A Modern Physicians Oath

The World Medical Association

At the time of my being admitted as a member of my profession, I solemnly pledge myself to consecrate my life to the service of humanity;

I will give to my teachers the respect and gratitude which is their due; I will practise my profession with conscience and dignity;

The health of those in my care will be my first consideration; I will respect the secrets that are confided in me, even after a patient has died;

I will maintain by all the means in my power the honour and the noble traditions of my profession; My colleagues are my sisters and brothers;

I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation or social standing to intervene between my duty and my patient;

I will maintain the utmost respect for human life from its beginnings, even under threat, and I will not use my specialist knowledge contrary to the laws of humanity;

I make these promises solemnly, freely and upon my honour.

This oath was adopted in Geneva in 1948, and amended in Sydney in 1968 and in Liverpool in 1995.  Please note:  Contrary to popular belief, the majority of new physicians do not take any oath upon receiving their diplomas or certifications.

The Ancient World

Drugs and medicines have always been with us.  Where there were plants with psychoactive properties, there were people willing to use them, for pleasure or relief, or to kill.

Recorded history is filled with descriptions of potent psychopharmaceuticals, but some have been outstanding.  Alcohol has been nearly universal in use, and was already presenting itself as a problem among ancient Greeks and Romans.  There are records of cannabis use in the ancient Middle East.  Opium was known to the ancients, but seems to have been restricted to medicinal use.  Hemlock was certainly known -- Socrates met his death with a cup of hemlock.

More exotic substances were also available.  An extract of the nightshade or belladonna plant called atropine was used everywhere from Rome to India as a poison -- and as a cosmetic device:  women sometimes put a drop of weak solution in their eyes to dilate their pupils!  It is still used for the same reason today by eye doctors.

Another favorite was the extract of the foxglove plant, called digitalis.  A powerful poison, it was also used to treat various ailments.

And mushrooms provided many of our ancestors with interesting hallucinogenic experiences (and serious illnesses!).  Some believe that the holy drink of the ancient Aryans mentioned in the Vedas -- soma -- was a concoction involving mushrooms.

The Middle Ages

Alcohol continued to be used with great gusto during the Middle Ages in Europe.  Around 1250, Europeans developed the process of distillation and added brandy and other liquors to the already popular wine and beer.  The generic term for these distilled products was "the water of life" -- aqua vitae.

Early in the Middle Ages, Arab traders and warriors introduced the use of the opium poppy to India and China.  In China, it was used primarily as a medicine.  But in India, it became a widespread habit of the rich, and soldiers used it to bolster their fighting spirit.  At this time, opium was ingested primarily as a drink; sometimes it was eaten.

The Age of Exploration

By the sixteenth century, alcohol had developed into a serious social problem.  Worthies from Martin Luther to King James I of England condemned drunkenness.  And yet society at large continued to see alcohol as a gift from God.  Attempts to control its use invariably failed, and authorities were limited to regulating and taxing its sale.

Around 1650, a new leap was taken by the Dutch in the form of inexpensive distilled grain flavored with the berries of the juniper bush:  genever or, in English, gin.  It was an immediate success in England as well.

But new forms of psychoactive substances were pouring in from all over the world.  Coffee, for example, was introduced into Europe from Arabia, where they had invented coffee roasting centuries before.  Although Moslem religious figures condemned it, it was so popular among Moslems as a substitute for alcohol that it was dubbed "the wine of the Arabs."

Coffee was considered by Europeans and Arabs alike as healthful and therapeutic.  It also wound up being the focal point of a new social institution, the coffee house or café.  It was particularly praised as the long-sought substitute for the evils of alcohol.

In the latter part of this era, the East India Company and other trading companies began importing tea from China and India.  It, too, was praised as a medicinal drink, but would not compete with coffee for some time to come.

One of the first things that Columbus and his emulators discovered, after they discovered America itself, was tobacco.  The first seeds were brought to Europe by a French adventurer named André Thevet.  It was deemed a potent medicine, good for a great number of ailments, especially those involving the lungs, by Jean Nicot of France -- from whose name we get nicotine.

Tobacco seeds came to England ten years later, and spread throughout the upper classes through the salesmanship of a certain Sir Walter Raleigh.  It was praised as a panacea, and became a major crop for settlers in Virginia and other New World locales.  In an effort to control its use, it was heavily taxed.

Smoking also spread throughout Asia, from Turkey to China.  The response was far more negative than in Europe:  Selling tobacco was punishable by decapitation in China, for example, and carried the death penalty in the Ottoman Empire.  In Russia, one could be tortured and exiled for using it.  And the pope made excommunication the punishment for clergy who took up the habit.

None of this, of course, actually did any good.

Another major drug to enter the Western arena in this period is coca. Coca leaves had been chewed for ages in South America, especially among the Incas.  After Pizarro destroyed the Inca Empire in 1553, a Spanish adventurer named Monardes brought the plant to Europe, but it failed to catch on -- at this point!

The 1800s

In 1859, Dr. Pablo Mantegazzo isolated cocaine from the coca leaf, and wrote about its wonderful powers to combat fatigue, depression, and impotence.  A few decades later, a Viennese physician by the name of Sigmund Freud sang its praises as an anesthetic and a restorative.  With these and many other supporters, cocaine became quite popular.  It even became a part of the formula for a popular tonic in the US known as Coca-Cola.  Until 1903, "coke" contained 60 milligrams of cocaine per 8 ounce serving!  After causing a number of deaths by overdose, it was outlawed in 1914.

A more serious issue in the 1800s was opium.  In 1820, the Chinese, in an effort to stop the spread of opium addiction, prohibited the importation of opium.  The British -- who seem to play the part of the culprit in many of these situations -- actually declared war on China in order to protect their precious opium trade.  They ended up with their market intact and a piece of China called Hong Kong.

The use of opium was recommended by the medical profession in Europe and America, and few challenged them.  The problem was exacerbated by a number of novelties: Friedrick Serturner’s discovery of morphine, an opium derivative, in 1803;  the practice of smoking opium rather than drinking or eating it; and by the invention of the hypodermic in 1853.

Opium and its derivatives began to receive some well-deserved negative attention when the British author De Quincey wrote his best selling Confessions of an English Opium Eater in 1822.  By this time, opium was available in the form of hundreds of different non-prescription medicines, and was quite popular among both upper and working classes.

In 1874, heroin was synthesized from opium, and was touted as a less dangerous form than opium or morphine.  The name, in fact, refers to its supposed potential as the hero of medicines.  In 1896, the Bayer company began marketing heroin.

Several other drugs became available to the European and American public in the 1800s.  For one, laborers from India brought cannabis to Jamaica in the form of ganja.  The Indian Hemp Drugs Commission put its stamp of approval on cannabis, saying its use is accompanied by practically no negative consequences, and the drug spread among the Jamaican lower class.  It was available in the US and Europe, but it would not become popular until the next century.

Amphetamines, the first major synthetic drug, was discovered in 1887.  Its use as a stimulant quickly became widespread.  It was used in World War II to help energize soldiers and industrial workers alike.

Earlier in the 1700s, ether was discovered.  When its effectiveness as an anesthetic became known in the 1840s, inhaling it or mixing a few drops in water became popular among upper class youth in the US and Europe.  It would later spread to the poor of Ireland and other countries as a cheap alternative to alcohol.

And last, but not least, Claude Bernard began in 1856 to experiment with a poison from the Amazon jungles of South America called curare.

Psychedelic drugs

Psychedelic drugs  or hallucinogens have been with us since ancient times, as mentioned above.  But it wasn't until the 1900's -- especially the 1960's -- that they became as popular as they have.  Here is a partial list:

Scopolamine, an anticholinergic drug, is found in Atropa belladonna (belladonna or deadly nightshade), Datura stramonium (jimsonweed), and Mandragora officinarum (mandrake).

A large number of modern drugs have catecholamine-like effects.  The oldest is peyote (from the Lophophora williamsii plant), used by Mexican Indians.  Mescaline is derived from peyote.  There are two drugs, myristin and elemicin, which are found in nutmeg and mace.  And there are the methamphetamines with their endless initials (DOM, MDA, DMA TMA, MDE, and MDMA -- the last best known as ecstasy).

Arguably the most famous hallucinogens are the serotonin-like drugs.  Some have ancient roots:  Psilocybin and psilocin are derived from the mushroom Psilocybe mexicana;  Ololiuqui was used by Central and South American Indians, and is better known as morning glory seeds;  Harmine comes from the Middle Eastern plant called Peganum harmala;  And bufotenine comes from the skin secretions of the South American bufo toad!

In 1938, however, all these begin to pale in comparison with the discovery by one Albert Hofman, a Swiss chemist, of a derivative of ergot (a rye fungus), which he called lysergic acid diethylamide -- LSD.

And finally, we have the very dangerous psychedelic anesthetic drugs such as phencyclidine, discovered in 1956, and better known as PCP or angeldust.

© Copyright 2001, C. George Boeree

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