Greco-Arab and Islamic Herbal Medicine

by Bashar Saad

Published on: 24th June 2020

Extracted from Chapter 1 of “Greco-Arab and Islamic Herbal Medicine: Traditional System, Ethics, Safety, Efficacy, and Regulatory Issues” by Bashar Saad and Omar Said, 2011, John Wiley & Sons.  

Introduction

Natural products, such as plant, fungal, and bee products, as well as minerals, shells, and certain animal products, represent the oldest form of medical treatment. Currently, many of the commonly used drugs are of herbal origin and about 25% of the prescription drugs contain at least one herbal-derived active ingredient or synthetic compound, which mimics a plant-derived compound. There are over 80,000 plants that have medicinal uses throughout the world and usually a specific part of the plant is used for medical preparations such as tablets, infusions, extracts, tinctures, ointments, or creams. The pharmacological action of these medicines is often described in very general terms, such as carminative (an agent that prevents formation of gas in the gastrointestinal tract or facilitates the expulsion of said gas), laxative (an agent that induces bowel movements or loosens the stools), demulcent (an agent that forms a soothing film over a mucous membrane, relieving minor pain and inflammation of the membrane), antitussive (cough suppressants), or antiseptic (antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection). Unlike synthetic drugs, which usually consist of a single and often synthetic chemical, herbal-based medicines contain multiple constituents.

In the history of science, Arabic medicine, Islamic medicine, Arab–Islamic medicine, Greco-Arab medicine, or Greco-Arab and Islamic medicine are terms that refer to medicine developed during the Golden Age of Muslim civilisation. This civilisation became the centre of brilliant medical developments and innovations, as well as great achievements in astronomy, mathematics, chemistry, philosophy, and artistic culture. Arab and Muslim scholars translated and integrated scientific knowledge of other civilisations into their own innovations. These included the discovery of the immune system, the introduction of microbiological science, and the separation of pharmacological science from medicine. Medicine in general is considered to be one of the most illustrious and best-known achievements that influenced Western medical circles to such an extent that it was included in the curriculum of medical schools up to sixteenth century.

Despite great progress in allopathic medicine, Arab–Islamic medicine has continued to be practiced within the Mediterranean as well as most Muslim countries, where cultural beliefs and religion often lead to self-care or home remedies in rural areas and consultation with traditional healers. In addition, Arab–Islamic therapies are most often utilized by people who have faith in spiritual healers and herbalists. These people are the first to be consulted for problems such as infertility, impotence, diabetes, obesity, epilepsy, psychosomatic troubles, and many other diseases. The popularity of herbal preparations based on Greco-Arab and Islamic medicines has increased worldwide in the past four decades, probably because of the sustainability of this medicine over the years. Other factors include the notion that herbal-based drugs are safe, that they are relatively inexpensive, the restricted access to physicians imposed by managed care, and the adverse effects of synthetic drugs.

Greco-Arab and Islamic medicine was practiced in the Muslim world including countries other than those in the Middle East, such as Iran, India, Turkey, Maghreb region, and Pakistan. India is the only country where Greco-Arab medicine has an official status, usually referred to Unani-Tibb. “Tibb” is an Arabic word meaning “medicine,” while “Unani” is thought to be derived from “Ionan” (meaning Greek), acknowledging the influence of early Greek medicine Islamic medicine. An Unani physician is known as a hakim.

However, the Unani medicine currently practiced in the Indo-Pakistan subcontinent is vastly different from its Greco-Arab roots. It benefited from the native medical system or folk medicine in practice at the time in various parts of central and southern Asia, mainly Ayurvedic medicine and Chinese medicine.

The Development of Arab Medical Sciences

The health care practices of the medieval Muslim world over a large area and nine centuries were not uniform. The everyday practices and the public health were affected by many factors: fasting laws and dietary regulations during the holy month of Ramadan, hygiene and burying the dead by Muslims as well as by non-Muslims, the climatic conditions of the vast area, the living conditions of nomadic, rural, and urban communities, the amount of travel undertaken or commerce, or for pilgrimage, the maintenance of a slave class and slave trade, the injuries and diseases attendant upon army camps and battles, and the incidence of plague and endemic diseases.

The Abbasids moved the Islamic capital to Baghdad by the tenth century. The city became the centre of scientific knowledge and research activity and emerged as the capital of the scientific and cultural world. In addition to Baghdad, Seville, Toledo, Granada, and other cities established themselves as centres for medical sciences. The eagerness of the rulers and society for learning resulted in the translation of substantial amounts of Greek, Persian, and Indian medical texts into Arabic. During the Golden Age, collaborative works of physicians and scientists from different nations and ethnic groups raised the dignity and calibre of the medical profession. Disease was seen by physicians as a problem that can be challenged. The Prophet Muhammad was credited with many statements on health care problems and their treatments. For instance, “The one who sent down the disease sent down the remedy.” and “For every disease, God has given a cure.”  He was also credited with articulating several specific medical treatments, including the use of honey, olive oil, figs, and cupping. But most importantly, whereas other societies usually feared the sick and afflicted, at best isolating them and at worst leaving them somewhere to die, the Prophet had a very compassionate and forgiving view of the sick.

As a result, health care services rose in esteem from that of a menial calling to the rank of a learned profession. It had advanced from ephemeral talisman and theology to real hospital wards, mandatory examination for doctors, and the use of technical terminology. Baghdad and Cairo had hospitals that were open to both male and female patients staffed by attendants of both sexes. These hospitals contained libraries, pharmacies, intern systems, externs, and nurses. There were mobile clinics to reach the disabled, the disadvantaged, and those in distant areas, regulations were imposed by the health authorities to maintain quality control on drugs, medical ethics was introduced, and pharmacy became separated from medicine and a licensed profession.

Baghdad and Cordoba became the main centres for development of herbal medicines. Al-Zahrawi (Albucasis, tenth century) of Cordoba wrote The Book of Simples, an important source for European herbal medicine. The Andalusian botanist Abu al-Abbas al-Nabati introduced the use of experimental scientific methods in the thirteenth century. He also introduced empirical techniques in the testing, description, and identification of numerous materia medica. Al-Nabati separated unverified reports from those supported by actual tests and observations. This allowed the study of materia medica to evolve into the science of pharmacy. Later on, Ibn al-Baitar, who lived in Damascus, published The Book on Drinks and Foods, a collection of different drinks and foods. It is considered as one of the most prestigious books in the medieval pharmacopeia in which the drugs are classified in alphabetical order. Other pharmacopoeia books include that written by Abu Rayhan Biruni in the eleventh century and Ibn Zuhr (Avenzoar) in the twelfth century. Daoud al-Antaki used different herbs for treating patients and published a book on medicinal herbs summarizing the knowledge of his predecessors. Al-Antaki in the sixteenth century described in his book 57 plants that were used as a source for simple drugs, or frequently as one ingredient in complex herbal-based preparations. He described the plant and the way it was used by physicians. For instance, birthwort, carob, castor oil plant, common fennel, common myrtle, Persian cyclamen, saffron, serapias, sycamore fig, and Syrian bryony. Furthermore, Al-Antaki mentioned foreign plants that were brought to the area for their medicinal properties, such as cornelian cherry, purging croton, and gardenia. He also described pharmacological uses of typical agricultural crops, such as caraway, carrot, wild coriander, pear, quince, sugar cane, and walnut.

The development of medicine and pharmacy in the Muslim world laid the foundations for the development of modern Western medicine and pharmacy. Scholars from Muslim civilisation contributed many insights of their own to the development of medicine while acknowledging the knowledge they received from other civilisations. It is important to mention that they translated classical medical texts not only from Greek, but also from Persian, Indian, and Chinese sources. This synthesis resulted in a richer and universal medical system, based on scientific rules and experimentation. Al Tabbari (838–870), Al-Razi (Rhazes, 864–930), Al-Zahrawi (Albucasis, 936–1013), Al-Biruni (973–1050), Ibn Sina (Avicenna, 980–1037), Ibn al-Haitham (960–1040), Ibn al-Nafis (1213–1288), Ibn Khaldun (1332–1395) (Figure 3), Ibn al-Baitar (1197–1248), and Ibn Zuhr (Avenzoar, 1091–1161) are regarded as among the great medical authorities of the medieval world and as physicians whose textbooks were used in European universities up to the sixteenth century. They made accurate diagnoses of plague, diphtheria, diabetes, gout, cancer, leprosy, rabies, and epilepsy. Avicenna’s and Rhazes’s works on infectious diseases led to the introduction of quarantine as a means of limiting the spread of these diseases. Other physicians laid down the principles of clinical investigation, drug trials, and animal tests, and uncovered the secret of sight. They mastered operations for hernia and cataract, filled teeth with gold leaf, and prescribed spectacles for defective eyesight. And they passed on rules of health, diet, and hygiene that are still largely valid today. Physicians of different languages and religions cooperated in building a medical organization whose outlines are still visible in current medical practices.

The development and the recognition of the independent, academically-oriented status of pharmacy as a profession charged with the preparation of safe and effective drugs started in Baghdad during Al-Mamun’s caliphate (813–833). The main objectives of pharmacists were directed not only toward the translations and interpretations of accumulated data on natural product-based drugs, but increasingly toward the search for the potential of natural products as sources for new drugs, and they even started to elucidate physicochemical properties of these products. Drugs were classified according to their effects on the human body, for example, diuretics (promote urination and thus expel toxins), expectorants (remove mucous accumulation), topical antiseptic cleansers, stimulants (prescribed to increase blood flow and raise energy level), tonics (general strength building and disease prevention), analgesics and anesthetics, digestive aids, and oral health agents. Pharmacists, or saydalaneh in Arabic, managed to introduce a large number of new drugs to clinical use, including senna, camphor, sandalwood, musk, myrrh, cassia, tamarind, nutmeg, cloves, aconite, ambergris, and mercury. They also developed syrups, juleps, and pleasant solvents such as rose water and orange blossom water as means of administering drugs.

The first pharmacy shop was apparently in Baghdad, founded in 762, and medicines were manufactured and distributed commercially, and then dispensed by physicians and pharmacists in a variety of forms: ointments, pills, elixirs, confections, tinctures, suppositories, and inhalants. Saydalaneh were required to pass examinations and be licensed and were then monitored by the state.

The selection of potential natural products as sources for new drugs was based on traditional knowledge developed in the pre-Islamic era based on a long history of trial and error, and then by theoretical and practical knowledge introduced by Islam. These include natural products mentioned in the Holy Quran or in the Hadith of the Prophet Muhammad, notably honey, milk, dates, black seeds, olive leaf, and olive oil.

In addition, theoretical and practical knowledge developed in other medical systems, which became available to scholars after the translation of foreign scripts, played a central role in developing new medicines. The works of Galen, Hippocrates, and the Indian physicians Sushruta and Charaka were translated into Arabic. Physicians developed hundreds of new natural product-based remedies. They were not guided by a long history of trial and error, but mainly by scientific methods, which led to the development of evidence-based medication. Avicenna discussed in his book, on simple drugs (materia medica), the nature and quality of drugs and the way that compounding them influences their effectiveness. He stated “You can tell the potency of drugs in two ways, by analogy and by experiment. We say experimenting leads to knowledge of the potency of a medicine with certainty after taking into consideration certain conditions.” Physicians of Muslim civilisation considered all components of existence with equal importance, from breath and body to the soul and matter; both spiritual and physical health are treated equally. Hence, the body should be treated as a whole and not just as a series of organs and tissues. Physicians noted that there are individual differences in the severity of disease symptoms, and in the individual ability to cope with disease and healing. Hippocrates thus laid the foundations of the modern theory that thoughts, ideas, and feelings, which he proposed to originate in the brain, can influence health and the process of disease. Rhazes supported this concept by his recommendation: “The physician, even though he has his doubts, must always make the patient believe that he will recover, for state of the body is linked to the state of the mind.” Later on, Avicenna who defined medicine as “the science from which we learn the states of the human body with respect to what is healthy and what is not; in order to preserve good health when it exists and restore it when it is lacking” supported the views of Rhazes. He stated that “We have to understand that the best and most effective remedy for the treatment of patients should be through the improvement of the power of the human body in order to increase its immune system, which is based on the beauty of the surroundings and letting him listen to the best music and allowing his best friends to be with him.”

It is now clear that the mind and the body interact, influence, and regulate each other. The perception of stress can lead to production of “stress hormones” as well as mediators of the immune system, for example, cytokines and free radicals. Stress hormones act in a feedback pathway to regulate their own production and the production of certain immune products. These immune products act on the brain to modify behaviour and the ability to perceive and to respond to stressful challenges by inducing lethargy, fever, and vomiting.

Based on the recommendations of Rhazes and Avicenna, patients were treated through a scheme starting with physiotherapy and diet, and if this failed, drugs were used. Rhazes’s treatment scheme started with diet therapy; he noted that “if the physician is able to treat with foodstuffs, not medication, then he has succeeded. If, however, he must use medications, then it should be simple remedies and not compound ones.” Drugs were divided into two groups, simple and compound drugs. Physicians were aware of the interaction between drugs; thus, they used simple drugs first. If these failed, compound drugs consisting of two or more compounds were used. If these conservative measures failed, surgery was undertaken.

The Greek and Roman humour theory of the human body or humoralism had a great influence on the development of the Greco-Arab medical system. Hippocrates was the first who applied this idea to medicine and it became strongly accepted in the medical canon through the influence of Galen. The humoral theory was adopted and further developed by physicians of Muslim civilisation and it became the most commonly held view of the human body among European physicians until the advent of modern medical research in the nineteenth century.

Commonly Used Herbal Medicines and Diets in The Arab And Islamic World

Medicinal plants and their products have been used traditionally across the world for the prevention and treatment of almost all known types of diseases. Clinical and basic scientific research confirmed the efficacy and action mechanism of several plants for treating several ailments, including liver disease, diabetes, skin diseases, and hypertension. As a result, about 25% of the currently prescribed drugs are of herbal origin. For instance, milk thistle (Silybum marianum) has been shown to have clinical applications in the treatment of liver diseases, including toxic hepatitis, fatty liver, cirrhosis, ischemic injury, radiation toxicity, and viral hepatitis, via its antioxidative, antilipid peroxidative, antifibrotic, and anti-inflammatory properties. Furthermore, milk thistle has shown immunomodulating and liver regenerating effects. Another example is Nigella sativa (black seed). The seeds of this plant are known to have many medicinal properties and are widely used in Greco-Arab and Islamic medicine. Therapeutic potential and toxicological properties of the seeds have been extensively studied. A Medline search using “Nigella sativa” or “black seed” reveals more than 800 citations, including antioxidant, anti-inflammatory, antimicrobial, hypotensive, antinociceptive, choleretic, uricosuric, antidiabetic, antihistaminic, immunomodulatory, anticancer, and antifertility effects.

Food plays an important role in Arab–Islamic medicine in maintaining a healthy body, soul, and spirit. Muslims are commanded to follow a set of dietary laws outlined in the Holy Quran where almost everything is permitted, except what God specifically prohibited. Later on, when the Muslim world covered all of Arabia, half of Byzantine Asia, all of Persia, Egypt, the Maghreb (North Africa), and Spain, Arabs and Muslims became exposed to foreign and multinational culinary heritages. Furthermore, great developments in scientific fields, the establishment of “modern” hospitals, and growing socioeconomic conditions of Islamic empire increased the awareness of the relationship between food and health. During this period, a type of Islamic food therapy developed that was a blend of Quranic teaching and Greek medicine.

The foods favoured by the Prophet were dates, honey, olive oil, and black seeds. Concerning olive oil, he said: “Eat olive oil and massage it over your bodies, since it is a holy tree.” Black seeds were regarded as a medicine that cures and prevents all types of diseases.  

Safety and Efficacy of Herbal Medicines

The widespread use and popularity have also brought concerns and fears over quality, efficacy, and safety of the “natural” products available on the market as well as the professionalism of practitioners. It is well known that adulteration, inappropriate formulation, or lack of understanding of plant and drug interactions can lead to adverse reactions that are life threatening or lethal to patients. Safety assessment of herbal-based preparations has often been neglected since traditional and prolonged use is usually considered evidence of its safety. Another important factor is the belief that these medicines are prepared according to the principles of the Greco-Arab tradition that forms the basis for the current conventional product. However, a history of traditional usage is not always a reliable guarantee of safety since it is difficult for traditional practitioners to detect or monitor delayed effects (e.g., mutagenicity), rare adverse effects, and adverse effects arising from long-term use. Most reports concerning toxic effects of herbal medicines are associated with hepatotoxicity although reports of kidney, nervous system, blood, cardiovascular, dermatologic effects, mutagenicity, and carcinogenicity have also been published in the biomedical literature.  

There is little doubt that the use of the concept of Greco-Arab and Islamic herbal therapy has shown remarkable success in healing acute as well as chronic diseases. As mentioned above, Arab and Muslim physicians were the first to use scientific methods in the field of medicine and pharmacy, including the introduction of quantification, animal testing, and clinical trials. Hospitals in the Arab–Islamic world featured the first drug tests, drug purity regulations, and competency tests for physicians. In his Comprehensive Book of Medicine, Rhazes documented clinical cases of his own experience and provided very useful recordings of various diseases. He also introduced urinalysis and stool tests. Avicenna (980–1037) introduced experimental medicine and systematic experimentation and quantification in physiology. He discovered the contagious nature of diseases and described many medical treatments, including clinical trials, risk factor analysis, and the idea of a syndrome in the diagnosis of specific diseases. His book, The Canon of Medicine, was the first book dealing with evidence-based medicine, randomized controlled trials, and efficacy tests. Concerning the medical documentation, the first documented description of a peer-reviewed publication process was written by Ishaq bin Ali al-Rahwi (854–931). In his work, The Ethics of the Physician, he stated that a physician must always make duplicate notes of a patient’s condition. When the patient was cured or had died, the notes of the physician were examined by a local medical council of other physicians, who would review the practicing physician’s notes to decide whether the treatment had met the required standards of medical care.

Drug Development from Herbal Sources and Regulatory Issues

Herbal-based drug discovery research is a multidisciplinary approach combining ethnopharmacology and traditional knowledge on the one hand and botanical, phytochemical, biological, toxicological, pharmacological, and molecular techniques on the other hand. As mentioned above, about 25% of the currently used prescription drugs contain at least one herbal-derived active ingredient and several herbal-based drugs either have recently been introduced to the market or are currently involved in late-phase clinical trials. Although herbal-derived compounds continue to provide an important source of new drug leads, numerous challenges are encountered including the procurement of plant materials, for example, the selection and implementation of appropriate high-throughput screening bioassays and the scale-up of active compounds.

It is generally believed that the standardization and regulation of plant materials is not required when used by the rural communities for their primary health care. Nevertheless, regardless of whether the medicinal plant is to be used by local communities or by industry, a systematic approach is required for a traditionally used plant, as is done in modern medicine. It is necessary to standardize all stages of herbal-based drug discovery: from cultivation, ethnopharmacology, utilization, isolation, and identification of active constituents to efficacy evaluation, pharmacology, safety, formulation, and clinical evaluation.

In general, many herbs are effective when consumed as whole or as extracts. Current trends, however, are directed toward the use of purified herbal-derived agents that can serve not only as new drugs themselves but also as drug leads suitable for optimization by medicinal and synthetic chemists. Even when new chemical structures are not found during drug discovery from medicinal plants, known compounds with new biological activity can provide important drug leads. In this respect, the sequencing of the human genome paves the ways for identification of thousands of new pathologically active molecules. With the help of modern in vitro and in vivo screening assays directed toward these targets, known herbal-derived compounds may show promising and possibly selective activity. Several known herbal-derived compounds have already been shown to act on newly validated molecular targets (e.g., indirubin selectively blocks cyclin-dependent kinases). Other herbal-derived compounds have also been shown to act on novel molecular targets, thus reviving interest in members of these frequently isolated plant compound classes.

BASHAR SAAD PhD is professor of cell biology and immunology at the Arab American University in Jenin, Palestine, and at Al-Qasemi Academic College, Baga Algharbiya, Israel. He made a significant contribution in combining cell biology, immunology, and 3D cell culture techniques with Arab-Islamic herbal wisdom. He has written more than 150 original papers as well as review articles and book chapters on Arab-Islamic herbal medicine.

An Overview of Greco-Arab and Islamic Herbal Medicine

The Scent of Jasmine

Jasmine is a popular plant with wonderfully fragrant flowers. It’s native to the warmer parts of Europe, the Middle East, Central Asia, the Far East and Oceania. The white or yellow flowers have some uses in medicine and aromatherapy, particularly in South Asia and China.

There are more than 200 species of jasmine, including both climbing vines and shrubs. Two types popular in the Middle East are common jasmine (Jasminum officinale) and Arabian jasmine or al-full (Jasminum sambac). Arabian jasmine is the national flower of the Philippines and Indonesia.

Jasmine is a popular essential oil in aromatherapy. It has a strong, sweet fragrance, which is very common in flowers that bloom only at night. It promotes relaxation and, some say, mental alertness.

As the “Home Remedies for You” website describes it, jasmine has a number of medicinal uses:

Whether it is a jasmine flower or essential jasmine oil, jasmine can be used as an aphrodisiac, a sedative, an antiseptic, antidepressant, antispasmodic, and analgesic. In Ayurveda, jasmine has been used as an aphrodisiac and as a means to increase immunity and fight fever. It has also been regarded as a means to treat conjunctivitis. In traditional Chinese medicine, jasmine flowers are brewed and consumed as an herbal and remedial tea. An infusion of jasmine tea is known to be beneficial in treating fevers, urinary inflammation, and other infections. In addition, jasmine tea can be helpful in relieving stress and anxiety. It can be extremely helpful for people suffering from heat stroke or sunstroke.

Jasmine tea can also be administered as a tincture to treat cuts and scrapes. A compress using jasmine flowers can be useful for headaches and strokes. Jasmine juice is useful for treating corns. In fact, various skin conditions including sun burn and rashes can be treated by apply jasmine in lotion form. Jasmine oil is an integral part of aromatherapy. It is used in the form of incense, candles, and jasmine body oil, providing several benefits including uplifting the mood. The scent of jasmine is said to be useful in treating depression, in particular post partum depression and emotional depression. A body massage with jasmine oil is known to not only lift spirits but also relieve aches and pains.

However, the “Natural Remedies” website cautions:

Over the centuries, jasmine has acquired a veritable corpus of mythological beliefs. Some of these allegations, like the statement that jasmine green tea has spiritual benefits to the drinker, may never be able to be tested properly.

Although many people have reported experiential benefits from consuming jasmine in some form, many of these claims have not been tested. New users must remain cautious and approach using jasmine with an attitude of respectful curiosity. Jasmine may trigger allergic reactions in some people; the full extent to which this is possible has not yet been explored.

Among the spiritual beliefs linked to jasmine, there is the conviction in some parts of the Muslim world that the jinn, or genies – spiritual beings said to interact with the human world – are attracted by the plant’s heady and perhaps intoxicating fragrance. For example, India’s The Statesman recently carried a review of Jasmine and Jinns, a cookbook/memoir by Sadia Dehvi:

Are Jinns (Djinns) attracted to jasmine, the much celebrated flower that women love to adorn their hairdo with? According to author Sadia Dehlvi, mothers and grandmothers in the olden days forbade unmarried girls from scenting their bed with jasmine because the Jinns were so fond of it that they fell in love with them.

Sadia has made this the title of her new book, Jasmine and Jinns (Harper Collins). It may be a far-fetched title for book of mainly non-vegetarian recipes and family history but perhaps given in the hope that it would attract readers too (despite its high price of Rs 699 for just 211 pages). In this connection one remembers another belief: that girls shouldn’t walk on the terrace at dusk with hair open after a bath as Jinns, the invincible beings created from fire, took possession of them and they pined away under their influence.

A perfect plant for future investigation…

Theriacs and Snake Bites

Vipera aspis in France – By Orchi – Self-photographed, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11182655

Theriacs were medicinal concoctions developed by the ancient Greeks (or even earlier) and used to treat toxic snake bites, scorpion stings and other poisonous contacts with animals.

Theriacs (from the Greek thēriakē, “pertaining to animals”) often consisted of dozens of herbal ingredients and other substances mixed together and fermented over months. They were applied to wounds as a salve or paste or consumed internally in chunks. Theriacs often featured many of the well-known natural remedies of Arabia, including honey, castor oil, ginger, cinnamon, anise, cardamom, pomegranate, black seed, myrrh and many others.

Theriacs were adopted by Arabic-speaking physicians of the Middle Ages and were used in the Islamic world and in Europe up to the 19^th century. Theriacs were used by such prominent Muslim physicians as Ali ibn al-Abbas al-Majusi (known as Haly Abbas in the West), Abu Bakr Muhammad Al-Razi (Rhazes) and Ibn SIna (Avicenna), as well as by the Arabic-speaking Jewish scholar-scientist Maimonides, court physician of Saladin.

A medical historian recently cited an example of how theriacs popularized in Arabic medicine survived as standard practice in Renaissance Europe. The example appeared in a recent academic paper by Kathleen Walker-Meikle, a Wellcome Trust fellow in Medical Humanities at the University of York.

The account was written in the 14^th century by Gentile da Foligno, professor of medicine at the University of Perugia in Italy.

The case involved a young man who was bitten on the ankle by a poisonous asp viper while hiking in the mountains near Perugia. The victim tried self-treatment, binding his leg above the bite to stop the spread of the venom, but his effort was in vain. The snake was brought in, and Foligno identified it as a short deaf asp (now identified as an asp viper or vipera aspis, known to have a powerful venom):

Foligno immediately went to work. First the Great Theriac of Galen was applied externally over the heart; then a cupping-glass to the wound location, which was then scarified, and the patient was given draughts of stale butter. The usual treatment of sucking the wound (after application of olive or rose oil to the practitioner‘s mouth) was not done, as no one was found willing to suck the wound with his mouth, on seeing the patient‘s symptoms. Foligno had made a theriac of ground-up gentian, balsam seed, rue, and anise, which was to be drunk with strong wine. On the second day, the patient was examined in the morning. The young man still had closed eyes, a heightened pulse and labored breathing, with a ‘foul’ face. Although the patient had difficulty in swallowing, he was given emerald powder was given along with citrus seeds infused in wine. Maimonides cited the beneficiary power of emerald powder and citrus seeds, and Foligno would use these two ingredients throughout the treatment.

The snake-bite victim had great difficulty swallowing medicine. Later the same day, the patient had not improved and his urine was described as “livid”:

Foligno sent him to his associates for a second opinion and when he returned gave him the theriac of Haly Abbas made of castor oil, cassia wood, round aristolochia, anise seed and pepper, and given with wine. It caused the patient to speak for the first time, and by that evening the patient was conscious and had recognized the doctors. Foligno prescribed emerald powder, citrus seeds and two doses of the Haly Abbas theriac for the night, along with massage and for the patient to be kept awake.

On the third day, his condition had stabilized but not improved, so he was given chicken soup with emerald powder and citrus seeds sprinkled on top, as well as more theriac and some cupping of the wound.

By the fourth day, Foligno found the patient with an improved urine despite a complaint of stomach and kidney pains. Foligno prescribed a clyster of milk and decoction of mallow. The patient was then to be washed with a decoction of aristolochia rotunda and Haly Abbas theriac was administered again. By the fifth day, the patient had much improved and the prescription of Haly Abbas theriac was stopped and a diet of good food and wine was prescribed, with a suggestion to eat something sour in two days time due to the hot poison causing ‘derangement,’ as that species of snake‘s venom affected the brain and nerves. Foligno finished his account by noting that most people bitten by the deaf asp do not open their eyelids for months, citing Avicenna.

In short, the patient recovered.

 

 

Dandelions in the Middle East

Dandelion is a powerful herbal medicine. You don’t hear much about its use in the Arabian Peninsula these days, but it was once highly regarded by the great Muslim physicians of the Middle Ages.

Its Latin name “Taraxacum” derives from medieval Persian writings on pharmacy, and was known to the Arabs as “tarashaquq.”

The Persian physician Al-Razi (Rhazes) wrote in Arabic in about 900 AD that “the tarashaquq is like chicory.” Ibn Sina (Avicenna) wrote an entire chapter on Taraxacum. Gerard of Cremona, translating Arabic works to Latin around 1170, spelled it “tarasacon.”

In a recent article, Natural News discussed the various traditional medicinal uses of dandelion, which many regard as an invasive weed:

The roots, leaves and flowers of the dandelion plant are a potent and healthy herbal medicine, although folks might think those yellow dots popping up in their landscape are just nuisance weeds. Not so, as reported by Reset.me, who emphasizes that the botanical name for dandelion – Taraxacum officinal – aptly describes its medicinal potential. Taraxacum translates into an “inflammation curative.” Officinal means that the lowly dandelion is revered as a bona fide, official medicinal plant. The use of the dandelion plant as a healing agent “predates written records,” but it is understood that the Greeks and the Chinese used dandelion compounds to aid in digestion, and as a liver tonic and diuretic.

New research has revealed that dandelion is a potential cancer-fighter:

Traditional herbalists, both in the East and the West, have utilized the properties of the dandelion for liver support and as a blood purifier. It is this blood purifying action that intrigued Canadian researchers at the University of Windsor to pursue whether dandelion roots could be effective for individuals suffering from end stage blood cancer. The team experimented by applying dandelion root extract into petri dishes on “blood drawn from a leukemia patient and lab rats.” They discovered that the “dandelion root extract was effective in inducing apoptosis, or cell suicide, in tumor cells, while leaving healthy cells alone.”

This remarkable outcome garnered approval to test their dandelion root protocol on thirty Canadian cancer patients. It is the first time in Canada that a natural extract has been approved for utilization in a clinical trial. The lead researcher is Dr. Siyaram Pandey, a biochemistry professor at Windsor, who discovered the power of dandelions from an oncologist whose own patients had had enough chemotherapy and chose to drink dandelion tea instead – and lived!

A Tree Stands in the Desert….

In 2005 there were two ‘aqul trees. Now there is only one….

A Saudi desert expert recently told me about an unusual tree that grows near the old town of ‘Ain Dar, in Saudi Arabia’s Eastern Province. More than a decade ago, there were two of these trees there; only one has survived. The tree is four or five meters tall, and local lore maintains that it has been around for hundreds of years. It is extremely rare; he only knows of one other tree like it, near the archaeological site of Thaj to the north.

The tree is called ‘aqul in Saudi Arabia and Oman. Its scientific name is Alhagi maurorum and it is known in the English-speaking world as camelthorn or camel’s thorn.

The woody plant is unusual because its sap crystallizes into manna, an edible famine food known to many from Exodus in the Old Testament as well as from the Qur’an. No one really knows which plant or process provided the original manna cited in the Bible and Qur’an. A minority view is that it was Alhagi, because of its appetite-suppressing effect.

According to a description of A. maurorum on the website Practical Plants:

A sweet-tasting manna is exuded from the twigs at flowering time. It is exuded during hot weather according to one report. It contains about 47% melizitose, 26% sucrose, 12% invert sugar. Another manna is obtained from the pods – it is sweet and laxative. Root – cooked. A famine food, it is only used in times of need.

‘Aqul shrub in desert

‘Aqul normally grows as a shrub, about a meter high, with dark red flowers and pods. The shrub rarely survives in the desert long enough to be transformed into a proper tree.

‘Aqul has many medicinal uses in the Arabian Peninsula. Here is one description of its value as an Arabian natural remedy:

Medicinal uses The whole plant is used for treating cataracts, jaundice, migraine, painful joints and as an aphrodisiac.

Treatment An infusion of the plant or juice is used for treatment. The root is cleaned and boiled with water to make a tea. Lemon or lime is added to it and taken orally. The solution is very bitter to taste.

Chemical composition Several β-phenethylamines and a tetrahydroisoquinoline have been isolated from the plant. The roots contain essentially the same alkaloids as the stems, but in different quantities.

Up north, in Iraq, ‘aqul is used for rheumatic pains, liver disorders, urinary tract infections and for various types of gastrointestinal discomfort.

I have seen A. maurorum referred to by some writers as a “noxious weed.” I suspect that accusation is exaggerated.

Dental Care in Ancient Sudan

Purple nutsedge rhizomes

Archaeologists recently reported that 2000-year-old skeletons of farmers excavated in Sudan were found to have remarkably healthy teeth. They discovered that the reason for this was a rather strange item in the Sudanese diet: the bad-tasting tuber of a noxious weed called purple nutsedge (Cyperus rotundus). The tuber is known to have antibacterial properties, and it appears to have protected ancient Sudanese farmers from cavities.

As National Geographic Daily News reported:

Early humans generally had relatively few cavities, thanks in part to meals that were heavy on the meat, light on the carbs.

Then humans invented farming and began eating more grain. Bacteria in the human mouth flourished, pouring out acids that eat away at the teeth. The first farmers tended to have much more tooth decay than hunter-gatherers did.

But when scientists looked at the teeth of people buried roughly 2,000 years ago in an ancient cemetery called Al Khiday 2, they found that fewer than one percent of the teeth had cavities, abscesses, or other signs of tooth decay, though those people were probably farmers, says study co-author Donatella Usai of Italy’s Center for Sudanese and Sub-Saharan Studies.

Analysis of hardened bits of plaque on the teeth showed those interred at the cemetery had ingested the tubers of the purple nutsedge, perhaps as food, perhaps as medicine. People buried at Al Khiday at least 8,700 years ago—before the rise of farming there—also consumed the tubers, probably as food.

The scientists published their findings in the online, peer-reviewed journal PLOS ONE. Their paper was entitled “Dental Calculus Reveals Unique Insights into Food Items, Cooking and Plant Processing in Prehistoric Central Sudan.”

As Geographic noted:

The purple nutsedge tuber may have many virtues, but a nice flavor isn’t one of them. People might have tried to tame the tubers’ bitterness by cooking them, says study co-author Karen Hardy of the Catalan Institution for Research and Advanced Studies at the Autonomous University of Barcelona, or they may have just tolerated the bad taste.

“They might have been using it for some medicinal purpose,” Hardy says. “Medicine always tastes horrible, so it would be par for the course.”

The report also quoted a biological anthropologist unconnected with the study as saying that no other example has been reported of a specific plant that kept tooth decay in check among ancient people.

This is actually an error. A well-known and quite ancient tooth-cleaning plant is the arak or toothbrush tree (Salvadora persica), from which comes the natural toothbrush known as the miswak, a chewing stick prepared from the tree’s root. It has antiseptic and astringent properties that help clean and protect the teeth and gums. For more on the arak tree, see Natural Remedies of Arabia by Robert Lebling and Donna Pepperdine.

 

Medieval Europe’s Dependence on Asian Natural Remedies

Black cardamom

I recently came across an article on herbal medicine of the early Middle Ages in Europe that showed the importance of Middle Eastern and South Asian natural remedies to the Western pharmaceutical tradition.

The article, “The Introduction and Use of Eastern Drugs in the Early Middle Ages” by John M. Riddle, appeared in a German journal in 1965.  The paper was something of a challenge to the Pirenne thesis, advanced in Henri Pirenne’s Mohammed and Charlemagne (1937), which argued that “Arab expansion” throughout the Mediterranean from the 8^th century onward resulted in an isolation of Europe from traditional commerce with the East.

As Riddle shows from a study of medieval recipe literature, almost all of the drug mixtures used in the Middle Ages relied on herbs and other substances found only in Asia. Clearly the trade continued, despite or perhaps because of the “Arab expansion.”

For example, one of the works Riddle studied was a 9^th-century European antidotary or medicinal recipe book containing a total of 123 recipes with some 361 different ingredients used a total of 944 times. Without natural remedies from the Middle East and Asia, the antidotary would have had precious few recipes.

Riddle notes:

From a list made of the substances, the following are those appearing in eight or more recipes (The number of times per recipe is in parenthesis): aloes (15), ammonicum (11), amomum (9), apium semen (10), cassia (12), ciminum (8), colofonia (14), fenuogrecum (10), libanus (12), linum (11), mastice (16), murra (17), piper [white, long, and black] (33), petroselinum (17), picea (10), scamonia (14), storace (13), terebentina (17), and zinzibar (8).

An examination of the identities of these drugs reveals a startling fact: most can only be found in the orient. Eastern drugs seemed to have been the “miracle drugs” of the Age.

Here is a breakdown of specific Middle Eastern natural remedies used in Europe during the Middle Ages, as cited in Riddle’s study:

Aloes – The juice or liquid exuded from a cut in the leaves of the succulent plant aloe. There are more than 500 species of aloe but only a few were used as traditional remedies, primarily Aloe vera but also a few others, including A. perryi and A. ferox. The medicinal use of A. vera is cited in the Materia Medica of Dioscorides.

Ammonicum – This is a salt, ammonium chloride. It was associated in antiquity with the oracular Egyptian deity Amun or Hammon, famously based at the oasis of Siwa in Egypt’s Western Desert, where ammonicum is found. Both Pliny and Galen note the use of this salt in early medicine. It is known to have been manufactured in the late Middle Ages, distilled from the horns and hooves of oxen.

Amomum – This is the spice known as black cardamom, which is different in flavor from the more common green cardamom. It usually has a smoky flavor derived from drying of the pods over open flame. According to Riddle, amomum is an aromatic scrub said by Pliny to come from India, Persia and the Aral Sea region and currently attributed to the latter two areas. In Chinese medicine today, black cardamom is used to treat stomach upsets and malaria.

Cassia – This is Chinese cassia or Chinese cinnamon, less subtle in flavor than Ceylon cinnamon, or true cinnamon. Cassia is the dried bark of a plant in the Laurel family. Riddle believes this type of cassia is “probably a product of Cinnamomum pauciflorum Nees, is said by Pliny to be the ‘skin’ of a scrub, and it is known to be found only in the far east.” Most types of cinnamon are known to reduce blood sugar.

Ciminum – Ajwain or Ajowan seeds or Ethiopian cumin (Trachyspermum ammi). It has a flavor reminiscent of thyme. Though the plant is found in modern, southern Europe as well as in Egypt and Asia, Pliny spoke only of a species from Ethiopia. In the Middle Ages, it was grown in Swiss herbal gardens, but was also imported from Islamic countries. It is used as a digestive aid or for relief of stomach problems in South Asia and parts of the Middle East.

Crocus – This is the Latin term for saffron, a well-known product from the East. Saffron is a spice made of the dried red stigmas of the flower of the saffron crocus (Crocus sativus). It originated in Greece or Asia Minor, and is believed to have first been cultivated in Greece. Iran today produces about 90% of the world’s saffron.  The spice has long been used for various medicinal purposes. Recent research has found it has anticancer properties.

Fenogrecum or Fenum Grecum – Fenugreek (Trigonella foenum-graecum) was first cultivated in the Near East. Fenugreek seeds have been shown to have antidiabetic effects, among other medicinal benefits. Fenugreek seeds were found in the tomb of Egyptian Pharaoh Tutankhamun.

Libanus – This is frankincense (Boswellia sacra and related species), a well-known product of the Arabian Peninsula and the nearby African coast. The best frankincense is produced in Yemen and on the northern coast of Somalia. A tree resin, it is burned for incense and is chewed for medicinal purposes. Recent research has shown frankincense is able to suppress cancer cells and provide relief from osteoarthritis.

Mastice – Mastic, a resin from the tree of the same name (Pistacia lentiscus), originated in the Eastern Mediterranean, and in the Middle Ages it was imported from this region. The best mastic comes from the Greek island of Chios. Mastic is antibacterial and antifungal, and has antioxidant properties. It has been used since ancient times to treat colds, indigestion and other ailments.

Murra – Myrrh is the aromatic gum resin of Commiphora myrrha, a tree found in southern Arabia and eastern Africa. Myrrh has antiseptic and other medicinal properties. Its gum is used to treat numerous ailments, including colds, asthma, skin problems and even cancer.

Piper – This term refers to the Old World spices black pepper (Piper nigrum), its unripe form white pepper and its hotter cousin long pepper. These forms of pepper, native to south India, are unrelated to the chili pepper, which originated in the New World. Dried ground black pepper, white pepper and long pepper have been used since ancient times both for flavoring foods and as medicine. Pepper had many medicinal uses in medieval times and earlier, but few of these uses have survived the scrutiny of modern medicine.

Scamonia – Scammony (Convolvulus scammonia) is a weed native to the countries of the Eastern Mediterranean. The juice of its root or a resin made from the root acts as a powerful purgative. Scammony also kills roundworms and tapeworms in the process of passing through the digestive tract.

Storace – Storax is a resin exuded by the Oriental or Turkish sweetgum tree (Liquidambar orientalis). The resin is often used in incense or as a fixative in perfumes. The biblical “Balm of Gilead” cited in Jeremiah is storax.

Zinzibar – This is ginger, or ginger root, from the rhizome of the south Asian plant Zingiber officinale. As a kitchen spice, ginger is hot and fragrant. It has traditionally had various medicinal uses in the Middle East, among them ginger tea for colds and flu. Recent studies have been undertaken to determine if ginger has the ability to shrink cancerous tumors, but so far the results have not been conclusive.

Other natural remedies cited by Riddle traditionally make their home in Western Europe but are also known in the Middle East – including Apium Semen (parsley seeds), Colofonia (rosin), Linum (flax), Petroselinum (rock-parsley), Picea (pitch) and Terebentina (terebinth or turpentine).

Sirens & Pomegranates

Siren with pomegranate, 5th century BC, Getty Museum, Malibu.

Most people are familiar with the Greek mythological creature known as the Siren, usually via Homer’s Odyssey, in which Odysseus, on his way back to Greece from the Trojan War, determines to hear the Sirens’ song as his ship passes by their island. Anyone who hears the song of the Sirens becomes captivated, and is destined never to return home. The only one who had successfully resisted the Sirens was Orpheus, who drowned out their song with his own music. Odysseus, for his part, has his crewmen stop up their ears with wax, so they won’t hear the Sirens. He then has the crew tie him to the mainmast, where he can listen to the Sirens’ song with ears unstopped, and yet not interrupt his voyage.

The Sirens were strange creatures, with the head of a woman and the body, wings and feet of a bird. They also had human hands according to some Greek representations. The Sirens were associated with the pomegranate, that extraordinary fruit of the Mediterranean and Middle East.

The J. Paul Getty Museum in Malibu, California, has an intriguing bronze representation of a Siren, described here by Greek archaeologist Despoina Tsiafakis:

The Siren published here, a bronze askos in the J. Paul Getty Museum, Malibu, was presumably used to hold expensive scented oils. The name of the artist is unknown, though there is no doubt that the askos was made by a South Italian workshop. Features of the face and the head as well as the musculature of the figure of the male youth that serves as the handle date the Siren to the second quarter of the fifth century B.C. The piece is of great importance both because it is an early Classical bronze of fine quality and because it provides valuable insight into bronze-casting techniques….

… As human-headed birds, Sirens represent both chthonic and demonic powers, closely related to music and the world of the dead. Famous for their musical abilities, they used their skills to charm men and keep them away from home forever. With the exception of Orpheus and Odysseus, no moral heard the Sirens’ song and lived to tell about it….

Tsiafakis writes about the symbolism of the pomegranate, showing how the red fruit connects the Sirens with the underworld….

The rendering of the Getty Siren is in keeping with the iconography of Sirens in the Archaic and Classical periods. She holds a syrinx [Pan flute] in her right hand and a pomegranate in her left. As we have seen, pomegranates occur in association with two of the Greek bronze Sirens of the sixth century B.C., namely the Siren from the Peloponnese and the one from Crotone, but in both cases the fruit hangs around the neck as a necklace. Whether in the hand or around the neck, the pomegranate is a symbol closely related to the world this human-headed bird represents. Both the Siren and the pomegranate are connected with Persephone’s kingdom [the underworld], and Sirens were well-known as Hades’ musical birds. Plato relates that their home is the underworld, and they often occur on graves or funerary scenes….

The red juice of the pomegranate is suggestive of blood and the fruit itself is the symbol of Plouton [Pluto, or Hades] and Persephone. According to the myth, when Hades raped Kore [Persephone], he gave her some seeds of this fruit to eat, by which means he kept her one-third of the year with him in the underworld. Moreover the relation of the pomegranate with chthonic cult is indicated by its frequent presence as a votive offering in graves and its depiction on grave reliefs and in vase-painting. It is at once a symbol of death and of rebirth; its numerous seeds symbolize fertility and life. Pomegranates are very often represented in art, especially in South Italian tomb-painting, particularly in Campania and Lucania, together with other fruits, such as apples, as well as eggs – all symbols of the cult of the dead.

Despite their symbolic relation to the world of the dead and its deities, Sirens with pomegranates are not often depicted in Greek art. There are two known examples from Magna Graecia: the Getty and the Crotone Sirens; and two more from mainland Greece: the Peloponnesian Siren and a terra-cotta one from Boeotia. The latter has a clearly rendered red painted fruit hanging from a necklace around the neck and a polos [tall, cylindrical headdress] on the head. The provenance of the terra-cotta, combined with the fruit and polos, connect the Siren with Hera, as a chthonic goddess. According to Mueller, the goddesses who mostly wear poloi are Kore and Demeter; Hera usually has a polos decorated with palmettes and flowers, such as that on the Boeotian Siren. In contrast, the Getty Siren has a plain polos, such as that worn by Demeter and Persephone….

The fruit symbolizes life and death at the same time. Fascinating!

Costus: Vermifuge with a Difference

Costus is a medicinal plant that grows in the high valleys of Kashmir and some other parts of the Himalayas. It is usually found in moist shady locales, sometimes as the undergrowth in birch forests. Costus root is used extensively in Chinese and Ayurvedic medicine, and has been a minor product of Arabian traditional medicine for several millennia.

The Greek geographer Strabo (about 64 BC – 24 AD) says that costus was not grown in Arabia in his era and had to be imported, presumably from India. To this day, it is still exported from India to the Gulf countries. However, most of the Indian exports go to China and Japan.

While costus root has culinary and fragrance uses, its medicinal properties are as an anodyne, antibacterial, antispasmodic,  aphrodisiac,  carminative,  emmenagogue,  skin treatment, stimulant,  tonic and vermifuge:

Costus is a commonly used medicinal herb in China and is considered to be one of their 50 fundamental herbs. It is also used in Ayurvedic medicine where it is valued mainly for its tonic, stimulant and antiseptic properties. It is said to be aphrodisiac and to be able to prevent the hair turning grey.

The root is anodyne, antibacterial, antispasmodic, aphrodisiac, carminative, skin, stimulant, stomachic, tonic and vermifuge. It is used internally in the treatment of abdominal distension and pain, chest pains due to liver problems and jaundice, gall bladder pain, constipation associated with energy stagnation, and asthma. The root is harvested in the autumn or spring and either dried for later use or decocted for the essential oil. It is normally used with other herbs.

The root is also used in Tibetan medicine where it is considered to have an acrid, sweet and bitter taste with a neutral potency. It is used in the treatment of swelling and fullness of the stomach, blockage and irregular menses, pulmonary disorders, difficulty in swallowing and rotting/wasting of muscle tissues.
An oil from the root is very beneficial in the treatment of rheumatism.

 

Environmental scientists in India said in a 2005 study that the cultivation of costus root or kuth was at a standstill, due to economic and other reasons, and the plant was endangered:

Kuth cultivation in [the Himalaya] region is among the interesting examples of domesticating wild medicinal herb by some innovative farmers during the 1920s. However, in the recent past farmers have been less interested to continue this practice due to its larger cultivation cycle, more profits with cash crops like pea and potato, and permit formalities at the time of export from the valley. In addition to being the oldest cash crop in the cold desert environment, Kuth is an endangered medicinal herb that has to be conserved on a priority basis.

Interestingly, costus root has long been used in Arabia and the Gulf as a treatment to encourage the expulsion of demons or evil jinn that have taken possession of humans.

Dr. Abu’l-Mundhir Khaleel ibn Ibraaheem Ameen, in his book The Jinn and Human Sickness: Remedies in the Light of the Qur’aan & Sunnah (Riyadh: 2005),  quotes the Prophet Muhammad in a Hadith as recommending nose drops made from costus root be administered for this purpose:

Nose drops made of Indian costus may be used to annoy a stubborn jinn [who has possessed a person and is not easily expelled]. The patient should take it in through the nose, so that the costus goes straight to the brain where the jinn is located, and he will be greatly annoyed by it, so much so that he will not be able to bear it and will hasten to flee, or he will talk to the practitioner and promise to leave and not come back. The Sunnah mentions the virtues of Indian costus, such as in the report narrated by Al-Bukhaari (may Allaah have mercy on him) in his Saheeh:

It was narrated that Umm Qays bint Mihsan said: I heard the Prophet say:

“You should use the Indian incense [al-‘ud al-hindi] for in it is healing for seven diseases. It may be taken in the form of nose drops for trouble in the throat or given in the side of the mouth for pleurisy.”

Dr. Ameen provides a recipe and procedure for administering anti-jinn nose drops, as follows:

An Uqiyah of Indian costus should be ground to a powder.

In Fath Al-Baari, Ibn Hajar described how to use Indian costus. He said: The patient should be made to lie on his back, and something should be placed beneath his shoulders in order to raise them, so that his head will be tipped back. Drops of olive oil mixed with costus should then be placed in his nose so that they may reach the brain and whatever sickness is present may be expelled by sneezing.

Usually the jinn may be expelled in this fashion….

It is not known if anti-jinn nose drops have ever been produced commercially either in the Indian Subcontinent or the Middle East.

Almost Myrrh

The celebrated aromatic tree resin and health remedy myrrh (Commiphora myrrha) has a poor cousin called bdellium (Commiphora mukul).

In ancient times bdellium was sometimes mixed with or substituted for “real” myrrh, which was widely regarded as superior both as a medicine and an incense. Bdellium was sometimes steeped in wine to enhance its fragrance when burned. But this resin, whose trees grow primarily in South Asia but also in Arabia, has retained its reputation as a natural remedy and aromatic, particularly in the context of traditional Indian Ayurvedic medicine.

Pliny said the best bdellium grew in Bactria, though he noted it was found in Arabia and other areas as well. (Today bdellium trees still grow alongside the frankincense trees in the Omani province of Dhofar, but they are said to be rarely harvested.)

The people of ancient Mesopotamia called this popular incense “guhlu” (an Akkadian word) and Sanskrit speakers called it “guggulu.” By the 19^th century, the Anglo-Indian term for bdellium was “googul balsam,” and today a common term for the resin in Asia and the Middle East is “mukul myrrh.”

In India today, bdellium gum is sold in herbal shops and spice stores, and is used as an astringent, anti-inflammatory and antiseptic. Bdellium is taken internally as a bitter, stomachic, carminative and digestion aid.

Says one online Ayurvedic herbal marketer:

Commiphora mukul resin oil possesses a powerful stimulant, anti-inflammatory, antioxidant, astringent, and it exerts prostaglandin.

Commiphora mukul is one of the most respectable herbs known in Indian Herbal System (Ayurveda). Commiphora mukul gum resin is used in treatment of rheumatism, neurological disorders, obesity and related disorders, hypothyroidism, scrofula, syphilis, skin and urinary disorders.

Properties include astringent, antiseptic, aperitif, carminative, diaphoretic, diuretic, emmenagogue, expectorant, stomachic, alterative, uterine tonic and sedative.

The smoke out of burning resin has been used in treating hay fever, nasal catarrh, laryngitis, bronchitis and phthisis.

A standard work on Indian medicinal plants reported in 1935:

[The gum of C. mukul is a] laxative, stomachic, aphrodisiac, alterative, tonic, anthelmintic … heals fractures, ulcers, pistula, piles … cures indigestion, urinary discharges, urinary concretions, leucoderma, tumours, inflammation, tubercular glands in the neck … useful in ascites, asthma, and troubles of the chest; removes bad discharges from the ear … cures abdominal troubles. [It is also] useful in muscular rheumatism, lung complaints [and] dyspepsia … is a demulcent, aperient, carminative … especially useful in nervous diseases, scrofulous affections, urinary disorders and skin diseases. It is applied locally as a paste in haemorrhoids, incipient abscesses, and bad ulcers. It is also used as an expectorant. [Blatter, Caius and Mhaskar 1935: 527-528]

According to ancient Arabia specialist Daniel Potts and his colleagues, bdellium was transported by the ton from Arabia, Bactria and other sources to distant destinations in India, Mesopotamia, and even the Mediterranean, both by camel caravan and cargo ship. It was sometimes used as tribute to powerful regional rulers, including Assyrian kings.

Potts has posted online an interesting paper on the ancient trade in bdellium and the various terms used for this significant and underrated herbal remedy.