Medicinal Uses of Cannabis Throughout History

Cannabis, one of the oldest plants used in medicine, has a rich history of cultural, medical and legal implications. Today on the Cannactiva blog, we explain the history of the medicinal use of cannabis and the plant’s journey through the years to help humanity.

First evidence of medical cannabis use

The medicinal use of cannabis dates back thousands of years. Cannabis is one of the first plants cultivated by humans, with evidence of its cultivation dating back to 4,000 BC in China.

In the pharmacopoeia ‘Pen Ts’ao Ching’, the oldest Chinese medical text mentioning cannabis, dating from the 1st century AD, its use is described to relieve rheumatism, gout and malaria (1). This knowledge dates back to the time of Emperor Shen Nung, around 2,700 BC.

In Egypt, there are ancient descriptions of hemp or cannabis in a text engraved in the Pyramids of Memphis, dated 2,350 BC, where it is mentioned as a plant for making ropes. On the other hand, papyri from 1,700 B.C. speak of the medical properties of cannabis to treat eye problems, gynecological disorders and migraines (2).

Expansion of medical cannabis to India

The medicinal use of cannabis spread from China to India, the Middle East and finally to Europe. In India, cannabis was used to treat pain, indigestion, diarrhea and skin conditions.

The ‘Sushruta Samhita’, an ancient Indian text, mentions cannabis as a remedy for diarrhea, catarrh and fever (3).

While the ‘Atharvaveda’, a text from 1,600 BC, categorizes cannabis as a sacred plant, bestowing happiness and freedom (4).

Contributions from the Middle East in medical cannabis

During the Islamic Golden Age, cannabis was also noted for its medicinal uses. It was mentioned in medical compendia from 1,000 A.D., such as those of Avicenna, where it is noted that cannabis was used as a diuretic, digestive and to cleanse the brain.

Years later in 1464, it was reported that cannabis resin cured the epilepsy of one person (5), being the first data on the use of cannabis for epilepsy.

Africa, America and Europe in the historical medical use of cannabis

Muslims introduced cannabis to Europe around 1,150 A.D., through paper made from hemp fiber. Although there is no concrete evidence of its medicinal use until medieval times, it is known to have been part of folk medicine to treat tumors, coughs and jaundice. The medieval text ‘The Herball, or General Historie of Plantes’ (1597) by John Gerard, mentions cannabis as a remedy for various ailments (6).

In Africa, cannabis is known to have been present since at least 1,400 A.D., being used mainly to treat malaria, childbirth, anthrax, asthma and dysentery (5).

The first cannabis seeds arrived in America in the 16th century, through the trade of African slaves, who were already using cannabis medicinally. In Brazil, for example, it was used in rural areas to relieve dental pain and menstrual cramps (7).

19th century: Cannabis in Western medicine

Despite the use of cannabis in different traditions around the world, cannabis was introduced into Western medicine thanks to the work of the Irish physician William B. O’Shaughnessy.

O’Shaughnessy’s work, which was conducted in India over several years, led him to evaluate, describe and introduce cannabis into Western medicine. Among the medicinal applications of cannabis described by O’Shaughnessy, its ability to treat rheumatism, epilepsy and pain stand out. His findings, published in ‘Transactions of the Medical and Physical Society of Bengal’ (1838-1840) influenced the adoption of cannabis in Europe and North America.

One of the most popular anecdotes of the time is that of Sir John Russell Reynolds (1828-1896), physician to Queen Victoria of England, who prescribed cannabis to relieve the monarch’s menstrual cramps. Reynolds was an advocate of medical cannabis, including the treatment of epilepsy and pain. He published several articles on its therapeutic benefits, and considered it one of the most valuable drugs.

Another prominent personality was Jacques-Joseph Moreau (1804-1884), a French psychiatrist who was one of the first to study the psychotropic effects of cannabis. Moreau traveled to the Middle East to research the effects of hashish, and founded the Club des Hashischins in Paris, a meeting place to experiment with hashish.

Cannabis use began to spread around the world. More than 100 scientific articles supporting the medical value of cannabis were published in Europe and the United States.

The medical indications of cannabis during these years until the 20th century were mostly attributed to its sedative, hypnotic and analgesic capacity (5).

Rollback of medical cannabis in the 20th Century

In Western culture, interest in medicinal cannabis declined due to the varied effects observed from plants grown in different regions and regulatory restrictions, such as the Marihuana Tax Act of 1937 in the United States. In 1941, cannabis was removed from the American pharmacopoeia (5).

On the other hand, recreational use of cannabis exploded in this century, peaking in the 1960s. A crucial aspect was the 1961 Single Convention on Narcotic Drugs. This international treaty, adopted under the auspices of the United Nations, marked an important milestone in shaping global drug policy, including cannabis. The Convention classified cannabis flowers and resins among the substances subject to international control, which led to the adoption of strict measures against their production, commercialization and non-medicinal use. This treaty has had a lasting impact on the legislation and social perception of cannabis as a dangerous drug, producing stigma and policies that have limited both individual freedom and medical research and therapeutic use of cannabis.

Although its recreational use contributed to the wave of prohibition and restriction of cannabis in many countries, it also rekindled the interest of the scientific community to study the properties of cannabis and its potential benefits to mankind.

Late 20th and early 21st century

The discovery of the endocannabinoid system in the 1990s and subsequent research underscored the therapeutic potential of cannabis. Mechoulam and Parker (2013) in ‘Nature Reviews Neuroscience’ (8) explore the role of this system in modulating physiological processes, laying the foundation for understanding the medical applications of cannabis.

Raphael Mechoulam deserves additional recognition for his pioneering work. This Israeli chemist, often referred to as “the father of medical cannabis,” first isolated and synthesized THC (tetrahydrocannabinol), the main psychoactive compound in cannabis, in 1964. His research has been instrumental in understanding how cannabinoids interact with the human body.

Also noteworthy is the work of Lester Grinspoon, psychiatrist and professor emeritus at Harvard Medical School. He was an early advocate of medical cannabis after initially being skeptical of its benefits. He published one of the most iconic cannabis books, “Marihuana Reconsidered” in 1971, a book in which he re-evaluates cannabis and advocates its medicinal use. His work helped change public perception of cannabis at a time when it was heavily criminalized.

Legalization and current medical use of cannabis

The 21st century is marked by a wave of legalization of medical cannabis in Europe and several regions, driven in part by growing scientific evidence and public advocacy. Its medical use is now legal in numerous countries and states, albeit under strict regulations.

Conclusion

The journey of cannabis, from an ancient medicinal plant to a controversial substance and then a therapeutic agent, reflects the complexity of its relationship with society and medicine. The historical context and current scientific research provide a compelling narrative on the medical potential of cannabis, however, the debate over its use and legality will remain an open window to new conclusions.

References

1. Li HL, Lin H. An archaeological and historical account of cannabis in China. Econ Bot 1974;28(4):437-47. Available at: https://www.jstor.org/stable/4253540
2. Russo E. B. (2007). History of cannabis and its preparations in saga, science, and sobriquet. Chemistry & biodiversity, 4(8), 1614-1648. https://doi.org/10.1002/cbdv.200790144
3. Bania G. (2022). Shifts in therapeutic practices and decline of medicinal cannabis in Indian North-Eastern Frontier (1826-1925). Journal of cannabis research, 4(1), 52. https://doi.org/10.1186/s42238-022-00159-4
4. Touw M. (1981). The religious and medicinal uses of Cannabis in China, India and Tibet. Journal of psychoactive drugs, 13(1), 23-34. https://doi.org/10.1080/02791072.1981.10471447
5. Zuardi A. W. (2006). History of cannabis as a medicine: a review. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 28(2), 153-157. https://doi.org/10.1590/s1516-44462006000200015
6. House of Lords, Science and Technology – Ninth Report. (1998). Chapter 2 – History of the Use of Cannabis. Science and Technology Committee Publications. Available at: https://publications.parliament.uk/pa/ld199798/ldselect/ldsctech/151/15103.htm
7. Pinho AR. Social and medical aspects of the use of cannabis in Brazil. In: Rubin V, eds. Cannabis and culture. Paris: Mounton Publishers; 1975. p. 293-302. Available at: https://cannalib.eu/wp-content/uploads/2022/03/Cannabis-and-Culture-1975.pdf
8. Mechoulam, R., & Parker, L. A. (2013). The endocannabinoid system and the brain. Annual review of psychology, 64, 21-47. https://doi.org/10.1146/annurev-psych-113011-143739