Science in Christian Perspective

 

 

 

Tranquilizing Drugs
JOHN E. McLENNON, M.D.
Box 876, Palos Verdes Estates, California


From JASA 9 (September 1957): 11-15.

In 1847 Sir James Y. Simpson introduced ether as obstetrical anesthesia. Shortly he found chloroform to be more acceptable. Since the introduction of obstetrical analgesia and anesthesia, controversy has flowed between the two extremes. At first it encountered great opposition from physicians, clergy and laymen. Ideas have changed since then. Today there is no out-cry against man's interference with a Divine edict-"in sorrow thou shalt bring forth." Genesis 3:16, now historically accepted even by most devout Christians, if but by default. The subject is simply that of obstetrical anesthesia and analgesia.

In 1847 the first known use of a drug, ether, was used to lessen the pain and stress of childbirth. Since the dawn of the obstetrical anesthesia-analgesia field, medicine has been enlightened, and many women's lives have been made brighter, not alone from the freedom from pain but also by aiding in the prevention of the psychic trauma that develops in human female minds from traumatic childbirth. Many homes have experienced more love and harmony because of the lack of fear of childbirth and the prevention of frigidity in the female that follows the psychic and physical trauma during this physiological act.

Yet are we contrary to Scripture, for as we know, God pronounced a curse "that in pain thou shalt" Genesis 3:16? Do we orthodox (fundamental) Christians err in accepting this Obanestgesia? The majority of even staunch Christians accept this is routine, (that is, Obanesthesia) never even ' considering the philosophical conflicts. Wherein do we stand, in error or in pity, or as God put Adam asleep when he took the rib from his side to make the woman, are we justified in anesthesia-analgesia in childbirth? There has been a great change in medicine since 1847, for in 1956 many children are born alive because of anesthesia. Can we as Christians assign them to death by opposing the revealed gift that allows them to live?

This paper has as its purpose the removal, or prevention of additional misunderstandings between fundamental Christianity and Science, specifically dealing with complex problems of psychiatric nature, and biochemical association as they directly affect Christian problems of today.

In Christian circles it has obviously been difficult to accept scientific material. Perhaps not so greatly in the physical science as it has been in biological, physiological, medical and allied fields. This rejection was undoubtedly aided substantially by introduction of the conflict of evolutionary hypothesis with Christian principles, and the great tendency on the part of men of science to wage open warfare against Christian teaching. During the past twenty years, as science has advanced, many conflicts have dissolved; scientific principles have been more readily accepted.

The drugs to be discussed are generally known as tranquilizing drugs. These drugs have opened many new fields of investigation and are involved principally with the psychic, emotional, life and the alteration that they bring forth. This new field involved is that of chemo psychiatry. The drugs have several sources. that is, sources or derivation from distinct chemical or pharmacological analogies. Most all of the drugs are not related to barbituric acid derivatives. They have pharmacological properties distinctly different from them.

Although some of the drugs involved in this discussion have been known for many years, their use and understanding of the pharmacodynamics have been largely associated with the post World War II years and the atomic-hydrogen age. Many drugs are under investigation-many are in use today, and undoubtedly more will be found and used. Some drugs possess remarkable qualities for producing hallucination, reducing fear, calming emotions and dulling sensation Thus the field of Chemo psychiatric Therapeutic mingles with the field of Philosophy and Religion. Concurrent with these discoveries were great advances in nuclear physics and chemistry, resulting in the Atom and Hydrogen bomb - A great insecurity began to develop when values of peace and security, protection, distance, etc. melted away. The resultant general tension brought on stresses in the human personality and its integrative qualities that had never been known.

The effect o the tensions is evident in all walks of life. Coincidental, perhaps it is providential that the Author of our Faith allowed in his permissive Will, the uncovering of tranquilizing drugs. But we have here a problem, a crossroad of decision, especially one who accepts Christian faith. The great question exists-Is Christ enough for the Hydrogen age? The only answer that is valid is yes, for Col. 1:16.  "We know that it is He that causes all things to consist." What then can we say about these drugs, and the use of them by Christians and non-Christians? I believe we have an issue that encompasses all phases of human endeavor.

In this field the Christian finds himself in a peculiar place-and likewise the philosopher and the Theologian perhaps uncomfortably so. We are of a dual nature and are under pressures of the world and its conflicts constantly. As Paul wrote, "Oh, wretched man that I am, who can deliver me." The Christian may have a severe over-use of the alarm reaction mechanism; he may be anxious; over-anxious about the conversion of another soul to the extent that he may become useless or ill because of such great anxiety. He may be made useful again by application of tranquillizing drugs without beino, a failure or falling into great self-condemnation. The Christian has not been promised freedom from stress, illness, conflict and frustration, but has been promised victory in spite of them through Christ's strength.

The issue of psychosomatization is held under consideration at this point. For the sake of completeness, we must understand that the stresses of the Hydrogen Age release a physiological mechanism is some people the so-called alarm reaction of Hans Selye. Briefly, his is the organism's response to a challenge to or assault on its integrity; that is, if a person is attacked by a man with an axe, he will prepare to f ight or will undertake flight. This reaction is a complex phenomenon mediated by the pituitary adrenal axis, and is again illustrated by the cat frightened by a dog. If the dog is big, the cat will run. If the dog is judged small, or the threat to something great then the cat fights. This is exhibited by humped back, claws out, eyes dilated and tense muscle system, caused by the elaboration of epinephrine and the functioning of the autonomic nervous system. In humans, whether Christians or non-Christian, this alarm reaction functions, in some more so than in others. We may not have a man with an axe after us but it may be a verbal attack, yet it is still an assault upon us. If we over-work this alarm mechanism, we may become ill, even incapacitated or useless even to the cause of Christ. Yet, if under proper treatment an anxious, tense, useless individual may be rendered useful-not tense, not anxious-then we have performed a great service.

The abuse of the alarm reaction is thought to be the cause of many psychosomatic illnesses. To make a correlation at this point in our thinking, as far as Biblical interpretation goes-I know of no promise which involves complete trans formation in this life, that is, alteration of human psychology contrary to normal human physiological processes. Christian women bear children in the same manner as non-Christians and the adaptation of alarm mechanisms are the same in Christian as in non-Christian. For the Christian the ultimate end of life will be changed, the stress of life will be met with different attitudes. The Christian life does not promise freedom from stress but help in spite of the stresses of life.

Also it must be understood that psychosomatic disease, neurosis, anxiety states, mesenchymal diseases, etc., are not intended to be classified with psychosis, but perhaps are of a similar nature, that is possibly a biological defect or metabolic disorder of a biochemical system not yet understood, or as yet uninvestigated. They have a common ground of being ef f ectively treated by tranquillizing drugs. It has not been established why two people under similar tension will break down in different ways, nor why some may not break down in any visible way. There cannot be any clear cut separation of the organism from his environment for we have biological, chemical, physical forces operating in all organisms in any environment.

Tranquillizing drugs have produced several noteworthy points of interest:

Among these drugs we will consider three which are representative of distinctly different drug families.

The Rawolfia group had an interesting history, having been known in India for 2500 years. Steeped in mystery and sorcery, it had been used for legions of illnesses from infantile colic, dysentery, to madness. In the 16th century Leopold Rauwolf brought the snake root out of India to Europe, and gradually it had its natural course of investigation until 1948 when it was introduced to the United States and Europe for its antihypertensive qualities, and simultaneously its action on the mentally disturbed was studied. Finally in 1950 to 1952 it was released for use as an anti-hypertensive agent and in 1954 released for psychiatric treatment.

Since the use of Rawolfia in hypertension and on psychiatric problems, greater interest has been shown in basic research into the central mechanism of emotions. The Department of Neuropsychiatry at Tulane University under the direction of Robert G. Heath has directed investigation of the Septal region of the Corpus Callosum (the Rhineceptalic region below the knee of the Corpus Callosum.) It is his impression that emotional reactions are largely initialed by memory, and that painful emotion is the nuclear factor of disordered behavior in man.

By placing electrodes deep in the brain (Septal area) the Heath group has recorded changes in behavior, body chemistry, EEGS and motor function accompany-ing or following stimulation in this area. H. E. Himwich investigating the mesodiencephatic activating system with electrodes has established criteria for arousal and depression of the activating system. Rawolfia derivatives stimulate arousing effect of the activating system, and its depressing effect on the Hypothalmus is offset by this stimulation. A side effect of the arousal is evidenced by the Parkinsonism with heavy doses of reserpine.

Work with LSD the Hallucinogenic drug, (related through the indole nucleus to Epinepherine) has shown that LSD inhibits or impairs the function of Serotonin, (O'Hydroxytryptamine) (5HT) which is a normal constituent of nerve and brain tissue. Evidently reserpine facilitates this substance's utilization or manufacture. We can correlate Serotonin to the function of the autonomic nervous system.

Interesting information derived from these investigations has produced two schools of thought. One school is impressed by the fact that 5HT is necessary to normal brain function. The Hallucinogenic substances (LSD) impair the action of 5HT and an excess of 5HT produces mental disease. Biochemical investigations into mental disease would bring much work of Freud-et al to naught.

This reference to Freud, etc. is by no means bias, but for years men of analytical minds have questioned some of his interpretations, for they were based on observed, information, circumstantial subjective evidence, etc. Now we have observed the onset of a more concrete approach to mental and emotional disease. The use of drugs in psychiatry is not new, and this is not an attempt to throw psychiatry back 100 years like some think, but an ef fort to utilize the new approach of the Ataraxtic Drugs and resultant avenues of research to the advantage of those mentally or emotionally ill.

More pronounced in Christian thinking are the enlightening facts brought about by this investigation, for Freud expressed definite antagonism to God, and religion in general. Now his dogmatic interpretations are tottering, when viewed tinder the light of biochemical, pharmacologic research.

If mental and emotional disease is a biochemical, metabolic, developmental or combined disease, then the behaviorism, analytical, schools of phsychiatric methodology have been weighed in the balance and found wanting. For these illness are then to be interpreted in a similar manner as Diabetes Mellitus, Addisons Disease, Hemophilia, etc., and not just mal-adjustment state or frustration of libido.

Phenotheozine derivatives are drugs possessing remarkable activity in the field of Chemopsychotherapeutics. The physiological sight of action is that of blocking the sub-cortical areas. Large doses produce sleepsmall doses produce detachment from environment, relative indifferences, etc.

First studied in Europe then introduced to this country for use in pain control, nausea, etc. These drugs do not change the cerebral oxygen consumption in usual doses. The drug inhibits the alerting mechanism of the reticular formation as previously introduced. These drugs act immediately and are the drugs of choice in the acutely disturbed patient and anxiety reactions, somatic disturbances, surgical preanesthetic medication, OB analgesia, alcoholics and agitated psychotics. Observation of patients under their influence is nothing short of amazing. Children lose their fear of tonsillectromies. The use of narcotics in preanesthetic medication is cut in half or eliminated. Obstetrical labors are less turbulent, and hostile parents are more accessible.

In 1946 Myensin was investigated by Berger et al. From this analogue mephenesin was derived and utilized initially for muscle spasm. Finding a great calming effect in 1952, popular articles appeared advocating its use in calming nerves before speaking and flying. The next step was the development of (Mephrobametes) Miltown and its respective relatives, and the first association with the laity's knowledge of "Happy pills".

The pharmacological action of Meprobamates is a blocking of interminicial circuits between cortex and thalmus, inhibiting electrical activity in that region. These drugs have little or no ef f ect on the physiological patterns of the body. The body temperature, metabolic rate, emetic center, blood pressure, pulse, intestinal functions, are not changed, however sleep induction is moderate, and muscle relaxation is a prominent feature of their action.

As a tool in the attack on chronic anxieties, the meprobomates have proven to be exceptionally usable. It might be pointed out here that misuse, abuse or indiscriminate use, improper use is not advocated. Diligent, discriminating selection of patient and drugs have produced desirable responses in Christian and non-Christian alike.

The material covered thus far is not comprehensive nor exhausted, however the more subtle application again must be stressed. The normal or philosophical position of whether these drugs are acceptable or usable must be diligently considered. The application of the information derived, in relationship to its impact on (Biological Hypotheses) as applied in the field of Pharmacology-eg. species reaction or specificity, etc. must be fully investigated. Also, its direct effect on the opening of new understanding in Neurophysiology and the physiology of emotions, which does not support the cause and effect relationship as proposed by the analytical schools of psychiatry, must be considered jointly, and cannot be accepted or rejected separately.

F. P. Gerty in several recent articles, has separately and with totally different approach, expressed dissatisfaction with the Bleulerian) classification of Schizophrensa etc., and has uncovered features in the phos phorilization in R.B.C. which under his investigation has proven 89% accurate in identification of people with this type of emotional problems. Thus he has given support to the suggestion that emotional illness may be a defect or dearrangement in cerebral or total biochemical patterns. Therefore the Christian attitude toward these problems as well as the general attitude must be re-evaluated, and again if these problems are biochemical diseases etc., ataraxties are as applicable as insulin, and the behavior and analytical approach to problems of emotions is as outmoded. Scripturally, the use of tranquillizing drugs must be considered efficacious as Penicillin. It is still Christ that causes all things to consist. Col. 1 :16.

The application of this discussion is best illustrated by a few simple case histories.

I. W/F-age 33, pastor's wife, devout Christian because of inadequacies of personalities, and definite psychotic manifestations, ideas of reference, increased psychomotor activities, hallucinations, etc., all but wrecked her home life, the growing church that her husband pastored and all those associated with him. The patient was placed on Chloropromazine and ultimately Reserpine. For the pasts 20 months she has been calm, willing to accept a lesser position, useful in church and community activities. She has been able to accept her family responsibilities, resulting in much less discord, and dissention in the home and church life.

II: W/F-age 43, chronic Alcoholic 2 years, lost her exceptionally good position as an executive secretary in a large office because of alcoholism, instability etc., was placed on chloropromazine and subsequently institution of treatment 15 months ago she has been gainfully employed and has been more receptive to Christian teaching.

Lest we understand that these drugs are useful in only severe illness we will illustrate case number III.

W/M-age 42, bank cashier, Sunday school teacher, lay choir director, presented himself with symptoms physically expressed by fear of impending disaster, BP 160/110, headaches, dilated pupils, sweaty hands, etc., and chronic constipation. He was to a point of complete incapacitation. He was placed on Res.. serpine and after 4 weeks BP 120/80, anxiety symptoms improved, eliminated, constipation corrected back to full duty, with less extra-curricular activity.

In concluding, the Ataraxtic drugs are useful tools in salvaging people from emotional stress and related illness. They produce greater access to those who are in spiritual distress, but confused by the environment surrounding them. The drugs are useful in helping even Christians with psychosomatic illnesses. They are helpful in dealing with problems of stress associated with the Hydrogen age.

On the more subtle side, the drugs in question have opened avenues of investigation into unknown fields and have facilitated much our understanding of cerebral and lower CNS function in health and disease. By this in the future, theories and dogmas of pseudoscientific approach will melt away. The investigation of pharmacological properties of chemicals, may some day be a key feature in the fall of the ascent approach to developmental biology, etc.

Perhaps for the Christian, we must refer to Peter's vision, where Peter learned that nothing is unclean of itself-and so he ate after giving thanks to God, for like Peter, with thanksgiving to God we accept his gift, even yet Ataraxtic drugs.


A. A very real moral problem exists for
B. Turmoil in the world is on the increase.

C. With increase of knowledge.

                    a. All things work together for good for those who are the called according to his purpose.


          5. No time for ostrich philosophy, narrow attitude, blind faith

         6. It is by Christ that all things consist.


                                                   Conclusion

Tranquillizing drugs a useful tool in medical armament that can be utilized to great advantage in

           1. Christian and non-Christian alike
(1) Simpson, On the Employment of the Inhalation of Sulphuric Ether in the Practice of Midwifery, Month J. Med Sc. 1847, p. 248. 1847, p. 248.

(2) Stander, H. J., Obstetrics, Third Edition, Appleton, Century, N. Y., p. 411.

(3) Selye, Hans, 1946 General Adaptation Syndrome and Disease, J. Allergy, 17:358.

(4) Serpasil, The Story Of, Ciba Pharmaceutical Co., 1955, p. 6.

(5) Scope, Upjohn Co., Vol. IV, No. 8, Winter 1955.

(6) Brodia BA, Shore, PA., Pletcher A., Serotonin Releasin., Activit-v Limited to Rawolfia Alkaloids with Tranglielizing Action, Science Vol. 123, No. 3205, June 1956, p. 992.

(7) Berger, F. M. and Bradley, W., The Pharmacological Properties of A.B. Dihvd oxy v (2Methvl-Phenoxy) propane (Myenesin), Brit. J. Pharmacology, 1:256, 1946.

(8) Berger, F. M., Meprobamates (Miltown) its Pharmacological Properties and Clinical Cses, Internat. Rec. Med., 169:184; 1956.

(9) Boszormenvi-Nagy

Between the Phosphorus Metabolism of Erythcocytes of Normals and of Patients Suffering from Schizophrenia. The Journal of Nervous and Mental Disease, Vol. 121, No. 1, Jan. 1955.

(10) Boszormenyi-Nagy, Ivan and Gerty, F. J., Diagnostic Aspects of a Study of Intracellular Phosphorylations in Schizophrenia. The American Journal of Psychiatry, Vol. No. I, July 1955.

(11) Fazekas, Joscph et al, The Pharmaeodimanlics of Ataraxics, A Rational Approach to Therapy. Scientific Exhibit, Psychiatric and Medical Services of the Georgetown and George Washington Divisions of the District of Columbia; General Hospital, Washington, D.C.