For centuries, human beings only had products of natural origin, whether vegetable, mineral or animal, to make medicines. Many of these medicines had no effect, others worked somewhat, and others caused too many adverse effects, so that as technology advanced, human beings considered improving the therapeutic arsenal available to them using chemical synthesis.
The 20th century saw the development of synthetic medicines in quantity, following the idea of Paul Ehrlich’s “magic bullet”: it seeks to create molecules capable of acting directly on the site of interest, improving efficacy and avoiding the adverse effects of drugs. products known up to that time.
This objective has not been forgotten, but it is difficult to achieve that a synthetic molecule only acts on the site of interest, without “touching” anything else. The magic bullet is a dream that we are getting closer to thanks to technological advances, such as pharmacogenetics or some modern cancer drugs. But until that time comes, let’s review. What were some of the medicines that marked a before and after in the history of humanity?
the theriac
Theriac is a very special medicine. He did not save lives, but he is one of the great representatives of a conception of medicine that took almost two thousand years to be superseded in Europe. It was used for generations hoping in vain that it would cure ailments such as coughs, colic, angina pectoris, or the plague. The malfunctioning of European medicine was what eventually prompted the investigation of other, more innocuous types of therapy, such as homeopathy or the use of medicinal mineral waters.
Theriac was considered a universal antidote, a panacea. It has its origins around 100 B.C., when Mithridates VI ruled northeastern Turkey. In order not to die from poisoning, he invented an antidote called mitridate in which he mixed more than 30 ingredients, and took it every day. The idea was based on the fact that the mitridate, having various poisons in its formula, would protect him from being poisoned by his enemies. Legend has it that when he wanted to die, he had to die by the sword because no poison could kill him.
The mitridate formula was modified by Andromachus, Nero’s doctor, to enhance it by adding snake meat: this formula is known as triaca. Avicenna, a great physician of the eleventh century, added new ingredients to it. Over the centuries it came to have more than 65 ingredients: the main one was snake meat, but plants such as opium, gentian, anise, and ingredients such as honey or wine were also added. It was expensive and ineffective, but since medical properties were attributed to it from the application of prevailing medical theories and not from medical practice, it did not stop using it: there was a whole rational apparatus behind its use. We had to wait for other medical theories to emerge to stop manufacturing triac.
There are records of its manufacture in Venice up to the middle of the 19th century and in Naples up to 1906.
anesthetics
Until the 19th century, if you had to perform a tooth extraction or an amputation, you had to do it without any help other than alcohol: drunkenness did not take away the pain, but at least it allowed you to better tolerate the procedure. There was nothing to alleviate pain that was effective enough to allow surgery until the first anesthetics became known in the 19th century. In the year 1844 it was known that nitrous oxide had anesthetic properties, but its use did not become widespread until the year 1860. Ethyl ether was recognized as an anesthetic around the years 1840-1845, when its effects were verified in various parts of the world. . Finally, the 1850s saw the rise of the use of chloroform.
These three products, although they were replaced by other better medicines, radically changed medical treatment, since they allowed tooth extraction, simple operations and painless deliveries, opening the way for surgical medicine.
The antibiotics
Knowledge of microorganisms, as well as the diseases they could cause, had to wait until Louis Pasteur and his microbial theory of disease.
Before this time there were treatments for infectious diseases, but the cause of the disease was not known and many times the treatments were ineffective, or downright dangerous. Sometimes they associated diseases with “humours”, other times with “miasmas”, and the treatments were faced based on what theoretically had to be fixed, with what did not really cure people. Antibiotics improved and prolonged life, because with antibiotics diseases that were chronic before began to be cured, and lives were saved that before there was no way to save.
The first antibiotic was marketed under the name Prontosil, and it belongs to the sulfanilamide family. One of the first effective treatments with this medicine occurred in 1935, when it was possible to cure septicemia (blood infection) contracted by a girl by pricking her finger. Starting in 1940, several molecules belonging to this family began to be synthesized. They were replaced by penicillin and other antibiotics, although some are still used today.
The history of penicillin dates back to the 19th century.
Pasteur was the first to note antagonism between a Penicillium fungus and some bacteria: for some reason bacteria do not grow in the presence of this fungus. There were other studies at the end of the 19th century and beginning of the 20th, and it was in 1941 when enough penicillin was obtained to carry out a test in humans.
Unfortunately, there was not enough antibiotic to save the life of this patient, but it was seen that the improvement was noticeable and that science was on the right track. The first penicillin for oral use was obtained in 1953.
The next antibiotics to be marketed were tetracyclines, chloramphenicol, and streptomycin, around the same time. We had to wait for amoxicillin until 1972, and for its more potent relative, amoxicillin with clavulanic acid, until the 1980s.
Today, antibiotic research continues, although not at the rate of discovery of the last century. In order to have new antibiotics, it is important to find new mechanisms to kill bacteria, which is not easy. It is for this problem that the doctor’s prescription for antibiotics is so insisted: self-medication with antibiotics not only makes you take a medicine that you do not need, but also increases the possibility that more bacteria become resistant to the antibiotics that we already have. .
oral contraceptives
Although today it seems like a normal and current medicine that women can ask their doctor without many more complications, oral contraceptives were a real revolution in the lives of families and women.
In 1960, for the first time in history, a sexually active woman could control if and when she wanted to become a mother: she could trust that the five or six years of a university degree would go smoothly, or she could work hard to get a promotion, or even enjoy life as a couple, for two and only for two, the time that was decided. It also brought with it a revolution in the field of morality: first, because now women could have the sexual relations they wanted and with whom they wanted, without fear of an unwanted pregnancy. And second, because it was a medicine that the woman controlled, since the woman decided and could inform (or not) the husband about that decision.
Oral contraceptives have been evolving since 1960: today there are oral, patch, ring, injectable, subcutaneous versions, with more or less hormones, but they are always feminine. And although they have not saved lives, they have completely changed them, earning their place among the revolutionary drugs.
