What is Botanical Medicine?
Botanical medicine is a vital component of the healing arts that draws on the accumulated and developing knowledge of the medicinal properties of plants in the prevention and treatment of disease. Botanical medicine includes medical herbalism, healing art that relies on plants' synergistic and curative properties to treat symptoms and illness and maintain health, and pharmacognosy, the study of natural products. Botanical medicine is an essential component of numerous traditional medical systems and therapies, including traditional Chinese medicine (TCM), Ayurvedic medicine, naturopathy, indigenous and shamanic medicine, homeopathy, flower essence therapy, and aromatherapy. Botanical medicine has survived for thousands of years in some form and in all cultures worldwide. The study of the plant lore of these various cultures is known as ethnobotany.
Plants have been used since prehistoric times as medicinal remedies applied in various ways to relieve irritations as minor as a mosquito bite to situations as catastrophic as the plague. In modern medicine, some drugs are derived from plants, and many of these medicines are used in ways that are similar to their traditional uses. Many more medications in modern treatment, however, are synthetic. Part of this trend is economic: plants can rarely be patented, so a pharmaceutical company will not gain the exclusive right to sell a plant-derived medication even after expensive research and marketing. Also, the processing of plants into medicine cannot be as quickly standardized and controlled as manufacturing a synthetic. As a result, the efficacy and safety of only a relative few of the traditionally used botanical remedies have been verified by clinical research. Approximately only 5,000 of the estimated 500,000 known species (including subspecies) of plants have been identified and studied for their medicinal properties.
Origins
The knowledge of the healing properties of herbs has been preserved from the time of the clay tablets of the ancient Sumerians over 5,000 years ago, to the sacred texts and pharmacopeias of the Hindu and Chinese cultures, to the works of Greek and Roman physicians preserved by Byzantine scholars, to the European folk herbalists and physicians such as Nicholas Culpeper and, more recently, to the Native American herbalists. One of the earliest records of botanical medicine is the Pen T'Shao Kang Mu, a work attributed to China's Yellow Emperor around 2500 b.c. Another is the Ebers papyrus, an Egyptian medical text dating from 1,550 b.c. The Rigveda, an ancient Hindu scripture, lists more than 1,000 medicinal plants used in the ancient Ayurveda system of medicine, already well developed by 1000 b.c. Theophrastus, who lived from 327–285 b.c. is considered the first scientific botanist; he recorded the use of more than 500 medicinal plants. The Greek physician Dioscorides produced what has been called the first authentic herbal text, or herbal, the De materia medica in the first-century a.d. By the Middle Ages, the monks in medieval European monasteries were working to preserve this ancient knowledge by copying texts and cultivating extensive gardens of medicinal plants. European folk medicine was passed from generation to generation through oral tradition. Later, with the introduction of the printing press, information became more widely available in popular written texts. Colonists brought their herbal knowledge and plant specimens to settlements in North America. They learned from the Indigenous Americans how to use numerous additional plants native to the New World. The first record of Native American herb use is the manuscript of the Native Mexican physician Juan Badianus in 1552.
Herbs for medicinal purposes have been developed over the centuries by personal experimentation, local custom, anecdote, and folk tradition. According to the World Health Organization, 80% of the global population continues to rely on medicinal plant preparations to meet primary healthcare needs. For example, a 2003 study found that traditional Arabic herbal medicine is still practiced in the Middle East. The specific chemical constituents of herbs and their unique medicinal action is the subject of ongoing scientific experimentation.
Benefits
When administered correctly and in designated therapeutic dosages, botanical medicines can be effective, trigger fewer side effects for most patients than pharmaceutical drugs, and are generally less costly than prescription pharmaceutical drugs.
The benefits of botanical medicine may be subtle or dramatic, depending on the remedy used and the illness being addressed. Herbal remedies usually have a much slower effect than pharmaceutical drugs. Some herbal remedies have a cumulative effect and work slowly to restore balance; others are indicated for short-term treatment of acute symptoms. Botanical medicine may be especially beneficial to help with chronic ongoing symptoms.
Description
Traditional Chinese medicine (TCM): This healing system employs ancient techniques developed for thousands of years. For example, TCM's techniques are acupuncture, moxibustion, and herbal formulas to restore health. Moxibustion is a process that combines acupuncture with the traditional application of the herb mugwort, Artemisia vulgaris, known as Ai ye or Hao-shu. This method of heating specific acupuncture points on the body treats physical conditions, particularly chronic pain. When burnt, the mugwort produces a mild heat able to penetrate deeply into the muscle. TCM also employs specific herbal formulas to restore health and maintain a dynamic balance between two distinct forces known as yin and yang, particularly concerning the qi. Qi is the vital energy flowing along the meridians or energy pathways of the body. The TCM practitioner is a skilled observer who relies on diagnostic techniques, including measuring pulse rate from several positions and noting the patient's general appearance, such as complexion, eyes, nails, hair, tongue, and posture. The assessment includes consideration of the patient's symptomatic complaints and numerous personal characteristics, including family history, lifestyle, emotional health, environment, diet, and exercise. The prescribed medicinal herbs are usually prepared as a formula based on each patient's needs.
Ayurvedic medicine: This healing system, literally the science of life or longevity, has been practiced in India for over 5,000 years. Ayurvedic medicine is concerned equally with the person's body, mind, and spirit and combines natural therapies to restore balance and harmony. Like traditional Chinese medicine practitioners, Ayurvedic physicians use educated observation in diagnosis. In Ayurvedic medicine, there are three primary doshas or metabolic body types. The success of Ayurvedic treatment depends on the proper diagnosis of imbalances in these distinct aspects. Ayurvedic medicine emphasizes self-care strategies such as a healthy diet, yoga, meditation, breathing, and exercises to restore the innate harmony of the body. Taste is an essential indicator of the medicinal properties of an herb. Plants are categorized according to six plant essences: sweet, sour, salty, pungent, bitter, and astringent. Understanding how these plant essences act in the body is necessary for Ayurvedic medicine for prescribing herbal remedies.
Indigenous and shamanic medicine rely on extensive folk knowledge of botanical and animal medicine and ceremonial rituals to treat disease. The particular form of indigenous medicine is unique to each tribe. The specific herbal remedies are primarily passed on through oral tradition.Naturopathy: Naturopathic medicine was established in the eighteenth and nineteenth centuries. The naturopathic doctor, or naturopath, uses gentle methods to boost the body's healing, including nutritional supplements, herbal remedies, proper diet, and exercise to restore health. The doctor works with the patient to educate him or her on restoring and maintaining a healthy balance in the internal environment that will prevent further illness. Licensed naturopathic doctors pass rational exams that include basic clinical botanical medicine competency and homeopathy.
Homeopathy: Homeopathy was founded in the late eighteenth century by the German physician Samuel Hahnemann. Homeopathy embraces the philosophy of "like cures like." Homeopathy uses exceptionally dilute solutions of herbs, animal products, and chemicals that are believed to hold a "trace memory" or energetic imprint of the substance used. Sold as over-the-counter medicine, homeopathic remedies are exempt from government regulations applied to pharmaceuticals. Homeopathic remedies may be sold without proof of safety and efficacy as long as they are labeled with the directions for use and the level of dilution.
Flower essences: The use of flower essences attempts to address more subtle energy beyond the physical symptoms, to treat the emotional and mental roots of disease. The English physician Edward Bach developed a method of extracting what he considered the essence of flowers with the ability to address a broad range of psychological conditions of the human spirit. This system became known as Bach flower remedies. This botanical therapy attempts to match the energetic essence of particular flowers with the same energy in an individual's higher self, thus strengthening the higher powers, promoting self-realization, and restoring health. Bach's theory was that the source of all illness could be found in the conflict between the demands of one's higher self, striving to realize its full potential, and the individual personality or ego with its limiting beliefs and actions that obstruct and block this self-realization. The remedies are believed to have a subtle, soul-healing effect based on an instinctual soul rapport with the herb.
Aromatherapy: Aromatherapy uses the essential oil of various herbs extracted by steam distillation or cold pressing of flower, leaf, stem, or root to treat various physical and emotional problems. Herbs have long been valued for their healing fragrance. In 1564 an alchemist named Giovanni Battista della Porta wrote about methods to separate essential oils from the aromatic distilled waters used in previous centuries. Modern-day aromatherapy was developed by the French chemist Réné-Maurice Gattefosse in 1937. Aromatherapy identifies the distinct healing properties of various pure essential oils. The small size of the molecules in essential oils enables the chemicals to penetrate bodily tissue easily and to act rapidly on the limbic system, which is believed to be the seat of emotions.
Preparations
The quality of any herbal remedy and the chemical constituents found in the herb depend greatly on the weather conditions and the soil where the herb was grown, the timing and care in harvesting, and the manner of preparation and storage. Herbs are prepared in various ways depending on the part of the medicinally active plant and the results sought. The list of kinds of herbal preparations is long and varied. Some of these preparations include:
Infusion is appropriate for extracting the medicinal properties of the plant's leaf, flower, and stem. Either fresh or dried herbs may be used. A standard infusion combines 1 tsp of dried herb or 2 tsp of chopped fresh herb per cup of water. Fresh, nonchlorinated water is brought to the boiling point in a non-metallic pot, and the herbs are added. A cover prevents the escape of volatile oils. The tea is infused for 10 to 15 minutes, strained, and can be consumed warm or cold. The prepared tea will keep up to two days in the refrigerator.
The decoction is the best method to extract the mineral salts and other healing components from the coarser herb materials, such as the plant's root, bark, seeds, and stem. One ounce of the dried plant materials, or 2 oz of fresh plant parts, is added to 1 pt of pure, unchlorinated water in a non-metallic pot. The mixture is brought to a boil, and then the heat is lowered so that the mixture can simmer for about 30 minutes. After straining and covering, a decoction may be refrigerated for up to two days and retain its healing qualities.
A tincture is a method to prepare a concentrated form of a new herbal remedy for therapeutic use. These solutions, properly designed and stored, will retain medicinal potency for many years. To schedule a tincture, a clean glass container is packed with chopped fresh or dried herbs, and enough good quality brandy or vodka to cover is poured over the herb. The alcohol/water ratio varies depending on the plant and the intended extract. The concentration (depending on the herb) is 25-90%; often, the percentage of alcohol in water is about 50/50. The container then needs to be sealed with an airtight lid. The mixture must be left in a darkened place to steep for two weeks and shaken daily. After straining the mixture through a cheesecloth or muslin bag and pouring it into a dark bottle for storage, it is ready for use. The dosage depends on the herb and its designated use. A standard dosage is 2–4 ml of the tincture thrice daily. Other fluid extracts may be prepared with glycerine or vinegar.
Capsule. A capsule is convenient for ingesting dried, powdered herbs, usually in a gelatin capsule. Gelatin capsules are available in the standard size 00, which holds 200–250 mg of powdered herbs. Prepared capsules should be stored in dark glass containers.
Oil infusion. This method places the chopped fresh or dried herb in a glass storage container. Enough cold-pressed vegetable oil, such as sunflower or olive oil, is poured into the jar to cover the herb completely. This mixture is sealed and placed on a sunny windowsill for two or three weeks. The infused oil is strained into another chopped fresh or dried herb jar. This mixture steeps on a sunny windowsill for another two weeks. After being strained through a cheesecloth, this infused oil can be stored in a cool, dark location.
Ointments. These are prepared with powdered or freshly chopped plant parts, melted petroleum jelly, beeswax, and vegetable oil. The mixture is simmered in a double boiler for about two hours. The mixture is strained through cheesecloth and poured into small glass storage containers. Ointments provide a spreadable consistency and protective layer for the topical application of medicinal herbs to the skin.
Poultice. A poultice is a hot mixture of chopped fresh or dry herbs that have been boiled briefly and cooled to a tolerable temperature before applying to the affected area. A small amount of oil should be applied to the skin before placing the poultice to prevent the herb from sticking. The poultice can be covered with a gauze strip to hold it in place. The poultice can be refreshed every two or three hours as needed.
Essential oils. This is the highly concentrated extract of an herb obtained through steam distillation or cold compress methods. Essential oils should be diluted in water or nontoxic carrier oil before applying to the skin to prevent contact dermatitis or sensitization. Essential oils are used for topical application, in bathwater, and aromatherapy. The toxicity of the concentrated essential oil varies depending on the herb's chemical constituents.
The above list is by no means exhaustive. There are many other botanical medicine preparations available.
Precautions
Herbal remedies prepared by infusion, decoction, or alcohol tincture from the appropriate plant part, such as the leaf, root, or flower, are generally safe when ingested in properly designated therapeutic dosages. However, many herbs have specific contraindications for use when certain medical conditions are present and by pregnant or lactating women. Some herbs are toxic, even deadly, in large amounts, and there is little research on the chronic toxicity that may result from prolonged use. Herbal remedies are sold in the United States as dietary supplements and are not regulated by the Food and Drug Administration (FDA) for content or efficacy. Self-diagnosis and treatment with botanical medicinals may be risky. A consultation with a certified clinical herbalist or naturopathic physician is prudent before undertaking a course of treatment. A 2002 report said that patients often fail to inform their physicians about herbal products they are using and that patients don't think of them as medicines. Yet many botanical remedies can interact with allopathic medicines and either cancel their effects or cause adverse effects. For example, garlic, ginseng, ginkgo, feverfew, licorice, and other common remedies have anticoagulant properties that can put patients at risk of bleeding during surgery.
Communication technology advancements have made warnings about herbal remedies more important than ever. The Internet includes many sites with unregulated and often unhealthful advice about herbal remedies. Many herbalists and allopathic physicians urge patients to use caution when seeking information on herbal treatments online. One cancer-related study found that only 36% of the websites in a search offered information that complied with regulatory guidelines regarding unsubstantiated claims about the treatment or cure of disease.
Essential oils should not be taken internally without expert guidance due to the potential for toxicity, even in very small amounts. They are not to be used in any form by pregnant or lactating women without competent medical consultation. Essential oil extracts do not contain the full range of phytochemicals in the whole plant.
Homeopathic remedies are safe because of their highly dilute nature. These remedies must not be relied upon to treat any serious illness or injury. If symptoms persist, other qualified medical help should be sought.
Side Effects
Herbs contain numerous phytochemicals formed in the metabolic process of the plant. These chemicals act on the body in different ways; some activities on the whole body, while others act on a specific organ or system. An herb's effect may be due to a particular chemical in the herb or due to interaction among constituents within the plant. Interactions with other herbs or with pharmacological drugs is a matter of concern and a growing area of research.
The pure essential oils of aromatic plants, extracted by steam distillation or cold pressing techniques, have been used for over a century in medicines, food, drink, perfumes, detergents, soaps, cosmetics, various industrial applications, and in aromatherapy. Some compounds in plant oils can cause sensitization, even in very small amounts. Side effects from external application of some essential oils may include mild skin irritation, such as itching and burning; sensitization, which may lead to recurrent mild to severe adverse reactions, such as burning and rash each time the essential oil is used; and phototoxicity, a situation in which certain essential oils react with ultraviolet light and cause reactions from mild skin blotching to severe burning any time the skin is exposed to sunlight.
Research & General Acceptance
Botanical treatments are generally accepted as part of mainstream medical treatment worldwide, except in the United States, where herbal remedies are sold as dietary supplements. As of 2003, the branch of the FDA that regulates botanical products under the rubric of nutritional supplements is the Center for Food Safety and Applied Nutrition (CFSAN). Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the manufacturer of a botanical preparation is responsible for ensuring that it is safe before marketing it; the FDA is responsible for taking legal action if the product proves to be unsafe after it is marketed. The other government agency that has some oversight over botanical preparations in the United States is the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health, established by an act of Congress in 1998. NCCAM also supports research into botanical products, herbalism, and other alternative therapies that make use of plant-derived products.
In Germany, the government established an expert committee known as the Commission E in 1978 to evaluate the safety and efficacy of the 300 herbs and herb combinations sold in that country. No equivalent regulatory commission exists in the United States.
Animal testing has primarily determined the safety or toxicity of essential oils. Human trials of essential oils using volunteers have also been conducted. Some regulation of and guidelines for using essential oils, particularly in food, is accomplished by the World Health Organization (WHO), the Council of Europe, and the U.S. Food and Drug Administration (FDA). Two sources of information on the safety of essential oils used in aromatherapy are the Research Institute for Fragrance Materials and the International Fragrance Research Association. These organizations conduct ongoing research evaluations of crucial oils and publish the findings in Food and Chemicals Toxicity journal.
Homeopathic remedies have been tested clinically, and in 1997, an international team of researchers reviewed more than one hundred controlled studies and concluded that the pooled results of 26 of these controlled studies indicate that homeopathic remedies produce a somewhat more significant benefit than a placebo in the treatment of illness.
Training & Certification
In many states, naturopathic physicians are licensed as primary care physicians and complete a four-year graduate-level course at a naturopathic medical school. Naturopaths are trained in nutritional medicine, homeopathic medicine, botanical medicine, hydrotherapy, psychology, and counseling.
Traditional Chinese medicine practitioners are heir to the benefits of thousands of years of tradition. This ancient healthcare system is experiencing a revival in China after efforts by Chinese Nationalists in the 1930s to eliminate traditional Chinese medical practices in favor of Western medical methods. The ancient way persisted, and traditional Chinese medicine was taught in Chinese medical schools using conventional medical literature. By the 1990s, China had opened its hospitals to American students of acupuncture and Chinese herbology.
Western herbalism is taught in numerous schools of herbal medicine in the United States and through correspondence and online courses. Certification as a clinical herbalist is not required in the U.S.; herbal remedies are widely available commercially as food supplements without a medical prescription.