Understanding and Using Herbal Medicines

The Complete Guide To Herbal Medicines
by Charles W. Fetrow, Pharm.D., Juan R. Avila, Pharm.D.

The Complete Guide to Herbal Medicines is the first scientific quick-reference book compiled by two trained, experienced clinical pharmacists. In clear, everyday language, they share the most up-to-the-minute, reliable, and accessible information available on more than three hundred herbal medicines. You'll find:

• a complete, dependable overview of herbal medicines
• what the scientific research shows
• a glossary of medical terms
• what happens when herbs interact with drugs
• references to key scientific studies
• and much, much more.

No other guide gives you such a complete directory of herbal medicines, or such detailed, practical advice about each one. To expand your knowledge and interest in herbal medicines, you should have The Complete Guide to Herbal Medicines.

Chapter 1

Most people are familiar with herbs as foods — for example, basil and oregano in sauces, parsley as a garnish. However, for thousands of years many cultures around the world have used herbs and plants not just to eat but to treat illness. Archaeological evidence shows that even prehistoric man used plants to heal. Today, the World Health Orgamization estimates that 80ő of the world's population uses some form of herbal medicine.

Many of the drugs now prescribed come from plants that ancient cultures used medicinally. (The word drug comes from the Old Dutch word drogge, meaning "to dry," because pharmacists, doctors, and ancient healers often dried plants to use as medicines.) About one-fourth of all conventional pharmaceuticals — including roughly 120 of the most commonly prescribed modem drugs — contain at least one active ingredient derived from plants. The rest are chemically synthesized. (See Common drugs made from plants.)

Common drugs made from plants

Many drugs in common use today have botanical origins. Here's a selected list.

• Aspirin (salicylic acid) — from white willow bark and meadow sweet plant

• Atropine, used to treat irregular heartbeat — from belladonna leaves

• Colchicine, used for gout — from autumn crocus

• Digoxin (Lanoxin), the most widely prescribed heart medication — from foxglove, a poisonous plant

• Ephedrine, used to widen or relax the airways — from the ephedra plant

• Morphine and codeine, potent narcotics — from the opium poppy Paclitaxel Taxol), used to treat metastatic ovarian cancer — from the yew tree

• Quinine, a drug for malaria — from cinchona bark

• Vinblastine (Velban) and vincristine (Oncovin), anticancer drugs — from periwinkle

Potentially dangerous herbs

Herbs can harm as well as heal. The herbs below may pose special risks.

• Bloodroot, promoted as an expectorant purgative, stimulant and plaque and cavity preventer, is used in such a range of doses that it can be dangerous. It has caused death when used to induce vomiting.

• Chan su, a topical aphrodisiac also known as stone, love stone, and rockhard, has been fatal when mistakenly ingested.

• Chaparral tea, claimed to be an antioxidant and pain reliever, has caused liver failure, necessitating liver transplantation.

• Coltsfoot, used for respiratory problem has caused liver problems.

• Comfrey, used to promote wound healing (and formerly to relieve ulcers of the bowel, stomach, liver, and gallbladder), has caused liver problems and cancer.

• Indian herbal tonics can lead to lead poisoning.

• Jin bu huan, an ancient Chinese sedative and analgesic, contains morphine-like substances and has caused hepatitis.

• Kambucha tea, made from mushroom cultures and used as a cure-all, has caused death from a blood acid disorder.

• Lobelia, used to treat respiratory congestion, has led to respiratory paralysis and death.

• Ma huang, or ephedra, an ingredient in many diet pills, can cause psychotic behavior, seizures, irregular heartbeats, heart attack, stroke, and death. It's also sold under such names as Herbal Ecstasy, Cloud 9, and Ultimate Xphoria to induce a 'high' associated with illegal drugs.

• Pennyroyal, used to induce menstruation and treat colds, fevers, and the flu, has caused liver failure, kidney failure, coma, and death.

• Sassafras, used as a diuretic and a treatment for skin disorders and rheumatism, has caused liver damage. It has also been linked to narcotic poisoning and miscarriage. The Food and Drug Administration has banned sassafras volatile oil and the component safrole as food additives and flavor enhancers.

• Yohimbe bark, used as an aphrodisiac and hallucinogen, has caused psychotic behavior.

Misleading claims

The herbs below have been misrepresented as cures for serious illnesses.

• Mistletoe has been falsely touted as a cure for cancer.

• Pau d'Arco tea has been falsely touted as a cure for cancer and AIDS.

Some herbs and plants have value not just for their active ingredients but for other substances they contain, such as:

• minerals
• vitamins
• volatile oils (used in aromatherapy)
• glycosides (sugar derivatives)
• allkaloids (bitter organic bases containing nitrogen)
• bioflavonoids (colorless substances that help maintain collagen and blood vessels).

In the United States, many traditional health care providers lack knowledge about herbal remedies, and their patients may be reluctant to reveal their use of such remedies. But renewed interest in all forms of alternative medicine has led consumers, health care providers, and drug researchers to reexamine herbal remedies. Medicinal herbs have been touted in magazines, books, and television shows, sometimes with advocates making amazing claims for their benefits.

Unfortunately, herbs don't have magical or mystical properties. Like all drugs, they must be taken in the right doses for the right length of time-and for the right purpose — to produce a benefit. While some herbs are safe and effective, others can cause lasting harm and even death. (See Potentially dangerous herbs.)

Still other herbs are neither harmful nor effective.

History of herbal medicine

Herbal medicine, also called phytotherapy or phytomedicine, has been practiced since the beginning of recorded history. Specific remedies have been handed down from generation to generation.

In ancient times, medicinal plants were chosen for their color or the shape of their leaves. For example, heart-shaped leaves were used for heart problems, while plants with red flowers were used to treat bleeding disorders. This primitive approach is called the Doctrine of Signatures. Practitioners determined the best use for each plant by trial and error.

The formal study of herbs, called herbology, dates back to the ancient cultures of the Middle East, Greece, China, and India. These cultures revered the power of nature and developed herbal remedies based on the plants found in their home environments. Written evidence of the medicinal use of herbs has been found on Mesopotamian clay tablets and ancient Egyptian papyrus.

The first known compilation of herbal remedies was ordered by the king of Sumeria around 2000 B.C. and included 250 medicinal substances, including garlic. Ancient Greece and Rome produced their own compilations, including De Materia Medica, written in the I 1st century A.D. Of the 950 medicinal products described in this work, 600 come from plants and the rest from animal or mineral sources.

The Arabs added their own discoveries to the Greco-Roman texts, resulting in a compilation of more than 2,000 substances. Eventually, this work was reintroduced to Europe by Christian doctors traveling with the Crusaders. Herbal therapy is also a major component of India's Ayurvedic medicine, traditional Chinese medicine, Native American medicine, homeopathy, and naturopathy.

In the United States, herbal remedies handed down from European settlers and learned from Native Americans were a mainstay of medical care until the early 1900s. The rise of technology and the biomedical approach to health care eventually led to the decline of herbal medicine.

The herbal revival that we're seeing today has several causes:

• general disillusionment with modern medicine

• the high cost and side effects of prescription drugs

• widespread availability of herbal medicines

• the belief that natural remedies are superior to manmade drugs.

Copyright © 2000 by Springhouse Corporation

About the Author

Charles W. Fetrow, Pharm.D., is coordinator of pharmacokinetics, outpatient anticoagulation, and drug evaluation services at St. Francis Medical Center in Pittsburgh. Dr. Fetrow teaches pharmacology topics at St. Francis and at Duquesne University.

Juan R. Avila, Pharm.D., Formerly an assistant professor at Shenandoah University and Duquesne University and a clinical pharmacy specialist at St. Francis Medical Center in Pittsburgh, is now medical therapeutics liaison for Sanofi-Synthelabo Pharmaceuticals in New York.