Is it necessary to treat traditional medicine with derision?

Is it necessary to treat traditional medicine with derision?

I once knew a man who dismissed everything that was traditional, and lauded everything that was modern, refusing to be balanced and see some good in both.

He repeatedly emphasized that once human beings had finished determining the sequence of the entire human genome, we would all understand everything that remains to be understood, about the entire human organism and about how it functions, immediately thereafter.

Two decades have passed since the sequence of the human genome was first determined. The man has also passed on, about five years ago.

Unsurprisingly, we are still as far away from a complete understanding of the human organism or, for that matter, even a complete understanding of how it is formed through the genetic control of embryonic development, as we have ever been.

It is one thing to know the sequences of genes, and quite another to guess at the functions performed by the proteins they encode, and quite something else to understand how it all comes together to give rise to a living organism as complex as a human being.

Things, people, systems and approaches do not always deliver on what they promise. In the fullness of time, it almost always seems in hindsight that everything could have been important; both that which we paid attention to, and that which we neglected.

It is in the nature of knowledge to be vast, inexhaustible and infinite. And sometimes it is necessary to be structured and systematic, and sometimes to wait and see what comes our way. And sometimes it is good to be confident about what we know, and sometimes to discover that what we thought we knew was only a misapprehension, requiring a correction of course.

Humanity can probably justifiably pride itself on what it has learned, as a species, but only if this pride serves as an inspiration for us to go on learning. When this pride, and the associated prejudice, exceeds a certain limit, it ends up standing in the way of our appreciating that everything that we have learned until now is a mere scratch upon the surface of the vast body of knowledge that remains to be gathered, assimilated and integrated into our understanding.

As the ancients never tired of saying to us, “Man, be not proud, … or prejudiced”.

I once knew a little child who heard her parents talking to her grandparents on the telephone about whether, or not, she needed to get the BCG vaccine before making a trip to the home country. The little child was listening-in on an extension phone-line. She couldn’t resist interrupting the conversation, when she realized that her parents were so very clearly wrong about something, and so she proceeded to interrupt them. She said to her parents and grandparents ‘It’s not BCG. It’s BCD. It’s ABCD. Haven’t you learned this in school?’. She was comparing what she knew with what she was hearing, and her confidence stemmed from the assumption that her body of knowledge was right, and that the knowledge of her parents and grandparents was wrong. The silence of the elders was born of the resignation that comes from knowing that this is the way of things. The new always derides the old. And the old just looks at the new, and sighs.

Sometimes, I get the feeling that this is how it is with regard to the unnecessary conflict between modern knowledge and traditional knowledge in both oriental and occidental societies. The occident too often behaves like that little girl. Too many assumptions. Too much grandstanding. Too much dismissiveness. Too much prejudice. Insufficient objectivity. Insufficient dissemination of insight. Great pride in applications. Great investment in commercial success. Not enough desire to seek the truth, regardless of the quarter from which it emerges. The orient, and other old parts of the world, patiently wait for the occident to grow up, even as the little girl grew up.

One part of such a conflict between the traditional and the modern is happening within the minds of scientists, doctors and people with backgrounds in STEM, and it relates to medications derived from modern medicine, on the one hand, and medications derived from traditional herbal medicine, on the other. I know a lot of people who swear by one, and forswear the other, and I know people of both categories. Instead of being open to both and being ready to explore both, without pride or prejudice, they have taken up stands. Actually, there is really no conflict, except for one born through ego and the tendency to dismiss what went before and draw attention to what one is currently selling. There are several reasons that this conflict can be called unnecessary, if not fratricidal and outright harmful to humanity.

(1)   Much of modern medicine is anyway derived from traditional medicine. Many people tend to forget this, but modern medicine did not arise from a vacuum. It arose from the study of Chinese, Indian, Middle-eastern and other ancient systems of medicines relating to the products of plants that have been known to have medicinal value for centuries. Modern medicine arose from the application, to medicinal plants and their extracts, of the sciences of natural products chemistry and techniques for separation of molecules and examination of their individual effects. Such techniques facilitated identification of specific individual chemicals within larger milieus of plant-based aqueous or alcoholic extracts, as active principles to be explored further in respect of their utility as medicines; however, this approach also neglected the presence, and value, of other molecules that could function as antidotes to the toxicities of purified natural products (i.e., molecules that were present in the traditional extract but not in the modern form of some medicines, causing the purified active principles to do more harm, than good, over time).

 Modern medicine also admittedly arose from the application of new techniques of assaying and standardization, and the use of statistics and clinical trials. And in more recent times, modern medicine has continued to progress through the characterization of molecular structures and inter-molecular interactions of drugs and their receptors, as well as through the use of combinatorial chemistry for the production of candidate drugs for screening, both of which were admittedly never a part of traditional medicine.

Even so, in comparison to the drugs and pharmaceuticals that are currently in use which have been derived from some form of traditional medicine, it might still be said that the drugs that have been invented from scratch (without the use of any traditional knowledge) are still in the minority.

The industry for discovering new drugs also seems to have lost its way through an overemphasis on the improvement of molecular binding affinities between drugs and their receptors, associated with complete neglect of attention to improving specificity of binding, or examining off-target effects and side-effects.

There appears to be a humbling under way, and a return to the roots, as well as a renewal of the search for more leads from medicinal plants known to traditional medicine.

 Given the nature of its umbilical linkage to traditional medicine, the tendency of modern medicine to completely deny, and denigrate, all traditional herbal medicine is actually very reminiscent of a successful human being denying his/her own mother after growing up and becoming successful. It is a pity that this attitude has percolated into the general population.

 (2)   Standardization in modern medicine is great, but also over-rated, and potentially harmful. Much is made of the standardization of testing, dosages, and trials, in modern medicine. I am (and have been) an admirer of these too. However, I am also a subscriber to the philosophy that unless one is in love, or desires to love something or someone unconditionally, no admirer must be blind to the faults of that which he/she admires, especially when it concerns something of practical value. Given the common origins of much of modern and traditional pharma, my criticism of the exclusivity of modern medication, to the exclusion and neglect of traditional medicine, is three-fold.

 Firstly, all the data and conclusions – i.e., all the recommended dosages per body weight, and various other related parameters – are almost all based on studies of applications of drugs to Caucasian populations. My friends who are doctors tell me that many dosages are also empirical and the products of fertile imaginations, or of ad-hoc experimentation that merely happened to become widely-cited as standards, subsequently. Thus, ranges of dubious intrinsic value are now being blindly applied to other populations, without reference to gender, ethnicity, dietary differences, and differences in lifestyle. This is causing more harm than good, through unnecessary over-medication as well as unnecessary under-medication.

Secondly, it is now quite clear that there is so much variation between human beings that what is sauce for the goose isn’t necessarily sauce for the gander. The emerging science of pharmacogenomics suggests that the medicinal needs of individuals may be quite different from those of other individuals, and it is difficult to determine what drugs or dosages a person really needs without an understanding of their intrinsic genetic or metabolic constitutions. If anything, traditional medicine has always paid more heed to the simultaneous development of the intuitive and analytical faculties of physicians than modern medicine, and traditional medicine is suffused with an acute awareness of the differences in the needs of different patients, based on their individual constitutions, whereas modern medicine is moving away from the importance of good physicians. Everything is being increasingly left to diagnostics, and to the use of numbers, and standards, and computations. Admittedly, some of these are extremely helpful and are going to remain helpful. However, there is the danger that the tail will soon begin to wag the dog, with physicians becoming the least important cog in the wheel, through the entry of artificial intelligence and mechanized robotic surgery.

Thirdly, almost everything is being turned over to artificial intelligence today, almost as if it were a fashion, and people are even discussing the use of AI for everything from analyses of images to diagnoses of symptoms. I am an admirer of machine learning, and I do understand something about how it works (at least where artificial neural networks or support vector graphics happens to be concerned). What I feel is that everything depends on the training data-sets that are fed to machine-learning algorithms, and the layering and set-up of the artificial neural networks. For one thing, here too the old adage of ‘garbage-in, garbage-out’ applies eminently, i.e., the learning is only as good as the material that is used for the training, and the feedback that the machine receives. In the context of medicine, where is the availability of appropriate learning material that takes into account the different needs of different sub-populations differentiated by gender, ethnicity or other differences? Another aspect is that machine learning makes all nonsense of standardization, in any case. When one uses AI, the trained artificial neural network often works really well, and efficiently, within boundaries, but it produces neither learning nor standardization for the humans who set these up. Like dead men that tell no tales, AI set ups do not give us any insight into what learning the machine engaged in. There are no rules that emerge, nor causalities that become evident. In other words, once these transcend the experiences of humans, there will be no way of differentiating ‘garbage-in, garbage-out’ from ‘treasure-in, treasure-out’. What shall we do then? Overenthusiastic application of AI to everything can ruin not just knowledge, but also make a mockery of understanding, and the ability to make some limited sense of our world.  

 Thus, modern medicine is moving back towards apocryphal and anecdotal learning, and the differences between modern medicine and traditional medicine are getting smeared out.

 (3)   Everything has not been studied yet. Insights from traditional medicine can help modern medicine. Our understanding of the workings of the wonderful machine that we call the human body is still extremely immature, and incomplete at the molecular, cellular and metabolic levels at which drugs and pharmaceuticals have their effects. The worst thing that we can do now is to assume that we have understood everything that there is to know and understand, or that everything that we know today is new or was unknown to those who lived before (even if we understand the molecular basis better). Of course, remarkable progress has been made in the biomedical sciences; in particular, in the sciences of molecular and cellular biology, and immunology. Still, the more one learns the more one is filled with wonder at the design of the human body and its systems.

Why should we assume that all the medicinal plants of value have been studied fully, or that all the ways in which they can be used to treat human beings have been explored, when we know from the traditional systems that even the material (e.g., milk, honey, or water) in which a plant extract is prepared is perceived to affect the outcome of therapy in different ways, in people with different constitutions? How can we assume that modern medicine, with its inbuilt prejudices and preconceived notions has understood everything, or from every possible angle?

 After all, one cannot already know what one never ever knew. Also, one who knows not what one knows not can be dangerous, even if (sometimes) useful. Therefore, it is necessary to keep the door open for systems of medicine and therapy that are not ‘one-track-minded’.

(4)   Profit motive dominates everything in modern medicine, including the derision handed out to traditional medicine. Knowledge is a search for the truth, irrespective of who benefits from the truth and who doesn’t. Progress in medicine is highly dependent upon progress in knowledge. The profit motive constantly hits at the roots of the search for the truth, and knowledge, because it cares more about what is economical and about what sells, than about what works, or doesn’t, or about what is good, or isn’t.

The absurd costs of healthcare in some developed nations and the equally absurd defence of the current system of costs and insurances by those who remain invested in continuing to profit from healthcare is a virtual guarantee that modern medicine will not be the panacea that it once promised to be.

Modern medicine pays attention to the diseases of the rich and the well-to-do. This is evident from the neglect of the diseases prevalent in poor countries by big pharma, and the research that is funded and driven by such big pharma. Therefore, the reliance of poor countries upon the munificence of big pharma, based on the hope that big pharma will one day pay attention to the diseases of the poor is a modern day equivalent of the Stockholm syndrome in which one adores those who hold one in contempt.

There is much about traditional medicine that modern medicine has never properly explored. What could benefit humanity is the testing of traditional medicines and formulations using modern clinical trials, and statistical methods, tempered by the division of trial groups into cohorts classified by differences in constitution, ethnicity and gender.

Take the current pandemic. Isn’t it showing us that it is at least as important for us to have a constitution that is not pro-inflammatory, as it is for us to explore anti-viral drugs and compounds? How are we sure that such compounds are not present in the plant extracts that are used in traditional medicine? How are we sure that phyto-steroids and other anti-inflammatory substances of potential value are not present in traditional foods?

For those who may find it interesting, or useful, my family and I are taking some traditional remedies that could lower the reaction of the body to a SARS-Cov-2 infection. We boil diced lemon and diced ginger together for a few tens of minutes (the amounts vary, but our proclivity for standardization sees to it that they don’t vary too much). We then add a few (2-3) drops of garlic oil and a few (2-3) drops of eucalyptus oil to half a cup of the lemon-ginger extract, and drink it. This method was taught to us by a very good friend who understands these things. He said that this concoction is likely to keep the body in a state in which it is ready to face an exposure to the new coronavirus without the immune system mounting a strong inflammatory reaction. We have been having this concoction since May, 2020, and have been going about our work, with cloth masks on, while maintaining social distancing, and maintaining an anti-inflammatory diet.

You too can try it, if you are reading this. What have you got to lose?