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Herbal medicine

This article was devised in consultation with Trudy Norris, Information Officer for the National Institute of Medical Herbalists, the oldest herbalist organisation in the western world.

What are the origins of herbal medicine?

People have used extracts from plants to treat their ills for thousands of years. The Egyptians were using herbal remedies some 3,500 years ago, while there is evidence that other ancient peoples, like the Persians, Chinese, Indians and the people of the Americas have used medicinal herbs for centuries.

No one knows who the first people were who used plants to make themselves feel better. In fact, there’s evidence that apes and other animals seek out certain types of plant when they feel ill, so the use of herbal medicine could be older than human history.

More than eighty percent of the world's population uses herbal medicines in one form or another, from China to Australia and from America and Europe to Africa. Western herbalism evolved from the work of apothecaries and  alchemists, going as far back as the ancient Romans.

Herbal folklore slowly evolved over the centuries, with recipes for herbal remedies being passed down through families. The invention of the printing press in the 15th century led to an explosion in herbal medicine, as recipes for treatments could be copied and used by anyone who could read.

By the 17th century, Nicholas Culpeper had put together a book of herbal remedies, which became very popular. In his book, Culpeper built on the idea of the 'doctrine of signatures', which the early chemist Paracelsus had first though of. He believed that how a plant looked provided clues as to what ailment it would cure.

By 1985, the World Health Organisation agreed that herbal remedies are an important part of healthcare. In continental Europe their use has become very common, although they are only gradually becoming more popular in the UK.

How does herbal medicine work?

Herbalists try to find the underlying cause of an illness rather than treat the individual symptoms. They believe that the use of tinctures and herbal tonics can help the body to heal itself by restoring harmony and balance and activating the body's 'life force'.

Herbal 'synergy' is, herbalists believe, the key principle of herbal medicine. Their remedies are extracted from leaves, petals and roots of plants and are a complex mixture of lots of different compounds. While a conventional pharmaceutical will usually be a single active ingredient, the idea of herbal 'synergy' explains that the hundreds if not thousands of constituents of a plant extract all work together to treat an illness.

For example, ephedrine, an early anti-asthma drug, was first isolated from the herb Ephedra, traditionally used to treat chest complaints. One of the side-effects of ephedrine is that it raises the blood pressure. Herbalists point out that among the many compounds found in the plant itself is one that lowers blood pressure. So, the herbal remedy contains a compound to treat the chest, but also to counteract the side effects of that compound.

Another example of herbal synergy can be found in the plant meadowsweet, which is used to treat stomach complaints. The plant contains salicyclic acid, which is closely related to aspirin. The compound can cause internal bleeding from the stomach lining, but meadowseet contains compounds called polyphenols, which protect the stomach.

What happens during a treatment?

When you consult a herbalist, they will usually take about an hour to discuss your problem, your medical history, your diet and lifestyle and build up a picture of the 'whole' person. They will then use their knowledge of plants and their different effects on the body to find a mixture that will treat the underlying cause of a problem.

The herbalist will usually give you enough of the remedy, or tell you where to buy it, to take away with you to use before your next consultation. You can expect a lot of herbal remedies to taste nasty owing to the bitter compounds found in many plant extracts.

If appropriate, a herbalist may suggest you see a doctor to discuss your problem further.

What can herbal medicine help with?

Herbal medicine is thought to help with –
Certain forms of depression
Cold sores
Digestive problems
Hayfever and allergies
Menstrual and menopause problems.

Where's the evidence?

Numerous trials have shown the effectiveness of some herbal remedies. For instance, in a research paper in the medical journal The Lancet, St John's Wort was reported as being just as effective at treating depression as some pharmaceutical antidepressants. Echinacea, a traditional remedy of the North American Indians, has been shown to boost the immune system and allegedly staves off all kinds of illnesses, although there are concerns about the safety of repeated long-term use.
Other herbal remedies like garlic and ginger have been claimed to help with all sorts of problems from high cholesterol and heart disease to digestive complaints. There are many research papers that show positive effects but also some that show the research to be inconclusive.

What do doctors think of herbal medicine?

It may seem strange, but many of the conventional medicines we take today have their roots in herbal medicine. One herbal remedy for fever gave us aspirin (from willow bark), while a plant used to treat chest complaints was developed into the asthma drug salbutamol once scientists had extracted the active ingredient from the plants. Digoxin – a heart drug – comes from the poisonous foxglove, and quinine – once used to treat malaria and an ingredient in tonic water – originally came from the bark of the cinchona tree. The painkiller morphine was extracted from the opium poppy.

Mainstream doctors in the UK tend to side with the pharmaceutical approach and prefer regular medicines, because of the unknowns associated with herbal remedies. For instance, herbal remedies by their nature are not pure compounds, and some have been found to contain dangerous toxins.

While most manufacturers of herbal products try to maintain high standards,  there are some unscrupulous traders who may provide herbalists with poor quality remedies. Worse still, if you are buying herbal remedies for yourself through a health-food shop or elsewhere, there is an overwhelming range of products available and no certain guarantee of quality. At best, some of these products may simply have been so diluted down that they are effectively useless, and at worst they may be so strong as to risk overdosing on certain ingredients. They may even be contaminated with poisonous metals such as lead, mercury and arsenic. Some herbal remedies imported from the East have been found to contain dangerous levels of these substances.

The government is currently considering passing laws that will bring herbal remedies into line with pharmaceuticals, so that they have to pass stringent clinical tests and quality controls before they can be sold. Herbalists worry that this will mean they will not be able to use traditional remedies that have proved successful over centuries because of the costs of obtaining a licence. Many mainstream doctors hope such laws will bring herbal medicine into line with accepted safety and efficacy standards.

What should I look for in a practitioner?

You can find out more about herbal medicine through the National Institute of Medical Herbalists (NIMH), which can be reached on 01392 426022. Institute's web site is at  Members of the NIMH have to follow a programme of academic study, usually lasting three to five years, before they can join, and then to complete a minimum of 500 hours clinical training. The NIMH has an accreditation board to make sure the study that a prospective member is following is up to standard. The NIMH also has a post-graduate training board to make sure practitioners keep their skills up to date.

It's best to select an accredited practitioner, and the NIMH should be able to help you find one in your area. Members will have the letters MNIMH or NIMH after their name. It’s important to tell the practitioner your full medical history, such as whether you have disorders like high blood pressure or glaucoma or are pregnant. If you’re already taking prescribed medication, you should consult your GP before starting a herbal course, and do not stop taking prescribed medicine without the knowledge and agreement of your GP.