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  • Book extract

Why the NHS is worth saving

In this extract from his latest book, ‘Free For All’, Dr Gavin Francis poses challenging questions to be addressed if a health service that’s free for all at the point of use is to remain possible.

  • Article

A history of gestation outside the body

It’s been over 400 years since a Swiss alchemist theorised that foetuses could develop outside the womb. Claire Horn examines incubator technology past and present, and explores the possibilities recent prototypes might bring.

  • Article

Indian botanicals and heritage wars

Colonial botanical texts, as astonishingly beautiful as they are, may cast very dark shadows.

  • Article

Coleridge’s hypochondria

An intense focus on his own bodily sensations led poet Samuel Taylor Coleridge to self-medicate with narcotics. But this fascination also put Coleridge ahead of the medical sensibilities of his day.

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  • Plumbago auriculata Blume Plumbaginaceae Plumbago, Leadwort. Distribution: South Africa. It is used traditionally to treat warts, broken bones and wounds. It is taken as a snuff for headaches and as an emetic to dispel bad dreams. A stick of the plant is placed in the thatch of huts to ward off lightning.” Iwou (1993) reports other Plumbago species are used to cause skin blistering, treat leprosy, induce blistering, and to treat piles, parasites and to induce abortions. The genus name derives from the Latin for lead, but authors differ as to whether it was used as a treatment of lead poisoning, or that when it was used for eye conditions the skin turned the colour of lead. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Scutellaria baicalensis Georgi Lamiaceae. Baikal skullcap. Distribution: China. There are several hundred species of Scutellaria, also known as skull caps, so correct identification is important - in particular from Scutellaria lateriflora an American species known as Blue skullcap. The latter is used as an abortifacient and to expel placenta by the Cherokee and for cleaning the throat by the Iroquois (Austin, 2004). Much vaunted as a treatment for rabies with unlikely statistics (1,400 cases cured by one doctor alone). Also as ‘antispasmodic, nervine, [for] chorea, convulsions, tetanus, tremors, delirium tremens, [and as a] diaphoretic and diuretic'. Toxicity symptoms include mental confusion, stupor, headache, vertigo, photophobia, dilated pupils, difficulty in micturition, bradycardia, tremulousness and languor, followed by wakefulness and restlessness (Milspaugh, 1974). Hutchens (1991) reported that it reduces sexual desire and was used for almost every nervous illness. Scutellaria baicalensis contains baicalin, baicalein and wogonin (European Medicines Agency, September 2010). It is used in Traditional Chinese Medicine for treating inflammation, cancer, bacterial and viral infections of the lungs and gut and is one of the '50 Chinese herbs' in the lists of some authors. Scutellaria lateriflora (combined with Verbena officinalis, Passiflora incarnata and the seed of Avena sativa (oats) is licensed for use in Britain as a herbal medicine for temporary relief of mild symptoms of stress such as mild anxiety and to aid sleep, based upon traditional use only. Scutellaria baicalensis is not licensed for use in the UK (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Agrimonia eupatoria L. Agrimony, Eupatorium, Maudlein. Perennial herb. The species name comes from king Mithridates Eupator VI of Pontus (132-63 BC) who took regular doses of poison to develop an immunity to them. A 'Mithridate' was a medicine against poisons. Distribution: N. and S. Africa, N. Asia, Europe. '…provokes urine and the terms [periods], dries the brain, opens stoppings, helps the green sickness [iron deficiency anaemia], and profits such as have a cold weak liver outwardly applied it takes away the hardness of the matrix [=uterus] and fills hollow ulcers with flesh' (Culpeper, 1650). Dioscorides (Beck, 2005) recommends mashed leaves in hog's grease for healing scarring ulcers, and the seed in wine for dysentery and serpent bites. Goodyear's 1655 translation of Dioscorides (Gunther 2000) has this as cannabis, which Parkinson (1640) says is in error and summarises the manifold uses from classical authors, from removing splinters to stopping menorrhagia. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Paris quadrifolia L. Trilliaceae Herb Paris Distribution: Europe and temperate Asia. This dramatic plant was known as Herb Paris or one-berry. Because of the shape of the four leaves, resembling a Burgundian cross or a true love-knot, it was also known as Herb True Love. Prosaically, the name ‘Paris’ stems from the Latin ‘pars’ meaning ‘parts’ referring to the four equal leaves, and not to the French capital or the lover of Helen of Troy. Sixteenth century herbalists such as Fuchs, who calls it Aconitum pardalianches which means leopard’s bane, and Lobel who calls it Solanum tetraphyllum, attributed the poisonous properties of Aconitum to it. The latter, called monkshood and wolfsbane, are well known as poisonous garden plants. Gerard (1633), however, reports that Lobel fed it to animals and it did them no harm, and caused the recovery of a dog poisoned deliberately with arsenic and mercury, while another dog, which did not receive Herb Paris, died. It was recommended thereafter as an antidote to poisons. Coles (1657) wrote 'Herb Paris is exceedingly cold, wherupon it is proved to represse the rage and force of any Poyson, Humour , or Inflammation.' Because of its 'cold' property it was good for swellings of 'the Privy parts' (where presumably hot passions were thought to lie), to heal ulcers, cure poisoning, plague, procure sleep (the berries) and cure colic. Through the concept of the Doctrine of Signatures, the black berry represented an eye, so oil distilled from it was known as Anima oculorum, the soul of the eye, and 'effectual for all the disease of the eye'. Linnaeus (1782) listed it as treating 'Convulsions, Mania, Bubones, Pleurisy, Opththalmia', but modern authors report the berry to be toxic. That one poison acted as an antidote to another was a common, if incorrect, belief in the days of herbal medicine. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Cynara cardunculus L. Asteraceae. Cardoon, Globe Artichoke, Artechokes, Scolymos cinara, Cynara, Cinara. Distribution: Southern Europe and North Africa. Lyte (1576) writes that Dodoens (1552) could find no medical use for them and Galen (c.200 AD) said they were indigestible unless cooked. However, he relates that other authors recommend that if the flower heads are soaked in strong wine, they 'provoke urine and stir up lust in the body.' More prosaically, the roots boiled in wine and drunk it cause the urine to be 'stinking' and so cures smelly armpits. He adds that it strengthens the stomach so causing women to conceive Male children. He goes on to say that the young shoots boiled in broth also stir up lust in men and women, and more besides. Lyte (1576) was translating, I think with elaborations, from the chapter on Scolymos cinara, Artichaut, in Dodoen's Croydeboeck (1552) as L'Ecluse's French translation, Dodoens Histoire des Plantes (1575) does not mention these latter uses, but Dodoen's own Latin translation, the Pemptades (1583), and Gerard's Herbal (1633) both do so. It is useful in understanding the history of these translations to realise that Gerard uses, almost verbatim, the translation of the 'smelly armpit' paragraph from Lyte. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Cynara cardunculus L. Asteraceae. Cardoon, Globe Artichoke, Artechokes, Scolymos cinara, Cynara, Cinara. Distribution: Southern Europe and North Africa. Lyte (1576) writes that Dodoens (1552) could find no medical use for them and Galen (c.200 AD) said they were indigestible unless cooked. However he relates that other authors recommend that if the flower heads are soaked in strong wine, they 'provoke urine and stir up lust in the body.' More prosaically, the roots boiled in wine and drunk it cause the urine to be 'stinking' and so cures smelly armpits. He adds that it strengthens the stomach so causing women to conceive Male children. He goes on to say that the young shoots boiled in broth also stir up lust in men and women, and more besides. Lyte (1576) was translating, I think with elaborations, from the chapter on Scolymos cinara, Artichaut, in Dodoen's Croydeboeck (1552) as L'Ecluse's French translation (1575) does not mention these latter uses, but Dodoen's own Latin translation, the Pemptades(1583), and Gerard's (1633) both do so. It is useful in understanding the history of these translations to realise that Gerard uses, almost verbatim, the translation of the 'smelly armpit' paragraph from Lyte. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Pulmonaria rubra L. Boraginaceae A red-flowered species, mentioned in 16th and 17th herbals, but with the same properties as officinalis. Distribution: Europe. Pulmonaria or Lungwort are names for a lichen and a perennial plant in the Boraginaceae. This is the latter. Lyte (1578) has a woodcut of our plant and also calls it Sage of Jerusalem and says it is of 'no particular use in physicke, but is much used in meates and salads with eggs, as is also Cowslippes and Primroses, whereunto in temperature it is much alike.' He lists and describes the lichen separately. Culpeper (1650) said he found many sorts of lunguewort in perusing Authors 'Pulmonari, arborea and Symphytum maculosum [and the latter is our plant, the others the lichen] and that they 'helpe infirmities of the lungues, as hoarseness, coughs, wheezing, shortnesse of breath etc.' Coles (1657) who espouses the Doctrine of Signatures in a way unrivalled by any other English author, might have been expected to confirm the concept that the mottled leaves looked like the cut surface of a lung which indicates their purpose, but he only mentions the lungwort which is a lichen. However, Porta's beautiful book on the Doctrine, Phytognomica (1588), is clear that the plant called pulmonaria with hairy leaves like a bugloss, spotted white with purple flowers, commonly called 'cynoglossa' [with a woodcut which could be Pulmonaria officinalis] indicate its use for ulcerated lungs, spitting blood, shortness of breath and asthma equally with the lichen with the same name. Lobel & Pena (1570) call it 'PULMONARIA, masculosa folia Borrago. floribus Primula veris, purpureis[ PULMONARIA spotted, Borage-leaved, flowers like Primula veris - Cowslips - purple] and say that women mix the leaves with a little broth and make it into an omelette for lung disorders and to strengthen the heart. Lobel (1576) calls it Maculosa Pulmonaria and describes a white flowered form, with a good woodcut. Gerard (1633) uses the same woodcut as Lobel and calls it Pulmonatia foliis Echii, Buglosse Cowslips with red flowers, and a woodcut of a narrow leaved plant as Pulmonaria masculosa, Spotted Cowslips of Jerusalem with red, blue and purple flowers and says 'the leaves are used among pot-herbes. The roots are aso thought to be good against the infirmities of ulcers of the lungs...'. Quincy (1718) writes: '... it has a glutinous juice ... and heals ulcers and erosions. It is commended in coughs and spitting of blood but is little used either in the Shop or Prescriptions. Not used in modern medicine. It is in the family Boraginaceae whose species are often rich in pyrrolizidine alkaloids that cause liver toxicity and liver cancers, but levels in Pulmonaria officinalis may not be significant. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Pulmonaria officinalis L. Boraginaceae Distribution: Officinalis indicates its medicinal use in early medicine. Europe. Pulmonaria or Lungwort are names for a lichen and a perennial plant in the Boraginaceae. This is the latter. Lyte (1578) has a woodcut of our plant and also calls it Sage of Jerusalem and says it is of ' no particular use in physicke, but is much used in meates and salads with eggs, as is also Cowslippes and Primroses, whereunto in temperature it is much alike.' He lists and describes the lichen separately. Culpeper (1650) said he found many sorts of lunguewort in perusing Authors ' Pulmonari, arborea and Symphytum maculosum [and the latter is our plant, the others the lichen] and that they 'helpe infirmities of the lungues, as hoarseness, coughs, wheezing, shortnesse of breath etc.' Coles (1657) who espouses the Doctrine of Signatures in a way unrivalled by any other English author, might have been expected to confirm the concept that the mottled leaves looked like the cut surface of a lung which indicates their purpose, but he only mentions the lungwort which is a lichen. However, Porta's beautiful book on the Doctrine, Phytognomica (1588), is clear that the plant called Pulmonaria with hairy leaves like a bugloss, spotted white with purple flowers, commonly called 'cynoglossa' [with a woodcut which could be Pulmonaria officinalis] indicate its use for ulcerated lungs, spitting blood, shortness of breath and asthma equally with the lichen with the same name. Lobel & Pena (1570) call it 'PULMONARIA, masculosa folia Borrago, floribus Primula veris, purpureis [PULMONARIA spotted, Borage-leaved, flowers like Primula veris - Cowslips - purple]' and say that women mix the leaves with a little broth and make it into an omelette for lung disorders and to strengthen the heart. Lobel (1576) calls it Maculosa Pulmonaria and describes a white flowered form with a good woodcut. Gerard (1633) uses the same woodcut as Lobel and calls it Pulmonatia foliis Echii, Buglosse Cowslips with red flowers, and a woodcut of a narrow leaved plant as Pulmonaria masculosa, Spotted Cowslips of Jerusalem with red, blue and purple flowers and says 'the leaves are used among pot-herbes. The roots are aso thought to be good against the infirmities of ulcers of the lungs...'. Quincy (1718) writes: '... it has a glutinous juice ... and heals ulcers and erosions. It is commended in coughs and spitting of blood but is little used either in the Shop or Prescriptions. Not used in modern medicine. It is in the family Boraginaceae whose species are often rich in pyrrolizidine alkaloids that cause liver toxicity and liver cancers, but levels in Pulmonaria officinalis may not be significant. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Pulmonaria officinalis L. Boraginaceae Distribution: Europe. Pulmonaria or Lungwort are names for a lichen and a perennial plant in the Boraginaceae. This is the latter. Lyte (1578) has a woodcut of our plant and also calls it Sage of Jerusalem and says it is of 'no particular use in physicke, but is much used in meates and salads with eggs, as is also Cowslippes and Primroses, whereunto in temperature it is much alike.' He lists and describes the lichen separately. Culpeper (1650) said he found many sorts of lunguewort in perusing Authors ' Pulmonari, arborea and Symphytum maculosum [and the latter is our plant, the others the lichen] and that they 'helpe infirmities of the lungues, as hoarseness, coughs, wheezing, shortnesse of breath etc.' Coles (1657) who espouses the Doctrine of Signatures in a way unrivalled by any other English author, might have been expected to confirm the concept that the mottled leaves looked like the cut surface of a lung which indicates their purpose, but he only mentions the lungwort which is a lichen. However, Porta's beautiful book on the Doctrine, Phytognomica (1588), is clear that the plant called Pulmonaria with hairy leaves like a bugloss, spotted white with purple flowers, commonly called 'cynoglossa' [with a woodcut which could be Pulmonaria officinalis] indicate its use for ulcerated lungs, spitting blood, shortness of breath and asthma equally with the lichen with the same name. Lobel & Pena (1570) call it 'PULMONARIA, masculosa folia Borrago. floribus Primula veris, purpureis [PULMONARIA spotted, Borage-leaved, flowers like Primula veris - Cowslips - purple]' and say that women mix the leaves with a little broth and make it into an omelette for lung disorders and to strengthen the heart.. Lobel (1576) calls it Maculosa Pulmonaria and describes a white flowered form with a good woodcut. Gerard (1633) uses the same woodcut as Lobel and calls it Pulmonatia foliis Echii, Buglosse Cowslips with red flowers, and a woodcut of a narrow leaved plant as Pulmonaria masculosa, Spotted Cowslips of Jerusalem with red, blue and purple flowers and says 'the leaves are used among pot-herbes. The roots are aso thought to be good against the infirmities of ulcers of the lungs...'. Quincy (1718) writes: '... it has a glutinous juice ... and heals ulcers and erosions. It is commended in coughs and spitting of blood but is little used either in the Shop or Prescriptions'. Not used in modern medicine. It is in the family Boraginaceae whose species are often rich in pyrrolizidine alkaloids that cause liver toxicity and liver cancers, but levels in Pulmonaria officinalis may not be significant. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Lobelia tupa L Campanulaceae Tabaco del Diablo [Devil's tobacco]. Distribution: Central Chile. Dried leaves are smoked as a hallucinogen by the Mapuchu Indians of Chile. It was also used as a respiratory stimulant. The genus was named after Matthias de L’Obel or Lobel, (1538–1616), Flemish botanist and physician to James I of England, author of the great herbal Plantarum seu Stirpium Historia (1576). Lobeline, a chemical from the plant has nicotine like actions and for a while lobeline was used to help people withdraw from smoking, but was found to be ineffective. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
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