Natural Medicine vs. Modern Medicine

“Wherever the art of medicine is loved, there is a love of humanity.”(Hippocrates) [1]

The history of medicine coincides with the history of mankind. With the evolution of man, from Homo hablis to a modern human being, the concept of medicine has also evolved. [2] Early man used different herbs and extracts to treat different medical implications. He then discovered different synthetic compounds and found them efficient enough in the treatment of the disease. Today still in many parts of the world the use of traditional medicine, also known as complementary, ethnic, and alternative medicine, goes hand in hand with modern medicine. [3][4] There are different schools of thoughts describing the efficacy of traditional and modern medicine. Both offer certain therapeutic efficacy, side effects and adverse effects.

Since 60,000 years, man has been using plants and other natural products like microbes, animals, and marine creatures to treat multiple ailments. [7][(8] In the course of evolution, man has learned how to find edible food after seeing his fellow human being getting ill or die after eating poisonous plants. XM Gao in his publication “Science of Chinese material medica” states that in the proclivity to save himself and his loved ones, the ancient man had hankered after the products to reverse the symptoms of poisoning and disease e.g., nausea, vomiting, diarrhoea, fever and pain. This is how he had been able to find medicinal products, discover pharmacological components, and develop modern medicine. [9]

Traditional medicines though have many undocumented side effects; still serve as an encyclopedia and depository of human knowledge. Being the earliest known form of healthcare it is primarily used in the treatment of mental illness. The efficacy of traditional medicine in treating anxiety, depression, bipolar disorders, mood swings, schizophrenia, and in many other types of mental illness is medically proved and accepted worldwide. For example, a study conducted in Kingston and St. Thomas, Jamaica, Africa concluded that mental illness can better be treated with traditional and alternative therapy rather than modern therapy. [10] With traditional therapy, a patient is offered with multiple treatment plans and strategies. The massages, cupping, articulation therapy, psychoanalysis, desensitizing, and cognitive behavioural therapy, all lies in the index of traditional therapeutic approach

In traditional medicinal program conducted by WHO it was declared that a great proportion of the drugs of modern medicine system has the same therapeutic efficacy of those used in traditional medicines. [8] So, we cannot deny the fact that traditional medicines have well established therapeutic efficacy and are no less than modern medicine. Moreover, when the side effects of modern medicine are more it is usually recommended by healthcare professionals to opt for traditional medicines. For example, in a study in Iran, it was concluded that the use of sedatives for the treatment of insomnia can cause detrimental health damages. However, it is better if we opt for sleep hygiene, a concept of Iranian traditional medicine. It focuses on using different drugs along with anointing head and foot and foot massage for better sleep. It is observed that the oral and topical treatments in most of the ailments are preferred in traditional medicine while modern medicine offers less topical preparations. [12] The traditional use of Cinchona bark as an anti-malarial agent led to the discovery of quinine, the very first anti-malarial drug extracted from the plant source.

Unlike modern medicine system which has clinical trials and research of less than a decade, traditional medicine has a well-established clinical trial of thousands of years with complete knowledge of selection, extraction, preparation, execution, and disposal. From 5000 years man has a diverse and well- established knowledge of how to use natural products for medicinal purposes. With the development of modern technology and sensitive instruments, the pharmacological efficacy of medicinal plants and their active constituents is now better known and has produced more diverse literature. [13][14][15].

Moreover, herbal preparations ignore quality standards of the modern era in the manufacture, dispensing and use. Herbal preparations usually omit a proper label with the quantity of each component, expiry date, batch number, and manufacturing date. The therapeutic efficacy of each component is not wee developed and leads to severe mishandling events. Modern medicine is well known and researched with thousands of clinical trials with known efficacy, side effects, dose and adverse reactions. Modern medicine has a well-defined dose with a known therapeutic window which may not be the case with traditional medicine. In traditional medicine, the dose was established based on hit and trial method so, it has no scientific evidence. [16]

Traditional medicines do not follow any standard procedures or well-developed guidelines usually. Traditional medicine practitioners usually follow what they have learnt from their experience and what knowledge their elders inherited them. Many quacks also assume the role of a professional medical practitioner and sell products having delirious health effects. A study conducted in Pakistan covered the use of steroids into traditional medicine to have instant pain-relieving effects. This can result in liver damage, hormonal imbalance and kidney failure afterwards. Some of these quacks also sell some drugs incorporated in the natural products which have addiction potential. This is done to increase sale and achieve instant but temporary effects in case of pain, mental illness, or insomnia. Once the plasma concentration of drug drops the patient feels the same pain and craves for the same drug. More than 70% of people in underdeveloped countries visit traditional medicine practitioner, of which half are quack and have no knowledge of medicine. We cannot blanket all of them to protect people from a large group of fake practitioners. [17]

In many parts of the world, the eight different kinds of traditional medicine are practised have blossomed into a well-developed medical system. Traditional medicine is being practised globally for hundreds and thousands of years. Among these most widely practised are Ayurveda, Kampo, Unani, traditional Chinese medicine and traditional Korean medicine. Until1805, a little work was done in the discovery of pharmacological components in a medicinal plant. However, the discovery of morphine, the first pharmacological active compound, from the opium plant opened many new doors of discovery and interests for the researchers. This significant research proved to be a huge breakthrough in the modern medicinal system because of its efficacy as the best antitussive and analgesic. [6][22]

The quality, safety, and efficacy of traditional medicine are being questioned by the public, healthcare professionals, and policymakers all over the world. As the adverse effects in traditional medicine are not documented extensively, we cannot have complete knowledge of what this medicine does to the body as a whole, maybe it can lead to some other ailments. [5] The applications, mode of actions and, research of natural products are not satisfactory. As we know, more than one pharmacological compound exists in a single plant or other natural products it can lead to a synergistic effect. This will lead to dose potentiation and unwanted side effects. No clinically established data is available in this regard. We can use this synergism to have much better effects if addressed properly. Moreover, the unnamed adverse effects can affect the safety profile of certain medicines. [6]

There is a significant convergence between traditional medicine and modern medicine. Traditional medicine serves as a working strategy in the discovery of new drugs. Many novel drugs are discovered with a different mechanism of actions due to the known therapeutic efficacy of plant for a particular condition. We can refer 19th century as an era of modern therapeutics and it all started with the discovery of morphine in 1805, by a German Pharmacist, Fredrich Sertumer. [23] It also led in the successful production of artemisinin, in 1972. Artemisinin and its analogues are still used in the treatment of malaria. These discoveries turned the attention of the world to the extraction of pharmacologically active compounds from the natural resources and produce them synthetically to have a bulk product. This approach resulted in the successful discovery of many important drugs including antibiotics, anti-cancer etc. The first-ever antibiotic penicillin was discovered from fungi and the famous anti-cancer drug vincristine finds its origin in plant Cantharus roseus. So, we can establish a well-developed result, keeping in view the history of drug discovery, that most of the discoveries in modern medicine are the result of the inspiration of traditional medicine. [6]

From the data analysis of 3000 publication over the last 25 years it is proved that modern medicine has decided to value its worth and aimed to produce better and efficacious literature and research work. [18]

In a study done in Africa, it was concluded that the major benefit of traditional medicine over modern medicine is the cost reduction and less adverse reaction over time. It offers more acceptability by poor people who do not have enough dollars to access modern medicine. [19] Modern medicines tend to cause much more complications than traditional medicines. The risk to benefit ratio of modern medicine is higher than that of traditional medicine as developed by Haidan Yaun. [6]

Many new drugs have been discovered and invented by multiple reactions between different compounds. Plant-based medicine is still considered biochemically more efficacious than synthetic. Nonetheless, neither we hold the use of natural products at very high esteem for medicinal purposes nor do we encourage the unnecessary use of modern medicine. Better therapeutic results can be established if we look into finding a way to provide traditional and modern medicine simultaneously. Pharmacopoeias of traditional medicine are now being developed to provide better knowledge and understanding of natural medicinal products. [19]

Although traditional and modern medicine works in a completely different manner but to ensure a positive change we need to adopt a pragmatic approach. Some regulations are needed to be developed by the government and some methods should be introduced to ensure the skills and expertise of the traditional health practitioners. A strict filter is needed to be applied for the one who practices traditional medicine in community settings. The same condition goes for modern medicine practitioners and physicians, although they are focused a lot in this respect.

With the development of modern methods and technologies such as in pharmacokinetics, pharmacodynamics, chemo diversity and evolutionary techniques, we can develop better knowledge and discover new drugs and drug combinations by using the knowledge of natural medicine in the modern medicine or vice versa. [20] This can lead to the establishment of a huge library for new drugs and clinical methods. This will not only enhance the probability of treatment but also of prevention of disease. Humans need to dig in traditional medicine more to find novel ideas to incorporate in modern medicine. It is the only way both can work hand in hand. [21]

To cut to the quick, we can say that both modern and traditional medicine have their own benefits and side effects. The biggest benefit of traditional medicine is that it provides multiple therapeutic strategies to follow. It also provides with guidance in the adjustment of other factors like food, behaviour, routine, and sleep and wake cycle. Moreover, it also offers some therapies like massage which work in synergism to provide a better result. [22][23] It is cheap and more assessable by people. The system is not only developed in underdeveloped but also developed countries, where people believe in traditional medicine much more than modern medicine. The biggest disadvantage is the unavailability of enough literature, lack of standard, lack of research, lack of knowledge about pharmacologically active components, adverse effects, mode of action, side effects etc. [19] The presence of fake practitioners and low quality products is the major drawback of this healthcare system.

Modern medicine provides an advantage over traditional medicine in providing a good well-documented research work of all the aspects a drug could work. The mechanism of action is well defined. Even the structure and chemical reactions of the pharmacologically active compound is known. It will help us detect which physiological functions the drug can affect and which components can alter its efficacy, plasma half-life and excretion. This is not the case with traditional medicine. The biggest pitfall in the use of modern medicine is that we are delivering a pure compound whose data is never sufficient enough to know completely about the other complications caused by it. So, we are never 100% sure in this system too. The price range of modern medicine is quite high. Some of the medicine of certain diseases e.g., hepatitis, cancer and certain antibiotics are so expensive that the poor have no chance except to die with the disease. Moreover, there are some ailments of which risk to benefit ratio is too high and produce a lot of side effects. Many of these ailments are covered easily by traditional medicinal system efficiently.

William Osler once said,

“Medicine is the science of uncertainty and an art of probability.”

It is quite true as we are never cent per cent sure of the results either in traditional medicine or in modern medicine. After the whole discussion, the best bet lies in using traditional medicine along with modern medicine in the same prescription and making adjustments according to provided conditions. This can not only provide the best possible treatment strategy but also open new doors of research and discover new drugs and drug combinations required for better treatment.

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