Amazonian Medicine Research Articles

Kambó as a drug that can induce psychotic or manic symptoms. A case report

IntroductionKambó, also known as the “frog medicine,” is a traditional Amazonian medicine derived from the secretions of the Phyllomedusa bicolor tree frog. It has gained global attention for its purported therapeutic properties, including its use in addressing mental health issues. However, the psychiatric effects of kambó remain poorly understood, particularly concerning manic symptoms or psychosis.Objectives The primary objective of this review is to comprehensively analyze and evaluate the available literature regarding the connection between kambó use and psychosis or manic symptoms. Specifically, this review seeks to determine the prevalence of psychosis among kambó users, identify potential risk factors for the development of psychosis or manic symptoms in this context, explore the mechanisms underlying any observed psychiatric effects, and provide insights into the clinical implications of kambó use.MethodsA case report of a 34-year-old man with chronic delusional disorder who presented to the emergency department with manic symptoms coinciding in time with the use of Kambó.ResultsThe findings of this bibliographical review suggest that there is limited empirical evidence to establish a direct link between kambó use and psychosis. Most available studies are anecdotal or based on qualitative reports, making it challenging to draw definitive conclusions. While some case reports and interviews suggest that kambó use may be associated with transient psychotic-like symptoms, including visual and auditory hallucinations, more rigorous research is needed to confirm and characterize these effects. Several case reports and qualitative studies suggest that individuals who have undergone kambó ceremonies may experience transient manic-like symptoms, such as elevated mood, increased energy, and impulsivity. However, these reports lack systematic assessment and standardized measurement of manic symptoms. Mechanisms underlying these effects remain speculative, with some researchers proposing altered neurotransmitter systems as a potential explanation.Conclusions In conclusion, this review underscores the scarcity of scientific literature on the potential association between kambó use and psychosis or maniac symptoms. Although anecdotal reports and qualitative studies suggest a link, there is a notable lack of robust empirical research to support or refute this claim. Future research should focus on conducting controlled studies to elucidate the psychiatric effects of kambó, including its potential to induce psychosis and maniac symptoms, while also considering cultural and individual factors that may influence outcomes. Such research would contribute to a more comprehensive understanding of kambó’s psychopharmacological profile and its implications for mental health.Disclosure of InterestNone Declared

Antiprotozoal potential of Vismia species (Hypericaceae), medicinal plants used to fight cutaneous leishmaniasis

Ethnopharmacological relevanceSpecies of Vismia (Hypericaceae), known in Brazil as “lacre”, are commonly used in traditional Amazonian medicine for the treatment of skin lesions, including those caused by Leishmania infection. Aim of the studyHexane extracts from the leaves of Vismia cayennensis, V. gracilis, V. sandwithii and V. guianensis, as well as from the fruits of the latter, in addition to the anthraquinones vismiaquinone, physcion and chrysophanol isolated from these species were explored for their anti-promastigote and anti-amastigote activity on Leishmania amazonensis. Materials and methodsExtracts were prepared by static maceration with n-hexane. The compounds, isolated by chromatographic techniques, were identified by spectroscopic methods (1H and 13C NMR). Promastigotes of L.amazonensis were incubated with hexane extracts (1–50 μg/mL) or anthraquinones (1–50 μM) and the parasite survival analyzed. The action of compounds on reactive oxygen species (ROS) production, mitochondrial membrane potential, and membrane integrity of promastigotes were evaluated by flow cytometer, and the cytotoxicity on mammalian cells using MTT assay. Furthermore, the activity of compounds against amastigotes and nitric oxide production were also investigated. ResultsVismiaquinone and physcion were obtained from the leaves of V. guianensis. Physcion, as well as chrysophanol, were isolated from V. sandwithii. Vismia cayennensis and V. gracilis also showed vismiaquinone, compound detected in lower quantity in the fruits of V. guianensis. All extracts were active against the parasite, corroborating the popular use. The greatest activity against promastigotes was achieved with V. guianensis extract (IC50 4.3 μg/mL), precisely the most used Vismia species for treating cutaneous leishmaniasis. Vismiaquinone and physcion exhibited relevant activity with IC50 12.6 and 2.6 μM, respectively. Moreover, all extracts and anthraquinones tested induced ROS production, mitochondrial dysfunction, membrane disruption and were able to kill intracellular amastigote forms, being worthy of further in vivo studies as potential antileishmanial drugs. ConclusionsThe overall data achieved in the current investigation scientifically validate the traditional use of Vismia species, mainly V. guianensis, as an anti-Leishmania agent. Furthermore, the promising results presented here indicate species of Vismia as potentially useful resources of Brazilian flora for the discovery of therapeutic solutions for neglected diseases.

Ancient medicine for a modern disease: traditional Amazonian medicine to treat substance use disorders

ABSTRACTBackground: There exists an underexploited opportunity to develop innovative therapeutic approaches to SUDs based upon the complementarity between modern and traditional health systems.Objectives: Illustrate the feasibility and potentiality of such an approach through the comprehensive description of Takiwasi Center’s treatment model and program, where health concepts and practices from traditional Amazonian medicine work synergistically with modern psychotherapy and medicine in an intercultural dialog to assist in the rehabilitation of people suffering from SUDs.Methods: The description was built from a review of the literature, institutional data, participatory observation and unstructured interviews with staff, researchers and patients during treatment.Results: Since the foundation of the Takiwasi Center in 1992 in the peruvian Amazon, more than a thousand patients with different socio-cultural, ethnic and religious backgrounds have received residential treatment. We present how traditional Amazonian medicine techniques and health concepts cooperate to complement modern psychology in a therapeutic community setting and propose some hypotheses about the neurobiological, psycho-emotional and spiritual healing mechanisms triggered by the program to help people identify and heal the roots of their substance misuse and addictive behavior. We also summarize quantitative outcomes during treatment showing significant improvements in a wide variety of mental health indicators.Conclusion: Takiwasi Center’s program is an option for people seeking non-conventional treatment who are sensitive to traditional Amazonian medicine practices and ready to explore the roots of their addiction. From this intercultural approach, some lessons could emerge toward a broader understanding of SUDs that may result in better patient care.

Couroupita guianensis bark decoction: From Amazonian medicine to the UHPLC-HRMS chemical profile and its role in inflammation processes and re-epithelialization

Ethnopharmacological relevanceIn the Amazon rainforest, the shamans of the Mayantuyacu site use the healing virtues of decoctions and teas from different parts of the Couroupita guianensis Aubl. (Lecythidaceae) trees as remedies in Ashaninka medicine. However, composition of the remedy and the underlying mechanism remain unclear. Aim of the studyThis study was designed to compare the metabolite profile of Couroupita guianensis bark decoction produced by Amazonian shamans with that obtained under standardised laboratory conditions and to investigate biological properties of both decoction and isolated constituents in skin wound healing process and inflammation. Materials and methodsThe chemical analyses were carried out by Ultra-High-Performance Liquid Chromatography coupled with UV and High-Resolution Mass Spectrometry detectors (UHPLC-UV-HRMS). 1D and 2D-NMR experiments were performed to identify the main decoction constituents. The decoction and pure compound effect on keratinocyte migration was determined by the in vitro wound healing model; the mechanism of action was elucidated by western blot analysis. ResultsUHPLC-UV-HRMS analysis revealed the occurrence of polyphenolic compounds as catechins, ellagitannins and, notably, of unusual sulphated derivatives of ellagic acid isolated for the first time from Couroupita guianensis bark. A new natural sulphated molecule [4-(2″-O-sulphate- β-D-glucuronopyranosyl) ellagic acid] was identified as the potential active compound responsible for the efficacy of bark decoction stimulating wound healing in human HaCaT keratinocytes. The molecular mechanism involved the induction of pro-migratory pathways mediated by ERK and AKT phosphorylation and the increase of MMP2 expression in HaCaT cells. At the same time, the treatment inhibited inflammation interfering with NFkB activation. ConclusionBeyond identifying a new bioactive compound, the overall results scientifically validate the traditional use of Couroupita guianensis bark decoction as an anti-inflammatory remedy. Moreover, the beneficial effects on keratinocytes suggest promising therapeutic applications in skin diseases.

Clinical Safety of a Pharmaceutical Formulation Containing an Extract of Acmella oleracea (L.) in Patients With Premature Ejaculation: A Pilot Study.

Acmella oleracea (L.) R. K. Jansen (Asteraceae) is a plant species widely used in traditional Amazonian medicine to treat sexual dysfunction. The use of this plant has gained popularity because of its sensory properties, such as a tingling sensation. In this study on patients with premature ejaculation, we evaluated the clinical action of a nano-formulation containing an ethanolic extract of A. oleracea inflorescences. Major constituents in the extracts were identified based on gas chromatographic analysis. Participants used a spray preparation based on the A. oleracea extract for 12 weeks, during which they were instructed to apply the product 5 min prior to sexual intercourse. To assess therapeutic efficacy, participants were required to record the mean intravaginal latency time for ejaculation (IELT). During the period of spray treatment, the nano-formulation of A. oleracea increased participant IELT values (M = 293 s) compared with the baseline values (193 s). This nano-formulation reported clinical action in patients with premature ejaculation. It is accordingly considered to have potential application as a therapeutic alternative with benefits for both patients and their partners. Given the small number of participants in this study, further multicenter studies involving a larger number of participants are needed to confirm these observations.

Couroupita Guianensis Bark Decoction: From Amazonian Medicine to the UHPLC-HRMS Chemical Profile and its Role in Inflammation Processes and Re-Epithelialization

Couroupita Guianensis Bark Decoction: From Amazonian Medicine to the UHPLC-HRMS Chemical Profile and its Role in Inflammation Processes and Re-Epithelialization

Ayahuasca and Public Health II: Health Status in a Large Sample of Ayahuasca-Ceremony Participants in the Netherlands

ABSTRACT Ayahuasca is a plant decoction in traditional Amazonian medicine. Its ritual use has been internationalized, leading to policy challenges that countries should address. This study evaluates the impact of regular ayahuasca ceremony participation on health by assessing the health status of 377 participants in ayahuasca ceremonies in the Netherlands using validated health indicators. A questionnaire was developed and administered to study participants. The questionnaire included several health indicators with public health relevance (e.g., BMI, diet, physical activity) and psychometrically validated questionnaires (ELS and COPE-easy). The data retrieved through health indicators was compared to normative Dutch data. Participants (50.1% women) were mostly Dutch (84.6%) with a mean age of 48.8 years (SD = 11.6). Compared to normative Dutch data, regular participants in ayahuasca ceremonies showed better general well-being, fewer chronic or lifestyle-related diseases, more physical activity, and a more balanced diet. Participants also used less alcohol during the COVID-19 pandemic, and although they used more illegal drugs than the general population, they did not report associated harms. Our findings suggest that regular participation in ayahuasca ceremonies is not linked to relevant health harms. This data could help drug policymakers to develop and implement evidence-based public policies.

Traditional Amazonian medicine in addiction treatment: Qualitative results

Traditional Amazonian medicine, and in particular the psychoactive substance ayahuasca, has generated significant research interest along with the recent revival of psychedelic medicine. Previously we published within-treatment quantitative results from a residential addiction treatment centre that predominately employs Peruvian traditional Amazonian medicine, and here we follow up that work with a qualitative study of within-treatment patient experiences. Open-ended interviews with 9 inpatients were conducted from 2014 to 2015, and later analysed using thematic analysis. Our findings support the possibility of therapeutic effects from Amazonian medicine, but also highlight the complexity of Amazonian medical practices, suggesting that the richness of such traditions should not be reduced to the use of ayahuasca only.

Participant Experiences on a Medicinal Plant Diet at Takiwasi Center: An In‐Depth Small‐Scale Survey

AbstractThe medicinal plant diet is a healing process used in traditional Amazonian medicine (TAM), and it is poorly described within the scientific literature. This work analyzes the experience of seven participants in this therapy performed at the Takiwasi Center in Peru. Semistructured interviews were performed before and after treatment, documenting participants’ motivation, psychological experience, and perceived personal changes (physically, psychologically, socially, and spiritually), as well as the role played by each medicinal plant. All the interviews were recorded, transcribed, and analyzed using interpretative phenomenological analysis. Reasons to participate in the plant diet included self‐discovery, personal development, interest in plant medicine, and professional realization. The experience was perceived as intense and allowed participants to experience self‐acceptance, self‐discovery, mental balance, rest, cleansing, and connection with nature. Three months after the experience, participants felt physical changes (n = 6), psychological changes (n = 7), social changes (n = 5), and spiritual changes (n = 5).

Amazonian Medicine and the Psychedelic Revival: Considering the "Dieta".

Background: In Peruvian Amazonian medicine, plant diets (dietas) are a fundamental and highly flexible technique with a variety of uses: from treating and preventing illness, to increasing strength and resilience, to rites of passage, to learning even medicine itself. Many of the plants used in diets are psychoactive; for example, one now well-known plant that can be dieted is Banisteriopsis caapi—the vine also used in the psychoactive brew ayahuasca. The use of ayahuasca has attracted increasing clinical attention towards Amazonian medicine in recent decades, and much work has focused on the potent DMT-containing ayahuasca brew, thus placing the tradition within the purview of psychedelic science. Aims: In comparison to ayahuasca, the properties of diets have been studied less often. Our work draws on data from Amazonian healers to examine plant diets as medical practices, while also considering their fit within the “set and setting framework” that is central to psychedelic research. We argue that the framework is not sufficiently broad for understanding diets, and thus the investigation aimed to expand the conceptual field of Amazonian medicine, particularly in the context of a renewed psychedelic science and its theoretical concepts. Design: We used qualitative data from interviews with Amazonian healers, applying a thematic analysis and contrasting findings with the available literature. Setting: Interviews were conducted in various locations in the San Martín province of Peru between 2015 and 2017. Participants: We selected and interviewed eight healers who had been extensively trained in traditional Amazonian medicine. Measures: Semi-structured interviews were used to gain insight into the healers’ personal experiences with plant diets. Conclusions: Diets are complex but understudied medical practices that should not be explained by reference to pharmacology or psychology only. Intercultural and interdisciplinary research programmes are called for in order to not only better understand plant diets, but traditional Amazonian medicine on the whole.

Implementación y funcionamiento de un sistema de información clínica en una comunidad terapéutica

Las tecnologías de información y comunicación (TIC) tienen un impacto creciente en el sector de la salud orientado a la optimización de procesos y su aplicación abarca varios campos como la psicoterapia y la terapia ocupacional. El objetivo del presente estudio es describir el sistema de información Plus, una iniciativa de la comunidad terapéutica Takiwasi que nace de la necesidad de instaurar una plataforma de recopilación, almacenamiento y gestión de los diferentes procesos y datos clínicos que se generan en la institución a lo largo del tratamiento de pacientes drogodependientes. Las peculiaridades de este sistema son estrechamente vinculadas a la unicidad del protocolo de tratamiento de adicciones propuesto en Takiwasi, donde las prácticas de la medicina tradicional amazónica son asociadas a la psicoterapia moderna, al seguimiento biomédico clásico y a otros espacios terapéuticos de medicina alternativa y complementaria. Se presentan los diferentes módulos por el cual el sistema está constituido, así como el proceso de registro de la información. Esta TIC representa una herramienta fundamental para promover la investigación en las aplicaciones terapéuticas de la medicina tradicional y como retroalimentación para mejorar las intervenciones terapéuticas.

Within-treatment changes in a novel addiction treatment program using traditional Amazonian medicine.

Aims:The therapeutic use of psychedelics is regaining scientific momentum, but similarly psychoactive ethnobotanical substances have a long history of medical (and other) uses in indigenous contexts. Here we aimed to evaluate patient outcomes in a residential addiction treatment center that employs a novel combination of Western and traditional Amazonian methods.Methods:The study was observational, with repeated measures applied throughout treatment. All tests were administered in the center, which is located in Tarapoto, Peru. Data were collected between 2014 and 2015, and the study sample consisted of 36 male inpatients who were motivated to seek treatment and who entered into treatment voluntarily. Around 58% of the sample was from South America, 28% from Europe, and the remaining 14% from North America. We primarily employed repeated measures on a psychological test battery administered throughout treatment, measuring perceived stress, craving frequency, mental illness symptoms, spiritual well-being, and physical and emotional health. Addiction severity was measured on intake, and neuropsychological performance was assessed in a subsample from intake to at least 2 months into treatment.Results:Statistically significant and clinically positive changes were found across all repeated measures. These changes appeared early in the treatment and were maintained over time. Significant improvements were also found for neuropsychological functioning.Conclusion:These results provide evidence for treatment safety in a highly novel addiction treatment setting, while also suggesting positive therapeutic effects.

"Tobacco Is the Chief Medicinal Plant in My Work": Therapeutic Uses of Tobacco in Peruvian Amazonian Medicine Exemplified by the Work of a Maestro Tabaquero.

IntroductionHarmful usage of tobacco is a public health problem of global concern and, in many countries, the main risk factor for non-communicable diseases. Yet, in the Peruvian Amazon, the geographical region believed to be tobacco’s historical birthplace, this plant is associated with a strikingly different usage and repute: Tobacco (especially Nicotiana rustica L.) in this area is described as a potent medicinal plant, used topically or via ingestion to treat a variety of health conditions. The goal of this transdisciplinary field study was to investigate clinical applications of the tobacco plant as per Amazonian medicine exemplified in the practice of a reputed Maestro Tabaquero, an Amazonian traditional healer whose medical specialization focuses on tobacco-based treatments.MethodsUsing a transdisciplinary clinical approach, we conducted in-depth interviews with the tabaquero applying the systematizing expert interview method, in order to map modes of preparation and administration, indications, contraindications, effects, risks, adverse effects, and systemic aspects of tobacco-based remedies.ResultsThe informant’s descriptions revealed refined knowledge on this plant’s therapeutic properties and scope, safety profile, and application techniques. The main indications mentioned included “problems of the mind,” of the respiratory system, parasitic illnesses (intestinal/skin), gout, and Amazonian epistemic conditions described as spiritual-energetic in nature. A liquid remedy taken orally was his most commonly used preparation, with acute/sub-acute effects involving a pronounced psychoactive component (altered state of consciousness) and physiological response (emesis, nausea). A skilled tabaquero that knows how to dose, administer, and intervene in case of adverse effects was considered imperative for safe treatment delivery.ConclusionsTo our knowledge, this is the first study employing a transdisciplinary clinical approach to examine therapeutic applications of tobacco by an Amazonian tabaquero. Our findings significantly contribute to the growing research literature on Amazonian medicine and emergent psychedelic-assisted therapies and could, in the long-term, open new treatment avenues in several domains. Forthcoming studies should assess toxicity/safety and clinical outcomes of patients receiving Amazonian tobacco-based treatment.

Traditional Use of Banisteriopsis caapi Alone and Its Application in a Context of Drug Addiction Therapy

ABSTRACT Takiwasi is a therapeutic community for the treatment of Substance Use Disorders (SUDs) that combines traditional Amazonian medicine (TAM) with modern psychotherapy. One of the plant medicines from TAM used in this protocol is purgahuasca. It is a decoction of the vine Banisteriopsis caapi alone, whose use is traditional among the Awajún and other ethnic groups in Peru. The research began with a field trip to Awajún territory to explore the indigenous use of purgahuasca as an initiation rite. Then, analysis of its application was conducted in the clinical context of Takiwasi. Open-ended and semi-structured interviews with Awajún informants and Takiwasi’s therapeutic staff were performed and analyzed following the narrative methodological approach. Further clinical data on the ingestion of purgahuasca by Takiwasi’s SUD patients were obtained from the internal repository. These indicate that 359 (92.1%) patients reported having had the so-called mareación (dizziness), 299 (76.7%) experienced physical sensations, and 208 (53.3%) had visions. These effects can be related to the psychoactivity of β-Carbolines alkaloids from B. caapi, a medicinal plant that seems to have potential benefits also for SUD, especially giving a key contribution to the patients’ therapeutic process of becoming aware of the personal reasons behind addictive behaviors.

Pilot Evaluation of a Residential Drug Addiction Treatment Combining Traditional Amazonian Medicine, Ayahuasca and Psychotherapy on Depression and Anxiety

ABSTRACT Recent research highlighted the therapeutic potential of ayahuasca, a psychoactive plant brew used ritually in traditional Amazonian medicine (TAM). The present study evaluates the impact of integrating ayahuasca and TAM with psychotherapy on depression and anxiety in an inpatient addiction treatment program. Male patients (N = 31) were evaluated pre and post treatment using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI). Clinical and sociodemographic characteristics, motivation, quality of life, spirituality, and treatment satisfaction were also measured and analyzed by means of two tailed t-test, one way ANOVA and Spearman test. From pre- to post-treatment, patients showed significant reductions in scores of anxiety (from 20.8 to 11.6, p < .002) and depression (from 18.7 to 7.5, p <.001). Similarly, patients showed higher scores of quality of life (p < .001) and spirituality (p < .001) upon discharge, which correlated with their reduction in scores of anxiety and depression. While future results will evaluate the efficacy of this treatment on measures of addiction at follow-up, the present results build upon previous research to bring further support to the use of Ayahuasca and Amazonian medicine in mental health treatments with a transpersonal focus.

Who Turns to Amazonian Medicine for Treatment of Substance Use Disorder? Patient Characteristics at the Takiwasi Addiction Treatment Center

Complementary medicines are an emergent field in the treatment of substance use disorders (SUDs) and include Amazonian medicines, such as ayahuasca. The aim of this multimodal cross-sectional study was to investigate characteristics of people who seek treatment for SUDs at an accredited healthcare facility that applies Amazonian medicines along with conventional psychotherapy. We collected clinical and sociodemographic data of consecutive admissions at the Takiwasi Addiction Treatment Center (Tarapoto, Peru) using structured questionnaires, interviews, and letters submitted upon program application describing motivation for treatment. The sample of 50 male participants admitted between 2014 and 2016 was culturally heterogeneous, including patients from Peru (42%), other Latin American countries (34%), and North America/Europe (24%). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria indicated dependencies on cannabis (72%), alcohol (52%), cocaine/base paste (48%), and others; multiple substance use was common (84%). Self-reported depression and anxiety scores showed moderate elevation. Comparison of Addiction Severity Index composite scores to a large U.S. sample suggested somewhat more severe problems in the drug and psychiatric domains. Common motives for selecting the program included interest in Amazonian medicine, the Takiwasi concept of treatment, and unfavorable experiences with past treatments. Being motivated by family, a desire for self-transformation, and spiritual/existential motives were common themes for treatment initiation. Our results suggest that the Amazonian medicine-based therapy attracts a diverse patient group not limited to regional residents and may be particularly appealing to more impaired SUD patients with a history of unsuccessful treatment. The sample's cultural diversity suggests an existing interest in such therapies among international SUD treatment-seeking patients. These findings are relevant in light of the need for improved SUD therapies and contribute to the emergent research literature on ayahuasca-based treatments.

Synergism between Catholicism and Indigenous Spirituality within the Drug Addiction Rehabilitation Program of Takiwasi, a Therapeutic Community in the Peruvian High-Amazon

The association between spirituality and medicine is unfolding as a research theme that may have increasing practical implications in healthcare systems. Both spiritual and scientific dimensions are present within the treatment protocol for addiction applied at the Takiwasi Center, a pioneer therapeutic community that combines western approaches, including psychotherapy, biomedicine, and Catholic practices, with traditional Amazonian medicine. Through a series of open-ended and semi-structured interviews conducted on nine workers of the center during fieldwork research and comparison with the information obtained from literature review, the present article aims at testing the existence of an effective synergy between Catholic religiosity and indigenous-mestizo spirituality within the therapeutic process performed at the Takiwasi Center and puts in evidence some stimulating and problematic issues that arise from this synergy.

Short-Term Treatment Effects of a Substance Use Disorder Therapy Involving Traditional Amazonian Medicine

ABSTRACTChronic illness management today commonly involves alternative medicines. Substance use disorder (SUD), as a chronic psychosomatic illness, might benefit from a similar approach. The accredited Takiwasi Center offers such an SUD treatment program involving Amazonian medicine combined with psychotherapy. The current study assessed this integrative program‘s short-term therapeutic effects. We measured baseline data from 53 dependence-diagnosed males admitted to treatment (T1) and repeated clinical outcome variables at treatment completion (T2). Paired samples t-tests were used to assess changes between T1 and T2 (n = 36). Nearly all participants (age M= 30.86, SD= 8.17) were dependent on multiple substances, most prominently cannabis, alcohol, and cocaine-related drugs. A significant decrease (T1 to T2) was found for addiction severity outcomes drug use (p < .001), alcohol use (p < .001), psychiatric status (p < .001), and social/familial relationships (p < .001). Emotional distress also diminished significantly (p < .001), as did substance craving (p < .001). Quality of life increased significantly from T1 to T2 (p < .001). Our results provide first indications for significantly improved SUD symptoms after the Amazonian medicine-based treatment. These findings are preliminary given the design, but strongly encourage further investigation of this therapy, which in the long term may open new therapeutic avenues for SUDs.

An exploratory study of experiences with conventional eating disorder treatment and ceremonial ayahuasca for the healing of eating disorders.

Ayahuasca is a traditional Amazonian medicine that is currently being researched for its potential in treating a variety of mental disorders. This article reports on exploratory qualitative research relating to participant experiences with ceremonial ayahuasca drinking and conventional treatment for eating disorders (EDs). It also explores the potential for ayahuasca as an adjunctive ED treatment. Thirteen individuals previously diagnosed with an ED participated in a semi-structured interview contrasting their experiences with conventional ED treatment with experiences from ceremonial ayahuasca. The interviews were analyzed using thematic analysis. Participant reports were organized with key themes including that ayahuasca: led to rapid reductions in ED thoughts and symptoms; allowed for the healing of the perceived root of the ED; helped to process painful feelings and memories; supported the internalization of greater self-love and self-acceptance; and catalyzed spiritual elements of healing. The results suggest that ayahuasca may have potential as a valuable therapeutic tool, and further research-including carefully controlled clinical trials-is warranted. Level V, qualitativedescriptive study.

Doctor Thomas e a medicina tropical na Amazônia no início do século XX

Resumo Harold Howard Shearme Wolferstan Thomas foi um pesquisador da Escola de Medicina Tropical de Liverpool que teve fugaz destaque na medicina britânica na época em que foi deslocado para a Amazônia (1905). Cinco anos antes, uma expedição da mesma Escola estivera na região para investigar a febre amarela. Thomas e Anton Breinl viajaram para Manaus ainda com o objetivo de estuda essa doença. Naquele intervalo, transcorreram processos muitos dinâmicos na medicina tropical, em particular no tocante às tripanossomíases. Thomas ganhou projeção ao demonstrar que o atoxyl era eficaz no tratamento de animais e humanos infectados por tripanossomos. No presente artigo, Thomas é o fio que conduz a uma trama formada por diferentes atores e doenças na América, Europa e África, cujas sinergias revelam contornos da medicina tropical e o lugar nela ocupado pela região amazônica no começo do século XX. Enfatizaremos especialmente as tripanossomíases. Até sua morte em Manaus, em 1931, Thomas envolveu-se com outros problemas de saúde locais e com médicos que lideravam a saúde pública e a medicina experimental no Amazonas - curso discrepante daquele tomado pela maioria dos médicos europeus que participaram de missões em colônias e áreas de influência das metrópoles imperiais. Nos anos 1950, Thomas foi ‘redescoberto’, ao receber (postumamente) parte de um prêmio conferido aos descobridores da cura da doença do sono. Sua memória teve outros revivals em ambientes acadêmicos.