Accuracy of Dioscorides,' De materia medica (First Century C.E.), Regarding Diuretic Activity of Plants.

OBJECTIVES: Assess whether an ancient text on herbal medicine accurately characterizes a class of herbal diuretics. DESIGN: The Greek text of Dioscorides De materia medica was assessed for herbs stated to have diuretic activity, and then modern research was sought to determine how accurate the ancient assessment of these herbs was. RESULTS: Of the 105 plants cited as having diuretic activity by Dioscorides, 56 (53.3%) genuses are confirmed as being diuretic in animal or human research. For another 38 (36.2%) genuses, no research related to diuresis could be identified. Six (5.7%) genuses had mixed results in modern research, whereas a mere 5 (4.8%) genuses were shown to not have diuretic activity. Considering the 67 genuses that were investigated, 56 (83.6%) were confirmed. CONCLUSION: This analysis confirms that Dioscorides was accurate in determining the diuretic nature of herbs, raising the possibility that he was right about other therapeutic suggestions concerning herbs he made. For the remaining herbs that have not been assessed for diuretic effect, it is not yet known if Dioscorides was accurate. Our findings suggest that the 38 herbs Dioscorides categorized as diuretics that have not been studied for diuretic function are candidates for research in this regard.

Diuretic plants in the Bible: ethnobotanical aspects.

Besides its religious importance, the Bible, because of its ancient origin represents a relevant witness of the way of life of the people mentioned in it. The Holy Scripture is also the first text revealing the utility of plants for man, as natural sources of food, wood, fibers, oils and medicinal herbs. In the last 60 years, several distinguished botanists have attempted to identify the scientific names of the plants cited in the Bible. Nonetheless, these scholars have provided different lists of plants appearing in the Bible, none of which could be accepted as indisputable. The authors have combined their expertise to focus on the identification of the diuretic plants, through an historical analysis of the literature on this issue.

Herbal diuretics in medieval Persian and Arabic medicine.

OBJECTIVE: In accord with the notions of humoralism that prevailed in medieval medicine, therapeutic interventions, including diuretics, were used to restore the disturbed balance among the four humors of the human body: blood, phlegm, yellow bile, and black bile. Most diuretics were derived from plants. The primary textual reference on herbal diuretics was Dioscorides's De Materia Medica, which was written during the first century CE. DESIGN: The authors reviewed the medieval medical texts written in Persian and Arabic and compiled a list of 135 herbal diuretics used by the medieval medical authorities for treating various ailments. RESULTS: Between the 8th and 11th centuries CE, Middle Eastern physicians systematically reviewed extant books on medicine and pharmacotherapy and compiled new and expanded lists of herbal medicines, diuretics in particular. Furthermore, they introduced new chemical methods of extraction, distillation, and compounding in the use of herbal medicines. CONCLUSIONS: Several herbal remedies now are considered as potentially safe and affordable alternatives to chemical pharmaceuticals. Thus, research on medieval herbal therapies may prove to be relevant to the practice of current cardiovascular and renal pharmacotherapy. The authors propose that modern research methods can be employed to determine which of these agents actually are effective as diuretics.

The evolution of renin-angiotensin blockade: angiotensin-converting enzyme inhibitors as the starting point.

The renin-angiotensin system has been a target in the treatment of hypertension for close to three decades. Several medication classes that block specific aspects of this system have emerged as useful therapies, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and, most recently, direct renin inhibitors. There has been a natural history to the development of each of these three drug classes, starting with their use as antihypertensive agents; thereafter, in each case they have been employed as end-organ protective agents. To date, there has been scant evidence to favor angiotensin receptor blockers or direct renin inhibitors over angiotensin-converting enzyme inhibitors in treating hypertension or in affording end-organ protection; thus, angiotensin-converting enzyme inhibitors remain the standard of care when renin-angiotensin system blockade is warranted.

Releasing the flood waters: diuril and the reshaping of hypertension.

This article narrates the development and promotion in the 1950s and 1960s of Merck, Sharp & Dohme's Diuril (chlorothiazide), an antihypertensive drug, which played a significant role in the redefinition of high blood pressure as a widespread target for chronic pharmaceutical consumption. The joined careers of Diuril and hypertension in the late twentieth century demonstrate the connections between the clinical research, clinical practice, and marketing practices through which pharmaceuticals and disease categories come to define one another. By examining a series of internal documents preserved in the Merck Archives alongside a careful reading of the clinical literature and industry journals of the time, this article explores how the ambitions of marketers, physicians, and public health advocates found convergence in the expanding pharmaceutical prevention of chronic diseases.

The diuretic use of Scilla from Dioscorides to the end of the 18th century.

Ancient texts contain an extremely large and readily accessible body of information on traditional medicine describing a range of plants and other substances that have been recently investigated systematically. However, prospecting for drugs from herbals raises problems with philology and plant identification. We combined our expertise to re-examine Squill an ancient medicinal plant which deserves modern scientific investigation. For this, invaluable help has come from new computer technologies which allow access to the most important libraries of the History of Medicine.

The toxic torch of the modern Olympic Games.

One of the most enduring symbols of the Olympics is the torch or flame, an icon of peace and sportsmanship that has its roots in Ancient Greece. According to the Creed of the Olympics: "The important thing in the Games is not winning, but taking part. The essential thing is not conquering. but fighting well." The modern Olympic Games (1896-2000) have been heavy laden with controversy, as athletes have abused performance enhancing drugs to thrust themselves into the limelight in search of gold. It was not until 1967 that the International Olympic Medical Commission began banning drugs. Full-scale drug testing was instituted in 1972.: Retrospective review of modern summer and winter Olympics Game sources (1896-2002) was done for documentation of drug abuse, drug-related overdoses, and positive drug screens. Data were collected for the type of drug documented. the athlete's name, their country of origin, and Olympic event. Seventy cases were identified. The most common class of agents were steroids (29), followed by stimulants (22), diuretics (7), beta-2 agonists (2), and beta blockers (1). Alcohol and marijuana, while not historically prohibited, have been outlawed by several individual sport federations. Toxicities of these 2 agents were most likely under-reported. Countries of origin of individual athletes included Bulgaria (7), USA (7), Sweden (4), Spain (4), Japan (2), Poland (2), Greece (2), Canada (2), Hungary (2), Russia (2), Austria (2), and Great Britain, Norway, Romania, Armenian, and Latvian, each with 1. The most common Olympic events in which drug abuse was documented were weightlifting (25), trackand field (12), skiing (5), wrestling (5), volleyball (3), modern pentathlon (3), cycling (2), swimming (2), gymnastics (1), and rowing (1). As athletic pressures and financial gains of the Olympic Games heighten, more toxicities are likely to occur despite attempts at restricting performance-enhancing drugs.

Josephus Andreas Jacobus Plenck - a forerunner of modern diuretic therapy.

Joseph Andreas Jacobus Plenck was born in 1735 in Vienna where he studied surgery with Johan Christian Retter. At age 35 he was appointed Professor of Surgery and Obstetrics by Maria Theresia. Subsequently he became professor and life long secretary of the Medical Military Academy know as the Josephinum where he worked up to 1807. He was one of the most brilliant scientific writers of his time. Here we analyze his medical treatise, Icones Plantarum Medicinalium secundum systema Lynnaei cum enumeratione virium et usus medici, chirurgici et diaetetici, published in folio in Latin and German. This is a therapy based on plants in which the author discusses the medical use of 758 plants. This article is centered on 111 plants with diuretic properties which still appear in many pharmacopoeias.

Herbal diuretics revisited: from "wise women" to William Withering.

This contribution summarizes the use of herbal diuretics over the period of two thousand years. After describing the role of herbs in the framework of the theory of the balance of humors for well-being, it details the contributions of Pliny the Elder (23-79), Dioscorides (40-90), Hildegard von Bingen (1098-1179), Pietro Andrea Matthioli (1500-1577), and Leonard Fuchs (1501-1566) in providing increasingly more precise descriptions and illustrations of medicinal plants. Then, William Withering's (1741-1799) scientific analysis of the use of foxglove for the treatment of dropsy is presented, taking into account the role peasant "wise women" played in his discoveries and the role of "folklore medicine" before him.

A history of edema and its management.

The obvious disfigurement caused by clinically evident edema has been a matter of medical concern for ages. Most of the early writings on the subject (Sumerian, Babylonian, Egyptian, Greek) center on dropsy, its causes and management. While reference to the heart is made in the ancient texts, much of the focus is on the abdominal (ascitic) accumulation of fluid. The role of the heart and "dropsy of the chest" began to be differentiated and attract attention sometime by the end of the seventeenth century, and were well appreciated by the eighteenth century. By the beginning of the nineteenth century the reports of John Blackall and Richard Bright provided new insight by differentiating dropsy into that of cardiac and renal origins. The role of salt, initially measured and thought in terms of its anion chloride, began to be appreciated by the middle to late nineteenth century. Its mobilization, however, remained problematic. The "cure de dechloruration", which gained fame by the end of the nineteenth century, was not always a successful undertaking. The treatment of dropsy, which centered on augmenting secretions (diaphoretics, purgatives) or mechanical removal of body fluids (bleeding, leeching, lancing), remained a frustrating and chancy undertaking for much of the time that medicine has had to deal with it. Although mercury had been advocated as a diuretic in the sixteenth century, even the organic mercurials that were introduced after World War II were limited in their effectiveness. The discovery of sulfanilamide-induced sodium bicarbonate diuresis in the late 1940s was to provide the first step in the new age of clinically effective diuretics, which began in the 1950s with the introduction of chlorothiazide, the first orally effective agent to mobilize sodium chloride. The subsequent introduction of more potent diuretics was made possible by concurrent advances in renal physiology and the understanding of the sodium handling by the kidney.

Joseph Jacob Plenck (1735-1807).

Joseph Jacob Plenck (1735-1807) is considered to be the forerunner of modern European dermatology, who also compiled a list of about 800 plants with medicinal uses. Of these about 115 have diuretic properties and are currently included in various pharmacopeias. They were traditionally used to cure ascites of various causes, in urolithiasis, nephritis, cystitis, bladder ulcers, strangury, urinary retention and incontinence. Few of these plants have been fully investigated by modern medicinal chemists, and many are worthy of further study.