Drugs Before the Age of Science Flashcards
(35 cards)
lecture 1 outcomes
Critically describe current sources of knowledge about medicine in the prescience era.
* Describe the scientific method.
* Describe humoral theory.
* Describe how and when Western medicine made the transition from guesswork to science
What do we really know about prehistoric medicine and pharmacology?
Almost nothing! Isn’t it wonderful?
* Almost no forms of modern-day ‘traditional medicine’ can be authoritatively linked to prehistoric practice
Dig therapures al developed their own healing methods, includin
* These ways of healing were based on widely-differing beliefs and practices
Where’s the evidence?
Sources for information about ancient medicine include:
* Cave paintings
* Physical human remains e.g. skeletons, skulls, bog bodies
Some fragmentary items which may be tools
Cave paintings can be interpreted in any way you wish …
Interpretations of this image include:
Shaman figure
indigenous healer
evidence of prehistoric use of psychedelic drugs
* Alien (I’m not kidding)
Bones
7000 year old skull with hole bored in it - found in Sudan. Believed to be trepanation (medicinal skull drilling) but there is no evidence to suggest why this was done, or whether it was done pre- or post-mortem.
Tollund Man
New analysis of stomach contents of bog body ‘Tollund Man’
* 12 to 24 hours before his death, he ate a hearty meal!
* It was cooked in a clay pot
* Porridge containing barley and flax; maybe also fish
* Weed seeds - pale persicaria (Persicaria lapathifolia)
* Tollund Man was infested with parasites - stomach contained proteins and eggs from intestinal worms, probably from contaminated food or water
Ötzi
- Age: Ötzi’s thigh-bone = likely age of 45.
- Height: In life, 1.60 m tall (mummy size 1.54m)
- Weight: In life, around 5okg. Very wiry and strong.
- Hair: dark, medium-long hair and worn loose.
- Traces of arsenic = Ötzi was sometimes present where metal ores were being smelted.
- Nails: horizontal grooves, or Beau’s lines, were observed on the
fingernail = great physical stress. - Parasites and pathogens: Two human fleas were found in Ötzi’s clothing.
- Oldest evidence of Lyme Disease in Ötzi’s DNA.
The eggs of whipworm, an irritating intestinal parasite, were found in his digestive tract.
What evidence do we have for prehistoric medicinal drug
use?
We have no conclusive physical evidence of prehistoric drug use as we would recognise it.
* Plant remains found in prehistoric teeth and stomachs may have been food, rather than drugs.
* Pollen traces in a setting may not be indicative of medicinal plant
use.
* We can guess if we find local medicinal plants in a particular area, but these may be recently introduced.
* Why assume medicine? Why not beauty, religion, commerce, politics?
* There is a huge amount of “may’ and ‘could’ and “possibly” in written research around these areas.
Is recorded history better?
If we want to carry out reliable comparisons with modern scientific medicine, we must go to recorded history.
* Early recorded history is very fragmented - entire millennia are missing in some cases.
* Recorded history may only apply to the literate/noble class of that society.
* Only the broadest generalisations are possible about early civilisations and medical practice.
Did ancient medicine use the scientific method?
- No.
- Ancient recorded medical practices shows signs of observation (sometimes), of measurement (sometimes), of practical skills (sometimes), and of technology (sometimes).
- None of these by themselves is the scientific method.
What is the scientific method?
The ‘scientific method’ consists of
* organised efforts
* to come up with explanations of nature,
always modifying and correcting these
* through systematic observations
How it works
Method versus random stuff
- This is because modern thinking often confuses ‘science’ with things like technology and equipment.
- Ancient communities often had quite sophisticated technology and equipment at their disposal, and they certainly practised observation.
- However, you can have a fully equipped laboratory and still not be using the scientific method.
- You can be out in an open field and be using the scientific method to test something.
Hippocrates, the father of medicine?
Hippocrates of Cos (c.406-370 BC?) is referred to as ‘the father of modern medicine’.
* This is not true.
* We know almost nothing of Hippocrates’ life from actual historical sources.
* Plato mentions him in passing in two dialogues.
* We don’t know who wrote the Corpus Hippocraticum (the
Hippocratic Corpus - the body of work attributed to ‘Hippocrates’).
Strengths of the scientific method
- It allows discovery to proceed in an organised way.
- It eliminates a lot of repetition.
*It encourages us to change or revise explanations - or questions, or hypotheses - in the face of the evidence. - It provides a clear audit trail.
- The results should be communicable and replicable.
- All these things combine to speed up innovation and make it safer.
What did the Hippocratic approach really do?
The Hippocratic approach DID systematise the description of disease duration (short-term, long-term).
* The Hippocratic approach DID systematise some elements of basic clinical observation.
* The Hippocratic approach DID NOT use the scientific method to develop hypotheses about illnesses and test different remedies objectively.
* The Hippocratic approach may have held back the development of scientific medicine.
This is what held it back photo
This is what held it back
’ The word ‘humor’ comes from the Greek word Xupós, or chymos,
which means ‘sap’.
* Prominent in the Hippocratic Corpus.
* Thaiching the four ele ments of earch, al, fire and water that made up
the universe.
*Humors were caused by imbalance and excess in the four bodi
* Humoral theory was the single most enduring idea in Western medicine from the time of the ancient Greeks onwards
Humoral theory’s legacy
Humoral theory dominated Western medicine for centuries.
It was almost unbudgeable as a way of thinking about the human body, health and illness.
It probably originated in observations that were misplaced.
It was not tested using the scientific method.
Doctors themselves supported and promoted this theory.
Those who questioned it and used observation-based methods to experiment on their patients were called
‘empirics’ and ‘quacks’ and were denounced.
Goodbye, humoral theory!
- These new ways of thinking broke the centuries-old grip of humoral theory on Western medicine.
- Humoral theory literally didn’t measure up.
- New causes were found for diseases and illnesses.
- These were measurable and followed particular patterns and durations.
- They responded to particular drugs and treatments consistently pretty much every time.
The world of humoral theory
- Ancient Greeks
- Ayurvedic medicine - five elements: air, fire, water, earth, ether/space
- Traditional Chinese medicine - five elements: wood, fire, earth, metal, water
- Roman medicine
- Classical Islamic medicine
- Medieval European medicine
- Renaissance medicine
- Eighteenth century European medicine
Un-scientific medical thinking photo
What do you need to do this better?
- An Industrial Revolution!
- 18th century onwards: use of microscope, improved timing devices, grinders, distillation equipment, moulds.
- Isolate elements = artificial compounds now possible.
- Standardise doses.
- Mass-produce remedies = cheaper.
- Advertise and market products - wider audience.
- Better communication between researchers.
- Industrial processes also created new drugs by accident.
- ….. all of which is the beginning of ‘Big Pharma’!
So when DID medicine become scientific?
- What we now recognise as ‘science’ dates from no earlier than around the early Middle Ages - 12005 CE.
