History of Mr. P, who is a Khmer traditional healer. Since he was young, he never believed in herbal Medicine. One day, he got diarrhea and decided to use modern medicines for a few days, but diarrhea did not disappear. This was the first time he tried to use herbal Medicine by taking the coconut skull to boil the herbs. Mr. P said that after using the herbal medication, his diarrhea disappeared. He started to believe in herbal Medicine and has researched it until now. He is a famous Khmer traditional healer (Khmer Guru).

According to Mr. P’s story, we must have many questions related to the effectiveness of herbal and Modern Medicine, such as:

• Are traditional Medicine or herbal Medicine effective?
• What is the difference between herbal Medicine and Modern Medicine?

Traditional Medicine comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before Medicine. The World Health Organization (WHO) defines traditional Medicine as “the “total of knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.” Traditional Medicine is often contrasted with scientific Medicine.

In some Asian and African countries, up to 80% of the population relies on traditional Medicine for their primary healthcare need; healthcare opted for its traditional culture; traditional Medicine is often considered a form of alternative Medicine.

About 100 years ago, natural herbs were the main remedy for treating primary diseases. Most modern medicines contain plant-based ingredients, but scientists have carefully studied these ingredients and removed the unhealthy ones from those ingredients before making them into modern herbs.

However, there is limited scientific evidence to establish the safety and efficacy of most herbal products. With the wide application of synthetic drugs, herbal Medicine and other traditional therapies have shown sharp contraction. As a country with the rich herbal resource. In recent decades, the spectrum of disease has shifted, and complex chronic diseases have become the central part. The effect of Western medicine treatment is not satisfactory, and problems of adverse drug reactions are also very prominent. Complementary and alternative therapy, especially herbal Medicine, has gained more attention and has become popular.

• Safety Issues of Herbal Medicine. Along with the significant increase in worldwide consumption, herbal Medicine’s safety has been highlighted. Currently, there are misunderstandings and prejudice toward herbal Medicine’s safety. So, objective understanding, neutral and fair interpretation, and publicity are warranted.
• “Herbal Medicine Is Drug, Not Food.”. An advocate will advertise that herbal Medicine originated from nature, belongs to green therapy, has no toxin or adverse effect, and people can take it in the long term. These sayings are slogans of the advocates who have misled people with less medical knowledge on the one hand, and it will lead to many severe adverse events by misusing herbal Medicine; on the other hand, it will cause people anxiety due to some adverse events reports. We should recognize that herbal medicinal products are widely considered to be of lower risk compared with synthetic drugs; they are not entirely free from the possibility of toxicity or adverse effects. Exaggerated propaganda and giving up using it for adverse events are prejudiced against herbal Medicine. Therefore, to ensure the safe use of herbal medicinal products, herbal Medicine should be managed as a drug.
• Weak Basic Research on the Safety of Herbal Medicine. In the Chinese Pharmacopoeia

In 2010, 83 types of Chinese Materia medica were officially recorded and defined as toxic. They were classified into three categories: high toxicity, medium toxicity, and low toxicity. The efficacy and toxicity of the majority of them are primarily based on traditional knowledge and clinical experience. The toxicity classification lacks scientific standards and objective experimental data. There is no adequate data about toxic herbs, toxic target organs, safe dose range, safety window of effective dose, and minimum toxic dose. Thus, specifying the toxic and adverse effects of each herbal Medicine is a solid base to ensure the safe use of herbal Medicine.

Modern Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses various healthcare practices evolved to maintain and restore health through preventing and treating illness. Contemporary Medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and avoid injury and disease, typically through pharmaceuticals or surgery but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

The thrust of clinicians and researchers must now turn decisively towards prevention and cure. Also, longevity with well-being is modern Medicine’s big challenge. Advances in vaccines for hypertension, diabetes, cancers, etc., deserve attention, as also as the role of meditation, yoga, spirituality, etc., in preventing disease at various levels. Studies on longevity, lifestyle changes, and healthy centenarians deserve particular scrutiny to find what aids longevity with well-being. A close look at complementary and alternative Medicine is needed to find any suitable models they may have, cutting aside their big talk and/or hostility towards mainstream medical care.

Let’s see the real example of life expectancy; the base evidence of traditional and modern Medicine indicated life expectancy since the first modern Medicine was introduced in the 18th century and continues to grow to this day, meaning that before the 18th century, people needed to choose herbal Medicine to treat various diseases.

If we compare the age of people who had a decent standard of living to a higher standard of living before the 18th century:

For Cambodia, we don’t have life expectancy documentaries, but​ we can see the King who best takes life well-being, good take care

• SAMDECH PREAH CHAN REACHEA died at the age of 50 (1516-1566);
• King ANG DUONG died at the age of 64 (1796-1860); and
• OKNHA SOTAND PREY CHEA IND died at the age of 65 (1869-1924)

Conversely, since the relentless evolution of modern Medicine, Cambodian life expectancy has also been more extended than before modern medicine; the average life expectancy was between 70 to 75 years in the 20th century, such as King NORODOM SIHANOUK died at the age of 89 (1922-2012)

Herbalism has been criticized as a potential “min” field” of “unreliable product quality, safety hazards, and the potential for misleading health advice. Globally, there are no standards across various herbal products to authenticate their contents, safety, or efficacy. There is generally no high-quality scientific research on product composition or effectiveness for anti-disease activity. Presumed claims of therapeutic benefit from herbal products, without rigorous evidence of efficacy and safety, receive skeptical views from scientists.

Unethical practices by some herbalists and manufacturers, including false advertising about health benefits on product labels or literature and contamination or use of fillers during product preparation, may erode consumer confidence about services and products.

The World Health Organization (WHO), the specialized agency of the United Nations (UN) that is concerned with international public health, published Quality control methods for medicinal plant materials in 1998 to support WHO Member States in establishing quality standards and specifications for herbal materials, within the overall context of quality assurance and control of herbal medicines.

In the European Union (EU), herbal medicines are regulated under the Committee on Herbal Medicinal Products.

In the United States, herbal remedies are regulated dietary supplements by the Food and Drug Administration (FDA) under the current good manufacturing practice (cGMP) policy for dietary supplements. Manufacturers of products falling into this category are not required to prove the safety or efficacy of their product so long as they do not make ‘medical’ claims or imply uses other than as a ‘dietary supplement.’ However, the FDA may withdraw a product from the sale should it prove harmful.

Canadian regulations are described by the Natural and Non-prescription Health Products Directorate, which requires an eight-digit Natural Product Number or Homeopathic Medicine Number on the label of licensed herbal medicines or dietary supplements.