The Citrus in Pharmacology Treatises and in Therapy from the Eighteenth to Twentieth Centuries

2015

In the eighteenth and nineteenth centuries, all Materia medica and Pharmacology treatises reported drugs obtained from Citrus species, already present in the above-mentioned Pharmacopoeias (Boehraave, 1772; De Rochefort, 1789; Edwards and Vavasseur, 1829; Chevallier and Richard, 1830; Ferrarini, 1825; Semmola, 1836; Cassola, 1838; Targioni-Tozzetti, 1847; Bouchardat, 1855; Orosi, 1856-57; Cantani, 1887).

Boerhaave (1772) attributes to Citrus fruits the property of curing various illnesses (morbes), and lists citron oil among remedies for fevers in general, heart disease (Pulvis cardiacus, calidus, narcoticus), or to be used together with other medicinals against burning fevers (In siti febbrili, Decoctum in valida siti et debilitati); as an antiemetic (Haustus anti-emeticus), antiscorbutic (Antiscorbutica frigidiuscula), colluttorium (Colluttoria oris. In Calidis), in treating dropsy (Mistura aromatica, cardiaca, acida, sitim sedans, vires vitales excitans, lymphae fluorem concilians), infirmities in pregnant women (ad gravidarum morbos), as an aromatic cardiac medicated wine (yinum medicatum, aromaticum, cardiacuni) or in an acid aromatic cardiac mixture, and also in hue Venerea as Mistura anodina e diaforetica.

An interesting reference is to be found in the Cours Elementaire di Alatiere Medicale by De Rochefort (1789). He reports that the antispasmodic action of orange leaves was little known in the past and that this action, comparable to that of valerian, had been discovered no more than 30-40 years earlier (i.e. in the first half of the eighteenth century), and furthermore that he had seen it used to remedy even severe cases of ‘nervous’ epilepsy in children. And since the decoction’s very bitter taste made it unpleasant to drink, especially for children, he recommended using the pulverised leaf incorporated in bolus or in jam. He added that this antispasmodic was highly recommended by the school of Vienna and by Tissot and that orange blossom water was used to correct the flavour of purgative potions and other unpleasant tasting medicaments.

In the last century, lemon juice, the juice and peel of bitter orange, and the peel of citron were used as tonic bitters, as stomachics and carminatives, and for treating scurvy. Lemon juice was an ingredient in stomachic potions effective against vomiting and hiccups, and was also recommended for jaundice and feverish illnesses, especially in the case of strong thirst (Edwards and Vavasseur, 1829). These authors mention the so-called ‘Arancelli’ (Aurantia curassaventia. in other words the small oranges that fall from the tree before ripening, ivhich have properties similar to those of orange peel), which in France were used to make cautery balls and in England were used in the same way as orange peel and were included in the composition of numerous medicinals. Chevalier and Richard (1830) also report the use of these small oranges, gathered when they are the size of a cherry, for preparing a highly bitter, aromatic and stomachic tincture.

Semmola (1836) includes lemons and oranges among Aciduli vegetali, while essential oil of Cedrate (Citrus malus), lemon, orange, bergamot, neroli and orange leaves are included in the chapter on Aromatic simples. He adds that Lebreton had extracted a bitter substance that he called hesperidine from immature oranges.

Cassola (1838) mentions a method for preserving juice of cedri (citron ?) so that it can be taken on long journeys, as it is effective in the prevention of scurvy.

Targioni Tozzetti (1847), professor of Botany and Materia Medica at the Arcisped-ale di S. Maria Nuova in Florence, attributed numerous virtues to lemon (effective against dysentery, and in treating febrile and inflammatory illnesses, putrid, adynamic or typhoid fevers the juice was used in drinks and in enemas) and referred to its use as an antiscorbutic, vermifuge and antiputrid agent and for treating heart diseases (Devees in Targioni, 1847), syphilitic affections (Rollo in Targioni, 1847) and dropsy (Cahen in Targioni, 1847). Iced lemonade was used for internal haemorrhages, for which reason Evratt recommended it for local use in uterine haemorrhages, and it was also used as an antidote for poisoning by alcohol or narcotics, etc. Cooked orange flesh, again according to Targioni Tozzetti (1847), was applied by Wright as a poultice to foetid ulcers; orange peel was an ingredient in vermouths and antiscorbutic medicinal tinctures; the pulverised peel, in doses from half a dram to two drams, was used in various illnesses as a stomachic, stimulant, cordial, emmenagogue and vermifuge. He added that Heistero, Riverio, Verloff and others used it for intermittent fevers, especially quartan agues. Orange flower water, or Aqua Nanfa, was widely used as an antihysteric, cordial, cephalic, carminative, and anodyne agent. An infusion of candied flowers was used as a diaphoretic, as a sedative for coughs, and in rheumatic ailments. An infusion of the leaves was used as a diaphoretic, anodyne and fortifier against certain nervous and hysterical afflictions, and against weakness of stomach. De Haen and Lochner (Targioni Tozzetti, 1847) confirm its good effect in the treatment of epilepsy. The decoction of orange leaves was used in enemas as a stimulant, carminative, etc. The dried and pulverised leaves were used in the treatment of numerous neuroses, painful twitching, convulsions and Saint Vitus dance. Targioni Tozzetti adds that the effects of the juice and peel of the fruit of sweet orange are similar to those of bitter orange.

We find many of these uses in the second and subsequent third edition, which was translated into Italian, of the Manuals di Alateria Medica e di Terapeutica Comparata e di Farmacia by Bouchardat (1855, 1856), who states in the preface that in reporting the physiological properties and therapeutic uses of the drugs he referred to the works of various authors, including many of those mentioned above.

Cantani (1887), like the other authors, reports a whole series of therapeutic uses of the leaves, flowers, unripe fruits, and the peel (flavedo) of ripe fruits of orange or lemon, but acknowledges in the foreword that detailed research had not been conducted into the action of the various drugs obtained from the Citrus genus.

The third edition (1856—57) of Orosi’s Farmacologia Teorica e Pratica lists the various drugs extracted from sweet orange, strong bitter orange (Aurantium acre) and citron for their anodyne, stomachic, fortifying, catminative and cordial effects. In the second part of the book he gives the composition and methods of preparation of orange flower and whole citron aromatic water (Aqua Nanfa o Lanfa), citron syrup, orange peel spirits, Acqua Senza Part or Sanspairelle — an alcoholic solution containing essential oil of bergamot, lemon, citron and rosemary, Spirito gengwale which contained fresh citron peel among its ingredients, and the above-mentioned Carmelite Water.

Dujardin-Beaumetz (1889), in his Dizionario Terapeuttco di Materia Medica, di Farmacologia. di Tossicologia e delle acque minerali (Therapeutic Dictionary of Materia Medica, Pharmacology, Toxicology and mineral waters), published towards the end of the nineteenth century, reports under the heading Grangers the therapeutic virtues already attributed by previous authors to the infusion of leaves, wine and syrup of orange peel.

In the first half of the twentieth century, the industrialised nations had not yet seen the proliferation of synthetic drugs that would have such a major impact on the prevention and cure of numerous illnesses and which, together with improved conditions of hygiene and diet, would contribute to lengthening human life expectancy. In these countries, particularly in the Mediterranean area where citrus species grow luxuriantly, the fruits of some species (lemon in particular, but also orange, bergamot and citron) were cheap enough for all pockets. They were considered a divine gift and were widely used in therapy and hygiene.

According to an old popular Sicilian saying, orange is golden in the morning, silver at midday, but leaden in the evening, meaning that it would be harmful in the evening.

Lemon juice was used for washing greasy hair every day for a month to make it soft and shiny. After finishing the housework, women would wipe their hands with half a lemon; many home-made creams based on glycerine and lemon were used to soften the skin and to get rid of stains, wrinkles and chapping. Lemon juice diluted with water was considered the best eyewash and many actresses of the times gave written accounts of this on their photographs.

In the Annali di Odontojatria, Angelo Chiavaro writes of his conviction, ‘from clinical experience, of the effective disinfectant, astringent, acidulous and stimulating action that the juice of citrus fruits has on tooth caries and on gums if prescribed in aqueous solution for prolonged washes of the tissues of the mouth’ ().

The widespread use of citrus fruits attracted the attention of the medical profession, which began to note their effects in various clinical cases. Clinicians of the times prescribed the use of lemon or orange juice against scurvy due to its high vitamin C content, and paediatricians recommended administering a few drops of orange juice to children fed on sterilised milk. Lemon juice was used as an adjuvant for the gastric juices in order to improve digestion, and tonic tisanes for the stomach were prepared with lemon or orange peel.

As late as 1931, in an inquiry conducted by the Camera Agrumaria of Reggio Calabria (Citrus, 1931) and reported by national newspapers, we find that one of the doctors at the Ospedale Maggiore in Milan considered that lemon was useful for its antiscorbutic and antirachitic properties and that its juice had a beneficial digestive and thirst-quenching effect. It was also reported that some people considered it useful in treating uricaemia, gout and gravel and effective against arteriosclerosis.

According to other clinicians Pende (1926) maintained that the lemon countered obesity and allayed arteriosclerosis and hypertension, while orange was rich in vitamins and had a strong antiscorbutic, antihaemorrhagic and antiarthritic action. Even today orange peel is considered a mild sedative.

In a Congress of the American Dentistry Association held in Denver in the 1930s, Dr. Hanke, of the Otho Sprague Foundation of the University of Chicago, revealed the results of two years of study and research. He declared that adding lemon and orange juice to the diet improved children’s general growth and that administering a litre of orange juice every day for ten days produced a marked improvement to even the most severe inflammations of the oral cavity (Editorial, Citrus, 1930).

According to a London newspaper, orange juice or the juice of seeds chewed but not swallowed offered the most effective protection then known to science against grippe and pulmonary illnesses ().

In an issue of the Giornak Italiano di malattie veneree (Italian journal of venereal diseases) of 1884, it was reported that 3—4 injections of fresh lemon decoction could be used successfully in blennorrhagia without the need to resort to other therapeutic measures. This remedy also had the advantage that it could be used without the need to wait for all the inflammatory effects to disappear (Editorial, Citrus, 1959). Taking up from these studies, P. Stella (1929) wrote that he had used lemon juice in the prophylaxis of gonorrheal conjunctivitis in new-born babies with infected mothers and that in none of the cases was the disease found to develop.

 

Selections from the book: “Citrus. The Genus Citrus”. Edited by Giovanni Dugo and Angelo Di Giacomo. Series: “Medicinal and Aromatic Plants — Industrial Profiles”. 2002.