Blue Tits and the ‘Potpourri’ hypothesis

European Blue Tit – CC photo credit – marko_k

Following the bees, now the birds and more on the neologism pharmacophory*.

Other members of the animal world have been documented to ingest plant or mineral substances apparently in response to infection and illness. Though so far only a few have been documented to apply herbal or other natural substances in their local environment or around their dwellings.

One other animal that has been documented to also collect plant material containing pharmacologically active constituents is the European Blue Tit. A series of recent papers describe how it was found that Blue Tits collected foliage from highly aromatic herbs, Yarrow, Lavenders, Mints, Thyme, Pine even Eucalyptus (introduced to Mediterranean Europe), to line their nests. The presence in the nest of specific aromatic plants having a greater representation than would be expected compared to the immediately available surrounding flora, indicating an active seeking and collecting of this material for nests. The birds even replacing it when those pesky researchers had removed it to see what the birds did.

Blue Tit nest with a clutch of eggs – CC photo credit – fsphil

It probably isn’t just for decoration either, as they discovered that the aromatic foliage benefited the chicks through increased weight gain and feather development and higher hematocrit levels in their blood. The aromatic plant material contains anti-bacterial, anti-fungal and other active constituents that reduce the parasite and microbial burden and appears to be derived from a range of aroma types. Hence the Potpourri hypothesis, where a broad range of aroma types represent a broader spectrum of constituents or may mask the scent of chicks to predators or deter blood suckers like mosquitos. Perhaps they even help with attracting mates.

Picture credit – wonderful shot from Words @ Everything is Permuted

*Pharmacophory – literally ‘carrying’ or ‘moving of drugs’, was the neologism applied to the increased collection of propolis and application around the hive by bees when their hive was infected with the chalkbrood fungus mentioned in a previous post. Somewhere between the human use of antiseptics, incenses or mozzie and insect repellents, aromatherapy and preventative medicine it seems to me. Science is a boon for deriving precise but obscure classic terms for often seemingly mundane phenomena or experience. Seems like good one to me.

Refs.

Aromatic herbs in Corsican blue tit nests: The ‘Potpourri’ hypothesis
Aromatic plants in nests of blue tits: positive effects on nestlings
Aromatic Plants in Eurasian Blue Tit Nests: The ‘Nest Protection Hypothesis’ Revisited


Posted in Pharmacophory | 2 Comments

Snake Root and Medical misinterpretations

Could a 50-year-old pillar of modern psychiatry be based on a misunderstanding of an ancient herbal medicine and the already available evidence? Some researchers have suggested just that.

Notwithstanding the real and significant personal and social toll that mental health problems play in many people’s lives in the modern world. Our true understanding of what is happening physiologically still seems far from certain.

Perhaps no-one is sure quite where it was first applied as a medicine, likely a long time ago. Though Sarpagandha, aka Snake root, or Rauwolfia serpentina, looks like a relatively insignificant small woody shrub most of the time, but it is showy and distinctive when in flower and is found growing in forested regions from the Indian subcontinent to south-east Asia.

Rauwolfia serpentina from Hortus Malabaricus 1678-1703

The many historical synonyms and local names attest to the use of this plant in folk and traditional medicine for a considerable time across much of its range in Asia. Though it seems there was added botanical confusion for a while from multiple naming and typos. Rauvolfia or Rauwolfia?

As for many traditional medicines its indications are broad, but often focus on treatment for poisons, gastrointestinal infections including worms and yes even snake bite. One ancient Sanskrit name however, Chandra – the moon, refers to its use in ‘moon’s disease’, aka ‘lunacy’. So that seems to make that an ancient reference to mental illness to me.

It was (re-) introduced to the western world roughly 70 years ago, from the Ayurvedic medicine tradition of India, after the publication by Indian doctors on the effectiveness of the herb in both hypertension and mania in the 1930’s and 40’s. Reportedly a widely utilised and popular herb by the turn of the 20th century in India, Ghandhi is often cited as apparently utilising the relaxing qualities of this herb as a tea on a regular basis. Whilst that may or may not be the case, it certainly seems to have been a significant element of the local herb trade for centuries or millenia by then.

The pharmacological activity of this herb radically altered theories and perceptions of cardiovascular and neurological pharmacology then in the west. Though perhaps mistakenly some of those early ideas have also remained with us and to a large extent have been unquestioned since then.

Early clinical studies in the US reported dramatic results in hypertension, particularly in young “psychoneurotic” patients with tachycardia according to one early review of the herb. Whilst most of the Indian and earlier clinical studies used the whole herb extract, the isolation and identification of reserpine in the root soon led to investigations and clinical trials of this single constituent alone. As has been the case for most of the still used pharmaceuticals derived directly from herbal medicines in the world of pharma science, which includes reserpine.

Even in the mid 1950’s there was recognition that there was a varying mix of alkaloids in Rauwolfia, that could depend on source region and age, plus some early debate on the merits of whole herb versus reserpine alone. Not unexpectedly perhaps, some pharmaceutical companies were marketing the pure alkaloid for treatment by 1954, most widely under the name Serpasil. It soon became evident that long-term treatment with high doses of reserpine induced some serious negative symptoms in people. Causing reduced activity and apparent central nervous system depression.

1956 Serpasil ad from CIBA

Following reports of its use in India for mental disorders, schizophrenics were also treated with reserpine, which didn’t cure them but was sedating and anxiety reducing. It became popularly prescribed for mental disorders for a while.

Along with other findings such as monoamine oxidase inhibitors showing antidepressant action, came the discovery that reserpine acts by permanently inhibiting the transport proteins of our monoamine neurotransmitters (serotonin, dopamine, norepinephrine) into vesicles within neurons. This depletion over time of neurotransmitters caused a general shutdown of what are excitatory pathways of the central nervous system, ie. causes diminished activity. This of course is part of the reason why it is effective in overly excited states like mania.

Stopping reserpine allows the body to regenerate the proteins necessary for neurotransmitter transport over days and weeks, and gradually return to baseline function. This discovery, with other findings, came to be used in part as evidence for the so-called monoamine or serotonin hypothesis. A thesis that an ‘imbalance’ of one or more of these brain messengers is the cause of a whole host of mental disorders, particularly and popularly serotonin for depression in recent times. Though some researchers who have looked back through the data and reports of over 50 years ago are now asking the question about how valid or useful the serotonin hypothesis has been.

There appears to have been few if any reported cases of severe symptoms in the traditional use of the whole herb containing a mixture of alkaloids. It seems unlikely to have been taken endlessly or without reasons, as like many traditional herbal medicine preparations (often a tea) the intense bitterness is a generally a self-limiting factor on consumption for anyone but the ill.

The discovery of these pharmacological actions and the serotonin or monoamine hypothesis spawned whole new classes of psychiatric drugs, anti-psychotics and Selective Serotonin Reuptake Inhibitor (SSRI) anti-depressants in particular. Also reserpine remains in use for some types of hypertension to this day. Setting aside the brawl over the actual diagnosis of depression, so widely given in contemporary times. The hypothesis also saw a boom in the development of pharmaceutical agents targeting serotonin metabolism and action. However the lack of evidence of  effectiveness better than placebo for leading SSRI and other antidepressants, despite the marketing and billions spent on research or even the attempts to hide data away, seems to question the whole hypothesis more than support it.

Serotonin of course plays a role in many other aspects of physiology as well, being originally identified both as an agent from blood serum that caused vasoconstriction (sero-tonin) and as a gastrointestinal smooth muscle stimulant (originally named enteramine). Serotonin is also found in many plants, particularly seeds, some of them are common foods – particularly black walnuts, also pecans, banana, kiwifruit, pineapple, avocado and more.

Physiology of all living things seems to be a complex network of different systems, hopefully working in a kind of organised fashion together depending upon the internal and external environment. Although reductionist science appears to be focused on a mechanistic model, the magic bullet or single factor responsible. Life itself seems a lot more complicated than that in practice.

Rauwolfia serpentina from Curtis Botanical Magazine 1804

Rauwolfia serpentina has been listed in the CITES Annex for trade in medicinal plants. Though it seems to remain unknown how endangered it is, it’s continuing use in traditional medicines or as a source of reserpine and dramatic changes across its habitat in a world full of people are risk factors for unsustainability and loss of wild populations. Tissue and cell culture have been tried, synthesis of reserpine is complex and expensive. Cultivation projects in some countries (India, Pakistan) have been undertaken. Other plants also contain reserpine but it seems are not currently used as a source. Other related alkaloids from Rauwolfia and some closely related genera continue to see use in medicine or in research of treatments for mental health and other disorders.

Posted in Botany, Ethnopharmacology, Herbal Medicine, Pharma | Leave a comment

Reading matters – The Beginning and End of Western Botanical Sciences?

Been reading more than writing lately, and thought I’d share a few interesting posts and stories concerning the beginning and possible ending of field and practical botanical science in the western world.

Starting with the excellent ArtPlantae blog and their posts about the intriguing German/Dutch naturalist Georgius Everhardus Rumphius over April and the republished English translation of his seminal volumes on Indonesian and SE Asian foods, medicines and spices, The Ambonese Herbal.

A quite remarkable tale from the 17th and 18th centuries, it is a wonder the beautiful botanical art and original descriptions ever made it to print and are again available over 300 years later.

The history of the Dutch East Indies Company, or for that matter the British East India Company, and the spice trade of the 17th century is littered with incredible calamity and conflict, for locals often. Making it perhaps all the more remarkable that Rumphius was able to create such a work of ethnobotanical and natural science significance amidst all that.

Georgius Everhardus Rumphius, Soldier & Naturalist

Rumphius: A Naturalist for the People

Inside ‘The Ambonese Herbal’

I have seen it yet though wish I could.

The Ambonese Herbal – 6 volume reprint with English translation

The Ambonese Herbal

The original Latin/Dutch version of The Ambonese Herbal can be found at Botanicus.org

There are numerous other historical herbal and botanical texts back to the 16th century also available online or as pdf downloads at the great Botanicus.org site using material from the Missouri Botanic Gardens Library.

So 300+ years after Rumphius, through the industrial revolution, deep into the end game of the age of fossil fuel and oil, how does the future of practical botanical science in western society and the documentation of the world’s botanical diversity look?

Well students in agriculture and botanical sciences appear to be mostly absent or perhaps the opportunities, recognition or funding are not there. The ever more urbanised human world means many are simply alienated from understanding the importance of plants and biodiversity in a functioning global ecosphere and local ecosystems.

Aside from a few large botanical gardens, in a seemingly ever more corporatised world, where are resources and recognition for this work of cataloguing and understanding of the world’s biodiversity going to come from?

Another ArtPlantae post and this recent Nature article (via Among The Stately Trees) ponder some of the many issues.

Though interest in plants, gardening, herbs and ethnobotany amongst the public seems high, overall it seems inevitable that the general level of direct and practical knowledge of plants in human civilisation is on the way down.

Despite that I think plants will be vital for human existence on earth forever. Increasing ignorance I’m certain does us no good in the long run.

I’m sure there will aways be interest, it’s kind of necessary for someone to know enough for us all to survive. Though perhaps it will reside more in the gardeners and amateur naturalists rather than institutions like universities and their generally more corporatised interests these days.

The last botany student in the UK

Plant collectors becoming as rare as the plants they seek

Superstars of botany: Rare specimens

A handful of plant collectors has shaped the field of botany. Now they are disappearing, and there are no clear successors.

Posted in Botany, Ethnopharmacology, Herbal Medicine | Tagged | 9 Comments

The trials and triumphs of Bee-ing on Earth today

In the nice bee, what sense so subtly true From pois’nous herbs extracts the healing dew?” Alexander Pope

Bee collecting pollen, Jon Sullivan (via Wikipedia)

Bee collecting pollen, by Jon Sullivan (via Wikipedia)

The importance of Bees in pollination of plants generally and the success of human agriculture specifically seems hard to overstate.

These complex industrious creatures that have been around for maybe 100 million years continue to defy our understanding and exceed our expectations in many ways. Though we do seem to have altered the environment and habitats of the world these days to the point that life for these important insects is less than what the job description of visiting flowers and supping nectar and honey with pollen for a life might suggest.

Waggle Dance

The Waggle Dance - Image via Chittka L: Dances as Windows into Insect Perception, (Figure design: J. Tautz and M. Kleinhenz, Beegroup Würzburg.), PLOS Biology, doi:10.1371/journal.pbio.0020216

Not only their physical ability to fly has confounded us, which we are yet to understand or model successfully. Their memory and cognitive abilities expressed in their dancing to communicate the timing, quality and provide directions to sources of nectar puts them amongst the most intelligent tiny animals humans have studied.

The complex social structure of the Honey Bee has long served as a metaphor for human culture as well, despite some historical misunderstanding of exactly what was going on. The industrious ever toiling and apparently uncomplaining workers and distinct social organisation have been cited as an example for humans, or at least some selected groups of people, to follow since ancient times. Often little more than a thinly veiled anthropomorphism of the current human social status quo or as an example of the divine nature of feudalism. From the mellifluous to the queen bee, our language continues to draw from the bee for inspiration and ideas.

However modern recognition of swarm intelligence, the leaderless collective decentralised self-organising nature of most social insect colonies such as bees construct, has proven a boon to the development of computers and robotics for all manner of tasks, and the study of natural systems.

Though there are very many bees that are solitary or have only small colonies. What marks almost all of them as common is their specialised utilisation of nectar and pollen as food and by that their importance in the pollination of many of the worlds flowering plants.

The decimation of bee colonies in the Americas and Eurasia over recent decades has sounded alarm bells. Recent research again indicates that it could be human pesticides that are in part responsible for declining bee numbers and may play a role in the widespread and recent colony collapse disorder that has been plaguing the honey and pollinating bee industry in some areas.

Controversial Pesticide Linked to Bee Collapse

Despite ongoing human ignorance and stupidity, other recently published research has shone some more light on another interesting aspect of bee life, the likely self-medication and use of propolis, a mixture of resins, phenolics and other constituents harvested from plants. In an intriguing study published in PLOS One, researchers report how bees, in line with other members of the animal kingdom, appear to actively seek out and utilise specific plant materials (in nature resins from Populus and other spp.) for treatment of active and potentially pathologic organisms in their environment. Increasing their resin collection by ~45% when their hive is infected with the pathogenic bee larva fungal disease commonly called chalkbrood.

Increased Resin Collection after Parasite Challenge: A Case of Self-Medication in Honey Bees?

Propolis resin in beehive. Name derived from 'pro' (to support or defend) and 'polis' (a city or community), to defend the hive. (via Wikpedia)

The presence of non pathogenic fungus not eliciting the same response as the active one indicates some insight by the bees into the nature and threat of the substance by some means and altering their behaviour and collecting tasks. It seems even bees have knowledge of herbal medicines and when they might useful or necessary.

Previously others reported on the potential role of other specific secondary metabolites in nectar in reducing parasitic disease burdens, in this case the fairly toxic to mammals alkaloid gelsemine from the nectar of Carolina Jessamine (Gelsemium sempervirens). The alkaloid was found to significantly reduce the load of gut protozoans in vivo when consumed continuously as a small component of the nectar. Though interestingly did not appear to have significant anti-protozoan activity outside of the bee when researchers looked to measure the any protective effects of gelsemine on potential transfer of disease via nectar after being visited by different bees over time.

Consumption of a nectar alkaloid reduces pathogen load in bumble bees

No doubt with a relationship spanning virtually the entirety of the existence of flowering plants, bees and plants have assisted in their mutual growth, diversification and spread, which in the case of the latter is to be the now dominant class of plants on the earths land surface. The complexity of interactions between bees and plants and by extension plants and animals that require plants for their survival, underpins so much of the survival and health of all terrestrial life. Which we are yet to fully understand, but can still appreciate.

The healing qualities of honey itself had been described millenia ago, and in the case of some honeys the complex interaction between plant and bees that leads to potent anti-microbial activity such as that produced from Manuka (in NZ) and Jelly bush (in Australia) has now been vindicated by modern science.

Each worker bee produces about one teaspoon of honey in their shortish lives. This remarkable product that has allowed bees to remain perhaps the one insect many humans continue to actually look to with some appreciation. Particularly compared to their usually despised but just as industrious cousins the wasps and ants.

More important but less tangible or as sweet as honey and our appreciation of them as suppliers of what seemed like the ‘ambrosia’ of the gods to the ancients, is the role they play in the pollination of flowering plants the world over.

Posted in Pharmacophory, Pollination | Tagged , , | Leave a comment

Positive clinical trials of herbal medicines? You wouldn’t read about it.

Is media coverage of herbal medicines and research biased?

It seems a popular line from some in the current FSM campaign about natural medicine being taught in university is to claim that research, when done, shows it “all” to be ineffective rubbish anyway. Almost invariably this is claimed devoid of supporting evidence.

A few years ago some researchers put the news media representation in English-speaking countries of herbal and pharmaceutical trials to the test.

After identifying 201 and 352 articles on pharmaceutical and herbal trials respectively via searches of English language (US, UK, Canada,  Aust, NZ) newspapers between 1995 and 2005 . They had students review, analyse and rate the newspaper articles using a standardised coding method used previously (positive, neutral, negative tone). Then compared this analysis to the quality and detail of the original journal articles of 48 pharmaceutical and 57 herbal medicine trials identified through the newspaper articles.

The studies used were from mostly high impact well recognised journals, that were undertaken in the US, UK or Europe. The overall rating for the journals in the studies used was higher than average across the board for herbal medicines, ie many herbal studies are not published in such high-ranking journals, but those included in this study were.

Aside from some more readily acknowledged problems of media reporting regarding details and accuracy of reporting scientific research, such as benefits vs risks, conflicts of interest and funding, dosages and practical clinical implications. Which applied to reports of both pharmaceutical and herbal medicines, more or less for different issues.

The main finding was that overall there was a significant bias in the newspaper articles in favour of the pharmaceutical studies compared to the herbal medicine studies. With absolutely none of the 201 newspaper articles on pharmaceutical trials rated as negative (68.2% positive, 31.8% neutral). Where only 21% of articles covering herbal medicine trials were rated positive and the majority (57.1%) were rated neutral. Even with the articles on the pharmaceutical studies also reporting a significantly higher risk of adverse events.

Yes, out of 201 newspaper articles over 10 years on pharmaceutical trials not a single article was rated as negative. I can only wonder if one of those trials included vioxx.

The researchers also suggest that overall the high impact factor scientific journals that they  sourced the studies from were more likely to publish negative result herbal medicine trials than negative pharmaceutical trials. Though the negative tone of newspaper articles was even greater than this accounted for.

All of this was despite the quality of the trials investigated in the study being considered of equal quality, although some elements of the studies such as patient numbers and length of study were significantly different.

The latter probably reflecting the historically marginal status of herbal medicine within institutional research bodies and in regard to funding in the English-speaking world, at least over much of the last century.

They conclude by suggesting that even though there are shortfalls generally in regard to newspaper reporting of scientific research. That there does appear to be a significant negative bias in regard to reporting herbal medicine trials and research, a failing in particular in light of the growing pool of evidence and scientific research around herbal medicines over the last two decades.

Also a failing in light of the growing public interest in and use of natural and traditional medicines such as herbal remedies, this study suggests a balanced and accurate portrayal of the research is generally not being provided by the news media in English-speaking countries.

Interestingly enough, this study suggesting that there is a negative bias in media reporting of what is apparently a growing element of public health has not been cited by any other articles (on PubMed Central at least) in the three years since it was first published.

Given the contention and sometime vociferous debate flying around about natural medicine, its place in university and the significant debates around the efficacy or research evidence of herbal medicines. It is all the more remarkable that such research concerning common public information sources appears to be completely ignored.

Other researchers analysing the content of 11 medicine journals also found a negative relationship between the pharmaceutical advertising content of journals and the likelihood of publishing any ‘dietary supplement’ studies or more negative research findings. So the more pharmaceutical advertising was in the journal, the less likely to be any reports regarding herbal, vitamin or mineral supplements, and even if present they were more likely to be negative.

It seems the chances of well conducted research that reflects some efficacy and safety of herbal remedies in the English-speaking world is required to overcome a range of economic and professional biases in both the peer-reviewed and general media. Entirely over and above any actual scientific findings determined in the process of the study.

Herbal remedy clinical trials in the media: a comparison with the coverage of conventional pharmaceuticals
http://www.biomedcentral.com/1741-7015/6/35

Does pharmaceutical advertising affect journal publication about dietary supplements?
http://www.biomedcentral.com/1472-6882/8/11

Posted in FSM, Herbal Medicine | Leave a comment

Friends of Science in Medicine, Umckaloabo and Secret Remedies – Everything Old is New Again

It’s hard to not agree with Mark Twain’s supposed commentary that history rhymes, if it doesn’t actually repeat.

The current campaign by the so-called group Friends of Science in Medicine in 2012 seems to echo some previous attempts to discredit natural or traditional folk medicine almost exactly a century before.

You wonder how that story has turned out?

Interesting in at least one case for sure.

In 1909 the British Medical Association (BMA) put out a small book called Secret Remedies in an attempt to discredit what they saw as nine of the main ”quack remedies” of the day. A primary target of their campaign and book was one Stevens Consumption Cure, aka Umckaloabo or Lungsava (Newsom 2002).

The product was made and marketed by a company run by a Charles Henry Stevens who ‘discovered’ the herb through his own treatment for his ‘consumption’ or TB as we call it now.

After being diagnosed at 17 in Birmingham (in 1897), he went to South Africa on doctor’s advice, for the benefit of the warmer drier climate and a lack of any effective treatment. However, whilst there he met an indigenous healer, reportedly a Zulu called Mike Chichitse, who offered him a local herb remedy, which induced a ”marvellous recovery” within months (Newsom 2002).

After experiencing the efficacy of the remedy he had been given, Stevens went on to establish a business back in England in 1907 to produce extracts of the herb, from material he imported from South Africa. Like many other remedies of the time he advertised in the press using testimonials from patients and doctors to spread the news and claims about this herb in regard to ‘consumption’. TB was an endemic problem in most European cities and societies and one of the most significant diseases of the day (Newsom 2002).

Stevens had a huge potential market, or a significant number of fellow citizens in need of some effective medicine. Safe to say there’d be a range of views depending perhaps upon your own distant perspective and biases on his motivations and what should be done in such a circumstance, in the context of having felt yourself cured of a socially burdensome and at the time generally fatal disease.

The BMA published an analysis of the Stevens Cure by their chemist which described it as nothing more than kino or rhatany root (another more common herb) and fraudulent quackery, accusing Stevens of swindling people in their campaign. Whilst the BMA were apparently unhappy about the lack of response at first, the book and campaign started to dent the reputation of the Stevens Cure over the next few years (Newsom 2002).

So Stevens later took the BMA to court for libel, and on the face of it he seems to have had something of a case according to Newsom reviewing the case in the Journal of the Royal Society for Medicine in 2002. The BMA chemist analysis was completely erroneous and Stevens was able to provide actual plant materials to the court to prove it. The chemist withdrew his accusation of swindling in court. Stevens also had doctors and patients testify to the efficacy of the cure. Convened in front of a jury, the first case in 1912 was abandoned when the jurors determined they would never agree on a verdict (Newsom 2002). The case in London was noteworthy enough at the time to be reported in the NY Times in November 1912, and perhaps remarkably in this digital age the full text of that report is available as a pdf online to anyone.

The second court case in 1914 went badly for Stevens, the BMA had now identified that the plant was not in the British Pharmacopoeia at the time and suggested he was acting under false pretences in selling it. He lost the case and had to pay costs for himself and the BMA, some £2000, a small fortune at the time (Newsom 2002, Bladt & Wagner 2007).

The first world war intervened in further developments for a while, Stevens is reported to have served in the Royal Flying Corps with distinction and survived the war ending up as a major. Though it seems he continued the production of Stevens Cure up until at least 1939 and it seems to have been available in England up until 1953. By 1931 Stevens business reportedly employed some 50 people. Evidently there were enough satisfied customers and enthusiasm for the treatment to keep production going (Newsom 2002).

However, the exact identity of and constituents in the herb remained unclear, probably in part due to hostility from the BMA towards the product and any research about it, or between Stevens and the medical establishment. Indeed it was not until the mid 1970s that any clear botanical and chemical descriptions were published of the herb utilised by Stevens (Bladt & Wagner 2007).

Sechehaye book cover via Newsom, J Royal Soc. Med. 2002

The most significant developments in understanding and application of the herb occurred in Europe after the publication of The Treatment of Tuberculosis with Umckaloabo (Stevens’ Cure) by Dr Adrien Sechehaye of Geneva in 1930. Originally in French, then German and English, the text is a collection of 64 case studies (out of hundreds more) using Umckaloabo for TB. A companion English version was published anonymously by a doctor reputed to be a medical writer for a major newspaper of the time. The original company was sold by Stevens son sometime after his death in 1942 to a German medicine company (Newsom 2002, Brendler & van Wyk 2008).

Pelargonium sidoides via Wikipedia

The identification of Umckaloabo as the root of a species of Pelargonium did not occur until the mid 1970s, from the work of a German researcher (Dr Sabine Bladt) sponsored by a German company (ISO-Arzneimittel). Eventually identifying the primary source as being Pelargonium sidoides, a plant first described as early as 1685, which was also ascribed by some as a subspecies of the similar Pelargonium reniform (Bladt & Wagner 2007).

Since the early 1990’s liquid and other extracts of P. sidoides root have entered the herbal medicines market, particularly in Germany. It has grown to be one of the most popular over the counter respiratory infection treatments in Germany with a turnover of some €80 million in 2006. Various P. sidoides extracts and products are also now available in Russia, Ukraine, the US and Mexico, as well as in its source country South Africa. However, the German market is the most significant and developed (Brendler & van Wyk, 2008).

An array of chemical and pharmacological studies have identified the major classes and specific constituents and investigated their activities in vitro and in vivo. Clinical trials, observational and placebo controlled, primarily involving a proprietary liquid extract, in both adults and children have occurred. These report significant activity compared to placebo in acute bronchitis with very high tolerance and acceptance by patients. Other trials indicate benefits in sinusitis and other respiratory tract infections (Newsom 2002, Brendler & van Wyk 2008).

Pharmacological studies indicate significant immuno-modulatory (eg. increased phagocytosis, altered cytokine levels) rather than direct anti-microbial activity as the primary basis for action (Brendler & van Wyk, 2008).

Even a recent meta-analysis by the now well known CAM sceptic Edzard Ernst concludes on the basis of well done randomly controlled clinical trials that there is evidence that P. sidoides, aka Umckaloabo, is a safe and effective medicine for children and adults with acute bronchitis. With less adverse events than placebo in the trials conducted (Agbabiaka, Guo & Ernst 2008).

A few Pelargonium species are documented as utilised by indigenous peoples in Southern Africa, though it has been a long tortuous path for modern science to get its head around what this was and why it was used by the indigenous people (Brendler & van Wyk, 2008). Particularly it seems in the English-speaking world.

This is just one herb, out of thousands identified by people from almost every human culture. Despite institutional hostility for the best part of a century (at least in the Anglosphere), it has continued to be sought out and used by people and scientific investigations (outside the Anglosphere) have identified a range of pharmacological properties that are quite clearly of interest and benefit to people. Clinical evidence supports its safety and efficacy for what are very widespread and common conditions that impact significantly on people.

For anyone in science to now believe that they or anyone else would’ve had any inkling to the value of this herb or its constituents without the original knowledge imparted by others is completely disingenuous. The source people, Khoi, Xhosa or Zulu, were probably illiterate and uneducated by modern measures, but obviously intelligent and capable people to survive for millennia in their lands. Without their traditional knowledge none of this history would’ve been possible. The existence of this apparently cheap and safe natural medicine for people in highly educated developed societies would never have occurred.

It does also seem ironic that in an age where so much time and legal resources of corporations, or governments at their behest, are devoted to the notion of intellectual property, where individual copying of files or an idea is declared as piracy or counterfeiting, suitable for fines and imprisonment. That so little acknowledgement is given of the intellectual property established by traditional local herbalists and healers the world over.

Medicine it seems is keen to exploit or lay claim to any fruits of this great human endeavour spanning millennia and many cultures. To own and control everything associated with human dis-ease. Whilst at the same time ridiculing or attacking the very existence of what has historically been the source code for the vast majority of modern pharmacy and much of our historical understanding of pharmacology. Is it a surprise that more informed and experienced indigenous and traditional medicine people are more wary of science (or more specifically industry) and researchers these days (Rosenthal 2007).

There is no evidence I can find that Stevens was ever shown or identified the Pelargonium plant he used. There is no evidence that the BMA made any real effort to identify the material, their so-called analysis was merely a manufactured result aimed at discrediting Stevens Cure.

If anything, the Zulu and other indigenous healers of South Africa probably had most reason and justification for keeping their intellectual property, herbal knowledge, close to their chests.

[PS, in 2010 an African NGO and other parties were the first ever Africans to successfully appeal to the European Patent Office, in the case to revoke a German company’s patent in regard to P. sidoides, due to lack of inventiveness]

As it turns out Pelargonium seems to have been a regular part of the local herb trade and the identification was eventually made simply through the fact that an informed open-minded researcher actually went to South Africa. In contrast to the ideologically or wilfully ignorant BMA of the early 20th century it seems.

If nothing else this story reflects many of the complexities of human relationships with plants, in particular medicinal herbs, which includes but also transcends simple scientific analysis.

It seems to me to also reflect the follies of trying to repress and attack others armed with only your own limited perspective, no matter who you are. This merely seems to exacerbate everyone’s collective stupidity and ignorance. Even without all the uninformed hostility, a detailed scientific understanding of even a single herbal can take a long time and much effort from many people.

I’d bet the BMA and probably Stevens never could have imagined the outcome of it all 100 years later. In the case of the former they might feel somewhat disappointed, and the latter somewhat vindicated.

Actually the BMJ ran an editorial lamenting the presence of all manner of herbals in 2009, wondering why things had hardly changed. Apparently oblivious to further developments and their evidently unsound attack on this herbal remedy (Pelargonium sidoides) they wrongly and unscientifically slammed as quackery a century before.

Posted in Ethnopharmacology, FSM, Herbal Medicine | 2 Comments

Friends of Un-Science in Medicine?

In perhaps one of the most remarkable documented cases of trying to manipulate an unscientific online opinion poll on an Australian newspaper website that I’ve heard of.

It seems that some supporters of the current campaign being conducted by the group so-called Friends of Science in Medicine (FSM) seem to have gone well out of their way to try to rort an unscientific online poll to their advantage.

Whilst the apparent leader of FSM (Prof John Dwyer) disavowed himself of such cheap tactics when the poll results and logs were put to him. It is kind of surprising that he did say that FSM were planning on using this unscientific online poll as part of their campaign. Science?

SMH online poll manipulated – Feb 11 2012

 

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