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JNEPHROL 2013; 26 ( Suppl 22): S180-S186 ORIGINAL ARTICLE DOI: 10.5301/jn.5000352 Some useful plants for renal therapy listed in De Plantis Aegypti Liber by Prospero Alpini in the 16th century: modern considerations Giovanni Aliotta 1, Natale G. De Santo 2, Giuseppe Ongaro 3, Antonino Pollio 4 Introduction With the introduction of the printing press during the Renaissance, many books about edible and medicinal plants were printed, so the number of known species increased, and their iconography was related to reality rather than imagination. Moreover, colonial expansion, the spice trade and the presence of European settlements worldwide enabled improvements to historical sources, and generated a new figure, the traveling naturalist. The job of the naturalist has always overlapped that of the historian, as gathering information on the lifestyle of indigenous peoples in faraway regions is based also on studying historical sources (1, 2). Indeed, new crops and spices, once considered as precious as gold, were highly sought after in Europe during the 16th and 17th centuries, when the major powers, while trying to obtain these plants, undertook actions that changed the course of history. Traveling naturalists and spice traders supplied botanical gardens, natural history museums and scientists with specimens that had to be classified. This is how many new species were discovered, and the way was paved to have more solid bases on which to develop new crops and classify different forms of life (3). Prospero Alpini was one of the first and most important scientist who S180 University Center for Research in Bioethics, Naples - Italy Department of Medicine, Second University of Naples, Naples - Italy 3 Center for the History of the University of Padua, University of Padua, Padua - Italy 4 Department of Biological Sciences, University of Naples Federico II, Naples - Italy 1 2 visited the African continent in modern times, gathering new and fundamental information on plants that for different reasons played an important role in Western countries. Prospero Alpini was born in 1553 in Marostica, Italy, and studied in Padua, where he graduated in philosophy and medicine. He spent some years in Egypt as the physician of Giorgio Emo, consul of the Venice Republic. Alpini’s scientific activity was very intense, and his observations, not only in medicine and natural history but also ethnology and archaeology, were the basis of his work De Plantis Aegypti Liber (4), recently translated into Italian by Cappelletti and Ongaro (5). The first of 2, Cappelletti, also gave the scientific names of the plants it cited. In 1603, at age 50, Alpini was appointed Prefect of the first ever Botanical Garden in Padua, a prestigious institution founded in 1545 that has always been exchanging plants, seeds and scientific material with other international institutions. (For more details of Alpini’s biography, see De Santo et al, in this volume of the Journal of Nephrology). The origin and evolution of some important cultivated plants have come into sharp focus only in recent years. New studies have been launched on near relatives, their distribution, their ecological behavior and their genetic interaction with cultivated races. However, some unresolved © 2013 Società Italiana di Nefrologia - ISSN 1121-8428 JNEPHROL 2013; 26 ( Suppl 22): S180-S186 questions remain, especially for indigenous African plants (such as coffee, sweet melons and watermelons), although the evidence indicates that the genus Homo originated in Africa over 2 million years ago and most of human evolution has taken place in this area (6). Indeed, contact between the Mediterranean world and sub-Saharan Africa was extraordinarily tenuous from the beginnings of recorded history until the rise of Islam, and the Western World did not learn much about Africa until Portuguese explorations in the 15th century (7). In this paper, the authors have combined their expertise to focus on some African plants listed in De Plantis Aegypti Liber by Prospero Alpini, reviewing past and present botanical and ethnomedicinal aspects, with a special focus on their use against kidney affections. Alpini’s De Plantis Aegypti Liber and its modern outcomes De Plantis Aegypti Liber (Fig. 1) was written in the form of a dialogue, reporting conversations between Alpini himself and his mentor Melchiorre Guilandino, taking place in the Padua Botanical Garden. Alpini aimed to spread knowledge mainly on therapeutic uses of wild and cultivated plants in Egypt, thus legitimating medicines that were unknown to physicians. Alpini describes the plant named Bon by the Egyptians as well as the preparation and the properties of a coffee beverage, but does not mention its diuretic properties. “De Bon” (Chap. 16) Alpini: I saw a tree in the garden of the Turkish-man Halybei, and you will see a picture of it too; it produces seeds known as bon or ban. Everybody from Egyptians to Arabs use these seeds to make a very popular decoction that is drunk instead of wine. This decoction is served at local diners, just like wine is sold in ours: they call it caova. These seeds come from the Arabia Felix. It seems that the tree I saw is similar to Evonimo, but it featured thicker leaves, harder and greener. Everybody knows how to use the seeds to prepare the decoction I am talking about: I already explained how to prepare it in the De Medicina Egyptorium. They use it to strengthen a cold stomach, to favor digestion, and also to remove obstructions in the guts. They drink the decoction for many days, successfully treating liver and gallbladder tumors, and chronic obstructions of veins as well. The decoction can also cure uterus, warming it up, and removing obstructions: thus, it is very popular among Egyptian and Arab women, and when they are on their period, Fig. 1 - Title page of De Plantis Aegypti Liber (1592) by Prospero Alpini. they drink large amount[s] of it, taking small sip[s] of this hot drink, to facilitate the menstrual flow. The prolonged use of this decoction has a cleansing effect, and it helps putting an end to the period. Guilandino: Avicenna talks about these seeds, and he describes characteristics similar to those you talked about. In his opinion, they are warm at the third degree, and dry at the second degree. I don’t think this is correct though, since their taste is rather sweet, slightly bitter, not irritating at all. Alpini: Anyhow, he explained that these seeds are very helpful in the obstructions of the guts and in liver and gallbladder tumors. He also says they cause nausea, and while I was in Egypt I learned by experience other effects of these seeds. This is the tree I once saw in Cairo (4). © 2013 Società Italiana di Nefrologia - ISSN 1121-8428 S181 Aliotta et al: Plants for renal therapy by Prospero Alpini Uses of Coffee Leonhard Rauwolf (1535-1596), a German physician and botanist became acquainted with the beverage in Aleppo in 1573, and was the first European to mention coffee, telling how the drink was prepared by the Turks. But Alpini was the first to print a description of the coffee plant and the drink, in De Plantis Aegypti (Fig. 2). He also makes note of the medicinal qualities attributed to coffee by those living in the East, and many of these were soon incorporated into Europe’s materia medica (8). The word coffee is derived from the Italian caffè, Turk kahve from Arab qawva (1598). It indicates both the beverage and the plant (9). In 1753, the Swedish botanist Carolus Linnaeus (1707-1778) published his work Species Plantarum, which contained a brief description of every known species of plants and their scientific names. The coffee plant is reported as Coffea arabica L (10). Joseph Plenck (1735-1807), a forerunner of modern diuretic therapy, published his work Icones Plantarum Medicinalium secundum systema Lynnaei cum enumeratione virium et usus medici chirurgici et diaetetici. This work, published in folio and in several volumes beginning from 1788, was written in both Latin and German. Plenck reports the therapeutical uses of 758 plants, 111 of which have diuretic properties The diuretic properties and uses of Coffea arabica L. are described in the second volume, folio 30: Fig. 2 - Illustration of the bon (coffee) plant from De Plantis Aegypti Liber (1592) by Prospero Alpini. VIRTUS. Semina ustulatione redduntur, subempyreumatica, motum sanguinis accelerant, calefaciunt, exsiccant, humores attenuant, stomachum roborant, urinam et diaphoresim movent, vermes et flatus pellunt. Virtues: Seeds improve blood circulation, dry up fluids, strengthen the stomach, favor urination, and eliminate worms. taken orally for the treatment of diarrhea and amoebiasis (13). In Gimbi Woreda, in the West Wellega zone, western Ethiopia, the roasted, powdered seed is eaten or drunk on an empty stomach for 2-3 days against diarrhea (14). According to John Crawford: USUS. In indigestione, menstruatione nimis tarda aut par- The greatest curiosity about the use of coffee is the discov- ca, in febris nervosae languore. Cephalalgiam ex ventric- ery of its property by roasting, as the seed in its raw state is uli debilitate nervosa vel transpiratione suppressa ortam insipid until its virtues are developed by a partial roasting. discutit, urinam movendo sabulum expellit. Diarrhaeam Who discovered this process is not known; but it was most chronicam sanat. (Use. For indigestion, slow menstrual probably the Arabs, for the Christians of Abyssinia, on what flow, and high fever. It is diuretic and cures chronic diar- pretext is unknown, hold its use to be unlawful, and do not rhea) (11). cultivate it for their own use (15). The species Coffea arabica L. is considered native to the Ethiopian highlands (6), where the plant is used as a folk remedy by different ethnic groups presently living in Ethiopia. In the Wonega Woreda region, dried leaves and an infusion of the leaves are used as an emetic (12). In rural central Ethiopia, roasted and powdered coffee is pasted with honey and S182 Over the course of the 16th century, coffee’s popularity spread from Yemen to Egypt, Syria and Turkey, and then into Europe (15). The popular use of coffee as a diuretic is known in the Makkah Al-Mukarramah area, Saudi Arabia (16), and traditional Indian medicine prescribes of coffee as diuretic in dropsy (17). © 2013 Società Italiana di Nefrologia - ISSN 1121-8428 JNEPHROL 2013; 26 ( Suppl 22): S180-S186 In Western medicine, dried ripe seeds of coffee are used as a stimulant, nervine and diuretic, acting on the central nervous system, kidney, heart and muscle. Reported to be analgesic, anaphrodisiac, anorexic, cardiotonic. diuretic, hypnotic, nervine and stimulant, coffee has also been used as a folk remedy for asthma, jaundice, nephrosis, opium poisoning and vertigo. In humans, caffeine (1,3,7-trimethylxanthine) is demethylated into 3 primary metabolites: theophylline, theobromine and paraxanthine (18). “De Cypero” (Chap. 37). The Cyperus rotundus (nut grass) that the Egyptians call Hodveg is widespread by the river Nile and around swamps and creeks in Egypt. Its leaves have a distinct midrib, are very dark green and are similar to those of chive. The roots are black; they feature some round swellings, the size of a big olive, and most of them hang together from the same string of the root, and they have a nice smell and pungent taste (Fig. 3). The Egyptians made a decoction with the root, and also crushed it to a dust that was used to break stones in the kidney and in the bladder, and to induce urination; they also used it to cure chronic fevers, and all long-term diseases. Surprisingly, Cyperus rotundus L. is described by some as the world’s worst weed today. It is a sedge, native to India and is widely known by the common names nut grass or purple nut sedge. The outstanding characteristic of this plant is the prolific production of tubers that can remain dormant and the plant through the extreme conditions of heat, drought and flooding (19). Thus, nut grass properties have been verified with recent research. Today, in North Africa the tubercles of nut grass are used in folk medicine to cure a wide range of affections. The plant is considered an aphrodisiac, carminative, diuretic, sedative, stomachic, tonic and is administered as a colic remedy and to remove renal calculi (20). In several countries of the Maghreb, it is frequently used for hair care (21). Crawford has confirmed that Cyperus rotundus and other members of the Cyperaceae family were highly appreciated in ancient Egypt, as edible and medicinal plants (22). Alkaloids, flavonoids, phenylpropanoids, phenolic acids, quinones, sesquiterpenes, along with a steroid glycoside and furochromones have been isolated and identified from C. rotundus (23). “Chatè, Abdellavi e batecha el navi” (Chap. 38). Alpini: the present day Egyptians use a kind of melon called chatè. This melon differs from ordinary melons in size, color and tenderness. The plant has smaller leaves, which are Fig. 3 - Illustration of Cyperus rotundus (nut grass) from De Plantis Aegypti Liber (1592) by Prospero Alpini. whiter, more round, and it produces fruit that is much different from Italian melons. Egyptians use this melon cooked with milk with good results, to cure diseases of the kidney and bladder. For the same purposes, they also drink the juice they get from the melon seeds. To treat pain caused by podagra, they use the pulp juice of the fruit, and mix it with milk and rose oil to rub the limbs that have been hit. Egyptians also eat cucumbers cooked with milk for many days to cure inflammations of the kidney and bladder. They use the plant juice mixed with milk and oil of roses to ease the pain caused by gout. Sick people drink up to a pound of the juice obtained from the fruit to mitigate the inflammed liver, and to heal inflamed kidneys and their stones: it has been confirmed that this liquid is effective in such cases. © 2013 Società Italiana di Nefrologia - ISSN 1121-8428 S183 Aliotta et al: Plants for renal therapy by Prospero Alpini Egyptians also have watermelons, which differ from those in Italy only in size: They are bigger, with brighter yellow peels, they only contain seeds, and have a very sweet water. Nowadays Egyptians drink much of this water to quench their thirst and to mitigate excessive heat in the stomach, liver and kidneys. This water is much praised, and it is used also in cases of high fever. Distillation makes the water lighter, and they use it as a common drink, and to cure bilious stomachs, liver ailments and kidney stones. Turkish men and Arabs drink this watermelon juice during heat waves in the summer, and some people add rose water, musk and amber to it. Egyptians often greet foreigners by giving them this fruit to eat. They also keep the watermelon in straw for 1 year, so that they can sell it for a higher price when people who are ill need it. I have heard of watermelons sold for a silver coin, or a gold one. Their water is so diuretic that those who drink a large amount of it get incredibly large hernias in their testicles. This is why hernias are so common in these countries. Zohary and Hopf consider the cultivated melon, Cucumis melo L., as an important cucurbit, which was probably brought into cultivation in Southwest Asia or in Egypt at a relative early date (6). This is a very variable crop which includes both (i) sweet fruited varieties (melon or muskmelons) and (ii) nonsweet green-fruited forms (chate melons) (Fig. 4). The latter are rare today, frequently bear fruits that are bent, and they are consumed like cucumbers. They were traditionally referred to as Cucumis melo L. var. chate Naud. The archaeological remains of melons are few. The only exception is Egypt, were numerous noncarbonized vegetables and tubers survived because of the extreme dryness. Yet those remains seem to indicate that melons were cultivated already in the Bronze Age. Illustrations of offerings of what are clearly the bent fruits of the chate melon decorate several ancient Egyptian tombs (6). Moreover, the different varieties of Cucumis melo overlap and interbreed so readily that attempts to find a precise botanical classification can never be completely successful (25). Muskmelon and chate melons are used for the treatment of renal disease in different African and Asian countries (26, 27). Their seed extracts significantly increase urine volume, and also cause increases in urinary chloride excretion, which might be due to the extract interfering with absorption in the renal tubules (28). The watermelon, Citrullus lanatus (Thunb.) Mats. & Nakai. (syn. Citrullus vulgaris Schrad.), was cultivated in the Nile Valley at least since the start of the 2nd millennium bc. Numerous seeds were found in Tutankhamun’s tomb. The cultivated watermelon is closely related to, and fully inS184 Fig. 4 - Illustration of the chate melon from De Plantis Aegypti Liber (1592) by Prospero Alpini. terfertile with, the wild colocynth, Citrullus colocynths (L.) Schrad., and the crop is very probably derived from this wild watermelon (6). Alkaloids, antraquinone, phlobatannin, saponin, steroids, tannin and terpenoids have been isolated from watermelon. The whole fruit contains saponins, alkaloids and flavonoids (29). Citrullus lanatus is used against kidney disorders and as a diuretic, stomachic, to purify the blood, and to cure skin and eye infections (23). The seed extracts are also commonly used as a home remedy for urinary tract infections (30). © 2013 Società Italiana di Nefrologia - ISSN 1121-8428 JNEPHROL 2013; 26 ( Suppl 22): S180-S186 Conclusions The origin and evolution of numerous plant species of ecological or economic importance have come into sharp focus only in recent years. New studies have been launched on near relatives, their distribution, their ecological behavior and their genetic interaction with cultivated races. The interest in screening plants for new medicines is rising also because some of these plants have for centuries represented a source of remedies widely used in folk medicine, and about three quarters of the biologically active plant-derived compounds presently in use worldwide have been discovered through follow-up research to verify the authenticity of data from folk and ethnomedicinal uses (31). However, some unresolved questions remain especially for indigenous African plants. Indeed, contact between Mediterranean world and sub-Sahara Africa was extraordinarily tenuous from the beginnings of recorded history until the rise of Islam, and the Western World did not learn much about Africa until Por- References 1. Plomelli D, Pollio A. Medicinal plants. Nature. 1994; 371(6492):9. 2. Aliotta G, De Santo NG, Pollio A, Sepe J, Touwaide A. The diuretic use of Scilla from Dioscorides to the end of the 18th 3. 4. 5. 6. 7. 8. 9. century. J Nephrol. 17 (2):342-347. Mayr E. 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Therefore, the reexamination of early descriptions of African plants, such as those given by Alpini in De Plantis Aegypti Liber, which included a botanical description along with information on their cultivation and uses, could give an important contribution to improving our knowledge of their chemical, nutritional and clinical characteristics. Financial support: No grants or funding have been received for this study. Conflict of interest: None of the authors has financial interest related to this study to disclose. Address for correspondence: Giovanni Aliotta Via Stadera 86 80143 Naples, Italy [email protected] 10. Aliotta G, Capasso G, Pollio A, Strumia S, de Santo NG. Joseph Jacob Plenck (1735-1807). Am J Nephrol. 1994;14(4-6): 377-382. 11. Plenck J.J. Icones Plantarum Medicinalium secundum systema Lynnaei cum enumeratione virium et usus medici chirurgici et diaetetici. 8 Vol. Vienna: Apud Rudolphum Graeffer et Soc; 1788-1812. 12. Mesfin F, Demissew S, Teklehaymanot T. 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Screening plants for new medicines. In: Wilson EO, ed. Biodiversity. Washington DC: National Academic Press; 1988:83-97. Accepted: September 21, 2013 © 2013 Società Italiana di Nefrologia - ISSN 1121-8428