Key takeaways
- In a trial in Mali published in 2010, 89% of people given a home-brewed plant remedy for malaria needed no second treatment over 28 days, compared with 95% of those given a standard drug.
- In 2004, Mi’kmaw Elders Albert and Murdena Marshall introduced Two-Eyed Seeing, which a Cape Breton University institute describes as seeing with the strengths of Indigenous and Western knowledge together.
- Testing has backed some traditional uses in a narrower form: honey probably eases children’s coughs for up to three days, and ginger may help pregnancy nausea but mostly not motion sickness.
- Testing has also caught serious harm, and in 2002 a WHO cancer agency classed herbal remedies containing Aristolochia as a cause of cancer in humans.
- Before you try a traditional remedy, ask the tradition’s questions (which plant, how it’s prepared, for whom) and the evidence questions (what was tested, against what, and what harms turned up).
In a remote village in Mali, researchers enrolled 301 people who seemed to have uncomplicated malaria1. Half of them were 5 years old or younger1. Each patient got one of two first treatments, assigned by chance.
One group received artesunate-amodiaquine, a standard drug combination built around artemisinin1. The other got a decoction, a tea made by boiling a plant, of Argemone mexicana1. The researchers called it a traditional medicine that families make for themselves from one common plant1.
After 28 days, 95% of the drug group had needed no second-line treatment. In the plant group, 89% had needed none1. Severe malaria was rare, and no more common with the plant than with the drug1.
So who won? Neither, in the way people usually mean it. By the time the results appeared, Mali’s government had approved the remedy, and the researchers suggested testing it as a first-line partner to standard drugs where malaria is common1. A follow-up study also showed where it fell short2.
That is the real relationship between traditional knowledge and modern science. It isn’t a boxing match. It works best as a conversation, and two Mi’kmaw Elders in Nova Scotia gave a name to doing it well.
Two ways of knowing, built in two different ways
Traditional knowledge grows through long practice. In late 2022, two White House offices issued guidance to federal agencies on Indigenous Knowledge3. It described that knowledge as a body of observations, practices and beliefs that Tribes and Indigenous Peoples built through long experience with the natural world3.
That knowledge builds over long stretches of time, sometimes thousands of years, and passes from one generation to the next3. It also keeps changing3.
It can be strikingly accurate. In 2012, researchers from the University of Reading, Imperial College London and the Royal Botanic Gardens, Kew, studied more than 1,500 medicinal plants used in Nepal, New Zealand and the Cape region of South Africa4. These regions were unlikely to have traded knowledge about medicinal plants. Yet people there often chose closely related plants, and often for the same health problems4.
The team saw this as people in different places finding the same useful plants on their own4. They also noted that many modern drugs come from those same plant groups4.
A controlled trial builds knowledge another way. Volunteers are assigned to treatments by chance, a step called randomization, so no one’s choices decide who gets what5. In a double-blind trial, neither the volunteers nor the research team knows who is getting which treatment5.
Many trials also use a placebo, a look-alike with no active ingredient5. Comparing against it shows how much of the change came from the treatment itself, rather than from hope, time or chance.
Each method answers different questions. Tradition is rich in context: which plant, which part, how to prepare it, who it suits and when. Trials are good at separating cause from coincidence and at measuring how big an effect is. Neither one sees everything.
Two-Eyed Seeing, a guiding principle from Mi’kmaw Elders
Albert Marshall was born in 1938 in Eskasoni First Nation, on Cape Breton Island in Nova Scotia6. He is a Mi’kmaw Elder of the Moose Clan, a fluent Mi’kmaw speaker and a longtime spokesperson for his nation on natural resources and the environment6.
In 2004, he and his late wife, Elder Murdena Marshall, introduced the term Etuaptmumk, or Two-Eyed Seeing7. They brought it forward to guide an Integrative Science research project linked to researcher Cheryl Bartlett7.
Cape Breton University’s Institute for Integrative Science and Health describes the idea this way. You learn to see with the strengths of Indigenous ways of knowing through one eye and the strengths of Western knowledge through the other, and then you use both eyes together6. Marshall calls it a guiding principle, not a theory6.
The key word is together, not blended. A 2021 review in the journal PLOS ONE examined 80 articles that used Two-Eyed Seeing in Indigenous health research, 71 of them based in Canada7. The original authors were clear that it does not fuse two systems into one, and it does not treat Indigenous knowledge as an add-on to Western science7.
Some newer authors still called it blending, which the reviewers said clashed with the original meaning7. Marshall has also warned that this work can slide into tokenism, a show of inclusion without the substance7. The original authors spoke about spirit, and about people as part of the natural world, far more often than later writers did7.
The idea has traveled. Marshall co-created an Integrative Science program at Cape Breton University, the first of its kind in Canada, which ran from 1999 to 20076. He also advised the Canadian Institutes of Health Research on including Etuaptmumk in a strategic plan for its Institute of Indigenous Peoples’ Health6.
In 2023, Nova Scotia began piloting a Grade 12 environmental course built on Two-Eyed Seeing8. That same year, Marshall was named an Officer of the Order of Canada6.
Reverse pharmacology starts with what people already use
Most drug research starts in a lab and moves toward patients. Reverse pharmacology runs the other way. Researchers begin with remedies people already use and with records of how patients did, then work back toward the lab to learn what the remedy does9.
Researchers who draw on Ayurveda, India’s traditional medicine, sum it up as a path from clinics to laboratories9. They argue that long human use gives a head start on safety. In their view, lab studies can run alongside careful clinical studies instead of years ahead of them9.
They describe three stages10. First, document real results, with good records from before and after treatment. Next, run small studies to find doses. Last, run rigorous clinical trials.
The Mali study fits that pattern. It tested a remedy that families already brewed at home, head to head with the standard drug1. Our article on plant-derived medicines explains how the World Health Organization now views this research path.
The safety argument has limits, though. A long history did not protect people from every traditional herb, as you’ll see below.
Where testing backed tradition, usually in a narrower form
Ginger. People have used ginger in folk medicine since ancient times for indigestion, stomach upset and flu, according to the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health11. Research suggests ginger may help with nausea and vomiting in pregnancy11.
But most studies have not found ginger helpful for motion sickness11. It’s also unclear whether it adds anything to standard anti-nausea care during chemotherapy or after surgery11. Ginger supplements can cause heartburn, stomach discomfort and diarrhea, and NCCIH advises talking with a provider before using them in pregnancy11.
Honey. People have used honey to calm coughs12. A 2018 Cochrane review pooled six randomized trials with 899 children ages 1 to 1812. Honey probably eased coughs more than no treatment or a placebo, and it may have worked better than diphenhydramine, an antihistamine12.
Against dextromethorphan, a common cough suppressant, honey may make little or no difference12. The evidence covers only up to three days of use12. Never give honey to a baby under 12 months old12.
Cranberry. Native Americans, and later European settlers, used cranberry as food, dye and medicine, including for bladder problems13. Today, NCCIH says cranberry products may cut the risk of repeat urinary tract infections (UTIs) with symptoms in women by about a quarter, though results are mixed13.
Cranberry is not a treatment for a UTI you already have13. If you take the blood thinner warfarin, talk with a clinician first, since studies on how the two interact conflict13.
Our articles on traditional knowledge and on plant-derived medicines tell even bigger success stories, including the malaria drug artemisinin. The pattern here is quieter but common. Tradition pointed in a real direction, and testing drew a tighter line around it: which symptom, which people, for how long.
Where testing said no, or not quite
Some results are mixed. The Mali remedy kept people well in the short term, but it did not fully clear malaria parasites from the blood in most patients2.
Researchers followed 294 patients to day 84 to see whether that mattered2. New malaria episodes were about the same: 0.33 per patient in the plant group and 0.31 in the drug group2. The team concluded that full clearance did not seem to matter in that setting, and called for more studies to confirm it2.
Some results are alarming. Several Aristolochia species were used in traditional Chinese medicine for joint pain, swelling and to increase urine14. In Belgium, at least 100 people, mostly middle-aged women on a weight-loss regimen, took a mislabeled herbal mixture containing Aristolochia and developed fast-moving kidney disease14.
Among 39 of those women who had their kidneys and ureters removed as a precaution, 18 had cancers14. In 2002, the International Agency for Research on Cancer, part of WHO, classed herbal remedies containing Aristolochia as carcinogenic to humans14.
Our article on historical healing philosophies explains how counting patients’ outcomes in the 1800s turned medicine against routine bloodletting. The lesson is the same. Long use tells you a remedy mattered to people. It can’t tell you, by itself, which remedies are safe.
Why some traditions are hard to put in a trial
A standard trial tests one thing at a time, at a fixed dose, given the same way to everyone. Many traditional systems don’t work like that. A healer may adjust a formula for each person and pair it with diet, prayer, ceremony or counseling.
The reverse pharmacology group suggests adapting trials to fit, including what they call “double-vision” trials in place of strictly double-blind ones10. Our article on traditional medicine research covers other hurdles, such as finding a fair placebo for a hands-on practice.
Some knowledge is not meant to be tested at all. The 2022 federal guidance noted that some Indigenous Knowledge is sensitive or sacred, and it told agencies to get consent from Tribal Nations and Indigenous Peoples before including it3. It also said agencies didn’t need to check that knowledge against other kinds of knowledge before using it in federal research and decisions3.
The guidance now sits on the archived website of the Biden White House3. We could not confirm whether the current administration has kept, revised or withdrawn it. Still, its core point stands: knowledge belongs to people, and respect starts with asking.
Medicine adds a second duty. When a remedy is sold or given to strangers, people deserve to know what it does and what it risks. In that setting, asking for evidence is a form of care, not an insult.
How tradition and evidence can work together
| Step | What tradition brings | What science brings | What respect looks like |
|---|---|---|---|
| Finding leads | Generations of watching plants, foods and practices | Lab screening and records of how patients did | Ask permission and credit the community by name |
| Defining the remedy | Which plant, which part, when it’s picked, how it’s made | Confirming the plant and measuring what’s in it | Test the remedy as it is made, not a stand-in |
| Testing | Who it helps and how healing shows up | Fair comparisons, with groups assigned by chance | Design studies with knowledge holders, not just about them |
| Reading results | What counts as getting better in that community | How big the effect is and how sure we can be | Share results back in plain language |
| Everyday use | Context such as diet, ceremony and family | Dose, drug interactions and who should avoid it | Leave alone knowledge that isn’t offered |
What the evidence shows for the examples here
| Traditional use | Evidence level | What studies found |
|---|---|---|
| Argemone mexicana tea for uncomplicated malaria in Mali | 89% needed no second treatment, vs. 95% on a standard drug; parasites often not fully cleared12 | |
| Ginger for nausea in pregnancy | Research suggests it may help11 | |
| Ginger for motion sickness | Most studies found no help11 | |
| Honey for cough in children 1 and older | Probably better than placebo for up to three days12 | |
| Cranberry to prevent repeat UTIs in women | Roughly 25% fewer infections, with mixed results13 | |
| Cranberry to treat an active UTI | Not recommended as a treatment13 | |
| Herbal remedies containing Aristolochia | Kidney failure and cancers; classed as a human carcinogen14 |
If the answers on either side are missing, the honest label is “not yet known.” Gentle, food-like remedies, such as ginger tea for an upset stomach or honey for an older child’s cough, are reasonable to try. A serious illness is different. A fever after travel to a malaria area, a spreading infection or a fever in a young baby needs a clinician right away.
Honoring a tradition means taking its claims seriously
If you value tradition, Two-Eyed Seeing offers a way to honor it without asking it to be something it isn’t. It doesn’t ask tradition to prove itself on science’s terms alone. It doesn’t ask science to drop its methods either.
Testing a remedy is a form of respect. So is crediting the people who found it, and listening when they say some knowledge is not for sale. The ginger in your cupboard and the honey on your shelf carry centuries of experience. Good research tells you how to use that experience well.
Questions readers ask
Is Two-Eyed Seeing just a polite way of saying science should check tradition?
No. Its originators describe learning that runs in both directions, with each knowledge system keeping its own strengths7. They have warned against merging the two and against token gestures7. Scientists are asked to learn from knowledge holders, too.
If a remedy has been used for centuries, isn’t that proof enough?
Long use is a strong reason to study a remedy. But it can miss harms that take years to show up, as kidney damage and cancer did with Aristolochia14. It also can’t measure how large a benefit is, or for whom.
Can I use a traditional remedy alongside my medicines?
Often, but tell your clinician and pharmacist first. Cranberry may interact with warfarin13, and NCCIH advises checking with a provider before using ginger if you take any medicine11.
How can I learn about Indigenous medicine respectfully?
Start with sources created by or with Indigenous communities, and follow their lead on what is shared with outsiders. Ceremonies and healing knowledge belong to the nations that keep them. Our article on white sage offers practical steps for appreciating without taking.
The bottom line
Tradition and science are two ways of paying attention. Tradition watches over generations and remembers what seemed to help. Science compares carefully and measures what really did. Each catches mistakes the other can miss.
Two-Eyed Seeing, a gift from Mi’kmaw Elders, asks you to keep both eyes open. Honor where a remedy came from, ask what testing shows, and let each kind of knowledge sharpen the other.
Related reading
About this article
This article was researched from NIH and Cochrane evidence summaries, peer-reviewed trials and reviews, federal guidance, the International Agency for Research on Cancer, and Canadian institutional sources on Two-Eyed Seeing, all listed below. It was reviewed in October 2026. It is general education and not medical, legal or financial advice.
Sources
- Graz B, Willcox ML, Diakite C, et al. “Argemone mexicana decoction versus artesunate-amodiaquine for the management of malaria in Mali: policy and public-health implications.” Transactions of the Royal Society of Tropical Medicine and Hygiene, 2010;104(1):33–41 (abstract record). pubmed.ncbi.nlm.nih.gov
- Willcox ML, Graz B, Diakite C, et al. “Is parasite clearance clinically important after malaria treatment in a high transmission area? A 3-month follow-up of home-based management with herbal medicine or ACT.” Transactions of the Royal Society of Tropical Medicine and Hygiene, 2011;105(1):23–31 (RERO DOC record). doi.org
- White House Office of Science and Technology Policy and Council on Environmental Quality. “Guidance for Federal Departments and Agencies on Indigenous Knowledge.” November 2022 (archived website). bidenwhitehouse.archives.gov
- University of Reading. “Super-family tree finds flora that fights disease.” News release on Saslis-Lagoudakis CH, et al., Proceedings of the National Academy of Sciences, September 11, 2012. archive.reading.ac.uk
- National Institutes of Health. “NIH Clinical Research Trials and You: The Basics.” NIH, reviewed April 2025. nih.gov
- Moore S. “Albert Marshall.” The Canadian Encyclopedia, November 2023, edited January 2024. thecanadianencyclopedia.ca
- Roher SIG, Yu Z, Martin DH, Benoit AC. “How is Etuaptmumk/Two-Eyed Seeing characterized in Indigenous health research? A scoping review.” PLOS ONE, 2021;16(7):e0254612. journals.plos.org
- Pottie E. “Eskasoni elder bringing ‘two-eyed seeing’ into classrooms.” CBC News. cbc.ca
- Patwardhan B, Vaidya ADB, Chorghade M, Joshi SP. “Reverse Pharmacology and Systems Approaches for Drug Discovery and Development.” Current Bioactive Compounds, 2008;4(4):201–212. eurekaselect.com
- Raut AA, Chorghade MS, Vaidya ADB. “Reverse Pharmacology.” In: Innovative Approaches in Drug Discovery. Elsevier, 2017, chapter 4 (author-shared PDF). lavierebelle.org
- National Center for Complementary and Integrative Health. “Ginger.” NIH, updated February 2025. nccih.nih.gov
- Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. “Honey for acute cough in children.” Cochrane Database of Systematic Reviews, 2018. cochrane.org
- National Center for Complementary and Integrative Health. “Cranberry.” NIH, updated November 2024. nccih.nih.gov
- International Agency for Research on Cancer. “Herbal Remedies Containing Plant Species of the Genus Aristolochia.” IARC Monographs Volume 82, 2002 (INCHEM summary). inchem.org