Herbal medicine, vaginal secretions, and the Scientific Method.

Black_pepper_corns

In comments to this post on WRSA (and a BIG hat tip to CA for linking to us) a couple of commenters indicated that cayenne pepper, or black pepper, could be used as a topical hemostatic agent, in similar fashion to QuickClot.

So, sez I: Sweet.  That’s a great find, let me jump on PubMed (which is a searchable database of most scientific papers published in the last 50 years) and find a couple of studies, and see how good black and/or cayenne pepper really is.  Cause a huge bottle at Sam’s is way cheaper than QuickClot, easier to store, more likely to actually be pepper than some random stuff at an herbal medicine store, albeit harder to grow in a grid-down situation.

So I search: “black pepper topical hemostatic“. Nothing. “black pepper hemostatic”. Nothing.  Then “black pepper hemostasis”. Nil.  “black pepper bleeding” gives a paper that investigates whether ingestion of black pepper causes stomach bleeding, not really what I am after. “Black pepper blood” gives 37 articles, none of which discuss bleeding or the stopping thereof.  Several on blood pressure, several on cholesterol, one interesting one on angiogenesis and another on remodeling of the aorta in hypertension. (And yes, I’m a medicine geek.  I think that’s a good thing, given my current profession.)

As a side note, when I Google either type of pepper, there are plenty of folks who claim it works.  The instructions usually say “apply black pepper and hold pressure for 5 minutes.” Folks, this is known as a confounder. The primary treatment for bleeding is 5 minutes of pressure, and it has been known to work since the dawn of time.  You could apply [random substance X] and hold pressure for 5 minutes; this would fix anything but a major bleed.

But I’m starting to get irked.  And this is one of my main gripes about herbal medicine.  It’s very easy to say: [substance X] helps with [disease Y], if you don’t have to bring data along to prove it.  The standards for FDA regulation of herbal supplements, herbal medicine, and dietary supplements, are all quite loose, and do not involve documented, scientific proof that they actually do what they say they do on the label.  In fact, if you can provide proof that your [substance X] does modify the body to a detectible degree in some fashion, then it is classified as a drug, and subject to very stringent FDA requirements that will cost tens of millions to comply with.  There is no motive on the part of the maker to do this.

So I can say anything I want, and because I am a doctor, someone out there will believe.  “Black pepper stops bleeding”.  “Black pepper makes you bleed.” “Black pepper turns you into an oversexed super-lover that makes the ladies swoon when you walk down the street.”  “Vaginal secretions stop bleeding.” “Vaginal secretions make you bleed.” “Vaginal secretions turn you into an…” Well, you get the point.  All of these have equal [in]validity in their appeal to authority to verify the claim.

This is NOT to say that herbal medications don’t work, or don’t have an effect on the body.  The NIH has set up the National Center for Complementary and Integrative Health to apply some science to these claims. The NIH is itself heavily funded–around $30 billion–and a good chunk of that money is going to investigation of herbal meds.  It’s a pretty hot research topic, and a lot of folks are pushing hard to discover which herbal meds, if any, work.  And it’s not hard to understand why–most modern drugs came from herbal meds; this is, in effect, a large taxpayer funded drug discovery effort.

(As a side note, you should go here to look at the NIH’s “Herbs at a glance” which can be visited one-by-one or download the whole thing as an ebook; this gives you quick summaries of the actual science on the (fairly limited) list of herbs they review.)

So now I’m stuck.  Folks say black pepper stops bleeding, but apparently no one has felt strongly enough about that to actually apply the scientific method and test that claim.  Perhaps I have the wrong search string?

The active ingredients in black pepper is piperine.  “Piperine hemostasis” shows two papers that indicate that piperine actually prevents platelet aggregation and clot formation; we also see in the first paper that capsacian (the active ingredient in cayenne peppers) also inhibits clot formation. Indeed both are at least as strong, if not stronger clot-preventers than aspirin, itself quite a potent platelet inhibitor, so much so that it is one of the mainstays of care for heart attacks.  Oops.  Now we have a problem with our hypothesis.

Redoing the above searches with “piperine” instead of “black pepper” yields nothing useful. Same with “cayenne pepper”.  “Capsaicin” and “hemostasis” yields an even dozen papers that indicate that it is more likely to make you bleed than not; in fact, cayenne pepper is a stronger anti platelet agent than black pepper.

So I’m gonna say that the claim that topical black pepper and cayenne pepper stop bleeding, is not supported by any scientific evidence that I can find; indeed, the evidence that exists argues that it should make it worse.

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By the way, I did happen across something interesting that is a herbal hemostatic agent, while doing this search.  And the makers do indeed publish the recipe.  And it has quite a bit of data behind it, including human and animal data.  Should you be interested.

—————————————————————

Assignment #1: Prove me wrong.  Show me some data.  Am I using the wrong search string? Looking at the wrong compound?  Is it not the chemicals inside the pepper, but instead the surface of the pepper, acting as a scaffold for a clot to form?

P.S.  I’m just as demanding of all the drug reps from Big Pharma that come calling.  Pisses them off that free lunch doesn’t counteract lousy data.

—Grouch

 

21 responses to “Herbal medicine, vaginal secretions, and the Scientific Method.

  1. In my 20+ years working in restaurant kitchens as a professional chef,I’ve seen a lot of guys use black pepper,I’ve even used it a couple of times. At least in the restaurant field,the claims that black pepper stopped cuts came from the old timers-that’s where I got it from,and old,cranky Austrian guy that I worked for as part of my apprenticeship told me to use it.
    It seems that as you fill the cut with the pepper,it soaks up the blood,and acts as a sort of bandage?
    Don’t know the scientific reasons but I know I’ve seen it work,and it’s worked on me.
    Could be that washing the cut with soap and water makes it bleed more,and after pepper is added,the body’s natural clotting process is already working?
    Never used the pepper trick in the field,before quik clot was around,I used a veterinary product that was simply called blood stop-and it did that,very well.

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    • It may work, it may not. There are no published scientific studies, to my knowledge. I wonder, however, if it is more the surface texture of the ground pepper? Perhaps it acts as a scaffold for the platelets to build on? absorptive agent? who knows.

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      • My guess would be absorptive agent,having used a few times myself-also all the examples I’ve seen are cuts to mainly fingers and thumbs,which were first washed out with soap and water.
        I should have worded my original comment a whole lot better than saying black pepper works like quick clot.
        It kinda sorta soaks up blood and the cut stops bleeding would have been a better explanation.

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  2. Being a mechanic for over thirty years, I always heard to put black pepper in a leaky radiator because the little particles find the hole, gets stuck and then swell up, stopping the leak.
    That may be what the basis of this theory is.
    As for capsacain , I was always under the impression that it actually opens up the circulatory system and that people used red pepper, chili powder, etc, as a home remedy for high blood pressure.

    BTW, I am liking this site already.
    I put you on my Blogroll.
    No need to reciprocate.

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  3. Ref Colloidal Silver..

    An article ABOUT the BYU study:

    http://www.deseretnews.com/article/760249/Is-silver-an-antibiotic-alternative.html?pg=all

    And the actual study results:
    http://www.colloidalsilver101.com/BYU_study.html

    That’s the output chart.

    I’ve seen but lost the link to the ACTUAL STUDY.

    Had NO problem with the study design, and consider it to have been a fair in vitro test of legitimate concentrations of all test materials (antibiotics or CS)

    (you DID ask, boss)

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    • Interesting study data.
      Unfortunately, if you are considering a grid-down scenario in Australia this is a help. If considering such a scenario in CONUS, not so much.

      I’d be interested in any study you may have come across as to the shelf life of the efficacious agent in Manuka honey and whether it survives crystallization and storage.

      All in all, this has changed my mind on this particular honey. I was already on board with raw honey for wound care for adults but hadn’t seen any real advantage for manuka. Now I do.
      [It should be noted that in certain online venues, I’m considered pretty much an allopathic shill with SOME herbal knowledge. I maintain a set of herbalists I discuss things with frequently, all of whom are much more experienced than I.]

      THOUGH if one is playing grid down CONUS, one may consider Povidone-Sugar preparations or local honey, even with the decrease in efficacy, it will still have SOME. Provided one maintains good wound care/dressing change protocols.

      bmp

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  4. My anecdotal experience (observation from afar) with colloidal silver is that it turns you into an idiot.

    Further testing is required on this hypothesis, but early results are promising. More funding is needed….

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  5. Grouch, Thank you for helping dispel these medical myths. I fear it can be a life long challenge to address every one of them though. I have seen stuff as wild and crazy as this; A Bedouin tribesman was brought to me with an infected wound on his leg. When I began cleaning and debriding the wound I had a large amount of brown material to remove. When I asked what it was, I was told it was dried camel dung.
    Many of the Saharan and Arab tribes believe it has healing properties and have used it for hundreds of years. What it proves is that when it works, the person had a vigorous immune system. Sort of a modern day Darwinism for medicine.
    Have I experienced primitive medicine work ? Yes, I once had a Cherokee Indian make a tea from the bark of an elm tree’s root and gave it to me for a URI. I sweated that night like I was a 300 pound Navaho in a sweat lodge full of squaws. All symptoms gone the next day. Is that what cured me or was it just time for my immune system to kick in and ramp up my fever ?
    Its hard to get modern people who rely on a pill to fix everything to understand that most of the time having a fever is a good thing. Hell,
    in most situations going into shock is a good thing. Its the body trying to fight to save your life.
    Having seen maggots placed in a necrosed wound I do firmly believe that not all modern medicine is good and that some primitive medicine
    is absolutely the best there is but….it has to be backed up with empirical evidence. The herbal alternative medicine science is just not there yet. Would I give my child suffering an asthma attack a tea made from daffodils because someones grandmother said it works or the albuterol inhaler his doctor prescribed for him ?
    I have an amusing story about putting sugar in a wound too but I’ll save it for another time.

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  6. Great website.

    Off topic, yet similar.

    Years ago, in an old book of home remedies,
    I saw onions mentioned as a topical burn treatment. Red or white, fresh cut only. Filed it away mentally.

    Years later, my toddler griddled his arm on the fireplace grate. No silvadene cream in house, kid screaming bloody murder. In despiration, I remembered the recipe. Grabbed an onion, cut it open, slathered it on his arm.
    He stopped crying in 5 minutes.
    30 minutes later the marks were gone.

    Told the story to a friend of mine. He proceeds to burn both forearms on a BBQ flare-up. His wife, an RN, wants to take him in, he says put some onion on it.

    30 minutes later the pain and redness were gone.

    Anecdotes aren’t evidence. But seeing something firsthand…..

    I’m not aware of any studies regarding this.

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  7. Two comments: first, I understand that using sugar mixed with betadine in a wound is accepted practice in veterinary medicine, and some studies have been done re using it on humans, as well. Supposedly quite effective.
    http://www.ncbi.nlm.nih.gov/pubmed/8954426
    http://www.ncbi.nlm.nih.gov/pubmed/17680256

    Second, given that – these days – those peppercorns may very well have been picked by the left hand of an Indonesian muslim, I’d be a little reticent about cramming a bunch into an open wound on _my_ body. YMMV.

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  8. Sorry if my following comment seemed over the top, Dr. Grouch. I suppose it’s proper that the blog owner be the only one to speak of vaginal secretions. I’ll refrain from bringing up the even older joke about cowboys and chapped lips.

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