Towards a More Rational Approach to the Use of Plants and Herbs, and Natural Remedies in Modern Medical Preventive and Curative Treatment

Introduction

All over the world, people have relied on plants, flowers, vegetables, fruits, other organic materials (“botanicals”) and diet for millennia to play a major role in preventing and treating many diseases, from headaches and eye problems to heart ailments to stomach disorders. In the World Health Organization’s 2012 World Health Statistics it was revealed that “Surveys conducted in more than 70 mainly low- and middle-income countries indicate that the average availability of selected generic medicines at health facilities was only 42% in the public sector.” (World Health Organization, 2012). Moreover, according to the same report, there are numerous countries around the world in which there is extremely limited access to a doctor. For example, in Zambia, with a population of over ten million, there are only 649 doctors in the whole country, a density of only 0.6 per 10,000 people. By comparison, in the United States, the density is 24.2 doctors per 10,000 people, with almost 750,000 doctors. With literally billions of people around the world living in areas without access to a physician, many people have to rely on natural remedies both for prevention and treatment of a great number of maladies.

However, distinguishing superstition from effective treatment has never been easy for laypeople, and therein has been a danger in health care outside the parameters of what is considered “medical science”. Nevertheless, even some of today’s effective medical treatments have come out of research following anecdotal reports of botanicals or foods having some curative or treating effect that had not theretofore had any scientific explanation. But these natural ingredients when properly used or applied have been known to have positive effects, such as the effect of mango leaves on hypertension or lemon on mild diabetes, or in some cases, perhaps even dramatic effects, such as aloe.

It is only recently that the medical profession has come to terms with what everyone else seems to have known for the last five thousand years – that there are natural substances that have been used to treat a host of maladies with some success, especially when considered as part of an overall approach to health or specific treatment. Unwilling to accept merely anecdotal evidence of effectiveness, doctors and medical professionals had long eschewed these remedies until the continuing usage of these and other natural remedies created a wave of calls for some acceptance. Since professionals were constantly faced with diagnosis and treatment of patients who were likely to have already accessed some alternative or complementary natural remedy such as CBD oil for autoimmune disorders, the medical community needed to know much more about what their patients were using and how effective these remedies were, and what effect those remedies might have on the medicines they might themselves prescribe.

Finally the term Complementary and Alternative Medicine was coined to describe those categories of treatments and medicines “not considered part of conventional medicine” (National Center for Complementary and Alternative Medicine  (“NCCAM”) definition), and NCCAM was established to organize a scientific research-based approach to CAM to assist in professionals’ and patients’ decisions about CAM treatments and to determine scientifically the effectiveness and utility of many CAM treatments.  Making CAM part of the federal government’s NIH was a strategy which appears to be based on “If you can’t beat them, join them,” considering that for some CAM treatments, a huge percentage of the American populace is not only familiar with them, but uses them regularly (“[A]ccording to the 2007 National Health Interview Survey, omega-3 supplements are the most common natural product taken by U.S. adults, and the second most common supplement taken by children” (NCCAM, 2012b, )). By incorporating CAM into the NIH through NCCAM, the NIH has a chance to exert some control of CAM treatments in a way previously considered only antagonistic.   Of course, it has long been the medical field’s desire to rein in CAM’s appeal to the common person by being able to provide top-rate scientific assessment research, especially given the ease of access to CAM for the ordinary person, and the fact no medical degree is necessary to decide to use it.

One hundred years ago, few laymen had the information to know, much less suggest, alternative treatments for ailments to a doctor. Today, with another hundred years of results from the full range of available treatments, and with the spread of the Internet, the information (or indeed in some cases misinformation) available to anyone with an Internet connection is astonishing. The consequences of this are both good and bad.  It is good because there is so much more of an opportunity for the average person to learn about preventive steps, whereas in the past, only consultations with doctors or chance encounters with medical magazines would provide this information. It is bad because, given the breadth of the Internet, and the trend toward people feeling more comfortable with self-diagnosis, all of the available information could constitute what might be considered “noise”, and as such, not useful to make any rational decision. After all, it is possible to have two completely opposite points of view expressed on the same website, and it has become increasingly difficult for laypeople to distinguish between the relative qualifications of those who write there, including professionals.  In addition, providing “natural” anything has become a huge business, and the Internet has become a marketplace for the sale and marketing of a vast array of products and services which claim to provide remedies for almost any ailment.  

Rather than keeping the vast resources available today hidden away from the average person’s consideration, and instead of insisting that every single alternative approach to treatment is impossibly dangerous and ill-advised if not recommended by a licensed physician, it is far better to come to some overall rational approach to the millennia of experience providing alternative or additional rational opportunities for treatment from ordinary resources, such as plants, herbs, flowers, and foods, and incorporating such auxiliary treatments into the panoply of available solutions to the maladies patients are faced with every day.  In this way, doctors, instead of being simply naysayers who must reject every single alternative approach as unscientific and unacceptable, become the facilitators of the entire spectrum of available treatments, including those the medical community has in the past come to abhor, perhaps for the competition, perhaps for the sheer simplicity.

There are literally billions of people in the world today who do not have the chance to ever see a doctor, and for them, the only chance they might ever have to treat a medical problem is with some alternative medicine or approach. By bringing these treatments in from out of the cold, professionals can help everyone understand and perhaps even have access to these remedies in a far more constructive and effective way. 

There have been thousands of trials and tests and surveys into the results of alternative medicine, but those results are simply more likely to create noise than the confusing alternatives themselves. Oftentimes the studies are based on faulty facts or survey designs, and often the studies are designed with a specific result in mind (E.g., Laetrile, which for every objective scientific research study that concluded laetrile had no effect on cancer, there was a subjective survey offered on behalf of laetrile advocates, offering contradictory and often inaccurate assessments (Wilson, 2012); Also, see the study regarding the effects of Milk Thistle on chronic liver disease (Fried et al., 2012). The subjectivity of any test must be taken into consideration when determining the actual facts about the logic and effectiveness of the subject treatment. 

At its website, NCCAM offers guides regarding the use of various “botanicals” However, as might be expected, in almost every case when providing information regarding botanicals, the website indicates that the herb, or plant, or flower, or root in question either does not provide the benefits expected, or are limited, or such benefits are unconfirmed, subject to some study being done or to be done or contemplated. One might regard the information as a caution against using the subject botanical. This would apply to aloe, ginseng, and chamomile, for instance. For ginseng, a root used by likely over a billion people, mostly in Asia, the NCCAM site says “Although Asian ginseng has been widely studied for a variety of uses, research results to date do not conclusively support health claims associated with the herb. Only a few large, high-quality clinical trials have been conducted. Most evidence is preliminary—i.e., based on laboratory research or small clinical trials”(NIH, 2005).  However, the written recorded history of ginseng, as part of historical Chinese medicine, dates as far back as Imhotep and 170 BC. For millennia the Chinese, Korean, Japanese, Indian and other Asian cultures have known that ginseng has benefits. Today’s medicine is still skeptical. Apparently, 2100 years of anecdotal data is insufficient (Dharmananda, 2002).  This study will distinguish between those categories of purported remedies which have little or no evidence to support them, aside from subjective tests, and those remedies that have had long histories of anecdotal evidence, or clinical success, and suggest some methodology or clearinghouse to make data available to professionals and laypeople in order to assist in making informed decisions. Whereas many physicians’ first reaction is to reject all such remedies out of hand, herein it is suggested that by adopting effective alternative treatments they become no longer alternative but as CAM suggests, complementary. 

While doctors are loath to approve CAM and skepticism can be useful, every single advance in medicine throughout history has some aspect of innovation, doing something that has not been done before. There are members of the medical community who are wedded inextricably to the notion that there are rules and guidelines that must be followed in treating patients of certain diseases or conditions, and eschew innovation, whether because of a lack of creativity, fear, liability or narrow-mindedness. Most medicines are in fact extracts or reformulations of chemicals from plants that are part of nature in any event. There are plants and other herbal remedies that have the power to prevent and heal if only used properly, and it is time to establish a mechanism for getting reliable information out about a wider range of remedies to benefit those billions without access to regular medical care, as well as all of those people who are looking for natural medical treatment.

References

Dharmananda, S. (2002) The nature of ginseng: From traditional use to modern research. Herbalgram (Number 54) Journal of the American Botanical Council.. Retrieved from http://www.itmonline.org/arts/gisengnature.htm.

Fried, M. W., Navarro, V. J., Afdhal N., Belle, S. H., Wahed, A. S.,… Reddy, K. R. (2012). Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C who failed interferon therapy: A randomized, placebo-controlled trial. JAMA 308(3), 274–282.

NCCAM. (2012a). About NCCAM. Retrieved from http://nccam.nih.gov/about.

NCAAM. (2012b). Director’s page. Retrieved from http://nccam.nih.gov/about /offices/od/2012-11

NIH. (2005). Herbs at a glance: Ginseng. NCCAM Publication No.: D284. Retrieved from http://nccam.nih.gov/health/asianginseng/ataglance.htm. Updated: April 2012.

Wilson, B. (2012). The rise and fall of laetrile. Quackwatch. Retrieved from http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/laetrile.html.

World Health Organization. (2012). 2012 world health statistics. World Health Organization. Geneva: WHO Press.