Herbalism is the study of herbs involving a holistic approach that incorporates ecological, emotional, medical, mental, and physical applications (Hoffman, 2003). Herbalism draws from various herbal traditions to study how herbs can be used to treat and prevent disease (Gale, 2014). Herbal medicine has several branches, one of which is phytotherapy, a “medical modality that uses whole plants to treat whole people, facilitating the healing process within the framework of holistic medicine” (Hoffman, 2003, p. 6). Other branches include phytochemistry, the study of chemicals in plants; phytopharmacy, the preparation of natural drugs; and phytopharmacology, the study of chemical constituents of plants (Weiss & Fintelmann, 2000).
Herbal traditions have existed in every culture throughout the world, and have been integral to long-standing healing traditions such as Ayurveda and Traditional Chinese Medicine (TCM). In Western approaches, herbal medicine uses a combination of clinical experience and traditional use of plant remedies maintained in oral and written folklore (Gale, 2014).
Herbal medicine is based on the premise that medicinal plants have beneficial effects, and these can be obtained from the active constituents within the plant (Rodriguez-Fragoso, Reyes-Esparza, Burchiel, Herrera-Ruiz, & Torres, 2008). Active constituents are believed to work synergistically, each greater collectively than when acting individually. When constituents are isolated, they are weaker or not as potent (Rodriguez-Fragoso et al., 2008).
Herbal treatments use whole or parts of the fresh plant. Alternatively, active constituents may be extracted from the plants as decoctions, extracts, infusions, teas, tinctures, or other forms. Active constituents can also be purified and studied in labs to determine their clinical effect, how to synthesize them in the lab, or how to change and patent them (Gale, 2014).
Herbal medicine is the foundation for modern drugs and pharmaceutics, as many originated from herbs (Gerber, 2001). For example, aspirin or acetylsalicylic acid was derived from salicylic acid extracted from willow plants, and digoxin is the synthetic version of digitalis, the active constituent of foxglove (Gerber, 2001). Opium poppy was the first narcotic, birth control pills came from Dioscorea villosa, a Mexican yam, and vincristine and vinblastine used in cancers treatments came from Catharanthus roseus or Madagascar periwinkle (Freeman, 2009).
Herbal medicines are believed to be safe because they are natural. This is often true, but some herbs have side effects, are toxic, interact with other herbs and drugs, and even cause death (Rodriguez-Fragoso et al., 2008). Others do not. Some herbs are infected with contaminants, such as heavy metals, which are purposefully or illegally placed, and these can have deleterious effects on health. Others work synergistically with conventional medicines and produce enhanced effects that are beneficial to health (Rodriguez-Fragoso et al., 2008). Some are safe to use on everyone, including children, chronically ill patients, elderly people, or pregnant women, while others are not. Thus, it is important to study and understand herbs and their proper use.
The first recorded evidence of herbal remedies dates back 60,000 years. A Neanderthal skeleton was found near seeds of aromatic plants, marking the origin of aromatherapy. The skeleton was also found with eight species of herbal plants that were believed to be healing. These plants are still used medicinally today (Freeman, 2009).
The origin of Western herbal medicine is credited to the Greeks, although they were heavily influenced and gathered knowledge from the Babylonians, Egyptians, and Persians (Gale, 2014). The Greek physician and herbalist Hippocrates, who lived 2,500 years ago, is regarded as the father of modern medicine. He considered that diet, good quality water, climate, and social environment played a role in disease, and he incorporated herbal remedies to bring back health (Gale, 2014). Another Greek, Theophrastus, wrote the founding text in botany, Historia Plantarum, in the 4th century B.C. In the 1st century B.C., the Greek physician Pedanius Dioscorides wrote De Materia Medica, one of the most influential texts in western herbalism, used for over 1,500 years as a standard reference book among herbal practitioners (Gale, 2014). The book had plant drawings and details about their administration, dosage, medicinal properties, and possible toxicity (Gerber, 2001).
Galen of Pergamum, a Roman physician, developed the Galenic medical system that was used throughout the Middle Ages, and involved complex formulas and drastic techniques, such as blood letting. It was a rigid system that pushed herbal healers out of the mainstream. With the Black Pague in 1348 the Galenic medical system lost its zenith, as many lost their lives (Gale, 2014). Herbalism persisted with medieval monks and women continuing to use herbal traditions, even though the Catholic Church persecuted them (Gale, 2014).
The discovery of the New World exposed European botanists to new plants, which expanded their knowledge on herbal medicines. They learned from Native Americans how to use native medicinal plants. In 1597, the English physician and gardener John Gerard published The Herball or General Historie of Plantes, which compiled these discoveries, and also provided descriptions of more than 1,000 English plants and flora (Gale, 2014). European colonists brought plant specimens and herbal knowledge back to the New World, which contributed to the spread of these plants to North America. Juan Badianus, a native Mexican Indian physician, published some of this knowledge in a manuscript in 1552 (Gale, 2014). American herbalism originated as a blend of European and Native American herbal traditions.
Later medical developments, like alchemy, homeopathy, and naturopathy that were developed in the 17th, 18th, and 20th centuries, kept herbalist practices within natural therapies, but herbalism was no longer the mainstream approach to healing (Gale, 2014). The advent of modern medicine in the late 1800s and early 1900s pushed herbalism more to the periphery, particularly in the United States (US). However, other countries continued to rely on herbal treatments, which were often more affordable and readily available than allopathic options (Gale, 2014).
At the turn of the 21st century, an estimated 80% of the global population relied on herbal remedies (Gale, 2014). Germany is the world leader in ensuring herbal safety and efficacy, as they follow the same approval process for herbs as for drugs (Freeman, 2009). The German Commission E expert panel develops monographs on herbs, and checks their safety and efficacy through clinical trials, field and case studies, and medical expertise. Herbal remedies in Germany are covered by insurance and an estimated 70% of physicians prescribe them (Freeman, 2009).
Around 5 billion dollars were spent on herbal products in the US in 2013 (Gale, 2014). However, herbalism is not part of allopathic treatment. Herbal products are considered dietary supplements and regulated by the US Food and Drug Administration (FDA). The efficacy of these supplements is not based on clinical studies, but on traditional use and anecdotal evidence (Gale, 2014). In 1994, the Dietary Supplement Health and Education Act (DSHEA) allowed herbal products to be labeled with the nutritional support, safety, side effects, and warnings, but not with any therapeutic claims. The DSHEA prohibits labeling an herb as able to treat, cure, or prevent a disease (Freeman, 2009). Dietary supplements are a branch of CAM. The approach is different in England, Italy, France, and Germany, where herbal medicinal products are available by prescription and over-the-counter (Gale, 2014).
In the US, herbal medicine is not a licensed practice. But, practice and prescriptions are regulated in some states. However, Western herbal studies are available nationwide. Herbalism is part of the curriculum in Naturopathic medical colleges to obtain a Doctor of Naturopathy, as well as Ayurvedic, Homeopathic, Traditional Chinese Medicine, and other programs.
Freeman, L. (2009). Mosby’s Complementary & Alternative Medicine, A Research-Based Approach (3rd ed.). St. Louis, MO: Mosby Elsevier.
Gale (2014). The Gale Encyclopedia of Alternative Medicine, (4th Ed). Farmington Hilla, MI: Gale Cengage Learning.
Gerber, R. (2001). Vibrational Medicine (3rd ed.). Rochester, VT: Bear & Company.
Hoffman, D. (2003). Medical Herbalism, The Science and Practice of Herbal Medicine. Rochester, VT: Healing Arts Press.
Rodriguez-Fragoso, L., Reyes-Esparza, J., Burchiel, S. W., Herrera-Ruiz, D., & Torres. E. (2008). Risks and benefits of commonly used herbal medicines in Mexico. Toxicology and Applied Pharmacology, 227(1), 125-135. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2322858/pdf/nihms40773.pdf
Weiss, R. F. & Fintelmann, V. (2000). Herbal Medicine: Second Edition, Revised and Expanded. Stuttgart: Thieme.