NaturalMedications

One of the most significant virtues of the Romans, responsible for the long lasting success of their civilization, was their practicality. This is best seen in their ability to adopt local customs, religions and cultural mores, along with incorporating the accumulated knowledge and wisdom of foreign cultures under Roman dominion. Being great administrators, they soon saw the value of hygienic principles such as forbidding the burial of the dead within city limits, providing a minimum space of two feet between neighboring buildings, water transport via aqueducts, refuse and sewerage disposal. The Cloaca Maxima, which was a sewer built by the Etruscan Tarquins in the sixth century BC was first used to drain the marsh close to the Roman Forum and went on to serve the City of Rome for centuries to follow.

While private medical practice continued, the Romans were very instrumental in evolving group medicine in the form of hospitals. This was especially important to serve the needs of the military. Each Roman legion, numbering from seven to eight thousand men, were divided into ten to twelve cohorts, and to each, Augustus Caesar assigned four doctors with a supervising legionary physician. In addition, the soldiers themselves were well versed in first aid.

Army hospitals called valetudinaria were used to receive the soldiers. The remains of these hospitals are to be found throughout the Roman Empire. One located on the old Roman road to Cologne, called Novaesium was typical. It contained forty sick wards, administration buildings, large kitchens, and a well-stocked apothecary shop.

What the Romans contributed to practical organization and medical care, they lacked in human sensitivity. The hospitals operated on a strictly military basis with physicians taking orders from military commanders. Soldiers shocked by the brutal combat of war, stationed 100's of miles from their family with inevitable concomitant mental suffering were nevertheless expected to maintain a strict code of discipline even while hospitalized. An order issued by Emperor Aurelius indicates the type of discipline:

"Let each soldier aid and serve his fellow; Let them conduct themselves quietly in the hospitalls... and he who would raise strife, let him be lashed."

It is no wonder that due to previous Roman lack of compassion, the new religion of Christianity was able to make significant headway, despite its early emphasis on faith healing. This occurred with the evolution of monasticism and a renewed spirit of humane compassion, exemplified by the tradition of maintaining a medicinal herb garden and a monastic pharmacy, available to its reclusive residents as well as to the local people.

One of the most important steps in Roman medicine occurred in the year 46 BC when Julius Caesar granted citizenship to foreign doctors. Since the best doctors along with the best philosophers were Greek, this meant that the couple of centuries previous, wrought with suspicion and distrust associated with Greeks generally, and Greek doctors in particular, was lifted. Again this was a wise and practical decision on the part of the Romans, since by the second century AD, Rome with its vast army was sprawled over an empire ranging from Africa to England. Such expansiveness is often subject to squalor and disease for which trained medical personnel were required.

Previous to this edict Greek doctors were maintained as skilled and knowledgeable slaves. In part, due to the skill of one such doctor slave, the emperor Augustus in 23 BC went so far as to exempt doctors from taxes. Augustus had been a sickly man, suffering with rheumatism that effected his left leg that caused him to limp, arthritis, which had stiffened his right hand, chronic insomnia and frequent severe colds which in winter caused him to wear four tunics along with a heavy toga. No doctor had been able to alleviate his suffering until Antonius Musa, a freed slave diagnosed his problem as inflammation of the liver and prescribed cold sulfur baths. In gratitude for his cure, Augustus ordered Musa to be sculptured in the form of Asclepias.

The two most important medical figures of Rome whose contributions remained the uncontested "standard" for botany and medicine were Dioscorides and Galen. Dioscorides, was born in Anazarbus which is a town presently part of Turkey. Living sometime in the first century, his most significant contribution was the five botanical books entitled De Materia Medica. This became the foundation for all subsequent materia medicas for the next 1600 years throughout Europe.

Approximately 80% of Dioscorides' materia medica consists of plant medicines while the remaining 20% is divided more or less 10% mineral and 10% animal. This approximates a 1976 report describing the sources of Western drugs as follows:

(a) chemically synthesized 50 percent;

(b) higher flowering plants, 25%;

(c) minerals, 7 percent;

(d) animals, 6 percent.

If we consider that many chemically synthesized drugs were once derived from plant products, the percentages of Dioscorides is remarkably similar to today's.

The organization of Dioscorides' work, especially with plants follows an organized pattern of one plant, one chapter. The description of the plants themselves are laid out as follows:

1. plant name, synonyms and picture

2. habitats

3. botanical description

4. drug properties or actions

5. medicinal usage 

6. harmful side effects

7. quantities and dosages

8. harvesting, preparation and storage instructions

9. adulteration and methods of detection

10. veterinary uses

The most significant aspect of his work which he, himself described as "new and superior", despite his surmise that it would be immediately apparent, seemed to escape the understanding of scholars for centuries. Instead of grouping various plants according to botanical families, or treatment of specific diseases, or even according to the organoleptic criteria of flavors and energies (hot, cold, moist, dry), he arranged them according to their physiological effects. Being first and foremost an empiricist, Dioscorides sought to classify drugs according to broad physiological categories of action. These include the following:

1. Warming

2. Mollifying and softening

3. Astringent, bitter, or binding

4. Diuretics

5. Drying

6. Cooling

7. Concocting

8. Sharpening

9. Making thin

10. Dilating

11. Gluing

12. Sleep inducing

13. Relaxing

14. Diaphoretic

15. Stopping of pores

16. Causing thirst

17. Checking

18. Cleaning

19. Cleaning thoroughly or emetic

20. Decocting

21. Hardening

22. Nourishing

By so doing, Dioscorides raised herbal medicine beyond the purely empirical principle of finding a specific herb for a specific disease. It presupposed a corresponding system of diagnosis for which the above physiologic actions would be useful. Separating the diagnostic "system" from the treatment or the temptation to name a specific disease and treatment regardless of the holistic evaluation of the patient and the symptom complex, does not allow one to perceive either the meaning or the value of Dioscorides' "new and superior" method of organization.

In fact, his method as set forth in De Materia Medica is not at all unsimilar to methods used in the organization of traditional Chinese materia medicas. A materia medica such as that described in Planetary Herbology or in subsequent lessons of this course is organized according to functional intention and use in clinical practice.

A traditional Chinese materia medica includes the following:

1. relieving the surface

2. purging Heat

3. lubricating dryness

4. heat clearing

5. stimulant

6. dampness dispelling

7. clearing phlegm dampness

8. internal warming

9. relaxing

10. calming the spirit

11. blood regulating

12. chi regulating

13. tonics

14. parasiticides

How are these different from the pharmaceutical classification of substances as diaphoretics, laxatives, alteratives, stimulants, sedatives, nervines, emmenagogues, carminatives, etc.? Certainly both materia medica's include these elements as well as the organoleptic classification according to flavors as well as organs effected and so forth. The difference is in the idea that an expectorant can be either cooling or heating. For instance, coltsfoot and elecampane are both classified as expectorants. Where coltsfoot is more suitable as an expectorant for a hot cough with accompanying feverishness and yellow phlegm. While elecampane (Inula helinum) root is better used for a cold or cough associated with coldness, weak digestion, low energy and whitish to clear mucus discharge.

As another example different nervines and sedatives will be more appropriate for certain kinds of nervousness. Some forms of nervousness are caused by a toxic or stagnant liver for which skullcap (scutellaria lateriflora) is more suitable, other forms of anxiety (associated with food allergies and diseases such as candidiasis) are caused by depressed circulation and digestion for which asafoetida taken with food will be more appropriate. Skullcap will probably not be very effective for the individual with weak digestion and internal coldness while asafoetida will probably not be effective for the individual with a toxic, stagnant liver. Valerian (V. officinalis), is a nervine with a warm, acrid flavor. This suggests that it might not be so effective for an individual with a tendency towards liver congestion and hypertension as skullcap might be, for instance. Finally, extreme nervous restlessness, mania or breakdown, may require a heavier substance to lower the energy such as calcium carbonate from oyster shells, abalone or pearls decocted in a tea. These are very cold and would not be appropriate by themselves, for the individual suffering from internal coldness and associated weak digestion.

Since one plant, such as Red clover (Trifollium pratense), usually has more than one property, its placement as an alterative with cooling properties in a materia medica is merely a reflection of its primary use by one or a consensus number of practitioners. Its placement as a cooling, anti-inflammatory herb however also allows the practitioner to access its primary therapeutic effect. In actual usage, red clover could be used not only for fevers and infections but to help dissolve blood clots and thus aid circulation, calm the nerves and relieve hot bronchial conditions. It can also be used to aid the metabolism of protein and thus be useful in the treatment of certain forms of cancer.

One may also mistakenly assume herbal traditions as settled matters. In fact the history of herbalism shows a quite different state of affairs. What has come down to us as tradition is really the current expression and distillation, in most instances, of centuries of opposing views and opinions

Tradition is useful when it provides continuity and a point of departure for understanding. It is useless when it inhibits our ability to act and respond to the demands of the moment. According to John M. Riddle, the most modern translator of the only English version of De Materia Medica and sad to say, a work that has been long out of print, he says, "By Dioscorides' time medical practitioner  were neither unified about the nature of disease and illness nor in agreement on a set principle on which to organize experiences and to approach therapy." Regarding the notion that the humoural theory was a universally accepted concept among Greeks and Romans, he further says, there was never complete agreement about the number, designation, or even existence of humours. Among the dissenters was Dioscorides, who did not accept so few as four humours and largely ignored the whole matter."

Parallels can be drawn today between the theoretical basis of Traditional Chinese Medicine with its Yin-Yang and Five element theories or the theoretical basis of East Indian Ayurvedic medicine with its sacrosanct Tridosha (Three humour) and other theories compared with clinical practice.

The same can be said for any theoretical concept of Western scientific medicine and the pragmatic reality of what works. What may be gained from theoretical study has much value including developing some intangible attitude or way of approaching a condition that may inspire greater confidence within the practitioner involved in the enterprise of healing, a fundamentally imprecise and therefore artful science.

What Dioscorides was attempting in the organization of his materia medica was to create a definitive and practical clinical manual. The fact that he had differences conforming to strict traditional theoretical precepts such as the flavors as absolute indicators of medicinal properties or the humors shows the limits of theory. Rather, Dioscorides, the successful clinician, sought to treat disease according to the complex of its symptoms and what was empirically most effective. Like other Greek physicians of his time, he integrated "diet, exercise, and baths" as being "preferable to harsh drugs and surgery." Being the great herbalist that he obviously was, he sought "to cure, safely, swiftly, and pleasantly." Just as he rejected the hard theoretical humoural line of the Hippocratic practitioners of his day, he also rejected the more psycho-spiritual Asclepians. While he chose not to tell why, one can only surmise that such methods of healing, again tending towards a dogmatic methodology, was contrary to Dioscorides thought process.