Herbal Medicine

Herbal medicine is also called herbology, phytomedicine, or botanical medicine. Because many plants have medicinal properties, about one quarter of pharmaceutical drugs are derived from plants. Drugs developed from plant sources include digitalis for heart problems, vincristine for leukemia, morphine for pain, and aspirin for aches, pains, and fevers.

Herbs have been used for medicinal purposes in most cultures since ancient times, either as single entities or as complex mixtures of several herbs or of herbs and other substances. In industrialized societies, use of herbal medicines has declined since the development of powerful manufactured drugs.

Herbal remedies are more widely used in Europe (particularly in Germany and France) and in Asia than in the United States. Because herbs cannot be patented, pharmaceutical companies are unlikely to invest the millions of dollars required to test them and then submit them to the FDA for approval as drugs. Moreover, unlike pharmaceutical companies, which isolate the active substances in herbs in order to produce standardized drugs, advocates of herbal remedies believe that the number or combination of substances in each herb results in a synergy that is superior to the singular impact of extracted drugs.

A meta-analysis (review of pooled studies) of the herb St. John's wort (Hypericum perforatum) for mild and moderately severe depression, published in 1996 by German and American physicians, concluded that it was more effective than a placebo and was as effective as standard antidepressants but with fewer side effects. The authors raised questions about its methods and cautioned about its efficacy in seriously depressed patients. The active chemical in the herb, they claimed, was not appropriately standardized. Furthermore, the study only compared St. John's wort with anti-depressant drugs that were given at or below their lowest level of efficacy. And, finally, patients were treated for only 6 weeks. An accompanying editorial concluded that: "longer term studies are needed before it can be recommended in major depression."

This report led Wayne Jonas of NIH's Office of Alternative Medicine to call for a trial comparing St. John's wort with the popular antidepressant fluoxetine (Prozac^TM). The Office of Alternative Medicine (OAM), the National Institute of Mental Health (NIMH), and the Office of Dietary Supplements (ODS) are collaborating on a study to evaluate the efficacy and safety of a standardized extract of Hypericum in major depression. NIMH, the administering agency, issued a Request for Proposals (RFP) for a randomized controlled trial, and Duke University was awarded a three-year contract in the amount of $4.3 million to conduct the study.

Consumers usually choose and administer herbal medicines themselves, following recommendations by friends, employees in health food stores, and the increasing numbers of books, magazines, and magazine articles devoted to the subject. Health food stores display publications by manufacturers that contain articles recommending the use of particular herbs.

Traditional Chinese medicine and Ayurvedic practitioners usually blend several herbs into one mixture. These mixtures have been effective in treating, for example, atopic eczema and acute bronchiolitis caused by respiratory syncytial virus in infants. The National Certification Commission for Acupuncture and Oriental Medicine administers an examination in Chinese herbal medicine.

Herbs that have been beneficial, according to researchers, also include: bromelain (reduced post-surgical pain and swelling); topical capsaicin from chili peppers (decreased tenderness and pain in osteoarthritis, fibromyalgia, diabetic neuropathy, and post-herpetic neuralgia); cranberries (decreased urinary tract infections); evening primrose oil (decreased breast pain, both cyclical and constant, reduced itching in atopic eczema, decreased use of painkillers in rheumatoid arthritis); feverfew (prevented severe migraines); garlic (lowered cholesterol, inhibited blood clotting); ginger (reduced nausea and vomiting); ginkgo (improved blood flow in small blood vessels); licorice (acted as an anti-inflammatory agent during treatment of stomach and intestinal ulcers); milk thistle (helped to restore diseased livers); saw palmetto (decreased symptoms of an enlarged prostate); sweet wormwood (decreased malaria parasites in the blood); and valerian (induced sleep). Some herbs, however, are either dangerous or can interact harmfully with prescription drugs.