Herbalism: Kill or cure?

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Line after line of colourful cardboard boxes hug the edges of a stack of shelves. Sitting inside a herbal remedy store in west London, the containers' evocative images of plants, bark and berries are emblematic of the natural world's healing properties.

But soon, such remedies, sold by the likes of herbal medicine retailers such as Cornucopia, run by 91-year-old Margaret Weesz just off the capital's King's Road, could be in trouble. From 2011 European law will dictate that sales of all herbal remedies will need to be licensed by the Government. Licenses are likely to only be granted to a small number of products for minor ailments, which include St John's Wort (used to treat low mood) and echinacea (which can cut the chances of catching a cold). This will hugely restrict the practices of the country's 750 herbalists – as well with the UK's Chinese herbalists – who use a blend of many herbs to treat major ailments that can include everything from epilepsy to hysteria.

"It's just silly," says Weesz, who sells a wide variety of herbs at her shop, many of which are likely to be banned. "I have a number of different herbs which I import from all over the world. In Italy, I can buy them in the chemist so I don't see why I can't do the same thing here. I want to go to the House of Commons and tell them about the clinical evidence for the herbs that I sell. The Government could save a lot of money through using herbs instead of expensive medicines."

For some, though, the legislation could not come soon enough. Many in the medical world say there is scant clinical evidence that herbal remedies are of any use at all – and those that are can have harmful side effects. In 1993 Professor Edzard Ernst left his chair in physical medicine and rehabilitation at the University of Vienna to set up the department of complementary medicine at the University of Exeter. Since then he has written more than 700 papers in an attempt to scientifically test herbalists' claims regarding complementary medicine.

"I am keen not to write off herbal medicine because scientifically, around half of modern drugs were derived from herbs," he says. "But it is important to realise that herbs are pharmacologically active compounds and can cause harm and sometimes even kill." He says there is evidence to suggest some herbs work: like devil's claw, used to treat back pain, or St John's Wort, which can effectively treat depression.

He does, however, have less approving words to say about Britain's herbalists. "They assess you according to a series of criteria that are obsolete in modern medicine," he says. "They then treat you according to a further list of rules before giving you their individually tailored treatment." He says there is little scientific evidence to suggest this approach works. "We have reviewed the work published and conclude there is no evidence that this type of herbalism does more good than harm," he continues. "That is to say, the potential for harm is greater than the potential for good."

So what do the herbalists think? The European Herbal and Traditional Medicine Practitioners Association chair Michael McIntyre says a herbalist is someone who uses plant medicines to "restore and strengthen the body's systems". "Oats can strengthen the nervous system," he explains. "If you are very stressed we might give you skullcap [a type of mint] or valerian [a flowering plant which has sedative properties]." He says far from being quacks, herbalists are following a tradition that has been practised for thousands of years, and have often studied for several years to become experts in their craft. What's more, when confronted with a serious medical complaint, they will often refer the patient to a traditional doctor. But when they can, herbalists rely on taking long medical histories, analysing people's constitution, diet and lifestyle, before treating the patient with a complex, individually tailored combination of natural substances.

"What I would say is that clinical trials work in a reductionist way whereas herbalists don't," says Kent-based herbalist Hayley Jones. "In orthodoxy there is no room for synergy or interactions between different things, which is what herbalists talk about. We might prescribe between three to 12 herbs for a patient that are tailored specifically to their make-up; there is no one-size-fits-all prescription, which is something doctors rely upon."

The herbalist community also takes issue with the way the Government has consulted them over their future. "The herbalist community was due to receive its own form of regulation after we were consulted earlier in the year, but out of the blue the Government appeared to change its mind and asked us again," says National Institute of Medical Herbalists spokesperson Andrew Hoyle. "But the way they organised this process was so clouded with obfuscation that even experienced medical professionals are unable to make sense of it."

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