Pharmaceutical Journal Vol 263 No 7065 p537-538
October 2, 1999 The Conference

History of pharmacy session

'Primitive physic' and an ancient plant

The history of pharmacy session on September 15 heard presentations from Dr John Cule (University of Wales College of Medicine), who talked about John Wesley's book 'Primative physic', and Dr William Court, who described the medical history of

Dr John Cule (University of Wales College of Medicine) told the Conference that 'Primitive physic' was the title of a famous book by the founder of Methodism, John Wesley, who had described it as "an easy and natural method of curing most diseases". Dr Cule said that this remarkable work was a "home doctor" type of book, first published in 1747. It had run to at least 38 editions in England and 24 in America by 1880. Nine editions in Welsh had also been published. It was still in print. With a life that spanned most of the 18th century, John Wesley was born in 1703 and died in 1791. He had not been a medical doctor, although he had shown some interest in medicine during his time as an undergraduate at Oxford, but had been a firm advocate of the need for "good works", so it was not surprising that he had been able to find a medium for this in medical practice. "I had made anatomy and physic the diversions of my leisure hours," Wesley had written, "though I never properly studied them, unless for a few months when I was going to America, where I imagined I might be of service to those who had no regular physician among them."

'Primitive Physic' advocated a return to sound, old authority in place of new theories

Referring to the Welsh element, Dr Cule mentioned that Wesley had had a follower in John Jones, a doctor of medicine from Llandysul who had studied at Oxford. Jones had wished to become a Wesleyan Methodist minister, but owing to his earlier following of the Welsh revivalist Howell Harris, he had been found unacceptable for ordination by the Anglican church. With characteristic determination, Wesley had arranged for him to be ordained by the Bishop of Smyrna, who happened to be passing through London.
"I feel sure," said Dr Cule, "that John Jones was the inspiration for Wesley's medical interests in the dispensaries that he founded in London and Bristol, and for his work as a pioneer of electrotherapy."

Medical science is ephemeral

In Wesley's time the causes of disease had been imperfectly understood, if at all, but there had been a strong belief in "certain cures" and "tried remedies". Wesley had developed a reasoned view of which remedies were harmful, and was a thoughtful prescriber, feeling the need for treatment of the whole person.
"The only lesson of medical history I acknowledge," claimed Dr Cule, "is the ephemeral nature of the treatment inflicted on the suffering patient. Modern heroic treatments, such as chemotherapy and electroconvulsive therapy, have displaced the heroic radical and fearsome surgery of yesteryear: temporarily."
Wesley himself had claimed that men of learning had begun to set aside experience, to build physic on hypothesis, to form theories of diseases and their cure, and to submit these in the place of experiments. A firm believer in empiricism, Wesley had claimed that there was no more need for mystery in medicine than to appreciate the simple fact that "such a medicine removes such a pain". The best physician, in Wesley's view, was not the one who talked best or who wrote best, but the one who performed most cures.

Enlightened empiricism

In advocating primitive physic Wesley had intended a return to sound, old authority in place of new theories which sought to displace experience. He had believed that medicine had originally been traditional and based on experiment and experience, whereas the more that new theories had increased, the more simple medicines were disregarded and disused and eventually forgotten. He had also believed that the profit motive compounded the mystique of medicine, filling it with unintelligible terms and costly and dangerous ingredients.
In his book, Wesley had suggested a few plain, easy rules to health and simple medicines for many diseases. He had offered the work as a "home doctor" and had advised that in serious cases the patient should apply without delay to "a physician who fears God".
It had been his great contribution to the simplification of what he saw best and safest in current therapy and the avoidance of what he called the Herculean medicines, such as mercury compounds.
Dr Cule concluded by recalling Wesley's famous health advice by way of his best remembered adage: "I never wish to see a dirty Methodist. Cleanliness in next to godliness."

An insignificant plant

Dr William Court told the session that ginseng was the collective name of a group of plants esteemed by the Chinese for over 5,000 years but forgotten by the Western world until recent reinvestigations of the therapeutic activity of plants for the alleviation of ills arising from modern stressful lifestyles. The name was loosely applied to plants of the genus Panax of the family Araliaceae (the ivy family), although some wrongly named species were also encountered as "ginseng" in modern commerce.
Araliaceae was one of the most ancient plant families, said Dr Court, evolving some 65 to 100 million years ago in the Cretaceous period. Fossil evidence in Colorado and Alaska suggested that Panax species were of great antiquity and might be regarded as living fossils.
The true ginseng was Panax ginseng, a small and inconspicuous shade-loving perennial shrub cultivated in China and also growing in maritime areas in Siberia, Manchuria, Korea and Japan. The mature roots of the plant might be considered to have a vague resemblance to the human form.
Referring to the Yin and Yang theory, the speaker explained that it alleged that good health depended on the balance of the material Yin and the metaphysical Yang. The former, meaning standstill, included passive and dark aspects of life, including death, the moon and earth, night, darkness, damp, cold and feminine subjects. Yang, meaning motion, embraced active and light subjects including the sun, heaven, day, heat, dryness, creation and masculine subjects. In the way that light changed to darkness and winter changed to spring, so the changing balance of Yin and Yang controlled natural phenomena. In the body, excess of the cold Yin caused chills and colds while excess of hot Yang brought on fevers.

"Spirit of the earth"

In early Chinese medicine ginseng had been considered to be "spirit of the earth" or "man essence" — the elixir of the earth crystallised in human form which was responsible for its healing properties. Restoring the Yang could induce rejuvenation and retard the ageing process. During the T'ang dynasty (618-905) ginseng had been considered to be a royal plant and during the Sung dynasty (926-1126) the price of ginseng had been determined by its weight in silver. Its popularity and the over-usage of wild ginseng had resulted in a great shortage and decline in quality. Some 500 years later cultivation methods had been developed. In Chinese medicine ginseng had been, and still was in use in polypharmaceutical mixtures. No mention of it had appeared in Western medicine until about 1000, when a Moorish adventurer, Ibn Cordoba, had brought a cargo to Spain. Marco Polo had brought supplies to Europe in 1294 and Dutch traders had imported it in 1616. References to ginseng had appeared in Theophilus Redwood's ‘Gray's supplement to the pharmacopoeia' published in 1848, and in Hanbury and Fluckiger's textbook of 1879 as a possible adulterant of the North American drugs senega and rattlesnake root. In early 20th century Europe and America, ginseng had been sought only by scattered Chinese communities, but by 1970 it was appearing on pharmacy and supermarket shelves and in pharmacopoeias. By the end of the century sales had been considerable, exceeding $300m annually in the United States alone.

Ginseng: many more secrets to reveal (picture from the Museum of The Royal Pharmaceutical Society)

Of about nine species of Panax, four were important and had revealed around 100 glycosides. Tissue culture methods had enabled the production of ginseng compounds on a commercial scale. Ginseng offered tonic properties particularly useful for the sick and aged and had been used to improve memory and intellectual skills. It was slow acting with low toxicity and few side effects, which were readily reversible.
Despite the fact that more clinical research was necessary, this insignificant little plant still had many more secrets to reveal.

'Primitive physic'

Copies of the book 'Primitive physic' are obtainable as a hardback facsimile of the 1792 English edition (120pp on cream tinted paper) at £7.50 per copy from John Wesley's Chapel, 49 City Road, London EC1.

Correction
The price we quoted for the facsimile of the 1792 edition of John Wesley’s ‘Primitive physic’ should have included an extra £1.50 to cover postage and packaging (bringing the total payment to £9). Orders should be addressed to Wesley’s Chapel, 49 City Road, London EC1Y 1AU. Envelopes should be marked "for the attention of the museum" and cheques should be payable to "Wesley's Chapel".