A Brief History of Herbalism
News and History of Herbalism
A BRIEF HISTORY OF HERBALISM
by Alan Hopking MA MNIMH
Who first used plant medicines is unknown. Trial and error began in many cultures - knowledge accumulated and was handed down in the community/tribe. Those who took a special interest in the healing qualities of plants and who became skilled in applying their knowledge gained an honoured place in society - medicine men. They attributed the healing powers of plants to gods, higher powers. Thus the medicine man became associated with religious beliefs and the priests became involved.
Medicinal plants have been confirmed by archaeological findings in Africa, India, China, Egypt, Assyria, Greece, the Americas, east and west Europe - medicinal, culinary, dyes, perfumes, cosmetics - rural wisdom has been held by men/women herbalists for centuries.
China - little known, but Emperor Chin Nong composed herbal 2700 BC. Sixty years later Emperor Huang-ti wrote a treatise on medicine.
India - in the Rig Veda (sacred books of the Brahmins) texts speak of medicinal plants (Ayurvedic medicine). This knowledge has been traced to have spread to Egypt, Mesopotamia and to the Eastern Mediterranean and Persia also to Armenia, ancient Greece, then to ancient Europe.
Egypt - Imhotep - the first Egyptian physician to survive. He served Zoser, a third Dynasty Pharaoh in about 2980 BC - an astrologer, magician and healer. He became known as a god of healing. The Ebers Papyrus (about 2000 BC) lists many herbal prescriptions - each describing the symptoms and instructions how to administer and prepare the remedy. Osiris - the god of vegetation; Isis had the power to renew life and gave "the secrets of healing to mankind." Thoth formulated each healing prescription - he holds in his right hand a staff around which a serpent is coiling itself (the symbol of the physician to this day).
Mesopotamia - sickness was seen to be devils and evil spirits attacking the body. Herbs used to heal.
Early Sumatran herbal 2500 BC; a copy survives from around 700 BC.
Assyrian knowledge of herbs extensive; Ashurbanipal, King of Assyria 660-626 BC had a library of medicinal tables - some 250 vegetable drugs are mentioned.
Ancient Greece - first established a scientific basis for medicine. Greeks believed the gods were the first herbalists (the Green Man) who taught the art of healing to man. Aesculapius (1250 BC), the greatest, possibly the first scientific herbalist. He was a great healer - legends have made him a god (said to be the son of Apollo, and whose daughter was Hygieia, goddess of health). Hippocrates 460-377 BC born on the Island of Cos and probably the best known herbal practitioner in the West. He became known as the father of medicine because he was the first to set down a scientific system of medicine (i.e. he cut out all the magic and mystery). The Hippocratic Oath is used to this day, "I swear by Apollo, the Physician, by Aesculapius, by Hygieia and Panacea and by all the Gods and Goddesses that to the best of my power and judgement..." This links today with the earliest medical scientists and gods of ancient times. Diocles Carystius wrote the first Greek Herbal - however no record remains. Theophrastus of Eresus 372-286 BC, a pupil of Aristotle, wrote the first scientific system of plants, their medical use and how to prepare them - a vast work - the first medical botanist. It remained the standard reference for a staggering 1500 years.
Ancient Rome. Pliny AD 77 devoted seven volumes of his epic 47 volume work on plants and their medicinal uses. It was here that the Doctrine of Signatures first began, i.e. the shape and colour of the plant or plant part represents its mode of use in the human, i.e. a heart shaped leaf is good for the heart (eg heartsease). Galen AD 131-201 was the greatest physician herbalist since Hippocrates.
Dark Ages. For six centuries after Rome fell nothing happened - no research, no science, no writing. In Europe, the monasteries kept medical and herbal practice alive. Outside the monasteries ritual and magic returned.
Arab World. Rhazes 865-925 a royal physician in Baghdad. Avicenna 980-1037 wrote Canon Medicinae which brought together all that was known in the Arab world. This remained a standard textbook in universities until 1650 (700 years!). Abulcasis d. 1013 of Spain, reached great heights of medical practice using herbal medicines.
Throughout this time and on into the present herbal medicine has been practised by all cultures - African, Indian, Chinese, Tibetan, Australian (Aborigine), New Zealand (Maori), South American, North American, Eastern European (including Russia) and everywhere on the globe.
Anglo-Saxon. One of the earliest manuscripts Leech Book of Bald compiled 900-950 by Bald a friend of King Alfred of England. This was the first book on herbs in the vernacular which was not based on the Greek texts. The knowledge it displayed of herbs is remarkable.
Constantine the African 1020-1087 an Arabic-speaking Christian translated Arabic medicinal works into Latin. This work marked the end of the Dark Ages.
At the Salerno School of Medicine a herbal was compiled by Matthaeus Platearius Liberde Simplici Medicina (mid-twelfth century), and Regimen Sanitatis Salern by Arnold of Villa Nova, a Catalan. These had considerable influence throughout the Middle Ages.
Rosa Medicinae 1314 (known as Rosa Anglica because it was in English) was the first major work in English on botanical medicine by a monk John of Gaddesden. It combines Greek, Arab, Jewish and Saxon medical and herbal and personal experience.
Book of Nature by Konrad von Megenberg 1309-1374 a German equivalent of the Rosa, - 89 herbs mentioned.
In the 16th century herbalism was still the dominant form of healing. But Paracelsus (1493-1541) had already laid the foundation for the use of chemical compounds in medicine. He introduced iron, antimony, mercury and other inorganic substances into medical practice. This caused the first crack in the break away from pure herbal medicine (using only plants in treatment). The horrific side-effects from the Paracelsus medicines are notorious.
Kreuterbuch by Hieronymus Tragus (publ. 1539 in Germany) gave precise descriptions of all known plants.
New Herball by William Turner 1551, studied herbs scientifically and medicinally. Turner lived and grew herbs in Kew (in fact where the Royal Botanic Gardens are today!).
John Gerard's Herball 1597 was based on a Flemish work by R. Dodoens. It was considerably extended by Thomas Johnson in 1633 which then made it a valuable work. However some herbals at this time after 1640 mention over 3000 plants!
Nicholas Culpeper 1616-54 wrote a popular herbal for ordinary people which included the Doctrine of Signatures and Astrological theories.
In 1617 the Worshipful Society of Apothecaries of London was founded. Apothecaries dispensed medicines and attended the patient while the physician was only to diagnose and prescribe. The Chelsea Physic Garden was started in 1673 by the Society of Apothecaries. It still flourishes today; well worth a visit.
A descendant of one of the Pilgrim Fathers, Samuel Thomson (1769-1843), is famous for popularizing local American Indian medicines and for establishing herbal schools and botanic societies all over the USA. In 1830 Dr A. I. Coffin brought Thomson's system of medicine to England and Europe, reviving herbal medicine by lecturing and writing about it. He joined the English tradition of herbalism with physiomedicalism of the American schools, and in 1845 he founded the Association of Herbal Medicine which in 1864 became known as the National Institute of Medical Herbalists (NIMH) It is the oldest professional organisation of herbal practitioners in the world. The School of Herbal Medicine began in 1978 in England. Since then a degree in herbal medicine can be taken at the University of Middlesex and other universities in England, Wales, France etc.
Today, in the conventional medicine of drug therapy, over 70% of drugs have a plant origin.
The United Nations in the World Health Organisation (WHO) recommends, promotes and assists traditional herbal medicine in all cultures and nations. Herbal Medicine is the most popular, the safest, and the most reliable form of medicine in the world. Here at Godshær Herbalist, Christchurch, we continue the ancient traditions of treatment using medicinal herbs from around the globe.
Plant Resume From The Beginning
Plants started in our oceans 3,800 million years ago.
Plants emerged from the waters around 480 million years ago.
There are an estimated half a million plants species (there is just one species of modern human).
We are intimately connected to a symbiotic relationship with plants.
Theophrastus, a pupil of Aristotle, published the earliest surviving treatises – Enquiry into Plants (9 vols) and Causes of Plants (6 vols) around 300BC. He described around 500 plants, as well as investigating the juices of plants and their medicinal uses. He is often called the ‘father of botany’. His emphasis was on useful plants – their medicinal and horticultural aspects.
Many of the botanical texts that followed focused on the role of plants in medicine. In AD50 Dioscorides, a Roman army doctor listed 650 species with curative properties in his De Materia Medica. It was a text that was consulted for the next 1,500 years.
The 16th century saw the physic garden developed at Pisa in 1544 and at Padua in 1545. And soon after in Florence, Leiden, Paris and Oxford. They were closely linked to medical schools. Plants could then be recognised and prepared for medicinal use. Herbaria were also made (collections of pressed plants mounted on sheets of paper).
John Ray, an English naturalist, listed 17,000 specimens in his book Historia Plantarum Generalis, in 1686. It is regarded as the first textbook of modern botany.
Carl Linnaeus, a Swedish naturalist, made important contributions to medicine, particularly through his interest in nutrition as preventative medicine. But his fame is based on his work in naming plants and animals.
The study of useful plants has always been central to the study of botany. Many of the European botanists from the 17th to the 19th centuries trained originally in medicine; among them were Linnaeus, Darwin and Joseph Hooker.
In his Systema Naturae (The System of Nature) published in 1735 when he was only 27, Linnaeus set out a five-tier hierarchy for plants: classes, orders, genera, species and varieties.
He identified 23 classes of flowering plants according to the number and relative length of the male organs (stamens). The classes were divided into orders on the basis of their female sexual organs.
Soon after 1778 when Linnaeus died and his wife wanting to keep the whole collection in tact it was offered to Joseph Hooker who recommended James Edward Smith should buy it. It is now housed in Burlington House of the Linnaean Society of London.
Kew’s Herbarium is now being arranged according to the results of DNA sequencing to produce a new family classification for angiosperms, or flowering plants.
International Union for Conservation of Nature lists over 2,440 species as threatened.
Anton de Bary, a German surgeon and mycologist, is considered as the founding father of plant pathology.
Beatrix Potter, a scientist, now better remembered for her children’s books, investigated and illustrated fungi and lichens. She drew the first record in Britain of the fungus Tremella simplex. She also presented a paper that lichens were formed by the combination of algae and fungal spores in 1897.
Charles Goodyear, rubber pioneer – in 1839 he created a durable stable material when heating rubber tree extract with sulphur and lead.
Orchids are a paradox. The orchid plant family’s intricate evolution has made it so successful that it is now the most diverse in the world. The family displays an incredible variety of shapes and forms, with blooms ranging from the showy Cattleya to the spider-shaped Brassia (whose shape assists its pollination by spider-hunter wasps – the wasp stings the lip while trying to grasp its supposed prey. The pollen is thus stuck to its head and when it flies to another Brassia flower, this flower gets pollinated).
Conrad Loddiges, who founded a famous nursery in London, introduced Rhododendron to gardens in England, from 1761. Rhododendrons were originally showcased by Joseph Hooker in Kew Gardens. However this set in motion what would still be wreaking havoc in the British countryside some 165 years later where it went from an attractive exotic from the Himalayas to a hated aggressive invader.
William Robinson in 1883 introduced the idea of a wild garden (to benefit insect life). [It is even more important to have a wild garden in today's world].
Lantana camara is a botanical aggressor which nothing seems to eradicate. It has striking golden flowers and is grown as an ornamental shrub Britain and which is now causing mayhem across sixty countries in just 100 years. There are 650 hybrids and is particularly problematic in India and has become a most troublesome weed in the forests there.
Fact: 2000 plant species that are new to science are being discovered (identified) every year.
Johann Mendel, born in 1822 in the Czech Republic, a botanist, is revered for unravelling Nature’s basic principles of heredity by experimenting on pea plants. His pioneering work (published in 1866) paved the way for the modern study of genetics.
Richard Willstatter in 1915 was awarded the Nobel Prize (the first ever awarded for Botany) for explaining how chlorophyll absorbs energy from light. Nutrients are drawn up with water from the roots. And food is generated in the leaves via a process whereby water and carbon dioxide are absorbed from the air and converted into glucose and starch, using energy from sunlight and releasing the waste by-product, oxygen, back into the atmosphere. This process is known as photosynthesis.
John Ray in the 17th Century asked himself how plants can get water to travel upwards, against gravity, and came up with an early prototype of the theory of capillary action. Following John Ray came Joseph Priestley from England, Antoine Lavoisier of France, Jan Ingenhousz from Holland and Nicolas-Theodora de Saussure in Switzerland who refined the science of how plants produce energy and breathe and why plants grow upwards.
Julius von Sachs (19thC) examined the internal structure of plants. He observed the green structures within cells, called chloroplasts, and the pigment that colours them, chlorophyll, which had first been isolated in 1817. In 1862, Sachs demonstrated that chlorophyll was involved in the production within the cell of tiny starch grains, which the plant then used as food. This was shown as the famous formula:
Carbon dioxide + water (+ light energy) = glucose + oxygen
Two decades later, in 1897, in USA two plant scientists called Charles Barnes and Conway Macmillan gave the process its name: photosynthesis.
Later it was found that plants in dissimilar environments have different photosynthetic pathways. Most plants use the C3 pathway. However, plants in hot, dry environments like savannahs, use either C4 or CAM (Crassulacean Acid Metabolism) as their pathway.
C4 – so-called because the first product of photosynthesis has 4 carbon atoms rather than the usual 3 – uses carbon dioxide and, more importantly, water, more efficiently, making it advantageous to plants in hot, dry environments (also crops such as maize and sugar cane).
In CAM plants, e.g. pineapples and cacti, the uptakes of carbon dioxide from the atmosphere occurs at night. This is because in areas of extreme heat and aridity, cooler night-time temperatures allow the pores in a leaf to be open and gases to enter without the risk of losing large amounts of water through evaporation. During the day the pores are closed.
Below is a picture of history, 'young' herbalist Alan Hopking meeting the famous modern herbalist Thomas Bartram, over 90 years old, author of the celebrated Encyclopaedia of Herbal Medicine, textbook of all NIMH colleges and universities. Photo taken by Kingsley Hopking 2005
Below is my first son Meredith, who has worked with me in the Herbal Clinic since he was pint-sized; he knows all the herbs in Latin and all the tonics I make. He has learnt the whole dispensary art of being a herbalist, from collecting herbs in the wild to tincture making. His primary work is now the creative design of web sites. www.hopkingdesign.com
Below is Alan and his younger son Kingsley in an ancient beech tree in the New Forest in winter, near Christchurch. Pic. taken by Susan Hopking.
What is health?
Health is not invisible, just as disease is not invisible.
Health is always defined by its signs which point somewhere to the mystery of health itself. But in practice, all medicine requires working definitions of health as its basis.
Within conventional medicine there are three separate kinds of health definition: the practical/medical, the utopian, and the social.
The practical/medical is that found in medical texts and that which medical students learn in university. A healthy person is symptom-free. A symptom is defined as an abnormality recognisable by professionals. They are not necessarily connected to the patient¹s subjective experiences of illness. For example a patient with non-specific discomfort and malaise, may be undiagnosable and may therefore remain untreated. This happened with the so-called post viral syndrome (M.E. or Myalgic Encephalomyelitis). Patients were not recognised as having a legitimate disease until they mounted an international public campaign to have their disease named and recognised. Only then could it be taken seriously in treatment and research. There has been a long critique of this biomedical description of health, beginning with Illich 1 . It points out that the pathological and mechanistic bias creates a medicine that can damage health while treating disease.
The utopian model goes beyond this. It is typified by the definition arrived at by the World Health Organisation in its 1977 conference at Alma Ata: ³A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity². It is an ultimate definition of health, determining it as the fulfillment of the human potential. However it is of limited usefulness, because modern medicine does not have the tools nor the ability to serve the human potential.
The social model is that developed by medical sociology, and pioneered by Antonovsky and others 2 . It has origins in the systems theory and in views of social conditioning. It states that health is a result of appropriate social adaptation and harmony. It is society as a whole that moves towards health or sickness by its sanction of Œsalutogenic¹ or disease-oriented behaviours. It is closely linked to the risk factor approach to health. The social model of health is as mechanistic as other conventional models, but it does break the pathological bias.
The well-being movement arose in the United States as a response to the extreme reductionist position of technical medicine. It defined health as feeling good, performing well, being fit and on top of the world. It expressed an interest in the psychosomatic origins of disease, but transcended it to embrace the psychosomatic origins of health. Health is a result of consciousness, of positive thinking, of affirmation. Health is achievable by mind-body techniques, such as meditation, relaxation, dance, massage, vitamins and having a good holistic physician at your disposal 3. The perspective here is individualistic, stressing personal responsibility and freedom.
Psychological treatments and psychotherapy which started with the question: 'what is wrong with this person, and how did she or he get this way?' were less effective than asking: 'what is right with this person, what are her or his unique strengths, enthusiasm, and zest for life? 5 . This definition of health mentions the Will To Live, inner development, involvement and engagement in life, autonomy, a conviction that life has meaning, and good social connections 6 . These qualities reveal what in Jungian terms might be described as individuation becoming a full person.
Health within alternative medicine is drawn from a tradition which is far more ancient than that of conventional medicine. Because of that it does not need to formulate its perspectives on health with biomedicine in mind, either in accord with it or in opposition to it. Thus it would view the symptom-based definition of health of biomedicine, the function-based definition of the WHO, the fitness-based definition of the well-being movement, the autonomy-based definitions of the psychological movement, and the systems theories of the salutogenic movement as partial and limited. It would draw on all of these as needed, but transcends them all. It is much more vitalistic and life oriented, without the need to constrain itself into western mechanistic, reductionist models of how the human being functions. The definitions of health arise from the main themes of alternative medicine. Here are some themes within complementary medicine which move in an opposite direction to conventional paradigms.
1. Self-Healing is Paramount . The in-built natural healing process is respected and recruited during treatment, although it is not necessarily understood. In Western herbal medicine there is very frequent use of a category of herbs called 'alteratives' or 'blood purifiers', to achieve this purpose.
2. Working with, not against, Symptoms . Symptoms are a guide in the journey to a cure. They are managed, not suppressed.
3. Individuality . Each person¹s condition is different, has arisen from different reasons, against a different constitutional background, and requires a different path for treatment. Decisions are personal and individualistic, not statistical. One of the indications of the richness of any medical system is the development of a typology with which individual differences in health, disease and response to the environment can be understood.
4. Integration of Human Facets . There is less a priori division between Mind-Body-Spirit or Environment-Society-Individual. Holism is the approach of the individual practitioner.
5. Beginning or Ending of Treatment Defined Contextually. There is less predetermined definition of state of illness where treatment must begin and wellness where treatment must end.
6. Conformity to Universal Principles. Remedies are discovered and employed in conformity to patterns of relationships (such as yin/yang) between all living creatures and their environment. These patterns are often subtle and involve energetic rather than material phenomena.
Considering these themes will demonstrate the inclusive yet pragmatic definitions of health implied within them. For example, health in Oriental medicine involves a harmonious relationship with all the energies and influences within which man is immersed. These include but are not limited to material, natural, environmental and social influences. But it also implies having a good constitutional and genetic basis, termed 'inherited energy'. In addition, it is recognised that health is a mind-body-heart issue, without acknowledging any boundaries between them. Oriental medicine and some major complementary medical systems never passed a Cartesian phase, so there is no need to postulate or evoke concepts like psychosomatic. These are qualities observed naturally within the mind-body-heart continuum, expressed as the total energetic body of man.
Since conventional medicine has drawn a line at the symptom boundary it also lacks an operational language to assess health itself.
The definitions of health employed in alternative medicine have as their philosophical basis a greater respect for what is 'natural', meaning unfabricated and less manipulated according to transient human intentions. This goes with a strong vitalism. This life-orientation necessarily implies a greater sense of the unknown and respect that goes with it. This leads directly to the lack of strong interventions that characterizes alternative medicine compared to conventional medicine, and the greater trust of self-healing capacities even if they cannot be understood.
Implications of Alternative Descriptions of Health on Health Care
Scientists and health professionals could learn a great deal from alternative medicine about defining and measuring health. Health care today would benefit from an awareness of more meaningful ways of describing and measuring health offered by alternative medicine, for example by including constitution and the quality of vitality. It could also provide a rich source of ideas and criteria for assessment of health. For example the question whether lowering cholesterol contributes to overall health has been tested using billions of dollars of research money and many years of investigation, yet the question is still not finally decided, and official advice on this question remains ambiguous. If more appropriate assessments of health were used it would be much easier to ascertain what is healthy and what is not, for each person, and design appropriate ways of assessment of therapeutic interventions. Alternative medicine is rapidly increasing in popularity. As its conceptual basis is prior to, and in many respects opposite to, conventional medicine, it provides a challenge to it which has not yet been accepted. Alternative medicine¹s concentration on healing the healthy as well as the sick, and its familiarity with the origins of disease on the ground of human life, give it special skills at understanding states of health. It sees health as a process which is intricately related to the way a constitution and personality develops through time within the matrix of all the influences and relationships that are experienced.
1. Illich, I. (1976). Limits to Medicine, Harmondsworth. Penguin. Engel, G.L. (1977). The need for a new medical model: a challenge for biomedicine . Science, 196:129-36.
2. Antonovsky, A. (1981). Health, Stress and Coping, San Francisco. Jossey-Bass; Antonovsky, A. (1994) A social critique of the 'well-being movement'. Advances, 10: 6-12.
3. Dossey, L. (1982). Space, Time and Medicine, Boulder. Shambala.
4. Cousins, N. (1979) The Anatomy of an Illness as Perceived by the Patient, New York. Norton.
5. LeShan, L. (1979) Cancer as a Turning Point, New York. Dutton.
6. Sheehy, G. (1985) Pathfinders, New York. Bantam; Rijke, R. (1993) Health in medical science In: Lafaille, R. and Fulder, S.J. Towards a New Science of Health. London. Routledge.
7. Fulder, S. (1996) The Handbook of Complementary Medicine, Oxford. Oxford University Press.
8. Levine, S. (1997) A Year To Live, London. Thorsons, Harper Collins.
9. Barsky, A. (1988). The paradox of health . New England Journal of Medicine, February 18, 414-8.
With thanks to Stephen Fulder who is the Director of Consultancy and Research on Biomedicine (CAROB). This article has been edited by Alan Hopking. Complete text can be found in Scientific and Medical Network website.
|400 Medicinal Plants Face Extinction|
Over 400 medicinal plants are at risk of extinction, according to Botanic Gardens Conservation International, largely because of over-collection and deforestation.
Since over 50 percent of prescription drugs are derived from chemicals identified in plants, researchers are concerned that potential cures could become “extinct before they are ever found.”
Although many of the active ingredients from these at-risk plants are now created in a lab, billions of people in the developing world, who still use plant-based medicine as their primary form of health care, will be harshly impacted by their loss.
Hundreds of medicinal plants are at risk of extinction, threatening the discovery of future cures for disease, according to experts.
Over 50% of prescription drugs are derived from chemicals first identified in plants.
But the Botanic Gardens Conservation International said many were at risk from over-collection and deforestation.
Researchers warned the cures for things such as cancer and HIV may become "extinct before they are ever found".
The group, which represents botanic gardens across 120 countries, surveyed over 600 of its members as well as leading university experts.
They identified 400 plants that were at risk of extinction.
These included yew trees, the bark of which forms the basis for one of the world's most widely used cancer drugs, paclitaxel.
Hoodia, which originally comes from Namibia and is attracting interest from drug firms looking into developing weight loss drugs, is on the verge of extinction, the report said.
And half of the world's species of magnolias are also under threat.
The plant contains the chemical honokiol, which has been used in traditional Chinese medicine to acts as a preventative against cancer and slow down the onset of heart disease.
The report also said autumn crocus, which is a natural treatment for gout and has been linked to helping fight leukaemia, is at risk of over-harvest as it is popular with the horticultural trade because of its stunning petals.
Many of the chemicals from the at-risk plants are now created in the lab.
But the report said as well as future breakthroughs being put at risk, the situation was likely to have a consequence in the developing world.
It said five billion people still rely on traditional plant-based medicine as their primary form of health care.
Report author Belinda Hawkins said: "The loss of the world's medicinal plants may not always be at the forefront of the public consciousness.
"However, it is not an overstatement to say that if the precipitous decline of these species is not halted, it could destabilise the future of global healthcare."
And Richard Ley, of the Association of the British Pharmaceutical Industry, added: "Nature has provided us with many of our medicines.
"Scientists are always interested in what they can provide and so it is a worry that such plants may be at risk."
Sources:BBC News January 19, 2008
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General advice to consumers on the use of herbal remedies from the Medicines Healthcare products Regulatory Agency
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
• Remember that herbal remedies are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care. • Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist). • Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care. • Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing. • If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking. • Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.
Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being “natural” and completely “safe” alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.
Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.
A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.
A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.
Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.
The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John’s Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John’s Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
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