The applications of wormwood continue with its reputation as a herb against melancholy. This action may well be as attributable to the effect of its bitter nature on the liver, as well as the general tonic effect so roundly affirmed from application thus far. There is support of a humoral nature for bitters working through the spleen in hypochondriac melancholy where an overheated spleen causes noxious vapours to rise to the heart and brain. Some modern authors, among them Chevallier, Menzies-Trull and Hoffman, refer to use in depression/melancholy but not a lot of guidance as to source is given. Grieve gives a recipe of 1 oz of herb infused 10-12 minutes in one pint of water taken in glassful doses to relieve melancholia, but again no source is offered. The tradition does not appear in the ancients. Hildegard is an early mention, with a recipe of fresh wormwood pounded and expressed through cloth added to wine cooked with honey, so that the wormwood overcomes the wine and honey flavour, to be drunk every other day, to check not only melancholy, but ‘it will ease sickness in the loins and make your eyes clear’. Serapio cites Mabix that an infusion or decoction, especially mixed with epithymum, will cure melancholy. Otherwise there seems to be no specific mention among the Arabic writers, nor our other sources.
There is a little more written on wormwood as a nervine. Grieve calls it a nervine tonic, embracing the idea of vermouth made from wormwood, named from Wermuth, ‘preserver of the mind’, deriving from its medicinal virtues as nervine and restorative. ‘If not taken habitually’, she says, ‘it soothes spinal irritation and gives tone to persons of highly nervous temperament’. Menzies-Trull also designates it nervine, a stimulant of the central nervous system and heart for ‘nervous and physical exhaustion with fatigue’. Wood explores wider fields in this regard. He documents his use of the herb for hopelessness and for people who have suffered severe trauma, physical and mental, ‘brutalised by the reverses of life’, with depression of life forces in general. He suggests it is indicated in ‘thin, scrawny, malnourished individuals’, yet he has used it with success, he says, for the ‘large, waterlogged and stiff. Is this the earlier ‘dual quality’ on another level? Bartram suggests its use for assisting withdrawal from benzodiazepine addiction. From tradition, the closest association in respect of nervine is that of headache. The National Botanic Pharmacopoeia, in the not too distant past, records use of wormwood for some nervous affections, especially headache. Although Dioscorides and others say the juice causes headache, other applications are commended to ease it, including the use recorded in the Salernitan herbal of wormwood juice in hot water and sugar for pains in the head arising from the stomach. The majority of other remedies involve variations on external application. Hildegard says take the juice in warm wine and wet the entire head, including eyes, ears and neck, on going to bed and cover the head with a woollen cap until morning. This will also relieve head pain from gout and the more ‘inner pain of the head’. Bauhin and Dalechamps both record a suggestion from Mesue of taking wormwood and the root of field cucumber cooked in wine, water or oil, and binding sponges soaked in this mixture to the head to ease migraine. Parkinson says bathing the temples with distilled water should ease headache from an old cause.
Too much wormwood, as we have seen, will have the opposite effect. Presumably Dioscorides’ caution about the juice is founded on experience of reaction that might now be attributed to particular constituents, in particular thujone, which leads to the cerebral dysfunction, epileptiform seizures, delirium and hallucinations that Schulz et al (1998) record. A detrimental effect is not unnoticed in tradition. For example, Cook notes that larger doses or long continued use lead to excitement of the stomach, pulse and brain, although he estimates it is not narcotic but has a slow and persistent stimulating and tonic action upon both the heart and nervous centres. Cullen writes in similar vein, that some authors strongly asserted its narcotic power, although, he says, Linnaeus knew of people taking wormwood daily for 6 months with no narcotic effect. Nevertheless, Cullen estimates the odour as ‘temulentans – giving some confusion of the head’. He records the earlier custom of drinking ‘purl’, a wormwood infused ale which intoxicated more than other ales. He concludes that every bitter ‘when largely employed’, has ‘a power of destroying the sensibility and irritability of the nervous power. The question of safety surrounding absinthe has some relevance here (see the discussion below under safety issues).
Internal dosages need only be small. Bartram records an average dose of 1-2 g of fluid equivalent three times a day, tea of 1 teaspoon to each cup of cold water steeped overnight and drunk in the morning; liquid extract 1:1 in 25% 1-2 mL in water; tincture 1:10 in 45% 1 teaspoon three times a day. This seems rather large, and smaller doses should be effective. Barker suggests 0.1-0.25 mL in combination. Menzies-Trull warns ‘always use a small dose – this is a very stimulating remedy’. Cook recommends 5-15 grains (325-975 mg) three times a day, usually given as infusion. Half an ounce in a pint of boiling water is strong enough, he says, and 2-4 drachms (8-16 mL) of this is a dose. ‘In combining it with other tonics I seldom use more than ½ oz of this in each gallon of the preparation’ he says, ‘for it is too concentrated an article to employ in such large doses as are generally used’. Cullen says tinctures are best by short infusion, anticipating here later findings on thujone extraction. Wood recommends micro doses, one drop per day is often enough, he says. I never use more than 5 mL per week and find this dose effective.