Herbs in History: Blueberry
By Alain Touwaide & Emanuela Appetiti | November 2022
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Illustration 1: Vaccinium myrtillus L.
Illustration 2: Vaccinium corymbosum L.
Blueberries, be they the so-called European or the Americano-Canadian species (Illustrations 1 and 2), along with blackberries, raspberries, cranberries, and mountain cranberries, Chinese lanterns, blackcurrants, or gooseberries have been on the rise over the past decades. Once found in the wild, they are now extensively cultivated to meet a constantly higher demand. And their health benefits are increasingly investigated, with numerous positive effects being discovered.
Harvesting information about berries in the historical documentation is a difficult task that perfectly illustrates the many fallacies of apparent evidence and the problem met by ancient herbalists in their effort to adapt the heritage of Classical Antiquity to their own environment and flora.
In the body of botanico-medical literature compiled in the Mediterranean World in Classical Antiquity, berries appear as early as the writings by the Hippocratic physicians, which go as far back as the last decades of the 5th century BCE. There, we find berries in the form of blackberries (Morus nigra L. or Rubus fruticosus L.) (Illustrations 3 and 4). Characteristically enough, all their uses appear only in gynecological treatises, to treat womb’s pathologies (metrorrhagia and hemorrhages, the latter including a case of stillbirth) and stop discharges, in addition to cases of womb prolapsus, dilated cervix (unrelated to pre-delivery conditions), and breast infections. Whereas in twelve out of twenty cases the Hippocratics did not specify the part of the plant they were using, in two they explicitly mentioned the fruit and in six the leaves. In three cases, the plant was mixed with several other drugs resulting in a compound medicine. In one such medicine, blackberry was amalgamated with buckthorn (Rhamnus spp.), olive tree leaves, the so-called hydromel (honey diluted with water), and flour. The second formula combined blackberry with olive tree leaves as the previous one, together with myrtle bays and lotus wood. In the third, blackberry was crushed with pieces of solidified resin, cinnamon, myrrh, rose leaves, saffron and styrax. We can hypothesize by default that blackberry was the only ingredient in all other cases. The forms in which blackberry was applied greatly varied, from a liquid (probably a decoction) to a powder, including a cataplasm. The ways of administration also were diverse, from uterine injection to fumigation and fomentation, to cataplasm, to powder.
Illustration 3: Morus nigra L.
Illustration 4: Rubus fruticosus L.
The rationale for all such uses appears in the 1st century BCE/CE, in no less than four works: the encyclopedias by the Roman Celsus and Pliny, the manual of materia medica by the Hellenized Dioscorides, and the treatise on gynecology by the Greek Soranos. Although all these works are very different from all viewpoints (context, literary genre, goal and scope, as well as function), they all agree: blackberry is an astringent agent. To this Celsus and Soranos added that it is cooling, and Dioscorides and Pliny added that is desiccative. Such unanimity in so different works reveals the state of knowledge about blackberry in the period of the 1st century BCE/CE among the medical professionals. The cooling and desiccative actions are specifications of astringency.
Going beyond such unanimity, we see a gradual transformation over time about the part to be used: whereas Celsus, in the 1st century BCE/CE, and Dioscorides in one mention in the 1st century CE still referred to the leaves as did the Hippocratics, Dioscorides, in another case, prescribed the stalk as did also his contemporary, the Latin Scribonius Largus, who mentioned only this part in all the uses of the plants he listed. Finally, in Pliny in the 1st century CE, we observe a greater diversification: the leaf, the fruit, and the root, about the latter of which Pliny specified that it is a more powerful astringent.
On the medical conditions for which treatment blackberry was used, we see a similar gradual diversification. In all mentions in Dioscorides, in one in Pliny, and in one in Soranos, blackberry was prescribed in gynecology, to treat an unspecified uterine condition in Pliny and discharges in both Dioscorides and Soranos. In another of Pliny’s passages and in Scribonius it is recommended to alleviate intestinal pain in addition to closing wounds (the latter only in Pliny). In one of Celsus’ passages, it is administered in a case of inflammation of the uvula, and in another of Pliny’s passages it is used to reduce condyloma. Despite their divergences and the diversity of the anatomico-physiological systems and pathological mechanisms they are referred to, all such indications can probably be accounted for by the astringency considered typical of the plant.
The Rise of Blueberry
With the division of the Roman Empire in the early 4th century, the foundation of Constantinople as the capital of the Eastern Roman Empire (Byzantium), and the deposition of the Roman Emperor in 476 CE, the unity of the Mediterranean world was fractured and each part had a different history, including in the field of medicine, materia medica, and therapeutics.
In the Eastern Roman Empire, physicians assimilated, adapted, and updated the legacy of classical antiquity, attesting to efforts probably aimed to optimize this legacy and maximize the use of natural resources. Regarding blackberry specifically, their efforts targeted both the parts to be used and the medical conditions the plant was expected to treat.
In the 4th century CE, the Greek Oribasius collected information provided by the previous works about materia medica. His treatment of blackberry is significant: whereas he credited it with astringent and drying properties as did the Ancients, he greatly diversified the parts to be collected: the leaves and the roots (one case for each) as in previous literature; the offshoots and the flower (one case, also, for each) in a new way of using the plant; and the fruit (two occurrences, one time with a ripe fruit and the other with it unripe). The plant is generally considered as astringent, and the unripe fruit as drying, in a way that reminds classical antiquity.
Two centuries later, Aetius, physician to the Byzantine Emperor Justinian in the 6th century, confirmed and accentuated the evolution already reflected by Oribasius’ encyclopedia. If he considered blackberry to be astringent and drying as did the ancient literature, he also estimated that it is strongly drying in a new way. Contrary to previous literature (Celsus and Soranos), he also stated that it is warming, though lightly. He used the roots, offshoots, leaves, and flowers (each once), as well as the fruit, ripe and unripe (each one case). The most revealing aspect is the extension of the use of blackberry to a great many applications: oral care (wounds and ulcers in the mouth) and nephrology (kidney stones), dysentery and vomiting, and hemoptysis (the latter without allowing us to know whether this might have been tuberculosis, for example). As often in the ancient medical literature all these applications are symptomatologic and not etiologic, and most can be accounted for by the astringence of the plant. A new indication appears: a tonic action, which is found also in the more original manual of Aetius’ contemporary Alexander of Tralles.
In the next centuries, the use of the leaf almost disappeared, whereas that of the fruit became the most important (in one case unripe and dry), with some presence of the root. Indications can all be explained by the astringency of the plant.
The West, as for it, went through a first phase of loss of information followed by a second phase of slow recovery from the time of Charlemagne on (late 8th/9th centuries) characterized by a first reappropriation of the classical literature. When studying blueberry, physicians had to cope with a difficult problem: since blueberry does not appear in the classical literature (as it is not typical of the Mediterranean environment), they did not find a word to designate it in the classical heritage. They did use an existing term, which they transferred from one plant genus to another in a creative way. This transfer was based on the external similarity of the fruit. They thus took the term myrtus, which designates Myrtus communis L. in the classical literature, to identify blueberry. However productive it was, this transfer sometimes generated confusion because of the overlapping of blueberry and myrtle.
After the medico-botanical manuals of Classical Antiquity became more easily available again in the West (even though, from the 11th century on, it was in the form of Latin translations of earlier Arabic versions), the Latin medical literature of the Late Middle Ages, when discussing blueberry, provided used the description and indications typical of myrtle in a confusion that was further transmitted to the Renaissance.
This amalgam is nowhere clearer than in the translation of, and commentary on, Dioscorides’ De materia medica by the famous Italian physician Pieto Andrea Mattioli (1501-1577). A great classicist erudite, Mattioli devoted his entire career to the study of Dioscorides’ work, even when he was physician to the Emperor of the Holy Roman Empire in Prague. From a simple translation into Italian as early as 1544, he rapidly shifted to a deep analysis of the work to assess the possibility to use it as a manual of materia medica in a different natural environment: the central-northern European, instead of the Mediterranean. In so doing, he introduced into his commentary on Dioscorides the plant species of this new environment, proceeding by assimilation, mostly basing these associations on external botanical similarity. This is how we find blueberry in his commentary on Dioscorides’ chapter devoted to myrtle, in accordance with the medieval use.
Illustration 5: Remberti Dodonaei …, Stirpivm Historiae Pemptades Sex Sive Libri XXX Varie ab Avctore paullo ante mortem, aucti & emendati. Antverpiae: Ex Officina Plantiniana apud Balthasarem et Ioannem Moretos, 1616, p. 768.
Contrary to his medieval predecessors, however, Mattioli distinguished the two genera. His text is worth citing:
In Germany and Bohemia, where no species of myrtle grows, they use … a plant called “Myrtillus”. It grows in the mountains and the forests … leaves like those of Buxus … From its flowers … grow the berries, which are like those of Juniper for their color and their size, but full of a juice like wine … This plant is used in all Germany instead of myrtle, of which it has similar therapeutic properties …
It was the Flemish medical botanist Rembert Dodoens (1517-1585) who distinguished blueberry from myrtle under the name Vaccinia. In his Pemptades originally published in 1583, with a posthumous second edition in 1616 referred to here, he characterized blueberry as early as the 2nd/3rd lines of its description as a bay (read: berry, bacca in Latin), and not by its flower as usual at that time. His description, partially reproducing that of Mattioli, leaves no ambiguity (Illustration 5):
The black berries are most common in Germany, the fruit of which is called by some Myrtillus … with leaves of the greater Buxus … berries quite corresponding to those of Juniper by their size, with, at their top, a concavity like the navel ... their color from dark blue to black, with a slightly acid taste, astringent … the berries appear toward the end of June and in July … As far as I know, they do not have a name among the Greeks and ancient Latins …
After a discussion—and elimination—of all the plants mentioned in the Greek and Latin literature of Classical Antiquity that might bear some similarity to Vaccinia, Dodoens explains the name he gave to the berries:
[The berries] Vaccinia might not seem to be identified as fruits, since they are berries (bacca in Latin). Indeed, from bacca they might be called Vaccinia as well as Baccinia … (that is, small berries, as per the suffix -inium added to bacca; hence, baccinium singular, baccinia plural) …
The term Vaccinia was not created by Dodoens; it already appears in Classical Latin. However, as Dodoens himself explains, it identifies an aquatic plant in Latin literature. Here instead, Dodoens uses it to designate a plant that grows in high mountains exposed to winds, which does not appear to be known in Italy. The point for him was to characterize the plant by its berries, which he identified as baccae (plural; bacca singular).
Dodoens then concluded with the property (quite cooling) and action of this plant (astringent and desiccative). As such, it relieves stomachache, quenches thirst, reduces burning fever, stops diarrhea and vomiting, dysentery caused by an excess of bile, and is useful against excess of bile (cholera).
The choice of the term Vaccinia by Dodoens attests to a solid classical education and a great linguistic awareness with the shift from b to v in the pronunciation, with b pronounced v, according to a phenomenon still attested in Greek and Spanish. Hence baccinia pronounced and written vaccinia. However erudite the designation might have been, it left the subsequent generations of botanists, taxonomists, and philologists with a conundrum still looming in present-day botanico-medical literature.
Out of the Wood
It might be significant of these confusions that blueberry does not appear in the famous Pharmacographia by the German pharmaco-chemist Friedrich Flückiger (1828-1894) and his British colleague Daniel Hanbury (1825-1875) (first published in 1874), which was the last sum of pharmacognosy before the advent of pharmaco-chemistry.
Now, however, blueberry is coming out of this wood of confusion and is increasingly consumed and studied, with its benefits coming to light from one new publication to another.
In a rare anomaly due to the difference in the flora of the Mediterranean World and Central-North Europa—not to mention the American Continent—, the ancient literature was not of help. It is up to present-day pharmacognosy to explore new ground.
Literature (selection, chronological order)
Oh D. et al. Antidepressant-Like Effects of Vaccinium bracteatum in Chronic Restraint Stress Mice: Functional Actions and Mechanism Explorations. American Journal of Chinese Medicine 46(2) (2018): 1–31.
Lujan Domínguez M.E., C.I. Ayala-Jara, E.F. Castillo Saavedra, C. Pinedo Torres, C. Durand Lujan. Desarrollo de un gel de fruto de Vaccinium corymbosum L. (Ericaceae) con actividad regeneradora de tejido dérmico/Development of a gel of Vaccinium corymbosum L. (Ericaceae) fruits with regenerative activity of dermal tissue. Arnaldoa 25(2) 2018
Zoratti L., H. Klemettla, L. Jaakola. Bilberry (Vaccinium myrtillus L.) Ecotypes. In M. Simmonds, V. Preedy (eds). Nutritional Composition of Fruit Cultivars. London: Academic Press 2016: 83–99.
Mostacero León J., T. Rázuri González, A.E. Gil Rivero. Fitogeografía y morfología de los Vaccinium (Ericaceae) “arándanos nativos” del Perú. Revista Indes 3(1) (2015): 43-52.
Teimouri M. The Chemical Composition and Antimicrobial Activity of Essential Oils of Vaccinium Arctostaphylos L. International Journal of Advanced Biological and BiomedicalResearch 3(3) (2015): 270-274.
Abreu O.A., G. Barreto, S. Prieto. Vaccinium (Ericaceae): Ethnobotany and pharmacological potentials. Emirates Journal of Food and Agriculture 26(7) (2014): 577-591.
Markus M. et al. Distinguishing Vaccinium Species by Chemical Fingerprinting Based on NMR Spectra, Validated with Spectra Collected in Different Laboratories. Planta Medica 80(8/9) (2014): 732–739.
Feshani A.M., S.M. Kouhsari, S. Mohammadi. Vaccinium arctostaphylos, a common herbal medicine in Iran: Molecular and biochemical study of its antidiabetic effects on alloxan-diabetic Wistar rats. Journal of Ethnopharmacology 133 (2011): 67-74.
Torri E., M. Lemos, V. Caliari, C.A.L. Kassuya, J.K. Bastos, S.F. Andrade. Anti-inflammatory and antinociceptive properties of blueberry extract (Vaccinium corymbosum). Journal of Pharmacy and Pharmacology 59(4) (2007): 591–596.
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