Herbal medicine, also known as botanical medicine or phytotherapy, is the most ancient form of health care known to humankind. Herbs have been used in all cultures throughout history. Extensive scientific documentation now exists concerning their use for major and minor health conditions, including premenstrual syndrome, indigestion, insomnia, liver problems,and heart disease, among others.
The World Health Organization notes that of 119 plant-derived pharmaceutical medicines, 74% are used in modern medicine in ways that correlate directly with their traditional uses as plant medicines by native cultures.
Herbs have always been integral to the practice of medicine. The word drug derives from the old Dutch word droog meaning “to dry,” as pharmacists, physicians, and ancient healers often dried plants for use as medicines. Today, approximately 25% of all prescription drugs are still derived from trees, shrubs, or herbs.1 Some are made from plant extracts and others are synthesized to mimic a natural plant compound. The World Health Organization notes that of 119 plant-derived pharmaceutical medicines, about 74% are used in modern medicine in ways that correlate directly with their traditional uses as plant medicines by native cultures.2
Yet, for the most part,modern medicine has veered away from the use of pure herbs in its treatment of health disorders. One of the reasons for this is economic. Herbs, by their very nature, cannot be patented. Because of this, drug companies cannot hold the exclusive right to sell a particular herb and they are not motivated to invest in testing or promoting herbs. The collection and preparation of herbal medicines cannot be as easily controlled as the manufacture of synthetic drugs, making profits less dependable. In addition, many of these medicinal plants grow only in the Amazonian rain forest or other politically and economically unstable places, which also affects the supply of the herb.
Before the 1970s, the demand for herbal medicine decreased in the United States because Americans had been conditioned to rely on synthetic, commercial drugs to provide quick relief, regardless of the potential adverse side effects. This viewpoint is changing, however. “The revival of interest in herbal medicine is a worldwide phenomenon,” says Mark Blumenthal, Founder and Executive Director of the American Botanical Council, the leading nonprofit herbal education organization in the U.S. This renaissance is due to the growing concern of the general public about the side effects of pharmaceutical drugs, the impersonal and often demeaning experience of modern health-care practices, and a renewed recognition of the unique medicinal value of herbs.
“The scope of herbal medicine ranges from mild-acting plant medicines, such as chamomile and peppermint, to very potent ones such as foxglove (from which the drug digoxin is derived). In between these two poles lies a wide spectrum of medicinal plants with significant medical applications,” says Donald Brown, N.D., a leading author and researcher on herbal medicine and former Professor of Botanical Medicine at Bastyr University, in Seattle,Washington. “One need only go to the older editions of the United States Pharmacopoeiato see the central role that plant medicine has played in American medicine.”
What is an Herb?
The word herb in herbal medicine refers to a plant or plant part that is used to make medicine, spices, or aromatic oils for soaps and fragrances. An herb can be a leaf, flower, stem, seed, root, fruit, bark, or any other plant part used for its medicinal, food flavoring, or fragrant property.3
Herbs have provided humankind with medicine from the earliest beginnings of civilization. Throughout history, various cultures have handed down their accumulated knowledge of the medicinal use of herbs to successive generations. This vast body of information serves as the basis for much of traditional medicine today.
There are an estimated 250,000 to 500,000 plants on the earth today, but only about 5,000 have been extensively studied for their medicinal applications.“This illustrates the need for modern medicine and science to turn its attention to the plant world once again to find new medicines that might cure cancer, AIDS, diabetes, and many other diseases and conditions,” says Norman R. Farnsworth, Ph.D., Research Professor of Pharmacognosy at the University of Illinois, in Chicago. “Considering that 121 prescription drugs come from only 90 species of plants, and that 74% of these were discovered by following native folklore claims,a logical person would have to say that there may still be more ‘jackpots’ out there.”4
How Herbal Medicine Works
In general, herbal medicines work in much the same way as conventional pharmaceutical drugs—via their chemical constituents. Herbs contain a large number of naturally occurring chemicals that have biological activity. Since 1804, chemists and pharmacists have been isolating and purifying the “active” compounds from plants in an attempt to produce reliable drugs. Examples include such drugs as the cardiac stimulant digoxin (from foxglove, Digitalis purpurea), blood pressure-lowering reserpine (from Indian snakeroot, Rauwolfia serpentina), the anti-inflammatory colchicine (from autumn crocus, Colchicum autumnale), the pain-reliever morphine (from the opium poppy, Papaver somniafera), and the anti-cancer drug Taxol (from the bark and leaves of the yew tree, Taxus).
According to author and integrative medicine proponent Andrew Weil, M.D., because herbs and the dietary supplements made from them use an indirect route to the bloodstream and target organs, their effects are usually slower in onset and less dramatic than those of purified drugs administered by more direct routes. “Doctors and patients accustomed to the rapid, intense effects of synthetic medicines may become impatient with botanicals for this reason,” Dr. Weil states.5
Herbal medicine often has much to offer when used to facilitate healing in chronic problems. By skillful selection of herbs, a profound transformation in health can be effected with less danger of the side effects inherent in conventional drug-based medicine. However, the common assumption that herbs act slowly and mildly is not always true. Adverse effects can occur if an inadequate dose,a low-quality herb,or the wrong herb is consumed.
The Actions of Herbs
A great deal of pharmaceutical research has gone into analyzing the active ingredients of herbs to find out how and why they work. This is referred to as the herb’s pharmacological action, the ways in which the remedy affects human physiology. In some cases, the action is due to a specific chemical present in the herb (as in the antiasthmatic effects of ephedrine and pseudoephedrine in the Chinese herb ma-huangor Ephedra sinica) or it may be due to a complex synergistic interaction among various constituents of the plant (the sedative action of numerous components in valerian, Valeriana officinalis, is an example).
A much older and far more relevant approach is to categorize herbs by looking at what kinds of conditions can be treated with their help. Plants have a direct impact on physiological activity and by knowing what body process one wants to help or heal, the appropriate action can be selected. The actions of herbs that make them beneficial in treating the human body include the following:
- Adaptogenic: Adaptogenic herbs increase resistance and resilience to stress, enabling the body to adapt around the problem and avoid the adverse effects of stress, such as fatigue. Some adaptogens are thought to work by supporting the function of the adrenal glands.
- Alterative: Alterativeis a term that is seldom used today, but refers to herbs that gradually restore proper functioning of the body, increasing health and vitality.
- Anthelmintic: Herbs that destroy or expel intestinal worms.
- Anti-inflammatory: Herbs that soothe inflammation or reduce the inflammatory response of the tissue directly. They work in a number of ways, including inhibiting the formation of various chemicals produced by the body that tend to increase the inflammatory process.
- Antimicrobial: Antimicrobials help the body destroy or resist pathogenic (disease-causing) microorganisms. While some herbs contain chemicals that are antiseptic or poisonous to certain organisms, in general they aid the body’s own natural immunity.
- Antispasmodic: Antispasmodics ease cramps in smooth and skeletal muscles and alleviate muscular tension.
- Astringent: Astringents have a binding action on mucous membranes, skin, and other tissues, reducing irritation and inflammation and creating a barrier against infection that is helpful to healing wounds and burns. This may result in the toning and tightening of skin and tissues.
- Bitter: Herbs with a bitter taste have a special role in preventative medicine. The taste triggers a sensory response in the central nervous system leading to a range of responses, including stimulating appetite and the flow of digestive juices, aiding the liver’s detoxification work,increasing bile flow, and motivating intestinal self-repair mechanisms.
- Carminative: Plants that are rich in aromatic volatile oils stimulate the digestive system to work properly and with ease. They soothe the gut wall, reduce any inflammation that might be present, ease griping pains, and help with the removal of gas from the digestive tract.
- Demulcent: Demulcent herbs are rich in mucilage and soothe and protect irritated or inflamed tissues. They reduce irritation down the entire length of the bowel, reduce sensitivity to potentially corrosive gastric acids, help prevent diarrhea,and reduce the muscle spasms that cause colic.
- Diuretic: Diuretics increase the production and elimination of urine, helping the body eliminate waste and support the whole process of inner cleansing.
- Emmenagogue: Emmenagogues stimulate menstrual flow and activity. With most herbs, however, the term is used in the wider sense for a remedy that affects the female reproductive system.
- Expectorant: Herbs that stimulate removal of mucus from the lungs. Stimulating expectorants “irritate” the bronchioles (part of the bronchial tubes) causing expulsion of material. Relaxing expectorants soothe bronchial spasms and loosen mucus, which helps dry, irritating coughs.
- Hepatic: Hepatics tone and strengthen the liver and, in some cases,increase the flow of bile. In a broad, holistic approach to health, they are of great importance because of the fundamental role of the liver in maintaining health by facilitating digestion and removing toxins from the body.
- Hypotensive: Hypotensives are plant remedies that lower abnormally elevated blood pressure.
- Laxative: These are plants that promote bowel movements. They are divided into those that work by providing bulk, those that stimulate the production of bile in the liver and its release from the gallbladder, and those that directly stimulate peristalsis (the wavelike contractions of the smooth muscles of the digestive tract).
- Nervine: Nervines help the nervous system and can be subdivided into three groups—tonics that strengthen and restore the nervous system, relaxants that ease anxiety and tension by soothing both body and mind, and stimulants that directly stimulate nerve activity.
- Stimulating: Stimulants quicken and invigorate the physiological and metabolic activity of the body.
- Tonic: Tonics nurture and enliven. They are used frequently in traditional Chinese medicine and Ayurvedic medicine, often as a preventative measure. Tonic herbs like ginseng are thought to build vital energy, or qi.
Herbs in Many Forms
Herbs and herbal products come in many forms and are now available not only in natural and gourmet food stores, but also grocery stores,drugstores,and mass market retail stores. Also, a number of mail-order purveyors sell herbal products, as do alternative and conventional health practitioners.
Whole Herbs: Whole herbs are plants or plant parts that are dried and then either cut or powdered. They can be used as teas or for a variety of products at home.
Teas: Teas come in either loose leaf or teabag form.
Because of the obvious convenience, most Americans today prefer to purchase their herbal teas in teabags, which include one or more finely cut herbs. When steeped in boiled water for a few minutes, the fragrant, aromatic flavor and the herb’s medicinal properties are released. As a general rule, most teas are consumed for three reasons:
- As alternatives to caffeinated tea or coffee, although some herbal teas do contain caffeine, such as yerba mate (Ilex paraguariensis)
- As a component to a meal strictly for the flavor; for example, peppermint (Menthaxpiperita), spearmint (M. spicata), rosehips (Rosa canina), lemon grass (Cymbopogon citratus), and anise (Pimpinella anisatum)
- For their mild medicinal effects—peppermint and chamomile (Matricaria recutita) for upset stomach or to improve digestion; chamomile or hops (Humulus lupulus) as a nighttime sleep aid or insomnia remedy; cinnamon (Cinnamomum zeylanicum) tea as a home remedy for mild diarrhea.
Capsules and Tablets: One of the fastest growing markets in herbal medicine in the past 15 to 20 years has been capsules and tablets. These offer consumers convenience and,in some cases,the bonus of not having to taste the herbs, many of which have undesirable flavors, from intensely bitter due to the presence of certain alkaloids to highly astringent due to the presence of tannins.
Extracts and Tinctures: These offer the advantage of being quickly assimilated compared to tablets, which take more time to disintegrate and ingest. Extracts and tinctures almost always contain alcohol. The alcohol is used for two reasons: as a solvent to extract the various non-water-soluble compounds from an herb and as a preservative. Properly made extracts and tinctures have virtually an indefinite shelf life. Tinctures usually contain more alcohol than extracts (sometimes up to 70% to 80% alcohol, depending on the particular herb and manufacturer).
Essential Oils: Essential oils are usually distilled from various parts of medicinal and aromatic plants. Some oils, however, like those from lemon, orange, and other citrus fruits, are actually expressed directly from the peels. Essential oils are concentrated, with one or two drops often constituting adequate dosage. Thus, they are to be used carefully and sparingly when employed internally. Because some oils may irritate the skin, they should be diluted in other oils or water before topical application. There are a few exceptions, most notably eucalyptus (Eucalyptus globulus) and tea tree (Melaleuca alternifolia) oils, which can be applied directly to the skin without concern of irritation.
See Aromatherapy.
Salves, Balms, and Ointments: For thousands of years, humans have used plants to treat skin irritations, wounds, and insect and snake bites. In prehistoric times, herbs were cooked in a vat of goose or bear fat, lard, or some vegetable oils and then cooled in order to make salves, balms,and ointments. Today, a number of such products, made with vegetable oil or petroleum jelly, are sold in the U.S.and Europe to treat a variety of conditions. These products often contain the herbs aloe (Aloe vera), marigold (Calendula officinalis ), chamomile, St. John’s wort (Hypericum perforatum), comfrey (Symphytum officinale), and gotu kola (Centella asiatica).
Conditions Benefited by Herbal Medicine
Herbal remedies can be used for a wide range of minor ailments that are amenable to self-medication, including stomach upset, colds and flu, minor aches and pains, constipation and diarrhea, coughs, headaches, menstrual cramps, digestive disturbances, sore muscles, skin rashes, sunburn, and insomnia. A growing number of American health consumers use herbal remedies for these conditions, which have been traditionally the domain of non-prescription or over-the-counter drugs. Other conditions that respond to herbal medicine include: digestive disorders such as peptic ulcers, colitis, and irritable bowel syndrome; rheumatic and arthritic conditions; chronic skin problems such as eczema and psoriasis; problems of the menstrual cycle and especially premenstrual syndrome (PMS); anxiety and stress; bronchitis and other respiratory conditions; hypertension; and some allergies.
Herbal medicine can also be used for a number of conditions normally treated by prescription only. One example is milk thistle seed extract for use in cirrhosis and some forms of hepatitis.12 Another example is the use of hawthorn as a heart tonic.13 This herb is highly recommended for patients with early stages of congestive heart failure by physicians in Germany (see “The Herbal Medicine Chest” section in this chapter). However, readers are cautioned that they should not self-medicate for suspected cardiac conditions; professional advice is always required.
“When treating chronic illness with herbal medicine, it is extremely important to treat the entire body, as the illness may be simultaneously affecting many systems of the body at various levels,” says Mary Bove, N.D., L.M., former head of the Department of Botanical Medicine at Bastyr University, in Seattle, Washington, and now in private practice in Vermont. “The course of the treatment must include nutritional, tonic, and restorative plants in conjunction with herbs that support the body’s elimination functions. Alterative and adaptogenic plants can be very effective. Digestive function is also an important consideration in most chronic diseases.” The duration of treatment is often longer, with a constant dose of the remedy being given over a longer period of time.
“I had a 38-year-old woman who came in with a ten-year-old case of colitis,” Dr.Bove reports. “She had been seen by several M.D.s and N.D.s over the past decade with some improvement. After discussing her long history, I chose to treat her from a different perspective. Primarily, I gave her digestive nervines and tonic herbs like catnip, lemon balm, and tilia flowers. Within three days, she went from 11 stools per day to two per day. I continued with these herbs, adding some others for gut healing. We had excellent results, which were supported by diagnostic imaging.”
Herbal medicine has also had great results with arthritic conditions. Consider the case of a 42-year-old woman with rheumatoid arthritis, confined to a wheelchair due to extreme and almost constant pain and swelling. She consulted with David Hoffmann, B.Sc., M.N.I.M.H., past President of the American Herbalists Guild. Her treatment involved herbal medicine and a reevaluation of her diet and lifestyle. Herbs were selected initially to ease the digestive problems (caused by medications she was taking) and to help her sleep. Once such side effects were alleviated, a program was started that enabled her to completely abandon the wheelchair after six months. Though she still had some arthritic pain, she was able to live with it comfortably.
Additional research into the medical benefits of herbs will speed the integration of herbal medicine into the American health-care system. The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) is funding millions of dollars worth of well-designed controlled clinical studies on herbs to determine from a valid scientific perspective what benefits they offer.
The Herbal Medicine Chest
Aloe Vera
Aloe is such a widely used ingredient in cosmetics that it is considered a mainstream cosmetic product and many people do not realize it is a medicinal herb. Aloe gel is used externally on the skin primarily for its emollient (skin-softening) property,as well as for its ability to heal wounds and burns. Applied to wounds,aloe gel is a mild anesthetic, relieving itching, swelling, and pain. It is also antibacterial and antifungal, increases blood flow to wounded areas, and stimulates fibroblasts (the skin cells responsible for healing).14
Another use for aloe comes from the latex of the inner leaf. Aloe latex is recognized as a safe and effective stimulant laxative ingredient by the U.S. Food and Drug Administration (FDA) as well as by many European countries. Normal precautions regarding laxatives apply to aloe: anthraquinone (a plant-based, organic compound) purgatives like aloe need to be used short-term only and not during pregnancy or lactation. Long-term use or misuse may cause an electrolyte imbalance, resulting in depletion of potassium salts and thus may adversely affect heart function.15 Keep in mind that these warnings are for aloe latex used as a laxative, not the aloe gel or juice commonly consumed by health enthusiasts for inner cleansing.
Bilberry (Vaccinium Myrtyllus)
Bilberry is a European blueberry usually sold as a dried concentrate of the blue-purple fruits. These fruits contain compounds known as anthocyanidins that have antioxidant activity. Dried bilberry extracts are used in pill form for various circulatory benefits and to enhance vision, based on the modern legend that Royal Airforce pilots in World War II noticed increased nighttime visual acuity during bombing raids after they had eaten bilberry jam. Several clinical studies have been conducted to test this potential benefit. Bilberry’s antioxidant activity and ability to increase microcirculation, especially in the retina, tends to support the ophthalmic benefits. Modern research has supported bilberry as an antioxidant and anti-inflammatory, as well as its ability to stabilize collagen and reduce vascular wall permeability.16
Cayenne Pepper (Capsicum Annuum)
Cayenne or red pepper is the most useful of the systemic stimulants, increasing blood flow and strengthening the heartbeat and metabolic rate.17 As a general tonic, it is helpful specifically for the circulatory and digestive systems and may be used in flatulent dyspepsia (painful indigestion) and colic.18 If there is insufficient peripheral circulation, leading to cold hands and feet and possibly chilblains (a form of cold injury characterized by redness and blistering), cayenne may be used. It is also useful for debility as well as for warding off colds.19 Externally, it is used in problems like lumbago (a dull, aching pain in the lumbar region of the back) and rheumatic pains.20
Chamomile (Matricaria Recutita)
Chamomile flower is used in many cultures for its pleasant-tasting tea, often consumed as an after-dinner beverage to help digestion. In Europe, chamomile is noted as a digestive aid, as a mild sedative, and for its anti-inflammatory property, especially in over-the-counter preparations for oral hygiene and in skin creams.21 In Germany, chamomile is licensed as an OTC drug for intestinal spasms and inflammatory diseases of the gastrointestinal tract. Externally, the extract is approved for skin and mucous membrane inflammation, bacterial skin diseases of the mouth and gums, and as a bath for inflamed conditions of anal and genital regions.22
Chasteberry (Vitex Agnus-Castus)
Chasteberry, also called chaste tree or vitex,is becoming widely used as an herb that addresses various hormonal imbalances in women.The clinical results are thought to be due to some regulatory effect upon the pituitary gland.23 Recent findings confirm that chasteberry helps restore a normal estrogen-to-progesterone balance.24 It is indicated for irregular or painful menstruation,25 premenstrual syndrome (PMS),26 and other disorders related to hormone function.Recent research conducted in Germany supports the use of chasteberry preparations in reducing symptoms associated with PMS.27 It is especially beneficial during menopausal changes, relieving symptoms such as hot flashes, and may be used to aid the body in regaining a natural balance after the use of birth control pills. Other ailments treatable with chasteberry include fibroid cysts in smooth muscle tissue or body cavities and endometriosis. Several studies suggest that chasteberry can help control acne in teenagers, among both young women and men.28
Devil’s Claw (Harpagophytum Procumbens)
A native of the deserts of western South Africa and Namibia, where this plant has been used in traditional medicine for centuries, devil’s claw is becoming increasingly popular as a safe and effective treatment for rheumatoid arthritis and related inflammation, as well as lower back pain.Clinical studies have strongly suggested its safety and effectiveness.29 One recent study in France compared devil’s claw favorably with a conventional analgesic drug in the treatment of pain in people with osteoarthritis of the hip.30 Devil’s claw is approved by the German Commission E as an aid to stimulate appetite and for arthritic conditions that affect the arms and legs.31
Echinacea (Echinacea Purpurea, E. Pallida, E. Angustifolia)
Often called purple coneflower, the term echinacearefers to several species of plants that are generally found in the Great Plains region of the U.S. It was the most widely used medicinal plant of the Native Americans of this area, who often exploited echinacea for its external wound-healing and anti-inflammatory properties. Ironically, it was a German researcher, Dr. Gerhard Madaus, who imported echinacea seeds to Europe and initiated the first modern scientific research on the immuno-stimulating properties of this plant.
Echinacea has become one of the most important OTC remedies in Germany, where it is employed for relieving the common cold and flu.Over 180 products are marketed in Germany, including extracts and fresh-squeezed juices from both the roots and leaves of echinacea.32 The German government has approved echinacea for use in recurrent infections of the respiratory and urinary tracts, progressive systemic disorders such as tuberculosis, leukosis (abnormal growth of white blood cells), connective tissue disease, and multiple sclerosis. When applied topically, echinacea is helpful for wounds with a poor tendency to heal.
Liquid echinacea preparations have immune-stimulating activity when administered both orally and parenterally (any medication route other than the intestine, such as intravenously): increasing the number of leukocytes (white blood cells) and splenocytes (white blood cells of the spleen) and enhancing the activity of granulocytes and phagocytes (cells that have the ability to ingest and destroy substances, such as bacteria, protozoa,and cell debris).33 While most clinical studies on echinacea tend to support its effectiveness as a treatmentfor upper respiratory tract infections associated with colds and flu, recent research does not support the use of echinacea as a preventive for such conditions.34
Eleuthero (Eleutherococcus Senticosus)
Eleuthero, also popularly called Siberian ginseng, is not considered a “true ginseng” but is a member of the same family (Araliaceae) as Asian and American (Panax) ginsengs. Eleuthero is considered an adaptogenic herb, increasing the body’s ability to resist and endure stress, and has a very low toxicity.
A wealth of clinical and laboratory research has been conducted on eleuthero in the former Soviet Union.Initial findings from controlled experiments indicate a dramatic reduction of total disease occurrence, especially in diseases related to environmental stress.35 There is a long list of illnesses that can improve with the use of this herb, including chronic gastritis, diabetes, and atherosclerosis (hardening of the arteries). Results from surgical studies show that eleuthero speeds post-operative recovery and is being used in this way in the treatment of cancer patients,easing the stress response that can aggravate metastasis (the spreading of a tumor to distant sites).36 Eleuthero has been shown to reduce the cytotoxicity (cell-attacking nature) of cancer-fighting drugs and the narcotic effects of sedatives.37
Ephedra or Ma-Huang(Ephedra Sinica)
Ephedra is a medicinal plant that has been cultivated for over 5,000 years in China, where it was used for asthma and hay fever–like conditions. Also known as ma-huang, ephedra’s stems contain two primary alkaloids, ephedrine and pseudoephedrine, used in OTC decongestant drugs. Ephedrine has a marked peripheral vasoconstricting action (causing constriction of the blood vessels). Pseudoephedrine is a bronchodilator (able to expand the bronchi in the lungs, necessary for proper breathing), approved for use in asthma and certain allergy medicines. Ma-huangand its extracts are found in a number of herbal formulas that are designed to increase energy and reduce appetite.
Due to the relatively large number of adverse reactions (including some deaths) reported to the FDA associated with the use of ephedra-containing dietary supplements, ephedra has become controversial over the last decade.The FDA has tried to limit the amount of the alkaloids in ephedra supplements,their duration of use,and their actual uses; however, another government agency has found the FDA proposal lacking in scientific merit and its adverse event reporting system faulty. At present, the herb and supplement industries have initiated voluntary label warnings and limits on the levels of ephedrine and pseudoephedrine in supplements (usually limited to 25 mg of total alkaloids per dose; a total of 100 mg per day).38
Both ephedrine and pseudoephedrine have central nervous system–stimulating properties, with ephedrine being more active.These alkaloids have been characterized as being stronger than caffeine and weaker than methamphetamine. Therefore, this herb should be used with caution or avoided by those with high blood pressure, heart disease, diabetes, glaucoma, prostate conditions, and related conditions where hypertensives are contraindicated.39 Consumers should check with their physician before taking supplements with ephedra.
Feverfew (Tanacetum Parthenium)
Feverfew is an herbal remedy that dates back to Greco-Roman times. It was formerly employed as a remedy for difficulties associated with menstrual cycles in young women (the word partheniumis derived from the Greek word parthenos, meaning “virgin”) and was later used in European herbalism to reduce fevers (the name feverfew is a corruption of the Latin word febrifuga, meaning an agent that lowers fevers).40
Interest in this herb has increased in the past 15 years because of several clinical studies published in British medical journals. Research showed that feverfew leaves brought relief in a significant number of migraine patients who had not responded positively to conventional medications and also helped to prevent the onset of additional episodes.41 The Canadian government’s Health Protection Branch (equivalent to the FDA) has approved feverfew leaf extract for migraine prevention,as long as the products contain a minimum of 0.2% parthenolide, a substance in feverfew incorrectly considered to be its primary active component.42 According to Blumenthal, parthenolide has been shown to be inactive for this use, but can be used as an indicator of the proper plant chemical profile for quality control. Early herbal literature also attributes antirheumatic properties to feverfew, but this has not been confirmed by modern research.43
Garlic (Allium Sativum)
Garlic is probably the most well-recognized medicinal herb. It is used by traditional medicines all over the world and its applications are as varied as its geographical distribution. The chemistry and pharmacology of garlic is well studied: as of 1998, there were an estimated 1,990 scientific publications on the activities of garlic and chemical compounds from garlic, including chemical, toxicological, pharmacological, clinical, and epidemiological studies.44
Garlic is known for its antibiotic, antifungal, and antiviral activities; for helping clear congested lungs; for coughs, bronchitis, and sinus congestion; as a preventive measure for colds and flu; for intestinal worms, dysentery, and certain ulcers; and for gout and rheumatism.45 Garlic may also help prevent certain cancers. A National Cancer Institute report on a large Chinese population indicated that the consumption of garlic and other members of the Alliumgenus (onions, leeks, shallots) can help lower the incidence of stomach cancer.46
Western countries have shown interest in garlic’s ability to provide important cardiovascular benefits, including slightly lowering blood pressure, aiding in the thinning of blood, and reducing platelet aggregation (blood coagulation).47 One four-year study showed that 900 mg per day of a garlic supplement helped reverse arterial plaque buildup, thereby reducing the risk of cardiovascular disease.48 Garlic has also shown an ability to aid immune function, particularly increasing the activity of natural killer cells.49
Studies indicate general benefits from almost any type of garlic—raw, dried, garlic oil, or a prepared commercial product.50 However, odorless or odor-controlled garlic preparations, such as kyolic, have a high degree of activity and are appropriate for those who do not wish to suffer the problems associated with garlic’s characteristic odor, such as bad breath. In Germany, garlic extracts are approved by the Commission E as nonprescription drugs to supplement dietary measures in patients with elevated cholesterol levels and to avert age-associated vascular changes.51 Although one early meta-analysis (statistical evaluation of many studies) of clinical studies concluded that garlic lowered total cholesterol about 9%-12%, several recent evaluationshave found that garlic may only lower cholesterol about 4%-6%.52
Ginger (Zingiber Officinalis)
In addition to its popularity as a food flavoring, ginger is widely used as a medicinal herb in Chinese and Ayurvedic medicine, often added to herbal formulas to increase digestion and the activity of other herbs. In the past 15 years,ginger has become best known for its anti-nausea and anti-motion sickness activity. A number of clinical studies have confirmed ginger’s ability to act on the gastrointestinal system and allay nausea.53 Unlike the leading OTC drug, Dramamine, ginger does not relieve nausea by suppressing central nervous system activity. Rather, the effect is explained by the antiemetic properties of this herb on the digestive tract, which are well documented.54 A recent study in Thailand on pregnant women has also documented the safety of ginger when used to relieve morning sickness during the first trimester of pregnancy.55 Ginger is also known to have cardiotonic properties56 and has been used in traditional medicine for migraine relief.57 In traditional Chinese medicine, fresh ginger juice is applied topically as a burn remedy.58
Ginkgo (Ginkgo Biloba)
Ginkgo is an excellent example of why protecting plants and animals from extinction can help create new medicines. Ginkgos, the oldest living trees, first appeared about 200 million years ago and, except for a small number in northern China, were almost completely destroyed in the last Ice Age. Ginkgo leaves contain several compounds called ginkgolides and one called bilobalide that have unique chemical structures. The leaves,used as a remedy for lung problems,were mentioned in major Chinese herbal texts as far back as 1436.
A highly concentrated, pharmaceutically prepared standardized extract was developed in the past 30 years in Germany to treat various conditions associated with peripheral circulation.59 It is currently licensed in Germany for the treatment of cerebral dysfunction (short-term memory problems, dizziness, tinnitus), mainly in older people. A study in the Journal of the American Medical Association concluded that ginkgo extract was effective in treating patients in the early stages of dementia associated with Alzheimer’s disease.60
Ginkgo is also approved in Germany as a supportive treatment for hearing loss due to impaired circulation and for peripheral arterial circulatory disturbances, such as intermittent claudication (a severe pain in the calf muscles resulting from inadequate blood supply).61 Ginkgo leaf extracts are also used for heart and eye diseases, as well as accidents involving brain trauma. At least three volumes of information on the chemistry, pharmacology, and clinical uses of Ginkgo bilobaextract have been published.62
Ginseng (Panax Ginseng, Oriental Ginseng; P. Quinquefolius, American Ginseng)
Ginseng has an ancient history and has accumulated much folklore about its actions and uses. The genus name Panaxis derived from the Latin word panaceameaning “cure all.” Many of the claims that surround ginseng are exaggerated, but it is clearly an important remedy, receiving attention from researchers around the world.63 Research suggests that it is adaptogenic, aiding the body in coping with stress, primarily through effects upon the functioning of the adrenal glands.64 Ginseng also has antioxidant, liver-protecting, and hypoglycemic effects.65 There is a wide range of possible benefits, but the main application is with weak, debilitated, stressed, or elderly people, where these properties can be especially useful.66
In addition, ginseng may help to lower blood cholesterol and stimulate a range of immune system and endocrine responses.67 Several small studies on American ginseng suggest that it can help normalize blood sugar levels in both Type II diabetic adults and normal healthy adults after meals.68
Goldenseal (Hydrastis Canadensis)
One of the most widely used Native American herbs, goldenseal root is popularly considered a remedy for colds and upper respiratory tract infections. However, Blumenthal points out that there is a disappointing lack of scientific research to support the potential benefits of this herb. “Many consumers consider goldenseal a tonic remedy that stimulates immune response, although there are no scientific data to support this,” he says.
Because of its bitter effects, goldenseal is considered by some to be helpful for digestive problems, from peptic ulcers to colitis.69 Its bitter stimulation helps in loss of appetite and the alkaloids it contains stimulate production and secretion of digestive juices. Sometimes erroneously called an antibiotic, goldenseal actually has antimicrobial properties, due to the presence of alkaloids, such as berberine.70 Berberine has a broad spectrum of activity against bacteria, protozoa, and fungi, including Staphylococcus, Streptococcus, Candida albicans, and Gardia lamblia.71 For this reason, goldenseal can be useful for helping to treat and prevent traveler’s diarrhea. Berberine’s action in inhibiting Candidaprevents the overgrowth of yeast that is a common side effect of antibiotic use. This alkaloid has also been shown to activate macrophages (cells that digest cellular debris and other waste matter in the blood).72
Applied externally, it can be helpful in eczema, ringworm, itching, earache, and conjunctivitis.73 Traditionally, goldenseal has been used during labor to help contractions and, for this reason, it should be avoided during pregnancy.
Hawthorn (Crataegus Oxyacantha)
Hawthorn has been used in folk medicine in Europe and China for centuries. Hawthorn is one of the primary heart tonics in traditional medicine. Europeans have employed both the edible fruit as well as the extract of the leaves and flowers, primarily for their beneficial effects on the cardiovascular system (cardiotonic, sedative, and hypotensive activities).
In Germany, hawthorn extracts are used for a number of heart-related conditions, often in conjunction with digoxin, the primary conventional pharmaceutical drug used for congestive heart failure. Hawthorn has been extensively tested on animals and humans and is known to cause the following actions: decreases blood pressure with exertion, increases the heart muscle’s ability to contract, increases blood flow to the coronary muscles, decreases heart rate, and decreases oxygen use by the myocardium (the middle layer of the walls of the heart).74 Hawthorn extracts are approved by the German Commission E for declining heart performance.75
Hops (Humulus Lupulus)
Hops has been used as a bittering and preservative agent in brewing for centuries. In Germany, hops is approved for use in states of unrest and anxiety as well as for sleep disorders, due to its calming and sleep-inducing properties.76 European researchers have approved the use of hops for such conditions as nervous tension, excitability, restlessness, and sleep disturbances, and as an aid to stimulate appetite. Unlike other types of sedatives, there are neither dependence nor withdrawal symptoms reported with the use of hops, nor are there any reports of adverse side effects.77 A hops and valerian combination is approved by the German Commission E as a sleep aid, based on scientific research on both herbs; recent research on the combination supports this approval.78
Horse Chestnut (Aesculus Hippocastanum)
Horse chestnut seed extract (HCSE), a standardized extract from the seeds of the horse chestnut tree, is widely used in European phytotherapy to treat “chronic venous insufficiency”(CVI), most commonly poor circulation in the lower legs and the resulting edema (swelling), and nighttime leg cramps. A meta-analysis published in the Archives of Dermatologyon clinical studies involving 1,100 people concluded that HCSE was safe and effective for conditions associated with CVI. Moreover, adverse effects were mild and infrequent.79 Horse chestnut is also used for varicose veins and hemorrhoids.
Kava-Kava (Piper Methysticum)
Kava-kava is the root and rhizome (lateral root) of an herb from the black pepper family from Polynesia, Samoa, Fiji, and Vanuatu. Kava is the most revered herb in Polynesia, being an important part of the culture there. Kava beverages are given to visiting dignitaries as a measure of respect—President Lyndon B. Johnson received kava when he went to U.S. Samoa and Pope John Paul II drank kava in Fiji. Kava is often consumed in a mild, relaxing beverage on a social basis.
European researchers have carried out numerous clinical studies on standardized kava extract to confirm its mild relaxing effects and the herb has been approved by the German Commission E for anxiety.80 A statistical review of three publishedclinical trials conducted on a German extract (standardized to 70% kavalactones, the active compounds in kava) showed kava to be safe and effective for treatment of anxiety when compared to placebo.81
However, caution is advised when taking kava as recent reports from Europe indicate an association between kava and liver problems. Blumenthal recommends that kava not be used by those with existing liver problems, those taking pharmaceutical drugs that adversely affect the liver, or people who regularly drink alcohol. He also suggests that kava not be taken on a daily basis for more than four weeks and that its use should be discontinued if symptoms of jaundice occur. Anyone with a history of liver problems should consult with their physician before using kava.
Licorice (Glycyrrhiza Glabra)
Licorice is a traditional herbal remedy and modern research has shown it to have effects upon the endocrine system, liver, and other organs. Constituents of this herb, called triterpenes, are metabolized in the body into molecules that have a similar structure to the adrenal hormones, which my be the basis for the anti-inflammatory action of licorice.82 Glycyrrhizin, a triterpene, inhibits liver cell injury caused by many chemicals and is used in the treatment of chronic hepatitis and cirrhosis, especially in Japan.83 Glycyrrhizin inhibits the growth of several viruses and inactivates the herpes simplex virus.84
Licorice is also used as a treatment for peptic ulcers and gastritis, colic, and bronchial problems such as bronchitis and coughs. There is a small possibility of affecting electrolyte balance with extended use of large doses of licorice. It can cause retention of sodium, thus raising blood pressure. The whole herb has constituents that counter this effect, but it is best to avoid licorice in cases of hypertension, kidney disease, or during pregnancy.
Milk Thistle (Silybum Marianum)
Historically, this herb has been used in Europe as a liver tonic. Current phytotherapy indicates the use of the standardized extract of its seed (technically, the fruits) for a range of liver and gallbladder conditions, including hepatitis and cirrhosis. A wealth of laboratory and clinical research on this herb reveals its ability to reverse liver damage as well as offer protection from potentially toxic chemical agents.85 These findings highlight a role for milk thistle in the treatment of toxic/metabolic liver disease (both alcohol- and drug-induced forms), some forms of hepatitis (usually A, sometimes C), cirrhosis of the liver, and fatty degeneration of the liver.86
Milk thistle shortens the course of viral hepatitis, minimizes post-hepatitis complications, and protects the liver against problems resulting from liver surgery. It is an excellent remedy for use in the prevention and treatment of many liver disorders. The leading milk thistle extract product from Germany has been termed “undoubtedly the best documented pharmaceutical agent for the treatment of liver diseases.”87
Nettle (Urtica Dioica)
Nettle, also known as stinging nettle, is one of the most widely used herbs in the Western world. However, this common plant has received little attention from the medical community. Throughout Europe, nettle is used as a spring tonic and detoxifying remedy. When steamed or boiled, the leaves can be eaten. If used regularly, it can be remarkably successful in cases of rheumatism and arthritis, often when the stinging hairs on the leaves are slapped across a swollen area, producing a counter-irritant effect.88
Based upon its traditional uses, it might be inferred that nettle is a safe, immunomodulating tonic. A lectin (plant protein) found in nettle leaf stimulates the proliferation of white blood cells.89 Traditional use of nettle in the treatment of allergic rhinitis (hay fever) is gaining some limited research support.90 It is especially indicated for all varieties of childhood eczema. Fresh nettle as a tea has been used as a safe diuretic.91
Nettle roothas an altogether different use as an aid in treating benign prostatic hyperplasia (BPH), a condition characterized by swelling of the prostate and urinary disturbances. Nettle root extract has anti-inflammatory properties and is approved by the German Commission E for BPH.92
Passionflower (Passiflora Incarnata)
Passionflower has enjoyed a tradition of use for its mildly sedative properties. In Germany, passionflower is approved as an over-the-counter drug for states of “nervous unrest.”93 In Europe, passionflower is often added to other calming herbs, usually valerian and hawthorn. Passionflower and hawthorn are used together as antispasmodics for digestive spasms in cases of gastritis and colitis. Pharmacological studies indicate antispasmodic, sedative, anxiety-allaying, and hypotensive activity of passionflower extracts.94
Peppermint(Menthapiperita)
Peppermint has been a popular folk remedy for digestive disorders for over 200 years and is currently one of the most economically significant aromatic food/medicine crops produced in the U.S.95 In some European countries, peppermint leaf is recognized as a digestive aid due to the gas-preventing and bile-increasing action of the aromatic oil. In Germany, peppermint oil is approved as an OTC drug for upper gastrointestinal cramps and spastic conditions of bile ducts, catarrh (inflammation of mucous membranes) of the upper respiratory area,and inflammation of oral mucous membranes.96 It is also approved (in enteric-coated capsule form) for irritable bowel syndrome,as the oil exerts a relaxing effect on the smooth muscles of the bowel.97
Peppermint oil also has antibacterial properties, as do many essential oils. Peppermint oil and menthol are common ingredients in external analgesic products like balms and liniments. In Germany, this combination is approved for external use for muscle and nerve pain.98 In addition to the above conditions, peppermint oil is approved by the European Scientific Cooperative in Phytotherapy for gallbladder inflammation and gallstones and skin conditions such as pruritis (severe itching) and urticaria (eruption of wheals with intense itching).99
Pygeum (Prunus Africana or Pygeum Africanum)
Pygeum bark comes from a hardwood tree in Africa and has become increasingly popular in Europe and the U.S. as a treatment for benign prostatic hyperplasia (BPH). The bark extracts exhibit anti-inflammatory activity and are helpful in reducing the urinary symptoms associated with BPH.100nNumerous clinical studies support its use in modern BPH therapy.101
St. John’s Wort (Hypericum Perforatum)
A remedy long used as an anti-inflammatory, woundhealing nervine valued for its mild sedative and painreducing properties, St. John’s wort has recently regained medical attention. Taken internally, it has traditionally been used to treat neuralgia, anxiety, tension, and similar problems. In addition to neuralgic pain, it will ease fibrositis, sciatica, and rheumatic pain.102 It is especially regarded as an herb to use in the case of menopausal changes triggering irritability andanxiety. Used externally, it is a valuable healing and anti-inflammatory remedy.103 As a lotion, it will speed the healing of wounds and bruises, varicose veins, and mild burns (especially for healing sunburn).104
The primary use of St. John’s wort, and the reason for its popularity during the past few years, is its clinically proven benefit for the treatment of mild to moderate depression.105 It is not effective for cases of more serious or chronic depression, however, and can adversely affect the activity of conventional drugs (antivirals, immunosuppressants, cardiac medications, and possibly others); therefore, people should not use St. John’s wort if they are taking conventional medicines, without the consent of their physician.
Saw Palmetto (Serenoa Repens)
Saw palmetto is the fruit of an American dwarf palm tree from Florida that has become popular as an herbal remedy for maintaining the health of the male urinary tract. It is most effective in cases of benign prostatic hyperplasia, the noncancerous enlargement of the prostate gland associated with aging.106 A review of 18 controlled clinical studies on a total of 2,939 men revealed that saw palmetto extract was more effective than a placebo. In three of the studies where the herbal preparation was compared to the leading conventional drug for BPH, finasteride or Proscar®, saw palmetto had about 90% fewer adverse side effects.107 Another study showed that saw palmetto lowered the levels of the hormone dihy drotestosterone (DHT) in prostate tissue. DHT levels are known to increase with age and higher levels are associated with prostate enlargement.108 An earlier study by the same researchers showed evidence that saw palmetto may help shrink prostate tissue.109
Senna (Cassia Senna)
Senna is a laxative from the leaves and pods of the senna plant, a member of the pea family, that is derived from ancient Arabic medicine. In Europe and the U.S., extracts from senna are approved in OTC laxatives. The German government has approved senna for all conditions of constipation in which the need for soft stools is indicated. There are no adverse side effects connected with the use of senna, other than those normally associated with the use of stimulant laxatives (long-term use or misuse can result in dependency and electrolyte loss).110 Like other stimulant laxatives, senna should not be used during pregnancy or lactation unless professionally supervised.
Valerian (Valeriana Officinalis)
The odorous root of valerian has been used in European traditional medicine for centuries. In Germany, valerian root and its teas and extracts are approved as over-the-counter medicines for “states of excitation”and “difficulty in falling asleep owing to nervousness.”111 A scientific team representing the European community has reviewed the research on valerian and concluded that it is a safe nighttime sleep aid. These scientists also found that there were no major adverse reactions associated with the use of valerian and, unlike barbiturates and other conventional drugs used for insomnia, valerian does not have a synergy with alcohol.112 Herbalist and author Christopher Hobbs, L.Ac., notes that other uses for valerian include nervous heart conditions, children’s anorexia caused by excitement, trembling, and stomach complaints.He recommends a valerian-hops preparation as a good daytime sedative as it will not interfere with or slow one’s reflexive responses.113 A valerian-hops extract combination has been introduced in the U.S. as a dietary supplement for aiding sleep, based on clinical studies strongly suggesting the safety and efficacy of this herb combination, as well as the fact that the German Commission E had approved a similar combination based on previous research.114
Witch Hazel (Hamamelis Virginiana)
Witch hazel comes from a tree native to North America and is considered a safe astringent for common usage, approved for external use as an OTC medicine. It is found most commonly in the form of a distilled liquid, usually containing about 14% alcohol (which some authors suggest is the actual reason why American witch hazel products possess astringent properties). As with most astringents, this herb may be used wherever there has been bleeding, internally or externally. It is especially useful in easing the pain and swelling of hemorrhoids.115 Topically, it can be used in the treatment of bruises and swelling and also with varicose veins.116 Internally, witch hazel teas and extracts have been used to stop diarrhea and aid in the treatment of dysentery. However, commercial witch hazel preparations found in most drugstores are not intended for internal use.
The Future of Herbal Medicine
According to James Duke, Ph.D., an ethnobotanist, former herb specialist with the U.S. Department of Agriculture, and author of numerous books on herbs,one of the reasons that research into the field of herbal medicine has been lacking is the enormous cost of the testing required to prove a new “drug”safe. Dr.Duke has seen that price tag rise from $91 million as of 15 years ago to the present figure of around $500 million. Dr. Duke asks,“What commercial drug maker is going to want to prove that saw palmetto is better than their multimillion dollar drug, when you and I can go to Florida and harvest our own saw palmetto?”
In recent years, however,the research agenda has changed considerably in the U.S.Stimulated by funding from the National Center for Complementary and Alternative Medicine at the National Institutes of Health, millions of dollars have been committed to the development of human clinical trials to test the efficacy of such herbs as St. John’s wort, ginkgo, echinacea, black cohosh, and many more. The future looks bright for those who want to explore the benefits of herbal medicine. The demand for natural medicines has grown significantly, to the point that herbal preparations are now available in supermarkets, drugstores, and other large retail outlets. According to a 1999 survey, about 48% of adult Americans had used herbs within the previous year and 24% admit to using herbs regularly.
One of the major problems in the U.S. is the lack of a regulatory system that allows the therapeutic benefits to be put onto the label of herbal products. Without these recognized benefits, consumers will be exposed to media stories that overemphasize the risks and underplay the benefits of these natural remedies.
—Mark Blumenthal, Executive Director, American Botanical Council
“The use of herbal products requires that people learn about their benefits and their potential risks,”says Mark Blumenthal.“People must realize that herbs can have some risks if they are not used properly and responsibly. But one of the major problems in the U.S. is the lack of an effective, rational regulatory system that allows the therapeutic benefits to be put onto the label of herbal products. Without these recognized benefits, consumers will be constantly exposed to media stories that overemphasize the risks and underplay the benefits of these valuable natural remedies.”
Where to Find Help
As part of the resurgence in environmental awareness, herbs and herbal remedies are receiving increased attention as a natural, cost-effective alternative to pharmaceutical products. For more information on herbal medicine, or to find a physician who uses herbal remedies, contact:
American Association of Oriental Medicine
433 Front Street
Catasauqua, Pennsylvania 18032
(888) 500-7999
Website: www.aaom.org
The AAOM is a national professional trade organization of acupuncturists who meet acceptable standards of competency. They also can provide names and locations of local members.
American Association of Naturopathic Physicians
8201 Greensboro Drive, Suite 300
McLean, Virginia 22102
(703) 610-9037
Website: www.naturopathic.org
Provides referrals to a nationwide network of accredited or licensed practitioners. Publishes a quarterly newsletter for both professionals and the general public and also offers a series of brochures and pamphlets on a variety of subjects.
American Botanical Council
P.O. Box 144345
Austin, Texas 78714-4345
(512) 926-4900
Website: www.herbalgram.org
The leading nonprofit herbal research and education organization. Publishes HerbalGram, a highly respected peerreviewed magazine, booklets on herbs, books, reprints of scientific articles, and has an extensive catalog of books, monographs, audio and videotapes, CD-ROMs, and other educational materials for health professionals and consumers. Also provides continuing education for health professionals, plus herbal medicine ecotours of the Amazon and other areas.
American Herbal Pharmacopoeia
P.O.Box 5159
Santa Cruz, California 95063
(831) 461-6318
Website: www.herbal-ahp.org
AHP is a nonprofit educational and research organization that develops national quality control standards for the man ufacture of botanical supplements and provides extensive therapeutic information through the publication of comprehensive monographs on herbs.
American Herbal Products Association
8484 Georgia Avenue, Suite 370
Silver Spring, Maryland 20910
(301) 588-1171
Website: www.ahpa.org
AHPA is the major trade association dedicated to ethical and responsible commerce and advancement of the herbal products industry.AHPA’s members consist of botanical suppliers,distributors,growers,and marketers who are dedicated to creating products that are used to enhance health through the use of herbs.
American Herbalists Guild
1931 Gaddis Road
Canton, Georgia 30115
(770) 751-6021
Website: www.americanherbalist.com
AHG is a nonprofit membership organization dedicated to meeting the professional needs of herbalists and other practitioners of botanical medicine, offering an academic journal, education guidelines, mentorship opportunities, and national certification standards.
Herb Research Foundation
1007 Pearl Street, Suite 200
Boulder, Colorado 80302
(303) 449-2265
Website: www.herbs.org
Provides research materials for consumers, pharmacists, physicians, scientists, and the industry. Members receive HerbalGram and/or Herbs for Health as benefits.
North American College of Botanical Medicine
1104 Park Avenue S.W.
Albuquerque, New Mexico 87102-2941
(505) 873-8107
Website: www.swcp.com/botanicalmedicine
A leading center for herbal education in the U.S.and a catalyst in the effort to integrate traditional healing practices with contemporary health care. It was founded to meet the growing demands for definitive herbal education and the need for trained professional herbalists.
United Plant Savers
P.O.Box 98
East Barre, Vermont 05649
Website: www.plantsavers.org
An organization committed to the preservation of medicinal plants in North America. Produces conferences, books, and operates a native medicinal plant sanctuary in central Ohio.