THE USE OF MEDICINAL PLANTS FROM ANTIQUITY TO THE PRESENT DAY
The first name in the history of the last two millennia in the field of medicinal plants is that of Cassiodorus (490-580), healer at the court of the Ostrogothic prince Theorodic. This ancient healer made the first attempt to systematise the medical and pharmacological knowledge of Western culture. In his regulations Cassiodorus recommends the study of ancient authors such as Hippocrates, Dioscorides, Galen and Aurelian of Sicca and Dioscorides' work "De materia medica".
Apart from documents inherited from antiquity, some anonymous texts and treatises written in the 4th and 6th centuries were decisive for monastery medicine.
The Lorsch Codex, published around 795, is a Carolingian manuscript from the monastery of Lorsch, near Woms in Bavaria. This ancient medical manual provides an overview of medieval pharmacopoeia. The text consists of recipes, some of which are difficult to understand, and includes many old plant names.
In the 9th century, the abbot of the monastery of St. Gallen and the poet Walafrid Strabo (born in 808) wrote a compilation entitled "Hortulus", which, in addition to describing how the monastery garden was laid out, included 24 varieties of plants and their therapeutic indications. The famous plan of St Gallen, designed before 830 and found in the monastery on the island of Reichenau, shows the architectural plan of an ideal monastery, which would have included, in addition to a doctor's surgery and a hospital, an extensive herb garden. The plan also recommends the varieties of plants to be cultivated. The plants mentioned in this context are the same as those in the work 'Hortulus'.
In the 11th century the monk Odo, Bishop of Meung, wrote the poem "De viribum herbarum", in which he describes the therapeutic indications for 64 medicinal plants. A more detailed version, attributed to the ancient author Aemilius Macer of Verona and known as 'Macer Floridus', is considered the most widely read herbal book of medieval times.
Monastic medicine of that period unquestionably did an immense service to medicine in so far as it restored and supplemented the knowledge that came from antiquity.
Ecclesiastical scholars have appropriated this knowledge. Christian beliefs then took over the representations from antiquity. God was recognised as the One who provided people with natural therapeutic means. This association, however, advanced to considering it as a sin as serious as suicide to refuse to be cared for or to take a remedy. As the power of the church grew, folk medicine knowledge was sometimes Christianized. Some herbs were given Christian names and sometimes such practices were opposed by the Inquisition.
The repression of folk medicine spread the superstition that what could only be administered in secret was adulterated or embellished at will. Unpopular pagan beliefs simply gave way to authorized Christian practices. In 1130 the Council of Clermont forbade clerics to practise medicine, and towards the end of the Middle Ages monasteries gradually stopped providing medical care.
Monastery medicine has recently become a field of research in its own right. At the Institute for the History of Medicine at the University of Wurzburg (Germany), a specialist research group has been set up to examine the use of medicinal plants. This work has led to the rediscovery of medicinal plants and areas of use that had been forgotten. Specialists are now working on historical profiles of plants described in ancient books.
Hildegard von Bingen (1098-1179) was the twelfth child of a German noble family. Hildegard was a Benedictine prioress of Rupertsberg and wrote several works in various fields, including "Physica" and "Causae et curae". The former is a treatise on therapeutic modalities in nine volumes, two of which are devoted to plants and trees. For the first time, Latin and common names have been used very well. Taking into account the many plants never described before, the abbess has succeeded in associating monastic medicine with traditional popular therapeutic modalities. In her medical work "Causae et curae" she went beyond the teaching of humoral pathology and developed personal descriptions of the human body, including sexuality.
The starting point of academic medicine was obviously monastic medicine. Medicine on Mount Cassin played a decisive role by founding a hospital at Salerno for sick monks. In the 11th century Constantine the African, a merchant of remedies and spices, became a monk. He had medical knowledge and translated many Greek and Arabic texts into Latin. In addition, he compiled his own teaching, 'Liber grandum', which describes over 200 plants and minerals.
The school in Salerno became the first medical school where those who trained were mostly lay people. Monasteries gradually lost their monopoly on medical education. Academic medicine took hold and was taught in the new universities. The schools of Montpellier and Padua in northern Italy were among the most famous. Constantine's translations led to the emergence of a new systematic literature.
The herbal medicine work "Circa instans", written in the 12th century, contains 260 detailed monographs of plants. As well as describing plants, the work also describes herbal remedies and their properties. This writing presents an enumeration of properties and main effects, together with precise indications for use, as well as certain combinations of plants and other possible remedies.
The "Circa instans" spread very quickly throughout Europe. Together with the seminal work "Aggregator" of Moorish origin, translated into Latin in 1290, it served as the basis of the huge collections of the late Middle Ages. These were assembled in the 13th and 14th centuries by Dominican monks. These scholars aimed to organise existing knowledge into an encyclopaedia. These universal encyclopaedias contained many important passages on various medicinal plants. From the 14th and 15th centuries onwards, specific works on medicinal plants and remedies were written, comprising more than 100 chapters.
In parallel with the early monastic medical writings dating from the Carolingian era, which essentially referred to the works of Pliny and later developments, Galen's theory of humours, based on the teachings of Hippocrates, attracted increasing interest from the 11th century onwards. Because a small number of scholars were able to understand this refined system correctly, Galen's medicine was practised in an incomplete way in the Middle Ages.
With the outbreak of the Black Death (1346) the situation changed. This dramatic event profoundly changed the approach to medicine. Paracelsus rejected the old belief that illnesses were the result of an internal imbalance in the body and pointed to the role of external factors. Paracelsus advocated signature theory, astrology and alchemy. The signature theory can be related to astrological theories or religious beliefs. Based on the argument of the influence of the stars, the structure of a plant can highlight aspects of its therapeutic effects. This can be expressed by shape, colour or structure.
Paracelsus was based on the idea that "Nature creates all plants according to what is useful". Thus, red roots were useful for stopping haemorrhages. The sclipe was one such example. This understanding also applies to the willow and poplar whose branches shake in the wind, the leaves of these trees being useful for fevers and chills. The same is true of St. John's wort flowers, whose leaves have small transparent dots and are used to heal wounds.
Ginseng root is similar to a human silhouette and is used as a general tonic. The 16th century marks the renaissance of botany and plant medicine, which become the subject of assiduous study. Numerous works are published in Italy, France, Spain and Germany. Interest is focused on different varieties of plants.
Otto Brunfels, a German monk turned physician and botanist, first classified plants by botanical family name. The Swedish botanist Carl von Linne reformulated the names and classification of living things. The burgeoning trade in medicinal plants, but also differing opinions about their properties and how to cultivate them, led to the introduction of rules.
The rules were primarily intended to ensure that the preparation of remedies guaranteed their properties. In Florence, the collaboration of the pharmacists' guild with the medical profession led to the publication in 1498 of the 'Nuovo Receptario', the first pharmacopoeia with official status, which was to be respected by all pharmacists under Florentine jurisdiction. The rules were applied in other regions 50 years later. The 17th century saw the return of a part of monastic medicine and pharmacy. Monks in monasteries no longer lived in the isolation of the Middle Ages. The Counter-Reformation led to the rebuilding of many monasteries. Some of the monasteries were equipped with pharmacies that provided remedies for those nearby. In the monasteries of nuns, women had the same training and authorisation to practise medicine.
In France, Nicolas Lemery (1645-1715) brought together the medical knowledge of his time in his work "Universal Pharmacopoeia", published in 1697 and reprinted eight times. Before taking a job with an uncle who was a pharmacist, he left him and attended the classes of Galzer, who gave chemistry demonstrations in the Jardin du Roi. At the same time his reputation as a pharmacist was growing. Having fled to England because of persecution against Protestant supporters, he returned to France in 1683 and was admitted as a doctor of medicine in Caen. Prevented from practising because of his religious convictions, he preferred to abjure in 1686. He is the author of numerous works. In the preface to the "Universal Pharmacopoeia", Lemery writes "This is a universal pharmacopoeia. I have given descriptions of remedies of ancient and modern times, from France and other parts of Europe, described their virtues, their dosages, their mode of operation, and made remarks either as to dosage or as to the elimination or addition of other ingredients".
Theophrastus Bombastus von Hohenheim, called Paracelsus (1493-1541) studied medicine in Italy. As a young teacher in Bale he caused a scandal because he gave his lectures in the language of the people, German, and not in Latin as prescribed. He wrote a huge medical work in which he brought together the various medical theories. He was sympathetic to the old German customs, in particular the observation of the phases of the moon, and he also considered vital processes to be alchemical processes. He thought that curing illnesses was alchemy. Paracelsus sought to isolate the active principles of plants and to obtain healing water through chemical processes. His thinking was appreciated as being far beyond the mentality of the time.
The 18th century brought the scientific rigour of the Age of Enlightenment to phytotherapy. Bernard de Jussieu (1699-1777) illustrates this contribution. After being "demonstrator of botany" in the Jardin du Roi, he published his "History of the Plants around Paris" in 1725, admitted to the Academy of Sciences. He devoted his time to reflecting on the laws governing organised beings.
In 1758, when he was commissioned to design a botanical garden at the Trianon, instead of doing it according to Linne's system, adopted almost exclusively at that time, he classified plants according to a natural method based on their relationships. Jussieu was one of the contributors to the creation of the Natural History Museum. The Plant Garden features the cedar of Lebanon, which he brought into his hat in 1734 and which is today one of the most imposing trees in the garden.
With the colonisation of America, ancient Indian remedies were discovered in Europe, including plants that are useful in the treatment of malaria and scurvy. In North America, native communities excelled in herbal therapy. By virtue of their great principles they lived sober lives, taking a vital interest in agriculture and horticulture. They developed a good practice of using medicinal plants.
In the early 19th century, homeopathy, as it is known today, emerged. Its founder, Samuel Hahnemann (1755-1843) opposed the practices of blood-taking, cupping, fumigation and hydrotherapy. He believed that disease was an energetic process that could be treated energetically and formulated strict rules for carrying out therapeutic means. However, the general trend of the time was the opposite. From the 17th century onwards, the aim was to differentiate the effects and explain the active principles. Attempts to understand the chemical composition of plant substances were first successful with the development of organic chemistry. At the beginning of the 19th century the German pharmacist Friedrich Wilhelm Adam Seeeturner succeeded in isolating morphine as the active principle of opium. At the same time, he also discovered the new class of alkaloids.
Joseph Pelletier (1788-1842) and Joseph Bienaime Vacentou (1795-1877) discovered strychnine from the vomica nut and quinine from the bark of the cinchona tree, used to cure malaria. Certain pharmacists began producing these substances in large quantities.
Isolated substances had the advantage that they were of consistent quality and could be dosed accurately and were always available. The use of structurally defined isolated substances allowed pharmacological examination from which mechanisms and chemical correlations could be deduced.
Over time it has been found that a single active substance is often insufficient and needs to be combined with other substances.
The pharmacologist Berne Emile Burgi (1872-1947) observed that two or three remedies that have the same effect, potentiate their effect when they are together and when they have the same pharmacological component, but have different pharmacological effects when the components are not identical. This finding confirmed a much older, ancient view that remedies were more effective as a whole, and not just as isolated substances, as is the case with medicinal plants.