Old-Fashioned Pharmacy : Arab World Still Turns to Exotic Herbal Cures

A woman enveloped in black whispered her illness across the counter to Suhair Darkal as if passing a secret. Without hesitation, Darkal thrust a grimy hand into a barrel of aromatic herbs and neatly folded a palmful into a square of newspaper.

“Do you have incense?” shouted another customer.

“Do I have incense?” Darkal roared back. “I have 75 kinds of incense. What’s the problem?”

Darkal was dispensing medicine, the old-fashioned way, as a crowd gathered in front of the dimly lit shop on the Via Recta, the street called Straight by the Romans, which is now the main thoroughfare of Damascus’ ancient Medhat Pasha souk , or market.

Anise, Rhubarb, Lizards

As donkeys and Toyotas compete for space on the cobblestone street outside, the impish-looking Darkal, clad in a blue lab coat, moves surely from ropes of dangling cinnamon to drums of anise and rhubarb. The walls are filled with glass jars containing ominous-looking specimens, such as dried lizards.

Darkal is one of Damascus’ most famous attars , or druggists. Unlike conventional druggists, however, the attars of the Arab world dispense natural remedies, usually herbs that are taken as tea.

Modern medicine is almost as common in the Arab world these days as anywhere in the West. Doctors’ shingles speak of training in the United States and Europe. Doctors in Jordan have performed a number of heart transplants. Governments take pride in modern hospitals, and pharmacies are on virtually every street corner of most big cities.

Yet, tibb ashab , or herbal medicine, continues to have considerable appeal. Crowded shops are prominent in the souks of many Middle Eastern capitals from Damascus to Cairo.

“Some of my patients have been sent by doctors, others have tried doctors and have given up hope when there was no cure,” Darkal said. Instead of a university diploma on the wall, Darkal, who was trained as a lawyer, displays a Koranic inscription: “If God has your support, nobody can defeat you.”

Drawing on local crops and imports from as far away as India and China, natural druggists in the Arab world frequently offer 250 “prescription” drugs for a variety of ailments and maladies.

A local radio show in Syria devotes five minutes a day to herbal remedies, vastly increasing the market here. Newspapers throughout the Arab world regularly carry articles promoting a particular herb’s curative properties.

Fixture Since 11th Century

Although enjoying a popular revival lately, herbal cures have been a feature of Middle Eastern medicine since the time of the legendary physician Ibn Sinna in the 11th Century, an era when science achieved dramatic heights in the Arab world.

The modern Arabic word for pharmacy, saydaliiah, is derived from sandal, the word for sandalwood, one of the most common early herbal medicines.

A Koranic injunction, first recorded 1,400 years ago, helps to explain the continuing popularity of herbal medicine in the Muslim world: “God inflicted diseases and maladies,” the Muslim 1752132729herbal drug miswak for toothache.

“Interest in natural products and ecology was a corollary to the Muslim belief that God provides for the creatures he has created,” said Dr. Sami Hamarneh, a professor of the history of medicine at Jordan’s Yarmouk University. “The belief motivated Muslim naturalists, herbalists, pharmacists and physicians to seek remedies in nature, rather than in scarce synthetic drugs.”

Little Formal Education

Unlike druggists of an earlier era, most of the modern Arab attars have relatively little formal education in medicine, having learned their art by apprenticeship. Many have learned from a father or grandfather, and they carry the formulas for hundreds of brews and concoctions in their heads.

“I used to watch my father after school and then came to work full time,” said Ahmed abu Sham, whose father was the most famous druggist in Jordan until his death two years ago. The shop has branched out, stocking grass seed and condiments along with the herbal cures.

Some of the remedies sold, such as camomile tea, have long been accepted in Western medicine as having a benign effect. Other herbs have gone on to become well known drugs: belladonna becoming atropine, for instance, and foxglove serving as the basis for digitalis.

“Historically, a lot of major drugs have been extracted from plants so there is a rational basis for herbal cures,” said Ray Kodratas of the National Museum of History and Technology at Washington’s Smithsonian Institution.

“For general disorders such as colds and flu, they’re probably just as useful as anything else on the market. Traditional healers know what they can and cannot treat,” Kodratas said.

Headaches, Stomach Ailments

Indeed, there was general agreement among the druggists interviewed that migraine headaches and stomach ailments constitute the vast majority of the maladies that people bring to attars for treatment.

“If I’m not sure that what I’m giving will work, I won’t prescribe the drug,” said Darkal’s cousin Abdulrahman, who operates a rival shop. “People have to trust me and I have to trust my medicine.”

In addition to the common problems and cures, the traditional druggists also stock unusual cures that seem more aimed at solving psychosomatic problems in an innocent if dubious manner.

Many druggists sell small silver tubes containing fulminate of mercury, which is said to ward off the evil eye. Others claim they can cure impotency--with dried lizard--or falling hair.

“At least 30% of my patients are sick for psychological reasons,” Darkal noted.

Prescribes Incense

Ahmed abu Sham in Amman regularly prescribes incense to settle family disputes, claiming that the burning dispels unhappy vapors. Another of his cures causes sweating to enable barren women to conceive.

“They aren’t able to get pregnant because of trauma,” he said. “So I make them sweat it out.”

Despite their popularity, the attars rarely seem hygienic or particularly scientific, with the drugs stored in sacks, or, in one case, old cigar boxes. Wrapping the finished prescription in old Arab newspapers is popular as well.

One of the largest suppliers of herbal remedies in Damascus, the Khatib family, also is in the pharmacy business. Mohammed Khatib operates a modern pharmacy in the Damascus suburb of Zabadani, while his brother Adib changes from the pin-stripe suit he wears as a civil engineer into blue jeans to open the family drug shop in the old souk.

Paradoxically, Mohammed Khatib is a great believer in herbal remedies, preferring them to many Western medicines.

Herbal Cures Cheaper

According to Khatib, herbal cures are popular because they are much cheaper than Western medicines. Also, he says, drug manufacturers in the West often send old or aging pharmaceuticals to the Third World, so that many have lost potency by the time they are sold. And the teas sold in druggists’ shops rarely cause bad side effects because the dosage is lower than pure forms in which Western medicines are sold.

Khatib said he has developed an herbal cure for migraine headaches that is 80% effective.

Other druggists believe herbal treatments to be superior to synthetic Western drugs because they contain a number of substances in their natural form that the druggists believe interact to alleviate side-effects.

A medical doctor, Hikmat Fraihat, recently wrote in a weekly Jordanian newspaper about the “synergistic effect” of herbs, noting, for example, that rhubarb contains acids that prevent abdominal cramps, which is beneficial when the herb is used as a laxative.

“When you use a plant, you’re never quite sure of the dosage, because potency varies from place to place,” Sami Hamarneh of Yarmouk University noted. “On the other hand, the drug as a natural product can have more influence than a synthetic drug. At the least, there are fewer bad results.”