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Western Herbal Medicine: Nature's Green Pharmacy

Herbal medicine has entered the mainstream in America and abroad. It's estimated that about one-third of all adult Americans, or some sixty million people, use herbal medicinal products each year, spending over $3.2 billion. In the rest of the world, approximately 64 percent of the population relies on herbal medicines. Over 1,500 herbs are currently marketed in the United States, and are sold not only in health food stores but also in pharmacies, supermarkets, department stores, and even truck stops!

Equally indicative of herbs? importance is the fact that about one-quarter of all U.S. prescription drugs are derived from herbs. Approximately 119 plant-derived compounds are currently used as drugs, and nearly three-quarters of them were discovered by following up on folklore. Examples include quinine, from the bark of a South American tree, which is used to treat some strains of malaria; digoxin, the widely prescribed heart medication, which is derived from the foxglove plant; salacin (the source of aspirin) from willow bark; and, recently, taxol for cancer prevention from the yew tree.

In the parlance of herbal medicine, the term herb applies to any plant or plant part that is used to make medicinal preparations. Herbal medicine, or botanical medicine, is also known in Europe as phytomedicine, from the Greek phyto, "plant." A phytomedicine, or phytopharmaceutical, is a complex mixture derived from plant sources that is used as a medicine or drug. Parts of plants used in herbal medicine can include leaves, flowers, stems, roots, seeds, fruit, bark, or any other plant part that is used for its medicinal, flavoring, or fragrant properties.

Early in human history, herbal medicine was practiced as a magical, or religious, healing art. Out of this, systems of herbology evolved on every continent, including Europe, North and South America, and Asia.

In colonial America, botanical medicine evolved through the blending of two separate traditions. Passengers on the Mayflower carried with them a book on European herbology. In America, the colonists encountered not only new plants but also a population of Native Americans who were knowledgeable about them.

During the 1800s, many of the most effective American healers were those who combined European and Native American herbalism. Soon, Chinese immigrants added their own herbal tradition to the mix, especially on the West Coast.

Following the Civil War, herbology began to lose influence, partly because of improvements in conventional medicine that were achieved during the war. By the beginning of the twentieth century, chemists had become more adept at isolating the active ingredients in plants, and the use of raw, whole-plant materials began to seem crude and unscientific. In 1910, the Carnegie Foundation, at the request of the AMA, issued a study of American medicine called the Flexner Report. This report elevated pharmaceutical medicine, and was critical of schools that taught herbal medicine and other nonconventional approaches. Historically, this influential report contributed greatly to the decline of alternative medicine, including herbology.

By the end of World War II, synthetic drugs were increasingly being produced by companies that had originally sold herbs, such as Merck and ParkeDavis. Unlike herbs, these pharmaceuticals could be protected by patent, offering greater profit. Modern physicians also preferred synthetic drugs. Drugs seemed more scientific than natural products, and were supported by clinical studies. Moreover, since drugs required prescriptions from doctors, the new drugs - unlike herbs - brought the medical profession a guaranteed business.

In the 1970s, however, there was a resurgence of interest in herbal medicine, led primarily by patients who objected to the inaccessibility, high cost, and toxicity of pharmaceutical drugs. Many patients found that herbs could have actions that were similar to those of herb-derived drugs, without drug side effects. Also, many patients became aware that pharmaceutical drugs were often ineffective for the modern wave of degenerative diseases. Mild herbal medicines, however, could help prevent some of these diseases.

Interest in herbalism was also spurred by the global search for new plant products that were effective medicinally. Between 1960 and 1986, the National Cancer Institute tested more than 35,000 species of plants, and found that nearly 4 percent of them had antitumoral actions.

Renewed interest in herbs has become even stronger in Europe than in America. In Germany, 70 percent of physicians currently prescribe herbal remedies, which are paid for by government health insurance. Since 1993, the licensing examination for German physicians has included a section on herbal medicine.

One reason that Western herbalism is popular in modern America and Europe is because its principles are essentially consonant with those of conventional medicine. Unlike traditional Chinese medicine, Ayurveda, or even homeopathy, Western herbal medicine does not have its own distinct theory of disease and treatment. Also, unlike TCM or Ayurveda, Western herbalism generally uses single-plant preparations, which often have specific effects, rather than combinations of herbs or herbs that have a broad range of effects.

Unfortunately, though, we now know that purified, isolated plant products often have more side effects than whole herbs. Isolated herbal preparations, however, are at least gentler than most pharmaceuticals.

Even whole herbs that have relatively specific effects usually have a significantly wider range of effects than most drugs. For instance, pharmaceutical researchers are now scrambling to find new arthritis drugs (such as antiprostaglandins, anti-inflammatories, and antileukotrienes) that target a variety of possible receptor sites. Herbs, on the other hand, naturally address arthritic symptoms with precisely this degree of complexity. Bilberry, for example, contains nineteen phytochemicals that have a demonstrated activity against arthritis, including pain-killing compounds, general antiarthritics, antiedemics for reducing swelling, and anti-inflammatories.

Americans now use herbs mostly for a variety of minor conditions. According to a 1997 Prevention magazine survey, the most common conditions for which they use herbs are colds (59 percent), followed by burns (45 percent), headaches (22 percent), allergies (21 percent), rashes (18 percent), insomnia (18 percent), PMS (17 percent), depression (7 percent), diarrhea (7 percent), and menopause (4 percent).

Among American consumers, herbs are extremely popular as adaptogens, which are products that help the body adapt to a broad range of physical and emotional stressors, and which are considered safe for long-term use. The most frequently used adaptogen is ginseng. In light of Americans? awareness of the connection between chronic stress and major killer diseases, it is not surprising that there has been a strong demand for adaptogenic herbal remedies.

Herbs are most often ingested as teas, and in capsules and tablets. They are also used in a concentrated form, as tinctures and extracts. Sometimes, herbs are added to oils and ointments and applied topically.

Current government regulations on herbs are moderate. Herb manufacturers are not required to conduct the expensive safety and efficacy studies that are necessary for new drugs. However, the FDA can remove herbal products it considers unsafe. It must justify the removal in an administrative hearing. Herb manufacturers are largely prohibited from making claims on labels that an herb can cure a disease, but they are allowed to make claims about how an herb can affect the body's function or structure.

In 1994, the FDA threatened to remove herbs from the open market, but this caused a letter-writing campaign to Congress that has been described as the most extensive since the Vietnam War. Under current regulations, consumers have been left in an informational vacuum concerning the value and safety of herbal products. Detailed information regarding therapeutic use of herbs is not permitted on product labels, and the spate of enthusiastic booklets, books, and articles touting the latest herbal crazes are not necessarily reliable.

Although herbal products are now commonly carried in drugstores, most pharmacists are not experts on herbology. Similarly, many health food store clerks may have only a smattering of knowledge, and will often be influenced by the desire to sell their products. Most naturopathic physicians will be well versed in Western herbology, but are licensed to practice in only a limited number of states.

In the absence of any organized professional body that can help unravel the complex questions about herbal remedies, consumers are often left to their own devices. Herbal medicine is not a regulated health profession in the United States, and there is no licensing body for practicing herbal medicine.

Without official standards of quality, herbal preparations may not always be pure, and may not be accurately labeled. According to a 1979 review by Dr. Ara Der Mardersosian at the Philadelphia College of Pharmacy and Science, 60 percent of fifty-four ginseng preparations contained so little ginseng that they were essentially inactive, and about 15 percent contained no ginseng at all.

In a study by Heptinstall, analyzing the herb feverfew, which is used to prevent migraine headaches, researchers found that two out of three of the feverfew products contained no active ingredient. Also, it was estimated by Awang in 1991 that more than half of the echinacea sold in the United States from 1908 through 1991 was actually Parthenium integrifolium, and not echinacea.

One way of dealing with the problem of variable contents in herbal remedies is to follow the European example of producing herbal preparations that are standardized, so that each unit of dosage contains a known quantity of the active constituents. This not only provides a clinically effective dosage, but is also more cost-effective.

With regard to scientifically determining the safety and efficacy of herbs, the best current research is an extensive collection of monographs published by the German government's Commission E. In late 1998, this herbal compendium was translated into English in both written and electronic text. It is considered to be the definitive text on herbal medicine and is available from the American Botanical Council in Austin, Texas, under the title of The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines, edited by Mark Blumenthal.

Many of these Commission E studies are referred to in the following examinations of the herbs that are among the most widely used natural medications in America today.



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Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.

Reprinted by permission of Simon & Schuster, Inc., New York, New York.


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