Tuesday, October 25, 2016

Rheumatoid Arthritis

Leonora Curtin was told plants like gumweed, sunflowers, and prickly poppy were used to treat rheumatism in northern New Mexico in the 1940s. None have been analyzed by scientists and none are reported as cures for joint pain by any group of Native Americans in the United States.

In fact, when you look at the list of antirheumatic plants compiled by Dan Moerman, you discover at least 225 have been used externally and 120 used internally. At the genus level where he created his index, just over a third were reported by more than one band. The most commonly mentioned were artemisia, discussed last week; stinging nettles, which were introduced from Europe, and yarrow.

The other common herbal plants in Moerman’s index were evergreens in the spruce, pine, juniper, and hemlock genera. Curtin found locals ground dried piñon pitch and rubbed the powder on rheumatic joints. Pinus edulis sap is widely used by natives in New Mexico, but mainly as a band-aid to seal sores from exposure to the air.

Local native groups who mentioned externally applied cures for arthritis or rheumatism were the Isleta and the Zuñi. Those who took medicines internally were the Jémez and the Navajo. Keres speakers and the Hopi did both.

Since so few plants were known by more than one band, I wondered if rheumatoid arthritis was in fact an introduced disease that had been met with a variety of responses. Instead, researchers believe it was a New World malady taken to Europe. Bruce Rothschild discovered bone lesions on remains from 35 pre-Columbian sites, but said they weren’t reported in Europe until 1785. He believed what had been attributed to rheumatoid arthritis before was actually spondylarthritis.

Since he first published his findings, others have reviewed evidence from bones, paintings, and literature. A group in Guadalajara noted the first distinction between rheumatoid arthritis and gout was made in México in 1578. In the early 1600s, Thierry Appelboom said Peter Paul Rubens and other Flemish painters were depicting deformed hands. He suggested the disease had been imported through the port of Antwerp that then was under Spanish rule.

Today, rheumatoid arthritis is not equally distributed among all groups of Native Americans. The highest incidence is among the Mille Lacs Chippewa of central Minnesota and the Pima of Arizona. It also has a significant presence among the Tlingit of southeastern Alaska and the Yakima of cental Washington.

Medical specialists agree that it is an immune system problem with an unknown precursor. They’ve identified the genetic factor that controls its appearance. However, they’ve found that the allele only defines who can, not who will, develop the disease.

Some researchers suspected processed sugar, flour, caffeine, and tobacco were the activating culprits. The first two didn’t exist before the Spanish, and the other two probably were used in different forms. Many now think such dietary factors influence the progress of the disease once it has been launched, but don’t initiate it. So far, no one has been able to identify the virus or bacteria that converts "might have" to "do have," though they’ve eliminated several suspects.

This all leaves the question, could Miguel de Quintana have developed rheumatoid arthritis in Santa Cruz in the 1730s? The fact it spread to Europe meant there was some microbe or animal that migrated in bodies or cargoes or shipboard grime when Spanish sailors returned to European ports. He could have been afflicted in Santa Cruz, or he may have been affected when he still lived in Mexico City. That there’s no evidence of antirheumatic cures among the northern Tewa speaking pueblos means little more than no anthropologist asked the right question at the right time.

The few barbers who came north in the 1690s, or the common knowledge shared among the colonists from Mexico City, recognized the difference between gout, which was a blood condition, and rheumatism, which was a spleen problem. However, the fact I’ve found so little on-line about arthritis cures within the schema of the Four Humors suggests the best doctors in Europe didn’t then have ready treatments.

That means, if he had any medical care, and it’s hard to believe he didn’t try things to relieve his pain, they were still in the experimental stage of trying everything and seeing if anything worked. His diet may have helped, if he ate peppers, and may have contributed to his problems, if he ate sweets or smoked much tobacco. Probably nothing happened systematically enough to have produced positive or negative results.

Notes:
Aceves-Avila, F. J., F. Medina, and A Fraga. "The Antiquity of Rheumatoid Arthritis: a Reappraisal," Journal of Rheumatology 28:751-7:2001; based in Guadalajar.

Appelboom, T. "Rubens - One of the First Victims of an Epidemic of Rheumatoid Arthritis That Started in the 16th-17th Century?, Rheumatology 44:681-683:2005.

Curtin, Leonora Scott Muse. Healing Herbs of the Upper Rio Grande, 1947, republished 1997, with revisions by Michael Moore.

Ferucci, Elizabeth D., David W. Templin, and Anne P. Lanier. "Rheumatoid Arthritis in American Indians and Alaska Natives: a Review of the Literature," Seminars in Arthritis and Rheumatism 34:662-667:2004. She was primarily interested in the far northwest, and used the Arctic Health Literature Database and the American Indian and Alaska Native Health Bibliography. Those sources may not have covered this part of the country comprehensively.

Halberg, P. "The History of Rheumatoid Arthritis," Dansk Medicinhistorisk Arbog :173-93:1995.

Moerman, Dan. Native American Ethnobotany, 1998.

Ortiz y Pino III, José. The Herbs of Galisteo and Their Powers, 1971.

Rothschild, B.M. and R. J. Woods. "Does Rheumatoid Polyarthritis Come from the New World?," Revue du Rhumatisme et Des Maladies Osteo-Articulaires 57:271-4:1990.

Silman, Alan J. and Jacqueline E. Pearson. "Epidemiology and Genetics of Rheumatoid Arthritis," Arthritis Research 4:S265-72:2002.

Wednesday, October 19, 2016

Miguel de Quintana’s Possible Treatments

The four humors were predicated on the ideal of balance, of a golden mean. Diabetes and gout were caused by excesses of blood, arthritis and rheumatism by too much black bile. Good health was the consequence of a balanced diet and physical activity, on the avoidance of extremes.

The connection between diet and health probably existed in people’s minds before it was rationalized by medical practitioners. The perception of some relationship continued after the four humors were replaced by the molecular chemistry based medical theory that prevails today.

Jens Kjeldsen-Kragh has said, "The notion that dietary factors may influence rheumatoid arthritis (RA) has been a part of the folklore of the disease." He added, the connection was hard to prove because human beings weren’t inclined to follow dietary regimens and were inclined to lie about their failures.

He and his team followed patients with rheumatoid arthritis who were eating foods used at a Scandinavian health farm in the early 1990s. They began by fasting, then ate a gluten-free vegetarian diet for 14 weeks. Participants then were able to add dairy products. At the end of a year, clinical tests showed the biochemical factors related to the disease showed improvements.

Members of his team contacted participants two years later. Those who stayed with the diet said their symptoms got worse when they ate meat or sweets, or drank coffee.

Following some ideal balanced diet was a luxury in the early eighteenth century when Miguel de Quintana lived in Santa Cruz. He was restricted to what would grow in this arid country, and to things imported from Chihuahua by mule train that weren’t perishable. It’s likely he ate corn or wheat, beans, chiles and probably some eggs, cheese and meat. We can gather from last week’s post he ate sweets when they were available.

We can only guess how diet influenced the pain felt by Quintana, if he in fact had rheumatoid arthritis, or if any available treatments were effective. Few of the herbs Leonora Curtin was told were used to treat rheumatism in the 1940s have been studied. Pharmaceutical companies already have products that limit the damage caused by inflammation. The factor that separates those who suffer today from those who do not isn’t excess, but access to doctors, and the insurance needed to pay for care.

The two plants that have been studied, áñil del muerto and estafiate, have attracted interest for their abilities to reduce sugar levels in the blood. The first is the tall yellow daisy that blooms in September. Verbesina enceloides contains galegine, which has been synthesized as metformin to treat type 2 diabetes. Curtin said the leaves were ground and added to cold water, or made into a tea for rheumatism. José Ortiz y Pino remembered it as a tea in Galisteo in the 1930s.

Estafiate is a generic term for Artemisia species. Curtin thought it usually was the ludoviciana mexicana subspecies that was used for a bath. Pino called it black sage and said a tea was used for internal pain, while a bath was used for rheumatism. In 1912, Elmer Wooton and Paul Standley said the perennial grew then in Pecos, Farmington, and other high areas. Because Pecos and Galisteo were targets of Comanche raids in the 1740s, it may not have been easily available to Quintana.

I mentioned last week that baths as we think of them probably weren’t available when Quintana was alive, but wet cloths and teas were. Another Artemisia subspecies called mariola or ludoviciana ludoviciana, was used in a tea made with boiling water. The large sagebrushes, called chamisa hediondor or Artemisia tridentata, were used as tea, usually with piloncillo, a kind of brown sugar.

Researchers in Mexico, where estafiate has been used medicinally for centuries, found its active ingredients were able to alter glucose absorption and liberate insulin in mice. In a separate study, the group determined an essential oil blocked the first steps in the transmission of pain messages to the brain.

Artemisias contain a number of ingredients, common to many members of the genus. Rachel Mata’s group thought estafiate’s effects came from different chemicals attacking different problems simultaneously. Depending on species and where it grew, any found in the Santa Cruz area could have had some of the effects discovered by her team.

While the four humors classified diabetes and arthritis as opposites, Daniel Solomon found there was a tendency today for patients with rheumatoid arthritis to develop diabetes. He hypothesized inflamation was the link, because patients given some modern drugs containing an anti-inflammatory drug containing hydroxychloroquine were less likely than others to develop insulin resistence.

Notes: The chemicals in both the yellow flowered Verbesina enceloides and in Artemisias can be extremely dangerous. Sheep have died from insulin shock after eating the first. The second may contain thujone, a highly variable ingredient in absinthe. When the Norwegian researchers experimented with diet, they insisted their patients continue taking their prescribed arthritis medications.

Curtin, Leonora Scott Muse. Healing Herbs of the Upper Rio Grande, 1947, republished 1997, with revisions by Michael Moore.

Escalante, A. and I. del Rincón. "Epidemiology and Impact of Rheumatic Disorders in the United States Hispanic Population," Current Opinion in Rheumatology 13:104-10:2001.

Haugen, M, D. Fraser, and O. Forre. "Diet Therapy for the Patient with Rheumatoid Arthritis?," Rheumatology 38:1039-1044:1999.

Keeler R.F., D. C. Baker, and K. E. Panter. "Concentration of Galegine in Verbesina Encelioides and Galega Officinalis and the Toxic and Pathologic Effects Induced by the Plants," Journal of Environmental Pathology Toxicology and Oncology, 11:11-7:1992.

Kjeldsen-Kragh, J. "Rheumatoid Arthritis Treated with Vegetarian Diets," The American Journal of Clinical Nutrition 70:594S-600S:1999.

_____, M. Haugen, et alia. "Controlled Trial of Fasting and One-year Vegetarian Diet in Rheumatoid Arthritis." Lancet 338:899-902:1991.

Lopez, T.A., C. M. Campero, R. Chayer, B. Cosentino, and M. Caracino. "Experimental Toxicity of Verbesina Encelioides in Sheep and Isolation of Galegine," Veterinary and Human Toxicology 38:417-419:1996.

Mata, R., G. D. Anaya-Eugenio, I. Rivero-Cruz, R. Bye, and E. Linares. "Antinociceptive Activity of the Essential Oil from Artemisia ludoviciana," American Society of Pharmacognosy, 2015 Annual Meeting.

_____, _____, _____, and J. Rivera-Chávez. "Hypoglycemic Properties of Some Preparations and Compounds from Artemisia ludoviciana Nutt.," Journal of Ethnopharmacology 155:416-425:2014.

Ortiz y Pino III, José. The Herbs of Galisteo and Their Powers, 1971.

Solomon, D. H., T. J. Love, C. Canning, and Schneeweiss. "Risk of Diabetes among Patients with Rheumatoid Arthritis, Psoriatic Arthritis and Psoriasis," Annals of Rheumatic Diseases 69:2114-2117:2010.

_____, et alia. "Effect of Hydroxychloroquine on Insulin Sensitivity and Lipid Parameters in Rheumatoid Arthritis Patients Without Diabetes Mellitus: a Randomized, Blinded Crossover Trial," Arthritis Care and Research 66:1246-51:2014.

Wooton, Elmer O. and Paul C. Standley. Flora of New Mexico, 1915.

Sunday, October 09, 2016

Common Rheumatoid Arthritis Remedies

The cold and damp are descending. If Miguel de Quintana were alive, he would be dreading the onset of winter. He was living in a simple adobe house. One can assume it had a dirt floor, a single wood fire, and a poorly sealed entry opening. Once the summer heat retained in the walls was drained, keeping warm must have been difficult.

Many arthritis and rheumatism sufferers believe their suffering gets worse with wet or cold weather. Scientists have found independent evidence rheumatoid arthritis pain increases with the low atmospheric pressure that accompanies cloudy weather. They hypothesize it’s a function of the relative weight of dense or thin air pressing on joints. The comments on high humidity and low temperature are too common to be dismissed, but no one has found a similar link yet.

His treatments would have followed from the then current assumptions that his problems developed when the spleen produced too much black bile that then sank into his joints.

The four humors defined the spleen as a cold and dry organ related to the earth. To bring it back into balance, one used heat and moisture, which were related to air. Rather then bleeding, which was associated with a different humor, David Osborn said conditions of the spleen required increasing circulation.

He added the best herbs were pungent or bitter. Many had "a musky or earthy aroma to them, which resonates with the humors associated Earth element."
The examples Osborn gave were from Europe. I went through the local herbal collections hoping to discover which had been used in this area. Leonora Curtin collected medicinal plant uses in the 1940s. In 1972, José Ortiz y Pino noted which of her cures had been used in the Galisteo area when he was a child, and added some of his own.

They made their notes 200 years after Quintana lived. I eliminated those that used ingredients introduced to the area since 1750. I also discounted those that came from the mountains. The Utes, Apache, and Comanche were making so many raids in those years that people simply didn’t go beyond settled areas. At least some of the plants had to be available in the winter.

Many of the modern cures involved baths. I eliminated those because I found no evidence people had the necessary utensils. Quintana’s daughter died a year after him. She said she owned an old round-bottomed pot, an old saucepan, three dishes, a new gourd dish, and white mesh for a sieve. Juana Roybal was much wealthier when she died in 1770. Still she only declared a copper kettle, a chocolate pot, some Puebla chinaware, two barrels and a jug in her will.

How ever people were keeping themselves and their clothing clean, it wasn’t with the large tubs or pots we see in artists’ reconstructions. They must have been introduced in trade later.

As I read through the remedies I realized the specific herbs were less important than their applications. People crushed leaves or roots over painful areas, thereby releasing essential chemicals. If that didn’t work, they boiled them in small containers, then dipped cloths in the liquids. They often bound the herbs or soaked fabrics around the affected areas. They also drank the same liquids they used in their compresses.

While they boiled the leaves, roots and stems, no one said if they applied the extracts while they were warm, or if they waited until they cooled. Contemporary medicine recommends applying cold to sore joints to decrease inflamation. It suggests using heat to stimulate the flow of blood.

One plant Curtin and Ortiz y Pino mentioned I know was available was chile. Quintana’s daughter left "seven ristras of chile, two in an old bunch" when she dictated her will in May. Curtin was told a pepper was split, then soaked in warm vinegar for a day. Next, "a cloth is steeped in the liquid and applied to the afflicted part." Ortiz y Pino echoed her comment.

Modern scientists have determined chile, in fact, would have been effective. The important ingredient, capsaicin, binds with the neurotransmitter in the skin that sends pain messages to the brain, and thus reduces its power. An Italian team even found capsaicin, when used in large doses, might also affect the chemicals within the synovial tissue. However, they considered their results preliminary.

Some capsaicin tests have yielded contradictory results. I suspect it’s because the experimenters used different pepper species. Anyone here now knows there are great differences even within Capsicum frutescens.

Notes:
The post for 3 July 2010 outline evidence Quintana may have been suffering from rheumatoid arthritis.

Christmas, Henrietta Martínez. "Juana Roybal - Will 1770," posted 1 June 2014 on her 1598 New Mexico website.

Curtin, Leonora Scott Muse. Healing Herbs of the Upper Rio Grande, 1947, republished 1997, with revisions by Michael Moore.

Lomelí, Francisco A. and Clark A. Colahan. Defying the Inquisition in Colonial New Mexico, 2006; contains Spanish and English versions of Lugardia Quintana’s will.

Mason, Lorna, R Andrew Moore, Sheena Derry, Jayne E Edwards, and Henry J McQuay. "Systematic Review of Topical Capsaicin for the Treatment of Chronic Pain," British Medical Journal 328:991:2004.

Matucci-Cerinic, M., S. Marabini, S. Jantsch, M. Cagnoni, and G. Partsch. "Effects of Capsaicin on the Metabolism of Rheumatoid Arthritis Synoviocytes in Vitro," Annals of the Rheumatic Diseases 49:598-602:1990.

Ortiz y Pino III, José. The Herbs of Galisteo and Their Powers, 1971.

Osborn, David K. "Pathologies of Black Bile" and "Adjusting and Regulating Black Bile and the Nervous Humor," Greek Medicine website.

Terao, Chikashi, et alia. "Inverse Association between Air Pressure and Rheumatoid Arthritis Synovitis," Plos One, 15 January 2014.

Monday, October 03, 2016

Santa Cruz Diet

Miguel de Quintana died in 1748. His daughter Lugarda died the following June at age 50. She had married Asecncio Archuleta, who was the grandson of Juan de Archuleta and Isabel González through Andrés de Archuleta and Josefa Martín Serrano. When she was dictating her will in May she said her "husband is absent and I do not know where."

They had three children: Cristóbal, Nicolás Marcos, and Juana Josefa. One family genealogist said Cristóbal was born in 1720, another said that was the year Nicolás was born. Juana was born around 1725, and married in 1745. A Marcos Archuleta, who may have been her son, married in 1751, after she died. María Rosa was a witness.

Lugarda didn’t mention owning any captives, but she and Archuleta probably were responsible for the Apache girl, María Josepha, they baptized in 1743. In 1732 Lugarda and her brother were godparents for the son of María Rosa and in 1734 she and her husband sponsored the baptism of María Olaia, who had no known parents. Lugarda also mentioned a niece, who may have been living with her in 1749.

The details in her will give enough information to reconstruct much of her diet. The house where she lived and its land had belonged to her husband’s father, but the title was still in probate. Separately she had purchased half an acre from her husband’s uncle, Luis de Archuleta, that reached to the main acequia.

Acreage is hard to determine. The Spanish used a vara, which was roughly equivalent to a yard. More often, they used a fanega, meaning the amount of land a fanega of seed would plant. It varied in size for corn or wheat. Her half acre probably produced enough corn to support one person for one year, with little saved for seed. She mentioned no surplus left after spring planting.

Her husband’s land must have been greater then hers. She owned "four lead oxen and two bull oxen," along with three plow shares. From this one can assume she was raising corn or wheat.

She did leave a "wooden dough bowl" and a guitar. The translators believed that should have read guijarra, which was "a small stone from a river bed that could have been used as a pestle." It may be what was used to grind the corn or wheat.

More important for her diet, she said, within her husband’s land, she had built a "garden 10 varas long of which I claim only the walls and roof," the "paredes y techo." She also left two shovel picks or coas, one smaller than the other, which probably were used to break ground. She had "two old hoes," which probably were used for leveling and weeding.

We know she grew peppers in her huerto, but what else is a guess. This may be where beans and squash were grown. Those were the conventional plants of the time. There’s nothing to signify she grew other greens, vegetables or herbs. No dried remains were mentioned, and it was too early in the season to mention her current crops.

In addition, to the land she owned "a cow for breeding and a two-year-old calf," along with "three hens and two roosters." This means she had eggs, and probably milk. Her white mesh cloth used for a sieve may have been used to make simple cheese.

She probably did not get protein from meat very often, though she did own a spit. She did say she had four cowhides. Since they were usable as trade items, they may have accumulated since her husband or her representative last went to Chihuahua.

She had inherited "110 head of goats and cattle" from her father, but she can’t have had them long enough to have used much of their milk. He only died the previous year. There’s no indication where she grazed them; perhaps they were on land owned by a sibling.

She said she had traded eight goats for sheep and appears to have been using some of the other animals as a source of income. She had leant some out to others. She didn’t give the terms, but they probably owned her some of the young.

She may not have been able to grow enough to sustain herself and the others in her household, and definitely may not have had enough to eat the winter before she died. 1748 was the beginning of a decade long drought with more forest fires than usual. She just said she was "enferma en cama de la emfermedad," translated as "sick in bed with the illness."

In such bad times, the animals could have been eaten or used in barter. In addition, she did have her children, her siblings, and her husband’s family for support, although they too would have had seen reduced crops in 1748. Her brother-in-law, Pedro Sánchez, was her executor. Another brother-in-law, Hilario Archuleta, transcribed her will.

The one surprising thing she mentioned was a "jar of sugar-paste candies." One would guess they came from Chihuahua. At this time, men made annual trips there to trade animals, hides and fleeces. Merchants there were loathe to give them cash in return. Candy might have been offered as a high-value, compact item, much as it is today.

She didn’t mention the real luxuries of the time, sugar and chocolate. Her father, apparently, was paid occasionally with them for his work writing documents for others. He speculated, when he was writing a coloquio, maybe they "will give you a reward of sugar and some pieces of chocolate."

Notes:
Ancestry genealogical website. Anonymous entry on Nicolás Marcos Archuleta.

Chávez, Angélico. Origins of New Mexico Families, 1992 revised edition.

Lomelí, Francisco A. and Clark A. Colahan. Defying the Inquisition in Colonial New Mexico, 2006.

Mestas, Orlando Ricardo. Entries on Gertrudis Lugarda de Quintana and two of her children on Geni genealogical website, 20 November 2014.

New Mexico Genealogical Society. New Mexico Baptisms, Santa Cruz de la Cañada Church, Volume I, 1710 to 1794, transcribed by Virginia Langham Olmstead and compiled by Margaret Leonard Windham and Evelyn Luján Baca, 1994.

_____. 100 Years of Marriages, 1726-1826, Santa Cruz de la Cañada, New Mexico, extracted and compiled by Henrietta Martinez Christmas and Patricia Sánchez Rau.

Quintana, Gertrudis Lugarda de. Will, 12 May 1749; original in Ralph Emerson Twitchell, Spanish Archives of New Mexico, volume 1, 1914; English and Spanish versions in Lomelí.

Quintana, Miguel de. Coloquio, 1732; English and Spanish versions in Lomelí.

Scurlock, Dan. From the Rio to the Sierra: An Environmental History of the Middle Rio Grande Basin, 1998.

To calculate the yield on her land:
Rowlett, Ross. "How Many? A Dictionary of Units of Measure," 2001, website. He says, "one fanega of land grows one fanega of corn seed." It was standardized to 1.59 acres in 1801, or .75 acres for a half fanega. Half an acre would then be one third of a fanega.

Gibson, Charles. The Aztecs Under Spanish Rule, 1964. He calculates the corn yield in a good year would have been 75 to 125 fanegas for one sown, with 11 fanega or 17 bushels an acre. That would mean half an acre would produce 8.5 bushels.

Fat Knowledge. "How Many People Can the Earth Support?, 30 November 2008 blog posting. He calculates a "bushel of corn can support a person for 52 days at 2,400 kcal/day with 25.4kg/bushel)," or 7 bushels a year. I reduced that number, since nutritional values may be greater today.