Illuminations
Illuminations
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灯饰
DOI：
10.1136/bmj.298.6680.1113
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发表时间：
1989
影响因子：
--
通讯作者：
John Melmoth
中科院分区：
文献类型：
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作者：
John Melmoth
使用植物治疗疾病必须追溯到有记录的历史之前，因为植物在公元前3000年左右的最早医学著作中得到了很好的描述。到公元100年，著名的Dioscorides草药包含500种植物，而在1597年John Gerard草药中的1000多种植物中，几乎没有一种植物没有被赋予某种治疗价值。在诊断是原始的时代，药物的使用是一种偶然的事情，试图使之合理化的尝试导致了奇怪的概念，如库尔佩珀的占星草药学和签名学说。但是，尽管许多明显无用的补救措施是由共同使用引入的，但正是同样的社区经验导致了我们今天使用的主要植物药物的发现。我们不知道这些药物是如何被发现的。毫无疑问，它采取了许多世纪的自我实验，学习，例如，乳胶的鸦片夹竹桃（夹竹桃或玫瑰湾）罂粟是一个强大的止痛药。但事实上，目前使用的20多种主要植物药物中的每一种都要归功于民间医学的最初发现。没有一个是由医生或植物学家的个人研究最初选择的。然而，一旦给出了线索，那么这种药物的发展就多次归功于医学科学。埃及植物Ammi visnaga（Khella）被当地人用于治疗肾绞痛，但它受到了G V Anrep的启发，实现了其作为血管扩张剂的潜力，导致了半合成化合物色甘酸钠和胺碘酮。正如巴斯德所说，”机会青睐有准备的头脑。因此，草药给了我们无与伦比的价值，没有实验室可以发现或制造的药物，同时它产生并延续了数百种未经证实的植物疗法，这些疗法仍然由草药医生处方。草药目前的地位在于继续使用这些药物，通常是小剂量，相信整个植物上级纯化提取物，并声称治疗“整个人”。人们常问：“为什么医生不把植物当作药物呢？”“是的。这种药物可以直接来自植物，如地高辛，或者是半合成的，如羧苯恶酮，或者植物化合物的作用机制可能导致更好和更安全的合成药物，如帕金森病的抗胆碱能药物。
The use of plants to treat disease must go back well before recorded history as plants are well described in the earliest medical writings around 3000BC. By AD 100 the celebrated herbal of Dioscorides contained 500 plants, and scarcely one of the 1000 odd plants in John Gerard's herbal of 1597 did not have some therapeutic virtue ascribed to it. In an era when diagnosis was primitive the use of pharmaceuticals was a haphazard affair, and attempts to rationalise it led to bizarre concepts such as the astrological herbalism of Culpeper and to the doctrine of signatures. But although many obviously use-less remedies were introduced by common usage, it was nevertheless the same community based experience that led to the discovery of the major plant medicines that we use today. We have just no idea how these medicines were discovered. I No doubt it took many centuries of self experimentation to learn, for example, that the latex of opium Nerium oleander (oleander or rose bay) poppy was a powerful analgesic. But it is a fact that every one of the 20 or so major plant based drugs in current use owes its initial discovery to folk medicine. Not one was initially selected by the individual research of a doctor or a botanist. Once the clue had been given, however, then it has several times been the case that development of the drug owed everything to medical science. The Egyptian plant Ammi visnaga (Khella) was used by the local people for renal colic but it took the inspiration of G V Anrep to realise its potential as a vasodilator, leading to the semisynthetic compounds sodium cromoglycate and amiodarone. As Pasteur said," Chance favours the mind which is prepared." Therefore herbal medicine has given us drugs of incomparable value, which no laboratory could have discovered or made, and at the same time it has produced and perpetuated many hundreds of unproved plant remedies which are still prescribed by herbalists. The current position ofherbal medicine consists in its continued use of these remedies, often in small doses, in its belief that the whole plant is superior to purified extracts and in its claim to treat" the whole person." It is often asked," Why do not doctors use plants as medicines?" They do. The drug may come directly from the plant, as with digoxin, or be semisynthetic, as with carbenoxalone, or the mechanism of action of the plant compound may lead to a better and safer synthetic medicine such as the anticholinergic drugs in parkinsonism.