Of healing and henbane: what a medieval sedative says about modern medicine
Using modern pharmacokinetics to assess drug known as the "Great Rest"
“In fact, the history of medical treatment, until recently, has been essentially the history of the placebo effect.”
— Arthur and Elaine Shapiro*
For Nicholas Everett, the future of medicine may lie in the past.
Everett is an associate professor in the Department of History and an expert in the history of medicine. He argues that many ancient and medieval treatments, which were often mixtures of plants, minerals and animal products, were neither ineffective nor placebos – although he admits a few were lethal.
“A lot of experience and medical practice formed over millennia of trial and error underlie many historical recipes and recommendations,” says Everett. “In fact, the most commonly used medicines today derive from folk traditions, and many of the active ingredients in plant medicines are still the subject of intense research for new medicines.”
Everett has been busy uncovering practices that might spark new medical research.
In 2012, he published The Alphabet of Galen: Pharmacy From Antiquity to the Middle Ages. The book is an English translation, with critical notes, of a Latin text that describes almost 300 traditional medicines and why people used them.
And this summer Everett and Martino Gabra, a graduate student in the Department of Pharmacology and Toxicology, published a paper that describes the chemical composition and probable effects of a medieval medicine called the “Great Rest” which included opium, henbane and mandrake.
The pair calculated the likely effective dose and toxic dose for the popular sedative. The study represents the first assessment of a medieval drug using the principles of modern pharmacokinetics, which measures how the body processes drugs.
“One interesting finding about the Great Rest was that henbane may have reduced the potential for overdose or addiction by creating a sense of disassociation within 20 minutes, making repeated self-administration unlikely,” says Gabra. “The morphine in the opium would have kicked in later, providing pain relief for about 12 hours.”
Gabra says the idea that henbane can temper morphine abuse could be useful to researchers today, and that the history of medicine offers many possible avenues for new research. He and Everett plan to apply their approach, which they’ve dubbed “historical pharmacology,” to other medieval and ancient treatments.
Gabra also hopes their methodology will aid another coming area of research: how plant-based dietary supplements and food interact with drugs.
Many plant ingredients react with drugs and food to adversely affect health. For example, chemical compounds in grapefruit juice can change the activity of blood-pressure medications. Ginseng can increase bleeding in people taking aspirin.
“Some researchers view plant medicine as fringe science, but many people are using plant-based supplements,” says Gabra. “There’s almost no regulation of these products, and patients often have no idea what’s in them. As pharmacologists, we have an obligation to study alternative medicine.”
Gabra will begin graduate research on cancer and tumour suppression this fall in the lab of Assistant Professor Leonardo Salmena. He also plans to keep reading beyond his main area of study – a habit that led to him to Everett’s history of medicine course as a first-year undergrad in life sciences. (The two have stayed in touch since.)
Everett continues to step outside his discipline as well. He registered for a B.Sc. at U of T in 2011, and has taken several life sciences courses. He says the course work has confirmed his belief that humanities scholars can reap huge benefits from studying science – and that medicine has a lot to learn from the humanities.
“Scientists today are under great pressure to look forward and to create new knowledge, but there is huge value in looking at past traditions,” says Everett. “People in the past were not stupid. There was logic in many of their practices.”
*Shapiro, Arthur K, and Elaine Shapiro. The Powerful Placebo: From Ancient Priest to Modern Physician. Baltimore: Johns Hopkins University Press, 1997. Print.
Jim Oldfield is a writer with the Faculty of Medicine at the University of Toronto.