Sawbones: A Marital Tour of Misguided Medicine - Vomiting

Episode Date: June 22, 2022

What’s the deal with vomiting? Justin and Dr. Sydnee meditate on the various ways we get nauseated, from smelling something gross to getting hit in a sensitive spot, and what we’ve done over the years to help alleviate it. Although sometimes kids just vomit for no reason and we can’t really help you there.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. Hello everybody and welcome to Saw Bones, a Marital Tour of Miscite Admedicine.

I'm your co-host, Justin McElroy. And I'm Sydney McElroy. Me? I'm still Justin McElroy. No matter what, my wife's name is. That, yes, that's true. That's quantum physics where you said right there in a nutshell. I don't, that, that was not my of the sciences of the big sciences. That was not my strongest suit physics.

I was more of a bio then chem then physics last kind of gal. All right, but that's not I'm pretty sure that's not quantum physics. You're probably right about that Sydney. Probably maybe I mean, you know, it about that Sydney. Um, probably. Maybe, I mean, you know, it's hard to, it's honestly hard to say. It's been a heck of a couple weeks, haven't I, pal? Oh, man. Yeah. But I mean, you were gone through part of it. But that was hard in its own way for me. Because I had a lot of travel woes. You're on the road again. I'm away from my heart

and soul, my family, and I'm with my other heart and soul, the fans. But then our power went out. And then there was water dripping from the ceiling and the basement, which is not what you want. No. It's been rough. But you know what kicked it off really? This this this period of relative calm was we were having some friends over. Mm hmm. And this is a delightful evening. We never we never we never we never we never have adult friends over. The idea of us sitting with another couple and like having a drink and relaxing

and talking and eating some popcorn. That is so rare. It's like so rare. Like y'all, it never happened. Never had, and so we're sitting on the deck and relaxing and talking when our oldest daughter, Charlie comes running out in just pajamas pants. Yes.

And expliquable, yes. Our friends Tommy and Claire were there. We were all, I don't know, sitting there thinking like, this is so nice. were there. We were all I don't see anything like this So nice we should do this more often and then I see shirtless Charlie trucking it through the living room looking for us And we're like we're right here, and she's like Cooper puke Cooper Cooper puke because Cooper had indeed Poor thing doused herself her bed her clothes her hair. She didn't seem to Be sick.

This is one of the things they don't put in the parenting books. Sometimes kids, they just puke. Sometimes kids just puke. I'm going to actually, that's part of what, so. You know that thing in your body where you're like, I better not eat any more of this smoothie or I will puke. Kids don't have that switch. No.

And especially like kids eat, if it's yummy, they eat it fast so they eat it before the switch can even be flipped. But I am gonna talk about that specific issue in this episode of Sobbing's, which is about vomiting, which vomiting, this is sort of, this is one's a little different, I mean, there's history in here,

but it's more like a survey. I was just sort of like, What's up with vomiting? I just wanted to think, I wanted to like meditate on vomiting for an episode. No, this is obviously, this isn't really a content warning so much because you probably should have guessed this from like, yeah, it's yucky, it's vomit. Yeah, but if that's something you don't like to hear about, if that's like a rough topic

for you, please buy all means and enjoy our other episodes. Yeah, absolutely. So Sid, what's up, though? I mean, what's up? Well, okay, first of all, just see why do we, why do we, I'm going with vomit. We could go with puke, hurl, blow chunks, spew. Ew, blow chunks is the worst.

Blow chunks is the worst. I hate that one. We'll just sit with vomit. Like scientists. Why do we vomit? Ew, up, chuck, right down to. Why do we vomit? Well, Sid.

I always like to hurl. Our body has what I have. I like to think of as a few sort of emergency levers that circumvent you as a person and say like, I know that usually you're in control of the body, but right now, I, the body separate from the mind, I'm going to do an action that I need. Now, some of those reflexive actions that you need to survive, I'm thinking here of

your heart beating, your lungs breathing, things like that. But I think sometimes the body has like emergency levers too, where it's like, nope, nope, nope, nope. That's it. Nope. Come on, everybody out. I'm taking control. I think diarrhea's like that, sneezing's like that.

Like, yeah, I mean, is this similar? Yeah, similar idea. And I mean, you're basically right. Compense when you hear one of my hilarious jokes. Our body, either correctly or otherwise, sometimes it's not right about this, but generally, the least. It's always right.

It's the body. There is something in your stomach, in your gastric contents, that needs to be removed quickly, forcibly, out of concern for your safety. Some sort of toxin, some sort of poison. Something bad has upset our system and our system is saying, evacuate. Yes. That's vomiting, right? That's vomiting. That's vomiting.

So there's a point to it. There's a, and I think what's interesting when you look into medical history and we'll get into this is that that's why there are as many ways that humans have tried to like stop vomiting from happening as we have tried to enable ourselves to vomit. Yeah. Right? Because we thought it was curative for various reasons. So basically at that point, when your body has decided that there is something bad in it,

either nurse from your stomach, tell your brain, hey, I'm upset, I'm irritated, I got to get emptied out immediately. We can't wait for the usual method. That's going to take too long. We need to go the other route. Or sometimes your brain starts the process. There's actually different places that can be the like the stimulus for vomiting. There's an area, the area post-dreamer in your brain, the vomit center. There's not the brain in your ass, really mean the mind, if that distinction makes any sense. No, it's literally a part of your brain that will like, if stimulated, make you puke.

So basically when we get that signal back to our stomach, there's a whole series of things that happen. Your vocal cords close over, right? Our diaphragm is lowered, that gets pulled down to create negative pressure, and that opens up the esophagus, and then your stomach muscles contract in a certain order that forces all of the stuff in it through this open to esophagus, past the glottis that's closed and out.

It's really incredible. I mean, it is incredible. It's gross, but it is really incredible that your body's like, I have one, there's one, you're honestly, and you wouldn't be familiar with this concept, but in Star Trek, there was this thing where, you know that you can imagine the enterprise.

Okay, there's this thing where if stuff gets really bad, you can separate the saucer from the rest of the ship, right? And it's like a last ditch like, okay, we have one thing, and no one's gonna like this okay, we have one thing and no one's gonna like this, but we have one thing weird thing here that we know how to do for some reason. Now later on, after they did the first time, and I don't know when they did the first time, it became a much more common like, I don't know, somebody had a really bad tooth. They're like, uh, separate the sauce, or get it out of here. But that's what it reminds you of. Just your body's like, I mean, I have one last dish

throughout my life. No, he's gonna like it, but here we go. And this can be the result of something like a virus or a bacteria, like an illness, it can be a poison, a chemical toxin. It can be because of hormonal changes or other things that might affect the vomit center in your brain, like obviously pregnancy,

and we'll talk a little bit about vomiting and nausea and pregnancy. Medications can cause this. It can be something that like emotionally, psychologically, you know, your sensory stimulus, you smelled something gross, you saw something gross, you saw someone else vomit. That's what makes you vomit. That's a weird one. Do you know why? Do you know why it's thought, why do we probably vomit

when someone else vomits? Because you can trigger like a whole cascade of vomiting. Because theoretically we ate what they ate. So traditionally, the human animal, hunts and gathers and groups. And so it is likely from like an evolutionary standpoint that the person in your proximity, whatever they're eating, it is, it was likely, nowadays, I would say that's not necessarily true, but it was very likely that you ate the same thing that the person near you ate,

and so you see them puking, so it's sort of a, and your body is assuming I've also been poisoned, and I must also, I must also get rid of what's in my stomach. Now nowadays that doesn't really hold because like, what if you're in the food court at the mall, you know, like you ate at Sparo, they ate at Panda Express. But your stomach doesn't know that. It's too late. It doesn't know about the sparrow roll.

Yeah. Maybe my body's just kind of playing the odds that it was sparrow. I don't know. Um, why do kids puke so easily? I thought that was an interesting question, because they do. That this is something I, it's like the.

It's really weird. It's one of the, up there with like, everything is temporary. That's like my chief parenting tip for people and like how what's your what's your parenting advice? Transitions or seldom Smith. Transitions or seldom smooth. And by the way,

and I also would never give parenting advice unless somebody directly asked me. Yeah. That's another tip. That's your number one. Unless you ask me for advice, I'm not gonna give you any. But that is one thing I will say, kids just puke sometimes. And like always check and make sure they're okay. I'm not saying like assume it's nothing, That is one thing I will say, kids just puke sometimes.

And like always check and make sure they're okay. I'm not saying like assume it's nothing, but a lot of the times they just puke and then they're fine and you never really figure out what the heck happened. And that's kids. Their bodies are more sensitive to the same signals that make us vomit. Their bodies are just a lot more sensitive too.

Which makes any kinds of physical or emotional stressor. You're also quite more sensitive to any kinds of physical or emotional stress. You're also quite more susceptible to some of the toxins instead of that we talked about. So the body maybe has a shorter trip or that kind of thing. Yeah, it has a lower dose kind of tolerance. Also, like, just very practically speaking, the GI bugs that we all tend to get in our lifetime, we get the first time we're exposed to and we tend to be exposed to them when

we're kids. So, like, be exposed to them when we're kids. So kids are gonna get sick more often, we know this. And so they're gonna puke more for that reason too. So any illness or injury can make a kid hurl. Like anything that, I mean, if you stub your toe really hard, it might make you feel a little nauseated for a second. You know that feeling or like if you bonk your head

and you get that moment of like, oh, I feel nauseous for a second. You know that feeling or like if you bonk your head and you get that moment of like, oh, I feel nauseous for a sec. For a kid. For people with nuggets, it happens if you get struck in the nuggets. Or if you, it's actually worse if you get a nugget tap by like, if you're ever wrapping a cinch of cord or something like that or just bear,

sometimes that can be even worse. But anyway, yeah. There's a nausea. Yeah, any sort of physical thing that like, you may have as an adult that moment of like you feel sick for a moment for a kid, it will probably just turn into a puking episode. That's not to say that if your kid pukes ignore it, again,

obviously, you know, anytime our kids are sick, I am concerned. I am making an effort to keep them hydrated at that point. That's one of the biggest worries with kids. You know, if there are other serious symptoms, fevers or they're confused or they're hurting somewhere else, any abdominal pain, anything else, this is not me writing off vomiting.

It's just an acknowledgement that kids puke easier and sometimes like the other night, kids puke, and then they're fine. And the next day they're running around eating ramen for breakfast and having no problem. So I don't know. Morning sickness which is obviously a misnomer. Right, I think we covered that problem. Yeah, nausea and vomiting and pregnancy can happen. Anytime we've talked about this a lot, why does it happen? You know we still don't know. Great. Which by the way,

thanks science. Unsurprising. Unsurprising that this problem is not, has not historically been important to the people who decide what we research. We haven't done a lot of great studies. Hormones have always been blamed. Like well, probably your hormones, they're changing, so you're nauseous. What's interesting though is those levels don't peak at the same time that the nausea of vomiting of pregnancy usually occur. Like they don't coincide very well. So it's not a, it's a, it's a, it's a messy explanation. It's not a clean explanation. I'm not saying hormones don't have anything to do with it, but it doesn't hold water completely.

We know that smooth muscle relaxation happens in pregnancy. Part of that is like important. Everything's sort of relaxing, so you can stretch and accommodate, like, you know, a human, and then birth it from your body. But that stretching and relaxation is smooth. So it allows for the lower esophageal sphincter, the bottom of your esophagus to loosen, which allows for reflux.

A lot easier. Thank you very much, Charlie and Cooper. That was terrible. And also, it delays the speed that your stomach empties. So like, food will sit in there a little longer. All those things, I don't know. We also know it's genetic. We still don't know exactly why it happens.

Great. But part of this is we don't understand nausea very well. Really? No. We still, like, vomiting. We have a much better fix on, like, where do the impulses start and what triggers them and how can we block them and all those things. Nausea's still a little bit of a mystery

because nausea's worse in many ways. I would take pretty much any symptom of a nausea on say I hate being nauseous. The, and me too. And that's what's interesting about it is that we don't have a great fix for nausea, but we do have a lot of things that will probably make you stop puking most of the time. But nauseous tougher.

Yeah. Yeah, it's really interesting when you start digging into the research on nausea and vomiting, how there is still so much we don't understand and don't know how to fix and don't know. And I think part of it is because so often the causes of nausea and vomiting are transient. It's like it's over before you get to worked up about it. So we move on. And then I think the other part of it is what I want to get into with the history is that our perception of vomiting throughout time and place and different cultures is different. Whether it's a good thing or a bad thing, whether it's the goal or the thing that we are trying to treat, good thing or a bad thing, whether it's the goal or the thing that we are trying to treat, that has shifted.

I think that's part of it. We've all heard of the ancient Romans had something called a vomatorium. Yes, a big room that they vomited in. Right, that is what you think a vomatorium is, right? Yes. Okay. Yes. But why would they do that?

Because they were, oh, I thought I was telling you the facts, but okay, they were, they were doing the, you know, they were eating in great feasts and blankets. And they would eat so much. And then they would use a feather to throw up. And then they could eat more. Okay. So it was like intentional. You write so that they could just keep eating more and more. And it's used as like this symbol of how gluttonous the Romans were, right? Yeah. Okay.

The term vomit orium was first used by the Roman writer, macrobius in saturnalia. And he was not talking about a room where people vomit. Okay. Okay. That is not what a vomit orium was. It was talking about entrances and exits to like amphitheaters and arenas and how as people were coming in or out of an event, how it would look like they were vomiting people into

a space or back out of a space. Really? And he talked about how he called them vomitoriums kind of like a little as a joke, like tongue and cheek, because like a place where people are being vomited into or out of a space. That's where the word vomitarium came from. It is wild, okay. Wow, now that is interesting.

And like what happened, people built on that kind of concept that the Romans did feast, and they did drink a lot and drink to excess. And so like drunkenness and vomiting and eating so much, you vomit. Like that did happen. I mean, people did get drunk and puke. But like all through human history, that's happened. Yeah, you have a worldwide about that.

Not just the Romans, but that wasn't the plan. It wasn't part of the plan. Following that, there were many who wrote of Roman access and they built on that with like Seneca, the stoic wrote about it and made a comment like they eat so that they may vomit and they vomit so that they may eat. But he wasn't literal. That wasn't supposed to be a literal like they're eating. He just haven't subf-he's had a lot of-

He was a stoic. Exactly. And so to him, it was all gross and unnecessary and excessive. And so like, but it wasn't literal. However, over time, the word vomitarium and our understanding of the way, like the language was constructed, vomitarium would be a place where you would vomit. And so the myth persisted with this literal kind of understanding that all the Romans were so decadent that they would eat so much and then want to eat more, not be able to fit in their stomachs, so

intentionally go vomit to eat more so that they could eat, you know, just keep eating food all time. And like that was, I think, echoed in like the Hunger Games. They talk about that with like the people who live at the Capitol, and it's that same sort of idea. But that wasn't what vomitoriums were. Well, there you go. I know. I know. I know. I was fascinated as I was reading about vomiting and I learned this fact. So let's wonder now. I want to talk about vomiting used as either a symptom to treat or a means of treatment because we've done both. But before I do that, we got to go toartments. Let's go! The medicines, the medicines, The askin' if my car's before the mouth!

Hello, I'm a scuffic Dowager Countess. Travis? I'm judging everybody's manners. Oh no, Schwaners isn't, Judgy. It's about teaching you to be your best self and be a little more confident when you enter social situations that you don't understand, and maybe also teach you a little bit about history, didn't know, or give you interesting things to talk about

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Manor shmanners, get it! A man was walking along a beach which represented his life. At his feet were two sets of footprints, his and God's. But looking back down the beach, the man could see that in the hardest parts of his life, there was only one set of footprints. So the man said to God, why is there only one set of footprints when times were hard? Where were you?

And God replied, my precious child, I was in my car listening to the Beefent Dairy Network podcast. The Beefent Dairy Network podcast is a multi-award winning comedy podcast and you can find it at maximumfund.org or wherever you get your podcasts. All right, so let's get medical.

Let's get serious about nausea and vomiting. So we first, when we first started trying to treat it. So let's talk about trying to fix it. When we first started trying to fix it, it was really because of C sickness and we've done a whole episode on maldameir, C sickness. So I'm not going to go over it again. Is that separate from the C-Sync proof saloon? Is that part of the episode?

That was part of the episode. Wow. One of my favorite episodes. That's a good one. Yeah, if you haven't listened to it, I don't even wanna, I don't know, a guy built a C-Sync proof saloon and you don't know what that means,

but you should listen to the same thing. It's one of the best, it's weird that it's not a movie. Honestly, the C-Sync proof saloon should be a movie. Nobody's still this idea, TM. I wanna make a movie. No, they don't just steal the idea. I wanna make a movie. No, they don't have to steal the idea. I wanna make a musical, it needs to be a musical. I just haven't written it,

because I can't write music, but I'm going to. They should like someone should option that episode of a podcast. Like people do that, like just option that episode. Someone, please. I wanna be part of the creative force. I've pictured this musical on my head so many times. What if we could just get a big check?

Just a huge check. Because I want to be part of the creative process. Anyway. You artist, man. I tell you. Yeah. C-Signance was the first focus because it was inconvenient. We, like, sailors had a job to do.

And so if they were, you know, hanging over, overboard puking, that was inconvenient. One medication that seemed effective early on was high as seen or hyosyamine. It was derived from Beladonna and family. So a lot of these sort of plant-based things. Beladonna and families does sound like a full group from the system. That's true. They actually trialed giving it.

They actually tried these medications sort of like in a scientific fashion more or less. Like when sailors were going out during storms, like give some of them the medication and see if it worked. Which is like science. I mean, that's science. You know, it did work and later they started using

atropine and scopolamine, which we don't use atropine for this. We use atropine today for other things. We use scopolamine now. But we use scopolamine to this day. Yeah, you had a trans dermal scopolamine patch when you went on the crease before. And we have, and all of these medications

that I'm talking about, by the way, have a ton of like side effects, if not used properly or dosed properly, or like depending on if you're taking it early, or we're like on a patch. So like these were all early attempts that certainly did help with nausea and vomiting, but probably could have done a lot of bad stuff

and did at times. So early attempts, but not our best effort just yet. I mean, they can affect like your heart rate and things like that. So like they can do a lot of a lot of dangerous stuff. The next class we investigated were antihistamines. It took us a long time to figure out how to block histamine for allergic.

I know what you're thinking like antihistamines that's for allergies. Yes. Well, you've got different, there are also histamine blockers that we use for acid reflux. Oh, okay. In our stomach,

because we have histamine- So are like for- Relief years. In our stomach, because we have histamine. So I like for release there. Yeah, like femotidine, exactly. Pepsid, brand name. But we found that with some of these antihistamines, there were medicines that cross the blood brain barrier as well, and that helped with other things. That's also why the early ones caused drowsiness.

Like if you think about benadryl versus Claretin. Oh, yeah. That's what we're talking about. Stuff that can get into your brain and make you drowsy and stuff that doesn't. Can it get into your brain? But because these early ones did cross that barrier, it allowed them to get to parts of the brain that were responsible for nausea and vomiting, which made them somewhat useful for that too.

The first time we figured that out, it was just a lucky break. So diamond hydranate, which many of you may have taken for car sickness, Dr. Amin, is what we're talking about, was being checked out in 1947 as a treatment for allergies, for hay fever, right? So they're looking at it for allergic issues, and one of the patients who they were trialing it in was a pregnant woman who had nausea related to that and car sickness, and she took it for the hay fever,

but then noticed that when she rode the tram, she didn't get sick. And she mentioned that, hey, I think it actually helped with my car sickness. And so they trialed it again with a placebo and it didn't help. And so then they thought, well, hey, we're on to something. So then they started... Shout out to that lady, by the way, who must have had extremely limited transit options. Or she she was like every time I get on this tram, oh well, gotta get to work, here we go, give me a bag.

So they gave it to soon after that, a bunch of US troops who were crossing the Atlantic during a particularly rough water time and it worked really well compared with placebo again this led to like thin rail diaphan hydramine being used. Sorry, that's That's same for a woman also had hay fever so bad She would agree to participate in an untested experiment trial an experimental trial. Maybe we're drunk.

That is a rough, that is a rough life that woman has, man. I know, you know, it's a shame. I don't know her name. I need to, I need to see, I need to do more digging and see if I can find the name of this one. She needs to be made famous for her contribution to medical science. That's a rough one. Yes, and her bravery. We all need to stay the men'sed in our own ways, but the, the, whoof. So, so this was interesting.

So we had these drugs, like, I mean, what we're talking about now, arena hiss means like drama, mean and benedrill, which would help with these allergic symptoms. Would benedrill help with nausea? It does to an extent. Really? Yeah, it's not. The reason we don't think of that as like a nausea drug is we've got better ones now. But like if you had nothing else, you could take a benederal and it

would probably help to agree with an upset stomach. Same way that like if you take a drameamine, it'll stop you up a little bit. I wouldn't use it as a treatment for diarrhea. But if you take it, that will happen. Sometimes I take it on long fights to keep myself having to get a p-f-f-m-no-endosie. It does, it does that a little bit. A lot of these, and this is something too, a lot of these early medications weren't as, we now try to make drugs that are cleaner, and what I mean by that is they do one thing. A lot of these early medications sort of did all kinds of things. And we didn't know exactly what they did.

We knew it, they did this one thing, and then we'd get them in people and go, oh, look, they do these other things. Or we would know ahead of time, like, well, they're going to do these other things, but it's all we got. This cat was really depressed and then he quit smoking. What the heck? Well, I mean, that is, that is, that's right. Like, that's how we got. This cow was really depressed and then he quit smoking? What the heck? Well, I mean, that is, that's right.

Like, that's how we figured stuff out. Nowadays, we have, we usually have a better idea going in if we're going to find those sorts of unintended effects or like we find them in trials with animals and stuff before they get into humans. It does still happen, but it's not as common as it was back then. These drugs, including later on, Fenergan, which is a mainstay of nausea medicines today,

which came after those, only blocked some kinds of nausea, is what they began to find. Like I said, there are different ways that your body can start sort of the nausea-vomiting response, whether it's like something directly influencing the stomach or something in the brain. So they started trying to work on a class of psychiatric medications that worked on dopamine receptors in the brain. And they thought that that would help with the areas of the brain that can trigger

nausea and vomiting. This was also found, again, it did help some of the nausea, but once you start messing with dopamine, you get a lot of other side effects. Right. You know, the unintended, so like risk-benefit ratios start to not be so great. Similar issue with like steroids were tried later, and like that can help with nausea, but again, you can't take steroids.

There are lots of side effects, which is just taking steroids. There's a medication called metaclopromide or reglin you may have heard of. I was given reglin as a very young baby for reflux. We used to give reglin a lot or metaclopromide, but then we found that there were a lot of side effects with it too. It can still be used for people with delayed gastric emptying or gastroparesis, like related, usually to diabetes or something else that affects your nervous system. But again, long-term use has other side effects.

So you have to be careful. It's not for everybody. In the 70s, they started working on cannabis as an option. Still, a popular requested medication. Yeah, right. For nausea. People are wired about this. People love cannabis.

For nausea. That's why they love. People love cannabis, for nausea. That's why they love it. For 20, I'm nauseous, just as it happens. It was never studied to the extent as these other medications. For reasons that I don't think I need to explain. Once it was criminalized, it was really hard to study it as a useful medication. Because even if you found anything, it was still

legal. That's the same kind of short-sightedness that's blocking our research into psychoactive like hallucinogens and stuff like that, shrumes, all this stuff. Yeah. I mean, if we look at where we are with cannabis and sort of a side note as to like where we might end up with these other sorts of drugs, a lot of the problem with medical cannabis being legalized in places without recreational cannabis being legalized is that you're kind of thrusting this new medication, so to speak, into the hands of providers and of doctors,

and that we don't have the body of evidence to tell us exactly what to do with it. And then also you have sort of the cultural overlay of like, it should just be legal. And so I don't really care, you know, like everybody can use it if they use it responsibly and I don't, it's safer than alcohol and something, I don't know, but that's why it's so complicated.

I'm gonna tell the agree with you with everybody. I feel like kids probably shouldn't. No, okay, I'm an adult. No, I don't want- It's a different, it's a different church for different folks. I'm an adult, I didn't mean kids. You sitting back where I candid it for the West Virginia and how the house of represent it.

Those things should be blazing it. No, adults, adults. I just, I- Maybe House of Representatives thinks kid should be blazing it. No adults adults. I just I maybe that's why they absolutely that's why they get into blippy because they're like a little bit stone. No, but I have I am open about the fact that I think it should be legalized recreationally because I don't think as a physician I don't know that putting it in my hands like making me the gatekeeper is just damaging to, I mean, it certainly damages the relationship between patients and

doctors, which is already strained for a million other things that we are the gatekeepers to, I just think that this is more damaging to that relationship in the long run and doesn't help anybody in it should just be legal for adults. Good. Didn't you think you'd have to verify that? and doesn't help anybody in it, should just be legal. Four adults. Good. Didn't you think you'd have to verify that? Well, I didn't think I would, except you. Yeah.

Sorry. I didn't know you were like, you were my opposition on this one. Sitting McRoy says that she thinks everybody should have we. No, I don't. See, okay. The next decades would, after the 70s, and part of, this is also part of why cannabis was not further,

and some of these other things were an experience, like, weren't looked into further, is that chemo was really brought into, like, common use in those next decades, and so there became this increased focus on research into anti-medications that would stop nausea and vomiting because of the side effects of chemotherapy. Right.

At first metaclopromide was the best thing that we had, but it wasn't perfect, I said the recid effects. They knew that it was working on receptors that they weren't identifying. That was the thing about it. They knew it did one thing, but then it was also helping in other ways and they weren't sure. So they took them a while, but they figured out there's

this other set of receptors called the 5-HT3 receptors, which are only important in the sense that this is where we made a major breakthrough with nausea and vomiting. If we can block them, we can prevent a lot more nausea and vomiting than we did before, and we figured out how to with medications like on Dancetron, which you know better as Zofran, which has become like the main stay nowadays. It's called Dancetron. On Dancetron. Okay, on Dancetron, because they were going to be lost with me over my dancing robot, Dance Tron. No, I'm sorry. Dantite Tron,

Mosbo day, it is in my programming. And then, you know, since then, there are other medications that we have had in more recent years, especially like you'll see there are some medications that we really only use for the nausea and vomiting associated with chemo specifically. Zofran used to be that. Nowadays, we use it for a lot more, you know, conditions that the nausea and vomiting associated with chemo specifically. Zofran used to be that. Nowadays we use it for a lot more conditions that cause nausea and vomiting. But again, there are side effects, thanks to some monitor, but it's probably what most people turn to nowadays, if you're going to go with a prescription medication, if you

need something like that for nausea and vomiting. And there are medicines like that in other countries instead of Zofran, they have their own 5HT3 blockers. But anyway, pergatives, just a brief mention of the other side of that. Something for a long time, and we've talked about this a lot on the show, medicines that could make you have diarrhea,

that could make you pee, that could make you vomit, were thought to be really effective because they did something. And part of that has to do with overlap with spiritual and religious traditions that saw this as important. Like, it can be an important and not intentional,

but it's an okay part of certain ayahuasca ceremonies. You might vomit and that's part of it. There are exorcisms performed where vomiting becomes part of it. We've seen these documentaries. And that is like a spiritual purge, I guess, that is occurring at that point. And because of all these different sort of overlaps

and alongside with traditional and folk medicine which said like sometimes you need to throw up to be healthy. We figured out medications that do that. In the middle ages there was something called the antimonyl cup, which was a cup made of antimony. It would be something you would have in like your family, like you would have it up on the shelf. Like it wasn't like your individual.

It was like the family antimonyl, and you would probably pass it along throughout the generations. And basically, antimonious, a toxic substance that will make you vomit. So what you would do is if you were sick, you would put the traditional recipe was you would take some white wine. It could be any wine eventually,

but white wine was preferred. Put it in the cup at 6 p.m., let it sit all night, and then at 7 a.m., the following morning, you would drink the wine, a full dose for adults, half dose for kids and it would have leached enough antimony into the wine that it would make you vomit. That cannot be healthy. No, don't do that. No, we always do this anymore. And there are only, I think there are only like a handful of these cups that still exist in the world, but these used to be passed down through families. They antimonyl cup. There was Ipacac syrup, which was used,

I mean, into the 2000s before finally, like, people who took care of kids, especially, pedatures, the family doctors were like, stop using this stuff. So Ipacac was around for a very long time. You may have had it as a child. You may have seen it in the family medicine cabinet. Well, but for my time, I think it existed into the 2000s.

Well, I'm kind of a 2000s maybe our listeners. Yeah, they're yet even, we're all millennials here. I think we can all agree. It was known by people indigenous to Brazil for centuries before the Europeans caught on and they gave it to King Louis XIV and 16VI and XII and decided like this is great. We love it. The king likes it. It made him vomit when he was today.

Which is the highest review ever. So this is Mickey vomit. It's derived from a very pretty plant. I found an Ippercac plant growing out in the woods. One of there are a lot of different varieties of it, but I found one. I used my Seek Ippercac with very pretty white flowers, but I told the girls don't eat that. And that, you know, they're always eating flour.

It has two chemicals that will actually Cooper does eat plants a lot. I'm sure, of course. You have to stop it. They will induce vomiting, diarrhea, stomach pain, and at higher doses, they can make you really sick, but like this was found to be useful, especially if you thought somebody had been poisoned. That's where Ipecac came to be useful, especially if you thought somebody had been poisoned. That's where Ipacac came into play, was like if you thought your kid ate something that he weren't supposed to, or sometimes just like if you have that sort of, you're really sick and you feel like you need to vomit and you just can't,

you know, and you know that vomiting would make you feel better, we've all had that sort of sensation. Ipacac was on the shelf for these sorts of things things and again, mostly for people who'd been poisoned and And again up until it was like 2013. I think when it was finally stopped completely I mean, it had really fallen out of favor by the 90s, but it it took a while for it to completely go away It's still out there I guarantee and also remember that people you see mummies Yes, of course part of that reason is they could make you puke if you needed to, which is not surprising at all. That is like the least surprising thing that people would use for that. Nowadays, we know that like, even if someone's been poisoned, making

them vomit isn't really the best thing to do. If there's a toxic or poisonous substance in their stomach and you make them vomit, they could aspirate that, they could do damage again to the esophagus. If it's something that can be erosive to tissues, bring it back through the esophagus is not helpful. So there are a lot more helpful ways that we can treat poisonings than making people vomit now, which is why we don't pursue this anymore. Usually vomiting is not desirable, and so we have a number of medications to pretreat and post-treat and figure out why.

Although we don't always, there are things like cyclic vomiting syndrome, where people vomit and we still don't, vomiting is still somewhat of mystery, nausea even more so. And especially with kids, just to sum it all up, this was inspired by Cooper Puking,

and then being fine, she's fine. It's fine. Sometimes kids puke, it is scary. It's good to remember that kids do puke easily, and in the absence of other symptoms, keeping them hydrated, they usually just stop, and it's fine. You know, bonus pro tip for that.

You know how you don't wanna puke all over yourself, and then you're bedded on the floor, and you'll take five steps to try to avoid that happening. Kids will not give kids so up. It is the most important thing that is happening to them. So if you're going to have a ball out, make sure it's real close because they do not care. No, they know they don't have to clean it up. So they're pretty unmoved if they puke all over everything.

They do. And she really, she is, I just want to stress, we're not making light of something major. She was totally fine. I think it had to do with sugar and maybe swallowing some pool water. We had been swimming that day. Yeah, it is. Again, not a good idea, but kids do this stuff.

That's kids. Hey, thank you so much for listening to our podcast. We hope you've enjoyed it. You know, if you ever wanted some Sabah and some merchandise, some goodies, macaroidmarch.com is the address for that because all sales in June, this month that you're in right now, 10% of merch proceeds are going to Ferris West Virginia this month.

So buy some stuff from macaroidmarch.com this month. We have a book, the Sabbund's book, it's in our back, and paperback, and you can get it, read it, and I think you'd like it if you liked this. Thanks to the taxpayers for using their song medicines as the intro and outro program. Thanks to you for listening. I appreciate it.

Until next time, my name's Justin Macaroix. I'm Sydney Macaroix. And it's always, don't draw a hole in your head. Maximumfun.org. Comedy and culture. Alright!