Chapter one The Long and Winding Road Marijuana, which is derived from the Cannabis sativa plant, has had a very long, convoluted, and controversial history. In fact, the term marijuana wasn''t even used until the early twentieth century. Before the mid-eighteenth century, the plant was referred to as hemp (or Indian hemp) in English, and by a variety of names across the globe. The ancient Greeks referred to it as kannabis, which means canvas, because the plant was primarily used to make cloth. But it wasn''t called "cannabis" in English until 1753-when it was officially christened Cannabis sativa by the Swedish botanist Carl Linnaeus. Depending on what part of the plant was used, it was either turned into industrial fiber or consumed for medicinal or other, more controversial purposes. In fact, since ancient times, cannabis has been either revered as a sacred shrub, promoted as a panacea, or damned as the devil''s weed. In just the past one hundred years, marijuana has gone from being a common household cure, to being denounced as a dangerous drug, and finally to being declared illegal.
But now it''s being resurrected as a wonder weed and, once again, making its way into mainstream medicine. Just how this happened is worth exploring. The past not only can inform us about the potential benefits of medical marijuana, but it also can and should inform medical research. As cannabis researcher and historian Dr. Simona Pisanti explains, "It is surprising that most of the pharmacological properties of Cannabis that only now are being studied were indeed already known and used in medicine for the treatment of numerous pathologies in ancient times." The Ancient Eastern World Medical marijuana''s long journey started in ancient China, where archaeologists have dug up evidence that hemp was used for fiber, food, rituals, and medicine as far back as 4000 BC. Around 2700 BC, Emperor Shen-Nung described the medical benefits of hemp, called "ma," which were later recorded in the Shen Nung Ben Ts''ao (The Divine Farmer''s Classic of Materia Medica), the world''s oldest pharmacopeia. Ma was recommended for rheumatism, constipation, malaria, absentmindedness, and "female problems," and was used in childbirth for retained placentas and postpartum bleeding.
Not surprisingly, ma had its ups and downs; if used in excess, "ma-fen" (the fruit of hemp) could "produce visions of devils [and on the plus side] over a long term, it makes one communicate with spirits and lightens one''s body . ," Its long-term use was also said to make people fat, strong, and "never senile." What we now refer to as cannabis spread from China to other parts of the world through trading, migration, and military conquests. It arrived in India around 2000 BC, and by 1000 BC, it was considered to be a sacred plant used in religious rituals. "Bhang," as it was called in India, was said to cause happiness, joy, feelings of freedom, and relief from anxiety. It was also used medically as a painkiller, diuretic, anticonvulsive, anti-phlegmatic, appetite stimulant, and aphrodisiac, among other remedies. Ancient Middle Eastern and Western Countries Since the time of the pharaohs (ca. 3100 BC), cannabis was used in Egypt for a variety of conditions.
The first written evidence, which was found in the Ramesseum Papyrus (ca. 1700 BC), described it as a treatment for eye diseases, while the Ebers Papyrus (ca. 1550 BC) mentioned that it was used to induce childbirth contractions, treat infected fingers and toes, reduce fevers, and heal urinary and rectal problems. It was administered in a variety of ways: inhaled, taken orally, applied topically, and inserted rectally and vaginally, all delivery methods still used today. (See Chapter 3.) In Israel, archaeologists recently found residues of cannabis that contained THC in an ancient eighth-century BC temple. This is claimed as the first evidence that ancient Israelis used the drug for religious rituals. In the sixth century BC, cannabis, which was called "kaneh bosem," was mentioned in the Torah as part of the ritual offerings that Moses gave to God.
Almost one thousand years later, in AD 350, kaneh bosem (aka kaneh bosm) was referred to in the Talmud as an intoxicating incense that was burned during religious services. After taking root in India and Egypt, cannabis spread to Rome, Greece, and other parts of the ancient world. Around 450 BC, the ancient Greek historian Herodotus described in his book, The Histories, how the Scythians of Central Asia would inhale smoke from hempseeds during funerals and "howl in joy." But no mention was made of its medicinal use. Several centuries later, however, the Roman naturalist and historian Pliny the Elder (AD 23-79) wrote about its risks and benefits in his thirty-eight-volume book, Natural History (the world''s first encyclopedia): Hempseed, it is said, renders men impotent: the juice of this seed will extract worms from the ears, or any insect which may have entered them. A decoction of the root in water, relaxes contractions of the joints, and cures gout and similar maladies. About a century later, the Roman physician Galen wrote that cannabis juice helped relieve earaches, and hempseed cakes could cause hilarity, relaxation, and euphoria. But he also warned that hempseeds were difficult to digest and could hurt both the stomach and head.
In the twelfth century AD, Maimonides-the Jewish philosopher and physician to the Egyptian royal court-mentioned that hemp seeds and oil were used medicinally, but he didn''t provide any details. This may be because by the twelfth century, cannabis had been banned in Jewish and Muslim societies. The Middle Ages in Europe In medieval times in Western Europe, hemp was extensively used to make textiles and other products, but not necessarily for medical purposes. It was, however, a popular folk medicine in Eastern Europe, where it was used to treat toothaches, aid in childbirth, reduce fevers, relieve joint pain, and even prevent convulsions. An eleventh-century German, Hildegard von Bingen-a nun, herbalist, mystic, composer, and writer-was one of the first Europeans to write about hemp''s medical benefits. A true Renaissance woman before the Renaissance, she was also the first woman to write a medical book, Physica (translated as The Book of Medicinal Simples). She wrote that hemp could help the stomach, wipe out mucus, and relieve pain-especially head pain. As she rather cryptically observed: Whoever has an empty brain and head pains may eat it and the head pains will be reduced.
Though he who is healthy and full of brains shall not be harmed by it. He who has an empty brain shall be caused pain by indulging in hemp. The medical benefits of hemp became more widely known and accepted in the seventeenth century, when prominent herbalists, botanists, and scholars started writing about its use as a cure for a long list of conditions. In England, in 1640, the royal botanist, John Parkinson, described how cannabis seeds were used to treat intestinal and gallbladder diseases, and how concentrated hemp roots could reduce inflammation and swelling, as well as relieve pain from burns, tumors, gout, and other joint problems. The famous seventeenth-century herbalist and physician-scientist Nicholas Culpeper wrote in his book, Complete Herbal, "The seed of hemp consumes wind, and by too much use . dries up the natural seed of procreation . ," which may or may not have been considered a benefit. Cannabis wasn''t just believed to be useful for physical disorders; the Oxford scholar Robert Burton suggested in his popular book, The Anatomy of Melancholy (1691), that cannabis might be helpful for treating depression.
About 150 years later, Jacques-Joseph Moreau, a French psychiatrist who is considered the father of modern psychopharmacology, was also interested in the psychoactive effects of cannabis. In the 1840s, he experimented with hashish on himself and his students. Moreau later used it to treat his psychiatric patients and found that it not only helped calm them down, but it also improved their sleep, increased their appetites, and relieved their headaches. While hashish was all the rage for recreational use, cannabis wasn''t very popular for medicinal purposes in Europe at the time. Its big breakthrough came as a result of the careful observations and experimentations of William O''Shaughnessy, a British physician and an army surgeon in India in the 1830s. He was impressed by how the Indians successfully used cannabis as a cure for a number of conditions, which he meticulously documented. He then conducted research studies, first on animals and then on patients-the very first cannabis clinical trials in history. O''Shaughnessy found the drug to be both safe and effective: the gold-standard outcome for clinical trials.
He reported that hemp extracts and tinctures resulted in the "alleviation of pain in most-remarkable increase of appetite in all-unequivocal aphrodisia, and great mental cheerfulness," in all his subjects. And because the drug didn''t produce "headache or sickness of stomach," he concluded that "no hesitation could be felt as to the perfect safety of giving the resin of hemp." When O''Shaughnessy returned to England, he brought a large supply of cannabis with him, and produced and distributed a tincture of hemp, called "Squire''s Extract," to other physicians throughout Great Britain. This helped pave the way for the acceptance of cannabis into mainstream medical practice. Based on O''Shaughnessy''s research and writing, hemp extracts became widely used during the Victorian e.