Mithridates VI: Paranoia, Poisons, Antidotes, and Vaccines.
It was in the clove of seasons; the air was windy and the chirping birds had a few melodies to render. King Mithridates VI stood on the porch of his majestic palace and got a beautiful view of his city. His visage, however, was replete with fear. Something was wrong, but not with the city. Something was wrong with the king. It was easy. It was quick. There was no remedy. Drink and die, or eat and perish, depending on the recipe of your enemies. The act of poisoning wasn’t an entirely new concept around 120 BC. In fact, the act of poisoning is considered to be as old as time itself. Nature is full of it. From the harmless-looking fresh green vegetables to the foul-smelling decoction prepared by ancient apothecaries and to the coating of the edge of swords and spears with “poisonous materials”, King Mithridates VI had a reason to worry. He needed a plan. A viable one at that. He needed to do something to counteract the most ingenious plans of his enemies, and maybe his jealous uncles – and, who knows, maybe also his mistresses.
“Call me the court doctors!” Mith quizzed.
Let’s call him Mith, as Mithridates sounds a little too outdated. A septuagenarian strolled in, holding a crude mallet made of metal and moss. His white beard gave him away as the best doctor there was at the court at that time.
“We need to talk.” Mith retorted “and in private”, he added.
His voice sounded like the fading tune of a brass gong.
“I need a plan to prevent the fate of my father from happening to me”, he said.
“Have you any remedy for every poison that there is?” He asked.
The doctor shrugged. “No, your highness.” “We don’t know exactly all poison that there is. The wilderness is full of fruits and grass. And any could be poison. Each could be poison” He rambled, with wisdom and fear.
“Okay. Thank you. And go wash yourself.” The king dismissed the doctor.
It was a short meeting. Futile and definitely not fruity considering the expression of disgust on the face of young Mith.
In that instance, an idea popped into his brain, like an aneurysm. How about I ingest these poisons, maybe tiny potions and pills, and somehow, my ancestors will fortify my body based on the singular fact that I’ve consumed these poisons before my enemies bring them to me? Well, if it sounded like a brilliant idea without the knowledge of immunology, vaccination and even the rudiments of how the body works, King Mithridates VI should have gotten a bed in a mental institution. To be fair, who thinks of “poisoning himself”? He did.
In the next couple of years, the king gathered poisons of different kinds. It runs the gamut from decoction used for the execution of witches (assuming the woods were too wet for a bonfire) to the venom of animals and even to the serum of ducks believed to have consumed the poisonous plants hellebock and hemlock. He tried arsenic too and constantly armed himself with sublethal doses of different poisons. He would ground shark teeth (probably containing Calcium carbonate) as an antidote to arsenic (which could have worked as a result of the chelation reaction of calcium with arsenic.) It worked, or so.
His invention used to be called Mithridaticum.
The process of formulating such antidotal therapy is called Mithridatism. However rudimentary Mithridates’ approach was, it provided a strong insight into the science of poisons. First, the dose makes the poison. This belief was calcified by Paracelsus centuries after Mithridates’ little science project in a line that all toxicologists and pharmacy students have heard ad nauseam. What is the other line? “The mistake of a doctor kills a person but the mistake of a…..”
The dose of a “drug” determines whether it acts as a medicine or poison. Antidotal therapy involves using “biological neutralizers” to counteract the effect of a poison. For example, the use of atropine to block the actions of cholinesterase inhibitors, the use of protamine sulphate in heparin overdose, the use of N-acetylcysteine for paracetamol poisoning, the use of Dimercaprol for arsenic poisoning (by chelation), the use of Flumazenil for benzodiazepine overdose. Antidotes work via different mechanisms to produce effects that aim to prevent the physiological alterations caused by poisons. Antidotes are time-dependent too. The earlier they are used, the better it is. Not all antidotes are biological in nature. Activated charcoal is just, well, activated charcoal — or charcoal that has been activated. It works by binding to poisons and toxins.
In the context of infectious diseases, Mithridatism could be likened to vaccination if we decide to abandon technicalities. I presume we can not indeed abandon technicalities.The use of
vaccines, which are either attenuated infectious organisms incapable of causing full-blown
infections or antigenic portions of such organisms to stimulate immune response through
antibody creation, has become the premiere step involved in protecting ourselves against
infectious disease. These antibodies are produced by the body in response to the presence of infectious agents such as Bacteria and Viruses. Thanks to the discovery of Edward Jenner by the inoculation of a rather poor 13-year-old boy with cowpox (Vaccinia virus), and the consequent immunity of the boy to smallpox, the science of vaccines has saved countless lives. Infectious diseases that used to be death sentences have now been incarcerated forever in the penitentiary of vaccines. However, there are exceptions. For example, the stubborn retrovirus, HIV. Albeit we do have polio in our pockets, public health issues also plague the delivery of vaccines as well as public reception of the science. A growing substrate of the population called ‘anti-vax’ do exist and they decide against vaccination for reasons that border on religious, cultural, medical, and ethical beliefs. It is a story for another time. Routine vaccination does exist that prevents humans and other animals from infections. Some of them include the Oral polio vaccine (OPV) for Poliomyelitis, MMR vaccine for measles, mumps, and rubella, BCG for Tuberculosis, DTP for Diphtheria, and Hep B vaccine for Hepatitis B amongst others.
Basically, if you have a lot of mistresses or enemies, or you’re the heir to the throne of your ancestors, you might want to consider trying out the Mithridates recipe. I wouldn’t support you using yourself as a laboratory animal though.
Mithridates VI: Paranoia, Poisons, Antidotes, and Vaccines.