Thursday, February 12, 2015

Determination of the Determining Power:

Ode to an icon of 19th century medical reform and his contributions to the culture of Physiomedicalism.

“Some are in the belief, and are free to express that belief, that the name of Samuel Thomson will live in all future ages, and continue to brighten in proportion to the circulation and development of the full extent of his medical discoveries…For, if the future age should receive his character from the present, loaded with slander, it will nevertheless, place a due estimate upon that practice of medicine which he originated amidst the persecution and calumny of the present generation; and they will do justice to his name, and to his medical discovery…” - David Tower, Four Lectures on the Thomsonian Practice of Medicine, 18281

Introduction: the Battlefield of American Medicine

Regulars, Allopaths, Homeopaths, Root Doctors, Thomsonians, Neo-Thomsonians, Eclectics, Physios. Diving into the subject of 19th century American Medicine requires a suit of armored protection for unbiased inquiry and historical fact-checking prowess (to neither of which I lay claim).  It is a messy, brutal warscape, writhing with the confusion, complexity, and accusatory tone typical of conflict-driven sectarianism. Jacksonian era politics and social norms ensured that the laws that regulated the practice of medicine rapidly disappeared, and within this context, medical anarchy ensued.2-4 Different factions of therapeutic philosophy began to appear and publish literary arguments about the cause and more specifically the treatment of disease. They also argued internally about what to call themselves and their principles of practice and therapeutic strategy, about the nature and form of medical education, and about who should be qualified to receive the illustrious title of ‘Physician’ (or the acrimonious distinction of ‘Quack’). This hot bed of reformation also targeted elitism and classism as symptoms of an anti-democratic plague thereby empowering a common ‘do-it-yourself’ population.3 (p443) The concept of ‘self-help’ became the booming timpani within medical reform by challenging the perception that the role of physician was necessary for the healing of disease and more aggressively, that the ‘Regular’ practice of medicine was actually safe and efficacious.2(p15),5

There are a few historians that have attempted to traverse this hostile territory, many focusing on the merited evolution of modern allopathic medical practice out of an otherwise barbaric history.6-10 Even more to the point, there have been some medical historians that have looked into the face of what has been termed America’s Botanico-medical movement4 in an attempt to reiterate the foundations of therapeutic strategy for the ever-growing herbal medicine movement of modern times. Their attempts have been to reconnect practitioners of herbal medicine to a system of medical therapeutics that continues to be central to its present-day practice.11-15 Their work succeeds in reconstructing the long-lost tangibility of Western herbal medicine theory and practicum that many of us modern herbal medicine practitioners may feel is missing within our clinical practice. I take my hat off to them, for they are warriors in their own right.

The following essay is an investigation into Samuel Thomson, a true icon of 19th century medical reform, and his system of therapeutics (Thomsonianism) that spread like wild-fire across a violent and sickly landscape, creating fertile ground for the development of botanical medicine in America and abroad.  The nature of life and the human body and how to define disease and its causation, form the basis of the once widely utilized Thomsonian system of therapeutics.14  These foundational concepts, although metamorphic in nature, remain intact philosophies within the principles and practice of modern Physiomedicalism whose primary therapeutic objective is support of the ‘vital force’.13(p11),14(p7)

However, these fundamental Thomsonian concepts, as outlined below, were not novel ideas.  Although Samuel Thomson himself readily admits to being ‘uneducated’, there is little doubt that he was privy to the legacies of Galen and Hippocrates, as well as larger philosophical debates taking place within medicine and the neighboring fields of chemistry and physics during his time.  What made Thomsonian medicine unique however, was that it was the first system whose materia medica was solely based on medicinal plants (refusing the use of mineral preparations), and that brought the following larger concepts together to form a concrete therapeutic system with reproducible results (and had enough fortitude to publicly upset the entire practice of allopathy and even perhaps inform its evolution.)2(p17-18),5
Samuel Thomson (1769-1843), the father of Western herbal medicine. Holding his beloved No. 1, Lobelia inflata. Photo compliments of Center for the History of Medicine.
Planting the Seed of Vitalism
Thomsonian medicine was born within an era of opposing views regarding the nature of ‘life phenomena’17(p18), an academic, philosophical, and religious debate which was deeply influencing late 18th century and 19th century scientific research into the laws of organic and inorganic chemistry and physics, and hence the fields of physiology and medicine.17-19  One side of this vitalism vs. mechanism debate found its ancestry in Georg Ernst Stahl’s (1660-1734) principles of anima,2(p91) which declared that even though the living and the nonliving are both composed of matter, the difference between them is the presence of an immaterial vital principle (anima). This anima could only be described or studied within the context and understanding that living matter is endeavoring towards a particular goal or purpose and this endeavor, or goal-seeking effort, is driven by the directive agency of anima over the mechanical manifestations within living matter.20 Anima was endowed with intelligence and represented a ‘finite portion of the universal spirit that actuates all creation’.21(p531)

Samuel Thomson was revered by medical reformers for rekindling the concept of anima, or vitalism, in governance of physiology and hence medical therapeutics.2(p91) This concept was later termed ‘vital force’ by the Physiomedicalists,22 but Thomson himself never specifically referred to it as such. Instead, the presence of this concept within Thomson’s theory and practice is inferred from his explanations of the constitution of life and the body, the cause and treatment of disease, and his objections to the employment of blood-letting and the use of ‘depletive remedies’, such as mercury, arsenic and opium, by allopathic or ‘regular’ physicians.5(p191) Thomson states: 

“For there are but two great principles in the constitution of things, the principle of life and the principle of death.  That which contains the principle of life, can never be tortured into an administration of death.  If, then, a medicine is good in any case, it is because it is agreeable to nature, or this principle of life, the very opposite of disease.”5(p188)

Lobelia inflata. From Vegetable Materia Medica of the U.S. William Barton, 1818. Thomson claimed to have discovered the medicinal value of this species as a child.  It is by far the most important medicinal plant found in his New Guide to Health, for an entire system of medicine was built around its use.
This concept of animism or vitalsim is often directly stated by Thomson’s contemporaries under various and sundry titles and explanations.23-26 A clear example of this can be found in Four Lectures on the Thomsonian Practice of Medicine,1 whereby Tower embarks upon the clarification of what he calls ‘the active power’ with the premise that the organization of the human body and all its elements was proof in and of itself that it was designed for such animation.  He states:

“The great point with us, as physicians, is, to know what principles are active, and what passive, in animal motion.  The nature of the active power, and the nature of that on which it is exerted. For there must be such an agent as active power, and this active power acts on material substances.  It is necessary for the physician to have correct views of the active power, for in diseases the active power is weakened and diminished by inanimate matter, and it must be assisted…”1(p42)

Heat, or the Determining Power and the Vital Flame

Samuel Thomson actively called upon and quoted aspects of Galenic and Hippocratic medical philosophy in the formation of his system of medicine.  For example, he believed that the human body was comprised of the four elements (earth, air, fire and water), whereby earth and water constituted the ‘solids’, and air and fire (or heat) were the cause of life and motion.5(p185) In addition, Thomson quotes the Hippocratic sentiment of ‘nature is heat’,5(p190) forming his entire system of therapeutics around the axiom ‘heat is life, and cold is death’, whereby adding or diminishing heat could promote either health or disease.5(p43) Thomson described his theory of this vital heat as ‘the determining power’5(186) which flowed outward from a ‘fountain’5(p188), the stomach, having been fueled by the digestion of food and nourishing substances.  This is not dissimilar to the concept of Agni (its various types and functions) of Ayurvedic (Indian) medicine.27 Thomson writes:

“Our life depends on heat; food is the fuel that kindles and continues that heat…The stomach is the deposit from which the whole body is supported.  The heat is maintained in the stomach by consuming the food; and all the body and limbs receive their proportion of nourishment and heat from that source; as a whole room is warmed by the fire which is consumed in the fire-place.”5(p186)

We see many similar metaphors regarding this subject in the writing of Thomson’s contemporaries, all of which suggest that Thomson was not alone in his vitalistic argument of heat as the great animator of life. Often referred to as the ‘caloric’, it was evidenced from the observation of heat in the natural world, that it must play a role in the animism of the human body. This argument was based upon the seasons as observed within northern hemisphere, whereby the heated time of year brought forth the flourishing of movement and life just as the winter yielded stillness and death.1(p41-42)  This comparison was further indulged by the admiration of the sun as ultimate regulator of life which sits at the center of all known things, perpetually exerting an omnipotent energy outward into the universe.21(pvi)  Although this particular Romanesque argument venerated the heart as the seat of ‘calor vitalis’ and compared it as such to the Sun21(p530) (unlike Thomson who recognized the stomach and digestion as the source of vital heat), nonetheless it expresses inherent support for Thomson’s axiom and his concept of the ‘vital flame’.5(p188) These literary examples are furthermore fortified by discussions regarding the role of heat as a catalyst in chemical reactions,21 its effects on water in the creation of steam,1(p43) and many others.


Defining Disease and its Causation: an inherent philosophy of Vitalism

Building upon the apothegmatic construct of heat as the source of life, Thomson’s definition of disease and his views on its causation also speak to an inherent philosophy of Vitalism.  Although his sentiments were described differently by various Thomsonian authors, according to their doctrine there was one singular cause of disease and in describing this cause one could define disease in simple terms.  There was no need for the various and sundry names and titles denoted by the ‘Regular faculty’ in the differentiation of disease states.5(pg191), 24(p12)

To Thomson, the human body being made up of the aforementioned elements of earth, air, fire, and water, was only able to achieve a perfect state of health when each of these elements were in balance with one another5(p185).  When these elements were thrown off balance (for whatever reason), the imbalance created a diminution or absence of fire, or ‘heat’, and in this absence of heat the body would be proportionally affected by ‘cold’.5(p186) ‘Cold’ was henceforth the cause of ‘obstructions to perspiration’, and these ‘obstructions’ manifest themselves as symptoms of disease, often referred to by Thomson as ‘canker’ and ‘putrification’. It was ‘cold’, therefore, that was at the seat of all disease, being opposite to all that supported life. This was the singular cause of all of human suffering.5(p185-189)  Thomson himself was adamant about this singular causation:

“And I found that all disorders which the human family are afflicted with, however various the symptoms, and different the names by which they are called, arise directly from obstructed perspiration, which is always caused by cold, or want of heat.”5(p43)

Sorry...couldn't help myself. This picture definitely represents the epitome of both 'cold' and 'ill'. Jack Nicholson in The Shining.
This approach to defining disease from a physiological perspective (albeit potentially limited), rather than defining disease based upon its symptomatic presentation, represents support for the larger concept of vitalism present in Thomsonian medicine, as well as in its evolved state of Physiomedicalism.13-14,28-29 In this regard, Thomson often describes what could be interpreted as an epic battle between inward heat, or the determining power, and the external forces applied by ‘cold’ in the causation of disease. He likened this determining power, which originated in the stomach, to a fountain whose outward flow could be easily overpowered by the influence of the stream (the cold).  He writes:

“The inward heat is the fountain of life, and as much as that has the power above the outward heat, so much we have life and strength, and when we lose this power of heat, our strength and faculties decay in proportion; and it is immaterial whether we lose this power by losing the inward heat or raising the outward heat above it, as the effect is the same...When the outward heat becomes equal with the inward…cold assumes the power and death takes place.”5(p193)

We see different variations of these sentiments throughout Thomsonian literature.2(p25-43) Although narrowed down to a singular causation, the explanation of pathology, or the effects of an overpowering ‘cold’, sometimes shifted between concepts such as canker and putrification,5 obstructions as caused by canker and putrification,5,25,30 or in some perspectives ‘loss of tone to the organs’.24(p8)  By and large however, there was a general agreement within Thomsonian medicine that a singular cause and hence therapeutic strategy was clear. Countering cold, or supporting heat as the living power of the system (vital flame), was the primary therapeutic objective.

Thomsonian Therapeutics: In support of the Determining Power

As all disease within the human body was believed to be caused by cold and its obstructions, it was very evident to Thomson and his followers that this general causation need only be countered by a general remedy.  The Thomsonians were clear, however, that one general remedy did not mean a single therapeutic agent, but rather a single therapeutic approach.5,23-24,26 Thomson’s patented system, or the general cure, sought first and foremost to rekindle the vital flame, or determining power, by raising internal heat to clear obstructions, followed by a cleansing of the stomach and bowels so digestion, or ‘the fountain’, could once again maintain the determining power on its own:

“There is no mystery in it, the whole plan consists of keeping the determining power to the surface from the fountain of the body, which is the stomach; from which all the limbs receive their support and warmth, and when you cannot raise their support and warmth, and when you cannot raise the fountain sufficient to give nature its proper course, you must lower the stream, or outward heat, by keeping the heat down on the limbs and raising the inward heat, when there can no mortification ever return from the limbs to the body, any more than a log can float against the stream.”5(p138-139

Surprisingly, this sentiment of ‘general cause, general remedy’ was shared by different therapeutic philosophies even within the practice of allopathic or Regular medicine.2(p16-17),4,31 In this regard, there was also at times agreement between Thomsonians and Regulars about their respective therapeutic mechanisms as outlined in the following statement:

“Dr. Thomson by considering disease as the general effect of a general cause, obstruction, fixed his remedy, like the others.  Remove the obstruction is his cure.  Remove the debility is Dr. Brown’s cure [referring to Dr. John Brown and his Brunonian system]. Remove the morbid excitement is Dr. Rush’s cure [Dr. Benjamin Rush of Philadelphia who heavily employed the practice of blood-letting].  And all done by diffusive stimulants. The debility is to be removed by diffusive stimulants. The morbid excitement by diffusive stimulants. The obstruction by diffusive stimulants.26(p29)

Therefore, the mechanics of Thomsonian therapeutics did not differ much from the popularized heroic32 practices of Regular medicine, both of which sought to effect a cure through stimulating secretions from the body.2,4 However, even with the employment of strong emetics, purgatives, and diaphoretics, Thomson believed his practice was superior, safer, and more efficacious than that of allopathic practice because his system worked with the body rather than against it. He used steam baths and botanicals as the therapeutic agents, rather then what he called ‘depletive remedies’ or ‘instruments of death’,5(p187) such as mercury and arsenic, and the practice of blood-letting. These en vogue agents of the Regulars, Thomson argued, worked against nature and the determining power, by promoting cold and therefore death.5(p188)  A good example of this is present in Thomson’s opinions about the role of fevers:

“I have found by experience, that the learned doctors are wrong in considering fever a disease or enemy; the fever is a friend, and cold the enemy…it is the struggle of nature to throw off disease…If cold, which is the commonly received opinion, (and which is true) is the cause of fever, to repeatedly bleed that patient, and administer mercury, opium, nitre, and other refrigerents to restore him to health, is as though a man should, to increase a fire in his room, throw a part of it out of the house, and to increase the remainder, put on water, snow, and ice!”5(p191)

Breathing a Vein. James Gillray, published by H. Humphrey, St James’s Street, London, January 28, 1804. Thomson was adamantly opposed to the popular heroics of bloodletting as practiced by the Regular physicians of his time.
In reading Thomson’s New Guide to Health5 it becomes apparently clear that the primary objective in the treatment of disease was to support the body’s own recuperative agenda. This approach of supporting physiology, honoring the vital force by working with the body rather than against it, has become an essential feature in the practice of present-day Western herbal medicine.12,33 There is an emphasis placed upon the importance of investigating the physiology, rather than the symptoms of disease, prior to the application of a therapeutic strategy.14(p8),33 There is still present a belief or faith in the self-affirming and self-regulating power of nature, and the unprecedented importance of supporting this power in the negotiation for wellness.

Conclusions: Vix Medicatrix Naturae

The irony of modern day historical investigation into the heart of turbulent 19th century medicine lies in an apparently biased interpretation of historical literature.  The side you are investigating from (because yes, there are still sides), modern orthodoxy or the holistic paradigm, continues to dictate the outcomes of our perceptions of history.  However, in my days of studying linguistic anthropology I learned that one must speak the language if they are hopeful of ever even attempting to understand a culture.  Therefore, it is in the language of the Thomsonian approach to the treatment of disease where the present day practitioner of Western herbal medicine can begin to appreciate the culture of Physiomedicalism.

https://francisjogottlieb.files.wordpress.com/2014/01/loss.jpg

 Thomsonianism promoted the principle of supporting the vital force that became the cornerstone of the practice of past and present-day Physiomedicalism.13-14,22,28-29 Physiomedicalism is therefore an evolution of a system of medicine that seeks to work with the physiology of the body (vital force) rather that against it.  There is an underlying respect for the intelligence of the anima, the immaterial essence of nature that was designed to moderate itself, the vix medicatrix naturae, or healing power of nature.2(p94) Physiomedicalism is then a culture that lives within the foundations of the present-day theory and practicum of Western herbal medicine and its holistic paradigm, which also seeks to celebrate this intelligence and support of the vitality of the human body, rather than medicate against it.12.33

In addition, Thomson believed that every person should have access to the knowledge of how to heal themselves and be their own doctor.2,5,16 This, as an inalienable human right, is very much upheld in the present-day practice of Western herbal medicine. As Western herbalists we are trained to empower those individuals plagued by illness and disease to reclaim their responsibility for their health and educate themselves about the promotion thereof.  It is an echo of a larger democratic appeal not dissimilar to that of Samuel Thomson’s time, a concept know deeply engendered in the struggle for health sovereignty taking place on the battlefields of the present-day American healthcare system.

In closing, Samuel Thomson is indeed an icon of 19th century medical reform and who has rightfully been knighted as the father of present-day Western herbal medicine.  It was out of his determination that the philosophies of Physiomedicalism were born, giving rise to a culture and system of medicine that was, and continues to be, “of the people, by the people, and for the people”.

Footnotes

1.       Tower, D. Four Lectures on the Practice of Thomsonian Medicine. By David Tower Physician at Avon Mineral Springs. Canandaigua: Bemis, Morse and Ward; 1828.
2.       Haller Jr., JS. Kindly Medicine. Physio-medicalism in America, 1836-1911. Kent, OH: The Kent State University Press; 1997.
3.       Flannery, MA. The early botanical medical movement as a reflection of life, liberty, and literacy in Jacksonian America. J Med Libr Assoc. 2002; (90)4: 442-454.
4.       Berman, A, Flannery, MA. America’s Botanico-Medical Movements Vox Populi. New York, NY: Pharmaceutical Products Press; 2001.
5.       Thomson, S. New Guide to Health; or, Botanic Family Physician, containing a Complete System of Practice, upon a plan entirely new; with a description of the vegetables made use of, and directions for preparing and administering them to cure disease, to which is Prefixed a Narrative of the Life and Medical Discoveries of the Author. Boston: E.G. House; 1822.
6.       Starr, P. The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry. New York: Basic Books; 1984.
7.       Starr, P. Remedy and the Reaction: The Peculiar American Struggle over Health Care Reform. Revised Edition. New Haven, CT: Yale University Press; 2013.
8.       Warner, JH. The Therapeutic Perspective: Medical Practice, Knowledge, and Identity in America, 1820-1885. Reprint edition. Princeton, NJ: Princeton University Press; 1997.
9.       Shortt, SED. Physicians, science, and status: issues in the professionalization of Anglo-American medicine in the nineteenth century. Medical History. 1983; 27:51-68.
10.    Numbers, RL. The history of American medicine: a field in ferment. Reviews in American History. 1982; December: 245-263.
11.    Griggs, B. Green Pharmacy: The History and Evolution of Western Herbal Medicine. Second edition. Rochester, VT: Healing Arts Press; 1997.
12.    Wood, M. The Practice of Traditional Western Herbalism. Berkeley, CA: North Atlantic Books; 2004.
13.    Menzies-Trull, C. Herbal Medicine: Keys to Physiomedicalism including Pharmacopoeia. Second edition. New Castle: Faculty of Physiomedical Herbal Medicine Publications; 2013.
14.    Priest, AW, Priest, LR. Herbal Medication: A Clinical and Dispensary Handbook. London: LN Fowler & Co; 1983.
15.    Winston, D. American botanic medicine from Thomson to the Eclectics. 1999. Available at: https://www.herbaltherapeutics.net/_media/american_botanic_medicine.pdf. Accessed January 28, 2015.
16.    Haller Jr., JS. The People’s Doctor: Samuel Thomson and the American Botanical Movement, 1790-1860. Carbondale, IL: Southern Illinois University Press; 2001.
17.    Melzer, SJ. Vitalism and Mechanism in Biology and Medicine. Science, New Series. 1904; 19(470): 18-22.
18.    Sawyer, ME. An Inaugural Dissertation: Contain an enquiry into the Existence of the Living Principle and Causes of Animal Life. Philadelphia: T Dobson; 1793.
19.    Payne, MD., M. Essays on the Philosophy of Vitality as Contradistinguished from Chemical and Mechanical Philosophy and on the Modus Operandi of Remedial Agents. New York: Hopkins & Jennings; 1842.
20.    King, LS. Stahl, Georg Ernst. In Complete Dictionary of Scientific Biography. 2008. Encyclopedia.com. Available at: http://www.encyclopedia.com/topic/Georg_Ernst_Stahl.aspx. Accessed February 5, 2015.
21.     Metcalfe, SL. Caloric: its mechanical, chemical, and vital agencies in the phenomena of nature. Vol. 1. Philadelphia: Lippincott; 1859.
22.    Thurston, MD., JM. The Philosophy of Physiomedicalism, its theorem, corollary, and laws of application for the cure of disease. Richmond, IN: Nicholson Printing & Mfg Co; 1900.
23.    Thomson, J. A vindication of the Thomsonian System of the practice of medicine on botanical principles, as originated by Samuel Thomson, and continued by his coadjutors. Albany, NY: Webster & Wood; 1825.
24.    Howard, H. An improved system of botanic medicine, founded upon correct physiological principles; Comprising of a complete treatise on the practice of medicine. New edition. Cincinnati: OH: Kost, Bigger & Hart; 1854.
25.    Mattson, M. The American vegetable practice, or, a new and improved guide to health, designed for the use of families. 2 vols. Boston: Daniel L Hale; 1841.
26.    Stevens, J. Medical reform; or physiology and botanic practice for the people. London: Whittaker; 1848.
27.    Agrawal AK, Yadav CR, Meena MS. Physiological aspects of Agni. AYU. 2010; 31(3): 395–398.
28.    Curtis, A. A fair examination and criticism of all the medical systems in vogue. Second ed. Cincinnati: Printer for the proprietor; 1865.
29.    Cook, W. The Physio-medical dispensary: a treatise on therapeutics, materia medica, and pharmacy, in accordance with the principles of physiological medicine. Cincinnati: By Author; 1869.
30.    Smith, E. The botanic physician; being a compendium of the practice of physic, upon botanical principles. New York: Murphy and Bingham; 1830.
31.    Wood, M. Study guide to the six tissue states. 2010. Available at: http://www.portlandherbalschool.com/wp-content/uploads/2010/03/Study-Guide-to-the-Six-Tissue-States.pdf. Accessed January 5, 2015.
32.    Berman, A. Heroic approach in 19th century medical practice. Bulletin of the American Society of Hospital Pharmacists. 1954; 11: 321-327.
33.    Mills, S. The Essential Book of Herbal Medicine. London: Penguin; 1991.

Monday, January 5, 2015

The rediscovery of American Beech (Fagus gradifolia Ehrh.)

Re-posted from The Medicine Gardener: www.themedicinegardener.com

“When the leaves have forsaken the trees, and the woods are chilly and desolate, there seems nothing to attract one to these bare sentinels of the forest, but Mother Nature has always something to offer to those who love her.”  - Elizabeth H Kirkbride, “A Winters Walk”, February 1907 (1).

Winter. I’ve never much cared for the cold. The moisture from my hot breath is forming icicles on the scarf wrapped around my head as I persevere upslope. “It’s easy to scorn away the beauty of the world in such temperatures”, I say to myself, awaiting the warmth of an elevated heart rate and rushing circulation. Eyes wide open; I begin to recognize a color and movement in the winter woods that I have often ignored.  The breeze is tickling the marcescent copper-colored leaves of the American Beech (Fagus grandifolia Ehrh.) (2).  They are everywhere…speckling the slopes of this mixed mesophytic winterland (3), donating their brilliance and tenacity to an otherwise sleepy landscape. My mind is now deeply entranced with what is sparkling before my eyes…“Surely I have noticed you before?” I ask through labored breath.

Photo: Rain drops and American Beech (Fagus grandifolia) shining in the background. The Medicine Gardener, December 2014. Wayne National Forest, Ohio.

It is what it is.

American Beech is known as Fagus grandifolia Ehrh. amongst today’s Latin name-calling folks (4), although historically it was referred to as Fagus ferruginea Dryand., or Fagus ferruginea var. caroliniana Loudon (5).  

Once upon a time, North America celebrated three distinct ‘races’ (not species) of American Beech. These races, ‘gray”, “red”, and ‘white”, represented different biogeographical regions as well as hair-splitting differences in morphological characteristics (6).  To further this concept, genetic research from 2001 found American Beech populations consisting of two genetically distinct clusters (7). So, some botanical authorities hold that Northern and Southern beeches vary, and have described the southern form as F grandifolia var. caroliniana, or Carolina beech (8). But before I totally lose your attention here, I will go on to quote a highly respected botanist and naturalist who clarified the topic of “American Beech varieties” for me with the following sentiment:

“When it comes to Fagus grandifolia, I've never personally taken it to the varietal level, nor have I ever worked or talked with anyone who does…As far as I care to take it, even at my more advanced level of botany: a beech is a beech, is a beech and so on and so forth.” 
 (Andrew Lane Gibson, personal comm.)

So there you have it…American Beech is a noble and solitary species, the only one of its kind in the genus Fagus on North American soil.  It is special that way. Thank you Andrew Lane Gibson, aka. the Buckeye Botanist, for simplifying the matter.

As I continue my trek up-slope, I am filled with a sensation somewhere between ignorance and epiphany.  Looking over my shoulders as to not miss one moment of the copper-glittered forest, I pry myself open to a greater philosophical meaning: American Beech is the only species in its genus here in the United States, but yet it is so incredibly common (9). And then the voice of Henry Ward Beecher (June 24, 1813 – March 8, 1887) enters my consciousness reciting his famous optimism: “The art of being happy lies in the power of extracting happiness from common things.” (10) I giggle aloud…leave it to my brain to quote Beecher while admiring Beech trees.
American beech is either a dominant or codominant species in the northern hardwoods of the Northeast, Lake States, and the Appalachian Mountains.  Classified as a shade-tolerant species, American Beech is able to survive and flourish under the shadows (aka canopy) of more sun-necessitating species such as Oaks and Hickories. Under optimum conditions, beech trees may reach 120 ft in height but generally average between 60 to 80 ft. These lone soldiers may attain ages of 300 to 400 years (11). Oo rah! Range Map compliments of the USDA Forest Service. Available online: http://www.fs.fed.us/nrs/atlas/tree/531

What do stiletto heals, a long-distance runner, and elephants have in common?

Still climbing, almost there.  I can hear the whining laughter of black crows chasing away the Red Tail Hawk that has taken up residence in this long-forgotten hollow.  I am on the hunt for the secrets of winter’s woods, preying upon opportunities to chase away the cold that so easily penetrates the heart and mind during this time of year. Today I have seized the occasion of American Beech, glowing steadfast against a somber background.  And then I ask myself, “What do stiletto heels, a long-distance runner, and an elephant have in common?”

In any season the American Beech is most easily recognizable by virtue of its almost Casper white-gray bark and smooth complexion that glows in the woods amongst the darker faces of its neighbors (12). In winter, the eye-catching identifier is the golden-bronze, or copper-colored leaves that have remained attached to its branches, quivering in the slightest breeze.  When they move they make a crackling sound, not unlike the burning of paper in a fireplace.  When I look at the Beech I see many things, such as a sexy lady in stilettos (referring to the twigs and leaf buds) or the body of long-distance runner (the sinewy nature of its branches). I have often also likened the stout trunks of Beech trees to the appearance of the legs of elephants (at least this is how I am teaching my stepdaughter to recognize them). These trunks are smooth and unbroken, unless infected with Beech Bark Disease at which time the bark becomes pockmarked with blisters and cracks (13), not unlike the festering ulcers of human skin it is meant to remedy.  

More often than not, one can also easily recognize a Beech tree from the various carvings, or ‘dendroglyphs’, that tattoo its tender and shallow surface.  It is an American favorite in regards to professing love or claiming territory, and like R.W. Shufeldt (14) writes: “The majority of these [carvings] generally indicate that, in the spring the young man’s mind has a certain gentile inclination that ages ago became proverbial.”  I am not so sure I could be wooed by such defacement, but to each one’s own.


Photo: American Beech. Typical love-professing 'dendroglyphs'.  This one is rather old, but will expand over time as the tree grows. Please note the 'elephantesque' appearance of the trunk. The Medicine Gardener. December 2014. Wayne National Forest, Ohio. Photo is part of my Winter Hiking Treasures series on Instagram (www.instagram.com/themedicinegardener).

 

Don't tread on me.

I can no longer sense the cold as I reach the ridge and pause for a moment.  And then I feel it…the ultimate awareness of accomplishment as I turn back around to admire the view that elevation has provided.  I am maintaining a warm resistance to the sleeping world, remembering how alive I really am.  I crouch down to fix my bootlaces only to be met by the most curious yet unfriendly looking object begging not to be stepped on.
Photo: The husk of an American Beechnut. Beech ordinarily begins to produce a substantial amount of seeds when about 40 years old, and by the time it is 60 years old may produce large quantities. The seeds are enclosed in a prickly casing, or bur, that can be opened using a fingernail. The distinctive triangular nuts inside are eaten by people and are an important food for wildlife. Beechnuts require one growing season to mature and they ripen between September and November. Two or (rarely) three nuts may be found within a single bur (15). The Medicine Gardener. December 2014. Wayne National Forest, Ohio. Photo is part of my Winter Hiking Treasures series on Instagram (www.instagram.com/themedicinegardener).
Ahh, the Beechnut.  Long believed to actually be an ingredient of Beechnut™ gum (I can assure it was not).  The American beechnuts are said to be one of the sweetest and most delicious of our native forests (16).  But before I go further I must relate to you that there is a significant difference reported between the edibility of American Beechnuts and European Beechnuts (Fagus sylvatica).  The latter has been described as unpopular in regards to human consumption, only being eaten when dictated by extreme famine (17).  In fact, both American and European beechnuts are full of nutrition, being dominated by fats and fat soluble vitamins, protein, and starch (18). However, the European beechnuts have much higher levels of saponins and alkamides, phytochemicals that can cause headaches and abdominal symptoms such as cramping pain, profuse vomiting, and explosive diarrhea (19).  In fact, the over indulgence of Beechnuts (unclear as to American or European) has even been blamed as the culprit in messy and uncomfortable deaths (20).  Nonetheless, it has been recommended that beechnuts, American or otherwise, be roasted or cooked before consumption as the heat nullifies the substances which are thought to induce such dubious results (19).  However, where there is poison there is also medicine. For example, one of the most popular uses for raw American Beechnuts among the Cherokee people was not as a food source, but rather as an anthelmintic (a substance that destroys parasitic worms) (21).  This makes sense in regards to the phytochemistry of saponins and alkamides and their pharmacological action within the human digestive system (22).

There are many other delights to the American Beechnut, beyond being nutritious and more agreeable than their European version.  They were once considered a delicious (albeit tedious) source of culinary oil comparable in flavor to olive oil, and were collected and used as such by the European settlers who no doubt had carried the tradition with them from the Continent (17).  However, long before the settlers arrived here in the United States, this nutmeat oil was employed by the False Face Societies of the Iroquois as an ingredient in the medicinal mush of their healing ceremonies, although I could not track down why (23).  The Iroquois also crushed and boiled fresh beechnuts to make a nutritious beverage (note it reads ‘boiled’, which implies ‘cooked’) (24). However, the medicinal virtues of American Beech do not stop at the mast...
A dancer of an Iroquois False Face Society.  Image compliments of Popular Science Monthly (1892), Vol. 41., New York, Popular Science Pub. Co., etc. Pg. 740. Accessed online [1/1/15]: https://archive.org/stream/popularsciencemo41newy#page/740/mode/2up

 

More than meets the eye.

The historical use and therapeutic employment of medicinal plants in American medicine can be seen as the confluence of British, European and Native American knowledge and experience.  As inferred above, the Iroquois appear to have had the most developed relationship with the species out of all other Native American tribes where an ethnobotanical record is present (25).  The Iroquois revered both the leaves and the bark of American Beech as blood medicine (referring to its ability to ‘cleanse’ the blood) as well as an astringent (or drying) tonic to the respiratory system when employed in ‘wet’ conditions of the lungs like pneumonia or tuberculosis (26).

British and European knowledge contribute to the use of American Beech in American medicine perhaps as a result of the use of European Beech (Fagus sylvatica) in European medicine. European Beech has its own medicinal history that was most definitely carried ‘across the pond’ during the colonial period and projected onto its cousin, the American Beech (27).  The clearest picture of the historical medicinal use of European Beech comes from the famous writings of Nicholas Culpeper (1616-1654) (28,29).  He writes of the leaves as being governed by the influence of Saturn, and therefore cooling and binding in their nature (medical astrology used a fascinating classification system for the plethora of diseases and remedies of that age).  He goes on to indicate the species use to relieve hot swellings and running tetters (29, 30). In addition to the medicinal virtues of the leaves, there is also a history of using the tar made from European Beech wood for various and sundry skin afflictions, most notably weeping eczema (31), as well as internally as a stimulating expectorant in chronic bronchitis (32).  But more on tar later…

This is where we arrive at the conclusions of the American Eclectic and Physiomedicalist traditions of medicine which contain, in part, an amalgamation of Native American and European knowledge in regards to the therapeutic nature of American Beech and its various parts (33). The American Eclectic Materia Medica claims astringent (drying), tonic, and antiseptic properties of the bark and leaves stating their efficacy in treating dysentery, diarrhea, indigestion (perhaps from ulcers?), and low-grade fevers internally, as well as foul ulcers, frostbite, and burns of the skin (34).  In addition to this, we have the Physiomedicalist application of American Beech in cases of atony of the urinary system (35).  These indications and employments of American Beech match those of both Native American traditions and the European tradition.  There is an agreement as to the cooling, drying, and toning nature of both the bark and the leaves, being applicable to a number of internal and external conditions as defined by hot, wet, and atonic manifestations. However, we are cautioned by the Physiomedicalist approach which states that there are more appropriate medicines that should be employed when these types of conditions are deep-seated and mortifying in nature (35).   American beech is good at the mild, tonic stuff.

Based on this collective knowledge, American Beech appears to have an affinity for the respiratory, integumentary, and digestive systems (although I must say that I have never used this species in clinical practice, nor do I know of anyone who has).  But believe it or not, it is highly likely that you have relied upon the American Beech in times of sickness without even knowing it. However, in order to convince you of this I must first tell you a story. Bear with me, this is where things get really interesting.

 

My dear patient, would you please swallow this tar?

This vintage advertisement is from 1898.  The schematic shows bronchiectasis in the base of both lungs. Image compliments of Tywkiwdbi. To see this image and learn a bit more about this curious practice please visit: http://tywkiwdbi.blogspot.com/2012/01/inhaled-creosote-as-medicine.html
Let me take you back a step and remind you about use of Beech Tar in Europe as a stimulating expectorant for chronic bronchitis (32).   I followed this beech tar tradition through my research within American medicine and found John King’s 1854 The American Eclectic Dispensary speaking of ‘a peculiar substance obtained from tar’ (36).  It turns out this ‘peculiar substance’ is creosote…yes that’s right, creosote. Many of us are familiar with the smell of railroad ties or telephone poles on a hot day? That smell is creosote, well at least the coal-tar variety.

You see, there are two main types of creosote produced; the stronger, more toxic, and highly carcinogenic coal-tar variety (which is predominantly used in the preservation of wood), and the less toxic wood-tar variety which was traditionally employed for medicinal purposes as an expectorant, anti-septic and anesthetic as well as in the preservation of meat (37,38). Creosote derived from the wood of American Beech was considered the best for medicinal purposes because it distills with higher proportions of guaiacol and creosol, two plant phenolics which are considered the ‘active’ medicinal ingredients (39,40). 

The derivation of wood tar creosote. Source: Price, Overton W.; Kellogg, R.S.; Cox, W.T. 1909. Forests of the United States: Their Use. Government printing office.
Beechwood creosote (CAS #:8021-39-4) has been used as a disinfectant, a laxative, and a cough treatment. In the past, treatments for leprosy, pneumonia, and tuberculosis also involved eating, drinking, or inhaling beechwood creosote (yum!).  It is rarely used for this purpose today, and is no longer produced in the United States (41). However, back in the 1940’s a Canadian chemist by the name of Eldon Boyd experimented with guaiacol and from it derived the substance glycerol guaiacolate, now more commonly known as Guaifenesin (42).  He discovered that Guaifenesin increased secretions in the respiratory system and this substance is now a component of the modern over-the-counter cough remedies Mucinex, Robitussin DAC, Cheratussin DAC, Robitussin AC, Cheratussin AC, Benylin, DayQuil Mucous Control, Meltus, and Bidex 400 (42).

Ahem…let me clear my throat.

 

There is medicine in the moment.

The deathly quiet chill of winter is no match for me today, as the act of observation has been warming in nature, like a hearth fire for the soul. The American Beech is trying to teach me that its medicinal virtues go way beyond the phytochemistry of its mast, bark, or leaves. As if there is medicine in the moment of appreciation itself.

Let me explain…

As a medical herbalist I am always on the search for these types of ‘moments’. When a connection to a medicinal plant species takes on a form other than a capsule, tea, or extract.  Don’t get me wrong here, my feet are firmly planted in the ground of scientific inquiry, but my definition of ‘medicine’ goes beyond the act of consuming therapeutic matter.  To me, medicine is also about changing patterns.  Patterns of behavior, patterns of emotional response, patterns of belief.  Medicine comes in many forms.  In this particular case, I am no longer the grumpy, unforgiving human that I was when I took off on this journey today.  My attitude has changed, quantifiably so.  And yes, yes…I should thank the increased blood flow, endorphins, and other biochemical ‘tailgate parties’ going on in my body due to the exercise (43). But today I will also thank the American Beech.  It is hard to feel dull when surrounded by such beauty.

Upon returning home I am concentrated with the American Beech experience.  As I sit on my back porch removing my muddy boots, I am flashed with a clinical memory that I cannot shake.  I hustle indoors to my bookshelf (The caveat here is this: I have often included the almost-homeopathic energetics of flower essences into herbal supplement mixtures for added emotional support for clients who have an affinity for such substances. I understand that many of you dear readers might roll your eyes at such ‘mumbo-jumbo’).  I open my book of Bach Flower Remedies, remembering the Beech within its pages.  And this is what I found for the Beech Flower Essence:

“For those who feel the need to see more good and beauty in all that surrounds them. And, although much appears to be wrong, to have the ability to see the good growing within. So as to be able to be more tolerant, lenient and understanding of the different way each individual and all things are working to their own final perfection.” 
 – Dr. Edward Bach, The Twelve Healers and Other Remedies, 1936.

“My sentiments exactly,” I thought.  
 
Photo: Under a canopy of American Beech. The Medicine Gardener. December, 2014. Wayne National Forest, Ohio.  Photo is part of my Winter Hiking Treasures series on Instagram (www.instagram.com/themedicinegardener).

Acknowledgements

And so ends my journey into the rediscovery of American Beech, the chronicle of which I am grateful to have shared with you all.  I would like to extend specific gratitude to Steven Foster for his support of my writing and photography as well as exposing me to the all-consuming world of historical literature online.  I would also like to thank Andrew Lane Gibson for responding to my inquiry regarding the varietal classification of American Beech (and for his continued botanical inspiration).  Both of these gentlemen have exceptional blogs that you should check out by clicking on their highlighted names. Thank you, dear reader, for paying attention to this post until the very end. I wish you all warmth and beauty for this January and I look forward to connecting with you again next month.

Footnotes

1. Kirkbride, Elizabeth H. 1907. ‘A Winter’s Walk’ in The Friend: A religious and literary journal, printed by W.M.H. Pile’s sons, Philadelphia, Vol. 80, 1907, Fourth Month 20, 1907. Pg.322
2.  Marcescent or marcescence, the term used to describe leave retention, is common with many oak species, and of course our beloved American Beech. Marcescent leaves are often more common with smaller trees or more apparent on lower branches of larger trees. Prolonged abscission period could indeed be an adaptive trait of the species better suited to more infertile soils. Escudero, A. and J.M. del Arco. 1987.  Ecological significance of the phenology of leaf abscission. Oikos 49:11-14 
3.  The mixed mesophitic forest is defined as a climax community in which the dominant trees of the arboreal layer are Beech, Tuliptree, Basswood, Sugar Maple, Chestnut, Sweet Buckeye, Red Oak, White Oak, and Hemlock. Braun, L. 1950. The Deciduous Forests of Eastern North America. The Blackburn Press, Caldwell, NJ.
4.  USDA Plant Profile database: Fagus grandifolia Ehrh. Accessed online [12/10/14]: http://plants.usda.gov/core/profile?symbol=FAGR
Also: Tubbs, C.H. and D. R. Houston. 1990. Fagus grandifolia Ehrh.  Silvics of North America vol. 2: Hardwoods. Agriculture Handbook 654.  U.S. Department of Agriculture, Forest Service, Washington, DC.  Accessed online [12/10/14]: http://www.na.fs.fed.us/pubs/silvics_manual/volume_2/fagus/grandifolia.htm
5.   This is especially the case when scouring historical medical texts, as American physicians of old seemed to deem it so.  Please see Henriette Kress online (Henriette’s Herbal Homepage) for various historical texts using the name Fagus ferruginea.  Accessed [12/9/14]: http://www.henriettes-herb.com/
6.   Camp, W.H. 1950. A biogeographic and paragenetic analysis of the American Beech(Fagus).  Yearbook. The American Philosophical Society. Philadelphia. pp. 166-9. One could liken this differentiation to that of three different clans of Ent (J.R. Tolkien reference here folks), all looking like Ents and acting like Ents, but distinguished by their homelands and the pattern of tartans they wore (yes, I realize that Tolkein’s Ents did not wear tartans). 
7.  Kitamura, K and Shoichi Kawano. 2001. Regional Differentiation in Genetic Components for the American Beech, Fagus grandifolia Ehrh., in Relation to Geological History and Mode of Reproduction . Journal of Plant Research. Volume 114, Issue 3, pp 353-368.
8.  Elias, Thomas S. 1971. The genera of Fagaceae in the southeastern United States. Journal of the Arnold Arboretum 52:159-195.
9.   Although beech is now confined to the eastern United States (except for the Mexican population) it once extended as far west as California and probably flourished over most of North America before the glacial period (U.S. Department of Agriculture, Forest Service. 1965. Silvics of forest trees of the United States. H. A. Fowells, comp. U.S. Department of Agriculture, Agriculture Handbook 271. Washington, DC.)
Also, Beech is prevalent in all nine of Lucy Braun’s forest regions of eastern North America, It is a characteristic species of four of those regions, and is dominant in two northerly regions including the namesake beech-maple and beech-birch-maple regions.  It is prominent in most exemplary stands in the Northeast, as well as in many old-growth forests of the region (Braun, L. 1950. The Deciduous Forests of Eastern North America. The Blackburn Press, Caldwell, NJ.).
10.  Henry Ward Beecher. Summer in the Soul. 1858
11.  U.S. Department of Agriculture, Forest Service. 1965. Silvics of forest trees of the United States. H. A. Fowells, comp. U.S. Department of Agriculture, Agriculture Handbook 271. Washington, DC.
12.  American Beech is often found in the company of sugar maples (Acer saccharum), red maples (A. rubrum), yellow birch (Betula alleghaniensis), American basswood (Tilia americana), black cherry (Prunus serotina), southern magnolia (Magnolia grandiflora), eastern white pine (Pinus strobus), red spruce (Picea rubens), hickories (Carya spp.), and oaks (Quercus spp.), to name a few.  Tubbs, C.H. and D. R. Houston. 1990. Fagus grandifolia Ehrh.  Silvics of North America vol. 2: Hardwoods. Agriculture Handbook 654.  U.S. Department of Agriculture, Forest Service, Washington, DC.  Accessed online [12/10/14]: http://www.na.fs.fed.us/pubs/silvics_manual/volume_2/fagus/grandifolia.htm
13.  Michael Wojtech, M. 2001. Bark: A Field Guide to trees of the Northeast. University Press of New England, Lebanon, NH.
14.  R.W. Shufeldt, C.M.Z.S. 1918. Studies of Leaf and Tree (Part II). American Forestry Vol. 24, No 289. American Forestry Association, Washington D C. Pg 100. Accessed online [12/12/14]: http://biodiversityheritagelibrary.org/page/20781520#page/111/mode/1up
15.  U.S. Department of Agriculture, Forest Service. 1974. Seeds of woody plants in the United States. C. S. Schopmeyer, tech. coord. U.S. Department of Agriculture, Agriculture Handbook 450. Washington, DC.
16.  Thomas, M.C. & Schumann, D.R. 1992. Seeing the forest instead of the trees - Income opportunities in special forest products. Kansas City, Missouri, Midwest Research Institute.
17.  Fernald, M.L., A.C Kinsey, and R.C. Rollins. 1958. Edible wild plants of eastern North America. Harper & Row.
18.   Duke, J.A. 2000. Handbook of Nuts: Herbal Reference Library. CRC Press.
19.  Turner, N.J. and  P. von Aderkas. 2009. The North American Guide to Common Poisonous Plants and Mushrooms. Timber Press.
20.  Allen, T.F and R. Hughes. 1874. The encyclopedia of pure materia medica: a record of the positive effects of drugs upon the healthy human organism. Vol 10. National Center for Homoeopathy (U.S.), donor. ; American Foundation for Homoeopathy, former owner. Boericke & Tafel, New York. Accessed online [12/17/14]: http://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-64240040RX10-mvpart.  Allen and Huges recount the story of a 13 year old boy who had eaten a large quantity of beechnuts (what I believe to be of the European variety): “…Soon after eating the nuts he had been seized with torpor, gloominess, and dread of liquids. He had not been bitten by a rabid animal. Next (fifth day), seemed to talk more in his wildness and perturbation of mind, and his mouth flowed with foam more abundantly. Red and fiery urine with copious turbid white sediment, resembling and emulsion of beechnuts. ‘A few hours before he dies he vomited a poraceous bile, after which he died quietly.”  Pg. 521.
21.  Hamel, P. B., and M. U. Chiltoskey. 1975. Cherokee Plants and Their Uses – A 400 Year History. Sylva, North Carolina: Herald Publishing.
22.  Pengelly, A. 2004. The Constituents of Medicinal Plants 2nd edition. CABI Publishing. United Kingdom.
23.  Waugh, F.W. 1916. Iroquois Foods and Food Preparation. Ottawa: Canada Department of Mines.
24.   Parker, A. C. 1910. Iroquois Uses of Maize and Other Food Plants. Albany, New York: University of the State of New York.
25.  Moerman, D. E. 1998. Native American Ethnobotany. Timber Press, Portland, OR.
26.  Herrick, J. W. 1977. Iroquois Medical Botany. Ph.D. Thesis, State University of New York, Albany.
27.  Burlingame, J.  1826. The poor man's physician, the sick man's friend, or, Nature's botanic garden exhibited to view: its medical qualities unfolded, symptoms of diseases described, and cures made easy ; designed wholly for the use and benefit of families. Norwich, N.Y. Printed by Wm. G. Hyer for the author. Accessed online [12/20/14]: http://collections.nlm.nih.gov/catalog/nlm:nlmuid-2544072R-bk.  In this text we find verbatim the musings of the above mentioned Nicholas Culpeper when Burlingame writes: “ The water found in decayed beeches, in hollows, will cure both man and beast, of any scurf, scab, or running sore. The leaves in poultice or ointment are very good to apply to hot swellings.” pg.113
28. Tobyn, Graeme. 1997. Culpeper’s Medicine: A Practice of Western Holistic Medicine. Element, United Kingdom. Nicholas Culpeper (1616 – 1654), a physician from London, England who practiced medial astrology and is remembered for his desire to deliver medicine to the common people from the confines of the wealthy and educated elite. During his time, all medical texts were written in Latin so that only those who could read Latin could use the information within the text. Nicholas Culpeper was ostracized by the Royal College of Physicians for translating medical texts from Latin to English and was eventually expelled from the College.
29.  Culpeper, Nicholas. 1652. The English Physician. Also, 1653. The Complete Herbal. Now found at the following references: Culpeper, Nicholas. 1800. The English Physician Enlarged : With Three Hundred and Sixty-Nine Medicines, made of English Herbs, that were not in any impression until this. Being an astrologo-physical discourse of the vulgar herbs of this nation ... . Barker, London. Digital edition by the University and State Library Düsseldorf and Culpeper, Nicholas (1995). Culpeper's Complete Herbal: A Book of Natural Remedies of Ancient Ills (The Wordsworth Collection Reference Library) (The Wordsworth Collection Reference Library). NTC/Contemporary Publishing Company.
30. According to The American Heritage Dictionary (https://ahdictionary.com/), tetter is a term for “any of various skin diseases, such as eczema, psoriasis, or herpes, characterized by eruptions and itching.” Apparently, there are many kinds of tetter, including moist, branny, scally, scald-head, salt-rheum, and running tetter. 
31.  Weiss, MD, R.F.  and V. Fintelmann, MD. 2000. Herbal Medicine. 2nd ed. Thieme, Stuttgart, Germany.
32.  Grieve. M. 1931. A modern herbal. Vol. 1. Harcourt, Brace & Company, New York
33.  For a thorough overview of the traditions of American medicine: Traditions in Western Herbal Medicine by Peter Mackenzie-Cook, DBTh, FETC. In The Herbalist, newsletter of the Canadian Herbal Research Society. Copyright June 1989. Available online: http://www.henriettes-herb.com/faqs/medi-5-3-1-western.html For more information about Physiomedicalism: http://www.physiomedicalism.com/
34.  Hollembaek, H. and Foorte, A.E. 1865. The American Eclectic Materia Medica: containing on hundred and twenty-five illustrations of trees and plants of the American Continent. H Hollembaek , Philadelphia.
35. Cook, MD, W.H. 1869. The physio-medical dispensatory: a treatise on therapeutics, materia medica, and pharmacy, in accordance with the principles of physiological medication. by Wm. H. Cook, M.D., professor of botany, therapeutics, and materia medica in the Physio-Medical Institute; late professor of surgery in the Physio-Medical College of Ohio. Cincinnati: published by Wm. H. Cook, no. 101 West Sixth-Street 1869. The Physiomedical Dispensatory, 1869, was written by William Cook, M.D. Available online at: http://medherb.com
36.  King, J. 1854. The American Eclectic Dispensatory. Cincinnati : Moore, Wilstach, & Keys. Accessed [12/15/17]: http://collections.nlm.nih.gov/catalog/nlm:nlmuid-61660590R-bk
37.  Moriguchi N1, Sato A, Shibata T, Yoneda Y. 2011. [A historical review of the therapeutic use of wood creosote. Part II: Original plant source of crude drug wood creosote]. Yakushigaku Zasshi. 2011;46(1):13-20.  Accessed online [12/17/14]: http://www.ncbi.nlm.nih.gov/pubmed/22164686
38.  Wood tar creosote was discovered as the principle of meat smoking and became used as a replacement for the smoking process, Ambrose, A. and E.G. Smith. 1857. The preservation of food: From the "Aus der natur" of Abel. Press of Case, Lockwood and company.
39.  Carpenter, R.D. 1974. American Beech. American Woods, FS-220. US. Department of Agriculture, Forest Service July 1974. Accessed online [12/15/14]: http://biodiversityheritagelibrary.org/item/160811#page/1/mode/1up
40.  Allen, Alfred Henry (1910). "Creosote and Creosote oils". Allen's commercial organic analysis (P. Blakiston's Son & Co) 3: 346–391.
41.  ATSDR (Agency for Toxic Substances and Disease Registry, Division of Toxicology, Public Health Statement, Creosote, Cas # Wood Creostoe 8021-39-4, September 2002) Accessed online [12/17/15]: http://www.atsdr.cdc.gov/phs/phs.asp?id=64&tid=18
42.  Connell, W. F., Grant M. Johnston, and Eldon M. Boyd. 1940. On The Expectorant Action Of Resyl And Other Guaiacols. Can Med Assoc J. Mar 1940; 42(3): 220–223. Accessed online [12/17/15]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC537807/
43.  Powers, S.K and H.T. Howley. Exercise Physiology: Theory and Application to Fitness and Performance. 7th Edition. Available online: http://www.ipmr.kmu.edu.pk/sites/ipmr.kmu.edu.pk/files/Lectures/Endo-1.pdf