بسم الله الرحمن الرحيم

1. بسم الله الرحمن الرحيم

2. Infectious Diseases andTraditional Medicine MajidAvijgan MD. Professor of Infectious Diseases Ashraf Sadat Sahafi Isfahan University of Medical Sciences Aban 1392, November2013

3. Infectious Diseases/Antibiotics andTraditional Medicine!!! • Western Medicine (Infectious Diseases): • Newest findings of Medical sciences • Traditional Medicine: • Oldest findings or data of Medical Sciences

4. Infectious Diseases andTraditional Medicine!!! • П------------------------------------------П • Western Medicine (Infectious Dis.)------------------------------------------------------------Traditional Med. • ↓ • -----------------П--------------------П------------ • -Western Medicine (Infectious Dis.) -----Traditional Med. ------- • ↓ • -------------------ПП----------------------- • ------Infectious Dis./Traditional Med. -------

5. Traditional Medicine is full of superstition • Traditional Medicine is mixed and contaminated with superstition

6. Is this necessary to revive Traditional Medicine?!

8. History: Natural substances • Aarchaeologists excavated evidence of human remains in northern Iraq (Emperor of Persia) that were buried along with a variety of herbs, a number of which have now found to be antibacterial that were used by the prehistoric people of the region to eliminate bacteria or thwart their multiplication.

9. History: Natural substances • It is believed that the Egyptians were the first to make prescriptions for curing infections sometime around 1550 BC. • Blend of lard, honey and lint and was used in the form of a lotion for dressing wounds.

10. History: Natural substances • We are aware that honey possesses • 1-antibacterial properties, as it kills bacterial cells by means of extracting water from them. Moreover, honey encloses an enzyme called inhibine that transforms Glucoseand Oxygen into hydrogen peroxide - a widely accepted antiseptic. In current times, wounds have been found to be very resistant to healing by antibiotic medicaments. • 2-However, honey has the aptitude to heal them quite easily. In addition, honey is also known to be a wonderful natural medication for curing infected varicose ulcers.

11. History : Biosafe-bacteria • Several other experiments dealing with anthrax and cholera also corroborated these findings and established that harmless bacteria have the attitude to slow down the disease-causing or pathogenic bacteria.

12. History of dye • In 1910, scientists found a more potential agent known as salvarsan, which was basically a dye, demonstrating to be very effectual in treating the sexually transmitted disease syphilis. • Nevertheless, toxicity of the substance in humans proved to be the main obstacle in developing salvarsan as well as its extensive use.

13. History of antibiotic • While trying to develop the bacteria Staphylococcus spp. on an agar plate (a saucer used for preparing bacterial cultures) in 1928, Dr. Fleming detected that the development of this bacterium was slowed down by a mold which had contaminated the plate by accident. He immediately made up his mind to identify the mold that was ultimately known as Penicillium notatum.

14. History of antibiotic • Incidentally, it took another few years for two talented researchers, Dr. Florey and Dr. Chain, who were working at Oxford University in the late 1930s and early part of 1940s, to appreciate the significance of the findings of Dr. Fleming’s research. In fact, the pioneering work of these two researchers helped to bring penicillin into clinical use. Dr. Flory was an Australian physician who had been to Oxford on a scholarship to study pathology. On the other hand, Dr. Chain was a chemist from Germany who had escaped from the Nazis in the 1930s and went to England for rest.

15. History: Resistance • Before 1955, the sale of penicillin was not restricted and, hence, anyone and everyone were able to purchase it without a prescription. However, the overuse and unrestricted use of penicillin resulted in increasing resistant of bacteria.

16. HISTORY (Resistance) • In the meantime, in 1935, a German researcher demonstrated that a dye known as Prontosil Red was effective in treating mice infected with Streptococcus supp. - the bacteria responsible for Strep Throat. • In fact, the dye Prontosil Red was the predecessor of a group of drugs similar to Antibiotics and known as sulphonamidesor sulfa drugs. Even to this day, these drugs are in use. • For instance, Septra, which contains sulfamethoxazole, is given to patients suffering from infections of the respiratory as well as the Urinary Tract.

17. History : Complication • Merck and Company helped Waksman with funds in 1939 to begin an exploration for antibiotics with a view to offer optimism to patients suffering from tuberculosis (TB). Even to this day, the antibiotic is used to treat tuberculosis. • Soon after streptomycin was clinically used in tuberculosis patients, it was found that the use of the drug resulted in side effects that were absent in the case of using penicillin, counting kidney damage as well as deafness.

18. History • Nevertheless, the major problem faced by patients in using streptomycin, and what actually limited efficiency, was resistance. In fact, the pace at which bacteria were capable of developing resistance to this drug surprised Waksman and his colleagues. Owing to this factor, they were encouraged to undertake research to find other antibiotics. This search actually led to the development of neomycin - a medicament generally used in a number of antibacterial ointments these days.

19. History • In effect, the antibiotic medicament chloramphenicol was isolated for the first time from a soil sample in a place in Caracas, Venezuela. This discovery is significant in two ways. Firstly, it helped in detecting a new antibiotic substance and second, according to the findings of the clinical trial, chloramphenicol has the potential to treat diseases that were incurable earlier - for instance, typhus. Much later, this antibiotic medicament demonstrated outstanding results in treating typhoid fever, typhus, Meningitis and Brucellosis, undulant fever .

20. History (Complication) • Blood Disorders, such as anemia and even leukemia . • The use of the antibiotic drug chloramphenicol is presently restricted in the developed nations, as more expensive, but less harmful medications are available in these places. • However, in developing nations this antibiotic is still in use since its production does not entail great expenses. • However, this antibiotic medicament may also be used for treating other infections. In fact, it is possible that you have used this drug either in your ear drops or eye drops.

21. History • Benjamin M. Duggar was successful in isolating chlortetracycline from a mud sample obtained from a river in Missouri. While chlortetracycline was the first ever tetracycline, the discovery of Duggar has resulted in the isolation and then the development of numerous very potent antibiotics. Currently, these antibiotic drugs are only second to penicillin in terms of worldwide sales.

22. History (complication) • Tetracyclines results in the formation of calcium complexes in developing bone, which may cause : • permanent discoloration • teeth and, • lessen the growth of bone. • to slow down the growth of kids.

23. History: Start of Domino • In 1948, Brotzu made the findings of this clinical trials public and his work drew the attention of the research group formed by Dr. Florey in Oxford University. After obtaining the samples of the fungus, members of the Oxford University research group could isolate as well as purify a number of antibiotics similar to penicillin, which were known as cephalosporins. • particularly in cases where resistance to penicillin was a major worry. • in allergic reactions in approximately five per cent of patients.

24. Turning Points (New Generation) • Additional research undertaken in the 1960s led to the development of the second generation antibiotic drugs. These second generation antibiotics included methicillin, a partially synthetic derivative of penicillin produced to especially beat the problems of penicillin resistance. In effect, scientists hailed methicillin as a vital advancement in the fight against bacterial resistance to penicillin. Scientists were now of the view that they would be able to win the battle against bacterial infections. However, unfortunately, they were proved wrong and bacteria had the final word and today we have bacteria that are also resistant to the second generation antibiotic methicillin.

25. Antibiotics and infectious diseases:Super bugs • of antibiotic drugs is one of the major breakthroughs in modern medicine. It enables doctors to effectively treat many different types of infections. Unfortunately, decades of abuse and misuse have led to growing problems of bacterial mutation and resistance. Many of these "super bugs" can only be treated with the newest and most potent antibiotic drugs. Unfortunately, many of them have potent side effects as well. The key points are to select the correct antibiotic drug with least potential side effects and make sure the patient finishes the entire course of therapy. • http://acupuncturetoday.com/mpacms/at/article.php?id=31958

26. Antibiotics versus herbs:Super Super Bugs • Traditional medicine may be especially advantageous with modern complicated conditions where "bugs," "super-bugs," and "super-super-bugs" come in so many different forms that a single antibiotic fails to deal with them. The proper use of herbal formulas can not only inhibit bacterial, viral and fungal infections, but also minimize the need for antibiotics with their adverse side effects. • TB and MRSA……. • http://www.tcmpage.com/hpinfections.html

27. History of supports • In addition, it also throws light on why majority of the medical researches are sponsored by the pharmaceuticalfirms and the reason behind medical students being taught pharmacology or the use of medicaments as the key ways of treating patients.

28. Domino of Antibiotics • since the discovery of penicillin in 1928, infections still plague us. Many bacteria develop resistance to the antibiotics that once killed them. While antibiotics can be lifesaving when used appropriately, overuse and inappropriate use of antibiotics can cause widespread health problems. • Then consider the resistant's bacteria and overwhelmed Immune system • http://www.tcmpage.com/hpinfections.html

29. Domino

32. History of drugs • At 1856 first drug store has been presented in the California in USA

33. History • From the beginning of the world up to 1856. • From 1856 up to now.

34. Attention to Traditional Medicine • 1970 return to Traditional medicine

35. Immune system and infectious dis. Antibiotics and resistancy • Modern chemical antibiotics have been in existence less than a hundred years, whereas • the natural herbal antibiotics prescribed by traditional healers have been used for more than 2000 years by millions of people. • http://www.tcmpage.com/hpinfections.html

36. Immune system and infectious Diseases and Antibiotics • As a pillar of modern medicine, antibiotics play a tremendous role in dealing with infections. • When the body,s immune system is overwhelmed, antibiotics can be very useful. • since the discovery of penicillin in 1928, infections still plague us. Many bacteria develop resistance to the antibiotics that once killed them. • Bacteria, Fungi, TB, H.Pylori, HCV, HBV, and so on….. • http://www.tcmpage.com/hpinfections.html

37. (Superior or inferior medicine) or (treatment or Prevention ) • the fundamental concepts in traditional medicine is that "superior medicine prevents disease, • and inferior medicine treats disease."8 • Many herbs and formulas that tonify immune system. • http://www.tcmpage.com/hpinfections.html

38. Treatment versus prevention medicine • This compromise is that a strong immune system is fundamental if the body is to resist infections. A medicine which controls bacterial infection and sustains the immune system is always preferable • to a medicine which kills bacteria but depresses the immune system. • http://www.tcmpage.com/hpinfections.html

39. Immune system or infectious diseases • Two theories dominate the practice of medicine on infectious diseases. One theory is that germs cause infectious diseases. • The other theory is that diminished host resistance causes infectious diseases. • infection does not occur unless the host,s resistance diminishes. (TB,AIDS, ……) • http://www.nationalpainfoundation.org/articles/118/modern-vs--traditional-medicine

40. Modern medicine versus traditional medicine • Modern Medicine is consisted of Traditional Medicine plus Modern Technology, Innovation and explorations. • http://www.nationalpainfoundation.org/articles/118/modern-vs--traditional-medicine

41. Differences between modern and traditional medicine !!! • Major differences between modern and traditional medicine!!! • Salicylic acid and Whitlow cortex • Artemisia and Malaria • Leech Therapy for Cosmetic surgery

42. What does TM mean from antibiotics? • Immune system = Resistance to infection • Means No Infection

43. Immune system = Pathogens Immune system < PathogensImmune system > Pathogens

45. The first signs of TM in History • The first reference to infectious disease appeared in Huang Di Nei Jing (Yellow Emperor's Inner Classic), compiled in the first or second century CE. • R: ( Gilbert D, Moellering R, Sande M. The Sanford Guide to Antimicrobial Therapy. 29th Edition. Hyde Park, Vt.: Antimicrobial Therapy, Inc., 1999. ) • Other: TB in Egypt Mummies and HP

46. New Era • Review of Traditional Medicine

47. Epidemiologic features and Transmission • "from one person to the entire household, from one household to the entire street, and from one street to the entire village. • " The disease first affects the exterior of the body and progresses to the interior, following the patterns of wei(defensive), qi(energy), ying(nutritive) and xue (blood) levels.5 • …..transmitted from one person to another via "heaven [air-borne]" or "earth [direct contact], • ……" and affect individuals with low immunity.6 • R:Wen Re Lun (Discussion of Warm and Hot Disorders) by the apprentices of Ye Gui, 1745-1766. • Wen Yi Lun (Discussion of Epidemic Warm Disease) by Wu You-Xing, 1642.

48. Warm or Hot diseases versus cold diseases • recognized that these patterns of illness were significantly different from shang han(cold damage)patterns, so must be diagnosed and treated differently. Three of the most influential doctors during that era contributed to a new school of thought, namely wen bing (warm disease).2-4 Furthermore, the cause of these warm and hot disease have "no sound nor smell, and no shape nor shadow.”(6) • Wu You-Xing, also known as Wu You-Ko, circa 1580-1660. • Ye Gui, also known as Ye Tian-Shi, 1666-1745. • Wu Tang, also known as Wu Ju-Tong, 1758-1836.

49. Infectious diseases classification and treatment • Theory of Febrile Diseases and Synopsis of the Golden Cabinet, by Zhang Zhongjing, (150-219 AD), and Treatise on Differentiation and Treatment of Seasonal Febrile Diseases, by Wu Jutong, 1798, include effective formulas for "Expelling Cold," "Clearing Heat," and "Relieving Toxicity" which are used to treat infectious diseases. • http://www.tcmpage.com/hpinfections.html

50. ITM&TCM Explanation of human • There are thousand of questions about human existence. • Based on the Philosophy of the TCM human is not only a holistic being but is inseparable from the nature. • The human is a collection of constant composition and decomposition and • is in a dynamic interaction between internal activities and external environment.