In the beginning of time, people were destined to be born, fall ill and, on many occasions, end up perishing because of it. With the passage of time and through observation of the environment, cures were developed that were related to the gods, also the cause of disease according to tradition. Through the analysis of what took place in nature, it was possible to determine that there were certain elements that could be beneficial to health. Some animals, for example, avoid eating poisonous plants and ingest certain others when they suffer from problems in their digestive system. This series of events allowed the development of a clear idea: some plants or remedies could help the body to alleviate certain ailments, just as there were others that could be harmful. From Life Length we tell you about the evolution of medicines, from the origins of the most primitive medicine to the current process of elaboration:
The first medical documents belong to the Sumerian people, who were located in the lower course of the Tigris and Euphrates rivers from 3200 B.C. to the first century A.D. Sumer was one of the civilizations included by historians within Mesopotamia. It was a people rich in culture, the result of the invention of writing, which allowed the development of mathematics, astronomy and medicine, among other fields. Sumerian, like Latin later on, became the language through which culture was transmitted and continued to be used in written form even when it disappeared in spoken form. The texts that have survived to the present day are immortalized on clay tablets that were later fired. These writings of a medical nature deal with the elaboration of medicines and cures, as well as different diagnoses and remedies. The texts were engraved on clay tablets and in them we can observe the direct relationship established between health and the gods, relating pathologies with sins that could be cured with ointments, plants and, of course, rituals. It should be noted that these are the first written texts related to health, born in a civilization that invented writing. So it seems likely that medicine, at least in its earliest form, was even prior to this civilization.
The Ebers papyrus is another written testimony that illustrates what Egyptian medicine was like in the year 1550 B.C. Although it is not the only document of this culture, nor is it the oldest, it is the papyrus that speaks of medicine that is best conversed. In it you can read more than 700 medicinal remedies that were used in Egypt to cure the discomfort produced by illnesses and wounds. The Egyptians also established a direct relationship between ailments and the gods, considering that health resided in the balance between body and spirit.
But it was not until the 5th century B.C. that religious beliefs were separated from medicine. Hippocrates, born on the island of Cos (Greece today), was a famous physician who tried to rationally explain the ills of the body. Hippocrates based his research on experimentation and close observation to establish patterns among his patients. He detailed the symptoms of pathologies such as pneumonia or infantile epilepsy. In addition, he wrote a code of ethics on which the code of ethics of today’s physicians is based. He is considered the father of medicine as he was the first person on record to study medicine with a rational approach and to sustain his knowledge empirically, positioning medicine for the first time in history as a science and not as a set of rituals and beliefs.
Of particular interest is the story of Mithriades VI the Great, who was king of Pontus for 43 years from 120 B.C. When Mithriades was a child his father died of poisoning, which is probably why he took a special interest in antidotes against known poisons. This king ingested tiny doses of poison in order to develop a natural tolerance to the poison. So much so that after defeating the Roman generals Sulla and Lucullus, he lost the battle to Pompey. Expecting terrible reprisals at the hands of the rival who had defeated him, he decided to put an end to his life and that of his family by resorting to poisoning. His family died, but Mithriedes survived, as a result of the tolerance he had built up to the poison, so he had to beg a soldier to put him to death by piercing his chest with a sword.
Another important milestone is that the physician and the apothecary were embodied by the same person until 1240 when Frederick II of Hohenstaufen ruled that the work of one should be kept separate from that of the other. This system was gradually implemented throughout Europe until the first pharmacopedia was published in Florence in 1492.
It was in 1637 that Pope Urban VIII decreed that it was forbidden for religious bodies to carry out activities outside their ecclesiastical duties. Although they were not allowed to practice medicine, they were still allowed to produce medicines. However, in 1771 it was ordered to cease the manufacture of medicines by the church, closing the conventual pharmacies. This generated controversy as it left some areas totally lacking in medicines.
The purpose of alchemy was to convert certain elements into gold using a philosopher’s stone that was never more than a legend. However, in the 18th century, chemistry was consolidated as a science thanks to the advances of Lavoisier, who defined what the elements are and the Law of Conservation of Matter, which explains that matter can neither be created nor destroyed, it only changes state. These important discoveries have led Antoine Lavoisier to be considered the father of modern chemistry. Advances in chemistry continued to be made on an ongoing basis and led to the discovery and development of increasingly effective and complex drugs.
At the beginning, healing was carried out by people linked to cults and beliefs. Later, these healing remedies began to be traded and passed into the hands of merchants, who produced their remedies in small workshops. With the knowledge that the human being was acquiring about chemistry, more and more complex medicines began to be elaborated. To achieve this, technology and investment in research had to be greater, forcing the different pharmaceutical companies to merge in order to pool their resources.
Today, the process of drug discovery and distribution has changed. What was once a simple trial-and-error process is now a long and exhaustive exercise lasting 10 to 15 years. The development process consists of four distinct phases: discovery, preclinical, clinical, and approval and registration.
- Discovery phase. The first thing to do is to detect a protein that is related to the disease in order to develop a drug that acts effectively on it.
- Preclinical phase. In this phase, the efficacy of the drug is tested. To this end, it is tested in living organisms and in cells and tissues. In addition, pharmacological and toxicological studies are mandatory in this phase and must be submitted to the relevant regulatory agencies.
- Clinical phase. In the third phase, the drug is tested in humans to verify its efficacy and determine the appropriate dose to be administered.
- Approval and registration phase. In the last phase, the regulatory authorities determine whether the drug can be marketed. To do so, they evaluate all the documentation and results that those responsible for the study have produced over the years.
It should be noted that once the drug is on sale, it is necessary to closely monitor the drug and its effects on the population.
There are many diseases that today have no known cure and there is no drug that is totally perfect. On the other hand, it is interesting to reflect on how far we have come and, looking at it in perspective, how fast it has developed in recent years: the first text in which medicine is mentioned dates back to 3200 BC and the greatest advances have been made since the 18th century, in just 3 centuries. Today we have more remedies than ever before, they come to us in the most comprehensive way, and yet we still have so much to discover.