fear of illness and hopes of cure, or at least, the reduction of symptoms. Such hope has often been amazingly rewarding to both professionals and patients. But at other times these hopes have been unjustified, or even based on fraudulent claims. Most of the health industry is incredibly profitable and as consumers age, we are increasingly the source of its profitability. The genetic nature of cancer explains the apparent paradox of medicine. As we survive other illnesses, more of us will live long enough to develop cancer. The challenge, which genetics may help to meet, is to turn cancer from a fatal disease into a chronic one. The unanswered question is, will that result in a lifestyle which we are happy with?
This book is written in the belief that the more we understand the evolution of the major components of the health care system, the more we can determine the validity of a medication or a therapy and the more we can minimize the risks attached to self-medication, orthodox medicine and CAM therapies. Health literacy, plus a dose of healthy scepticism, are requirements for deciding which claims of efficacy and safety should be taken with ‘a grain of salt.’
[1] Kennedy, I (1981), The unmasking of medicine, London: Allen & Unwin, p. 46.
[2] Shaw, G B (1913), The doctor’s dilemma: A tragedy (preface), London: Constable and Co, p. xciii.
Herbal Medicine
It is easy, with the scientific arrogance of the twenty-first century, to forget that a century and a half ago most medicines were herbal remedies. The use of plants has a very long history indeed. We know that self-medication with the green pharmacy took place at least as long as 60,000 years ago. In a cave in Iraq, the grave of a Neanderthal man was found to contain many grains of pollen scattered about his body. Using modern scientific methods, the pollen was identified as coming from eight different species of flowering plants found today in the surrounding countryside. Most of these are still used as medicines by local people. One example is the shrub Ephedra, a remedy for asthma and a cardiac stimulant—a usage confirmed by modern science when the nerve stimulant ephedrine was extracted from it.[i]
Throughout the millennia ordinary people have sought remedies where they could, and plants offered an ever-ready supply to try, but were limited to the offerings of the local terrain and mediated by the seasons. We know very little about the early use of herbs since recipes were handed down orally through the wise men and women in peasant communities, however written records began to appear on tablets and stones as long ago as about 5,000 years. The stone tablets of the Sumerians (Southern Mesopotamia) include lists of useful herbal remedies. The public records of King Hammurabi of Babylon (1,754 BCE) were also written on stone and refer to healing plants. There is no doubt that herbs were and remain the principal medicine in India; as the world’s largest producer of medical herbs the subcontinent has been called the ‘botanical garden of the world’. The World Health Organisation has listed 2,500 species of medicinal plants of which 150 species are used on a large scale. Herbal medicine is also widely used in China. A Chinese researcher, Tu Youyou, has extracted artemisinin, the active ingredient of a plant that had been used to treat malaria for over 2,000 years. For this contribution to modern medicine Dr Tu shared the 2015 Nobel Prize for medicine.[ii]
Botanists classify herbs as seasonal, seed-producing plants that have flowers, and it is these parts that are mostly used in cooking. The flowers and other parts of the plant such as the bark, sap and roots are often used in herbal remedies. Originally herbs were picked where they grew and were used by all and sundry for maintaining health or the relief of symptoms. A glance around the well-stocked shelves of a pharmacy or a Chinese herbalist’s shop will show how popular they remain today.
The story of how plant remedies came to be pre-packaged staples of pharmacies and other retail outlets owes much to the early seafaring traders in the Middle East, Asia and later, the New World. Well before the eleventh century, the importation of herbs was such a lucrative international trade throughout the known world, that there is little doubt that merchants were among the first people to provide a continuous exchange of information and products. Interestingly, there is a remarkable resemblance between the ancient drug inventories extant in Mesopotamia, Egypt and India. The same herbs and minerals are frequently listed. The same minerals are also listed, together with other more exotic ingredients also used in remedies such as sulphur, antimony, iron, powdered precious stones and animal or human matter such as hair, fat, blood, faeces, urine (all of which were said to be consumed, not just applied!).[iii]
Traders were not the only ones to spread the use of herbs; soldiers were also responsible. Roman legions always travelled with healers and surgeons who found it expedient to carry their remedies wherever they went. Sometimes they planted the seeds and the herbs spread from one locality to another, leaving a legacy for the local healers. The spread of the madonna lily throughout Europe is thought to be a Roman legion legacy and an example of this. We also know that garlic was frequently used for coughs, colds, warding-off infections and as an antiseptic for wounds; while mustard (sinapis nigra) was used for poultices, as an emetic for food poisoning or upset stomachs, and as an aperient or laxative. Such was the army’s dependence on herbs, that one Roman soldier, Scribonius Largus, wrote descriptions of those found in Europe and the Mediterranean, including packing and transporting instructions. Not surprisingly, army healers were only interested in maintaining the supply of herbs for the health of their troops. The health of local populations was left to others. such as monks.
After Christianity arrived in England in the sixth century, Benedictine monks treated their own sick, the poor and the people in the surrounding district. Eventually they handed on their knowledge and skills to pupils outside the monastery as well as to the next generation of monks.
Welsh healers also influenced the development of herbal healing. The school for physicians, at Myddfai in Wales, was established in the sixth century and for over a thousand years they handed down their system of healing. Welsh healers are particularly interesting because they seemed to have had inquiring minds and sought the causes of illness. They were systematic in their approach, keeping careful records of repeated observations. Although the school grew its own herbs, most were culled from the countryside. Some herbs used in this period are well known and still in use today. Others sound exotic to modern ears and the conditions they treated seem very strange. For example, wood betony (stachys betonica) was used for headaches and nervous disorders, feverwort (erythraea centaurium) was used for fevers and tonics, vervain (verbena officinalis) for jaded appetites (used today in vermouth) and clivers (galium aparine) for scrofula and skin eruptions. For years clivers was used as a green brew in the spring to offset a seasonal tendency to scurvy and today herbal medicine practitioners use it for its diuretic properties.
The Welsh brewed herbal teas and made poultices by pulverizing their herbs and mixing them with lard. Like the monks, the Welsh physicians systematically added to the local ‘green pharmacy of the peasant’ and trained others in their use. These are two of the few sources of healing training that existed until the eleventh and twelfth centuries when the first universities were established in Europe. Although the monks and the Welsh were the first to establish schools, they were not the only ones interested in the education of early healers. The English ruler, King Alfred (870-899), actively encouraged learning of the healing arts. He corresponded with the Patriarch of Jerusalem and sent abroad for supplies of exotic remedies. King Alfred was the first to arrange for translations of the best medical texts into English. The written language of the medically-educated was Latin, so the use of the vernacular for a medical book was very unusual. In any event, the earliest Anglo-Saxon medical book that survives today is the Leech Book of Bald. Bald wrote this text for physicians—called leeches in the tenth century. Presumably this term referred to physician’s use of these parasites to draw blood from their patients and not to the high fees drawn from their pockets. Through the work of King Alfred, Bald, and others, new herbal concoctions were added to the European armoury of remedies.
From the eighth century on, it was the Arabs who dominated the trade in exotic herbs from India and Africa.[iv] Notwithstanding their enormous influence
