Welcome to the second part of this interesting conversation with Dr. Cyriac Abby Philips.
Dr. Parul: My next question, is calling today's medicine Allopathy correct? What about the fear-mongering among Indian people that it will cause side effects in the long run? It is the first line of treatment if a person lands in an emergency. Where do you draw the line between these things as a liver specialist?
Dr. Cyriac Philips: Actually, the first thing is that we should call it science-based medicine or modern medicine because it is not allopathy. When homeopathy was discovered or invented by Samuel Hahnemann, there were very crude methods of treatment for ailments. Allopathy was the term given by the scientist Samuel Hahnemann who discovered homeopathy. He just called other therapies "Allopathy".
Now the problem is that people also don’t understand that science is always correcting itself. This is the beauty of it. If we look at alternative medicine, for example, ayurveda or homeopathy, whatever was written in the classical textbook a century ago or homeopathy is 240 years old.
If you see whatever was written at that time that exactly the same stuff is followed even now so basically it has no changes ever, I mean even if you want to change it, you cannot! Its principles are obsolete and stuck in time.
Parul Soni: Why do people go under the wing of alternative treatments?
Dr. Cyriac Philips: If we take cancer as an example, look at liver disease per se, we have metastatic liver disease where cancer has spread all over and we have given the best of the best care. All treatments including chemotherapy, radiotherapy, immunotherapy, you name it. So all the possible treatment was given, but the patient is not improving. And you know that this patient is going to die. I think the first doctor must accept the fact that the patient is going to die and he should make the family or primary caretaker aware that the patient is going to die despite all the efforts.
We, doctors, do everything that is possible for the patient. That does not mean that modern medicine has failed. It means that certain diseases have a natural course that you may or may not be able to change.
Once the patient comes into a particular position natural to that disease then it is your honor, responsibility, and your duty to make sure that that journey forward is going to be comfortable. So medicine actually does not fail there. It has something else known as palliative care.
That is one of the most powerful aspects of medicine which is palliation, comfort, care, and a lot of patience. I am very sorry to say this a lot of patience and many people don't have that. The reason why there is this trend is that treatment in modern medicine is not effective so let’s go to an alternative practitioner. That gets the patient into more problems.
Parul Soni: What are the major cases you encounter or come across in your department? What are the major causes of poisoning or overdose in Homeopathy or Ayurveda?
Dr. Cyriac Philips: The cases that I find very difficult to manage and definitely take especially from complementary and alternative medicine. I would also say that there is a little bit of bias in my department for managing very severe liver injuries. I commonly see a lot of patients who actually have stable liver disease who opt for alternative therapies.
There is that thought block among people that if you take modern medicine for a long duration, there are many side effects in the long term which is actually quite wrong. A classical example is diabetes so if you know you are going to take insulin or you are going to take metformin. People think that it is going to cause a lot of future problems because you are taking these medicines. This thought process is actually wrong because insulin and other antidiabetic drugs actually slow down the disease.
The main complications of the disease come much later or they don’t come at all. For example, if you don’t take insulin or don’t take proper medicines for diabetes, you will have a complication like diabetic kidney disease or infection or ketoacidosis much earlier in the disease. But if you take this medicine properly, you might actually not have any complications or it might come much later in your life. The doctors actually manage the side effects of the medication with a benefit-to-risk ratio.
When I look at these patients who go for complementary to alternative medicine whether Ayurveda/Homeopathy or what not? Even herbal or dietary supplements. They take it for example to stop insulin. Somebody will tell them that they take these herbal medicines. This can stop insulin which is a common misconception. They start taking herbal medicine along with insulin and either their sugars drop so badly and develop liver injury or kidney injury because of this Herbal medicine.
When such patients come to us in such bad conditions, it is very difficult to manage this group of patients. It is definitely a herbal drug but we don’t exactly know what the herbal drug is that has harmed them. There is no specific focus treatment we can offer them. We give them the best supportive care and most of these patients actually progress into liver failure and kidney failure or both. Some of them die or receive organ transplant. So this is the common scenario that I see and we have actually seen a lot of patients coming into this category.
This is why we have the largest number of publications on complementary and alternative medicines. My unit has the maximum number of publications because we see a lot of this poisoning. I would say alcohol toxicity cases are number one in my clinic. Number two is herbal liver injury cases that are very difficult to manage. Especially if the patient has an underlying pre-existing liver disease or cirrhosis. If they (Patients) get liver cirrhosis on top of that, I think almost a hundred percent of them will actually die in one year without a liver transplant.
Parul Soni: As consumers, how do we track the misinformation all these health services are providing? How can people educate themselves? I read in the news that CBD tincture is working as a very good cancer treatment, without any solid research how is it possible?
Dr. Cyriac Philips: See at this moment because we have social media and information is available at our fingertips. A lot of people have lost that instinct that they should be asking or taking a piece of advice from an expert. In our recent publication in the journal, people show liver damage when cirrhosis patients took things for immune boosting. A large group of people also develop severe liver injury because of an immune booster they took. This landed them in death or liver transplant.
The immune system is a complex thing in immune physiology. You cannot boost it, that is point number one. The whole aspect of immune boosting is actually a wellness fraud to start with. If a particular person was actually going to take the immune booster, ask the doctor. Please don’t use it. I don’t think there is any evidence to show that it is of any help.
There is so much misinformation rotating around. I think they should go back to the stage where everyone used to talk to their family physician or family doctor.
Parul Soni: During the Covid Era, there were so many medications and Baba Ramdev came out with Coronil. What are your thoughts about that?
Dr. Cyriac Philips: In my opinion, the actual world of Ayurveda in India is actually good business. It’s a lot of import and export raw materials and finished products and a big deal in the wellness industry. If you come to Kerala you will see that almost all the resorts will have Ayurvedic services.
The wellness spa is an all that is a business that it was the same as Corona was already business. It has nothing to do with healthcare. It has everything to do with the business of the particular company making it, so Baba Ramdev’s company Patanjali looks at selling the product.