Old Medicine, New Rigor

Duncan Malcolm MacRae on a lifelong fascination with natural remedies, a growing concern about how casually the developed world reaches for a prescription pad, and why the two are more connected than they first appear.

If you read through the different chapters of my life—reptile breeding, snake venom, ethnobotany, Motark Enterprise—a quieter thread runs underneath all of it. I have spent most of my life fascinated by what nature can do for human health, and increasingly uneasy about how quick the modern world has become to reach for a synthetic pill before it has properly asked what else might work.

That is not an anti-medicine position. It is closer to the opposite. I believe traditional remedies deserve exactly the same rigour we apply to pharmaceuticals—tested, standardised, and trusted only as far as the evidence actually takes them. Nothing less, but nothing more either.

Where It Started: My First Cup of Jamu

I can trace this fascination back further than any of my businesses, to my first years in Indonesia after moving there in the 1980s, in my twenties, and the traditional jamu I was introduced to almost immediately: temulawak, kunyit asam, and meniran. These are three of the most common ingredients in Javanese herbal medicine—temulawak (Curcuma xanthorrhiza) and kunyit asam (a turmeric and tamarind tonic) for digestion and general vitality, and meniran (Phyllanthus niruri) for the immune system—and they had been prepared and passed down by Indonesian families for generations, long before anyone thought to test them in a laboratory.

What struck me from the start was not just that people believed in these remedies, but how specific and consistent that belief was. Nobody was claiming temulawak cured everything. Different plants were understood to do different, fairly narrow things, refined over generations of actual use. That is a very different kind of knowledge to folklore, and it planted a question I am still asking decades later: which of these traditions are just comforting ritual, and which are quietly correct?

A Concern That Has Only Grown

I have watched from a distance, for years, as the United States in particular has struggled with the consequences of over-prescription. The scale of it is genuinely sobering: roughly 806,000 Americans died from an opioid overdose between 1999 and 2023, and even with recent improvement, tens of thousands of people are still dying from drug overdoses every year, the large majority of them involving an opioid. A meaningful part of that crisis traces back to how freely powerful, addictive painkillers were prescribed in the first place.

I want to be careful here, because this is not a call to replace medicine with herbs, and it is not a suggestion that any traditional remedy is a substitute for proper pain management or addiction treatment. It is something narrower and, I think, more useful: a belief that reaching immediately for the strongest available synthetic option, without seriously exploring what else exists—including compounds nature has already produced and refined over millions of years—has real costs. Medicine should use the best tool for the job. Sometimes that tool is a new synthetic molecule. Sometimes, tested properly, it turns out to be something people have been using for a very long time.

Antivenom: Proof That the Old and the Rigorous Can Coexist

My own snake venom business is probably the clearest example of this principle I have been personally involved in. Snake venom is about as far from a comforting herbal tradition as you can get—it is a natural product that can kill—and yet it is also, quite literally, the raw material for antivenom, one of the most rigorously tested categories of medicine there is.

Supplying Indonesian venoms to researchers such as Bryan Grieg Fry taught me something that has stuck with me ever since: nature routinely produces compounds of extraordinary biological precision. The job of good science is not to dismiss that fact, and not to accept it uncritically either, but to study it properly—to work out exactly what a natural compound does, at what dose, in which population, and to prove it rather than assume it. Antivenom exists because scientists took something the natural world produced and refused to treat it casually in either direction.

Motark Enterprise: The Same Standard, Applied to Plants

That is precisely the standard I have tried to apply at Motark Enterprise, the botanical sciences business I founded to source and standardise plants with genuine traditional reputations—including, in a nice full-circle moment, Tongkat Ali, a rainforest root not far removed from the world of the jamu that first drew me into all of this.

The research picture differs meaningfully across the botanicals Motark works with, and I think that honesty matters more than marketing enthusiasm. Tongkat Ali has one of the more mature clinical pictures of the group, with placebo-controlled trials showing improvements in free testosterone and erectile function in men with age-related androgen decline. Kava has arguably the strongest single-outcome evidence of all of them, with repeated trials showing meaningful reductions in anxiety scores, and a 2023 neuroimaging study linking that effect to measurable changes in brain GABA activity. Moringa’s strongest signal sits in metabolic health, with trial data on blood glucose and inflammatory markers in people with metabolic syndrome. Bacopa has the longest trial history of the group but a genuinely mixed recent record, and kanna’s chemistry is unusually well understood even though its clinical trial base remains comparatively thin.

None of that is a therapeutic claim, and none of it should be read as one. It is the same discipline I try to bring to everything in this piece: say plainly where the evidence is strong, say plainly where it is still developing, and never confuse a plant’s traditional reputation with a settled scientific result.

The Case for Taking Old Remedies Seriously Enough to Test Them Properly

There is an instructive example from well outside botanicals that I think about often: colchicine, a compound derived from the autumn crocus and used since antiquity for joint pain, sat quietly in gout formularies for the better part of a century. Then, in 2019 and 2020, two large randomized trials tested low-dose colchicine in patients with existing heart disease and found it meaningfully reduced heart attacks, strokes, and cardiovascular death. In 2023, the FDA approved it specifically for cardiovascular risk reduction—the first anti-inflammatory medication approved for that purpose in atherosclerotic heart disease, one of the leading causes of death worldwide.

Nobody could have predicted that outcome from tradition alone. And nobody could have proven it without exactly the kind of patient, rigorous trial work that separates a real medical result from a folk claim. That, to me, is the entire argument in one example: traditional use is a genuinely useful signal about where to look, not a substitute for looking properly.

Why This Matters to Me

I am not a doctor, a pharmacologist, or a clinical researcher, and I have never claimed to be. What I am is someone who was introduced to jamu made from plants Indonesian families had trusted for generations not long after arriving in the country, who later spent years supplying venom to the scientists working out exactly what natural toxins could and couldn’t do, and who now runs a business built on the belief that a plant’s traditional reputation is a starting point for rigorous testing, not a finish line.

If any part of that helps a handful of people—researchers, formulators, or simply people trying to make sense of their own health choices—take both traditional knowledge and modern science more seriously, and take neither of them on faith alone, that feels like a worthwhile thing to have spent a career circling back to.

This same commitment to rigour runs through everything else I’ve built. Read the fuller story on my About page.

Sources

• Understanding the Opioid Overdose Epidemic, Centers for Disease Control and Prevention.
• Novianto, F. et al., “Pengaruh Formula Jamu Temulawak, Kunyit, dan Meniran,” Media Penelitian dan Pengembangan Kesehatan 30(1), 37–44 (2020).
• Motark Enterprise (official website). Kwun Tong, Kowloon, Hong Kong.
• Venom Supplies Pty Ltd (official website). Tanunda, South Australia.
• Professor Bryan Fry, UQ Researchers, The University of Queensland.
• Tardif, J.C. et al. (2019). “Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction,” New England Journal of Medicine (COLCOT trial); Nidorf, S.M. et al. (2020). “Colchicine in Patients with Chronic Coronary Disease,” New England Journal of Medicine (LoDoCo2 trial).

This article is a personal, biographical reflection by Duncan Malcolm MacRae. It is not a therapeutic claim about any botanical extract or supplement, and nothing in it should be read as medical or regulatory advice. Anyone with questions about pain management, opioid use, or any specific health condition should speak to a doctor or other licensed practitioner.