Prof. Jan Kabelik 

Treatment with cannabis in ancient, folk and official medicine up to the beginning of the twentieth century

1955 – ACTA UNIVERSITATIS PALACKIANAE OLOMUCENSIS – TOM. VI.

The knowledge of narcotics and stimulants extends far back to ancient and medieval times but since then, as far as is known, no new discoveries have been made. In Europe, of course, some of them appear not to have been known until later, as was the case with the narcotics of the Old World – for example, with hashish. Europeans learned of it for the first time through the Crusaders, but its deliberate use as well as abuse – according to Perrot – came from Napoleon’s soldiers, who introduced it after their return from the Egyptian campaign.

Cannabis is, however, a very old cultivated plant apparently indigenous to central Asia. Cannabis was found by our archaeologists to have existed in central Europe in the Bylony Culture (7,000 years ago). The Chinese knew of it perhaps 4,000 years ago, certainly in the 9th century B.C., primarily as a medicinal herb and a century later as a textile plant. According to Herodot, the Scythians knew it as a plant which can be spun and as an oil-producing plant and, apparently, even as a narcotic which they made use of in their steam baths – the sauna. Perhaps the earliest accounts of the medicinal utilization of cannabis may be found in Indian medical literature. Ancient Indian surgery, according to Susrat (Samhita), used hyoscyamus and cannabis as anaesthetics. From the Egyptian medical papyruses, information has been gained about a plant from which cordage could be made, and it was probably cannabis which was referred to. But no records could be found on its narcotic action. The preparations made from it (in all probability from the cannabis shoots) were applied externally-namely, exclusively as antiseptics – and then perhaps even as analgetics, in the same way as in Hellenic medicine. Cannabis extracts have been employed for irrigation in diseases of the anus, and in form of compresses the drug has been applied to sore toenails. In Rhamses’ papyrus, washing sore eyes with extracts from cannabis and also from some other plant is recommended. The papyrus of Berlin recommends fumigation with cannabis in some undefined disease. Cannabis has been prescribed in feverish diseases of the bladder and, even at present, in homoeopathic medicine it ranks first when cystitis is treated. Furthermore, extracts combined with honey were injected into the body of the uterus to achieve constriction of the uterus and, externally, an ointment combined with fat was applied antiseptically in the same way as was done in medieval medicine up to the present time. Cannabis shoots were well known to Galen and to Dioscorid. Homer’s nepenthes – potion of oblivion – has been identified by some authors as a cannabis drug, but generally it is believed to be a preparation made from Hyoscyamus muticus – a plant familiar to the Egyptians. Both these authors make greater use of the seeds and of the oil extracted from them than of the cannabis shoots. It is the same in old popular and even in modem medicine. The seed pulp was a favourite dish, and from the seeds an edible, industrial and medicinal oil was obtained. In Czechoslovakia, a preparation from seed pulp was recently introduced by Sirek to act as a roborant diet in treatment of tuberculosis.

Comprises an extensive survey of reports by authors from the USSR. The botanical-historical and technical aspects of cannabis are not dealt with in this report.

But hemp seed does not form the subject matter of this paper; it is only treatment with cannabis shoots which is discussed, and only with regard to the healing of wounds, and not to the hashish effect.

The uses mentioned in the Egyptian papyruses point fundamentally to antiseptic use. Analogous uses were known, in varying degrees, to African natives and were recorded in medical herbals. There is no information on the narcotic action. It is of interest that in Egypt they are supposed to have learned of the hashish effect only during the Middle Ages, from the Arabs. This could be explained by the fact that the Arabs were the first to import the variety producing the physiologically active resin, for at present Cannabis indica Lam. is not considered to he a species but a variety of Cannabis sativa L. and not even a particular variety, Cannabis is a very variable and plastic plant of variable height and variously membered and formed leaves; there exists a monoecious variety, too. Any cannabis plant can produce hashish under favourable climatic conditions. Vice versa, according to Pulewka the Indian variety does not always produce the narcotic substance, not even in warm countries. Plants cultivated in 369 places in Anatolia did not produce hashish substances throughout; the occurrence was conditioned by the climate and the habitat. Likewise, the hashish effect has not been found present in Cannabis indica cultivated in north Moravia, though this variety grows exceedingly well. The stem attains a height of about 4 m, bears rich seeds, and the tops produce resins which have a very pronounced antibiotic and analgesic effect. It is possible, however, that there was no hashish-producing Variety grown in ancient Egypt, for the climate was, at that time, in all probability rather damp and subsequently much cooler than it is at present. This may be concluded from the fact that in antiquity in Italy and the Balkans snow was a more frequent phenomenon than it is nowadays, and north Africa was the granary of Rome, and not a desert.

All the information obtained from European folk medicine with regard to treatment with cannabis shows clearly that there do not appear to be any narcotic substances in it, or if there are then only in a negligible amount. Instead of that, emphasis has been laid on the antiseptic effect, hence on the antibiotic and to a small extent even on the analgetic effect, which has been upheld in official medicine up to the beginning of this century. In Austria, up to World War I, a salicylate collodion combined with Extractum Cannabis was prescribed for application to corns. Unna’s green salve, which was used as a remedy for lupus, contained: Acid salicyl., Liq. Stib. chlorati aa 2.0, Extr. Cannabis ind., Creosoti aa 4.0 , Adeps lanae 8.0. It may be noticed that the substances contained in cannabis have a powerful antibiotic effect upon Myc. tuberculosis, as will be discussed later. On the basis of the results obtained from our investigations, it is suggested that in many analogous cases it would be advantageous to return to cannabis preparations again.

The ancient herbals and those of the Middle Ages mentioned medical use of the seed, the roots (emoelients) and of the tops containing resinous substances. As previously stated, only the latter will be discussed here in detail. The leaves and the juice extracted from them or the macerated leaves were used as a vermifuge for horses, and fisherman soaked the ground with a liquid prepared from them to force up the dew-worms, which they used as bait. Tabernaemontanus and Kramerarius recommended kneading the dried leaves with butter and application of them in form of an ointment to burns. We have obtained positive results with extracts from cannabis in treatment of burns. Ruellius cit. advised the use of cannabis extract as ear-drops in the treatment of ear ache, and also for treatment of wounds and ulcers. Women stooping due to a disease of the uterus were said to stand up straight again after having inhaled the smoke of burning cannabis. In cystitis and in urinary diseases, a decoction of hemp shoots with wine and water was recommended; the steam was allowed to rise as hot as could be endured against the perineum, after which the patient was advised to urinate. This use has more to do with the analgetic than the antiseptic effect. As previously mentioned, homoeopaths value highly both the teep cannabis D 2 – 0.25 g (teep is the fresh drug ground with lactose) and the tinctura Cannabis indicae D 3 up to D 4 which are employed in cases of cycstitis and of urethritis. The homoeopathic utilization of cannabis is fundamentally based on its effect on the central nervous system – i.e., in migraine as discussed in Schoeler’s Kompendium and by Auster & Schaefer. The homoeopaths do not otherwise utilize the antiseptic effect when they employ it internally; it is only the centrally sedative action they make use of in the same way as the allopathists did formerly – i.e., in gastralgias and the like. In these cases of internal application the antiseptic effect is, however, doubtful save in the case when the intestinal flora is concerned.

So far the cannabis preparations – hashish preparations – have been frequently investigated therapeutically, particularly in neurology and in psychiatry, but they were abandoned because the results achieved were not uniform. Nevertheless it would be advantageous to utilize the analgetically sedative effect without the narcotic action of the hashish. Burroughs Wellcome & Co. manufacture a special product: Cannabine Tannate – cannabis combined with tan, Hydrastis canadensis and Secale cornutum – which has a sedative effect in metrorrhagias and in dysmenorrhagias. From earlier times, otorhinolaryngologists have preserved a prescription against tinnitus aurium: ZnO, Extr. Valerianae, Extr. Hyoscyami, Extr. Cannabis aa 1.6 M.f. pill No. 60, D.S. 3-5 pills daily per os. Finally, some years ago, in the American Journal of Pharmacy, vol. II (cit. Dinand), the following treatment was recommended in migraine: before meals take for a fortnight conscientiously and daily 0.015 g Extr. Cannabis indicae, the third week 0.02 g, the fourth week 0.03 g, to be continued for some months. In all these cases it is the action on the central nervous system which makes its influence felt. Of rather particular interest is the frequent combination of cannabis with tan both for internal and external application. We have obtained very good results in stomatitis aphtosa, gingivitis, and in paradentoses with a mouth wash of the following composition: Tinct. Cannabis 20.0, Tinct. Salviae, Tinct. Chamomillae, Tinct. Gemmarum populi (or another tan – for example, Tinct. Gallarum) aa 10.0, to be applied in the form of sprays or liniments to the inside of the mouth. The use of cannabis as an analgetic but not as an antibiotic in stomatology has been also briefly mentioned by Hegi.

In folk medicine particular use is made of the seed. But we also come across the utilization of the shoots for antibiotic and repellent purposes. Around cabbage plants, cannabis plants are grown to repel pieris (caterpillars), and twigs of cannabis are hung in bedrooms to repel gnats and flies.

During the Middle Ages cannabis decoctions were given to cattle for diarrhoea. In Argentina cannabis is considered a real panacea for tetanus, melancholia, colic, gastralgia, swelling of the liver, gonorrhoea, sterility, impotency, abortion, tuberculosis of the lungs and asthma. In Argentina even the root-bark has been collected in spring, and employed as a febrifuge, tonic, for treatment of dysentery and gastralgia, either pulverized or in form of decoctions. The root when ground and applied to burns is said to relieve pain. Oil from the seeds has been frequently used even in treatment of cancer; we have also come across this application in European folk medicine. Also in Argentina, in folk medicine, hemp shoots extracted with butter (Extr. Cannabis ind. pingue) are supposed to have a powerful hashish effect, it is believed already, in an amount of 0.1 g; it is employed as a remedy in the Basedow disease. The ethereal extract is less active, and in Argentina it is administered for headache, neuralgia, gout, rheumatism, chorea, melancholia, hysteria, delirium, gastralgia and anorexia. The aqueous macerated product has no narcotic effect at all, and is employed for treatment of tuberculosis of the lungs and as a hypnotic for children and to relieve spastic constipation. An infusion of the leaves is considered to possess a diuretic and a diaphoretic effect. In Europe we also come across many of these uses. Thus Graemer (cit. Dinand) recommends the following for treatment of gastralgia: 0.75 g Extr. Cannabis ind., 10 g ether; 10 drops daily on sugar. For rheumatism a decoction of leaves (15-20 g/0.5 1) is taken internally, and externally poultices prepared of seeds and packings of shreds or tow are used. In Brazil hemp is considered to be a sedative, hypnotic and antiasthmatic remedy. A pronounced antibiotic effect has been observed in South America, where fresh leaves after being ground are used as a poultice for furuncles, and in folk medicine in Europe for treatment of erysipelas (Dinand). Even seed pulp is applied in such cases, but as there are no antibiotics in the seeds we must assume that there is another therapeutic factor involved. In the popular treatment of headache, the plant is preserved in vinegar together with juniper, and the extract is used in form of compresses. Githens and also Watt & Breyer-Brandwijk report on the utilization of cannabis (dagga) in South Africa. There it is smoked because of its narcotic action, but it is also used medicinally. Next to the effect upon the central nervous system we find a considerable use as an antibiotic. For example, the Xosa tribe employs it for treatment of inflammation of the feet. In Southern Rhodesia it is a remedy for anthrax, sepsis, dysentery, malaria and for tropical quinine-malarial haemoglobinuria. The Suto tribe fumigates the parturient woman to relieve pain. These analgetic, sedative and antibiotic properties of cannabis in internal and external application are well known to African tribes.

It may be concluded that ancient and folk medicine have utilized cannabis as an antibiotic and analgesic externally and later as a sedative internally. Narcotic effect has been observed in hot climates only.