Fresh From The Pharm Gate
It would be understandable if you thought I could eat and house myself with the eloquence of my prose. It is, after all, chock-a-block full of literary prowess. Or maybe I could grow and sell vegetables, as my lovely friend Borja does at his farm gate in Dural. For a crust, however, I am a nurse.
Often I sit at a computer while people come in to my little office, telling me how they sliced their finger open, or about the voices they are hearing, how they can’t breath, about their crushing chest pain. They might prefer to muse upon the subject of their ongoing haemorrhoids, or how they stuck a boiled lolly up their nose and now they can’t get it out. Then I type equal to or less than 300 characters and give them a category.
Psychotropic, Cardiotonic, Belladonnic
A man came in a few weeks ago after attempting to get ripped/high/experience another level of being. He had eaten a few angel trumpet flowers, Brugmansia spp., washed them down with a few beers, and didn’t feel very well. Being a plant trivia enthusiast, I suggested to a colleague, who was his doctor, to look at his pupils, which were extremely dilated and had taken over most of his iris. His heart was also cracking along at a not-so-healthy 130 beats per minute. The chemical responsible for this can cause tachycardia, hallucinations, a dry mouth and nausea. From it we derive the drug atropine, which, until recently, was used as a last resort effort to bring someone back after a cardiac arrest. It is also used occasionally for people with an acute episode of bradycardia, a condition in which one’s heart rate (in an adult) is less than 60 beats per minute.
Atropine is derived from plants of the nightshade family, including the deadly nightshade (Atropa belladonna), datura and mandrake. Datura is used by Central American shaman to reach other levels of consciousness, or to get ripped. The drug has other uses too, such as in the treatment of some forms of glaucoma, and also in palliative care whereby a dying person can be made more comfortable with the effect atropine has on reducing oral and lung secretions.
Interestingly, a similar drug is used for abdominal cramping, best known by its trade name Buscopan. It was used and traded in its raw plant form by central Australians for a few thousand years before a German pharmaceutical company started ‘pharming’ it from Duboisia hopwoodii, an Australian native of the nightshade family.
Bleeding bloody beasts
In the first half of last century, the ranchers of the northern US and Canada found they had a problem castrating and dehorning their cattle. It wasn’t that their souls were torn between convention and the ethical dilemma they faced in brutalising their animals, rather that the stock were bleeding to death following the otherwise ordinary procedures.
The cows had been feasting on sweet clover silage, sauerkraut for cattle. Unfortunately, the fermentation had been taken over by a fungus that converts a resident organic chemical compound in the clover to a potent anti-coagulant, called coumarin. The death of the cows inspired those that isolated the poison to make it into rat poison with the simple addition of ground glass.
Today we use this chemical compound, in its pharmaceutical form called Warfarin, as a therapeutic anticoagulant. It reduces the risk of stroke in people with certain heart conditions which may precipitate blood clots, it facilitates the body to break down deep vein thromboses, and protects cardiac stents from blocking.
Of course, use of Warfarin isn’t without its problems. I see our anti-coagulated elderly go the way of bloody bovine — a simple fall with a bump to the head can end in a haemorrhage around the brain, causing pressure to build in the skull and ultimately, without intervention, can lead to severe disability or death. You can find the precursor compound of coumarin in many plants, including Cinnamomum cassia (the cinnamon that is sold as chunks of bark as opposed to the curled sticks), and in tonka beans, a Latin American Fabaceae locally called kumaru, where coumarin derives its name.
I see a lot of chronically sick people. I cannot solve their problems, and neither can NSW Health. Neither can money paid to the world’s best surgeons and physicians. But I can almost always relieve their pain. The worst acute pain I have seen experienced by a patient is someone trying to pass a kidney stone. The problem is purely mechanical, the jagged little stone doesn’t fit through the ureter. (Disclaimer: I have not worked in a birthing centre or any antenatal care area, but I hear passing a human through one’s vagina tops renal colic.)
For said renal calculi sufferer, who walks in bent over, pale, nauseated and clutching their lower back, I usually start by putting an anti-inflammatory suppository up their clacker, then go to the cupboard to check out a drug with a story that can be woven through time, from pre-history, to ancient Egypt, to yesterday, when I finished my night shift at 8am. Morphine.
Morphine was first isolated from opium in early 19th century, but opium poppies (Papaver somniferum) were used before recorded history, with evidence of their use in the Neolithic Age. First evidence of cultivation was in Mesopotamia. It is mentioned in Egyptian medical texts from 1550 BC and was widely used in India, Persia, and throughout all of the old world. Three millennia later, the British tea addiction was only satiated by trading it for opium grown in their recently ransacked lands of the subcontinent. The ensuing Opium Wars were essentially a result of Chinese control of drug abuse in conflict with British trade.
Jump forward another 170 years, when I am lifting someone out of a scared Chinese man’s taxi who injected too much heroin and has gotten a little sleepy, then stopped breathing. We don’t give them too much of the antidote naloxone, the drug derived from the same plant and a similar alkaloid to morphine. They’ll wake up angry and scared, and feel robbed of their hit. Thebaine in its unchanged form is probably what the young Dane got an enamel mug full of in Tasmania recently, tragically killing him. But this isn’t even a dot on the effect this drug has in Australia.
Both the usefulness and the repercussions of abuse of the drug are so huge that any explanation will doubtlessly be an understatement. It is part of all our lives. We see people waiting outside the methadone clinic on the main drag of Sydney’s hip inner west suburb of Enmore, having had their dangerous heroin habit switched from aviation fuel to diesel. We take codeine in a whole range of over the counter analgesics; maybe you even need the oxycodone to function in life.
I will ask first generation Australian and botanist William Woolls to conclude for me, from his writing of 1867. (He cannot protest, he is long dead.)
“It is to be regretted that scientific men in this colony have paid so little attention to the subject of Medicinal Botany. Surrounded, as we are, by shrubs and plants possessing medicinal properties, there is a wide field for investigation; and, no doubt, it will be found in time to come, that we have been sending to distant countries for expensive medicines, whilst remedies equally efficacious might be provided close at hand in all their native freshness.”