Tuesday, December 17, 2013

10000 B.C. Opium discovered

Back in the 19th century physicians realized opium and Morphine benefited asthmatics suffering from air hunger (dypnea).  Since such opiates relax the mind, physicians back then used this as evidence asthma was a nervous disorder.

Today various opiates are used to help take the edge off when a person is suffering from air hunger caused by a variety of diseases, such as asthma, chronic bronchitis, emphysema and lung cancer.  The medicine relaxes the mind, eases pain and suffering, and is a mild bronchodilator.

Yet opiates are by no means a modern remedy.  As a matter of fact, opium was one of the first medicines ever discovered by humans, if not the first.
It was also the first cultivated medicine.  It benefited many suffering from disease, and it also brought great suffering.  It was the first recreational drug, and it was even responsible for a war.
An opiate is basically any medicine that is derived from opium, which is a medicine derived from the opium poppy, or Papaver somniferum.  

It was probably discovered by a random person in the prehistoric world, probably long before alcohol was discovered.  (11, page 15) Perhaps the person was in a frantic search for food and ingests the bulbs of the plant.  He soon forgets his hunger.  Some say it was discovered around 10,000 B.C., although some speculate it was discovered much earlier.

Perhaps a young man, in a jolly mood, during a month later known as February, in a frantic search for something jolly to show a girl, finds the pretty flower in an open, sunny field.  He breaks off a variety of bulbs or capsules and takes them home to show her. He sets them in the woods where only he would find them.   (1)(2, page 4)

The next day he walks a girl to that spot, and together they study the bulbs.  By accident, the young man pokes a stick into one of the bulbs, and a white milky juice pours out.  Several days, weeks, months or maybe even years later, further studies are performed on these interesting flowers, and in one the juice was set in a bowl over night.  By the end of the next day, which was hot and sunny, the juice turned into a dark brown mass.  This, it would be learned later, was the crude form of a drug later to be named poppy or opium.  (8)

The dark brown mass was ingested by a man who was grieving the loss of his wife. It tasted bitter, yet he forced it down. H no longer felt agony.  He credited the juice from the poppy, and told all his friends of the paradise created.  He told them the flower was a gift to him from the spirit of his grandfather.  He ingested the opium every day for a week, having no idea how much he ingested.  In was now April.  He had now become a nervous wreck, with headache and constant tremors.  He yearned for more opium.

A friend of his happened upon the flower, and he admired the plant.  He picked it and took it back to his clan.  He prepared the plant later that night, and shared it during story time around the fire the next night.  That night was especially pleasant, and a new dance emerged out of spontaneous celebration.  Those who drank of the mass seemed to make contact with parts of their mind previously un-visited.

So the benefits of ingesting the plant were quickly learned.  Soon the no more poppies were in the woods, and a young man was presented to the lady members of the clan as a physical wreck.  He was diaphoretic, anxious, restless, had a raging headache, and had horrible tremors.  He yearnedf for more of the juice.  He was taken to the medicine man who said the young man must be suffering from the curse of a mad man.  But who was the mad man?  A frantic search was on.

A few days later the medicine man found he had some of the plant in his possession, and he prepared it in a drink and gave it to the young man.  Almost immediately his symptoms dissipated.  It was here the side effects of the opium poppy were learned.  The plant allowed visitation with the white spirits, yet used too frequently resulted in possession of black spirits.

This was the first apparent overdose of opium.  The medicine man took charge.  He dissected the plant.  He found the plant contained a dark brown soft, gummy mass.  He decided the poppy must be used wisely, and so he kept the formula to himself.  He did not share it until he was on his deathbed, when he shared it with his grandson.

His grandson became the next medicine man. The new medicine man prescribed opium to an elderly man who was suffering from gout.  The formula he prepared had a strong smell, and was given in an amount just enough to take the edge off.  He put it on the sick man's tongue, who winced at it's bitter taste.  (1)

The new medicine man grew old, and became ill and on his deathbed told his grandson of the opium remedy.  The grandson prescribed it many times in his life, and before he grew too old he told of it to his son in the form of a poem to make the recipe easy to remember.  His son grew to be an old and wise member of the clan, and his grandson became among the first physicians.  He, like his great grand father, believed opium to be a gift from the gods.

Over time medicine men must have experimented with this medicine, learning of its ability to take the edge off life.  It must have become one of the first and best remedies in his repertoire. Whenever he had a patient who was ailing, be it from a broken bone or an ailment causing dyspnea, poppy seeds were prepared in a potion, and once injested would have taken the edge off the pain and suffering. It would have created an "artificial paradise" of sorts. (10, page 30)

By word of mouth the effects of the medicine made its way to ancient civilizations of Sumeria, and is written about in 5000 B.C. on stone tablets.  It was known then as Hul Gil, which meant the "joy plant."  It was also written about in the Assyrian medical tablet arat pa pa.   It was also used in Europe at this time too, including what would later become known as Italy.   (1)  This is significant, because many believe from here it made its way into ancient civilizations of Greece and Rome.

Many experts estimate the Biblical beginning of time to be about 4004 B.C., so it must have been shortly thereafter that Adam and Eve walked the Garden of Eden.  The use of a "soporific medicine" was mentioned in Genesis, and it's easy to speculate the medicine might have been opium: (10, page 29)
And the Lord caused a deep sleep to fall upon Adam, and he slept; and he took one of his ribs, and closed up the flesh instead therof."
It was soon cultivated for it's ability to relieve pain, dull the senses, and induce sleep.  It may also have been cultivated for its perceived ability to cause peace and calmness and creativity, or what otherwise may have been perceived as pleasure.  It brought upon a relaxed state of mind induced by the spirits or gods.

It was prepared in wine, which was sweetened with pepper and other aromatics.  Ancient Roman texts note how the Egyptians yearned for it, and were addicted.  It was given to sooth children who were teething as early as 2000 B.C., and the recipe is mentioned in the Eber Papyrus of about 1550 B.C.  

Around 1300 B.C. cultures started cultivation of the poppy in poppy fields.  "The opium trade flourished during the reigns of Thutmose, Akhenaton and King Tutankhamen. The trade route included the Phoenicians and Minoans who move the profitable item across the Mediterranean Sea into Greece, Carthage, and Europe."  (7)

The Hebrews learned about it, perhaps when they spend time as slaves in Egypt, and it's therefore alluded to in the Hebrew Bible.  It was called rosh, which means head, perhaps alluding to the head of the poppy.  It was also referred to as me-rosh, or juice of the poppy.

Ancient Roman and Greek physicians new of it.  The Greeks referred to is as apyun.  (2, page 5) While Homer doesn't necessarily write a medical book, he alludes to ailments and wounds from time to time, although there would be little known of specific diseases when Homer walked the earth around 800 B.C. Many historians speculate Homer was a surgeon, and so from his experiences he describes battle wounds and treatments, one of which may have been opium to sway away pain and suffering. (3, page 22-23)

In his epic poem Odyssey, Homer writes that an arrow aimed at Hector missed him and hit another son of Priam.  Homer writes, "Just as a poppy in a garden hangs on one side, its head laden with fruit and with the dew of spring, so he bent on one side his head, made heavy by his helmet."  (2, page 3-4)

The Odyssey has other allusions to opium, such as described by historian Henry Sigerist: "the drug given to Helen by the Egyptian lady, Polydamna, had strong euphoric properties so that whoever took it forgot all unpleasant memories and would not shed a tear even if his closest relative died; this drug might be opium, or hashish.  But it could just as well be the kind of miracle drug found in many fairy tales." (3)

Very little is mentioned about opium by Hippocrates, the father of Medicine, who lived around 400 B.C., although he is given credit for the first mention of poppy juice. While he wrote little of it, it must certainly have been known to him, especially considering he was one of the most noteworthy and prominent physicians of his time.  (2, page 4)

It most certainly would have been used at healing temples, such as those of Apollo or his son Aesclepeons.  The sick would sleep in the Aesclepeons and, supposedly, the god would appear in a dream with a remedies.  Success stories were recorded at the temple, and some believe Hippocrates had access to the the recordings at the Temple at Cos.

Perhaps this is why Hippocrates had knowledge of the "juice of the poppy," and that it has soporific effects.  Although mentioned by him, it was barely by by physicians until the Arabs started studying Greek medicine, including the works of Hippocrates.  (6, page 280)

Pedanius Dioscorides, who lived 40-90 A.D., may have been the "first to give a detailed account of opium and its uses in medicine.  Treating of the cultivated poppy, he says, that it's juice is very congealing (solidified), incrassative (thick), and desiccative (preserved), when taken in small quantity, to the size of a vetch, is anodyne (relieves pain), soporific (induces sleep), concoctive (mixed with food or drink), and is useful in coughs, and caeliac affections.  Taken in greater quantity, it proves injurious, inducing lethargy and death. (6, page 280)

He is the first to describe the best time of year to prepare the opium, and he wrote about a technique the involved finely incising the capsules to release a white milky juice.  It was set out overnight, and by the end of the next day, after sitting in the hot sun, the contents turn into a dark brown gummy mass.  This method of preparation was basically unchanged through the 19th century.  

Dioscorides noted that it benefits:  (6, page 280)
  • Headache when rubbed in with rose oil
  • Earache when injected  with almond oil, saffron, and myrrh
  • Inflammations of the eyes with the roasted yelk of an egg and saffron
  • Erysipelas and wounds with vinegar
  • Woman's milk and saffron
  • Inducing sleep when applied as a suppository per anum
Dioscorides recommends the following preparation of opium: (6, page 280-81)
The best kind is that which is dense, has a heavy stupefying smell, is bitter to the taste, readily incorporating with water, smooth, white, not rough, nor grumous, nor moulding like wax in the process of straining; when laid in the sun softening, and when applied to a lamp not burning with a smoky flame, and after being extinguished preserving its powers in its smell. He then mentions several modes of adulterating it which were practised in his time, and then adds, it is roasted for ophthalmic medicines upon a recent shell until it becomes soft and of a tawny colour
Dioscorides also described the method that
Themison of Laodicea, who lived in the century before the birth of Christ, wrote of opium and other narcotics, and he used "confection of poppies, which he employed in the diseases of the respiratory organs (John Watson, page 110).  This may be the first allusion of the medicine to relieve the suffering from dyspnea, such as that caused by diseases later referred to as heart failure, kidney failure, bronchitis, emphysema, and asthma.  Although please note these diseases were not defined until much later, so to Laodicea they would have been all lumped under "diseases of the respiratory organs."

In the century after the birth of Christ, Galen was one of the many who warned that while opium has benefits, it should be used sparingly as it can do more harm than good.  For this reason Galen more often recommended simple things like good eating, cleansing and exercise as opposed to drugs, and many other physicians did the same.   (4, page 61)

In the second century Celsus describes a drug called "pavaverus lacryma" and many historians seem to think this was opium, or the juice of the poppy. He described various remedies, both internal and external, where it was used as part of the formula.  One formula used it in an emollient plaster to rub on arthritic joints, and in another it was part of an injection for ear ache, or salve for the eyes.(6, page 28)

Paulus Aegineta, who lived from 625-690 A.D., did not specifically write of the analgesic effects of opium, although he does allude to "counteracting it's toxicity:"
When one has drunk from the juice of the poppy, drowsiness comes on, with coldness and intense itching, so that often when the medicine takes effect such an itching comes on that the person is roused by sleep thereby.  The smell of the medicine too is emited from the whole body.  The remedies in such cases after rejecting the substance taken by vomiting with oil and evacuating downward by a stimulant clyster and oxymel drunk with salts, or honey with warm rose-oil and much undiluted wine with wormwood and cinnamon, and warm vinegar by itself, and natron with water, and marjoram with wine.  We must also arouse by aromatics, put the person into a hot bath, and foment on account of the pruritus which supervenes; and after the bath we may use fat broths with wine and must.  Marrow also drunk with oil is useful." (5, page 75)
During his quest to conquer the world, Alexander the Great introduced the Persians and Indians to Opium.  (6)  By the founding of Baghdad in 763 A.D. the Arabs were studying the medical texts as written by the ancient Greeks and were applying opium for their own medical purposes, and writing about it in their own texts.  The medicine was referred to as afyun, mainly because the Semitics had a habit of mispronouncing p's with f's.  The Persians referred to it as apyun or abyun, although it is from the former that the term opium is derived.  (2, page 5)

They Arabs and Persians started trading with the Chinese, and one of the products of trade was opium and other drugs, as well as precious stones, brocades, and rose water.  So it's believed opium was introduced to China during the Tang dynasty (618-907) by the Arabs. They used the Arabic formulas for the poppy seed in treatment of ailments.  (2, page 5)

It was written about in the first half of the 8th century during the reign of Tang Ming Huang by Chen Tsang Chi in a work called "Supplement to the Pentsao."  His quotes on opium were from a earlier Chinese author named Sung Yang-tzu, who wrote that "the poppy has four petals.  It is white and red.  Above them is a pale red rim.  The seeds are in a bag, which is like one of those arrow heads which have air-holes to make a sound as the arrow cuts through the air. Within these are seeds like those of millet." (2, page 7)

So the Chinese now had opium, and the ability to make it themselves, and so they did.  They made it and used it as did people of the rest of the civilized world.  In 973 the Emperor Sung Tai-tsu instructed nine men to write a book in which is written: "It's seeds have healing powers.  When men have been taking the stone that confers immortality, feel it powerfully operating, and cannot eat with appetite, they must be benefiting by mixing these seeds with bamboo juice boiled into gruel and taking this." (2, page 8)

Opium is also mentioned in a poem by Su Tung Po (1036-1101): "The Taoist advises yon strongly to partake of the drink chi-su-shui.  The boy may prepare for you the broth of the ying-su." Ying-su is the name given to opium during the Tang Dynasty, and it means "jar millet," because the poppy head resembles a jar (ying). (2, page 8-9)

Avicenna (980 A.D.) was among the most prolific Arabic medical writers during the dark ages of medicine, and he wrote that opium should be treated as a poison, and if given in doses higher than two drachmas can prove deadly, with the "proper dose the size of a tare.  Around 1020 he calls it narcotic and sedative of all pains, whether taken internally or rubbed in." (6, page 282)

Narcotic is your prototypical term that gives reference to the effects of drugs like opium, reducing pain, inducing sleep, and dulling the senses.  To ancient physicians it must have been a very nice drug for physicians to know about, as life can bring about great pains and sufferings.  Physicians wanting to alleviate such sufferings may have prescribed opium.  Although, as Avicenna notes, it must be used carefully because it is a poison.

He said it was useful for (6, page 282):
  • Apostemes (Abcess):  It dries up the ulcers
  • Gout:  It must be mixed with the yelk of an egg to form a linemint (lotion)
  • Anxiety/ suffering:  Soak a cloth smeared with it below the head
  • Ear pain:  Inject it into the ear, along with myrrh and saffron
  • Chronic head pain:  Soak a cloth in it can relieve suffering, and may cure it
  • Opthalmy:  Eye pain can be remedied (mix with the milk of a woman)
Warning:  placing opium in the eyes may induce blindness.  Yes, Avicenna warns, if your eye pain is bad enough you cannot bare it any more, you may try this remedy.  Yet you must do so knowing the risks of this poison.  All of you who use it must know it is a poison, as well as a possible remedy and cure.  It must be used with caution.

 It also known to allay or improve: (6, page 282)
  • Incessant coughs, and often cures that kind which is noisy
  • Stomach peculiarities
  • Diarrhoea
  • Dysentery (diarrhoea with mucous and blood)
  • Ulcerations of intestines
However, one must be careful, because excessive use can "impairs digestion."  Although by observing this side effect, it became among the first effective treatments to stop diarrhoea. 

Again, however, as did other physicians, he observed that "it proves fatal, he says, by congealing the vital powers and extinguishing the innate heat; and its antidote is castor. He concludes by saying, that three times the amount of the seed of hyoscyamus, or double of the seed of mandragora may be given as a substitute for it." (6, page 282)

The Arabs were also among the first to perform surgeries, and opium must have proven a useful anaesthetic.  So it's uses were varied.  Yet a plant that was once found to be a beautiful flower, and randomly used for by primitive people, was eventually cultivated and used as a potent option for physicians.

The Chinese became addicted to the medicine, and it became very valuable to them.  However, they were unable to cultivate as much of it as was needed or desired.  So the resulted in a trade route between England, India and China.  It also resulted in a war, as we'll learn in my next post.

References:
  1. Aggrawal, Anil, Dr., "The story of opium," from "Narcotic Drugs," 1995, National Book Trust of India
  2. Edkins, Joseph, "Opium: historical note: or the poppy in china," 1898, American Presbyterian Mission Press
  3. Sigerest, Henry, E., "History of Medicine," Volume II, "Early Greek, Hindu, and Persian Medicine," 1961, Oxford University Press, page 23
  4. Prioreschi, Plinio," A History of Medicine: Byrzantine and islamic medicine," 2004, Horatius Press, page 
  5. Prioreschi, page 61, quoted by Prioreschi from "The Seven Books of Paulus Aegineta," V, xlii, translated by Francis Adams, London, The Sydenham Society, 3 volumes,  1844-1847, 2, page 213
  6. Paulus Aegineta, translated by Francis Adams, "The Seven Books of Paulus Aegineta," V, xlii, 1847, The Sydenham Society, 3 volumes, (1844-1847), volume 2, page 279-283; here we find a good discussion of opium use by the ancients as recommended by Plinio Prioreschi (see reference 5 above)
  7. "Opium Timeline", http://www.opioids.com/timeline/, accessed 12/20/12
  8. Allan, Nathan, "The Opium Trade," 1853, 2nd edition, Lowell
  9. Kane, Harry Hubbell, "Opium-smoking in America and China," 1882, New York, G.P. Putnam's Sons
  10. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922,
  11. Booth, Martin, editor, "Opium: a history," 1996, Great Britain, Simon and Schuster Ltd.

No comments:

Post a Comment