All cultures have long folk medicine traditions that include the use of plants and plant products. Even in ancient cultures, people methodically collected information on herbs and developed well-defined herbal pharmacopoeias. Indeed, well into the twentieth century, much of the pharmacopoeia of scientific medicine was derived from the herbal lore of native peoples. Many drugs commonly used today are of herbal origin. Indeed, about one-quarter of the prescription drugs dispensed by community pharmacies in the United States contain at least one active ingredient derived from plant material.

The World Health Organization (WHO) estimates that 4 billion people, 80 percent of the world population, presently use herbal medicine for some aspect of primary healthcare. Herbal medicine is a major component in all indigenous peoples’ traditional medicine and a common element in Ayurvedic, homeopathic, naturopathic, traditional oriental, and Native American Indian medicine.

Drug Regulation

Although, the discovery of useful therapeutics from plants has changed the face of medicine and the course of civilization, many people, especially some in the Federal Government, evaluate herbal remedies as though they were either worthless or dangerous. Today in the United States, herbal products can be marketed only as food supplements. An herb manufacturer or distributor can make no specific health claims without FDA approval. A growing number of Americans are interested in herbal preparations.

Two features of European drug regulation make that market more hospitable to natural remedies. First, it costs less and takes less time in Europe to approve medicines as safe and effective. This is especially true of substances that have a long use history and can be approved under the "doctrine of reasonable certainty." European guidelines for the assessment of herbal remedies follow up on WHO’s Guidelines for the Assessment of Herbal Medicines, which state that a substance’s historical use is a valid way to document safety and efficacy in the absence of scientific evidence to the contrary.

France, where traditional medicines can be sold with labeling based on traditional use, requires licensing by the French Licensing Committee and approval by the French Pharmacopoeia Committee. Germany considers whole herbal products one active ingredient; this makes it simpler to define and approve the product. The German Federal Health Office regulates products such as ginkgo and milk thistle extracts so that potency and manufacturing processes are standardized. England generally follows the rule of prior use; that is, years of use with apparent positive effects and no evidence of detrimental side effects constitute enough evidence — in lieu of other scientific data — that the product is safe.

In Japan, China, and India, patent herbal remedies composed of dried and powdered whole herbs or herb extracts, often in tablet form, are the rule. Traditional herbals are the backbone of China’s medicine. Japan’s traditional medicine, kampo, is similar to and historically derived from Chinese medicine but includes traditional medicines from Japanese folklore. Herbal medicines are the staple of medical treatment in many developing countries and are used for many types of ailments.

European Phytomedicines

European phytomedicines are among the world’s best studied medicines, researched in leading European universities and hospitals. Some have been in clinical use, under medical supervision, for more than ten years, with tens of millions of documented cases. This form of botanical medicine most closely resembles American medicine. In Europe there have been credible research studies reporting positive effects on a variety of chronic illnesses for herbs such as Silybum marianum (milk thistle), Ginkgo biloba (ginkgo) Vaccinium myrtillus (bilberry extract), and Ilex guayusa. Many herbs in China have been studied extensively by methods that are acceptable from the Western perspective; among these herbs are ginseng, fresh ginger rhizome, Chinese foxglove root, baical skullcap root, wild chrysanthemum flower, and licorice root. A number of Ayurvedic herbs also have recently been studied in India under modern scientific conditions, including Eclipta alba, Indian gooseberry, neem, turmeric, and trikatu.

Reports of positive effects of herbal preparations in developing countries and Native American Indian herbs are primarily anecdotal. However, since much modern-day medicine is directly or indirectly derived from such folklore sources, it seems illogical to conclude that there are no more significant treatments or cures for major diseases to be found, in the world, from plant sources.

Adapted from Alternative Medicine: Expanding Medical Horizons, a report prepared under the auspices of the Workshop on Alternative Medicine, held in Chantilly VA on September 14-16, 1992.