Medicinal plants of the Bible—revisited

Background Previous lists number from 55 to 176 plant species as “Biblical Medicinal Plants.” Modern studies attest that many names on these lists are no longer valid. This situation arose due to old mistranslations and/or mistakes in botanical identification. Many previously recognized Biblical plants are in no way related to the flora of the Bible lands. Accordingly, the list needs revision. Methods We re-examine the list of possible medicinal plants in the Bible based on new studies in Hebrew Biblical philology and etymology, new studies on the Egyptian and Mesopotamian medicinal use of plants, on ethnobotany and on archaeobotany. Results In our survey, we suggest reducing this list to 45 plant species. Our contribution comprises 20 “newly” suggested Biblical Medicinal Plants. Only five species are mentioned directly as medicinal plants in the Bible: Fig (Ficus carica), Nard (Nardostachys jatamansi), Hyssop (Origanum syriacum), balm of Gilead (Commiphora gileadensis) and Mandrake (Mandragora officinarum). No fewer than 18 medicinal plants are mentioned in old Jewish post-Biblical sources, in addition to those in the Bible. Most of these plants (15) are known also in Egypt and Mesopotamia while three are from Egypt only. Seven of our suggested species are not mentioned in the Bible or in the Jewish post-Biblical literature but were recorded as medicinal plants from Egypt, as well as from Mesopotamia. It is quite logical to assume that they can be included as Biblical Medicinal Plants. Conclusions All our suggested Biblical Medicinal Plants are known as such in Ancient Egypt and/or Mesopotamia also. Examination of our list shows that all these plants have been in continuous medicinal use in the Middle East down the generations, as well as being used in the Holy Land today. Precisely in King Solomon’s words, “That which has been is what will be, that which is done is what will be done. And there is nothing new under the sun” (Ecclesiastes 1:9).


Identification of Biblical plants
Most of the massive research on the identity of Biblical plant names is based on linguistics and philology [1-8 and references therein]. Włodarczyk [9] reviewed "how many plants are mentioned in the Bible" and concluded that the list contains 206 plant names, 95 of which "are recognized by all contemporary researchers of the floras of the Bible." This discrepancy is not at all surprising since most authors of books on plants of the Bible [4, 10-17 a except 3, [5][6][7] were not familiar with Hebrew and/or the Holy Land flora. For example, Duke [1] enumerates at least 176 species as "Biblical Medicinal Plants" (hence BMPs), while the total number of recognized plants in the Bible is about 100 [8]. Needless to say, too many species of his list are not related at all to the flora in the region and were never grown or traded in the ancient Middle East. Jacob [2] listed 55 plants (most on a species level but some on a genus level) as BMPs, based on a comparison to Ancient Egyptian and Mesopotamian literature.
Amar [8] revised the flora of the Bible, based particularly on old Jewish post-Biblical sources and their succession down the generations. He arranged all the traditional plant names in several categories according to identification reliability: (a) plant names identified with certainty (40); (b) plant names identified at a high reliability level (11); (c) plant names whose identification is on a high reliability level but not fail-safe (22); (d) plant names that are unidentifiable or whose identification reliability is very low (13); (e) accumulative names and non-species-specific names like "thorn" or "lily" (20); (f) names suspected of not being related to plants at all (35). Thus, after Amar's rigorous scrutiny, we have some 75 "valid" plant names, which are regarded with some identification validity. The Mishna and the Talmud mention about 400 plant names [3], 43 of which are mentioned in relation to medicine [18]. In most cases of disagreement among the leading authorities [3][4][5][6][7], we chose to follow Amar's [8] (see the discussion for few exceptions).

Identification of Ancient Mesopotamian and Egyptian plants
Plants are undoubtedly the main source for curing and alleviating diseases in Ancient Mesopotamia and Ancient Egypt. Both civilizations belong to the world of the Old Testament, which explains why a short survey about their knowledge of medicinal plants is included. In the strict sense, Mesopotamia refers to the "land between the rivers," namely the Tigris and Euphrates, but the region includes the area most of now Iraq, eastern Syria and southeastern Turkey. While the first written documents, namely clay tablets, date to the end of the 4th millennium BCE the main information on medicinal plants comes from cuneiform tablets dating to the second and first millennia BCE. Ancient Egypt spans the region of the Nile Valley, reaching areas east and west of it along the Mediterranean coast; to the south, Ancient Egypt stretched deep into the north of modern Sudan. The first hieroglyphic texts on medicine date to the middle of the second millennium BCE. The pharmacopoeia of both cultures included more than 200 plants, most of which cannot be identified. Ethnobotanical studies (e.g. Borchardt [19:190]) often refer to the pioneering work of Campbell Thompson [20] for the identification of Mesopotamian plant terms, or von Deines and Grapow [21] for ancient Egypt; they are unaware of the present, often highly specialized, linguistic and philological discussions in the fields of Assyriology and Egyptology. Philologists such as the Egyptologist Pommerening [22] or the Assyriologist Böck [23] attest to the need to challenge and revise the methodology used so far to identify ancient Egyptian and ancient Mesopotamian plant terms. The comunis opinio in both fields of research is rather skeptical about the identification of plant terms with actual plants. In fact, revisions comparable to the comprehensive work of Amar [8] on the Biblical flora are still in process. As for ancient Mesopotamia, identifying language terms in Akkadian, the language in which most of the medical cuneiform texts are written, depends heavily on etymological research. This consists of collecting cognate terms in other Semitic languages such as Aramaic or Hebrew and applying identification of the Aramaic or Hebrew term to the Akkadian name. As a result, learning the identity of Akkadian plants depends basically on studies about the Aramaic and Hebrew terminology of plants (e.g., Löw [3]). These identifications have entered the two basic dictionaries of the Akkadian language [24,25] but have enjoyed scant discussion and revision.

The use of medicinal plants in the world of the Old Testament
The ample number of medical recipes prescribing various "drug therapies" clearly shows the prominence of ingredients of vegetable origin in ancient Mesopotamia and ancient Egypt (e.g. [26,27]).
In the Bible, very few cases related to the use of plants for medicine, for example, the use of balm to treat of sores (Jeremiah, 8, 22; 46, 11; 51, 8) [31] found myrtle pollen in a stone mortar from Megiddo (Iron Age 12-11th centuries BCE). Preparation of powder from Myrtus leaves for medicine is also a practice still used today in Israel [32:210-211]. Koh et al. [33] analyzed the organic residues of wine jars found in a courtyard in the Middle Bronze Age (ca 1900-1600 BCE) in a Canaanite palace at Tel Kabri (13 km north of Haifa, Israel). The additives seem to have included honey, Storax resin (Liquidambar orientalis), Terebinth resin (Pistacia lentiscus/P. palaestina), Cedar oil (Cedrus libani), Cyperus (Cyperus rotundus) and Juniper (Juniperus communis/J. phoenicea), and perhaps even mint, myrtle, or cinnamon. They concluded that "the plants' materials were used to preserve wine (as resins), as well as a medicine already known from Ancient Egypt" [34]. They also mentioned that "these additives suggest a sophisticated understanding of the botanical landscape and the pharmacopeic skills necessary to produce a complex beverage that balanced preservation, palatability, and psychoactivity." Namdar et al. [35] found cinnamon residues in old wine flasks from Tel Dor (30 km south of Haifa, Israel). The flasks, originating in Phoenicia, were from the early Iron Age, namely 11th to mid-9th centuries BCE. Kislev et al. [36] studied the remains of flax (Linum usitatissimum) from the early Iron Age (12th century BCE, late 20th dynasty in Egypt) site of Tel Beth-Shean (70 km SE of Haifa, Israel). Like written sources of its uses, they suggest that part of the flax seeds was intended as a food component or for extracting medicinal oil. Weiss and Kislev [37] found one stone of bay laurel (Laurus nobilis) in Ashkelon (150 km south of Haifa, Israel l7th century BCE). The plant does not grow in that area, so the plant was probably taken for medicinal purposes. The Ancient Egyptian and Mesopotamian healing practitioners did not contrast or distinguish magical from pharmaceutical cures-both forms of healing were considered equally effective (for Egypt see 43; for Mesopotamia see 44). The two ancient cultures shared another feature: they did not invent terms that would denote "medicine" or "magic." Disease and illness could be caused by an array of incidents from natural causes to the supernatural influence of deities and demons or sinful behavior (for Egypt see 41: 96-112, for Mesopotamia see 45: 30-31). The healers seem not to have chosen their cures according to the cause of the disease. It is useful to differentiate healing cures accompanied by incantations from purely exorcist practices. In Mesopotamia, demons were deemed responsible for diseases [44: 179-180, 45: 27-39,] while in Egypt, it was evil spirits [41: 96-112]. Thus, healers also practiced magic and exorcism as part of the healing. In the Bible, magic and exorcism were forbidden [46:517-519]. In Egypt and Mesopotamia, sin was believed to be sanctioned with disease [47: 97-99]. Krymow [48:16] has noted that "The Israelites knew the medical practices of the Egyptians and took this knowledge with them, but the Israelites' priests taught the people to look to God for help." A similar view is expressed by Harrison [38:14]: "The religious tradition of the early Biblical period took exception to the idea of trying to cure the diseased body, since it was believed that God alone was the great healer. This paper does not aim at a detailed catalogue of specific uses for each plant in each civilization. Our study is limited to re-examining questions arising from the list of actual and potential medicinal plants of the Bible.

Methods
Working assumptions and problems in the identification of Biblical plant names: 2. Reconstruction of the inventory of potential BMPs was attempted, based on comparative data from Ancient Egypt and Mesopotamia. The medicinal plants of Egypt and Mesopotamia were surveyed, keeping with the recent literature, in an attempt to recognize species, or products thereof, related to Biblical times. We limited ourselves to any literary evidence that a certain species had any medicinal use; we did not set out to compare the different regions/cultures on the specific uses among them.
3. We also used complementary data from post-Biblical sources: Mishna (3rd century CE) and the Babylonian Talmud (3rd-5th centuries CE). We considered only plants referred to explicitly for medical uses and already known medicinally from Egypt and/or Mesopotamia, and/or from archaeological evidence. Concerning the identification of plants in the Talmud, in cases of disagreement, we followed the most modern commentary of Steinsaltz [67] (whose botanical advisor is the authoritative archaeobotanist and Talmudist M.E. Kislev). As a result, several of the previous identifications [3,18] are not recognized today.
4. Technically, we divided the surveyed plants into four classes, according to level of certainty as to their possible use as medicinal plants in Biblical times, based on identification reliability according to [8], as well as on subsidiary evidence: plants used or mentioned explicitly as medicinal in the Bible (Table 1); plants mentioned in the Bible and known as medicinal in Ancient Egypt and in Mesopotamia (Table 2); plants not cited in the Bible but mentioned as medicinal in post-Biblical sources and/ or Egypt and/or Mesopotamia (Table 3); and various patterns (Table 4).

Discussion
Only five species (Table 1) are mentioned explicitly as medicinal plants in the Bible: Fig (Ficus carica), Nard (Nardostachys jatamansi), Hyssop (Origanum syriacum), "Balm of Gilead" (Commiphora sp.) and Mandrake (Mandragora officinarum) ( Table 1). Twenty-seven species come under the category "Plants which are mentioned in the Bible and are known as medicinal in Ancient Egypt and Mesopotamia" ( Table 2). Thirteen species are included as "Plants which are not cited in the Bible but mentioned as medicinal in the Talmud and/or Egypt and/or in Mesopotamia" (Table 3). Six plants are classified under various patterns (Table 4).
At least 18 medicinal plants (Tables 2-4), in addition to those in the Bible, are mentioned in the Talmud and or Mishna, most of which (15) are known also in Egypt and Mesopotamia, while three are only from Egypt. Since most of the post-Biblical citations are from the Babylonian Talmud, one may consider it as having influenced the local medicine of Babylonia (where this Talmud was written) rather than reflecting Biblical reality. The data indicating that all these species were also known from Egypt, strengthen the idea that the post-Biblical literature was not biased to Mesopotamian plants.
Seven of the suggested species (Table 4) are not mentioned in the Bible or in the Talmud but were recorded as medicinal plants from Egypt, as well as from Mesopotamia; it is logical to assume that they can be included as BMPs.
About 60% of our suggested BMPs are foreign species; 40% are indigenous, 60% are imported, 30% are domesticated (each plant can belong to more than one group). The main sources of foreign imported species are East Asia (11%), Southwest Asia (11 %), West and South Asia (8%) and Arabia (4%).
The high proportion of imported plants (as medicinal materials) shows indirect evidence of prolific import in Biblical times [101][102][103][104]. Our list does not provide any evidence that any species were cultivated/imported solely as medicinal plants; all had some additional use. Most (87%) of the species had at least one additional use: for example, 16 are edible, 8 are used in rituals, 6 serve for perfume and cosmetics, and 5 are used as incense.
Duke [1] enumerated 176 plant species as "Biblical Medicinal Plants," while Jacob [2] suggested only 55. In our survey, we suggest reducing that number to 45 (Tables 1-4). The overlap between Jacob's list and ours was 29 species in total. Our contribution is 20 "new" suggested BMPs. It is noteworthy that some Biblical names are related to the genus level (e.g., Artemisia), or also to two genera as in the case of Cupressus/Juniperus.
The discrepancy between Jacob's list and ours is due to the following: (1) At least 22 species in Jacob's list are not recognized today as valid "Biblical plants" at all, or they are not related to any specific plant species or genus [8].

In R /Ap
We excluded about 24 plant species from Jacob's list [2] for the following reasons: they are no longer recognized by Amar [8] as plants, or the reliability of identification level is below "low probability of identification" or is an "aggregate name" and not a speciesspecific plant name (hence, indicated as NR); the identification by Campbell-Thompson is no longer recognized today or cannot be confirmed by any further evidence (NC-P); the plant is unknown to the flora of the Holy Land (NF); no evidence exists of international trading in the plant (NT); identification is obscure and/or non-specific (OB); they are recorded only from Egypt, with no further evidence related to the Holy Land (OE); they are found only in   Debatable species: "Ohalim / Ohalot". In the Bible "Ohalot" and "Ohalim" are mentioned four times-three of them in relation to perfumes (Proverbs 7:17; Psalms 45: 9 and Song of Songs 4: 14). Amar [8: 156-7] concludes that the old Jewish interpreters agree only on the identification of "Ohalim" cited in Songs of Songs as  [20:282], "erini" or "erinu" is used as a general term for the coniferous tree, a view not accepted today. In the Talmud (Gittin 69b), there is a remedy called Atarafa d'ara'a" ( ‫א‬ ‫ט‬ ‫ר‬ ‫פ‬ ‫א‬ ) against stomach worms; "tarfa" means a leaf and "de'ara'a" is translated by A. Steinsaltz [67] (in his commentary to Gittin 69b) as Laurus nobilis, based on the name of this species in other Semitic languages as "ar." Campbell-Thompson [20:298] mentions "ēru" (which he identifies as L. nobilis) against "anus troubles"; this identification cannot be confirmed or denied because of the lack of sufficient cuneiform evidence. Therefore, Feliks's [6:92] and Zohary's [7: 120] acceptance of "Oren" as Laurus has no solid evidence. It is worth mentioning that, as a rule that Campbell-Thompson's [20] [126: 352-354] suggests that the identification of the Hebrew "Kikkayyon" as Ricinus communis is of a "high but not sure level of identification's reliability" and that it could also be Lagenaria vulgaris Ser. ( = L. siceraria (Molina) Standl.). Although Lagenaria is known as a medicinal plant [127], it is not as common a medicinal plant as Ricinus. Felix [6:136] mentions the possibility of Lagenaria being included, based on some old Jewish sources. He states that "the Talmudic tradition identifies 'Kikkayyon' as Ricinus based on philology and the Geonim (the presidents of the great Babylonian Talmudic schools) evidence that this plant is common in Babylonia." Zohary [7:193] did not mention the possibility of Lagenaria at all. We prefer to relate "Kikkayyon" to Ricinus because of its wide use as an important medicinal plant in the ancient world since ancient times [rev.128], including the Talmudic period (Shabbat 21a).

Conclusions
All our suggested BMPs are known as such also in Ancient Egypt and/or Mesopotamia (Tables 1-4). Explicit evidence for use of medicinal plants is very rare in the Bible as well as in the Jewish post-Biblical writings. The comparison to adjacent ancient civilizations (in time and space) enables us to reconstruct the suggested list of BMP's. Examination of our list shows that all the plants in our suggested list are in continuous medicinal use in the Middle East down generations [138][139] and are used in the Holy Land today [138][139][140][141].
Shakya [142] published a review, "Medicinal plants: future source of new drugs." His "top 25 bioactive compounds of medicinal plants" include Ricinus communis, Piper nigrum, Aloe vera, Nigella sativa, Artemisia absinthium, and Allium sativum. This list accounts for 24% of our suggested list of Biblical Medicinal Plants. As once spoken by King Solomon, "That which has been is what will be, That which is done is what will be done, And there is nothing new under the sun" (Ecclesiastes 1:9).