White willow (Salix alba): the oldest anti-inflammatory

Salix alba, also known as willow, is a genus of trees and shrubs found primarily in the Northern Hemisphere. The genus is known for its medicinal properties and has been used in traditional medicine for centuries. One of the earliest recorded mentions of willow is traced back to Hippocrates, the famous ancient Greek physician who is considered the father of medicine. According to some, Hippocrates prescribed an infusion of willow leaves to relieve pain; according to others, he recommended chewing willow bark. In his writings, however, we find only one reference to willow: he proposed burning willow leaves to produce smoke to “fumigate” the uterus and get rid of an aborted pregnancy.

Dioscorides, a Greek physician and botanist who lived in the first century AD, in his treatise “De Materia Medica” mentions willow, which he calls Itea, and that it is a tree whose fruits, leaves and bark are astringent. He recommended willow bark for the treatment of fever, pain, and inflammation.

According to Dioscorides, the leaves pounded into small pieces and taken in a drink with a little pepper and wine help those suffering from painful intestinal obstructions.

Also, taken alone with water, willow leaves have contraceptive properties.

He suggested burning willow bark, soaking it in vinegar and using it to rub corns and calluses to remove them.

He also suggested the use of a warm compress prepared from willow leaves to counter gout (an inflammatory disease that causes pain and deposition of uric acid crystals in the joints, particularly in the knees).

Juice from the leaves and bark, heated with rose oil and pomegranate juice and applied with compresses, would help heal ear sores, according to Dioscorides.

Finally, he recommends willow leaf decoction applied locally against eczema of the skin.

In the Middle Ages, remedies made from decoctions of white willow bark and leaves were widely used to combat fever and rheumatism. The first clinical evidence of the efficacy of willow bark was reported by Edward Stone in 1763, who successfully treated malarial fever with a willow bark extract.

Dioscorides' description of willow is very important because this plant contains salicin, which is a glucoside of salicylic alcohol. It is a pro-drug that has antipyretic, analgesic, and anti-inflammatory properties. At the molecular level, it has been found to be an inhibitor of the cyclooxygenase-2 biochemical signaling pathway, specifically the enzyme prostaglandin-endoperoxide synthase.

Salicin was the original source of aspirin. In fact, in 1829, French pharmacist Pierre Joseph Leroux isolated pure salicin. Raffaelle Piria and Hermann Kolbe succeeded in synthesizing salicylic acid, and acetylsalicylic acid (aspirin) was first prepared by Charles Gerhardt in 1853, but he failed to identify its structure. In 1897, Felix Hoffmann, Arthur Eichengrun and Heinrich Dresen of Bayer Laboratories succeeded in synthesizing acetylsalicylic acid and popularized its use as a drug. In 1971, John Vane demonstrated that aspirin-like drugs inhibited prostaglandin synthesis.

In conclusion, willow has been known for its medicinal properties for centuries, and Dioscorides was one of the first to write about its use in treating fever, pain, and inflammation. Today, willow bark extract containing salicin is used in traditional medicine and in the field of dietary supplements for its anti-inflammatory properties, associated not only with salicin but also with other compounds contained in the plant.