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History of pharmacology part 1
- 1. HISTORY OF PHARMACOLOGY - I - Dr. Chandini Y Rao Moderator – Dr. Nicole Pereira 1
- 2. What is Pharmacology? ‘ Study of substances that interact with living systems through chemical processes, especially by binding to regulatory molecules and activating or inhibiting normal body processes. ’ pharmacon = active principle logos = a discourse or treatise Science that deals with drugs 2
- 3. What is a drug? Synthetic chemicals, chemicals obtained from plants or animals, or products of genetic engineering. Substance must be ‘administered’ (rather than released by physiological mechanisms). What is a medicine? Chemical preparation, which usually but not necessarily contains 1 or more drugs, administered with the intention of producing a therapeutic effect. Usually contains other substances (excipients) besides the active drug, to make them more convenient to use. 3
- 4. History.. Intro – • Born as a science – mid 19th century. • Long before that – use of natural substances eg. plants, animals, minerals.. (some of are still used today) • But no scientific basis. • Eg. Concoctions of worms, dung, urine & moss from a dead man’s skull. 4
- 5. • Homeopathy (similar suffering) • ‘like cures like’ ‘dilution enhances potency of drugs’ • Dilutions of 1:1060 (equivalent to 1 molecule in a sphere the size of orbit of Neptune!) Dr. Samuel Hahnemann 5
- 6. • Allopathy (other suffering) • Blood letting, emetics and purgatives – many deaths • To introduce ‘other suffering’ to relieve pain/suffering. James Gregory (1735-1821) • Treatment of malaria – Cinchona bark Calomel (mercurous chloride) 6
- 7. Reason for failure – • Poor knowledge of functioning of the body. • lack of experimentation and observation. • Close relationship between religion and treatment of diseases. (drugs were thought to be magical!) End of 17th century – observation and experimentation began to replace theorizing. * Materia medica – precursor to pharmacology Lack of methods for testing hypotheses. 7
- 8. • In the late 18th & early 19th centuries : Francois Magendie & Claude Bernard - Experimental Physiology & Pharmacology. • Simultaneous developments in botany, zoology, chemistry & physiology. • New drugs New challenges establishment of Pharmacology. 8
- 9. 9
- 11. India • Vedas – earliest records. Rig veda (3000 BC) • Charaka – Father of Indian medicine - along with Sushruta & Vagbhata described about 300 herbal preparations (50 grps). • Ayurveda (2500 BC) – ‘Science of life’ 11
- 12. Ayurveda • Based on 2 treatises : Charaka Samhita – medical, > 650 drugs (animal, plants and mineral origins) Sushruta Samhita - surgical • Lord Dhanvantari (Physician of the Gods) - Father of Ayurveda - natural remedies - antiseptic properties of turmeric - preservative properties of salt 12
- 13. • Disturbances in 4 elements – Wind (Vayu), Bile (Pitta), Phlegm (Kapha) & Blood (Rakta), responsible for disease. (4 humors of Greek medicine) • Plant-based treatments – roots, leaves, fruits, bark or seeds • Animal products – milk, bones & gall stones. (fats) • Minerals – sulphur, arsenic, lead, copper sulphate & gold. 13
- 14. • Alcoholic beverages (Madya) • Purified opium – diarrhoea & dysentery, increasing sexual & muscular abilities. • Oils – head massage, applied on affected areas. • Still widely practiced today 14
- 15. 15 Siddha system • Tamil Nadu • Siddhars – Spiritual adepts with supernatural powers. Agasthya – Father of Siddha medicine. • Palm leaf manuscripts • A healthy soul can only be developed through a healthy body. • Herbal products, inorganic substances & animal products.
- 16. 16 • Based on mode of application – Internal medicine – oral route External medicine – nasal/eye/ear drops & leech application • Still practiced in Tamil Nadu – jaundice. • BSMS – Bachelor in Siddha Medicine & Surgery.
- 17. Unani • Persio-Arabic traditional medicine, created by Arabic physicians by combining Greek medicine with Ayurveda. • Mughal India • Similar to Ayurveda. • India – Egg oil (Roghan Baiza Murgh) & Almond oil (Roghan Badaam Shirin) for hair care. 17
- 18. • Therapies – Ilaj-Bil-Tadbeer wa Ilaj-Bil-Ghiza (Regimenal therapy) : Cupping therapy (Hijamat) Aroma therapy (Shamoomat) Ilaj-Bil-Advia (Pharmacotherapy) Ilaj-Bil-Yad (Surgery) • Currently practised in South Asia & modern day Central Asia. 18
- 19. China • ‘Pan Tsao’ - Chinese materia medica (~2500 BC) - plant & metallic preparations, few animal products. - 1st mention of the medical/euphoriant uses of Cannabis. • ‘Nei Chang’ – Acupuncture. • Yin (female) & Yang (male) • Extensive pharmacy - 2000 items, 16000 remedies Pulverized seahorses for goiter Snake meat for eye ailment Octopus ink with vinegar for heart disease Elephant skin for sores 19
- 20. Traditional Chinese medicine still used today – Ginseng root 5000 yrs ag0 – Northern China (Manchuria) ‘Man root’ Energy drinks or herbal teas (Ginseng coffee) Folk medicine – aphrodisiac or stimulant treatment Snake oil Liniment – joint pain Higher eicosapentanoic acid No scientific basis 20
- 21. Gingko biloba Symbol of longevity & vitality Seed, root & leaves – asthma, bronchitis & leukorrhoea Seahorse (Hai Ma) Originally used for goitre. Asthma, throat infections, insomnia & abdominal pain Powerful aphrodisiac Skin infections & sores. 21
- 22. Egypt • ‘Ebers Papyrus’– Egyptian materia medica (1550 BC) - 800 prescriptions. - ‘Recipes’ for treatment of diseases - beer, turpentine, berries, poppy, lead, salt & crushed precious stones etc • George Ebers (1872 AD) – 700 herbal prescriptions, including opium. • 3 different interacting branches : Physicians – used internal & external remedies for cure (lettuce & onions to hippopotamus fat & human excreta!) Surgeons Sorcerers or exorcists 22
- 23. Imhotep – • ‘God of Medicine’ • Introduced simple surgeries • Diagnosed over 200 diseases • Treated TB, gallstones, appendicitis, gout and arthritis • Position of vital organs and circulation of blood 23
- 24. • Atropine extracts - Cleopatra Atropine – species: ‘Belladonna’ (beautiful women) deadly nightshade, to dilate pupils Roman empire & Middle ages – prolonged poisoning Atropa belladonna (Atropos) Used by ancient Hindus to treat asthma. Introduced to western medicine in early 1800s 24
- 25. Babylo-Assyrian civilization • 1 of the earliest sources of western medicine. • Sorcerers (ashipu) & Physicians (asu). • Ritual incantations, herbal remedies & physical therapy 25
- 26. 26 • Clay tablets – lists conditions, remedies & prognoses ‘Sumerian clay tablet’ (2150 BC) • Possibly the 1st to regulate medicine by law - ‘Hammurabi code’
- 27. Greece • 4 humors – blood, phlegm, yellow bile & black bile. • Hippocrates (400BC) – ‘Father of modern medicine’ introduced the concept of disease as a pathologic process. Observation, analysis & deduction did not believe in magical remedies Medicatrix naturae – ‘healing power of nature’ recommended judicious use of simple & efficacious drugs. Hippocratic oath Hippocratic corpus – 70 volumes haemorrhoid & polyp removal 27
- 28. Galen (460-355 BC) Contributed greatly to Ancient Greek Medicine. Elevated Hippocratic humoral basis of medicine. Drugs possessed certain fundamental effects (warming, cooling, drying, humidifying) Dogmatic approach ill health & many deaths hampered scientific growth for a 1000 years. Pharmaceutical works - used for reference for centuries 28
- 29. Temple medicine – • Spiritual side of healing. • Patients attended 1 of the many temples (asklepieia) • Asklepios – God of Physicians. • ‘dream drug’ or ‘dream surgery’ while asleep. 29
- 30. Pedanius Dioscorides – Greek physician De Materia Medica (“Regarding medical matters”) o preparation, properties & testing of drugs. o 1000 plants & minerals o basis for the Western pharmacopeia through the 19th century. o Mercury, copper, lead topical application. o Anaesthesia – ‘absence of sensation’ wine from mandragora 30
- 31. Persia Avicenna (980-1037) o Canon Medicina – medical bible o Supplanted Galen’s work – Arab world & then western Europe. o Contagious nature of TB o Dissemination of diseases by water & soil. o use of cautery instead of knife in surgeries 31
- 32. TheMiddleAges • Roman medical regulations disappeared. • Medical care taken over by the Church. • Medicine became a matter of faith & prescriptions became prayers. • The greek concept of 4 humors - basis of all diagnoses & treatments. • Cupping, blood letting, leeches, medications & diet – Roman, with ritual added • Most prescriptions - multiple ingredients. 32
- 33. Black death • One of history’s greatest tragedies. • ‘God’s punishment for the sinfulness of mankind’ • ‘pestinential atmosphere’. • Huge fires of aromatic wood lit, bells rung, guns fired, birds made to fly around rooms. • Mass hysteria – persecution of Jews • 1894 – plague bacilli identified - disease of black rats, spread by fleas 33
- 34. TheRenaissance&Enlightenment • “Re-birth” • 15th & 16th century. • Paracelsus - ‘Grand father of Pharmacology’ Challenged Galenic medicine Dose-response concept: ‘Poison is in everything, and no thing is without poison. The dosage makes it either a poison or a remedy. use of chemicals and minerals (zinc) in medicine. 34
- 35. • Coined – ‘Alcohol’ • Distilled oils as remedies. • Mercury, antimony, sulphur & potassium salts. • “Laudanum” (opium dissolved in alcohol) - effective painkiller. 35
- 36. Jenner’s breakthrough • Discovery of small pox vaccine in 1796. • Studied dairy workers for 20 yrs. • 14th May 1796 – inoculated an 8 yr old boy with cowpox & 6 wks later with small pox - proved to be immune. • By 1801: 100,000 people in Britian – vaccinated • Spain, America & rest of the world. • Eradicated by 1975. 36
- 37. 37
- 38. The story of ASPIRIN (the tree & the flower) • 400 BC: Hippocrates – bark & leaves of the Willow tree - reduces pain & fever. • 1820s: Johann S. F. (Swiss pharmacist) - extracts from the leaves of Spirea Ulmaria (meadowsweet) - pain reliever • 1835: Karl Jacob Lowig (German chemist) - ‘Spirsaure’ (acid) Salicylic acid 38
- 39. • 1853: Karl Friedrich Gerhardt - discovered the molecular structure. - tried to eliminate ‘painful irritation of the stomach lining’ - time-consuming – abandoned the drug. • 1895: Herr Hoffman – arthritis Felix (chemist at the Bayer drug plant) - Acetylsalicylic acid - also reduced fevers & inflammation (along with pain) • 1899: Hoffmann & Dreser – Aspirin (‘A’ for acetyl, ‘spir’ for Spirea & ‘in’ to round it off) 39
- 40. • US – marketed aspirin as ‘Bayer’ • 1826: 2 Italians - ‘Salicin’ (active ingredient) from willow bark Salicylic acid. - obtained from both the willow & meadowsweet. (now made from ‘phenol’) • 1971: British researchers – mechanism of action ‘Prostaglandins’ • Aspirin – NSAIDs • 1980 – superceded by Paracetamol 40
- 41. OPIUM ‘The miracle cure that addicted millions’ • Sumerian writings (4000 yrs old) – hul gil ‘joy plant’ • Ancient Egyptian, Persian, Indian, Greek and Roman medicine • 16th century – established in Western European medicine. • Paracelsus – ‘stone of immortality’ - ‘Laudanum’ • Addiction – rare. 41
- 42. • Opium wars - British imported opium from Turkey - British East India company exported to China in exchange for silver - First opium war(1840-42) - Second (1857- 60) • Cholera, dysentery, toothache, flatulence, insanity and menopause • Friedrich Serturner – Morphine (1805) (Morpheus = the Greek god of sleep) 42
- 43. • US – Importation of crude opium grew patent medicines • 1900 – 250,000 addicts in the US. • 19th century – Opium concern • Hypodermic syringe – exacerbated morphine & codeine abuse 43
- 44. • 1898 – Dionin (semisynthetic morphine derivative) Heroin (diacetylmorphine) – ‘heroic drug’; safer • 1860 – Restrictive legislation 1st passed in Britian • 1909 – smoking opium prohibited in the US 44
- 46. Francois Magendie (1783-1855) • Early 19th century • French Physiologist. • Pioneer of Experimental Pharmacology. • Studied action of nux vomica (Strychnine) spinal cord – site of action. • Introduced morphine, codeine, quinine & strychnine. • Foramen of Magendie 46
- 47. Claud Bernard (1813 – 1878) • Magendie’s student. • Father of Modern Experimental Medicine • 1842 - arrow poison Curare specifically acts at the neuromuscular junction. • Pancreatic juice, liver glycogen & its importance. • Existence of Vasomotor system – Vasodilatation & Vasoconstriction. 47
- 48. Oswald Schmiedeberg (1838 – 1921) • Father of Modern Pharmacology • 1869 – muscarine had similar effect on the heart as electrical stimulation of the vagus nerve. • 1878 – classic text: “Outline of Pharmacology”. • Discovered glucuronic acid. • 1885: urethane - hypnotic 48
- 49. John Jacob Abel (1857 – 1938) • Father of American Pharmacology. • Gave the name ‘Pharmacology’ as a subject (earlier – Materia Medica) • 2nd to isolate Epinephrine from adrenal gland. (1st - Napolean Cybulski in 1895) • Isolated amino acids from the blood (1914) • Isolated histamine from pituitary extracts (1919) • Prepared pure crystalline Insulin (1926) 49
- 50. Colonel Ram Nath Chopra (1882 – 1973) • Father of Indian Pharmacology. • 1921 : Calcutta School of Tropical Medicine. HOD of Pharmacology – Calcutta Medical College • 1941 – 1957: Director – Drug Research Lab at Srinagar. • 1st introduced & studied Rauwolfia Serpentina • 1st National Drug Research Institute of India, Lucknow (Central Drug Research Institute, CDRI) • pioneered research on herbal drugs in India sarpagandha 50
- 51. Louis Lasagna (1923 – 2003) • Father of Clinical Pharmacology • 1954 - 1st clinical pharmacology dept – Johns Hopkins University. • Conceptualized Controlled clinical trial & placebo effect. • Improvement in testing drug effectiveness & regulation of drugs for effectiveness & safety. • 1964 – revised the Hippocratic oath “The incidence of patient availability sharply decreases when a clinical trial begins and returns to its original level as soon as the trial is completed.” - Lasagna’s Law 51
- 52. Paul Ehrlich (1854 – 1915) • Father of Modern Chemotherapy • Syphilis & autoimmunity • Coined – Chemotherapy & Receptor ‘Magic bullet’ • Effective preparation of diphtheria antitoxin • 1908 – Nobel Prize in Medicine. • 1909 - Salvarsan: most widely prescribed & most effective drug for treating syphilis until penicillin. 52
- 53. 53
- 54. References : 1) A History of Medicine - Nancy Duin & Dr Jenny Sutcliffe 2) The Pharmacological Basis of Therepeutics -Goodman & Gilman, 12th edition 3) Basic and clinical pharmacology : Katzung, Masters and Trevor, 11th edition 4) Medical Pharmacology – Dr Padmaja Udaykumar, revised 4th edition 5) Rang & Dayle’s pharmacology, 7th edition 6) Pharmacognosy – Dr C.K Kokate, A.P Purohit, S. B Gokhale 7) Pictures from the internet 54
Editor's Notes
- Derived from greek words -
- To count as a drug Substance must be ‘administered’ (rather than released by physiological mechanisms). * Excipient - an inactive substance that serves as the vehicle or medium for a drug or other active substance.
- Before the advent of synthetic organic chemistry, pharmacology concerned itself exclusively with natural substances But they did not have a scientific basis to understand the drug effects.
- Some were absolutely worthless – For eg Samuel Hahnemann who introduced homeopathy, believed in 2 principles – this system rapidly drifted into absurdity as he began recommending use of drugs @
- Some were actually harmful..rather fatal! – 1 of those was allopathy introduced by james Gregory, which included… Basic motive was to introduce… Hence the name allopathy = other suffering Another eg is use of cinchona bark for malaria, replaced by large doses of calomel, both of which were harmful, were used for as long as 40yrs!
- Thus several systems of medicine were practiced in different parts of the world (homeopathy, Ayurveda, unani, siddha system & allopathy) of which only a few survived. The basic reason for failure of these systems – Poor knowledge of the normal & abnormal functioning of the body. . . drugs were thought to be magical in their actions & their knowledge often rested with the priest or holymen Materia medica – science of drug preparation & medical uses of drugs began to develop as the precursor to pharmacology However further understanding about the nature of drug actions was prevented by lack of…
- It was In the late 18th & early 19th centuries : Francois Magendie & his student Claude Bernard began to develop methods of Experimental … Simultaneous developments in other branches of sciences - botany, zoology, chemistry & physiology helped in better understanding of drug actions & their effects. Each new drug class that emerged gave pharmacologists a new challenge & it was then that pharmacology really established it’s identity & its status among the biomedical sciences.
- Siddha system – traditional treatment system generated from Tamil culture. Palm leaf manuscripts say that the Siddha system was first described by Lord Shiva to his wife Parvati. Siddhars were spiritual adepts who possessed the ashta siddhis, or the eight supernatural powers. Agastya is considered the first siddha father of siddha medicine practSiddhars were of the concept that a healthy soul can only be developed through a healthy body. So they developed methods and medication that are believed to strengthen their physical body and thereby their souls. ced intense yogic practices, including years of periodic fasting and meditation, The drugs used by the Siddhars could be classified into three groups: thavaram (herbal product), thadhu (inorganic substances) and jangamam (animal products) T
- According to their mode of application, the siddha medicines could be categorized into two classes: Internal medicine was used through the oral route and further classified into 32 categories based on their form, methods of preparation, shelf-life, etc. External medicine includes certain forms of drugs and also certain applications (such as nasal, eye and ear drops), and also certain procedures (such as leech application). It also classifie Siddha has lost its popularity after modern medicine was introduced, as a scientific medical system, even in Tamil Nadu. Still, there are a few ardent followers of the system who prefer Siddha for only a few diseases like jaundice. The Tamil Nadu state runs a 5.5-year course in Siddha medicine (BSMS: Bachelor in Siddha Medicine and Surgery).
- Perso-Arabic traditional medicine as practiced in Mughal India and was created by arabic physicians by combining Greek Medicine with Ayurveda Unani medicine has similarities to Ayurveda. Both are based on theory of the presence of the elements As an alternative form of medicine, Unani has found favor in India where popular products like Roghan Baiza Murgh (Egg Oil) and Roghan Badaam Shirin (Almond Oil) are commonly used for hair care.
- treatment is decided as per the Unani medicine which may be one or more of the following: Ilaj-Bil-Tadbeer wa Ilaj-Bil-Ghiza (Regimenal Therapy Hijamat (Cupping Therapy), Shamoomat (Aromatherapy), Ilaj-Bil-Advia (Pharmacotherapy). Ilaj-Bil-Yad (Surgery)
- The Chinese materia medica’Pan Tsao’ was probably written in 2500(2735)B.C and contained many plant and metallic preparations and a few animal products. The first mention of the medical or euphoriant uses of Cannabis appear in it. Much of early Chinese medicine is contained in the Nei Chang – deals almost exclusively with acupuncture. Believed in existence of 2 opposing forces – yin & yang. Yin – dark, moist female aspect, Yang – bright, dry, masculine aspect. Extensive pharmacy – not all herbs, many of them seemed strange n even repulsive from the western view point.
- Ginseng root is the most widely sold traditional Chinese medicine. is believed that ginseng was discovered in the mountains of Northern China (Manchuria) over 5000 years ago. more simply ‘man root’. This refers to the root's characteristic shape, which resemble a body with the legs of a man. is any one of the 11 species of slow-growing perennial plants with fleshy roots, belonging to the genus Panax of the family Araliaceae. Ginseng may be found in small doses in energy drinks or herbal teas, such as ginseng coffee. Folk medicine attributes various benefits to oral use of American ginseng and Asian ginseng (P. ginseng) roots, including roles as an aphrodisiac or stimulant treatment.[11][12][13] 3)Snake oil is a traditional Chinese medicine used to treat joint pain by rubbing it on joints as a liniment. This is theoretically possible because snake oil is higher in eicosapentaenoic acid than most other oils. But there are no scientific studies showing that rubbing it on joints has any positive effect
- 2) Ginkgo -The gingko tree is generally recognized as one of the oldest trees in the world.has long been cultivated in China; some planted trees at temples are believed to be over 1,500 years old. tree was primarily a symbol of longevity and vitality. Seed,root and leaves - asthma, bronchitis, and leukorrhea. 4) Seahorse (Hai Ma) originally pulverised and used for goitre. treat are asthma, infections of the throat, insomnia, and abdominal pain. Sea horse is also believed to be a powerful aphrodisiac, and is often taken to increase sexual potency. Sea horse can also be applied to the skin to treat skin infections and sores.
- The earliest sources of Western Medicine come from egypt and the 2 kingdoms of assyria & babylonia. The papyri were the first written account of medical experiences from egypt and date back to 1550 b.c. Ebers Papyrus – oldest & most imp papyri ‘Recipes’ for treatment of certain diseases & symptoms ….are some of the Egyptian remedies Papyrus discovered by George ebers… Egyptian medical profession gradually evolved into 3 different interacting branches – 1st – Physicians – used internal & external remedies for cure, consisting of vast no of substances ranging from lettuce & onions to hippopotamus fat & human excreta 3rd - …who fought evil with incantation & amulets.
- Was a vizier in the court of the pharaoh & a royal architect. Because of his skill s a doctor people sang his praises for for >2000 yrs & was given full status as a god.
- Atropine extracts from the Egyptian henbane were used by Cleopatra in the last century B.C. to dilate her pupils, in the hope that she would appear more alluring. The species name “belladonna” (“beautiful woman” in Italian) comes from the original use of deadly nightshade to dilate the pupils of the eyes for cosmetic effect by Italian women. Atropine and the genus name for deadly nightshade derive from Atropos, one of the three Fates who, according to Greek mythology, chose how a person was to die. Preparations of belladonna were known to the ancient Hindus and have long been used by physicians. During the time of the Roman Empire and in the Middle Ages, the deadly nightshade shrub was frequently used to produce an obscure and often prolonged poisoning, prompting Linnaeus to name the shrub Atropa belladonna, after Atropos, the oldest of the three Fates, who cuts the thread of life British colonists observed this ritual and introduced the belladonna alkaloids into western medicine in the early 1800s.
- 1 of the earliest sources of western medicine. Medical profession consisted of sorcerers (ashipu) & physicians (asu). Babylonian medicine combined ritual incantations, herbal remedies & physical therapy
- Their medicine comes alomost exclusively from wedge shaped cuneiform writing on clay tablets – lists conditions, remedies & prognoses. World’s oldest medcal record – sumerian clay tablet (2150 BC) Possibly the 1st to regulate medicine by law - Hammurabi code – deals mainly with surgery. ‘bad results from surgery were subject to penalty but not those from drugs & incantations’ (as they believed that if people became ill it was their fault)
- Like Indians & Chinese, greeks too believed in the existence of 4 humors - pretty much the basis of their medical practice. Hippocrates – (400bc) Father of modern medicine. greatest of all doctors of ancient Greece Modern medicine is considered to date from Hippocrates who for the 1st time introduced the concept of disease as a pathologic process & tried to organize the science of medicine on the basis of observation. Analysis & deduction. & not based on religion/superstition. The therapeutic approach was based on "the healing power of nature" ("vis medicatrix naturae" Hippocratic practice did not include extensive use of drugs. He did not believe in magical remedies, but instead recommended judicious use of simple & efficacious drugs. His work & those of his followers are contained in the Hippocratic corpus – 70 volumes Developed his pledge of proper conduct for doctors – Hippocratic oath Also a surgeon – performed minor procedures – haemorrhoid & polyp removal.
- Claudius Galenus Galen another greek physician, was a noteworthy doctor who influenced medicine for nearly 15 centuries and scientist who contributed greatly to Ancient Greek Medicine. Followed Hippocrates’ (460-355 BC) humoral basis of medicine. He taught that drugs possessed certain fundamental effects (warming, cooling, drying, humidifying) which might be combined in different ways to obtain those effects. Dogmatic approach resulting in ill health & many deaths hampered scientific growth for a 1000 years. His pharmaceutical works were used for reference for centuries
- The greek doctors recognized the spiritual side of healing. When all else failed they would recommend their patients to attend 1 of the many temples (asklepieia), to the god of physicians Asklepios. Pilgrims were told of the miraculous cures performed by the god while they were asleep Asklepios would appear as they slept to give them a dream drug or perform a dream surgery. He would often be accompanied by a snake, the drakon – hence the medical symbol of a snake wound round a staff.
- Pedanius Dioscorides, a Greek physician, He personally researched each plant and its uses. About 65 AD, he wrote De Materia Medica, "Regarding Medical Matters",on the "preparation, properties, and testing of drugs." five volume book on the uses of over 1,000 plants and minerals. For nearly 1500 years, De Materia Medica was the supreme authority on medicine and pharmacology in western civilization. . it formed the basis for the Western pharmacopeia through the 19th century Mercury, copper, lead topical application. Dioscorides describes how the wine made from mandragora produces anaesthesia.Here Dioscorides used for the first time the word anaesthesia as absence of sensation as we mean it today
- Avicenna [ Ibn Sina ] – Canon Medicina Became a medical bible, supplanting galen’s work, 1st in the arab world & then in western Europe until the 17th century He recognized the contagious nature of tb & the dissemination of diseases by water & soil. Also recommended the use of cautery instead of knife in surgeries.
- With the fall of rome, roman medical regulations disappeared Medical care was taken over by the church. The flame of scientific enquiry was extinguished. Medicine became a matter of faith & prescriptions became prayers. Despite this a few secular physicians remained as well as practitioners of folk medicine or magic. The greek concept of 4 humors as revised by galen was the basis of all diagnoses & treatments. Many medieval treatments like cupping, blood letting, leeches, medications & diet – were roman, but more elaborate, with ritual added, & most prescriptions involving a multiplicity of ingredients.
- Medicine remained stagnant until one of history’s greatest tragedies known as “the Black Death’ swept through the world taking its terrible toll. It entered Italy in 1347 and 1348 and 100,000 people lost their lives in Florence. According to the church it was God’s punishment for the sinfulness of mankind. Medieval doctors blamed ‘pestinential atmosphere’. they lit huge fires of aromatic wood to purify the atmosphere,olive oil as food was considered fatal,some believed the air had become stiff and and had to be broken up by loud noises so bells were rung,guns were fired and birds were released to fly around rooms. They tried every possible cure & preventive measures. Mass hysteria ws also a charachteristics of the black death. Lead to persecution of jews as they were accused to have had started the plague by poisoning wells Only in 1894, during an epidemic in hongkong was plague bacillus identified & was found to be disease of black rats & other rodents spread by fleas.
- As the Black death swept through Italy in 1347 and 1348, taking its terrible toll, along with doctors’ failure to get to grips with it, a new air of enquiry into medicine began, with analysis & reassessment of classical texts, humanist thoughts beginning to replace dogma, soon spread throughout Europe. Galens erroneus theories were finally overthrown. Paracelsus ‘Grand father of Pharmacology’ was a Swiss German Renaissance rebel. He founded the discipline of toxicology. Challenged Galenic medicine Believed in dose-response concept - All drugs are poisonous – its only the dose that makes it a poison. Contributions -1) Paracelsus pioneered the use of chemicals and minerals (zinc) in medicine
- 3)He created a number of metallic remedies, including mercury to treat syphilis, and developed medicines using antinomy, sulfur, and potassium salts 4) He also dissolved opium in alcohol and called it “laudanum"; it was used for centuries as an effective painkiller. 5)He coined the word "alcohol," Used distilled oils as remedies
- The next notable breakthrough in the history of pharmacology came with the discovery of the small pox vaccine by Edward Jenner in 1796. It was common knowledge in the west of england that milkmaids who contracted cowpox never caught smallpox.For almost 20 years Jenner studied dairy workers and On 14 May 1796, Jenner tested his hypothesis by inoculating James Phipps, an eight-year-old boy who was the son of Jenner's gardener. He scraped pus from cowpox blisters on the hands of a milkmaid .Jenner inoculated Phipps in both arms that day with cowpox and 6 weeeks later with smallpox and the bow proved to be immune. Jenner published his findings in 1798.by 1801 about 100,000 people in Britain had been vaccinated.It spread to Spain and America and the rest of the world.Small pox was controlled and was eradicated by 1975
- Edward Jenner administering the first smallpox vaccination in 1796
- The use of salicylic acid and its derivatives dates back at least to 400 BC when Hippocrates prescribed the bark and leaves of the willow tree to reduce pain and fever. 1820s: Johann S. F. (Swiss pharmacist) - extracts from the leaves of Spirea Ulmaria (meadowsweet) - pain reliever in folk medicine 1835: Karl Jacob Lowig (German chemist) used the ‘extract’ to obtain an acid he called - ‘Spirsaure’ later known to be called Salicylic acid
- Its molecular structure was discovered by 1853: Karl Friedrich Gerhardt (French chemistry professor) - tried to eliminate its rather severe sideeffect ‘painful irritation of the stomach lining’ since the procedure was time-consuming he abandoned the drug. Salicylic acid was then Used only by those whose pain was worse than that caused by the drug itself. One of them was Herr Hoffman from Germany who was crippled by arthritis. his son Felix (who worked as a chemist at the Bayer drug plant nearby) tried to simplify Gerhardt’s methods & came up with Acetylsalicylic acid, which he gave to his father who experienced his 1st pain free night for yrs. it was soon found that it was not only a painkiller but also reduced fevers & inflammation. 1899: Hoffmann & Dreser – invented a new name for their new drug: Aspirin (‘A’ for acetyl, ‘spir’ for Spirea plant family & ‘in’ to round it off) Became the best selling product of the bayer company, all over the world.
- Following Germany’s defeat, bayer company lost its exclusive rights to both the name & the manufacture of the drug, to the british government. Howvever the US continued to market aspirin as ‘Bayer’ with its wellknown cross trademark. But the discovery of willow bark all those yrs before did not remain unnoticed ( 400 BC Hippocrates prescribed the bark and leaves of the willow tree to reduce pain and fever. 1826: 2 Italians found the bark’s active ingredient - ‘Salicin’ from which Salicylic acid was prepared. - n from then on the active ingredient in aspirin could be obtained from both the willow & meadowsweet. (now made synthetically from ‘phenol’) It was in 1971 that researchers in britian came up with atleast 1 reason why aspirin works – ‘Prostaglandins’ – aspirin appeared to interfere with the effective action of these substances. Aspirin eventually became a part of a grp known as NSAIDs 1980 – superceded by Paracetamol which had become a popular painkiller for all ages by then.
- Opium has been used for millenia as a medicinal and recreational drug. Sumerian writings 4000 years old refer to it as hul gil, the "joy plant".it has been mentioned in ancient egyptian,Persian,indian, Greek and Roman medicine. By 16th century opium was well established in Western European medicine. Paracelsus called it the ‘stone of immortality’ In the Mid-17th century: Thomas Sydenham (‘The English Hippocrates’) -1st dissolved opium in alcohol ‘Laudanum’ Addiction rarely a cause for concern.
- In the 19th century The medical conditions for which it was used included cholera, dysentery, toothache, flatulence, insanity and menopause. Friedrich Serturner (german pharmacist) separated various constituents of the drug & called the narcotic substance he discovered ‘morphine’ after Morpheus, the god of sleep. By the 19th century the opium trade was a significant part of British commercial life ,imported primarily from Turkey. The British East India company which grew opium poppies in Bengal imported the drug illegaly into China in exchange for silver China grew concerned about the moral dangers of the drug and the drain on silver reserves and thus there was a crackdown on opium traders .this was a substantial economic loss for the The British thus queen Victoria began the First Opium War in 1840 and Britain defeated China winning trade concessions.After being defeated in the second war as well China legalised opium and started massive domestic production
- In US – Importation of crude opium grew from the time of the civil war. Much of it was used in patent medicines. Even baby-soothing remedies contained opiates. By 1900 it was found that nearly 250,000 americans were addicts. Throughout the 19th century – concern about opium increased. These discoveries though of great medical benefit, brought increasing morphine & codeine abuse, exacerbated by the greater availability of the Hypodermic syringe –
- In 1898 2 new opium extracts were added to the list – Dionin (1st commercially available semisynthetic morphine derivative, now used as a cough sedative) Heroin (diacetylmorphine) – ‘heroic drug’, which was said to have the ability of morphine to relieve pain, yet safer. Restrictive legislation 1st passed in Britian in 1860 in an attempt to control the new substances. In 1909 – smoking opium prohibited in the US
- In the early 19th century, there was a rise of experimental pharmacology.physiologists performed pharmacological studies. A French physiologist, considered a pioneer of experimental physiology. He is known for describing the foramen of Magendie Francois magendie studied the action of nux vomica(a strychnine containing plant drug) and showed that spinal cord was the site of its anticonvulsant action. Because of such experiments, Magendie was able to introduce into Western medicine a variety of new drugs, including morphine, codeine, quinine and, strychnine.
- A French Physiologist Further expanded work of Francois Megendie In 1842, Claude Bernard discovered that the arrow poison curare specifically acts at the neuromuscular junction to interrupt the stimulation of muscle by nerve impulses. Also k/a Father of Modern Experimental Medicine Bernard's experiments changed medicine Discovered role of pancreatic juice in digestion, liver glycogen and its importance, and experiments on the vasomotor nerves. Effect of carbon monoxide gas on hemoglobin He also established the existence of Vasomotor system and observed Vasodilatation & Vasoconstriction
- professor of pharmacology at university of Strassburg In 1869, demonstrated that muscarine had a similar effect on the heart as electrical stimulation of the vagus nerve. In 46 years,he trained 120 pupils from 20 countries. In 1878,Classic textbook "Outline of Pharmacology" (1878). Discovered glucuronic acid. In 1885, he introduced urethane as hypnotic Was a major factor in the success of the German pharmaceutical industry upto WWII.
- trained under Schmiedeberg. Gave the name Pharmacology as a subject (earlier k/a Materia Medica) He was second to isolate epinephrine (1897–1898) from adrenal gland extracts (first was Napoleon Cybulski in 1895) Isolated amino acids from the blood (1914) Isolation of histamine from pituitary extract (1919) Preparation of pure crystalline insulin (1926). (pic – 1st insulin crystals prepared by john Jacob abel)
- In 1921 : Appointed as the first professor of pharmacology in newly established Calcutta School of Tropical Medicine and parallely headed the Department of pharmacology at he Calcutta medical college From 1941 to 1957: he was Director of the Drug Research Lab at Srinagar He 1st introduced and done systematic study of Rauwolfia serpentina (sarpagandha/indian snake root) Had a major contribution in establishing the 1st National Drug Research Institute of India, Lucknow ( presently known as Central Drug Research Institute, CDRI) He pioneered research on herbal drugs in India
- Lasagna joined the faculty of Johns HopkinsUniversity in 1954, where he established the first ever clinical pharmacology department. In 1964, Lasagna revised the Hippocratic Oath Conceptualize controlled clinical trials and the placebo effect Lasagna's work led to the improvement of controlled clinical trials to test drug effectiveness, and improved the regulation of drugs for effectiveness and safety. Lasagna's Law : The incidence of patient availability sharply decreases when a clinical trial begins and returns to its original level as soon as the trial is completed.
- German scientist in the fields of hematology, immunology, and chemotherapy He is noted for curing syphilis and for his research in autoimmunity He coined the term chemotherapy and popularized the concept of a magic bullet. ( He envisioned that just like a bullet fired from a gun to hit a specific target, there could be a way to specifically target invading microbes without harming the body itself.) Also coined the term Receptor (earlier called as receptive substance by Langley) Ehrlich skillfully transformed diphtheria antitoxin along with Emil Adolf von Behring, into an effective preparation, his first world renown achievement In1908, Ehrlich was awarded the Nobel Prize in Medicine In 1909 he and his student Sahachiro Hata developed Salvarsan, a treatment effective against syphilis. Salvarsan became the most widely prescribed drug in the world, most effective drug for treating syphilis until penicillin became available in the 1940s