The fascinating story behind the discovery of Streptomycin
Streptomycin has been referred to as the “wonder drug” due to the transformative effect it had on the prognosis of patients suffering from tuberculosis when it was first discovered. It spurred the discovery and invention of antibiotic drugs within the category know as aminoglycosides. Over the decades, it has saved the lives of millions worldwide. Yet the story of its discovery has largely either been wrongly told or simply forgotten, except to those with a special interest in medical history.
In this episode we look at the story of the discovery of streptomycin. We review what is now known about the actions of Professor Selman Waksman, the man credited with its discovery in the 1952 Nobel Prize for Physiology or Medicine, and Albert Schatz, the young researcher who is now acknowledged to have made the actual discovery. It is a gripping story full of intrigue and academic skullduggery.
The video version of this podcast, with images and associated slides, can be found here.
We start off with an article by Seeseei and others, published on the 9th of November 2021, in the Proceedings of the National Acedemy of Sciences of the United States of America, in which they discuss a study that has shown that the leaves of the Samoan tree, matalafi, are as good at relieving inflammation as ibuprofen. As discussed by Bob Yirka of the Medical Express,
“For hundreds of years, natives of Samoa have been using the leaves of the matalafi tree to treat a wide variety of inflammation related ailments, including injuries, wounds, and elephantiasis. It was not until recently that modern science took notice and began to look at the leaves, as well. …. After discovering that material in the plant leaves reduced inflation, they compared its efficacy against one of the most popular drugs used to treat inflammation—ibuprofen. They found that the leaves were equally effective in treating inflammation.
The researchers suggest more work is required to further isolate the chemicals in the leaves that reduce inflammation and to make sure that their use does not result in unintended negative side effects. Of particular interest is determining whether the chemicals in the leaves can be mass produced in a factory, and if so, whether the resulting therapeutic has fewer side effects than ibuprofen.”
In 1974, American Samoa benefited from a comprehensive study of indigenous medicine carried out by the Office of Comprehensive Health Planning, Department of Medical Services, American Samoa Government. The study resulted in a publication by Charles R. McCuddin, Director, Office of Comprehensive Health Planning, entitled, “Samoan Medicinal Plants and Their Usage.” A second edition, revised and updated in 2001, is available from the University of Hawaii as a PDF download. The publication gives some useful insights on medicine and drug therapy among the Samoan Polynesian communities. It gives useful background information on Samoan medicine. We find out that little is known about indigenous Samoan medicine before contact with Europeans. We therefore make references about long-standing practices among Samoans based on observations at first contact and ongoing practices to this day.
 Seeseei Molimau-Samasoni et al, Functional genomics and metabolomics advance the ethnobotany of the Samoan traditional medicine “matalafi”, Proceedings of the National Academy of Sciences (2021). DOI: 10.1073/pnas.2100880118
In our last episode we looked at Drug Use in the Renaissance, which brought us to the cusp of the modern age of medicine. So far, in our podcasts, we have looked at the Far East, the Middle East and Europe. In the next few episodes, we plan to cover Australia and the South Pacific Islands of Samoa, the indigenous peoples of North and South America, and traditional African Medicine. In this episode we look at traditional Australian Aboriginal drug therapy. We give special mention to Marina Kamenev, Dayman Steptoe and Jessie Pasananti of the Australian Geographic for their insightful articles on Aboriginal bush medicines,.
In traditional Aboriginal culture, the concept of healing an individual through the natural environment – using bush medicine – was ultimately entwined with the spiritual world and not just the physical. Most traditional health care practices believe that the mind and body are inseparable and that to prevent ill health there is a need to maintain a balance between the physical and spiritual selves. A healer was not just a ‘bush clinician’, but also an expert medium operating between the sick and the spiritual world. The medical healing process often involved a two-pronged approach whereby both the spiritual and physical components would be treated in harmony.
In Aboriginal culture, nothing was written down; instead, it was passed on through singing and dancing ceremonies, which are becoming increasingly rare. Most Aboriginal medical treatments were derived from food. A big part of maintaining their health was just eating right.
When Aboriginal people did fall sick, they used plants in a variety of ways to quell their ills. Some plants, like goat’s foot, were crushed, heated and applied to the skin. Others were boiled and inhaled, and occasionally drunk. There were also saps which were directly smeared on the skin, and barks that were smoked or burned.
Healing required two types of ‘doctors’: the spiritual doctor and what we might call the ‘medicine man’. Spiritual doctors were considered a supreme authority and oversaw curing the ill partly through correcting spiritual disharmony. Carrying full responsibility of both diagnosis and treatment, the spiritual doctor was the only person who had the ability to determine a cause of death, for example.
In our last episode we looked at Drug Use in the Middle Ages. In this episode we look at Drug use in the Renaissance, the period from the 15th to the 18th centuries.
At this point it is useful to mark an important transition of relevance to this podcast. In the first two episodes we discussed the concept of a “drug” and the challenges posed by using a modern-day medical understanding in the context of historical practice. We therefore adopted a “middle-ground” view that sought to be sensitive to the context in which various substances were used as curative agents in history. Whilst they might now be known to be ineffective, the iterative nature of growth in medical understanding demands an honest mention of such substances so that a fuller appreciation of developments in medicine can be attained. Moreover, we have several examples of substances used as medicines today that do not meet the strict definition of a drug. Some commercial, over-the-counter products and all homeopathic substances fall into this category.
Against this backdrop, a discussion by Winston Black in 2012 provides useful insights into changes in drug therapy in the latter part of the Middle Ages and moving onto the Renaissance. Black observes that the word ‘drug’ was not used until the very end of the Middle Ages to refer to medicine. He also provides the following insight:
Medieval pharmacy until the twelfth century was based on ‘simples’, single ingredients (herbs, spices, stones, animal parts) whose properties could be learned through apprenticeship or, for the literate, from ancient and early medieval herbals, like the seventh-century Alphabet of Galen. Recipes survive which call for multiple ingredients, but most cures were dependent on these simples, usually from local plants, well known and easily obtained.
What was new after ca. 1100 was the notion that a natural substance could be, and in fact should be, identified, collected, studied, modified, measured, and administered by professionals trained in the art of medicine or, later, pharmacy. The ingredients of drugs were still found in nature, like the old materia medica, but patients, physicians, and pharmacists came to expect these natural substances to be unlocked, and their secrets to be compounded, inhaled, applied, or injected for the purposes of healing or intoxication. This change in attitude can be seen in antidotaries, pharmaceutical texts providing recipes for compound medicines like theriac, which became popular after 1100, overshadowing though not replacing simple herbals in the Later Middle Ages. There is some scope for belief that contact with Islamic societies during the crusades (1095 – 1291) was a factor in these developments. And so, as we move from the end of the Medieval Period into the Renaissance, we see the embryonic stages of the development of scientific medical and pharmaceutical practice in the western world.
In our last episode we looked at Drug Use in Hellenistic and Roman Times. In this episode we look at drug use in the Middle Ages. For clarifications purposes, the Medieval period started with the fall of the Roman Empire in 476 AD and lasted until the 15th century.
As we saw in our discussion of drug use in the Roman empire, the influence of Greek medicine, namely the Hippocratic Corpus, lasted well beyond the Greek Empire into the 19th Century. This was predicated on health being determined by the proper balance of four humours: blood, black bile, yellow bile, and phlegm. With the benefit of modern understanding of medicine, this is now known to have been false. However, in medieval times, true progression in scientific inquiry appears to have stalled, and in some cases regressed.
Rachel Hajar, writing in the Journal Heart Views, describes it this way:
““The glory that was Greece and the grandeur that was Rome” ended when Rome fell to Germanic tribes in the 5th century AD. The Ancient Romans, Greeks, and Egyptians had pushed forward medical knowledge, but after the demise of these civilizations, artistic, cultural, and scientific outputs were sadly lacking when compared to both earlier and later times. Medical knowledge stagnated in the Middle Ages and did not develop until the 17th/18th centuries.”
Hajar provides more contextual information that suggests the cause for this stagnation and decline:
“The center of Western learning shifted to Constantinople (now Istanbul), the capital of the Byzantine Empire, which had been Christian since the 4th century AD, with the conversion of the Roman emperor Constantine. The Church quickly gained converts – and power – throughout Western Europe.
The Roman Catholic Church effectively dominated what direction the medical world took. Any view different from the established Roman Catholic view was labelled heresy and punished accordingly. The Roman Catholic Church stated that illnesses were punishments from God and those who were ill were so because they were sinners. No one contradicted such world view; it was accepted. Suffering was seen as part of the human condition. As people became obsessed with their souls, they neglected their bodies; medicine became a matter of faith and prescriptions became prayers. Medicine became steeped in superstition. Ideas about the origin and cure of disease were based on factors such as destiny, sin, and heavenly influences. Therefore, in this period, there was no tradition of scientific medicine, and observations went hand in hand with spiritual and religious influences. Medicine during the Middle Ages was composed of a mixture of existing ideas from antiquity and spiritual influences. Standard medical knowledge was based chiefly upon surviving Greek and Roman texts preserved in monasteries and elsewhere.”
This makes for a sad picture of the state of medical understanding. Some of the views described by Hajar persist to this day. Despite these vies, however, we still find that use of drugs for medicinal and recreational purposes persisted.
In this episode we look at Drug Use in Hellenistic and Roman times. We are specifically interested in Greece after the demise of Alexander the Great in 321 BC, up to the period of Imperial Rome, which ended around 476 AD.
As we discussed in our episode on Drug Use in Ancient Greece, by the time we get to the beginning of the Hellenistic period, the major influences on medical practice are those arising from the Hippocratic school of thought and a move away from superstition to scientific belief. The Hippocratic Corpus introduced the theory of humors, which was to hold sway for several centuries, even after the passing of the Roman Empire.
“After the time of Aristotle, the centre of Greek culture shifted to Alexandria, where a famous medical school was established about 300 BCE. … Alexandria continued as a centre of medical teaching even after the Roman Empire had attained supremacy over the Greek world, and medical knowledge remained predominantly Greek.”
There were challenges to the teachings of the Hippocratic Corpus.
“Asclepiades of Bithynia (born 124 BC),” differed from Hippocrates … and … denied the healing power of nature.” He “insisted that disease should be treated safely, speedily, and agreeably. He opposed the humoral theory and drew upon the atomic theory of 5th-century Greek philosopher Democritus in advocating a doctrine of strictum et laxum — the attribution of disease to the contracted or relaxed condition of the solid particles that he believed make up the body. To restore harmony among the particles and thus effect cures, Asclepiades used typically Greek remedies: massage, poultices, occasional tonics, fresh air, and corrective diet.” In the process he made Greek medicine much more acceptable to Rome.
In this episode we look at Drug Use in Ancient Greece a period stretching from about 800BC to 323BC. We start off with a brief overview of key developments in medicine in this period; before moving to a discussion of drug use in both therapeutic and non-medical settings. This follows our review of drug use in Ancient Egypt. Here are some snippets from the podcast.
In ancient Greek medicine illness was initially regarded as a divine punishment and healing as, quite literally, a gift from the gods. … Ancient Greek physicians regarded disease as being of supernatural origin, brought about from the dissatisfaction of the gods or from demonic possession. The fault of the ailment was placed on the patient and the role of the physician was to conciliate with the gods or exorcise the demon with prayers, spells, and sacrifices.
By the time we get to the 5th century BC, lasting until about 400BC, the most influential medical views derived from the cult of Asclepius, which was a major provider of medical care. At an Asclepion (one of the temples) a patient would be expected to partake in a number of rituals, which, it was believed, would cure the infirm. In brief these rituals consisted of making sacrifices, bathing and sleeping in the courtyard.
.. The humoral theory states that good health comes from a perfect balance of the four humors: blood, phlegm, yellow bile, and black bile. Each of the four humors was linked to an organ, temper, season and element. Consequently, poor health was believed to result from improper balance of the four humors.
… Hippocrates, known as the “Father of Modern Medicine”,established a medical school at Cos and is the most important figure in ancient Greek medicine. Hippocrates and his students documented numerous illnesses in the Hippocratic Corpus, and developed the Hippocratic Oath for physicians, a form of which is still in use today.
… The World History Encyclopaedia indicates that they used wine, opium, and henbane to help with pain and toothache, and they used aloe (originally from Egypt) to cure burns. They used crushed garlic to disinfect cuts, and mint tea to help with stomach aches.
… Greeks used drugs with psychedelic, hypnotic, narcotic, analgesic, suppressive, euphoric and stimulating effects in various ways.
… in Homer’s The Odyssey, .. Helen of Troy dopes wine with a drug “that took away painful memories and the bite of pain and anger. Those who took this drug dissolved in wine could not shed a tear even at the death of a parent. Indeed not even if his brother or son were put to the sword before his eyes”
In this episode we are reviewing drug therapy in ancient Egypt, between 3,300 BC and 525 BC. We draw our information from publications in the Saudi Journal of Biological Sciences, The US National Library of Medicine, The World History Encyclopaedia and other sources.
This follows our discussions on drug use in China, Babylon and Assyria, and Jewish culture as rereleased in the Bible.
Here are some excerpts from the episode:
“The ancient Egyptians practiced medicine with highly professional methods. They had advanced knowledge of anatomy and surgery. Also, they treated a lot of diseases including dental, gynaecological, gastrointestinal, and urinary disorders. They could diagnose diabetes and cancer. The used therapeutics extended from different plants to include several animal products and minerals. Some of these plants are still used in the present day.”
In most cases, doctors prescribed a remedy of different drugs, not a single drug. The routes of drug administration were basically five; oral, rectal, vaginal, topical, and fumigation. Treatments were given in different forms like, pills, cakes, ointments, eye drops, gargles, suppositories, fumigations, and baths.
“…the famous Ebers Papyrus, written around 1550 BC, … was a compilation of 328 different ingredients (most of them are derived from plant species) to make 876 prescriptions for use in helminthiasis, ophthalmology, dermatology, gynecology, obstetrics, dentistry, and surgery.”
Medical practice in ancient Egypt was so advanced that many of their observations, policies, and commonplace procedures would not be surpassed in the west for centuries after the fall of Rome and their practices would inform both Greek and Roman medicine.
The Compelling Story of Drugs and the Bible, from the Perspective of the Authors
In this episode we get an overview the compelling story of drugs and the Bible, from the perspective of the authors. The Bible is a collection of sixty-six books, some, or all of which are regarded as sacred text by followers of Judaism, Christianity, Islam, Rastafarianism, Samaritanism, and other faiths.
Some excerpts from this week’s episode are as follows:
We start off with a continuation of a discussion we began at the end of of our discussion on drugs in Assyria and Babylon. We find the connection between the Bible and Babylon or Assyria in the book of Genesis … in which Abram (later Abraham) is born and comes out of Ur of the Chaldeans. Abraham … lived around the second millennium BC. He is the … forebear of Jews, Muslims and Christians, whether in a physical or spiritual sense.
Chaldea was in the Persian Gulf, around the second millennium BC, that overlapped what was to later become Assyria and Babylon. …
The book of Genesis talks about two plants in the garden of Eden with effects that transcend the standard physiological effects of drugs. These are the tree of life and the tree of knowledge of good and evil. The first of these … possessed remarkable repair and regenerative powers, to the effect that it would make humans live forever. …
The next plants we come across, used as drugs, are mandrakes. We find them in Genesis 30:14-16 and in Song of Solomon 7:13. They were were aphrodisiacs, fertility drugs as well as used for their fragrance in enhancing the mood of intimacy.
… it would be remiss of us to not mention another drug that appears several times in the Bible, right through from Genesis to Revelation. This, you might have guessed, is alcohol. In fact, one can argue that this appears more than any other drug in the Bible.
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