The gathering of medicinal herbs is one of the oldest branches of the medical profession.
It is most likely that at first there was no distinction between the gathering of plants for food and collecting them for medicinal needs, especially since most human food sources originated in plants.
However, since people have always suffered from various forms of disease and illness, the therapeutic value of plants was gradually discovered in part by accident and in part through trial and error.
History of Medicinal Herbs in the Middle East
Archaeological findings at an ancient burial site in Iraq demonstrate the use of several plants that still serve in herbal medicine today – yarrow, marshmallow, hyacinth, groundsel, thistle and the controversial weight loss herb, ephedra.
In ancient Babylon, medical practice was one of the functions of priests. Many archaeological excavations have found evidence of the use of medicinal herbs.
In numerous Sumerian and Babylonian sites, archaeologists have discovered clay tablets bearing medical prescriptions. Hammurabi, king of Babylon in 1800 BCE, wrote an account of the use of medicinal plants including cassia, henbane (from the Solanaceae/nightshade family) and liquorice. He documented the use of peppermint in the treatment of digestive system ailments. Hammurabi prescribed the use of mint for digestive disorders.
About 400 Assyrian remedies derived from plant and mineral sources are known today. One well-known Assyrian remedy is a resin derived from pine, which was used both externally as a muscle ointment to relieve pain, and internally as a treatment for kidney and liver diseases. The Assyrians knew of the narcotic properties of opium (poppy) seeds and of the medicinal qualities of mandrake (another member of the nightshade family).
Egyptian papyri often included “recipes” – medical prescriptions with the various ingredients and their quantities.
The oldest medical document known is the papyrus of Ebers. It is dated to the sixteenth century BCE and was buried until its discovery, during the nineteenth century, in Egypt. The document comprises 877 prescriptions and remedies, some of which include frankincense, myrrh and many other spice plants.
History of Medicinal Herbs in India
In India, evidence of traditional herbal medicine dates back to about 1000-1500 BCE, when two principle texts of Ayurveda, Charaka Samhita and Sushruta Samhita were composed. Charka and Sushruta are respected names in the fields of medicine and surgery respectively. Both the texts have dealt in detail with the use of medicinal plants. Chebulic myrobalans (Terminalia chebula), Arjuna (Terminalia arjuna), Guggul (Commiphora mukul), Shatavari (Asparagus officinalis) and Ashwagandha (Withania somnifera) are popular medicinal plants targeted for application in modern science.
Many of the plants known in the Indian folklore were put to use by the Egyptians and by the Greeks after them, and, ultimately, found their way into European folk medicine as well.
History of Medicinal Herbs in China
The Shen Nong Ben Cao Jing, written in about 200 AD, is the oldest book on Chinese herbs. It details the medicinal and agricultural knowledge of the mythical Chinese emperor Shen Nong, who is said to have lived around 2800 BCE. The book comprises three volumes and records and classifies 365 traditional herbs (including goji berries).
The first volume of the treatise included 120 drugs harmless to humans, offering “stimulating properties”: reishi, ginseng, jujube, orange, Chinese cinnamon, Eucommia bark, cannabis, the root of liquorice (Glycyrrhiza uralensis). These herbs are described as “noble” or “upper herbs”.
The second volume is devoted to 120 therapeutic substances intended to treat the sick, but they have toxic, or potentially toxic properties of varying degrees. In this category, we find ginger, peonies and cucumber. The substances of this group are described as “human,” “commoner,” or “middle herbs”.
In the last volume there are 125 entries corresponding to substances which have a strong or violent action on physiological functions and are often poisonous. Rhubarb, different pitted fruits and peaches are among those featured. These herbs are referred to as “low herbs”.
As far back as 5,000 years ago, the Chinese were known to drink tea made from a leafless creeper known as “Ma-Huang” (Ephedra sinica), as a treatment for lung diseases. The Shen Nong Ben Cao Jing ancient Chinese book particularly specifies the value of this tea, which purportedly accelerates the circulation of the blood, reduces fever and relieves coughing. However, its main importance was in clearing disturbances in the respiratory system.
‘Ephedrine’ was first extracted from this plant in the nineteenth century. The compound is still used today as a medication for asthma, various allergies, sinus congestion and influenza. It is commonly known as psuedoephedrine in its pharmaceutical form. In some countries its use had been restricted because of its potentially “speed” like effects.
The Chinese and the Indians introduced the world to the use of cannabis (marijuana), which is known today mainly for its narcotic qualities, but which for thousands of years was famed for its medicinal properties, including the treatment of eye disorders and pain relief. Today, there is increasing interest and research into the potential therapeutic benefits of cannabis.
Medicinal Plants in the Bible
We have only indirect evidence of the medicinal use of plants during the biblical period. Several plants which were known in the ancient Orient as medicinal plants are referred to in the Bible as sources of perfume – labdanum, tragacanth, frankincense and myrrh. The Bible mentions various poisonous plants including mandrake, hemlock, wormwood and bitter apple. Spices mentioned include garlic, onion, cumin, hyssop and fennel. Although there is much evidence of the medicinal use of these plants in the region, there are no direct references in the Bible as to their usage for these purposes.
Medicinal Plants in the Talmud
In contrast to the total of about 120 plants which are mentioned in the Bible, about 400 are introduced in the Jewish Mishnah and the Gemara, which together make up the Oral Law (Talmud). It is clear that until the period when the Talmud was codified (about 550 AD), the people of Israel had their own tradition of folk medicine, which they had developed mostly from within their own society, rather than as a consequence of external influences.
History of Medicinal Herbs in Ancient Greece and Rome
The ancient Greeks excelled in the field of herbal medicine and their heritage left its mark on European culture for hundreds of years to come.
Hippocrates (fourth century BCE) is considered to be the father of modern medicine. In his writings he lists about 300 medicinal plants. Some of these plants are used to this day in modern herbalism, including mint, poppy, sage, rosemary, and vervain.
However, some of his recommended medicinal herbs have since been proven to be unsafe – one example is Rue. This herb is now considered relatively safe when consumed in food amounts, but unsafe when used as a medicine. In the past, it was used for a long list of complaints – including loss of appetite, upset stomach, diarrhea; heart and circulation problems including palpitations and “hardening of the arteries” (arteriosclerosis); painful conditions including headache, arthritis, cramps, and muscle spasms; and for nervous system problems including nervousness, epilepsy, multiple sclerosis, and Bell’s palsy. Other uses included treatment of fever, hemorrhage, hepatitis, “weakness of the eyes,” water retention, intestinal worm infestations, and mouth cancer. Rue was also used to kill bacteria and fungus. Taken by mouth, it can cause side effects such as severe stomach irritation, changes in mood, sleep problems, dizziness, spasms, serious kidney and liver damage, and death. When applied to the skin, it can cause rash and increased sensitivity to the sun.
The Athenian botanist, Theophrastos (371-287 BCE), is known as “the Father of Botany”. He studied the plants of Greece and neighboring countries. His two surviving botanical works, “Enquiry into Plants” (Historia Plantarum) and “On the Causes of Plants”, were an important influence on Renaissance science. Both books were pioneering treatises in both botanical research and in the history of medicinal plants. Some of his prescriptions are, in their essence, in use up to this day. In this work, he introduced details of the appearance of plants, their manner of cultivation, their classifications and their uses. His book was used as a basic textbook for more than 2,000 years.
Dioscorides (40-90 AD) was a Greek physician, pharmacologist and botanist who served in the Roman army in the days of the Caesar Nero. He is famous for writing “De Materia Medica” – a 5-volume encyclopedia/pharmacopeia about herbal medicine and related medicinal substances. It describes almost 800 remedies derived from plant, animal and mineral sources. The book includes directions of how to find them, recommended harvesting time, preparation procedures and medical designation. The book proved to be extremely influential in the West and laid the foundations for herbal medicine up to the Renaissance period – it was widely read for more than 1500 years.
In the medieval period, De Materia Medica was circulated in Latin, Greek, and Arabic. De Materia Medica is the prime historical source of information about the medicines used by the Greeks, Romans, and other cultures of antiquity. The work also records the Dacian and Thracian names for some plants, which otherwise would have been lost.
The Romans did not introduce many innovations to the field of herbal medicine and, as in other issues, mainly derived their knowledge from the Ancient East and especially from the Greeks. Both Greeks and Romans used medicinally active plants for production of cosmetics, extraction of perfumes, and as edible spices. Much of this information was gathered by Pliny the Elder (79–23 BC), in his book, “Natural History”, a compilation of information from about 2,000 Greek and Roman manuscripts. Pliny’s writings, although not exclusively medicinal, do contain some information on the use of plant-derived medicine.
The influence of Galen (129-200 AD) a Greek physician, surgeon and philosopher in the Roman empire, persisted in the medical world for many centuries. Arguably the most accomplished of all medical researchers of antiquity, Galen influenced the development of various scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology.
Many of his treatments included the use of medicinal plants. Plant-based remedies to this day bear the heading “Galenic medicine”.
Marcus Aurelius (161-180 AD) explained the use of opium (Papaver somniferum) in the treatment of headache, epilepsy, asthma and skin diseases. In fact, he documented the use of medicinal herbs in his work Meditations.
After the fall of the Roman Empire, the active development of medicine, including the medicinal use of plants, ceased in the West; early Christianity believed that diseases were divine punishment for sins, and that their cure was a matter for God, not the intervention of science.
History of Medicinal Herbs in the Arab World
In sharp contrast to the “all in God’s hands” approach, Arabic/Muslim medicine flourished during the seventh century AD onwards, reaching its peak in the eleventh century AD.
It was influenced mainly by the ancient medicinal practices of Mesopotamia, Greece and India. Many principles of Arabic medicine, including the use of medicinal plants, are widespread today among many millions of people across North Africa, Europe and Asia. Although ancient Arab medicine had inherited traditions from Greek and Roman practices, it extended the use of plants, and introduced many which had not been known previously in the West.
The most famous medical scientist of that period was Avicenna – or Ibn Sina – (980–1037), who was born in what we now call Uzbekistan.
Of the 450 works he is known to have written, around 240 have survived, including 150 on philosophy and 40 on medicine.
His most famous works are The Book of Healing – a philosophical and scientific encyclopedia, and The Canon of Medicine – a five-volume medical encyclopedia which became a standard medical text at many medieval universities and remained in use as late as 1650. In 1973, Avicenna’s Canon Of Medicine was reprinted in New York.
However, like Hippocrates and many other ancient scholars, not all Avicenna’s recommendations have stood the test of time. For instance, Avicenna recommended the use of a plant known as groundsel (Senecio vulgarises – from the ragweed/daisy family) as a purgative for clearing the gall bladder. Groundsel is now considered unsafe for anyone to use, unless it has been treated to remove toxic compounds. There is much concern about using groundsel as medicine, because it contains chemicals called hepatotoxic pyrrolizidine alkaloids (PAs), which may block blood flow in the veins, causing liver damage. Hepatotoxic PAs might also cause cancer and birth defects. Groundsel preparations that are not certified and labeled “hepatotoxic PA-free” are considered extremely unsafe. It is even unsafe to apply groundsel to broken skin – the toxic chemicals can be absorbed quickly through broken skin and can lead to dangerous body-wide toxicity.
Ibn el Beithar (1197–1248), was a famous Arab pharmacist, botanist, physician and scientist.
His largest and most widely read book is his Compendium on Simple Medicaments and Foods. It is a pharmacopoeia listing 1400 plants, foods, and drugs and their uses. It is organized alphabetically by the name of the useful plant or plant component or other substance. For each item, Ibn al-Baitar makes one or two brief remarks himself and provides brief extracts from a handful of different earlier authors about the item. The book contains references to 150 previous Arabic authors, as well as 20 previous Greek authors.
He describes the medical practices of Dioscorides, Galen and Ibn Sina, and introduces additional information from his own research. The book specifies the names of the remedies and of the plants in various languages, thus providing an innovative tool for comparative research of medicinal plants.
Maimonides (Moses ben Maimon, known by the Hebrew acronym Rambam, 1134–1240), was born in what is now modern-day Spain. In addition to his vast publications in the fields of Torah and Jewish Law (Halachah), he published numerous medical books, which were considered the epitome of advanced medicine at that time.
His books included:
The Art of Cure – Extracts from Galen
Commentary on the Aphorisms of Hippocrates
Medical Aphorisms of Moses – contains 1500 aphorisms and many medical conditions are described
Treatise on Haemorrhoids, also discusses digestion and food
Treatise on Cohabitation contains recipes as aphrodisiacs and anti-aphrodisiacs
Treatise on Asthma discusses climates and diets and their effect on asthma and emphasizes the need for clean air
Treatise on Poisons and Their Antidotes is an early toxicology textbook that remained popular for centuries.
Regimen of Health is a discourse on healthy living and the mind-body connection.
Discourse on the Explanation of Fits advocates healthy living and the avoidance of overabundance.
Glossary of Drug Names represents a pharmacopeia with 405 paragraphs with the names of drugs in Arabic, Greek, Syrian, Persian, Berber, and Spanish.
These books attribute great importance to the use of medicinal plants, several hundred of which are mentioned in Maimonides’ writings.
History of Medicinal Herbs in Europe
In medieval Europe, knowledge of medicinal plants was preserved mainly in the monasteries. The monks grew medicinal plants with great dedication in their gardens. They gathered and dried the plants, extracted essential oils from them, and used them for medicinal treatment according to the traditions of the Greek and Roman manuscripts, which they had copied and translated with great diligence, drawings included.
The moratorium on medicine in Europe was total in the early to mid-Middle Ages. Even the “Black Plague”, which spread across Europe during the mid-fourteenth century, did not encourage fresh research into the causes of the disease. As mentioned previously, Christian beliefs dictated that healing should come only from God.
However, many people did hang bunches of bay leaves, dill, mint, roses and other aromatic plants above entrances to hospitals and houses, because these were believed to fend off the plague by power of their fragrance. It would later be known that some of these plants do possess disinfecting properties.
In Europe of the Middle Ages, great importance was attributed to plants of the Solanaceae (nightshade) family: mandrake, henbane, stinkweed and belladonna (deadly nightshade). These plants owe their medicinal characteristics to the high concentration of tropane alkaloids in them. These were mainly used during the Middle Ages for witchcraft and magic, due to their hallucinogenic, anesthetic and poisonous properties.
For this reason, later medical publications would refuse to include them in an authorized list of medicinal plants, in spite of their medicinal importance. It should be noted that several plants of the Solanaceae family, especially belladonna, are used up to this day in herbal medicine, while in modern medicine they are sources of indispensable drugs such as atropine (relaxes muscle spasms and regulates heart rate) and scopolamine (reduces body secretions, such as stomach acid). However, as herbs these should be used with great care and caution, as they can be extremely toxic and cause allergic reactions.
In medieval Europe, an interesting philosophy of herbal medicine was developed, known as the “Doctrine of Signatures”. It was first introduced by herbalists many years before, but was documented in writing by Paracelsus, a Swiss fifteenth century doctor. The Doctrine of Signatures introduced the concept that plants were created to serve mankind, and that they had been given their forms by the Divine Creator in accordance with the objective that they were to serve.
Heart-shaped leaves and flowers were believed to be designated for treatment of heart diseases; kidney-shaped fruits, such as pulses, were to treat diseases of the kidneys. Red flowers and plants with red juice, such as pomegranate and beetroot, were considered excellent for treatment of problems in blood circulation; yellow plants or those with yellow juice were to be beneficial for treating jaundice; walnuts, which resemble the skull and brain, were used for treatment of illnesses related to the head or brain; hairy plants would benefit the hair; long-lived plants would bring longevity to those who ate them, etc.
It was only by the mid-fifteenth century that the influence of Dioscorides, and that of the classic herbalists, began to fade within European botany and medicine. During this period, the European herbalists began researching plants purely for the purposes of research. This resulted in descriptions and drawings of plant life worldwide, as advances in ship-building technology allowed Europeans to begin exploring the globe.
The Age of Herbals
Culpepper (1600 AD) wrote about the principle and practice of herbal medicine in his work, The English Physician. In this work, Culpepper described 1,653 drugs with information on mode of preparation and dosage. Many of his unpublished manuscripts were published after his death but many more were lost in the Great Fire of London in 1666.
The period between 1488-1682 is known as the age of herbals. Otto Brunfels wrote a herbal text in 1488, which was published in 1534. This period produced a number of distinguished herbalists like Gesner Conard, Leohard Fuchs, Hieronymus Boch, William Turner and John Parkinson. Friedrich Wilhelm Serturner (1783-1841) isolated morphine from Papaver sominferum in 1805 and showed the medical world that certain chemical constituents are responsible for curative actions of plant based remedies.
Felix Hoffman isolated aspirin from willow bark (Salix spp.) His work augmented the rational use of willow bark by ancient people. The bark was used in the treatment of arthritis and rheumatism. Aspirin is still prescribed in reducing pain and stiffness associated with joints. William Withering (1741-1799) reported to the scientific community about separation of cardiac glycoside, digoxin from foxglove (Digitalis purpurea). The discovery of digoxin proved to be a milestone in the history of medicine (particularly cardiology) as digoxin was once considered a first line drug in treating cardiac edema.
Klie isolated reserpine from Rauwolfia serpentina and the alkaloid remained as the drug of choice for the treatment of hypertension for almost 50 years. Jean Robiquet reported the isolation of antitussive (cough suppressant) alkaloid, codeine from the opium plant. Clark Noble did a great service for humanity by discovering Vinca alkaloids from Madagascar periwinkle (Catharanthus roseus). Vinca alkaloids (vinblastine and vincristine) are drugs for treating leukemia. Discovery of taxol from Pacific yew (Taxus brevifolia) by Mansukh C.Wani and silymarin from milk thistle (Silybum marianum) by Jack Masquelier are some recent examples of drugs obtained from plants.
Before the discovery of antibiotics (penicillin and streptomycin), analgesics and steroids, people were completely dependent on medicinal plants for treating health conditions. With the discovery of phytochemicals, the interest of the scientific community shifted to organic synthesis and several drugs were synthesized. The growing popularity of the allopathic system of medicine was a major setback for herbal medicine. Emergency treatment and surgical advances are the gifts of modern healthcare systems to the people.
Today we can see the renaissance of the herbal system of medicine. Ayurveda and Traditional Chinese Medicine (TCM) are popular systems of healing in western countries. Recent studies have shown that an increasing number of patients are consulting doctors of alternative systems of healing. Relative safety and cost effectiveness may be factors responsible for renaissance of the herbal system of medicine.
Although there is no doubting the predominance of chemical research in modern medicine, there is a notably increasing interest, within both medical circles and the general public alike, in herbal medicine. Further research into the biochemical mechanisms of herbal medicines will enable a synthesis of traditional and modern methods of health care, to the benefit of all.
No-one expects to turn back time nor to ignore the achievements of modern science, or to restore herbal medicine dominancy into society, just because its use has persisted throughout the long history of mankind. Nevertheless, in spite of the mystery and magic associated with the practice of herbal medicine, the centuries-old traditions and knowledge of herbal practitioners has been passed down to us; practices and methods that has been tested throughout time and tradition hold an invaluable source for further developments, in both herbal and conventional medicine.
Today, there is an ongoing growth in the worldwide market of plant-based cosmetics and of over-the-counter, non-prescription herbal medicine. However, the marketing and administration of such products is subject to varying degrees of regulations, depending on government policy in different countries.
It is important to continue the knowledge of traditional practices in order to develop new remedies for modern use. The process is not easy. It involves, first, the proper cultivation of selected plants with a commercial and medicinal potential, using controlled production methods. The next step involves modern extracting methods. The purpose is to come up with an active fraction or, if possible, a purified active compound. At this stage tests aimed at standardizing the compound and testing for toxicity and validity of function should follow.