√ 13 Perkembangan Sejarah Awal Mula Penggunaan Obat di Dunia

Sejarah obat dan definisi obat – Obat adalah zat yang dapat mempengaruhi aktifitas fisik atau psikis pengertian obat menurut WHO. Sedangkan menurut pengertian obat Kebijakan Obat Nasional (KONAS) ialah bahan atau sediaan yang digunakan untuk mempengaruhi atau menyelidiki sistem fisiologi atau kondisi patologi dalam rangka penetapan diagnosis, pencegahan, penyembuhan, pemulihan dari rasa sakit, gejala sakit dan atau penyakit untuk meningkatkan kesehatan dan kontrasepsi. Definisi obat adalah senyawa kimiawi baik yang berasal dari alam maupun sintetis selain makanan yang dalam dosis layak mempunyai pengaruh terhadap atau dapat menimbulkan efek pada organisme hidup baik efek psikologis, psikologis, fisiologis maupun biokimiawi, digunakan untuk menyembuhkan, meringankan atau mencegah penyakit berikut gejala-gejalanya, juga untuk mendiagnosa penyakit, gangguan atau menimbulkan suatu kondisi tertentu.
Sejarah Awal Mula Penggunaan Obat di Dunia
Sejarah Awal Mula Penggunaan Obat di Dunia
Pada akhir abad 19, obat-obatan yang ada berasal dari produk alam baik berupa tanaman kering maupun segar. Obat yang pertama digunakan adalah obat yang berasal dari tanaman yang di kenal dengan sebutan obat tradisional (jamu). Obat-obat nabati ini di gunakan sebagai rebusan atau ekstrak dengan aktivitas yang seringkali berbeda-beda tergantung dari asal tanaman dan cara pembuatannya. Secara empiris orang purba mendapatkan pengalaman dengan berbagai macam daun atau akar tumbuhan untuk menyembuhkan penyakit. Pengetahuan ini secara turun temurun disimpan dan dikembangkan, sehingga muncul ilmu pengobatan rakyat, sebagaimana pengobatan tradisional jamu di Indonesia. Hal ini dianggap kurang memuaskan, maka lambat laun ahli-ahli kimia mulai mencoba mengisolasi zat-zat aktif yang terkandung dalam tanaman – tanaman sehingga menghasilkan serangkaian zat – zat kimia sebagai obat misalnya efedrin dari tanaman Ephedra vulgaris , atropin dari Atropa belladonna, morfin dari Papaver somniferium, digoksin dari Digitalis lanata, reserpin dari Rauwolfia serpentina, vinblastin dan Vinkristin adalah obat kanker dari Vinca Rosea.
Namun tidak semua obat memulai riwayatnya sebagai obat anti penyakit, ada pula yang pada awalnya digunakan sebagai alat ilmu sihir, kosmetika, atau racun untuk membunuh musuh. Misalnya strychnin dan kurare mulanya digunakan sebagai racun panah penduduk pribumi Afrika dan Amerika Selatan. Contoh yang lebih baru ialah obat kanker nitrogen-mustard yang semula digunakan sebagai gas-racun (mustard gas) pada perang dunia pertama.Obat nabati ini digunakan sebagai rebusan atau ekstrak dengan aktivitas dan efek yang sering kali berbeda-beda tergantung dari asal tanaman dan cara pembuatannya. Kondisi ini dianggap kurang memuaskan, sehingga lambat laun para ahli kimia mulai mencoba mengisolasi zat-zat aktif yang terkandung didalamnya. Hasil percobaan mereka adalah serangkaian zat kimia: yang terkenal diantaranya adalah efedrin dari tanaman Ma Huang (Ephedra vulgaris), kinin dari kulit pohon kina, atropin dari Atropa belladona, morfin dari candu (Papaver somniferum) dan digoksin dari Digitalis lanata.
Dari hasil penelitian setelah tahun 1950 dapat disebutkan reserpin dan resinamin dari pule pandak (Rauwolfia serpentina), sedangkan obat kanker vinblaastin dan vinkristin berasal dari Vinca rosea, sejenis kembang serdadu. Penemuan tahun 1980 adalah obat malaria artemisinin yang berasal dari tanaman China, qinghaosu (Artemisia annua). Penemuan terbaru adalah onkolitika paclitaxel (taxol) dari jarum-jarum sejenis cemara (konifer) Taxus brevifolia/baccata (1993) dan genistein dari kacang kedele
Sejak zaman dahulu, obat-obatan telah digunakan untuk mengobati penyakit pada manusia dan hewan. Tanaman obat kuno menggambarkan kekuatan terapi tanaman dan mineral tertentu. Kepercayaan terhadap kekuatan penyembuhan dari tanaman dan sejumlah substansi tersimpan secara eksklusif pada pengetahuan tradisional, yang informasi empirisnya tidak dikenakan dengan pemeriksaan kritis.  Berikut di bawah ini teori dari beberapa tokoh di dunia yang mengungkapkan tentang sejarah obat dan praktek pengobatan.
1. Praktek pengobatan dicatat dimulai di daratan Mesopotamia sekitar 2600 sebelum masehi. Naskah pengobatan ditulis di atas cetakan tanah liat, dalam catatan tercantum simtom penyakit, resep dari campuran obat yang digunakan, dan juga doa-doa yang digunakan dalam penyembuhan. Di daratan Mesir, praktek pengobatan telah dimulai sejak sekitar 2900 tahun sebelum masehi (SM). Dalam mitologi mesir kuno dikenal dewa matahari (Iris/Ra/Holy Eye) dipercara sebagai dewa pengobatan. Dalam praktek pengembuhan dewa matahari disimbulkan dengan R/. Simbul ini saat ini digunakan oleh dokter sebagai simbul resep dalam menuliskan resep obat yang ditujukan kepada apoteker.
2. Ilmu pengobatan Cina, menurut legenda berasal dari akar kata Shen Nung (sekitar 2000 SM), seorang kaisar cina, yang mencari dan meneliti sekitar ribuan tanaman yang berpotensial sebagai obat. Kaisar telah mencoba sendiri kasiat obat dan pengalamannya tertuang dalam buku Pen T-Sao, yang memuat sekitar 365 tanaman sebagai obat. Shen Nung telah mencoba setiap bagian dari tanaman, seperti akar, kulit batang, daun, bunga untuk mengobatan, dan beberapa tanaman obat masih digunakan sampai sekarang, seperti tanaman gingseng, huang ma (efedra).
3. Naskah pengobatan dikenal dengan ”Papyrus Ebers” (1500 SM.) didalamnya tercatat sekitar 800 resep dan tertulis dalam 700 jenis obat. Praktek pengobatan di jaman ini dilakukan oleh dua atau lebih kelompok, yaitu sekelompok yang mengiapkan obat-obatan dan pimpinan produsen obat atau ketua farmasis. Penyiapan obat dilakukan dilingkungan rumah tangga, resep dibacakan oleh ketua ahli obat. Pimpinan juga bertingak sebagai penentu senyawa aktif yang digunakan dalam campuran resep.
4. Hippocrates (459-370 SM) yang dikenal dengan “bapak kedokteran” dalam praktek pengobatannya telah menggunakan lebih dari 200 jenis tumbuhan. 4 Pengobatan moderen diawali di Yunani sekitar 2500 tahun yang lalu oleh seorang pria Hippocrates. Terlahir di Pulau Cos, Yunani sekitar tahun 460 SM, praktek Hippocrates dalam lingkungan medis terselubung dalam ketidaktahuan, tahayul dan mitologi. Pengobatan Yunani pada awalnya terpusat pada supranatural. Hippocrates mengubah seni diagnosa kedokteran dengan mengganti persepsi supranatural dengan metodologi berlandaskan-observasi. Terpisah dari pengetahuan kedokteran, Hippocrates menekankan perawatan pasien secara keseluruhan bertentangan dengan sekolah kedokteran pada zamannya Cnidian school yang hanya berfokus pada penyakit saja.
5. Claudius Galen (131-201) pertama kali mencoba untuk mempertimbangkan teori latar belakang farmakologi. Teori dan pengalaman praktis, keduanya memberikan kontribusi yang sama untuk penggunaan rasional obat-obatan melalui interpretasi hasil pengamatan dan pengalaman. “Para empirisis mengatakan bahwa semua telah ditemukan oleh pengalaman. Kami, bagaimanapun, berpendapat bahwa hal itu ditemukan sebagian oleh pengalaman, sebagian lagi oleh teori. Bukanlah teori maupun pengalaman masing-masing yang dapat menemukan semuanya”
6. Selanjutnya Ibnu Sina (980-1037) telah menulis beberapa buku tentang metode pengumpulan dan penyimpanan tumbuhan obat serta cara pembuatan sediaan obat seperti pil, suppositoria, sirup dan menggabungkan pengetahuan pengobatan dari berbagai negara yaitu Yunani, India, Persia, dan Arab untuk menghasilkan pengobatan yang lebih baik.
7. Paracelsus (1493-1541) berpendapat bahwa untuk membuat sediaan obat perlu pengetahuan kandungan zat aktifnya dan dia membuat obat dari bahan yang sudah diketahui zat aktifnya. 4 Paracelsus lahir sebagai Philippus Aureolus Theoprastus Bombastus von Hohenheim, pada tahun 1493 di Einsiedeln, sebuah kota kecil dekat Zurich, Switzerland. Dia merupakan anak dari seorang ahli fisika. Berdasarkan pada semua ajaran Paracelsus sangat diyakini bahwa pengetahuan adalah hasil dari pengamatan seseorang terhadap alam dan pengalaman seseorang dalam hidupnya. Jika terdapat sesuatu yang tidak jelas, maka manusia harus merencanakan eksperimen untuk membuktikan atau menolak sebuah hipotesis. Dia meyakini bahwa, “pengobatan hanya dapat dipelajari dari apa yang telah terlihat oleh mata dan disentuh oleh jari, latihan tidak seharusnya berlandaskan pada teori spekulatif, teori harus diperoleh dari latihan”. Paracelsus mendalami kimia dan meyakini bahwa tubuh manusia laksana laboratorium kimia.
8. Johann Jakob Wepfer (1620-1695) berhasil melakukan verifikasi efek farmakologi dan toksikologi obat pada hewan percobaan, ia mengatakan :”I pondered at length, finally I resolved to clarify the matter by experiment”. Ia adalah orang pertama yang melakukan penelitian farmakologi dan toksikologi pada hewan percobaan.
9. Institut Farmakologi pertama didirikan pada tahun 1847 oleh Rudolf Buchheim (1820-1879) di Universitas Dorpat (Estonia). 4 Dengan demikian mengantarkan farmakologi sebagai disiplin ilmu pengetahuan independen. Selain itu, untuk keterangan efek, ia berusaha menjelaskan sifat kimia obat.
10. Selanjutnya Oswald Schiedeberg (1838- 1921) bersama dengan pakar disiplin ilmu lain menghasilkan konsep fundamental dalam kerja obat meliputi reseptor obat, hubungan struktur dengan aktivitas dan toksisitas selektif. Konsep tersebut juga diperkuat oleh T. Frazer (1852-1921) di Scotlandia, J. Langley (1852-1925) di Inggris dan P. Ehrlich (1854-1915) di Jerman.
11. Sumber obat sampai akhir abad 19, obat merupakan produk organik atau anorganik dari tumbuhan yang dikeringkan atau segar, bahan hewan atau mineral yang aktif dalam penyembuhan penyakit tetapi dapat juga menimbulkan efek toksik bila dosisnya terlalu tinggi atau pada kondisi tertentu penderita. Untuk menjamin tersedianya obat agar tidak tergantung kepada musim maka tumbuhan obat diawetkan dengan pengeringan. Contoh tumbuhan yang dikeringkan pada saat itu adalah getah Papaver somniferum (opium mentah) yang sering dikaitkan dengan obat penyebab ketergantungan dan ketagihan. Dengan mengekstraksi getah tanaman tersebut dihasilkan berbagai senyawa yaitu morfin, kodein, narkotin (noskapin), papaverin dll; yang ternyata memiliki efek yang berbeda satu sama lain walaupun dari sumber yang sama Dosis tumbuhan kering dalam pengobatan ternyata sangat bervariasi tergantung pada tempat asal tumbuhan, waktu panen, kondisi dan lama penyimpanan. Maka untuk menghindari variasi dosis, F.W.Sertuerner (1783- 1841) pada tahun 1804 mempelopori isolasi zat aktif dan memurnikannya, dan secara terpisah dilakukan sintesis secara kimia. Sejak itu berkembang obat sintetik untuk berbagai jenis penyakit.
12. Pada permulaan abad ke-20, obat-obat kimia sintetis mulai tampak kemajuannya, dengan ditemukannya obat-obat termasyhur, yaitu Salvarsan dan Aspirin sebagai pelopor, yang kemudian disusul oleh sejumlah obat lain. Pendobrakan sejati baru tercapai dengan penemuan dan penggunaan kemoterapeutik sulfanilamid (1935) dan penisilin (1940). Sebetulnya sudah lebih dari dua ribu tahun diketahui bahwa borok bernanah dapat disembuhkan dengan menutupi luka mengguanakan kapang-kapang tertentu, tetapi baru pada tahun 1928 khasiat ini diselidiki secara ilmiah oleh penemu penisilin Dr. Alexander Fleming.
13. Sejak tahun 1945 ilmu kimia, fisika dan kedokteran berkembang pesat (mis. sintesa kimia, fermentasi, teknologi rekombinan DNA) dan hal ini menguntungkan sekali bagi penelitian sistematis obat-obat baru. Beribu-ribu zat sintetik telah ditemukan, rata-rata 500 zat setiap tahunnya, yang mengakibatkan perkembangan revolusioner di bidang farmakoterapi. Kebanyakan obat kuno ditinggalkan dan diganti dengan obat-obat mutakhir. Akan tetapi, begitu banyak diantaranya tidak lama ‘masa hidupnya’, karena segera terdesak oleh obat yang lebih baru dan lebih baik khasiatnya. Namun menurut taksiran lebih kurang 80% dari semua obat yang kini digunakan secara klinis merupakan penemuan dari tiga dasawarsa terakhir.

Nah bagaimana ternyata penemuan obat pada jaman dahulu begitu panjang prosesnya ya, beruntung kita di jaman modern seperti sekarang ini pengobatan sudah sangat maju. Maka dari itu untuk jangan pernah melupakan sejarah karena sejarah adalah bagian dari masa depan kita. Terima kasih sudah menyempatkan membaca walaupun sangat panjang sekali, hehehe… semoga ulasan kali ini dapat menambah wawasan anda tentang sejarah awal mula obat dan praktik pengobatan di dunia. Jangan lupa share dan nantikan artikel selanjutnya yang pastinya juga bermanfaat..

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