Traditional medicine

Cannabis is an ingredient of medicines in the traditional medicine of South and Southeast Asia, China and Korea, and in the household remedies of Africa and the Caribbean. In the 19th century its extract and tincture were official drugs of British and American pharmacy. The traditions use different parts of the plant. The compendia of Ayurveda class the drug among the semi-poisonous plants and direct that it be purified before use.^[1]^: 73 In Thai traditional medicine the drug is the dried female inflorescence.^[2]^: 539 Chinese medicine recorded every part of the plant, but uses only the seed in clinical practice today.^[3]

South Asia

Swagata Tavhare and Rabinarayan Acharya surveyed 41 texts of Indian alchemy (rasaśāstra) and 26 medical compendia. In those texts 210 formulations contain bhaṅgā, and 157 more use its juice or decoction to process other drugs.^[1]^{: 59, 61}^[4]^: 136 In 1877 Uday Chandra Dutt set out three medicines in which the bhang equals all the other ingredients together: the powder jātīphalādya churna, the pill jvālānala rasa and the confection madana modaka.^[5]^: 239–241 The Ayurvedic Formulary of India includes jātīphalādya cūrṇa and the confection jīrakādi modaka, made with roasted cannabis seed.^[6]^{: 39, 109} In Sri Lanka the Ayurveda pharmacopoeia of 1961 gives Kameshwari modakaya, a confection of 22 plant drugs with cannabis seed and leaf fried in ghee.^[7]^: 81–83

Some of the hemp sweetmeats eaten across India were also medicines. In the Bijapur district of the Bombay Presidency in 1893, majum was sometimes given to the sick as a sleeping draught in villages without medical aid, and some took it as a nervine tonic.^[8]^: 94 The Indian Hemp Drugs Commission reported that majum and the sweetmeats like it were credited with aphrodisiac qualities.^[9]^: 158

Thailand

By August 2021 Thailand's Department of Thai Traditional and Alternative Medicine had compiled 45,134 formulas from national texts and stone inscriptions, and had found cannabis in 162 of them.^[10]^: 2673 The royal formulas of King Narai of Ayutthaya, the Tamra Phra Osot Phra Narai, hold three: Akkhiniwakhana, for vomiting; Thipphakat, with cannabis leaf and opium; and Suk saiyat, for sleep and appetite.^[11]^{: 6, 19–20} In January 2019 the department named 16 cannabis formulas for use once the narcotics law allowed it.^[12] The national list of essential herbal medicines of 2023 includes four of them: Suk saiyat, Thamlai Phra Sumen, Kae lom kae sen and Ammarit osot.^[13]^{: 48, 56, 84, 87, 99}

In the popular medicine of the early 1970s, the ethnobotanist Marie Alexandrine Martin wrote, cannabis went into Thai medicines against dizzy spells, was taken with sandalwood as a tea and was a remedy for cholera on its own. From December 1971 it had to be used with other plants and could not be the only drug in a medicine.^[14]^{: 67, 71–72}

Cambodia, Laos and Vietnam

In Cambodia, Martin recorded, the remedies used the whole plant, male or female, in decoctions, infusions, alcoholic extracts and cigarettes, taken for loss of appetite, poor digestion, the troubles that follow childbirth, malaria and other complaints.^[14]^: 70 Medicinal uses seemed few to her in Laos, perhaps because opium derivatives were available there. In Vietnam, traditional medicine drew on Chinese medicine and used mainly the seed kernels.^[14]^{: 67, 72}

Indonesia

Mohd Affendi Mohd Shafri and Ain Najihah Nazarudin describe the Tajul Muluk, a compilation of herbal formulations by the Acehnese scholar Shaykh Isma'il al-'Asyi printed in Mecca in 1893. In its medical chapter they found cannabis only in combination with other ingredients that temper its effect, in formulations to be taken in small amounts.^[15]^{: 75, 80} In his survey of 1918 the pharmacologist Willem Boorsma quoted a report from Aceh that the Klingalese made from Indian hemp a medicine called madjoen, to which they attributed an erotic action.^[16]^: 330

China and Korea

The physician Zhang Zhongjing recorded maziren wan, a honey pill of cannabis seed and five other drugs for constipation, around the 2nd century AD, and it is still prescribed.^[3] His Shanghan lun also puts the seed into zhigancao tang, a decoction for an irregular pulse with palpitations.^[17] In the Bian Que xinshu, dated by E. Joseph Brand and Zhao Zhongzhen to between 1127 and 1270, the flowers of cannabis and datura make shuisheng san, a powder taken to sleep through the pain of moxibustion. They call it the first well-documented use of cannabis in an anaesthetic formula in China.^[3] The Korean Donguibogam of 1613 has the seed in the honey pill daemainhwan, given for wind impediment with swelling and wandering pain in the joints.^[18]

Africa

Southern Africa

John Mitchell Watt, emeritus professor of pharmacology and therapeutics at the University of the Witwatersrand, summarised in 1961 the medicinal uses he and Maria Breyer-Brandwijk were about to publish. In his account cannabis was a snakebite remedy among the Mfengu and the Khoikhoi; Sotho women were reported in 1906 to smoke it to stupefy themselves during childbirth; and the Sotho of Basutoland were reported in 1917 to give the ground seed, with bread or maize porridge, to children being weaned. The Xhosa used the plant against bots in horses, and in Southern Rhodesia it was an African remedy for malaria, blackwater fever, blood poisoning, anthrax and dysentery, and a war medicine. Watt knew of no magical use of the plant in southern Africa, and wrote that there it was always smoked, never taken by mouth.^[19]

The anthropologist Brian du Toit argued that the early Cape accounts of a dagga that was eaten or drunk describe other plants, among them Leonotis leonurus, whose local names also contain the word, and that the cannabis of those accounts was smoked.^[20]^{: 89, 91–92}

Central and East Africa

In Rwanda, survey answers collected in 1959–1960 tied the smoking of injaga to Twa men and mentioned only occasional medicinal use among Hutu and Tutsi.^[21]^: 221

Réunion

On Réunion, where cannabis is called zamal, the plant was grown in house gardens and cane fields and had a place in both the magical and the herbal medicine of the island. Healers put it in their infusions: boiled roots were given to stop infants vomiting and a leaf infusion against fever. The anthropologist Jean Benoist wrote in 1975 that strict laws had led healers to replace it with less dangerous plants, and these uses had almost disappeared. Pounded leaves were still commonly put in chickens' drinking water against infectious disease.^[22]^{: 227, 230–231}

The Caribbean

In rural Jamaica in the early 1970s many who never smoked ganja, children among them, took it as medicine: as ganja tea, given to children from infancy, as ganja tonic made with rum or wine, and in poultices and compresses for pain and open wounds.^[23]^{: 38, 47–51} Of the 60 men in Rubin and Comitas's clinical sample, 53 had used ganja in some form as medicine, and the ailments they named included asthma, colds, stomach disorders, marasmus, fevers and rheumatism.^[23]^{: 126, 184} Rubin and Comitas found no evidence of cannabis being smoked or used in folk medicine in Jamaica before indentured labourers arrived from India in 1845, and traced the Jamaican uses to India.^[23]^: 16–19

Pharmacy in Europe and America

The London pharmacist Peter Squire wrote that W. B. O'Shaughnessy first brought Indian hemp to Britain, and that Squire made the drug into an extract, which was distributed among the profession under O'Shaughnessy's directions.^[24]^: 80 The British Pharmacopoeia of 1864 made the extract from the flowering tops by maceration in rectified spirit, and the tincture of Indian hemp by dissolving an ounce of it in a pint of spirit.^[25]^{: 222, 346} The British Pharmaceutical Codex of 1907 calls the extract "the basis of medicinal preparations of this drug". It also gives a paint for corns and warts made with the extract, compound salicylic collodion, and a hypnotic powder of hemp and tannic acid, cannabin tannate.^[26]^{: 201, 203, 273}

Published formulas of several patent medicines contain Indian hemp. A formula for the American hypnotic Bromidia printed by the American Medical Association in 1911 gives an eighth of a grain of extract of Cannabis indica with chloral hydrate, potassium bromide and hyoscyamus.^[27]^: 429 Charles W. Oleson's Secret Nostrums and Systems of Medicine of 1894 reprints a formula for Piso's Cure for Consumption with fluid extract of Cannabis indica, and two formulas for chlorodyne with the tincture. It also reprints the American pharmacist Fred. Rohnert's view that it had never been proved that the original chlorodyne contained cannabis.^[28]^{: 42–43, 137} The Paris pharmacists Grimault & Cie sold cigarettes indiennes of Cannabis indica for asthma.^[29] In French and Spanish pharmacy a purified alcoholic extract of hemp was called haschischine, and in Spain the hemp extract went into a liquor sold for stomach pain, Licor Montecristo de Haschisch.^[30]

Medicines