What is herbal medicine?

Herbal medicine, sometimes referred to as Herbalism, Botanical medicine or Herbology, is the use of plants, in a wide variety of forms, for their therapeutic value. Herb plants produce and contain a variety of chemical compounds that act upon the body and are used to prevent or treat disease or promote health and well-being.

A brief history of herbal medicine.

Humans, and even Neanderthals, have used plants to treat their ailments for at least tens of thousands of years; most likely even longer than that.

The first written accounts of the use of herbs originate in China, although all other civilisations from the ancient world were using plants as natural remedies for their ailments. Western herbal medicine dates back to ancient Greece and its famous doctors like Hippocrates and Galen.

The 15^th to 17^th centuries were the most popular time for herbalism in Europe. Herbal remedies are still relatively popular today, mainly due to the fact that they are regarded as harmless because they are natural.

The theory of how they work.

As herbal treatments have been around for so long, and in so many cultures, there are numerous ways that they are believed to work. Many explanations lie in the mystical thinking of ancient cultures. Some believe that the appearance of the plant gives an indication of what it can be used to treat; this physical resemblance between the plant and the body part to be cured is known as the "'Doctrine of Signatures"; a heart shaped plant would be used to treat heart problems, for example.

From the middle ages on, many practitioners have tried to classify herbal remedies by observation of their effects. This is closer to the modern scientific approach of gathering evidence.

Eastern herbal medicine still adheres to the mystical approach in its theories whilst western herbalists tend to use herbs for the ingredients they contain; mixing and matching them in the way that conventional medicine does with modern drugs.

The three main branches of herbal medicine are:

• The Western herbal tradition based on Greek, Roman and medieval sources;
• The Ayurvedic tradition of India;
• Chinese herbal medicine.

Remedies are produced by either taking the whole plant, or just the part of the plant required, and often mixing it with other plants. They are usually boiled in water or alcohol, and made into: herbal teas; herbal decoctions; herbal syrup; herbal tincture; infused oils; salves & ointment/creams.

Scientific evidence and herbal medicine

There is a lot of mysticism behind it. The approach involves: "balancing" the body's vital energy; the belief that it can treat anything; it is holistic, which is the reason given why no two practitioners will prescribe the same treatment for exactly the same condition in the same person; and they insist that it is natural and therefore safe.

There is no doubt that herbs contain chemical compounds, often many thousands, many of which have a physiological effect on the body. In fact up to 25% of modern medicines are based on plant origins: Aspirin; Quinine; and Digitalis, for example, are well known.

A substance that has a physiological effect on the body is by definition: a drug. Therefore those herbal remedies that have an effect, do so because of the drugs that they contain; and drugs can be beneficial or harmful. Although some very useful drugs are obtained from plant sources, it should be noted that some of the most deadly poisons are also obtained from plants: the alkaloid poisons for example.

There is some scientific evidence to support some herbal remedies. The evidence is not strongly in favour of the remedies that do show up positive results, although it does show up the need for more quality research.

Example: Glucosamine has been shown in quality studies to be beneficial for arthritis sufferers compared to a placebo. However the effect was not large; showing a comparable improvement of the same magnitude as patients taking Ibuprofen. Source: Bandolier

Is herbal medicine dangerous?

Yes, dangers certainly exist.

The most important point to understand is:

Just because something is natural does NOT mean that it is harmless.

It is the "natural" aspect of herbal remedies that is their big selling point, and the one that advertisers emphasise when advertising their products. It should be noted that plants manufacture compounds for their own benefit: not ours. Plants often contain toxins for their self protection.

The potential dangers of herbal remedies:

• Active compounds. Herbal remedies contain physiologically active compounds. i.e. drugs. Even where remedies are known to have an effect, the compounds responsible are often unknown or not well understood.
  
  
• Interference with prescribed drugs. As herbal remedies contain drugs they can have an effect not only on the body, but also with other drugs. St John's wort, for example, is known to counteract the effect of warfarin. This can lead to the death of the patient. see: Fatal mix of herbal pills and medicines
  
  
• Dubious safety. Natural does not mean safe (!)
  
  Most herbal remedies have not been tested for their true effectiveness or their safety. There is a big misconception about these remedies being inherently safe. This can lead to consumers taking these remedies without a thought about overdosing or side effects.
  
  
• Regulation. Regulation is now in force (see: stricter rules for herbal drugs - new window). This means that companies that manufacture herbal remedies have to ensure that they are both safe and of standardised quality.
  
  Hopefully, this will address the problem which existed where herbal remedies were potentially dangerous due to that fact that no-one knew what they contained and in what quantities. Of course, it also may lead to herbs which do contain active compounds being banned; thus leading to a group of herbs on sale that are safe, but non-effective.
  
  NOTE: this legislation will only affect over-the-counter herbal remedies produced in the EU. It does not mean that the problem has been wholly solved (see: Chinese outlets investigated).
  
  The glaring omission of the new legislation is that nowhere does it require evidence that herbal remedies actually work.
  
  Many potential dangers of using herbs are known. See Government safety report (PDF - 519Kb). It will be interesting to see what effect this new legislation actually has.
  
  
• Adulteration. Remedies, especially those imported from abroad, may have more than just herbs in them to make them appear more effective. See Adulteration.
  
  
• Self diagnosis and self prescription. Many people, encouraged by books, will self diagnose their conditions and may pick and mix their remedies for themselves.
  
  Initial misdiagnosis is an inherent danger in itself, and the fact that most compounds in herbal remedies are not known, it is possible that a quite inappropriate, or even damaging, remedy will be concocted.
  
  Drugs are often more potent when administered in the presence of other drugs. This works whether the drug is beneficial or if it is harmful.
  
  
• Untargetted response. Remedies taken for one condition may not have the expected response. As they contain active drugs that are unknown and untested, the active compound could have a deleterious effect on a part of the body that was not considered as part of the initial problem.
  
  As there are often thousands of chemicals in herbs there is a strong likelihood, if not a certainty, that some of them will contain toxins and carcinogens. Overuse of such untested compounds could lead to health problems caused by the "remedy".
  
  
• Pregnancy and breast feeding During pregnancy. A woman shares her bloodstream with that of her baby via the placenta. Toxic and harmful chemicals in the woman's body will be shared with her child. Many women sensibly quit smoking and give up alcohol during pregnancy.
  
  In an effort to avoid "drugs" women may be tempted to use "natural" remedies as they are believed to be harmless. This is not the case. It is the untested nature of so many herbal remedies that is the cause for concern; their dangers and/or side effects are simply unknown.
  
  Even advocates of herbal remedies are cautious about their use during pregnancy: see Taking herbs during pregnancy
  
  We recommend that women should avoid all herbal treatments whilst pregnant, and seek any health care required from a medical professional.
  
  Toxic chemicals can also show up in breast milk, having been ingested by the mother. The same precautions should apply to breast feeding as to pregnancy.
  
  For an overview of the dangers of herbal medicine see: Chinese medicines 'can damage your health'

Conclusion

Herbal medicine is a pseudoscientific approach to healthcare and healing. It is based on mystical thinking and there is little quality scientific evidence to support the claims of its efficacy.

Whilst there is undoubtedly merit in testing plants for beneficial compounds they may contain, it is through a truly scientific approach that these benefits will be realised.

Unlike homeopathy, herbal remedies do contain active ingredients. This is the key to why some of them can be shown to have a physiological effect; it is also why the potential dangers from them are higher than with other alternative remedies, especially with home-made remedies or those imported from abroad.

The main problems are that there is very little regulation of this highly profitable industry, and the fact that consumers are under the false impression that these 'remedies' are intrinsically harmless.

Buyer beware!

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