By Chandre Dharmawardana –

Dr. Chandre Dharmawardana

A recent newspaper headline carried a “Plea to try traditional medicine before importing billions worth of anti-COVID 19 vaccines”. There are two questions to examine here. (a) In a country afraid of even burying post-Covid corpses and insisting on cremations, should one “release” infectious patients to practitioners of traditional medicine who come in all shades and colours? Should the much abused precautionary principle be applied here? (b) If the country uses indigenous preparations, will it save  billions?

We answer these two questions, and then discuss their rationale. (a)Patients who wish to be treated by traditional medical practitioners should be ALLOWED to do so, as long as they use registered practitioners. Secondly, (b) using scientific medicine and its vaccines is not only EFFECTIVE, but also  MUCH CHEAPER and safer.

The choice of the treatment should be open to the patient

Sri Lanka reports 50,000 Covid cases since the pandemic began, together with a death toll of approximately 250 in early January 2021. This means, given 200 patients, there is going to be only ONE fatality.  Of course, this low fatality rate is partly due to the success of Sri Lanka’s doctors. It is also established that many fatalities are cases of  “co-morbidity”, with diabetes, cardio-vascular problems, or asthma and respiratory health problems.

So the threat of the pandemic is not its mortality rate, but its rapid infectiousness. The pandemic  generates  large numbers of patients,  saturating  hospitals and exhausting the staff.  Many homes are too poor and  unequipped to  isolate sick individuals. Thus they need hospitalization. So, many who need hospitalization do not need special procedures and intensive care, but they need health care.

The known biochemistry and physiology of  viral infections suggest that a good course of action is to  treat the patient’s fever, body pains  and other symptoms  and allow the patient  to rest, sleep well, and hydrate well.  Then the normal defence mechanisms of the body  kick in and the viral infection  pass away, just as with common influenza. So, if the patient wishes to use traditional medications, the main difference for Covid 19 is proper isolation to prevent the infection spreading to care givers and others. 

So, patient  may choose Indigenous medicine, and that choice should be respected if quarantine requirements can be ensured. The patient  uses “pas-panguva” and other brews, special preparations based on herbs like “rasakinda (Tinospora Cordifolia), veni-ael-gaeta (Coscinium fenestratum), heen-bin kohomba (andrographis paniculata), pitawakka (Phyllanthus Niruri) etc., as recommended by a traditional herbalist. Heen bin-kohomba is also well known in Chinese herbal medicine. It  is said to be officially prescribed for Covid in Thailand. A perusal  of the “Vattoru” (herbal lists) given by the late Ven. Ananda Maithreeya is sufficient to identify the herbs of interest for the relevant class of infections. The pharmacological properties, and botanical details of many local herbs and plants are given in the website that I have developed over decades.

All these herbal  medications, even the recommended “best ones”, are much less efficacious than, say,  acetaminophen (paracetamol, Tylenol, Panadol)  in lowering fever and body pain. Rasakinda extracts, even when given in high doses take over two hours to bring down the fever of laboratory mice tested in clinical studies, while acetaminophen does it at a much lower dose, and within half an hour. Furthermore, many herbs like “heen-bim kohomba”  or “Rasakinda”, while more effective than the ubiquitous “pas-panguva”, also have adverse consequences (see our website).

In contrast, acetaminophen is very safe even for pregnant mothers, and the reported problems have arisen from  “human error” or “patient folly”. Indigenous  medicine lacks effective antipyretics like acetaminophen or ibuprofen.  Of course, some say, “we let nature take its course”, and do not lower the fever! But high fever can have adverse effects, and the febrile sick find it hard to sleep and get rest.

Nevertheless, if someone chooses traditional medicine for a Corona-SARS type infection, they should have their wish, subject to proper quarantine procedures that hospitals of indigenous-medicine can easily provide. Such hospitals should have the right to transfer patients to hospitals practicing scientific medicine if the health of the patient needs it.

Covid vaccine use is far cheaper than Traditional Medicine!

People are surprised to hear that vaccines and “Western Treatment” are  much cheaper than local brews or herbal medications. A 500 mg tablet of acetaminophen at the State Pharmaceutical Corporation costs Rs 1.00 (or at most Rs 3.00 if a name brand is purchased). Three such tablets, costing Rs 3 per day is usually enough to control fever. A packet of Paspanguva costs Rs 200-400, and usually  at least 4-5 packets may be needed  since viral infections take 7-10 days to heal. The total cost of the “Western treatment” may be Rs 21, while the cost of the herbal treatment using 5 packets of “paspanguva” is about Rs 1500, i.e.,  70  times more expensive. In addition, if other less common preparations (e.g., using Rasakinda, or Heen Bim Kohomba) were used, the cost would be even more.

So, the treatment of an uncomplicated viral infection using indigenous medicine is about a hundred times more expensive than  using scientific medicine. The latter is also less prone to side effects (e.g., for complications from Rasakinda or Bin Kohomba, see our plant website).

It is also claimed that various special brews like the “Dhammika Paneiya”, or the “Sudharshana” brew etc., can cure or  protect against Covid-19 infections. Owing politicization, and opposition to any scientific review as being a part of “Western Hegemony”, no peer-reviewed clinical studies are available. How preparations saturated with sugar can be approved for invalids who may well be diabetic is unclear. However, assuming that accredited medical personal of the  Dept. of Indigenous medicine accept  the brews, we include them in our discussion.

The Dhammika Paeniya (containing honey, nutmeg, and two undeclared ingredients) is said to cost about Rs 6000- Rs 8000, and needs to be taken during four days to obtain a cure. Assuming that a US dollar is Rs 200, a bottle of the “Paeniya” costs $30-40.  According to reports, such a bottle may be adequate for two people. Hence the cost of immunization, or treatment with the “Paniya” is $15-20 per person. The other available local preparations are as costly. They are in extreme short supply, the price would move up, and there would be no more at any price.

Unlike the “Paeniya”, extensive clinical trials have been used with the Pfizer-Biontech vaccine, the Moderna vaccine,  as well as with the AstraZeneca Oxford vaccine. The Oxford vaccine is the most convenient for Sri Lanka as it does not need  ultra-cold storage. It is said to costs about $2., i.e., 7-10 times CHEAPER than the “Dhammika Paeniya” whose performance is unknown.

If approximately 65-70% of the adult population were vaccinated,  “herd immunity” is said to set in, benefiting  the whole population. Sri Lanka’s adult population is about 14 million; the approximate cost of the vaccine for 70%  (9.5 million) is $19 million. Sri Lanka can do it and has led the way in South Asia in the past, in successful vaccination programs to counter common diseases where traditional treatments failed.

To assume that 9.5 million doses of the Dhammika Paeniya (or the preparations offered by its competitors) are available at any price is pure fantasy. Nevertheless, even at $20 per portion of a local brew, the local treatment will cost the country $190 million, not including organizational costs. 

Sri Lanka should avoid becoming the country that made a pooja of $190 million to “Kali Amma”, and yet earned the wrath of the Goddess – “Deva Udahasa”.  If the Paseniya fails to work, it is surely not the fault of the “Kapuva”, but “Deva-Udahasa”!

*The author maintains a website, viz., dh-web.org/place.names/bot2sinhala.html on local plants, ethno-botany, phyto-chemistry and plant pharmacology