P. Sarischouli - Hope For Cure and The Placebo Effect

TC 2021; 13(1): 254–284
Panagiota Sarischouli*
Hope for Cure and the Placebo Effect:
The Case of the Greco-Egyptian Iatromagical
Formularies
https://doi.org/10.1515/tc-2021-0009
Abstract: The present paper focuses on healing rituals from Greco-Roman Egypt,
where medicine and religion were inextricably linked to each other and further
connected to the art of magic. In Pharaonic Egypt, healing magic was espe-
cially attributed to the priests who served a fearsome goddess named Sekhmet;
although Sekhmet was associated with war and retribution, she was also believed
to be able to avert plague and cure disease. It then comes as no surprise that
the majority of healing spells or other types of iatromagical papyri dating from
the Roman period are written in Demotic, following a long tradition of ancient
Egyptian curative magic. The extant healing rituals written in Greek also show
substantial Egyptian influence in both methodological structure and motifs, thus
confirming the widely accepted assumption that many features of Greco-Egyp-
tian magic were actually inherited from their ancient antecedents. What is par-
ticularly interesting about these texts is that, in many cases, they contain magical
rites combined with basic elements of real medical treatment. Obviously, magic
was not simply expected to serve as a substitute for medical cure, but was rather
seen as a complementary treatment in order to balance the effect of fear, on the
one hand, and the flame of hope, on the other.
Keywords: Placebo, Egyptian, iatromagical, papyri, healing, magic
*Corresponding author: Panagiota Sarischouli, Aristotle University of Thessaloniki,

E-Mail: psarisch@lit.auth.gr
Hope for Cure and the Placebo Effect 255
Preliminary considerations: Religion, Magic, and

Medicine in Ancient Egypt
In Egyptian tradition1 (similar to many ancient cultures),2 magical rituals were
generally thought to border on the domain of religion, or – at least – on reli-
gion’s private facets, insofar as they concerned private and not public issues.3
This is easily understood when we recall that magic4 has been a fundamental
feature of Egyptian culture from its very beginning: Ancient Egyptians believed
that Creation itself had come into being through ḥk3 (heka), an Egyptian word
which is usually translated as ‘magical power’ or simply ‘magic’.5 The creator
gods were credited with the invention and use of magic, but all deities as well
as lesser supernatural beings (such as the spirits of the dead) were believed to
possess their own ḥk3, which was neither good nor bad, as Egyptian magic was
completely amoral. Moreover, as the Pharaohs were considered to be the sons of
gods,6 they were also automatically thought to have ḥk3; in fact, already in the
Pyramid Texts the king is referred to as a ḥk3w (hekau, usually rendered as ‘pos-
sessor of magic’),7 and anything that came from him (such as his nails or his hair
clippings) was thought to be imbued with magic.
Like magic, the art of medicine was also intermingled with religious awe in
ancient Egypt.8 We can find at least three different priestly classes associated
with medicine, although the exact division of their tasks remains debatable:9
1 I would like to thank Nils H. Korsvoll and Korshi Dosoo for their helpful comments on former
drafts of this article.
2 For the interweaving of magic and religion in many ancient Mediterranean cultures, see Asir-
vatham/Pache/Watrous 2001.
3 See Ritner 2008; David 2002; Brashear 1995, 3391, n. 4; Pinch 1994, 9–17.
4 For the complex notion of Egyptian ‘magic’, see the clarifications suggested by Gordon/
Gasparini 2014, 39–40; the nature, functions, and perceptions of Egyptian temple and private
ritual are discussed in detail in Dieleman 2019b, 87–114.
5 See Zucconi 2007, 31. For a recent overview of the term’s meaning, see Dieleman 2019b, 87–93.
It should be noted that Heka is also used to refer to the homonymous primeval deity who repre-
sented the deification of magic: see Ritner 2008, 14–35; Leitz 2002, V, 552a–556b; Te Velde 1970.
6 Although the ancient Egyptians were well aware that their kings were mortal, they also
believed that all of Egypt’s living Pharaohs were incarnations of the god Horus, for the kings
were believed to trace their ancestry back to Osiris.
7 Hekau is often to be understood as the “application or mobilization of heka”, although the
word is usually translated in English as ‘magic’, similar to heka: see Dieleman 2019b, 91. For the
notions of hekau and akhu (which was often used as a close synonym for hekau), see Borghouts
1987.
8 Cf. Veiga 2009; Zucconi 2007; Nunn 1996, 96–112.
9 See Dieleman 2005, 220–221, n. 87; Pinch 1994, 47–60.
256 Panagiota Sarischouli
(i) The swnw-priests who probably dealt with injuries caused by accidents or
fighting,10
(ii) The ḫrp-priests of the goddess Serket, who used magical spells to ward off
poisonous reptiles and insects, but could also cure all kinds of stings and
bites,11 and
(iii) The w‘b-priests who served Sekhmet,12 one of the Egyptian goddesses most
associated with healing.13
Another function related to healing magic was that of the ‘amulet man’ (s3w) who
might have practiced medicine, but was mainly specialized in making protec-
tive amulets, or using spoken or written charms to protect people from various
dangers.14 Finally, midwives and nurses occasionally employed magical skills to
provide protection for pregnant women and young children, or in coping with
difficult childbirth and diverse other gynecological health issues.15 That said, in
Pharaonic Egypt we can hardly make a distinction between priests and ritual spe-
cialists: “Titles such as magician, scorpion charmer, Sekhmet priest and amulet
man often seem to be used interchangeably”.16
The contents of the ten or so extant Egyptian manuscripts (mainly dating
from the 2nd millennium BCE), which are traditionally categorized as medical,17
confirm that medicine and religion were inextricably linked to each other, but
were also connected to the art of magic in an ‘unscientific’ way,18 when viewed
10 See Nunn 1996, 113–135.

11 See Sauneron 1989, 198–201.
12 See Engelmann/Hallof 1996.
13 Sekhmet was a fearsome goddess, who was associated with war and retribution, but was also
believed to be able to avert plague and cure disease: see Wilkinson 2003, 181–182; Germond 1981.
14 See, e. g., Von Känel 1984; Gardiner 1917.
15 See, e. g., Töpfer 2014, 332–334.
16 Pinch 1994, 56.
17 Cf. Zucconi 2007; Nunn 1996, 24–41; Westendorf 1966 and 1999, 4–79.
18 In total, several dozen Egyptian magico-medical manuals for healing and protection have
been preserved; the earliest manuscript (Kahun papyrus) dates to the middle of the Middle King-
dom and the latest texts to the Roman period (such as P. Vindob. D. 6257, a partly preserved
Demotic Medical Book from the 2nd century CE, which was probably composed in the Ptolemaic
period: Dieleman 2005, 111–112, n. 23; more examples from the Roman period can be found in
Dieleman 2011, 89, n. 7). Extant are also many medical remedies written on ostraca or limestone,
which date from the Eighteenth Dynasty to the Roman period: see Nunn 1996, 41. Dieleman 2011,
88–91 rightly argues that the Demotic Magical Papyri may be regarded as the last manifestations
of Pharaonic medical tradition.
from a modern medicinal perspective.19 Most of these manuscripts contain a

unique mixture of magical and medical remedies, while the texts often state that
they are intended for the use of “any doctor or any Sekhmet priest”. It thus seems
safe to assume that in ancient Egypt rational medicine and treatments based
on magical techniques were complementary parts of a doctor’s education; the
latter often held part-time priesthoods, as ancient Egyptians did not see these two
careers as opposed to one another.
Paul Ghalioungui suggested that the therapeutic use of magic was regulated
by four fundamental principles:20
a) the principle of (cosmic or mystical) participation, according to which any
change in one part provokes a reaction in the whole; this principle asserts the
existence of mysterious ties between humans and the universe,
b) the principle of solidarity according to which the parts of a whole remain in
solidarity, even if separated; in this context, Egyptians believed that acting,
for example, on the patient’s fingernail or a lock of hair influenced the person
as a whole,
c) the principle of identity, according to which the written representation or the
mere utterance of the name of an organ, plant or symptom was in itself suf-
ficient to enable it to be acted upon; in this context, medicinal properties
could be inferred on the basis of a certain visual resemblance between, for
example, an organ requiring treatment and a plant selected to be used in a
herbal remedy, and
d) the principle of homeopathy, according to which ‘like evokes like’; in this
context, if an event had once a certain consequence, this consequence would
be each time repeated (as in, e. g., the so-called historiolae),21 since “two
events that follow one another once will necessarily follow one another in
the future”.22
Originally, all magical knowledge must have been transmitted verbally, but as the
written word increasingly acquired prestige, magical or iatromagical texts were
fixed in sacred books,23 which were kept in the House-of-Life, the institutional-
19 See Györy 2011; Jones 2009, 352–354; Allen 2005; David 2004; Jacq 1985, 106–127; Ghalioungui
1983; cf. also Töpfer 2014, 318, n. 1; Brashear 1995, 3391, n. 4.
20 See Ghalioungui 1983, 17–25.
21 Historiolae (brief allusions to – often invented – mythical events) are considered as a marked
feature of Pharaonic magical practice, which has survived in both the Greek and Demotic Magi-
cal Papyri: see Frankfurter 1995; Podeman Sørensen 1984.
22 Cf. also Bélanger Sarrazin 2015, 9–10.
23 Cf. Dieleman 2011, 88–97.
ized cultic temple library. The so-called ‘lector priests’ were skilled in the fault-
less recitation of the hymns and invocations contained in the ritual texts, as well
as in the correct performance of rites, while the ‘scribes of the House-of-Life’ were
trained to copy, edit, and perhaps even compose the magical handbooks. Both
the lector priests and the temple scribes were an important link connecting the
Egyptian temples and the lay public, whom they provided with magical charms
and amulets.
Magic and Medicine in Greco-Roman Egypt

As is well known to those interested in post-Pharaonic magic, the texts we – for
convenience – call the Greek and Demotic Magical Papyri (hereafter PGM and
PDM, respectively)24 add substance and color to our modern understanding of
magical practices and religious beliefs in Greco-Roman Egypt, where the recep-
tion of ancient Egyptian religious culture underwent a complex and manifold
process.25
Already in the late 4th century BCE, with the establishment of Ptolemaic rule,
Egypt had become not only a bilingual, but also a multicultural society. None-
theless, while throughout the Ptolemaic period magical knowledge continued to
be closely linked to the senior temple priesthood, with the shift to Roman rule
and the subsequent deterioration of temple finances,26 priests and ritual experts
had to accommodate the new circumstances, adapting their magical repertoire
to fit the needs of a rapidly changing clientele, the Greek-speaking population.27
By this time, magical rituals were also performed by practitioners who had no
direct links with the temples (freelance ritual experts), while any literate person
(including the Greek and Roman élite) could have chosen to include magical lit-
erature in their library, whether this would be for scholarly (or even antiquarian)
purposes, or for practical use.
24 The system of numbering (Roman numerals) introduced by Preisendanz and continued in

GMPT is used here to identify both the PGM (Papyri Graecae Magicae) and PDM (Papyri Demot-
icae Magicae), while papyrus texts published in SM are cited according to the system followed
by Daniel/Maltomini (Arabic numerals); for the over-simplistic use of the PGM/PDM labels in
modern scholarship, see Dieleman 2019a, 283; Gordon/Gasparini 2014, 40.
25 Cf., e. g., Clarysse 2009; Jones 2009; Dieleman 2005; Dickie 2001; Fowler 1995; Faraone/
Obbink 1991.
26 For the fate of the temples in late antique Egypt, see Dijkstra 2011.
27 Cf. Dieleman 2012, 338–342.
These unique texts provide a very personal glimpse into the psyche of men
and women in antiquity, which makes it clear that most (if not all) types of magical
rituals function as a valuable psychological resource for individuals facing times
of emotional stress and distress. Both the PGM and PDM contain genuine reflec-
tions of the emotions involved in a series of tumultuous interpersonal relation-
ships, but also in the interactions between mortals and gods, since emotion pen-
etrates every interaction in life: “[I]t is there as a subtext to everything we do and
say”,28 both in antiquity and in modern times.29 That said, we have to acknowl-
edge that any modern attempt to interpret the human behavior in ancient times
is handicapped by the relation of ancient material to our “conditions of under-
standing”,30 which are individually influenced by various variable factors, such
as gender, social and cultural identity, as well as temporal trends.
As the present study aims at exploring possible placebo responses to iatro-
magical therapies employed in Roman Egypt, we concentrate on iatromagical
papyri from the Roman era. Among the extant papyri with a medical or healing
intention, we find many texts written in Demotic,31 a form of Egyptian that only
temple priests continued to command by the Roman period. It is well known that
the PDM have in general much more Pharaonic influences than their Greek con-
temporaries; it thus comes as no surprise that the Demotic iatromagical papyri
seem to continue the long tradition of ancient Egyptian curative magic, which
was discussed above. On the other hand, the extant PGM (irrespective of con-
tents) also show substantial Egyptian influence in their methodological structure
and motifs, as many technical features, which are found in both the PGM and
PDM, were inherited from their common ancestors. Nonetheless, while there can
be little doubt that most texts in the PGM are deeply rooted in ancient Egyptian
religious thought, at the same time, it is also clear that their authors sought inspi-
ration in Greek, Jewish, Near Eastern, and later in Christian religion and mythol-
ogy.32
It remains to be seen whether the Greek iatromagical papyri exploit the same
methods, as the ones employed in the Demotic texts, to predispose individuals to
a placebo response.
28 Strongman 2003, 3.
29 Cf. Chaniotis/Ducrey 2013; Chaniotis 2012; Cairns 2008.
30 Winkler 1991, 215.
31 See n. 18 above.
32 Cf. Noegel/Walker/Wheeler 2003; Jordan/Montgomery/Thomassen 1999; Meyer/Mirecki
1995 and 2002; Meyer/Smith 1994.
Elpis vs. Hope

It is a commonplace in (modern) medicine that the placebo response to a treat-
ment is mainly based upon the effective manipulation of an individual’s emo-
tions.33 The installation and maintenance of hope is, of course, crucial to any
therapeutic treatment, and even more so in one involving placebo. As Simon
Kwan rightly points out, “clinical observations reveal that placebos are intimately
related to hope”.34
Therefore, it is necessary to first define the concept of hope, since the Eng-
lish-language concept of hope does not convey the same sense as the Greek elpis,
but can rather be understood as having only the prototypical meaning of the
Greek term. In ordinary ancient Greek, elpis – unlike hope – is associated with
both good and bad outcomes, and – more importantly – lacks hope’s desidera-
tive and motivational aspect. In English (and in many other Western languages,
including Modern Greek), hope encompasses desire, yearning, and anticipation,
but also uncertainty. Moreover, it reflects a creative-thinking process35 – com-
monly after experiencing failure or difficulties – through which an individual
realizes that he or she is able to pursue uncertain, yet usually achievable, goals.36
It is then remarkable that elpis or related words are very rarely attested in
the PGM. A search of the TLG database of magical texts yielded only three cases,
where elpis or related words occur. And of these, only one text has a clear medical
or healing intention: PGM LXXXIII.1–20 (P. Princ. II 107 = SM I, 29) is a 5th or 6th
century prescription for a fever amulet, which has triggered a scholarly debate
on its ‘Gnostic’ or ‘syncretistic’ character.37 Although written in a very irregular
orthography, the text incorporates (at ll. 10–13) a part of Psalm 90 (which was
frequently used in protective amulets; see SM I, 26 note on ll. 6–8), in which the
sufferer reminds himself to put his hope in the power of God: ἐλπίδω ἐφ᾽ αὐτών
(l. ἐλπίζω ἐπ᾽ αὐτόν). In this context, it should be noted that various other psalms
as well as many Christian prayers were copied (as divine texts) to create a power-
ful amulet.38
33 Cf. Koshi/Short 2007; Stewart-Williams/Podd 2004, 326.

34 Kwan 2016, 123.
35 Hope is rarely associated with malicious intent, whereas despair – hope’s antonym – is often
negatively charged: cf. Lazarus 1999.
36 Cf. Kazantzidis/Spatharas 2018; Cairns 2016.
37 See, e. g., Sanzo 2014, 50–51. The other two texts are: PGM IV 3125–3171, a formulary favor-pro-
cedure, which is found in a 4th century magical handbook, and PGM P20 verso (= BKT VI 7.2 =
LDAB 6225 = TM 64984 = Van Haelst 733), a protective 7th-century amulet with a prayer from
Alexandrian liturgy (kephaloklisia).
38 As in, e. g., PGM P20 verso (see n. 37 above).
As the existing examples, in which elpis or related words occur, are not suf-
ficient to understand – not even remotely – the role of hope in healing magic,
the present paper focuses on the power of the hope/expectancy-effect in placebo
treatment, examining certain examples from a selection of Demotic, bilingual,
and Greek formularies. That is, instructional handbooks, usually in the form of
rolls or codices,39 which contain one or more recipes that instruct a practitioner
on how to perform various types of magical or medico-magical rites.
Categorization of the Source Material

Although this is something of a simplification,40 the procedures found in both
the Greek and Demotic iatromagical formularies can be divided into three differ-
ent – and often complementary – types:
(i) Procedures of the ‘substance-type’: procedures instructing the practitioner
on how to prepare (using certain quantities and measures of substances from
plants, solids and animals) and administer (how, i. e. internally or externally,
and when) a medicament (a drug, potion, ointment etc.) to treat various ail-
ments,
(ii) Procedures of the ‘healing rite-type’: procedures instructing the practitioner
on how to perform a healing rite, which may include the invocation of a
divine intervention, the uttering of a magical formula, the allusion to a histo-
riola, the drawing of apotropaic imagery, or another magical technique, and
(iii) Procedures of the ‘amulet-type’: procedures with instructions on making
therapeutic or preventive amulets.
Demotic magico-medical formularies

The Demotic Magical Papyri (PDM) that survive today date mainly from the mid-2nd
to the 3rd centuries CE. However, the original prescriptions copied in the surviving
magical handbooks are believed to have been produced up to a century earlier,
as the result of a complex process of adapting, consulting and editing magico-re-
ligious texts (occasionally with a healing intent), which were written not only in
39 See De Haro Sanchez 2010.

40 The current categorization is based upon Dieleman 2011, 91–97 (Hieratic formularies), and
98–116 (Demotic formularies), as well as De Haro Sanchez 2015a, 181 (Greek formularies).
Egyptian (Hieratic, Demotic, or Old Coptic), but also in Greek.41 As the surviving
five Demotic manuscripts, which comprise this corpus,42 also contain shorter or
longer sections in Greek,43 the PDM are thought to be closely related to the PGM.44
Among the PDM, we can find a few magico-medical texts in which magical
elements clearly outweigh all else; such are mainly the texts, which may be listed
under the second and third type in the categories of iatromagical prescriptions
discussed above. For example: PDM XII 21–49: A lengthy prayer aimed at the
revelation of a remedy for a disease; XIV 1003–1014: A recipe to make a thera-
peutic amulet for gout, which incorporates a long string of voces magicae; XIV
1219–1227: A spell against fever, etc. In all these cases, the placebo effect would
be expected to work perfectly, although the treatment incorporates no elements
of traditional medicine practices (drugs, potions, ointments, etc.). This is not at
all surprising, since “belief in the force and the perceived efficacy of magic is
rooted in the perception that speech acts have power to disrupt and destroy, or to
persuade, influence and convince others”.45
Nonetheless, the vast majority of the iatromagical texts in the PDM corpus
are either short recipes of the ‘substance-type’, or more elaborate procedures
combining elements of the ‘substance-type’ with those of the ‘healing rite-type’:
that is, procedures in which the instructions on how to prepare and administer
a – relatively rational – medicament are enriched with magical elements, such as
the invocation of a deity associated with healing, or precise instructions in regard
to the time of the day when certain herbs are to be gathered. Both techniques are
meant to impart the comfort of hope to the sufferer by providing an (illusory)
impression of improved health to him/her.46
Several examples of this sort can be found in P. London-Leiden (also known
as PDM/PGM XIV among classicists, and as P. Magical among Egyptologists; cf.
CDD), which is often listed among the Egyptian medical manuals. PDM/PGM XIV
is a bilingual (Greek/Demotic) formulary preserved on a papyrus roll (nowadays
divided into two parts), which belongs to the so-called ‘Theban Magical Library’,
a single archive containing many of the magical handbooks, which have survived
41 Cf. Dieleman 2005, 285–294; Ritner 1995, 3358–3371.

42 The corpus of the Demotic Magical Papyri consists of PDM/PGM XII (P. Leiden I 384 verso);
XIV (P. Leiden I 383 + P. BM EA 10070); LXI (P. BM EA 10588); PDM Suppl. (P. Louvre E3229),
and P. BM EA 10808 (a manuscript from Oxyrhynchus without PDM number; ed. Osing 1976; cf.
Sederholm 2006 and Quack 2009). To these we may also add O. Strassburg D 1338 (copy of a rec-
ipe to alleviate menstruation pains; ed. Spiegelberg 1911; cf. Ritner 1995, 3343–3344).
43 Cf. Dieleman 2019a, 283.
44 See Dieleman 2011, 86–88.
45 Weiner 1983, 705.
46 Cf. Harrington 2006, 181.
from Roman Egypt.47 The base language of PDM/PGM XIV, which contains alto-
gether 98 individual prescriptions of various contents, is Demotic, but some of its
texts seem to have been, at least partly, translated back from Greek.48 The hand-
book is believed to have been originally composed by (Hellenized) Egyptian ritual
experts (probably priests), who drew mainly upon Egyptian traditions (combined
with Greek and Jewish elements) that they reworked in several layers of redac-
tion,49 and thus offers the most vivid testimony to the aims of the present study.50
A first case in point would be a formula against dog-bite, which reads:
[…] according to the voice of Isis, the magician, the lady of magic, who bewitches everything,
who is never bewitched in her name of Isis, the magician. You [should] pound garlic with
gum (?), put it on the wound of the dog-bite, and speak to it daily until it is well.
(PDM XIV 554–562 at 560–562 = col. xix, 7–9, transl. Johnson, GMPT 226).
The text includes an explicit reference to the magical powers of Isis and her
long-standing connection to healing, which is, for example, seen several times on
the Metternich stele.51 The allusion to Isis’ healing powers in our text is undoubt-
edly meant to impart to the sufferer a feeling of confidence in the efficacy of the
procedure, and thereby raise his/her expectations of a cure.52 Nonetheless, the
current prescription combines magical elements with rational medical knowl-
edge to help cure the wound of the dog-bite, as it instructs the practitioner on how
to pound garlic with a thickening ingredient in order to apply it on the wound,
and to actually relieve him/her from pain or any other discomfort; garlic oint-
ments are known to have been used by many ancient cultures to heal wounds.53
Similarly, in another prescription to cure a dog-bite (PDM XIV 585–593), the
practitioner is to accuse the dog, briefly alluding to fearsome mythical events
(historiolae), while the sufferer is instructed to cleanse the wound and treat it
with a mixture of ground salt, which was intended to dry the wound out and
prevent infection,54 and Nubian hematite; in the light of ancient Egyptian
47 See Dosoo 2016 and 2014; Dieleman 2005, 11–21; Tait 1995.
48 See Dieleman 2005, 127–144.
49 Cf. Dieleman 2005, 35–40.
50 Cf. also De Haro Sanchez 2008.
51 In, e. g., Spell VI, ll. 48–50, 58–59; text and transl. in Sander-Hansen 1956, 35–38, 41.
52 There can be little doubt that the placebo effect in this case is linked to “unconscious, auto-
matic conditioning”; see Korsvoll, this issue. For the role of conditioning and learned expectan-
cies in placebo treatments, see Fuente Fernández 2012, 1309; Humphrey 2002, 276; Morris 1997,
190–192.
53 Cf. Alhashim/Lombardo 2018 and 2020.
54 Cf. Rooney 2013, 141.
views on Nubia, a ‘Nubian’ ingredient would enhance the exotic nature of the
recipe.55
In another Demotic recipe, the practitioner is to invoke the golden cup of
Osiris to save a man from dying from a poison draught that he has been made
to swallow. The unfortunate victim should drink wine from this cup, which is
claimed to have magical powers, because Isis, Osiris, and the Great Agathodai-
mon have already drunk from it: The effectiveness of a magico-medical remedy
was often seen to depend on the favorable intervention of a deity.56 At the same
time, the text instructs the practitioner on how to add some fresh rue in the
wine, which the victim should drink “at dawn before he has eaten” as an emetic:
rue (ruta graveolens L.) is a medicinal, somewhat shrubby plant, indigenous to
southern Mediterranean shores, which was known to ancient writers for its vom-
it-inducing properties, a fact confirmed by modern botanists.57 Our text clearly
demonstrates that the author of this healing ritual is aware of the plant’s medici-
nal effects on the human body:
May I be healed of all poison, pus, [and] venom; they shall be removed (?) from my heart.
When I drink you, may I vomit them up in her name of Sarbitha, the daughter of the Aga-
thodaimon […]
(PDM XIV 563–574 at 568–570 = col. XIX, 14–17, transl. Johnson, GMPT 226).
A similar example is found in a spell against scorpion sting (PDM XIV 594–620):
The practitioner is to impersonate Anubis, the son of Sekhmet-Isis,58 so that his
mother will come to his help; the goddess is said to appear and give instructions
on how to soak a strip of linen in oil and put it on the sting daily for seven days,
while reciting a spell, which supposedly charges the oil with magical power;
the text claims that the oil will heal the paralyzed limb since the same oil was
employed to heal Isis’ son Anubis when he was stung (historiola). Although the
recipe does not give precise instructions on the type of oil to be used, we may
recall that ancient folk medicine often applied oils to treat the pain and swell-
ing symptoms caused by toxic bites of various insects and snakes; in fact, many
essential oils (such as myrrh and frankincense) were known since antiquity for
their anti-inflammatory and/or antiseptic properties.59
55 See Dieleman 2005, 140–143.

56 In this case too, the placebo effect is linked to conditioning and learned expectancies: on
which, see n. 52 above.
57 Cf. Chevallier 1996, 262–263.
58 For Anubis as the foster son of Isis, cf. Plut. De Is. et Os. 14.356 F.
59 For the use of incenses (such as λίβανοϲ and ζμύρνα) in PGM recipes, see LiDonnici 2001,
65–79.
Another historiola is invented in a Demotic ritual (PDM XIV 1097–1103 = col.

XX verso, 1–7), which is probably meant to cure an eye-ailment, or perhaps to
break the spell of the “evil eye” (the title of the procedure is not clear).60 The
practitioner is to impersonate Isis, claiming that the same ritual was used to heal
her son Horus;61 he is then to prepare an ointment (using oil, salt and nasturtium
seed; the latter is used in traditional medicine against bacterial and fungal infec-
tions, while Plin. HN 19.44; 20.50–51 informs us that it was believed to sharpen
the senses); the ointment is to be rubbed on the whole body of the sufferer. To
strengthen the placebo effect of the ritual, the text instructs the practitioner, while
preparing the ointment, to recite over it an invocation, which incorporates “three
spells in the Nubian language”: these spells are rather an incomprehensible col-
lection of sounds, which were meant to serve as an exotic and, therefore, pow-
erful element of the procedure (see also above), contributing to the increase of
the positive expectations of the patients. The invocation, together with the words
“you are this eye of the heaven” and the drawing of an eye, should be inscribed on
a new papyrus sheet, which the sufferer was to wear (as an amulet) on his body.
This prescription combines all three types of iatromagical procedures.
A further example from this handbook is found in a Demotic ritual used for
the removal of a (fish-)bone stuck in a patient’s throat. Although the text instructs
the practitioner to first utter a magical formula addressing the sufferer (probably
as a validation of the procedure’s trustworthiness), the patient is mainly treated
with rational medical methods to help the bone to come up:
You should speak to a little oil, you should put the man’s face up; you should put it down in
his mouth; you should move your finger and your thumb [to the] two sinews of his throat;
you should make him swallow the oil; you should make him rise up suddenly; and you
should eject the oil which is in his throat immediately. The bone comes up with the oil.
(PDM XIV 574–585 at 581–585 = col. XIX, 28–32, transl. Johnson, GMPT 227).
A less rational recipe for the removal of bone stuck in the throat is found in PDM
XIV 620–626 = col. XX, 27–33, in which the practitioner is instructed to cast (seven
times) a spell on a cup of water, which the (female) patient is then to drink to
bring the bone out of her throat.
Our examples show that the healing methods employed in the Demotic texts
range from miraculous, if not absurd, interventions (such as invocation of deities,
allusions to mythical events, or readings of magical verses) all the way to psy-
60 Cf. Draycott 2011, 193–194; Dieleman 2005, 138–143, 315.

61 It is worth noting that modern placebo research underlines the role of trust in the physician’s
authority in a positive placebo response: see Miller/Colloca/Kaptchuk 2009, 530; Benedetti 2011;
Humphrey 2002, 276–277; cf. also Korsvoll, this issue.
chosomatic cures (such as drinking of potions, ritual baths, and fasting). They
also contain methodological medical treatments, which often include the use of
substances known for their therapeutic value;62 in one case (PDM XIV 574–585
at 581–585), the practitioner is even instructed on how to perform a life-saving
medical ‘maneuver’ to save someone from choking on food.
There can be little doubt that, in all the foregoing examples (and in many
more),63 magic was not simply expected to serve as a substitute for medical cure,
but was rather seen as a complementary treatment to medical care, which some-
times managed to balance the effect of fear, on the one hand, and the flame of
hope, on the other.64
Greek magico-medical formularies

In total, 27 Greek formularies containing one or more individual magico-medi-
cal prescriptions were unearthed from the sands of Egypt.65 The vast majority of
them date from the 2nd century CE and later, up to the 6th-7th centuries, while there
are also a few – poorly preserved – texts predating the 2nd century CE.
As already stated in the categorization of the source material, the PGM corpus
(similar to the PDM corpus) encompasses all three types of iatromagical proce-
dures. This practically means that healing in the PGM follows the same path-
ways as in the PDM. Our aim here is to explore the contents of the Greek mag-
ico-medical formularies a little further,66 by examining whether the instillation
of hope and the resulting placebo response of the Greek-speaking patients to the
prescribed treatments continues to be somehow connected to relatively ‘rational’
62 For the use of minerals and metals, or parts and fluids from animals and plants, as ingre-
dients in magico-medical recipes in PDM/PGM XIV, see Dieleman 2005, 111–120; cf. also n. 77
below.
63 See PDM XIV 935–939: prescription to heal a “watery ear” sensation; 940–952: listing of mag-
ico-medicinal properties of various herbs; 953–955 and 961–965: prescriptions to stop bleeding;
970–977, 978–980, and 981–984: prescriptions to treat gynecological infections; 985–992 and
993–1002: prescriptions to heal gout; 1015–1020: prescription for unidentifiable affliction; 1021–
1023 and 1024–1025: prescriptions to cure a stiff foot; 1104–1109: prescription to prepare an eye
ointment; PDM/PGM LXI 43–48: prescription to treat an ulcer (?) of the head; 49–57: prescription
to treat an unidentifiable affliction of the head; 58–62: prescription to get an erection.
64 Cf. Horstmanshoff 1999.
65 See De Haro Sanchez 2015a, 2008, and 2004; Bélanger Sarrazin 2015, 69–92; Draycott 2011;
Hirt Raj 2006.
66 For a classification of the methods employed in the Greek iatromagical papyri, see Chronop-
oulou, this issue.
medical/healing practices, similar to the magico-medical cures prescribed in the

extant Demotic recipes above. In doing so, we will divide our examples into three
sections:
– Procedures found in Greek handbooks of the Early Empire (the texts date
from the late 1st century BCE to the 3rd century CE).
– Procedures found in Greek handbooks of the Late Empire (in this section, we
list texts which were written between the 3rd and 4th centuries CE).
– Procedures found in late antique handbooks; this section is subdivided into:
a) procedures which lack Christian elements: the texts date from the 4th to
the 6th/7th centuries CE, and
b) procedures which incorporate Christian elements: the texts date from the
5th to the 6th centuries CE.
Greek handbooks of the Early Empire

One of the earliest Greek manuscripts is PGM XX (the so-called ‘Philinna Papyrus’:
P. Amh. II 11 + P. Berol. inv. no. 7504 recto = TM 65576), a one-column text dated
around the turn of the first century BCE, which contains a collection of short hex-
ametrical incantations (labeled as epaoidê); the incantations were undoubtedly
intended for healing, but the text contains no instructions for use.67 Although
an Egyptian or Near Eastern influence on the mythical events addressed in the
second charm’s historiola is plausible, the unique layout and the alleged female
authorship of this small collection seem to suggest that the texts reflect a tra-
dition of metrical charms, which must have originated outside Egypt:68 These
hexametrical incantations are nowadays generally believed to have been origi-
nally conceived as part of a Greek poetry anthology rather than as magical for-
mularies intended for practical use.69 As such, they represent a category of their
own and require a special approach, which is beyond the scope of this paper.70
67 For the ‘Philinna papyrus’, see Dieleman 2019a, 317–318; Sarischouli 2019, 319; Bélanger
Sarrazin 2015, 85–86; Collins 2008; Lehnus 2007; Faraone 1995, 2000, 197–202, 209–213; Ritner
1998; Dickie 1994; Daniel 1988; Henrichs 1970, 204–209; Koenen 1962; Merkelbach 1958, 85–86,
no. 1046; Maas 1942.
68 See mainly Faraone 2000, 197–202, 209–213.
69 Cf. Plant 2004, 112–114.
70 A complete re-edition of the text is being prepared by Michael Zellmann-Rohrer and will
become the new standard reference (under preparation through an international project funded
by the Neubauer Collegium for Culture and Society: <http://neubauercollegium.uchicago.edu/
faculty/magical_knowledge/> [16/01/2020]).
Nonetheless, it is worth recalling here that SM II, 88 (a formulary from Oxyrhyn-

chus written more than three centuries later) preserves two iatromagical charms
to treat skin condition, and one of them contains (at ll. 6–8) a close parallel to the
epaoidê of the Syrian woman on the ‘Philinna Papyrus’.
Another early (Augustan era) formulary is PGM CXXII (= SM II, 72), which
contains a series of love charms (the first of which consists of an incantation in
hexameters labeled as epaoidê, similar to the ones in the ‘Philinna Papyrus’),71
along with a charm against headache. The text claims that the charms belong
to a Holy Book called “of Hermes”, which was allegedly found in the innermost
shrine of the temple at Heliopolis, written in Egyptian and translated into Greek:
this is a typical ‘mystifying motif’, applied almost routinely in the introductions
to the Greek formularies as a validation of the procedures’ trustworthiness.72 To
undo the disorder caused by the headache, the practitioner is instructed to allude
to Egyptian mythical events, which are invented ad hoc, a common feature of
Pharaonic magical practice:73 This technique is based upon the belief that the dis-
order represented by various symptoms (ranging from a headache to a life-threat-
ening disease) will be fixed by referring to an ideal mythical order:
Against headache: “Osiris has a headache, Ammon has a pain in the temples of his head,
Esenephthys has a pain all over her head. Osiris will not stop having a headache, Ammon
will not stop having a pain in the temples of his head, Esenephthys will not stop having a
pain all over her head, until first he, NN, stops completely (?) …”
(SM II, 72 at 26–30, transl. Daniel/Maltomini).
A comparable historiola can be found in a Demotic text against stomach or diges-

tive trouble, in which the patient is imagined to explain to Isis and Nephthys his/
her health problems, as if the goddesses were physicians.74 The Demotic text,
however, also includes a now lost remedy, which might have involved elements
of conventional medicine:
“Come to me, mother Isis and sister Nephthys! See, I am suffering inside my body (or rather)
the members there! ‘Do the worms interfere? Does it look like worms?’ – so said the goddess
Isis. Come Horus! See, as for anything painful in your body – I am the one <who says> ‘get
away!’ for you. [Sentence prescribing a remedy.] He will leave as a fart from your behind”
(P. Leiden I 348 recto 12, 7–11, transl. Borghouts 1978, 22, no. 26).
71 See Faraone 2000, 202–209.

72 See Dieleman 2005, 256–266.
73 For the historiolae, see n. 21 above.
74 Cf. n. 61 above.
In a somewhat later Greek iatromagical prescription, the healing method is

reduced to the utterance of magical formulae: SM II, 79 is a 3rd century papyrus
leaf, which contains two spells (ll. 1–5 and 6–11) aimed at promoting conception
after copulation: A man is to recite two magical formulae, in which the male
semen is referred to as the blood of a great god,75 so that the woman conceives.76
At the end of the text, begins a new recipe to be used “in case of fever”, which
probably runs in the same vein, but is too fragmentary to allow further conclu-
sions.
Early Greek formularies also contain a fair number of procedures, which fall
into the ‘substance-type’. These texts seem to be quite close to the Pharaonic
curative magic, in which various herbal, mineral or animal substances were used
as ingredients for magico-medical drugs and potions.77 In fact, one Greek text
from the ‘Theban Magical Library’ (PGM XII 401–444) claims to provide a “trans-
lation key” (more accurately, a synonym-list) translated from (Egyptian) sacred
writings (ἑρμηνεύματα ἐκ τῶν ἱερῶν μεθερμηνευμένα), which associates a series
of euphemistic names for ingredients prescribed in magical recipes with their
decoded solutions; human, animal, and divine fluids, or bodily parts are said to
correspond to herbs, minerals, and human, animal, or plant parts and fluids.78 It
is worth noting, in this context, that a 4th century formulary includes recipes with
instructions on how to pick plants for various magical purposes, so as to preserve
their efficacious qualities (PGM IV 286–295 and 2967–3006).
Some recipes of the ‘substance-type’ can be found in PGM XCVII (= SM II,
78), a damaged papyrus leaf dating from the 2nd or 3rd centuries CE. It contains
altogether six fragmentary iatromagical prescriptions; col. ii 1–14 preserves five
recipes to treat eye ailments, one of which employs the eye of a lizard (the animal
most frequently used in remedies against eye disease);79 next follows a recipe
against every illness (at ll. 15–17), which employs a beetle (the blister beetle was
often associated with the making of aphrodisiacs).80
75 On the correlation between bodily fluids and the belief in their divine origin, see SM II, p. 158.
76 A similar charm for conception, inscribed on a 4th-century CE gold lamella from Ballana in
Nubia (Cairo Archaeological Museum, inv. no. J 71204), is discussed in Gordon/Gasparini 2014,
47–48.
77 For the use of plants in Greek iatromagical prescriptions, see De Haro Sanchez 2015b; gener-
ally, for the use of plants in PGM, see Ballesteros Castañeda 2019. For the employment of animal
species and their body-parts and effluences in magical medicine, see Gordon 2010. For a statisti-
cal analysis of the use of animals as magical ingredients in PGM, see Salayová 2017.
78 See Dieleman 2005, 185–203; LiDonnici 2002.
79 Cf., e. g., Cyranides 2.14, p. 139 Kaimakis.
80 See Scarborough, GMPT 168, n. 106.
Another series of magico-medical prescriptions is found in PGM CXXVII

(= SM II, 76), which preserves a portion of the last column of a 2nd or 3rd century
papyrus roll, containing – alongside other magical recipes of general interest –
a prescription (at ll. 1–2) to relax an erect penis,81 which employs “the brain of
an electric ray” (cf. Plin. NH 32.139; Ps.-Gal. Rem. 2.27.1), another prescription
(at ll. 5–6) intended for sexual play with a woman, which employs “the juice of
deadly carrot” (cf. Diosc. Mat. Med. 4.153.3–4), and a third one (at ll. 11–12) to
achieve frequent sexual intercourses, which employs “celery and rocket seed”
(cf. Geopon. 12.23.3; Diosc. Mat. Med. 2.140). All recipes are reminiscent in style
and content to the Jocular Recipes of Democritus in PGM VII 167–185, which are
discussed below.
Magico-medical recipes concerned with sexual intercourse (similar to PGM
VII 167–185) can also be found in SM II, 83 dating from the 3rd century CE: A pre-
scription (at ll. 1–4) to enjoy the company of a concubine (?), which employs
the excrement of a swallow (cf. Diosc. Eupor. 2.48; Gal. Comp.med.sec.loc. 6.6)
together with honey (the most common ingredient in Egyptian medicine),82 and
another prescription (at ll. 5–9) to copulate a lot, which employs rocket seeds (see
above) and pinecones83 together with wine.
Another relatively early recipe, in which the treatment involves medicinal or
pseudo-medicinal preparations, is found in PGM CXIXb 1–5 (= SM II, 82 fr. B).
This is a very fragmentary papyrus leaf from the 3rd century CE, which contains
two badly damaged prescriptions, one to treat wounds, which instructs the prac-
titioner to mix a number of, now lost, substances, and another, which is prob-
ably intended for the making of an amulet for daily and nightly fever. To the
above examples we may add PGM LXXXII (dated to the 3rd century CE), which
preserves a damaged section of a magical handbook concerned with the making
of an unspecified (presumably curative) ingredient that is probably to be used in
a magico-medical treatment. The foregoing examples show that the procedures
of the ‘substance-type’ outnumber those of the ‘healing rite-type’ in early Greek
handbooks.
Let us now turn our attention to the representation of procedures of the ‘amu-
let-type’. From the most ancient of times, the therapeutic power of these texts
did not derive from their substances, but rather lay in the placebo effect stem-
ming from an individual’s mindset towards the power of magic: The patients
81 Modern placebo research admits that men experience response to placebo treatments more
often compared to females: see Vambheim/Flaten 2017; Aslaksen et al. 2011; cf. also Korsvoll,
this issue.
82 See Hansen 2001, 161.
83 For the use of pinecones (ϲτρόβιλοι) in PGM recipes, see LiDonnici 2001, 79–83.
would consciously put their hopes solely in the effective inscribed power of the
amulets, which included prayers, divine names, and incantation formulae. The
placebo response is here undoubtedly linked to learning,84 since the wearers of
the amulets had been conditioned to expect healing or protection from the invo-
cation of a divine intervention and/or the uttering of a magical formula or prayer.
The prescriptions for the making of amulets are deeply rooted in Pharaonic
religious thought, as protective amulets are known to have existed from the
4th millennium BCE. It is, however, worth noting that no Demotic or Hieratic
amulets (as activated texts) are extant for the Roman period. Jacco Dieleman sug-
gests that this is due to the fact that Greek had fully replaced Egyptian by then.85
Although this assertion is most probably true, it is interesting to note that in the
PDM corpus – and likewise among the earliest Greek handbooks – we also rarely
find recipes of the ‘amulet-type’, so Demotic-language amulets may well have still
been in use – to some extent – into the 3rd century CE, even if they were too few in
number in comparison to the Greek examples to have survived.
A relatively early Greek example of this sort is found in SM II, 74, a 2nd century
CE papyrus, which contains two formulary prescriptions for the making of
amulets against insomnia (at ll. 1–7) and against sciatica (at ll. 8–21); the power
of both amulets lies in the inscribed, mostly untranslatable magical names (the
same principle is apparent in, e. g., PDM XIV 1003–1014: amulet for gout), which
seem to represent garbled Egyptian and Jewish divine names and epithets.86 Some
more early examples can be found in PGM LXIII 24–25 and 26–28 (prescriptions
for contraceptive amulets) and CIV (prescription concerned with the making of a
fever-amulet).
Greek handbooks of the Late Empire

A more-or-less coherent collection of formulary prescriptions with a healing
intention can be found in PGM VII, a magical handbook preserved on a large
papyrus roll, written in Greek and dated to the 3rd or 4th centuries CE. Although
the roll was often associated with the ‘Theban Magical Library’ in earlier publi-
cations, this assumption has proven to be incorrect, even though the roll does
84 For learned expectancies, see n. 52 above.

85 See Dieleman 2012, 348.
86 The use of voces magicae is a common technique in both the PGM and PDM, and one of the
most marked features of late antique magic, as they are not attested before the 1st century CE: see
Brashear 1995, 3429–3438 and 3576–3603.
likely come from the Theban region.87 It is particularly interesting that 12 out of
the 13 iatromagical prescriptions gathered in this handbook are concerned with
the preparation of protective or therapeutic amulets that are to be worn by the
patient; their contents are predominantly magic,88 as no rational medical treat-
ment is employed in the texts; sometimes the voces magicae serve as a code to
establish a linguistic communication between the practitioner and the divine,
while in other cases the charaktêres convey a (presumably) unutterable message
to the gods in order to cure the sufferer. The only exception seems to be a pre-
scription for fever with shivering fits (PGM VII 211–212), which includes a spoken
magical formula, but also instructs the practitioner to spread oil on the back of
the sufferer, from the base of his/her spinal column to the feet, probably to relieve
him/her from the discomfort caused by fever and chills. To these we may perhaps
add some of the Jocular Recipes of Democritus (at ll. 167–185): alongside many
humorous remedies and tricks, which were presumably intended to be used at a
dinner table, we find a short recipe for a breath freshener (at l. 173: similar to one
found in Athen. Deipn. 3.84e), a recipe to prevent drunkenness (at ll. 180–181:
which also has a parallel in Athen. Deipn. 2.52d), another recipe to have frequent
sexual intercourse (at ll. 182–183; cf. Athen. Deipn. 1.18d-e), and also a recipe
to get an erection at will (at ll. 184–185; similar to the recipe in PDM/PGM LXI
58–62). All these recipes prescribe the use of substances from plants and animals.
As fever is a symptom that accompanies many diseases, from the 3rd up to
the 6th/7th centuries we find not only many activated texts against fever,89 but
also many formulary prescriptions concerned with the making of fever-amulets,
which occasionally list all the different kinds of fever that were known to con-
temporary physicians (daily, every third or fourth day, etc.), or claim to be able
to heal the shivering fit, which might accompany fever. Examples dated between
the 3rd and 4th centuries CE can be found in PGM LXXXVII and XCI. But the amulet
recipes were of course concerned with all real or imagined health problems;90
thus, in CXIV = SM II, 84 (3rd or 4th century CE) we can find a prescription for the
87 See Dosoo 2016, 265–266.

88 These prescriptions are: PGM VII 193–196 (healing amulet for a scorpion sting); 197–198 (heal-
ing amulet for treatment of eye discharge); 199–201 (spell against migraine, similar to the one
in PGM CXXII [= SM II, 72]); 201–202 (amulet against migraine); 203–205 and 206–207 (healing
amulets for coughs); 208–209 (healing amulet for treatment of breast hardening); 209–210 (for
swollen testicles); 213–214 and 218–221 (protective amulets for fever); 260–271 (for the ascent
of the uterus), and 579–590 (phylactery against daimons, phantasms, and every sickness and
suffering).
89 Cf. Bélanger Sarrazin 2015, 19–49.
90 Cf. Bélanger Sarrazin 2015, 50–68.
making of a protective amulet against daimon-attacks and epilepsy, which was

often associated with daimonic possession.
By the end of the Late Empire, amulet recipes become more frequent: this
observation seems to correspond with the fact that, although among the 60 sur-
viving activated texts with healing as their purpose (inscribed charms, or object
amulets created in the course of a ritual),91 we find examples dating from as early
as the 3rd century CE, yet the vast majority of the texts date from the 4th to the 6th-7th
centuries CE.92
Late Antique formularies without Christian

elements
In a 4th century CE ostracon (SM II, 89) we find two formulary prescriptions to
create two charms against the sting of a scorpion. Although the charms seem
to also include elements of Jewish magic (at ll. 3–4), they are, no doubt, deeply
rooted in Egyptian tradition. Comparable are the charms for curing snakebites
and scorpion stings, which were written all over the so-called healing statues and
Horus cippi. Two further iatromagical charms (one against erysipelas, and one
against red eruption) are found in SM II, 88, a 4th century formulary from Oxyrhy-
nchus, which was discussed above.
That said, plants, solids and animals continue to be used up to the 5th or 6th
centuries in the preparation of magico-medical ointments, or in other therapies
prescribed in Greek formularies. It is, however, remarkable that although all texts
claim to prescribe substances with medicinal properties, most of the later pre-
91 Examples of pagan amulets: PGM XVIIIb; XXXIII; CXV; SM I, 4, 9, 19 (fever amulets); CXXX
(= SM I, 3: amulet for every illness and fever); SM I, 18 (amulet for every illness); XXVIIIa-c, CXII
= SM I, 16, and CXIII = SM I, 17 (prophylactic or therapeutic amulets against scorpion sting).
Examples of Christian or Jewish amulets: PGM XVIIIa (headache amulet); XLIII; XLIV; XLVII;
LXXXIX (= SM I, 13); LXXXVIII (= SM I, 11); CVI; CXXVIII (= SM I, 28); SM I, 14, 21, 23, 25, 29, 35
(fever amulets); XCIX (= SM I, 33: a protective amulet containing a slightly modified version,
i. e. “God is the one who heals every sickness”, of the common acclamation: εἶϲ θεὸϲ ὁ βοηθόϲ/
βοηθῶν: see Versnel 2011, 281, n. 142); C (= SM I, 20); SM I, 30, 31, 34 (amulets for every illness);
SM I, 26 (amulet against eye ailments); PGM CXX (= SM I, 1: a ‘winged’ formation which served
as an amulet against swelling of the uvula); SM I, 32 (amulet against headache and discharge
produced by eye-disease). To these we may also add PGM XC (= SM II, 92), a 4th- or 5th-century CE
papyrus leaf folded to be worn as an amulet, which also contains (at ll. 14–18) a badly damaged
formulary prescription for the making of a fever amulet.
92 Cf. Hirt Raj 2006, 268–278, 347–351.
scriptions clearly recommend implausible medical methods, and this does not
apply only to the Jocular Recipes discussed above. One clear example is found
in PGM XXXVI 320–332 (dated to the 4th century), a complex prescription for the
making of a contraceptive amulet, which indicates no relation whatsoever to
conventional medicinal practices or pharmacopoeia: The prescription instructs
the practitioner to steep bitter vetch seeds in menstrual blood, which a frog is
to swallow and then is to be set free. The practitioner is then to mix different
seeds and grains with disagreeable substances, such as nasal mucus of an ox and
earwax of a mule, in order to create an amulet that the woman is to wear during
the waning of the moon.
Another example is found in PGM XCV, a fragmentary formulary dated to the
5th or 6th century CE, which probably contains (at ll. 7–13) a prescription for epi-
lepsy, enumerating the magico-medicinal properties of the blind mole rat (Spalax
sp.), and further on (at ll. 14–18) another remedy for epilepsy, followed by the
beginning of a remedy for lung disease.
Also of interest is a collection of 13 magico-medical prescriptions in PGM
XCIV (= SM II, 94), which survives on a fragmentary leaf from a papyrus codex
dated to the 6th century CE; although the badly damaged text remains at places
uncertain (ll. 1–3, 12–16, 30–35, and 59–60), lines 4–6 preserve a fragmentary
formulary prescription for the making of a drying powder with saffron, which is
intended for sharp eyesight (κρόκος was often used to treat eye disorders).93 This
seems to be the only text in this formulary to employ some sort of (presumably)
curative ingredients; the rest of the prescriptions are concerned with the making
of therapeutic or protective amulets: At ll. 7–9 (for easy childbirth); 10–11 (against
fever?); 17–21 (against daimonic possession); 22–26 (a protective or healing amulet
for the eyes); 27–29 (against tumors); 36–38 (against strangury); 39–43 (against
migraine); 44–58 (against possible complications of a wound, perhaps from a
scorpion sting or another venomous bite).
Further examples of recipes for therapeutic or protective amulets intended to
deal with any possible health issue can be found in PGM LXV 1–4 (prescription
for a contraceptive amulet); LXV 4–7 (prescription for a migraine-amulet); XXIIa
1–17 (a series of prescriptions for the making of amulets for bloody flux, for pain
in the breasts and uterus, amulets to serve as contraceptives, or to help one who
suffers from elephantiasis).
93 Cf. Youtie 1975, 526, n. 24.

Late Antique Formularies with Christian Elements

An interesting text, which is issued from a Christian milieu and contains recipes
that can be categorized under the ‘substance-type’, is P. Oxy. XI 1384 (dated to
the 5th century CE). The text is divided into five sections: The first section seems
to provide a recipe for a purgative; all the listed ingredients (cumin, parsley,
coriander, fennel, costus, mastic, pennyroyal, silphium, salt and vinegar) were
thought in antiquity to have purgative properties, or at least to help digestion;
the last two sections preserve two recipes, one to treat difficulties in urinating
by using two well-known diuretics, that is, basil (Diosc. Mat. Med. 2.141 and 3.43;
Plin. NH 20.48) and wine (Plin. NH 23.19–25), and another one to treat wounds.
In-between, we find two sections containing historiolae about cures, where Jesus
is said to have used olive oil and myrrh to heal the sick.94
Another manuscript of particular interest is PGM CXXIIIa-f (= SM II, 96),
a large papyrus sheet (from a roll) and five smaller fragmentary pieces, which
preserve damaged portions of a magico-medical handbook dated to the 5th/6th
centuries CE. The manuscript contains altogether 14 sections separated by long
horizontal strokes; at ll. 48–72 we find ten short prescriptions, eight of which are
probably iatromagical. Most of the prescriptions are concerned with the making
of therapeutic amulets (at ll. 48–50: An amulet to help a woman in labor, which
alludes to a Christian historiola; at ll. 51–52: An amulet for sleep; at ll. 53–55: An
amulet for strangury; at ll. 56–58: An amulet against shivering fits; at l. 59: An
amulet for uncertain purpose). The papyrus, however, also contains a recipe for
potency (at ll. 60–62), which instructs the practitioner to pound marble dust with
wax,95 and two complex iatromagical recipes of uncertain purpose (at ll. 63–65
and 66–68), which employ a series of substances known for their medicinal prop-
erties, but no magical praxeis and logoi.
Our overview confirms that the PGM corpus includes texts, in which the
healing rituals incorporate allusions to mythical events (usually linked with the
Osiris myth, and later with Jesus Christ), but also texts whose ritual power ema-
nates from the invocation not only of Egyptian and Greek, but also of Jewish and
Christian deities (such as Jehovah, the Holy Spirit, the Trinity, and the archan-
gels Gabriel and Michael), the reading of magical verses, or from another magical
technique. A fair number of texts found in handbooks of the Early Empire pre-
scribe substances with real medicinal properties, while most of the later prescrip-
tions seem to recommend rather contentious medical substances.
94 On the text, cf. Bélanger Sarrazin 2015, 77–80; Mazza 2007.

95 On the – supposedly – curative power of which, see SM II, p. 249, n. 60.
Nonetheless, there can be little doubt that the prescriptions for the making of
magically charged amulets, worn to provide therapeutic or preventive protection
for the owner, prevail in late antique formularies (the related examples become
gradually more frequent over the centuries). The magical power of these texts is
regularly based upon the inscribed voces magicae (mostly untranslatable magical
words) and charaktêres (magical signs), which are attested on both the PGM and
PDM from respectively the 1st and 2nd century CE onwards.
Conclusions
The iatromagical papyri unearthed in Egypt date from the second millennium BCE
to the 6th or 7th centuries CE, and were thus written in most stages of the Egyptian
language (Hieratic, Demotic and Coptic), but also in Greek or Latin, while a few
bilingual texts are also extant. The foregoing discussion confirms the hypothesis
that, although the Greek and Demotic iatromagical formularies prescribe similar
ritual techniques and have similar magical aspirations, the two corpora differ as
to the nature of their implied audience; that is, the PDM and PGM were most prob-
ably composed with a group of different users in mind.96
The Demotic texts, on the one hand, are clearly rooted in a long tradition of
Egyptian curative magic, in which the ritual experts were equated with the priests.
These texts, most probably, originated from Egyptian temple scriptoria, in which
“hieratic formularies had been produced since at least as early as the Middle
Kingdom”.97 Although the compilers of the Demotic formularies were also recep-
tive to magical concepts, which were foreign to traditional Egyptian culture (such
as the voces magicae or the charaktêres), they continued to command medical
knowledge: The Demotic healing procedures are predominantly concerned with
instructions on how to prepare and administer relatively rational medicaments.
In this group of texts, the audience’s belief in the efficacy of a healing remedy/
ritual/amulet seems to be grounded in the learned conviction that the ritual spe-
cialist was not only a servant of the gods (and as such in close contact with the
divine), but also a medical healer.
The Greek texts are also quite firmly rooted in traditional Egyptian thought,
as Egyptian components (such as the mythological references, the ritual tech-
niques, or the textual structure) play a significant role both in earlier and later
Greek texts. There is, however, a major difference between the longest and most
96 As already suggested by Dieleman 2019a, 315–316, and 2005, 282.

97 Dieleman 2011, 85.
complete manuscripts, which were produced in the Theban area in Upper Egypt
(these are dated on paleographical grounds from the mid-2nd to the 4th-5th centu-
ries CE), and the – more fragmentary – earlier Greek texts, which begin to appear
in the Augustan era, and come from various locations in Middle and Lower Egypt.
Although the earlier Greek texts also seem to be linked – at least partly – to
authentic Egyptian priestly knowledge, we can hardly assume that they origi-
nated (similar to the PDM) from Egyptian temple scriptoria as products of the
senior temple priesthood.98 This hypothesis may be only true for the limited, yet
considerable, case of the Theban handbooks (Greek and bilingual).
Be that as it may, the authors (or redactors) of the Greek formularies make use
of several distinct cultural traditions (Egyptian, Greek, Jewish, Persian, and later
Christian),99 sometimes incorporating elements completely foreign to Egyptian
rituals, so as to appeal mainly to a Greek (or Hellenized) audience, or perhaps to a
mixed audience of different ethnic or religious groups. The ritual experts (priests
or freelance ritualists) continue to be admired by the Greek (or Hellenized) audi-
ence; yet, the admiration of this new audience does not depend on the ritual
expert’s priestly ethos or their priestly relation to the divine, but is primarily asso-
ciated with their exotic otherness, which is believed to allow them to manipulate
a stressful situation, in which supernatural (most often daimonic) powers play a
significant role. After all, “the social basis of healing is the establishment of the
practitioner’s authority to intervene”.100
Although the borders between medicine and magic are fluid and often blurred
both in the PDM and the PGM (as in any ancient cultural context), it is remarkable
that the ingredients in the PDM seem to have been more carefully selected, based
on observation of their medicinal properties and their relation to the symptoms
of the patient, whereas the content of magic in medical treatment is significantly
increased in the PGM corpus, especially in texts of later date.
It is a commonplace among many modern medical studies that the more inva-
sive a placebo treatment is (the more discomfort, the better), or the more actively
it involves the patient, the more effective the placebo effect seems to be.101 This
(modern) observation seems to explain why the therapeutic efficacy of an ancient
herbal remedy is very often believed to be improved by magical means, despite
the fact that many plants have truly therapeutic value on their own and, there-
98 See, e. g., the discussion about the ‘Philinna Papyrus’ above.

99 Christian ritual experts (probably monks) later incorporated biblical verses to meet demand
from Christian clientele (cf. de Bruyn 2010), thus resulting into the appropriation of ancient
Egyptian magical expertise by Coptic magic: on which, see Dosoo, this issue.
100 Gordon 1995, 366.
101 Cf. Chaput de Saintonge/Herxheimer 1994.
fore, allow us to recognize some sort of rational basis in the treatment. Although,
of course, the magical aspects of the preparation could hardly have any rational
benefit, they certainly engender an expectation of cure and motivation in the
patient.102
As discussed in the introduction to this volume, expectancy and motivation
are consistently cited as key factors in achieving a positive placebo effect.103
Moreover, the placebo response is shown to be stronger, when the patients are
conditioned to believe in healing through magic.104 These three focal features
(expectancy, motivation, conditioning) are clearly visible in both the Demotic and
Greek iatromagical remedies. And, although the establishment of the practition-
er’s authority to intervene is linked to completely different reasons in the PGM
and PDM, there can be little doubt that the ‘sweet’ hope for a cure often created
a positive emotional state, which may have triggered the process of self-heal-
ing on the patients, irrespective of nationality or culture. To borrow Dieleman’s
ground-breaking conclusion: “[I]n the end, the two text corpora present only two
different realizations of the same phenomenon”.105
Abbreviations
For the abbreviations of papyrological editions used in this chapter, see John F. Oates et al.
(eds.), Checklist of Editions of Greek, Latin, Demotic and Coptic Papyri, Ostraca and Tablets, BASP
Suppl. 9, 5Oakville, CT 2001, of which the updated version can be found online at <http://papyri.
info/docs/checklist>. The following is a list of the abbreviations that are not included or differ
from those given in the Checklist.
CDD Johnson, Janet H. (ed.) (2001), The Demotic Dictionary of the Oriental Institute
of the University of Chicago, Chicago (https://oi.uchicago.edu/research/
publications/demotic-dictionary-oriental-institute-university-chicago).
GMPT Betz, Hans D. (ed.) (1992), The Greek Magical Papyri in Translation, Including the
Demotic spells, 2nd edition, Chicago.
LDAB Leuven Database of Ancient Books (https://www.trismegistos.org/ldab).
SM Daniel, Robert W./Maltomini, Franco (eds.) (1990/1992), Supplementum Magicum,
I–II, Papyrologica Coloniensia 16/1–2, Cologne-Opladen.
TLG Thesaurus Linguae Graecae. A Digital Library of Greek Literature (http://
stephanus.tlg.uci.edu).
102 See Nunn 1996, 97.

103 See, e. g., Benedetti 2014, 627; Shapiro/Shapiro 2000, 56–58; Spiro 1997, 42.
104 See n. 52 above.
105 Dieleman 2005, 294.
TM Trismegistos: An Interdisciplinary Portal of Papyrological and Epigraphical Re-

sources (http://www.trismegistos.org).
Van Haelst Van Haelst, Joseph (1976), Catalogue des papyrus littéraires juifs et chrétiens,
Paris.
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P. Sarischouli - Hope For Cure and The Placebo Effect

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TC 2021; 13(1): 254–284

Keywords: Placebo, Egyptian, iatromagical, papyri, healing, magic

*Corresponding author: Panagiota Sarischouli, Aristotle University of Thessaloniki,

Preliminary considerations: Religion, Magic, and

10 See Nunn 1996, 113–135.

from a modern medicinal perspective.19 Most of these manuscripts contain a

Magic and Medicine in Greco-Roman Egypt

24 The system of numbering (Roman numerals) introduced by Preisendanz and continued in

Elpis vs. Hope

33 Cf. Koshi/Short 2007; Stewart-Williams/Podd 2004, 326.

Categorization of the Source Material

Demotic magico-medical formularies

39 See De Haro Sanchez 2010.

41 Cf. Dieleman 2005, 285–294; Ritner 1995, 3358–3371.

55 See Dieleman 2005, 140–143.

Another historiola is invented in a Demotic ritual (PDM XIV 1097–1103 = col.

60 Cf. Draycott 2011, 193–194; Dieleman 2005, 138–143, 315.

Greek magico-medical formularies

medical/healing practices, similar to the magico-medical cures prescribed in the

Greek handbooks of the Early Empire

Nonetheless, it is worth recalling here that SM II, 88 (a formulary from Oxyrhyn-

A comparable historiola can be found in a Demotic text against stomach or diges-

71 See Faraone 2000, 202–209.

In a somewhat later Greek iatromagical prescription, the healing method is

Another series of magico-medical prescriptions is found in PGM CXXVII

Greek handbooks of the Late Empire

84 For learned expectancies, see n. 52 above.

87 See Dosoo 2016, 265–266.

making of a protective amulet against daimon-attacks and epilepsy, which was

Late Antique formularies without Christian

93 Cf. Youtie 1975, 526, n. 24.

Late Antique Formularies with Christian Elements

94 On the text, cf. Bélanger Sarrazin 2015, 77–80; Mazza 2007.

96 As already suggested by Dieleman 2019a, 315–316, and 2005, 282.

98 See, e. g., the discussion about the ‘Philinna Papyrus’ above.

102 See Nunn 1996, 97.

TM Trismegistos: An Interdisciplinary Portal of Papyrological and Epigraphical Re-

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