Introduction - Uppsala Monitoring Centre

not written in the form of tables. A random page referred to five
drugs, but with no harmful properties mentioned. The text area of a
page was about the size of A5 paper and with only 71 pages and
550 drugs and each drug having 16 categories would allow only a
few words per category.
There were two major Greek sources for medicinal substances
available through Arabic translations: Discorides’ treatise on materia
medica, which described approximately 500 substances, and
Galen’s treatise on simple remedies. (www.nlm.gov/hmd/arabic/).
Accessed 26th June 2008.
1181 Lord Guilhem VIII signed an edict declaring that anyone, regardless of
religion or background, could teach medicine in Montpellier, thereby
creating the oldest operating medical school in the western world.
1190 The first written document that recommended mercury as a treatment
was in the ‘Circa-instans’ (A shortened version of the full title ‘Circa
instans negotium in simplicibus medicinis’) [About the present business
with the medicinal simples]. It was also known as the ‘Liber simplici
medici na‘ [Book with simple medicines] or ‘Secreta salernitana
[Secrets known about in Salerno] of Matthaeus Platearius of Salerno.
In it the early herbals plants were referred to as ‘simples’ meaning
single plants or ‘compound’ meaning mixtures of more than one plant.
No mention of ADRs.
Adulteration of Drugs
The fear of adulteration of drugs is a constant theme in the laws governing
medicines and continues today with traditional Chinese medicines (TCM), which
may contain unmentioned western drugs such as cortisone. There have been
numerous similar laws throughout the world continuing until the present time. There
are six possibilities:
1. The drug was of poor quality, i.e. too little of the active drug, which was
accidental and affected efficacy, e.g. the quinine content of different cinchona
barks varies from 0–4% for C. calisaya, C. officinalis 2–7.5%, C. ledgeriana 3–
13%, C. succiruba 4–14 %. (This is not a true adulteration, but rather a cause
of inferior products)
The measured amounts of St John’s Wort (Hypericum perforatum) varies
considerably from those claimed on the labels, from 0% to 109% for capsules
and from 31% to 80% for tablets (Draves & Walker, 2003).
2. The drug was formulated with excipients, which might alter the efficacy or
safety of the active principal, e.g. diethylene glycol still used in 2006 in
Panama mixed with glycerine for a cough mixture (News, 2007).