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The puerperium
Vol. 13 No 2 | Winter 2011
Feature
Saffron: a Bronze Age oxytocic?
Dr Peter Mayall
FRANZCOG


This article is 9 years old and may no longer reflect current clinical practice.

Minoan frescoes appear to show the use of saffron to treat medical problems in women and, more specifically, to control life-threatening haemorrhage. Investigations have demonstrated that saffron has components with oxytocic and oestrogenic properties, which could possibly have been used to successfully treat severe uterine bleeding.

Life would have been hazardous for Minoan women during the Bronze Age, with the risk of significant obstetric and gynaecological conditions not the least of their problems. The excavation of Akrotiri, a Minoan village on Thera (now Santorini, in Greece), buried beneath volcanic ash 3500 years ago, has exposed frescoes that reveal traditional medical and religious practices that were potentially helpful in coping with some of these difficulties. The frescoes in the excavated house known as Xeste 3 depict women in ritual scenes featuring crocus blooms, specifically crocus sativus, leading to many interpretations as to their meaning that have emphasised the economic, ritual and medical uses of the major by-product of this particular species of crocus: saffron. The focus on women in these scenes (there are no males or children present) and, particularly, their association with the production of saffron, suggests that these frescoes symbolised the control of disorders that particularly affected women and perhaps emphasise the unique role of saffron in their management.

Two levels of the complex are decorated with the frescoes. The upper level displays a heaven-like scene with a goddess, mounted on a platform, symbolically flanked by two exotic animals, a griffin and a blue monkey that is presenting crocus blooms to the goddess. The goddess has crocus blooms decorating her clothes and crocus stigmas displayed on her left cheek. A young girl empties crocus blooms into a basket in front of her while, behind her, a young woman approaches carrying a basket on her shoulder. The adjacent wall shows two girls, wearing saffron-coloured robes, collecting crocus flowers from a rocky landscape.

It is apparent that not only are the crocus flowers represented, but also the stigmas in particular are displayed, emphasising their significance and the importance of their main product, saffron. Crocus sativus, the specific variety from which saffron is derived, has deep purple petals with three bright red stigmas that protrude from the flower. There is evidence in some of the restored frescoes that the crocus blooms shown were coloured purple, confirming that this is the variety of crocus depicted. Crocus sativus has to be grown by dividing the corms as it is an infertile genetic variant of a species native to Crete. Its cultivation is labour intensive, with the corms having to be lifted and replanted frequently to maintain their vitality, which restricts supply. Saffron would have been an expensive commodity and probably only available to elite individuals in the Minoan society, such as the elegant women depicted in the frescoes.

Three women of different ages are portrayed in the lower level, with indications of their levels of maturity shown by their body shapes and adornments, their hairstyles, clothing, jewellery and breast development. The veiled figure on the right is shown to be a young girl by her pre-pubescent figure and shaven head, which was the convention in that society. She wears a filmy cloak and turns backwards to look towards an altar displayed on the adjacent wall. The figure on the left is an older woman with long hair tied in a kerchief wearing a sheer garment embroidered with crocus stigmas. She has a mature figure and swings her necklace, indicating her age and social status. The central figure, a young woman, sits on a rocky ridge sprouting crocus flowers. She holds her left hand to her head and has a pained expression on her face as she reaches with her right hand to her bleeding left foot, which has two crocus stigmas lying beside it. She is directly below the goddess and appears to be the crucial figure in the ritual. The altar on the adjacent wall draws the attention of the three females. It is decorated with crocus blooms and mounted with the horns of consecration, a Minoan religious symbol, which are depicted smeared with blood.

The presence of females only, including females of different ages, has suggested that the scenes illustrate an initiation ritual. The young woman with the bleeding foot was thought to represent a ritual involving the onset of menarche or her forthcoming marriage.1 The association of the crocus stigmas with the bleeding foot has also been interpreted as depicting the celebration of the use of saffron as a healing remedy. The absence of any males or juveniles seems to indicate that this only involved women. However, these interpretations do not completely explain the significance of the young woman with the bleeding foot. The upper scenes showing the goddess and the exotic animals together with the altar on the lower level confirm the shrine-like nature of the complex and the ritual nature of the illustrations. This religious theme is continued in the mountainous landscape and also on the stairway leading to the complex, alluding to the peak sanctuaries, which were important religious ritual centres in rural Minoan societies. The frescoes obviously involve a religious celebration involving saffron, but the previous interpretations that have been given do not fully explain their meaning.

Obstetric and gynaecological haemorrhage was a dilemma facing ancient physicians and their patients as evidenced by the many and varied treatments that were employed, most of which now appear to be quite bizarre. Examples of these from Bronze Age Egypt are recorded in the Ebers and Kahun Papyri. Meanwhile, saffron has been used to treat numerous medical conditions over the past four millennia, including many gynaecological disorders, eye ailments, traumatic wounds and gastro-intestinal ailments. Its medicinal use in ancient Egypt was noted in the Ebers Papyrus and Dioscorides, in the first century AD, included it in a preparation for the treatment of non-specific female complaints. It is still listed in the Martindale Pharmacopoeia to be prescribed for various eye, joint, gastro-intestinal and dental problems and in the Aegean it is evidently still currently used for menstrual disorders.2

In many cases, there is no obvious reason for saffron to have been used, but such was its reputation it would have had a powerful placebo effect, particularly as its administration would have been enhanced by an accompanying religious rite involving ritual incantation by an important religious healer in the name of the appropriate deity. However, it is evident that there is a pharmacological basis to the successful treatment of some of the medical conditions in which saffron was given and its reputation as a virtual panacea may have been based on empirical observations that demonstrated some of these beneficial effects. A physiological action of saffron demonstrated in laboratory studies is its ability to cause uterine muscle to contract in both pregnant and non-pregnant isolated and intact uteri of laboratory animals.3 This oxytocic property is due to a component of saffron, crocin, which has a molecular structure very similar to prostaglandin and misoprostol. It would be feasible that saffron could have been effectively utilised to increase uterine tone and control uterine bleeding, particularly after childbirth as well as for inducing labour and as an abortifacient. It is known to have been prescribed for these purposes since antiquity.2

Saffron may also have proved useful in controlling uterine bleeding, not only for its oxytocic effects, but also because of its oestrogenic activity due to phytoestrogen components. This has been confirmed by the ability to produce oestrogenic changes in susceptible tissues.3 This would enable it to be potentially helpful in treating bleeding caused by hormonal dysfunction. Its use for this purpose is also ancient and has been noted in Assyrian, Greek, Roman, Tibetan and medieval medical literature and in recent publications dealing with herbal therapies.4

The dosage of saffron required for treatment was up to 10g, which required about 1000 crocus blooms to be gathered and processed, but the usual dosage was 0.5g. Deaths have occurred with the ingestion of higher doses when used as an abortifacient. Clinical controlled trials have never been carried out to confirm the benefits of saffron in the treatment of these conditions, but there is empirical and pharmacological evidence asserting its effectiveness. The value of a remedy to treat abnormal haemorrhage in women in that society would have been immense. Studies of skeletal remains in many ancient societies, including those of Greece, have shown that women consistently had a life-span at least five years less than men, which has been attributed largely to problems associated with childbirth.5 In Africa, in areas where women are without access to proper medical care and looked after by traditional birth attendants, the maternal death rate was found to be about one per 100 births, which is similar to that reported from isolated areas in New Guinea and Laos. The risks to Minoan women were probably of the same order. It has been estimated from studying markings on the pubic bones at burials that women at that time had, on average, four or five children. This would appear to be approximately correct as the population increased by about four times over 1000 years, in spite of an infant and childhood death rate of about 50 per cent, comparable to that in undeveloped countries today.

The overall risk of a woman dying in childbirth was therefore approximately five per cent. This level of maternal mortality would have had a dramatic effect on these communities. It has been shown that uterine haemorrhage is the cause of maternal death in 25 per cent of cases in developing countries and a significant contributing factor in a further 25 per cent.7 It would be expected that these statistics would also apply to ancient societies. Abnormal uterine bleeding not related to pregnancy would have been an additional risk to the health of many women. When the frescoes are considered in light of the therapeutic effect of saffron, specifically for controlling life-threatening haemorrhage in women, the explanation behind the depictions appears to be clearer.

The bleeding foot being clutched by the distressed young woman appears to be more than an injury, perhaps it is a symbolic representation of major uterine haemorrhage. The extent of
this problem is shown by the three female figures representing the three phases of a woman’s life from her youth to maturity. The effectiveness of saffron in controlling uterine haemorrhage and the relief that this might therefore have given these women may explain the prominence of crocus sativus in the frescoes in Xeste 3. There have been no human remains recovered from Akrotiri to indicate any benefit to these women and, pending the decipherment of Linear A script, there is no written evidence as to its applications in Minoan society, but the inferences that can been drawn from the associations and symbolism in the frescoes appear to indicate its beneficial use.

Acknowledgement

I gratefully acknowledge the help and encouragement given by Assoc. Prof. Louise Hitchcock, Department of Classics and Archaeology, University of Melbourne, in the preparation of this paper.

Postscript

Akrotiri has been closed to visitors since 2005, following a fatal accident due to a partial collapse of the protective roof. It is due to re-open this year.

References

  1. Gesell, G.C. 2000. Blood on the Horns of Consecration, in Sherratt S. (ed.) The Wall Paintings of Thera, Vol. 2, Athens, Thera Foundation, 948.
  2. Ferrence, S.C. and Bendersky, G. 2004. Therapy with Saffron and the Goddess at Thera. Perspectives in Biology and Medicine, 47, 211.
  3. Chang Pei-Yen, Wang Chi-Kwang, Liang Chong-Dong and Kuo Wei, 1964. Studies on the Pharmacological Action of Zang Hong Hua (Crocus Sativus L.), Acta Pharmaceutica Sinica, 11,100.
  4. Daniel, M. 2006. Medicinal Plants, Chemistry and Properties. Enfield, New Hampshire, Science Publishers. 138.
  5. Grmek, M. 1989, Diseases of the Ancient Greek World, Baltimore, The Johns Hopkins University Press, 104.
  6. Sloan, N.L., Langer, A., Hernandez, B., Romero, M. and Winikoff, B. 2001. The Etiology of Maternal Mortality in Developing Countries. Bulletin of the World Health Organisation, 79. 805.
  7. Immerwahr, S. 1990. Aegean Painting in the Bronze Age. Pennsylvania State University Press. 60.

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