Native medicine and its place today

By Dr. Sarath Gamini De Silva

Much discussion and controversies have arisen today as the world is trying to find a remedy for the pandemic ravaging mankind. As allopathic (Western) medicine found no acceptable cure for the illness so far, vaccines are being introduced at a rapid pace seeming to be effective in preventing the disease. Due to the desperate situation, time taken for developing such vaccines and their use in human beings has been shortened to a fraction of what we have known hitherto. Thus, long term harmful effects, though we are reassured to be minimal, are yet to be seen. With new more virulent strains of the virus already appearing in the UK, how effective the vaccines would be in the long term is anybody’s guess.

To fill the gap in the availability of scientifically verified treatment, many Ayurvedic or native medicines (also called traditional or alternative medicines) have come to the fore. Almost every week a person with questionable credentials comes up with a decoction claiming to be based on an ancient formula brought down the generations secretly in ola manuscripts. They are appealing to the patriotic sentiments of the people expecting them to accept these out of respect for tradition. Sudarshani paanaya, Dhammika peniya are among the foremost. The claims of their origins from divine sources or being brought down from the Himalayas have added to the mystique. As a more recent example we remember how the leaves and the latex of Papaya were promoted for treating dengue fever, later found to be of no use.

In my childhood, I swallowed gallons of kottamalli with or without ginger and katuwelbatu as a remedy for fevers, common colds and the likes. Venivelgeta was added to prevent tetanus after an injury. During school holidays we were given aralu to “cleanse” the bowels to survive the next school term! Epsom salt (savinda lunu) was added to make the induced diarrhoea more profuse and hence to make the treatment more effective. Later on, I spared my own children the agony of going through that treatment. We have heard about various treatments given to prevent rabies after a dog bite, the success proven if the victim did not get the fatal illness after eating pork. Similarly, deaths after snake bites were supposed to be prevented by various forms of native treatment.

There is a scientific explanation for many of these so-called successes. With a very few exceptions most viral infections are self-limiting. A “drug’ given during the illness, whether allopathic or traditional, makes the patient feel comfortable, but the duration of the illness itself is not generally shortened nor complications made less likely. As for tetanus, a majority of wounds will not anyway lead to serious infection. Most snake bites are harmless needing no treatment; so are dog bites. These are a few examples where no one can claim success for their medication as the patients would have recovered anyway without any intervention. There are risks when people overlook well proven vaccines for the prevention of rabies, tetanus and other illnesses or antitoxins for snake bites and resort to traditional medicine.

Almost all the medications used by native physicians are of natural origin. Roots, yams, barks and leaves are the sources. Unfortunately, with the advance of scientific method little or no attempt has been made to isolate the effective chemical compounds in them. Hence in decoctions like kasayas, multiple plant derivatives have to be boiled together in a cumbersome procedure producing a bitter unpalatable drink. Fortunately, some preparations like paspanguwa, peyawa and samahan are available in sachets, which we still take for symptomatic relief showing our faith in native medication. Likewise, some Western medicines are of plant origin where the active ingredient has been isolated and produced in a palatable tablet form. Some original plant compounds are now manufactured in laboratories to increase the volume of production.

It was identified many years ago that some commonly available plants had blood sugar lowering properties. They are recommended by some for use by the diabetic patients. However, one is not aware of any attempts to isolate the active compounds and make them commercially available. It is the duty of governments, and the ministry in charge of traditional medicine, to facilitate and encourage research into finding active ingredients in traditional medicine.

The situation is even worse when non communicable diseases (NCDs) are considered. Illnesses like heart diseases, high blood pressure, diabetes or arthritis are cases in point. We are still unraveling the exact causation of these illnesses. In such diseases, giving immediate symptomatic relief and the prevention of well-known debilitating or life-threatening long term complications are mandatory. The allopathic drugs have been tested and tried over a long period of time in scientific analysis and well controlled clinical trials to prove that they are effective in treating the illnesses as well as having minimal side effects. Many chemicals, molecules and compounds which started off in laboratories with this process had to be abandoned due to such undesirable effects or lack of effectiveness. Whether any traditional medicine has been subjected to such intensive study is not known. It should be stressed that no “trial and error” method is acceptable when dealing with human life!

There are many anecdotal stories of malignant disease being cured by native medicine. In almost all these instances people have resorted to alternative medicine when allopathic treatment has failed to prevent the progress of the disease. In these instances, after some period of apparent improvement, the disease inexorably gets worse. Even without any treatment, many chronic illnesses are known to subside spontaneously. Alterations in the immunity of the individual may be a factor. Whether any form of treatment can claim credit for such “cures” is questionable. It has become the vogue to undertake extreme dietary changes and other forms of life style modification to alter the course of chronic diseases including malignancies.

People had total faith in native medicine and occult sciences in the olden days as there was no alternative remedy available. Stories about the times of King Ravana and the physician king Buddhadasa are legendary and would have played an important role at that time. But when more established scientifically proven allopathic medicine is available for many illnesses, quoting ancient unverified stories will not help. No one will ever think of going back to horse-drawn carriages because the fuel powered cars cause environmental pollution!

The merits of native medicine are further diminished by their “adulteration” with allopathic drugs alleged to be practiced by native physicians. It is widely suspected that syrups, gulis, etc., actually contain allopathic drugs powdered and reconstituted. Many Ayurveda and related study courses now include some teaching in allopathic medicine and pharmacology. Some traditional physicians prescribe antibiotics and pain killers to gullible public who are naïve enough to believe that they are trained in both systems of medicine! It is well known that a large number of native physicians take allopathic medicine for their own illnesses like hypertension and diabetes. How some such physicians publicly advise against the use of drugs for diabetes like insulin and metformin is deplorable. Over the years these drugs have been proven without doubt to improve the disease and prevent long term complications.

Many herbal products imported mostly from Asian countries currently do not require registration by the drug regulatory authorities. These are costly and are often of no proven benefit. They are commonly prescribed even by doctors registered in allopathic medicine. They should be brought under regulatory control without further delay.

The media play a big role in promoting unproven medications, both traditional and allopathic, spreading harmful misinformation. Politicians seem to take refuge in them when their action or inaction disappoint the public who are looking up to them to control the current pandemic. It is deplorable how they mislead the people by openly ingesting such decoctions. Obviously, they will not be held accountable if unforeseen toxic effects occur in those who swallow it. Those responsible have put the cart before the horse, by asking the experts to decide on the issue after they have already appeared to openly recommend the decoction to the people. The short term substantial financial benefits to those who peddle unproven medications is an incentive to continue hoodwinking the gullible public. The risk of such falsely reassured people ignoring effective public health guidance is worrying.

While showing scenes where alcohol is consumed or there is tobacco smoking, the television screens show a legend to say that these habits are harmful to health. Likewise, it should be mandatory that when questionable medication is shown or advertised, a legend to say that these claims are unproven could rectify the issue to some extent. Ideally, electronic media and other news organisations should have their own advisors on health matters, who can clarify issues before giving publicity to such products. This is especially so at a time when health programs are said to be very popular among viewers

This article is written in good faith to overcome the epidemic of misinformation which is as harmful as the pandemic itself. Coming from a physician trained in allopathic medicine who has much faith in the symptomatic relief given by them, it is not intended to discredit the native forms of treatment or their practitioners. Over thousands of years native medicines were the only form of treatment available to help the people survive illness. More properly conducted research is the urgent need to make the system relevant to today’s needs. However, being ignorant enough to get stuck in history and tradition would ensure that the nation will continue to stagnate without progress. Issues have been logically discussed in the hope that people will be informed enough to see things as they are.