In this article the authors look at ways in which Native North American peoples used medicinal plants, some of which can still be found in today’s pharmacopoeias
Traditional thinking is that the central figure in early Native North American indigenous culture was the medicine man — the shaman of ethnology. However this term can include a wide range of activity, including priest, sorcerer, quack, and even physician. More strictly, the shaman was the forerunner of the priest; that of the physician was the lay healer, often a woman. This distinction between priest and healer was strongly marked in certain Native North American tribes. Thus the Ojibways had four classes of shaman. Highest in rank were the priests; then the "dawn men"who practised a type of medical magic; third were the seers and prophets; and finally the herbalists, who were the true medicine men in the sense of being healers. In other tribes, some or all of these were combined in one person — a forerunner of today’s holistic treatment which aims at healing body, mind and soul at the same time.
When the European colonies were established in North America in the 17th century, the knowledge and practice of medicine by the Native North Americans were not greatly different from those of their European counterparts. In both cases, the treatment of externally caused injuries was rational and (in the absence of infection) often effective. This category included fractures, dislocations, wounds, snake and insect bites, and so on. However neither culture was able to treat most types of persistent internal disease where the cause was not apparent.
As the European nations spread across North America, they tried to eradicate Native North American culture as part of their programme of subduing the tribes. The primary barrier to this was the shaman, both as priest and as tribal leader. He or she was seen as antagonistic to foreign ideas and cultures and was opposed by Christian missionaries and by politicians alike. Yet despite this, Native North American medicine strongly influenced therapeutics among the early colonists.
Colonial medical practitioners, particularly in frontier regions, were not always physicians. They were often poorly trained (especially those educated in the colonies) and poorly equipped. As they pushed further into the interior, supplies of European medicines became unavailable because of the problems of distribution and so they had to resort to indigenous herbs. Moreover the practitioners were few in number — and even today there are complaints of inadequate physician and hospital cover in many rural areas of the United States.
Where there were no colonial medical practitioners — or where their prescribed treatments had failed — the colonists turned to the Native North American herbalists (the "medicine men"or "medicine women"). Just as in Europe, some of their treatments were ineffective — but there were others which worked. They had been discovered by sympathetic association, by casual observation, and by trial and error. But of course there were rarely any means of standardising decoctions and similar preparations, and often the particular batch had to be titrated against the patient’s response.
Nevertheless the Native North Americans developed an important range of remedies. The tribes in the present US and Canada used about 170 preparations which have been, or are, official in various editions of the United States Pharmacopeia or of the National Formulary. Moreover the use of 25 per cent of plants in the current British Herbal Pharmacopoeia (over 50 species) originated in North America, even though they are now grown and used in Europe.
One of the most important sources in early medicine was Indian pinkroot (Spigelia marilandica), a Cherokee vermifuge, which was formally recognised in 1752 and was included in the London, Dublin and Edinburgh pharmacopoeias.
However, sassafras bark (from Sassafras officinalis) was as commercially important as tobacco in the early 17th century. Sassafras extract was used as a febrifuge, carminative and flavouring ("root beer"is still a widely distributed soft drink in the US) and sassafras oil was used as a topical analgesic in the treatment of rheumatism and of gout.
At one time, the bark of wild cherry (Prunus virginiana and P serotina) was second only to sassafras in home medication. The bark was applied directly in poultices and, as an infusion, was given in the treatment of colds, coughs, fever and cramps; it was also used as an astringent.
Tobacco (Nicotiana tabacum) was official in earlier editions of the USP as a narcotic, sedative, diaphoretic and emetic. As a dust or as an infusion, it has been used as an insecticide on crops. Today, of course, it is primarily cultivated for smoking.
Cotton (Gossypium spp) is native to most subtropical countries. Spanish explorers in the mid 16th century found the North American species (G hirsutum) being cultivated in what is now western New Mexico by the Zuñi tribes; it is still the most important species commercially. Like tobacco, it also is grown mostly for non-medicinal purposes. The fibre is still used for dressings and a decoction of the roots was used as an emmenagogue and as an oxytocic.
Indian (or American) hemp (Apocynum cannabinum), indigenous to North America, is not to be confused with Indian hemp of India (Cannabis indica). The fibre of American hemp was used for making ropes, bags, quilts, etc, and the root was used as a cathartic and a diuretic.
Cascara (Cascara sagrada) is said to be the most widely used (natural) cathartic on earth. Anecdotally an unknown Spanish priest found the Native North Americans using it and was so impressed by its mildness and efficacy that he coined the botanical name (in Spanish) of "holy bark".
Slippery elm (Ulmus fulva) is still used as a demulcent and emollient. Native North Americans used it also for the treatment of colds, coughs and dysentery. The bark was used during 18th century military campaigns as a poultice in the treatment of gunshot wounds.
The name "snakeroot"is applied to a wide range of plants, some supposedly effective against snakebite, though the concurrent application of a ligature and the sucking out of the poison may have been major contributing factors. Seneca snakeroot (Polygala senega) was perhaps the most popular. It became an official preparation as an expectorant and cough remedy, a (cardiac) stimulant, irritant, emetic and diuretic.
Ginseng (Panax quinquefolia) developed a reputation — perhaps unjustifiably — as a panacea, particularly in the mid 18th century, and large quantities were shipped to China. Non-medicinally, it was used as a hygroscopic agent during the 1939-45 war to control the humidity of cigarettes.
Golden seal (Hydrastis canadensis) was used in the treatment of sore eyes, sore mouths, and as an escharotic. The root and official preparations of its derivatives, hydrastine and hydrastinine, were formerly in the British Pharmaceutical Codex and were used to stimulate involuntary muscle and to arrest uterine haemorrhage.
Poison ivy (and poison oak and poison sumac) cause intense itching of the skin when the leaves are touched, and scratching transfers the itching to other areas of the body. A fluid extract of grindelia (Grindelia robusta) was used to soothe the itching.
Bloodroot (Sanguinaria canadensis) was official (as the rhizome) in the United States Pharmacopeia from 1820 to 1926 and in the National Formulary from 1926 to 1965. It was used in medicine as a stimulating expectorant and emetic, and in early studies was compared favourably with ipecacuanha.
Most Native North Americans practised some isolation of communicable disease, generally by taking the patient to a place well away from the tribe.
On occasion, during an epidemic, the healthy members might remove themselves to a distance. Braves wounded in battle were usually isolated from the tribe until they were healed.
The sweat bath, or vapour bath, was widely used. It was similar to a Finnish sauna, initially with prolonged exposure to dry heat, followed perhaps with water dashed on to the heated stones. It was reportedly used for general hygiene (eg, the Hudson River Native North Americans), for the relief of pains in the joints (the Saponas) or with the addition of healing herbs (the Choctaws). The physical cleansing in the sweat lodge was often accompanied by religious rites as part of the holistic healing regime.
Early observers commented favourably on the high standards of personal hygiene of the tribes and the cleanliness of their villages.
While many of these Native North American remedies were being accepted as ethical medicines (in today’s meaning of the term), the patent medicine business was also springing up. The first North American patent medicine (1711) was Tuscorara Rice, named for an Iroquois tribe and sold as a cure for tuberculosis. This was followed by a flood of patent medicines, many with the word "Indian"in the name to suggest an aboriginal origin, even though the ingredients may have come from abroad. Many oral preparations were high in alcohol, giving an immediate sense of well-being.
The antecedents of today’s soap operas were the medicine shows. Native North Americans were hired to tour with a mini-circus, performing war dances, and giving exhibitions of riding and other displays. These brought in the crowds and the performance was accompanied by its "commercials"— the hard-sell of so-called "genuine native remedies", claiming to cure almost anything. These shows flourished particularly between the Civil War and 1914-18 world war (say, 1856-1917) but a very few survived the 1939-45 world war.
When the myth and mystery are stripped away, there was a sound basis of herbal medicine among the Native North American tribes, equivalent to that brought to North America by the colonists. As the colonists moved further out from the coastal settlements, they were less able to obtain medical support and supplies and came increasingly to rely on Native North American healers and their remedies. Those remedies that met the criteria of the time were then incorporated into the official compendia, just as in Europe, until superseded by synthetic preparations which could be better standardised in terms of purity and efficacy. Nevertheless, some of the original remedies are still in use today.
John Gwilt spent 41 years in the international pharmaceutical industry; Peter Gwilt is associate professor, pharmaceutical sciences, at the college of pharmacy, University of Nebraska Medical Center, Omaha 68198, US