Herbs and Healers....

Herbs and Healers from the Ancient Mediterranean through the Medieval West: Essays in Honor of John M. Riddle edited by Anne Van Arsdall and Timothy Graham. Farnham, England: Ashgate; 2012. Hardcover, 377 pages. ISBN: 978-1-4094-0038-7. $124.96.

John Riddle, PhD, a professor in the department of history at North Carolina State University, is the author of three books on the relationship between plants and sexuality in human history,1-3 a relatively uncharted area of investigation. In these books, Dr. Riddle claims that plant-based contraception was widespread in pre-modern times, and that this knowledge — systematically removed from medicinal treatises and herbal books because of political and/or religious reasons — still lingers in folk medicine. This view was dismissed as basically unproven by many historians, and, because the ancients had very vague ideas on the biology of human reproduction, it will remain controversial due to the difficult interpretation of existing texts. Nevertheless, the combination of history, medicine, and pharmacy that characterizes Dr. Riddle’s previous works makes them compelling and enjoyable, and they stand as an important contribution to the study of ancient medical treatises. Dr. Riddle has tried to read the ancient medical literature through the glass of contemporary medicine and pharmacy, and this book honors his work with a series of 11 essays on plant medicine in the ancient and medieval Mediterranean area. Only one of them is directly related to Dr. Riddle’s trilogy on plants and human sexuality, with the others addressing either general methodological issues or some specific topics related to various aspects of his scholarly productions.

For many readers, the most interesting essay will be the one dedicated to a critical analysis of the claim that the antidepressant activity of St. John’s wort (Hypericum perforatum, Clusiaceae) was documented in the pre-modern medical literature, where depression was referred to as melancholia. In this essay, “Saint John’s Wort … in the Age of Paracelsus and the Great Herbals,” Karen Reeds, PhD, convincingly explains why in Greco-Roman Galenic medicine no association was ever made between this plant and melancholia. As the archetypal malady was believed to be caused by an excess of black bile, melancholia was associated with a “cold and dry” temperament that required a “hot and moist” drug, like black hellebore (Helleborus niger, Ranunculaceae) and not a “hot and dry” agent like St. John’s wort. Also, the folk use of the plant was essentially apotropaic (used to ward off devils, ghosts, or other evil spirits), requiring only the presence of the plant, with no need to consume it. The claim that the 16th century iconoclastic physician Paracelsus introduced the use of the plant as an antidepressant is debunked next, identifying in the first clear association between mental diseases and St. John’s wort in the early–1600s work of the Italian physician Angelo Sala. The take-home message of this essay is that, if one plant works clinically, there is no need to have fictional history or pompous testimonials to support its use.

The opening chapter by John Scarborough, PhD, outlines the medical scene of Alexandria at the time of Cleopatra. The town was then at the forefront of art and science, and Cleopatra had a keen interest in poisons, cruelly experimenting — according to her Roman detractors — on prisoners and criminals. Although it is not known exactly how she committed suicide, the costly composition of her aphroditarion, an eye-drop preparation aimed at producing a copious flow of tears and, allegedly enhancing sexual attractiveness, is puzzling. The next chapter by Alain Touwaide, PhD, who also wrote the introduction to the book, addresses one confusing issue of the old medical literature — the practice of substituting one herb for another with alleged similar properties (quid pro quo). In the modern pharmaceutical lingo, the issue at stake here is the “bioequivalency” of plants. The author provides a list of the most common substitutes for various plants, identifying a series of reasons for the frequency of the practice. Cost, rarity, or toxicity can underlie this practice, and also urbanization and loss of contact with the natural environment and its resources. The population density of ancient Rome or Alexandria was such that only limited natural resources existed within the urban area, and access to many plants was difficult.

A thorny issue in the study of medieval medical treatises is the lack of a Mediterranean medicinal lingua franca, with Latin, Greek, and Arabic coexisting for many centuries. Florence Eliza Glaze, PhD, investigates this issue by analyzing a series of medical treatises from the Salerno medical school in southern Italy, the first “European” medical school. At the beginning of the new millennium, the Latin world was lagging behind the Arabic and the Greek ones. Many important Roman medical treatises had gone missing, and dependence on Greek and Arabic medicine was substantial. Translation of the medical literature, even from the more familiar Greek language, was not a simple task, and Glaze analyzes a series of glosses existing in various medical treatises from medieval southern Italy, in particular from Gariopontus’s Passionarius, a medical bestseller of medieval Italy. Two chapters revolve around Constantine the African, a Tunisian physician of the 11th century who converted to Christianity and translated the books of the great masters of Arabic medicine into Latin. These translations and Constantine’s own books remained popular throughout Europe until the 17th century, and he is credited with bringing rationality to medieval medicine. Curiously, the work by Constantine fostered a series of herbal poems, presumably as mnemonic repositories of pharmacological knowledge. Fifty of them are listed. Science poetry is still alive today, a remarkable example being a three-page article in iambic pentameter that Burnett and Kearley published in the Journal of Organic Chemistry in 1971, to describe the reaction of dihalobenzenes with potassium amide.4

The contribution by Maria Amalia D’Aronco focuses on the identification of a problematic plant name (elehtre) that appears in medieval Anglo-Saxon medical literature. Using Dr. Riddle’s approach to combine lexicographic and pharmacological information, D’Aronco claims that elehtre was not lupin (Lupinus spp., Fabaceae), but squirting cucumber (Ecballium elaterium, Cucurbitaceae). The following chapter by Linda Ehrsam Voigts is an analysis of late medieval English texts satirizing the use of herbs by so-called “quack doctors” and would-be healers. The best known example of this literature is found in the Canterbury Tales by Geoffrey Chaucer, in which expensive spices like grains-of-paradise (Aframomum melegueta, Zingiberaceae) and zedoary (Curcuma zedoaria, Zingiberaceae) are mentioned. 

The essay by Gundolf Keil, MD, PhD, printed in German but with a long summary in English, is an analysis of a Silesian late medieval medical treaty to treat battlefield wounds and abscesses, while John K. Crellin, PhD, discusses how therapeutic uncertainties can affect the interpretation of medical texts, using the efficacy of emmenagogues and abortifacients as an example. The final chapter by Helen Klug, PhD, and Roman Weinberger describe an Internet tool, the Medieval Plant Survey, which aims to compile all currently available information on medieval plants. The project evolved from a blog and also stores medieval cooking recipes and 1,300 different ingredients, including 350 plants or plant products.
This book will be appreciated especially by scholars and academics, unlike Riddle’s trilogy that can be read with pleasure by a larger share of readers. The many notes, the sections in Latin, and the chapter in German will probably deter many readers. Nonetheless, it represents a clear demonstration of how valuable historical information can be, especially when critically evaluated, for a greater knowledge of medicinal plants.

—Giovanni Appendino, PhD
Department of Pharmaceutical Sciences
Università del Piemonte Orientale
Novara, Italy

References
1. Riddle JM. Contraception and Abortion from the Ancient World to the Renaissance. Cambridge, MA: Harvard University Press; 1992.
2. Riddle JM. Eve’s Herbs: A History of Contraception and Abortion in the West. Cambridge, MA: Harvard University Press; 1997.
3. Riddle JM. Godesses, Elixirs, and Witches: Plants and Sexuality throughout Human History. New York, NY: Palgrave Macmillan; 2010.
4. Burnett JF, Kearley Jr. FJ. Comparative mobility of halogens in reactions of dihalobenzenes with potassium amide in ammonia. J Org Chem. 1971;36:184-186.

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