Herbs in History: Chamomile

Chamomile

Matricaria chamomilla L.


CONTENTS

By Alain Touwaide & Emanuela Appetiti | July 2023

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Matricaria chamomilla L. = M. recutita L., and Chamomilla recutita (L.) Rauschert

Illustration 1: Matricaria chamomilla L. = M. recutita L., and Chamomilla recutita (L.) Rauschert

Well Known, but Still Full of Promises?

Chamomile (Matricaria chamomilla L. = M. recutita L., and Chamomilla recutita (L.) Rauschert, Asteraceae) (Illustration 1) is now mostly known as a tea with a mild sedative effect that induces sleep. Over the centuries, it had a much more diversified range of applications that its humble appearance did not announce.
 

Beginnings

Chamomile started its career as a medicinal plant in a very modest way. It appears only once in the collection of writings attributed to Hippocrates (460-between 375 and 350 B.C.) but compiled in effect by physicians practicing medicine in Hippocrates’ way, by observing the patients’ clinical signs. In the treatise Nature of women, possibly dating as far back as mid-fifth century BCE, it is used in a post-partum context (7.346.17), in the form of an injection to clean the womb and provoke menstruation. It is highly probable that the mention of menstruation here does not refer to the exact meaning of the term, but rather to a hemorrhage provoked to further eliminate residual placenta.

Theophrastus (ca. 381-ca. 287 BCE), the successor to Aristotle (384-322 BCE) as the head of the Athenian Lyceum and the Father of Botany as per the historiographical tradition, barely mentioned Chamomile (Historia plantarum 7.8.3), classifying it among the low creeping plants, opposed to the cauline ones, with erected stem.

This classificatory information, typical of Theophrastus’ analytical botany, however unimportant it might seem, is instead revealing. It provides the interpretation of the name of Chamomile in ancient Greek, chamaimēlon. As early as Pliny (A.D. 23/24-79 CE), this name has been interpreted as referring to the smell of an apple. But Theophrastus’ classification provides a more convincing interpretation: Chamomile is a low-growing, dwarf fruit or plant. The meaning of Theophrastus’ classification is made perfectly clear by the choice of the examples: whereas Chamomile is among the low plants, Lily is among the cauline, erected ones. The opposition could not be clearer. Truth is that mēlon in ancient Greek refers to fruit generally speaking, but certainly not to apple only as Pliny understood it. Nevertheless, Pliny’s interpretation crossed the centuries and is still well present in current literature.
 

First Recognition

After such a modest start, Chamomile entered the world of medicine plants with the famous, yet extremely contested physician Asclepiades of Bithynia (1st cent. BCE), if we have to believe Pliny (22.53). Because of Asclepiades’ radical teaching—he claimed that medicine could be easily learned in just a couple of days—, all his writings are now lost, having been actually destroyed. However, we know that he thought of the human body as a mass of atoms (which are not our atoms, but small particles) circulating in ducts throughout the body. Disease resulted from any blockage and accumulation in any part of the body, provoking inflammation. This physiological atomo-corpuscular theory might have had an impact on Chamomile as the subsequent history shows. In therapy, Asclepiades did not profess such a radical theory and gained the fame to use non-invasive methods and to judiciously select drugs. According to Pliny, Asclepiades greatly celebrated Chamomile in ways that we do not know, unfortunately. Nevertheless, numerous uses of Chamomile appear in the literature of the 1st century CE, which might come at least in part from him. If not, they attest to research aimed to optimize and diversify the use of the plant.
 

Manuscript New York, Pierpont Morgan Library, M 652, 10th century, Constantinople, f. 193 recto: Dioscorides, De materia medica.

Illustration 2: Manuscript New York, Pierpont Morgan Library, M 652, 10th century, Constantinople, f. 193 recto: Dioscorides, De materia medica

As a possible sign of a greater attention to Chamomile, both Pliny (22.53-54) and Dioscorides (3.157) (Illustration 2) provide an exact, similar description of the plant. According to Dioscorides, who is a little bit more precise than Pliny, Chamomile is one span high (ca. 20 cm = 9 inch.), shrubby, with many axils, a little round, light yellow flower in the center, with a circular corolla of small petals. There are three species, distinguished only by the color of the petals: white, yellow and purple. All species grow in rough terrains and on roadsides. They are harvested in Spring. Pliny adds two elements of description: Chamomile’s small leaves resemble those of rue (Ruta graveolens L.), and the purple species has larger leaves and fruits.
 
Medical uses are fundamentally the same in Pliny and Dioscorides, with some more information, however, in Dioscorides. Generally speaking, and according to Dioscorides, Chamomile is warming and thinning, that is, reducing if not eliminating excessive liquid or volume in the body. Both properties are linked, as heat does reduce liquids by evaporation in a visual image. The parts to be used are the leaves in the form of tablets according to Pliny, and the roots and flowers according to both Pliny and Dioscorides, with possible different forms of administration.
 
Probably because of the reductive property it was credited with, the first and apparently most significant uses of Chamomile are in gynecology and about the urinary tract.
 
In gynecology, Chamomile provokes menstruation and facilitates delivery of intrauterine dead fetuses. The latter is the first application mentioned by Pliny, where it seems to be the most characteristic indication of the plant. It might justify Chamomile’s name in later literature—which also gave its name to the genus—Matricaria. This name explicitly refers, indeed, to the womb, matrix in classical Latin.
 
About the urinary tract, Chamomile stimulates diuresis. Interestingly, Dioscorides specifies that the white species is better for this, while the purple one is more indicated for the treatment of stones.
 
For all these uses, Chamomile was administered orally, in the form of a drink, the preparation of which is not specified. Dioscorides adds that, for the treatment of bladder (without exactly specifying what this treatment is about), a decoction should be used in the form of vapor-bath, probably under a piece of fabric rather than in a closed room in the way of a sauna, apparently to provoke sweating aimed to eliminate liquid from the body as per the reductive property attributed to the plant.
 
The next major bodily part for which Chamomile was used is the digestive system, with the reduction of gas, colic, liver problems and jaundice. The form of administration is not specified in Dioscorides, whereas it is identified as unction in external use in Pliny.
 
Other, apparently secondary uses as per Dioscorides include the treatment of lacrimal fistula in the form of a cataplasm and of mouth ulcers by chewing the plant, and a friction with an oil made of Chamomile and oil against periodic fever, which might be malaria. Pliny adds the treatment of all venomous snake bites.
 
At the end of Dioscorides’ chapter, we read a formula for a preparation explained with some detail:
 

Leaves and flowers must be put apart, chopping them separately and forming lozenges with them; the root must be dried; when necessary, give sometimes two parts of the flower and one of the green parts of the roots of the plant, and sometimes the opposite, one part of the flower and instead the double of the green, doubling the quantity alternatively every other day.
 

Ups and Downs

As early as the 2nd century CE, Galen (129-after [?] 216) analyzed Chamomile’s action in great detail in the theoretical part of his major treatise on materia medica On simple drugs mixtures and properties, when discussing the treatment of local inflammation by means of external applications. He compared Chamomile’s action to that of a Solanacea (probably Solanum nigrum L.), stating that, if the Solanacea’s sap is applied to an inflamed bodily part, it will make that part not only red, but also dark and even black (probably necrosis). If, instead, Chamomile is used, the opposite will happen: the swelling will reduce and the area will be less swollen, without becoming neither black nor dark; continuous application of Chamomile will dissolve the inflamed area, instead of making it dense and hard. According to Galen, this shows that the Solanacea and Chamomile have opposite properties. Further proof, a contrario, of their differentiated action is provided by the treatment of an inflamed part of the body with a mixture of the two plants. The bodily part will not become red, dark or black as with the Solanacea, or soft, reduced, and thin as with Chamomile. Strangely, Galen did not conclude by explicitly describing the exact effect of this complex mixture on the part of the body onto which it is applied, showing in that way that these statements are speculative, about an hypothetical result. Galen nevertheless pursued his analysis by comparing the action of Chamomile with that of rose oil, considering their respective action on inflammation. According to him, Chamomile is less effective than rose oil because it is more astringent than the oil, which is mildly astringent and not so warming.
 
In the analytical part of the same treatise, where he defined the specific properties of each materia medica, Galen dealt with Chamomile in a very brief way in his typical essentialist fashion. He qualified it as drying and warming at the first of his four-degree scale of properties of medicinal plants and natural materia medica, without providing any applications.
 
Contradictorily, whereas he virulently fought against Asclepiades of Bithynia’s theories and might have been responsible for the almost complete loss of his works, he used this very theory for his own purposes. In so doing, he considered that Chamomile’s matter is made of thin particles in the way of Asclepiades’ atoms. This is how, according to Galen, Chamomile is thinning (by reducing thick matter), distensive (relaxing the possibly dense state of the body resulting from the accumulation of particles as per Asclepiades’ pathological system) and, consequently, also diaphoretic (allowing for the elimination of matter in the body through sweating).
            
The small manual on the medicinal uses of plants incorrectly attributed by an ancient tradition to the neo-platonic Roman philosopher Apuleius (2nd cent. CE), but probably compiled Possibly in the 4th century, the Herbarium Apulei (Apuleius’ Book of Herbs), recommended the use of Chamomile to treat five medical conditions (chapter 25): jaundice, in the form of a drink of the whole plant with wine; fever, possibly as a decoction in hot water; venomous snake bites, either as a powder in local application or with wine; dropsy; and detoxification, with water and a differentiated dosage according to the age of the patients.
 
In the Arabic World, ibn Sina (980-1037), best known in the Western World from the Middle Ages on as Avicenna, devoted a long chapter to the Chamomile (II.2.2). He did not describe it, stating that it is known, and just mentioned that it has three species as per Dioscorides (whose treatise he knew and used). And he also cursorily discussed Galen’s statement about its properties. On the uses of Chamomile, instead, he provided a great wealth of information.
 
Avicenna started with a general statement on Chamomile as an “opener of obstruction”, softening, and decomposer. He immediately exemplified this main property about hot swellings (inflammations), which Chamomile softens and resolves. He then methodically proceeded by anatomico-physiological systems, starting with joints, which Chamomile relaxes when distended, while also strengthening all “nervous organs” and being “better than other drugs for fatigue”. For the head, it is a tonic of the brain, treats cold headaches, and evacuates head humors, which it dissolves. It is also good for stomatitis. He then continued with the eyes, repeating Dioscorides’ prescription of the treatment of lacrimal fistula and adding conjunctivitis, turbidity, itchiness, pain, and trachoma, in all cases in application as a bandage. Pursuing with the respiratory system, he prescribed Chamomile to stimulate expectoration and, for the digestive system, to treat jaundice. For the excretory system, Avicenna followed Dioscorides and repeated that Chamomile—especially the purple species—expels stones, treats bladder affections not otherwise specified, and calms violent colics. In gynecology, Avicenna recommended it for childbirth and placenta expulsion. He concluded the whole chapter with a specific treatment on fever:
 

... it is good for the treatment of intermittent fever when rubbed on the body, for chronic fever in the last phase in the form of a drink, and for any fever that is not too high in intensity and without a swelling of the viscera.
 

In the West

Manuscript London, British Library, Sloane 4016, 14th century, f. 25 recto: Tractatus de herbis.

Illustration 3: Manuscript London, British Library, Sloane 4016, 14th century, f. 25 recto: Tractatus de herbis

With the circulation of medical books and texts around the Mediterranean World from the 11th century onward, Chamomile appears in Southern Italy, in the Tractatus de herbis (Book on Herbs) of the 13th century, where it is also represented (Illustration 3). It is not described, but just defined as a plant growing in the fields of wheat and flax that should be harvested in March-April, boiled in olive oil and applied externally in unction, or boiled in a great quantity of hot water and administered internally.
 
Regarding its uses, Chamomile underwent a significant change of vocation when compared with antiquity as it is identified here as the plant par excellence for the treatment of pain of the eyes and defects of vision in a changing therapeutic vocation. For such use, it should be harvested before sunrise, reciting the short prayer “I harvest you for conjunctivitis and pain of the eyes, for you to come and help me”. It also should be worn around the neck, as an amulet.
 
For other uses, the Tractatus proceeded according to classical taxonomy, by types of pathologies, in an order that corresponds in some way to major anatomico-physiological systems. The first such system is the excretory and digestive ones treated jointly. Chamomile is prescribed for the treatment of stranguria, dysuria, and bladder stones in the form of a decoction; liver and spleen obstruction as a drink; stomachache, inflammation and stomach pain resulting from cold or gas, in a decoction with immediate efficacy. In gynecology, it provokes menstruation in external application on the genitals, and prevents premature childbirth as a decoction in wine. It treats quotidian fever in unction, cleans flecks in the face as a liniment with honey, and it is beneficial against venomous snake bites. To that, the Tractatus adds in a disordered way some other conditions, as spleen problems according to Pliny, eyelid induration, headache, and diarrhea.
 

Manuscript London, British Library, Harley 585, f. 160 recto: Nine Herbs Charm

Illustration 4: Manuscript London, British Library, Harley 585, f. 160 recto: Nine Herbs Charm

In a further diffusion from the Mediterranean to northern Europe, Chamomile appears in English treatises of the 14th century. In the so-called Agnus Castus—a treatise traditionally designate in that way from the name of the first plant dealt with—Chamomile is considered hot and dry in a reminiscence of the classical medical literature, and briefly recommended against jaundice (identified as the Evil Eye), stones, aching liver, and headache (172.22-173.1-3).

In another Early-English treatise of the 14th century (Macer Floridus de viribus herbarum [Macer Floridus on the properties of medicinal plants]), which is in fact the translation of an earlier Latin treatise dating back to the 11th century, Chamomile is analyzed in much more length. According to the first phrase of the chapter, Asclepius “hugely recommended Chamomile” in a clear confusion between Asclepiades of Bithynia who did use it abundantly as Pliny stated and as we have seen, and the god of medicine of classical Greek mythology, Asklepios. In its first part, the text closely recalls the classical treatment by Pliny, with the distinction of three species by their color. Then, it differs by using the taxonomy proceeding by pathologies as in the Tractatus above. Following this order, Chamomile is prescribed for the treatment of stones, stomachache, jaundice, fever, bites of venomous snakes, the spleen, leprosy, and headache.

 

Immunity Against Disease?

In its odyssey around the Mediterranean and up to northern Europe, Chamomile also entered the world of beliefs and legends as the prayer for the treatment of eye conditions in the Tractatus de herbis already indicated.
 
This is how Chamomile appears in the so-called Nine Herbs Charm possibly dating to the 10th century (Illustration 4). In addition to Chamomile, the Charm evokes Mugwort (Artemisia vulgaris L.), Plantain (Plantago spp.), Lamb’s cress (Cardamine hirsuta L.), Nettle (Urtica spp.), possibly Betony (Stachys officinalis L.), Crab-apple (Malus), Thyme (Thymus vulgaris L.) or Chervil (Anthriscus cerefolium (L.) Hoffm.), and Fennel (Foeniculum vulgare Mill.). For each of these plants, the Charm includes a versified evocation of its merits, which is the following for Chamomile:
 

Remember, Chamomile,
what you brought to pass,
what you accomplished,
at Alorford,
that no one should lose their life to disease,
since for him Chamomile was prepared.

 
To this, it adds the following for all plants:
 

These nine plants defeat nine venoms!

...

Now! May the nine plants do battle against nine glory-fleers,
against nine venoms and against nine air-diseases,
against the red venom, against the running venom,
against the white venom, against the blue venom,
against the yellow venom, against the green venom,
against the black venom, against the blue venom,
against the brown venom, against the purple venom,
against wyrm-blister, against water-blister,
against thorn-blister, against thistle-blister,
against ice-blister, against venom-blister.

If any venom comes flying from the east,
or any comes from the north,
or any from the west over folk!
Christ stood over illness of every kind.
Yet I alone know water running
where the nine serpents guard.
Now, may all plants arise,
seas ebb, all salt water,
when I blow this venom from you.

 
At the end, the Charm provides instructions on how to prepare the plants:
 

Prepare and apply the salve: Work these plants to dust and mix them with apple mush. Make a paste of water and ashes. Take Fennel and mix the plant into the boiling paste. Bathe the wound with an egg mixture before the patient applies the salve and after.
 
Sing the above charm over each of the nine plants. Sing the charm three times before the patient self-applies the salve and sing the charm three times on the apple. Sing the charm into the patient’s mouth, sing the charm into each of the patient’s ears, and—before the patient applies the salve—sing the charm into the patient’s wound.

 
As the Nine Herbs Charm clearly indicates, Chamomile has a strong allure in spite of its modest appearance. Popular memory and unwritten traditions are very much aware of this as they use Chamomile for other purposes than treating medical conditions. One of such uses is in hair care, with the blonding effect of Chamomile, as a shampoo duly composed or a rinsing made of a decoction of the plant, which give a shiny, sunny and golden appearance and add a seducing touch to a head that recalls Apollo, the god of the ancient Greek mythology and the best symbol of the sunny light, and also of inspiration, music, and poetry.


Scientific articles
 
Mailänder L.K., P. Lorenz, H. Bitterling, F.C. Stintzing, R. Daniels, D.R. Kammerer 2022. Phytochemical Characterization of Chamomile (Matricaria recutita L.) Roots and Evaluation of Their Antioxidant and Antibacterial Potential. Molecules 27(23) (3 Dec. 2022): 8508. https://doi.org/10.3390/molecules27238508
 
El Joumaa M.M, J.M. Borjac 2022. Matricaria chamomilla: A valuable insight into recent advances in medicinal uses and pharmacological activities. Phytochemistry Review 21 (2022): 1913–1940.
https://doi.org/10.1007/s11101-022-09817-0
 
A. El Mihyaoui A., J. C.G. Esteves da Silva, S. Charfi, M.E. Candela Castillo, A. Lamarti, M.B. Arnao 2022. Chamomile (Matricaria chamomilla L.): A Review of Ethnomedicinal Use, Phytochemistry and Pharmacological Uses. Life 12(4) (2022):479. https://doi.org/10.3390/life12040479
 
Hajizadeh-Sharafabad F., P. Varshosaz, H. Jafari-Vayghan, M. Alizadeh, V. Maleki 2020. Chamomile (Matricaria recutita L.) and diabetes mellitus, current knowledge and the way forward: A systematic review. Complementary Therapies in Medicine 48 (January 2020): 102284. https://doi.org/10.1016/j.ctim.2019.102284
 
Singh C.E., J. Aishwarya 2017. Chamomile an Ancient Aromatic Plant - A Review. Journal of Ayurveda Medical Science, 2(4) (October-December 2017): 251-255.
DOI: 10.5530/jams.2017.2.26
https://www.fulltxt.org/article/432
 
Mao J.J., S.X. Xie, J.R. Keefe, I. Soeller, Q.S. Li, J.D. Amsterdam 2016. Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial. Phytomedicine 23(14) (Dec 15 2016): 1735-1742.
DOI: 10.1016/j.phymed.2016.10.012 https://www.sciencedirect.com/science/article/abs/pii/S094471131630188X?via%3Dihub
 
Miraj S., S. Alesaeidi 2016. A systematic review study of therapeutic effects of Matricaria recuitta chamomile (chamomile). Electronic Physician 8(9) (Sept 20 2016): 3024-3031. DOI: 10.19082/3024
 
Das M., Chamomile: Medicinal, Biochemical, and Agricultural Aspects Boca Raton, FL: CRC Press, 2015.
http://abc.herbalgram.org/site/DocServer/CRCPRESSChamomile-Section_1.5978-1-4665-7759-6.pdf?docID=6362#:~:text=Chamomile%20originated%20in%20Europe%20and,the%20Sun%20(Salamon%201993).
 
Engels G. , J. Brinckmann 2015. Chamomile. Matricaria chamomilla (syn. M. recutita, Chamomilla recutita), Family: Asteraceae. HerbalGram 108 (Winter 2015): 8-17. https://www.herbalgram.org/resources/herbalgram/issues/108/table-of-contents/hg108-herbpro-chamomile/
 
Sharifi F., M. Simbar, F. Mojab, H. Alavi Majd 2014. Comparison of the effects of Matricaria chamomila (Chamomile) extract and mefenamic acid on the intensity of premenstrual syndrome.  Complementary Therapies in Clinical Practice 20(1) (February 2014): 81-88. https://doi.org/10.1016/j.ctcp.2013.09.002
 
del Carmen Romero M., A. Valero, J. Martín-Sánchez, M.C. Navarro-Moll 2012. Activity of Matricaria chamomilla essential oil against anisakiasis. Phytomedicine 19(6) (15 April 2012): 520-523.
https://doi.org/10.1016/j.phymed.2012.02.005
 
Singh O., Z. Khanam, N. Misra, M.K. Srivastava 2011. Chamomile (Matricaria chamomilla L.): An overview. Pharmacognosy Review 5(9) (Jan-Jun 2011): 82–95.
DOI:10.4103/0973-7847.79103    
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210003

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