
together by a “diversity of merits” like the seeds in a pomegran-...
Culpeper, Nicholas. 2009. Culpeper’s Complete Herbal. London:
Dionysius Periegeta. 1943. Dionysii Ixeuticon seu ...
Suter, Ann. 2002. The Narcissus and the Pomegranate: An Archaeol-
ogy of the Homeric Hymn to Demeter. Ann Arbor: Universit...
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Pomegranate and the Mediation of Balance in Early Medicine

Different elements of the pomegranate, both tree and fruit, had a wide range of uses in pre-modern therapeutics. Pomegranate also had a rich symbolic role in the art, literature, and religion of numerous cultures. In nearly every part of the globe where the pomegranate grew, it came to represent fundamental dualities: life and death, inside and out, many and one. The medicinal purposes for which healers recommended pomegranate at times reflected broader symbolic associations, and those associations are an important part of the therapeutic tradition. The dualistic symbolism that attended the pomegranate in various cultural traditions synergized with dualistic medical concepts, reinforcing the therapeutic power of pomegranate in otherwise diverse contexts. Reflecting this duality, pomegranate was both an astringent and a laxative, an emmenagogue and an antimenorrhagic, an expectorant and an antiemetic, a pyrogen and a febrifuge, a restorative and a soporific. In both literary and medical traditions, the pomegranate mediated transitions—or maintained balance—between opposing states. This essay provides an overview of the rich and sundry uses of pomegranate in pre-modern therapeutics, revealing how cultural associations both reflected and informed medical practices.
Published on: Mar 4, 2016
Published in: Health & Medicine      

Transcripts - Pomegranate and the Mediation of Balance in Early Medicine

  • 1. R E S E A RC H E S S A Y | A. R. Ruis, University of Wisconsin, Madison Pomegranate and the Mediation of Balance in Early Medicine Abstract: Different elements of the pomegranate, both tree and fruit, had a wide range of uses in premodern therapeutics. Pomegranate also had a rich symbolic role in the art, literature, and religion of numerous cultures. In nearly every part of the globe where the pomegranate grew, it came to represent fundamental dualities: life and death, inside and out, many and one. The medicinal purposes for which healers recommended pomegranate at times reflected broader symbolic associations, and those associations are an impor- tant part of the therapeutic tradition. The dualistic symbolism that attended the pomegranate in various cultural traditions synergized with dualistic medical concepts, reinforcing the therapeutic power of pomegranate in otherwise diverse contexts. Reflecting this duality, pomegranate was both an astringent and a laxative, an emmena- gogue and an antimenorrhagic, an expectorant and an antiemetic, a pyrogen and a febrifuge, a restorative and a soporific. In both lit- erary and medical traditions, the pomegranate mediated transitions —or maintained balance—between opposing states. This essay provides an overview of the rich and sundry uses of pomegranate in premodern therapeutics, revealing how cultural associations both reflected and informed medical practices. Keywords: pomegranate, Punica granatum, medicine, materia med- ica, religion, duality, balance. Introduction different elements of the pomegranate, both tree and fruit, had a wide range of uses in premodern therapeutics. Pomegranate was employed to regulate the stomach and bowels, reduce fevers, staunch bleeding, prevent putrescence, and promote expectoration. It was a common ingredient in topical applications for abscesses, chilblains, ulcers, earache, and ocular afflictions. The root bark expelled tapeworms, and the tree bark repelled insects and vermin. The tough rind of the fruit had numerous uses as a pessary in the treatment of pro- lapses.1 Women (and likely men) employed the fruit in contra- ceptive applications, which was perhaps one of its earliest uses. What distinguishes the pomegranate from the hundreds of other plants that filled ancient herbals and formed the core of nonsurgical therapeutics was its symbolic importance in numerous religious and cultural contexts. The pomegranate is one of the seven fruits with which the Promised Land was blessed (Deuteronomy 8:7–8), Christians regarded it as a sym- bol of both Mary’s chastity and the resurrection of Jesus, and the ripening of the fruit is a sign for true believers in the Quran (VI:99). Pomegranates were frequently used in Zoroastrian rites as symbols of prosperity and the immortality of the soul. The pomegranate is one of the three abundances (三多) in Buddhism, and it is a totem of the Hindu god Ganesha, lord of beginnings. In literature, the pomegranate often symbolized fundamental dyads: life and death, mortal- ity and immortality, fertility and barrenness, growth and decay, inside and out, many and one. These symbolic associations, which were common in numerous and diverse cultures, synergized with an equally diverse range of medical practices. In both literary and med- ical traditions, the pomegranate mediated transitions—or maintained balance—between opposing states. Maintaining or restoring the balance between opposites, such as hot and cold, wet and dry, or retention and expulsion, was nearly universal in premodern medical epistemologies, as was the management of fertility (and infertility). The dualistic sym- bolism that attended the pomegranate in various literary and religious traditions synergized with dualistic medical con- cepts, reinforcing the therapeutic power of pomegranate in otherwise diverse contexts. Reflecting this duality, pomegran- ate served a wide range of often opposing functions in med- ical recipes. It was both an astringent and a laxative, an emmenagogue and an antimenorrhagic, an expectorant and an antiemetic, a pyrogen and a febrifuge, a restorative and a soporific.2 Furthermore, ingesting pomegranate was at times both helpful and harmful, and like many fruits, it occu- pied an ontological position somewhere between food and drug in many physiological theories. It is perhaps unsurprising that premodern medical texts displayed such homology with literary and religious texts. gastronomica: the journal of critical food studies, vol.15, no.1, pp.22–33, issn 1529-3262. © 2015 by the regents of the university of california. all rights reserved. please direct all requests for permission to photocopy or reproduce article content through the university of california press’s rights and permissions web site, http://www.ucpressjournals.com/reprintinfo.asp. doi: 10.1525/gfc.2015.15.1.22. GASTRONOMICA 22 SPRING2015
  • 2. Literate physicians and clergy were educated in similar ways in many cultures, and there was often considerable overlap in writing styles across genres, both scholastic and artistic (Longrigg 1963; Oppenheim 1962; Selby 2005; Sluiter 1994). But in the case of pomegranate, there are particularly clear connections between cultural or religious symbolism and medicinal use. Despite the pomegranate’s inclusion in nearly all major therapeutic systems, from the earliest written records to the early modern period, there was remarkable consistency in how it was employed in medicinal recipes. This can be explained in part by the extensive transmission and appropriation of medical texts, even across different cul- tures, languages, and epistemological frameworks, but it also suggests that the pomegranate, because of its consistent sym- bolism across numerous cultures, was an intelligible remedy in diverse medical systems. This is not to suggest that there are no biochemically active compounds in pomegranate that produce observable effects in the body. But the medicinal efficacy of a substance is based not on essential properties but on cultural and social understandings of its use in therapy or prevention. This essay provides an overview of the rich and sundry uses of pomegranate in premodern therapeutics, revealing how cultural associations both reflected and informed medical practices.3 Cycles: The Duality of Life and Death, Fertility and Barrenness The pomegranate’s oldest and deepest symbolic associations are with life, fertility, and reproduction. Both the fruit and the tree were common totems of maternal deities in particular. Inanna, a goddess worshipped by the Sumerians as the “Lady of Fruitfulness and Sexuality,” was depicted on a vase from circa 3100 BC adorned with wheat and pomegranates (Riddle 2010: 5 ff.). Kubaba, a Hittite mother goddess better known by her Phrygian name, Cybele, was at times portrayed holding a pomegranate, as were Tanit, Astarte, Hera, Athena, and Aph- rodite (Muthmann 1982: 13–14, 34–38). Even the Homeric word for pomegranate, ῥοιά, may have been etymologically related to Rhea, the daughter of Uranos and mother of six Olympian gods. Like Cybele and Gaea, Rhea was first revered as a universal mother goddess. Hariti, a Gandharan demoness who devoured children, became in Buddhist tradition a benef- icent guardian who eased childbirth, promoted familial har- mony, and protected the young; in some stories, it was the consumption of a pomegranate that turned her from eating the young to guarding them. She was invoked to cure disease, and was often depicted in Buddhist art with a child in her arms and a pomegranate, her personal symbol (Olson 1994: 86). The ancient and widespread association between pome- granate and fertility is not particularly surprising. Pomegran- ate fruit has numerous, prominent seeds, and it is the seeds and arils, the reproductive matter, that are eaten. The pome- granate tree was also the source of life-giving waters in Meso- potamian religion (Muthmann 1982: 13–14), and Neoassyrian seals often depicted pomegranate, the “tree of life” (Avigad 1990: 165). Scholars have suggested that the Tree of Life from the book of Genesis was a pomegranate because of this symbolic history, though of course many fruit-bearing trees have auditioned for this role. Nonetheless, the connection between pomegranate and the creation of life remained common in later Christian and Islamic traditions (Goor and Nurock 1968: 73).4 The pomegranate later became a dualistic symbol, as numerous ancient authors employed the fruit not only to FIGURE 1: Punicae (Pomegranate) from Plantae Selectae by Christoph Jacob Trew. Georg Dionysus Ehret, Nuremburg, Germany, ca. 1750–73, pl. LXXII. courtesy of luesther t. mertz library, nybg / art archive at art resource, ny. GASTRONOMICA 23 SPRING2015
  • 3. represent fertility but also to suggest fundamental connec- tions between fecundity and barrenness, life and death. The Hymn to Demeter, composed in Greece in the seventh cen- tury BC, introduced this more complex symbolism, for the pomegranate instigates not fertility or life but the suppression of it. Persephone, the daughter of Zeus and Demeter, is kid- napped by Hades and taken into the underworld. Although Demeter is able to secure the return of her daughter, Perseph- one eats some pomegranate seeds given to her by Hades before leaving his realm, condemning her to spend half the year in the world above and half in the world below. Ingestion of the pomegranate seeds leads not to fertility but to cyclical barrenness. (In some later versions, Persephone spends a month in Hades for each seed consumed, suggesting a more direct correlation between pomegranate and infertility or death.) This story is variously interpreted as an allegory of the agricultural cycle of growth and decay, of death and resurrec- tion, of the onset of menarche and the transition into wom- anhood, of the mother-daughter relationship, of the parallels between rape or marriage and death, and of fertility rites and sacred marriage (ἱερός γάμος), but regardless of interpreta- tion, the pomegranate had come to represent more than sim- ple fecundity (Arthur 1977; Bonner 1939; Myres 1938; Suter 2002; Tsiafakis 2001).5 The historian John Riddle has argued that the prophylac- tic properties of pomegranate were widely known by that time, for pomegranate “kept the virgin goddess Persephone from being fertile” (Riddle 1992: 26).6 Pomegranate was a traditional symbol of fertility and life, but ancient medical writers recommended it as a contraceptive. Soranus of Ephe- sus (fl. ca. AD 100) gave six recipes for contraceptive suppos- itories that contained pomegranate. For example, a woman could “grind the inside of a fresh pomegranate peel with water, and apply [it]” (Soranus’ Gynecology I.62). The Byzan- tine healer Aetius of Amida (fl. ca. AD 500) gave several formulae for vaginal suppositories that induce sterility, some of which involved pomegranate. (These were quite similar to the recipes given by Soranus.) Furthermore, he suggested that a man could rub his penis with pomegranate rind before coitus to prevent conception (Gynaecology and Obstetrics XVII). Such recipes were likely well known to women in the ancient world, and they were widely used and adapted thereafter (Totelin 2011).7 But while the pomegranate was symbolic of the loss of virginity (after the tale of Perseph- one), it could also be used to restore it. In the Trotula, a twelfth-century Latin compendium of women’s medicine and cosmetics, a powder prepared with pomegranate rinds (presumably included as a source of red color) and other ingredients, dissolved in warm water, could be applied to the opening of the uterus to create the illusion of virginity (Tro- tula 307). Despite the application of pomegranate as a contracep- tive and its association with death and barrenness in the tale of Persephone, the fruit remained a common token of love and fertility. “Let us go early to the vineyards,” wrote the author of the Song of Songs, “and if the pomegranates are in bloom, there I will give you my love” (Song of Songs 7:12). Roman artists juxtaposed embracing lovers with pomegra- nates (Riddle 2010: 51). In the Egyptian Jewish folktale “Romana,” an early version of the Snow White story, a mys- terious old woman gives a childless queen an enchanted pomegranate. If the queen eats half, the woman tells her, and her husband eats the other half, the queen will give birth to a girl within a year. The woman’s only condition is that they name the girl Romana ( ‫ﺭ‬‫ﻣ‬‫ـ‬‫ﺎ‬‫ﻧ‬‫ـ‬‫ﺔ‬ ), the Egyptian Arabic word for pomegranate (Schwartz 1986: 67–78). Pomegranates were also a common symbol of fertility in the wedding rites of the Bedouin, Chinese, Greeks, Indians, Persians, and Romans, among others. In Buddhist tradition, the pomegranate is one of the three abundances, along with the peach and the Buddha’s Hand citron, and it represents the abundance of offspring. The Chinese expression 多子 means both “many seeds” and “many sons,” a pun linking the fruit to fecundity. Although used as a contraceptive in suppositories and topical applications, medical writers at times promoted inges- tion of pomegranate as an aphrodisiac, reflecting its complex metaphorical relationship with fertility. For example, the Tacuinum Sanitatis, a widely copied thirteenth-century work FIGURE 2: Detail from the Book of the Dead of Hirweben ca. 1075–945 BC (21st Dynasty). courtesy of alfredo dagli orti / art archive at art resource, ny. GASTRONOMICA 24 SPRING2015
  • 4. on the nonnaturals adapted from an earlier work by Ibn Butlan, claimed that ingestion of sweet pomegranate promotes coitus (Lie`ge: f. 4v, Paris: f. 5). Of course, virtually all foods were deemed to have aphrodisiac properties at one time or another—encouraging copulation, it turns out, is not particu- larly difficult. But in the case of the pomegranate, this further emphasized the fruit’s role in the mediation of fertility. The intricate relationship between pomegranates and (in)fertility was widely adopted and developed in Western literature. In a second-century AD version of the story of Side (σίδη is the Boeotian word for pomegranate), she is a young virgin who commits suicide to avoid being raped by her father; the blood she sheds on her mother’s grave yields a pomegranate tree (Dionysius Periegeta, De Aucupio I.7). In this inversion of the Hymn to Demeter, the reunion of mother and daughter in death produces pomegranates, the very fruit that prevented Persephone from reuniting with Demeter. Persephone’s consumption of the seeds, which can create life, instead condemns her to a living death; Side’s death, in contrast, becomes the seed of new life. In both stories, the pomegranate mediates the transition between life and death, girl and woman, fertility and infertility. “The Tale of Pomegranate-Flower and Badr Basim” from the Arabian Nights collection employs a similar construction, creating a complex correspondence between marriage and rape, life and death. A childless king receives a virgin slave who does not talk, even after he spends a year with her to the exclusion of his wives and duties as a ruler. When she does finally speak, it is to tell him that she is pregnant. Julnar ( ‫ﺟ‬‫ـ‬‫ـ‬‫ﻠ‬‫ـ‬‫ﻨ‬‫ـ‬‫ﺎ‬‫ﺭ‬ , pomegranate blossom) informs the king that she is the daughter of the lord of the sea. She came onto the land in search of a new life, and the first thing she did was fight off a would-be rapist. She tells the king that his first “violence” nearly compelled her to throw herself back into the sea, but she remained out of pride. As her brother remarks later in the story, “For a girl there is but marriage or the tomb” (The Tale of Pomegranate Flower: 35). This theme is even more pro- nounced in Romeo and Juliet. In Act III, the nightingale sings in a pomegranate tree (III.5: 1–5), suggesting a parallel between Juliet and Persephone. Juliet had already drawn an association between death and marriage in the first act, when she says of Romeo, “If he be married, / My grave is like to be my wedding-bed” (I.5: 134–35), and the imagery of the pome- granate tree reinforces the connection between the loss of virginity and death (Watson and Dickey 2005: 140ff.). The juxtaposition of the pomegranate with marriage or rape (which are not always distinct events in early literature) reveals further intricacies in the fruit’s symbolic uses. Sexual intercourse in this context represented both life (the potential to conceive) and death (the loss of innocence). Indeed, pome- granates were used in both wedding and funeral rites in a number of ancient cultures (Bennett 2011). What unites Persephone, Side, Julnar, and Juliette is not their circum- stances, per se, but their ages; each of them is faced with a sexual experience, namely the loss of virginity, that repre- sents their transformation from girls into women. In each of the stories, the pomegranate suggests transition, couched in the duality of maiden and matron, and the protagonist must choose between remaining a child or becoming a woman. In addition to life, fertility, and birth, pomegranates also represented immortality and resurrection or rebirth. The Babylonians ate pomegranate seeds, an agent of resurrection, for longevity (Mahdihassan 1984: 37). According to Herodo- tus, the elite Persian soldiers known as The Immortals carried weapons adorned with pomegranates when the armies of Xerxes invaded Greece in 480 BC. One thousand warriors bore spears “with golden pomegranates instead of spikes” on the butts; another nine thousand carried spears with silver pomegranates (Herodotus, The Histories VII.41). Aaron’s robe in the book of Exodus is adorned with pomegranates and golden bells, and if he wears it when he ministers, he will not die (Exodus 28:33–35). Chinese scholars during the Six Dynasties period (AD 222–589) referred to pomegranate blos- soms as longevity flowers (延年花), and Daoists associated the fruit with immortality (Fang 2004: 154; Harper 1986: 143). When Isfandiyar eats a pomegranate consecrated by the prophet Zaratust in the Zaratust Name, a thirteenth-century Zoroastrian poem, he becomes invincible like “stone and bronze” (Boyce 1984: 60). The pomegranate symbolized eter- nity in Zoroastrianism, and it was “the most highly prized of the fruits that are blessed” (Boyce 1975: 281). The association between pomegranate and resurrection, or the cycle of life and death, was already strong in the tale of Persephone, and it became even stronger in the art and liter- ature of European Christians. Sandro Botticelli’s Madonna della Melagrana depicts the Virgin Mary and an infant Jesus jointly holding a pomegranate.8 The pomegranate connects Mary to the ancient mother goddesses as an icon of divine fertility, but paradoxically it also represents her chastity. Fur- thermore, the pomegranate references the resurrection of Jesus. Like Persephone, who inhabits both the land of the living and the land of the dead, Jesus has two natures for Christians, one mortal and one divine. The pomegranate also reflects the torments of Jesus on the cross, for the fruit “bleeds” when opened. In Juan de Dios y Anto´n Martı´n, a play written by Lope de Vega circa 1610, the split pomegranate is the fruit of Juan’s life from the seeds of Christ’s death, seeds that are but drops of blood (esta granada partida / tiene el fruto de tu GASTRONOMICA 25 SPRING2015
  • 5. vida/ por los granosde mimuerte, / que gotas desangre son) (Graf 2007: 114). The last of The Hunt of the Unicorn tapestries depicts thebleedingandimmobilizedunicornsittingbeneathastylized pomegranate tree, a clear reference to the suffering of Jesus. In many pagan mythologies, however, the unicorn represented virginity and purity, and so the tapestry also suggests the associa- tions between the pomegranate and the lossofinnocence, recal- ling the Hymn to Demeter and other stories. In numerous cultures, the pomegranate symbolized cycli- cal, dualistic relationships between life and death, fertility and barrenness, childhood and motherhood. Importantly, the pomegranate often mediated these dualities, serving to govern the transition from one part of a dyad to the other. Medicinal use of the pomegranate as both a contraceptive and an aph- rodisiac reinforced and was reinforced by this transformative narrative. But while pomegranate mediated transitions between mutually exclusive states, it also established balance between antagonistic forces. Balance: The Duality of Hot and Cold, Retention and Expulsion Pomegranate enflamed the passions and represented the heat of sexual ardor, but healers also employed it as a cooling agent, especially in the treatment of deadly fevers. Acid pome- granates were more cooling (ψυκτικώτεραι) than sweet pome- granates according to Hippocratic healers (On Regimen II.55, Littre´ VI.562), who employed the juice to treat fevers (Epi- demics VII, Littre´ V.436).9 Aulus Cornelius Celsus, a Roman physician who flourished in the early first century AD, wrote that pomegranate repressed and cooled (reprimunt et refriger- ant) (De Medicina II.33:2). This attribute was particularly helpful in the treatment of smallpox and other deadly febrile diseases. The Persian polymath and physician Al-Razi (Muhammad ibn Zakariya al-Razi, AD 865–925) recommended that those who had not yet contracted smallpox “frequently eat acid pomegranates, and suck the inspissated juices of acid and styp- tic fruits, as of pomegranates,” to dissipate heat (A Treatise on the Small-Pox and Measles V.2). A maceration containing rose water, vinegar, pomegranate peels, and pomegranate flowers reduced heat in the blood and the liver, the organ widely FIGURE 4: ‘‘The Unicorn in Captivity,’’ the seventh of the seven tapestries in The Hunt of the Unicorn, woven in the Netherlands between 1495 and 1505. The Cloisters, New York City. courtesy of the metropolitan museum of art / art archive at art resource, ny. FIGURE 3: Sandro Botticelli, Madonna della Melagrana, ca. 1487. Uffizi Gallery, Florence, Italy. courtesy of erich lessing / art archive at art resource, ny. GASTRONOMICA 26 SPRING2015
  • 6. regarded as the source of blood (V.9–10). Acid pomegranate juice, when dripped into the eyes of a patient just having con- tracted smallpox, prevented the development of pustules in the eyes (VII.1–2). The latter treatment recalled a much older Assyrian prescription: “If a man’s eyes are full of yellow rheum, thou shalt bray pomegranate-skin [and apply it]” (Thompson 1926: 44).10 In Abolqasem Ferdowsi’s Shahnameh, the Persian Book of Kings, the physician Khorad-Borzin uses pomegranate juice and cress to cure the empress’s daughter of a “fever in her brain” (Shahnameh, “The Reign of Khosrow Parviz,” 795). Such practices were embraced even beyond the healing encounter. Sitala, the North Indian goddess of smallpox, was at times depicted with a pomegranate, which symbolized cooling. Typically called Mata, or mother, women prayed to her and offered her cooling drinks to protect their chil- dren from the ravages of smallpox, especially the intense heat of fever, which was the symptom most likely to cause death. In India, Pakistan, Bangladesh, and Nepal, many believed that Sitala used her hosts (those with smallpox) to rid herself of heat and restore her coolness, the very action that pomegranate achieved in the fevered body (Arnold 1993: 121–25; Slusser 1972: 100–4). The pomegranate’s antipyretic properties were a different aspect of the duality of life and death. In this context, the fruit maintained the balance between hot and cold, a common element of all ancient medical epistemologies. Pomegranate allowed the goddess to shed her heat, and thus live, while saving the smallpox victim from death. Pomegranate was employed to regulate balance in other ways as well, particularly in the regulation of the stomach and bowels, the treatment of hemorrhage, and the expulsion of tapeworms. The fruit was either a laxative or an astringent, depending on which parts were ingested. In the Hippocratic treatise On Affections, the pomegranate, when eaten with its seeds, was astringent, but taken without them, it was laxative (On Affections, Littre´ VI.264).11 Pomegranate was also a com- mon ingredient in Ayurvedic remedies for severe diarrhea (Sharma 1996: 179). In fact, the use of pomegranate to regulate the bowels was so common that even in regions where the tree did not grow particularly well, such as Britain, it was included in materia medica. The fifteenth-century Middle-English trans- lation of the Compendium Medicinae, originally composed by Gilbertus Anglicus in Latin sometime in the early thirteenth century, relates that the bark of a pomegranate tree (psidie) treated “a flux of dissenterie” (f. 258v–259), suggesting that pomegranate was a remedy important enough to remain in the text even after redaction (Healing and Society 1991). The astringent properties of pomegranate also made it a valuable antihemorrhagic. The Hippocratic author of On Affections recommended sweet pomegranate for poultices used to treat inflamed wounds (τὰ φλεγμαίνοντα) (On Affec- tions, Littre´ VI.248), and this may have been Assyrian practice as well (Thompson 1926: 63–64). Dioscorides suggested that pomegranate blossoms (κύτινοι) would achieve the same end (De Materia Medica I.110: 3), and Celsus regarded the flowers as gentle corrosives that arrested putrescence (De Medicina V.22: 2; cf. Al-Kindi, Medical Formulary 86, f. 109b; 128, f. 119b). Furthermore, pomegranate reduced menorrhagia. Accord- ing to Aetius, wild pomegranate blossoms were one of the “stronger” remedies for heavy menstruation, and a bath with decocted pomegranate rinds treated red uterine discharge (Gynaecology and Obstetrics LXIV).12 Nicholas Culpeper’s seventeenth-century herbal, perhaps the most widely used in the English language, recommended pomegranate seeds and rinds, “whether the powder or the decoction be taken,” to “stay…women’s menses” (Culpeper 2009: 301). As with the regulation of the bowels, though, the pomegranate was also used to induce menstruation. The Hippocratic treatise On the Nature of Women, for example, gives numerous recipes con- taining pomegranate to treat amenorrhagia (On the Nature of Women, Littre´ VII.324, VII.356). Controlling the retention and expulsion of fluids, the bal- ance of hot and cold, and other fundamental relationships in the body was a central element of Greco-Arabic humoral, Ayurvedic, Siddha, and traditional Chinese and Tibetan medical systems, suggesting one reason for the pomegranate’s widespread adoption. In some Ayurvedic systems, for exam- ple, health and illness were based on the interrelationship of the three vital elements (दोष), the seven bodily constituents (धातु), and the three waste products (मअ);13 maintaining the balance of these within the body as well as the balance between the body and its environment was a central goal of medical practice (“Vagbhata’s Heart of Medicine” 2003: 206). Of course there were many concepts of balance, even within the same tradition. In Hippocratic medicine, the authors of On Regimen and Diseases IV characterized the body as being in a perpetual state of flux, with health being a state of dynamic equilibrium and disease a state of exaggerated or prolonged disequilibrium. The author of On the Nature of Man, in contrast, suggested that the body remained in a state of static balance until something disrupted it. Pomegranate, which depending on application could induce either the retention or expulsion of fluids, heating or cooling, was a par- ticularly powerful therapeutic agent across otherwise diverse medical frameworks in part because the maintenance or res- toration of balance was such an important element of health in the medical theories of the premodern world. GASTRONOMICA 27 SPRING2015
  • 7. Perhaps the oldest and most common use of pomegranate involved the expulsion of tapeworms. The Ebers Papyrus, com- posed in Egypt around 1550 BC, recommended a concoction involving pomegranate root to kill hefat-worms. The specific kindofintestinalwormreferred tobyhefat isnot known, though presumably it was a tapeworm (Nunn 1996: 72). According to Dioscorides, the decoction of pomegranate root killed and expelled tapeworms (ἕλμεις τὰς πλατείας ποθὲν ἐκτινάσσει καὶ ἀποκτείνει) (De Materia Medica I.110: 3; cf. Paul of Aegina IV.57), and the remedy was widely repeated in pharmacopias. The use of pomegranate root as a vermifuge was nearly universal. The Compendium of Materia Medica (本草綱目), composed by Li Shizhen (李時珍) in the late sixteenth cen- tury, contained numerous cures for tapeworms (寸白虫病). In one, Li suggested harvesting a handful of eastward-growing sour pomegranate roots that were not cut with an iron tool. After boiling the roots in three pints of water until only about one-sixth of the liquid remained, the resulting drink, if taken just before dawn, would completely expel all the worms. (The admonition against use of an iron tool when harvesting the roots may have ensured that the astringent tannins were not affected [Read 1931: 645–46, 651 n. 4].) The pomegranate (安石榴), introduced to China no later than the third cen- tury AD, was likely used in such treatments long before the sixteenth century. According to Tao Hongjing (陶弘景, AD 456–536), a botanist of some repute, healers in the Six Dynasties period were already using the roots of sour pome- granate in their work (Harper 1986: 140). Some remedies, however, particularly those that had crossed cultural boundaries, were not as reliable. The Roman naturalist Pliny (AD 23–79), who received most of his informa- tion from travelers and other secondhand sources, reported that both the fruit and the blossoms of the pomegranate neu- tralize scorpion stings (Natural History XXIII.59–60). Unbe- knownst to Pliny, this was not a medical practice but rather a religious ritual. During the Zoroastrian festival of Isfanda- gan, a festival celebrating women, pomegranate seeds and raisins were mashed together and eaten to nullify scorpion poison, but this was not a medical antidote, only a symbolic one (Flattery and Schwartz 1989: 79). Nonetheless, such rem- edies were widely repeated in pharmacopias (cf. Culpeper 2009: 301), particularly in areas where scorpion stings were an unlikely occurrence. Although the pomegranate’s cultural roles and medical applications often shared common ele- ments, which may have encouraged use of the pomegranate across many medical systems, the conflation of symbolic and therapeutic practices also led to misappropriations. The ubiquity of concepts of balance in most premodern medical systems and the pomegranate’s symbolic role as a mediator between opposites enabled the pomegranate to bridge the medical and the literary even across cultures. But while the homology between cultural and medical practices lent the pomegranate therapeutic intelligibility across time and place, it also at times blurred the distinction between ritual and therapy, as the example of scorpion antivenom reveals. The similarly blurry distinction between food and drug—and between drug and poison—in premodern medical systems also aligned with symbolic uses of the pomegranate, whose many prominent seeds in a single rind was often employed to represent synecdochal relationships. Synecdoche: The Duality of Inside and Out, Many and One The pomegranate’s wide range of medicinal uses stemmed from its numerous parts (the roots, bark, and blossoms of the tree and the rind, arils, and seeds of the fruit), each of which had different properties in premodern therapeutics. Among its other symbolic associations, the pomegranate represented the superposition of inside and out, many and one. John Chrysostom, one of the Nicene fathers, likened vainglory (κενοδοξία) to a pomegranate: “Vainglory…has a fair sem- blance and the beholder, as he views it, receives the impres- sion of wholesome fruit. But if he takes in his hand a pomegranate or apple, straightaway it is soft to his fingers and the rind that covers it outside is crushed and lets the fingers light upon dust and ashes” (John Chrysostom 1951: 87). Although the metaphorical duality of life (the “whole- some fruit”) and death (the “dust and ashes”) was already ancient in the fourth century AD, John employed a different dimension in the traditional trope by using the pomegranate to symbolize that which is one thing without and another within. The Spanish rabbi Moses de Leo´n (fl. ca. 1280) sug- gested that all Jews contain the commandments as the pome- granate contains seeds, and the pomegranate also represented the Shekhinah ( ‫ה‬‫ש‬‫כ‬‫י‬‫נ‬ ), the divine presence, which similarly contains all the commandments (Book of the Pomegranate 1988: 19). This use of the fruit to symbolize part-to-whole relation- ships was especially pronounced, as the literary scholar E. C. Graf has argued, in late medieval and early modern Spain. In 1492, Queen Isabella and King Ferdinand ended the Recon- quista of Spain when they conquered Granada, the last Islamic stronghold in Andalusia. Just before the city fell, Ferdinand allegedly swore, “I will take down one by one the seeds of that pomegranate” (Yo arrancare´ uno a uno los granos de esa granada), a linguistic pun on the name of the city (which, GASTRONOMICA 28 SPRING2015
  • 8. being of Arabic origin, had no etymological relationship with “pomegranate”). The Reconquista unified Spain politically but did nothing to stem cultural strife and interethnic violence. Once the most cosmopolitan region of Europe, Spain became instead a cauldron of conflict. In Don Quixote (El Ingenioso Hidalgo Don Quijote de la Mancha), Graf argues, Cervantes used the pomegranate as a symbol of both the cultural and ethnic diversity of Spain and the Christian concept of “social harmony through sacrifice,” the idea that unity can emerge from diversity, to suggest that unification should celebrate rather than suppress dissimilar parts to create a better whole (Graf 2007: 105, 113). This use of the pomegranate as a symbol for the unity that can arise from diversity was well established in the writings of the early Catholic Church fathers. “What is signified by pomegranates other than the unity of faith?” posed Pope Gre- gory the Great in AD 591. “For just as in the pomegranate many inner grains are covered by a single exterior peel, even so countless members of the Holy Church are covered by the unity of the faith, members held within by a diversity of merits” (Letter I.24, addressed to John of Constantinople et al.). In medicine, too, the pomegranate represented multiplic- ity in unity. Many ancient languages did not contain clear demarcations between substances that nourish, those that heal, and those that harm. Much like the modern “drug,” which has both positive and negative connotations, words like φάρμακον, venenum, and 藥 connoted alterative powers with no intrinsic valuation, either good or bad. In cases where “poison” and “medicine” were linguistically distinct, as in Sanskrit and the Semitic languages, the underlying connota- tive distinctions depended on context. As the Sanskrit word विषप्रयोग (to poison, but also to use a poison as medicine) sug- gests, linguistic distinctions did not necessarily connote con- ceptual ones. The divisions that separated food, medicine, and toxin were neither categorical nor crudely quantitative (Amigues 2001; Flint-Hamilton 1999; Gibbs 2009; Touwaide 1991).14 Manipulation of the diet was a key element of both the maintenance and the restoration of health in every ancient medical system, and the linkage between “food” and “nourishment” was typically fluid and contingent. In many cases, the pomegranate occupied a more significant role as a medicine than as a food, its benefits transcending the merely nutritive. Indeed, medical authorities disagreed about whether pomegranate provided any nourishment at all. The Bunda- hisˇn, a Zoroastrian cosmology and cosmogony, regarded pomegranates as fit to eat (Laufer 1919: 192), and they were used extensively in Persian, South Asian, Arab, and Near Eastern cuisines. But a number of ancient medical writers were openly dubious about the nutritive value of the fruit (and, indeed, of fruits more generally). Celsus considered pomegranates one of the many foods that were good for the stomach (stomacho autem aptissima sunt) (De Medicina II.24); it is unclear whether he meant this in the nutritive or the medicinal sense, though it was most likely the latter. Less equivocally, Dioscorides claimed that the fruit was good for the stomach but not nourishing (εὐστόμαχος ἄτροφος) (De Materia Medica I.110: 1), a view adopted by Galen and repeated by Oribasius and Moses Maimonides (Galen, On the Properties of Foodstuffs 605; Oribasius, Med- ical Compilations I.51; Maimonides, The Regimen of Health IV.14). The Persian scholar and physician Ibn Sina (ca. 980– 1037) deemed the pomegranate, like all fruits, to offer only “feeble” nourishment (Canon of Medicine I.359–60). This view remained common into the early modern era, as Cul- peper’s herbal suggests: “[pomegranates] yield but slender nourishment; they are very helpful to the stomach” (Culpe- per 2009: 301). In Chinese medicine, pomegranate had complex effects on the body that were neither exclusively medicinal nor exclusively nutritive. The Six Dynasties dietitian Cui Yuxi (崔禹錫) warned that ingestion of the seeds would reduce one’s vitality (精), and Tao Hongjing reported that the seeds were better left uneaten (Harper 1986: 140, 142).15 The Syn- opsis of Prescriptions of the Golden Chamber (金匱要略), attributed to Zhang Zhongjing (張仲景, AD 150–219) but first published during the Northern Song Dynasty (AD 960–1127), proscribed immoderate consumption of fruits, which could lead to pathologic conditions. Pomegranates, if eaten to excess, would harm the lungs (損人肺) (Synopsis of Prescrip- tions of the Golden Chamber XXV.12; cf. Hu, What Is Desir- able and Appropriate in Food and Drink III.35A). However, the distinction between food and medicine remained blurry. The dietetic treatise What Is Desirable and Appropriate in Food and Drink (飮膳正要), written during the Yuan Dynasty (1271–1368) by the Turkic court physician Hu Sihui (忽思慧), was both cookbook and pharmacopia. One of the recipes, a pomegranate soup with mutton, cardamom, cin- namon, and ginger, “treats a cold void in the primary recep- tacle, cold pain in the belly, and aching pain in the lower spine” (治元藏虛冷腹內冷痛腰脊酸疼) (I.41A).16 Hu also noted that pomegranates lack poison (毒) and stem leaking vitality (止漏精) (III.35A). This provides yet another exam- ple of the complexity intrinsic to the pomegranate’s thera- peutic uses. Where Cui Yuxi regarded the fruit as a food that reduces vitality, Hu Sihui suggested that it prevents such reduction. GASTRONOMICA 29 SPRING2015
  • 9. Pomegranate fruit, characterized by its bountiful seeds, lent itself to religious and literary metaphors linking the one and the many, the part and the whole. As food or medicine, pomegran- ate had complex effects on the body in premodern therapeutics. Depending on the part of the plant used and the preparation method, pomegranate could produce different, even opposite, therapeutic effects. The plant and the fruit it bore were a verita- ble pharmacopia unto themselves, one source of numerous remedies—a source that has continued to fascinate those seek- ing new therapeutic agents in old practices. Conclusion Interest in the medicinal properties of pomegranate contin- ued into the modern era, both as a result of the sustained popularity of traditional healing systems and because coloni- zation, exploration, and global traffic expanded the transmis- sion and appropriation of medical and botanical knowledge. As late as the 1880s, for example, English physicians were still “discovering” uses for pomegranate. “I found that whenever a young child lost its appetite, had more or less irregular bowels, somewhat tumid belly, was peevish by day and rest- less by night, when it was wasting in flesh, and the symptoms were negative as to worms or fevers,” wrote Brigade Surgeon Edward Nicholson who served in India, “the decoction of pomegranate root invariably effected a cure” (Nicholson 1886: 364). Soldiers in the American Civil War also were aware of the pomegranate’s medicinal properties. “A decoc- tion of the blackberry root and the rind of the pomegranate fruit boiled in milk,” wrote a pharmacist from Atlanta in 1898, “was a common remedy in diarrhoea” (Jacobs 1905). Today, this interest in the medicinal properties of pome- granate is experiencing something of a renaissance. Fewer than thirty scientific or medical papers were published on pome- granate in the late twentieth century, but nearly double that number now appear every year. Studies of pomegranate extracts in vitro have revealed a wide range of bioactive com- pounds. Chemicals that have antiatherogenic, antibiotic, anti- carcinogenic, antihypertensive, anti-inflammatory, antioxidant, astringent, estrogenic, neuroprotective, spermatogenic, and vermifugic properties have been isolated, and the actions of many of these compounds reflect medical practices thousands of years old (Jurenka 2008; Lansky and Newman 2007; Seeram et al. 2006). Researchers worldwide are now seeking to learn if pomegranate can play a significant role in yet one more med- ical system: twenty-first-century biomedicine. Indeed this interest, both ancient and modern, in the medicinal properties of pomegranate has led to its use as a symbol of medicine itself. Along with the staff of Asclepius, the caduceus, and the red cross, the pomegranate is a widely employed device in medical iconography. The insignias of the British Medical Association, the Royal Colleges of Physi- cians, Anaesthetists, Midwives, and Obstetricians & Gynae- cologists, the Royal Australasian College of Physicians, the Brothers Hospitallers of St. John of God, and the U.S. Army’s 61st Surgical Hospital all feature pomegranate, and the fruit was the logo for the Millennium Festival of Medicine. This use of the plant and its fruit in medical iconography reflects the historical role of the pomegranate both in therapeutics and as a religious and political symbol, as well as the current revival of interest in pomegranate-based therapeutics. Although the medical evidence is at best inconclusive, the concept of “superfoods” with intrinsically healthful properties has captured the popular and scientific imagination. Every- thing from berries to yogurt, liver to mushrooms, phytoplank- ton to microgreens, and of course pomegranate, has been labeled at one time or another a superfood, with spending on research in the botanic pharmaceutical industry well over $20 billion a year worldwide. But while many premodern writers regarded pomegranate as a medicine yet doubted its nutritive value, today the fruit is a nutritious food whose medicinal properties are investigated and debated. In bridg- ing historic and modern anxieties about health and diet, the pomegranate is even now a symbol of duality. As in Gregory’s FIGURE 5: Stained glass window in the Museum of the History of Science, Oxford, England, depicting the crest of the Royal College of Physicians, 1929. ‘‘stained glass - royal college of physicians crest,’’ by andrew gray used under cc 3.0, http://commons.wikimedia.org/wiki/file:stained_glass_-_royal_college_of_ physicians_crest.jpg. GASTRONOMICA 30 SPRING2015
  • 10. metaphor of the Catholic Church, whose members were held together by a “diversity of merits” like the seeds in a pomegran- ate, scientists and physicians continue to seek a “diversity of merits” in the pomegranate’s many bioactive compounds. Acknowledgments Research for this work was generously supported by a grant from POM Wonderful. The opinions, findings, and conclu- sions expressed in this work are those of the author and do not reflect the views of POM Wonderful or its subsidiaries. Rima Apple, Fred Gibbs, Ari Mackler, and two anonymous reviewers provided many insightful suggestions and criti- cisms, and Brad Schantz patiently answered numerous ques- tions about Semitic linguistics and etymology. notes 1. A pessary is a rigid or semi-rigid spheroidal object inserted into the vagina to treat and provide support for a prolapsed uterus. 2. Astringents reduce the discharge of fluid from the digestive tract, and laxatives increase it; emmenagogues stimulate the flow of mentrual blood, and antimenorrhagics reduce it; expectorants encourage the discharge of fluid from the respiratory tract, and antiemetics prevent the discharge of fluids from the digestive tract; pyrogens induce fevers and febrifuges reduce them; restoratives reinvigorate the body and soporifics induce sleep. 3. Wherever possible, I cite accessible, modern editions of the texts to include as wide a base of source material as possible. I leave it to others with expertise in the respective cultural-linguistic traditions to explore issues of paleography, textual criticism, and manuscript tra- dition. Translations are my own unless otherwise noted. 4. Riddle argues that the Tree of Knowledge was a pomegranate (and thus so was the fruit that Eve ate), but he provides no direct evidence for this assertion, and the circumstantial evidence is unconvincing. 5. An alternate version of the story can be found in Ovid, Metamorphoses V.387–658. In Ovid’s version, Proserpina eats seven pomegranate seeds (the number is unspecified in the Hymn to Demeter). In the unfinished De Raptu Proserpinae by Claudianus (fl. ca. AD 400), Zeus gives Persephone to Hades as a bride to prevent war between the gods above and the underworld. Zeus warns her not to eat anything, but she eats pomegranate anyway. The Persephone stories also recalled elements of the myth of Attis, whose mother conceived by putting to her breast a pomegranate grown from the severed penis of the intersex being Agdistis. In these stories, too, the pomegranate was explicitly linked to the cycle of fertility and infertility. 6. In Goddesses, Elixirs, and Witches, Riddle argues that there is evidence for the use of pomegranate as a contraceptive in Mesopotamia and Near Eastern cultures as far back as there are written records. 7. The use of pomegranate as a contraceptive appears in the works of Al-Razi, Ibn Sina, and Al-Jurjani, among others. 8. Lorenzo di Credi painted a similar work, the Madonna and Child with a Pomegranate, sometime between 1475 and 1480, and it became a common theme in Renaissance art. 9. Paul of Aegina considered acid pomegranates more cooling than sweet pomegranates and the seeds more astringent than the juice or rind (The Seven Books of Paulus Aegineta, 319). 10. To bray is to grind up or crush, as with a mortar and pestle. Ibn Ridwan (AD 998–ca.1061) devised a recipe using both sweet and sour pomegranates that “preserves the body in the time of a pestilence.” He also cited a recipe composed by Ibn Masawayh that “is useful for high fevers in an epidemic and opens obstructions” and another by Ibn al-Jazzar that “is astonishing in its effect during a pestilence and for erysipelas, smallpox, and measles”; both recipes employed the juice only of sour pomegranates (Medieval Islamic Medicine 1984: 144–46). 11. See also Epidemics VII, Littre´ 450; Dioscorides, De Materia Medica I.110:2; Celsus, De Medicina IV.26:9; Pliny, Natural History XX.53:149–50, XXIII.57–60; Al-Razi, A Treatise on the Small-Pox and Measles XII.1, XIII.1. 12. A decoction is a liquid concentrate produced by boiling something in liquid. 13. The three elements are air, bile, and phlegm; the seven bodily constituents are lymph, blood, flesh, fat, bone, marrow, and semen; and the three waste products are urine, feces, and sweat. 14. 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