From the 8th century until the 15th century, the Republic of Venice and neighbouring maritime republics held the monopoly of European trade with the Middle East. The silk and spice trade, involving spices, incense, herbs, drugs and opium, made these Mediterranean city-states phenomenally rich. Spices were among the most expensive and demanded products of the Middle Ages, as they were used in medieval medicine, religious rituals, cosmetics, perfumery, as well as food additives and preservatives. They were all imported from Asia and Africa.