Tuesday, June 9, 2009

Mutations and Opportunities

Donald McNeil Jr. wrote about potential mutations of the H1N1 "Swine Flu" virus in today's New York Times. After explaining the highly unlikely process by which the virus could become considerably more lethal, McNeil noted that:

A much more likely change, scientists have said, is that the H1N1 swine flu will become resistant to the antiviral drug Tamiflu. A gene for Tamiflu resistance is now almost universal in seasonal H1N1 flus.

If that happens, the world’s Tamiflu stockpiles will be all but worthless, and doctors may have to switch to Relenza, which is a powder used with an inhaler, which makes it more expensive and harder to take.

Depending on the mutation, older antiviral drugs like rimantidine may be useful, but so much resistance to them developed in seasonal flu that they were largely abandoned a few years ago.

This is one of the biggest problems with modern, synthetic pharmaceuticals. As complex as they may seem to us, they are far simpler than the chemicals produced by living things -- be they viruses, bacteria, plants, animals, or humans. So it doesn't take long for a virus or a bacteria to crack the code and develop an effective technique to resist our pharmaceuticals. But rather than seeking a different approach, most of the medical community looks to new generations of pharmaceuticals to combat viruses and bacteria that resist existing drugs.

Modern pharmaceuticals do have the advantage of causing quick and dramatic changes in the body that can buy time for healing in life threatening situations. But those advantages are lost completely when the drugs are used so widely that resistance to them becomes widespread.

Herbal medicines have the advantage of more complex chemistries than synthetic pharmaceuticals. As James Duke writes in the foreword to Stephen Buhner' Herbal Antibiotics:

It is easy for a rapidly reproducing bug to outwit (or out-evolve) a single compound by learning how to break it down or even to use it in its own metabolism, but not so easy to outwit the complex compounds found in herbs. Scientists are recognizing this fact and developing more complex compounds such as the AIDS cocktail and multiple chemotherapies for cancer. The same super-scientists who downplay the herbalists' claims of synergies that account for the effectiveness of particular herbs and herbal formulas, are now resorting to synergies of three or four compounds in their pharmaceutical formulas.

It is certainly easier to demonstrate how two compounds can work together synergistically than it is to figure out how 200 or 2000 different compounds (and more, as are present in all herbs) can work synergistically. So the scientific community will be reluctant to consider the remarkable synergistic suites of compounds that have evolved naturally in plants. But we really cannot afford to ignore these. For nature favors synergies among beneficial, plant-protective compounds within a plant species (with antibacterial, antifeedant, antifungal, antiviral, and insecticidal properties,) and selects against antagonisms.

What's more, plants are constantly modifying their chemistries in response to environmental changes -- the same changes our bodies are experiencing -- while the chemistry of synthetic pharmaceuticals remains fixed.

But speaking in these terms, we are still missing something important.

Influenza, or any other diesease, isn't caused simply by the presence of a virus. Rather it is the result of a virus opportunistically multiplying out of control in a body whose natural defenses are already weakened and whose internal ecology is already out of balance. The virus is necessary for the disease to occur, but not sufficient.

Because the presence of the virus is the one common recurring element in the bodies of different people presenting similar symptoms, modern medicine tends to focus on eliminating the virus. In so doing, it tends to ignore the different factors that made each person susceptible to infection, and the differences between them and the people who are exposed to the virus but don't get sick.

(Think, for example, about the fact that the majority of sexually active adult women who have had multiple partners have been exposed to strains of the Human Papiloma Virus linked to genital warts and/or cervical cancer, but only a small percentage of the women exposed to HPV ever develop these diseases.)

Traditional herbalists and other holistic healers tend to look at these differences in detail, and employ therapeutic protocols that support the body's own ability to fight off infection and restore healthy function to all of the body's systems. In treating severe acute infections such healers will sometimes rely on high doses of certain "anti-viral" or "anti-bacterial" or "anti-fungal" herbs or even synthetic pharmaceuticals to address an emergent situation -- but these medicines serve primarily to open the way for other medicines to do the subtler work of helping the body heal itself. As Matthew Wood writes in The Practice of Traditional Western Herbalism:

Biomedicine is constructed upon a materialistic interpretation of nature, which looks to its molecular structure as a guide. Holistic medicine is founded on the concept and experience that the organism is a functional unit or whole under the guiding hand of an intelligent, self-regulating, self-correcting guiding force or energy. Since Nature in the organism is self-maintaining and self-healing, holistic medicine is further based upon the assumption that the organism can be cured, that is, returned from an unbalanced state to one of balance or homeostasis.

The molecular level is, of course, very real. But it is also a level of reality whose existence we have only recently discovered. And we are tinkering there before we understand its logic, its flow, and its guiding principles.

It is the height arrogance to think that we can understand whats happening in our cells at a molecular level so well that we can afford to completely ignore the big picture of what is happening in our bodies, or that our creations can surpass the genius of the medicines that plants have developed over billions of years.

The proliferation of drug resistant viruses and bacteria provides us with an opportunity to reflect on and correct that arrogance while choosing another path -- one that uses synthetic pharmaceuticals sparingly and as a last resort, while relying primarily on the insights of the 150,000 year old science of herbal medicine to restore and maintain health. In the process, we just may remember that we are part of a living planet -- something essential to our prospects for survival.

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