Dear Dr. Gott: I was prescribed Coumadin/warfarin in 2005. I have just recently learned that both are a form of rat poison! Is that the best our "medical industry" can come up with? What's next? Leeches? I want to know what I can take in place of the "rat poison". There has to be something better.

Reply: It is true that Coumadin's generic form, warfarin, is one of the main ingredients in rat poison. However, that does not mean it is not beneficial for humans. Many life-saving medications and treatments have been found in unlikely places. Aspirin was derived from the bark of willow trees. Penicillin was discovered by accident when mould blew in from an open window into a petrie dish containing bacteria. Many cancer treatments have been developed from plants found in rainforests and jungles. Even certain food additives and colorings come from unlikely sources, such as the ground-up shells of beetles.

The value of something cannot be determined only by where it comes from. Without warfarin and Coumadin, there would be several thousand more deaths per year due to clotting abnormalities and heart conditions. While its source may be a bit bizarre, the fact remains that without this medication, people would die unnecessarily.

As for your statement about leeches, well, yes, they can be successfully used for medical purposes. The leech is a bloodsucker. Its saliva contains certain substances that don't allow blood to clot properly while it's feeding. It also has a certain anaesthetic quality, since leech "bites" often cause no pain. While not common practice, especially here in the United States, leeches can be used successfully to treat some conditions, such as regrafting amputated appendages.

Another uncommon and rather disgusting yet beneficial treatment is maggots. These ugly little fly larvae can improve healing of extensive burns. Maggots eat only dead and decaying flesh, leaving healthy skin and muscle intact. In essence, they do the same job as surgical debridement.

For some, this may be a better option, especially those allergic or sensitive to general anaesthetics or those who have wounds over a majority of their bodies, making surgery inadvisable or impossible.

Both leeches and maggots are approved by the Food and Drug Administration as medical devices and are therefore raised in sterile laboratories in order to be considered "medical grade".

So before you go dismissing Coumadin because of where it got its start, I suggest you take a look at its benefits and what it has done to help people.

As for an alternative, that would depend on why you are taking the medication. Some people may be able to use standard or low-dose aspirin. Some may benefit from the use of Plavix, with or without aspirin. However, without knowing your medical history and reason for taking it, I can't give you a clear-cut answer.

Warfarin, if taken according to physician directions and monitored with regular blood tests, will not cause adverse reactions in most people. The most common side effect is easy bruising and bleeding, which can be reversed by simply lowering the dose. Speak with your physician about alternatives if taking warfarin disturbs you.

Dr. Gott is a retired physician and the author of "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook". Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.