When Musa includes three treatments with betony for the nervous system, one concerns trauma and probably both the other two bear some relation to indications contemplated by modern practitioners. Firstly, the leaves powdered and applied heal severed nerves. Other traumas appearing elsewhere in Musa’s list of conditions are ruptures, and in those who have tumbled down from a high place, for which 3 drachms (12 g) in old wine is used. It is not clear whether internal or external administration is meant here, but the former is presumed, since The Old English Herbarium specifies internal ruptures and Dioscorides mentions ruptures with spasms, uterine problems and suffocations, for which cases he advises 1 drachm of the powdered leaves in water or honey water. We have already noted, too, when discussing mugwort, that uterine suffocations are renamed hysterical affections in the later tradition. To this supposed nervous state we can add Musa’s ‘unnerved’ or enfeebled condition (Bauhin’s ‘resolutos’), unless another traumatic injury such as the wrenching of a joint is meant. The Salernitan herbal, however, advises betony for those in a weakened state, where 1 drachm (4 g) in 3 cyathi (135 mL) of good wine taken daily for 5 days will be curative. The same dose in vinegar and honey water to miraculously restore the strength of those who have made a long journey is Musa’s third indication. The Old English Herbarium wants a coin’s weight of betony decocted in sweet wine as a pick-me-up ‘if a person becomes tired from much riding or much walking’. Dioscorides makes no mention of weakness or fatigue but recommends betony for epileptics and the insane. Galen mentions epilepsy also, together with ruptures and spasms.
These indications are passed down to some extent through our authors. While Serapio describes wounds of the nerves and convalescence and the Salernitans repeat severed nerves and fatigue without acknowledging Musa’s authorship as Dalechamps and Bauhin do, others are silent on these uses because Dioscorides does not mention them. Parkinson suggests ‘any vein or sinew that is cut’ and in a separate statement lists palsy alongside epilepsy. Others mix ruptures with cramps, spasms, internal pains and colic. Fuchs, Turner, Dodoens, Gerard and Mattioli presumably, if he had written more on this herb, follow Dioscorides in giving epilepsy and madness as conditions treatable but do not mention Musa’s fatigue. Since Parkinson (and Culpeper, because he has copied Parkinson’s entry) does mention fatigue, we once again assume that he has enjoyed the benefit of Bauhin’s herbal. On the other hand, Parkinson omits madness as an indication, but includes epilepsy and also continual pains in the head which may be severe enough to produce a frenzy. This last is a use for betony that has persisted in texts to the present day.
We find an earlier recording of head pain in Serapio alongside scalp laceration, trauma to the cranium and inflamed eyes. Powdered betony is to be applied topically to join the wound together and even to draw out shards of broken bone but the plaster must be renewed often, every third day according to Musa from whose essay these uses are taken. The Old English Herbarium suggests drinking betony in beer for a shattered skull and its editor rightly questions this radical departure from the Latin text of its source and from Dioscorides. She wonders whether the Old English text is referring to migraine, which can feel as if the skull is broken, but this seems fanciful since we have no reason to believe this does not refer to the healing of head wounds. More than 200 years later and from the then dominant culture, Serapio proposes to relieve pain in the head by placing the powdered root or herb on the forehead, while in the Salernitan herbal, itself influenced by Arabic writings, a decoction in wine is made for ingestion in cases of headache due to vapours rising from the stomach, or a gargle made from betony and poisonous stavesacre decocted in vinegar for headache due to cold. The 18th century writers first emphasize the head as the main target for medicinal effects. Quincy describes betony as ‘accounted by all a very good cephalick’ and proposes its inclusion in a herbal tobacco, the smoking of which corrects rheums in the head. He too cites Musa on wounds to the head and reports that a plaster of betony is official in the London dispensatory but little used. Miller confirms the plaster, as well as a conserve of the flowers, as official preparations and lists head pains, convulsions, nervine affections, vertigo and sore eyes as indications. Smoking betony in a mix with tobacco cures headaches, but Hill deems this a more uncertain method of treatment. The herb gathered when just coming into flower, Hill writes, and given presumably as a tea, treats disorders of the head and all nervous complaints. Cullen countenances the use of betony as a mild sternutatory for symptoms in the head but dismisses the suggestions of Bartholin and Pauli that the herb is hypnotic and anodyne. It is tempting to conclude that the later indication of headache derives from the earlier one for head trauma, in which headache would be inevitable.
Betony is not among Coffin’s botanic remedies and is not mentioned by the American writers. Fox writes that it is excellent for those distracted by pain in the head, and the herb will cure dizziness and all nervous complaints in the head, including ‘softening of the brain’. Hool denotes it as nervine and tonic, treating headache, pains in head and face, neuralgia and delirium, for which he recommends betony 1 oz, rosemary Rosmarinus ojficinalis ½ oz, and English scullcap, Scutellaria galericulata, ½ oz infused in 2 pints of boiling water, steeped for 20 minutes, strained and taken in wineglassful doses three or four times a day. As a daily tea, for Grieve tells us that the weak infusion has somewhat the taste of tea and is used extensively as a substitute for tea, or in fevers and insensibility Hool proposes 1 oz each of betony, greater burnet Sanguisorba officinalis, raspberry leaf Rubus idaeus, agrimony Agrimonia eupatoria, meadowsweet Filipendula ulmaria and wood avens Geum urbanum, ¼ oz of the mixture to be infused for 10 minutes in a pint of boiling water and drunk sweetened in place of tea or coffee. The National Botanic Pharmacopoeia adds palpitations to the indications for the herb, confirms that it is usually used in combination with other herbs and assures that it may be used with the utmost safety and benefit in all cases of cerebral affections. Grieve’s contributions to the history of betony involve a citation from the Medicina Britannica of 1666 concerning the curing of very obstinate headaches with a daily decoction of betony in new milk and support for Cullen’s evaluation of the sternutatory action of the plant: ‘a pinch of the powdered herb will provoke violent sneezing. The dried leaves formed an ingredient in Rowley’s British herb snuff, which was at one time quite famous for headaches’.
The modern focus is on a cephalic action. Priest & Priest consider betony ‘especially indicated for neuralgic and ischaemic conditions affecting the head’, including forget-fulness and lack of concentration. The British Herbal Pharmacopoeia styles it sedative and bitter, and lists headache, specifically that in neurasthenia, a now outdated term which may include today’s chronic fatigue syndrome, anxiety states, neuralgia, vertigo (Bartram has dizziness) and hysteria. It proposes a use in combination with skullcap Scutellaria lateriflora and states a dose of 2-4 g dried herb by infusion, 2-4 mL of the liquid extract and 2-6 mL of tincture 1:5 45%. Chevallier adds ‘frayed nerves’ and pre-menstrual syndrome, like hysteria an echo of the old classification as a herb for treating the womb, and Menzies-Trull includes chorea, nervous eye disorders, amnesia, menopausal depression, panic attacks and cerebral atrophy. He too proposes combinations of herbs: betony with skullcap Scutellaria lateriflora or valerian Valeriana officinalis for nervous headaches, with elder flower Sambucus nigra for headache from a cold or chill, with milk thistle Silybum marianum for memory loss, and Hool’s mix with skullcap and rosemary for neuralgia or ischaemia of the head. Menzies-Trull, Hoffmann and Wood list hypertension among the indications. Wood suggests betony for Parkinson’s disease, stroke and as a restorative after concussion, as well as for insomnia. The herb is suited to tall, thin intellectuals dissociated from their body, he says, or for elderly people disconnected from their surroundings. We may recall the magical uses we have heard of from Musa and Hildegard, when we read Wood extending the traditional European use for demon possession to cover unwanted alien abduction experiences. Who says that betony is now of little value?