In India, it is very common to see house-hold remedies suggested and used by older members. They are called as “Dadimaa ke nuskhe” in Hindi which literally translates to solutions of a grandmother. It is not uncommon to see people gulp decoctions after decoctions to get rid of their acidity or headache (and to my amusement these are done without any attempts to change one’s lifestyle or eating habits).
Our life has dramatically changed in the last 5000 years. As a civilization what we knew 5000 years ago, is minuscule to what we know today about the human body, nature and the space. We were a civilization that once though earth quakes and volcanoes were the wrath of God and most of the science that existed at that time was observation based and passed on by word-of-mouth through generations. Anyone who has played the game “Chinese whispers” as a child knows very well what is wrong with word-of-mouth transmission of knowledge. It gets distorted at every step and after a few 100 years, it makes no sense whatsoever.
This is the problem with the idiom “Old is Gold”, which is commonly used in the context of herbal medicine or ayurveda. We have known the medicinal value of plants since the very beginning. 60 percent of medications used in modern medicine are plant-based molecules. Aspirin, morphine, paclitaxel (used in cancers), vinblastine (again used in chemotherapy), quinine (used in malaria) etc. are all active ingredients of plant extracts. The difference is that in the earlier era, we didn’t know what made a particular extract medicinal. It was a guessing game about the way to prepare it, medicinal dose versus toxic dose, side-effects and range of therapeutic action. I am absolutely certain that countless people might have died of wrong dosage or the side-effects during these treatments and none of those were recorded.
Where there is no evidence, we can argue from either side. When people tell me “Oh people were healthy those days and rarely fell sick or recovered with natural medicines”, I ask them, how can you be sure they didn’t fall sick? Death was an acceptable outcome for many conditions and no one really batted an eye. People were crippled, disabled and sometimes even rotted to death due to lack of medical understanding. We didn’t understand the importance of sanitation and aseptic precautions. Today the scenario is very different. Death is not an acceptable outcome even in life-limiting diseases like cancer. This is why euthanasia is not legal in majority of the countries.
Let’s take another view also here. Our soil and plants were very different 5000 years ago. We know for a fact that nutritional composition of all the crops grown today have changed and we still trying to optimize it using modern farming techniques. So how do were know that what formulations worked 5000 years ago would also work today? Again, just like in homeopathy, we need better understanding of why a plant is medicinal. How to understand the effects of a particular extract in our body.
Once we actually understand what in the extract is being medicinal, we can titrate it better. A simple example is the use of Mucuna puriens in Parkinson’s patients. I have come across many ayurvedic doctors prescribing mucuna puriens extract (commonly available as Zhandopa) in India. The active ingredient in Mucuna pruriens is L-DOPA (levodopa), a naturally occurring amino acid and precursor to dopamine. However, by potency it is 1/5th the potency of the starting dose of L-dopa that these patients normally take. So, because the strength is less, the side-effects are also less. However, this dosage doesn’t work equally for everyone. To add to the trouble, herbal medicines are not as stringently regulated as their drug counterparts. Hence, the percentage of L-dopa can highly vary across samples. I for one, haven’t understood why would someone prescribe the same active molecule but in a plant form for which a drug is available (that has passed multiple drug trials). Another example I can give is Rowolfia serpentina (sarpgandha) which is commonly used for hypertension (both in homeopathy and ayurveda). The active ingredient is reserpine. Reserpine works by inhibiting the uptake of neurotransmitters such as serotonin, norepinephrine, and dopamine, leading to its therapeutic effects. However, due to its potential side effects and the availability of newer antipsychotic and antihypertensive medications, the use of reserpine has declined in modern medicine. Reserpine can cause liver damage even in physiological doses over a period of time. So again, my question, what do you gain by replacing a drug molecule with sarpagandha?
I can give countless more examples from what I have seen being used in integrative or alternative medical practice. Some herbs really do wonders when added to existing treatment protocol. One very common supplement used in Vitex agnus-Castus in women facing premenstrual symptoms. I can vouch for some with my clinical experience and with what I have researched on these molecules. However, larger trials are still missing. Chinese medicine doctors are doing just that since last 25 years. They are trying to bring traditional Chinese medicine at par with modern medicine. They have identified many active molecules in commonly used extracts in traditional Chinese medicine to give us better understanding of what we are using. We need the same in Ayurveda and in herbal medicine across the world.
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