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Garlic: a success story in herbal medicine

Professor Edzard Ernst looks at the history and research surrounding garlic's medicinal benefits

The medicinal use of garlic has a long and fascinating history.

• In ancient India, it was recommended to treat conditions as diverse as infections with parasites, fatigue and digestive problems.

• In ancient China, garlic was used for respiratory or digestive problems and to enhance male potency.

• In ancient Egypt, it was employed to prevent disease and, in the Codex Eber, it was recommended as a treatment for a wide range of conditions.

• It is also mentioned repeatedly in the Bible and in the Talmund.

• The slaves in Egypt apparently were given garlic to stay strong and fend off infections.

• In ancient Greece, it was used for soldiers and athletes to give them stamina.

• Hippocrates advocated garlic for many diseases.

• In ancient Rome, it was used for conditions such as cardiovascular and gastrointestinal diseases, musculoskeletal problems and epilepsy.

• In the Middle Ages, garlic became a popular remedy for the poor, allegedly protecting them from the plague and other epidemics.

Some indications for garlic look adventurous to us today. There is hardly an illness garlic does not seem to alleviate or cure. Recent research has focused on some of the historical experiences with garlic. For several decades there has been active basic research aimed at defining garlic's mechanisms of action as well as clinical research aimed at finding out how effective and safe garlic really is. I think it would be difficult to find an herbal medicine that has attracted more scientific study than garlic.

As a consequence, we understand what constituents of garlic are pharmacologically active, by what mode of action they operate and which body systems they affect. We know that garlic lowers cholesterol and blood pressure, inhibits coagulation and platelet activity.

But does it affect clinical outcomes? Even after several thousand publications and decades of research, all we can truthfully say is 'probably, but we cannot be sure'. To be certain, we need clinical long-term studies with endpoints related to morbidity and mortality.

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