When the term herb is used, we are referring to a plant used for medicinal purposes. For many people of the world, herbal medicines are the only therapeutic agents available. The World Health Organization has estimated that about 80% of the world's population relies on herbs for primary health care needs. This widespread use of herbal medicines is not restricted to developing countries, since it has been estimated that 70% of all medical doctors in France and Germany regularly prescribe herbal preparations.
Herbal medicine has existed since the dawn of time. However, knowledge of how plants actually affect human physiology, still remains largely unexplored. Many individuals formulate their view of herbal medicine based on opinion, philosophy, and ideology. I believe that the continued evolution of the tradition of herbal medicine can be accomplished within the context of continued scientific and clinical investigation.
Throughout the world, and especially in Europe, the United States, Canada, Australia, and Japan, a tremendous renaissance in the use and appreciation of herbal medicine occurred in the latter part of the twentieth century. For example, in the United States, the sale of herbal products skyrocketed from $200 million in 1988 to more than $3.5 billion in 1997 before leveling off in the $4 billion a year range. Within the European Community annual sales exceeded $7 billion in 1997.
The rebirth of herbal medicine, especially in developed countries, is largely based on a renewed interest by the public and scientific researchers. During the past 20 to 30 years, there has been a huge increase of scientific information concerning plants, crude plant extracts, and various substances from plants as medicinal agents. For example, a PubMed search of the term “herbal medicine” yielded over 1300 hits in 2010. However, the number of studies of botanical medicines is much higher. For example, there were 130 studies published on Ginkgo biloba alone in 2010.
Improvements in analytic techniques and modern pharmacology have given researchers the tools and understanding necessary to evaluate herbal medicines properly. Improvements in plant cultivation techniques and the quality of herbal extracts (quality control and standardization) have also led to the development of some effective plant medicines. These advances have created a renaissance in the appreciation and use of herbal medicine. It seems that science and medicine have finally advanced to a level where nature can be appreciated rather than discounted. The scientific investigation of plant medicines is replacing some of the mystery and romance of herbalism with a greater understanding of the ways in which herbs work. Thirty years ago it was impossible to determine exactly how herbs promoted their healing effects because analytic science had not advanced to a sufficient level of sophistication. This point is well illustrated by the fact that the main mechanism of action responsible for aspirin's anti-inflammatory effect was not understood until the early 1970s, and its mechanism of action for pain relief has yet to be fully understood.
In general, herbal preparations are thought to have three major advantages: lower cost, fewer side effects, and medicinal effects that tend to normalize physiological function. When used most effectively, the mechanism of action of an herb often corrects the underlying cause of a disorder. In contrast, a synthetic drug is often designed to alleviate the symptom or effect without addressing the underlying cause. Interestingly, research has often shown for many plants that the whole plant or crude extract is much more effective than isolated constituents. In many instances, multiple components produce multiple pharmacologic actions.
Herbal medicine will certainly play a major role in future medicine. As modern medicine gains more knowledge and understanding about health and disease, it is adopting therapies that are more natural and less toxic. Lifestyle modification, stress reduction, exercise, meditation, dietary changes, and many other traditional naturopathic therapies are becoming much more popular in standard medical circles. This illustrates the paradigm shift that is occurring in medicine.
With the continuing advancement in science and technology, there has been a great improvement in the quality of herbal medicines available and in the understanding of their optimal clinical use. Improvements in cultivation techniques coupled with improvements in quality control and standardization of potency will continue to increase the effectiveness of herbal medicines.