{{Alternative medical systems}} {{mergefrom|Medical herbalism}} [[Image:Arabic_herbal_medicine_guidebook.jpeg|thumb|350px|'''[[Dioscorides]]’ Materia Medica''', c. 1334 copy in Arabic, describes purported medicinal features of [[cumin]] and [[dill]].]] '''Herbalism''', also known as '''Herbal medicine''' and '''phytotherapy''', is folk and traditional [[medicinal]] practice based on the use of [[plants]] and [[plant extract]]s. Finding healing powers in plants is an ancient idea. People in all continents have long used hundreds, if not thousands, of indigenous plants for treatment of various ailments dating back to prehistory. There is evidence that [[Neanderthals]] living 60,000 years ago in present-day [[Iraq]] used plants for medicinal purposes (found at a burial site at [[Shanidar]] Cave, Iraq, in which a Neanderthal man was uncovered in 1960. He had been buried with eight species of plants) {{fact}} These plants are still widely used in [[ethnomedicine]] around the world. The first generally accepted use of plants as healing agents were depicted in the cave paintings discovered in the [[Lascaux]] caves in France, which have been [[Radiocarbon]] dated to between 13,000 - 25,000 BCE. Over time and with trial and error, a small base of knowledge was acquired within early tribal communities. As this knowledge base expanded over the generations, tribal culture developed into specialized areas. These 'specialized jobs' became what are now known as healers or Shaman. Plants have an almost limitless ability to synthesize [[aromatic]] substances, most of which are [[phenols]] or their oxygen-substituted derivatives such as [[tannins]]. Most are [[secondary metabolite]]s, of which at least 12,000 have been isolated, a number estimated to be less than 10% of the total. In many cases, these substances (esp. [[alkaloid]]s) serve as plant defense mechanisms against predation by microorganisms, insects, and [[herbivore]]s. Many of the herbs and spices used by humans to season food yield useful medicinal compounds. The use of and search for drugs and dietary supplements derived from plants have accelerated in recent years. Pharmacologists, microbiologists, botanists, and natural-products chemists are combing the Earth for phytochemicals and leads that could be developed for treatment of various diseases. In fact, many modern drugs have been derived from plants. The use of [[herb]]s to treat [[disease]] is almost universal among non-industrialized societies. A number of traditions came to dominate the practice of herbal medicine in the [[Western world]] at the end of the [[twentieth century]]: * The Western, based on [[Ancient Greece|Greek]] and [[Ancient Rome|Roman]] sources, * The [[Ayurveda|Ayurvedic]] from [[India]], and * [[Traditional Chinese medicine|Chinese herbal medicine]] ([[Chinese herbology]]). Many of the [[pharmaceuticals]] currently available to Western physicians have a long history of use as herbal remedies, including [[opium]], [[aspirin]], [[digitalis]], and [[quinine]]. ==Biological background== All plants produce chemical [[Chemical compound|compounds]] as part of their normal [[metabolism|metabolic]] activities. These can be split into primary metabolites, such as [[sugar]]s and [[fat]]s, found in all plants, and secondary metabolites found in a smaller range of plants, some only in a particular [[genus]] or [[species]]. The [[autologous]] functions of secondary metabolites are varied. For example, as [[toxin]]s to deter [[predation]], or to attract insects for [[pollination]]. It is these secondary metabolites which can have therapeutic actions in humans and which can be refined to produce drugs. Some examples are [[inulin]] from the roots of [[dahlia]]s, [[quinine]] from the [[cinchona]], [[morphine]] and [[codeine]] from the [[poppy]], and [[digoxin]] from the [[digitalis|foxglove]]. [[As of 2004]], the [[National Center for Complementary and Alternative Medicine]] started to fund [[clinical trial]]s into the effectiveness of herbal medicine.[http://health.nih.gov/result.asp/324 NIH Institute and Center Resources], National Institute of Health. Surveys of a scientific approach to herbal medicine can be found in the books ''Evidence-based herbal medicine'',"Evidence-based herbal medicine" edited by Michael Rotblatt, Irwin Ziment; Philadelphia: Hanley & Belfus, 2002 and ''Herbal and traditional medicine: molecular aspects of health''."Herbal and traditional medicine: molecular aspects of health", edited by Lester Packer, Choon Nam Ong, Barry Halliwell; New York: Marcel Dekker, 2004. ==Popularity== A survey released in May 2004[http://nccam.nih.gov/news/2004/052704.htm More Than One-Third of U.S. Adults Use Complementary and Alternative Medicine] Press release, May 27, 2004. [[National Center for Complementary and Alternative Medicine]] by the [[National Center for Complementary and Alternative Medicine]] focused on who used [[:category:alternative medicine|complementary and alternative medicines]] (CAM), what was used, and why it was used. The survey was limited to adults age 18 years and over during 2002 living in the United States. According to this recent survey, herbal therapy, or use of natural products other than [[vitamin]]s and minerals, was the most commonly used CAM therapy (18.9%){{cite web|url= http://nccam.nih.gov/news/report.pdf |title=Complementary and Alternative Medicine Use Among Adults: United States, 2002 |accessdate= |accessmonthday= September 16 |accessyear= 2006 |author= |last= Barnes |first= P M |authorlink= |coauthors= Powell-Griner E, McFann K, Nahin R L |date= 2004-05-27 |year= |month= |format= PDF |work= Advance data from vital and health statistics; no 343 |publisher= National Center for Health Statistics. 2004 |pages= 20 |language= |archiveurl= |archivedate=}} (See table 1 on page 8). when all use of [[prayer]] was excluded. Herbal remedies are common in Europe. In Germany, the term apothecary (Apotheke) is still used, and next to prescription drugs one can order essential oils, herbal extracts, or herbal teas. It is even seen as a preferred treatment over the unnecessary overuse of industrialized production of chemical medication. == Types of herbal medicine == Medicinal plants can be used by anyone, for example as part of a salad, a herbal tea or supplement, although some herbs considered dangerous are restricted from sale to the public. Western herbalists often purchase their herbs from specialist suppliers; these herbs are not intended for sale to the public and are rarely marketed or standardised. Many people in the developing world still rely on traditional herbal medicine for everyday healthcare. Traditional healers might not purchase herbal supplements, but rely on herbs that they have gathered themselves. Medicinal herbs can be used in various forms: ===Herbal teas=== Heating the leaves, roots or flowers of a medicinal plant in water to make a decoction is the simplest way to use herbal medicine. {{sectstub}} ===Herbal tinctures=== Steeping a medicinal plant in alcohol extracts the alcohol-soluble principles into a liquid form that can be stored for long periods. Herbalists may mix several herbal tinctures to form an individualised prescription for each patient. Plant tinctures are also the basis for many homeopathic medicines. {{sectstub}} ===Fluid extracts=== Fluid extracts are stronger than herbal tinctures, and can be made with alcohol or glycerin. {{sectstub}} ===Solid extracts=== {{sectstub}} ===Herbal poultices=== {{sectstub}} ===Powdered herbs and tablets=== {{sectstub}} ===Herbal creams and ointments=== {{sectstub}} ===Essential oils=== {{main|Essential oil|Aromatherapy}} Extraction of volatile liquid plant materials and other aromatic compounds from plants gives essential oils. These plant oils may be used internally in some forms of herbal medicine as well as in aromatherapy and generally for their perfume. ===Herbal supplements=== Herbal supplements tend to be commercial products in tablet or capsule form manufactured and marketed by the health food industry for sale in retail outlets to the general public, although there are some types that are sold only to healthcare practitioners for prescription. Herbal supplements are often standardised to contain stated levels of active phytochemicals. Some herbalists may not agree with the standardisation of active ingredients, preferring instead to use the whole plant. ==Examples of herbal medicine== {{main|List of medicinal herbs}} There are hundreds of of herbal remedies. An experienced practitioner can offer a comprehensive holistic approach to health. Examples of some commonly used herbal medicines: * [[Artichoke]] and several other plants reduced total serum [[cholesterol]] levels in preliminary studies.Thompson Coon JS, Ernst E. "Herbs for serum cholesterol reduction: a systematic view." ''J Fam Pract.'' 2003 Jun;52(6):468-78. PMID 12791229 * [[Black cohosh]] and other plants that contain [[phytoestrogen]]s (plant molecules with [[estrogen]] activity) have some benefits for treatment of symptoms resulting from [[menopause]].Kronenberg F, Fugh-Berman A. "Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials." ''Ann Intern Med.'' 2002 Nov 19;137(10):805-13. PMID 12435217 [http://www.annals.org/cgi/reprint/137/10/805.pdf annals.org] (133 K PDF file) Full text article * [[Echinacea]] extracts limit the length of [[Common cold|colds]] in some clinical trials, although some studies have found it to have no effect.Block KI, Mead MN. "Immune system effects of echinacea, ginseng, and astragalus: a review." ''Integr Cancer Ther.'' 2003 Sep;2(3):247-67. PMID 15035888 * [[Garlic]] lowers total cholesterol levels, mildly reduces [[blood pressure]], reduces [[platelet]] aggregation, and has [[antibacterial]] properties.[http://www.herbaled.org/THM/Singles/garlic.html www.herbaled.org] Garlic * [[Grapefruit seed extract]] is a minimally effective anti-bacterial, anti-parasitic, and anti-fungal herb. Marketers suggest it is good for intestinal problems, [[IBS]], [[Crohns Disease]], and other intestinal symptoms due to its minimal negative impact on the intestinal flora.{{fact}} * [[Nigella sativa]] (Black cumin) is a generalist medicinal plant used for diverse ailments such as cough, pulmonary infections, asthma, influenza, allergy, hypertension and stomach ache. The seeds are considered carminative, stimulant, diuretic and galactogogue. It is often taken with honey. Seed powder or oil is externally applied for eruptions of skin. * [[Peppermint tea]] for problems with the [[digestive tract]], including [[irritable bowel syndrome]] and [[nausea]]. * [[Rauwolfia|Rauvolfia Serpentina]], used extensively in India for sleeplessness, anxiety, and high blood pressure. The first proven allopathic medicine for high blood pressure was extracted from this herb. * [[St John's wort]], though dangerous in incorrect doses,{{fact}} is more effective than a [[placebo]] for the treatment of mild to moderate [[clinical depression|depression]] in some clinical trials.Gupta RK, Moller HJ. "St. John's Wort. An option for the primary care treatment of depressive patients?" ''Eur Arch Psychiatry Clin Neurosci.'' 2003 Jun;253(3):140-8. PMID 12904978 *[[Valerian root]] can be used to treat [[insomnia]]. ==Dangers == A common misconception about herbalism and the use of 'natural' products in general, is that 'natural' equals safe. However many plants have chemical defence mechanisms against predators that can have adverse or lethal effects on humans. Examples are [[poison hemlock]] and [[nightshade]], which can be deadly. Herbs can also have undesirable side-effects just as pharmaceutical products can. These problems are exacerbated by lack of control over dosage and purity. Furthermore, if given in conjunction with drugs, there is danger of 'summation', where the herb and the drug have similar actions and add together to make an 'overdose'. In animals, there are other dangers. There may be residues in food from farm animals (e.g. [[Egg (food)|eggs]], [[milk]], [[meat]]) or danger of '[[doping]]' in competition animals. The latter may also apply to human [[athlete]]s. === Effectiveness === As noted above, there have been scientific studies which show that certain plant products can cure or prevent certain diseases, and these products or pharmaceutical drugs derived from them are patented by pharmaceutical companies and sold for high profit in modern Western medicine. Pharmaceutical firms argue that the individual should not have control over their health to the point of experimenting with "potentially hazardous materials". {{fact}} Most herbal traditions have accumulated knowledge without modern scientific controls to distinguish between the [[placebo effect]], the body's natural ability to heal itself, and the actual benefits of the herbs themselves. This is because most knowledge also pre-dates modern discoveries in human physiology and biochemistry. In fact, much knowledge dates back to medieval Europe, and was exterminated along with the witches during the burnings. Together the church and male-dominated 19th and 20th century medicine discredited much of this knowledge, and most has been lost. There is a danger that herbal remedies will be used in place of other medical treatments which have been scientifically proven to be safe and effective, resulting in the development or worsening of a medical condition which could have been better prevented or treated. There is also a danger that an herbal remedy may itself cause harm which is unanticipated due to a lack of a full understanding of its composition and biochemical effects. === Name confusion === The common names of herbs ([[folk taxonomy]]) may not reflect differences in [[Taxonomy|scientific taxonomy]], and the same (or a very similar) common name might group together different plant species with different effects. For example, in 1993 in [[Belgium]], in a [[Traditional Chinese medicine|TCM]] remedy for weight loss, one herb (''[[Stephania]] tetrandra'') was swapped for another (''[[Aristolochia]] fangchi'') whose name in Chinese was extremely similar but which contained higher levels of a [[Kidney|renal]] [[toxin]], [[aristolochic acid]]; this ''[[quid pro quo]]'' resulted in 105 cases of [[Renal failure|kidney damage]]. Vanherweghem JL, Depierreux M, Tielemans C, et al. "Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs." ''[[The Lancet|Lancet]]''. 1993 Feb 13;341(8842):387-91. Vanhaelen M, Vanhaelen-Fastre R, But P, Vanherweghem JL. "Identification of aristolochic acid in Chinese herbs." ''[[The Lancet|Lancet]]''. 1994 Jan 15;343(8890):174. PMID 7904018 === Standards and quality control=== The legal status of herbal ingredients varies by country. For example, [[Ayurvedic]] herbal products may contain levels of heavy metals that are considered unsafe in the [[United States|U.S.]], but heavy metals are considered therapeutic in Ayurvedic medicine. In the [[United States]], most herbal remedies are regulated as [[dietary supplements]]. Many herbs for home use can be grown in a small home garden too. === Medical interaction === In consultation with a physician, usage of herbal remedies should be clarified, as some herbal remedies have the potential to cause adverse drug interactions when used in combination with various prescription and [[over-the-counter]] pharmaceuticals. Dangerously low blood pressure may result from the combination of an herbal remedy that lowers blood pressure together with prescription medicine that has the same effect. In particular, many herbs should be avoided during pregnancy.[http://www.gaiagarden.com/articles/healthnotes/hn_herbtoavoidduringpregnancy.php gaiagarden.com] Herbs to avoid during pregnancy However, most herbal books alert the reader to necessary precautions. Not all physicians may be familiar with the effects of different types of herbal medicine, but general practitioners should be able to refer patients to a specialist, or investigate the medical literature on their behalf. ==See also== *[[Alternative medicine]] *[[Anesthesia]] *[[Ethnobotany]] *[[Folk medicine]] *[[Folk remedy]] *[[Herbal]] (book on herbs and their uses) *[[History of alternative medicine]] *[[Homeopathy]] *[[King's American Dispensatory]] *[[List of medicinal herbs]] *[[Naturopathic Medicine]] *[[Traditional Chinese medicine]] *[[Chinese herbology]] ===Herbalists=== {{splitsection|List of notable herbalists}} *[[Demetria Clark]] *[[Nicholas Culpeper]] *[[James A Duke]] *[[John Gerard]] *[[Maud Grieve]] *[[Georg Joseph Kamel]] *[[Susun Weed]] == References ==
==External links== ===Regulation=== *[http://www.nhaa.org.au/ Website of the National Herbalists Association of Australia] *[http://www.nimh.org.uk/ National Institute for Medical Herbalists] Website for the governing body in the United Kingdom *[http://www.scq.ubc.ca/?p=494 An overview of medicinal plants from the Science Creative Quarterly] ===Neutral=== *[http://nccam.nih.gov/ Center for Complementary and Alternative Medicine] (National Institutes of Health) ===Criticism=== *[http://web.archive.org/web/19990116222214/http://www.nejm.org/content/1998/0339/0012/0839.asp New England Journal of Medicine] editorial about the risks of alternative medicine *[http://www.umm.edu/altmed/index.html University of Maryland] site about alternative medicine: uses, possible prescription drug interactions, and possible nutrient depletions *[http://www.theness.com/articles.asp?id=8 Herbal Mythology] - By Steven Novella MD *[http://www.cnn.com/2000/HEALTH/alternative/06/29/herb.kids.wmd/index.html Herbal supplements not child's play] - Cnn news article *[http://www.theness.com/articles.asp?id=15 Selling Suppliments] - Steven Novella MD [[Category:Alternative medical systems]] [[Category:Alternative medicine]] [[Category:Biologically based therapies]] [[Category:Botany]] [[Category:Dietary supplements]] [[de:Phytotherapie]] [[eo:Kuracplanto]] [[es:Planta medicinal]] [[fr:Phytothérapie]] [[he:הרבליזם]] [[it:Erboristeria]] [[pt:Planta medicinal]] [[lb:Phytotherapie]]