On My Youngest Daughter Ai Hsing (Front) Graduation Day

On My Youngest Daughter Ai Hsing (Front) Graduation Day

Tuesday, October 13, 2015

Artemisinin and Malaria a Nobel Prize Recognition of TMC

Dear Dr Chan Boon Lye

Thank you for your further info about Artemisinin and Chinese researcher Tu Youyou who won the 2015 Nobel Prize in Physiology or Medicine

This, indeed is a very great honour for a Chinese, and a giant leap for a medical researcher in TMC from China for a female Chinese to win this very prestigious Nobel Prize in Medicine or in Physiology.

As far as I know, there are 12 Chinese so far world-wide, 3 from Mainland China, including Tu Youyou, one from SAR Hong Kong, and the rest who won this coveted Prize in Physics and Chemistry were Chinese working in the United States.

But Tu Youyou is the first female Chinese from People's Republic of China, and the only Chinese to win one in Physiology or Medicine. What a tremendous honour for the super-fast growing superpower of China and the Chinese race world-wide.

What is more glaring is that she won this much esteemed Prize not in conventional allopathic medicine, but in a 2000-year old Traditional Chinese Medicine (TMC).  This gives the practice of TMC such a tremendous boost in recognition against the fast declining popularity of allopathic drug-based mainstream medicine. 

My Awareness as a Medical Researcher:

In the 1980’s when I was working at the Institute for Medical Research (IMR) there were already much  talks among us researchers at international  conferences,  scientific meetings and medical updates  about the resistance of MP (malaria parasite)  - Plasmodium falciparum  to most anti-malarial drugs, notably chloroquine a drug that has long been used against malaria.

Malaria claims the lives of nearly one million people each year, mainly in Africa. Chloroquine was then the best anti-malaria drug available against the scourge  of this tropical disease.

It was about the time I returned from London after completing my PhD in natural medicines. I went to London and universities elsewhere in the UK 3 times over for my postgraduates

I remember one afternoon standing on the open wooden corridor of the old colonial building, the old section of IMR after completing my PhD  in this field of expertise, I had a long discussion with Prof Dr Mak Joon Wah, MD PhD who then was the Head of the Malaria Division at IMR.

His office was just next door to mine. I asked him if he knew about a plant called Artemisia, a specie called Artemisia annua  in which contains  a therepeutic principle called Artemisinin.  

 I told Prof Mak that artemisinin has been used in Traditional Chinese Medicine as a very effective treatment for malaria. That was the knowledge I brought home from the London School of Hygiene and Tropical Medicine, University of London.

The year when I suggested that to Dr Mak, was around 1988 or 1989? I then proposed to Prof Dr Mak, that he  should consider using  this naturally-occurring medicine instead of using the conventional chloroquine-resistant  synthetic agent  against  P. falciparum (malarial parasite) since  the parasite was already showing resistance to chloroquine,  first observed in Vietnam and in Thailand.

 Fortunately Prof Mak told me he was aware of artemisinin, but unfortunately he also told me the World Health Organization has recommended that artemisinin should be reserved as the last resort as the only last hope left for treating malaria since MP has already shown resistance to most anti-malarial drugs, the best then was chloroquine, the chemical analogue of quinine from the bark of the cinchona tree.

So it looks like artemisinin is now a reserved natural drug-of-choice against malaria

Spoke to a WHO Malariologist:

I also remember some years later I also spoke to a WHO Consultant Malariologist who was posted to IMR.

During our dialogue, he admitted we were losing our battle against malaria and that mosquitoes have existed even much earlier than the dinosaurs, maybe about 100 million years ago.

He told me he was sent by WHO to Malaysia from Assam in the south-eastern region of the Himalayas

He told me malaria existed even in Assam, it was not a huge problem there because the Assamese used traditional medicine to treat themselves. In the case of malaria or any form of fevers, they did this by chewing the bark of a tree (presumably, the bark of the cinchona tree) 

Then the fever and malaria were all gone within hours. It was not a problem for the Assam people because they rely on their good old traditional medicine.

But he said WHO had a “better” idea for them.  WHO then started introducing chloroquine and other synthetic anti-malarial drugs into Assam to fight the disease en masse

After WHO did that he said, malaria took revenge, and ravaged the population there uncontrollably.   That was why he escaped from Assam and came to Malaysia to do the same to this country to the loud laughter of both of us.

 Our Experience among Orang Asli in Malaysia:

The same thing we experienced here in Malaysia among the Orang Asli. When our malaria team from the IMR went into the jungles and the orang asli settlements to do a survey, we found almost all of them carry Plasmodium falciparum or other species of Plasmodium in their blood as seen in thick blood films on Giemsa stains

But they do not suffer from any of the classical clinical signs and symptoms of malaria. They merely walk about healthily with the malarial parasites in their blood.  It was a kind of symbiosis between their body and the parasites.

Despite that, we still dosed all of them with synthetic chloroquine with the hope of getting rid of all the MP (malarial parasites) in the blood.  Then naturally the MP count fell.   

We were very happy because we thought we were very clever, we have achieved our objectives. We also thought we were very clever and smart, smarter than Mother Nature.

We then returned to our sophisticated research laboratories at IMR in Kuala Lumpur and ‘bemused’ at our ‘victory’ because we thought we have solved their chronic sub-clinical malaria problems.

Then we returned to re-evaluate our findings and our prophylactic and therapeutic regimen a month later. What did we find? Well, this time the entire settlement there not only got back all the MP into their blood, but they all also came down with clinical malaria as well, which was never there before.

It only shows if we have not interfered with Mother Nature with our synthetic drugs, we would not have made the problem worse.

The Orang Asli have been living peacefully in the jungles in harmony with Nature, and the malaria parasites too have been living peacefully with them in their blood without attacking them. They were in harmony with Nature, some kind of natural symbiosis.  

We are not too sure about this biological phenomenon as the malarial parasites require at least 6 major steps in their life cycle for their development once the malarial parasites or other species of Plasmodium, such as P.  falciparum P. vivax, P. ovale, and P. malariae enters  the body from the bite of the Anopheles mosquito during which clinical manifestations of malaria will develop.

But most of the native people living in the jungles or in malarial infested regions have high loads of malarial parasites in the blood without suffering from the classical clinical presentations of the disease.  It is quite a  phenomena we cannot quite understand.

Perhaps they are immune to it with chronic and long exposures to the bit of the Anopheles mosquitoes till they do not respond clinically? It could be the exhaustion phase from an acute to the chronic phase a disease until the body fails to respond as postulated by the famous Canadian physician Dr Hans Seyle in his theory  of General Adaptation Syndrome when the body undergoes from acute to chronic stress.  This could be the best explanation.

Alternatively, they may have developed a symbiotic relationship with the parasites in their blood

Yet, once we interfere with this biological relationship we invite trouble. The parasites attack back.

Perhaps if we have used artemisinin or other natural medicines, the scenarios would have been entirely different.

As doctors and research scientists we have much to learn from other alternative systems of medicine such as traditional medicines, botanical and herbal medicines, naturopathic medicine, nutraceutical and nutritional medicines.

Allopathic Medicine vs Traditional and Complementary Medicines:

Doctors and practitioners of most  alternative systems of medicine learn their therapeutics from Mother Nature thousands of years ago. 

Conventional allopathic doctors use chemical drugs and surgery only less than 100 years ago compared with thousands of years of therapeutic experiences for traditional and other systems of medical practices. 

Conventional drug-based medicine handles chronic and degenerative diseases such as metabolic syndrome (diabetes and endocrine disorders), hypertension, CVA, cardiovascular disorders, cancers, renal and neurological disorders, etc  poorly using synthetic chemical drugs to control (not cure) the disease,  compared to the slower but more responsive therapies of botanical and natural medicines.

Traditional Chinese Medicine for instance has served the Chinese civilization very effectively for over 2000, while naturopathic medicine or natural medicine based on food, rest, physiological fasting, etc  has been around since the time of Greek Physician, Hippocrates of Kos, the Father of Medicine around   460 – c. 370 BC.  Hippocrates advocated

 "Let Food Be Your Medicine"

This is therapeutic nutrition or nutritional medicine. Food especially plant-based (fruits and vegetable) contains hundreds of phytochemicals including antioxidants. They are functional foods and also be nutraceuticals. Almost half the present generations of synthetic chemical drugs used in conventional medicine have their origin from herbs and medicinal plants.

Hippocrates only advised “let food be your medicine” not the other way round. How can that be using medicine and drugs as our daily food? This round about quote was put there into Hippocrates mouth by modern allopathic doctors and drug companies working hand-in-gloves to promote their chemical drugs as food. The root causes was never taken into account, but simply to supply the same medication month-to-month till the next routine appointment three months later comes round!  

Unfortunately this last claim by Hippocrates that "let medicine be your food" was repeatedly quoted by many, including health-care professionals like parrots who has not a clue what they are uttering.

They just follow the repeated quotation from others like parrots. They merely follow the crowd to be on the safe side, but has no clue what were they were uttering.

Food and herbs do contain medicinal principles besides their nutrient contents, and can be used as food as well as medicine. But we need to be selective

But how illogical is it to advise someone to take tablets, pills, drugs, injections, including herbal medicines as our daily food and bread?

This last quote is highly illogical and can only come from someone who has no knowledge on the difference between medicine, food and nutrition.

They merely blare out their ignorance by following what others have quoted.

Hippocrates, the Father of Medicine only advised physicians of his time to treat their patients with food, rest and exercise

Never did he advise taking natural medicine as food. Food and medicine are two different things

How illogical to take drugs and all kinds of medicines as our daily food and bread. The body must be terribly ill to be supported like that! 

Hippocrates, the Father of Medicine had never advised that! 

Lim juboo  BSc (Physiol) PG Dip Nutri  MSc  MD  PhD (Med)  FRSPH  FRSM

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