What the ancient Greeks and Romans knew (and did not know) about seasickness

Objective:To find and analyze descriptions in ancient Greek and Roman literature that reveal what was known at the time about seasickness.Methods:A systematic search was made in the original literature beginning in the Greek period with Homer in ca 800 bc and extending up to Aetios Amidenos in the late Roman period in ca 600 ad.Results:Rough seas and unpleasant odors were recognized as the major triggers; susceptibility was greater in persons not adapted to sea travel, of a labile mental state, or with anxiety; nausea, emesis, vertigo, anorexia, faintness, apathy, headache, and impending doom were frequently reported symptoms. Preventive and therapeutic measures included habituation to sea travel, looking at stationary contrasts on the coast, fasting or certain diets, inhaling pleasant fragrances, medicinal plants, and ingesting a mixture of wine and wormwood.Conclusion:The triggers, symptoms, and preventive measures of seasickness were well-known in antiquity. The implications for transport of troops and military actions were repeatedly described, e.g., by Livius and Caesar. At that time, the pathophysiologic mechanism was explained by the humoral theory of Empedokles and Aristoteles. Seneca Minor localized the bodily symptoms in various organs such as stomach, gullet, and esophagus, and also attributed them to an imbalance of bile. Recommended medication included ingestion of the plant white hellebore, a violent gastrointestinal poison. This remedy contains various alkaloids but not scopolamine, which today is the most effective anti-motion-sickness drug.