In the remote Qinghai-Tibetan Plateau, a rare fungus grows inside dead caterpillars. In traditional Chinese medicine, this parasitic fungus is prized for its purported medicinal effects. Known as Ophiocordyceps sinensis – colloquially, caterpillar fungus or “Himalayan gold” – it can fetch astronomical prices on the herbal medicine market: up to US$63,000 per pound.

Ophiocordyceps sinensis fungus is a parasite that targets the caterpillar that is the larva of the ghost moth. The process begins in late summer to early fall, when fungal spores infect the caterpillars. Over time, fungal filaments called mycelia slowly spread out and consume the caterpillars from within, turning them into hardened, mummified shells by winter. When spring arrives, the fungus enters its final stage: A grasslike fruiting body sprouts from the preserved caterpillar’s head and pushes up through the soil.

While many traditional Chinese/herbal medicine consumers are drawn to the fungus for its supposed health benefits, my interest lies in a darker side of its harvest: the deadly relationship between caterpillar fungus collection and lightning strikes. As a meteorologist, I study lightning and its impacts around the world. A few factors come together to make the situation on the Qinghai-Tibetan Plateau so dangerous.

A deadly harvest

People hunt for this fungus during late spring and summer, exactly when lightning strikes are most common in these mountains. Villagers often spend weeks scouring the rugged mountains for this precious resource, sometimes up to 16,400 feet (5 kilometers) above sea level. That’s an altitude of more than 3 miles.

At these heights, the weather can change in an instant, and there’s nowhere safe to hide from storms. While this area doesn’t get as many lightning strikes as some parts of Asia, it’s still dangerous enough to be a serious threat during these crucial harvesting months.

Tragically, caterpillar fungus hunting has led to at least 31 lightning-related deaths and another 58 lightning-related injuries in the past decade, according to the yearbooks of Chinese meteorological hazards (中国气象灾害年鉴) and government websites, including the China Meteorological Administration and the National Disaster Reduction Center of China.

In May 2022, seven villagers from China, including a young child, were killed by lightning while harvesting the fungus. The following year, three people from Nepal were injured by lightning when collecting the fungus and had to be rescued by helicopter after spending days stranded in the mountains.

In our recent study, my colleague Ronald Holle and I found that the population-weighted lightning fatality rates in the fungus-collection hotspots of Yushu and Garze counties, located in the Sichuan Province of China, are staggering – 10 to 20 times higher than the already elevated rates in China overall. These numbers are on par with some of the most lightning-prone regions of Africa, where there is little lightning-safe infrastructure or safety education.

But lightning isn’t the only threat these villagers face in the mountains. They could encounter hail, heavy rains, strong winds and other severe weather. The complex terrain makes weather patterns highly dramatic and unpredictable. Making things even worse, cellphone signals and other communication options are limited or nonexistent, leaving villagers cut off from weather hazard alerts.

They could also face threats from wild animals and risky mountain slopes. In one tragic case, a collector was struck by lightning and fell to his death on steep terrain. Medical care is rarely available. When accidents occur, it may be days before help arrives.

Why take the risk?

It all comes down to the high-risk, high-reward nature of caterpillar fungus collection.

For local villagers, the potential rewards of harvesting caterpillar fungus are significant. With limited income opportunities in this remote region, many see the fungus trade as their best hope for survival. They face a tough choice: risk their lives or sink into poverty.

Improving lightning safety education and infrastructure are important but far from easy. Any real change would take a lot of investment.

While the local government does organize some lightning safety education, these mountain communities are isolated and the information is often outdated. And there’s simply no practical way to install adequate lightning protection across the vast, rugged terrain where the fungus is collected.

A fragile pursuit

The environment is suffering, too. With so many people hunting for the fungus, they’re damaging the delicate mountain soil, cutting down trees for firewood and leaving trash at their camps.

Years of overharvesting have forced collectors to spend more time in the mountains to find enough fungus, increasing their exposure to lightning and the fungus’s decline. Scientists warn that if this aggressive harvesting continues, the fungus might disappear completely in the next few decades.

There might be some hope. Researchers are exploring ways to cultivate the fungus as a possible substitute for the wildly harvested variety. Meanwhile, governments in China, India, Nepal and Bhutan have implemented regulations to protect the sustainability of caterpillar fungus.

But any solution will need to address the underlying economic and educational inequities in this remote region, opening up new opportunities for these communities to make a living so they don’t need to risk their lives chasing “Himalayan gold.”

Daile Zhang is an assistant professor of Atmospheric Sciences, University of North Dakota. This article is republished from The Conversation.

Can Indian Systems of Medicine, such as Ayurveda, Siddha, and tribal medicines, be evidence-based? These questions have come to the fore in the Ramdev Baba Coronil dispute, in which an herbal product was claimed to be a cure for COVID-19 without sufficient scientific evidence.

Many decades ago, in Vietnam, during the war, more soldiers fighting the American army were dying from chloroquine-resistant malaria than American bullets. At the request of Ho Chi Min, China’s Mao Zedong initiated Project 523, sending researchers to scour traditional Chinese medicinal literature to identify herbs for malaria-like symptoms.

The most remarkable outcome was the discovery of artemisinin, a life-saving anti-malarial drug. Tu Youyou and her team, inspired by a 1,700-year-old treatise, discovered artemisinin using modern scientific methods. This breakthrough saved millions of lives and earned her a Nobel Prize in 2015.

Despite initial scepticism, clinical trials and pathophysiological studies confirmed the efficacy of artemisinin in controlling malaria. This robust evidence convinced the global health community and led the World Health Organization to endorse artemisinin. Today, academia worldwide investigates traditional Chinese medicine using modern science tools.

In the past, Indian systems were evidence-based

In ancient Indian philosophy and scientific texts, rationalistic epistemological keywords such as pariksha, anumana, ganita, yukti, nyaya, siddhanta, tarka, and anvesana share space with some form of mythology. According to Narasimha (dated 7th-8th century), the commentator of the Rasavaiseshika-sutra, attributed to Bhadanta Nagarjuna in the 5th-6th century, only two types of evidence count in Ayurveda: pratyaksha (directly observed) and anumana (conjectured/inferred), with no role for ‘belief’ in the sense of blind faith. (Na hy āyurvede pratyakṣārthānumeyārthābhyām āgamābhyām anyacchraddheyārthatvam asti, dṛṣṭaphalatvād iti. -RVSBh 3.45).

Caraka distinguished between Yuktivyapashraya bheshaja (reason-based) and Daivavyapashraya bheshaja (faith-based) therapies, emphasising the process of investigation, ‘pariksha‘, as critical for arriving at scientific truth. He stated that a claim becomes generally acceptable only after it has been thoroughly investigated by several investigators and is supported by robust and rational evidence.

Then why has Ayurveda fallen on the way?

From the sixth to tenth century CE, Ayurveda was a thriving and active field. New medicinal formulas were discovered and added to its extensive corpus. For example, Vagbhata (6th century CE) emphasised the importance of updating medical literature, ‘yuga anurupa,’ and authored new commentaries on Charaka Samhita and Sushruta Samhita. Dalhana (11th century CE) did not deter to amend and add two new iron formulations for anaemia treatment in his commentary on Sushruta Samhita.

“Ayurveda does not derive its authority because it is divined by Brahma; its merit comes simply from the verifiable truths it contains”, according to Vagbhata. However, numerous practitioners of Ayurveda believed that it was attained by ancient ‘rishis’ through their divine ‘yogic’ powers rather than as an experimental and experience-based scientific therapeutic system subject to critique.

“Subservience to the written word and textual authority, reinforced by the societal effects of caste hierarchy and mystical philosophies, gradually replaced the spirit of scientific adventurism and enquiry that characterised the work of Ayurvedic pioneers,” says MS Valiathan, a noted cardiologist and author of the book series Legacy of Charaka, Sushruta, and Vagbata.

In recent history, conservatism and mysticism were reinforced and promoted by the trope formulated by Captain G Srinivasa Murti, a practising medical doctor, to the committee constituted by the Government of the Madras presidency in 1921 under the chairmanship of Muhammad Usman on the question of recognising and encouraging indigenous medical systems. While modern Western science used external aids such as the microscope, telescope, spectroscope, and so on to comprehend things beyond the range of the senses, he asserted that the Hindu sages “sought to effect the same results, not by providing their senses with external aids, but by improving their own internal organs of sense”.

“The general unwillingness of contemporary practitioners of Ayurveda to question the wisdom enunciated in the classical Samhitas is contrary to the teachings of the sages in ancient India who preferred pratyaksha (direct evidence), anumana (inferential evidence), and yukti (logic) over shabda pramana (textual narrations)“ says Subhash C Lakhotia, professor of cytogenetics at the Banaras Hindu University and a pioneer in using the drosophila model to study Ayurvedic biology.

Western and Eastern

Not all invoke the divine to refuse scientific scrutiny; some hide behind cultural relativism. They argue that ‘allopathy’ is based on Western science and that Ayurveda is an epistemologically different yet valid knowledge system, which can be validated only using Ayurvedic logic and methods.

According to Ayurvedic physiology and anatomy, shukra (semen) is formed in majja (bone marrow), and urine is formed without the involvement of the kidneys. The text further states that the combination of semen and menstrual blood results in the creation of an embryo. All of these contradict ‘pratyaksha‘, and can these be accepted as alterative ‘ways of seeing’?

Kishor Patwardhan, a Kriya Sharir Ayurveda professor at Banaras Hindu University, explains that Ayurveda’s epistemology aligns with Nyaya Vaisheshika schools of thought, similar to modern science but using simple tools. “In ancient times, pratyaksha meant employing the sense organs to acquire knowledge; today, we use tools like microscopes for the same purpose”, he says.

Clinical trials

Randomised control trials (RCTs) are the gold standard for clinical trials assessing medication efficacy. Allopathy prescribes the same therapy for two people with identical diagnostic assessments.

However, Ayurvedic treatment is individualised based on the constitution (prakriti, agni, samhanana, etc). Due to its complexities, including multiple medications, mid-course correction, therapies, diet restrictions, and lifestyle modifications, the RCT appears to be not feasible for Ayurvedic clinical trials. Some argue that only case studies from the personal experience of Ayurvedic medical professionals are viable.

The situation is not hopeless, however. Recently, methotrexate-based treatment was compared to Ayurvedic intervention in patients with radiological indications of rheumatoid arthritis, proving the viability of double-blind, placebo-controlled trials even for individualised treatments. If there is a will, there is a way.

The elephant in the room

It is frequently argued that modern science gives stepmotherly treatment to studying old medical systems. But this is not the case. Prompted by a fortuitous talk by former President of the Indian National Science Academy, M S Valiathan, on Ayurveda and modern medicine, Naveen Khanna and his team at the International Centre for Genetic Engineering and Biotechnology (ICGEB) discovered a potent antiviral against all four dengue strains, after reviewing Ayurvedic literature. After years of research, they found that a botanical extract of Cissampelos pareira Linn (Cipa) was beneficial against dengue in both in vitro and animal models. Human clinical trials are currently underway.

Similarly, researchers at the CSIR-Indian Institute of Integrative Medicine in Jammu isolated Sinococuline, a bioactive constituent of Cocculus hirsutus, which has a powerful anti-dengue action, and discovered IIIM-290, a botanical medicine with anti-cancer characteristics.

China is investing massive amounts of government funds to revalidate ancient medicine using current evidence standards, by accepting therapies that work while rejecting those that do not. In India, we lack both funding and an unflinching commitment to evidence.

Aura of mystical, the critical hurdle

Sushruta maintains that medical interventions are trustworthy not just because they are effective in his own experience (pratyaksha / phaladarshana) but only because they have been rationally vetted by the community of specialists. He is seeking what is now known as a rigorous peer assessment before the claims are accepted. It is obvious that case studies cannot replace well-designed clinical trials in evaluating efficacy and assessing the underlying pathophysiology of disorders.

Naturally, classical medical texts from centuries ago contain imprecise anatomy and physiology, with outdated theories of pathophysiology and aetiology. Yet, practitioners often claim divine revelation and do nothing to update or change this knowledge. Unearthing the biological basis of this knowledge trove can benefit both the Indian System of Medicine and biology.

Can Indian Systems of Medicine, such as Ayurveda, Siddha, and tribal medicines, be evidence-based? These questions have come to the fore in the Ramdev Baba Coronil dispute, in which an herbal product was claimed to be a cure for COVID-19 without sufficient scientific evidence.

Many decades ago, in Vietnam, during the war, more soldiers fighting the American army were dying from chloroquine-resistant malaria than American bullets. At the request of Ho Chi Min, China’s Mao Zedong initiated Project 523, sending researchers to scour traditional Chinese medicinal literature to identify herbs for malaria-like symptoms.

The most remarkable outcome was the discovery of artemisinin, a life-saving anti-malarial drug. Tu Youyou and her team, inspired by a 1,700-year-old treatise, discovered artemisinin using modern scientific methods. This breakthrough saved millions of lives and earned her a Nobel Prize in 2015.

Despite initial scepticism, clinical trials and pathophysiological studies confirmed the efficacy of artemisinin in controlling malaria. This robust evidence convinced the global health community and led the World Health Organization to endorse artemisinin. Today, academia worldwide investigates traditional Chinese medicine using modern science tools.

In the past, Indian systems were evidence-based

In ancient Indian philosophy and scientific texts, rationalistic epistemological keywords such as pariksha, anumana, ganita, yukti, nyaya, siddhanta, tarka, and anvesana share space with some form of mythology. According to Narasimha (dated 7th-8th century), the commentator of the Rasavaiseshika-sutra, attributed to Bhadanta Nagarjuna in the 5th-6th century, only two types of evidence count in Ayurveda: pratyaksha (directly observed) and anumana (conjectured/inferred), with no role for ‘belief’ in the sense of blind faith. (Na hy āyurvede pratyakṣārthānumeyārthābhyām āgamābhyām anyacchraddheyārthatvam asti, dṛṣṭaphalatvād iti. -RVSBh 3.45).

Caraka distinguished between Yuktivyapashraya bheshaja (reason-based) and Daivavyapashraya bheshaja (faith-based) therapies, emphasising the process of investigation, ‘pariksha‘, as critical for arriving at scientific truth. He stated that a claim becomes generally acceptable only after it has been thoroughly investigated by several investigators and is supported by robust and rational evidence.

Then why has Ayurveda fallen on the way?

From the sixth to tenth century CE, Ayurveda was a thriving and active field. New medicinal formulas were discovered and added to its extensive corpus. For example, Vagbhata (6th century CE) emphasised the importance of updating medical literature, ‘yuga anurupa,’ and authored new commentaries on Charaka Samhita and Sushruta Samhita. Dalhana (11th century CE) did not deter to amend and add two new iron formulations for anaemia treatment in his commentary on Sushruta Samhita.

“Ayurveda does not derive its authority because it is divined by Brahma; its merit comes simply from the verifiable truths it contains”, according to Vagbhata. However, numerous practitioners of Ayurveda believed that it was attained by ancient ‘rishis’ through their divine ‘yogic’ powers rather than as an experimental and experience-based scientific therapeutic system subject to critique.

“Subservience to the written word and textual authority, reinforced by the societal effects of caste hierarchy and mystical philosophies, gradually replaced the spirit of scientific adventurism and enquiry that characterised the work of Ayurvedic pioneers,” says MS Valiathan, a noted cardiologist and author of the book series Legacy of Charaka, Sushruta, and Vagbata.

In recent history, conservatism and mysticism were reinforced and promoted by the trope formulated by Captain G Srinivasa Murti, a practising medical doctor, to the committee constituted by the Government of the Madras presidency in 1921 under the chairmanship of Muhammad Usman on the question of recognising and encouraging indigenous medical systems. While modern Western science used external aids such as the microscope, telescope, spectroscope, and so on to comprehend things beyond the range of the senses, he asserted that the Hindu sages “sought to effect the same results, not by providing their senses with external aids, but by improving their own internal organs of sense”.

“The general unwillingness of contemporary practitioners of Ayurveda to question the wisdom enunciated in the classical Samhitas is contrary to the teachings of the sages in ancient India who preferred pratyaksha (direct evidence), anumana (inferential evidence), and yukti (logic) over shabda pramana (textual narrations)“ says Subhash C Lakhotia, professor of cytogenetics at the Banaras Hindu University and a pioneer in using the drosophila model to study Ayurvedic biology.

Western and Eastern

Not all invoke the divine to refuse scientific scrutiny; some hide behind cultural relativism. They argue that ‘allopathy’ is based on Western science and that Ayurveda is an epistemologically different yet valid knowledge system, which can be validated only using Ayurvedic logic and methods.

According to Ayurvedic physiology and anatomy, shukra (semen) is formed in majja (bone marrow), and urine is formed without the involvement of the kidneys. The text further states that the combination of semen and menstrual blood results in the creation of an embryo. All of these contradict ‘pratyaksha‘, and can these be accepted as alterative ‘ways of seeing’?

Kishor Patwardhan, a Kriya Sharir Ayurveda professor at Banaras Hindu University, explains that Ayurveda’s epistemology aligns with Nyaya Vaisheshika schools of thought, similar to modern science but using simple tools. “In ancient times, pratyaksha meant employing the sense organs to acquire knowledge; today, we use tools like microscopes for the same purpose”, he says.

Clinical trials

Randomised control trials (RCTs) are the gold standard for clinical trials assessing medication efficacy. Allopathy prescribes the same therapy for two people with identical diagnostic assessments.

However, Ayurvedic treatment is individualised based on the constitution (prakriti, agni, samhanana, etc). Due to its complexities, including multiple medications, mid-course correction, therapies, diet restrictions, and lifestyle modifications, the RCT appears to be not feasible for Ayurvedic clinical trials. Some argue that only case studies from the personal experience of Ayurvedic medical professionals are viable.

The situation is not hopeless, however. Recently, methotrexate-based treatment was compared to Ayurvedic intervention in patients with radiological indications of rheumatoid arthritis, proving the viability of double-blind, placebo-controlled trials even for individualised treatments. If there is a will, there is a way.

The elephant in the room

It is frequently argued that modern science gives stepmotherly treatment to studying old medical systems. But this is not the case. Prompted by a fortuitous talk by former President of the Indian National Science Academy, M S Valiathan, on Ayurveda and modern medicine, Naveen Khanna and his team at the International Centre for Genetic Engineering and Biotechnology (ICGEB) discovered a potent antiviral against all four dengue strains, after reviewing Ayurvedic literature. After years of research, they found that a botanical extract of Cissampelos pareira Linn (Cipa) was beneficial against dengue in both in vitro and animal models. Human clinical trials are currently underway.

Similarly, researchers at the CSIR-Indian Institute of Integrative Medicine in Jammu isolated Sinococuline, a bioactive constituent of Cocculus hirsutus, which has a powerful anti-dengue action, and discovered IIIM-290, a botanical medicine with anti-cancer characteristics.

China is investing massive amounts of government funds to revalidate ancient medicine using current evidence standards, by accepting therapies that work while rejecting those that do not. In India, we lack both funding and an unflinching commitment to evidence.

Aura of mystical, the critical hurdle

Sushruta maintains that medical interventions are trustworthy not just because they are effective in his own experience (pratyaksha / phaladarshana) but only because they have been rationally vetted by the community of specialists. He is seeking what is now known as a rigorous peer assessment before the claims are accepted. It is obvious that case studies cannot replace well-designed clinical trials in evaluating efficacy and assessing the underlying pathophysiology of disorders.

Naturally, classical medical texts from centuries ago contain imprecise anatomy and physiology, with outdated theories of pathophysiology and aetiology. Yet, practitioners often claim divine revelation and do nothing to update or change this knowledge. Unearthing the biological basis of this knowledge trove can benefit both the Indian System of Medicine and biology.

(The author acknowledges Krishna GL, particularly in his paper ‘Ayurveda awaits a new dawn’, for providing perspectives on the philosophical and epistemological aspects of Ayurveda)