History of medical cannabis

Last updated December 09, 2023

The history of medicinal cannabis goes back to the ancient times. Ancient physicians in many parts of the world mixed cannabis into medicines to treat pain and other ailments. In the 19th century, cannabis was introduced for therapeutic use in Western Medicine. Since then, there have been several advancements in how the drug is administered. Initially, cannabis was reduced to a powder and mixed with wine for administration. In the 1970s, synthetic THC was created to be administered as the drug Marinol in a capsule. However, the main mode of administration for cannabis is smoking because its effects are almost immediate when the smoke is inhaled. Between 1996 and 1999, eight U.S. states supported cannabis prescriptions opposing policies of the federal government. Most people who are prescribed marijuana for medical purposes use it to alleviate severe pain.

Ancient China

"Dama", the Chinese word for "cannabis", compounds "big; great" and "cannabis; hemp." Da-ma.png — "Dàmá", the Chinese word for "cannabis", compounds "big; great" and "cannabis; hemp."

Cannabis, called má 麻 (meaning "hemp; cannabis; numbness") or dàmá 大麻 (with the compound Wikt:大, meaning "big; great") in Chinese, was used in Taiwan for fiber starting about 10,000 years ago.^[1] The botanist Hui-lin Li wrote that in China, "The use of Cannabis in medicine was probably a very early development. Since ancient humans used hemp seed as food, it was quite natural for them to also discover the medicinal properties of the plant."^[2] The oldest Chinese pharmacopeia, the (c. 100 AD) Shennong Bencaojing 神農本草經 ("Shennong's Materia Medica Classic"), describes cannabis.

The flowers when they burst (when the pollen is scattered) are called 麻蕡 (Pinyin: máfén) or 麻勃 (Pinyin: mábó). The best time for gathering is the seventh day of the seventh month. The seeds are gathered in the ninth month. The seeds which have entered the soil are injurious to man. It grows in Taishan (in Shandong ...). The flowers, the fruit (seed) and the leaves are officinal. The leaves and the fruit are said to be poisonous, but not the flowers and the kernels of the seeds.^[3]

The early Chinese surgeon Hua Tuo (c. 140–208) is credited with being the first recorded person to use cannabis as an anesthetic. He reduced the plant to powder and mixed it with wine for administration prior to conducting surgery.^[4] The Chinese term for "anesthesia" (mázui 麻醉) literally means "cannabis intoxication". Elizabeth Wayland Barber says the Chinese evidence "proves a knowledge of the narcotic properties of Cannabis at least from the 1st millennium B.C." when ma was already used in a secondary meaning of "numbness; senseless." "Such a strong drug, however, suggests that the Chinese pharmacists had now obtained from far to the southwest not THC-bearing Cannabis sativa, but rather Cannabis indica.^[5]

The Dutch sinologist Frank Dikötter's history of drugs in China says,

The medical uses were highlighted in a pharmacopeia of the Tang, which prescribed the root of the plant to remove a blood clot, while the juice from the leaves could be ingested to combat tapeworm. The seeds of cannabis, reduced to powder and mixed with rice wine, were recommended in various other materia medica against several ailments, ranging from constipation to hair loss. The Ming dynasty Mingyi bielu provided detailed instructions about the harvesting of the heads of the cannabis sativa plant (mafen, mabo), while the few authors who acknowledged hemp in various pharmacopoeias seemed to agree that the resinous female flowering heads were the source of dreams and revelations. After copious consumption, according to the ancient Shennong bencaojing, one could see demons and walk like a madman, even becoming 'in touch with the spirits' over time. Other medical writers warned that ghosts could be seen after ingesting a potion based on raw seeds blended with calamus and podophyllum (guijiu).^[6]

Cannabis is one of the 50 "fundamental" herbs in traditional Chinese medicine,^[7] and is prescribed to treat diverse indications. FP Smith writes in Chinese Materia Medica: Vegetable Kingdom:

Every part of the hemp plant is used in medicine ... The flowers are recommended in the 120 different forms of (風 feng) disease, in menstrual disorders, and in wounds. The achenia, which are considered to be poisonous, stimulate the nervous system, and if used in excess, will produce hallucinations and staggering gait. They are prescribed in nervous disorders, especially those marked by local anaesthesia. The seeds ... are considered to be tonic, demulcent, alternative [restorative], laxative, emmenagogue, diuretic, anthelmintic, and corrective. ... They are prescribed internally in fluxes, post-partum difficulties, aconite poisoning, vermillion poisoning, constipation, and obstinate vomiting. Externally they are used for eruptions, ulcers, favus, wounds, and falling of the hair. The oil is used for falling hair, sulfur poisoning, and dryness of the throat. The leaves are considered to be poisonous, and the freshly expressed juice is used as an anthelmintic, in scorpion stings, to stop the hair from falling out and to prevent it from turning gray. ... The stalk, or its bark, is considered to be diuretic ... The juice of the root is ... thought to have a beneficial action in retained placenta and post-partum hemorrhage. An infusion of hemp ... is used as a demulcent drink for quenching thirst and relieving fluxes.^[8]

Ancient Netherlands

In 2007, a late Neolithic grave attributed to the Beaker culture (found near Hattemerbroek [ nl ], Gelderland; dated 2459-2203 BCE) was found containing an unusually large concentration of pollen. After five years of careful investigation these pollen were concluded to be mostly cannabis along with a smaller amount of meadowsweet. Due to the fever-reducing properties of meadowsweet, the archeologists speculated that the person in the grave had likely been very ill, in which case the cannabis would have served as painkiller.^[9]

Ancient Egypt

The Ebers Papyrus (c. 1550 BC) from Ancient Egypt describes medical cannabis.^[10] Other ancient Egyptian papyri that mention medical cannabis are the Ramesseum III Papyrus (1700 BC), the Berlin Papyrus (1300 BC) and the Chester Beatty Medical Papyrus VI (1300 BC).^[11] The ancient Egyptians used hemp (cannabis) in suppositories for relieving the pain of hemorrhoids.^[12] Around 2,000 BCE, the ancient Egyptians used cannabis to treat sore eyes.^[13] The egyptologist Lise Manniche notes the reference to "plant medical cannabis" in several Egyptian texts, one of which dates back to the eighteenth century BCE.^[14]

Ancient India

Cannabis was a major component in religious practices in ancient India as well as in medicinal practices. For many centuries, most parts of life in ancient India incorporated cannabis of some form.^[15] Surviving texts from ancient India confirm that cannabis' psychoactive properties were recognized, and doctors used it for treating a variety of illnesses and ailments. These included insomnia, headaches, a whole host of gastrointestinal disorders, and pain: cannabis was frequently used to relieve the pain of childbirth.^[16] One Indian philosopher expressed his views on the nature and uses of bhang (a form of cannabis), which combined religious thought with medical practices. "A guardian lives in the bhang leaf. …To see in a dream the leaves, plant, or water of bhang is lucky. …A longing for bhang foretells happiness. It cures dysentery and sunstroke, clears phlegm, quickens digestion, sharpens appetite, makes the tongue of the lisper plain, freshens the intellect and gives alertness to the body and gaiety to the mind. Such are the useful and needful ends for which in His goodness the Almighty made bhang."^[15]

Ancient Greece

The Ancient Greeks used cannabis to dress wounds and sores on their horses.^[17] In humans, dried leaves of cannabis were used to treat nose bleeds, and cannabis seeds were used to expel tapeworms.^[17] The most frequently described use of cannabis in humans was to steep green seeds of cannabis in either water or wine, later taking the seeds out and using the warm extract to treat inflammation and pain resulting from obstruction of the ear.^[17]

In the 5th century BC Herodotus, a Greek historian, described how the Scythians of the Middle East used cannabis in steam baths. These baths drove the people to a frenzied state.^[17]

Medieval Islamic world

In the medieval Islamic world, including Northern Africa as well as Al-Andalus in present-day Spain and Portugal, Arabic physicians made use of the diuretic, antiemetic, antiepileptic, anti-inflammatory, analgesic and antipyretic properties of Cannabis sativa , and used it extensively as medication from the 8th to 18th centuries.^[18]

Cannabis sativa from Vienna Dioscurides, 512 AD Cannabissativadior.jpg — *Cannabis sativa* from *Vienna Dioscurides* , 512 AD

Modern history

An advertisement for Maltos-Cannabis, a Scandinavian cannabis-based drink popular in the early 20th century Maltoscannabis.png — An advertisement for *Maltos-Cannabis*, a Scandinavian cannabis-based drink popular in the early 20th century

In the mid 19th century, medical interest in the use of cannabis began to grow in the West.^[20] In the 19th century cannabis was one of the secret ingredients in several so-called patent medicines. There were at least 2,000 cannabis medicines prior to 1937, produced by more than 280 manufacturers.^[21] The advent of the syringe and injectable medicines contributed to an eventual decline in the popularity of cannabis for therapeutic uses, as did the invention of new drugs such as aspirin.^[20]

An Irish physician, William Brooke O'Shaughnessy, is credited with introducing the therapeutic use of cannabis to Western medicine in English-speaking countries. He was Assistant-Surgeon and Professor of Chemistry at the Medical College of Calcutta, and conducted a cannabis experiment in the 1830s, first testing his preparations on animals, then administering them to patients to help treat muscle spasms, stomach cramps or general pain.^[22] Modern medical and scientific inquiry began with doctors like O'Shaughnessy and Moreau de Tours, who used it to treat melancholia and migraines, and as a sleeping aid, analgesic and anticonvulsant. At the local level, authorities^{[ which? ]} introduced various laws which required preparations containing cannabis and were to be sold over the counter must be marked with warning labels under the so-called poison laws.^[23] In 1905 Samuel Hopkins Adams published an exposé entitled "The Great American Fraud" in Collier's Weekly about the patent medicines that led to the passage of the first Pure Food and Drug Act in 1906.^[24] This statute did not ban alcohol, narcotics, and stimulants in the medicines; rather, it required medicinal products to be labeled as such and curbed some of the more misleading, overstated, or fraudulent claims that previously appeared on labels.

At the turn of the 20th century the Scandinavian maltose- and cannabis-based drink Maltos-Cannabis was widely available in Denmark and Norway.^[19]^[25] Promoted as "an excellent lunch drink, especially for children and young people", the product had won a prize at the Exposition Internationale d'Anvers in 1894.^[19] A Swedish encyclopedia from 1912 claim that European hemp, the raw material for Maltos-Sugar, almost lacked the narcotic effect that is typical for Indian hemp and that products from Indian hemp was abandon by modern science for medical use. Maltos-Cannabis was promoted with text about its content of maltose sugar.^[26]

Later in the century, researchers investigating methods of detecting cannabis intoxication discovered that smoking the drug reduced intraocular pressure.^[27]^{[ unreliable source? ]} In 1955 the antibacterial effects were described at the Palacký University of Olomouc. Since 1971 Lumír Ondřej Hanuš was growing cannabis for his scientific research on two large fields in authority of the University. The marijuana extracts were then used at the University hospital as a cure for aphthae and haze.^[28] In 1973 physician Tod H. Mikuriya reignited the debate concerning cannabis as medicine when he published "Marijuana Medical Papers". High intraocular pressure causes blindness in glaucoma patients, so he hypothesized that using the drug could prevent blindness in patients.^{[ citation needed ]} Many Vietnam War veterans also found that the drug prevented muscle spasms caused by spinal injuries suffered in battle.^[29]

In 1964, Dr. Albert Lockhart and Manley West began studying the health effects of traditional cannabis use in Jamaican communities. They discovered that Rastafarians had unusually low glaucoma rates and local fishermen were washing their eyes with cannabis extract in the belief that it would improve their sight. Lockhart and West developed, and in 1987 gained permission to market, the pharmaceutical Canasol: one of the first cannabis extracts. They continued to work with cannabis, developing more pharmaceuticals and eventually receiving the Jamaican Order of Merit for their work.^[30]

Later, in the 1970s, a synthetic version of THC was produced and approved for use in the United States as the drug Marinol. It was delivered as a capsule, to be swallowed. Patients complained that the violent nausea associated with chemotherapy made swallowing capsules difficult. Further, along with ingested cannabis, capsules are harder to dose-titrate accurately than smoked cannabis because their onset of action is so much slower. Smoking has remained the route of choice for many patients because its onset of action provides almost immediate relief from symptoms and because that fast onset greatly simplifies titration. For these reasons, and because of the difficulties arising from the way cannabinoids are metabolized after being ingested, oral dosing is probably the least satisfactory route for cannabis administration.^[31]

Voters in eight U.S. states showed their support for cannabis prescriptions or recommendations given by physicians between 1996 and 1999,^{[ needs update ]} including Alaska, Arizona, California, Colorado, Maine, Michigan, Nevada, Oregon, and Washington, going against policies of the federal government.^[32] In May 2001, "The Chronic Cannabis Use in the Compassionate Investigational New Drug Program: An Examination of Benefits and Adverse Effects of Legal Clinical Cannabis" (Russo, Mathre, Byrne et al.) was completed. This three-day examination of major body functions of four of the five living US federal cannabis patients found "mild pulmonary changes" in two patients.^[33]

Among the more than 108,000 persons in Colorado who in 2012 had received a certificate to use marijuana for medical purposes, 94% said that severe pain was the reason for the requested certificate, followed by 3% for cancer and 1% for HIV/Aids. The typical card holder was a 41-year-old male. Twelve doctors had issued 50% of the certificates. Opponents of the card system claim that most card holders are drug abusers who are faking or exaggerating their illnesses; three-fourths male patients is not the normal pattern for pain patients, it is the normal pattern for drug addicts, claim the critics.

Related Research Articles

Cannabis is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: Cannabis sativa, C. indica, and C. ruderalis. Alternatively, C. ruderalis may be included within C. sativa, all three may be treated as subspecies of C. sativa, or C. sativa may be accepted as a single undivided species. The genus is widely accepted as being indigenous to and originating from Asia.

A cannabis edible, also known as a cannabis-infused food or simply an edible, is a food item that contains decarboxylated cannabinoids from cannabis extract as an active ingredient. Although edible may refer to either a food or a drink, a cannabis-infused drink may be referred to more specifically as a liquid edible or drinkable. Edibles are a way to consume cannabis. Unlike smoking, in which cannabinoids are inhaled into the lungs and pass rapidly into the bloodstream, peaking in about ten minutes and wearing off in a couple of hours, cannabis edibles may take hours to digest, and their effects may peak two to three hours after consumption and persist for around six hours. The food or drink used may affect both the timing and potency of the dose ingested.

Medical cannabis, or medical marijuana (MMJ), is cannabis and cannabinoids that are prescribed by physicians for their patients. The use of cannabis as medicine has not been rigorously tested due to production and governmental restrictions, resulting in limited clinical research to define the safety and efficacy of using cannabis to treat diseases.

<i>Materia medica</i> Historical Latin term for pharmacology

Materia medica is a Latin term from the history of pharmacy for the body of collected knowledge about the therapeutic properties of any substance used for healing. The term derives from the title of a work by the Ancient Greek physician Pedanius Dioscorides in the 1st century AD, De materia medica, 'On medical material'.

Bhang is an edible preparation made from the leaves of the cannabis plant originating from the Indian subcontinent. It has been used in food and drink as early as 1000 BC in ancient India. Bhang is traditionally distributed during the spring festival of Maha Shivaratri and Holi. Bhang is mainly used in bhang shops, which sell the cannabis-infused Indian drinks bhang lassi and bhang thandai.

Chinese herbology is the theory of traditional Chinese herbal therapy, which accounts for the majority of treatments in traditional Chinese medicine (TCM). A Nature editorial described TCM as "fraught with pseudoscience", and said that the most obvious reason why it has not delivered many cures is that the majority of its treatments have no logical mechanism of action.

Cannabis indica is an annual plant species in the family Cannabaceae indigenous to the Hindu Kush mountains of Southern Asia. The plant produces large amounts of tetrahydrocannabinol (THC) and tetrahydrocannabivarin (THCV) with levels up to 53.7% of total cannabinoid. It is now widely grown in China, India, Nepal, Thailand, Afghanistan, and Pakistan, as well as southern and western Africa, and is cultivated for purposes including hashish in India. The high concentrations of THC or THCV provide euphoric effects making it popular for use both as a recreational drug, alternative medicine, and a clinical research drug.

Different religions have varying stances on the use of cannabis, historically and presently. In ancient history some religions used cannabis as an entheogen, particularly in the Indian subcontinent where the tradition continues on a more limited basis.

Cannabis tea is a cannabis-infused drink prepared by steeping various parts of the cannabis plant in hot or cold water. Cannabis tea is commonly recognized as an alternative form of preparation and consumption of the cannabis plant, more popularly known as marijuana, pot, or weed. This plant has long been recognized as an herbal medicine employed by health professionals worldwide to ease symptoms of disease, as well as a psychoactive drug used recreationally and in spiritual traditions. Though less commonly practiced than popular methods like smoking or consuming edibles, drinking cannabis tea can produce comparable physical and mental therapeutic effects. Such effects are largely attributed to the THC and CBD content of the tea, levels of which are drastically dependent on individual preparation techniques involving volume, amount of cannabis, and boiling time. Also in common with these administration forms of cannabis is the heating component performed before usage. Due to the rather uncommon nature of this particular practice of cannabis consumption in modern times as well as the legality of cannabis throughout the World, the research available on the composition of cannabis tea is limited and based broadly around what is known of cannabis as it exists botanically.

Cannabis strains are either pure or hybrid varieties of the plant genus Cannabis, which encompasses the species C. sativa, C. indica, and C. ruderalis.

The history of herbalism is closely tied with the history of medicine from prehistoric times up until the development of the germ theory of disease in the 19th century. Modern medicine from the 19th century to today has been based on evidence gathered using the scientific method. Evidence-based use of pharmaceutical drugs, often derived from medicinal plants, has largely replaced herbal treatments in modern health care. However, many people continue to employ various forms of traditional or alternative medicine. These systems often have a significant herbal component. The history of herbalism also overlaps with food history, as many of the herbs and spices historically used by humans to season food yield useful medicinal compounds, and use of spices with antimicrobial activity in cooking is part of an ancient response to the threat of food-borne pathogens.

Cannabis in India has been known to be used at least as early as 2000 BCE. In Indian society, common terms for cannabis preparations include charas (resin), ganja (flower), and bhang, with Indian drinks such as bhang lassi and bhang thandai made from bhang being one of the most common legal uses.

Cannabis in Portugal is decriminalized, as a result of the decriminalization of all drugs in Portugal in 2001. Medical use of cannabis was legalized in 2018.

Cannabis in Sri Lanka is legally sold through Ayurveda herbal shops, and can be used for medical and scientific purposes if given a license by the Ministry of Health. For recreational usage cannabis is not legal.

Cannabis in China is illegal except for industrial purposes (hemp) and some forms of medicine. Historically, cannabis has been used in China for fiber, seeds, as a traditional medicine, as well as for some ritual purposes within Taoism.

Cannabis has served as an entheogen—a chemical substance used in religious or spiritual contexts—in the Indian subcontinent since the Vedic period dating back to approximately 1500 BCE, but perhaps as far back as 2000 BCE. It was introduced to the New World by the Spaniards in 1530-1545. Cannabis has been used by shamanic and pagan cultures to ponder deeply religious and philosophical subjects related to their tribe or society, to achieve a form of enlightenment, to unravel unknown facts and realms of the human mind and subconscious, and also as an aphrodisiac during rituals or orgies. There are several references in Greek mythology to a powerful drug that eliminated anguish and sorrow. Herodotus wrote about early ceremonial practices by the Scythians, thought to have occurred from the 5th to 2nd century BCE. Itinerant Hindu saints have used it in the Indian subcontinent for centuries. Mexican-Indian communities occasionally use cannabis in religious ceremonies by leaving bundles of it on church altars to be consumed by the attendees.

<span class="mw-page-title-main">History of cannabis</span> Aspect of history

The history of cannabis and its usage by humans dates back to at least the third millennium BC in written history, and possibly as far back as the Pre-Pottery Neolithic B based on archaeological evidence. For millennia, the plant has been valued for its use for fiber and rope, as food and medicine, and for its psychoactive properties for religious and recreational use.

Michael Alan Krawitz is a US Air force veteran, Executive Director of the non-profit Veterans for Medical Cannabis Access, researcher on the history of medical cannabis, and international advocate for cannabis policy reform with FAAAT think & do tank and the International Association for Cannabinoid Medicines.

Ma is the Chinese word for cannabis. The term ma, used to describe medical marijuana by 2700 BCE, is the oldest recorded name for the hemp plant.

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