The pharmacology of medieval sedatives: the "Great Rest" of the Antidotarium Nicolai

J Ethnopharmacol. 2014 Aug 8;155(1):443-9. doi: 10.1016/j.jep.2014.05.048. Epub 2014 Jun 4.

Abstract

Ethnopharmacological relevance: Past practices of compound drugs from different plant ingredients enjoyed remarkable longevity over centuries yet are largely dismissed by modern science as subtherapeutic, lethal or fanciful.

Aim of the study: To examine the phytochemical content of a popular medieval opiate drug called the "Great Rest" and gauge the bioavailability and combined effects of its alkaloid compounds (morphine, codeine, hyoscyamine, scopolamine) on the human body according to modern pharmacokinetic and pharmacodynamic parameters established for these compounds.

Calculations and theory: We reviewed the most recent studies on the pharmacodynamics of morphine, codeine, hyoscyamine and scopolamine to ascertain plasma concentrations required for different physiological effects and applied these findings to dosage of the Great Rest.

Results: Given the proportional quantities of the alkaloid rich plants, we calculate the optimal dose of Great Rest to be 3.1±0.1-5.3±0.76 g and reveal that the lethal dose of Great Rest is double the therapeutic concentration where all three alkaloid compounds are biologically active.

Conclusion: This study helps establish the effective dose (ED50), toxic dose (TD50) and lethal dose (LD50) rates for the ingestion of raw opium, henbane and mandrake, and describes their probable combined effects, which may be applied to similar types of pre-modern pharmaceuticals to reveal the empirical logic behind past practices.

Keywords: Alkaloids; Codeine (PubChem CID: 5284371); Dosage; Medieval medicine; Morphine (Pubichem CID: 5288826); Opium; Scopolamine (PubChem CID: 5184); Sedatives; l-hyoscyamine (PubChem CID: 154417).

Publication types

  • Historical Article

MeSH terms

  • Alkaloids / administration & dosage*
  • Alkaloids / history
  • Alkaloids / pharmacology
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / history
  • Analgesics, Opioid / pharmacology
  • Dose-Response Relationship, Drug
  • History, Medieval
  • Humans
  • Hyoscyamus / chemistry
  • Hypnotics and Sedatives / administration & dosage*
  • Hypnotics and Sedatives / history
  • Hypnotics and Sedatives / pharmacology
  • Mandragora / chemistry
  • Opium / administration & dosage
  • Opium / history
  • Opium / pharmacology

Substances

  • Alkaloids
  • Analgesics, Opioid
  • Hypnotics and Sedatives
  • Opium