Traditional and Alternative Medicine Part 1: Ethnopharmacology and Pharmacognosy

With all the technological advances of the modern age, it is reasonable that one might be led to  think all drugs are developed through highly sophisticated, novel experimental methods and human ingenuity. There’s no way that a drug that cost millions of dollars to create could have come from a humble plant, right? In fact, of all the drugs approved from 1981 to 2014, only 27% were purely synthetic while 50% came from mimics, derivatives, or unaltered forms of natural products!1 There may be an air of exoticness or crudeness associated with natural products, but they are clearly prevalent even among the cutting-edge science of today and continue to occupy a significant space in medicine.

Two fields within the wide scope of pharmacy concerning natural products include pharmacognosy and ethnopharmacology. Pharmacognosy is the study of the biochemical and biological properties of drugs of natural origin as well as the search for new drugs from natural sources.2 Closely related, ethnopharmacology deals with the observation and experimental investigation of the biological activities of plant and animal substances used in the traditional medicine of past and present cultures of different indigenous groups.3 While one is in the realm of natural science and the other sits at the intersection of natural and social sciences respectively, the two are not mutually exclusive and both possess an acute understanding and appreciation of nature as a master chemist of diverse, complex molecules that provides invaluable resources for drug development.

From drugs that can treat cancer to medicines that help relieve a simple headache, the range of drugs that have been created from the trees and microorganisms that make up the background of our lives is astounding. A compound first isolated from the purple-pink flowers of the foxglove plant has been used for hundreds of years to treat a condition first referred to as “dropsy.”5 Although the name for the condition of fluid retention in the heart and lungs has become more refined under the category of heart failure, the same active ingredient in those dried, powdered leaves has been used for hundreds of years and even now is sold and dosed as the familiar digoxin.4 

Scientists continue to isolate and discover viable structures from natural products as they have done for centuries past, but now they have the technology and innovations of today to help guide them in not only creating new drugs but also understanding current drugs. The therapeutic windows for dosing, toxicity, and other factors are becoming better elucidated as we are able to narrow down optimal doses and even generate synthetic antibody-type antidotes to drugs such as digoxin. On the other hand, researchers at universities are exploring novel compounds from natural sources in treating disease states. For example, the universal yet poorly understood state of pain is currently being treated mostly with opioids, another class of drugs isolated from the opium plant. Researchers at the Boston Children Hospital have found a potential delivery system for TTX, a neurotoxin found in pufferfish.6 This treatment could potentially reduce dependence on opioids and dosing frequency and combat the opioid epidemic plaguing the world.

However, the transition from traditional to modern society is not always so innocuous. The Matses people of Brazil and Peru remain isolated in one of the most carbon-rich, densest parts of the Amazon rainforest. As they are integrated into the outside world, the elderly medicinal shamans have found their knowledge at risk of being lost forever and have thus created an encyclopedic trove of information regarding their interpretations of disease states and various natural treatments, drawn from their environment in the rainforest.7 It is critical to preserve these wealths of knowledge passed down through generations of indigenous groups as they are disappearing at an alarming rate. As pharmacists, we have to keep in mind the important role traditional medicine continues to play in the lives of many patients who come from different cultural backgrounds.

The advancement of modern medicine provides life-saving therapies for millions around the world, but we also cannot forget the vast influences traditional medicine exerts. What connects the two together is the limitless opportunities that natural products offered in the past, continue to offer in the present, and, undoubtedly, will offer in the ages to come.


Authors: Aimee Ho and Anna Li


1.    Newman DJ, Cragg GM. Natural Products as Sources of New Drugs from 1981 to 2014.JournalofNaturalProducts.2016;79(3):629-661. doi:10.1021/acs.jnatprod.5b01055.
2. AbouttheASP.TheAmericanSocietyofPharmacognosy.https://www.pharmacognosy.us/ what-is-pharmacognosy/. Accessed February 20, 2020.
3.   Journal of Ethnopharmacology. Aims & scope - Journal of Ethnopharmacology | ScienceDirect.com.https://www.sciencedirect.com/journal/journal-of-ethnopharmacology/about/aims-and-scope. Accessed February 20, 2020.
4. Digitalis.https://www.ch.ic.ac.uk/vchemlib/mim/bristol/digitalis/digitalis_text.htm. Accessed February 20, 2020.
5.     McLachlan A, McLachlan A. Weekly Dose: Digoxin, the heart medicine that may have givenusVanGogh'sStarryNight.TheConversation. http://theconversation.com/weekly-dose-digoxin-the-heart-medicine-that-may-have-given-us-van-goghs-starry-night-57980. Published August 23, 2019. Accessed February 20, 2020.
6.  Liu A. Could a pufferfish toxin be a safe alternative to opioids? FierceBiotech. https://www.fiercebiotech.com/research/could-a-pufferfish-toxin-be-a-safer-painkiller-than-opioid. Published June 12, 2019. Accessed February 23, 2020.
7.  Amazon tribe creates 500-page traditional medicine encyclopedia. Mongabay Environmental News. https://news.mongabay.com/2015/06/amazon-tribe-creates-500-page-traditional-medicine-encyclopedia/. Published December 20, 2018. Accessed February 23, 2020.

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