The discovery that won the latest Nobel Prize for Medicine wouldn’t have been much of a revelation to doctors in ancient China. Pharmaceutical chemist Tu Youyou established that the compound artemisinin could treat malaria in the early 1970s. But the plant the chemical comes from, Artemisia annua L. (sweet wormwood), was used to treat fevers perhaps caused by malaria as early as the third or fourth century CE.
Tu discovered the properties of artemisinin (qinghaosu in Chinese) after reading traditional Chinese texts that dated to this era listing medicinal herb preparations. The route to the discovery and its dissemination was not easy due to both the difficulties of trawling through and testing hundreds of plant samples and the political climate in China in the 70s. Fortunately, persistence paid off and artemisinin is now a key antimalarial drug.
While this story might be unusual in modern medicine, artemisinin is far from the only compound used today that was initially derived from plants. For example, another malaria treatment, quinine, is derived from the bark of South American rainforest tree Cinchona officinalis L. The painkiller morphine comes from the opium poppy Papaver somniferum L. And the poison strychnine comes from the Strychnos nux-vomica L. tree. Those plants had been in use for centuries, even millennia, before chemists isolated their most active constituents.
So can we hope to find new remedies by studying ancient medical texts, as Tu did so successfully? The answer to that question is complex and unfortunately cannot be an unmitigated, resounding “yes”. Ancient pharmacological texts, whether they are written in Chinese, Arabic or Greek (or any other ancient language) are not easy to navigate for several reasons.
Ancient cookery books
These pharmacological texts normally present themselves as a series of recipes without much information as to whether they were used or not. Think of your favourite cookery book: you probably do not make all the recipes in it and if you do not annotate it then nobody would know which ones you used and how much you enjoyed them (or not). We rarely find annotations on ancient pharmacological texts.
It is often difficult to know exactly which plants are listed in an ancient recipe. Nowadays, the international Linnaean plant nomenclature is used worldwide to name plants, with each given a genus and a species name, as well as an author’s name. For instance, in “Artemisia annua L.”, “Artemisia” refers to the genus, “annua” refers to the species, and “L” refers to Linnaeus, the famous Swedish botanist.
But before the Linnaean system became widely accepted, plant nomenclature was extremely unstable and various local names could be used to refer to the same plant. This means it is not always possible to know for sure which plants are referenced in ancient texts. If we cannot translate ancient recipes accurately, how can we evaluate their efficacy?
Definitions of diseases are culturally bound. This means that each culture will define its diseases in a different way. For instance, the Greeks and the Romans considered fever to be a disease, whereas we would think of it as one symptom of a disease.
In Greek and Roman texts, there are many descriptions of “intermittent fevers”, fevers that reoccur every few days. Now, intermittent fevers are a symptom of malaria, but they are also symptomatic of other diseases. Should scientists test all ancient Greek and Roman remedies for “intermittent fevers” in their search for new antimalarial drugs?
Perhaps most importantly, historians of medicine believe that every medical system should be considered in its entirety. That means, from a historian’s point of view, it is problematic only to focus on aspects of ancient medicine that are successful by modern standards and reject the rest as uninteresting.
While there are many ancient medicines that are effective by modern standards, many are not or are frankly dangerous. For instance, very few of us would think it wise to purge ourselves of a disease by overdosing on hellebore, as the Greeks often did.
With all these provisos in mind, I would still argue that there is much potential for discoveries of new drugs in ancient medical texts. This will require collaborations between pharmacologists, historians and ethno-pharmacologists (who study traditional medicine use by different ethnic groups).
Such collaboration will prove challenging as everyone will feel they are speaking a different language. But the wonderful example of Tu Youyou should remind us that the rewards can be high, especially when they lead to advances in the fight against such widespread diseases.
There’s no respite from Trump’s vindictiveness and foolishness
As we know, even in the midst of a national emergency, Donald Trump could find time and bandwidth to continue his retribution campaign.
He dismissed Michael Atkinson, the inspector general for the intelligence agencies, for doing “a terrible job,” satisfying his own thirst for vengeance for anyone who actually adhered to law and practice over blind loyalty to Trump himself. Indeed, asked about it the next day, Trump underscored his action by saying, Atkinson “was no Trump supporter, that I can tell you.”
It was an act that we once would have labeled corruption, by Democrats and Republicans – that is using the office for personal purposes – if Congress and too many Americans had not since become inured by so many like instances.
This is how Taiwan and South Korea bucked the global lockdown trend
As the coronavirus pandemic sparks global lockdowns, life has continued comparatively unhindered in places like Taiwan, South Korea and Hong Kong after their governments and citizens took decisive early action against the unfolding crisis.
At first glance Taiwan looks like an ideal candidate for the coronavirus. The island of 23 million lies just 180 kilometres (110 miles) off mainland China.
Yet nearly 100 days in, Taiwan has just 376 confirmed cases and five fatalities while restaurants, bars, schools, universities and offices remain open.
The government of President Tsai Ing-wen, whose deputy is an epidemiologist, made tough decisions while the crisis was nascent to stave off the kind of pain now convulsing much of the rest of the world.
Republican ex-lawmaker with coronavirus scolds Wisconsin GOP for forcing voters to risk their health
On CNN Tuesday, former Rep. Charlie Dent (R-PA), who is himself dealing with a bout of COVID-19, chastised the Wisconsin GOP for doing everything in their power to block the state elections from being moved — and forcing many voters to stand in line and risk exposure to the virus to cast their ballot.
"I have to tell you, here in Pennsylvania we have a Democratic governor and Republican legislature," Dent told host Don Lemon. "They postponed the election here from April 28 until June 2. Without any controversy. Everybody agreed it was the right thing to do and they moved on. I'm surprised Wisconsin took this risk, knowing they don't have to."