camwatch

Kala CP. Aboriginal uses and management of ethnobotanical species in deciduous forests of Chhattisgarh state in India. J Ethnobiol Ethnomed. 2009 Aug 4;5:20. PMID: 19653889; PMCID: PMC2729299.

Chandra Prakash Kala of the Indian Institute of Forest Management reports on a comprehensive ethnobotanical survey of rural Surguja, a biodiverse region of rich deciduous forests in the Chhattisgarh state of central India. 

The people of this region have developed herbal remedies over centuries, perhaps millennia, for a number of tropical maladies. Here’s one extract from the article, in which Kala discusses plant products used for cobra bites, scorpion stings, and mosquito protection:

"Many species of snakes including cobra were found in the study area, and snakebite was one of the frequent problems. In case of snakebite, the person was treated by some specialized expert, who used some plant species and also chanted some spiritual words while curing snakebite. Diospyrus melanoxylon Roxb., Elaeodendron glaucum Pers., and Garura pinnata were some of the important plant species used for curing snakebite. Similarly, the scorpion bite was treated by using the leaf paste of Achyranthus aspera L., and tuber of Urginea indica Kunth. The Surguja district is a mosquito prone area, and death by malarial fever is a common phenomena. The local people spend most of the time in the forest for rearing of their livestock, collection of fuelwood, fodder, medicinal and edible plants. To keep mosquito away from their body, they rubbed leaves of Chloroxylon swietenia DC. on the exposed body parts and also put its twigs on the head and back."

Kala documents 73 ethnobotanical species used as medicines, food, tonics, dyes, beverages, fish poisons, and mosquito repellent. She also proposes screening and standardizing compounds according to medicinal potency and nutritive values, and developing sustainable harvesting and production practices that make fair-trade use of local resources and knowledge rather than exporting plant products in raw forms. [Read the article.]

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger).This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine malaria conservation

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Chang FY, Lu CL. Treatment of irritable bowel syndrome using complementary and alternative medicine. J Chin Med Assoc. 2009 Jun;72(6):294-300. PMID: 19541564

A thoughtful and enlightened review of CAM practices used by patients with irritable bowel syndrome, by researchers at Taipei Veterans General Hospital and National Yang-Ming University School of Medicine in Taipei.

From the abstract:

"Unfortunately, none of the currently available drugs … are globally effective in treating all IBS symptoms, and the advanced receptor-targeted drugs are not always successfully and safely marketed. Consequently, more than half of patients may seek complementary and alternative medicine (CAM) to treat the annoying bowel symptoms. Physicians have considered these CAM measures to have an "enhanced placebo effect". For example, many herbal medicine and plant products are globally used to treat IBS, whereas their efficacies are often inconclusive because of small sample sizes, inadequate data analyses and lack of standardized preparations. Meta-analyses do not establish their true efficacy. Acupuncture has long been employed by patients themselves to treat functional gastrointestinal disorders with satisfactory response, but its effect on IBS does not seem to be promising. Peppermint oil, melatonin and clay-like materials are effective in treating some IBS symptoms, while their true pharmacology remains enigmatic."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger).This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine irritable bowel syndrome

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Liu Y, Dao Z, Yang C, et al. Medicinal plants used by Tibetans in Shangri-la, Yunnan, China. J Ethnobiol Ethnomed. 2009 May 5;5:15. PMID: 19416515.

Researchers at Chinese Academy of Sciences, China College of Life and Environment Sciences, and China University for Nationalities inventoried traditional medicinal plants used by Tibetans in the county of "Shangri-La" (formerly Zhongdian), Yunnan Province, Southwest China.

The authors note an impending loss of traditional Tibetan medical knowledge, and attribute it to the voluntary adoption of dominant Han ways by all but the most elderly Tibetans. Two ethnobotanical field surveys are undertaken, often hampered by lack of access to expert herbalist guides.

Still, work is accomplished. From the results section:

"Sixty-eight medicinal plant species in 64 genera of 40 families were recorded and collected. Among them, 23 species were found to have medicinal values that have not been recorded in any existing Tibetan literatures before, and 31 species were recorded to have traditional prescriptions. Moreover, the traditional preparations of each species and some folk medicinal knowledge were recorded and analyzed. These traditional prescriptions, preparations, new medicinal plants and folk medicinal knowledge and principles were discovered and summarized by local traditional Tibetan healers through times of treatment practices, and were passed down from generation to generation."

Medical applications included dysentery, gastropathy, cold/fever, and rheumatism/arthritis, among others.

In the conclusion, the authors note that the disappearance of Tibetan traditional medical knowledge "would be a great loss not only to the Tibetan cultural wealth but also to the great cultur[al] diversity of China." Choices made by Tibetans themselves, rather than government policies, are held to be the cause:

"…most traditional Tibetan healers were found to be almost 70 years old, and their descendants are scarcely willing to inherit this traditional profession and the precious traditional knowledge handed down. They prefer other jobs with more income instead. They believe that the traditional medicines are not so indispensable to their life nowadays and their reasons are given as follows: 1) the medical treatment of Han community is more advanced and has better condition than the traditional ones; 2) Tibetan became more and more dependent on the money-consuming substances outside their village, but traditional healers didn’t earn much."

A note in the methods section could shed some light on those observations. The field researchers elected to consult only with "official workers, traders and local healers who have to contact with different people very often," and only with those who speak Mandarin: "So we all speak mandarin and didn’t use any interpreters in communicating." I’m not an ethnobotanist, but that does not strike me as a great way to learn from indigenous herbalists in Tibet.

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger).This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine tibetan medicine

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Long C, Li S, Long B, Shi Y, Liu B. Medicinal plants used by the Yi ethnic group: a case study in central Yunnan. J Ethnobiol Ethnomed. 2009 Apr 23;5:13. PMID: 19389251

Researchers at Chinese Academy of Sciences, Minzu University of China, Yunnan Agricultural University, and Chuxiong Research Institute of Yi Medicine and Pharmacology inventoried traditional Yi medicinal plants in Chuxiong, central Yunnan Province, Southwest China. From the results:

"One hundred sixteen medicinal plant species were found to be useful by the local people in the treatment of various diseases or disorders, especially those relating to trauma, gastrointestinal disorders and the common cold. Among these 116 species, 25 species (21.55%) were found to have new curative effects and 40 species (34.48%) were recorded for their new preparation methods; 55 different species were used in treating wounds and fractures, and 47 were used to treat gastrointestinal disorders. Traditional Yi herbal medicines are characterized by their numerous quantities of herbaceous plants and their common preparation with alcohol."

Speaking of alcohol:

"Traditional Yi medicine is especially characterized by its use of alcohol. The Yi people adore alcohol, and it has come to symbolically represent this cultural minority due to its significance in their lives. Home-made alcohol is the most important beverage for the Yi: it is used daily, for ceremonies and holidays, served to respected guests and friends, and is the most common method of administering plant medicines. The practice of combining plants and alcohol has a long history in Yi medicine."

The authors are motivated by a desire to preserve "indigenous knowledge, and folk knowledge in particular," which "continues to be impacted by mainstream culture and decreasing biodiversity; traditional practices using specific medicinal plants decreases more quickly than that of the general biodiversity. It is thus urgent and necessary to prevent the further loss of the specialized knowledge of minority peoples."

 

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine

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Witt CM, Lüdtke R, Mengler N, Willich SN. How healthy are chronically ill patients after eight years of homeopathic treatment?–Results from a long term observational study. BMC Public Health. 2008 Dec 17;8:413. PMID: 19091085

Researchers at Berlin’s Charité University Medical Center continue their long-term study of nearly 4,000 adults and children with chronic illness treated by homeopathic practitioners.

Patients in the study presented with a variety of conditions, including migraine, tension type headache, sleep disorders, depression, anxiety disorders, multiple eczemas, psoriasis, allergic dermatitis, allergic rhinitis, allergies, dysmenorrhea, multiple infections, hypertension, low back pain, and asthma. 

Their data "consistently show substantial health improvements in patients under homeopathic treatment, which persisted through the whole observation period. Improvements were more pronounced in younger patients, females, and those with greater disease severity at baseline."

However, the authors could not attribute the outcomes exclusively to homeopathy:

"As patients were allowed to use conventional therapies and other complementary therapies during the study period, the observed improvements cannot be attributed to homeopathic treatment alone. The aim of this study, however, was not to test the effectiveness of homeopathic drug treatment, but rather provide an unbiased representation of contemporary homeopathic health care and its outcome in routine care."

First do no harm.

The authors believe their study is significant in that it may be the first large study with a high follow-up rate to evaluate health outcomes under homeopathic treatment for such a long observation period.

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine

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Kunwar RM, Bussmann RW. Ethnobotany in the Nepal Himalaya. J Ethnobiol Ethnomed. 2008 Dec 2;4:24. Review. PMID: 19055723

Investigators at the Ethnobotanical Society of Nepal and Missouri Botanical Garden partnered for this comprehensive review of indigenous knowledge and use of plant resources in Himalayan Nepal. Their analysis included more than 200 studies focusing on ethnobotany, ethnomedicine, and diversity of medicinal plants, carried out over the past three decades.

The article underscores the importance of diverse Himalayan flora to medical systems throughout Asia:

"Asia represents one of the most important centers of knowledge with regard to the use of plant species for treatment of various diseases. Examples are the Ayurveda, Amchi (traditional healing system of Tibet and mountain areas of Nepal), Siddha, Unani, and Chinese systems of medical care. Folklore medicinal systems (traditional healing and faith healing) are also important in Nepal. In this context, it is interesting to note that the Himalayan medicinal plants are the major contributors to the aforementioned systems. The topographical characteristics of the Himalayas have resulted in a variety of ecological niches that host diverse medicinal plants. It has been estimated that the Himalayan region harbors over 10,000 species of medicinal and aromatic plants, supporting the livelihoods of about 600 million people living in the area. The Nepal Himalayas include about 2,000 species with medicinal and aromatic values, and more than 1,400 of these are known to be used locally particularly as medicines."

The authors approach ethnobotany and ethnomedicine as integral elements of the public health, culture, environment, and economies of the Himalayas, concluding that "Enhancing the sustainable use and conservation of indigenous knowledge of useful and medicinal plants may benefit and improve the living standard of poor people."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine

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Büssing A, Cysarz D, Edelhäuser F, et al. The oil-dispersion bath in anthroposophic medicine–an integrative review. BMC Complement Altern Med. 2008 Dec 4;8:61. Review. PMID: 19055811

An introduction to anthroposophic medicine - a whole medical system introduced by the Austrian polymath Rudolf Steiner - from the vantage of the oil-dispersion bath, a specific AM practice developed by the massage therapist Werner Junge. In an oil-dispersion bath, patients soak in warm water containing a very fine oil dispersal.

From the discussion:

"We found a small number of clinical and field studies which mainly focused on the exploration of physiological effects of ODB [oil-dispersion bath]. The studies can roughly be subdivided into two groups: (1) mechanisms of transdermal resorption of the oil, and (2) regulatory effects of ODB. While there are good clinical studies which confirm that conventional balneotherapy is an effective treatment modality in elderly patients with osteoarthritis of the knee or with chronic low back pain, or can alleviate low back pain, there is an obvious lack of clinical studies on ODB which address the unique contribution of the oil dispersal in water."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine

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Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. National health statistics reports; no 12. Hyattsville, MD: National Center for Health Statistics. 2008. [Read the report.]

This nationwide survey of CAM practices in the United States, developed by the National Center for Complementary and Alternative Medicine, was undertaken within the latest National Health Interview Survey.

The study, published in December 2008, includes questions on 36 types of CAM medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture used in the previous year.

The authors give their definition of CAM in the Introduction:

"Complementary and alternative medicine (CAM) covers a heterogeneous spectrum of ancient to new-age approaches that purport to prevent or treat disease. By definition, CAM practices are not part of conventional medicine because there is insufficient proof that they are safe and effective. Complementary interventions are used together with conventional treatments, whereas alternative interventions are used instead of conventional medicine."

The survey found that the most commonly used CAM therapies among adults were:

• Nonvitamin, nonmineral, natural products (17.7%)
• Deep breathing exercises (12.7%)
• Meditation (9.4%)
• Chiropractic or osteopathic manipulation (8.6%)
• Massage (8.3%)
• Yoga (6.1%)

This is the first national study in the U.S. to measure CAM use by children. Reported CAM use in children was substantially less than in adults. The most common practices among children were nonvitamin, nonmineral, natural products (3.9%), chiropractic or osteopathic manipulation (2.8%), deep breathing exercises (2.2%), yoga (2.1%), and homeopathic treatment (1.3%).

The report includes a brief discussion of systematic reviews of CAM therapies published between 2002 and 2007, identifying 10 that "found sufficient evidence to conclude that a given CAM therapy was effective for a given condition," including acupuncture and yoga for back pain, and acupuncture for knee pain (including osteoarthritis), insomnia, and nausea or vomiting (in pregnancy, following surgery, and induced by chemotherapy).

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine

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Madsen MV, Gøtzsche PC, Hróbjartsson A. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 2009 Jan 27;338:a3115. PMID: 19174438

This study by researchers at Rigshospitalet in Copenhagen looked at 13 trials (3,025 patients) with pain from a number of clinical conditions including knee osteoarthritis, tension-type headache, migraine, low back pain, fibromyalgia, abdominal scar pain, postoperative pain, and procedural pain during colonoscopy.

They found "a small analgesic effect of acupuncture… which seems to lack clinical relevance and cannot be clearly distinguished from bias," and concluded that "whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear." From the discussion:

Our review is the first that identifies and analyses three armed trials of acupuncture for pain, thus providing an estimate of the general analgesic effect of acupuncture and its direct comparison with the analgesic effect of placebo acupuncture. The review is fairly large, includes several trials of high methodological quality, and covers a broad range of common painful conditions…."

Our findings question both the traditional foundation of acupuncture, which is based on the existence of meridians and Qi sensations, and the prevailing hypothesis that acupuncture has an important effect on pain in general. If this hypothesis is wrong, and our results point to that, then acupuncture would seem to be unlikely to have an effect on pain related only to certain conditions, but further studies may examine this question."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine pain

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Hollinghurst S, Sharp D, Ballard K, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation. BMJ. 2008 Dec 11;337. PMID: 19074232

Researchers at the University of Bristol led this economic evaluation of therapeutic massage, exercise, and lessons in the Alexander technique for treating persistent back pain. They found that six lessons in the Alexander technique combined with an exercise prescription was the most cost-effective option for patients in Britain’s National Health Service. From the discussion:

"Our associated clinical paper showed that an exercise prescription alone had only a moderate effect on disability scores and that massage was unlikely to provide a sustained improvement, whereas lessons in the Alexander technique were effective in the longer term over a range of outcomes. Considering the level of uncertainty around the effectiveness of normal care plus exercise, and taking account of all evidence, we conclude that a series of six lessons in Alexander technique combined with an exercise prescription seems the most effective and cost effective option for the treatment of back pain in primary care."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine back pain

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