National Institute of Medical Herbalists

In herbalism we have the longest running human trials of all medicines because herbal medicine has been the basis of our tradition since records began. To understand why the current medical model of basing use of medicines on evidence does not and cannot be applied to herbs as used in herbal practice it is necessary to look a little at the methods used in drug research.

The methods used in drug research to prove the efficacy and safety of a treatment are randomised controlled trials (RCTs); the gold standard being randomised double-blind placebo controlled trials (RDPCT). This produces an evidence base for use of the drug in the treatment of humans. Many herbs have also been trialled in this way.

There are, however, some very fundamental problems with attempting to trial herbs in the same way as drugs. The herbal preparations used in such trials are often standardised to contain one constituent of one part of the plant which is thought to have one action and applied for one outcome. This is a very narrow application of a living plant which contains many hundreds of active parts. However this application has to be this narrow and reduced as possible in order that the research methods used in orthodox medicine can support it.

And this system works if what you want to do is use herb constituents as substitutes for pharmaceutical drug prescriptions. There are 3 such herbs whose use and sale OTC has been mass promoted and marketed based on this type of clinical trials and which targets the 3 main health challenges of the 21st century: echinacea (colds – immunity), St. John’s Wort (mental health - depression), and ginkgo (dementia). These trials using as they do one or two constituents of the plant are not likely to ever produce conclusive results even with variation of the range of methodologies sometimes used to overcome fundamental flaws in study design. This is because it is not possible to produce an evidence base for herbal practise using the same tools and methodologies used in drug research.

To clarify the inherent difficulties of this approach it must be known that there are nine different species of Echinacea and while usually only two of those are used in herbal practise different parts of both species are used, in different situations, and using different methods in order to emphasise some constituents ahead of others. A herbalist would not always use St John's Wort in the way that it is popularly and commonly advertised for use.

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Why Tradition matters

Herbalists are the guardians of the traditional medicine native to these shores. Traditional medicine is based on plants that have medicinal value and this use has been recorded for thousands of years. This evidence base of empirical or traditional use is supported by the efficacy and safety of a system of medicine that is valid in its own right. Traditional-based evidence has been independently established away from biomedical models of RCTs which reduces herbs into their constituent parts separating healing from the herb.

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