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.
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