I hope this prize leads to a more systematic (re)look at traditional medicine - both Chinese and Indian. It would be important (and exciting) to understand what thousands of years of 'wisdom' can offer modern science and the drug industry.
Can we discover new active ingredients by studying 'traditional' medicine? Should there be a branch of study dedicated to this?
Other comments have covered this angle already; we do actively look at herbs, "traditional", and "plant-based" cures. The vast majority (99.9%+) do absolutely nothing. The tiny percentage that have some effectiveness are usually just starting points.
In fact this woman's discovery is exactly that because the malaria parasite is already developing resistance to it which is why the recommended therapy combines it with other drugs to prevent a resistant strain from spreading. That doesn't belittle her accomplishment by any means, but if you stop to check under rocks you'll occasionally find some money hidden there. Doesn't mean we can find billions in free $$$ by sending an army of people out into the world to turn stones.
Much like pyrethrin-based insecticides, this chemical is already being studied and modified in an attempt to discover variants that are easier to make, have fewer side effects, or which organisms can't develop resistance against quite as easily.
> if you stop to check under rocks you'll occasionally find some money hidden there. Doesn't mean we can find billions in free $$$ by sending an army of people out into the world to turn stones.
China: research into TCM happens a lot, even in Western laboratories
Amazonian and African plants are cataloged and analyzed for the pharmacological properties. I cannot name specific research projects, but plenty of books from respectable sources can be found. When traveling the Amazon I even met some pharmacologists who scout for plants (all but one working for pharmaceutical companies).
Unfortunately the alternative healing movement got a 20 or 30 year head-start and thus the hardest part for the interested amateur pharmacologist is filtering out all the pseudo-scientific publications in that field. It's not all bad, a lot is even useful as a starting point for serious research, but hard facts are hard to come by.
> the alternative healing movement got a 20 or 30 year head-start
I don't think it's really meaningful to say that. To start with, what do you mean by "alternative healing movement"? The label didn't start being used until the latter half of the 1900s. But many of the practice and of course many of the inspirations are a lot older.
On the other hand, ethnobotanists have been cataloging pharmacological properties for over a century. Indeed, this Nobel Prize is for similar research done in the 1960s, so to say 'a 20 or 30 year head-start' would be to say the alternative healing movement started doing this no later than the 1940s.
The confounding problem is that herbalism is a much older practice, with a recorded history stretching back 1000s of years. When did the alternative healing movement not use herbalism?
I don't know enough about the history to really clear things up, but I can point to the 1987 essay on various aspects of the traditional medicinal aspects of celery - http://garfield.library.upenn.edu/essays/v8p164y1985.pdf - to show that it's hard to say that the modern alternative healing movement added anything new to the long and world-wide herbalist tradition.
> The label didn't start being used until the latter half of the 1900s
Yes, I am referring to the group(s) that applied that label to themselves, not to herbalists as a whole, but to groups that elevated wishful thinking and superstition to "facts". They always had cures for aids, cancer or you-name-it, based on "nobody of the natives who used the plant ever had it" (reality: were never diagnosed because they never saw a doctor).
I am talking about the groups that give every scientific mind the creeps and that harmed traditional medicine by putting it into the esoteric corner. But as I said, even these groups added some value - if only by collecting hints at useful plants and their applications that can serve as a starting point for further (actual) research.
My personal low was a Swiss "healer" who attributed the pain-killing effect of cloves to their shape - the discussion turned really nasty when I pointed her at Eugenol (https://en.wikipedia.org/wiki/Eugenol).
The personal highlight was the Moroccan herbalist in Fez, who knew the limits of what he can do, knew the pharmacology (to some degree) behind his plants and always could explain why they did things the way they did (and it's not "because tradition"...)
Then I am certain that the scientific cataloging and analysis of the the pharmacological properties of traditional medicines started before the alternative medicine movement.
> ETHNOBOTANY is virtually a new field of research, a field which, if investigated thoroughly and systematically, will yield results of great value to the ethnologist and incidentally also to the botanist. Ethnobotany is a science, consequently scientific methods of study and investigation must be adopted and adhered to as strictly as in any of the older divisions of scientific work. It is a comparatively easy matter for one to collect plants, to procure their names from the Indians, then to send the plants to a botanist for determination, and ultimately to formulate a list of plants and their accompanying Indian names, with some notes regarding their medicinal and other uses. ...
> Ethnobotanical research is concerned with several important questions: (a) What are primitive ideas and conceptions of plant life? (b) What are the effects of a given plant environment on the lives, customs, religion, thoughts, and everyday practical affairs of the people studied ? (c) What use do they make of the plants about them for food, for medicine, for material culture, for ceremonial purposes? ....
Ive heard of people who dedicate their studies to this. Also Ive an anthropologist friend who spent time living in a developing country studying how people culture blended their traditional vs modern medicine usage.
IMO a real boon for medicine will be increasing sophisticated personal monitoring and the data this makes accessible to the world when shared. If sure we'll see some amazing cause/effect relationships from all sort of areas being identified in coming years .
can we patent them? or is traditional going to be considered prior art? because I don't see big pharma jumping in without profit and with all the regulations around it it's going to be very hard to pay for all the tests for societies not part of the big entourage.
There already is; it's called organic chemistry. Completely synthetic medicines are a relatively new thing; for hundreds of years chemists have tested everything they could get their hands on for everything they could think of. Even so, novel natural products are discovered every year, and new uses for them likewise. Even those are usually synthesized, however, for cost reasons. If you find something interesting by grinding up sea sponges or something then you'd better hope you can synthesize it, or you'll never have enough to be useful. Also, if you can synthesize it then you can try a bunch of different modifications to it, and possibly find something similar which works even better. Evolution gives you random scatter-shot of chemicals; it's as likely to miss a really good one as it is to find it. (Plus the sea sponges and algae and so on are all optimizing for their own survival, not biocompatibility with humans.)
The only difference between medicine and "traditional" medicine is that "traditional" medicines are never discarded once they're proven to be ineffective.
The cool thing about the modern way of approaching natural products is that it's reaching far beyond what traditional herbal medicine is able to. Case in point, I heard of a promising new antibiotic that originated from a soil bacterium found in a random grassy field in the US somewhere. The latest edition of Foreign Policy has a good piece on these things.
The origin of that antibiotic is notable for the new method of culturing the soil bacteria in situ, but antibiotics from soil bacteria are not new. Most antibiotics with a name ending in "mycin" were isolated from soil bacteria.
In many cases , the right method to test medicinal properties of plants is to break them into their contituents and test each separately ? and you miss a lot by not doing so(although it is hard) ?
Yes. While most of the components of a plant will have no particular effect, the one component that you're looking for may be lost in the noise. Worse, it could be cancelled out by some other component or components. (Think of proteins which inactivate other proteins.)
There are some who say there were more deserving members on that team who didn't get recognition. In other words, it was a team effort and there were others whose work figured more into the discovery but who didn't get recognized.
Who knows, its possible the objectors are being political, or biased, but some people contest her getting all the recognition when there was a team with other prominent researchers, and that's unfortunate.
Even if that's the case, don't blame Tu Youyou for getting the credit. In every interview I've seen with her over the last few years she insists on this being a team effort, and almost appears to prefer staying unknown and unrecognised (one interview even suggests it may be an result from the culture instilled in her during the Mao years, where being a known intellectual wasn't exactly a benefit).
There are some who say there were more deserving members on that team who didn't get recognition.
This seems to be the standard call for every science prize these days. I wonder if the Nobel committee will ever change their rules so they can start giving prizes to teams rather than 2-3 individuals.
That defeats the purpose of the prize, which is to inspire individuals (among other things). Fairness per se isn't the point.
Why not give the prize to a whole university, since the researchers couldn't do it without the admin staff and the students? Or to the whole country of taxpayers?
I usually balk at herbal cures, but it's actually a really dumb thing for me to do, eh? Perhaps it's just the egoist in me that wants to think there's nothing nature or a random plant can figure out or has figured out, that we can't figure out synthetically in the lab.
I should probably stop - there is something to be said for herbal cures, meditation, etc., I think.
> Perhaps it's just the egoist in me that wants to think there's nothing nature or a random plant can figure out or has figured out, that we can't figure out synthetically in the lab.
It's the other way around - most of the drugs we have are reverse-engineered plants. But there's nothing nature can do that we can't do better once we know how it works. What we do is, we take from nature the parts that actually do the healing and refine them, and we throw away the irrelevant rest.
The reason some old herbal cures may be worth looking for is that it's likely that there is yet another plant-based substance that we could turn into actual, much more powerful medicine.
An example of this is the single most used medicine ever, aspirin.
"Plant extracts, including willow bark and spiraea, of which salicylic acid was the active ingredient, had been known to help alleviate headaches, pains, and fevers since antiquity. The father of modern medicine, Hippocrates (circa 460 – 377 BC), left historical records describing the use of powder made from the bark and leaves of the willow tree to help these symptoms.In 1763, Edward Stone, at Oxford, isolated the active ingredient of aspirin in his discovery of salicylic acid."
We lose a lot when the oceans and rain forests are destroyed beyond repair including chemical compounds, proteins, and processes that have taken eons to evolve which we have not yet discovered.
How important to medicine are the ancient remedies derived from poppy and coca leaves?
On the flip side, there is this essential oil, naturopath movement posting things on my Facebook stream about how tea tree oil is a natural antibiotic and to use it on everything. Unfortunately, tea tree oil is effective against MRSA which is now developing resistance to it because of careless overuse by the natural health community. There are dozens of products at Whole Foods that contain it but not at therapeutic levels so one of two things are happening, first, people are killing bacteria on their skin which for the most part is beneficial and, second, bad bacteria is developing resistance.
> I usually balk at herbal cures, but it's actually a really dumb thing for me to do, eh?
No, you're in the right direction. The difference between a folk remedy and medicine is a lot of scientific inquiry, peer review, and reproduction of results. It's an error to lump folk remedies in with scientific findings. That's not to say folk remedies don't work; it's to say we don't have much objective proof that they work.
I'm fine with making objective proof (through hypothesis testing, precise measurement, reproducible results, etc.) my threshold for acceptance.
> there is something to be said for herbal cures, meditation, etc., I think
Certainly. We should say, "Wow. That's worth some scientific inquiry to see if and how it works."
It's not worth cutting corners on this stuff. Some plants interact with medication or affect fetal development. We need experimentation and trials to rule out negative effects as well as prove positive results.
That is a quite odd stance to have. A very large part of modern drugs does come directly from plants, and are only later on produced synthetically, if it has the desired effect (and can be produced cheaper or cleaner synthetically)
Well, just like modern/western/industrial pharmacology, traditional medicines range from Very Effective down to Actually Quite Bad For You ... and their efficacy and safety are heavily influenced by the preparation method, dosage, the subject's physiology, other medications (including food) being taken, and so on.
So while it's not 'really dumb' to discount any traditional medicine because it wasn't made by a profit-driven multi-national corporation, it perhaps indicates some naivete regarding the provenance of many current 'modern' medicines. Some casual reading on digitalis, neem, cinchona, and willow bark may be enlightening -- most people on the planet, including you, have almost definitely used at least one of those (or, I'll concede, a synthesized version of the active chemicals taken from those plants).
There's some great resources on the net that speak to the role of plants in modern medicine - apart from the story you just read - keep in mind how many $'s have been spent over the past hundred years trying to come up with a synthetic cure for malaria.
People say that traditional herbal medicine is unscientific, and to a degree they are correct. But just because no one has published a paper with a controlled experiment doesn't mean they don't work. Some of them does work because of trial and error.
Consider how the original discovery of a poison is made the hard way. It's morbid to think, but someone probably died to figure out that some plants are poisonous. Now extend that to thousands of herbs that may treat pain such as weed or may treat gout. Its not an efficient process but there was an observer that recorded the data when someone took a herb. That observer may not have recorded the data but s/he may spread it by word. This is sort of like an expert that gives small weights to its neighbors in a training group. So over time and through many iterations (sort of like a training group that iterates through many cycles), some final accumulated "common truth" is collected. That is analogous to a fuzzy logic or probability in whether a herbal medicine may work.
But that's with only 1 herb. Even with just 1000 herbs, a 2 herb combination is already half a million. You see how inefficient that is? Even with over 6000 years of human history, the trial and error is still very limited in drug exploration. So just because theres no recorded data of the tests that it doesn't mean it can't work.
Except we have no idea that traditional medicines were developed by effective trial and error. It's more likely that some mystic just declared some arbitrary potion to be medicine for some arbitrary disease and the placebo effect, appeal to authority and the desperation of sick people did the rest of the work popularizing them. The ancient Chinese used the positions of the stars to help choose their medicines. This ineffectiveness is shown by the fact that the traditional recipe Tu found actually involved destroying the active ingredient by boiling it! Clearly the original authors didn't know if it worked or not, since it didn't but they still recommended it to patients anyway.
Today in China, almost everyone still uses traditional medicines. It's a massive national problem. They use them for minor diseases like colds and coughs and continue to believe they're effective because "I took the medicine and a few days later I recovered". The medicine companies are ripping off uneducated poor people and the "medicine" doesn't deserve any respect other than as a source of compounds to test using actual science. The scam is reinforced by doctors in hospitals who often prescribe a combination of traditional and modern medicine so that the modern medicine does the work while the (sometimes more expensive) traditional medicine leaves an opportunity for the patient to credit it instead.
> People say that traditional herbal medicine is unscientific, and to a degree they are correct
Maybe we have different definitions of "unscientific". It doesn't mean the same as "works well".
> just because no one has published a paper with a controlled experiment doesn't mean they don't work.
No, that just means they are unscientific.
If we want people to stop treating science like magic, we need to stop conflating "effective", "natural", and "is consistent with scientific findings" with "scientific".
If your experiments are not reproducible, it's not scientific. If the experiments and observations don't deal with sufficiently precise measurements (no '3 pinches of this'), it's not scientific. If it can't be tested with prediction, experimentation, and observation, it's not scientific.
That's not to say it's wrong or that collective discovery isn't a thing. It's just not science. This is important because collective memory can be right, but it can be wrong. Folk medicine says things like "pregnant women should eat protein to have a boy" and "rhino horn cures diseases of the pancreas". We need a way to collectively vet these hypotheses. That's what the scientific method is for.
"People say that traditional herbal medicine is unscientific, and to a degree they are correct. But just because no one has published a paper with a controlled experiment doesn't mean they don't work. Some of them does work because of trial and error."
Some of these herbs might work, but I imaging it's all do to the Placebo Effect.
If uneducated people want to ingest herbs--I really don't care. The problem is these people are killing Tigers, Bears, Rhinos, etc. falsely believing they will be cured of their alignment.
These people need to be educated. I am really bothered when I see another animal killed out of absolute ignorance, and tradition.(an unexamined tradition is just a folk tale?)
A well done double blind study is beautiful. We can argue about standard deviations, etc, but the studies need to be done.
Herbs great! Just leave animals out of the mystical cures.
Personally, I would think like this. Not matter it is herbal cures or chemical medicine, I only trust the one comes from the true scientific process like double blind tests.
I wont say the traditional Chinese herbal medicine is absolutely crap as some of current wonderful medicine is the extraction of plant.
Many people think so, to the point there are people who create medical problems for themselves by drinking large but feasible amounts of 'harmless' herb teas for enjoyment.
Some of them have effects such as lowering or increasing your blood pressure, for example, and that's everyday herb teas from the supermarkets. Not a problem if you drink one or two cups (most effects are small), and not a problem if you're not vulnerable. But if it's all you drink.. well.
As many others have pointed out this is exactly where a lot of our medications come from. We isolate a naturally-occurring chemical, refine it to make it more potent or eliminate unwanted side-effects, test it, then release it as a drug.
There was also https://news.ycombinator.com/item?id=10338213 earlier today, which turns out to have been her 2011 paper, though few of us seem to have recognized it.
Edit: there's also https://news.ycombinator.com/item?id=10342856.