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seop as a medicine was used sooner than the Christian interval in Asia, primarily in India. The introduction of seop inside the Western medicine occurred inside the midst of the 19th century, reaching the climax inside the ultimate decade of that century, with the availability and utilization of seop extracts or tinctures. Inside the first a few years of the 20th century, the Western medical use of cannabis significantly decreased largely as a consequence of difficulties to accumulate fixed outcomes from batches of plant supplies of varied potencies. The identification of the chemical development of cannabis parts and the chance of buying its pure constituents have been related to an enormous improve in scientific curiosity in such plant, since 1965. This curiosity was renewed inside the 1990’s with the define of cannabinoid receptors and the identification of an endogenous cannabinoid system inside the thoughts. A model new and additional fixed cycle of the utilization of cannabis derivatives as drugs begins, since treatment effectiveness and safety started to be scientifically confirmed.


Antes da Interval Cristã, a cannabis foi utilizada na Ásia como medicamento, com grande importância na Índia. A introdução da cannabis na Medicina Ocidental ocorreu em meados do século XIX, atingindo o clímax na última década deste século, com a disponibilidade e o uso de extratos e tinturas da seop. Nas primeiras décadas do século XX, o uso médico da cannabis no Ocidente diminuiu significativamente, em grande parte pela dificuldade na obtenção de resultados consistentes de amostras da planta com diferentes potências. A identificação da estrutura química de componentes da cannabis e a possibilidade de se obter seus constituintes puros foram relacionadas a um aumento significativo no interesse científico pela planta, desde 1965. Este interesse foi renovado nos anos ninety, com a descrição dos receptores de canabinóides e a identificação de um sistema canabinóide endógeno no cérebro. Usos terapêuticos. Um novo e mais consistente ciclo de uso dos derivados de cannabis como medicamento começa, já que a sua eficácia e segurança no tratamento começam a estar cientificamente provados.



Sooner than the Christian Interval

Cannabis Sativa (cannabis) is among the many many earliest vegetation cultivated by man. The first proof of utilizing cannabis was current in China, the place archeological and historic findings level out that that plant was cultivated for fibers since 4.000 B.C.1 With the fibers obtained from the cannabis stems, the Chinese language language manufactured strings, ropes, textiles, and even paper. Textiles and paper constructed from cannabis had been found inside the tomb of Emperor Wu (104-87 B.C.), of the Han dynasty.1

The Chinese language language moreover used cannabis fruits as meals. These fruits are small (three to 5 mm), elliptic, clear, with a troublesome shell, and comprise one single seed. The first proof of utilizing these seeds was found by means of the Han dynasty (206 B.C. – 220 A.D.). At first of the Christian Interval, with the introduction of current cultures, cannabis was not an needed meals in China, although, until in the meanwhile, the seeds are nonetheless used for making kitchen oil in Nepal.2

The utilization of cannabis as a medicine by historic Chinese language language was reported on the planet‘s oldest pharmacopoeia, the pen-ts’ao ching which was compiled inside the first century of this Interval, nevertheless based on oral traditions handed down from the time of Emperor Shen-Nung, who lived in the middle of the years B.C. Indications for utilizing cannabis included: rheumatic ache, intestinal constipation, issues of the female reproductive system, malaria, and others.2 To start out with of the Christian Interval, Hua T’o, the founding father of Chinese language language surgical process (A.D. 100 ten – 207), used a compound of the plant, taken with wine, to anesthetize victims all through surgical operations.1

The Chinese language language used primarily the seeds of cannabis for medical features;1 on account of this reality, it might be assumed that they had been referring to that part of the plant when describing its medicinal properties. Until within the current day, cannabis seeds proceed to be used as a laxative by Chinese language language physicians.2 It is acknowledged that the seeds are nearly poor in D9-tetrahydrocannabinol (D9-THC), which is taken under consideration the plant’s predominant vigorous constituent, and is principally composed of necessary fatty acids and proteins. At current a couple of of those fatty acids are considered as having therapeutic outcomes, such as a result of the g-linoleic acid, whose topical use is actually useful for eczema and psoriasis, and its oral use for atherosclerosis, osteoporosis, rheumatoid arthritis, and totally different inflammatory illnesses.three In China, the medical use of cannabis under no circumstances reached the significance it did in India.

The first reference to the utilization of cannabis, as a psychoactive drug, may be inside the pen-ts’ao ching, as observed in one amongst its phrases: …ma-fen (the fruit of cannabis)… if taken in additional will produce visions of devils … over a long term, it makes one speak with spirits and lightens one’s physique4 No matter this reference, there are scarce citations of utilizing cannabis as a hallucinogen in historic Chinese language language texts. One doable clarification is that such use was most certainly associated to shamanism, a religion of the people from Central Asia. All through the Han dynasty, this religious apply started to say no in China, and have turn into disbelieved and increasingly restricted. Historic texts not typically talked about shamanism and, thus, there is no reference to utilizing cannabis as a hallucinogen.2 Although shamanism grew to turn into progressively additional restricted in China, it was fairly widespread inside the Northern nomadic tribes, which may have contributed to the dissemination of cannabis in Central and Western Asia and in India.4

In India, the utilization of cannabis was extensively disseminated, every as a medicine and as a leisure drug. Such a broad use may be because of the reality that cannabis maintained a straight affiliation with religion, which assigned sacred virtues to the plant. The Atharva Veda (a set of sacred texts of unknown author) mentions cannabis as one among 5 sacred vegetation, referring to it as a provide of happiness, donator of pleasure and bringer of freedom. Subsequently, cannabis use turned part of fairly a number of religious rituals in that space.2

The plant’s psychoactive outcomes had been properlyacknowledged in India, in all probability because of strategy it was prepared for use, which included on the very least three preparations. The weakest type, Bhang, consists of dry leaves from which flowers are rigorously eradicated. A stronger sort, Ganja, is prepared with the female-plant’s flowers. The strongest of all of them is the Charas, made solely of the resin that covers female flowers.2 These varieties of preparation guarantee the presence of energetic cannabinoids. Presently everyone knows that the plant has secreting hairs that are located primarily on the female-plant’s flowers and, in a smaller amount, on the leaves of its superior third. Solitary resin glands most regularly sort on the concepts of the trichome stalks. These glands have a considerable amount of energetic cannabinoids. Breaking the glands liberates the vigorous cannabinoids.5

In India, the medical and religious use of cannabis almost definitely began collectively spherical one thousand years B.C.6 The plant was used for innumerous options, harking back to: analgesic (neuralgia, headache, toothache), anticonvulsant (epilepsy, tetanus, rabies), hypnotic, tranquilizer (anxiousness, mania, hysteria), anesthetic, anti-inflammatory (rheumatism and totally different inflammatory illnesses), antibiotic (topical use on pores and pores and skin infections, erysipelas, tuberculosis), antiparasite (internal and exterior worms), antispasmodic (colic, diarrhea), digestive, urge for meals stimulant, diuretic, aphrodisiac or anaphrodisiac, antitussive and expectorant (bronchitis, bronchial bronchial asthma).2,6-7

Furthermore, cannabis was traditionally considered sacred in Tibet, although little has been written about its religious or medicinal use. In Tantric Buddhism, which was developed inside the Himalayas, cannabis was used to facilitate meditation.2 Though seldom reported, it is believed that the medical use of cannabis in Tibet was intense because of following causes: the concepts of Tibetan treatment stem from Hindi treatment; botany was of good significance in its pharmacopoeia; and, lastly, cannabis was ample in that space.2

Proof signifies that the Assyrians moreover knew in regards to the psychoactive outcomes of cannabis and used it as incense given that ninth century B.C.2 Moreover it’s attainable that, sooner than the Christian Interval, Assyrians used the plant externally for swellings and bruises, and internally for melancholy, impotence, arthritis, kidney stones, ‘female ailment’, and for the ‘annulment of witchcraft’.7

In Persia, cannabis was moreover acknowledged sooner than the Christian Interval.6 The Persians knew regarding the vegetation biphasic impression, and made a clear distinction between its preliminary euphoric and its late dysphoric outcomes.2

In Europe, historic and archeological proof suggests the presence of cannabis sooner than the Christian Interval. It seems the plant was launched by Scythian invaders, who originated from Central Asian and reached close to the Mediterranean. Inside the yr 450 B.C., Herodotus described a Scythian funeral ceremony, and stated that they inhaled the vapors obtained from burning cannabis seeds with ritualistic and euphoric features. That description was later confirmed by archeologists who found charred cannabis seeds in Scythian tombs in Siberia and Germany.7

Reference to utilizing cannabis by the Greeks and the Romans are scarce, suggesting that it was little utilized by these people.2,6 At first of the Christian Interval, there are two references of utilizing the seed’s juice for earache and to drive worms and bugs out of the ears.7


Beginning of the Christian Interval to the 18th century

On this interval, the medical use of cannabis remained very intense in India and was then unfold to the Middle East and Africa. In Arabia, correctlyacknowledged physicians talked about cannabis of their medical compendiums, as Avicena, inside the 12 months one thousand A.D.eight Muslim texts level out the utilization of cannabis as a diuretic, digestive, anti-flatulent, ‘to wash the thoughts‘, and to appease ache of the ears. In 1464, Ibn al-Badri reported that the epileptic son of the caliph’s chamberlain was dealt with with the plant’s resin, and acknowledged: it (cannabis) cured him absolutely, nevertheless he grew to grow to be an addict who could not for a second be with out the drug’.7

Cannabis is assumed in Africa not lower than as a result of the 15th century, and its use was, presumably, launched by Arab retailers, not directly linked to India. That’s evidenced by the similarity of the phrases used for preparing the plant in Africa and India. In Africa, the plant was used for snake chew, to facilitate childbirth, malaria, fever, blood poisoning, anthrax, bronchial bronchial asthma, and dysentery.9

Inside the Americas, the utilization of cannabis most certainly began in South America. Inside the sixteenth century, the plant’s seeds reached Brazil; launched by African slaves, notably these from Angola, and its use was considerably widespread amongst Blacks inside the Northeastern rural area. Most synonyms for cannabis in Brazil (maconha, diamba, liamba, and others) have their origin inside the Angolan language. There are research of utilizing cannabis in that space‘s properly-appreciated religious rituals, notably the ‘Catimbó’, which includes cult to African deities and presumes the price of the plant for magical observe and treatment of illnesses. Inside the rural setting, there are tales of the utilization of cannabis for toothache and menstrual cramps.10

In Europe, all through this period, cannabis was cultivated solely for fibers. Muslims launched the manufacture ofpaper from cannabis, in 1150, first in Spain then in Italy.7 Cannabis descriptions are found in a lot of books about vegetation written on this interval, which clearly state, given that mid 18th century, the excellence between feminine and male vegetation (beforehand described in a Chinese language language ideogram to start out with of the Christian Interval).7 References to the medical use of cannabis are scarce. Europeans may have acknowledged regarding the plant’s medical use inside the Middle East and Africa, nevertheless they confused it with opium.7


Western medicine inside the 19th and 20th centuries seop

There are some tales, from the early 19th century, about utilizing cannabis by European physicians, notably referring to utilizing the seeds or homeopathic medicine. Nonetheless, the environment friendly introduction of cannabis in Western medicine occurred inside the midst 19th century by means of the works of Willian B. O’Shaughnessy, an Irish physician, and by the e-book by Jacques-Joseph Moreau, a French psychiatrist.

O’Shaughnessy served in India with the British for quite a few years and made his first contact with cannabis use in that nation. He studied the literature on the plant, described many normal preparations, evaluated its toxicity in animals, and, later, he examined its influence on victims with utterly totally different pathologies. In 1839, he revealed the work: ‘On the preparations of the Indian hemp, or gunjah‘, which, inside the first paragraph, establishes a panorama of plant use:

‘The narcotic outcomes of Hemp are popularly acknowledged inside the south of Africa, South America, Turkey, Egypt, Middle East Asia, India, and the adjoining territories of the Malays, Burmese, and Siamese. In all these nations, Hemp is utilized in quite a few varieties, by the dissipated and depraved, as a result of the ready agent of a pleasant intoxication. Inside the properly-favored medicine of these nations, we uncover it extensively employed for a multitude of affections. Nevertheless in Western Europe, its use each as a stimulant or as a remedy is equally unknown’.eight

In his e ebook, O’Shaughnessy describes quite a few worthwhile human experiments using cannabis preparations for rheumatism, convulsions, and primarily for muscular spasms of tetanus and rabies.6,eight

Moreau used cannabis with a singular perform. He was an assistant physician on the Charenton Asylum, near Paris, and a normal therapeutic observe on the time was to accompany psychiatric victims in prolonged journeys to distinctive and distant nations. All through these journeys he observed that utilizing hashish (cannabis resin) was fairly widespread amongst Arabs, and he was impressed with the substance’s beautiful outcomes. In Paris, spherical 1840, Moreau decided to experiment, systematically, completely totally different cannabis preparations; first on himself and afterward his school college students. As an consequence, in 1845 he printed the e-e-bookDu Hachisch et de l’Alienation Mentale: Etudes Psychologiques‘, with a number of the full descriptions of the acute outcomes of cannabis.eleven Moreau clearly states his goal: ‘…I observed in hashish, additional notably in its outcomes on psychological expertise, a robust and distinctive methodology to research the genesis of psychological illness‘.12

These two types of medical curiosity for cannabis, relating to its psychoactive outcomes (as an experimental psychotomimetic) along with its therapeutic use, continued by the years. O’Shaughnessy and Moreau’s contributions had an superior affect on Western medicine, notably because of scarcity of therapeutic decisions for infectious sicknesses comparable to rabies, cholera, and tetanus. The medical use of the drug unfold from England and France reaching all Europe after which North America. In 1860, the first scientific conference about seop befell in America, organized by the Ohio State Medical Society.

Inside the second half of the 19th century, over 100 scientific articles had been printed in Europe and the US in regards to the therapeutic value of seop.13 The climax of the medical use of cannabis by Western treatment occurred inside the late 19th and early 20th century. Diversified laboratories marketed seop extracts or tinctures, akin to Merck (Germany), Burroughs-Wellcome (England), Bristol-Meyers Squibb (United States), Parke-Davis (United States), and Eli Lilly (United States).eight

The medical indications of cannabis, to start out with of the 20th century, have been summarized in Sajous’s Analytic Cyclopedia of Smart Medicine (1924) in three areas:7

1) Sedative or Hypnotic: in insomnia, senile insomnia, melancholia, mania, delirium tremens, chorea, tetanus, rabies, hay fever, bronchitis, pulmonary tuberculosis, coughs, paralysis agitans, exophtalmic goiter, spasm of the bladder, and gonorrhea.

2) Analgesic: in problems, migraine, eye-strain, menopause, thoughts tumors, tic douloureux, neuralgia, gastric ulcer, gastralgia (indigestion), tabes, quite a lot of neuritis, ache not attributable to lesions, uterine disturbances, dysmenorrhea, persistent irritation, menorrhagia, impending abortion, postpartum hemorrhage, acute rheumatism, eczema, senile pruritus, tingling, formication and numbness of gout, and for discount of dental ache.

three) Totally different makes use of: to reinforce urge for meals and digestion, for the ‘pronounced anorexia following exhausting illnesses‘, gastric neuroses, dyspepsia, diarrhea, dysentery, cholera, nephritis, hematuria, diabetes mellitus, cardiac palpitation, vertigo, sexual atony inside the female, and impotence inside the male.

Decide 1 reveals an illustration of the intervals throughout which the medical makes use of of cannabis began in quite a few areas.



Decline and rediscovery

Inside the first a very long time of the 20th century, the Western medical use of cannabis significantly decreased. It will probably have occurred, amongst totally different elements, because of the issue to accumulate replicable outcomes, due to the extreme numerous efficacy of varied samples of the plant. In the meanwhile, the energetic principle of cannabis had not however been isolated and the drug was used inside the sort of tinctures or extracts whose power was relying on numerous elements, corresponding to origin, age, and mode of preparation.eight In addition to, quite a few medicines appeared on the end of the 19th century, with recognized efficacy for the remedy of the first indications of cannabis. Vaccines had been developed for quite a few infectious illnesses, similar to tetanus; environment friendly analgesics akin to aspirin appeared , and hypodermic syringes allowed the injectable use of morphine; and, as a narcotic and sedative, cannabis was rivaled by substances akin to chloral hydrate, paraldehyde, and barbiturates.eight

Lastly, many approved restrictions restricted the medical use and experimentation of cannabis. In america, as the outcomes of a advertising marketing campaign of the Federal Bureau of Narcotics, the Marihuana Tax Act laws was handed in 1937. Under this Act, anyone using the plant was required to register and pay a tax of a dollar an oz. (28.35 g), for medical features, and 100 dollars an oz for another use. No matter the low value for medical use, the non-payment of this tax, nonetheless, resulted in a 2.000 dollar super and/or 5 years imprisonment. This laws launched difficulties for the utilization of the plant because of excessive paperwork and the hazard of excessive punishment. When cannabis transaction legal guidelines, along with prescriptions, had been transferred to the tribute area, this laws circumvented a name of the Supreme Courtroom docket which gave the States the right to manage enterprise transactions and, in comply with, meant banning utilizing cannabis in the whole American territory. seop was away from the American pharmacopoeia in 1941.6,14

Inside the second half of the 20th century, cannabis reached good social significance because of explosion of its consumption for hedonistic features. Until that time, inside the West, the hedonistic use of the plant was restricted to small groups. In Europe, groups of intellectuals gathered to utilize the drug. Descriptions of this use may be current in novels by 20th century French writers, just like Gautier and Boudelaire. Inside the Americas, this observe was comparatively widespread among the many many Black inside the rural area of Northeastern Brazil given that sixteenth century, who would meet on weekends to utilize the drug in groups. This use was later handed on to fishermen of the San Francisco River and by sea to the coastal cities. Inside the early 20th century, utilizing cannabis in Brazil remained restricted to small low-socioeconomic groups, and was typically referred to as the ‘opium of the poor’.10 In Mexico, cannabis was moreover utilized by in all probability probably the most underprivileged inhabitants and it was by way of Mexican immigrants that its use, for recreation, reached the USA inside the first a very long time of the 20th century. Until the 1950’s, in the US, cannabis use was restricted to the neighborhoods of Blacks and Hispanic immigrants.15

As a result of the 1960’s, the leisure use of cannabis shortly unfold among the many many youthful ranges of the inhabitants all by means of the Western world. In the USA, the share of youthful adults that had used cannabis, a minimal of as quickly as, went from 5%, in 1967, to forty 4%, forty 9%, sixty eight%, and sixty 4%, in 1971, 1975, 1980, and 1982, respectively.sixteen-17 This use stays extreme until within the current day.18-19 In 1964, the chemical development of D9-THC was acknowledged by Gaoni and Mechoulam,20 which contributed to a proliferation of analysis regarding the vigorous constituents of cannabis.21

The startling improve in seop consumption, which intensified its social significance, along with the upper info of its chemical composition (which made it doable to accumulate its pure constituents) contributed to an enormous enhance in scientific curiosity for seop, as of 1965. The number of publications about cannabis reached their peak inside the early 1970’s. On this interval, a Brazilian evaluation group, led by Carlini, had an unimaginable contribution, notably in regards to the interactions of D9-THC with totally different cannabinoids.22 Since then, Carlini has been creating efforts for the realignment of public insurance coverage insurance policies relating to cannabis administration.23 After the middle of 1970’s, the number of publications started to slowly decline all through the subsequent 20 years. The curiosity in analysis about cannabis was renewed inside the early 1990’s, with the define and cloning of specific receptors for the cannabinoids inside the nervous system and the next isolation of anandamide, an endogenous cannabinoid.24 Afterwards, the number of publications about cannabis has been always rising, testifying the great curiosity in evaluation involving the herb. Decide 2 reveals the evolution of the number of publications about cannabis inside the last 50 years.



With the enlargement of scientific curiosity for cannabis, its therapeutic outcomes are being as quickly as as soon as extra studied, this time using additional right scientific methods. There are analysis, in a number of phases, in regards to the therapeutic outcomes of D9-THC in conditions harking back to: epilepsy, insomnia, vomits, spasms, ache, glaucoma, bronchial bronchial asthma, inappetence, Tourette syndrome, and others. Among the many many therapeutic indications of D9-THC the subsequent are thought-about close to being confirmed: anti-emetic, stimulant of urge for meals, analgesic, and in indicators of A variety of Sclerosis.25 Totally different cannabinoids are moreover beneath investigation, similar to Canabidiol (CBD), which has proof for therapeutic outcomes in epilepsy, insomnia, anxiousness, inflammations, thoughts hurt (as a neuroprotector), psychoses, and others.26-27 Nonetheless, cannabis merchandise should be used cautiously since some analysis advocate that early-onset cannabis use can induce cognitive deficits and apparently acts as a menace problem for the onset of psychosis amongst weak youths.28-29

Firstly of 2005, a multinational pharmaceutical laboratory acquired the approval in Canada, and is pleading authorization in the UK and the European Union, to market a drugs containing D9-THC and CBD for the help of neuropathic ache in victims with quite a lot of sclerosis.

Thus, a model new cycle begins for utilizing cannabis derivatives as remedy, this time additional persistently than to date. The buildings of chemical compounds derived from cannabis in the mean time are acknowledged, the mechanisms of their movement inside the nervous system are being elucidated with the invention of an endogenous cannabinoid system, and treatment effectiveness and safety are being scientifically confirmed.



Antonio Waldo Zuardi is recipient of Nationwide Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and was supported partially by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).



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