Evolution of Therapy
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Some Moments in the Evolution of Therapy |
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In the foreground, Galen and Hippocrates debate a therapeutic
dilemma, while in the background apprentices collect ingredient
necessary to ensure the efficacy and the infinitely complex
medication – theriac. |
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Early pharmacotherapeutic remedies, sometimes multiple but often
bizarre, had a rather dubious success when it came to treating
medical diseases. |
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The development of a rational therapeutic strategy depended upon
the identification of active principals in herbal remedies –
belladonna, and mandragora. |
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Cinchona derived from Peruvian bark made its appearance in
European drug markets during the 17th century. Thomas Sydenham
was one of the first to use it as a specific for fevers. |
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The development of Homeopathy during the 19th century by Samuel
Hahnemann achieved widespread popularity. His theory was not
significantly different to that of Paracelsus. |
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Paul Ehrlich deserves the credit for initiating the concept of
the chemical target of pathogenic agents. His concept allowed
for a targeted drug reality to develop. |
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In 1973, a team of scientists led by Sir James Black, produced
the first clinical H2-receptor antagonist, cimetidine, thereby
ushering in the age of acid suppressive medication and therapy. |
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Proton pump inhibitors that irreversibly target the
acid-secreting proton pump in the stomach were developed from
1977-1981, and helped revolutionize acid therapy. |
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Some Moments in the Evolution of Gastro-Esophageal Therapy
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Theodore Billroth and colleagues, Rydygier and Eiselsberg,
attempted to treat acid diseases (e.g. obstructions) by
performing gastro- or esophagectomies (1881). |
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Ismar Boas (top) and Karl Ewald (bottom) were the founders of
modern Gastroenterology. They wrote the first textbooks,
established the first journal and performed gastric function
tests. |
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Bertram Sippy devised a complex dietary regimen of bland food
that included hourly feedings of milk to relieve dyspeptic
symptoms and treat acid-related diseases. |
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Andre Latarjet recognizing the role of vagal nerves in the
regulation of acid secretion sought in 1923 to show that their
resection resulted in a resolution of acid diseases. |
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Rudolf Nissen in 1956 described his operation – a
gastroplication – for the treatment of reflux esophagitis. One
of his patient’s who declined the procedure was Albert Einstein. |
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The evolution of gastro-esophageal therapy has coincided with
that of therapy per se, and has included herbal, medical,
surgical and ultimately pharmacological intervention. |
