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Botanical view of the use of plants in medieval medicine in the Eastern Mediterranean according to the Cairo Genizah

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Abstract

This article presents the medicinal plants that were used by the inhabitants of the medieval Eastern Mediterranean (mainly tenth to thirteenth centuries AD) and analyzes their geographical/phyto-botanical origin and their frequency of use at the medieval time. It also discusses various issues such as their historical trade and the continuation of their use in present-day Middle Eastern traditional medicine. The Cairo Genizah is an historical source containing about 250,000 documents, found in a semi-archeological context (synagogue and graves). Since Cairo became the capital and consequently the economic and administrative center of the Muslim empire, the Jewish community had close connections with the Jewish communities of the Middle East, North Africa, Southern Europe, Sicily and India. Therefore, these highly valued documents record every aspect of life and reflect on the whole Mediterranean region and beyond. The inventory of the practical materia medica was reconstructed thanks to hundreds of documents such as prescriptions, list of drugs, and medical letters. It consists of 278 drugs, 223 of which are of plant origin. Asian medicinal plants became highly used in medieval Mediterranean medicine; the vast majority of them are still sold in Middle Eastern markets, although not with the same importance. It is important to note that some of them are sold today mainly for their other uses as spices, perfumes, incense, etc.

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This study uses historical texts in order to obtain information on the natural products used in traditional medicines in European/Mediterranean therapeutics over the last two millennia. The information obtained may lead to new directions in the area of drug discovery, as recent research has demonstrated the continued promise of looking to natural products for bioactive compounds. Researchers have increasingly turned to traditional medicines to provide clues as to which natural products to investigate, but the oral traditions on which much of this medical knowledge rests are often unstable. Thus researchers have been prompted to use historical medical texts, as this study does, to find potential sources of new drugs. This study uses twelve Mediterranean/European medical texts from the 5th century BC to the 19th century AD to compile a list of the most commonly used "simples"--or single action drugs substances--used in therapeutics in traditional European medicine. This list was then compared to present-day herbal pharmacopoeia as represented by the National Institutes of Health (NIH). This study finds that traditional European materia medica was based on a Dioscoridean tradition that lasted through the 19th century with remarkably little variation, but is significantly different from the present-day herbal pharmacopoeia according to the NIH. The most prominent simples in the European/Mediterranean medical tradition can provide clues to further bioactive compounds that have not as of yet been fully exploited for their potential, but were clearly of great use in the past.
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Examples are presented of plants with folkloric reputations that have recently afforded constituents with great potential for use as drugs or pharmaceutical excipients. Described are the results of laboratory investigations at this institution on the biologically active compounds of four plants with reputed medicinal properties and of six sweet plants used by local populations in various regions of the world. It is concluded that folklore information should be considered seriously in programs designed to yield prototype, biologically active molecules from plant sources.
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The mass screening of plants in the search for new drugs is vastly expensive and inefficient. It would be cheaper and perhaps more productive to re-examine plant remedies described in ancient and mediaeval texts.
Article
Recent years have witnessed a renewed interest in plants as pharmaceuticals in the Western world. This interest is channeled into the discovery of new biologically-active molecules by the pharmaceutical industry and into the adoption of crude extracts of plants for self-medication by the general public. In both of these areas some attention is being paid to the investigation and use of ethnopharmacology, the traditional use of plants for medicinal purposes by particular cultural groups. Ethnopharmacologic leads have resulted in the introduction of new single molecule drugs but have a greater role to play if crude extracts are accepted for clinical use in the West. The problems confronting such usage are discussed. Considerable benefits for developing countries are possible when the local medicinal plants are subjected to scientific methods of validation of traditional use and quality control. This approach has met with success in some parts of the world but is not always appreciated by national governments and international agencies. Related areas of concern such as conservation of ecology and culture must be integrated with any such program. Plants used in traditional medicine therefore have an important role to play in the maintenance of health in all parts of the world and in the introduction of new treatments.
Article
We do not know at the beginning of this new millennium if ethnobotanists and anthropologists will be able to rescue most of the indigenous knowledge systems before they are lost forever. [Cox][1] describes the importance of knowledge from many cultures in finding new therapeutic drugs and his experiences as an ethnobotanist. [1]: http://www.sciencemag.org/cgi/content/full/287/5450/44
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This report deals with the results of a study of present day uses of traditional medicinal materials in Israel. The survey covered selected markets in medicinal materials, belonging to various religious and ethnic communities, and also included questioning of the sellers and buyers about the healing characteristics of the various materials. The survey yielded information on many and varied medicinal materials, of which 310 are identified according to the following classifications, 264 species of plants (85.1%); 20 species of animals (6.5%); 19 kinds of minerals (6.5%); and seven materials of other or mixed origin (2.3%). Analysis of the data showed that a significant proportion of the materials were of local origin (51.5%) and some were imported from other countries. These data demonstrate that there is still a flourishing and well developed trade in these materials - a trade which is the remnant of a rich and ancient medical culture, which is disappearing from the modern world.
Article
This article presents the results of a study of the medicinal uses of natural substances in medieval and Ottoman al-Sham (the Levant). It involved a meticulous survey of a wide range of historical sources spanning approximately 1100 years and including medical and pharmacological literature, travelogues, geographical and agricultural literature, dictionaries, archives, the Genizah and other medieval sources. Our main goal was to arrive at a reconstruction of the unwritten materia medica of the medieval and Ottoman Levant. Of the many and varied medicinal substances on which we were able to extract information, we were able to identify 286. These are presented according to the following classification: 234 species of plants (81.8%); 27 species of animals (9.5%); 15 kinds of minerals (5.2%) and 10 substances of other or mixed origin (3.5%). Analysis of the data showed that the region under study served as the geographic origin of the majority of the substances, only a minority of the materials was imported. The main reason for this is the geographic location of the Levant as a junction between three continents, as a cultural meeting point and as trade center. Finally, our data revealed that the al-Sham region was an independent source of production and marketing of medicinal substances during the medieval and Ottoman periods.
Article
The results of a survey of present-day traditional medicinal materials conducted in 1998-1999 in the Kingdom of Jordan are reported. The study covered selected markets of medicinal substances of ethnic communities throughout the kingdom, and also included questioning of the sellers about the healing characteristics of the various materials. The survey yielded information on many and varied medicinal substances, of which 304 are identified according to the following classifications: 236 species of plants (77.6%); 30 species of animals (9.8%); 29 kinds of inorganic substances (9.6%); and 9 materials of other or mixed origin (3%). Analysis of the data showed that some substances were of local origin (41.8%), but the majority of the substances (45.4%) were imported from other countries. 12.8% of the substances were both local and imported. These data demonstrate that there is still a flourishing and well-developed trade in these materials--a trade that is the remnant of a rich and ancient medical culture, which is disappearing from the modern world.
Article
To assess the current situation of sales and uses of herbal medicines in Jordan, more than 100 herbalists throughout the country were interviewed. The collected data included the types of herbs present in the market, the recommendations made by the herbalists in the treatment of ailments, the level of education and training of the herbalists, and miscellaneous observations. One hundred and fifty medicinal plant species were present in the local market. Based on their availability in the market and on the herbalists' recommendations, 9 plant species were considered very common and 17 were considered as common. The survey indicated that most of the herbalists were not educated or trained in the field of herbal medicine except for their expertise gained from their predecessor, none were licensed for this particular purpose; several odd or unprecedented recommendations were passed to the customers. This survey emphasizes the necessity of proper handling of herbal medicines that requires proper regulations and licensing.
Article
Determining what fraction of texts and manuscripts have survived from Antiquity and the Middle Ages has been highly problematic. Analyzing the transmission of texts as the "paleodemography" of their manuscripts yields definite and surprisingly high estimates. Parchment copies of the foremost medieval textbooks on arithmetical and calendrical calculation closely fit age distributions expected for populations with logistic growth and manuscripts with exponential survivorship. The estimated half-lives of copies agree with Bischoff's paleographically based suggestion that roughly one in seven manuscripts survive in some form from ninth-century Carolingian workshops. On this basis, many if not most of the leading technical titles circulating in Latin probably survived, even from late Antiquity.
Article
Plants have provided Man with all his needs in terms of shelter, clothing, food, flavours and fragrances as not the least, medicines. Plants have formed the basis of sophisticated traditional medicine systems among which are Ayurvedic, Unani, Chinese amongst others. These systems of medicine have given rise to some important drugs still in use today. Among the lesser-known systems of medicines are the African and Australian, Central and South American amongst others. The search for new molecules, nowadays, has taken a slightly different route where the science of ethnobotany and ethnopharmacognosy are being used as guide to lead the chemist towards different sources and classes of compounds. It is in this context that the flora of the tropics by virtue of its diversity has a significant role to play in being able to provide new leads. Nonetheless the issue of sovereignty and property rights should also be addressed in line with the Convention for Biological Diversity (CBD). This paper highlights the above, provides an overview of the classes of molecules present in plants and gives some examples of the types of molecules and secondary metabolites that have led to the development of these pharmacologically active extracts. The paper also presents some data on the use of plant products in the development of functional foods, addresses the needs for validation of plant extracts and always stressing on safety, efficacy and quality of phyto-medications.
Article
The Taylor-Schechter (T-S) collection at Cambridge University Library is the biggest of all Cairo Genizah collections in the world. The importance and the potential of research into the medical aspects of the Genizah documents were clear to researcher since the early 1960s. A few works have been published since, usually focusing on one subject, or even important single manuscripts. The current research concerned mainly with one aspect of the history of medicine of the Jewish community of Cairo (as a reflection of Eastern medieval societies), namely the practical uses of natural substances for medicine. The most interesting and original information is undoubtedly to be found in the 141 prescriptions, as they reflect the medical reality that actually existed. And indeed, 242 substances were recorded in the prescriptions identified: 195 substances of plants origin (80.6%), 27 inorganic materials (11.2%) and 20 substances of animal origin (8.2%) were recorded as being in practical used for medicinal purposes. The most frequently mentioned substances were the rose, myrobalan, sugar, almonds, and endive. The most prevalent ailments: eye diseases, headache, constipations (purgative), cough, skin diseases, stomach, fever, gynaecological problems, haemorrhoids, liver ailments, lice, swellings, dental trouble, ulcers, and problems of the urinary tract.
Article
The importance of the Genizah for the research of the medieval Mediterranean communities, supplying information on almost every aspect of life, is well known among historian. Less known is that pharmacy was the most popular of all branches of the healing art in the medieval Jewish community of Cairo, according to the Genizah manuscripts. Sources for study of medieval practical drugs are extremely rare since most records naturally vanish over the years, and only some medical books, which contained theoretical pharmacology, have survived to the present day. Drugs lists enable us to understand medieval practical pharmacy and to reconstruct their inventories. This study reports on 71 original drugs lists that were found in the Genizah; they are different from merchants' letters dealing with commerce in drugs and give no instructions for the use or preparation of formulas as usually found in prescriptions. Twenty-six lists are written in Judeo-Arabic and 45 in Arabic, none of the lists is written in Hebrew. The longest list contains 63 identified substances. These lists were apparently used by pharmacists for professional and business purposes as inventories of drugs, records, orders, or even receipts. Two hundred and six different drugs are mentioned in the drugs lists of which 167 are of plant origin, 16 are of animal origin, and the remaining 23 are inorganic. The lists point directly to the place they occupied on the shelves of the pharmacies that could be found in the lanes and alleys of the Jewish quarter of Cairo. The most frequently mentioned substance were myrobalan (27), pepper and saffron (21), lentisk (15), almond, basil, rose, rosemary (14), cattle products, camphor and spikenard (13).