Chiraito and Kidney Damage

Mention of Chiraito (चिराइतो) terrifies me these days. Chiraito (Swertia chirayita) is a plant that seems to be widely used in alternative medicine. Nepal apparently is the major exporter of Chiraito, to such an extent that IUCN has listed it as a "vulnerable plant" because of "over-harvestation." My introduction to this herb was through a cousin's husband who told me a tale of his kidney damage in his venture to quash diabetes through the bitter solution of this plant. Luckily, after stopping it and spending a fortune in investigating the reason for kidney damage, including a pilgrimage to Indian healthcare system, his kidney has slowly started normalizing. It has now been several years since his initial tryst with the bitter devil. Although he still has a happy go lucky attitude to difficult struggles in life, I am sure it has left an aftertaste. 

I had not made much of Chiraito but recently another patient with diabetes came to me. This  man had taken Chiraito and his kidney functions went from completely normal to those requiring dialysis within a span of a month. I referred him to a kidney specialist. Who knows which direction his kidney functions will go, but its for sure that he will have to endure a suffering attributable to apparently benign Chiraito. Herbs don't have side-effects compared to allopathic medications, we have been told. But not to these two people and perhaps many more that I do not know.

This time, I decided to look up if there was any information about Chiraito. There was a recent lab study conducted in India that showed that it has a bitter chemical called amarogentin that inhibits an enzyme called COX-2 (cycloxygenase-2). Inhibition of COX-2 is a process used in several pain medications. And we do know that several of these pain medications can cause kidney damage if used for long time and at high doses. What must have happened with two of these Chiraito patients is that they had too much and too long of this substance.

That is an uncertain territory we enter with alternative medicine. We have no systematic  information about the substance that we are given. It is based almost entirely upon a blind trust: of a kabiraj or a relative who swears to its usefulness. It might work or it might be a poison. But it would be a mistake to claim that all herbs are innocuous and without side-effects.   

About Our Work

Our work has received some attention. Annapurna Post has listed us as an innovator in Nepalese health field on their especial publication commemorating their 13th anniversary of publication. Dr. Karki is a dear friend and mentor, we would like to thank him for his kind words. Here's the scan of the publication:

Bring Back Our Girls

They must have run around the ground of the boarding school at the afternoon break. A girl giggling after another one tripped over. That girl might have cried, angry that she was giggled at. Finally, after the boring classes were over, they must have returned to the hostels, changed their clothes, had their snacks, and huddled in a class room to do their homework. They must have repeatedly looked at the wall clock, for the time when they would be allowed out of the room. As soon as the clock hit the time, they must have rushed out, only to be back to bed. In the quiet of the night, ceiling fans must have made whirring noise, fighting off the Nigerian summer. The girls must have been deep into sleep, dreaming perhaps.

What must it be like when they were woken up with noise, perhaps of gunfire, of crying and screaming friends? Bearded men brandishing machine guns in their hands must have grabbed their collars, pulled the girls out from their bunk beds, dragged them through the hallway while they were screaming and crying, loaded them in the truck like garbage bags and speeded through the dirt road, the truck jumping at the bumps, synced with the screams of terrified girls.

James Orbinski, who witnessed the horror of Rwandan genocide first hand as one of the only few doctors daring to care during the carnage writes, "...Over the last twenty years, I have struggled to understand how to respond to the suffering of others. I have come to know perhaps too well that only humans can be rationally cruel. Only humans can choose to sacrifice life in the name of some political end, and only humans can call such sacrifices into question...."

Boko Haram, a religious extremist group, kidnapped 276 girls from a Nigerian boarding school on the night of April 14-15. They are yet another testament to that rational cruelty. Hell needs not be imagined in various religious forms, the face of the evil ruling that hell can not be any crueler than of these kidnappers.