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Historical narrative from fatty liver in the nineteenth century to contemporary NAFLD - Reconciling the present with the past.

ABSTRACT: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder worldwide. This historical narrative traces the evolution from basic descriptions of fatty liver in the nineteenth century to our contemporary understanding of NAFLD in the twentieth and twenty-first centuries. A detailed historiographic review of fatty liver from 1800s onwards was performed alongside a brief review of contemporary associations. Archived published literature dating back to the 1800s describe clinicopathological features of fatty liver. In the nineteenth century, doyens of medicine associated fatty liver with alcohol, malnutrition or wasting conditions, and subsequently adiposity, unhealthy diets and sedentary lifestyle. Microscopically, fatty liver was described when 5% or more hepatocytes were distended with fat. Recommendations to reverse fatty liver included reducing consumption of fat, sugar, starchy carbohydrates and alcohol, plus increasing physical exercise. Fatty liver was associated with liver fibrosis and cirrhosis in the late 1800s, and with diabetes in the early 1900s. The diagnostic labels NAFLD and non-alcoholic steatohepatitis (NASH) were introduced in the late 1900s. Metabolic dysfunction-associated fatty liver disease (MAFLD) was recently proposed to update the nosology of fatty liver, recognising the similar metabolic pathogenesis evident in individuals with typical NAFLD and those with heterogenous "secondary" co-factors including alcohol and other aetiologies. Fatty liver has emerged from being considered a disorder of nutritional extremes or alcohol excess to contemporary recognition as a complex metabolic disorder that risks progression to cirrhosis and hepatocellular carcinoma. The increasing prevalence of NAFLD and our growing understanding of its lifestyle and metabolic determinants justify the current exercise of re-examining the evolution of this common metabolic disorder.

SUBMITTER: Ayonrinde OT

PROVIDER: S-EPMC8135048 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundKrummhübel (after 1945, Karpacz) in the Sudety Mountains (now SW Poland) was called "the village of pharmacists". At the end of the seventeenth century, there were 57 households, of which about 40 were inhabited by herbalists. Krummhübel herbalists were the first in the Sudety region who applied medicinal mixtures for the treatment of various diseases (using, among others, plants, oils, minerals and even viper venom) in contrast to previous herbalists who only indicated the use of individual plant species for specific diseases. Riesengebirge (in Polish Karkonosze) potions were sold in Austria, the Czech Republic, Poland and Russia, and some of them could even be purchased in Scandinavia and England. The purpose of this paper is an ethnopharmacological analysis of historical texts of herbalists from Krummhübel. Based on their recipes, we analysed the use reports of drugs. Recently, research on ethnobotany and ethnopharmacological analyses of historical materials or egodocuments related to formulations used in folk medicine have become an important source of acquiring knowledge about new medicines.MethodsBased on 46 recipes of Krummhübel herbalists re-written by Reitzig (1943), we analysed the use reports of drugs which included plant taxa and other constituents such as animal formulations, fungi, inorganic and organic substances and minerals as well as tinctures (with alcohol/spirit) and elixirs (without alcohol/spirit). For each usage mentioned in the text, we recorded (i) the putative botanical identity of the taxon; (ii) the plant family or origin of other than the plant constituent; (iii) the reported plant part; (iv) the number of the recipe; (v) the name of the recipe; (vi) the vernacular name of ingredient; (vii) the described symptom, ailment or specific use; (viii) our modern (viz. biomedical) interpretation of the described symptom or ailment; (ix) the mode of administration; and (x) the category of use under which we filed the specific use. We also cross-checked the medicinal plants of Krummhübel herbalists with the species described in old manuscripts and regional surveys and compared their use with contemporary plant use.ResultsThe paper introduces the generated database comprising 348 use reports of 46 drugs based on 70 plant taxa and other constituents. Besides, we address patterns such as the frequent recommendation of Fabaceae herbs for respiratory system issue and gynaecology and Asteraceae for respiratory system and cardiovascular problems. Gastrointestinal use reports are based on Asphodelaceae, Burseraceae and Rosaceae species.ConclusionsRemedies that lost importance over time as well as drugs used for diseases now controlled by conventional medicine may be interesting starting points for research on herbal medicine and drug discovery. It seems to be important to attempt to reproduce therapeutic mixtures from the preserved recipes of Krummhübel herbalists, which offers an opportunity to learn more about the real effects of the former medicines and their therapeutic activity. The obtained data can also be used to search for new drugs.

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Historical narrative from fatty liver in the nineteenth century to contemporary NAFLD - Reconciling the present with the past.

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