Between heaven and earth – the mythology and medicine of mistletoe

Something for the festive season –  from the January 2012 edition of the Marshwood Vale Magazine

As a child, I remember that sinking feeling when I spotted the sprig of Christmas mistletoe hanging from the door frame.  It was our annual Boxing Day visit to my grandparents in Sturminster Newton and I did my best to avoid being caught in the doorway by anyone keen to give me a Christmas kiss.  Things were different when I was a young man and kissing under the mistletoe at Christmas parties began to offer interesting possibilities.  The practice of kissing under the mistletoe is familiar at Christmas in this country but it is in fact a remnant of a complex symbolism associated with this unusual plant with its green leaves and white berries. 

Mistletoe is an evergreen semi-parasitic plant that grows attached to branches of trees, with apple being a favoured host.  Birds love to eat the white berries and when they wipe their beaks on the bark of another tree they leave the sticky juice and seeds which germinate and the plant grows.  There is no other plant quite like mistletoe and the sight of an otherwise leafless tree in winter with a large ball of green mistletoe is very striking.  The plant appears to grow “between heaven and earth” and this gave it a strong symbolic significance; for some it came to symbolise the life force of the host tree preserved during winter and hence fertility.  For others, imagination gets the better of them and they see a strongly sexual image in the paired leaves and white berries with their sticky juice.  Not surprisingly, the plant has featured in fertility rituals.

Mistletoe also played an important role in several ancient cultures.  In Greek mythology, Aeneas must obtain the Golden Bough, probably mistletoe, for safe passage to the underworld.  The god Balder is killed by an arrow made from mistletoe, according to Norse legend.   In Celtic religion, mistletoe is central to Druidic practice.  From as early as the 16th century mistletoe formed part of Christmas decorations in this country.  Mistletoe was thought to protect the inhabitants of the house and to bring them good luck and fertility. 

The modern practice of kissing under the mistletoe also derives from a much older tradition.  In the early part of the 19th century, the most prominent decoration in houses at Christmas was the “kissing bough”.  This was spherical, decorated with ribbons and evergreens including holly and a large bunch of mistletoe.  It was hung from the ceiling with kissing occurring beneath. For each kiss a berry was removed from the mistletoe until none remained when the kissing had to stop.  In some houses, mistletoe was also placed in every doorway.  The origins of the kissing bough are probably much earlier.  In the middle ages, “kissing boughs” were placed at the threshold of a house.  The spherical decoration contained greenery but also effigies of the Holy Family.  Visitors to the house would be embraced under the decoration thus indicating that they brought no harm.  In the middle of the 19th century, the Christmas tree became the most popular symbol of Christmas in this country; the “kissing bough” began to disappear and all that remains now of these kissing customs are the sprigs of mistletoe. 

Mistletoe has featured strongly in folk medicine, possibly because of the strong associations of the plant with life forces.  The leaves and berries are poisonous but mistletoe preparations have found several medicinal uses.  Culpeper suggested in his herbal that mistletoe would “ripen hard tumours” and it has also been used in the past to treat epilepsy.  Modern herbal medicine uses mistletoe extracts for their beneficial effects on the heart and circulatory system.

The most prominent use for preparations of mistletoe nowadays is, however, in cancer treatment.  This seems to be particularly popular in German speaking countries and up to two thirds of patients in Germany and Austria undergoing treatment for cancer receive alternative therapies, principally mistletoe.  Preparations of the plant are given either as a sole therapy or in combination with another treatment and positive effects on the quality of life and on survival have been reported in clinical trials. 

This is obviously of great interest but it is important to know whether these observations on the effects of mistletoe in cancer therapy are secure.  A systematic review of published studies in 2008 concluded that although there were positive reports on the effects of the plant, the evidence was weak.  For many of the studies, the design of the trials did not allow unambiguous conclusions to be drawn.   One of the principal criticisms concerned the small number of patients in some of the trials.  This is an important point so let’s try to understand its relevance.  Humans are inherently variable and so responses to drugs in humans will also be variable.  An apparent effect of a drug in a small group of patients could, therefore, be down to chance.  This means that if you want to test the effects of a drug you will need to enrol large numbers of patients and this was not done in some of the trials of mistletoe preparations.  This is a pity as there do seem to be beneficial effects of the therapy.  It would be good to establish this unequivocally and in fact a carefully controlled trial is being run by the National Cancer Institute in the USA.  Preliminary results from the trial have been positive.

So, when you indulge in the apparently innocent practice of kissing under the mistletoe, remember the centuries of myth and tradition attached to the plant and reflect on its potential importance as a therapy for cancer.  But most of all enjoy the kiss!

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