malaria, leprosy, arthritis, dropsy, twilight sleep, cortisone, aspirin, prostaglandins

1
Plants, medicine, and culture
M. Keffer Waterloo-Oxford may, 2001

• malaria, leprosy, arthritis, dropsy, twilight
  sleep, cortisone, aspirin, prostaglandins .
• ethnobotany, bioprospecting, and rain forest
  degradation
• social and cultural aspects of healing shown by
  plant remedies
• comparison of healing styles
• plants and religious activity
• toxins and drugs
• Doctrine of Signatures

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Plants, medicine, and culture
stay tuned for future presentations on

• Plants as biochemical factories
• phytoremediation, bioremediation, and Living
  Machines
• oxygenators and water purifiers for space travel
• genetic engineering and new uses for tobacco

• Plants of economic importance
• spices, flavourings, and trade
• coffee, tea, saffron, cinnamon, nutmeg, cloves
  and clove oil, coconut
• the Moluccas and the Spice Wars
• industrials -- rubber, cotton
• rubber and World War II
• structural materials wood, palm
• lignins and structural strength
• alternate food sources algae

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ethnobotany
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Ethnobotany 1

• the study of plants learned from the people who
  use them
• often includes medicinal plants
• often includes the study of indigenous peoples
• research methods involve living with the people
  who use the plants, and learning their methods
  from them
• in many cases the proper use of the plants is
  wrapped up with their everyday lives, and
  therefore difficult to explain to foreigners
• e.g. its hard to walk into the forest and find a
  cure for cancer when the local people dont even
  have a word for cancer
• therefore foreigners like us must go to learn in
  THEIR environment, on THEIR terms.

5
threats to ethnobotanical knowledge

• Threats include
• expansion of civilized cultures into their
  habitat
• mining
• transport
• slashburn agriculture
• pollution
• attrition
• (young members of tribes leaving and not
  returning to learn from their elders -- no one to
  carry on the traditions)

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Significance of ethnobotany

• Currently there are new diseases for which there
  is no known cure
• also some existing diseases have become resistant
  to antibiotics
• the forest may be the best place to learn about
  drug substances
• forests are disappearing, and with them, the
  people who know how to use these plants
• Note an admixture is something added to the
  active ingredient to alter it in some way
• make it less toxic
• reduce its side effects
• increase its potency by allowing it to enter the
  bloodstream more quickly
• allow it to cross the blood-brain barrier

• its not just the plants its
• how they are used,
• their preparation,
• their admixtures, and
• knowledge of fine differences between them
  (closely related plants, plants that resemble
  each other at certain stages of the year)
• in most cases this knowledge is NOT written down
  ANYWHERE
• it is part of an oral tradition -- meaning it is
  only passed from person to person orally, through
  teaching
• not all peoples have writing
• even if they did, for most, their secrets are
  sacred and not to be told to just anyone

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Malaria life cycle

• parasites live in gut of female Anopheles
  mosquito
• when mosquito bites, it injects fluid to act as
  anticoagulant and anaesthetic
• parasites enter human bloodstream
• travel to liver for another stage
• enter bloodstream and replicate in red blood
  cells
• burst the RBC when they reach large enough
  numbers and size
• when another mosquito bites, parasites move back
  into the mosquito gut to start the next round of
  replication

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Malaria info from the WHO (World Health
Organization)

• Malaria kills more people than any other
  communicable disease except tuberculosis
• Caused by a protist parasite that lives both in
  mosquitoes and humans
• since it is not a bacteria, antibiotics are NOT
  effective against it
• it is curable if promptly treated
• multi-drug resistant strains are now becoming
  more prevalent
• major problem in areas covering 40 of the
  worlds population
• symptoms
• fever, shivering, pain in the joints, headache,
  repeated vomiting, convulsions, coma, severe
  anemia
• recurrent cycles of shivering and fever that
  coincide with the release of parasites within the
  blood
• kills over 3000 children per day worldwide -- far
  more than HIV
• a single bout of infection usually costs the
  equivalent of 10 working days
• ref http//www.who.int/inf-fs/en/fact094.html

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increased risk of malaria
a hidden risk of global warming.?
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cinchona

• Malaria is the one of the top killers in the
  world
• Evidence suggests it has been a concern at least
  back to 500 BC
• there were lots of remedies but no real cure
• the Cinchona tree from South America provided
  quinine
• for several hundred years it was the only cure
• Significance
• At this time European colonialism was expanding
  explosively into the Americas, Africa, India,
  Indonesia, and other areas of Asia.
• All these expansions were partially fuelled by
  the discovery of quinine
• Without it it is unlikely that expansion would
  have occurred nearly as quickly, since many
  colonialists were killed by malaria

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leprosy

• caused by mycobacterium similar to the one that
  causes tuberculosis
• infects and kills peripheral nerves (extremities)
• leads to numbness and lack of circulation
• this often leads to gangrene or muscle damage
• nasal membranes also often infected - -probably
  initial entry point of infection

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leprosy 2

• muscle wasting may cause bizarre contortion of
  joints (first picture)
• eyes also may be affected --
• nerves leading to cornea deteriorate
• therefore cornea and other membranes deteriorate
• cornea become numb, therefore dont know when
  somethings in the eye
• leads to damage of membranes and eventual
  collapse of the nose and nasal tissue
• for further information check this link

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social and historical implications of leprosy

• dates to biblical times -- very old disease
• lepers have traditionally been ostracized (booted
  out of normal society) and forced to live in
  leper colonies
• click here for further info on background

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chaulmoogra

• from an Indian tree
• only thing found to be effective for leprosy
  throughout history
• more recently replaced by dapsone (synthetic
  derivative)
• this was ONLY made possible by studying the
  active principle of the chaulmoogra plant
• currently there are many strains of M.leprae
  showing resistance to dapsone
• click here for more info
• also check here for specific details about the
  oil

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cancer remedies

• Found in Madagascar
• from the rosy periwinkle
• periwinkle currently almost extinct due to
  rainforest destruction
• vinblastine and vincristine have been isolated
  from this plant
• they are currently among the very few successful
  treatments for childhood leukemia

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the original Salix

• Native people in North America chewed willow bark
  to relieve headache
• Willow bark is one source of salicylic acid
• Salicylic acid has similar pain-relieving and
  blood-thinning properties as aspirin
• However, it also tends to cause stomach upset,
  and lead to ulcers
• By chemically adding an acetyl group (CH3-CH2-)
  to salicylic acid it is changed to
• AcetylSalicylic Acid (or ASA)

Willow blossom
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prostaglandins

• prostaglandins are secreted by most animal
  tissues
• wide array of activities
• stimulation or relaxation of smooth muscle
• dilation or constriction of blood vessels
• stimulation of inflammation responses
• enhancement of the perception of pain
• aspirin works by inhibiting the synthesis of
  prostaglandins

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ASA and other pain relievers

• ASA is still one of the best pain relievers for
  arthritis, muscle pain, etc.
• lowers fever, relieves pain, reduces
  inflammation, and thins the blood
• inhibits the formation of blood clots --
  therefore used to reduce risk of stroke and CVAs
  (cardiovascular accidents)
• ASA is packaged into many different brands of
  aspirin, as well as cough meds, cold remedies,
  etc.
• The other two main pain relief medications
  available without a prescription are
  acetaminophen and ibuprofen -- both reduce
  prostaglandin action
• acetaminophen is the active ingredient in Tylenol
  and many other headache pills
• it has many of the same actions as ASA but does
  not tend to cause the same amount of
  gastrointestinal discomfort
• acetaminophen does not work as well for reduction
  of inflammation or blood thinning -- ASA is still
  the best balance of relief and lack of side
  effects
• acetaminophen is a coal tar derivative

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worlds worst diet?
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Worlds worst diet 2

• This desert tribe survives on a frothed mixture
  of blood and milk.
• It provides all needed nutrients
• but should produce a high blood cholesterol
  level.
• However, members of this tribe regularly have
  among the lowest blood cholesterol levels of any
  group on earth
• Ethnobotanical research found that the members of
  the tribe add a type of bark to their mixture
• Further research suggests that this bark has
  blood cholesterol-lowering properties.

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epena and shamanism

• This shows a shaman (herbal healer) and his
  apprentice at the start of a healing ceremony.
• Which one do you think is the shaman?
• What do you think is happening in the picture,
  and why?

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Epena and shamanism 2

• Without diagnostic tools, indigenous peoples have
  relied on spirit helpers to help them discover
  what is wrong with a sick person.
• Shamans (healers) also ask their spirits to help
  the sick person get better.
• In order to speak with their spirits, shamans
  often go into a trance
• certain drug substances are often used to speed
  up the process of entering the trance
• in the picture, the shaman is the one on the
  right.
• His assistant is blowing a powder, called epena,
  into the shamans nose

Within minutes, the shaman will be deeply
entranced. (The patient is not in the picture.)
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Comparison of healing styles
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Western vs. indigenous pharmacopoeia
Note especially the differences for
cardiovascular, cancer, and dermatology (skin)
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connection with religion
Ancient Egyptian art showing a god pollinating a
papyrus plant Why would gods be associated with
plants?
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hunter-gatherers vs agriculturalists

• for hunter-gatherer societies, plants were
  important but not as important as the spirit of
  the animals on which they depended
• when a society sees something as being extremely
  important, they tend to deify it -- make it into
  a god in their art and culture
• through this, we can learn about their culture by
  looking at their religious art
• concept of sympathetic magic says that by
  portraying a thing, they can help to make it
  happen
• example rain dance
• with the agricultural revolution, people realized
  that their success depended on their plants
• stories involving gods were good ways to teach
• plants in some cases offered routes to things
  beyond the normal experience, and therefore
  became identified with gods

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poppies
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Opium and opiates

• opium has been used for centuries as a narcotic
  and a painkiller
• when research on brain chemicals began, it was
  found that the brain produces chemicals that
  look exactly like morphine
• the brain chemicals are called endorphins

• they are natural pain-killers
• morphine has its effect because it happens to
  have the same shape as the endorphins
• morphine and endorphins act as either hormones or
  neurotransmitters -- affecting the nerve cells
  they encounter

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Research significance of drug substances

• Understanding the structure of morphine allowed
  understanding of the receptors in the brain
  through which morphine functions
• one way to understand a pathway is to find an
  example where the pathway DOESNT WORK.
• Then look at the differences between the one that
  works and the one that doesnt.
• neurotoxic plant substances show how pathways
  work by shutting down certain pathways -- they
  provide a case where the normal doesnt work
• example saxitoxin blocks sodium channels

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Coca -- very different from cocoa

• Coca plant unmodified is an excellent source of
  calcium and vitamins
• many diets in the Andean highlands are deficient
  in calcium
• acts as a mild stimulant -- similar to strong
  coffee
• prevents fatigue and hunger
• excellent prevention against altitude sickness
  (common in the high altitudes of the Andes)

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coca

• Coca became a very popular additive to drinks
  such as wine
• it is still included in Coca-cola
• this is the only situation in which it can be
  legally imported
• you wont find it on the ingredients
• its allowed for it to be listed as a natural
  flavouring.
• many anaesthetics such as novocaine were created
  based on cocaine and its derivatives

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Coca -- significance

• important historical, social, and religious
  significance
• people feel that it connects them to their land
  -- they see it as a gift, and to use it
  responsibly is their way of returning the gift
• also seen as sacred reaffirmation that they
  belong
• reminder from their gods to take care of the land

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Coca -- VERY different from cocaine!

• Coca leaves must be treated with strong acids to
  modify the active ingredients into cocaine -- it
  is a long process that does NOT occur naturally
  under any circumstances
• many countries have destroyed wild coca growth,
  and coca plantations, in the attempt to cut down
  supplies
• these efforts are supported and promoted by the
  US War on Drugs
• this is in hope of reducing the amount of cocaine
  coming into the US BUT
• reduction in supply has the effect of increasing
  demand
• probably does little to reduce the amount of coca
  funneling through illegal routes
• however, this does remove it from natural users
  
• further info and source of pictures, click here.

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calabar, witchcraft, and voodoo
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Trial By Poison

• Trial by Poison was a common way to test a person
  who was suspected of lying
• person would be given calabar beans, which are
  TOXIC (due to the physostigmine)
• person would become very sick, dizzy, would foam
  at the mouth, and might die.
• If the person died, they were obviously guilty
• If they did not die, they must have been innocent.

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papaya

• provides papain (meat tenderizer)
• also chymopapain (contact lens cleaner and
  treatment for slipped discs)
• Inject enzyme into problem disk
• it dissolves the jelly in the disk
• This shrinks the disk and relieves pressure on
  the adjacent nerves
• reduces need for back surgery

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Jimsonweed

• also called angels trumpet, or
• Datura stramonium, or
• thorn apple
• toxic -- to people and livestock
• may be hallucinogenic if properly prepared
• attractive flower with nice floral smell
• leaves have distinctive unpleasant odour when
  touched

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Jimsonweed

• called Jamestown weed according to legend that
  soldiers marching through Jamestown were treated
  to a lunch by the residents
• the soldiers spent the next few days variously on
  the rooftops, in the gutters, and wandering
  around in a lunatic state.
• most active ingredient is scopolamine

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arthritis

• Joint disorder that can effectively cripple a
  person
• immune system begins attacking self tissue in the
  joints
• joints become inflamed and sore
• this calls even more inflammatory cells
• positive feedback cycle
• joint surfaces become pitted and misshapen

• this further accelerates inflammation
• many people have it and there is no cure
• otherwise not damaging -- affected people must
  often live with it for the rest of their lives
• can prevent simple tasks -- like driving a car,
  holding the phone, or opening the aspirin bottle

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Arthritis and cortisone

• 1930s rheumatoid arthritis patients showed
  dramatic improvement after jaundice
• jaundice is liver disease -- leads to yellowing
  of the skin and eyes occurs as a symptom of some
  other disease, such as hepatitis
• also arthritis would decrease during pregnancy,
  but come back after birth
• hormone called compound E found in both cases
• but compoud E was very difficult and expensive to
  synthesize

41
Cortisol and cortisone

• Steroid hormone made by the adrenal cortex
• causes
• increase in blood sugar
• increase in liver glycogen
• increased rate of conversion of protein into
  carbohydrate
• elevates blood sugar by conversion of
  non-carbohydrate molecules into glucose

adrenal gland
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Cortisone miracle cure for arthritis?

• first test on humans woman with severe
  rheumatoid arthritis -- so bad she could hardly
  move
• previously, no treatment had shown any effect
• after three days of cortisol injections she could
  move easily
• after eight days of injections her symptoms were
  mostly gone

43
Cortisone Overall Wonder Drug?

• Cortisone increased test animals resistance to
  cold, poisons, and other stresses
• Pneumonia symptoms would disappear, although the
  bacteria causing it was still there (remove the
  cortisone and the symptoms reappear!)
• tuberculosis symptoms would also disappear -- but
  bacteria still present also
• side effects high blood pressure, excessive
  hair growth mental problems ulcers brittle
  bones fluid retention obesity mood swings
• Often abused! Athletes with joint injuries find
  that cortisone injections directly into the joint
  will reduce swelling and allow them to continue
  playing
• however, this usually leads to further damage of
  the joint
• also can lead to softening of the joint and
  permanent damage and disability

44
Mexican Yams, cortisone, and Dioscorea

• In the 1930s and 40s, there was an intense search
  for a plant source of cortisone
• none were found, but a vine called Strophanthus
  was found that could produce a substance that
  could easily be modified to provide cortisone
• however, this plant could not be cultivated
  outside its native jungle (not sure why)
• later it was found that certain Mexican yams
  (Dioscorea) could provide the same substance very
  cheaply
• this is the source of cortisone, progesterone,
  and estrogen for many birth control pills also

45
cortisone and progesterone

• note the similarities between the different
  substances
• for such similar molecules, they produce vastly
  different effects in the body!

46
plant toxins
Larger bar more poisonous Huratoxin is more
than 10 million times more toxic than cyanide
47
distance to herbs

• Graph shows amount of walking time necessary for
  a particular healer to reach a forest large
  enough to find the plants he needs
• the time has increased greatly since 1940 due to
  forest being cut down in his area

48
may apple

• podophyllotoxin for cancer from the North
  American mayapple

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Strophanthus vine

• produces atropine
• also cortisone precursors

50
Digitalis (foxglove)

• A relatively common disease in the 16th - early
  20th century was called dropsy
• caused fluid retention in patients feet
  (swelling, also called edema)
• they also had weak hearts and often died of heart
  failure
• it was found that an extract of foxglove would
  help clear up the disease
• foxglove was often grown in gardens for its
  pretty flowers
• wise women had known of this cure for a long
  time
• but it didnt become valid until an established
  (male) doctor started treating patients with it
• now known that foxglove contains digitalis
• digitalis is, even now, one of our most important
  drugs for increasing the strength of the hearts
  contraction
• dropsy occurred due to weakening of the heart --
  therefore pumping was not strong enough, and
  fluids pooled in the lower limbs

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Scopolamine (hyoscine)

• Ophthalmic atropine, homatropine, and scopolamine
  are used to dilate (enlarge) the pupil of the
  eye.
• used before eye examinations, before and after
  eye surgery, and to treat certain eye conditions,
  such as uveitis
• obtained from plants of the nightshade family
  (Solanaceae), chiefly from henbane, Hyoscyamus
  niger.
• Structurally similar to the nerve substance
  acetylcholine
• scopolamine acts by interfering with the
  transmission of nerve impulses by acetylcholine
  in the parasympathetic nervous system
• produces symptoms typical of parasympathetic
  system depression
• dilated pupils
• rapid heartbeat
• dry skin, mouth, and respiratory passages
• Because scopolamine depresses the central nervous
  system, it is used as a sedative prior to
  anesthesia and as an antispasmodic in certain
  disorders characterized by restlessness and
  agitation, e.g., delirium tremens, psychosis,
  mania, and Parkinsonism.
• When combined with morphine, the effect produced
  is a tranquilized state known as twilight sleep
  this combination of drugs was formerly used in
  obstetrics but is now considered too dangerous.
• Overdosage of scopolamine causes delirium,
  delusions, paralysis, and stupor.

52
Solanaceae family (SOL-un-A-see-uh) (the
Nightshades)

• The chief drug plants of the family are
• belladonna, or deadly nightshade (Atropa
  belladonna),
• henbane (Hyoscyamus niger)
• mandrake (Mandragora officinum)
• Jimson weed (Datura stramonium) (angels trumpet)
• tobacco (Nicotiana tabacum).
• Many of the above were used in herbals and in
  magic potions
• The family also includes several important food
  plants
• potato (Solanum tuberosum) (note greens are
  poisonous, but not roots)
• tomato (Lycopersicon esculentum)
• peppers (but not black pepper, which is a
  different family)
• eggplant (Solanum melongena), (the only one
  native to the Old World)
• Species of salpiglossis, petunia, butterfly
  flower, and the genus Solanum are among the
  members of the family cultivated as ornamentals.

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Atropa (deadly nightshade)
54
Monks hood
Source of aconitine
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curare

• from strychnos plants
• these plants are the source of strychnine (rat
  poison)
• arrow poisons of many different tribes
• similar substance found in buttercups
• In preparing the arrow poison, the seeds,
  deprived of their hairs, are pounded to a pulp,
  the adhesive sap of another plant is added, and
  the mixture smeared for 6 inches along the point
  of the arrow. Game wounded by such an arrow is
  said to be rarely able to move 100 yards, while
  the flesh can be eaten without bad effect.
• (from encyclopedia.com)

• curare is a very important muscle relaxant for
  surgery
• an adventurer tried the drug on their donkey --
  no Westerners knew how the drug actually killed
• they used a set of bellows to keep its lungs
  inflated (simulate its breathing)
• the donkey survived after the drug wore off --
  with no ill effects
• drug works by paralyzing the muscles, including
  the breathing muscles
• otherwise it does no harm at all to the body

56
Doctrine of signatures

• use of various plants was indicated by the form
  or shape of the plant.
• Concept was in wide use throughout the middle
  ages and Renaissance (ca. 800 - 1500 AD)
• based on much older belief
• As Above, So Below.
• Things that happened in the heavens, and in
  nature, had influence on the affairs of humans
• God wanted to indicate the plants purpose to
  humans -- so thats why they were shaped as they
  were.

57
Bloodroot

• Click here for web link
• A blood red juice can be extracted from the
  reddish orange root
• The juice from the root was used as a body paint
  and dye by Native Americans.
• Warriors painted their faces with it
• produces a yellow-orange dye that is very fast
  (permanent)
• has flesh destroying properties
• therefore good for treating conditions of the
  skin such as ringworm, warts, polyps, fungal
  growths

58
boneset

• long been used to treat fevers from simple colds
  to typhus.
• tea often used as a diuretic
• leaves of E. perfoliatum were once considered
  useful in mending broken bones
• belief probably came from observation of the
  fusion of the leaves at their bases
• does have some toxic properties
• toxic propterties had nothing to do with healing,
  but led people to believe in its effectiveness

note fusion of leaves
59
hepatica
same
guess what people used this plant for.
60
Other notes

• Fishing and the source of rotenone
• admixtures that are not necessarily active
  ingredients, but that may increase toxicity or
  reduce side-effects
• frankincense
• cassava beer, bread
• role of modernization -- increased skin
  infections due to western clothing and also to
  discouragement of plant remedies as un-Christian

• Zoopharmacognosy
• elephant herbs
• monkey soil
• the spirit of the Great Bear
• Snake Oil and Indian Elixir
• as people moved west across North America, they
  learned many herbal remedies from the native
  people
• soon, anything that appeared to have come from a
  Native recipe was considered to be good
• entrepreneurs took advantage of this and began
  selling Indian Elixir on every corner -- often
  with absolutely no connection to any Native
  recipes