Take Your Medicine with a Pinch of Salt. Elizabeth Pittman
the powdered herb and honey). Numerous ways of administering herbs were invented including ointments, conserves, elixirs, pills, confections, tinctures, suppositories and inhalations. The Arabs also introduced new production methods: evaporation, filtration and distillation. They passed on instructions for the production methods that they had invented revolutionizing the herbal industry.
Arab pharmacies had an immediate impact on preparation and processing throughout the known world. By the end of the eighth century, the preparation of remedies was an important profession. Since these new products added value and range to the existing repertoire of remedies, European apothecaries and physicians were quick see their advantages. One of the most popular was the introduction of senna (cassia senna) as a purgative. Since it had an unfortunate taste, aromatic spices were added. Manna (fraxinus ornus), tamarind (tamarindus indicus), rhubarb (rheum palmatum) and scammony (convolvulus scammonia) were other introduced purgatives, although the latter was so violent in its action that some European physicians later maintained it should never be used. However, purging was such a popular treatment that it did not stop others including scammony in their repertoire.
The Arabs were also influential writers on herbal matters. Having overrun the Mediterranean region, the Arabs collected an array of Greek and Roman medical texts and translated them into Arabic (see Chapter 3). Between the eighth and the eleventh centuries the pharmaceutical industry benefited from Arabic medicine’s high level of technical research and inventiveness.
Around In the tenth century Italian medicine began to catch up with that of the Arabs, and the Salerno Medical School was established at a time when Europe was ready for an expansion of knowledge. By the twelfth century texts were being translated into the language of the Christian Church, Latin. An African named Constantine had a profound influence on the development of herbal medicine at Salerno. As a drug merchant, he had travelled throughout the Near East collecting herbs and other remedies and had mastered several languages. Retiring to an abbey in 1067, he began translating Arabic, Greek and Byzantine texts. It was largely through his work that ancient exotic herbal wisdom filtered into Europe.
Beside the Arabs and Italians, the Chinese were also influential in the spread of herbs and the development of herbal remedies. Over 2000 years ago a Chinese herbalist, Shen Nong, listed three hundred and sixty-six plants used as drugs. The oldest surviving Chinese text (167 BC) gives prescriptions for fifty-two diseases and describes methods of collection and processing of minerals and the parts of plants and animals.[v]
Since the time of Marco Polo (1254-1324), news of Chinese medicines had travelled to Europe and some of the features of Chinese medicine began to appear among the practices of elite physicians in India and Europe.[vi] For example, advice on the treatment of ailments by a sixteenth century French physician recommended a Chinese root (probably ginseng) for the treatment of venereal disease. Since the Chinese were just as observant and inventive as the Arabs, they knew that plants could vary depending on the region where they were grown, and that roots should be harvested before a plant was mature since after that its strength was transferred to the foliage or flowers. Herbal processing in China included steaming, boiling in various liquids, decoction to a syrup, roasting with wine, brief heating at high temperatures (reduction of poisonous constituents), stir-frying and slow-drying of flowers and insects.[vii] Medicines were given as a pill, powder, syrup or an infusion, and prescriptions altered from day-to-day as an illness progressed or diminished.
Thus, by the sixteenth century, a vast store of herbal information and products was being exchanged throughout the known world. The English eagerly drew on this information, yet many symptoms remained difficult to treat, as this story of King Henry VIII’s personal interest in herbs illustrates. It was King Henry’s own health that drove him to invent recipes and to publish a small book containing potions devised ‘by the King’s Majesty’. Henry VIII (1491-1547) suffered from a variety of ailments over the course of his fifty-six years. One problem was the inflammation of his penis. Such inflammation may have occurred when he contracted syphilis. The granulating ulcers that are the early manifestation of syphilis are usually self-healing, although if the disease itself is untreated, it does cause other severe late effects. Various cooling potions, using a combination of herbs, were invented for King Henry’s inflammation. Another seemingly unyielding problem was the severe ulceration of his leg for which he invented a variety of poultices. Either an injury caused by falling off a horse, or varicose veins, probably caused his ulcers; even today these are extremely difficult to treat. Unfortunately, King Henry’s legs remained ulcerated until the day he died; neither his own remedies nor the concoctions of his learned doctors could effect a cure.
Ironically, given King Henry’s intense interest in remedies, his other actions had a dampening effect on the study of herbal medicine. During his reign, King Henry, for personal and political reasons to do with his six marriages and the Roman Catholic Church, closed many monasteries and abbeys, thereby curtailing the activities of monks and the significant contributions they made to healing and education. As a result, the actual study of medicinal plants lacked impetus in Britain for many years.
An even more pervasive negative influence was provided by the works of one of the fathers of medicine. Galen (131-200CE) had put forward such an all-embracing herbal classification system that he stifled European research for centuries. In particular, Galen’s classification system for herbal materia medica evaluated plants in terms of their reactions to the patient’s humours (supposedly bodily fluids, see Chapter 3). Galen went on to specify very complex herbal concoctions containing dozens of ingredients. This must have increased the business of the merchants and traders and it certainly suited early physicians. A physician who spent years mastering the complexities of Galen’s system would not want the lay public to think that any village healer, using readily available herbs, could adequately treat complaints—his wealthy patients expected more of him. Hence physicians came to think that the more complex the herbal remedy the better it was bound to be.
One example of a complex remedy was called galene (named for Galen who refined and added to its ingredients). The recipe called for viper’s flesh, dozens of different herbs (some of which were separately compounded), squills (a liliaceous plant that is an expectorant and diuretic), mineral substances, wine and honey. Herbs included crocus from Cilicia, dittany and scordium from Crete, iris from Illyria and poppies from Asia Minor. The brewing went on for forty days and the mixture was allowed to mature for a dozen years to reach its prime. Another example is theriac, a nostrum that included opium, wine and honey among its many ingredients. By the time Galen redeveloped it, the herbs in the mixture increased from sixty-four to more than one hundred. Theriac was very popular as a potent remedy, no doubt due in part to the opium and wine it contained. It became the panacea for everything and theriac remained in use until the late eighteenth century. The vast range of exotic ingredients required for these two remedies must have impressed patients and been a wonderful stimulant to international trade.
In the fifteenth and sixteenth centuries, the exploration of the New World stimulated the pursuit of new healing plants. The exploration and colonization of the Americas brought cinchona, coca, sarsaparilla and tobacco from South America, while North America and Canada yielded a harvest of sassafras, lobelia inflata (a vomit-inducing plant used to treat syphilis), and petroleum (gathered from surface pools and used to soothe aches and pains). Other imported herbs included the balsam of Peru, capsicum, vanilla and ginseng. The ginseng root was considered auspicious as a tonic and aphrodisiac, partly because it resembles the form of male genitalia. It is still a highly sought-after remedy by the Chinese and many other people throughout the western world.
Interestingly, it was the Spanish who noticed that Indian women used guaiacum wood, apparently successfully, against a disease that seemed similar to syphilis. We now know that syphilis is caused by the spirochete, treponema pallidum. The disease the women were treating was in fact yaws, another highly infectious disease that is due to a different spirochete, treponema pertenue. Nevertheless, guaiacum wood found favour as a cure for syphilis long enough for the importers to make huge profits out of what, in the end, turned out to be a useless remedy. A far more successful remedy from the New World was Peruvian, or cinchona, bark. A Jesuit priest brought it to Rome, a city where malaria flourished. Then known as the ague, malaria was endemic in many parts of Europe. The Romans found cinchona effective—it contained quinine. Even today, quinine