The decoction of root in wine is recommended by Dioscorides for ‘belly aches’, the jaundiced, kidney disease and ‘those smarting in the bladder’. Astringency is referred to in the taste and Dioscorides states that boiled down in wine it stops diarrhoea, advice which is given by Galen too. The recommendation of an extract in wine is repeated by later authors. A compound medicine of 76 ingredients, including paeony, Potio sancti Pauli, is given in The Trotula for disease of the head and was used for ‘epileptics, analeptics, cataleptics’ with wine in which mixed paeony had been boiled. Pliny refers to use of paeony root as a food. He gives this after referring to a decoction in wine for the trachea and stomach, and with an astringent action on the bowels. Macer makes a similar suggestion of a mixture in honey water with powdered coriander for the stomach, spleen and kidney gravel. Macer and the Salernitan herbal suggest external use of the powder placed on the anus with a cloth for tenesmus caused by cold. Hildegard says that the crushed root in wine will chase away the tertian and quartan fevers, while the root in flour with lard or poppyseed oil as a porridge will act as a preventative.
Dioscorides, Pliny and Ibn Sina make recommendations for use of the black seeds or the unfertilized red ovules in digestive and urinary problems, in menstrual problems and in nightmares. This is difficult to interpret as the yield of seeds would be small. In addition, there is no research on their constituents, and I have not felt comfortable about recommending the seed. It can be hard to decide whether later authors merely copied Dioscorides and Galen or had used these preparations. However, Culpeper states that powder of the black seeds could be purchased, and Miller lists the official preparations as syrup of flowers, Syrupus Paeoniae compositus, the simple water and the mixed water, and powders of both seed and root. The seeds were listed in a supplement to the German Pharmacopoeia in 1926. Dioscorides and Ibn Sina recommend the seeds eaten to relieve gnawing in the stomach, and eaten or drunk to take away the beginnings of stones in the bladder in children (children can be subject to stones if dehydrated due to inadequate water supply). I have disregarded these indications as there are many common herbs that are more commonly used.
For paeony root and seed, Serapio gives the same qualities as Galen: that it is of subtle parts, a little astringent but with a sweetness that becomes sharp and biting on chewing. These same qualities are given by Fuchs and Parkinson, who both refer to Galen. Maybe using a different source, Serapio then describes paeony as slightly heating, strongly astringent and a herb which cleanses and strengthens. It is considered to treat the liver and kidneys because it is sharp and slightly bitter, and astringent so useful in fluxes. Ibn Sina describes the paeony as hot and dry, but not greatly, while the Salermitan herbal describes paeony as hot and dry in the second degree. Perhaps following Ibn Sina, paeony is described as dispersing and cleansing with the ability to dispel humours. Macer also describes it as hot and dry in the second degree and states that this derives from Hippocrates and Galen, but that others say the root is cold. The Salernitan herbal advises use of the decoction in wine when it is impossible to urinate, a use repeated by Fuchs.
Bauhin summarizes the texts of Dioscorides and Galen, and notes the action in clearing obstructions of the kidney and bladder. The indications given above may be the reasons underlying the long list of indications given by Commission E for paeony flower. Although it is included amongst unapproved herbs, it is listed for disease of the skin and mucous membranes, fissures, anal fissures associated with haemorrhoids, gout, arthritis, ailments of the respiratory tract, in combinations for nervous conditions, heart trouble and gastritis. The root is listed as antispasmodicbut is used in combinations for arthritis, the gastrointestinal tract, the cardiovascular system, neurasthenia, neuralgia, migraine, allergy and in tonics. Bisset & Wichtl (2001) suggest that the flowers can be used to enhance the appearance of herbs teas but caution that they can only be stored for less than a year as they fade rapidly.
Other recent authors focus on the antispasmodic action. Cook refers to the ‘showy paeonia of our gardens’ whose root is mildly relaxing and antispasmodic. He advises an infusion of 1 oz in 1 pint of warm water taken freely in spasms and colics of children to remove flatus. He considers it too mild to fulfil its previous reputation for use in epilepsy and chorea. However, Wren gives it as tonic and antispasmodic and thus successfully employed in convulsive and spasmodic nervous affections such as chorea, epilepsy and spasms. Menzies-Trull gives the main action as antispasmodic but adds uses as a bitter and cholagogue with a blood thinning action. He gives the indications of menopause and fibroids. Chevallier discusses Paeonia lactiflora and focuses on the antispasmodic action and sedative action in whooping cough, nervous irritation and advises use as a suppository in intestinal and anal spasm.
Root and seeds are advised in excessive menstruation. Culpeper generally prefers the root. Dioscorides makes no distinction between the two types of paeony. He recommends the root for women ‘not cleansed after childbirth’. He specifies a decoction of the amount of an almond to induce menstruation. This is repeated by Turner, who ascribes the same advice to Galen, adding that Galen recommended taking the root as a powder to bring on the menses. The version of Galen by Mattioli gives a preparation of the seed well crushed, sifted and sprinkled and the quantity of an almond in mead to provoke the menses. It is not clear whether the powdered seed is taken in mead or kept in mead and then taken when needed. This is analogous to use of Paeonia lactiflora and I would feel happier continuing with use of Paeonia lactiflora than seed. Dioscorides then advises up to 15 black seeds in hydromel or wine for suffocation of the womb and uterine pains. Pliny uses the phrase ‘healing to the uterus’. Culpeper includes both root or powdered black seed for women not sufficiently cleansed after childbirth. In the Salernitan herbal the advice for use to cleanse the womb is as a fumigation. In this same text use in childbirth is more specific, suggesting 15 black seeds for ‘deliverance of the bed of the child in her womb’. This must refer to deliverance of the afterbirth and could deserve further research to support this recommendation. Ibn Sina, however, who gives the dose as 600-900 mg, puts the indication differently as he suggests the seeds when menstruation does not return after childbirth.