The above is a fact gleaned from the Economist, one of my favourite magazines which occupy a lofty position along with National Geographic, Nature, PNAS, and Science. They have, however, a rather interesting (and persistent) stance on alternative medicine: ‘Virtually all alternative medicine is bunk; but the placebo effect is rather interesting’.
Alternative medicine is a comprehensive term referring to a mish mash of traditional, indigenous, and unconventional medical practices such as acupuncture, aromatherapy, chiropractic, homeopathy, reflexology, reiki, and many more. Indeed, some of the practices does merit healthy scepticism. I cannot deny that there are quacks in alternative medicine and that many (if not all) do exaggerate the supposed benefits of the drugs/treatments. But then, all conventional medicine cannot be discarded as dangerous chemicals and expensive treatments which expand the bank accounts of GPs and pharmas. Neither can all unconventional medicine be discarded as outdated, bizarre, and toxic. It is up to the patient to make a well-informed decision. But it is highly debatable whether herbal medicine/ethnopharmacology should be painted with the same brush.
The Economist grudgingly admits that a few treatment (‘mostly herbs containing active drug molecules, do have proven benefits’). Yet, their conclusion is that it is none other than the placebo effect, i.e. ‘the strange and inadequately explained tendency of certain medical conditions to respond to anything the patient thinks is directed at treating them, even when the treatment in question could not possibly have a direct effect on the disease’. In other words, a treatment, per se, would have no effect on the condition, but the belief in its efficacy works wonders, resulting in somatic changes. Apparently, this works most effectively with psychological problems (or anything pertaining to emotions) such as depression and pain. And ‘the alternative-medicine industry plainly excels as a placebo delivery service’. The article concludes by pointing out that practitioners of conventional medicine could be less clinically detached, and more caring and attentive to the patient.
The fact is that many (not ‘few’ as claimed by the Economist) of the conventional medicines are/were derived from herbal products (Analgesics such as Aspirin from Salix, Morphine, Codeine from Papaver somniferum; Digitalin from Digitalis purpurea; Malarial drugs such as Quinine from Cinchona and Artemsinin from Artemisia annua; Reserpine from Rauwolfia serpentina; Physostigmine from Physostigma venenosum; Tubocurarine from Chondrodendron; for cancer-Vinblastine/Vincristine from Catharanthus roseus/Vinca rosea, Etoposide from Podophyllum, Paclitaxel/Docetaxel/Taxol from Taxus, Combretastatins from Combretum caffrum….. to state a few).
Many such herbal remedies have been used since time immemorial in indigenous medicines around the world. Indeed, adopting these remedies directly may pose the concerns of drug toxicology, side effects, and general effectiveness. It is equally likely that their effects may not be significant, whilst studies by pharmas (on their chemically synthesised products) might show significant results (one must not overlook the importance of sample size in getting significant results!). Furthermore, pharmas have more than sufficient capital to invest in large-scale research to test drug efficacy and toxicology prior to clinical trials. An ethnopharmacological research team lacks such resources.Ma et al (2005) identified plant-derived medicines as becoming the next major commercial development in biotechnology. Their abstract states: ‘The advantages they offer in terms of production scale and economy, product safety, ease of storage and distribution cannot be matched by any current commercial system; they also provide the most promising opportunity to supply low-cost drugs and vaccines to the developing world’. Perhaps one emphatic evidence is in the form of the numerous clinical trials being conducted in the US on plant-derived medicines .
Conventional drugs too have side effects which we often overlook- after all, we blindly trust our GPs, believing that any medicine prescribed is fool-proof (reading the medicine's own fine print should throw at least some light on this). Extracting the active ingredients from a herb (thanks to coming across its usage in some traditional medicine), commercialising it and reaping the benefits, only to criticise the practice which had already identified its benefits centuries ago- a dog biting the hand that feeds?
What next? Chucking out vegetables?
References :
Ma, J. K-C., Chikwamba, R., Sparrow, P., Fischer, R., Mahoney, R., and R.M. Twyman (2005). Plant-derived pharmaceuticals – the road forward. Trends in Plant Science, Vol. 10, Issue 12, pp. 580-585.
Alternative medicine: Trust me, I've got a licence
Regulating alternative medicine: But does it work?
Medicine: There is no alternative
Image: Gingko biloba (© Creativ Studio Heinemann/Westend61/Corbis)
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