THE RESEARCH POTENTIAL IN TRADITIONAL MEDICINE

By SANJANA RAO ABHIJIT RAMAPRASAD

According to a 2004 press release by the World Health Organization (WHO), nearly 80% of the populations of developing countries rely on traditional or alternative medicine for their medical needs. Traditional medicine, as defined by the WHO, refers to “the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness”. Thus, when this article refers to traditional medicine, it is referring to the WHO definition, examples of which include Sowa Rigpa, Ayurveda, and Unani, while more modern, non-allopathic treatments are termed as alternative, or complimentary therapies. Most traditional medicine relies on therapies derived from trial-and-error over hundreds of years and on herbal/natural agents. As these agents have been used over centuries by these communities, they present an untapped trove of research potential for use in modern medicine.

R ar h P t t al Haldi (or turmeric) has been traditionally used by communities in India to treat everything from digestive disorders to respiratory conditions to skin cancer. The active ingredients in turmeric (curcuminoids) have been shown to exhibit anti-inflammatory abilities and are well documented anti-oxidants. The anti-microbial properties of turmeric have also been documented thoroughly, with in vitro studies demonstrating varying levels of inhibition in multiple varieties of bacteria and fungi when treated with turmeric extracts. Due to these properties and its use in traditional medicine, extensive research is being conducted into curcumin derived drugs and their potential use in conjunction with chemotherapy to increase remission rates of certain cancers.

Traditional medicine often makes extensive use of venoms and toxins. Since the period of Ancient Egypt, hirudotherapy or leech therapy has been used to treat a slew of disorders from hypertension to varicose veins. According to a study by the Vascular Disease Foundation, every five minutes a person dies due to a blood clot. Leech venom contains blood thinners, which can be used to stave off thrombosis. In 2000, FDA approval was granted for an anticoagulant drug derived from leeches, for use during surgery.

22 || pulse Other drugs derived from venom include Tirofiban and Integrilin, which are made from compounds isolated from the venom of the saw-scaled viper and the dusky pygmy rattlesnake respectively. These drugs work by inhibiting the same receptor preventing the formation of blood clots.

Ob ta l t th Spr a f Tra t al M If traditional medicine has such beneficial potential, why isn’t it more widespread and recognized by modern medicine? There are multiple obstacles to mass production/use of traditional therapies, including the difficulty of regulating quality, conducting clinical trials, and the risk of drug interactions. As traditional medicine often favors a "holistic view" of the affliction, and tailors the treatment to a particular individual based on his/her lifestyle and medical history, it becomes nearly impossible to properly conduct a randomized, double blind trial. Although the difficulty associated with performing randomized trials presents a large barrier, there are still potential avenues of research into establishing a basis for these traditional practices. This research is usually directed toward extracting the active ingredient (the compound responsible for the desired effect) from herbal remedies (e.g. curcumin from turmeric) and then conducting in vivo and in vitro experiments using just the active ingredient. Other forms of research delve into the field of complementary therapy, wherein traditional medicinal practices are combined with modern therapy in order to minimize side effects (e.g., combining massage and radiation therapy), or to increase the effectiveness of the therapy (e.g., using herbal products and chemotherapy in conjunction). Moreover, there is a large grey area regarding what constitutes a 'supplement', and the quality regulation of supplements across countries.

Th E l g al A p t The use of animal parts and secretions presents many ecological problems. Pangolins are the most trafficked animal, for their large keratin scales. These scales are believed to have medicinal properties and are used in traditional medicines all over the world. As with the use of pangolin scales (and the corresponding near extinction of pangolins), tiger phalluses are consumed in China to ward off impotence and increase fertility. Resources are finite, and traditional medicines can permanently damage populations of endemic species. Similarly, tiger bones are sold in China due to their perceived health benefits, although scientifically, none have been proven. Many species whose parts are used in traditional medicine are now classified as critically endangered due to overexploitation. Furthermore, if these endemic species are bred in countries where they are not native, they may become invasive, and destroy the native species in that area. The same is true of diseases and bacteria which can wreak havoc on the native species that do not have immunity to them.

H alth P l y Although the World Health Organization regulates these medicines worldwide, many countries (especially those with large

traditional/alternative medical systems) have their own legislation regarding these issues. These range from countries with minimal regulation (as in the case of New Zealand) to those with entire ministries dedicated to the proper regulation of traditional and alternative medicines (as in the case of India). There are many factors that must be taken into account when crafting health policy. For many communities, their medical practices have formed an integral part of their history and identity, and as they often utilize herbs and other resources from their indigenous land. However, if these drugs are to be mass produced, an ecological problem is presented as well. Furthermore, the question of property — both intellectual as well as in terms of resources — is brought into focus. For instance, Captopril is a drug used to control blood pressure and was derived from the venom of a Brazilian viper (the arrowhead viper). However, the tribes who first used this venom weren't given a penny; their traditional knowledge were packaged for the masses without compensation, in one instance of biopiracy. On the other hand, in the Kalahari Desert, the South

African government worked hand in hand with the San tribe to develop dietary supplements based on hoodia, a cactus well-known to the San for its appetite-suppressant qualities.

S ak O l Over the course of this article, the words "snake oil" may have come to mind. The phrase "snake oil" now refers to fraudulent drugs with no medicinal value used to mislead. However, true "snake oil," or the fat content of the Chinese water snake, has anti-inflammatory properties which justify its use to treat arthritis in traditional Chinese medicine, and contains omega-3-fatty acids, and 20% eicosapentaenoic acid (EPA), both of which are easily used by the human body. The modern connotation arises from the passage to the Western hemisphere. Due to the rarity of Chinese water snakes in the USA, your average 19th century peddler was most likely not selling traditional snake oil. Instead, it was either a mixture of mineral oils and herbs, with no snake component or medicinal properties, or rattlesnake oil, which contains a third of the fatty acid content of traditional snake

Global use of herbal traditional medicine.

oil. Thus, "snake oil" became associated with falsehoods, rather than its origins as a genuine product.

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