Gentian: A Bitter Pill to Swallow

The English, and subsequently the Americans, are not fond of bitter foods or herbs. In fact, bitter has often been spoken of disparagingly in the English language for example in the statement, “a bitter pill to swallow,” meaning, in a wider sense, that a person found something very difficult to accept. Such events as paying taxes or being forced, as a child, to eat some food we found particularly revolting fall into this category. It is no wonder then, that the druggist was often called upon to disguise drugs or herbal preparations that tasted bitter. For this purpose, a person trained in pharmacy would have many tricks, sugar coating, encapsulation, or the addition of sickeningly sweet syrups to bitter liquids to make an elixir. For what adult, or especially child, would take their medicine for long if it was very bitter? Many Europeans would. For instance, in modern Germany, it is estimated that over 40 million doses of bitters are consumed every day, and not just because people think that its good for them; they actually enjoy them. In the European tradition, exposure to a bitter flavor is said to give the digestive system strength and tone, much in the same way that cold water is applied in Russia. It is said that Russian people cut a hole in the ice and dip their babies in the icy water for a second or two, in order to give the baby vigor. Those who survive should indeed be the hearty ones. Referring to this effect, it was Parkinson who quoted Galen as saying, “if our stomackes could brooke (tolerate) this and other bitter medicines, and were not so nice and daintie to refuse whatsoever is not pleasing to the palate, it would worke admirable effects in the curing of many desperate and inveterate diseases inwardly…” One could speculate that people in the English-speaking countries have become so accustomed to the flavor of salt and sweet that the bitter flavor (as well as its benefits) has been completely forgotten. This may be a pity, for modern scientific research shows that some of the bitter herbs used in soft drinks, liquors, tonic waters, and even candies may have marked healing properties. For instance, modern German research shows that bitter tonic herbal formulas (called bitters) may activate digestive substances, such as bile and hydrochloric acid, enabling us to digest our food more efficiently and effortlessly. Bitters have been shown to stimulate and heighten nervous system function, as well as the immune system, helping people recover more quickly from various chronic illnesses. Bitters are often prescribed by physicians and natural health practitioners alike in many parts of Europe for mild to moderate digestive problems, such as irritable bowel syndrome, colic, gas, and constipation. Rudolf Weiss, a respected German herbalist, physician, and author of Herbal Medicine, says of bitters, “…pharmacological studies provide the explanation for something which has been known for a long time and which any careful observer is able to confirm for himself: that bitter plant principles have marked general stimulant effects that are far from limited to the stomach….generally [benefitting] physical and mental exhaustion.” Probably the best-known and studied pure bitter herb in the world is called gentian. Gentian is one of any number of species from the genus Gentiana in the family Gentianaceae. Some works list 40 or 50 different species; all of them seem to contain the bitter principle and sweet, aromatic taste that has made these herbs so popular. Although several ancient kinds of gentian will be mentioned below, the author has used several species that grow wild in the mountains of California completely unknown to Europeans, the Chinese, or Indians, in making home digestive tonics. These species seem to be even more bitter than the famous official species, Gentiana lutea L. In fact, it was the well-known English physician-botanist John Lindley who said in his Flora Medica (1838), “There is scarcely a plant of this natural order in which the bitter principle does not exist in considerable intensity.” Lindley considered all species of gentian as potentially useful in medicine. Just how long have the benefits of bitter herbs been known? In Traditional Chinese Medicine, an intact system of medicine that is more than 5,000 years old, gentian was called lung tan, meaning dragon’s gall because of its exceedingly bitter taste. Bretschneider, physician to the Russian Legation at Peking in the late 19th century, wrote in his Botanicon Sinicum that gentian was first recorded from around the time of Christ in the Shen nung Pen ts’ao king, one of China’s oldest and most revered works on materia medica. Traditionally, the Chinese did not usually differentiate individual species of a genus, and thus lung tan could have been any number of Gentiana species, although the most important species used today is Gentiana scabra, known as Lung-tan. Since the days of the Pen King, and probably before the beginning of recorded history, this herb has been used in China to help ease a variety of ailments. Gentiana scabra commonly grows in mountain valleys in middle China. The vivid blue flowers are bell-shaped and the twisted rhizome is white when fresh and reddish-brown with numerous rootlets attached as found in the Chinese apothecary shop. The root of this (and most gentians) tastes at first sweet then intensely bitter and is prescribed for fevers, rheumatism, toxicity of the bowels, and general debility. Further, it is considered effective as a liver tonic, as a strengthener to the memory, giving “lightness and elasticity to the body.” These uses in TCM are similar to the traditional uses of the European gentians, though the Chinese often have a way of making them sound more poetic. Compare the last statement with this line of Parkinson, the renowned 17th century English herbalist-—-“being dried and given in powder to any to drinke, will cause much venting or farting, and is given with good successe to helpe the torments of the wind-collicke…” It is significant that so many different species (about 10 or 12 are recorded) of gentians have been used for medicine in TCM, but what about other cultures? If the uses of an herb or similar species in the same genus are similar in widely divergent cultures, support is given to its overall efficacy. I have termed this concept Transcultural polypharmacy. One of the most ancient systems of healing is the East Indian system of medicine, called Ayurveda. In this system, a number of gentians have been reported as being used, probably for at least two thousand years, including Gentiana decumbens Linn. f., which is used as a stomach remedy and G. kurroo Royle (Indian gentian), a well-known tonic, stomach, and urinary-tract medicine and fever remedy. Although Chinese and Indian medicine are very ancient, with roots in oral and written traditions that are said to go back more than 4,000 years, Traditional European Medicine (TEM) is not less so. One can trace individual herbal remedies (such as fennel) back through the Greek culture to the Sumarian and Egyptian cultures nearly 5,000 years. There are many common features of these three great medical systems in diagnostics, therapeutics, and materia medica. Common threads such as pulse diagnosis, hydrotherapy, and herbalism, and even the use of some of the same herbs tie them together. Today they are coming together again, as many herbalists and medical practitioners are taking elements from all three to help create the medicine of the future. In the system of TEM, gentian has always been considered an important therapeutic herb. It was official in the first Pharmacopoeia Londenensis of 1618, and in many other official compendia—even the United States Pharmacopeia from 1820 until 1950. In 1967, gentian was still official in the Pharmacopoeias of Austria, Brazil, Chile, China, Czechoslovakia, France, Germany, Hungary, Japan, The Netherlands, Scandinavia, Poland, Portugal, Romania, Spain and Switzerland. In all but China and Japan, the official species is Gentiana lutea L. As legend has it, the medicinal qualities of the official European gentian was first discovered by Gentius, king of the Illyrians, who was defeated and taken prisoner by the Romans in about 168 B.C. Growing as it does in the mountains of most European countries, except in the extreme north, the herbal properties of the plant were mentioned by Galen, Pliny, and Dioscorides, but not by Hippocrates or Theophrastus, who lived before Gentius. Dioscorides, probably the most reliable and thorough enumerator of the western materia medica among the ancient western herbalists, confirms the main uses as protective and healing against “venemous beasts”, and for its beneficial effect on the “hepaticall and stomachical, being drunk with water.” He also extols its virtues as a poultice for inflamed eyes and the cleansing and healing of obstinate sores. These uses were all carried forward through the age of herbalism in the works of Brunfels, Fuchs, Parkinson, Gerard, and Culpeper, sometimes using nearly identical words. Especially in German-speaking countries, gentian was considered almost a panacea. For instance, Paracelsus, the great Swiss doctor, mentions gentian, and for centuries, a liquor distilled from the root has been highly prized in Switzerland, made by macerating the root in cold water, adding sugar and yeast and distilling the mixture. Hieronymus Bock praised it as the German “theriac,” a reference to the ancient Roman theriac, which was a combination of many herbs and other curative substances, considered a cure-all and protector against poison through the middle ages and still popular in the 19th century. Dodoens, the Dutch herbalist favored it highly, saying of it, “made into powder and taken in quantittie of a dram with wine, a little pepper and rue, is profitable for them that are bitten or stung of any venemous or mad beasts, and is also good for them that have taken any poison.” He gives detailed information on its wound-healing qualities, saying that it is best used by soaking a bit of lint or linen in the fresh juice for healing “fretting sores and wounds,” “mitigating the paine and burning heat of the eies, and evill favoured spots.” Gentian is also recommended by Dodoens for those that “have taken great fals and bruses, and are bursten: for it dissolveth and scattereth congealed blood and cureth the said hurts.” In Haller’s writings, one reads that the surgeons used gentian root as a plug to stop up wounds, by placing “sticks of it in decaying ulcers, which want to close before the [proper] time; through their bitterness, the root stimulates pus secretion.” The famous German “father of natural healing,” Sebastian Kneipp, praised gentian highly and gave the main effects of the herb as:

Strengthening and supportive to stomach secretion
Strengthening to the nerves

He indicated that nerve-weak people should take 5 drops every day, and that “it is suited for old people, for it warms the stomach.” Kneipp encouraged people to grow gentian in their garden, saying, “those who a small garden have, should therein have a Salbeistock (sage plant), a Wermutstock (wormwood) and a gentian.” In England, gentian was popular for dyspepsia, or painful digestion and considered a general tonic to help restore strength in people recovering from illness. All gentians were called felwort by the common people, which is said to come from fel, a hill and wort, herb or root, because gentian loves to grow in the mountains. Pereira claimed that most of the official gentian ultimately came from the mountains of Switzerland, Tyrol, Burgongne and Auvergne, “collected by peasants.” Today, G. lutea is scarce in the Alps and is protected by law. James, in his Pharmacopaeia Universalis (1747), indicates that the official gentian root “is so well known that it requires no description.” He says it is considered alexipharmic (protector from poisons), aperient and attenuating, and is “principally used in the plague, malignant disorders, and obstructions of the liver and spleen.” In official English medicine, the College of Physicians directed a wide variety of preparations to be made from the root, such as Infusum Amarum simplex, Infusum Amarum purgans, Vinum Amarum, Tinctura Amara, and others. Many of the common gentian bitter preparations meant for prescription or common use included aromatic or warming herbs designed to make the intense bitter of gentian more acceptable to the palate and grateful to the stomach. Lewis, in his Experimental history of the Materia medica (1791), gives this formula; it is one that is often found in materia medicas throughout the period, and on into this century both in Europe and the United States.

1 ounce dried gentian root
1 ounce fresh lemon peel
0.2 ounces dried orange peel

“Simmer this mixture for an hour or two in three quarters of a pint of boiling water [to] make a very elegant bitter.” Lewis also quotes the official compound gentian tincture from the Pharmacopoeia Londenensis and again, this formula and its variations are very often used, even today. Macerate the following mixture in an ounce of proof spirit (100 proof vodka will do).

1 ounce dried gentian root
0.4 ounces dried orange peel
0.2 ounces cardamom seed

Shake the mixture daily, and after 2 weeks, squeeze out the liquid and filter. Wine and other spirits can be substituted for vodka. Dose: 1/2 to 1 teaspoon half hour before meals. In the United States, the European fascination with gentian was brought over with the first settlers, but other members of the family found growing in the new world were popularly sought; among them, Frasera and Centaurium. Oddly, it is hard to find an original statement about gentian in the early American medical literature. Even illuminaries such as Bigelow, Barton, and Wood only copy English writers, such as Cullen and Pereira. Other writers on the materia medica of the 19th century, such as Chapman, Eberle, Smith, Ewell, and Stille report no American experience either. Samuel Thompson, everybody’s favorite herbal quack doctor, influential in the first half of the 19th century, even mistook gentian for ginseng, saying of it in his Botanic Family Physician, “It was formerly collected for exportation, and large quantities of it were sent to China, where it brought a great price.” His rival, Horton Howard did a little better; he at least reported that the herb is tonic to the digestion. Even the early Eclectic doctors did little to allay one’s suspicion that most American doctors had little clinical experience with the G. lutea. HiHistHiHisFor instance, in his American Dispensatory, King adds little to what is in all the other earlier American materia medicas, even repeating what Bigelow and other authors say about the American species, G. quingueflora, that it “is certainly a valuable tonic and cholagogue, and deserves further investigation.” The extensive Felter-Lloyd edition of the American Dispensatory is only slightly more enlightening. Without exception, it is the French and German authors that have the most insight on the physiological effects and practical uses for gentian and bitters in general. Today, bitters and gentian preparations are more popular than ever in Europe and China, with the rise in popularity of herbal and traditional medicine generally. In America, bitters are still little-known and only in the last year or two are beginning to be more recommended and known by herbalists and this can be attributable to the many herbal patent formulas now being imported and sold in natural food stores and some markets and pharmacies. Although sweets will always be more popular than bitters, the future may show that gentian isn’t such a bitter pill to swallow after all.

Bibliography

Ainslie, Materia Indica (1826), (Delhi, 1979).
Alleyne, A New English Dispensatory (London, 1733).
Bensky and A. Gamble, Chinese Herbal Medicine, Materia Medica, (Seattle, 1986).
Bretschneider, Botanicon sinicum, (Hong Kong, 1895).
Cazin, Plantes MÈdicinales. (Paris, 1866).
Chadha, chief ed., The Wealth of India (Raw Materials), 11 vols. (New Delhi, 1952-88).
Culpeper, A Physical Directory: or a Translation of the Dispensatory Made by the Colledge of Physitians of London, 2nd ed.,(London, 1650).
Dodoens, A New Herball, or Historie of Plants (London, 1586).
Felter, and J.U. Lloyd, King’s American Dispensatory (Cincinatti, 1898).
Gathercoal, and H.W. Youngken, Check List of Native and Introduced Drug Plants in the United States, (Chicago, 1942).
Gerard, and T. Johnson, (eds.), The Herbal or General History of Plants(1633), (Reprinted by Dover Publications, New York, 1975).
Gunther, The Greek Herbal of Dioscorides (New York, 1968).
Hooper, On Chinese medicine: drugs of Chinese pharmacies in Malaya. The Gardens’ Bulletin, Straits Settlements (Singapore) 6 (1) (1929): 1-165.
James, Pharmacopoeia Universalis: or a New Universal English Dispensatory (London, 1747).
Jones, Pliny—Natural History, 6 vols (Cambridge, 1964).
King, The American Dispensatory, 10th ed (Cincinnati, 1876).
Lindley, Flora Medica (London, 1838).
Linnaeus, Species Plantarum, 1753, (London, 1957).
Madaus, Handbook of Biological Medicine, 1938, (NY, 1976).
Parkinson, Theatrum Botanicum, The Theater of Plants, (London, 1640).
Perry, Medicinal Plants of East and Southeast Asia (Cambridge, 1980).
Pharmacopeia of the United States, 14th ed., (Easton, PA, 1950).
Pickering, Chronological History of Plants (Boston, 1879).
Polunin, Flowers of Europe (New York, 1969).
Smith, and G.A. Stuart, translators and annotators, Chinese Medicinal Herbs (derived from the Pen Ts’ao of Li Shih-chen, 1578), (San Francisco, 1976).
Syme, and Mrs. Lankester (text), and J. Sowerby, et al.(figures), English Botany (London, 1866).
Thomson, New Guide to Health; or Botanic Family Physician, (Boston, 1835).
Todd, ed., Martindale’s Extra Pharmacopoeia, 25th ed.,(London, 1976).
Urdang, Pharmacopoeia Londinensis of 1618 reproduced in facsimile (Madison, 1944).
Weiss, Herbal Medicine (translated from the 6th German edition of Lehrbuch der Phytotherapieby A.R. Meuss), (Beaconsfield, England, 1988).