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Wild Greens: Botanicals as Medicaments

By Seymour E. Wheelock, M.D.

This article is a web-exclusive supplement to a feature titled "Wild Greens" in the Spring 2006 issue of Dartmouth Medicine magazine. The feature explores the accidental poisoning in 1966 of seven individuals, including two members of the Dartmouth Medical School faculty, due to the accidental misidentification of a wild plant. Botanicals have, of course, been both used and misused through the ages. Following are some additional insights into ways that plants have helped and hindered the maintenance of human health.

The treatment of human ills with the leaves, weeds, roots, and seeds of plants is an ancient phenomenon. The Greek physician Dioscorides in the first century A.D. discoursed on botanicals at length. Theophrastus, an able pupil of Aristotle, lent his voice to the subject as well, reflecting critically on superstitions that he dutifully recorded. Pliny the Elder, "an industrious but wholly uncritical compiler" generated a baffling proportion of unnatural history in his work Natural History, a summary of all he could find in existing works about plants, animals, and minerals and their relation to humankind.

Each century absorbed information from the preceding one. The Dark Ages yielded to the medieval era and the medieval period drifted into the Renaissance. The end of the 16th century was notable for the transformation of the classic "herbal"—common wisdom regarding the medicinal use of plants—into a book describing plants that had value scientifically and/or esthetically in addition to their application to the multiple ills of human beings. But when the Systema Naturae of Linnaeus became available, it was clear that the age of the herbalist was fading fast before the more enlightened discipline of botany.

Consider these two 200-year-old quotations about materia medica—as drugs used to be called, a term whose literal meaning, in Latin, is "medical matter":

From Every Man his Own Doctor by William Buchan, M.D., published in 1816 by N. Whiting of New Haven, Conn.:

"In this small volume a treatise is presented of the Materia Medica and a scrutiny of the medicinal properties of indigenous plants that are most generally known in the United States. The reader will at once see the advantage of being made acquainted with the herbs that he is daily treading under foot and which were given for the use of Man. Thusly any person of common observation need not be at a loss (in most cases) to know which are the most proper to be used."

From The Indian Guide to Health by Pocahontas Nonoquet and Dr. Richard Carter, published in 1812 in Selby County, Kentucky:

"The wise man will find in the latter part of this work a Meteria Medica [sic] which points out the "simples" wherewith the Greate Creator has in his wisdom planted in our gardens, fields, and forests for the divine healing of most, if not all, of our Infirmities."

Now fast-forward to the 21st century and check out the shelves of any of the thousands of natural food stores scattered across the country. Take note of the bewildering profusion of botanical "remedies." Truly, we live in our therapeutic past, even as we deal with the complexities of today's pharmaceutical giants and their miracle drugs.

But back at the dawn of the 19th century, the United States comprised a disparate populace whose health care still perfectly illustrated the words of an anonymous German writer of the 15th century:

"Many thousands and thousands of perils and dangers beset man. He is not fully sure of his life for one moment . . . but the Creator of Nature who has placed us amid such dangers has mercifully provided us with a remedy—that is, with all kinds of herbs, animals, and other created things to which He has given power and might."

These words were penned by the author of one of many printed tracts on medicinal plants— treatises that still retain, across the centuries of their use, the name herbals. Herbalists' chimeric literature is based sometimes on reality, often on superstition, frequently on religious conviction, and cheerfully on idiosyncratic personal reflection.

Despite unabashed charlatanry, fraud, and misconception of reality, patients did get well— sometimes because of, but sometimes in spite of, the "simples" and compounds with which they had been treated. On innumerable occasions, the

vile concoctions they were prescribed had no physiological effect at all. But the herbalist did utilize a wide armamentarium of formulations whose actions were based on physiological fact. There were aromatics, emollients, mild digestive stimulants, antispasmodics, diuretics, carminatives, vermifuges, anodynes, purges, "cathartics for the costive" (that is, those afflicted with constipation), emetics, sudorifics, counterirritants, heart stimulants, and narcotics.

In some instances, herbalists of the past failed to recognize the usefulness of many plants whose active principles are familiar today—such as cascara, quinine, and, most spectacularly, digitalis, whose beneficial effect on diseased hearts did not reach Europe until the heyday of the herbalist was drawing to a close.

It was inevitable, therefore, that 19th-century practitioners of the healing arts in the United States felt adrift. There was no uniform organization of the materia medica at their disposal. The only pharmacopoeias to which they had recourse were based on the often-conflicting pronouncements of English and Irish herbalists, with liberal additions from assorted exotic cultures and the more than 100 different Native American groups then populating the United States and Canada.

True, some places had put in place measures to regulate the preparation of medicines early in the 19th century; the pharmacopoeias of the Massachusetts Medical Society (1808) and of the New York Hospital (1810) had some impact, but their influence was quite local. Elsewhere, the practice of pharmacy was exceedingly unsettled and varied from section to section, from village to village, and even from one physician to the competitor down the street.

The absence of a uniform national pharmacopoeia was keenly felt, but no significant action to create one was taken until 1818. In that year, Dr. Lyman Spalding, then an officer of the New York Medical Society, sounded the alarm: "In the United States the evil of irregularity

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