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22
The developmen T of herbal medicine
Rebirth of European Scholarship 1000–1400 ce
As European scholars slowly started to absorb the lessons  
of Arabic medical learning in the early Middle Ages, classical 
Greek, Roman, and Egyptian texts preserved in the libraries of Constantinople (later Istanbul) filtered back to Europe, and hospitals, medical schools, and universities were founded. Perhaps the most interesting among them was the medical school at Salerno on the west coast of Italy. It not only allowed students from all faiths—Christian, Muslim, and Jewish—to study medicine, but it also allowed women to train as physicians. Trotula, a woman who wrote a book on obstetrics, practiced and taught there in the 12th century ce. Herbs were, of course, central to the healing process. An adage from the Salerno school on sage (Salvia officinalis,  p. 131) went as follows: Salvia salvatrix, natura conciliatrix  
(sage, the savior; nature, the conciliator). By the 12th century, trade with Asia and Africa was 
expanding and new herbs and spices were being regularly imported into Europe. Hildegard of Bingen (1098–1179),  
the famous German mystic and herbal authority, considered galangal (Alpinia officinarum, p. 61)—used in Asia as a warming and nourishing spice for the digestive system—to be the “spice of life,” given by God to provide health and to protect against illness. Asian Unification
Marco Polo’s travels to China in the 14th century coincided with the unification of the whole of Asia from the Y ellow  
Sea in China to the Black Sea in southeastern Europe by Genghis Khan and his grandson Kublai Khan, whose capital  
was in China, not far from Beijing. Neither the Chinese nor Ayurvedic medical traditions were directly threatened by this conquest. The Mongol rulers were strict in banning the use of certain toxic plants such as aconite (Aconitum napellus,  p. 160), but their decree may have held an element of self-Marco Polo’s voyage to China in the 14th century opened the door for a flourishing  
reciprocal trade in goods, including medicinal herbs, between East and West. Eventually,  exotic herbs like ginger, cinnamon, and cloves became widely used in European medicine  and cooking. Manuscript page from an Anglo-Saxon herbal of about 1050 ce, illustrating the aerial parts and root system of a medicinal plant.preservation, given aconite’s alternative use as an arrow 
poison—one that could have been used against the ruling powers. Moreover, the Mongol unification may have encouraged greater communication between the two medical disciplines. In other parts of Asia, such as Vietnam and Japan, Chinese culture and medicine exerted the primary influence. While kampoh—the traditional herbal medicine of Japan— is distinctive to that country, its roots stem from  
Chinese practices. Trade between Continents 1400–1700
Trade routes had slowly expanded during the Middle Ages, bringing exotic new herbs in their wake. From the 15th century onward, an explosion in trade led to a cornucopia  of new herbs becoming readily available in Europe. They included plants such as ginger (Zingiber officinale, p. 155), cardamom (Elettaria cardamomum, p. 93), nutmeg (Myristica fragrans, p. 115), turmeric (Curcuma longa, p. 90), cinnamon (Cinnamomum spp., p. 81), and senna (Cassia senna, p. 75). US_018-027_Early_Origins_To_The_19_Century.indd   22 26/02/16   4:42 pm23 Early Origins t O th E 19th C EnturyThe trade in herbs was not entirely  
one way. The European herb sage,  
for example, came into use in China, 
where it was considered to be a  
valuable yin tonic. The arrival of Columbus’ ships in  
the Caribbean in 1492 was followed  
by the rapid conquest and 
colonization of central and 
south America by the Spanish 
and Portuguese. Along with 
their booty of plundered 
gold, the conquistadores 
returned to the Old World 
with previously unheard-of 
medicinal plants. Many  
of these herbs from the 
Americas had highly potent 
medicinal actions, and they 
soon became available in the apothecaries of the major 
European cities. Plants such as lignum vitae ( Guaiacum 
officinale , p. 218) and cinchona ( Cinchona  spp., p. 80) with 
strong medicinal actions were used with greater and lesser 
degrees of success as treatments for fever, malaria, syphilis, 
smallpox, and other serious illnesses. For most rural communities, however, the only foreign 
plants that were used medicinally were those that could also 
be grown locally as foods. Garlic offers one of the earliest and 
clearest examples. Originating in central Asia, over time it 
was cultivated farther and farther west and was grown in 
Egypt around 4500 bce. In Homer’s 8th-century bce epic 
poem The Odyssey , the hero is saved from being changed 
into a pig thanks to garlic. The herb was introduced into 
Britain after the Roman conquest in the 1st century ce, and 
by the time it reached the island its remarkable medicinal 
powers were well understood. In later centuries, potatoes 
(Solanum tuberosum , p. 271) and corn ( Zea mays , p. 154), 
both native to South America, would become common 
foods. These plants have clear medicinal as well as 
nutritional benefits. Potato juice is a valuable remedy for the 
treatment of arthritis, while cornsilk makes an effective 
decoction for urinary problems such as cystitis. Health & Hygiene 1400–1700
Between the 12th and 18th centuries, the influx of exotic 
medicinal plants added to an already large number of useful 
European herbs. Conceivably, an overall improvement of 
health in Europe might have resulted. After all, not only  
were new medicinal plants available, but Europeans had the 
opportunity to observe the different medical practices of 
people in South America, China, Japan, and especially in India, 
where trade was well established. But, in fact, the reverse was 
the case. People living in Europe during this period probably experienced some of the most unhealthy conditions the 
world has ever seen. In contrast, Native Americans before 
the arrival of Columbus lived longer, healthier lives than their 
counterparts in Europe. This fact is unsurprising given the cities 
of medieval Europe, with their open sewers, overcrowding, 
and ignorance of simple hygiene. Conditions such as these laid fertile ground for the spread 
of plague-infested rats from the ports of the Mediterranean 
throughout Western Europe. From the mid-14th century 
onward, plague killed millions, in some cases close to 50 
percent of the population. No medical treatment—herbal  
or mineral—was able to alter its fatal course. Epidemics 
continued to decimate the cities of Europe and Asia well into 
the 18th century. An outbreak in India in 1994 reawakened the 
terror inspired simply at the mention of the word “plague.”
 Syphilis was another disease spread by seafarers. It was 
reputedly brought back from the Caribbean to Naples by 
Columbus’ crew in the 1490s, spreading quickly throughout 
Europe and to the rest of the world, reaching China in 1550. European doctors had little success in combating diseases 
as devastating as plague. The medicine they practiced was 
based on the blind acceptance of Galen’s humoral principles. Perhaps if, as in Chinese and Indian medicine, European 
medicine had continued to evolve, revising ancient medical 
texts and reinterpreting them in the light of new discoveries,  
it would have had greater success. As it was, European 
physicians were at least as likely to kill their patients  
with bloodletting and toxic minerals  
in misbegotten attempts to balance 
the humors as they were to cure. Indeed, the increasingly 
fashionable use of 
mineral cures such  
as mercury led to the 
growth of chemical 
formulations, culminating  
in scientific medicine’s 
ultimate break away from 
herbal practices. The Influence  
of Paracelsus
One of the key European figures 
of the 16th century was Paracelsus 
(1493–1541), a larger-than-life 
character who rejected the tired 
repetition of Galen’s theories in 
favor of detailed observation in 
medicine. “I have not borrowed 
from Hippocrates, Galen, or 
anyone else,” he wrote, “having 
acquired my knowledge from 
the best teacher, that is, by Garlic  is native to Asia but was readily 
adopted for its medicinal and culinary 
qualities in the West. 17th-century doctor  wearing a  
costume designed to protect against 
contamination by the plague. US_018-027_Early_Origins_To_The_19_Century.indd   23 26/02/16   4:42 pm
24
The developmen T of herbal medicine
experience and hard work.” And again, “What a doctor 
needs is not eloquence or knowledge of language and of books, but profound knowledge of nature and her works.” He also paid great attention to the exact dosage, saying that “it depends only on the dose whether a poison is a poison  
or not.”
 As a result, Paracelsus was an influential force in the future development of chemistry, conventional medicine, herbal medicine, and homeopathy. Though he is known as the “father of chemistry,” he also explored alchemy, which concerned itself with the transmutation of base materials to gold, and the search for immortal life. Paracelsus also revived interest in the Doctrine of Signatures—the ancient theory that held that a plant’s appearance indicated the ailments  
it would treat—and affirmed the value of locally grown medicinal herbs over expensive imported specimens. Culpeper & Printed Herbals
Paracelsus’ advocacy of local herbs was later fiercely espoused 
by Nicholas Culpeper (1616–1654). The frontispiece to  his The English Physitian contains the memorable words: “Containing a Compleat Method of Physick, whereby a Man The iconoclastic Paracelsus, an alchemist and chemist, was one of the greatest scientists  
of the 16th century, and advocated the use of minerals in healing, but only in tightly  controlled dosages.may preserve his Body in Health, or Cure himself, being  
Sick, for three pence Charge, with such things only as grow  in England, they being most fit for English Bodies.” Wounded during the English Civil War fighting for the 
Commonwealth, Culpeper championed the needs of the ordinary people who could afford neither the services of a doctor nor the expensive imported herbs and formulations that doctors generally prescribed. Drawing to some degree on Dioscorides, Arabian physicians, and Paracelsus, Culpeper developed a medical system that blended astrology and sound personal experience of the therapeutic uses of local plants. His herbal became an instant “bestseller” and appeared in many subsequent editions. The first herbal published in North America, in 1700, was an edition of his herbal. While the popularity of The English Physitian was notable, other herbals also found a place in households. The development of the printing press in the 15th century brought herbal medicine into homes on a wide scale. Texts such as Dioscorides’ De Materia Medica were printed for the first 
time, and throughout Europe herbals were published and ran through many editions. Deadly Cures 1700–1900
By the end of the 16th century, Paracelsus had become the 
figurehead of the new chemical medicine. However, where he had insisted upon caution in the use of metallic poisons—mercury, antimony, and arsenic—the new medical thinkers were not so inhibited. Larger and larger doses of the purgative known as calomel (mercurous chloride, Hg
2Cl2) were given 
to those suffering from syphilis and many other diseases. The treatment was very often worse than the illness, with some patients dying and many more suffering from the long-term consequences of mercury poisoning. Hippocrates’ saying “Desperate cases need the most 
desperate remedies” was taken very literally, as is evident in the incredible excess of purging and bleeding that developed over the next three centuries in Europe and North America. These practices reached a peak in the “heroic” medicine of the early 19th century. Its leading proponent, Dr. Benjamin Rush (1745–1813), maintained that only bloodletting and calomel were required in medical practice. His position was obviously extreme, but it is clear that in this new climate herbal medicines were becoming increasingly irrelevant. The New Rationalism
Along with the new emphasis on chemical cures, modern 
medicine came to look askance at the notion of the “vital force.” Up until the end of the 16th century, nearly all medical traditions had been based on the concept of working with nature, with the body’s healing capacities, which could be supported and strengthened with appropriate medicinal herbs. In traditional Chinese medicine, qi is the primal energy that maintains life and health. In Ayurveda, it is prana, and  
US_018-027_Early_Origins_To_The_19_Century.indd   24 26/02/16   4:42 pm25 Early Origins t O th E 19th C Entury
Mask of a northwestern Native American shaman. The efficacy of techniques  
used by native healers often surpassed that of conventional medical practices  
of the time.in the Western 
tradition, Hippocrates 
writes about “ vis 
medicatrix naturae ”  
or the healing power of 
nature, while modern Western 
medical herbalists and homeopaths 
use the term “vital force.”
The importance of the vital force 
was diminished in the West by the 
philosophy of René Descartes (1596–1650). This French 
mathematician divided the world into body and mind, nature 
and ideas. His philosophy ordained that the intangible vital 
force that maintains life and governs good health was the 
province of religion rather than of the newly self-aware 
“science” of medicine. To the new medical establishment, 
inching its way forward toward scientifically sound medical 
practices, “supernatural” concepts such as the vital force 
were a reminder of the ignorance and superstition that were 
part and parcel of older healing practices. Even before Descartes’ theories, the rational approach  
to scientific and medical exploration was beginning to reap 
rewards. Slowly, medical understanding of bodily functions 
was gaining ground. William Harvey (1578–1657) made a 
detailed study of the heart and circulation, proving for the 
first time that, contrary to Galenic thought, the heart 
pumped blood around the body. Published in 1628, 
his study is a classic example of the revolution in 
medical science. Since Harvey’s time, science has had astounding 
success in revealing how the body works on a 
biochemical level and in distinguishing different 
disease processes. However, by comparison it has 
been altogether less successful in developing 
effective medical treatments for the relief and 
cure of diseases. The Gap in the Scientific Approach
In hindsight, it seems as if the new science 
of medicine could only be born in separation 
from the traditional arts of healing, with which it 
had always been intertwined. As a result, even though 
traditional medicine has generally lacked scientific explanation, 
it has frequently been far ahead of medical science in the 
way it has been applied therapeutically. In American Indian 
Medicine  (University of Oklahoma Press, 1970), Virgil Vogel provides a good example of “ignorant” folk medicine 
outstripping scientific understanding in therapeutic application:
 “During the bitter cold winter of 1535–6, the three ships 
of Jacques Cartier were frozen fast in the fathom-deep ice of 
the St Lawrence River near the site of Montreal. Isolated by 
four feet of snow, the company of 110 men subsisted on 
the fare stored in the holds of their ships. Soon scurvy was 
so rampant among them that by mid-March, 25 men had 
died and the others, ‘only three or foure excepted,’ were 
so ill that hope for their recovery was abandoned. As the 
crisis deepened Cartier had the good fortune to encounter 
once again the local Indian chief, Domagaia, who had cured 
himself of the same disease with ‘the juice and sappe of a 
certain tree’. The Indian women gathered branches of the 
magical tree, ‘boiling the bark and leaves for a decoction, 
and placing the dregs upon the legs.’ All those so treated 
rapidly recovered their health, and the Frenchmen 
marvelled at the curative skill of the natives.”
 Naturally, the Native Americans had not heard of vitamin C 
deficiency, which causes scurvy, nor would they have been able 
to explain in rational terms why the treatment worked. Indeed, 
it was not until 1753 that James Lind (1716–1794), a British 
naval surgeon, inspired partly by Cartier’s account, published 
A Treatise of the Scurvy , which showed conclusively that the 
disease could be prevented by eating fresh greens, vegetables, 
and fruit, and was caused by their lack in the diet. James Lind’s 
work is a marvellous example of what can be achieved by 
combining a systematic and scientific approach with traditional 
herbal knowledge.The symbol for “om” — 
life force—is used by 
followers of the Indian 
practice of Ayurveda  
as a focus for meditation. US_018-027_Early_Origins_To_The_19_Century.indd   25 26/02/16   4:42 pm
26
The developmen T of herbal medicineIsolating Chemicals
The discovery of the medicinal value of foxglove (Digitalis 
purpurea, p. 202) is another case where traditional herbal knowledge led to a major advance in medicine. Dr. William 
Withering (1741–1799), a conventionally trained 
doctor with a long interest in medicinal plants, 
started to investigate foxglove after encountering 
a family recipe for curing dropsy (water 
retention). He found that in some regions of 
England, foxglove was traditionally used to 
treat this condition, which is often one of 
the indications of a failing heart. In 1785,  
he published Account of the Foxglove, 
documenting dozens of carefully 
recorded case histories, and showing 
how foxglove’s powerful (and 
potentially dangerous) active 
constituents, now known as cardiac 
glycosides, made it a valuable plant 
medicine for dropsy. Cardiac 
glycosides remain in common 
use to the present day. Y et 
despite this clearcut example 
of the possibilities inherent  
in a marriage of herbal 
medicine and scientific 
method, conventional 
medicine was to take 
another path in the  
19th century. Laboratory versus 
Nature
From the early 19th 
century, the chemical 
laboratory began to 
regularly supplant Mother 
Nature as the source  
of medicines. In 1803, 
narcotic alkaloids were 
isolated from the opium 
poppy (Papaver somniferum, 
p. 244). A year later, inulin was 
extracted from elecampane 
(Inula helenium, p. 107). In 1838, 
salicylic acid, a chemical forerunner 
of aspirin, was isolated from white 
willow bark (Salix alba, p. 129), and 
was first synthesized in the laboratory 
in 1860. From this point on, herbal medicine and biomedicine were to take separate paths. Aspirin, an entirely new chemical formulation, was  first developed in Germany in 1899. But this was still an  early step. For the time being, the influence of the universities, medical schools, and laboratories of Europe would remain limited, and herbal medicine would prevail  as the predominant form of treatment for most people around the world. New Frontiers, New Herbal Medicines
Wherever Europeans settled during the great migrations of the 18th and 19th centuries—North America, South America, southern Africa, or Australia—much of the European medicine familiar from home was either unavailable or prohibitively expensive. Settlers came to learn that native peoples were a wellspring of information about the medicinal virtues of indigenous plants. For example, European settlers in southern Africa learned about the diuretic properties of buchu (Barosma betulina, p. 71) from native peoples; and Australian settlers came to understand the remarkable antiseptic properties of tea tree (Melaleuca alternifolia, p. 112) from observing the medicinal practices of the Aborigines. Mexican herbal medicine as it exists today is a blend of Aztec, Mayan, and Spanish herbs and practices. In North America, native herbalists were particularly 
adept at healing external wounds and bites—being superior in many respects to their European counterparts in this area of medicine. This is not surprising, given the range of highly Opium poppy, native to Asia, yields a resin that has long been smoked for its narcotic  
effect. The main active constituent, morphine, was first isolated in the laboratory in  1803 and is used to relieve pain. In the 18th century, the physician William Withering documented foxglove’s ability to restore a failing heart. US_018-027_Early_Origins_To_The_19_Century.indd   26 26/02/16   4:42 pm27 Early Origins t O th E 19th C Enturyeffective medicinal plants Native Americans had 
discovered—including well-known herbs such as echinacea 
(Echinacea spp., p. 92), goldenseal ( Hydrastis canadensis ,  
p. 105), and lobelia ( Lobelia inflata , p. 110). European settlers learned much from observing native 
practices. Over the course of the 19th and early 20th centuries, 
as pioneers moved west across the frontier territory, new 
plants were constantly being added to the official record  
of healing herbs. In addition to the three species mentioned 
above, about 170 native plants were listed in The Pharmacopeia 
of the United States . Samuel Thomson & his Followers
Lobelia was one of the key herbs, along with cayenne  
(Capsicum frutescens , p. 74), advocated by Samuel Thomson 
(1769–1843), an unorthodox herbal practitioner who believed 
that all illness resulted from cold. His simple approach was 
entirely at odds with the conventional practices of his time  
(see North America, p. 50). Thomson’s methods were often 
very effective and were well suited to the needs of people 
living in frontier territory. His system of medicine—in many 
ways an early form of naturopathy, in which ill health is 
treated with naturally grown food, sunlight, fresh air, and 
natural medicines—became extraordinarily popular, with 
millions of people across North America following his 
methods. Thomson’s success waned as other 
more sophisticated herbal approaches were 
developed—those of the Eclectics and 
Physiomedicalists, for example—in the 
fertile medical world of 19th-century 
America, which also saw the birth  
of osteopathy (a system of healing 
based upon the manipulation 
of bones) and chiropractic  
(a similar system primarily 
involving manipulation of  
the spine). Western Influences on 
Asian Medicine
Across the world in 
China, Thomson’s 
practices might have 
been looked on with 
a measure of surprise, 
but they would have 
been familiar. In Chinese 
medicine, there has 
always been a debate 
as to what degree 
illness arises from  
cold, and to what  
degree it arises from heat. The Shanghanlun (On Cold-Induced Maladies) , written in the 2nd 
century ce , and revised and reinterpreted in commentaries 
over the last 1,800 years, recommends the herb cinnamon 
(Cinnamomum spp., p. 81) as a principal remedy when the 
patient “shivers with fever, breathes heavily, and feels 
nauseous.” In the 14th century, Wang Lu distinguished 
between cold-induced illness and febrile illness, and treated 
them in different ways, and this distinction was elaborated in 
greater and greater detail by different Chinese herbalists right 
up to the 19th century. During the early 19th century, the influence of Western 
biomedicine was beginning to affect traditional practices in both 
China and India. This was certainly beneficial in many respects. The judicious incorporation of scientific principles and methods 
into traditional herbal healing offers the possibility of greatly 
refining the effectiveness of treatment. But in India under British rule, Western medicine eventually 
became the only alternative. Ayurveda was seen as inferior to 
biomedicine ( see India & the Middle East, p. 39). Western 
practice was introduced not as a complement to traditional 
medicine, but rather as a means to supplant it. According to 
one authority, “before 1835 Western physicians and their 
Indian counterparts exchanged knowledge; thereafter only 
Western medicine was recognised as legitimate and the 
Eastern systems were actively discouraged” (Robert 
Svoboda, Ayurveda, Life, Health and Longevity , 1992). In China, the influx of Western ideas was less traumatic. Increasing numbers of Chinese medical students studied 
Western medicine, but this did not stop the continuing 
development of traditional herbal practice. By and large, 
each tradition was recognized as having both advantages  
and disadvantages. Herbalism Outlawed 1850–1900
In Europe, conventional medicine was seeking to establish  
a monopoly for its own type of practice. In 1858, the British 
Parliament was asked to impose legislation banning the 
practice of medicine by anyone who had not been trained in 
a conventional medical school. Fortunately, this proposal was 
rejected, but in countries such as France, Spain, and Italy, and 
in some states of the U.S., it became illegal to practice herbal 
medicine without an orthodox qualification. Herbalists were 
forced to risk fines or imprisonment simply for providing 
herbal medicine to patients who had sought their help. In Britain, concerns such as these, combined with a desire 
to establish Western herbal medicine as an alternative to 
conventional practices, particularly in the industrial cities  
of the North of England, led to the formation in 1864 of the 
National Institute of Medical Herbalists, the first professional 
body of herbal practitioners in the world. Its history is an 
example of how tenacious herbal practitioners have had  
to be simply to retain their right to give safe, gentle, and 
effective herbal medicines to their patients.Ginseng  has been used 
as a tonic remedy in 
Chinese medicine for 
at least 5,000 years. US_018-027_Early_Origins_To_The_19_Century.indd   27 26/02/16   4:42 pm
28
The developmen T of herbal medicine20th Century Onward
For most of us, modern medicine is exemplified by drugs such as antibiotics and highly technical 
methods of diagnosis and treatment. However, many might be surprised to discover that,  for much of the last century, herbal medicines have been the primary form of treatment,  even in Western countries. Even as late as the 1930s, around 90 percent of medicines 
prescribed by doctors or sold over the counter were herbal in origin. It is only during the last 70 years that laboratory-produced medicines have become the norm. During the  First World War (1914–1918), for example, garlic (Allium sativum, p. 59) and sphagnum moss (Sphagnum spp.) were used by the ton in the battle trenches to dress wounds and  
to treat infections. Garlic is an excellent natural antibiotic,  
and was the most effective antiseptic available at the time, 
and sphagnum moss, gathered from the moorlands, makes  a natural aseptic dressing. Science & Medicine
The development of new medicines in the laboratory—either extracted from medicinal plants or synthesized—stretches back to the early 19th century, when chemists first isolated constituents such as morphine, from opium poppy (Papaver somniferum, p. 244), and cocaine, 
from coca (Erythroxylum coca, p. 206). From that time onward, scientists made tremendous progress in understanding how isolated chemicals affect the body, as well as how the body works in health and disease. From the 1860s, scientists—most notably Louis Pasteur (1822–1895)—began to identify the microorganisms that were ultimately responsible for causing infectious diseases, such as tuberculosis and malaria. Naturally enough, the first aim of those engaged in medical 
research was to seek out medicines that would act as “magic bullets,” directly attacking the microorganisms concerned and ridding the body of the threat. This eventually led to the  
discovery, or, more accurately, the rediscovery of penicillin  by a number of medical researchers, most notably Alexander Fleming (1881–1955) in 1929. However, while 20th-century scientists were the first to scientifically evaluate antibiotics as medicines, they were not the first to employ them in healing. Antibiotic molds had been grown and used to combat infection in ancient Egypt, 14th-century Peru, and in recent European folk medicine. In the decades following the Second World War (1939– 1945), when antibiotics first came into use, it seemed as though a new era had dawned in which infection could  be conquered, and life-threatening diseases such as syphilis, pneumonia, and tuberculosis would cease to be major causes of death in the developed world. Modern medicine also provided other highly effective drugs such as steroid anti-inflammatories, and it seemed as if it was simply a question  of time until cures for most illnesses were found. Ascendancy of Biomedicine
As Americans and Europeans became accustomed to medication that led to an almost instant short-term improvement in symptoms (if not in underlying health), herbal medicines came to be seen by the public as outmoded and ineffective. Increasingly, the practice of herbal medicine was outlawed in North America and most of Europe, while the wealthy in developing countries abandoned herbal medicine in favor of the new treatments available. This was in no small part due to the medical profession itself, which saw herbal medicine as a throwback to the superstitions of the past. From the late 19th century onward, the aim of organizations such as the American Medical Association and the British Medical Association had been to monopolize conventional medical practice. Herbal medicine thus neared extinction in many countries, especially  
in the U.S. and Britain. In Britain, for example, from 1941 until 1968 it was illegal to practice herbal medicine without medical qualifications. The Tide Turns
Although there were spectacular successes with modern chemical medicines,  
there were also horrific disasters, most notably the thalidomide tragedy in 1962 in Britain and Germany, when 3,000 deformed babies were born to mothers who had taken the drug for morning sickness during pregnancy. This event marked a turning point in the public’s opinion of chemical medicines. Louis Pasteur was a pioneer in the 
identification of bacteria. An electron micrograph of the parasite Plasmodium. Transmitted to man by infected mosquitoes, it causes the disease malaria. US_028-031_20th_Century_and_Beyond.indd   28 26/02/16   4:42 pm29 20th century onward
People began to realize that a serious cost could accompany 
the benefits of treatment with modern pharmaceutical  
drugs. This, and the factors described below, have brought 
about a sea change in public perceptions of the value of 
herbal medicine. The Chinese Example
Herbal medicine experienced a major gain in fortune in  
1949 in China, when Mao Zedong and the Communist  
Red Army gained control of the country. Traditional Western medicine by that time was well 
established in China, but most of the population had little 
hope of access to modern hospitals, let alone to new drugs. Out of necessity, traditional Chinese medicine—essentially 
herbal medicine and acupuncture—once more began to  
be used alongside Western conventional medicine. The 
authorities aimed to provide the best of both worlds. Five 
teaching hospitals for traditional Chinese medicine (TCM) 
were established, where it was taught on a scientific basis. In addition, great efforts were made to improve the quality  
of plant medicines. Contrary to the trend in conventional Western medicine 
that makes the patient ever more dependent upon the 
doctor and high-tech machinery, TCM, like other forms  
of complementary medicine, stresses the patient’s personal 
responsibility for his or her own cure, encouraging a holistic 
approach to treatment. In the 1960s, China also established a system of “barefoot 
doctors.” After a period of basic medical instruction that 
blended herbal medicine, acupuncture, and Western practices, 
these practitioners were sent out to provide health care  
for the millions of rural Chinese too remote from cities  
to benefit from the facilities available there. The barefoot 
doctors in the late 1960s became a model for the World Health Organization, which created a strategy of including 
traditional herbal practitioners in planning for the health care 
needs of developing countries. Western Medicine & Herbal Practices
Further to the initiative by the World Health Organization, 
experience has shown that traditional (usually herbal) and 
Western medicine can indeed work well in tandem, although 
the relationship is often quite complex. J. M. Janzen’s The Quest 
for Therapy in Lower Zaïre  (University of California Press, 1978) 
describes one such interaction in Africa:
 “The people of Zaïre recognize the advantages of  
Western medicine and seek its surgery, drugs, and hospital  
care, but contrary to what might have been expected, native 
doctors, prophets, and traditional consultations among 
kinsmen do not disappear with the adoption of Western 
medicine. Rather a [working relationship] has developed  
in which different forms of therapy play complementary rather 
than competitive roles in the thoughts and lives of the people.”
 The high cost of Western medical treatment is another 
factor that has encouraged people and governments to 
re-examine traditional healing. In China, Mexico, Cuba, Egypt, 
Ghana, India, and Mongolia, to give but a few examples, herbal 
medicines are being cultivated in greater quantities, and are 
being used to some degree by conventional as well as 
traditional practitioners. Likewise, different types of treatment have evolved 
to meet the variety of needs within a population. India offers 
an extraordinary example of the kind of choices available  
in types of medical care. Alongside physicians trained in 
conventional Western medicine, there are medically trained 
Ayurvedic practitioners, traditional Ayurvedic practitioners, 
local healers, and homeopaths. Changing Attitudes
Perhaps the most important factor behind the growing 
interest in complementary medicine is the poor state of 
health in Western societies. Conventional medicine has by 
and large brought serious infectious diseases under control, 
although there are worrying signs that infectious organisms 
are becoming resistant to antibiotic treatment, largely as a 
result of their indiscriminate use. Chronic illness, however, 
seems to be on the increase. Probably around 50 percent  
of people in Western countries daily take one or more 
conventional medicines—for conditions as diverse as high 
blood pressure, asthma, arthritis, and depression. Many 
Western countries such as the U.S. and France spend 
astronomical sums on health care, yet despite this massive 
investment, much of the population remains demonstrably 
unhealthy. Even the significant increase in life expectancy in 
developed countries is starting to go into reverse, perhaps  
a result of environmental pollutants and toxic accumulation 
within the body.“Slash-and-burn” farming in the rainforest of Brazil results in the eradication of native 
medicinal plants. Efforts are now under way to provide local farmers with alternative 
means of profiting from the land. US_028-031_20th_Century_and_Beyond.indd   29 26/02/16   4:42 pm
30
The developmen T of herbal medicineOver the years, changes in public awareness have led to a 
renewed interest in herbal medicine. In fact, some herbal preparations are now so commonly used that they are accepted as a part of everyday life. One of many possible examples is evening primrose oil, which is used by hundreds  
of thousands of women in Britain to help relieve premenstrual syndrome. It is extracted from the seeds of Oenothera biennis  
(p. 241), a North American plant. Peppermint oil ( Mentha x 
piperita, p. 114), prescribed for irritable bowel syndrome and other gut problems, is another example, while senna (Cassia senna, p. 75), a simple, effective treatment for short-term constipation, is one of the most frequently used medicines throughout the world. The growing awareness of how our lives as human beings are interwoven with the fate of our planet also reinforces the value of herbal medicines. As long as care is taken to prevent overharvesting, herbal medicine is ecologically in tune with the environment. Herbalism & Holism
The “germ theory of disease,” which holds that illness  
springs from contact with an infectious organism, remains  
the dominant view in mainstream medicine. Many people, however, recognize that this is only part of the picture. While illnesses such as cholera and typhoid are highly infectious and are indeed likely to be caught by almost anyone, many infectious diseases are not transmitted automatically from one person to another. The question arises, therefore, what weakness in the patient has allowed the “seed” of infection to find fertile ground? Unlike much conventional medical practice, which focuses on eradicating  
the “bug” or abnormal condition, herbal medicine seeks to treat the weakness that gave rise to ill health, and sets this  
in the context of the patient’s life as a whole. A complex  
web of factors may lie behind the onset of illness. While bodily signs and symptoms are the most obvious indicators, dietary, emotional, and spiritual factors may be of  
equal importance. Our bodies contain over one hundred trillion cells, which collectively must function in harmony if good health is to be maintained. Used wisely, herbs work in tune with our bodies, stimulating, supporting, or restraining different sets of cells in their allotted tasks within the body, encouraging a return to normal balanced function. Remedies aim to strengthen the patient’s own resistance, improve the vitality of weakened tissue, and encourage the body’s innate ability to return to good health. Of course, for people with severe acute illnesses, it may  be too late to use an herbal approach to treatment. In these circumstances, strong-acting conventional medicines such  as heart drugs, antibiotics, and painkillers, as well as surgery, can all be lifesavers. However, a health-care system that  
is carefully attuned to the needs of the patient might well provide herbal remedies as a first line of treatment, with conventional medicines held in reserve to be used only  when necessary. Evidence in Support of Herbal Cures
Many medical scientists still find it hard to accept that natural medicines, with their complex chemical makeup and variable constituents, can be as good as chemical cures in treating illness. However, as more and more research reveals that herbal medicines can be as effective as conventional medicines—and are far safer—this thinking is beginning to change. This is well illustrated by the change in attitude toward  St. John’s wort (Hypericum perforatum, p. 106)—a European plant commonly taken as an antidepressant. Extracts of the herb are now scientifically recognized as having value in mild to moderate depression. Since the 1980s, over 30 clinical trials have found extracts of St. John’s wort to be as effective as conventional antidepressants and to have far fewer side effects. In 15 of these trials, the herbal extract produced fewer side effects than the placebo (or inert “medicine”) used as a comparison. Other investigations suggest that St. John’s wort may have a role in countering viral infections, promoting wound healing, and helping withdrawal from addiction, especially from alcohol. As is so often the case, research has confirmed traditional views. In the 16th century, Paracelsus (see p. 23) had this  to say about the herb: “Nothing chases away disease like strength. Therefore, we should seek medicines with power and strength to overcome whatever illnesses they are used against. From this it follows that God has given to Perforatum [St. John’s wort] the strength to chase [away] the ghosts of nature…and all downheartedness.” As a result of scientific research, today’s practitioners have an important advantage—how the plant works in the body is Evening primrose is native to North America and has been used to treat a wide range 
of conditions, including premenstrual syndrome, asthma, whooping cough, digestive disorders, and eczema. US_028-031_20th_Century_and_Beyond.indd   30 26/02/16   4:42 pm31 20th century onwardnow better understood, so that it is possible to be precise 
about dosages, aware of side effects, and confident in what 
form the herb should be taken as a medicine. All over the world research is now being directed into 
plants with a traditional use as medicines, in the hope of 
finding new treatments for all manner of health problems. To give but two examples: the Indian gooseberry ( Emblica 
officinalis , p. 204) appears to protect the liver against cancer, 
lowers blood cholesterol levels, and may prove valuable  
for acute pancreatitis; while thyme ( Thymus vulgaris , p. 143), 
better known as a culinary herb, is a potent antioxidant that 
may prevent the breakdown of essential fatty acids in the 
brain and slow the aging process. Medicinal Herbs & Big Business
The major pharmaceutical companies have realized that 
rainforests, grasslands, and even along roads and fields are 
sources of potentially invaluable medicines. As a result, the 
industry has invested vast resources into screening the active 
constituents of medicinal plants from all over the world. The drug taxol, first extracted from the Pacific yew ( Taxus 
brevifolia ), and one of the most effective treatments for 
breast cancer, was developed in this way. In this search through the plant world it is likely that  
other remarkable medicines will be found, though far  
fewer new drugs have been successfully developed via this 
research than was originally anticipated. In fact, there is a key 
problem to this approach, for it is geared to the production  
of isolated plant chemicals which can then be synthesized  
and patented. With a patent, a company can make a profit, 
recouping the massive investment required to research  
and develop new medicines. Herbs, however, are whole, 
naturally occurring remedies. They cannot and should  
not be patented. Even if the major 
pharmaceutical companies were able  
to find an herb such as St. John’s wort, 
which proved to be more effective 
and safer than conventional 
medicines, they would prefer  
to develop synthetic chemical 
drugs rather than  
plant medicines. Herbal Synergy
One word more than  
any other separates herbal 
from conventional medicine: 
synergy. When the whole plant 
is used rather than extracted 
constituents, the different parts interact, often, it is thought, 
producing a greater therapeutic 
effect than the equivalent dosage 
of isolated active constituents 
that are generally preferred in 
conventional medicine. Increasingly, research shows 
that herbs such as ephedra 
(Ephedra sinica,  p. 95), hawthorn 
(Crataegus oxyacantha , p. 87), 
ginkgo ( Ginkgo biloba , p. 100),  
and lily of the valley ( Convallaria 
majalis , p. 194) have a greater-
than-expected medicinal benefit 
thanks to the natural combination  
of constituents within the whole 
plant. In some cases, the medicinal value of the herb may be 
due entirely to the combination of substances and cannot  
be reproduced by one or two “active” constituents alone. The Future of Herbal Medicine
The main issue for the future of herbal medicine is whether 
medicinal plants, and the traditional knowledge that informs 
their use, will be valued for what they are—an immense 
resource of safe, economical, ecologically balanced 
medicines—or whether they will be yet another area of life 
to be exploited for short-term profit. Another issue is convincing skeptics in the medical  
world that herbal medicine is not just a poor substitute for 
conventional medicine, but a valuable form of treatment in its 
own right. In trials into the effect of certain Chinese herbs 
on patients with eczema at London’s Royal Free Hospital in 
the early 1990s, conventional specialists were astonished 
when the addition of one extra herb to a Chinese formula 
containing 10 others resulted in a dramatic improvement in a 
previously unresponsive patient. This story offers evidence of 
the skill and art involved in herbal practice. In tailoring the 
remedy to suit the individual needs of the patient and in 
treating the underlying cause, major improvements were 
made. This approach is a far cry from the standard medical 
view of using a single drug to treat a single disease. In India and China, there have been university courses in 
herbal medicine for decades. In the West this process has 
been slower, with undergraduate courses emerging only in 
the last 20 years. There are now degree courses in herbal 
medicine or naturopathy in several Western countries, 
including Australia, the UK, and the U.S., while in Germany, 
medical students have been required to study naturopathy 
and phytotherapy (herbal medicine) as part of their medical 
training since 2003. Such developments point toward a future 
where patients might be able to choose between medical and 
herbal approaches when considering what medical treatment 
will suit them best.The Moreton Bay chestnut is being 
investigated for its anti-HIV activity. St. John’s wort’s traditional use as a remedy for  
nervous exhaustion and depression has been  
confirmed by clinical trials. US_028-031_20th_Century_and_Beyond.indd   31 17/03/16   4:00 pm
Valerian tincture
St. John’s wort 
infused oil
Dried St. John’s wort
Valerian (Valeriana 
officinalis, p. 148) is a good herb for calming nervous tension.St. John’s wort 
(Hypericum perforatum, p. 106)  is an astringent and antiviral herb, and  
is widely used in  
Europe as a remedy for depression. Goldenrod (Solidago 
virgaurea, p. 271) is  an astringent herb taken for sore throats, congestion, and problems of the urinary tract. Fresh and dried 
calendula petals Calendula (Calendula 
officinalis, p. 73) is  an age-old remedy  for soothing  inflamed skin.Each of the world’s major herbal traditions developed its own framework 
for making sense of illness. In Europe, the principal model for understanding and explaining illness was the “theory of the four humors,” which persisted well into the 17th century. It was laid down by Galen (131–201 ce), physician to the Roman emperor Marcus Aurelius. Galen was born in Pergamum, and part of his medical practice involved caring for the gladiators of the city, which gave him the opportunity to learn about anatomy and the remedies best suited to healing wounds. He wrote literally hundreds of books and had a crucial influence on European medicine for over 1,500 years. To this day, plant medicines are sometimes called Galenicals to distinguish them from synthesized drugs. The Theory of the Four Humors
Galen developed his ideas from the texts of Hippocrates (460–c. 377 bce) 
and Aristotle (384–322 bce), who in turn had been influenced by Egyptian and Indian ideas. Hippocrates, expanding on the early belief that the world was made up of the elements fire, air, earth, and water, classified herbs as having hot, dry, cold, and moist properties. Aristotle developed and endorsed the theory of the four humors. According to the theory, four principal fluids—or humors—exist within the body: blood, choler (yellow bile), melancholy (black bile), and phlegm. The “ideal” person bore all four  
in equal proportion. However, in most people, one or more humors predominate, giving rise to particular temperaments or characters. For instance, excess choler produced a choleric-type person, who was likely  to be short-tempered, sallow, ambitious, and vengeful. Galen also believed that pneuma (spirit) was taken in with each breath, and processed in  
the body to form the “vital spirit.” Vitality and health depended upon the proper balance between the four humors and the four elements and  
the correct mix with the inspired pneuma. Influence of Classical Herbalists
Two other classical writers strongly influenced the European 
herbal tradition. Dioscorides (40–90 ce), a Greek-born Roman 
army surgeon, wrote the classical world’s most comprehensive 
book on herbal medicines, De Materia Medica, based on 
observations of nearly 600 plants. Pliny the Elder (23–79 
ce) drew together writings from over 400 authors in 
his Natural History, recording, among other things, 
herbal lore of the time. Much traditional European 
knowledge of medicinal herbs comes from 
Dioscorides and Pliny. One of the most 
interesting herbs mentioned by both is Europe
Despite regional variations, European herbal 
practices largely arose from the common root  of the classical tradition. Today, herbalism is increasingly popular in Europe, and in some countries it is  
widely practiced by orthodox medical practitioners as well as  by qualified herbalists.The developmenT  of herbal medicine
US_032-035_Europe.indd   32 26/02/16   4:42 pm33Cramp bark 
berriesFresh hops
Dried hopsSeason  Winter 
Part of the body   
Brain 
Humor   
Phlegm 
Temperament   
PhlegmaticSeason  Summer 
Part of the body   
Liver 
Humor   
Y ellow bile 
Temperament   
CholericSeason   
Spring 
Part of the body   
Heart
Season   
Spring 
Part of the body   
HeartHumor   
Blood 
Temperament   
Sanguine
Humor   
Blood 
Temperament   
SanguineFire
earTHair waTermoiST
cold dryHoT
Hops (Humulus lupulus , 
p. 104) are generally 
sedative, but they  
also stimulate  
digestive function. Feverfew (Tanacetum 
parthenium , p. 140) is 
hailed as a breakthrough 
treatment for migraine. yarrow (Achillea 
millefolium , p. 56)  
may have been used  
by Achilles’ troops in  
the Trojan war to 
staunch bleeding. angelica (Angelica 
archangelica , p. 168) 
treats indigestion. chaste tree  
(Vitex agnus-castus ,  
p. 151) relieves 
menopausal problems. Nettle (Urtica dioica ,  
p. 146) treats anemia. Hyssop (Hyssopus 
officinalis , p. 222)  
was prescribed by 
Hippocrates for pleurisy. rosemary (Rosmarinus 
officinalis , p. 128) is 
traditionally taken to 
improve the memory. cramp bark  
(Viburnum opulus ,  
p. 150) relaxes 
muscles.mandrake ( Mandragora officinarum , see p. 232). With a forked root that 
resembles the human shape, mandrake was credited with great magical 
and healing powers. It was recommended by Dioscorides for many 
ailments, including sleeplessness and inflammation of the eyes. With the collapse of the Roman empire in the 5th century ce, the 
debate about how illness arose and how it should be treated shifted to  
the East. By the 9th century, Islamic physicians had translated much of Galen’s 
work into Arabic, and his ideas affected the development of Arabic medicine 
into the Middle Ages, influencing Avicenna (980–1037). Later in the 
Middle Ages, Galen’s writings were translated back into Latin from the 
Arabic and, for 400 years, his ideas held sway and were diligently applied in 
European medical practice. Even in the 16th and 17th centuries, students 
in university medical schools were given an academic training in the 
principles of the humoral system, as established by Galen. They learned 
how to diagnose an imbalance of the humors, and the methods of 
restoring equilibrium, primarily bloodletting and purging ( see pp. 23–24). Printing & Herbal Medicine
The invention of printing in the 15th century changed the face of herbal 
medicine in Europe. Before that time, European folk medicine had been 
handed down from generation to generation. While some early herbals 
were written in Anglo-Saxon, Icelandic, and Welsh, for example, for the 
most part the tradition was orally based. During the following centuries, herbals were published throughout 
Europe in different languages, making standardized catalogs of herbs and 
their applications accessible to the general public, not just to those who 
understood Latin. As literacy rates rose, women in particular used the 
advice in the herbals to treat their families. The ancient theory of the four humors holds that four fluids within the body—black bile, phlegm, yellow bile, 
and blood—correspond to the four elements (earth, water, air, and fire), the four seasons, and other aspects 
of the natural world. Until the 17th century, physicians believed that an imbalance of the humoral system 
caused mental and physical illness.Europ E
US_032-035_Europe.indd   33 26/02/16   4:42 pm
34The developmenT  of herbal medicine
In some cases, the printed herbals were written by physicians, and largely 
reflected the writings of classical authors such as Dioscorides. In other instances they were based directly on first-hand experience—the English herbals of John Gerard (1597) and Nicholas Culpeper (1652) being  
good examples. John Gerard’s The Herball is clearly the work of a horticulturist, rather 
than of an herbal practitioner, but is nonetheless a mine of information. The book includes many plants that had been recently brought back to Europe by explorers and traders. Culpeper’s The English Physitian has been widely used as a practical 
reference book ever since its publication. It is a rich blend of personal  
and practical experience, traditional European medicine, and astrological thought. Each herb is assigned a “temperature,” a use within the humoral system, and a ruling planet and star sign. Like Dioscorides’ De Materia Medica, it has the merit of being based on close observation and extensive experience in the use of herbal medicines. Foreign Herbs & Synthesized Drugs
The growing use of foreign herbs in the 17th century prompted heated 
debate about the relative value of indigenous European herbs, but for the majority of the population this was irrelevant as the imported herbs were well out of their price range. In the end, it created a rift in herbal medicine. Poor and rural peoples used locally available herbs, while affluent city-dwellers and aristocrats purchased plants of foreign origin, prescribed  
by university-trained physicians. By the beginning of the 18th century, approximately 70 percent of plant medicines stocked by European apothecaries were imported. Over time, this city-based herbalism evolved into conventional scientific medicine, which in turn rejected its herbal roots and regarded plant medicines as inferior. Once conventional medicine established its monopoly of practice—in 
most European countries by the end of the 19th century—it became (and in many cases still remains) illegal to practice herbalism without medical certification. In Greece, traditional herbalists, known as komboyannites, were persecuted, and the word itself became an insult meaning “trickster”  
or “quack.” In France and Italy, experienced traditional herbalists were imprisoned for providing treatment to their patients. The renaissance in herbal medicine that has occurred in the last 40 years offers hope that official censure will change. Modern Practitioners
The pattern of herbal medicine 
across Europe today is remarkably varied, but a common thread runs through the different traditions and practices. Most European herbalists use orthodox methods of diagnosis, looking for signs of infection and inflammation, for example. However, most also try to establish a broad, holistic picture, placing the illness in the context of the patient’s life as a whole. Herbalists then choose plant medicines and recommend suitable Blackberry (Rubus 
fruticosus, p. 264) is  a cleansing, diuretic plant that was recommended by classical physicians. Marshmallow 
(Althaea officinalis,  p. 165) is a soothing remedy for gastritis and irritable bowel syndrome. The ancient Greek physician Pliny extolled the plant  as a cure-all. Milk thistle  
(Silybum marianum,  p. 137) protects the liver from damage. Elderflower  
(Sambucus nigra,  p. 132) helps to relieve hay fever. Sage (Salvia officinalis, 
p. 131) was considered a cure-all in medieval times.Fresh rosemary
Marshmallow flowers
Milk thistle capsules
Healers in medieval Europe frequently sought to 
restore physical imbalance with bloodletting, purges, and preparations that caused vomiting. US_032-035_Europe.indd   34 26/02/16   4:42 pm35Europ E
dietary and lifestyle changes that will 
allow the body’s self-regenerating 
powers—the modern equivalent of the 
“vital spirit”—to establish good health 
once again. Recovery may take longer 
than it would if treated with conventional 
medicine, but relief is generally enduring 
and free from side effects. A patient with a stomach ulcer, for 
example, may be treated with a variety 
of herbs such as meadowsweet 
(Filipendula ulmaria , p. 98), German 
chamomile ( Chamomilla recutita , p. 77), 
marshmallow ( Althaea officinalis , p. 165), 
and deadly nightshade ( Atropa belladonna , 
p. 69) to soothe inflammation, astringe, 
and protect the inner lining of the stomach, 
and reduce excess acid production. In 
addition, herbal practitioners also address 
poor dietary habits, bad posture, and stress—which are all conditions that 
may have undermined the body’s healing ability. Problems such as these 
are reversed with herbs to relieve stress, a diet rich in non-acidic 
vegetables and fruits, and exercise. Popular Herbs
In European herbal medicine, native herbs are still highly popular. Alpine 
plants such as arnica ( Arnica montana , p. 172) and pulsatilla ( Anemone 
pulsatilla , p. 168) are much used in Swiss, German, Italian, and French herbal 
medicine, while comfrey ( Symphytum officinale , p. 138) is particularly well 
liked in Britain. There has also been a surge in demand for exotic herbs. The 
Chinese ginkgo tree ( Ginkgo biloba , p. 100), which improves circulation of 
blood to the head and helps the memory, is now cultivated in vast plantations 
in France, and has been a bestselling medicine in Germany for over 20 years. European Traditions & the Future
Sales of over-the-counter herbal medicines in Europe have continued to 
increase over the last two decades, though the reasons for this growth 
vary widely. It is possibly a reaction to the over-reliance on drug treatment in 
conventional medicine. Sound advice on a healthy diet and lifestyle, 
including food herbs, such as turmeric ( Curcuma longa , p. 90), might well 
prove more beneficial than conventionally prescribed drugs in helping  
an aging population to stay healthy for longer. Nevertheless, in several European countries herbal medicines are 
routinely prescribed, offering doctors a choice of gentle-acting 
treatments for chronic and more minor health problems. In Germany and 
Poland, herbal medicines can be frontline treatments for digestive disorders 
and chronic problems such as arthritis. This approach leaves conventional 
drug treatments available for more acute or serious conditions. In contrast, a barely reported trend is that more and more people are 
growing medicinal plants. There seems to be a desire to rediscover the 
magic of cultivating and harvesting plants, and involving them (as food and 
medicine) in one’s daily life.Hawthorn (Crataegus 
oxyacantha , p. 87)  
has a marked tonic 
effect on the heart. Cowslip (Primula 
veris, p. 256) is a 
sedative plant that 
helps calm what 
herbalist John Gerard 
called “the frensies.”
Thyme (Thymus 
vulgaris , p. 143) is a 
good antiseptic and 
tonic herb. It is 
particularly effective 
as a treatment for 
chest infections. Common foxglove 
(Digitalis purpurea ,  
p. 202) is the  
source of digitalis,  
a widely used  
cardiac stimulant. Heartsease (Viola 
tricolor , p. 282)  
gained its name  
from its former  
use in love potions. It is an effective 
expectorant, treating 
coughs and colds. Lavender (Lavandula 
officinalis , p. 108) 
yields an essential oil 
that is a good first-aid 
remedy for insect 
bites and sunburn.Dried hawthorn 
flowers and berriesDried feverfew
John Gerard’s 1597 Herball is one of the  
classic texts on healing plants. US_032-035_Europe.indd   35 26/02/16   4:42 pm
36The developmenT  of herbal medicine
36Myrtle (Myrtus 
communis, p. 239) is cultivated for its oil, which is used for bronchitis. Castor oil plant 
(Ricinus communis,  p. 262) is prescribed in India for nervous disorders. Garlic (Allium sativum, p. 59) is  a key herb in Ayurvedic medicine, highly regarded for  its detoxifying properties. The name Ayurveda derives from two Indian words: ayur meaning 
longevity, and veda meaning knowledge or science. Ayurveda is as much a way of life as a system of medicine, and encompasses science, religion, and philosophy. Its ultimate aim, drawing on its many different practices—yoga and meditation, for example—is to promote self-realization and a harmonious relationship with the world. Early Origins
Ancient Indian culture developed around 5,000 years ago along the banks of the Indus river in northern India. This is thought of as a time of great spiritual enlightenment, with knowledge and wisdom being transmitted orally from teacher to student over many generations, and eventually set down in Sanskrit poetry known as the Vedas. These writings, dating from approximately 1500 bce, distilled the prevailing historical, religious, philosophical, and medical knowledge, and form the basis of Indian culture. The most important of these texts are the Rig Veda and the Atharva Veda. In about 400 bce, the first Ayurvedic medical school was founded by Punarvasu Atreya. He and his pupils recorded medical knowledge in treatises that would in turn influence Charaka, the scholar who is thought to have written the Charaka Samhita. This compendium of writings, in the form that it has come down to us, dates from around 100 ce and describes 341 plant medicines as well as medicines of animal and mineral origin. The second major work was the Susruta Samhita, dating from around the same time; it displays detailed knowledge of surgery, especially plastic surgery, and is still consulted today. The Influence of Ayurveda
Other traditions of medicine share common roots with Ayurveda, and 
Ayurveda has some claim to being the oldest surviving medical tradition  
in the world. From the time of  the Buddha (563–483 bce) onward, Ayurvedic medical ideas and practices spread across Asia, accompanying the spread of Buddhism itself. Buddhism, and Ayurvedic approaches to medicine, strongly influenced the development of Tibetan medicine, and these ideas in turn combined fruitfully with traditional Chinese medicine.Ancient civilizations of East and India and the 
Middle East
In India and the neighboring regions, a variety of herbal traditions 
continue to flourish. Ayurveda is the main system of healing in India, but Unani Tibb, traditional Arabic medicine, and Siddha, practised in T amil areas of southern India and  Sri Lanka, are also major herbal traditions. Cloves (Eugenia 
caryophyllata, p. 97) help infections ranging from scabies to cholera. Storax (Liquidambar 
orientalis, p. 229)  
is an important ingredient in Western cough mixtures. Licorice 
(Glycyrrhiza glabra, p. 101) grows wild in India. It is  an indispensable medicinal herb.Garlic pearls
Garlic capsules
Garlic cloves
Powdered garlic
Dried licorice root
Powdered  
licorice root
Fresh licorice
Cloves have been used medicinally for thousands of 
years in India. The flower buds are dried in the open air. US_036-039_India.indd   36 26/02/16   4:42 pm37Ind Ia and the m Iddle east
Nutmeg
Fresh holy basilNutmeg & mace 
(Myristica fragrans ,  
p. 115) are different 
parts of the same 
tree. In India, nutmeg 
paste is applied to 
eczema, and mace is a 
warming herb for 
stomach infections. Holy basil (Ocimum 
tenuifolium , p. 116) is 
often planted in 
temple courtyards 
in India. It is used in 
Ayurvedic medicine 
to protect the heart, 
and recent research 
shows that it lowers 
blood pressure. Balloon vine 
(Cardiospermum   
spp., p. 183) is used  
in Indian herbal  
medicine to bring on 
delayed menstruation. Turmeric (Curcuma 
longa , p. 90) is a 
traditional Ayurvedic 
remedy for jaundice.Mace
Holy basil seedsWest were linked to one another 
by trade routes, campaigns, and 
wars. In each case, this led to the 
exchange of ideas, medicinal 
plants, and medical practices, 
including fertile connections 
between Ayurveda, Siddha, and 
traditional Chinese medicine  
to the east, and ancient Greek  
and Roman medicine to the west. Later, from around 700 ce, 
traditional Greek medicine, based 
on Hippocratic ideas, developed 
in the Arabic world as classical 
Greek texts were translated 
into Arabic. This tradition, 
known as Unani Tibb 
(meaning “Ionian medicine,” 
referring to the island of Iona 
where Hippocrates lived),  
at one time spanned from India to Spain, and is still the main form of 
herbal medicine practiced by hakims in the Middle East. The Five Elements
Ayurveda is a unique holistic system, based on the interaction of body, 
mind, and spirit. In Ayurveda, the origin of all aspects of existence is pure 
intellect or consciousness. Energy and matter are one. Energy is 
manifested in five elements—ether, air, fire, water, and earth—which 
together form the basis of all matter. In the body, ether is present in the 
cavities of the mouth, abdomen, digestive tract, thorax, and lungs. Air  
is manifested in the movements of the muscles, pulsations of the heart, 
expansion and contraction of the lungs, and the workings of the digestive 
tract and the nervous system. Fire is manifested in the digestive system, 
metabolism, body temperature, vision, and intelligence. Water is present  
in the digestive juices, salivary glands, mucous membranes, blood, and 
cytoplasm.
Encyclopedia_Of_Herbal_Medicine.txt
Summarize the following text section accurately and concisely. Maintain specific details and numerical information, and use anti-repetition mechanisms:

        US_018-027_Early_Origins_To_The_19_Century. indd   21 26/02/16   4:42 pm
22
The developmen T of herbal medicine
Rebirth of European Scholarship 1000–1400 ce
As European scholars slowly started to absorb the lessons  
of Arabic medical learning in the early Middle Ages, classical 
Greek, Roman, and Egyptian texts preserved in the libraries of Constantinople (later Istanbul) filtered back to Europe, and hospitals, medical schools, and universities were founded. Perhaps the most interesting among them was the medical school at Salerno on the west coast of Italy. It not only allowed students from all faiths—Christian, Muslim, and Jewish—to study medicine, but it also allowed women to train as physicians. Trotula, a woman who wrote a book on obstetrics, practiced and taught there in the 12th century ce. Herbs were, of course, central to the healing process. An adage from the Salerno school on sage (Salvia officinalis,  p. 131) went as follows: Salvia salvatrix, natura conciliatrix  
(sage, the savior; nature, the conciliator). By the 12th century, trade with Asia and Africa was 
expanding and new herbs and spices were being regularly imported into Europe. Hildegard of Bingen (1098–1179),  
the famous German mystic and herbal authority, considered galangal (Alpinia officinarum, p. 61)—used in Asia as a warming and nourishing spice for the digestive system—to be the “spice of life,” given by God to provide health and to protect against illness. Asian Unification
Marco Polo’s travels to China in the 14th century coincided with the unification of the whole of Asia from the Y ellow  
Sea in China to the Black Sea in southeastern Europe by Genghis Khan and his grandson Kublai Khan, whose capital  
was in China, not far from Beijing. Neither the Chinese nor Ayurvedic medical traditions were directly threatened by this conquest. The Mongol rulers were strict in banning the use of certain toxic plants such as aconite (Aconitum napellus,  p. 160), but their decree may have held an element of self-Marco Polo’s voyage to China in the 14th century opened the door for a flourishing  
reciprocal trade in goods, including medicinal herbs, between East and West. Eventually,  exotic herbs like ginger, cinnamon, and cloves became widely used in European medicine  and cooking. Manuscript page from an Anglo-Saxon herbal of about 1050 ce, illustrating the aerial parts and root system of a medicinal plant. preservation, given aconite’s alternative use as an arrow 
poison—one that could have been used against the ruling powers. Moreover, the Mongol unification may have encouraged greater communication between the two medical disciplines. In other parts of Asia, such as Vietnam and Japan, Chinese culture and medicine exerted the primary influence. While kampoh—the traditional herbal medicine of Japan— is distinctive to that country, its roots stem from  
Chinese practices. Trade between Continents 1400–1700
Trade routes had slowly expanded during the Middle Ages, bringing exotic new herbs in their wake. From the 15th century onward, an explosion in trade led to a cornucopia  of new herbs becoming readily available in Europe. They included plants such as ginger (Zingiber officinale, p. 155), cardamom (Elettaria cardamomum, p. 93), nutmeg (Myristica fragrans, p. 115), turmeric (Curcuma longa, p. 90), cinnamon (Cinnamomum spp. , p. 81), and senna (Cassia senna, p. 75). US_018-027_Early_Origins_To_The_19_Century. indd   22 26/02/16   4:42 pm23 Early Origins t O th E 19th C EnturyThe trade in herbs was not entirely  
one way. The European herb sage,  
for example, came into use in China, 
where it was considered to be a  
valuable yin tonic. The arrival of Columbus’ ships in  
the Caribbean in 1492 was followed  
by the rapid conquest and 
colonization of central and 
south America by the Spanish 
and Portuguese. Along with 
their booty of plundered 
gold, the conquistadores 
returned to the Old World 
with previously unheard-of 
medicinal plants. Many  
of these herbs from the 
Americas had highly potent 
medicinal actions, and they 
soon became available in the apothecaries of the major 
European cities. Plants such as lignum vitae ( Guaiacum 
officinale, p. 218) and cinchona ( Cinchona  spp.
The Salerno medical school allowed students from all faiths, including women, to study medicine and also promoted the use of herbs in healing.
What was the significance of the Salerno medical school in the development of herbal medicine?
Trotula
Who was the author of the book on obstetrics and taught at the Salerno medical school?
The Mongol conquest led to the exchange of goods, including medicinal herbs, between East and West, which contributed to the spread of herbal medicine.
What was the impact of the Mongol conquest on the spread of herbal medicine?
Paracelsus emphasized the importance of local, naturally occurring remedies and rejected the concept of the "vital force".
What was the focus of Paracelsus' work?
The main issue with calomel was its toxic properties and the risk of poisoning.
What was the main issue with the use of calomel in the 16th century?
Traditional Chinese medicine emphasizes the importance of the concept of qi (or life force) and the balance of the body's energy, and it also emphasizes the importance of the individual's responsibility for their own health.
What was the focus of traditional Chinese medicine?