The Guyton and Hall Textbook of Medical Physiology is considered a cornerstone of medical education. A visual analysis of its content reveals a startling oversight that has persisted for decades – the complete absence of the endocannabinoid system (ECS).
As illustrated in the timeline above, the Guyton and Hall textbook has diligently incorporated various milestone discoveries in human physiology over the years. From the discovery of prostaglandins in the 1970s to more recent findings like adiponectin and ghrelin in the early 2000s, the textbook has evolved to reflect our growing understanding of the human body.
However, there’s a glaring omission. The discovery of the endocannabinoid system in 1992 – a landmark event in physiological research – remains conspicuously absent from the textbook’s pages. This omission persists even in the most recent 2020 edition, a full 28 years after the ECS was first identified.
What makes this oversight even more egregious is the fact that the ECS has become a highly active, and importantly, influential area of biomedical research. Thousands of studies have been published exploring its role in various physiological processes and its potential as a therapeutic target for numerous conditions. The ECS is not a fringe topic – it’s a central player in our understanding of human biology and health.
The implications of this oversight are profound and far-reaching. The ECS is not just another physiological system – it’s a suprasystem that controls our entire physiology. Its role in maintaining homeostasis across multiple bodily functions cannot be overstated. From regulating mood and appetite to influencing pain perception and immune responses, the ECS is a crucial component of human biology. Yet, for 32 years, this vital system has been ignored in one of the most widely used medical textbooks. This is not merely an academic oversight – it’s a failure that directly impacts patient care. By excluding the ECS from medical education, we are sending generations of healthcare providers into the field with an incomplete understanding of human physiology.
The continued ignorance of the ECS in medical education is unprecedented and unacceptable, especially given its prominence in current research. It suggests that an unjustified stigma, likely stemming from the ECS’s association with cannabis, has influenced the content of our medical textbooks. This stigma has no place in scientific education, especially when it leads to the omission of a system so fundamental to our physiological functioning. The consequences of this knowledge gap are significant. Patients around the world continue to suffer from conditions that might be better understood and treated with a comprehensive understanding of the ECS. The potential for developing new therapies targeting the ECS remains largely unexplored in mainstream medicine, all because this crucial system is not being taught to medical students.
It’s time we demand change.
We must bridge the gap between cutting-edge research and medical education. The ECS deserves its rightful place in medical textbooks, alongside other well-established physiological systems.
We urge you to join us in our petition to let Elsevier, the publisher of Guyton and Hall, know that we have finally had enough. The ECS is an absolutely essential component of our physiology, and its continued omission from medical textbooks is no longer acceptable.
By signing this petition, you can help ensure that future generations of medical professionals receive a complete education in human physiology. Together, we can work towards closing this enormous knowledge gap and improving patient care worldwide.
Cannabis was wrongfully excluded from the US pharmacopeia and needs recognition immediately in order to correct the problematic issues of EndoCannabinoid Deficiency Syndrome which is now recognized by scientists in this field. Please start the program for demanding all medical doctors begin understanding cannabis plant therapy for patients in this country.
The ECS is a major metabolic system involved in restoring homeostasis. How can we leave such an important topic out of our medical textbooks because of a stigma?
The medical community needs to learn about one of the most important regulatory systems in the entire human body, The Endocannabinoid System (ECS). As a healthcare professional, I have seen how this system can be beneficial to learn about for the benefit of our patients. We currently have 2 medications that treat this system Marinol & Epidiolex.
If we are treating the system with FDA approved medications, we need to understand how and why it works.
This is long overdue.
Please get this important information into the Medical books.
I am hoping the next generations of Dr.’s are more informed and stop the damage pharma has pushed onto society.
Dangerous pills…. pick plants…. balance of the immune system seems like an ideal spot to start. #passionplantpowerpurpose
E C S – Cannabinoid biology, signaling in brain and peripheral tissues
Endocannabinoid system has four main components:
1. G-protein coupled cannabinoid receptors (CB1 and CB2)
2. Endogenous endocannabinoids that target receptors CB1 and CB2.
3. Enzymes that catalyze biosynthesis and metabolism of the endocannabinoids.
4. Mechanisms involving cellular accumulation of specific endocannabinoids.
The receptor CB1 is expressed in brain and peripheral tissues with multiple functions.
In brain G-protein coupled receptors mediate most of the psychoactive effects of THC in cannabis.
CB1 receptors are enriched in cerebellum (cognition, coordination), hippocampus (learning and memory), cortex (cognitive function, executive function and control, integration of sensory input),
basal ganglia (motor control and planning), ventral striatum (prediction and feeling of reward), amygdala (anxiety, fear, emotion), hypothalamus (appetitte, hormone levels, sexual behavior),
brain stem and spinal cord (vomiting, pain)
CB2 receptors are predominant on immune cells, hematopoietic system and other local cells and brain.
In the brain CB2 receptors modulate the release of chemical signals engaged in function of immune system (e.g. cytokines). Activation of CB2 receptors by THC does not cause psychoactive effects.
CB2 receptors are a therapeutic target as they may circumvent “adverse” effects of cannabis or THC.
The discovery of the endocannabinoid system (ECS) is the single most important scientific medical discovery since the recognition of the sterile surgical technique. As our knowledge expands, we are coming to realize that the ECS is a master control system of virtually all physiology. The total effect of the ECS is to regulate HOMEOSTASIS and prevent disease and ageing. The more we learn, the more we realize that we are in the infancy of this scientific field of study. The ECS is a control system that involves tissue receptor proteins, cellular communication and control, molecular anatomy and the scavenging of oxygen free radicals.
Outlook:
The discovery of the ECS will replace the current medical system of managing and treating disease. Instead of the management of symptoms after the disease has occurred, we do prevent disease and CANCER by manipulation of the ECS.