Western Herbal Medicine

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Medical herbalism is a modern medical practice that combines the ancient methods of traditional medicine with modern scientific knowledge.

Medical herbalism is often referred to as 'phytotherapy', which is a New Latin derivation of the Greek word for plant: 'phuto'. This factsheet will use the term 'medical herbalism'.

From traditional herbalism to western medicine

Traditional herbalism has largely been superseded by the more pragmatic practice of modern medicine. But how did western medicine develop from traditional practices?

Many different cultures across the world have historically attributed disease and healing to the powers of 'higher beings', or other uncontrollable forces. Pacific islanders call this force 'Maná', the Chinese call it 'Qi', the Ancient Egyptians believed it was the God of Healing, Imhotep, and many Christians and Muslims believe that all of life and health is the work of a single God. For many thousands of years, humanity's propensity for spiritual belief meant that healthcare rarely extended further than making sacrifices to the gods or praying for good health. 

During the Renaissance, however, all of this changed.  

Medicine in the Renaissance

The Renaissance (the 'rebirth' of Ancient Greek and Roman art, philosophy, science etc. after the middle ages) spread across Europe between the 14th and 17th centuries and radically changed the way people approached medicine and health care. 

Instead of accepting that human health rested in the hands of higher deities, physicians began to investigate the human body in more depth. With the emergence of Renaissance art, which was far more accurate and realistic than previous styles, artists could watch dissections and translate the human anatomy onto paper. These drawings could then be used to spread knowledge of the body and encourage research into the physical causes of certain diseases.

Bacteria and disease

In 1857, French chemist Louis Pasteur identified the connection between bacteria and disease. This realisation led to the eventual development of certain vaccines and treatments, and later, to the emergence of chemical drugs. 

Drugs

Almost a quarter of all modern drugs are derived from naturally occurring plant chemicals¹. These are known as 'phytochemicals', or 'secondary metabolites', and are used by the plant in the following ways:

• as toxins used to ward of predators
• as pheromones to attract insects for pollination
• as phytoalexins used to ward off microbial infections
• as allelochemicals used to deter competing plants from growing too near and taking up soil space and  light.

Secondary metabolites are not essential for a plant's survival but their effects do increase its chance of survival and quality of life.  

Scientists have discovered that, when isolated and extracted, these phytochemicals can have a significant effect on the neurological pathways in the human body. These phytochemicals are now commonly synthesized to make drugs that stimulate certain effects in the body (e.g. stimulants, painkillers, depressants) and treat illnesses.

Popularity of herbalism today

Herbalism has, in recent years, risen in popularity again throughout developed countries. According to a survey conducted in America in 2010, 74% of medical students believed Western medicine could benefit from integrating traditional herbalist practices².

In another study it was estimated that 80% of people living in developed nations have tried an alternative therapy such as acupuncture or homeopathy², suggesting that for many of us, western medicine isn't the answer to all of our health problems.

Difference between western medicine and medical herbalism

Unlike western healthcare professionals, medical herbalists believe that plants should be used in their full, original form and not synthesized to form chemical drugs.

The emphasis in medical herbalism is the 'whole'. Practitioners aim to:

• use the plant in its natural form
• heal the body and mind as a whole.

Herbalists look to harness the full power of the plant by using it in its natural form, whether it be the root, leaf, flower, stem or any other part. According to the National Institute of Medical Herbalists, "to isolate one constituent from a complex living being is to perform a disservice to the wisdom of nature." By isolating a single chemical in a plant, one is essentially destroying its natural balance and weakening its healing strengths.

Medical herbalism is also about healing the patient as a whole, not simply for one set of symptoms (as you might expect in an appointment with a GP). By treating just one set of symptoms, you are ignoring the natural and important balance of components in the human body.

Advantages of medical herbalism over western medicine

There are a number of reasons why some people  choose medical herbalism over western healthcare. These include:

Regulation - the regulation of modern drugs is extremely rigorous and costly. Bringing new medicines to the market can take years and cost millions. Stringent policies mean that new treatments and cures are prevented from reaching the patients who desperately need them. Herbal medicines are regulated in the EU but the standards are far less rigid. Because herbal knowledge has been a case of trial and error over thousands of years, there is less chance of severe reaction than there is with new chemical drugs, so rigorous testing is not so necessary.   

Protection - strict intellectual property laws on modern medicine ensures that scientific knowledge and research is highly protected. Herbalism is built around the sharing of knowledge between generations and cultures. Without that openness, practitioners wouldn't know the wealth of information they do now. This open, honest mentality demonstrates that health and compassion are the most important values in herbalism, and not money or power.

Consultation - whereas a GP will conduct a usually brief and brisk assessment of a patient's particular symptoms, a medical herbalist will take one or two hours discussing at length the patient's lifestyle as well as their medical concerns. This means that medical herbalist treatment can be more specific and more personal than western healthcare, with a far more rounded and holistic approach to healing.

Formulation - because medical herbalists take a far more holistic approach to healing, the prescribed remedy will tend to be a lot more personalised and individual than anything prescribed by a GP. Western drugs are manufactured in a standardised way using standard ingredients and standard processes. Herbal medicines on the other hand are prepared during the consultation and can vary greatly, meaning the patient gets a remedy tailored to their personal needs. 

Difference between traditional herbalism and medical herbalism

Medical herbalism, like traditional herbalism, aims to use the herb in its original form, rather than extracting its chemical properties. However, medical herbalism differs from its archaic predecessor, mainly because it incorporates modern scientific research and western healthcare standards as part of its practises. Medical herbalism, in short, aims to project traditional herbalism into the 21st century as a valid option for healthcare. 

What training and qualifications do herbalists need?

The regulation of herbal medicines

The European Directive on Traditional Herbal Medicinal Products (THMPD) is legislation that was introduced in March 2004 by the European Parliament and Council, with an aim of regulating the approval process for traditional herbal medicines within the European Union.

Under the regulation, all herbal medicine products must be authorised or registered in order to be sold within the EU. Any products marketed before this legislation was implemented were given until April 2011 to obtain a license or registration. After this date it became illegal for herbal medicines to be marketed without authorisation.

The authorisation scheme is known as the Traditional Herbal Medicine Registration Scheme, and its primary aim is to protect consumer health by requiring all traditional herbal medicines to meet stringent safety and quality standards.

Herbal medicines come in three different categories according to the strength of their regulations:

1. Unlicensed herbal remedies

These are medicines that have not met the required safety standards and could therefore be dangerous.

In April 2011, the EU passed a law stating that all herbal products on sale to the public must be licensed or registered. However, herbal practitioners are still able to prescribe unlicensed herbal remedies legally to those who want them.

2. Registered herbal remedies

This is a simple registration scheme that was established in 2005. Herbal medicines are required to meet certain safety and quality guidelines. They must also come with warnings and instructions for use.

3. Licensed/authorised herbal remedies

Some herbal medicines within the UK hold a product license, similar to that of conventional medications. Licensed/authorised herbal medicines must show evidence of safety, quality and efficacy and they must also be accompanied by information about safe usage. You can see if a herbal medicine is licensed by looking for its nine digit Product License (PL) number.

Taking herbal medicine safely

Whilst a huge number of us assume that herbal medicines are safe because they are natural (40% of us according to the Medicines and Healthcare products Regulatory Agency), as with all medication you should use with care and caution and ensure they are either licensed or registered.

For full and up to date information about herbal medicine regulation, please visit the Medicines and Healthcare products Regulatory Agency (MHRA). 

What are the risks?

• some remedies can interact with other prescribed drugs
• some herbal remedies can have poisonous effects (kava, related to the pepper, is used in some countries to treat anxiety. However, it is now suspected to cause severe liver poisoning.)

Yellow card system

The yellow card system is a way of reporting any adverse reactions from herbal remedies to the Medicines and Healthcare products Regulatory Agency (MHRA). You can do this yourself or you can ask your GP to report it on your behalf.

Tips for taking herbal medicine safely

• Always consult your GP before you take any form of herbal medicine.
• Do not exceed the recommended dose.
• Always take herbal medicine under the guidance of a trained medical professional.
• Always be particularly cautious if you are pregnant or nursing.

The regulation of herbalists

As it stands, herbalists in the UK currently face no legislation in terms of what qualifications and experience they must hold in order to deliver their services to the public. Whilst many practitioners are qualified to a high level and have plenty of industry experience, those who do not may be putting consumer safety at risk.

In February 2011, Health Secretary Andrew Lansley announced that herbalists would eventually be statutorily regulated. 

The Health Professions Council (HPC) (the statutory regulator of health professionals), will be the organisation responsible for establishing and running a statutory register for practitioners supplying unlicensed herbal medicines, and once this register is up and running it will then be a legal requirement for any practitioners wishing to supply unlicensed herbal products to register with the HPC. 

Although this process has already been set in motion and the Department of Health (DOH) has met with the HPC to develop a timetable for moving over to statutory regulation, this process is expected to take some time. The HPC have said they envisage the register will open in the autumn of 2013.

Professional bodies

Until the system for statutory regulation has been put into position, many herbalists will choose to remain on or join a professional organisation that has taken on the role of self-regulation.

Whilst herbalists are not legally required to register with any of these organisations, being a member means that a practitioner has met certain eligibility requirements put in position by the body, and also means they must abide by a code of ethics and complaints procedure.

Each professional member organisation will have developed their own set of entry requirements for membership; but generally speaking they will involve proof of a relevant qualification/training and evidence of experience within the field.

Practitioners who belong to a professional body will make this clear on their profile. For further information about some of the key organisations for western herbal medicine, please refer to the list below:

Please note, information about registration is subject to change, so for full and up-to-date details we always recommend you visit the professional bodies’ websites directly.

The College of Practitioners of Phytotherapy (CPP)

The College of Practitioners of Phytotherapy (CPP) is a membership organisation of phytotherapists, dedicated to setting high standards of practice within the herbal medicine industry.

Phytotherapists (‘phyto’ being taken from the Greek word for ‘plant’) registered with the college are all specialist herbal practitioners who have undergone a high level of university training. In order to be eligible for membership, there is a minimum requirement of a BSc (Hons) degree in Herbal Medicine from a recognised institution, as well as references from 2 current members to be eligible for membership.

There is only one level of membership available with the CPP: Member (MCPP), and only those who have met the above criteria are permitted to use the MCPP designation.

The Association of Master Herbalists (AMH)

The Association of Master Herbalists (AMH) is a member organisation representing qualified herbal practitioners who have undergone a high level of training within the field. All members of the AMH are insured, and are obligated to work to a strict code of ethics and conduct.

The National Institute of Medical Herbalists (NIMH)

The National Institute of Medical Herbalists (NIMH) is the leading professional body in the UK for herbal practitioners. The organisation is self-regulating, and is responsible for setting educational standards, running accredited training programmes and implementing mandatory Continuing Professional Development (CPD) courses for members.

Unified Register of Herbal Practitioners (URHP)

The Unified Register of Herbal Practitioners (URHP) is a professional organisation made of up of herbal practitioners.

Members come from all backgrounds and include graduates from courses recognised by the register, and honorary members who have been recognised by colleagues for being outstanding competent herbalists.

References

¹Natural Medicines of NC, 'FAQs'

²Scidev, 'integrating modern and traditional medicine fact and figures'.

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All content displayed on Therapy Directory is for provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional. Whilst some people have benefited from complementary and alternative therapies, no claims can be made to treat, cure or heal, and we strongly advise individuals with any health problem to seek independent medical advice from their GP before considering complementary or alternative medicine or treatment.

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