Apitherapy
Apitherapy is the medicinal use of various products of Apis mellifera--the common honeybee--including raw honey, pollen, royal jelly, wax, propolis (bee glue), and venom. Various studies attribute antifungal, antibacterial, anti-inflammatory, antiproliferative, and cancer-drug-potentiating properties to honey (Science News, 1993). In China, for example, raw honey is applied to burns as an antiseptic and a painkiller. Recently, propolis (the bee product that cements a hive together) has been identified as containing substances called caffeic esters that inhibit the development of precancerous changes in the colon of rats given a known carcinogen (Rao et al., 1993). Preparations from pieces of honeycomb containing pollen are reported to be successful for treating allergies, and bee pollen is touted as an excellent food. This section focuses on bee venom to treat chronic inflammatory illness because of the popularity of this treatment and the availability of related research material. That forms of apitherapy have been used since ancient times is not remarkable, because bees formed an important part of many early economies. Ancient writers as diverse as ~Hesiod (ca. 800 B.C.), Aristophanes (ca. 450-ca. 388 B.C.), Varro (166-27 B.C.), and Columella (1st century A.D.) all wrote on the cultivation of the hive, and Charlemagne (742-814 A.D.) is said to have had himself treated with beestings. The Koran (XVI: 71) refers to bee products in the following terms: "There proceeded from their bellies a liquor wherein is a medicine for men" (Kim, 1986). For apiculture and the scientific understanding of bees, real progress began about 100 years ago when physician Phillip Terc of Austria advocated the deliberate use of beestings in his 1888 work, Report about a Peculiar Connection Between the Beestings and Rheumatism. Today's proponents of apitherapy cite the benefits of bee venom for alleviating chronic pain and for treating many ailments including various rheumatic diseases involving inflammation and degeneration of connective tissue (e.g., several types of arthritis), neurological disease (e.g., multiple sclerosis, low back pain, migraine), and dermatological conditions (e.g., eczema, psoriasis, herpesvirus infections). In one sample description of the use of bee venom therapy, a physician reported anecdotally ~that among 128 patients with a wide spectrum of illnesses, all but 11 appeared to improve (Klinghardt, 1990). (Of the 11 who did not improve, 1 was worse and 10 were unchanged.) This report is typical of anecdotal apitherapy reports that begin with stories of beekeepers recounting various health improvements after receiving accidental multiple stings from their bees. Klinghardt's patients had diagnoses of gout, rheumatoid arthritis, fibromyalgia, spinal strain or sprain, spinal disc injuries, postlaminectomy pain, bunion, postherpetic neuralgia, incomplete healing of a fractured bone, intractable pain from large burn wounds, osteoarthritis, ankylosing spondylitis, vertigo, and multiple sclerosis. Earlier, Steigerwaldt and colleagues (1966) reported improvement among 84 percent of 50 cases of arthritis in a controlled study. In contrast, interest in bees has been sporadic in conventional medicine, focusing mainly on three areas unrelated to the therapeutic uses proposed above. These areas are (1) the danger of hypersensitivity reactions, including anaphylactic shock, from the sting of insects of the genus Apis; (2) the use of bee venom itself as immunotherapy for allergic reaction to such stings, especially to prevent life-threatening anaphylactic reactions in adults; and (3) the ~danger of infants contracting botulism from ingesting raw honey--possibly one death every 2 to 5 years (Wyngaarden and Smith, 1988). The modern movement promoting apitherapy is spearheaded by veteran beekeeper Charles Mraz of Vermont and physician Bradford Weeks of Washington State, assisted by other members of the American Apitherapy Society. They cite studies identifying various biological properties for semipurified fractions of bee venom and for more purified products to help explain the curative properties attributed to this venom. Table 1, adapted from Klinghardt (1990), summarizes these properties, which include pronounced anti-inflammatory, analgesic, and immunostimulatory properties. The American Apitherapy Society contends that hypersensitivity reactions to bee venom therapy are very rare, occuring mostly from stings by related species but not by the honeybee. The procedures the society recommends include always testing a new patient first with a small amount of venom to look for possible allergic reactions and never using bee venom without an emergency beesting kit (containing epinephrine) available.~In practice, proponents say that the best results are obtained when there is a "good reaction"--considerable swelling and inflammation--at the site of sting. Mraz believes that the optimal means of delivering venom is through a hypodermic needle administered by a licensed physician. However, since most medical practitioners do not recognize the benefits of bee venom, practicing apitherapists almost always use "the original hypodermic needle developed by Mother Nature and the honeybee some 30 million years ago: the bee stinger." Procedures for obtaining and purifying venom have been developed, but of course this product in liquid or dried form costs more than using live bees. The usual treatment involves stinging the patient at a specific site relative to the illness and repeating the stings over a period of time. For example, it is suggested that the venom be injected into arthritic patients at trigger points in a daily course of treatment that lasts 4 to 8 weeks. Proponents indicate that there are typical patterns of responsiveness, depending on the ailment. A 50-year-old patient with arthritis might note pain relief in 2 weeks, mobility in 3 weeks, and freedom from symptoms in 4 weeks (Weeks, 1994). ~Research on bee venom has included studies of whole venom and venom products. For example, in the 1960s and 1970s, studies on bee venom to treat rheumatic diseases were conducted by William H. Shipman of the U.S. Navy Radiological Defense Laboratory, James Vick of the Walter Reed Army Hospital Medical Research Center, and Gerald Weissman of New York University Hospital and their colleagues, with funding by private and public sources. One finding was that whole bee venom could suppress the development of an induced arthritis in rats, although it could not alleviate the illness after it had started (Zurier et al., 1973). Treatment with separate fractions of bee venom had no positive effect. In later studies in which the components of bee venom were purified further, the various properties, such as anti-inflammatory and antibacterial activity (see table 1), began to be associated with specific materials. In a more recent study (Kim, 1992), a randomized, controlled trial was conducted comparing true honeybee venom therapy with a "sham" product for 180 patients suffering from chronic pain and inflammation; solutions were injected twice weekly for 6 weeks. ~Significant posttreatment reductions in pain and inflammation were recorded in the true bee venom therapy group and were maintained at 6-month followups. The American Apitherapy Society endeavors to coordinate information on bee venom research. Starting with 100 citations 12 years ago, when patients in his medical practice first interested him in the subject, Bradford Weeks, the society's president, has now acquired more than 12,000 case reports on persons treated with bee venom (Weeks, 1994). Together, these 12,000 reports are the basis for the ongoing National Multicenter Apitherapy Study. Approximately 200 physicians and 200 beekeepers voluntarily contribute reports. At this time, the database for the multicenter study contains mostly anecdotal information, such as "I had an illness; I was stung by bees; my health improved." As Weeks notes, there is no proof in such reports that a person really had the specified illness and really improved because of the bee venom treatment. ~The American Apitherapy Society would like to obtain research funds to improve the collection of both retrospective (past) information and prospective (future) data. Funding could provide research staff to search out medical records for proof of illness, training for research staff and bee venom therapists on how to gather data, and support for statistical analyses. Meanwhile, the multicenter study has in its database some 1,300 reports on patients with multiple sclerosis (subjectively reporting increased sensation and bowel and bladder control), 2,800 with rheumatoid arthritis, and other groupings of data on such problems as gout, viral illnesses, and premenstrual syndrome--nearly 100 percent of 40 women being treated for premenstrual syndrome by apitherapy became symptom free, according to Weeks (1993). In some ways, apitherapy is a classic alternative therapy. It has ancient roots and, although discarded by mainstream medicine, has survived in folk practice.

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