North temperate Europe

Arnica Arnica montana / Asteraceae

It is well known that the German poet, philosopher, and natural historian J.W. Goethe (1749-1832) highly valued Arnica montana, and that he received a tea prepared with arnica after he had suffered a heart attack in 1823. Today, arnica is still an important medicinal plant, but pharmaceutical uses are exclusively external, for the treatment of bruises and sprains, and as a counterirritant. However, the task of establishing uses for the plant in the Middle Ages and the Renaissance has proven to be a difficult one. Arnica was hardly known in Greek, Roman, and Arabic medicine, and the first reliable evidence dates back to the 14th century (Matthaeus Silvaticus) and the 15th century. The situation was made even more complicated when this species was confused with water plantain, Alisma plantago-aquatica. In lacobus Theodorus Tabernomontanus’ New vollkommentlich Kreuterbuch (1588), there is a picture of Arnica montana. However, the text refers to water plantain (Alisma plantago-aquatica). Hence it comes as no surprise that the reported uses of these botanically completely different species are often very similar (especially during the 16th and 17th centuries). In the 16th century Arnica montana became an outstanding wound remedy.

Chamomile, German chamomile Matricaria recutita (syn. M. chamomilla) / Asteraceae

Chamomile is one of the most important medicinal plants of Europe, and has been in use for more than 2,000 years. It is used internally for gastrointestinal and respiratory complaints, as well as topically for inflammatory skin conditions (eczema, wounds, haemorrhoids). Hippocrates called it euanthemos (the real or good flower), Dioscorides called it anthemis and anthyllis, and Galen called it anthemis and chamaimelon (apple growing on the ground). It continues to be an important medicine in academic as well as popular medicine. The species has been exported to many areas and is today an essential element of medical systems all over the world. Chamaemelum nobile, or Roman chamomile, has very similar uses, especially as a (bitter) tonic and a gastrointestinal remedy, but it is chemically rather different. Historically it has been an important medicinal plant in England, France, and Italy.

European birthwort or snakeroot Aristolochia clematitis / Aristolochiaceae

Roots of the European snakeroot or birthwort, Aristolochia clematitis, and A. rotunda had long been used in medicine as an emmenagogue (to promote menstrual discharge), an abortifacient (to induce abortions), a diuretic, and for the treatment of arthritis. A. serpentaria (Virginia snakeroot) was similarly used in the United States, and was also used by Native Americans to treat snakebites. Until the early 1980s several phytomedicines from A. clematitis were widely sold in Europe. Its main active constituent, aristolochic acid, was also formerly used in Germany to treat abscesses, eczemas, and other long-lasting skin diseases and as a nonspecific stimulant of the immune system. However in 1981 both the extract and the pure compound were withdrawn due to serious carcinogenic and nephrotoxic (i.e., damaging to kidney cells) effects. A traditional Chinese medical herbal preparation which was used for its supposed weight-reducing effects, and which contained Aristolochia fangchi (Chinese Snake Root), known to possess large amounts of aristolochic acid, was used extensively in Belgium during the early 1990s. A. fangchi had inadvertently been substituted for another Chinese drug (Stephania tetrandra). Kidney failure owing to a progressive form of renal fibrosis due to the use of A. fangchi was observed eight to ten years later in many of the patients, and the import of this species is now widely banned.

Fennel Foeniculum vulgare / Apiaceae

Fennel and fennel seeds are a classic household remedy used as a cure for flatulence. It was important to Greeks and Romans and included in the Capitulare de villis as well as in the Hortulus of Walahfried Strabo (809 ad). It was reputed to ward off evil spirits. In his 16th century herbal, Leon-hard Fuchs recommends the aerial parts and the seeds for stimulating lactation and as a diuretic. The seeds are also reported to be useful if one has a “weak stomach.” Another of Fuch’s uses is for the macerated root: “if one puts it in honey it protects one against angry dogs” (sic).

Feverfew Tanacetum parthenium / Asteraceae

Feverfew has been used as a bitter tonic and an antipyretic (i.e., to reduce fever) for many centuries; there was renewed interest in the plant in the 1990s as a potential treatment for migraines. Tanacetum parthenium is known in South America as Santa Maria and is an important species in many indigenous medical systems, especially in South and Central America, where it is used for menstrual disorders.

Foxglove Digitalis purpurea and Digitalis spp. / Scrophulariaceae

Foxglove, Digitalis purpurea, is one of the best-known examples of a remedy developed from close observation of the pharmacological effects of the species. Digitoxin from this and related species is still extracted from several members of the genus and is used today in the treatment of coronary disease. It was reportedly used by an English housewife to treat dropsy, and then used more systematically by the physician William Withering (1741-1799). Prior to William Withering, herbalism in Britain spread simply by word of mouth; his endeavors transformed it into a form of science used by medical professionals. Herbalism during this period was more of a clinical procedure concerned with the patient’s welfare, than a systematic study of the virtues and chemical properties of medicinal plants.

Horse chestnut Aesculus hippocastanum / Hippocastanaceae

The seeds of the horse chestnut are used topically and orally for chronic varices (circulation problems in veins) and other inflammatory circulatory disorders. The active ingredient is a mixture of saponins collectively called aescin. The species originated in the Balkan peninsula or Anatolia, but is now cultivated in many regions of the world. In Europe the first trees were planted in Vienna in 1576 (Clusius), and the species was also introduced into North America, in the middle of the 19th century. The horse chesnut is commonly used in Continental Europe, and the German medical control agency published a “positive” (i.e., approved) monograph, or legally binding analysis of the accepted medical uses of the species, that was adopted by the health authorities (BFA 1994). However, the horse chesnut is of lesser importance in North America.

Mint Mentha spp. / Lamiaceae

Peppermint, Mentha x piperita, is a very widely cultivated medicinal and aromatic plant, and is particularly important for the production of menthol, which is used as a flavouring agent. Its medical uses are to treat flatulence and gastrointestinal cramps. The species is also used to flavour chocolate and in liqueurs. It is a hybrid of M. aquatica x M. spicata, which spontaneously originated in 1696 in an English garden. It can only be propagated via its runners. Today peppermint is one of the most important medicinal and aromatic plants, and is widely grown in some parts of Europe (southeastern Europe, Spain, Germany) and especially in the United States. It was reportedly first brought to the United States in the early 19th century and cultivated in the state of Massachusetts. From there the production spread to other East Coast states and to the northern Midwest (Michigan in 1835), and eventually to the West Coast (Oregon in 1919). In the 1940s production started in Wisconsin. Today the major production centers of the world are the Columbia River Basin, Washington, the Willamette Valley, Oregon, and the states of Indiana and Idaho. Another important representative of the genus, M. spicata, or spearmint, is menthol-free and commonly used to flavor toothpaste. The production of spearmint started later and its extension followed that of peppermint. It is mainly grown in the state of Washington.

Mentha arvensis, or corn mint, originally from Eurasia, is another prominent member of this genus used medically in numerous cultures of the world. The closely related M. canadensis is the lapanese peppermint used for a large variety of illnesses because of its high menthol content.

Scotch marigold Calendula officinalis / Asteraceae

Scotch or pot marigold is used pharmaceutically, for example, to treat chilblains, chronic wounds (including ones which heal very slowly), and other inflammatory conditions of the skin. In some rural regions of Europe (e.g., Switzerland and the German Black Forest) the species is still widely used externally as a veterinary anti-inflammatory remedy. Normally the flower heads are mixed with lard or another animal fat, heated for a short period in order to extract the active lipophilic constituents, and the resulting product is stored for usage. The flower heads are also used to color butter and to thicken soups.

The species originated in southeastern Europe and is today widely cultivated (most commonly as a garden plant). It is uncertain whether the species was already used by the Greeks and Romans. The core problem is the lack of proper botanical identification of plants with names similar to the ones used for Calendula in much later periods. The first certain evidence is from the Physica (first printed 1533) of Hildegard of Bingen (1098-1179). According to Mayer and Czygan (2000b), this points to use in the popular (peasant) medicine of this period and later became a constant element of the various medieval texts (especially the later Circa Instans). This species is an example of the continuous usage of a medicinal plant for similar medical indications.

St. John’s wort Hypericum perforatum / Hypericaceae

St. John’s wort is a perennial which plays a primary role in modern evidence-based phytotherapy. The aerial parts of the plant have been used as an anti-inflammatory, healing application for wounds and as an antimelancholia remedy since the time of the ancient Greeks. In the Middle Ages many believed it to have magical powers to protect one from evil. Early Christian mystics named the plant after John the Baptist and it is traditionally collected on St. John’s Day, June 24, and soaked in olive oil for several days in order to produce a red anointing oil to be used externally. This practice is still very common in many folk medicines of eastern and southern Europe, and some pharmacological evidence in support of the usage exists.

Several controlled studies have shown positive results when using standardized St. John’s wort extract to treat patients with mild depression. Improvements were shown with no reported side effects. The active constituents in the plant (there are over fifty) include antraquinones (hypericin and pseudohypericin), prenylated phloroglucinol derivatives (hyperforin), and flavonoids.

However, the side effects of St. John’s wort include stomach complaints, fatigue, and especially allergic reactions (photodermatitis). Most authorities warn strongly that Hypericum extracts should not be taken alongside other anti-depressants; doing so can result in a syndrome called serotonin syndrome.

Valerian (root) Valeriana officinalis / Valerianaceae

The combined root and rootstock of the (common) valerian with its characteristic “old socks” smell is used pharmaceutically to treat sleep disorders and other related conditions. It is a licensed medicine in many European countries and is currently grown commercially in Russia, Japan, the United States, Belgium, Holland, and Germany. The species has been used through the centuries in many European regions. L. Fuchs lists a variety of uses including as a diuretic and gynecological aid, but he does not include uses for sleep disorders.

White willow Salix alba and Salix spp. / Salicaceae

The genus Salix includes numerous trees and shrubs common in alpine ecosystems and along the margins of streams. The white willow, Salix alba, is a tree that commonly grows in areas periodically flooded along streams and lakes. Willow bark (known to pharmacists as Salicis cortex) is a European phytomedicine with a long tradition of use for treatment of chronic pain, rheumatoid diseases, fever, and headache, and one of its main compounds, salicine, served as a lead substance for aspirin (acetylsalicylic acid). Leonard Fuchs devotes a chapter in his New Kreutterbuch (1543), illustrated with three drawings of different species, to the various “classes” of willow. The leaves are reported to be good for treating some gastrointestinal complaints, and the bark to be useful for treating warts and corns. Acetylsalicylic acid is today used in a similar way. Fuchs’s use of willow as a treatment for podagra (i.e., gout, especially of the big toe) mirrors modern uses in the treatment of a variety of chronic inflammatory conditions. A positive monograph for its use in fever-related diseases, rheumatic complaints, and headache was published by the German medical control agency (BFA). The drug is also monographed in the European Pharmacopoeia. Clinical evidence, including two double-blind studies, points to the effectiveness of willow bark for the treatment of chronic pain and rheumatoid diseases. This potency as a treatment is the result of more than one substance (most of them so far unknown). The extract is effective at a dosage of salicylates (a group of compounds chemically related to salicylic acid) which is much lower than the one reported for aspirin. However, the mechanism of action of this complex mixture and the individual compounds responsible for this activity remain unknown.

Wormwood Artemisia absinthium / Asteraceae

Wormwood or absinthe has been used for many centuries not only as a bitter tonic, stomachic (strengthener of the stomach), and stimulant, but also in the production of liqueurs (e.g., vermouth) and it remains a useful phytotherapeutic option for mild gastrointestinal disorders. It was known to Wallafried Strabo in the 9th century and is the first species mentioned in Fuchs’ New Kreiiterbuch (1543). There it is recommended for a number of gastrointestinal problems, and for a large variety of other disorders. The species is an example of how systematic exploration of its clinical effectiveness and pharmacological effects over the last few centuries has helped to reduce the uses of wormwood to therapeutically validated ones. One of its constituents, the neurotoxic monoterpenoid (i.e., a terpenoid with ten carbons in the skeleton) thujone, is concentrated in vermouth wines, especially if they are distilled, but the use of such products has been outlawed in Europe since the 1920s. Consequently, thujone-free species and varieties are used in the production of such wines.

Yarrow Achillea millefolium / Asteraceae

Yarrow has been used as a medicine for many centuries. The species is native both to temperate Europe and to North America. Particularly common in Europe were uses associated with inflammatory conditions (e.g., in the form of an externally applied poultice). Even though the species had been an important medicinal plant in many European countries and, for example, is mentioned by Fuchs as a useful treatment for a variety of inflammatory conditions such as wounds and abscesses, today it is of limited importance and is only used in some regions, as a popular medicine.