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Medicinal

The leaves and bark of the willow have been mentioned in ancient texts from Assyria, Sumer and Egypt and in Ancient Greece the physician Hippocrates wrote about its medicinal properties in the fifth century BC.

Interpreting Mesopotamian cuneiform texts is a challenge, especially when looking for something as specific as a species of plant being used to treat a recognisable condition. Some 5,000 medical prescriptions have been identified from Babylonian writings of the 7th to 3rd centuries BC, involving 1,300 drugs from 340 different plants. Whether any of these relate to willow is uncertain. The seeds of the Haluppu-tree were recommended in the Sumerian narrative of Gilgameš, Enkidu and the Nether World as treatment for infertility, but the "Haluppu-tree" could have been oak, poplar or willow.

The ancient Egyptian Ebers Papyrus mentions willow (of uncertain species) in three remedies. One, as part of an elaborate recipe for a poultice to "make the met supple," which involved 36 other ingredients including "fruit of the dompalm, beans and amaa grains." The meaning of met is uncertain, but it may be something to do with the nervous system. The second is as part of a treatment for the "Great Debility," when "rush from the green willow tree" is combined with ass's semen, fresh bread, herbs of the field, figs, grapes and wine. Finally, it is used as a stiffening agent in a concoction of "fat flesh, figs, dates, incense, garlic and sweet beer" to put the heart into proper working order and make it take up nourishment.

The Roman author Aulus Cornelius Celsus only mentions willow once: the leaves, pounded and boiled in vinegar, were to be used as treatment for uterine prolapse, but it is unclear what he considered the therapeutic action to be; it is unlikely to have been pain relief, as he recommended cauterization in the following paragraph.

Nicholas Culpeper, in The Complete Herbal, gives many uses for willow, including to staunch wounds, to "stay the heat of lust" in man or woman, and to provoke urine ("if stopped"), but he makes no mention of any supposed analgesic properties. His recommendation to use the burnt ashes of willow bark, mixed with vinegar, to "take away warts, corns, and superfluous flesh," seems to correspond with modern uses of salicylic acid. William Turner 's account, written about 1597, focuses on the ability of the leaves and bark to "stay the spitting of blood, and all other fluxes of blood", if boiled in wine and drunk, but adds a treatment for fever, saying: "the green boughs with the leaves may very well be brought into chambers and set about the beds of those that be sick of fevers, for they do mightily cool the heat of the air, which thing is a wonderful refreshing to the sick patients."

In 1763, Reverend Edward Stone, of Chipping Norton, Oxfordshire, England, sent a letter to the Royal Society describing his experiments with powdered bark of white willow (Salix alba). He had noticed the willow bark tasted bitter, like 'Peruvian Bark' (cinchona), which was used to treat fevers, and he speculated that the willow would have a similar effect. Over several years he tested it on as many as fifty patients and found it to be highly effective (especially when mixed with cinchona). Whether this was a real effect or not is unknown, but although Stone's remedy was experimented with by others at the time, it was never adopted by medical practitioners. During the American Civil War, Confederate forces also experimented with willow as a cure for malaria, without success.

In his novel The Mysterious Island (1875), the French novelist Jules Verne outlined the state of scientific knowledge concerning medicinal uses of willow when one of his characters, Herbert (Harbert) Brown, was suffering from a fever induced by a bullet wound: "The bark of the willow has, indeed, been justly considered as a succedaneum for Peruvian bark, as has also that of the horse-chestnut tree, the leaf of the holly, the snake-root, etc.", he wrote. In the story, Herbert is treated with powdered willow bark to no effect, and is saved when a supply of quinine is discovered. It is clear in the novel that the causes of fevers were poorly understood, and there is no suggestion at all of any possible analgesic effect from the use of willow.

The first lasting evidence that salicylate, from willow and other plant species, might have real medicinal uses came in 1876, when the Scottish physician Thomas MacLagan experimented with salicin as a treatment for acute rheumatism, with considerable success, as he reported in The Lancet. Meanwhile, German scientists tried salicylic acid in the form of sodium salicylate, a sodium salt, with less success and more severe side effects. The treatment of rheumatic fever with salicin gradually gained some acceptance in medical circles.

The discovery of acetanilide, in the 1880s, gave rise to an 'acetylation' craze, where chemists experimented with adding an acetyl group to various aromatic organic compounds. Back in 1853, chemist Charles Frédéric Gerhardt treated the medicine sodium salicylate with acetyl chloride to produce acetylsalicylic acid for the first time. More than 40 years later in 1897, Felix Hoffmann created the same acid (in his case derived from the Spiraea plant), which was found in 1899 to have an analgesic effect. This acid was named " Aspirin " by Hoffmann's employer Bayer AG. The discovery of aspirin is therefore only indirectly connected to willow.

In the late 1990s, Daniel Moerman reported many uses of willow by Native Americans. One modern field guide claims that Native Americans across the Americas relied on the willow as a staple of their medical treatments, using the bark to treat ailments such as sore throat and tuberculosis, and further alleging that "Several references mention chewing willow bark as an analgesic for headache and other pain, apparently presaging the development of aspirin in the late 1800s."

Herbal uses of willow have continued into modern times. In the early 20th century, Maud Grieve described using the bark and the powdered root of white willow (Salix alba) for its tonic, antiperiodic and astringent qualities and recommended its use in treating dyspepsia, worms, chronic diarrhoea and dysentery. Like other herbalists, she makes no mention of it having any analgesic effect, despite widespread awareness of aspirin by this time, and she considered tannin to be the active constituent.

It was long after the invention of aspirin that the idea emerged that willow bark is an effective painkiller. It may often be based on the belief that willow actually contains aspirin. Articles asserting that the ancients used willow for this purpose have been published in academic journals such as the British Journal of Haematology. There are now many papers, books and articles repeating the claim that the ancients used willow for pain relief, and numerous willow-based products can be purchased for this purpose. Modern research suggests that only the mildest analgesic effect could be derived from the use of willow extract, and even that may be due to flavonoids and polyphenols as much as salicylic acid.