Herbal Medicine vs. Homeopathy

By Erin Holden

The world of natural and alternative medicine encompasses many modalities, and for the layperson, the different approaches and schools of thought can be confusing. When I tell people I’m an herbalist, they invariably think I practice homeopathy, acupuncture, Ayurveda, aromatherapy, you name it. And while many herbalists are also knowledgeable in these areas, they are very different subjects that each take additional study to practice safely and effectively. In my experience, most people think that herbal medicine and homeopathy are one and the same. Although there are similarities, they’re separate ways to approach natural healing, and I wanted to help people distinguish between the two. In the spirit of full disclosure, I must say that I don’t practice homeopathy and only have a little bit of knowledge on the topic – lectures touching on homeopathy are not uncommon in classes and at herbal conferences I’ve attended, so it’s easy to passively acquire tidbits of a more complex picture. 

According to the American Institute of Homeopathy, there are three principles of homeopathy. The first, “let likes cure likes,” means that “a substance taken in small amounts will cure the same symptoms it causes if taken in large amounts.” To illustrate that point, a preparation from the strychnine tree (Strychnos nux-vomica), nux vomica, is used for nausea. The second principle is “the minimum dose.” To maximize effectiveness while decreasing side effects, a full strength medicine (which can be herbal, mineral, or animal) is subjected to a series of dilutions and agitations (called succussions), until the original medicine is no longer detectable. The number of dilutions and succussions are noted on the remedy. For example, a 6X remedy is one part tincture to nine parts alcohol (the X here denoting 10), then succussed six times (National Center for Homeopathy). The third principle, “the single remedy,” dictates that practitioners suggest only one remedy at a time, although some homeopathic preparations contain a combination of remedies. Practitioners take a holistic approach, and match the specific remedy to the overall clinical picture of the client. Homeopathic remedies come in a variety of formulations, from sublingual pellets to liquids and topical ointments. Overall, homeopathy is considered safe for just about everyone, including babies, children, and those who are pregnant and breastfeeding.

Herbal medicine is also a holistic modality, where the practitioner looks at the client’s physical and emotional health, and herbalists also use herbs (obviously!), but that’s about where the similarities end. When selecting remedies, herbalists often choose those that oppose, and therefore balance, what’s going on with the client. For example, if a person runs cold or is feeling slow and sluggish, then warming herbs, like ginger, may be recommended. Many times herbalists make recommendations based on thousands of years of traditional uses, which are being increasingly validated by scientific study. Dosing and formulation are also very different between the two modalities. Herbalists use full strength preparations, often multiple grams of different herbs in formulas developed specifically for the client. I’ve formulated teas for clients that range anywhere from 4g to 15g of herbs per day; it all depends on what symptoms they’re presenting and how they respond to the herbs.  Formulas can be teas, powders, tinctures, glycerites, or topical preparations such as salves, poultices, and liniments. Sometimes the type of preparation depends on the active constituents in an herb – some are water soluble and call for a tea, while others are alcohol soluble and are only effective via tincture. Since herbs, as used by herbalists, are not used at the dilutions employed by homeopaths, there’s a potential for side effects and interference with medications, and some herbs are not recommended for babies, children, or pregnant/breastfeeding people. However, since herbalists do take the whole person into account, they can adjust dosing or herb choice to safely and effectively work with these populations and medications. 

In the end, the goal of both of these modalities is the same – overall wellness. They are just two different points on a continuum of natural healing.

Medicinal Disclaimer: It is the policy of The Herb Society of America, Inc. not to advise or recommend herbs for medicinal or health use. This information is intended for educational purposes only and should not be considered as a recommendation or an endorsement of any particular medical or health treatment. Please consult a health care provider before pursuing any herbal treatments.

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Erin is the gardener for the National Herb Garden at the U.S. National Arboretum in Washington, D.C. She is a member of the American Herbalists Guild, United Plant Savers, and a member at large of The Herb Society of America.

Learn to Use the Herbal Wellness Cabinet

By Paris Wolfe, Blogmaster, The Herb Society of America

Dana Eudy, owner of Field Apothecary in Germantown, New York, sees herbs as a contributor to a healthy lifestyle and that, she says, “keep us out of the expensive, over-burdened health care system.”

“Herbs can be used in so many creative ways from healing to cooking to skincare to cocktails,” she says.  “I like getting them in to my system in all forms and am always looking of ways to be inventive with them. They have the amazing power to heal us on our deepest levels.”

Thinking about it holistically, the herbal maker says, “They live in harsh elements and toxic environments but have evolved to tolerate and even defend themselves under these conditions. They also have the ability to capture our only true energy source – the sun and turn it into food and medicine.  While herbs can be used for treating illness, I suggest that a person work with a practitioner if they are dealing with a complicated health issue.”

I blogged about Field Apothecary  in February and sampled a CSA Wellness Box in March. This month, I return to owner Dana to learn more about the products delivered to subscribers of her Community Supported Apothecary (CSA) or sold individually on line. My figurative “place” in mainstream culture is so far removed from herbal treatments, that I asked Dana’s guidance to use some of the products such as bitters and flaming cider. Others, such as Poison Ivy Liniment, Lip Balm and Tulsi Tea, were self explanatory.

Q. How do you know which herbs and herbal products to combine?

A. I have been fortunate to have many great teachers such as Peeka Trenkle, David Crow, Dr. Vasant Lad. I use herbs like I would use food. I have many herbal books that I consider cookbooks. I keep these books stored in my kitchen and I refer to them often. It is certainly an indulgence and I have quite a library filled with herb reference books.  All the remedies that we make are also used in my own home so it is a personal experience.

Q. I received various bitters in my Wellness Box. What will Digestive Bitters do for me?
A. Bitters RULE! You will notice that many European diets have an apertivo or digestif before or after a meal. Meanwhile, Eastern medical traditions consider digestion the beginning of good health. Bitters help stoke digestive fires and help us assimilate and digest our food.  Because the digestive fire slows as we age it becomes increasingly important to get bitters (bitter food, too) into our diet.         Our digestive system is the seat of our health. If we are digesting well, we are typically more in balance throughout our system. And our gut and mind are interconnected. A healthy gut certainly leads to a healthy mind. We literally “think” more clearly.
Q. What do Clear Thinking bitters do for me?
A. I use them before meditation but also later in the day when I am feeling sluggish and need to bring my focus back. Field Apothecary’s remedy contains the two brahmi herbs gotu kola and bacopa which we grow at Field. Brahmi herbs are a very special class of herbs in Ayurveda that are considered brain food.

Q.  What does Flaming Cider do?
A. Flaming Cider as we call it is an amazing overall boosting tonic. Apple Cider Vinegar by itself is so beneficial. By adding herbs to this base we make it stronger. It is great for first-stage colds, congestion and stagnation. When our bodies are having a hard time keeping up with seasonal transitions such hot inside cold out, think fire cider. We use it as a vinaigrette, add it to cole slaw, guacamole, flaming cider margarita, bloody mary, roasted veggies . . . you can see how versatile and how I might work to get it in to my diet. A little goes a long way. Even my kids will ask me for it when they are feeling a bit off. A shot or one tablespoon should generally do it. If I am under the weather, I may take that amount 3 times per day. Flaming Cider also kick starts digestive fire with all the warming herbs such as garlic, ginger and horseradish.

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All Field Apothecary wellness products are made from herbs cultivated by Dana and her family. They grow about 65 different herbs – from hops to tulsi.  Her tinctures, ointments and more are sold individually online or through a CSA subscription. 

 

A Skeptic Contemplates Herbal Medicine

By Harriet Hall, M.D., Co-Founder Science-Based Medicine Blog

Harriet Hall, M.D., is known for her critical approach to medicine. In this post — reprinted from the March 22, 2011, entry at The Science-Based Medicine Blog — she cautions consumers to think carefully about using plants as medicine. Please post your comments below.

Herbal medicine has always fascinated me. How did early humans determine which plants worked? They had no record-keeping, no scientific methods, only trial-and-error and word of mouth. How many intrepid investigators poisoned themselves and died in the quest? Imagine yourself in the jungle: Which plants would you be willing to try? How would you decide whether to use the leaf or the root? How would you decide whether to chew the raw leaf or brew an infusion? It is truly remarkable that our forebears were able to identify useful natural medicines and pass the knowledge down to us.

It is equally remarkable that modern humans with all the advantages of science are willing to put useless and potentially dangerous plant products into their bodies based on nothing better than pre-scientific hearsay.

Ancient Sumerians used willow, a salicylate-rich plant that foreshadowed modern aspirin. Digitalis was used by the ancient Romans long before William Withering wrote about its use for heart failure. South American natives discovered that chinchona bark, a source of quinine, was an effective treatment for malaria. These early herbal remedies pointed the way to modern pharmaceuticals. How many other early remedies fell by the wayside? What else did the Sumerians, the Romans, and Natives use that did more harm than good? If “ancient wisdom” exists, so does “ancient stupidity.”

Plants undeniably produce a lot of good stuff. Today, researchers are finding useful medicines in plants that have no tradition of use. Taxol, the cancer-fighting product of Pacific yew trees, was discovered by the National Cancer Institute only by screening compounds from thousands of plants.

There is a reason pharmacology abandoned whole plant extracts in favor of isolated active ingredients. The amount of active ingredient in a plant can vary with factors like the variety, the geographic location, the weather, the season, the time of harvest, soil conditions, storage conditions, and the method of preparation. Foxglove contains a mixture of digitalis-type active ingredients but it is difficult to control the dosage. The therapeutic dose of digitalis is very close to the toxic dose. Pharmacologists succeeded in preparing a synthetic version: now the dosage can be controlled, the blood levels can be measured, and an antibody is even available to reverse the drug’s effects if needed.

“Ancient wisdom” argues that if an herbal remedy has been used for centuries, it must be both effective and safe. That’s a fallacy. Bloodletting was used for centuries but it wasn’t effective and it did more harm than good. If a serious side effect occurred in one in a thousand recipients of an herb, or even one in a hundred, no individual herbalist would be likely to detect it. If a patient died, they would be more likely to attribute the cause to other factors than to herbs that they believed were safe. Even with prescription drugs, widespread use regularly uncovers problems that were not detected with pre-marketing studies.

Arguments in favor of herbal remedies include:

• They’re natural. (So what? Strychnine is natural.)
• They’re safer than prescription drugs. (Maybe some are, some aren’t; how would you know?)
• They’re milder than prescription drugs. (That would depend on the dosage of active ingredient.)
• They’re less likely to cause side effects. (When they have been as well studied as prescription drugs, they may turn out to have just as many or more side effects. All effective drugs have side effects, and if an herbal medicine has fewer side effects it might have fewer therapeutic effects too. Formal systems for reporting adverse effects have long been in place for prescription drugs; not so for herbal remedies.)
• They’re different from prescription drugs. (Some are identical to prescription drugs, like red yeast rice which contains the same ingredient as prescription lovastatin; and some herbal products have been found contaminated with prescription drugs.)
• They’re less expensive. (True, but is a cheaper, inferior product a good bargain?)
• They’re easier to obtain. (True, you don’t have to make an appointment with a doctor; but that means you don’t get the benefit of a doctor’s knowledge.)
• The mixture of ingredients in a plant can have synergistic effects. (This is widely claimed but almost never substantiated. The other ingredients are just as likely to counteract the desired effect or to cause unwanted adverse effects.

For every disease, God has provided a natural remedy. Perhaps this is a comforting thought for believers, but it is not based on any evidence and is not convincing to atheists and agnostics. And it doesn’t help us find that natural remedy.

• Even when an herbal remedy works, finding a safe and reliable source is problematic. Horror stories abound:
• Contaminants (such as heavy metals, pesticides, carcinogens, toxic herbs, and insect parts).
• Wild variation in content (from no active ingredient to many times the amount on the label).
• Mislabeled products that contain an entirely different herb. When you take an herbal remedy, you are taking.

I won’t list specific examples here; they are easy enough to find. I’ll just say that natural medicines are not regulated the way prescription drugs are, thanks to the infamous Diet Supplement and Health Education Act (DSHEA) of 1994.

The term “street drugs” comes to mind: you don’t really know what you’re getting.

The herbalists’ arsenal can be a rich source of potential knowledge. But blindly trusting herbalists’ recommendations for medical treatment can be risky.

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Harriet A. Hall, M.D., is a retired family physician and former Air Force flight surgeon. She writes about medicine, “so-called” complementary and alternative medicine, science, quackery, and critical thinking. She has recently published Consumer Health, A Guide to Intelligent Decisions.”