Efraim Lev

Ethnopharmacological survey of traditional drugs sold in the Kingdom of Jordan

The results of a survey of present-day traditional medicinal materials conducted in 1998-1999 in the Kingdom of Jordan are reported. The study covered selected markets of medicinal substances of ethnic communities throughout the kingdom, and also included questioning of the sellers about the healing characteristics of the various materials. The survey yielded information on many and varied medicinal substances, of which 304 are identified according to the following classifications: 236 species of plants (77.6%); 30 species of animals (9.8%); 29 kinds of inorganic substances (9.6%); and 9 materials of other or mixed origin (3%). Analysis of the data showed that some substances were of local origin (41.8%), but the majority of the substances (45.4%) were imported from other countries. 12.8% of the substances were both local and imported. These data demonstrate that there is still a flourishing and well-developed trade in these materials--a trade that is the remnant of a rich and ancient medical culture, which is disappearing from the modern world.

Traditional healing with animals (zootherapy): medieval to present-day Levantine practice

Animals and products derived from different organs of their bodies have constituted part of the inventory of medicinal substances used in various cultures since ancient times. This article reviews the history of healing with animals in the Levant (the Land of Israel and parts of present-day Syria, Lebanon, and Jordan, defined by the Muslims in the Middle Ages as Bilad al-Sham) throughout history. Intensive research into the phenomenon of zootherapy in the Levant from early medieval to present-day traditional medicine yielded 99 substances of animal origin which were used medicinally during that long period. Fifty-two animal extracts and products were documented as being used from the early Muslim period (10th century) to the late Ottoman period (19th century). Seventy-seven were recorded as being used in the 20th century. Seven main animal sources have been exploited for medical uses throughout history: honey, wax, adder, beaver testicles, musk oil, coral, and ambergris. The first three are local and relatively easy to obtain; the last four are exotic, therefore, rare and expensive. The use of other materials of animal origin came to an end in the course of history because of change in the moral outlook of modern societies. Among the latter we note mummy, silkworm, stinkbug, scarabees, snail, scorpion, and triton.

Ethnopharmacological survey of traditional drugs sold in Israel at the end of the 20th century.

This report deals with the results of a study of present day uses of traditional medicinal materials in Israel. The survey covered selected markets in medicinal materials, belonging to various religious and ethnic communities, and also included questioning of the sellers and buyers about the healing characteristics of the various materials. The survey yielded information on many and varied medicinal materials, of which 310 are identified according to the following classifications, 264 species of plants (85.1%); 20 species of animals (6.5%); 19 kinds of minerals (6.5%); and seven materials of other or mixed origin (2.3%). Analysis of the data showed that a significant proportion of the materials were of local origin (51.5%) and some were imported from other countries. These data demonstrate that there is still a flourishing and well developed trade in these materials - a trade which is the remnant of a rich and ancient medical culture, which is disappearing from the modern world.

Reconstructed materia medica of the Medieval and Ottoman al-Sham.

This article presents the results of a study of the medicinal uses of natural substances in medieval and Ottoman al-Sham (the Levant). It involved a meticulous survey of a wide range of historical sources spanning approximately 1100 years and including medical and pharmacological literature, travelogues, geographical and agricultural literature, dictionaries, archives, the Genizah and other medieval sources. Our main goal was to arrive at a reconstruction of the unwritten materia medica of the medieval and Ottoman Levant. Of the many and varied medicinal substances on which we were able to extract information, we were able to identify 286. These are presented according to the following classification: 234 species of plants (81.8%); 27 species of animals (9.5%); 15 kinds of minerals (5.2%) and 10 substances of other or mixed origin (3.5%). Analysis of the data showed that the region under study served as the geographic origin of the majority of the substances, only a minority of the materials was imported. The main reason for this is the geographic location of the Levant as a junction between three continents, as a cultural meeting point and as trade center. Finally, our data revealed that the al-Sham region was an independent source of production and marketing of medicinal substances during the medieval and Ottoman periods.

Healing with animals in the Levant from the 10th to the 18th century.

Animals and products derived from different organs of their bodies have constituted part of the inventory of medicinal substances used in various cultures since ancient times. The article reviews the history of healing with animals in the Levant (The Land of Israel and parts of present-day Syria, Lebanon, and Jordan, defined by the Muslims in the Middle Ages as Bilad al-Sham) in the medieval and early Ottoman periods.Intensive research into the phenomenon of zootherapy in the medieval and early Ottoman Levant has yielded forty-eight substances of animal origin that were used medicinally. The vast majority of these substances were local and relatively easy to obtain. Most of the substances were domestic (honey, wax, silkworm, etc.), others were part of the local wildlife (adder, cuttle fish, flycatcher, firefly, frog, triton, scorpion, etc.), part of the usual medieval household (milk, egg, cheese, lamb, etc.), or parasites (louse, mouse, stinkbug, etc.). Fewer substances were not local but exotic, and therefore rare and expensive (beaver testicles, musk oil, coral, ambergris, etc.).The range of symptoms that the substances of animal origin were used to treat was extensive and included most of the known diseases and maladies of that era: mainly hemorrhoids, burns, impotence, wounds, and skin, eye, and stomach diseases.Changes in the moral outlook of modern societies caused the use of several substances of animal origin to cease in the course of history. These include mummy, silkworm, stinkbug, scarabees, snail, scorpion, and triton.

Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care

IntroductionComplementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East.Methods and resultsA multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author’s affiliation with an academic or clinical institution in the Middle East.ResultsWe identified 143 articles on CAM and cancer care that had been published in12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor–patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind–body medicine, shiatsu, therapeutic touch, and yoga.ConclusionsCAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.

Integrative oncology in the Middle East: from traditional herbal knowledge to contemporary cancer care

BACKGROUND Based on traditional, historical, ethnobotanical, laboratory, and clinical findings, we present research framework aiming to identify Middle Eastern herbs that are worthy of further research for their anticancer potential. METHODS A comprehensive research project was developed by a multinational team comprising family physicians, medicine specialists, oncologists, an Islamic medicine history specialist, a traditional medicine ethnobotanist, and a basic research scientist. The project followed two consecutive phases: (i) historical and ethnobotanical search for cancer-related keywords and (ii) Medline search for in vitro and in vivo studies. RESULTS This search yielded 44 herbs associated with cancer care. The Medline search yielded 34 herbs of which 9 herbs were reported in various clinical studies. CONCLUSIONS This multidisciplinary survey was found to be a valuable way to identify herbs with potential clinical significance in cancer care. Based on this pilot study, it is suggested that the Middle East can serve as a valuable region for future multicultural-oriented cancer research.BACKGROUND Based on traditional, historical, ethnobotanical, laboratory, and clinical findings, we present research framework aiming to identify Middle Eastern herbs that are worthy of further research for their anticancer potential. METHODS A comprehensive research project was developed by a multinational team comprising family physicians, medicine specialists, oncologists, an Islamic medicine history specialist, a traditional medicine ethnobotanist, and a basic research scientist. The project followed two consecutive phases: (i) historical and ethnobotanical search for cancer-related keywords and (ii) Medline search for in vitro and in vivo studies. RESULTS This search yielded 44 herbs associated with cancer care. The Medline search yielded 34 herbs of which 9 herbs were reported in various clinical studies. CONCLUSIONS This multidisciplinary survey was found to be a valuable way to identify herbs with potential clinical significance in cancer care. Based on this pilot study, it is suggested that the Middle East can serve as a valuable region for future multicultural-oriented cancer research.

“Fossils” of practical medical knowledge from medieval Cairo

AIM OF THE STUDY To asses the scientific value of the practical medical fragments found in the Cairo Genizah (10th century), as a useful source for ethnopharmacological purposes (in exposing rare and usually inaccessible original medieval practical knowledge of medicinal substances to present-day researchers), and to reconstruct the practical drugs and their uses. MATERIALS AND METHODS A methodology distinguishing between theoretical (about 1500 fragments) and practical medical knowledge (about 230 fragments) was created and used. The information regarding the practical medicinal substances was extracted from prescriptions (140), lists of drugs (70) and few letters of physicians. RESULTS The reconstructed lists of practical (278) and theoretical (414) drugs allow us to recognize and quantify the gap between them in medieval times (136). CONCLUSIONS We propose that the data obtained from ancient prescriptions is comparable to ethnopharmacological surveys. The finding of plants such as myrobalan, saffron, licorice, spikenard and lentisk, all of which have scientifically proven anti-microbial/bacterial and anti-fungal activity, sheds a helpful light on the medical decision-making of the medieval practitioners in respect of the plants they applied as drugs. With the wealth of information meticulously assembled from these time capsules we expect to make a significant contribution to contemporary efforts at locating modern drugs in ancient roots and gauging their feasibility.

The doctrine of signatures in present-day Israel

Some evidence of the existence of an ancient pharmacological theory—the Doctrine of Signatures—has been found in the folk medicine of Israel. The research reported 14 plants with folk medicinal uses based on the Doctrine of Signatures categories including: similarity of the plant or plant organ to the damaged human organ (Alhagi maurorum, camel thorn;Astragalus macrocarpus, milk-vetch; andCynoglossum creticum, blue hound’s tongue), similarity to animal shape or behavior (Heliotropium europaeum, European turnsole;Asteriscus spinosus, starwort; andBriza maxima, large quaking grass), similarity of plant color to the color of the disease’s symptoms or the medical phenomena (Rhamnus alaternus, Italian buckthorn;Citrullus colocynthis, bitter gourd; andEcballium elaterium, squirting cucumber), and similarity of plant habitat or characteristic to human features (Parietaria judaica, wall pellitory; andRuta chalepensis, African rue).

Use of Natural Substances in the Treatment of Renal Stones and Other Urinary Disorders in the Medieval Levant

Urinary disorders were common in the ancient world, especially in the Mediterranean region. In semi-arid zones and countries with unreliable water sources, renal stones and other urinary problems occur with greater frequency. A lack of water and correspondingly high levels of calcium saturation are among the main reasons for the formation of calcium sediments in the urinary tract, and it is hardly surprising, therefore, that many generations of physicians and healers have been called upon to treat these disorders, or at least alleviate the pain associated with them. Down the ages, many natural substances have been used for this purpose. This article focuses on 62 plants, 9 animal-based remedies, 1 mineral preparation and 4 medicinal substances of different or uncertain origin, traced in a recent survey of relevant historical literature (both medical and non-medical). Many of these materials, used to treat urinary disorders in the Levant between the 8th and the 18th centuries, had already been in use since the classical period, and several are still used today in traditional medicine.