Wednesday, November 20, 2013

The Problem with Origins

I was directed to this "enlightening" image by a Facebook friend.  I don't take umbrage with her sharing it with me.  I believe she only meant to guide me toward the origin of the word Pharmakeia.  However, after looking at the link, I have to take umbrage with the suggestion inherent in the text of the image.

Instead of writing a giant tirade of a comment on Facebook, I thought I would post it here.

The origin of the word pharmakis in Ancient Greek did indeed mean "witch".  This makes sense as much of the origin of pharmacy came from experts in botany and translating that into medicinal uses.  Many early chemists were considered "witches" by the medical establishment at the time, which is funny given that the docs thought disease was caused by unbalanced humours in the body and treated everything under the sun with blood letting.

And yes, they were seen as potions and witchcraft, but only because the science hadn't caught up to their use.  Use of pharmacologic substances was much more advanced in the Arabic world early on than it was in Europe.  It is there that pharmacology as a science originated.  Meanwhile in the "modern" world of Europe, because the drugs they used were not understood, those making them were considered witches, sorcerers, and poisoners.  All drugs are really just poisons brought to a dose tolerable by the human body.  Anyone suggesting that this means pharmacists are poisoning everyone doesn't understand science.

As the science of pharmacy evolved, it always remained connected to medicine.  It is only recently that it evolved into an independent profession, and, in turn, it evolved into a more clinical profession than one focussed solely on drugs.  The word "pharmacy" today means something very different than it did even 25 years ago, let alone in the Middle Ages or Ancient Greece.

If we are going to take the word literally, the original practitioners that were labelled this way practiced something more similar to modern herbalists and "natural" practitioners.  If homeopathy, for example, actually worked, it would only be through witchcraft, given that there is no detectable active compound in homeopathic substances.

As well, the word "physician" comes from "healer", "sage" and even "physicist".  "Doctor" comes from the word meaning "teacher".  That doesn't mean they teach kids in classrooms about how to prove String Theory.

More etymology fun.  "Sycophant" originates from "showing the fig".  Figure that out.  Or "clue".  Originates from "ball of thread".

The point is that the origins of words are meaningless without historical context and evolution.

The poster of the image above sells essential oils for a living.  She actually promotes essential oils for weight loss.  Essential oils have absolutely no scientific evidence whatsoever of effectiveness, no less for weight loss.

I'm not going to comment on her use of Bible quotes to deride and debase modern medical science.  If she wants to believe that using products that have no scientific evidence to support their use means she has "knowledge", she can go on thinking that.

Or MAYBE, just MAYBE, she is making those arguments because, gee, I don't know, she sells essential oils through her website?  And yes, I know I'm a pharmacist, before someone points out the obvious and says I also have a financial interest in promoting drugs as safe.

Too bad I spend more time talking people OUT of taking drugs (which, no matter what way you slice it, "natural" products are also considered; as a dietitian once said "If you get it from food, it is a vitamin.  If you get it in a bottle, it's a drug.").

And that the majority of problems associated with medication use are due to inappropriate use or prescribing.  Roughly 7.5% of hospital admissions in Canada are due to adverse drug reactions.  Roughly 40% of those adverse drug reactions are considered preventable.

But none were likely due to natural products, right?  Wrong.  Natural products cause serious reactions too.  Unless you think that hepatotoxicity leading to market withdrawal is not serious.  Sadly, many of them go unnoticed because, despite appearances, they are poorly regulated and there is very little in the way of formal pharmacovigilance monitoring programs.

If someone wants to go back to the time before modern medicine, they can be my guest.  But I'd rather revel in the advances of modern medicine that have expanded the human lifespan.  It has not been universal by any means, but we are getting somewhere.  Estimates range from roughly half of the 7.5 years gained in life expectancy since 1950 being due to medical care to 25 of the 30 years gained since the early 1900s being due to public health measures (vaccines, improvements in sanitation, etc.).  And yes, some of these things, like pasteurization (this is a really good article; check it out), were discovered by scientists and not necessarily "medical" practitioners, but the scientific method underpins the discovery, as it does medicine, so the argument still stands.

Natural does not mean safe.  Synthetic does not mean dangerous.  I wonder if proponents of this notion would be willing to part with all of the other synthetic products in their lives?  Or if they knew some essential oils were extracted with solvents like methanol and hexane? Or if they knew stevia is manufactured using a chemical extraction process and marketed by such major players as Cargill?

If worshiping modern technology means that I adhere to the scientific method and refuse to condone anything that has yet to be proven effective or has actually been proven completely useless, than a witch I am.  Or warlock I guess.

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