herbal remedies and pandemics - a brief history

We are living in special times indeed. If ten years ago humanity would celebrate the latest advances in medicine, scientists right now are struggling to make the point about the Earth being round and that face masks actually work. Still, the whole world is watching as scientists rush to develop a new vaccine against COVID-19 that could help lessen the damage this pandemic has wrought onto lives of millions around the world. But how did people treat themselves in the past?

Before the 19th century and the development of chemical drugs, the main available remedies came from medicinal plants. You can still find tonnes of manuscripts online from the Ancient Greeks to early 19th century’s American doctors-herbalists describing plant-based preparations used as drugs. What were the most important pandemics humanity had to face throughout the centuries and how were herbal remedies used to treat those diseases? And did they actually work?

(A small yet important note: do not try these recipes at home. They do not provide cure for COVID-19 nor help relieve its symptoms).

Source: Google Arts and Culture.

The Black Plague and the four thieves vinegar

The Black Plague or Bubonic Plague occurred in the Middle Ages (1347–1351), and is still considered the deadliest pandemic ever with an estimated loss of 30% to 50% of European population in 4 years. The disease was spread by fleas infested with a bacterium called Yersinia pestis, and transmitted to humans by the flea bites, then between humans by either direct contact or inhalation.

A popular herbal preparation at the time was called “the four thieves vinegar”. It consisted of a preparation brewed in vinegar and included several herbs:

-       Angelica (Angelica archangelica)

-       Camphor (Cinnamomum camphora)

-       Cloves (Syzygium aromaticum)

-       Garlic (Allium sativum)

-       Marjoram (Origanum majorana)

-       Meadowsweet (Filipendula ulmaria)

-       Wormwood (Artemisia absinthium)

-       Sage (Salvia officinalis)

Before going out, people would apply this remedy on their hands and face to avoid contracting the plague. If you’re thinking a hand sanitizer then in fact it’s not so far from the truth - some of these plants are known to be natural flea repellent.

People kept on using it when infected, since the meadowsweet contains a derivative of aspirin which would have helped with the pain. That could explain why this preparation worked for Middle Age people. Other prescriptions included lavender or rosewater baths, probably due to their antimicrobial and healing properties. Willow (Salix alba) bark extract was also given as a painkiller. Despite the medicinal properties of the above-mentioned plants, it of course did not cure the actual disease once contracted.

Here’s an interesting fact regarding facemasks during Middle Age: they were quite popular actually. Facemasks of the so-called plague doctors were filled with various strongly aromatic herbs and spices such as mint, rosemary, camphor, storax and even Indian spices, believed to be effective against bubonic plague. Unfortunately, plague doctors served mostly to count the dead.

Plague Doctor Schnabel von Rom. Source: Google Arts and Culture.

Smallpox

Smallpox is a viral disease caused by the Variola virus (V. major) and has been around since at least the ancient Egypt. In 1796, Edward Jenner discovered that exposure to cowpox - a similar virus that infested cow at the time - could provide immunity to smallpox. This led to the creation of the first vaccine (by the way, vaccine comes from the Spanish word “vaca” - cow). In the 1980’s, thanks to vaccination, smallpox was the first infectious disease to have been eradicated. (OK, Karen?!)

Sarracenia purpurea. Source: Wikimedia Commons.

While many herbal remedies were used to relieve symptoms, they were never considered as main treatments and we did not find any trace of any European remedy in particular. However, we did find an interesting historical source describing a traditional herbal remedy from a Native American community – The Micmacs (Mi’kmaq) of Nova Scotia. Deeply affected by smallpox in the 19th century, their treatments included poultices and herbal infusions of a carnivorous plants, the purple pitcher plant (Sarracenia purpurea). Known as Mqo’oqewi’k by the Mi’kmaqs, the plant revealed itself to be very efficient and was later described by U.S botanists as ‘‘the greatest remedy known for the dreadful scourge. It seemed to arrest the development of the pustules, killing, as it were, the virus from within.”

Because of vaccination, this remedy was then abandoned. It’s only in 2012 that researchers demonstrated the antiviral properties of the plant against smallpox, but also against various herpes viruses, including papillomavirus.

Malaria

Malaria is a disease coming from the bite of a mosquito species infected by a parasite (Plasmodium faciparum). The current name of the illness was given by the Italians around 19th century, as a contraction of the words “mala aria” (i.e., bad air).

The historical treatment against malaria is quinine, a molecule extracted from the bark of the cinchona tree (Cinchona officinalis). It belongs to the same family as coffee. The bark was brought to Europe by Spanish missionaries who had observed how the Quechuas in Peru used it to threat shivering. It is believed that the powder of the bark was first given to Europeans in the 1630s to treat malaria and remained the major antimalarial drug until the 20th century.

Just FYI, during this year corona outbreak, some of you may have stumbled upon the hydroxychloroquine. It is a synthetic alternative of quinine developed in the 1930’s and it is still a major drug in the prevention and treatment of malaria. No serious studies have confirmed its efficiency with treating COVID-19 though.

Cinchona offiinalis. Source: Wikimedia Commons.

Historically, in some areas the parasites developed resistance to quinine substances and researchers were asked to look for new alternatives. Funnily enough, the solution came again from the plant world: Chinese researcher and pharmacist Dr. Youyou Tu based her research by reading more than 2000 Chinese traditional medicine recipes. She quickly found that one plant was often used by Chinese herbalists to treat chills, and fevers: Artemisia annua known as qing-hao. After further lab work with the plant, she finally extracts a compounds called artemisinin which is still the main alternative to drug-resistance malaria.

In 2015 Tu was awarded the Nobel Prize for the discovery of artemisinin, which represents an important contribution of China to the global health, as well as the first Nobel prize in the sciences for China.

Artemisia annua in all its beauty. Source: Wikimedia Commons.

Spanish Flu

It was spring of 1918 and the world was about to live through one of the deadliest pandemics in recent history, caused by an aggressive strain of the H1N1 influenza virus. As with COVID-19, the main options back then were to avoid contact through lockdown and quarantines, to increase personal hygiene and to use disinfectants widely.

People also turned to traditional herbal remedies and some recommendations got more popular than others such as the consumption of garlic and onion. That is funny how certain things do not change over time, because in most blogs covering natural antivirals against COVID-19 you will still find garlic on their list. Garlic contains indeed a substance called quercetin that would have some antiviral properties, but there is no concrete evidence so far.

On the other hand, there was an experiment conducted by a group of US physicians known as “The Eclectics”. They reported positive results by treating the flu symptoms with plant remedies, together with other measures such as exercise. The plant preparation included:

-       Yellow yasmine (Gelsenium sempervirens): known to prevent or alleviate fever.

-       Boneset (Eupatorium perfoliatum) used by native Americans to treat cold-related symptoms.

-       Black cohosh (Actea racemosa) also used by Native Americans as a painkiller.

-       Pleurisy root (Asclepias tuberosa) used to treat respiratory problems.

Again, despite a very low fatality rate while using this herbal remedy, little research was done on these plants.

And that’s all folks - next week we’ll get into what medicinal plants are being researched right now in order to find cure for COVID-19. Excited? So are we.