Saturday, May 14, 2011

The Herbal Medicine Tradition. A Long-burning Torch for Darkening Times

Joseph Wright, The Alchymist 1771
Practitioners of herbal medicine hold the curious privilege of being carriers of a tradition whose origins cannot be traced during a time when traditional knowledge has been devalued by a technocratic ethos that celebrates transience and power.

Contemporary biomedicine continuously surfs the edge of ever-imminent "breakthroughs" that promise the conquest of refractory diseases and conditions through the discovery of new drugs. There are regular calls for increased funding from all available sources, from government, industry and the donations of a generous public in order that such salvific developments can proceed unhindered.

The biomedical establishment draws upon the energy of numerous dedicated individuals and also draws from the immense reserves of both national governments and multinational corporations in the knowledge that any successful "breakthrough" will bring immense financial returns.

The whole apparatus hangs on the assumption that there will be uninterrupted freedom and continuity in the various institutions and infrastructures through which such activities are initiated, pursued, marketed and delivered to established "health care" networks. We are just beginning to understand that business may not necessarily continue as usual in what is becoming an increasingly uncertain future.

The resources deployed within the biomedical enterprise are huge. They begin with the medical schools throughout the world that induct elite cadres of young aspirants through rigorous initiations which include a not-so-subtle professional socialisation while providing detailed and extensive training in anatomy, physiology, histology, embryology and pathology. The public hospitals in which their developing skills are exercised consist of vast and finely coordinated structures in which ambulance facilities, casualty departments, in-patient wards, operating theatres, intensive care wards, pathology units and pharmacy departments are serviced by large numbers of paramedics, nurses, nutritionists and caterers. medical officers, specialists, cleaners and hospital administrators.

The hospital system itself both supports and is supported by medical practitioners within the general community, by manufacturers of medical hardware ranging from disposable syringes, swabs and bandages to intravenous drips, cardiac monitors, fibre optic devices, defibrillators and magnetic resonance imaging scanners, and by a vast and powerful multinational pharmaceutical industry that produces the drugs which are dispensed and sold in huge quantities throughout the world.

This vast and interconnected network of activities both defines and supports the institution of biomedicine. Most governments in the developed world uphold this structure through political and legislative support, through the bankrolling of medical schools and public hospitals, and through subsidising the cost of diagnostic testing and pharmaceutical drugs.

Practitioners of herbal medicine are largely outside of the loop. They have little if any legislative support, receive their training in exceedingly modest educational facilities, have no access to the public hospital system, limited access to diagnostic services, and a questionable professional status. Despite this, the practice of herbal medicine continues to remain a vital and enduring source of satisfaction both for those who would carry the tradition through mastery of its methods and for those who seek out the services of knowledgeable practitioners.

What is going on here? Are practitioners of herbal medicine a quaint and harmless anachronism determined to cleave to largely discarded ways during a time where health care in most of the developed world has been technologised, corporatised and universalised? Are those who practise herbal medicine obstinately refusing to accept the reality of modernism with its celebration of centralisation, globalisation and standardisation? How is it that they do not covet the awesomely powerful methods that have become the signatures of biomedicine? Just what does the contemporary practice of herbal medicine represent?

The Promethean Entrancement

Francis Bacon
Much of the driving force that has propelled technological civilisation and its remarkable productions - including biomedicine - derives its influence from a philosophical position that separates us from the natural world. Francis Bacon exhorted all who would build the New Atlantis to subject nature to their will and to forcibly extract those "secrets" that enable control and mastery of her forces. By mid-century, Rene Descartes declared the world and all that was in it to be a soulless machine that could be understood, controlled and manipulated by the exercise of human reason. And by the end of the century, Isaac Newton had confirmed that the physical universe operated according to immutable laws that, once known and understood, conferred immense powers of control and predictability to those who understood them.

The so-called European "Enlightenment" further encouraged a philosophical clearing of the decks of all that was deemed to be uncertain or "irrational" in order that a new era based on development, progress and control could proceed without interference.

The fruits of such methods and understandings have, over the past three centuries, completely transformed the world. Yet our fascination with the productions of industry and technology, and our participation in the power they confer, have blinded us to their effects on our view of ourselves, on our relationship with powerful institutions, and on our sensitivity to the natural world.

At the most basic level, we have become perversely and erroneously alienated from those potencies within our own natures and within the natural world by which we are formed, sustained and regenerated. Though we may live by more than bread alone, that bread has now been tainted and denatured by the methods of industrial agriculture and food production. Top-soils have been everywhere destroyed; fruits, often laced with low levels of insecticide residues, are gathered long before they are ripe and transported over long distances - even across the great oceans - before they reach our tables; the genetic structure of many staple grains has been knowingly altered with unknown consequences to future generations; the bee populations in many countries have begun to cave under the onslaught of agricultural chemicals. And this is to say nothing of the obscene plethora of heavily processed foods stacked on the overburdened shelves of supermarkets everywhere.

We seem to have collectively lost sight of the fact that our physical bodies are continuously reconstituted from the foods that we eat, the air that we breathe, and the liquids that we drink. In the early 1950s, long before chemical-heavy industrial agriculture had reached anything like its present levels, Max Gerson showed through his nutritionally-based cancer therapy the vital importance of using fresh, unprocessed, chemical-free foods if health is to be restored in serious conditions. This understanding has yet to reach the busy kitchens of public hospitals throughout the Western world.

The anatomising of the body into its constituent tissues and organs is echoed in the anatomising of our foodstuffs into their constituent fats, proteins, sugars and calories. There is no measure that can accommodate the integrity, the totality and the equilibrium of living matter.

Dark Fruits
And so it is with the natural world. Our civilisation has recklessly plundered every identifiable resource with little thought to its relationship with the rest of the created order. Our forests have been felled, our soils destroyed, our rivers and lakes laden with the detritus of industry, our oceans robbed of their myriad fish species, our air oppressed by the burning of fossil fuels. And we wonder why the cost of health care throughout the developed world continues to steadily escalate despite the endless "breakthroughs" and all the fancy hardware and clever medicines.

Two decades ago, Thomas Berry reflected:

"We cannot have well humans on a sick planet. Medicine must first turn its attention to protecting the health and well being of the Earth before there can be any effective human health."

Guarding the Flame

Before we can seriously direct our attention to protecting the health and well being of the earth, we must somehow reverse our sense of separation from the phenomenal world. We must somehow shake free from the illusion that we are masters of creation capable of doing what we will with both the earth and with our bodies. We must somehow reconnect with the forces that unite us with the natural world from which we can never truly be separate without damaging ourselves and the world within which we live.

The force by which a grain of pollen unites with an ovule to produce a seed that carries the full potency of the parent plant is no different to that which enables every new human life to come into existence. The power by which a plant draws water and nutrients from the earth, and oxygen, carbon dioxide and sunlight from the air to produce its myriad structures and chemical compounds is no different to that which enables our physical bodies to grow and to repair themselves after injury and illness.

Howard Terpning. Medicine Man, 1983
Generations of healers in all times and in all places have identified plants that will serve as reliable allies so long as we continue to take human form upon the earth. In the present time, the biomedical profession has claimed the exclusive right to make use of extracts and derivatives of such plants as Papaver somniferum, the opium poppy, Claviceps purpurea, ergot of rye, Digitalis purpurea and D. lanata, the purple and woolly foxgloves, Ephedra sinensis, ma huang, and Atropa belladonna, the deadly nightshade. Yet these and other powerful plants were long known and used skilfully and carefully by untold generations of healers, herbalists, midwives and shamans. These and many other plants of softer power will continue to spring forth from both wild and cultivated spaces for as long as the earth remains hospitable and habitable.

There will always be a community of knowledgeable individuals who will safeguard and transmit the knowledge of how these plants can enable us to better pass through the pains and afflictions that are an inevitable part of human life.

The methods of phytochemistry and pharmacology have recently confirmed the particular usefulness of many plants which have long been used in the various herbal medicine traditions. These include such plants as Echinacea angustifolia, which stimulates activity in the immune system, Ginkgo biloba, which enhances cerebral circulation, Serenoa repens, which is useful in the treatment of prostatic enlargement, Hypericum perforatum, used in the treatment of depression and other nervous system disorders, Crataegus monogyna, which can lower blood pressure and stimulate coronary circulation, Valeriana officinalis, useful in the treatment of insomnia, and Silybum marianum and Cynara scolymus, both of which support liver function. Such plants and their extracts are no longer used exclusively by herbalists and are now prescribed or recommended to patients by a growing number of practitioners of biomedicine.

Yet there remain may other plants within the herbal medicine traditions whose actions are perhaps too subtle to be easily determined by the harsh methods of phytochemical fractionation and pharmaceutical statistics. It is important to understand that medicinal plants and their extracts are categorically different to the pharmaceutical drugs used in biomedicine. A single medicinally active plant or its extract typically contains small quantities of numerous compounds and influences which can, both individually and synergistically, interact with our own natures. Although any given plant may contain a specific potency, as is the case with opium poppies and their narcotic alkaloids, foxglove and its cardioactive glycosides, and the buckthorns with their purgative anthracenosides, most plants used as medicines carry a constellation of influences which may include minerals, organic acids, essential oils, bitter compounds, flavonoids, steroids and so forth. This is certainly the case with such gentle treasures as lemon balm, golden rod, white horehound, cleavers, agrimony, motherwort, chamomile, plantain, dandelion, yarrow and many other plant medicines.

During this time when the ways of herbal medicine are often dismissed and demeaned as outmoded and useless superstitions, we are well advised to deepen our familiarity with the healing plants both in our gardens and in the wild. This will ensure that regardless of whether the future holds a bang or a whimper, this soft system of healing will remain available as a living force for the benefit of future generations.

Vincent Di Stefano D.O., M.H.Sc.
May 2011


  1. Dear Vincent,

    Thank you - a great read.
    keep up your excellent work.

    Best Wishes,
    Bernie. L.

  2. Removing the Past

    Samuel Pepys noted in his diary in 1644 that he was feeling in especiaally good health and wondered why. Was it because he’d been wearing a hare’s foot around his neck on his doctor’s recommendation? Or perhaps it was the pill of turpentine he swallowed every morning?

    In theory we no longer have to wonder about such things. There is a vast clinical trials industry designed to test and prove the efficacy (or otherwise) of pharmaceutical cures for our illnesses. Establishing an evidence base is now central to practicing medicine.

    But the relentless application of any big idea can have destructive secondary consequences, particularly if it’s politically driven. As Vincent di Stefano has quite correctly illustrated in his paper, the past few years have seen increasingly vociferous attacks on non-drug remedies, usually lumped together as CAM (complementary and alternative medicine), on the grounds that they lack a proper evidence base. Nobody can disagree on the principal weeding out ineffective treatments, but the assault on CAM (particularly homeopathy and herbal medicines) by the new puritans of evidence-based medicine has become a dangerous distraction from a much more serious problem: the failings in the regulation of drug-based medicine.

    This was highlighted when two reports were published in February 2009. One, from the Commons Science and Technology Committee, concluded that: “using money on homoeopathy’s highly diluted remedies could not be justified.” The other came from the finance committee of the US senate and followed a two-year investigation of the drug company GlaxoSmithKline (GSK), makers of Avandia, a drug used to treat diabetes. It, too, reached a damning conclusion—not only about the drug’s safety, but the lengths the company had gone to conceal evidence that the drug raised the risk of heart disease. “GSK executives,” it said, “had attempted to intimidate independent physicians, and focused on strategies to minimise or misrepresent findings.”

    Yet while the homeopathy ruling made news across Britain, the Avandia story did not—despite the fact that over 550,000 prescriptions were written for it in England alone last year. There is also the matter of prescriptions of Off-Label medicines. What are they? They’re involved in the practice of prescribing pharmaceutical for an unapproved indication, unapproved age group, unapproved dosage or form of administartion. In short off-label drugs have no evidence base, yet this practice is widespread amongst doctors, and prescribing pharmacists.

    Off-label use of medications is common. Generic drugs generally have no sponsor as their indications and use expands, and incentives are limited to initiate new clinical trials to generate additional data for approval agencies to expand indications of proprietary drugs. Up to one-fifth of all drugs are prescribed off label and amongst psychiatric drugs, off-label use rises to 31 % (Radley, 2006). New drugs are often not tested for safety and efficacy specifically in children and even when they are tested, the results of these trials may not be disseminated to hospital-based doctors and GP’s. A 2009 study found that 62% of U.S. pediatric office visits included off-label prescribing, with younger children at higher risk of receiving off-label prescriptions. Specialist physicians also prescribed off-label more frequently than general pediatricians (Bazzano et al., 2009)

    A 2006 study found that off-label use was the most common in cardiac medications and anticonvulsants. This study also found that 73% of off-label use had little or no scientific support (Radley, 2006).


    Alicia Bazzano, Rita Mangione-Smith, Matthias Schonlau, Marika Suttorp, Robert Brook (2009). "Off-label prescribing to children in the United States outpatient setting.". Ambulatory Pediatrics 9: 81–8.
    David C. Radley; Stan N. Finkelstein; Randall S. Stafford (2006). "Off-label Prescribing Among Office-Based Physicians". Archives of Internal Medicine 166 (9): 1021–1026.

  3. Dear Vince,
    interesting. Probably much to learn from the "first Australians" regarding medicinal properties of indigenous plants.
    Eating freshly picked home grown vegies is certainly more healthful and flavoursome than eating the dead ones in cans and supermarkets.
    Keep up your research Vince.
    Paul R

  4. Beautifully expressed Vince; great to be reminded of the power of subtlety.

    Jenie S