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A VIEW OF THE DEVELOPMENT OF SOME ANAESTHESIC AND ANAELGESĐC
DRUGS IN THE WESTERN WORLD AND IN TURKEY AND SOME ORIGINAL
DOCUMENTS
P o .D .Öz an Öncel(x) P o .D .Ayşegül Demi han E demi (xx)
x) Đs anbul Uni e si y ,Đs anbul Facul y o Medicine , Depa men o Deon ology
,Đs anbul- Tu key
e-mail:oz anusmanb[email p o ec ed]
xx) Uludag Uni e si y ,Facul y o ,Medicine ,Depa men o Deon ology , Bu sa-Tu key
e-mail:[email p o ec ed]
Summa y
Reason o his pape is o s udy his o ical de elopmen o some anes hesic and
anaelgesic d ugs in he Wes e n Wo ld and in Tu key. Mo eo e , ano he aim is o commen
on some his o ical documen s in he O oman A chi es and so , some o iginal esul s a e
ob ained. As a me hod , his o ical de elopmen s o hese d ugs a e gi en as ch onogical and
O oman A chi es a e commen ed.
Anaes hesia is one o he mos impo an b anches o medicine and also su ge y. Seda ion,
analgesia and anaes hesia ha e become one o he mos impo an opics o medicine since
ancien ages..
In he Ancien Times , henbane ( Hyoscyamus nige L ) , mand ake , opium and hellebo e
we e used as analgesic and anes he ic d ugs . Fo example , in he Indian pe iod , Cannabis
Indica was also used o ha pu pose.
In he Middle Ages , “ sopo i ic sponge” was used wi h he aim o analgesia o
anaes hesia. These sponges con ained opium, mand ake , hemlock, henbane e c.
In Tu key,in he Seljukian and he O oman Pe iods, anelgesic and anes hesic d ugs we e
also used o some aims . Some O oman A chi es’ Documen s gi e some o iginal
knowledge on his opic.
In his pape , he de elopmen o hese d ugs a e poin ed ou om he poin o he his o y
o Wes e n medicine and Tu kish Medicine and some o iginal esul s a e ob ained.
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These kinds o d ugs ha e been used as analgesic and anes ehesic since ancien ages.
Ancien Mesopo amian clay able s con ain some p esc ip ions.Fo example , henbane seeds
we e mixed wi h gum and his mix u e was applied o he oo h ca i y o oo hache.This was
an analgesic p esc ip ion and i p o ides anes hesic e ec .We suppose ha his applica ion
was known as he ea lies eco d o anes hesia in he his o y o medicine.We know ha
henbane con ains hyoscyamine and scopolamine alcaloides.Hyoscyamine has an icoline gic
e ec and i dec eases sali a and phlegm.Scopolamine shows seda i e e ec s and oday ,i is
used o p emedica ion.Mo eo e ,mand ake,henbane and opium we e p esen in
Mesopo amian codex.These d ugs a e analgesic.
In ancien Egyp , su gical papy us con ained 40 su gical diseases and hei
he apies.This papy us was disco e edby Edwin Smi h in Teb in 1862. I belongs o 2000
B.C.Ancien Egyp ian physicians ga e a sy up wi h opium o he pa ien be o e
ope a ion.Mo eo e , medical papy us (Ebe s Papy us) who was disco e ed by D .Geo ge
Ebe s in Teb in 1862 belongs o 1550 B.C. and con ained 700 d ugs.Opium and henbane
we e eco ded as analgesic d ugs in his papy us. Fu he mo e, in he ancien Egyp ,analgesic
e ec o mand ake was known.
In he ancien India , henbane ,opium e c we e used o analgesic e ec . Acco ding o an
ancien manusc ip , Sus u a(622-542 B.C) , henbane was used o analgesic
e ec .Mo eo e , hashish was also used o he same e ec .
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In he ancien China,a p esc ip ion wi h mand ake was adminis e ed o he pa ien in
o de o elie e pain be o e ope a ion. Mo eo e ,Chinese su geons used opium ,hashish ıo
analgesic e ec . Opium was also used be o e ope a ion in ancien Is ael and I an.
In ancien G eece , bo h henbane and opium was also used as analgesic . Hippoc a es
used henbane ,opium and alchohol in o de o elie e ope a ion pain in his ope a ions wi h
ega d o disloca ion , ac u es ,hemo hoides and epana ion e c.
In ancien Rome, ,some su gical ope a ions we e applied .Some o hem we e ope a ions
wi h ega d o spea wounds and o hopaedic ope a ions.Pedanius Diosco ides (Fi s cen u y
A.D) used mand ake o su gical applica ions.2 pa s mand ake and 2 pa s opium we e boiled
wi h wine and his mix u e was adminis e ed o pa ien be o e ope a ion.Diosco ides
men ioned ano he p esc ip ion wi h mand ake in his book wi h he name o Ma e ia Medica
Acco ding o his au ho ,mand ake was used o ec al anes hesia:Wine , quinquina ba k and
mand ake a e mixed and his mix u e is used in he o m o supposi o y .We know ha
mand ake (Mand ago a o icina um L) con ains hyoscyamine and scopolamine and hese
ma e s a e an ispasmodic ,analgesic and a odisiac . Mo eo e , Aulus Co nelius Celsus
who was a ba be su geon(3-64 A.D) men ioned henbane and opium as analgesic d ugs in his
book wi h he name o De e Medicina. Pline l’Ancien o Rome (23-79 A.D) used he
mix u e o wine and mand ake as anes he ic.He men ioned ha cau e iza ion and some
su gical ope a ions we e applied wi h his mix u e. Mo eo e , Galen who was a amous
physician p epa ed opium in he o m o supposi o y and used i as a hypno ic ma e .
Analgesic d ugs we e also used in Eu ope in he Middle Ages. Bambe g
An ido a ium which was a manusc ip o he IX h cen u y con ained sopo i ic sponge
p esc ip ion.This sponge was massed wi h he juice o some plan s and hen i was applied o
he nos ils o he pa ien and a kind o inhala ion anes hesia was p o ided.A p esc ip ion o
sopo i ic sponge is as ollows: 1 ½ ounces(ounce is equal o 28.3 g ammes) opium , 8 ounces
mand ake lea es’ juice ,3 ounces henbane juice a e mixed wi h su icien wa e .A clean
sponge is soaked wi h his mix u e and is d ied.When i is necessa y , his sponge is soaked
wi h cool wa e and is applied on he nos il o he pa ien and so, he pa ien goes o sleep.
A e ope a ion , he pa ien is woken up wi h clean sponge wi h inega .
Acco ding o Hen y Sige is , ano he sopo i ic sponge was p epa ed om henbane,
mand ake and le uce lea es.This p esc ip ion was p esen in Manusc ip Mon pellie H 185
belonging o he 11 h cen u y.We suppose ha i was used o anes hesia. Mo eo e , A nold
o Villano a om Mon pellie Medical School w o e a manusc ip B e ia ium P ac icae a
he beginning o he 14 h cen u y. Acco ding o his book ,opium ,mand ake ba k and
henbane we e used o sopo i ic sponge .Lan anchi o Pa is ( he X111 –XIV h cen u ies)
men ioned ha opium was applied on he wounds and so,local anes hesia was p o ided in
Cy u gia Pa a and Cy u ugia Manga, his manusc ip s.
Mo eo e ,Guy de Chauliac (1300-1368) also used sopo i ic sponge in he
ampu a ions.,He also men ioned he side e ec s o opium .Opium caused asphxia , conges ion
and dea h.
Acco ding o John A de ne , a amous English su geon , he pa ien ’s hands and head
we e washed wi h mand ake juice o opium powde was applied on his(he ) head.So,when he
pa ien slep , he ope a ed him(he ).
In he pe iod o Renaissance , sopo i ic sponge we e also used .Fo example, acco ding
o An ido a ium o Nicolaus Sale ni anus , a sopo i ic sponge wi h poppy , henbane and
inega , u nip and pig bile was used.Mo eo e ,Hie onymus B unschwig also used
sopo i ic sponge.
Bu , all he sopo i ic sponges had some ha m ul e ec s .Because hey couldn’
p epa ed in he he apeu ical doses.
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As o Islamic wo ld in 9 h cen u y, opium-addic ion was no e y much and opium
was used in he ea men . Ibn Māsawayh (777-857), one o amous au ho s o ha cen u y,
used opium in he cu e o bilia y pains. The same au ho ga e his d ug o pa ien s as an
analgesic ma e in head-aches, oo h-aches, eye-aches, dysen e y. Abū’l-Hasan al-Tabā i
(9 h cen u y), one o he i s Islamic au ho s mixed opium wi h some oils and used his
mix u e in co yza and mig aine. Thus, he same au ho ga e opium in he o m o able in he
ea men o cough. Al-Tabā i no i ied ha opium wi h gum should be used as a na co ic
ma e . In addi ion, opium was an impo an agen o he iac and some o he an ido es.
Hama neh w o e ha al-Tabā i men ioned ha opium was used in poisonings in Pe sian
palaces.
Besides, Cabi (Gebe ) and some o he chemis s in es iga ed poisoning cha ac e is ics
o opium and no i ied ha opium should be ca e ully used. Sahl ben Sabou , ano he
in es iga o , adminis e ed opium o pa ien s in he o ms o elec ua y, pas ille, la emen ,
powde , and decoc ion and w o e a codex. This in es iga o ea ed co yza, cough, head-ache
and gou wi h opium. Sahl ben Sabou men ioned ha opium was an an ido ic ma e .
Abū Bak al-Rāzī (854-932) men ioned he apeu ic cha ac e is ics o opium.
Acco ding o him, a man who swallows 2 d achms opium shows he poisoning-symp oms and
ho d ill, he decoc ion o adish, sal and honey wi h wa e should be adminis e ed o he
pa ien o ea men . This au ho also used poppy in he cu es o head-aches, melancholy,
s omach and kidney diso de s.
Ibn Sīnā (980-1037) who domina ed on medicine o ha pe iod because o Canon
(Al-Qānūn), his amous book, men ioned opium in ha book and used i in a ious diseases.
He d opped he solu ion o poppy in eye o eye-co yza. He mixed opium wi h he oil o bea
and yolk and ubbed his medicine in he eye. Besides, he used opium as a d ug in eye-cance .
Mo eo e , his amous au ho made use o opium in ea -aches: “Some opium is mixed
wi h woman milk and is d opped in he ea . Some opium is pounded and mixed wi h wine in
he o m o able which is adminis e ed o he pa ien o he ea men o ea -aches. 20
almonds, 1.5 d achms opium, 6 d achms sa on a e pounded wi h inega ; he mix u e is
d ied and hen soaked wi h ose-oil o be gi en o he pa ien by d ops.
Mo eo e acco ding o Ibn Sina:’’ Some opium is mixed wi h mo he -milk and i is d opped
in ea s. In addi ion, some opium is pounded and i is mixed wi h wine and his medicine is
adminis e ed o pa ien in he ea men o ea ache in he o m o able .’’ Aco ding o Ibn
Sina, analgesic d ugs also ha e anes esic e ec and so, hey anes he ize he o gan wi h pain.
Mo eo e ,a amous Tu kish-Islamic physician ,Ebu Reyhan Bi uni( 973-1051)
men ioned seda i e and analgesic e ec s o henbane in his book wi h he name o Ki ab al-
Saydala.
Opium was also used in Islamic wo ld in 12 h cen u y. Thus Ibn Māsawayh
Yūhannā men ioned opia es in his book, called De Medicinis Uni e salibus e
Pa icila ibus.
Ibn an-Na is (1210-1288) w o e na co ic cha ac e is ics o opium and sugges ed ha
he head o poppy should be mixed wi h honey and suga and his mix u e should be
adminis e ed o child en as a hypno ic agen .
As o Andalusia-Spain, a la ge numbe o physicians used opium. Abū’l Qāsim
Hala Ibn al-Zah āwī, who was he a he o mode n su ge y, applied opium as an anes he ic
agen . A e wa ds, Ibn al-Bay ā (1197-1248), one o Andalusia’s physicians and
pha macis -bo anis s, men ioned opium in de ail in his book, Ki āb al-Cāmi al-Mü eda al-
Ed iye el-agdiye: “I opium in he size o len il is adminis e ed o he pa ien , i cu es
cough. I his d ug is mixed wi h ose-oil and is applied on head, i ea s head-aches. Some
opium is mixed wi h almod-oil, sa on, my h and his mix u e is d opped in ea s in ea -
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aches. Some opium is mixed wi h sa on and his mix u e is adminis e ed o a pa ien o
gou ”. So, we know ha opium and poppy we e used in a ious ea men s and in a ious
Galenical o ms in e e y pe iod o Islamic ci iliza ion and hey had hypno ic and analgesic
cha ac e is ics.
In he Seljukian pe iod .Tu kish physicians used sopo i ic sponges.A ha ime ,su geon
Hugo Von Lucca Bo gogni o Bologne (?-1252) lea ned o p epa e sopo i ic sponge om
Seljukian physicians du ing C usade s.He lea n anes he ic me hods in he ope a ions o
Seljukian su geons in he hospi als o Moslem A mies. When he e u ned o I aly , made
ope a ions by using sopo o ic sponges. Theodo ich Von Bo gognoni , Hugo’s son also
applied hese me hods. We can gi e an example om hese p esc ip ions:’’ Opium,hellebo e,
henbane,mand ake ,le uce e c a e mixed in he mo a and sponge is added o his mix u e
and is boiled.This boiled sponge is applied o he pa ien ’s nose and he pa ien sleeps.When
he ope a ion inishes , he sponge wi h inega is applied o he pa ien ’s nose o his
awakening.
We do no know he exac ime when poppy cul i a ion s a ed in Ana olia. Acco ding
o pic u es on some s ones which ha e been ob ained du ing a chaeological exca a ions, i is
obable ha he cul i a ion o poppy began in Ana olia in he pe iod o Hi i es.
We know ha some da a abou opium a e ound in some pha macological manusc ip s
belonging o he 14 h cen u y. Ishaq bin Mu ād says in his Mun ehāb-i Shi ā, a Tu kish
medical book: “Opium gi es sleep, has analgesic e ec , heals dia hoea and p ocedu es a
sicca i e e ec on he h oa ”.
Ano he amous Tu kish physician-pha macis Haci Pasha (1335-1424) says on
opium in his Teshil-i De ā: “Opium has cold cha ac e is ics, i is a we d ug in he ou h
deg ee. I cu es pains”. So, his physician explained he analgesic cha ac e o his d ug.
Abou he wine o poppy he says: “The seed o poppy should be boiled wi h i s pa k”. The
wine o poppy called Ti yāq-i E baa which con ained opium was used especially o he
ea men o sleeplessness.Hacı Pasha w o e abou his opic : “This he iac cu es pains o
li e and spleen and all o he pains”.
Nidai, a amous physician o 15 h cen u y, speci ies opium as analgesic and as ingen
d ug. He says: “Some opium is p epa ed in he o m o pill and i is applied on head”. Fo
example , he also used hellebo e o acne he apy:’’ Hellebo e ,amylum and gum a abic a e
mixed and his mix u e is p epa ed in he o m o a pill and hese pills a e adminis e ed o
pa ien wi h acne’’
Ano he Tu kish physician Salih bin Nas ullah w o e an impo an medical manusc ip
wi h he name o Gaye al Beyan i Tedbi -i Beden al-Đnsan in 1665.This manusc ip
con ained some d ugs.Fo example opium was also used as a medicine in he se en een h
cen u y. Acco ding o Salih E endi:’’ Opium cu es cough ,pains,dia hoea.I opium is mixed
wi h ose oil and applied on head,i heals head-aches.’’
Mo eo e ,opium had a g ea impo ance, om he s and-poin o bo h in e nal and
ex e nal ade, in 19 h cen u y. I is w i en in a documen , da ed 1807, ha he income o
elec ua y-house had dec eased and a minis e o s a e mus be appoin ed o his kind o ade
as he p ices o opium we e e y high and he elec ua y o opium was no sen o he coas s o
Black Sea and Medi e anean Sea which we e closed due o wa s. So he adminis a ion o
elec ua y-house could no ob ain income and could no pay o he deb i owed o he s a e.
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