Betel nut (see above) is prescribed by hakimseither alone or in mixtures.
There may be a risk of interactions between this herbal medicine and
orthodox drugs.
Safety of surgical and manipulative procedures
The inclusion of surgical techniques adds another potential danger from
non-sterile instruments and consulting environments, and incompetent
procedures. There is also a risk from undue pressure or incorrect manipulation
by inexperienced practitioners.
Evidence
There are difficulties in applying western methods to proving the effective-
ness of traditional therapies. Data from both animal and human trials
suggesting efficacy of ayurvedic interventions in managing diabetes have
been published.^27 However, the reported human trials generally fall short of
contemporary methodological standards. There are some encouraging results
for its effectiveness in treating various ailments, including chronic disorders
associated with the ageing process. Pilot studies have also been conducted on
depression, anxiety, sleep disorders, hypertension, Parkinson’s disease and
Alzheimer’s disease.^28
The Indian Council of Medical Research has set up a unique network
throughout India for carrying out controlled clinical trials of herbal medi-
cines.^29 The programme is monitored by a scientific advisory group consisting
of people from the ayurveda, unani and modern allopathic systems of medi-
cine. This group contains experts in pharmacognosy, toxicology, pharma-
cology and clinical pharmacology, as well as clinicians and experts in
standardisation and quality control. Trials are planned and protocols
prepared by the whole group. All trials are comparative, controlled,
randomised and double blind unless there is a reason for carrying out a
single-blind study. The trials are planned by the whole group but carried out
at the centres of allopathic medicine with established investigators. There are
over 20 clinical trial centres throughout the country for carrying out the
multicentre studies. Using this network the council has shown the efficacy of
several traditional medicines, including Picrorhiza kurroa in hepatitis and
Pterocarpus marsupium in diabetes.^30 As a result of these trials these
traditional medicines can be used in allopathic hospitals.
The Central Council of India’s systems of medicine oversee research insti-
tutes, which evaluate treatments. The government is adding 10 traditional
medicines into its family welfare programme, funded by the World Bank and
the Indian government. These medicines are for anaemia, oedema during
pregnancy, postpartum problems such as pain, uterine and abdominal com-
plications, difficulties with lactation, nutritional deficiencies and childhood
diarrhoea.^31
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