A long and potent history in traditional medicine
For centuries, squill, often referred to as sea onion, was a powerful staple in the apothecary's cabinet. Its use was documented by some of history's most renowned medical figures and was a go-to remedy for a surprising number of ailments.
Ancient and classical use
Evidence of squill's medicinal properties dates back to ancient Egypt, noted in the Ebers Papyrus from the 16th century BC. Ancient Greek and Roman physicians further developed its use:
- Pythagoras (6th century BC) wrote about squill and believed hanging the bulb offered protection from evil spirits.
- Hippocrates (4th century BC), the "Father of Medicine," used it to treat jaundice, convulsions, and asthma.
- Dioscorides and Pliny also employed squill concoctions, commonly mixing the bulb with vinegar and honey to create a syrup known as 'oxymel of squill'. This preparation was famously used for various respiratory and cardiac issues.
Persian and folk medicine
Beyond Europe, squill and squill formulations were widely incorporated into traditional Persian medicine. Here, its uses were expanded to include treatments for:
- Respiratory disorders, such as pneumonia, chronic bronchitis, and asthma.
- Cardiovascular and digestive problems.
- Dermatological issues and rheumatism.
- As a wound healer and for abortion induction.
Pharmacological properties and active compounds
The effects of squill are primarily due to a class of compounds called bufadienolide cardiac glycosides, which are similar in action to the more famously known digitalis (derived from the foxglove plant).
Cardiac effects
The cardiac glycosides found in squill, such as scillaren A and proscillaridin A, influence the heart muscle. Their mechanism of action involves inhibiting the Na+/K+-ATPase pump, which leads to:
- Positive inotropic effect: Stronger heart muscle contractions.
- Negative chronotropic effect: A slower heart rate. This action was historically prized for treating edema (or 'dropsy') associated with heart failure. However, squill's effects are often less potent and less reliably absorbed than digitalis.
Expectorant and diuretic action
In smaller doses, squill was valued for two other key properties:
- Expectorant: It helps to thin and loosen mucus secretions in the lungs, making it easier to cough up. This made it a common ingredient in cough remedies for conditions like bronchitis and whooping cough.
- Diuretic: By affecting the heart and possibly through other mechanisms, squill increases urine production, helping to relieve fluid retention.
The crucial distinction: White vs. Red Squill
An important safety factor in squill's history is the stark difference between its two varieties.
- White Squill (Medicinal): The inner, white scales of the bulb were traditionally used for medicinal preparations.
- Red Squill (Rodenticide): The red variety contains a highly toxic compound called scilliroside. While potent, it was considered a selective rodenticide because rats lack the ability to vomit, making them susceptible to lethal poisoning. Humans and other animals, however, are likely to vomit before a lethal dose is absorbed. Despite this, misuse has led to human fatalities.
The decline of squill in mainstream medicine
The medicinal use of squill began to wane in the 19th century with the rise of modern pharmacology.
Reasons for squill's decline:
- High Toxicity: The cardiac glycosides in squill have a narrow therapeutic window, meaning the line between a therapeutic and a toxic dose is very thin.
- Inconsistent Potency: The concentration of active compounds can vary significantly depending on the plant variety, harvest time, and preparation method.
- Poor Absorption: Squill components are poorly absorbed through the gastrointestinal tract, leading to unpredictable effects.
- Safer Alternatives: The discovery and standardization of safer, more predictable drugs like digitalis and modern diuretics made squill obsolete in mainstream medicine.
Modern perspectives and limited research
While squill is no longer recommended for self-medication and is considered unsafe to take orally due to high risk of adverse effects, some limited research and traditional use continues.
- Asthma/COPD: A pilot study explored Squill-Oxymel as an add-on treatment for moderate to severe persistent asthma, showing some modest improvement in spirometry parameters. Another study looked at its effect on COPD patients.
- Alopecia Areata: One small randomized trial found a 2% squill solution potentially effective for topical application to the scalp.
- Traditional Formulations: Squill preparations like tinctures and oxymel are still manufactured and used in some herbal traditions, emphasizing the need for extreme caution.
Comparison: Squill vs. Modern Cardiovascular Drugs
| Feature | Squill (Historical) | Digitalis (Historical/Standard) | Modern Standard Treatments |
|---|---|---|---|
| Toxicity | Very High | High | Lower (Safer profile) |
| Standardization | Low (Variable potency) | Medium (Bio-assayed) | High (Synthesized, standardized) |
| GI Absorption | Poor & Inconsistent | Variable (Oral digoxin) | High (Predictable) |
| Primary Use | Expectorant, Diuretic, Cardiotonic | Cardiotonic, arrhythmia control | Diuretics, ACE inhibitors, Beta-blockers |
| Current Status | Obsolete & Dangerous | Limited use, specific indications | Widespread, well-defined guidelines |
Conclusion: A valuable lesson from history
While squill held significant medical importance for millennia, its history serves as a powerful illustration of the evolution of medicine. Its potent but unpredictable cardiac glycosides, combined with a narrow therapeutic index, made it a dangerous remedy susceptible to severe and fatal toxicity. The advent of standardized, safer alternatives like digitalis and, subsequently, modern cardiovascular drugs effectively ended squill's role in mainstream medicine. Today, it is primarily of historical interest, and taking it orally is strongly advised against by health authorities. Any use of squill should only be undertaken under strict medical supervision due to its severe cardiac risks. For those interested in its traditional role, it offers a fascinating look into the practices and dangers of pre-modern herbalism.
