Three Spoonfuls of Hemlock

Gavin Francis

  • Dragon’s Blood and Willow Bark: The Mysteries of Medieval Medicine by Toni Mount
    Amberley, 288 pp, £20.00, April 2015, ISBN 978 1 4456 4383 0

On my morning commute through Edinburgh I pass a herbalist’s shop opposite the old medical school building. It was established in 1860. The windows are dressed at present with hand-made green paper leaves and a cardboard parrot; there are allergy salves for hay fever, iron tonics for fatigue and slippery elm for heartburn. At the back of one of the windows is a more permanent exhibit: two earthenware jars. The jars are old and empty now, but you can still read their labels. ‘Sennae P.V.’ one says, ‘Pimento’ the other.

Senna is made from the plant Cassia acutifolia which, when swallowed, accelerates the squeezing action of your gut (peristalsis). Your intestine will do all it can to get rid of the stuff – which is particularly helpful if you’re suffering constipation. The shop probably sold bucket-loads of senna to the city’s constipated in the 1860s, and a century and a half later I prescribe bucket-loads of it to their descendants. Pimento is less familiar to me as a drug, but it’s actually a name for allspice, once used as a rubefacient applied to relieve the pain of aching joints. Rubefacients diminish your experience of pain by irritating the skin over the same area: they distract your pain-conveying nerves by giving them an alternative stimulus. They too are still big business, though not in the form of pimento: Tiger Balm and Deep Heat are just two of the rubefacients that you can pick up in any of the modern pharmacies a stone’s throw from the herbalist.

I once knew a woman, a complementary therapist, who thought it hilarious that herbal therapists did business opposite the medical school: ‘They must come out of their respective buildings and shake fists at one another.’ I never saw the incongruity: animosity between herbalism and orthodox medicine is a recent phenomenon; until the 1950s the study of botany was integral to medical training. One study estimates that ten per cent of 21st-century drugs are derived from plants, and when you restrict that inquiry to antibacterial and anticancer drugs, the proportion rises even higher. As the paper leaves in the herbalist’s windows suggest, many of our most effective drugs are derived from tropical plants. Vincristine, a chemotherapy used in leukaemia, comes from a Madagascan flower; the local anaesthetic lidocaine is related to the cocaine of the coca plant. One of my patients – a woman in her eighties – often reminds me that before the NHS came along, poor folk like her went to the herbalist rather than trouble the doctor. Herbal treatments were less effective, she says, but they weren’t ineffective. And they were cheaper, then, than orthodox medicine.

I usually pass the shop without entering, but recently I did go inside. Just by the door was a display stand labelled ‘Belif – believe in truth’. The contents of the Belif products were listed in Korean, and when I asked for a translation, the slip of paper I was given was mostly in Latin. I picked up another package at random, which was advertised as containing ‘organic essential oil of frankincense’. ‘Frankincense has been used for centuries,’ it went on, ‘for a great variety of things including anxiety, coughing and asthma.’ I didn’t need to take the manufacturer’s word for it: the salve had been endorsed by an ‘M.D.’ who has his own television programme. There have been scandals in recent years about the provenance and safety of some herbal treatments – a series of herbal eczema creams imported from the Far East were shown to contain veterinary doses of steroids, far more harmful and ‘allopathic’ than anything that would be prescribed in orthodox Western medicine.

Several kinds of emotional appeal seem to be at work in the promotion of ‘naturopathic’ products. There’s a nostalgia for an age when treatments were less chemically processed, together with an idea that such treatments are in some indefinable way more authentic. There’s a worryingly pseudoscientific mingling of statistics with conjecture. There’s a capitalising on widespread disenchantment with the brevity and perceived indignity of the contemporary clinical encounter. Herbal products have retained some of the mystique they acquired in earlier ages, when medicine was arcane and expensive; perhaps this is alluring to those who hanker for a time in which less was known. Some consumers prefer to believe in the efficacy of a 19th-century apothecarial salve rather than put their trust in drugs approved after randomised, double-blind, placebo-controlled clinical trials.

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