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narrative_review·ophthalmology, dermatology, nutrition, public health, veterinary medicine·PMC10609972

The Use of Shells of Marine Molluscs in Spanish Ethnomedicine: A Historical Approach and Present and Future Perspectives

Pharmaceuticals · 2 authors, 2 centres

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This historical and ethnographic review documents the traditional use of marine mollusc shells (cuttlebone and nacre) in Spanish folk medicine for conditions such as corneal leukoma, dermatological spots, and foreign body removal. The paper traces these practices from ancient Greco-Roman sources through 19th-century pharmacopoeias and links them to modern pharmacological evidence supporting anti-inflammatory, wound-healing, and osteogenic properties. The findings highlight the potential of these marine-derived biomaterials for drug development and tissue engineering.

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**Background** Since ancient times, shells of marine molluscs have been used therapeutically and prophylactically across many cultures. In Spain, seashells were incorporated into medical and pharmaceutical practice until the 19th century, often prepared by dissolving in vinegar and used in plasters, powders for toothpaste, or treatments for dyspepsia, heartburn, and leprosy. Nacre (mother-of-pearl) was regularly employed in Royal Colleges of Surgery and hospitals during the Cortes of Cadiz era. In contemporary Spanish ethnomedicine, shells have been used both as magical amulets (e.g., to prevent breast cracks during lactation, avoid teething pain, remove facial spots, cure erysipelas) and as empirical remedies. The two main resources are cuttlebone (internal shell of cuttlefish, *Sepia officinalis*) and nacre from external shells of species such as *Pinna nobilis* and *Haliotis tuberculata*. This paper provides a historical, cultural, and anthropological perspective to open new epistemological paths in marine-derived product research.

**Methods** The authors conducted a narrative qualitative systematic review of international and national databases, including Web of Science (SCI, SSCI, A&HCI), Cambridge Digital Library, Anthropology Plus, JSTOR III, TESEO (Spanish PhD theses), CSIC databases, Dialnet, Google Scholar, and the catalogue of Public State Libraries. Search terms covered ethnozoology-related disciplines (UNESCO codes for anthropology, history of medicine, zoology) and specific terms: marine molluscs, seashells, shells, cuttlebone, cuttlefish bone, nacre, mother-of-pearl, folk medicine, folklore, ethnobiology, ethnozoology, ethnomedicine, and zootherapy, in conjunction with the Spanish geographical context. No language restrictions were applied. Collections from the Historical Library of the University of Cadiz and the Complutense Library of Madrid were also consulted. Data were entered into a database with fields for animal species, disease/condition, geographical location, and bibliographic citation. Vernacular names were verified using biological, ecological, and biogeographical criteria. Taxonomy followed the Catalogue of Life and World Register of Marine Species (accessed 3 August 2023 and 29 July 2023, respectively).

**Key Results** - **Cuttlebone in ethnomedicine**: Dried and pulverised cuttlebone was applied externally to cure corneal ulcers, infectious bovine keratoconjunctivitis, and udder injuries in veterinary medicine. In human ethnomedicine, it was used in Tenerife (Canary Islands) to treat corneal leukoma by applying the powder to the affected eye. In Asturias, it was used for dental hygiene. - **Nacre in ethnomedicine**: - *Chemical remedies*: In Palamós (Gerona), women macerated mother-of-pearl shells in lemon juice for 9–10 days to obtain a white paste applied to postpartum melasma/chloasma. In Extremadura, mother-of-pearl buttons dissolved in lemon juice or vinegar were used to treat acne and pimples. In the Canary Islands, a button dissolved in lemon juice overnight was used for eczema. In Cádiz, Badajoz, Málaga, and Navarre, the mixture was applied to remove freckles, with treatment repeated for at least a week. - *Physical-mechanical remedies*: Small mother-of-pearl buttons were placed under the eyelid to remove foreign bodies (documented in Extremadura, Alicante, and Soria). In Humanes (Guadalajara), a button was inserted into the eye for a stye to reduce inflammation and release pus. - **Historical medical use**: - Dioscorides (*De Materia Medica*, ca. 40–90 AD) mentioned cuttlebone for treating leukoma in livestock. Pliny the Elder (*Naturalis Historia*) indicated cuttlebone powder could cure cataracts. The *Hortus Sanitatis* (attributed to Johannes de Cuba) cited Aristotle stating cuttlebone powder mixed with salt cures “white ulcers” in eyes of humans and domestic animals. - The 14th-century *Tresor de Beutat* (Manuel Dias Calatayud) included cuttlefish bone powder to whiten face or teeth. - The *Libro de las utilidades de los animales* (Ibn al-Durayhim, 1312–1361) described mother-of-pearl for heart palpitations, fear from black bile, lacrimation, and eye conditions; burnt shell mixed with honey for hardness of breasts; plasters for ear inflammations; ashes for gangrenous scrofulas; burnt shell as eye drops for leucoma; powdered shell for nosebleed; mixed with duck fat for milk accumulation; with coriander and honey for pustules, warts, and scabies; cooked with oil and salt for poisoning and chronic inflammations. - In the 18th century, the Pharmacopoeia of the Spanish Navy used mother-of-pearl as an absorbent powder to precipitate acid humours, calm stomach pains and flatus. Thick shells of *Magallana angulata* (oyster), calcined and mixed with other ingredients, were used for constipation and as a diuretic. Cuttlebones were recommended for scrofula. - In the 19th century, Ignacio Ameller (Professor at RCS of Cadiz Navy) assessed oyster shells as a lithontriptic medicine for bladder stones, though falling into disuse. Seashells were prepared by dissolving in vinegar for poultices, or ground for powders used as toothpaste and to treat dyspepsia, heartburn, leprosy, scrofula, goitre, and rabies. Pearls were considered a cordial remedy for cardiac tonics. - **Modern pharmacological evidence**: - *Cuttlebone*: Composed primarily of aragonite and β-chitin. Demonstrates anti-inflammatory, immune-modulatory, and wound healing activities. Used in bone grafting (hydroxyapatite from cuttlebone stimulates bone formation and regeneration). Antimicrobial activity against *Klebsiella oxytoca* and antifungal against *Aspergillus flavus*. Cuttlebone extracts promote cell proliferation and matrix metalloprotease expression in fibroblasts. Formulations show high antacid capacity. - *Nacre*: Composed of >95% aragonite and <5% organic matrix. Exhibits osteogenic potential, biocompatibility, and biodegradability. In vitro and in vivo studies show nacre promotes osteoblast proliferation, bone formation, and does not cause inflammation when implanted in bone. Water-soluble nacre components promote differentiation of preosteoblast cells and matrix mineralization. Nacre powder promotes skin wound healing by increasing collagen synthesis and angiogenesis. Nacre extracts show anticonvulsant and sedative-hypnotic activities, down-regulate 5-HT3 receptor and up-regulate GABAB levels. Nacre extract improves scopolamine-induced memory impairment and increases brain-derived neurotrophic factor and nerve growth factor. Water-soluble matrix has antioxidant activity (free radical scavenging, inhibits lipid peroxidation).

**Clinical Implications** The historical and ethnographic data presented support the continued investigation of cuttlebone and nacre as sources of bioactive compounds for drug development. Cuttlebone-derived hydroxyapatite is a safe, osteoconductive material for bone repair, and cuttlebone extracts have potential as natural antacids with fewer side effects. Nacre’s osteogenic, wound-healing, and neuroprotective properties make it a promising biomaterial for orthopaedic, dental, dermatological, and neurological applications. The paper underscores the value of integrating traditional knowledge with modern pharmacological research to identify novel therapeutics and biomaterials, aligning with the “One Health” philosophy and Sustainable Development Goals.

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narrative_review

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ophthalmology

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ORIGINAL PAPER

PMC10609972

The Use of Shells of Marine Molluscs in Spanish Ethnomedicine: A Historical Approach and Present and Future Perspectives

Pharmaceuticals

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ABSTRACT

Since ancient times, the shells of marine molluscs have been used as a therapeutic and/or prophylactic resource. In Spain, they were part of practical guides for doctors or pharmacists until the 19th century. In general, seashells were prepared by dissolving in vinegar and were part of plasters or powders used as toothpaste, or to treat dyspepsia, heartburn and leprosy. Thus, the nacre or mother-of-pearl of various molluscs was regularly used in the Royal Colleges of Surgery and in hospitals during the times of the Cortes of Cadiz, as a medicine in galenic preparations based on powders. In contemporary Spanish ethnomedicine, seashells, with a high symbolic value, have been used as an amulet to prevent cracks in the breasts and promote their development during lactation, to avoid teething pain in young children, to eliminate stains on the face or to cure erysipelas. But, as in other countries, products derived from seashells have also been empirically applied. The two resources used traditionally have been the cuttlebone, the internal shell of cuttlefish and the nacre obtained from the external shells of some species. Cuttlebone, dried and pulverised, has been applied externally to cure corneal leukoma and in dental hygiene. In the case of nacre, a distinction must be made between chemical and physical remedies. Certain seashells, macerated in lemon juice, were used in coastal areas to remove spots on the face during postpartum. However, the most common practice in Spain mainland was to dissolve mother-of-pearl buttons in lemon juice (or vinegar). The substance thus obtained has been used to treat different dermatological conditions of the face (chloasma, acne), as well as to eliminate freckles. For the extraction of foreign bodies in the eyes, a very widespread traditional remedy has been to introduce small mother-of-pearl buttons under the lid. These popular remedies and practices are compared with those collected in classic works of medicine throughout history, and data on the pharmacological activity and pharmaceutical applications of the products used are provided. The use of cuttlebone powders is supported by different works on anti-inflammatory, immune-modulatory and/or wound healing properties. Nacre powder has been used in traditional medicines to treat palpitations, convulsions or epilepsy. As sedation and a tranquilisation agent, nacre is an interesting source for further drug development. Likewise, nacre is a biomaterial for orthopaedic and other tissue bioengineering applications. This article is a historical, cultural and anthropological view that can open new epistemological paths in marine-derived product research.

CITATION EXPORT

José A. González, José Ramón Vallejo. The Use of Shells of Marine Molluscs in Spanish Ethnomedicine: A Historical Approach and Present and Future Perspectives. Pharmaceuticals. (2023). https://doi.org/10.3390/ph16101503

AUTHORS

2 · 2 CENTRES

José A. González, José Ramón Vallejo

1Grupo de Investigación de Recursos Etnobiológicos del Duero-Douro (GRIRED), Facultad de Biología, Universidad de Salamanca, E-37071 Salamanca, Spain
2Departamento de Anatomía Patológica, Biología Celular, Histología, Historia de la Ciencia, Medicina Legal y Forense y Toxicología, Área de Historia de la Ciencia, Facultad de Medicina, Universidad de Cádiz, E-11003 Cádiz, Spain; [email protected]

EDITOR / REVIEWER

Noelia Duarte