Tiryaq (Theriac): The Opium Antidote and the Products Named After It

Tiryaq (theriac in English) means antidote, and for almost two thousand years the word named one specific thing: a dark, honeyed paste of dozens of herbs, opium and viper flesh that Greek, Arab, Persian and Mughal physicians kept as the universal remedy against poison. The products on a Pakistani shelf today that carry the name, Tiryaq e Arba and Tiryaq e Nazla, are ordinary herbal mixtures trading on that legend, and one of them has an ingredient problem worth knowing about before you buy.

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What does tiryaq mean, and where does the word come from?

Start with the Greek. Theriake meant “to do with wild beasts”, and the first theriacs were antidotes to bites. King Mithridates of Pontus, in the first century BCE, is credited with the earliest famous version, mithridatium, a mixture that already included opium, myrrh, saffron and cinnamon. Andromachus, physician to the emperor Nero, reworked it into about sixty-four ingredients and added the flesh of vipers, on the logic that a snake must carry the counter to its own venom. Galen wrote a whole book about it and prescribed it to Marcus Aurelius.

The Arabic physicians received the recipe with the rest of Greek medicine and called it tiryaq. The version with the most ingredients was tiryaq al farooq, “the theriac that distinguishes” between life and death, and Ibn Sina (Avicenna) gave detailed formulations of it in the Canon. From Baghdad the paste travelled to Persia, where teryaq came to mean opium itself in everyday speech, and to India with the Mughals, where Unani hakeems compounded it for courts and the wealthy. In Europe it became Venice treacle, made in public ceremonies, and Italian pharmacies were still selling it in the early twentieth century.

English “treacle” began as the name of this antidote and ended as the name of a sugar syrup, because the paste was held together with honey.

What was in Tiryaq e Farooq, and why does it matter now?

The classical grand theriac was a polyherbal paste: dozens of roots, seeds, gums and resins, including myrrh, saffron, cinnamon, cassia, gentian, valerian, pepper, frankincense and many more, bound in honey, with two defining animal and drug components: trochisks of viper flesh, and opium. The opium is why patients felt it work. A paste that eases pain, stops diarrhoea, quiets a cough and brings sleep looked like a universal medicine in a world with no other painkiller.

That is also why no recipe appears here, and why none should be followed from any book or video. Opium and its preparations are controlled substances in Pakistan and India. A paste compounded with raw opium has no reliable strength, is easy to overdose, and creates dependence. A product sold as “asli Farooqi tiryaq” or “tiryaq e azam” by a roadside hakeem, a social media seller or a “taqat” shop is either opium-free and trading on the name, or it contains an opiate and is illegal. There is no safe third option.

Tiryaq e Arba: four herbs, one serious question

Tiryaq e Arba (also written tiryaq arba, “the four antidotes”) comes from the classical Unani pharmacopoeias, Qarabadeen Qadri among them. The four ingredients, in equal parts, are habb ul ghar (bay laurel berry, Laurus nobilis), juntiyana rumi (yellow gentian root, Gentiana lutea), murr makki (myrrh, Commiphora myrrha) and zarawand taweel (long birthwort root, Aristolochia longa), ground and bound in honey. Tradition gives it as a mild antidote, a digestive, a tonic for the heart and brain, and a protective taken during epidemics of coughs and colds. A 2020 Unani review proposed it as a preventive during respiratory epidemics while stating clearly that no systematic data supported any effect against COVID-19.

The fourth ingredient is the problem. Aristolochia species contain aristolochic acids, which cause progressive, irreversible kidney damage and cancers of the urinary tract. The US National Toxicology Program lists aristolochic acids as known human carcinogens. The US FDA has had an import alert on Aristolochia botanicals and products for over two decades because of outbreaks of kidney failure, some requiring dialysis or transplant, and it has asked consumers to stop using anything containing them. The harm builds silently with repeated use, and cancer can appear a decade after the exposure.

What this means for the shopper is straightforward. A classical paste with zarawand in it is not a safe daily tonic, whatever its history. Some modern makers may substitute or drop the root; the label is the only way to know, and many labels list only the Unani names, so look for “zarawand”, “aristolochia” or “birthwort”. If it is there, our honest view is skip it. If you have taken such a product regularly in the past, tell your doctor; a urine and kidney check is a sensible step.

Tiryaq e Nazla: a cold paste with an old name

Hamdard-type Tiryaq e Nazla is a modern branded majoon for the common cold, blocked nose and cough, sold as a paste in a jar. The listed botanicals are the familiar nazla herbs: liquorice (mulethi), mint (pudina), rose (gulab), coriander and poppy seed, in a sweet paste base, with the maker’s label setting the amount. There is nothing of the ancient antidote in it beyond the word. Treat it as you would any sweet herbal cold paste: soothing, sugary, not for diabetics without thought, not for children under 1 if honey is listed, and not a substitute for rest and fluids. Our day-by-day nazla routine covers what actually shortens a miserable week.

A note on poppy seed: the seed, as in halwa, is not opium and carries only traces of alkaloid. Its presence in a cold paste is tradition, not sedation.

Snake bite, scorpions and the antidote myth

The whole reputation of tiryaq rests on bites, so this has to be said in plain words. No tiryaq, no stone, no herb, no cut-and-suck, no tourniquet, no electric shock helps a venomous bite. The World Health Organization counts snake bite among the neglected tropical diseases, estimates between roughly 81,000 and 138,000 deaths a year, and states that antivenom in a hospital is the effective treatment and most deaths are preventable with it. Minutes spent on a paste are minutes of venom spreading.

1. Move away from the snake and sit the person down. Do not try to catch or kill it; a photo from a distance is enough.
2. Keep the bitten limb still and below heart level. Remove rings, watches and tight clothing before swelling starts.
3. Go to the nearest hospital with antivenom now. Phone ahead if you can. In Pakistan that usually means a district hospital, not a clinic.
4. Do not cut, suck, tie a tight band, apply ice, give alcohol, or give any tiryaq, herb or stone.
5. Note the time of the bite and any symptoms, and tell the doctors what the snake looked like.

Our full guide to snake bite, scorpion and bee sting first aid covers what to do for each.

Is the Lattafa “Teriaq” perfume related?

Only by name. Teriaq by Lattafa, launched in 2024, is an eau de parfum with caramel, honey, leather and rose notes. The brand borrowed the Arabic-Persian word for its sense of a potent, precious elixir, the way perfume houses borrow “elixir” and “potion”. It has nothing to do with Unani medicine and nothing in it is meant to be swallowed.

Questions people ask about tiryaq

Bottom line

Tiryaq is a word with a great past: the honey-bound universal antidote of Galen, Avicenna and the Mughal court, carried by opium and myth. What is known: it never neutralised venom, its effects came from opium, and the grand recipe is history, not pharmacy. What the modern products are: mild herbal pastes with a famous name, one of which carries a kidney-damaging root worth avoiding. The safety issues are the opiate hidden in loose “tiryaq”, the Aristolochia in Tiryaq e Arba, and the deadly delay of using any paste for a bite. Snake bite is hospital and antivenom. For the rest of the Unani shelf, see Unani & Herbal, Decoded and our pillar on jawarish, majoon, khameera, arq and sharbat.

Sources

• Karaberopoulos, Karamanou and Androutsos, 2012: The theriac in antiquity, The Lancet 379(9830)
• Theriac: history from Mithridates and Andromachus to Venice treacle, opium and viper flesh, decline by the 1930s
• Ansari et al., 2020: Tiryaq Arba, a polyherbal Unani formulation (four ingredients including Aristolochia longa), Middle East J Rehabil Health Stud 7(3)
• US FDA Import Alert 54-10: products containing aristolochic acid, a potent carcinogen and nephrotoxin
• US National Toxicology Program, Report on Carcinogens (15th edition, 2021): aristolochic acids listed
• WHO fact sheet: Snakebite envenoming, deaths per year and antivenom as the effective treatment