Middle ages to 18th century

Around 800 CE, the knowledge and expertise of Arabic medicine – in part, resulting from the rediscovery of ancient Greek texts and the Hippocratic tradition, began to filter through into Europe. Arabic medicine, or Unani Tibb (= Greek medicine) as it is known today, remains a tradition that retains the Greek principle of the four humours, and has evolved as a uniquely Islamic form of medicine. Arabic medicine was practised from Persia to Spain in the early middle ages and its positive influence on public and private health was in stark contrast to the parochial nature of medicine in Europe. Slowly, medical schools opened up in Europe, notably in Salerno, (near Naples in Italy) which was founded in the 9th century CE. Remarkably this school allowed both men and women to train, whether Christian, Jewish or Muslim. Trotula, a woman who wrote a book on obstretrics, practised and taught there in the 12th century CE. Herbs were of course central to the healing process – one saying from the school went – Salvia salvatrix; natura conciliatrix - Sage the saviour; nature the conciliator.

While those trained in medical schools studied both local and exotic, imported plant medicines, for the vast majority of people everywhere, herbal medicine meant using the plants on their doorstep. Sometimes knowledge of local plants was combined with scholarly knowledge – the mediaeval Welsh tradition based at Myddfai in south Wales, for example, clearly knew of ancient Greek medicine, but more often than not local and regional plant lore held sway.

Women in particular, knew about plant medicines, using them to heal the ills of their household. Herbs such as Lady’s Bedstraw (Galium verum) would be strewn across floors to freshen and cleanse in bed and birthing rooms. Many herbal recipe books survive written by women as a guide to domestic medicine.

With the advent of printing, for the first time the popular herbal became a possibility. In the English language, Culpeper’s Herbal (The English Physitian) has been in print ever since it was published in London in 1652. It also became the first herbal to be published in North America, in 1700. Across Europe, many herbals were published - some like Culpeper claiming that native plants were best for local people, others incorporating newly introduced plants from distant lands. Published in Seville in 1574, The Medicinal History of Things brought from our West Indies introduced Europe to many previously unknown medicinal plants. Written by Nicolas Monardes (c. 1493 – 1588), a Spanish doctor, it catalogued and assessed the therapeutic properties of plant medicines such as Guaiacum, Sarsaparilla and Sassafras, brought to Seville from the Americas. An instant sensation in its day, it opened up new horizons in the therapeutics and practice of plant-based medicine, detailing the use of medicinal plants that are still in common use today.

As rational enquiry into the natural world developed, so early scientists began to ask how plant medicines might work, and whether individual active constituents could be extracted and identified. The difference between scientific method and traditional folk medicine is revealed in William Wittering’s discovery of the benefits of Foxglove (Digitalis purpurea), a poisonous plant that at low dosage is an effective treatment for heart failure. Wittering (1741 - 1799), a botanist and physician, practised in the English Midlands and had a keen knowledge of medicinal plants. In 1775, he was asked to give his opinion on a remedy for dropsy (probably due to heart failure) that had “long been kept a secret by an old woman in Shropshire, who had sometimes made cures after the more regular practitioners had failed.” The medicine was made up of twenty or more different herbs, but Wittering was able to see “that the active herb could be no other than the foxglove.” He went on to prescribe it to his patients and publish his findings in 1785. Wittering clearly deserves credit for this ground-breaking work - digitoxin, an alkaloid from Foxglove, still finds use in hospital treatment of heart failure. Yet as is often the case, history fails to record the name of the woman herbalist from Shropshire.