Over a thousand years ago, Nuh ibn Mansur, the reigning prince of the medieval city of Bukhara, fell badly ill. The doctors, unable to do anything for him, were forced to send for a young man named Ibn Sina, who was already renowned, despite his very young age, for his vast knowledge. The ruler was healed.
Ibn Sina was an 11th century Persian philosopher, physician, pharmacologist, scientist and poet, who exerted a profound impact on philosophy and medicine in Europe and the Islamic world. He was known to the Latin West as Avicenna.
Avicenna’s Canon of medicine, first translated from Arabic into Latin during the 12th century, was the most important medical reference book in the West until the 17th century, introducing technical medical terminology used for centuries afterwards.
Avicenna’s Canon established a tradition of scientific experimentation in physiology without which modern medicine as we know it would be inconceivable.
For example, his use of scientific principles to test the safety and effectiveness of medications forms the basis of contemporary pharmacology and clinical trials.
Avicenna has been in the news recently due to his work on contagions. He produced an early version of the germ theory of disease in the Canon where he also advocated quarantine to control the transmission of contagious diseases.
Uniquely, Avicenna is the rare philosopher who became as influential on a foreign philosophical culture as his own. He is regarded by some as the greatest medieval thinker.
He was born Abdallāh ibn Sīnā in 980AD in Bukhara, (present day Uzbekistan, then part of the Iranian Samanid empire). Avicenna was prodigious from youth, claiming in his autobiography to have mastered all known philosophy by 18.
Avicenna’s output was extraordinarily prolific. One estimate of his body of work counts 132 texts. These cover logic, natural philosophy, cosmology, metaphysics, psychology, geology, and more. Some of these texts he wrote while on horseback, travelling from one city to another!
His work was a virtuosic kind of encylopedism, gathering the various traditions of Greek late antiquity, the early Islamic period and Iranian civilisation into one rational knowledge system covering all of reality.
Avicenna’s texts were forged out of the colossal Graeco-Arabic translation movement that took place in medieval Baghdad. They then played a key role in the Arabic to Latin translation movement that brought Aristotle’s philosophy back, in a highly enriched manner, into Western thought.
From the 12th century on, Avicenna shaped the thought of major European medieval thinkers. Thomas Aquinas’s writings feature hundreds of quotations from Avicenna regarding issues such as God’s providence. Aquinas also sought to refute some of Avicenna’s positions such as that which argued the world was eternal.
Book of Healing
Avicenna’s Kitāb al-shifā , The Book of Healing, was as influential in Latin as his medical Canon.
Avicenna’s Canon brilliantly synthesises Islamic medicine with that of Hippocrates (460 – 370 BC) and Galen (129 – 200 AD). There are also elements of ancient Persian, Mesopotamian and Indian medicine. This was supplemented by Avicenna’s extensive medical experiences.
In the Canon, Avicenna introduced diagnoses and treatments for illnesses unknown to the Greeks, being the first doctor to describe meningitis. He made new arguments for the use of anaesthetics, analgesics, and anti-inflammatory substances.
Avicenna’s detailed descriptions of capillary flow and arterial and ventricular contractions in the cardiovascular system (the blood and circulatory system) assisted the Arab-Syrian polymath Ibn al Nafis (1213-1288), who became the first physician to describe the blood’s pulmonary circulation, the movement of blood from the heart to the lungs and back again to the heart.
This happened in 1242, centuries before scientist William Harvey arrived at the same conclusion in 17th century England.
Another innovative aspect of Avicenna’s Canon is its exploration of how our body’s well-being depends on the state of our mind, and the interaction between the heart’s health and our emotional life.
In the wake of COVID-19, we’re seeing intense international competition for urgently-needed supplies including personal protection equipment and ventilators. In Australia, this could extend to other critical imports such as pharmaceuticals and medicines. And when our manufacturing sector can’t fill unexpected breaks in supply chains, we all face risk.
However, Australians have lived through crises of comparable magnitude before. During and after the two world wars, scientific innovation played a crucial role in reform. It led to the creation of the Council for Scientific and Industrial Research (CSIR) and an array of subsequent discoveries.
Some may assume life will go back to normal once COVID-19 withdraws. But if the past is to be learnt from, Australia should prepare for a greatly different future – hopefully one in which science and innovation once more take centre stage.
It was WWI that heightened awareness of the role of science in defence and economic growth. In December 1915, Prime Minister William (Billy) Hughes announced he would set up a national laboratory “which would allow men of all branches of science to use their capabilities in application to industry”.
This led to the formation of the CSIR in 1926, and its rebirth as the CSIRO in 1949. In the years after WW1, the CSIR contributed greatly to improvements in primary production, including through animal nutrition, disease prevention, and the control of weeds and pests in crops. It also advanced primary product processing and overseas product transport.
In 1937, the CSIR’s mandate was expanded to include secondary industry research, including a national Aircraft and Engine Testing and Research Laboratory. This was motivated by the government’s concern to increase Australia’s manufacturing capabilities and reduce its dependence on technology imports.
War efforts in the spotlight
The CSIR’s research focus shifted in 1941 with the attack on Pearl Harbour. Australian war historian Boris Schedvin has written about the hectic scramble to increase the nation’s defence capacities and expand essential production following the attack, including expansion of the scientific workforce.
The John Curtin government was commissioned in October, 1941. Curtin appointed John Dedman as the Minister for War Organisation and Industry, as well as the minister in charge of the CSIR. Dedman’s department was concerned with producing military supplies and equipment, and other items to support society in wartime.
Dedman instructed the council to concentrate on “problems connected with the war effort”. The CSIR responded robustly. By 1942, the divisions of food preservation and transport, forest products, aeronautics, industrial chemistry, the national standards laboratory and the lubricants and bearings section were practically focused on war work full-time.
Scaling up production
The Division of Industrial Chemistry was the division most closely involved in actual production. It was formed in 1940 with Ian Wark as chief, who’d previously worked at the Electrolytic Zinc Company.
Wark was familiar with the chemical industry, and quickly devoted resources to developing processes (using Australian materials) to produce essential chemicals to the pilot plant stage. They were soon producing chemicals for drugs at the Fishermans Bend site, including the starting material for the synthesis of the anaesthetic drug novocaine (procaine).
The researchers developed a method to separate the drug ergot, which is now essential in gynaecology, from rye. They also contributed directly to the war effort by manufacturing the plasticiser used in the nose caps of bullets and shells.
Australian scientists have made monumental contributions on this front in the past. In the 1980s, CSIRO and its university collaborators began efforts that led to the creation of anti-flu drug Relenza, the first drug to successfully treat the flu. Relenza was then commercialised by Australian biotech company Biota, which licensed the drug to British pharmaceutical company GlaxoSmithKline.
The CSIRO also invented the Hendra virus vaccine for horses, launched in 2012.
Prior to that, Ian Frazer at the University of Queensland developed the human papillomavirus (HPV) vaccine which was launched in 2006.
COVID-19 is one of many viral diseases that need either a vaccine or a drug (or both). Others are hepatitis B, dengue fever, HIV and the viruses that cause the common cold. Now may be Australia’s chance to use our world class medical research and medicinal chemistry capabilities to become a dominant world supplier of anti-viral medications.
As was the case during WWI and WWII, this pandemic drives home the need to retain our capabilities at a time of supply chain disruption. While it’s impossible for a medium-sized economy like Australia’s to be entirely self-sufficient, it’s important we lean on our strengths to not only respond, but thrive during these complicated times.
In 2020, Australia has a much greater and broader research and production capacity than it did in 1940. And as we march through this pandemic, we can learn from the past and forge new paths to enhance our position as pioneers in sciencific innovation.
After World War II, evidence was given at the Nuremberg Trials of reprehensible research carried out on humans. This includes subjects being frozen, infected with tuberculosis, or having limbs amputated.
At the beginning of World War II, Nazi leadership saw medical and pharmaceutical research as a front-line tool to contribute to the war effort and reduce the impact of injury, disease and epidemics on troops.
Nazi leaders believed concentration camps were a source of “inferior beings” and “degenerates” who could (and should) be used as research subjects.
At first, the crimes were carried out via carbon monoxide poisoning.
In 1941, a second phase was launched: so-called “discrete euthanasia” via a lethal injection of drugs such as opiates and scopolamine (anti-neausea medication), or the use of low-doses of barbiturates to cause terminal pneumonia.
These techniques were combined with food rations and turning off the hospital heating during winter.
These euthanasia programmes led to what amounted to psychiatric genocide, with the murder of more than 250,000 patients. This is possibly the most heinous criminal act in the history of medicine.
Experimenting with healthy subjects
Medical experimentation became another tool of political power and social control, over both sick people from the T4 Program, as well as healthy people.
Those in good health were recruited in the concentration camps of ostracised ethnic or social groups such as Jews, Gypsies, Slavs and homosexuals.
A number of experiments were undertaken, including the study of:
the effect of sulfonamides (antibiotics) on induced gas gangrene (Ravensbrück)
the use of the toxic chemical formalin for female sterilisation (Auschwitz-Birkenau)
the use of vaccines and other drugs to prevent or treat people intentionally infected with malaria (Dachau)
the effects of methamphetamine in extreme exercise (Sachsenhausen)
the anaesthetic properties of hexobarbital (a barbiturate derivative) and chloral hydrate (a sedative) in amputations (Buchenwald)
the use of barbiturates and high doses of mescaline (a hallucinogenic drug) in “brainwashing” studies (Auschwitz and Dachau).
Faced with all this evidence, how it is possible that up to 45% of German doctors joined the Nazi party? No other profession reached these figures of political affiliation.
What were the reasons and circumstances that led to these perverse abuses?
The banality of evil in medicine
The answer is difficult. Many doctors argued that regulations were designed for the benefit of the nation and not the patient. They invoked such misleading concepts as “force majeure” or “sacred mission”.
Some believed everything was justified by science, even the inhumane experiments carried out in the camps, while others considered themselves patriots and their actions were justified by the needs of wartime.
Some were followers of the perverse Nazi ethos and others, the more ambitious, became involved in these activities as a means of promoting their professional and academic careers.
Lastly, avoiding association with the Nazi apparatus may have been difficult in a health sector where fear had become a system of social pressure and control.
Arturo Pérez-Reverte, in his book Purity of Blood, defines this type of motivation very well:
… although all men are capable of good and evil, the worst are always those who, when they administer evil, do so on the authority of others or on the pretext of carrying out orders.
However, as has happened in many moments of history, sometimes tragedies bring positive posthumous effects.
After the trial of the Nazi doctors, the first international code of ethics for research with human beings was enacted, the Nuremberg Code, under the Hippocratic precept “primun non nocere”. This code has had immense influence on human rights and bioethics.
Although unfortunate, the incident has focused attention on the importance of being able to share scientific specimens around the world, and the vital role that herbaria play in modern science.
Despite being sometimes described as “museums for plants”, herbaria aren’t just natural history storage and displays. In this era of DNA barcoding, big data, biosecurity threats, bio-prospecting, and global information sharing, herbaria are complex and evolving institutions.
The modern herbarium is steeped in tradition and full of antiquities, but it also leads the application of modern approaches to understanding our past, present and future natural world.
The power of 8 million specimens
If you tell someone that you work at a herbarium, most will ask “what’s that?”, or perhaps “oh, what kind of herbs do you grow there?”.
Conventionally, a herbarium is a collection of preserved plant specimens that are stored and managed in an organised and structured way by curators and botanists who specialise in plant taxonomy and systematics.
There are some 3,000 active herbaria worldwide. As a collective, they contain more than 380 million specimens, spanning collections dating back as far as 500 years ago.
In Australia there are nine state, territory or national herbaria that, along with some university collections, hold close to eight million specimens. Four major Australian herbaria hold over a million specimens:
Herbarium specimens exist in many forms, including “pickled” plants or plant parts such as flowers or other delicate structures, dried specimens still attached to the surface on which they grew (like tree bark and rocks), and fruits or seeds preserved whole. But the overwhelming majority are dried, pressed plant specimens attached to archival card. Alongside these specimens there are sometimes drawings, paintings or photographs of the species, which capture details that are not discernible in the preserved specimen.
The Australasian Virtual Herbarium
The plant specimens don’t just exist on their own inside herbaria. Along with the specimens, the accompanying information is vital, such as where and when they were collected, specific details of the environments where they were collected, and who collected them.
In Australia, the major herbaria have been actively adding this information into a digital repository, resulting in a world-leading dataset: the Australasian Virtual Herbarium.
The collation of these resources helped to inspire the development of the Atlas of Living Australia, and gives anyone with an internet connection access to specimen records from around Australia and the world.
Specimen-based, online data sets provide evidence of what species are found in a particular place at a particular time. They are a direct link from the presence of a species in the field, to collections of physical specimens held in herbaria, with the current name (that is, the latest changes in taxonomy) for that specimen.
There are many applications of such evidence including tracking changing species distributions such as ferals and weeds (an example of the weed “Salvation Jane” is shown in the figure above). Herbaria have been active in supporting detection of biosecurity threats. New introductions of species to Australia need careful determination of their identity and herbaria work with agencies to assist with this.
Sometimes, herbarium or museum specimens are the only evidence that a species existed at all. For example Gentianella clelandii, a species of native Gentian, is only known from the collection made of it in 1947 in the South East of South Australia. This species and others like it are likely to have been lost as a result of changing land use in the region at this time.
Samples from Cook, Flinders and Baudin
Important historical, scientific or cultural plant specimens exist in herbarium collections.
Plants collected during the voyages of early European explorers – including Dampier, Cook, Flinders and Baudin – are still found in herbaria. Some of these plants were also shipped live back to Europe, and have been grown in gardens and in scientific collections all over the world.
Remarkably, due to the care in methods of preserving them, these specimens are often in excellent condition more than 200 years after their collection and still able to be used productively in scientific research.
These historical specimens are often the first known collections of a previously undescribed species. If so, they will be designated as “type” specimens by the taxonomist naming the new species. Type specimens are very important as they allow the work of taxonomists to have a global frame of reference. This allows scientists to work out if two (or more) species have been assigned the same name.
Herbarium records enable resource managers to track distributions of both pest plants and endangered plants, providing a historical and current view of how widely spread and common the various species are across Australia.
You say River Red Gum, I say Yarrow
Taxonomy is the science of describing, classifying and naming plants, animals and microorganisms of the world. Taxonomists do the work of describing and arranging plant species into classifications based on their morphology (what they look like), their genes and sometimes other features.
While highly scientific by nature, taxonomy is also vital to society at large. For invasive plant control, for border control, for environmental management and for urban planning, there must be no ambiguity as to which plant species we are talking about. Common names of plants can be misleading, the same plant often having many different common names. For example, the Australian iconic tree species Eucalyptus camaldulensis is known as River Red Gum, Blue Gum, Murray Red Gum, Red Gum, River Gum and Yarrow. We know these are all the same species, because taxonomists can compare herbarium specimens and determine if they share the same characteristics.
Expansion of the search for new biological compounds for human use — including medicines, food, cosmetics and other applications — exemplifies the problem of misapplied taxonomic names. For example the search for bioactive compounds in marine algae yields very different results for different species.
But imagine if there wasn’t a way to apply the precision of taxonomy in the search for information on the characteristics of a species to be used for biological control? Not only would time and money be lost, but the incorrect species could be used and unforseen outcomes may occur.
An example from the insect world is the Southeast Asian termite. A potentially harmful species of the termite genus Coptotermes was known regionally by another name, affecting its management as a pest causing building damage in the Americas and Malaysia.
Herbaria as a research resource
In addition to storing and organising specimens, larger or highly specialised herbaria usually have an associated research program. Focus scientific areas typically include taxonomy, systematics (how living things are classified and named), evolutionary biology, conservation biology and applied botany (using plants for economic benefit) .
Many herbaria have molecular genetics laboratories attached to them. DNA can be extracted from many specimens, even very old ones, and thus they can become a core part of ongoing DNA based scientific research. Today, DNA barcoding can provide a rapid tool for identifying species when flowers or fruits are not available, or if we have only fragments. Globally, DNA barcodes are now available for more than 265,448 species in the BOLD database. This aggregation of DNA sequences, which for plants are linked to herbarium vouchers, are a global resource that can be used in a “big data” context to explore ideas.
The value of herbaria samples extends beyond just the plants themselves. Herbarium specimens have been used to collate data for inferring changes in flowering times, leaf morphology and species ranges with climatic shifts.
Scientists also analyse chemicals that herbarium specimens have been exposed to, such as heavy metals associated with urban development, and different elements incorporated as leaves grow. Knowledge about waxes on leaf surfaces, as well as inhabitation by insects, fungi and bacteria are all possible through herbarium samples.
The global network of herbaria share specimens so that taxonomists and other researchers can benefit from their existence. With online resources making it known exactly what specimens are in which herbarium, there is an ever growing set of demands made on the use of specimens.
Curators who look after collections must balance the requests for using specimens in the present with long term preservation. The ability to track the impact of climate change and other unforeseen influences on plant health may make our current herbaria collections even more priceless in years to come.