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Drugs: ideas and traditions

Five pieces of red terra sigillata, Europe, 1401-1800

Five pieces of red terra sigillata, Europe, 1401-1800

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Drugs have been a central element of medical treatment in many different medical traditions. In Traditional Chinese Medicine (TCM) physicians developed complex combinations of different ingredients in specific proportions to try and restore the vital energy qi in the patient's body. Physicians used their judgment to adapt the proportions of ingredients to the patient and the severity of the illness.

Building on previous knowledge - the development of drugs

In ancient Greece the physician Dioscurides (1st century CE) listed many different types of pharmakon (a Greek word meaning ‘drug’ or ‘poison’) and their effects. In the second century Galen incorporated this empirical knowledge into his humoral system, thus providing explanations for why these drugs worked in the way they did. Galen ascribed four basic qualities to all things: substances such as food and drugs could be hot or cold, and wet or dry. In this system a drug treatment aimed to create balance in the body.

New trade, new ideas

In the Middle Ages new trade routes to the Middle East introduced to Europe medical drugs used in Islamic medicine, such as balsam, myrrh and rhubarb (which became a popular laxative).

Paracelsus and chemistry

A whole new set of treatments and drugs was introduced in Europe in the 1500s by the important medical reformer Paracelsus. Paracelsus advocated ‘iatrochemistry’, the application of chemistry to medicine. Most famous among his new methods was the use of the metal mercury for the treatment of syphilis. His system was controversial, because it contradicted medical authorities such as Galen. Early modern physicians such as Nicholas Culpeper (1616-54) also used the ’doctrine of signatures‘ to determine the healing powers of a plant - its physical features were supposed to reflect its potential uses.

New plants from around the world

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The reforms of Paracelsus were not the only source of change in early modern drug treatment: many new plants were imported from around the globe along trade routes, from voyages of exploration and overseas empires. From the Americas came such exciting new plants as tobacco, introduced after Columbus's voyage in 1492, and cocoa, brought to Spain by Cortez in 1528. The stimulating properties of both were frequently used for medical purposes, e.g. as tonics or cocoa suppositories.

Organising the use of drugs, testing on people

Throughout the early modern period, patients and practitioners in Europe frequently resorted to ‘polypharmacy’, the use of many different drugs at the same time. Patients reasoned that one of the drugs might work, but they ignored the possibility that different substances might act against each other. In the 1700s many physicians, such as the German Samuel Hahnemann, set out to systematise the use of medical drugs. He suggested testing drugs on healthy humans in order to obtain secure knowledge of a drug's effects. Hahnemann's experiments eventually led him to found a radical new method of treatment: homeopathy.

Ehrlich and the development of chemotherapy

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In the early 1900s, German scientist Paul Ehrlich developed chemotherapy - his idea was to supplement vaccines and serums with synthetically produced chemical drugs. His model was quinine, a substance used to combat malaria which killed the germ but did not affect the rest of the patient's body too much. Ehrlich sought to produce new chemicals that had similar effects on other germs. Today chemotherapy is an important technique for the treatment of cancer: drugs which inhibit the growth of tumour cells supplement surgical removal and radiotherapy, but they tend to have strong side effects because they also damage other cells in the body.

Antibiotics and the use of penicillin since the Second World War

Ehrlich's work led to the development of antibiotics in the first half of the twentieth century. Since the Second World War (1939-45) antibiotics such as the ground-breaking penicillin have saved many lives on the battlefield, in the home and at the hospital. However, the widespread use of antibiotics has led to the emergence of new strains of germs which are resistant to antibiotic treatment. These ’superbugs’ have caused new concerns for doctors and public health specialists.

 

Bibliography

D Greenwood, Antimicrobial Drugs: Chronicle of a Twentieth Century Medical Triumph (Oxford, New York: Oxford University Press, 2008)

M. Gijswijt-Hofstra, G. M. van Heteren and E. M. Tansey (eds), Biographies of Remedies: Drugs, Medicines and Contraceptives in Dutch and Anglo-American Healing Cultures (Amsterdam: Rodopi, 2002)

P U Unschuld, Medicine in China: a History of Pharmaceutics (Berkeley, Los Angeles: University of California Press, 1986)

M Weatherall, ‘Drug therapies’, in W F Bynum and R Porter (eds), Companion Encyclopedia of the History of Medicine, 1 (London: Routledge, 1993), pp 915-938

Glossary:

Laxative

An agent that acts to encourage evacuation of the bowels

Syphilis

A sexually transmitted infection resulting in the formation of lesions throughout the body.

Suppository

A drug that is inserted into the rectum, vagina or urethra, where it dissolves.