※ 引述《DaiRiT (QSOFA)》之铭言：
: ※ 引述《lepputte (华英成秀)》之铭言：
: : 如果你嫌它旧，keyword都有了，其实你应该也有能力查新的，
: : 叫我一个中医不停地上pubmed查英文期刊给你
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
: : 我真心觉得累。
^^^^^^^^^^^^
: 专门回一篇砒霜/三氧化二砷的历史跟你说明
: 因为你写的太奇怪，中医理论没有癌症或白血病的概念，怎么可能会有用砒霜治疗癌症/
: 白血病的开端
科学的方法是这样说的
科学方法涉及到很多步骤，首先，需要观察大自然并且对于自然现象提出有意义的问题，
然后再想出假说来解释自然现象，之后设计实验来检验这些假说，核对从这些假说所给出
的预言是否正确无误。为了要防范在做实验时发生错误或误解，这些步骤必须具有可重复
性。一个假说在被学术界广泛接受之前，必须先通过科学方法的严格验证，以有条有理的
方式来将理论结果与实验数据互相比较。只有当理论结果和实验数据互相吻合时，这假说
才能被学术界接受。
科学的讨论是这样干的
1.列出你看到的文献，好好的阅读
2.提出你的假说来解释当下的现象
3.然后继续查文献(如果你没办法做实验)或设计实验(如果你有能力)来验证你的假说
4.保持中立的态度，思考别人(实验/所查文献)与你冲突的地方
5.与别人沟通，解决中间的歧异
6.如果无法否定对方的实验/文献，让两种说法并存。
你....唉~~ 你知道为什么我有时候只能默默的静静的看你装逼吗?
不是说你讲的完全都错，其实你讲的有些东西我也蛮认同的，中医确实该进步改变
因为你已经先有默认立场
(因为你写的太奇怪，中医理论没有癌症或白血病的概念，
怎么可能会有用砒霜治疗癌症/白血病的开端)
然后完全看不到你自己看不到的东西，
别人看到了，提醒你，你仍旧照你自己的想法依然故我
于是我只好悲情的再点一下你。
我只是要让你有点醒悟，其实我本意不是要跟你吵架，
请原谅这次，我只好打醒你。
回去看一下我给你的2005年review，我给你看的文章
In traditional Chinese medicine, the arsenic trioxide (As2O3) form of
arsenicals has been used thousands of years in the treatment of a great
variety of illnesses, including cancers, and in Western medicine it has
been used in the last decades to treat chronic myeloid leukemia and
was known as Fowler’s solution. However, due to toxic side effects of
Thousands of years 也不一定是千年都拿来治癌症，但你好歹去念一下中医文献
因为你想一下吧，中医文献又不会翻译成英文给外国人看，你是不是该科学一点，
先广泛蒐罗证据，再来提你的想法呢？
好吧，大家都忙，没时间这样干。
不然就去看一下当初拿砷剂治疗APL的那个中国医师到底是怎么想，怎么启发的。
(假如你很喜欢唸英文，不喜中文尤其是中医的中文)
那不然至少去读一下我给你的文章，OK？
Fowler's solution需要你再去查吗? 我给你的文章不就有了吗?
long-term intake of high doses of oral arsenic and with the advent of
modern radiotherapy and chemotherapy, treatment for CML with arsenic
However, due to toxic side effects of long-term intake of high doses of oral
arsenic and with the advent of modern radiotherapy and chemotherapy,
treatment for CML with arsenic was given up in Western medicine.
对，2005年的last decades, 就有了，也拿来治癌症了，但你看到这句了没?
因为长期服用的高毒性以及现代放疗化疗的进步，所以西医放弃砷用来治疗CML.
A recent renaissance of arsenic trioxide (ATO) came about,
following the discovery in China of its therapeutic effect in acute
promyelocytic leukemia (APL) which revived the interest in this ancient drug.
最后是在中国医师治疗APL重新兴起使用ATO治疗....
: 于是我就查了一下，查到一些史料，其中一篇是在American society of hematology美国
史料...嗯...1997年的叫史料
2005年的review叫旧资料
: 血液科期刊一位读者给编辑的回信
: Delicious Poison: Arsenic Trioxide for the Treatment of Leukemia
: Y.L. Kwong, D. Todd
: Blood (1997) 89 (9): 3487.
: To the Editor:
: Lately, arsenic trioxide (As2O3 ) has been described in the treatment of acute
: myeloid leukemia. Experiments in vitro showed that As2O3 induced the acute pr
: omyelocytic leukemia (APL) cell line NB4 to downregulate bcl-2 expression, as
: well as to undergo apoptosis. Clinically efficacy has been shown in 14 of 15 p
: atients with relapsed APL, where the use of intravenous As2O3 at a dose of 10
: mg/d for 4 to 9 weeks resulted in complete morphologic remission without assoc
: iated bone marrow suppression. In these cases, partial differentiation of the
: APL cells and downregulation of the fusion protein PML/RARα could also be sho
: wn, which might account for the pharmacologic action of the drug.
: Arsenic has been known to be poisonous for centuries. Medicinal use of arsenic
: began in the 15th century. In the 18th century, Dr Thomas Fowler developed a
: solution preparation of As2O3 in potassium bicarbonate (1% wt/vol), known gene
: rally as Fowler's solution, which was used empirically for the treatment of a
感谢补充啊， 先不提我给你2005年review你K我说给你旧资料，
结果你给我1997... 你知道我都快晕倒了吗?
好吧~~反正你就是这样，我其实也知道。
你先看一下它用多浓，(你要不要去查看看，ATO 如果是口服治疗APL 吃多少？)
所以毒性太强，没办法用了，放弃了，看到了吗?
: variety of infectious and malignant diseases. The effect of Fowler's solution
: on the reduction of white cells in two normal people and one patient with “l
: eucocythemia” studied at Boston City Hospital, MA was first described in 1878
: .
: This lead to the use of As2O3 for the treatment of leukemia, until the advent
: of radiotherapy caused a decline in its clinical application. Its popularity
不唸我给你的
这你自己查的文章，可以好好念吗?
: waxed again when Forkner and Scott, also at Boston City Hospital, described ni
: ne of 10 patients with chronic myeloid leukemia (CML) who responded to As2O3 t
: reatment. These results were subsequently confirmed by other reports, so that
: As2O3 was considered next to irradiation as the most effective treatment of CM
: L before the development of modern chemotherapy. Clinical improvement of the l
: eukemia, including the control of fever, reduction of white cell count, amelio
: ration of anemia and decrease in the size of spleen, could often be achieved.
: Sometimes, a remission might be maintained for a long period. As expected, tox
: ic side effects were observed in the majority of patients given long-term As2O
: 3 , including skin pigmentation and keratosis, cirrhosis, polyneuritis, and ga
: strointestinal problems. In this department, As2O3 was used by hematologists i
: n the 1950's for the treatment of a variety of leukemias. Figure 1 shows the t
: ypical course of a patient treated with As2O3 for CML in chronic phase. As As2
: O3 appeared to be effective for leukemias of different morphologic types, thea
: ction was probably related to an intrinsic toxicity of arsenic to marrow cells
: .
: 后面还有一个个案讨论跟药物几转讨论，总之三氧化二砷在西方从15世纪就有了，到了18
: 世纪，Dr Thomas Fowler用三氧化二砷跟碳酸氢钾溶液调配出Fowler’s solution，这个
: 福肋溶液会经验性拿来治疗感染疾病跟恶性疾病，后来在波士顿医院有医师报导关于三氧
: 化二砷在白血病(还包括CML)的效果。
: 中途查了APL的发展史，是在1957年：APL was first described in 1957 by the Norweg
: ian hematologist Leif Hillestad[1]
: 然后我就去查这个福肋溶液跟“砷治疗”，有关历史上的治疗，写说拿来治疗疟疾、梅毒
: 和非洲锥虫，里面也有写到中国研究三氧化二砷在APL的治疗，最后是美国进行RCT被FDA
: 认证为APL治疗之一[2,3]
: 总结：砒霜/三氧化二砷拿来治疗血癌是西方有、两百年以前就开始有的，拿砒霜/三氧化
: 二砷治疗白血病不是中国开始的，中医也没有血球、白血病概念，而且是西医先有AML分
你再想想我跟你讲的，
至少去查一下APL那个医师是怎么启发，重新使用砷剂的
然后他看到什么文献.... 那个文献是什么时代的。
理论上这应该是我要查给你，但是....我读了好多英文，可以拜托你念一下中文文献吗?
而且我很伤心，我查给你的英文，你都不好好念。让我觉得
我本真心向明月，奈何明月照沟渠
: 型和APL研究成果。说拿砒霜治疗血癌是由中医导入有点牵强。
好吧，讲到这里你觉得我说的话，有问题?
如果你很坚持你看到的文献，Fowler先，OK我接受，
毕竟中医文献没有先发journal所以先者为王。
那我修正成
拿砒霜治疗血癌由 中国医师(也不要写中医，免得你说自己贴金) 复兴可以吗?
: 话说我也是有查到资料写说中医用砒霜治疗肺结核、梅毒等等，但是中医理论无法诊断肺
: 结核和梅毒啊，这存在逻辑上的bug。
Fowler's solution也有被拿去治疗梅毒.... 砷剂治疗梅毒这可是中西方都有。
: Reference:
: 1. Thomas, X. Acute Promyelocytic Leukemia: A History over 60 Years—From the
: Most Malignant to the most Curable Form of Acute Leukemia. Oncol Ther 7, 33–6
: 5 (2019). https://doi.org/10.1007/s40487-018-0091-5
: 2. Antman KH. Introduction: the history of arsenic trioxide in cancer therapy.
: Oncologist. 2001;6 Suppl 2:1-2. doi: 10.1634/theoncologist.6-suppl_2-1. PMID:
: 11331433.
这篇，也是你查的，
我列一下abstract
Arsenic is a natural substance that has been used medicinally for over 2,400
years. In the 19th century, it was the mainstay of the materia medica. A
solution of potassium arsenite (Fowler's solution) was used for a variety of
Fowler's solution 又出现了
systemic illnesses from the 18th until the 20th century. This multipurpose
solution was also primary therapy for the treatment of chronic myelogenous
leukemia until replaced by radiation and cytotoxic chemotherapy. The past 100
所以又再一次地说治疗CML被化疗和放疗取代了
years have seen a precipitous decline in arsenic use and, by the mid-1990s,
the only recognized indication was the treatment of trypanosomiasis. Much of
后来砷剂唯一被认可的适应症是治疗热带疾病trypanosomiasis
this decline was due to concerns about the toxicity and potential
carcinogenicity of chronic arsenic administration. The rebirth of arsenic
therapy occurred in the 1970s when physicians in China began using arsenic
trioxide as part of a treatment for acute promyelocytic leukemia (APL). Their
accumulated experience showed that a stable solution of arsenic trioxide
given by intravenous infusion was remarkably safe and effective both in
patients with newly diagnosed APL leukemia and in those with refractory and
relapsed APL. The mechanisms of action of arsenic derivatives in this disease
1970年中国医师复兴
一开始是口服，我其实前面文章有简单跟你提一下
但这里复兴开始改成静脉注射，
我想你会说静脉注射不是中医的，中国医师也不是中医....
我也不要一直强调中医好了，这样你可能会稍微理性一点。
ATO又开始绕回口服，我之前查给你的就是这种的randomized trial
我可是一直都逻辑一致吗? 现在的医学是中西不分，互相启发渗透。
所以才需要好好讨论，看能不能彼此启发。
不过，要讨论前，先不要默认立场，先读一下别人给你的文章，
不然也自己好好读一下自己查的文章。
我也不是要给你打脸，
我只是要点一下你的态度，理性一点，科学一点，多听听别人在说什么。
学习一下怎么跟别人沟通，ㄟ，应该是学习怎么跟你"瞧不起的人"沟通。
愚者千虑，还必有一得
不要太过强势听不进去别人讲的，急诊是需要当下决断没错，但不要变成职业病
我去run过急诊，知道我自己不适合，但很敬佩别人做到我没做到的。
一直觉得急诊医师很帅气，影集看不少。
我想你在自己岗位上应该很优秀的，毕竟你认真回文。
一个认真努力的人到哪里都是受人尊重的
and other malignancies are many and include induction of apoptosis, partial
cytodifferentiation, inhibition of proliferation, and inhibition of
angiogenesis. Molecular studies and ongoing clinical trials suggest that, as
a chemotherapeutic agent, arsenic trioxide shows great promise in the
treatment of malignant disease.
不要觉得丢脸，智者千虑，总会一失。
没人能保证自己永远正确，所以，讨论的意义也在这里。
看到自己没看到，想到自己没想到的，然后让讨论的双方都成长。
不要受你情绪影响，不要急着反驳，
你再想想，我想告诉你的。
这样也不枉费我，花了这么多时间，跟你讨论。
我希望你是能沟通的人，
因为不能沟通的，
我真的只能默默，
给予祝福。