Kapronczay Károly szerk.: Orvostörténeti Közlemények 190-193. (Budapest, 2005)
KÖZLEMÉNYEK - COMMUNICATIONS - Paskalev, Dobrin - Kircheva, Anna B.: Bulgarian contributions to the development of medicine - Bolgár hozzájárulások az orvostudomány fejlődéséhez
Bulgarian folklorist, ethnographer and writer issued in 1890 his work "Something about the Bulgarian folk medicine". In it the author mentions the folk healer old Aleksandar from Gabrovo ( a town in Northern Bulgaria), who applied an extraction from deadly nightshade to chronically ill people with locomotive disorders. As a result of the treatment the patients would initially "go crazy" but would later recover (27,30). The overall treatment scheme of Ivan Raev includes: roots from deadly nightshade, animal black (carbo animalis), pills from ground mace with roasted wheat meal and finely chopped roots from sweet flag {Acorus calamus). Every component of the proposed combination pursues a certain medicinal effect. To approximately 30g roots from belladonna one shall add a coffee cupful of animal black, after which the mixture must be boiled in 600g white wine for about 10 min in a closed pot. The ready decoction must be filtered and kept in a well-corked glass bottle. The ready salts of the wine acid (tartarates), which white wine forms with the alkaloids of the belladonna have a higher resorption in the stomach (23,27,32,34). It is widely believed that the various alkaloids contained in the roots of the deadly nightshade {atropine, scopolamine, apoatropine, hiosciamine) ensure a more beneficial effect than treatment with atropine only (31). Carbo animalis used in this curative combination reduces the irritation of the stomach mucous (24,27). The ill person starts taking the wine extraction 1 teaspoon 3 times a day before meal. The dosage is increased on a daily basis by one teaspoon till it reaches 10 teaspoons. After each dose the patient receives one pill containing mace, which has a relaxing effect. Every two hours the patient chews a small piece of the sweet flag roots. The roots of the plant {Rhizoma calami) contain the bitter substance acorin, which stimulates the secretory function of the glands in the gastro-intestinal tract (32). Thus, the unpleasant dryness of the mouth related to the continuous use of atropine is overcome (25,27). Many years later series of pharmacological observations and experiments have considerably broadened the understanding of basal ganglionic function and led to the scientific explanation of Ivan Raev v s empirical treatment of parkinsonism. It has been postulated that a functional equilibrium exists in the striatum between the excitatory cholinergic and the inhibitory dopaminergic mechanisms. In patients with Parkinson's syndrome due to encephalitis lethargica, the concentration of dopamine is decreased in the substantia nigra and in the striatum. The degree of pigmented depletion appears to correlate with the degree of pigmented cell loss in the substantia nigra, i.e. with the main pathologic finding obtained post mortem. In Parkinson's syndrome, the decreased release of dopamine within striatum leads to disinhibition of the neurons synthesizing acetylcholine and thus, to considerable predominance of cholinergic activity (22,34). By this reason, Ivan Raev v s treatment with belladonna alkaloids known to be anticholinergic drugs, restores the ratio between dopamine and acetylcholine (34). Later, some synthetic "successors" of the classical atropine such as trihexyphenidyl and benztropine mesylate were introduced in use and are still favoured by some neurologists as the initial therapy of Parkinson's syndrome (22). Ivan Raev succeeds in healing an Italian colonel sent to Bulgaria by the Queen of Italy with a wine extraction of roots of belladonna. Back then Italy was stricken by an epidemics of encephalitis lethargica and the Bulgarian healer was invited to Rome in 1934. In the summer and the autumn of 1934 jointly with the neurology professors Panegrossi and
