This story was originally published in our Mar/Apr 2023 issue. Click here to subscribe to read more stories like this one. Whoever studies the history of medicine finds L’Orvietan,” says Lamberto Bernardini. In his laboratory in Orvieto, Italy, a medieval hill town famous for its soaring duomo, that history is all around. Bernardini’s vaulted, frescoed space dates to the 1200s. One of the rooms in his lab is a museum-like space filled with historic books and framed antique letters, advertisements, and certificates. Centuries-old apothecary jars line the wooden shelves, their labels hand-painted in Italian script: angelica, genziana, mirra. Separated by a glass wall, the other room could be a medieval alchemist’s studio were it not for the modern stainless steel vats, which sit amid rows of glass bottles and stacks of cartons and labels. It’s here that Bernardini brews up his 21st-century version of an old and storied recipe. Through a hobby that became a passion that became a vocation, he’s revived a 17th-century formula for L’Orvietan, an herbal antidote and cure-all that was known throughout Europe and Britain. The remedy even made it as far as North America in the hands of missionaries and explorers: At Michigan’s Colonial Michilimackinac historic site, a lead cap found in the excavation of a 1700s rowhouse was recently identified as the lid to a L’Orvietan bottle. Bernardini now sells L’Orvietan as a digestif — a liqueur that’s likely much more palatable than the original mixture, which would have been sold as a powder, paste or syrup. The history he’s helped uncover sheds light on a product that was coveted by the kings of France, sanctioned by popes, sold by traveling charlatans, and earned mentions in the works of Molière, Voltaire and Balzac. Seeking a recipe The antidote has been in the historical record since 1603, when Girolamo Ferrante, considered the inventor of the herbal remedy, was granted permission to sell it in the public square in Orvieto. Whether the product had an official name before that is unknown, but Ferrante is referred to in the document as L’Orvietano — the man from Orvieto — and his product was thereafter known as L’Orvietan. A traveling salesman who wasn’t actually from Orvieto, Ferrante moved about Italy and sold his cure to crowds that would assemble in the piazzas. He probably worked from a raised stage so that he could shout to the assembled townspeople, and very likely peddled his wares with a healthy dose of theatrical flair in the form of dramatic sketches that would end with the sick being cured once L’Orvietan was administered. Ferrante fought to protect his patent and authority to sell the original L’Orvietan, but within a few years, scores of other formulas, either claiming to be the original or of similar benefit, had sprung up across Italy and the rest of Europe. L’Orvietan outlived Ferrante, who died in 1640. His widow’s second husband, Cristoforo Contugi, presented it to Louis XIV and in 1647 earned the privilège du roy — “the king’s privilege” — to sell it, but even the favor of the king didn’t last. Eventually L’Orvietan, like so many other patent remedies before it, passed into obscurity. Bernardini had to travel across Europe on the trail of L’Orvietan. He scoured historic archives and antique bookstores. He acquired rare medical books and documents, and met with scholars, herbalists and pharmacists. Finally, in a Venice library, he found the missing link in his search: a 1623 recipe, written by Ferrante’s son Gregorio, which lists the ingredients, and, importantly, their measures, for the original L’Orvietan. Bernardini says he left just one ingredient out of his modern mix: burnt viper’s flesh. Yet the mixture of herbs that Ferrante developed and others copied wasn’t necessarily all that original. L’Orvietan and its imitators had their roots in a more antique antidote called theriac. Theriac was a preferred preventive and cure of Roman emperors who were justly afraid of being poisoned, either from something slipped into their food or drink or by a venomous snake slipped into their bed at night. In fact, Theriaca Andromochas, developed by Nero’s physician, also contained viper flesh — similar in concept to antivenoms made of snake venom — and became the gold standard of antidotes. Theriac continued to be used as a cure-all and antidote for centuries, including throughout the Black Death years and well into Ferrante’s time. But with its long list of as many as 80 ingredients and high status, theriac was expensive and exclusive. In L’Orvietan, Ferrante was able to reduce the number of ingredients and develop a product that he could claim worked just was well — and that the working classes across Europe could afford. Curative claims Throughout the 1600s, L’Orvietan and its imitators were sold throughout Europe as a cure for stomach aches, shortness of breath, dizzy spells, and lovesickness, and as an antidote to poison — which in historical context could have meant any number of things, including fever, foodborne illnesses, and constipation. And, according to modern scholars, L’Orvietan’s curative claims probably weren’t just pre-Enlightenment quackery. Historian David Gentilcore, who devotes a chapter of his book Healers and Healing in Early Modern Italy to L’Orvietan, explains that in Ferrante’s era, “disease was seen as an accumulation of poison in the body, whether that meant you’d actually been poisoned, or you ate the wrong kind of food.” The objective of taking a remedy like L’Orvietan was often to defecate or vomit, to get relief from symptoms rather than to find a cure in the modern sense, he says. In modern terms, Gentilcore likens L’Orvietan to aspirin — used to manage pain and allow people to resume their work. Some medical and pharmacological historians contend that there was another active ingredient in L’Orvietan and its contemporaries, which might have had even greater feel-good effects than all those other herbs and roots combined. “Many secret remedies were big successes, and some seem to have actually worked,” says Dutch pharma-historian Wouter Klein. Theriac and its precursor, mithridatium, were listed as ingredients in many versions of L’Orvietan (though, curiously, not in the Gregorio Ferrante recipe). And the principal ingredient of both these ancient cures, says Klein, was opium. “I think we can safely assume that any effect of L’Orvietan in the past depended on the level of opium in it,” he says, and that the other ingredients were there “for color, taste, smell, or simply to make it more fancy, more expensive, and more difficult to counterfeit.” He suggests that the popularity of the remedy may have had a lot to do with its consumers’ opium addiction. But L’Orvietan’s non-opiate ingredients might not have been just filler. Victoria Sweet, a doctor of internal medicine who has a Ph.D. in medical history and premodern medicine (particularly the work of Middle Ages abbess and medical practitioner Hildegard von Bingen), points out that many of the herbs used in Ferrante’s formula have accepted uses in modern herbal medicine. For example, “lavender is still used for relaxation and to decrease insomnia,” says Sweet. “Rhubarb and mallow — these are considered digestive aides.” And it’s not just herbalists who put stock in these old-world cures, says Sweet. “Big pharma is taking basic remedies and researching them to find what they could slightly change and patent.” For instance, theophylline, a common asthma drug sold under several different brand names, has as its active principle black tea, which Sweet says has “long been used cross-culturally to open up the lungs.” Poultices made from vinca (periwinkle) leaves have traditionally been used for drawing pus out of cankers and infections. And vinca alkaloids derived from that same family of plants, says Sweet, were developed into two standard chemotherapy drugs. Gentilcore, who considers the claims that L’Orvietan contained opium credible but unprovable, emphasizes that at the time, L’Orvietan and contemporary cures weren’t “alternative medicine,” as herbal cures are considered today. While modern medicine offers more reliable results, in its historical context, L’Orvietan likely sold as well as it did because, to a certain degree at least, it was perceived to work. “Ferrante was using the science of the day. Viper’s flesh may sound ludicrous to us, but every ingredient — and there were a lot of them — could be justified. And that’s why he got a license to sell it. Medical authorities could understand it and had no problems with it,” he says. In an era where the overall state of health was poor, infant mortality was high and typical illnesses would have included fevers, consumption, gastrointestinal diseases, lice, scabies and syphilis (not to mention recurring bouts of the plague), L’Orvietan, says Gentilcore, “would have worked as well as any other medicine of the time.” When Charlatan Wasn’t a Bad Word What do you think of when you hear the word charlatan? A quack? Asnake-oil salesman? A faker and a thief? In its original usage, charlatan didn’t have any of those negative connotations. Charlatan, or ciarlatano in Italian, is a combination of two words, ciarla and cerretano. Ciarla means “to chatter.” Cerretani were men from the Umbrian town of Cerreto di Spoleto who were licensed to travel from town to town to collect alms. As a side business, they took up selling cures, including L’Orvietan. Their sales pitches, whether soliciting donations or selling their wares, involved lots of ciarla. In the vernacular of the day, these beggar-peddlers from Cerreto became known as ciarlatani. When doctors and pharmacies started selling L’Orvietan and similar cures, they used their credentials to differentiate themselves from the ciarlatoni:“Who do you trust? Me, a trained doctor, or that ciarlatano shouting out on the piazza?” Their tactics worked and, over time, the pejorative meaning of charlatan stuck.