Opiates

Author Kathleen Rouser returns to discuss the historical use of plants for medicinal and not so medicinal purposes. You can find Part I here.

Plants: Poisons, Palliatives and Panaceas

Part II

Foxglove/Anne Burgess

From the Middle Ages onward, medicinal plants grown by wives and mothers for their families were referred to as “simples”. One of them, foxglove, had been used to treat many maladies, even tuberculosis. By itself, ingesting a single leaf of foxglove can cause immediate heart failure. But housewives learned how to use digitalis, the drug derived from foxglove, as a stimulant for the heart. By the late 18^th century, an English doctor recorded that digitalis would strengthen an ailing heart. Today, digitalis is often prescribed to treat heart failure, regulating the heartbeat and strengthening the cardiac muscle.

Deadly Nightshade/David Hawgood

Another poisonous plant, deadly nightshade, grows berries that can be fatal if eaten. Larger pupils were considered more attractive during the Middle Ages, so drops of juice from this fruit were once used to dilate the pupils of young women. It was called “belladonna”, meaning “beautiful woman” in Italian. Today, atropine is produced from deadly nightshade, to dilate patients’ pupils, so eye care practitioners can further examine their eyes.

American frontier families carried dried simples, some of them familiar to us as food seasoning, such as marjoram or thyme. They believed tasty sassafras would purify or thin the blood.

A popular tonic once used by mothers and prescribed by doctors in the nineteenth and early twentieth centuries was derived from the castor bean. A powerful laxative, castor oil cleansed the bowel, a treatment often used to cure whatever ailed you.

In ancient times Hippocrates warned against the use of opium, a painkiller made from the milky juice of poppies, because of its powerful addictive properties. This didn’t stop mankind from using it, whether to develop dangerous drugs such as heroin or pain relieving narcotics. In the 1660s, the English physician Thomas Sydenham produced laudanum from mixing opium with wine and saffron. This painkilling drug was used into the twentieth century. During the earlier 1800s, both the powerful narcotic morphine and the less potent codeine, were first made from opium extracts.

Willow Tree

As chemists learned how to extract and isolate chemicals in plants, they found just which components actually worked. German chemists were eventually able to analyze the bark of the willow tree. From ancient times extracts of willow bark had been used to reduce fever and relieve achiness, but not until 1899 was it known that the active ingredient was salicylic acid. Yet, decades passed before they figured out how this active ingredient, we know as aspirin, worked!

The shelves of our local health food stores are filled with herbs and ingredients made from many different plants. Some of these are based on folk remedies, proven successful throughout history, while others are yet unproven. Who doesn’t enjoy the soothing calm brought to one’s nerves through a cup of chamomile tea on a cold winter’s eve? Or settled an upset tummy with ginger ale or peppermint tea? God knew what He was doing when He provided us with curative and nourishing plants—plants that we even derive many helpful and healing pharmaceuticals from today.

Thanks so much, Kathleen, and be sure to check out her forthcoming multi-author novel, The Great Lakes Lighthouse Brides Collection, releasing November, 2018

Plants: Poisons, Palliatives and Panaceas Part 2/2: Click to Tweet.

*Originally posted May, 2011.*

Resources:

Court, William E. “Pharmacy from the Ancient World to 1100 A.D.

Making Medicines: A Brief History of Pharmacy and Pharmaceuticals. Ed. Stuart Anderson. London, UK: Pharmaceutical Press, 2005. 21-36. Print.

Facklam, Howard and Margery. Healing Drugs: The History of Pharmacy. New York: Facts on File, Inc., 1992. Print.

Steele, Volney, M.D. Bleed, Blister and Purge: A History of Medicine on the American Frontier. Missoula, MN: Mountain Press Publishing Company, 2005. Print.

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Kathleen lives in Michigan with her hero and husband of over 30 years. First, a wife and mother, she is “retired” after 20 years of home educating their three sons, who are all grown and have moved away. Kathleen has been published in Home School Digest and An Encouraging Word magazines. She writes regularly for the local women’s ministry “Sisters” newsletter. She also contributes articles and author interviews to Novel PASTimes, a blog devoted mostly to historical fiction. You can connect with Kathleen via her website.

Proper Treatment of a Suicidal Patient.

clinical-netflix Netflix recently released a psychological suspense (perhaps some would call it horror) movie called Clinical. It surrounds the story of psychiatrist Dr. Jane Mathis who is an expert in dealing with PTSD. She is recovering from her own traumatic experience, a patient attempting suicide in front of her, and has vowed to not care for these types of patients until her own issues are resolved. However, the work of regular psychiatric problems doesn’t seem fulfilling enough so she takes on the case of a facial transplant patient named Alex.

In one particular scene, Alex calls Jane and states he “took too many pills”. I don’t know how this could be viewed other than a suicide attempt. Instead of calling 911, she goes to his home. Once there, Alex is first scene barely conscious, but is evidently able to stand up and answer the door. From that point on, the conversation goes something like this:

Alex: “Did you call an ambulance?”

Jane: “What did you take? If you don’t tell me, I’m going to have to call 911.”

Alex eventually becomes unconscious. Jane then administers a drug via IM injection. In the next scene, Alex is vomiting.

Jane is holding a prescription bottle in her hand. “How many of these pills did you take?”

Alex: “I just wanted to sleep for a while. What did you give me?”

Jane: “It’s called naloxone. I only use it for emergencies.”

Just. Awesome.

Issue One: I can’t imagine how many ethical and legal lines it crosses that this psychiatrist did not have this patient involuntarily committed to the hospital under an M-1 hold when he clearly tried to commit suicide. I’ve seen M-1 holds placed on patients for far less than an actual attempt. Clearly, this is a big medical no-no and really doesn’t do the patient any favors. Just because the patient’s worried financially about an ambulance ride doesn’t mean he doesn’t get one.

Issue Two: Let’s discuss the medical drug naloxone or Narcan. This is a reversal medicine for drugs that contain opiates. This would include drugs like morphine and heroine. It’s not clear what drug Alex took— all he says is sleeping pills. To me, sleeping pills would more than likely contain some kind of benzodiazepine, of which there is no reversal a doctor would personally carry, though one is available in the hospital setting.

Issue Three: The scene where the patient is vomiting after the Narcan is administered. I’m not sure if the writers are portraying that the drug induces vomiting so that the patient throws up the pills. If so, that’s not medically accurate. Narcan reverses the effects of opiates at the receptor level. It immediately brings the patient out of their high and they’re usually not very happy about that. Most often, we don’t want to fully reverse the drug as this can put a patient at risk for seizures so we may titrate the dose just to reverse the diminished (or lack of) breathing induced by taking too much of the drug.

I actually think it’s okay the doctor did these things if it would have been pointed out by her mentoring/treating psychiatrist that she acted inappropriately and he was going to report her to the Board of Healing Arts because of her actions.

That would have ramped up the tension/conflict on many levels.