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History
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13.09.19

From ma to CBD: History of Medical Cannabis

by Or Rozenberg
2161 Words
From Ancient China to the modern USA: the history of medical cannabis throughout the ages

If you’ve ever been to a cannabis museum, like the one in Las Vegas, chances are you finished the visit even more confused than when you entered the building. Truth is, the history of cannabis is complicated and confusing. There are several genera of the cannabis plant, several accepted uses for it at different times and places, plus cultural references and politics thrown in for good mix.

Let’s put controversy aside for a minute. We are here to discuss medical cannabis, meaning the use of cannabis for medicinal purposes. Such use is now legal in many countries, and people have used cannabis for medicinal purposes since ancient times. Cannabis has even been backed by science for use in dealing with chronic pain and some specific medical conditions, but we’ll discuss that later. For now, it’s important to understand what medical cannabis is and why we call it “medical.”

Cannabis Field

What is medical cannabis?

Medical cannabis is cannabis or sometimes cannabinoids, the chemical components of the cannabis plant, that are used for their therapeutic qualities (unlike in recreational use, in which they are used for their psychoactive effect). For cannabis to be considered “medical”, it needs to be prescribed by physicians for their patients. In other words, medical cannabis is legal cannabis. In the countries and states in which cannabis was legalized this way, the doctors who are prescribing it mostly need to have a permit. Cannabis can be prescribed in many countries, including Canada, Germany, Australia, Thailand, Israel, Italy and dozens of US states.

It is worth noting that in many countries you can also buy Cannabidiol (CBD), a specific component in the cannabis plant, with no need for a prescription. In these situations, CBD is extracted from hemp, a genus of cannabis that contains little to no amount of delta-9-tetrahydrocannabinol (THC). THC is another component of cannabis, which is widely known for its psychoactive properties. CBD alone is considered neither intoxicating nor addictive, and is known to be anti-inflammatory. Therefore, many use it to deal with chronic pain or just to maintain general health.

However, before the world knew how to extract CBD from cannabis, using the plant as a whole was the only way of consuming it. Anyway, the first documented use for cannabis wasn’t purely medicinal.

Ancient China

Cannabis was known in ancient China as “ma,” as a source for food and other products, as well as a medicine. Hemp was specifically popular since it turned out to be useful in producing paper and clothing. Because hemp was also proved to be durable and long-lasting, it was used in the military to produce bowstrings for archers.

It was around 2700 B.C. that Emperor Shen Nung suggested cannabis as a treatment for more than 100 conditions, including rheumatism and malaria. The emperor is considered the father of Chinese Medicine, and is thought to have established the foundations for Pen Ts’ao Ching, the world’s oldest pharmacopeia.

The first health care professional to experiment with cannabis as an anesthetic was the founder of Chinese surgery, Hua T’o. Around the second century A.D., he combined cannabis resin with wine and called it ma-yo. He reported that the anesthetic reduced patients’ pain even during painful procedures like chest and loin incisions.

Cannabis in the Ayurvedic tradition

Cannabis was and is still widely used in India, when mixed into special drinks that locals consume for enjoyment, as well as for medical reasons. One of the most popular drinks is bhang, a mix of cannabis paste (made from leaves and buds) with milk, ghee and naturally for India – spices.

In the sacred book Atharvaveda (“science of charms”), bhang is referred to as one of the “five kingdoms of herbs… which release us all from anxiety” (2000-1400 B.C.). Ancient Indian writers described it later as having “mental powers” since it “removes wind phlegm” and makes people happy. Bhang was also used as a cure for fever, dysentery, and sunstroke.

Cannabis bhang

Medical cannabis in ancient Egypt

Following traces found in mummies, several studies suggest that cannabis and substances like cocaine and nicotine were used by the Ancient Egyptians of the Pharaonic era. However, these findings have been widely criticized.

In about 1550 B.C., ancient Egypt’s Ebers Papyrus made note of medical cannabis as a way to treat inflammation. Some experts say the plant still pops up in ancient texts and that SmSmt is the Ancient Egyptian word that describes it. Other experts argue that this word is meant to describe conjecture.

Medical cannabis in Greco-Roman history

The Ancient Greeks had the misfortune of living in a geography where the only cannabis genus available was Sativa, which seems to have only a fraction of the active medical ingredients found in Cannabis. That means they had little chance of learning firsthand about its medical qualities.

However, the ancient Greeks did occasionally use cannabis for medical purposes. Cannabis was used to dress wounds and sores on their horses while in humans, dried cannabis leaves were used to treat nose bleeds. Additionally, cannabis seeds were used to expel tapeworms, and there is a mention of using them to prepare a warm extract that treats inflammation caused by the obstruction of the ear.

The contribution of William O’Shaughnessy

Born in 1809, William O’Shaughnessy was a medical doctor from Ireland who became famous for his work in pharmacology and chemistry. His research also introduced the therapeutic use of Cannabis sativa to modern medicine.

William O’Shaughnessy
William O’Shaughnessy

O’Shaughnessy was an employee in the British East India Company, who touted the benefits of medical cannabis for the treatment of rheumatism and nausea in England and America. His first work on cannabis was published [O4] when he became a member of the Medical and Physical Society of Calcutta.

O’Shaughnessy recommended cannabis for a variety of therapeutic purposes and established his reputation by successfully using cannabis to relieve the pain of rheumatism and still the unexplained convulsions of an infant. He later also used resin to quell the wrenching muscle spasms of tetanus and rabies.

The early history of medical cannabis in France

While O’Shaughnessy was reintroducing cannabis for England, the psychiatrist Jacques-Joseph Moreau was doing the same for France. His work was the first to systematically document the effects drugs have on the central nervous system. He also observed people’s reactions to Hashish, the name given to the resin of cannabis in the middle east, including his own reaction.

His 1845 studies on hashish theorized that the substance’s psychoactive effects could either treat or replicate mental illness in a way that helps in curing patients. The way he carefully recorded both physical and mental responses ultimately led to modern psychopharmacology and the concept of psychotomimetic drug treatments.

During the 19th century, the most famous European literary club to embrace hashish was Club des Hashischins,[O7] a Parisian club that consisted of literary luminary members like Victor Hugo, Alexander Dumas, Honoré de Balzac, and Charles Baudelaire. The latter also wrote Les paradis artificiels in 1860, in which he described the influence of opium and hashish in person.

The modern history of medical cannabis in the US

Americans grew interested in cannabis in the late 18th century after some medical journalists suggested that hemp seeds and roots could help in treating many health problems, including skin inflammation. These were supported by Dr. William O’Shaughnessy’s findings in the treatment of various conditions in the United States and England.

Because none of the drugs at the time were properly regulated, some people became addicted to heroin, opium, and morphine. The US Food and Drug Administration (FDA) was established in 1906 to prevent another crisis by regulating the use of opium and morphine.

Cannabis became marijuana when immigrants from Mexico (the word “marijuana” was originated in Mexico as “Mary-Juana”, or “Mary Jane” in Spanish) made the recreational use of the plant popular. This associated the drug with lower social class and by 1914, drug use had officially been declared a crime. By 1970, marijuana was categorized as a Schedule I drug, and was listed as having no accepted medical use. An attempt of undeclaring cannabis as a schedule I drug was revoked by President Nixon himself. 

Further efforts to petition the DEA for rescheduling or to pass a bill in Congress (in 1981) were also unsuccessful. The federal government began providing the drug to a limited number of patients with severe or life-threatening conditions under the Compassionate Investigational New Drug Program in 1978. However, the program was closed to new patients in 1992 due to a flood of new applications from AIDS patients. Another possible reason was concerns in the Bush administration that the program was undercutting the efforts to discourage illegal drug use. 

California voters approved a proposition to legalize the medical use of cannabis in 1996, which made the Clinton administration reiterate its firm opposition to medical cannabis. The efforts to enforce federal law over the use of cannabis escalated during the eight years of the Bush administration and a strong federal crackdown was noted as President Barack Obama stepped into office. At first, it seemed that Obama was going to enable each state to determine its own policy on medical cannabis, stating, “I’m not going to be using Justice Department resources to try to circumvent state laws on the issue.” However, during his first two years in office, the number of raids on medical cannabis providers by the administration increased, even in comparison to the Bush administration. 

In April 2015, on the heels of some recent medical research, 23 US states legalized medical cannabis. The legalization applies only in certain ages and conditions, such as children with epilepsy or adults with cancer who use cannabis to ease the side effects of chemotherapy. Some states also allow use for patients with Parkinson’s disease, multiple sclerosis, and Crohn’s disease. 

On June 25, 2018, the FDA announced its first-ever approval of a Cannabis-derived pharmaceutical drug, called Epidiolex. This drug is used to treat seizures caused by two severe forms of epilepsy that usually appear in early childhood or infancy. 

over the counter CBD products

Americans can also purchase CBD products, either online or over the counter, and at cannabis-specific dispensaries. Many countries enable it and the FDA also mentioned in May 2019 that it was willing to consider classifying CBD as a dietary supplement ingredient. It is worth mentioning that according to the DEA, CBD is still deemed a Schedule I controlled substance.

Roger Adams’ cannabis research

Another researcher who contributed to the study of cannabis was American organic chemist Roger Adams. While working at the Noyes Laboratory at the University of Illinois, Adams and his 250 students identified and isolated CBD from cannabis and showed how it is related to CBN and THC. They also synthesized CBN and THC analogs, meaning their chemical structures.

CBD,  CBN and THC

The problem was that Adams conducted his research at the beginning of the 20th century, while the plant had been banned by the passage of the 1937 Marijuana Tax Act. For samples of cannabis, Adams had to obtain a red oil extract of the plant from the United States Department of Treasury, which cost him his security clearance from the Office of Naval Intelligence.

Raphael Mechoulam’s research and discovery

After CBD and THC were isolated in the time of Adams, what remained was to isolate cannabinoids in their pure form. This was achieved thanks to advanced technology and by Israeli medicinal chemistry professor Raphael Mechoulam in 1964, along with his colleague Y. Gaoni. Mechulam is best known for the isolation, structure elucidation and total synthesis of THC.

Another study by Mechulam led him to the isolation of the first described endocannabinoid anandamide, and two of his postdoctoral researchers later isolated and characterized the anandamide.

The story of cannabis doesn’t come to an end 

The use of cannabis for medicinal purposes dates back to ancient times in Egypt, China and Greece. Its qualities were rediscovered by researchers William O’Shaughnessy, Jacques-Joseph Moreau, and Roger Adams, who researched it carefully before promoting its medicinal properties across the Western world. After studies showed it may be beneficial for patients with epilepsy and other conditions, cannabis has been approved for medical use in many countries. 

While there’s still much research to be done, more and more countries are becoming aware of the benefits of cannabis in treating other conditions.

That’s why countries are trying to regulate it in a way that helps people in improving their quality of life. Just because cannabis has medicinal properties doesn’t necessarily mean that you should use it yourself. Cannabis, or even CBD specifically, are substances that should be used with caution, in moderate doses, and under a doctor’s supervision. If you believe that you have a medical condition that can be treated with cannabis, start by finding out the legal status of medical cannabis in your country. Afterwards, consult your doctor whether you should be prescribed with the substance or not.