Saturday, June 28, 2008
One of the biggest hurdles to phytotherapy is that plants are, after all, living things. Much like my two black (loveable) cats above, even though two plants may be growing side by side, they may still produce a different bouquet of molecules--and they are very different cats; one of them could be white--they're that different.
Some of the more practical amongst us may wonder whether or not it actually matters. After all, 5000 years of practical application have, essentially, confirmed that these plants work.
On the other hand, standardized medications make dosing and scheduling much easier. Can you imagine the tizzy your family physician/GP would be thrown into if the New England Journal of Medicine suddenly recommended that every patient's aspirin be titrated to the optimal dose? Of course, this sort of individualized therapy is part of what makes TCM so powerful--that each and every patient receives a tailored concoction--but you can hardly expect a harried doctor (who's probably more worried about getting sued) with exactly 10 minutes of time, half of which is spent deciphering his colleague's handwriting, to give the sort of individual attention that personal dosing requires. Add to this the fact that a bad licorice season, or a factory being built within 500 feet of a ginseng field, can drastically affect the quality, growth, and compound within a plant, and you can see how things begin to go disastrously wrong if there is no standardization.
At the molecular level, there simply is no way to guarantee that batches of plant extracts from one plant (much less many) will contain exactly the same components, unless we are after only one compound. This is, in part, why we synthesize Taxol (the other part being that Pacific yew is an endangered tree). The best we can hope for, therefore, is an average of chemical signatures given by a particular plant--a "fuzzy fingerprint", if you will.
And this is what makes TCM so unsatisfying for Western physicians. From the Age of Enlightenment onwards, the philosophy of science and medicine has been that knowing more about how we (human bodies) work will lead us to understanding more about how to fix it* when it gets broken. Now, nobody will doubt that bodies get broken, in terms of the physical, physiological, and chemical. The human race has been fixing physical problems for as long as its history, but the physiological and chemical problems have had to wait for the advances of science before we could understand what the nature of the problem was. The history of diabetes provides a wonderful example of how, even in the face of knowing what was wrong, we were still powerless to do anything about it. We are so used to equating "disease" with "broken"--with one single concrete cause, and one single effective cure--that it's now wonder we are surprised when the magic bullet turns out to be a dud. Contrast that with the view TCM takes, that the body isn't really broken, it just needs help getting to where it should be--and that help can come in many, many forms, and they are not all the same for everybody--and you begin to see how the divergence in thinking begins to cause rifts.
This is not to suggest that any old ginseng or lavender plant will yield the right proportion of effective:noneffective ingredients. Maybe the difference matters, and maybe it doesn't. The fuzzy fingerprint may be as close as we will ever get to standardizing things chemically. But that doesn't mean we can't standardize what we can: the soil content and acidity, drainage and water availability, amount of light and darkness. It is even conceivable that air quality could make a difference.
Allow me to end on a note of conceit and ask, "Is there any better reason to ensure that our climate and environment are not going to go to hell in a handbasket?" Considering how much we already depend on it, how much it costs us when things go wrong, and that the potential to save lives could be floating around in some undiscovered plant (or some already-discovered plant), can we really afford to take the chance that the poisons we spew and the trash we discard doesn't have an effect?
*I usually try to avoid using Amazon.com when pimping books, but the synopsis is so wonderfully exact that I didn't think I could do it any better