Exam 3 Flashcards
figures in early pharmacology (medieval)
- Hippocrates: father of medicine; wrote Hippocratic corpus detailing using the 4 humors to find bodily sources of disease; recorded many plants including purgitives and emetics
- Diascorities: wrote Materica Medica containing illustrations (some misinterpreted); specific information like time of day for opium harvest
- Aristotle: philosopher; made list of medicinals
- Galen: standardization of medicine and dosage
- Theophrastus: botanist who emphasized opium for pain
- Hans Weiditz: wrote Spiegel der Artzney (medical handbook)
Galenic preparations
- dry medicine: tablets, capsules, powderes
- liquid medicine: teas including infusions (water or oil), decoctions (water), tinctures (alcohol), extracts (other solvents)
medicine in the Roman empire
- Greek physicians given Roman citizenship
- many “rhizotomi”–people who were plant experts and assisted physicians who lacked botany experience (slaves, old women)
general medieval medical history
- fall of Constantinople disrupted trade, esp spice
- church dogma–witch burning and torture
- belief in doctrine of signatures (sympathy): plants resembling body parts can fix them
Islamic history during medieval period
- hospitals invented in Islamic civilization (Baghdad)
- Avicenna wrote the Canon of Medicine about use of anesthesia! (sponge soaked with opium, mandrake, or henbane)
general aspects of traditional medicine
- healing is about the mind, body, and external environment
- plant/animal medicinals heal by restoring balance
- body is a conduit of energy
main difference in traditional vs allopathic medicine
- traditional medicine is belief-based
- allopathic (modern) medicine is evidence-based!
Paracelsus
- lived during Renaissance (lots of intellectualism, scientific inquiry, anatomic art)
- was an iconoclast and rejected doctrine of signatures and Greek medicine
- believed in alchemy (plant extracts)
- developed idea of toxicology
traditional Indian medicine
- ayurveda: system of plant medicinals
- few animal parts compared to traditional Chinese
- first medication for schizophrenia (snakeroot)
traditional Chinese medicine text + beliefs
- Pen Tsao: texts with medicinal plants (including chaulmoogra), attributed to Shen Nung??
- believed body was conduit of energy (chi); meridians in the body
history of medicine in Europe post-renaissance (Enlightenment)
- dispensatorium (early pharmacopia by Valerius Cordus)
- Herball: English book about many plant species, by John Gerald
- Carl Linnaeus: wrote wrote Species Plantarus; binomial classification of plants (naming system)
history of medicine in North America
- Asa Gray: identified plant species and helped Darwin with botanical aspects of natural selection; believed there was genetic connection between all species
- shakers: traded medicinal plants in NH with Native Americans
- heroin invented during civil war to replace morpheine
vitalism
- belief that living things were distinctly different from non-living things
- disproven with inorganic synthesis of urea
- Pasteur and Koch invented vaccines, further disproving
Misama vs Germ theory
- Misama theory: diseases came from polluted air (Galen)
- Germ theory: diseases came from microorganisms
foxglove
- used in indigenous medicine to treat swelling
- scientific basis: foxglove tea is an antiarythmatic agent that helps CHF and thus treats dropsy (edema)
- contains cardiac glycosides digitalin and digoxin–different onset time so must be careful with dosage!!
common chemical compounds in medicinals
- fatty acids and oils: purgatives, emulsifiers, antiseptics
- glycosides: sugars bound to another fxl group
- alkaloids: cyclic compounds with N
glycosides
- sugars bound to fxl group
- can be medicine or poison depending on dosage
- example: caterpillars ingest glycosides from milkweed which become part of monarch wings (anti-predatory)
alkaloids
- cyclic organic compounds with N
- can be addictive (opium, nightshade, hemlock)
- poisonous depending on dosage–standardization of dosage is important!
use of chaulmoogra for leprosy
- Hansen’s disease (leprosy) is caused by Mycobacterium leprae; causes sores and PNS damage
- lepers historically isolated in colonies
- chaulmoogra seed oil applied topically to sores in ayurvedic medicine and TCM
- Joseph Rock from Univ. of Hawai’i went to India to obtain chaulmoogra to bring back to leper colonies (bioprospecting)
- chaulmoogra replaced by dapsone in 1920s
bioprospecting and biopiracy
- bioprospecting: exploration to new areas to obtain medicinal plants
- biopiracy: bioprospecting when knowledge of medicinals or plants themselves are taken without consent
use of quinine for malaria
- natives in Brazil used Cinchona bark to prevent + treat malaria (contained quinine)
- when Portuguese governor’s wife got malaria, a shaman was starved to get information on treatment (biopiracy)
- turned into tonic by colonizers–now tonic water today!
conducting ethical ethnobotanical surveys
- interviewing shamans can infringe on intellectual property rights (their medicinal cures should be kept private)
- better to go to markets with medicinal plants which are accessible to everyone!
- look for triangulation for strongest evidence of medicinals (multiple cultural groups that use it)
alternative medicine in the US
- lifestyle industry–people want to be healthy and fit
- Complimentary and Alternative Medicine (CAM): includes herbalism, aromatherapy, accupuncture, massage, etc (mixture of many different worldwide cultural healing systems)
Dietary Supplement Health and Education Act
states that branding of herbal/botanical/dietary supplements can’t guarantee any cures
positive and negative motivations for trying CAM
negative:
- poor doctor-patient relationship
- insufficient time with doctor
- “high tech low touch”
- no effective allopathic treatment
- rejection of technology
positive:
- better relationship with provider
- more in control of treatment
- “high touch low tech”
- more accessible
- less invasive
- pleasant experience
using St. John’s wort vs prozac
both can treat depression!
- St. John’s wort has several active compounds with different effects and onset time that must be considered!
- prozac has one active compound that’s more concentrated; easier to dose
common herbals for digestive system
- ipecac: emetic
- triphala: laxative
- pedia-calm: treats acidity and gas
- gasex: treats gas and cramping
other common herbal supplements
- bitter melon; gymnema: drop blood sugar
- valerian root: helps anxiety
preparation of herbal medicines
- often have to be dry to make medicines (require <10% moisture)
- some dry in sunlight, others hung
system of care in Arabic medicine
- physicians diagnosed, pharmacologists gave prescriptions and had medicinal knowledge
how have Arab herbalist practices changed?
herbalists are increasingly less educated on medicinals! (add info)
pharmacognosy and zoopharmacognosy
- pharmacognosy: study of medicinal drugs obtained from natural sources
- zoopharmacognosy: behavior where non-human animals self-medicate with medicinal plants
zoopharmacognosy in chimps
- Aspilia plant held in mouth or swallowed
- contains thiarubine compound which was toxic to parasitic nematodes
- wasn’t chewed, as this breaks down the thiarubine!
dietary supplements definition
- contains 1 or more of: vitamin, mineral, herb/other botanical, metabolite, amino acid,
- different from conventional food!
rules for labeling dietary supplements
- must be labeled as dietary supplements (can’t be intended to replace meals)
- must say it’s not intended to treat or cure a disease
- must have ingredients on label, but precise contents of supplements are not required to match label!! (not actually tested)
concerns with dietary supplements for chemo patients
- supplements may interact with and decrease efficacy of chemo drugs
- some supplements promote tumor growth!!
definitions for disease
- a disease event
- a classification in pathology
- abstract notion opposite of health; associated with evil
***disease has a social element! people classified as “ill”
nosology and pathology
- nosology: symptoms and severity of a disease; how it is classified
- pathology: actual manifestations of symptoms
general themes in Asian medical systems
- historical texts often attributed to legendary figures (didn’t actually write them)
- codified: passed down through text
- corpus updated frequently
- emphasis on tradition
- body functions attributed to balance of humoral fluids
- pairs: hot/cold, light/dark, etc
- mind and body on opposite ends of spectrum!
- combination of indigenous and introduced systems (Greco-Roman system of Unani)
- both learned (formal training) and popular (folk/rural) traditions
influence of conquest on Asian medical systems
- Asian medicine influenced by conquest (adoption of Greco-Roman system)
- colonizers also curious about systems!
early Indian medicine history
- Indus valley civilization 10k years ago
- well planned cities, public baths
veda and 4 types
veda: ancient Indian texts
- rigveda: daily life protocols
- yajurveda: fine arts
- samaveda: philosophy
- atharvaveda: black magic (including ayurveda)
ancient Hindu texts (auyrveda)
-
Samahitas
early Ayurvedic medical text; includes info on smoking herbs, human anatomy, very few illustrations!! - Vedas: religious texts (rigveda, samaveda, yajurveda, atharaveda)
humors in ayurveda
- 3 humors: kapha (mucus), pitta and vatta (both bile)
- balance of humors influenced by environment, age, personality, etc
- also involves external elements: fire, water, earth, wind, space
personality types in ayurveda
- rajas: energy, anxiety, anger (red meat, alcohol)
- tamas: dull, fear, laziness (fermented foods)
- sattvia: calm, harmony, clarity (vegetarian, no garlic)
vaidya
traditional Indian doctors
3 elements in diagnosis in ayurveda (and other Asian medicine)
- darsana: looking
- sparvana: touching
- prasana: questioning
elements in Traditional Chinese Med
- anatomically correct textbooks
- system used alongside allopathic system
- dolls uses to describe body
traditional texts in TCM
-
Yellow Emperor’s Canon is traditional text on health and healing, written by Huang Di
- part practical, part shamanistic
- contains info on acupuncture using meridians in body, also moxibustion
- 5 elements: fire, water, earth, wood, metal (plants manifest as different elements)
- Pen Tsao was first text about mecinal plants, attributed to Shen Nung
- Nanjing about difficult aspects of medicine; movements that help muscles and joints
elements in symbol for TCM
- quiver of arrows and swords: connection between medicine and war
- martial arts: many traditional practitioners did martial arts
- emphasis on healing with medicine AND shamanistic traditions
shen nung
divine farmers and father of TCM, credited with writing Pen Tsao (earliest TCM materica medica) BUT didn’t actually write it
current texts in TCM
- zuozhuan
- zuangzhi
causes of disease in TCM
- disharmony from lack of jing
- imbalance of qi; can come from external environment (Liuyin are 6 environmental manifestations of qi)
- sickness though to be caused by cold things
curing diseases in TCM
- involves finding root of problem (different than symptoms)
- disease is “constantly changing”
- often involves detachment from materialism
tools of diagnosis in TCM
- look, examine, interrogate, touch!!
- reading tongue: areas correspond to body parts; asking what the patient tastes
- reading pulse from certain points gives info on certain organs
- dolls used to describe where bodily ussue was
therapies in TCM (traditional methods)
- exercise, herbal teas
- vomiting: purging toxins
- lowering: laxative
- harmonizing: bringing upper and lower digestive system in sync
- warming: making temp rise when disease is caused by cold
- purifying: cooling/clearing heat when disease caused by heat
overview of Tibetan medical system
- Tibet has been taken over by China; traditional practitioners exiled
- Dalai Lama is spiritual leader
- Tibetan medicine remains in China but is not formally recognized
- all training for Tibetan medicine is done at Tibetan Medical Institute
- Tibetan leaders found refuge in Dharamsala India
history of Tibetan medicine
- Csoma de Koros is founder of Tibetology (study of Tibet)
- origin of ancient Tibetan medical texts in India
texts in Tibetan medicine
- Gyushi (4 tantras) credited to Padmasambhava, but he didn’t actually write them
- Songsten Gampo compiled initial texts–incorporates many systems (Galenos, TCM, ayurveda)
- manuscripts of traditional Tibetan medicine found in Dunghao caves in early 1900s!
ideology of Tibetan medicine
- the Buddha is thought to be the king of healers
- 5 tenets of Buddhist inner science: medicine, grammar, epistemology, arts, skill
4 tantras of Tibetan medicine
- root tantra: synopsis of all aspects of medical science
- explanatory tantra: anatomy and physiology
- instructional tantra: pathophysiology and types of disease
- subsequent tantra: challenges in diagnosis and treatment
tree diagrams in Tibetan medicine
- each trunk represents looking, feeling, or asking
- smallers branches have leaves with more specific diagnostics within a category (e.g. looking at tongue, looking at urine)
Bach’s remedies
- Edward Bach noticed patients with the same illness reacted differently to medicine depending on personality and mood
- created infusions of flower petals to heal problems
- 3 remedies: face your fears (anxiety), live the day (unfocused), reach out to others (loneliness)
- different flower infusions for specific problems within each remedy category
aromatherapy
- massages with essential oils
- helpful for relaxation
- may be most effective of alternative therapies discussed
homeopathy
- Hahnemann hypothesized that therapies should produce symptoms that match those of the disease (principle of similars)
- mother tincture: homeopathic therapy that is potentized (diluted) to minimize toxicity
- homeopathy dismissed in the US as ineffective
yin vs yang
Yin: cool, moist, dark, passive, female (heart, lungs, liver, spleen, kidneys)
Yang: hot, warm, bright, active, male (stomach, gallbladder, inestines, bladder)
medicine buddha
barrel blue Buddha holding a bowl of myrobalans (laxative) with the nectar of everlasting life
history of Egypt
- multiple gods
- medicinals included aloe, mandrake, opium, juniper berries
- embalming common–fluid identity between healers and morticians!
- papyrus (paper) used for text
history of mesopotamia
- land along Tigris and Euphrates riverbeds
- cunieform (stone tablets) used to document writing
- Assyrian King Ashurbanipal had >600 tablets about medical plants, animal parts, mineral substances, incantations, etc!
- Babylonian King Hammurabi documented >300 medical plants including opium!
medicinal plant evidence from shanidar cave
- Shanidar Cave in Kurdistan (60k years ago)
- 4 skeletons and 1 with deformities, evidence of medicinal plants
early uses of medicinal plants
- evidence from paleolithic graves in the fertile crescent
- trial and error: plants could cause sedation, hallucination, pain relief, poisoning, etc
what is biocultural healing?
healing the social, ecological, and biological aspects of health
- takes into account historical factors
- understands that every body is different
- treats someone beyond their obvious symptoms
red queen hypothesis
constant evolutionary race between hosts and parasites (plants and insects)
Yi Wu
name for TCM
- Yi = medical practice
- Wu = shamanistic traditions
Chao Shi Bing Yuan
TCM book describing causes and symptoms of disharmony
Qiqing
7 emotional states in TCM; recognition of mental health problems
