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Vol. XXVI, 4th Quarter
October –December 2008

Mang Kepweng’s medical gift

Mang KepwengWho could forget the legendary Mang Kepweng, the albularyo?

Even now in many far-off areas, the sick are brought to a “medicine man,” popularly called albularyo, from herbolario (traditional herbal healers), for treatments consisted of herbs and parts of plants. Treatments are always aided by some kind of oil and a mouthful of chants and prayers, be it simple wounds or exorcising wayward spirits.

The use of herbs for medicinal purposes is an ancient practice. Man has relied on herbs as antiseptic, expectorant, antibiotic, astringent, antihistamine, fungicide, antifungal, anti-inflammatory, diuretic, and even tonic for old age and related illnesses. Herbs were used fresh, as decoctions, infusions, tinctures, capsules, extras, creams, compresses, suppositories, and even ointments. It is then no surprise that man cultivated herbs for medicinal remedies for generations.

With the advent of modern medicine, experts and doctors began to cast doubt on the albularyo’s methods. The iconic albularyo in fact is derisively called “quack doctor” to indicate his dubious status in the medical field. Herbal treatments became a disputed issue.

Back to the albularyo

In 1977, the Department of Science and Technology’s Philippine Council for Health Research and Development looked into herbal medicine as a research and development interest. The first major task was interview sessions with 1,250 albularyos in 500 villages, which revealed 900 plants used in curing various ailments.

What followed were decoctions and infusions made from some of the commonly-used plants. These were formulated and subjected to rapid clinical screening that involved chemical, bioassay, pharmacological, toxicological, mutagenic, and agricultural aspects. The researches confirmed the efficacy of various plants for 27 common ailments.

The R&D on herbal medicines resulted in formulation of tablets, suspensions, syrups, tinctures, and lotions using indigenous plants for various ailments. Through effective technology transfer, herbal products are now widely accessible.

Herbal preparations

The Department of Health endorses, and DOST promotes the following as promising herbal preparations:

Hypes

Because the effectiveness of some herbal preparations was validated by DOST and DOH, some enterprising companies took on the trend and began promoting their own herbal products. But not all of these products are accurate in their claims.

The DOH’s Bureau of Food and Drugs issued warnings on the risk of using some herbal medicines. It warned that certain herbal medicines, instead of healing, may even cause death. Doctors also have apprehensions on herbal medicines in capsule forms as they do not have any idea how these medicines were actually prepared. BFAD required clinical runs to ensure the safety and efficacy of herbs used as medicines.

Once an herbal company gets registered with BFAD, it no longer has a hand on its advertisement promotions. BFAD says that some herbal medicines are registered as food supplement, but advertisements claim therapeutic capability.

This is especially true in herbal supplements touted as miracle drugs. People tend to believe such advertisement hypes, stop taking doctor-prescribed drugs, and rely completely on herbal medicines. It also helps that many herbs are freely available and can be found easily in most parts of the country.

Controversies

Medical associations are also concerned with standards that must cover each natural product. This involves manufacturing processes that need to be developed and established to ensure purity, safety, and quality of the product, including its labeling. The medical sector bats for more clinical studies on herbal treatments. Regulatory standards applied to pharmaceutical products, they say, should also be applied in herbal products.

Critics of herbal medicines focus on safety and lack of clinical evidence of effectiveness. Herbal products are not as rigidly regulated as conventional drugs in purity and potency, and may possibly cause adverse effects and drug interactions.

Margaret McHugh, executive director of the Ontario Association of Naturopathic Doctors, admits that many herbal medicines do react with prescription medications. “This is a good reason to see an expert in herbs and drug interactions such as a naturopathic doctor,” she says.

Quality herbal medicine

According to Dr. Jaime Montoya, clinical trials of herbal medicines endorsed by DOST and DOH involved human volunteers to evaluate the efficacy of the drugs and to determine the most effective dose. “The trials also took into account the environment and health habits of people,” explains the DOST-PCHRD director, a diplomate in clinical tropical medicine himself.

To further ensure the safety and efficacy of herbal medicines, pharmacists in far-flung areas were trained to produce herbal tablets under strict manufacturing standards. They were also tasked to promote and undertake market acceptability studies to facilitate technology transfer.

Moreover, firms producing herbal medicines also found ways to solve mass manufacturing problems involving shelf life, microbial content, and texture. Two products, lagundi and sambong tablets marketed as Ascof and Re-leaf respectively, actually won silver medals in the “New Techniques and Products” category in the 25th International Exhibition of Inventions in Geneva, Switzerland in 1997.

Dr. Jaime C. MontoyaDr. Montoya also disclosed that the agricultural component or supply of quality raw materials for herbal medicines is handled by agricultural research institutions such as the University of the Philippines Los Baños. This includes propagation techniques, proper farming practices, post-harvest technology, safe pest management, and even management of medicinal plant diseases. Such comprehensive approach ensures that herbal medicines on the shelves are safe and effective.

Modern technology and continuing R&D have bolstered the scientific reliability of herbal medicines. But experts say it is still always wise to consult with doctors and professional herbalists before taking herbal medicines as alternatives to prescription drugs.