Men and women working in a Victorian drug store.

20th Century History of Medicinal Plants

For most of us, modern medicine is exemplified by drugs such as antibiotics and highly technical methods of diagnosis and treatment. However, many might be surprised to discover that, for much of the last century, herbal medicines have been the primary form of treatment, even in Western countries.

Even as late as the 1930s, around 90 percent of medicines prescribed by doctors or sold over the counter were herbal in origin. It is only during the last 70 years that laboratory produced medicines have become the norm. During the First World War (1914–1918), for example, garlic (Allium sativum) and sphagnum moss (Sphagnum spp.) were used by the ton in the battle trenches to dress wounds and to treat infections. Garlic is an excellent natural antibiotic, and was the most effective antiseptic available at the time, and sphagnum moss, gathered from the moorlands, makes a natural aseptic dressing.

Science & Medicine

The development of new medicines in the laboratory—either extracted from medicinal plants or synthesized—stretches back to the early 19th century, when chemists first isolated constituents such as morphine, from opium poppy (Papaver somniferum), and cocaine, from coca (Erythroxylum coca). From that time onward, scientists made tremendous progress in understanding how isolated chemicals affect the body, as well as how the body works in health and disease. From the 1860s, scientists—most notably Louis Pasteur (1822–1895)—began to identify the microorganisms that were ultimately responsible for causing infectious diseases, such as tuberculosis and malaria.

Naturally enough, the first aim of those engaged in medical research was to seek out medicines that would act as “magic bullets,” directly attacking the microorganisms concerned and ridding the body of the threat. This eventually led to the discovery, or, more accurately, the rediscovery of penicillin by a number of medical researchers, most notably Alexander Fleming (1881–1955) in 1929. However, while 20th-century scientists were the first to scientifically evaluate antibiotics as medicines, they were not the first to employ them in healing.

Antibiotic molds had been grown and used to combat infection in ancient Egypt, 14th-century Peru, and in recent European folk medicine. In the decades following the Second World War (1939–1945), when antibiotics first came into use, it seemed as though a new era had dawned in which infection could be conquered, and life-threatening diseases such as syphilis, pneumonia, and tuberculosis would cease to be major causes of death in the developed world. Modern medicine also provided other highly effective drugs such as steroid anti-inflammatories, and it seemed as if it was simply a question of time until cures for most illnesses were found.

Ascendancy of Biomedicine

As Americans and Europeans became accustomed to medication that led to an almost instant short-term improvement in symptoms (if not in underlying health), herbal medicines came to be seen by the public as outmoded and ineffective. Increasingly, the practice of herbal medicine was outlawed in North America and most of Europe, while the wealthy in developing countries abandoned herbal medicine in favor of the new treatments available.

This was in no small part due to the medical profession itself, which saw herbal medicine as a throwback to the superstitions of the past. From the late 19th century onward, the aim of organizations such as the American Medical Association and the British Medical Association had been to monopolize conventional medical practice. Herbal medicine thus neared extinction in many countries, especially in the U.S. and Britain. In Britain, for example, from 1941 until 1968 it was illegal to practice herbal medicine without medical qualifications.

The Tide Turns

Although there were spectacular successes with modern chemical medicines, there were also horrific disasters, most notably the thalidomide tragedy in 1962 in Britain and Germany, when 3,000 deformed babies were born to mothers who had taken the drug for morning sickness during pregnancy. This event marked a turning point in the public’s opinion of chemical medicines.

People began to realize that a serious cost could accompany the benefits of treatment with modern pharmaceutical drugs. This, and the factors described below, have brought about a sea change in public perceptions of the value of herbal medicine.

The Chinese Example

Herbal medicine experienced a major gain in fortune in 1949 in China, when Mao Zedong and the Communist Red Army gained control of the country. Traditional Western medicine by that time was well established in China, but most of the population had little hope of access to modern hospitals, let alone to new drugs.

Out of necessity, traditional Chinese medicine—essentially herbal medicine and acupuncture—once more began to be used alongside Western conventional medicine. The authorities aimed to provide the best of both worlds. Five teaching hospitals for traditional Chinese medicine (TCM) were established, where it was taught on a scientific basis.

In addition, great efforts were made to improve the quality of plant medicines. Contrary to the trend in conventional Western medicine that makes the patient ever more dependent upon the doctor and high-tech machinery, TCM, like other forms of complementary medicine, stresses the patient’s personal responsibility for his or her own cure, encouraging a holistic approach to treatment.

In the 1960s, China also established a system of “barefoot doctors.” After a period of basic medical instruction that blended herbal medicine, acupuncture, and Western practices, these practitioners were sent out to provide health care for the millions of rural Chinese too remote from cities to benefit from the facilities available there. The barefoot doctors in the late 1960s became a model for the World Health Organization, which created a strategy of including traditional herbal practitioners in planning for the health care needs of developing countries.

Western Medicine & Herbal Practices

Further to the initiative by the World Health Organization, experience has shown that traditional (usually herbal) and Western medicine can indeed work well in tandem, although the relationship is often quite complex. J. M. Janzen’s The Quest for Therapy in Lower Zaïre (University of California Press, 1978) describes one such interaction in Africa: “The people of Zaïre recognize the advantages of Western medicine and seek its surgery, drugs, and hospital care, but contrary to what might have been expected, native doctors, prophets, and traditional consultations among kinsmen do not disappear with the adoption of Western medicine. Rather a [working relationship] has developed in which different forms of therapy play complementary rather than competitive roles in the thoughts and lives of the people.”

The high cost of Western medical treatment is another factor that has encouraged people and governments to re-examine traditional healing. In China, Mexico, Cuba, Egypt, Ghana, India, and Mongolia, to give but a few examples, herbal medicines are being cultivated in greater quantities, and are being used to some degree by conventional as well as traditional practitioners.

Likewise, different types of treatment have evolved to meet the variety of needs within a population. India offers an extraordinary example of the kind of choices available in types of medical care. Alongside physicians trained in conventional Western medicine, there are medically trained Ayurvedic practitioners, traditional Ayurvedic practitioners, local healers, and homeopaths.

Changing Attitudes

Perhaps the most important factor behind the growing interest in complementary medicine is the poor state of health in Western societies. Conventional medicine has by and large brought serious infectious diseases under control, although there are worrying signs that infectious organisms are becoming resistant to antibiotic treatment, largely as a result of their indiscriminate use. Chronic illness, however, seems to be on the increase.

Probably around 50 percent of people in Western countries daily take one or more conventional medicines—for conditions as diverse as high blood pressure, asthma, arthritis, and depression. Many Western countries such as the U.S. and France spend astronomical sums on health care, yet despite this massive investment, much of the population remains demonstrably unhealthy. Even the significant increase in life expectancy in developed countries is starting to go into reverse, perhaps a result of environmental pollutants and toxic accumulation within the body.

Over the years, changes in public awareness have led to a renewed interest in herbal medicine. In fact, some herbal preparations are now so commonly used that they are accepted as a part of everyday life. One of many possible examples is evening primrose oil, which is used by hundreds of thousands of women in Britain to help relieve premenstrual syndrome.

It is extracted from the seeds of Oenothera biennis, a North American plant. Peppermint oil (Mentha x piperita), prescribed for irritable bowel syndrome and other gut problems, is another example, while senna (Cassia senna), a simple, effective treatment for short-term constipation, is one of the most frequently used medicines throughout the world.

The growing awareness of how our lives as human beings are interwoven with the fate of our planet also reinforces the value of herbal medicines. As long as care is taken to prevent over-harvesting, herbal medicine is ecologically in tune with the environment.

Herbalism & Holism

The “germ theory of disease,” which holds that illness springs from contact with an infectious organism, remains the dominant view in mainstream medicine. Many people, however, recognize that this is only part of the picture. While illnesses such as cholera and typhoid are highly infectious and are indeed likely to be caught by almost anyone, many infectious diseases are not transmitted automatically from one person to another.

The question arises, therefore, what weakness in the patient has allowed the “seed” of infection to find fertile ground? Unlike much conventional medical practice, which focuses on eradicating the “bug” or abnormal condition, herbal medicine seeks to treat the weakness that gave rise to ill health, and sets this in the context of the patient’s life as a whole. A complex web of factors may lie behind the onset of illness. While bodily signs and symptoms are the most obvious indicators, dietary, emotional, and spiritual factors may be of equal importance.

Our bodies contain over one hundred trillion cells, which collectively must function in harmony if good health is to be maintained. Used wisely, herbs work in tune with our bodies, stimulating, supporting, or restraining different sets of cells in their allotted tasks within the body, encouraging a return to normal balanced function. Remedies aim to strengthen the patient’s own resistance, improve the vitality of weakened tissue, and encourage the body’s innate ability to return to good health.

Of course, for people with severe acute illnesses, it may be too late to use an herbal approach to treatment. In these circumstances, strong-acting conventional medicines such as heart drugs, antibiotics, and painkillers, as well as surgery, can all be lifesavers. However, a health-care system that is carefully attuned to the needs of the patient might well provide herbal remedies as a first line of treatment, with conventional medicines held in reserve to be used only when necessary.

Evidence in Support of Herbal Cures

Many medical scientists still find it hard to accept that natural medicines, with their complex chemical makeup and variable constituents, can be as good as chemical cures in treating illness. However, as more and more research reveals that herbal medicines can be as effective as conventional medicines—and are far safer—this thinking is beginning to change. This is well illustrated by the change in attitude toward St. John’s wort (Hypericum perforatum)—a European plant commonly taken as an antidepressant.

Extracts of the herb are now scientifically recognized as having value in mild to moderate depression. Since the 1980s, over 30 clinical trials have found extracts of St. John’s wort to be as effective as conventional antidepressants and to have far fewer side effects. In 15 of these trials, the herbal extract produced fewer side effects than the placebo (or inert “medicine”) used as a comparison. Other investigations suggest that St. John’s wort may have a role in countering viral infections, promoting wound healing, and helping withdrawal from addiction, especially from alcohol.

As is so often the case, research has confirmed traditional views. In the 16th century, Paracelsus had this to say about the herb: “Nothing chases away disease like strength. Therefore, we should seek medicines with power and strength to overcome whatever illnesses they are used against. From this it follows that God has given to Perforatum [St. John’s wort] the strength to chase [away] the ghosts of nature…and all downheartedness.” As a result of scientific research, today’s practitioners have an important advantage—how the plant works in the body is now better understood, so that it is possible to be precise about dosages, aware of side effects, and confident in what form the herb should be taken as a medicine.

All over the world research is now being directed into plants with a traditional use as medicines, in the hope of finding new treatments for all manner of health problems. To give but two examples: the Indian gooseberry (Emblica officinalis) appears to protect the liver against cancer, lowers blood cholesterol levels, and may prove valuable for acute pancreatitis; while thyme (Thymus vulgaris), better known as a culinary herb, is a potent antioxidant that may prevent the breakdown of essential fatty acids in the brain and slow the aging process.

Medicinal Herbs & Big Business

The major pharmaceutical companies have realized that rainforests, grasslands, and even along roads and fields are sources of potentially invaluable medicines. As a result, the industry has invested vast resources into screening the active constituents of medicinal plants from all over the world.

The drug taxol, first extracted from the Pacific yew (Taxus brevifolia), and one of the most effective treatments for breast cancer, was developed in this way. In this search through the plant world it is likely that other remarkable medicines will be found, though far fewer new drugs have been successfully developed via this research than was originally anticipated. In fact, there is a key problem to this approach, for it is geared to the production of isolated plant chemicals which can then be synthesized and patented. With a patent, a company can make a profit, recouping the massive investment required to research and develop new medicines. Herbs, however, are whole, naturally occurring remedies.

They cannot and should not be patented. Even if the major pharmaceutical companies were able to find an herb such as St. John’s wort, which proved to be more effective and safer than conventional medicines, they would prefer to develop synthetic chemical drugs rather than plant medicines.

Herbal Synergy

One word more than any other separates herbal from conventional medicine: synergy. When the whole plant is used rather than extracted constituents, the different parts interact, often, it is thought, producing a greater therapeutic effect than the equivalent dosage of isolated active constituents that are generally preferred in conventional medicine.

Increasingly, research shows that herbs such as ephedra (Ephedra sinica), hawthorn (Crataegus oxyacantha), ginkgo (Ginkgo biloba), and lily of the valley (Convallaria majalis) have a greater than expected medicinal benefit thanks to the natural combination of constituents within the whole plant. In some cases, the medicinal value of the herb may be due entirely to the combination of substances and cannot be reproduced by one or two “active” constituents alone.

The Future of Herbal Medicine

The main issue for the future of herbal medicine is whether medicinal plants, and the traditional knowledge that informs their use, will be valued for what they are—an immense resource of safe, economical, ecologically balanced medicines—or whether they will be yet another area of life to be exploited for short-term profit.

Another issue is convincing skeptics in the medical world that herbal medicine is not just a poor substitute for conventional medicine, but a valuable form of treatment in its own right. In trials into the effect of certain Chinese herbs on patients with eczema at London’s Royal Free Hospital in the early 1990s, conventional specialists were astonished when the addition of one extra herb to a Chinese formula containing 10 others resulted in a dramatic improvement in a previously unresponsive patient.

This story offers evidence of the skill and art involved in herbal practice. In tailoring the remedy to suit the individual needs of the patient and in treating the underlying cause, major improvements were made. This approach is a far cry from the standard medical view of using a single drug to treat a single disease.

In India and China, there have been university courses in herbal medicine for decades. In the West this process has been slower, with undergraduate courses emerging only in the last 20 years. There are now degree courses in herbal medicine or naturopathy in several Western countries, including Australia, the UK, and the U.S., while in Germany, medical students have been required to study naturopathy and phytotherapy (herbal medicine) as part of their medical training since 2003. Such developments point toward a future where patients might be able to choose between medical and herbal approaches when considering what medical treatment will suit them best.