Civil War Approaches to Medicinal Plants

One of the perks of operating the Pry House Medicinal Garden is that it allows us to look at how Civil War era surgeons might have approached medicinal plants like the ones we grow.

Questions are commonly asked about the medical textbooks surgeons, hospital stewards and pharmacists had available to them during the Civil War. The first “references” providing the organized direction for the preparation and use of medical plants to treat illness were the Sumerian Clay tablets dating back over 5000 years. The tablets outlined 12 recipes for using specific plants to treat illness.

A Sumerian pharmacy tablet

Note, that a recipe in pharmacy or medicine is called a prescription. A collection of recipes is called a cookbook and a collection of directions for prescriptions is called a Dispensatory. These types of books provide the instructions for making grandma’s apple pie or Doc Goodin’s poison ivy remedy.

In pharmacy, the symbol meaning recipe; “Rx” originated in medieval manuscripts as an abbreviation of the Late Latin verb recipe, the second person singular imperative form of recipere, “to take,” thus: “take thou.” Medieval prescriptions invariably began with the command to “take” certain materials and compound them in specified ways. A number of types of references were published over the ensuing thousands of years.

Several textbooks available to the Civil War Surgeon and Hospital Steward for writing and preparing prescriptions included The Pharmacopoeia of the United States of America, The Dispensatory of the United States of America, and Therapeutics and Materia Medica.

Important titles in the world of Civil War pharmacy

These were the more formal textbooks while The Physicians Pocket Dose and Symptom Book might have been carried in the surgeon’s field bag for quick reference in the field.

These are the books that I will be using to describe the preparation and uses of the medicinal plants found in the Pry House medicinal garden.

One of the plants we have in the medicinal garden is Digitalis purpurea, commonly known as Foxglove. The benefits of digitalis in treating the symptoms of dropsy (congestive heart failure) were first described by William Withering in 1775.

A physician’s field guide

So, for example, if a soldier went to a surgeon with the symptoms of dropsy, the surgeon might first review the evidence supporting the use of digitalis for treating dropsy in the Therapeutics and Materia Medica textbook and then refer to The Physicians Pocket Dose and Symptom Book to determine the appropriate dose. Digitalis would typically be administered as a pill, manufactured according to the standards outlined in the Pharmacopoeia of the United States of America and dispensed by the hospital steward to the patient.

Today, similar books still exist. Although the US Dispensatory is no longer published, the 41st edition of US Pharmacopeia will be published in 2018. The most famous modern material medica (aka pharmacology) and therapeutics textbook is Goodman and Gilman’s The Pharmacologic Basis of Therapeutics.

Health care practitioners still carry pocket reference books with them while they are caring for patients. Some of these references are paper and some are electronic. A modern pocket handbook similar to The Physicians Pocket Dose and Symptom Book is The Handbook of Clinical Drug Therapy written by my colleagues and myself at The National Institutes of Health Critical Care Medicine Department. This is a quick drug dosing reference text for the ICU practitioner.

A large number of websites books and pamphlets are available describing the modern-day benefits of herb medications. The American Herbal Pharmacopoeia is an organization dedicated to promoting the responsible use of herbal products and herbal medicines. AHP produces critically reviewed documents called monographs that outline the quality control criteria needed for ensuring the identity, purity, and quality of botanical raw materials. Each document also presents a complete and critical review of the traditional and scientific literature regarding the efficacy and safety of herbal medicines.

Another handy book for those with a casual interest in medical plants is Peterson’s Field Guide to Medicinal Plants and Herbs. This guidebook is available in both Eastern and Central North America and Western North America editions and provides an overview of the plants, where they are found and their uses.

In following posts, I will get down to the root of the blog by getting into the weeds of medicinal gardens. I will be seeding the blog with discussions of the plants we have in the Pry House medicinal garden.

This is the second in a series of posts about the Pry House Medicinal Garden. Click below to be directed to the others.

PART ONE PART Three Part four part five part six part seven part eight

About the Author

Greg Susla has been a volunteer at the National Museum of Civil War Medicine since January 2011. Greg’s interest in the Civil War stems from his home town, Torrington, CT, the birth place of the abolitionist John Brown. Greg received his pharmacy degrees from the Universities of Connecticut and Florida and completed a critical care pharmacy residency at the Ohio State University Hospitals. Greg spent the majority of his career as the ICU pharmacist at National Institutes of Health in Bethesda, MD and volunteered his time in the ICU at the National Naval Medical Center in Bethesda, MD. Greg has been active in the Society of Critical Care Medicine for over 25 years serving on a number of the Society’s committees, and is a Fellow in the American College of Critical Care Medicine. Greg recently retired as the Associate Director of Medical Information at MedImmune in Gaithersburg, MD. Greg is leading the restoration of the garden and is being assisted by his wife Lisa and other staff members and volunteers at the Museum and Pry House. Greg and his wife Lisa live in Frederick, MD.