Book review: The Old Vegetable Neurotics, Hemlock, Opium, Belladonna and Henbane (1869)

Book cover, "The Old Vegetable Neurotics"

It may seem odd to be reviewing a book which is over 150 years old, but let me explain the background to it.  For the last few years I have been trying to recreate the plant based anaesthetics used in ancient Greek and Roman times, medieval Europe, and more recently in World Wars 1 and 2, for a thought experiment: what would we do for anaesthetics if civilisation collapsed and global supply chains and the pharmaceutical industry no longer functioned?

Recipes for making these anaesthetics must have existed in times past, but it is difficult to find them today, either because they have disintegrated through passage of time, or they were never written down because the practitioners who used them were illiterate, or they are written in medieval English or Latin and are hard to understand.  

Opium poppies growing on Douglas Promenade, Isle of Man

I am hoping that an ongoing research project, Curious Cures in Cambridge Libraries may provide some answers.  This is a project to digitise, catalogue and conserve over 180 medieval manuscripts, and to transcribe more than 8,000 medical recipes which they contain.  It was launched almost two years ago, ran into delays due to staffing and computer problems, but hopes to start publishing its results sometime this summer.

In the meantime, I came across this book in the free downloadable Google Books project:

“The Old Vegetable Neurotics, Hemlock, Opium, Belladonna and Henbane: Their Physiological Action and Therapeutical Use Alone and in Combination, Being the Gulstonian Lectures of 1868, Extended and Including a Complete Examination of the Active Constituents of Opium” by John Harley M.D., an eminent but eccentric London physician in Victorian England.

Henbane, growing on my allotment

This book and its author are best appreciated if you understand their historical context.  Harley was born in 1833, soon after the end of the Napoleonic Wars and the start of the Industrial Revolution.  He received his medical qualification in 1858, the same year in which the first Medical Act was passed, marking the start of modern medical regulation in the UK.  Before that, medicine was practiced by an assortment of people including village midwives, “cunning folk”, apothecaries and monks.  Harley was also interested in botany and was a Fellow of the Linnean Society of London.

In his book, Harley tried to combine elements of modern medicine with the herbal preparations used in earlier times.  Instead of using oral or inhaled herbal preparations, as was the traditional practice, he extracted and purified the active ingredients from the plants by dissolving them in ether (which he spelt æther), alcohol or chloroform and injected them subcutaneously (under the skin).  He conducted numerous experiments on mice, dogs, horses, patients and himself, many of which probably wouldn’t pass the scrutiny of a modern Medical Ethics Committee.

Belladonna, growing on my allotment

In the course of his experiments Harley made several observations:

• The effect of these plants is dose related: what may be poisonous at high dose may be therapeutic at a lower dose

• The effect of the same plant may vary between species.  This has been observed in other contexts, for example chocolate, delicious to humans, is toxic to dogs, and the berries of belladonna (deadly nightshade), edible to birds, are toxic to humans

• The main effects of opium are drowsiness, pain relief, bradycardia (slow pulse), respiratory depression (in high dose), pupil contraction, constipation

• Hemlock, belladonna and henbane have similar effects including drowsiness, dizziness, muscle weakness (paralysis at high dose), pupil dilatation and blurring of vision, dry mouth, tachycardia (rapid pulse) and respiratory depression.  This is because all three plants contain the tropane alkaloids hyoscyamine, atropine, tropane and scopolamine in varying amounts.

• There may be some benefit in using a combination of drugs.  For example, they all cause drowsiness, so the same degree of drowsiness may be achieved using smaller quantities of each drug in combination, possibly resulting in fewer side effects.  Also, some side effects may cancel each other out; for example, opium causes a slow pulse and pupil constriction, whereas belladonna causes a rapid pulse and pupil dilatation, so giving them together may cause fewer side effects.

This is all useful to know, but Harley’s recipes wouldn’t be much use in the event of a (hypothetical) collapse of civilisation, relying as they do on chemical solvents (alcohol, ether and chloroform) and needles and syringes to perform the subcutaneous injections.  What I really need to know is: how did medieval and earlier practitioners use these plants in the absence of the above?  I’m hoping that the Curious Cures in Cambridge Libraries project may eventually provide some answers.

To be continued…

Slaynt vie, bea veayn, beeal fliugh as baase ayns Mannin