Neem-The Bitter Sweet Medicine!

Dr Pat Nair writes about a tree nearer to ‘kalpaka’ if ever there was one!t.

As I sat back in the chair folding my papers in the middle of a review of a clinical trial I heard my colleague Say, "of course we should recommend Neem oil”.  Did this pony-tailed scientist from London School of Hygiene actually say “NEEM”, I wondered.  He is an entomologist and thrives on killing insects by hitting on their enzymes and hormones with chemicals.  He went on.  Insecticide, pesticide, anticancer, anti- viral anti-fungal hypotensive… he extolled the virtues of this tree; references were at his fingertips.  I sincerely wished I had a tree in my back garden this summer when I could have got rid of the nasty, ugly, menacing snails which partly destroyed my plants.  Neem leaves would have finished them off!!

Neem had been taken for granted by many in India although it had many uses for them.  Villagers grew the trees for its shade along roads and market places. Trees were chopped down to be used as chip-bark and fertiliser in paddy fields. The Tamils used its leaves regularly in their food as Veppilakkatty.  Even Gandhji, it is said, had included Veppilakkatty in his daily diet. The references showed a multitude of uses for it - from reforestation and alkalinisation of soil to dental hygiene and contraception, the list goes on and on.

Neem had been extensively researched by scientists, particularly entomologists in India, USA and elsewhere.  Probably, originally grown in Assam and Burma, it is now spread all over India and outside, from the tropic to the sub tropic, from semi-arid to wet tropic and from sea level to about 700 metre elevation.  Scientists like Nigel had worked on this tree this century but its place in Medicine had been established in India several centuries earlier.

It is effective against a variety of skin diseases.  Poultices made out of its leaves had been used in treatment of ulcers and lesions of skin.  Professionally it was a revelation for me to see references of its anti infective properties against a variety of agents such as fungi, bacteria, viruses and parasites.  Bacteria such as Staphylococcus Aureus, and Salmonella Typhi are killed by its extracts.  Anecdotally, it is effective against smallpox and chickenpox, and patients were treated with a paste of Neem leaves directly applied to the skin.  More recently there are papers published from USA and Germany on its efficacy on Herpes and Hepatitis B viruses.  It has antiparasitic activity particularly in treating Chaga's disease and Malaria, both causes of high mortality and morbidity in Africa and elsewhere.  Unsubstantiated reports claim to reduce blood pressure and treat stomach ulcers.  With the reported spermicidal effect of this versatile tree and its use in birth control, it is no wonder that the World Bank which recently has discovered the association between Health and Economy is taking an active interest in this humble tree.

Neem is currently used in tooth pastes in some countries as it is expected to heal and prevent gum diseases.  Many of us may remember the early morning sight of people walking around chewing a twig and cleaning their teeth with it.  Often Neem is given the credit for the clean teeth people in India have. It also has been used in veterinary medicine extensively.

Sanskrit medical literature of over thousands of years wrote about the usefulness of Neem, but it had taken at least a 1000 years for the modem medicine to take an interest.  Plants are the major source for modern medication.  Chrysanthemum had the distinction of contributing pyrethroids and even foxgloves had saved many a heart from collapsing after years of abuse by its owners.  Neem has taken longer to get there, but once established, it seem to have staying power!

Dr Pat Nair is a Consultant in Communicable Diseases at the Department of Strategy and Public Health, Bedfordshire Health Authority

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