Subject: Alt.folklore.herbs - medicinal herb FAQ (v.1.19) Part 5/7
Date: 22 Mar 1996 21:37:10 GMT
Summary: Frequently asked questions with answers, a general
 introduction to and a resource list for medicinal herbs.

Posting-Frequency: monthly (on or about 20th)
Version: 1.19

==========
3 General Info

==========
3.1 Introduction to side effects, safety and toxicity of medicinal herbs
-----
by Jonathan Treasure (jonno@teleport.com)

This introduction concerns WESTERN medical herbs and their clinical
use.  Some herbal agents are common to different traditions but the
indications and methods of use may vary between e.g. TCM, Ayurvedic and
Western practices.

The purpose of these notes is to provide a general understanding of
the actions of herbal medicines, and hence a background for
understanding questions of safety and toxicity - NOT to provide a list
of problematic herbs.  A brief bibliography gives sources of reliable
information on the safety of herbal medicine and further reading.

-----
Conventional medicine considers that if a drug is to be effective, it
will inevitably have side effects.  The medical establishment
considers herbal medicines as drugs, and as such, they must either
have side effects - or ergo be ineffective.

Paradoxically tens of thousands of people every year turn to herbal
medicine because they regard plant remedies as being free from
undesirable side effects.  Herbal medicines are considered to be
generally safe AND effective agents.

Although there is a spectrum of viewpoints in western herbal medicine,
most herbalists reject the view that plant medicines are naturally
occurring analogues of the pharmaceuticals used in orthodox clinical
medicine i.e. drugs.

This is ultimately a rejection of the dominant paradigm of orthodox
clinical science.  It is necessary to outline the elements of the
alternative paradigm shared by most herbalists, before questions of
toxicity and safety can be discussed in context of clinical herbal
therapeutics, rather than of orthodox medical science.

-----
I.  MEDICINAL PLANT ACTIONS CANNOT BE REDUCED TO THE EFFECTS OF THEIR
    ISOLATED "ACTIVE CONSTITUENTS"

There ARE a few plants that are almost "drug like" and whose action
approaches that of pharmaceuticals.  Digitalis is the classic example.
Herbalists use these plants in near allopathic treatment strategies if
at all, and in some countries e.g. UK, their availability is
restricted by law.  The number of herbs in this category is relatively
few.

The vast majority of medicinal herbs contain dozens of different
compounds, often of great complexity, mucilages, tannins,
polysaccharides etc. that buffer, modulate and modify the effects of
any "active principles".  Study after study has shown that effects
produced by extracts of whole plants cannot be mimicked by
administering isolated purified constituents of the plant.

(It is ironic this proposition even has to be asserted given that
biological sciences have for some time used a systems theory model in
which the whole being greater than the sum of the parts is axiomatic -
this simply reflects the inherent conservatism of the medical
establishment.  However for most herbalists the view of the whole
being greater than the parts is derived from vitalism, not systems
theory!)

-----
II.  MEDICINAL HERBS ACT "MULTI-SYSTEMICALLY"

Pharmaceutical drugs are designed to elicit very specific reactions.
Their associated "side effects" are undesired actions, usually traded
as a "risk" against the "benefit" of the primary effect.  Herbs tend
to have several broad actions on a number of whole physiological
systems at the same time.  These actions are usually oriented in the
same general therapeutic direction, and are usually complementary or
synergistic, often non-specific, and very rarely adverse.  Herb
actions cannot be adequately described using the vocabulary of "drug"
action terms, e.g. diuretic etc. - they are too complex.  The clearest
example of this is the coining of the term "adaptogenic " used to
describe the multiple non-specific effects of herbs such as Ginseng.

-----
III.  HERBS ACT ON THE HEALING PROCESSES IN THE BODY.

A pharmaceutical drug addresses symptoms caused by specific disease
mechanisms as understood by scientific pathology.  Herbal medicines
are directed towards aiding the body's own healing processes.  These
approaches are diametrically opposed.  Herbal medicines act gently,
usually attempting to "nudge" or "support" systems and processes that
have become deficient or help remove excesses that have become
preponderant.  Symptom relief is only a component of herbal
therapeutic strategy.

This is a crucial difference.  For example, serum arthritic conditions
are conventionally treated with steroid anti-inflammatory drugs.
These have widespread and disturbing side effects, which at sustained
high doses become intolerable and potentially dangerous if not lethal.
The herbal approach to these conditions uses dietary modification of
metabolism; facilitation of elimination via kidneys and hepatic/
biliary routes; stimulation of circulation in the affected regions,
moistening of dry synovia, etc. Topical treatments for acute joint
pain or systemic anti-inflammatory herbs that help joint pain are used
as required, but this is not the thrust of the treatment strategy.
Lay persons often make the related mistake of seeking a "natural
alternative" to a pharmaceutical they have been prescribed rather than
challenging the diagnosis and therapeutic strategy.

-----
IV.  HERBS ACT MULTI- DIMENSIONALLY

Herbal medicine is a wholistic therapy, it integrates mental,
emotional and spiritual levels seamlessly into its understanding of
both human function and of the plant remedy, while respecting the
planetary and ecological dimensions of natural medicine provided by
plants.  Although subject to differing interpretations this view is
held in one form or another by most herbalists .

Life style, mental, emotional and spiritual considerations are part of
any naturopathic approach, herbalism included.  Flower essences,
homeopathic preparations and drop doses of standard herb extracts all
demonstrate that herbal agents can produce consistent and powerful
effects at subtle levels in ways quite inexplicable by the
pharmacokinetic model underlying orthodox pharmacology.

Centuries of medicinal plant usage overarch even the Graeco - Roman
heritage of medical thought, itself already forgotten by its amnesiac
infant technological medicine, extending into magical, esoteric and
religious domains of prehistory.  The great Asian systems of medicine
have continued uninterrupted for thousands of years to today,
integrated into profound cosmological and philosophical systems.  From
any serious study of the application of herbs to healing a perspective
emerges that reveals modern doctors to be tragicomically "like
educated peasants running around pretending to be chiefs"
(Grossinger).

-----
V.  SIDE EFFECTS VS CONTRAINDICATIONS

Many herbalists would tend toward the radical homeopathic view that
the "side effects" of orthodox medicine are in fact iatrogenic
developments of the very disease for which the pharmacological
intervention was intended.  The symptoms simply change, and the real
underlying dysfunction is further obscured - or driven further into
the interior to manifest in deeper and more intractable ways.

Notwithstanding this iatrogenic view of side effects, we have seen
that the use of herbs anyway does not generally involve "drug" actions
or adverse effects.  Of course, if the body processes are nudged in
the wrong direction for long enough, then imbalances can worsen rather
than improve.  Hence the need for informed knowledge of the effects of
herbs as well as a clinical training to understand their appropriate
medical application. Herbalists learn about the CONTRAINDICATIONS as
well as the indications for using a herb.  This term is more useful
and appropriate than "side effects".

CONTRAINDICATIONS are incongruences between the metabolic/systemic
predisposition (constitution) of the individual - and the spectrum of
multi-systemic actions of a given herb agent or class of agents.
Essentially, herbalists use their in depth knowledge to devise a
mix'n'match prescription tailored precisely to fit an individuals
unique profile.  This approach is most sophisticated in the tonic
energetics of the Oriental medical traditions, but is empirically
applied by most herbalists.

Contraindicated remedies can account for apparently idiosyncratic "bad
reactions" to a herb.  Valerian is a classic example, its powerful
autonomic effects can make it "disagree" with stressed adrenergically
hyperactive individuals, who paradoxically are often those seeking
sedative treatment for insomnia.  Anyone experiencing such reactions
to a herb for more than a couple of days should stop taking it and
seek further advice.  However a second and vital aspect of
contraindications especially today is the question of DRUG
INTERACTIONS.

Many people seeking herbal medical treatment are already involved in
pharmaceutical therapies.  Herbal remedies may act either as agonists
or potentiate some drug therapies, and an understanding of
conventional drugs is an essential prerequisite for effective herbal
therapeutics.  In many cases, herbalists would not treat the primary
presenting symptom undergoing drug treatment - be it ulcers treated
with Zantac or cardiac arrythmia treated with Digoxin - but rather
concentrate on supporting other systems and functions stressed by the
primary symptom.  This allows the body to recover its strength and
healing potential so it can then direct these capabilities toward
repairing the presenting condition.  In other cases, it can be a
priority to wean someone off drugs, e.g. steroids, in which case
supportive therapy to restore adrenal function is vital.

-----
VI.  SAFETY AND TOXICITY OF HERBAL MEDICINES

The definition of *toxic* is a ultimately a matter of viewpoint. Many
ordinary foods contain constituents that could be regarded as
poisonous, such as the alpha gliadin produced by gluten in wheat oats
and rye, the cyanogenic glycosides in many fruit seeds, the
thiocyanates of the brassica vegetables, alkaloids of the Solanaceae
and lectins of many pulses including soya and red kidney beans.
Nonetheless these foods are generally regarded as safe.  Similarly,
both water and oxygen - can kill in excessive amounts, so quantity is
often an important consideration.  In practice however, three groups
of herbs can be identified from a safety point of view.

Firstly there are a handful of herbs that contain near pharmaceutical
concentrations of poisonous constituents which should on no account be
taken internally by unqualified persons except in homeopathic
potencies.  Examples are Atropa belladonna, Arnica spp, Aconitum spp,
Digitalis spp.  In many countries availability of these herbs is
limited by law.  Regulations vary from country to country and the
appropriate regulatory authorities or Herb Organisations can be
consulted for details.  Wildcrafters should be unshakably confident
in their identification of the local variants of these species, and
children warned to avoid them.  Fortunately this is a numerically tiny
category.

Secondly, are herbs with powerful actions, often causing nausea or
vomiting, (that usually were traditionally prized for this action).
They are perfectly safe used under appropriate conditions.  Some of
these herbs are restricted in some countries but freely available in
others.  Lobelia and Eonymus spp are examples.  There is some
inconsistency here, for example Ephedra is restricted, perhaps with
justification, in the UK, but is freely available in the US.

Finally, there is an idiosyncratic grouping of herbs which have been
alleged, with some scientific support, to exhibit specific kinds of
toxicity.  The best known is the hepatotoxicity of pyrrolizidine-
alkaloid-containing plants such as Comfrey (Symphytum).  Other
examples are Dryopteris (Male Fern), Viscum (Mistletoe) and Corynanthe
(Yohimbe).  Although much of the evidence is contentious (see below),
lay users would be advised to avoid internal consumption of these
herbs.

The vast majority of medical herbs are safe for consumption, but for
those without specialised knowledge, it would be prudent to follow
simple but sensible guidelines in self treatment:

- Use only herbs recommended in respected herb books, especially in
  countries like the US where there are few restrictions on
  availability.

- Avoid new or unproven *wonder remedies*.

- Do not persist with a remedy if no benefit or result obtains after a
  moderate period, and if adverse reactions take place, stop the
  treatment and seek experienced advice.

- Do not persist with a treatment that has brought improvement without
  testing to see if continued further consumption is necessary to
  maintain improvement.

- Do not engage in self treatment for complex conditions without
  experienced advice.  Drug interactions and contraindications must be
  considered on an individual basis and herbal treatment strategies
  are often involved and multifaceted.

Unfortunately, training and licensing of herbalists is not
internationally consistent.  In the US the situation is especially
complex - no recognised herbal licensing exists.  ND's are licensed in
a few states, but their herbal training could theoretically be less
than that of an unlicensed but experienced herbal practitioner.  In
the UK, the NIMH accredits herbalists who have trained at approved
courses: practitioners are recognised by MNIMH or FNIMH
qualifications.

-----
VII.  PREGNANCY

It is axiomatic that pregnancy should be a time of minimal medical
intervention, and herbalists in particular regard pregnancy as a
"contraindication" to taking herbal medicines. Nutritive "food herbs"
such as nettle, and uterine tonics such as raspberry leaf are
encouraged, and perhaps gentle treatments against typical symptoms
such as constipation or morning sickness are in order.  There is NO
evidence of teratogenicity in humans arising from herbal remedies, but
since such evidence would be hard to come by, erring on the side of
caution is regarded as prudent.

-----
VIII.  UNDERSTANDING TOXICITY RESEARCH - POLITICS AND IDEOLOGY

Medical orthodoxy at best does not understand herbal medicine, and at
worst, sees it as a threat which it attempts to rubbish, regulate or
ridicule.  Quackery has a fascinating role in the history of medicine
and its institutions, but much of the hostility towards herbal
medicine comes from its apparently greater proximity to orthodoxy than
say acupuncture or homeopathy.  This is the unfortunate political
context in which toxicity and safety of herbal medicines are debated.

Additionally, both professional herbalists and regulatory authorities
exhibit differing degrees of education, organisation and aptitude in
different countries.  In the United States, the situation is
particularly lamentable, with scare mongering stories regularly aired
in medical, scientific and popular press, whilst the lack of
accredited professional herbalist training means that well intentioned
self-appointed spokespersons for herbalism can cause more harm than
good, and the quixotic federal regulatory stance on herbs as
foodstuffs means that the potential of lay self-iatrogenesis with
freely available OTC herbal products is a serious possibility.

Toxicity of herbal medicines needs to be seen in context however. As
Paul Bergner, Editor of the journal Medical Herbalism and author of
several articles on herbal toxicity recently pointed out:

*Approximately 8% of all hospital admissions in the U.S. are due to
adverse reactions to synthetic drugs.  That's a minimum of 2,000,000.
At least 100,000 people a year die from them.  That's just in the
U.S., and that's a conservative estimate.  That means at least three
times as many people are killed in the U.S. by pharmaceutical drugs as
are killed by drunken drivers.  Thousands die each year from
supposedly "safe" over-the-counter remedies.
Deaths or hospitalizations due to herbs are so rare that they're hard
to find.  The U.S. National Poison Control Centers does not even have
a category in their database for adverse reactions to herbs.*

Similar figures apply in the United Kingdom, and even hepatoxicity,
where perhaps the strongest case against some herbs lies, the
statistics are horrendously clear - over 80% of cases of fulminant
hepatic failure presenting for liver transplant (or death) over ten
years in the UK were due to poisoning by freely available OTC non-
prescription NSAID's, such as paracetomol and aspirin.  Not one case
was due to ingestion of medicinal herbs.

For the lay person, analysis of so called "scientific evidence" about
toxicity is clearly problematic.  Some of the most useful sources of
information are to be found in review presentations made by
representatives of the herbalist community to regulatory authorities
such as the FDA or MCA.  Informative reviews of the literature in
defence of Comfrey and Mistletoe have been made in this way.

Herbalists justifiably point out that scientific studies with isolated
compounds, on non human or even non mammalian organisms, or in vitro,
with doses tens or even hundreds of times the equivalent medicinal
dose, simply have no arguable extrapolation to the clinical situation
using whole herb at appropriate medicinal doses.

Lack of herbal knowledge by some scientific investigators (let alone
journalists or self appointed defenders of the public) leads to often
ludicrously misleading results - one of the commonest mistakes being
the failure to verify the actual identity of plant material used in
their experiments, let alone the detection of contaminants!

These points beg the question of what paradigm can be used for
research into the safety and efficacy of herbal therapies.  That
shibboleth of orthodoxy - the double blind placebo controlled clinical
trial is open to a range of criticisms from the paradigm employed by
herbalists - but that, as they say, is another story.

-----
FURTHER READING

HERBAL /MEDICAL CONTRAINDICATIONS:
Synergistic and Iatrogenic Potentials when some herbs are used
concurrent with Medical Treatment or Medical Health Care by Michael
Moore, 1995, on line at
http://www.rt66.com/hrbmoore/HOMEPAGE/HomePage.html

HERB INFORMATION RESOURCE:
The Information Source book of Herbal Medicine: David Hoffmann,
Crossing Press 1994.

TOXICOLOGY:
Brinker F : An Introduction to the Toxicology of Common Botanical
Medicines, NCNM 1983
AMA Handbook of Poisonous and Injurious Plants AMA, Chicago 1985
NAPRALERT database at UIC.

Example REVIEWS OF PROBLEMATIC HERBS:
In Defence of Comfrey:  EJHM1.1 1994 11-17
The Case For Mistletoe: EJHM1.1 1994 17-22
EJHM = European Journal of Herbal Medicine (see 4.3 below)

HISTORY:
Planet Medicine - Richard Grossinger, North Atlantic Books 1990
The Magical Staff, Matthew Wood North Atlantic Books, Berkely 1992

GENERAL HERB BOOKS:
(as in 4.1 below):
J.A. Duke, CRC Handbook of Medicinal Herbs.
C. Hobbs, many booklets.
D. Hoffmann, The Herbal Handbook.
S. Mills, Out of the Earth: The Essential Book of Herbalism.
M. Moore, Medicinal Plants of the Mountain West.
M. Moore, Medicinal Plants of the Desert and Canyon West.
M. Moore, Medicinal Plants of the Pacific West.
R.F. Weiss, Herbal Medicine.

==========
3.2 Wildcrafting Ethics
-----
by Howie Brounstein (Howieb@teleport.com) (posted with permission)

This are the guidelines I teach to my students.  It is copyrighted
material that took me years to develop.  Please respect this
copyright.  I ask you not to publish it without permission.  Happy
Herbing.

-----
I.  WILDCRAFTING CHECKLIST

Do you have the permission or the permits for collecting at the site?
Do you have a positive identification?
Are there better stands nearby? Is the stand big enough?
Are you at the proper elevation?
Is the stand away from roads and trails?
Is the stand healthy?
Is there any chemical contamination?
Is there any natural contamination?
Are you in a fragile environment?
Are there rare, threatened, endangered, or sensitive plants growing
  nearby at any time of the year?
Is wildlife foraging the stand?
Is the stand growing, shrinking, or staying the same size?
Is the plant an annual or a perennial?
Is tending necessary and what kind?
How much to pick?
Time of day? Time of year?
What effect will your harvest have on the stand?
Do you have the proper emotional state?
Move around during harvesting.
Look around after harvesting.  Any holes or cleanup needed?
Are you picking herbs in the proper order for a long trip?
Are you cleaning herbs in the field? Do you have the proper equipment
  for in-field processing?

*Wildcrafting is stewardship*

c1993hb

-----
II.  HOW DO I FIND OUT ABOUT ENDANGERED PLANTS (IN THE USA)?

Check your local Heritage Program Database, call the Dept. of AG or a
local Native plant society chapter to find its address.  This will
connect you to experts on particular plants and current lists.

The endangered species act has many flaws, I personally believe there
should be an endangered ecosystems act instead but it's all we've got
and better than nothing.

Some listed plants are truly rare, once numerous but destroyed by loss
of habitat through man or nature.

Many listed plants are endemics, located in a specific area. These may
be geographically isolated islands of flora as are often found in the
intermountain west, or they can be found at the border of major plant
systems.  Many endemics are found in southern Oregon, where the
Northern California system blends with the Pacific Northwest system,
with a spattering of Great Basin plants.  This does not mean these
plants are sensitive, just unique.  The threatened Penstemon peckii
grows only within twenty miles of my house, and nowhere else on earth.
It can withstand trampling, wildlife grazing, and disturbance. In
fact, now that the forest service has realized that this species
thrives with moderate disturbance (partial cuts), it has become a
reason to log, i.e. increased health of the population of this plant.

Plants become listed due to political boundaries.  Gentiana newberryi
grows nearby, and is threatened in Oregon.  It's northernmost sighting
is within a half hours drive.  There you can see people play football
on it, run horses on it, pick its beautiful flowers only to find they
wilt immediately, and then the flowers end up on the ground.
Sometimes hundreds of them.  Elk graze it heavily.  It isn't a
sensitive plant, and it's population is healthy and stable in
California, but the population happens to cross over to Oregon where
there isn't that many stands.  Thus it receives the same protection as
the truly rare plant. Southern Oregon has many of these kinds of
listed plants.

There has to be a perceivable threat to the plant population in order
for it to be listed.  Sometimes the threat is obvious, and sometimes
the threat is obscure.

What about an introduced plant that has become a pest, or a native out
of control in a system out of balance.  When the St. John's Wort,
Hypericum perforatum, is down to a handful of populations, it will fit
the definition of threatened, even though humans intentionally
irradicated it!!

-----
III.  WHAT PLANTS SHOULDN'T I PICK

Some plants are not damaged easily.  Blackberry, Rubus sp., and
Dandelion, Taraxacum officinale, are two that are nearly impossible to
eliminate, even if you dig their roots.  If a piece of root stays in
the ground, it will grow back.  Yarrow, Achillea millefolium, can be
cut with a lawnmower and still flourish regularly.  Nettles, Urtica
dioca, when grown for fiber can have 3-4 aboveground harvest in a
growing season.  Plants that fit into this category are generally
perennials. You can pick them and not threaten their survival.

Rare, Threatened and Endangered Plants

Endangered plants are species in danger of becoming extinct in the
foreseeable future.  Threatened plants are likely to become endangered
in the foreseeable future.  A species can be threatened or endangered
throughout its range, which means if it goes extinct we will lose its
hidden secrets forever.
Many of these plants only grow in one special area (endemic).  The
Columbia Gorge on the border of Oregon and Washington hosts many
endemic species.  Peck's Penstemon, Penstemon peckii, grows only in
the Ponderosa Pine Forest in Deschutes and Jefferson Counties.  A
species can also receive protection for part of its range.  Newberry's
Gentian, Gentiana newberryi, has stable populations in California, but
is listed as threatened in Oregon.  Deschutes County is at the end of
its range, and there are less of them.  Rare plants have small,
localized populations.  They may not be listed as threatened or
endangered if the populations are both stable and numerous.
The US. Fish and Wildlife Service determines which plants receive
federal protection.  Unfortunately, they are very slow in reviewing
candidate species.

Many have become extinct while waiting to be listed.  The Department
of Agriculture and the Department of Fish and Wildlife of each state
is responsible for determining state protection.  We also have the
Oregon Natural Heritage Program.  This program has its own list of
plants that deserve protection, but haven't made it into the clogged
federal and state lists.  They also have a list of plants to watch and
monitor.  A copy of Rare, Threatened and Endangered Plants and Animals
of Oregon is available from:
  The Oregon Natural Heritage Program
  1025 NW 25th Avenue
  Portland, Oregon 97210
  (503)-229-5078
Do not pick these plants.  Unfortunately, they are not always easy for
an amateur to identify.  They are not always showy.  There may be
large amounts of them in one spot, so that they appear plentiful.
There are some good picture books available.  All folks who pick
plants from the wild should try to familiarize themselves with the
local protected plants.  When in doubt, don't pick it.

Sensitive Plants

Some plants are sensitive to disturbance.  Please do not pick them
even if they aren't protected.  The Calypso Orchid, Calypso bulbosa,
is a fragile plant that lives partially off leaf mold.  Its little
root is close to the surface, and easy prey to slugs and others.
Minor disturbances can easily dislodge the root from the mold.  If
someone picks its flower, it can ooze fluid and essentially "bleed" to
death. Even disturbing the area around it during flowering could kill
it.  The law does not protect this plant because it is too numerous.
It is our responsibility to help sensitive plants survive.
How can you tell if a plant is sensitive? Most plants that are not
green (contain no chlorophyll) are "no picks." These weird species are
white, brown, red, or purple and just plain eerie.  Botanists call
them parasites or saprophytes.  They are particularly fascinating.
These include Broomrape, Orobanche sp., Coral Roots, Corallorhiza sp.,
and Indian Pipe, Monotropa uniflora.  Other "no picks" include the
Orchid Family (Orchidaceae) and almost all the Lily Family
(Liliaceae).  The Orchid Family includes Calypso Orchid, Calypso
bulbosa, and the Rein Orchids, Habenaria sp.  The Lily Family includes
Trillium, Trillium ovatum, and Mariposa Lilies, Calochortus sp.  These
families are easy to recognize with a little practice.  Not every Lily
and Orchid is sensitive, but it's a good place to start.
Most (but not all) of the unusual or showy plants are no picks.  If
you are not sure, don't harvest it.

Howie B
Columbines and Wizardry Herbs
Eugene, Or USA

==========
3.2.1  United Plant Savers - ADDITION
-----
From Gregg Pond <gpond@integ.micrognosis.COM>

United Plant Savers - Statement of Purpose

These are exciting times for herbalists. The current "herbal
renaissance" in American health care is accompanied by an ever growing
demand by the American public for herbs an herbal products. While
positive on one hand, this situation has endangered a unique new set of
problems for the wild plant world and for herbalists who love plants.

The pressure on our wild medicinal plant communities is growing yearly.
Vast numbers of plants have been and continue to be taken, and
indiscriminate wild harvesting has devastated many areas of former
abundance. Perhaps even more disturbing, native North American
medicinal plants are being exported to meet the demand in other
countries, where wild plant populations have already been gravely
depleted.

United Plant Savers was formed in a spirit of hope, as a group of
herbalists committed to protecting and re-planting threatened species
and to raising public awareness of the plight of our wild medicinal
plants. Our membership reflects the great diversity of American
herbalism and includes wildcrafters, seed collectors, manufacturers,
growers, botanists, practitioners, medicine-makers, educators, and
plant lovers from all walks of life.

Our Goals
* Identify and compile information on threatened medicinal plants in
  each state and/or bioregion.
* Make this information accessible to herbal organizations, communities
  and individuals.
* Provide resources for obtaining seeds, roots, and plants for re-
  planting and restoration.
* Secure land trusts for the preservation of diversity and seed stock
  for future propagation efforts.
* Raise public awareness about the tragedy of over-harvesting and the
  current plight of native wild herbs.
* Identify and disseminate information on the therapeutic alternatives
  to threatened species.
* Encourage more widespread cultivation of endangered medicinal plants
  and greater use of cultivated plants.
* Develop programs for school systems and communities to re-plant
  threatened plant species back into their native habitats.

For Membership information send E-mail to:
  gpond@integ.micrognosis.com

or snailmail to:
  United Plant Savers
  P.O. Box 420
  East Barre, VT 05649
  USA

-----
For more information try my 'neat stuff' -page - the articles should
be there latest Monday the 25th:
http://sunsite.unc.edu/herbmed/neatstuf.html

==========
3.3 Different schools of Herbal Healing

==========
3.3.1  Traditions in Western Herbal Medicine
-----  Thanks to Jonathan Treasure for sending this one over.

This Article is taken from The Herbalist, newsletter of the
Canadian Herbal Research Society. COPYRIGHT June 1989.

Traditions in Herbal Medicine     Peter Cook  DBTh, FETC

-----
The Development of Theory in North America

Introduction: To one trained as a medical herbalist in Britain, it is
a curious fact that herbal medicine, as it seems to be most widely
known in Canada and the U.S., has been so little influenced by the
great systems of herbal thought which once flourished here. Only
remnants of these systems can now be found in the writings of Kloss,
Christopher, Shook and others whose primary sources appear to be the
European and native North American folk traditions.

These folk traditions are very valuable medical resources in their own
right; a fact which has been recognized and supported by the World
Health Organization (1978). It has also been recognized and
increasingly exploited by the pharmaceutical industry. Folk medicine
however, is also important as a rich source for the periodic
historical development of major systems of traditional medicine.
Examples of the development of two such systems in North America will
be discussed here, together with some of the more important
theoretical and practical contributions to herbal medicine which these
systems generated.

Early American Folk Medicine: Eleanor Sinclair Rohdes (1922) has
written very eloquently of the hardships faced by early American
settlers in their efforts to cultivate the familiar medicinal plants
of England and Europe. In many cases it seems these efforts failed
completely and the pioneers were forced to supplement their folk
medicine traditions with lore relating to indigenous plants obtained
from the native people. To the extent that any special knowledge would
have been likely, then as now, to remain a closely kept secret by the
native medicine societies, it is probable that the native plant-lore
passed onto these settlers was a matter of common knowledge amongst
the native people. In fact, it may be said that a distinguishing
feature of any folk tradition is that the lore contained in that
tradition is, or has once been, common knowledge.

Another distinguishing feature of folk medicine, regardless of its
historical or ethnic origin, is that the indications for the use of
individual remedies are always given in terms which refer to specific
symptoms or illnesses. Thus, comfrey (Symphytum officinale) is said to
be useful in healing fractures, while white horehound (Marrubium
vulgare) is recommended for cough. Typically, such lore has been
handed down from generation to generation, often for hundreds if not
thousands of years. Each new generation learns at first hand the look
and 'feel' of particular symptoms and illnesses. They learn which
plants may be used to treat these illnesses, and the best methods for
collecting, preserving and administering them. Such a tradition is
entirely dependant upon repeated experience and observation; usually
only minor changes can be detected in these traditions over relatively
long periods of time.

Thompsonianism: The popular medicine of all peoples however, has
always given rise to, and been counterbalanced by a more specialized
type of knowledge, acquired by individuals who have devoted their
entire lives to the study and practice of healing. As resource
persons, these individuals have served their communities by providing
access to that specialized knowledge in circumstances where the more
common folklore was insufficient to meet the needs of the moment.

A very popular figure in early American medicine, who managed to
combine native and settler folklore with a more specialized approach,
was Samuel Thompson (1769-1843). Thompson came from a farming family
and evidently learned some of the 'root and herb' practice at an early
age. Later, he seems to have become an avid reader of medical
literature and was particularly impressed with the Hippocratic
writings.

Probably as a consequence of his regard for Hippocrates, Thompson
believed that medicine should be based exclusively upon observation.
The formulation of theories, he felt, prevented ordinary people from
taking responsibility for the care of their own health, and that
theories obscured the simplicity and made a needless mystery of
medicine.

Thompson himself however, after 'long observation and practical
results', borrowed theory from Hippocrates and used it as a basis to
explain the 'why and how' of his own medical system. According to this
theory, disease was the result of a decrease or derangement of the
vital fluids, brought about by a loss of animal heat. The resulting
symptoms were interpreted as efforts of the Vital Force to rid itself
of the toxic encumbrances thus generated. Essentially, treatment was
aimed at restoring vital energy and removing disease-generated
obstructions. In specific terms, Thompson believed that in restoring
vital heat by means of steam baths and cayenne (Capsicum annum),
toxins which obstructed health would be thrown into the stomach where
they could be eliminated by emetics such as Lobelia inflata (Griggs,
1981).

This simple theory constituted a dramatic departure from pure folk
medicine in that it recognized and sought to treat an underlying,
fundamental cause of illness. Moreover, in perceiving symptoms as an
expression of the organism's defensive efforts, this theory implied
that the treatment of symptoms and illnesses, per se, might actually
hinder the healing process. It is interesting to note that Thompson
believed this theory was quite complete and needed no further
refinement or extension. Nevertheless, despite his vehement
opposition, Thompsonianism became a potent influence on the
development to two major streams of thought within American herbalism.

Eclecticism: The earliest of these was 'Eclecticism', founded by a man
who had originally apprenticed to an old German non-Thompsonian
herbalist, and who later qualified as a 'regular' medical doctor.
Although the founder of this system, Wooster Beach (1794-1868), had
been horrified by the 'regular' medicine of his day, and fervently
wished for radical reform, Thompsonianism had impressed him negatively
in two ways. First, Beach was keenly aware of the   bitter antagonism
which Thompson had roused in the regular medical profession. As a
result he decided to attempt reform (unsuccessfully as it turned out)
from within, rather than as another medical 'outsider'. Secondly,
Beach was disgusted by Thompson's evident arrogance in thinking that
no further learning could possibly enhance the practice of herbal
medicine.

Beach was well acquainted with the developments then taking place in
such fields as chemistry, physiology, pathology and even botany. He
was also quick to realize that this new thinking might have a valuable
role to play in botanic practice, and began to move in this direction
with the creation, in 1829, of his own school of 'Reformed Medicine'.

In terms of the study of medicinal plants, Beach's orientation
resulted in the development and proliferation of an entirely new
style. Eclectic monographs on individual herbs became more formal and
typically included notes on the plant's chemistry, toxicology,
physiological and therapeutic actions, as well as appropriate forms of
preparation and dosage (e.g. King, 1900). Later Eclectic physicians
became increasingly interested in obtaining preparations which
represented the entire chemistry of the original plant as closely as
possible. Although this preoccupation had near-disastrous consequences
in at least one instance (Griggs 1981a), in general their research
supported and developed the fundamental position of the value of using
whole plant preparations rather than isolated extracts of a particular
plant constituent (Lloyd, 1910).

Eclecticism was also a major contributor to herbal medicine in other
areas. Beach himself, for instance, realized the fundamental
importance of the blood and circulatory system in maintaining health,
and began to develop herbal methods for 'equalizing the circulation'.
Several valuable techniques used in the modern herbal treatment of
fevers are probable directly attributable to Beach's work.

A later physician by the name of W.H. Cook (1879) expanded on this
work in his correlation of the functions of the nervous and
circulatory systems. Cook also developed a concept which related
illness to deviations in trophic (i.e. structural) and/or functional
tone. According to this view, disease consisted of excessive or
diminished tone in organs, or in the functions of those organs.
Corresponding herbal approaches to the correction of these kinds of
imbalance were also eventually developed (Priest & Priest, 1982).

Another major development fostered by Eclecticism, was the clinical
emphasis placed on treating a group or pattern of symptoms, usually
with small doses of only one so-called 'specific' remedy. As the
pattern of symptoms changed with the progress of disease, a new and
more currently appropriate remedy would be indicated (Fetter, 1922;
Lloyd 1927).

Perhaps significantly, this approach was and is still fundamental to
the practice of homeopathic medicine, which was rapidly becoming the
most popular of all medical systems in the U.S. during the mid-19th
century (Coulter, 1973). In fact Hahnemann (1810), the founder of
homeopathy, had already written at some length concerning the relative
merits of prescribing for what he called the 'Totality of symptoms',
versus the treatment of individual symptoms or named diseases. The use
of small doses of a single remedy was also an established fundamental
tenet of homeopathy (e.g. Kent 1900).

Prescribing for patterns of symptoms had also been typical in
traditional Chinese medicine for many generations. Clear examples of
the fluidity of prescribing in accord with changes in symptom patterns
may be found in the Chinese classic, 'Shang Han Lun' (Hsu & Peacher,
1981). However, although the use of a single remedy is an established
technique within Chinese medicine under certain circumstances, Chinese
herbal prescribing more often involves the use of formulae (e.g.
Bensky & Gamble, 1986).

Physiomedicalism: The second major stream of thought in American
herbal medicine, which arose directly out of the Thompsonian movement,
was 'Physiomedicalism'. Although not so heavily influenced by the
developing sciences as Eclecticism, the originator of this 'neo-
Thompsonian' movement, Alva Curtis, felt, like Beach, that Thompson's
resistance to theoretical development was a mistake.

Above all, Curtis wanted to open a school based upon Thompsonian
principles, but encouraging a freer atmosphere for broader
intellectual enquiry and learning. In 1835, despite Thompson's
opposition, Curtis realized his ambition and opened the 'Botanico-
medical School and Infirmary' at Columbus, Ohio. As evidence that he
was not alone in his thinking, during that same year, a colleague
opened the 'Southern Botanico-Medical School' in Georgia (Griggs
1981b).

Ultimately this new system of herbal medicine retained much of what
had been accepted as fundamental in the Thompsonian theory. Thus,
organic function was thought of as the aggregate expression of Vital
Force, acting through cellular metabolism to maintain the functional
integrity of the entire organism. Illness was seen as a disordered
response at the cellular level, brought about by internally or
externally generated toxic obstructions. Essentially, treatment
remained a matter of supporting the efforts of the Vital Force, and of
eliminating the toxic encumbrances which hindered those efforts.

A significant departure form Thompsonian thinking however, came with
the recognition that some symptoms represented positive, eliminate and
reconstructive efforts of the Vital Force, while others resulted from
physical impediments to those efforts. If treatment was to be directed
to the underlying cause of illness, therefore, symptoms which
expressed a purely functional disorder had to be distinguished
clinically from those produced by organic changes in cells and
tissues.

Eventually it was also realized that the organism was capable of
establishing a compensatory equilibrium in which toxic encumbrance
would be tolerated to a degree, in order to maintain a relative
functional integrity. This was a major step forward in understanding
and had important implications for herbal therapeutics. Certain
symptomatic crises which had been observed, particularly in the
context of treatment with herbal alteratives and eliminatives, could
now be explained and avoided.

Another significant development in Physiomedical thinking was
stimulated through the work of W.H. Cook (see above). If health could
be understood as the unimpeded and balanced function of all cells and
tissues, then it was clear that the blood and circulatory system
played a vital role in maintaining health, both in terms of nutrient
delivery, and of waste and toxin transport to eliminative organs.

Cook had shown that, in addition to the quality of the blood itself,
the chronic relative contraction or relaxation of tissues and
particularly arterioles and capillary beds could also have serious
consequences. Cellular function, and eventually cellular structure,
could be strongly influenced by a relative excess or deficiency of
blood and tissue fluid. Further, as understanding of human physiology
increased it became obvious that hyperaemia in one part of the body
would necessarily imply a relative ischaemia elsewhere.

The implications of this thinking for herbal medicine were threefold.
Firstly, herbs which acted to increase or decrease tone in the three
primary divisions of the circulatory system (arterial, capillary and
venous) had to be distinguished. Secondly, the general, portal and
pulmonary aspects of circulation had to be considered in treatment, as
did the distinction between visceral and somatic components. Thirdly,
the circulation to particular organs and tissues had to be taken into
account, not only to support or modify the related functions, but also
to restore normal trophic conditions, where possible.

The achievement of these goals became much more accessible following
the work of J.M. Thurston (1900), which stressed the regulatory
importance of the autonomic nervous system. Thurston made many
important contributions to Physiomedical thought in the areas of
diagnosis, prognosis, treatment and, perhaps especially, in the area
of herbal pharmacy. A number of aspects of his work, and of
Physiomedicalism in general, have been described by Priest & Priest
(1982a).

Even by the close of the 19th century, Physiomedicalism could be
described as a system which emphasized the role of herbal remedies in
supporting Vital Force, balancing the circulation to various tissues,
modifying and enhancing body functions, restoring optimum trophic or
structural conditions, and in eliminating toxic encumbrances (Mills,
1985).

Unfortunately, the publication of the Flexnor report in 1910 and the
subsequent forced closure of the 'irregular' medical schools put an
end to any further developments of the kind described here in American
herbal medicine (Cody, 1985; Gort, 1986).

Conclusion: Curiously, despite the slightly more open attitudes which
prevailed in Canada (e.g. the government regulation of naturopathy on
Ontario, 1925; Govt., 1986), neither the Eclectics nor the
Physiomedicalists seem to have moved north across the border. In fact
both systems, together with a version of Thompsonianism, had been
taken to England where they were eventually integrated into one system
of professional herbal medicine, regulated by law and still taught in
the U.K.

In Canada and the U.S. however, only traces remain of these once
influential and effective systems. The Dominion Herbal College in
British Columbia for instance, has referred in its course notes to the
need for 'equalizing the circulation' (1969). References can also be
found in these notes and elsewhere to 'relaxing' or 'stimulating'
herbs (i.e. plants capable of increasing or decreasing functional
tone). The importance of supporting vital force and of eliminating
accumulated toxins is also still widely recognized and practised.
Nevertheless, there are probably few today however, who can apply
physiomedical principles in distinguishing for instance, those lung,
bowel and kidney conditionsrespectively requiring relaxing or
stimulating expectorants, laxatives and diuretics.

Due principally to repressive legislation, herbalists in North America
must once again rely heavily on folk traditions as their major source
of learning and inspiration. It should be noted here that much of the
valuable herbal lore once utilized widely by native North Americans is
now known by only a small handful of native elders (PC. 1988). It is
very fortunate therefore, that Canadian and American herbalists have
preserved some of this knowledge in their own practices.

Folk medicine traditions are virtually impossible to legislate against
directly, and even in the recent Ontario government recommendations,
treatment of oneself and one's family had been specifically exempted
from prosecution under the proposed legislation (HPLR, 1989). Direct
legislation however, was not the only factor contributing to the
decimation of native culture and the virtual loss of their traditional
healing knowledge.

The proposals tabled in the Ontario legislature will almost certainly
impose or support severe restrictions on the cultivation and/or sale
of medicinal plants, should they be passed into law. Furthermore, such
legislation will definitely prevent or seriously delay the free
development and re-emergence of a professionally oriented system of
herbal medicine in Ontario.

Consequently, those who choose to make use of this 'valuable medical
resource' (W.H.O., 1975a), will be forced to rely on their own
experience and to gather and use only wild plants. This assumes
however, that environmental policies in Ontario and the rest of North
America will not poison even this source in the very near future.

References
Bensky, D., Gamble, A. (Compl. & Ed.) Chinese Herbal Medicine
Materia Medica; Eastland Press; Seattle, 1986.

Cody, G. 'History of Naturopathic Medicine', in A Textbook of
Naturopathic Medicine, Pizzorno, J.E.; Murray, M.J.; John Bastyr
College Pulos, Seattle, 1985.

Cook, W.H. The Science and Practice of Medicine; 1879 - quoted in
Priest & Priest, ibid.

Coulter, H. Divided Legacy: a history of the schism in medical
thought Vol. 111. McGrath Pub. Co., Washington, D.C., 1973.

Dominion Herbal College, Home Study Notes, 1969.

Felter, H.W. The Eclectic Materia Medica, Pharmacology and
Therapeutics, Scudder, Cincinnati, 1922.

Gort, E.H. A Social History of Naturopathy in Ontario: the
formation of an occupation; M.Sc. Thesis; Univ. Toronto, 1986.

Griggs, B. Green Pharmacy, a history of herbal medicine; J.
Norman & Hobhouse Ltd.; London, 1981.

Hahnemann, S. Organon of Medicine. 1810; 6th Ed. Trans. Hahnemann
Foundation; Victor Gollancz Ltd.; London, 1983.

HPLR, Striking a New Balance: a Blueprint for the Regulation of
Ontario's Health Professions', Government of Ontario. 1989.

Hsu, H.; Peacher W.G.(D) (Trans. & Ed.) Shang Han Lun; Oriental
Healing Arts Institute; Los Angeles, 1981.

Kent, J.T. Lectures on Homoeopathic Philosophy: 4th Indian
Reprint, B. Jain Publishers; New Delhi, 1977.

Kings's American Dispensatory; Felter & Lloyd, 1900; Reprinted by
National College of Naturopathic Medicine; Portland (undated).

Lloyd, J.U. Fragments from an Autobiography, a paper read at the
63rd meeting of the Ohio Eclectic Medical Assoc., Arkon, May,
1927; Eclectic Medical Journal, 1927.

The Eclectic Alkoloids. LLB no. 12, Pharmacy Series 2, P41; 1910.

Mills, S. The Dictionary of Modern Herbalism; Thorsons Pub. Gp.;
Wellingbourgh, New York, 1985.

Personal Communication, Art Solomon and other Ojibwa Elders;
Native Elders Conference, Trent Univ., Peterborough, 1988.

Priest, A.W.; Priest, L.R. Herbal Medication, a clinical and
dispensary handbook; Fowler & Co. Ltd.; London, 1982.

Rohde, A.C. The Old English Herbals, 1922; 3rd Ed. Rohde, E.S.;
Minerva Press Ltd; London, 1974.

World Health Organization The Promotion of Traditional
Medicine; Technical Report Series No. 622; Geneva, 1978.

W.H.O. Document EB/57/21, Training and Utilization of Traditional
Healers and Their Collaboration with Health Care Delivery
Systems; Nov. 1975.

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