Reviving Humoral Medicine
with Dr. Hani El Batal
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The Fatwa on Hawthorn
In recent years, information has become widespread among people claiming that hawthorn helps open blocked arteries, especially the coronary arteries of the heart, to the point that some patients have come to rely on it for this purpose. However, a review of the writings of the classical physicians reveals that this information is not correct. On the contrary, hawthorn may have the opposite effect in such cases due to its strong astringent properties, which can contribute to the narrowing and hardening of the arteries and increase obstruction within them.
In this article, we review the opinions of renowned physicians such as Dawud al-Antaki, Ibn al-Baytar, Ibn Sina (Avicenna), and others regarding the different varieties of hawthorn and their temperaments. We also explain the conditions in which hawthorn may be beneficial and others in which it may be harmful, so that the reader may gain a clear understanding of its benefits and risks according to the principles of humoral medicine.
Medical Note
Praise be to Allah, and peace and blessings be upon the Messenger of Allah.
There has been much discussion about the benefits of hawthorn for opening blocked heart arteries, and this belief has become widespread among people. Therefore, out of concern for patients suffering from coronary artery disease, it is necessary to point out that this claim is not correct.
According to the classical physicians, hawthorn exists in both wild and cultivated varieties. Both are strongly astringent. The wild variety and the cultivated variety are cold and dry and generate black bile. Black bile coagulates but does not dissolve what is inside the arteries. Some physicians stated that the cultivated red hawthorn is cold and wet and generates phlegm, and phlegm thickens but does not dissolve what is inside the arteries.
In all cases, it is incorrect to claim that hawthorn opens the arteries of the heart, because it either coagulates or thickens what is inside the arteries. Furthermore, it is strongly astringent. In the terminology of the physicians, an astringent substance causes the parts of an organ to contract and become denser in their place, thereby blocking and narrowing the passages. As a result, the flow of substances through these passages becomes more difficult. Hawthorn acts in this manner: it constricts, hardens, narrows, and obstructs the arteries.
Therefore, anyone suffering from arterial hardening or narrowing should not use hawthorn, because this condition may worsen due to its tendency to coagulate or thicken substances and because of its strong constricting, narrowing, and hardening effects on the arteries.
This does not negate its usefulness for other conditions, such as excessive hotness in the blood, disorders of yellow bile, and hot conditions of the liver and stomach, among others.
From Tadhkirat Dawud al-Antaki:
“Hawthorn, known in agriculture as mountain apple, is a tree larger than the apple tree, with many branches and hard wood. It grows in cold mountainous regions. Its fruit is larger than a hazelnut and smaller than an apple, triangular in shape, containing either three attached seeds or one triangular seed. Its fragrance resembles that of an apple. It is cold in the second degree and dry in the first degree. It contains excess wetness, mucilaginous substances, and acidity. If its juice is extracted and drunk with sugar, it relieves headaches immediately. When ground and applied to hard swellings and severe redness, it resolves and disperses them. It quickly calms disorders of hot temperaments, stimulates appetite, and may increase sexual desire in hot-natured individuals. It generates phlegm and corrupts humors. Excessive consumption excites corrupted humors, nausea, and vomiting. Sikanjabin benefits hot temperaments affected by it, while agarwood and anise benefit cold temperaments. The dose of its juice is twenty dirhams, and the dose of the fruit itself is twelve dirhams. Bitter apples may be used as a substitute.”
From The Book of Simple Medicines:
“Hawthorn is a thorny tree with small fruits resembling apples in shape. It is astringent, beneficial for the stomach, and binds the bowels. Its temperament is cold and dry in the first degree. It calms yellow bile and blood disorders and should only be used after it ripens because otherwise it causes colic.”
The text continues by distinguishing between wild and cultivated hawthorn and describes both as cold and dry, with effects including strengthening the stomach and liver, stopping vomiting, and strongly binding the bowels.
From Ibn al-Baytar’s Compendium of Simple Drugs and Foods:
“Hawthorn is a thorny tree with small apple-like fruits. It is astringent and beneficial for the stomach, while also restraining bowel movements.”
Galen stated that hawthorn fruit is strongly astringent and should not be eaten except after proper ripening. Its fruit and even its branches and leaves possess considerable astringency.
Ibn Masawayh stated:
“Its temperament is cold and dry in the first degree. It strengthens the stomach and provides only slight nourishment. Excessive consumption is not praiseworthy. It should be used as a medicine rather than as food.”
Al-Razi stated:
“It calms yellow bile and blood.”
Rufus wrote:
“It stops vomiting and restrains the bowels without preventing urination.”
From Kamil al-Sina‘ah al-Tibbiyyah:
“As for the yellow mountain hawthorn, which is slightly acidic, it is cold and dry. It extinguishes hotness, suppresses yellow bile, strengthens the hot liver and stomach, restrains bowel movements, and stops vomiting. As for the cultivated red hawthorn, it is cold...”