Herbalists use the leaves, flowers, stems, berries, and roots of plants to prevent, relieve, and treat illness. From a "scientific" perspective, many herbal treatments are considered experimental. The reality is, however, that herbal medicine has a long and respected history. Many familiar medications of the twentieth century were developed from ancient healing traditions that treated health problems with specific plants. Today, science has isolated the medicinal properties of a large number of botanicals, and their healing components have been extracted and analyzed. Many plant components are now synthesized in large laboratories for use in pharmaceutical preparations. For example, vincristine (an antitumor drug), digitalis (a heart regulator), and ephedrine (a bronchodilator used to decrease respiratory congestion) were all originally discovered through research on plants.

Undisputedly, the history of herbology is inextricably intertwined with that of modern medicine. Many drugs listed as conventional medications were originally derived from plants. Salicylic acid, a precursor of aspirin, was originally derived from white willow bark and the meadowsweet plant. Cinchona bark is the source of malaria-fighting quinine. Vincristine, used to treat certain types of cancer, comes from periwinkle. The opium poppy yields morphine, codeine, and paregoric, a treatment for diarrhea Laudanum, a tincture of the opium poppy, was the favored tranquilizer in Victorian times. Even today, morphine-the most important alkaloid of the opium poppy-remains the standard against which new synthetic pain relieves is measured.

Prior to the discovery and subsequent synthesis of antibiotics, the herb echinacea (which comes from the plant commonly known as purple coneflower) was one of the most widely prescribed medicines in the United States. For centuries, herbalists prescribed echinacea to fight infection. Today, research confirms that the herb boosts the immune system by stimulating the production of disease-fighting white blood cells.

The use of plants as medicine is older than recorded history. As mute witness to this fact marshmallow root, hyacinth, and yarrow have been found carefully tucked around the bones of a Stone Age man in Iraq. These three medicinal herbs continue to be used today. Marshmallow root is a demulcent herb, soothing to inflamed or irritated mucous membranes, such as a sore throat or irritated digestive tract. Hyacinth is a diuretic that encourages tissues to give up excess water. Yarrow is a time-honored cold and fever remedy that may once have been used much as aspirin is today.

In 2735 B.C., the Chinese emperor Shen Nong wrote an authoritative treatise on herbs that is still in use today. Shen Nong recommended the use of Ma Huang (known as ephedra in the Western world), for example, against respiratory distress. Ephedrine, extracted from ephedra, is widely used as a decongestant. You'll find it in its synthetic form, pseudoephedrine, in many allergy, sinus, and cold-relief medications produced by large pharmaceutical companies.

The records of King Hammurabi of Babylon (c. 1800 B.C.) include instructions for using medicinal plants. Hammurabi prescribed the use of mint for digestive disorders. Modern research has confirmed that peppermint does indeed relieve nausea and vomiting by mildly anesthetizing the lining of the stomach.

The entire Middle East has a rich history of herbal healing. There are texts surviving from the ancient cultures of Mesopotamia, Egypt, and India that describe and illustrate the use of many medicinal plant products, including castor oil, linseed oil, and white poppies. In the scriptural book of Ezekiel, which dates from the sixth century B.C., we find this admonition regarding plant life: "..and the fruit thereof shall be for meat, and leaf thereof for medicine." Egyptian hieroglyphs show physicians of the first and second centuries A.D. treating constipation with senna pods, and using caraway and peppermint to relieve digestive upsets.

Throughout the Middle Ages, home-grown botanicals were the only medicines readily available, and for centuries, no self-respecting household would be without a carefully tended and extensively used herb garden. For the most part, herbal healing lore was passed from generation to generation by word of mouth. Mother taught daughter; the village herbalist taught a promising apprentice.

By the seventeenth century, the knowledge of herbal medicine was widely disseminated throughout Europe. In 1649, Nicholas Culpeper wrote A Physical Directory, and a few years later produced The English Physician. This respected herbal pharmacopeia was one of the first manuals that the layperson could use for health care, and it is still widely referred to and quoted today. Culpeper had studied at Cambridge University and was meant to become a great doctor, in the academic sense of the word. Instead, he chose to apprentice to an apothecary and eventually set up his own shop. He served the poor people of London and became known as their neighborhood doctor. The herbal he created was meant for the layperson.

The first U.S. Pharmacopeia was published in 1820. This volume included an authoritative listing of herbal drugs, with descriptions of their properties, uses, dosages, and tests of purity. It was periodically revised and became the legal standard for medical compounds in 1906. But as Western medicine evolved from an art to a science in the nineteenth century, information that had at one time been widely available became the domain of comparatively few. Once scientific methods were developed to extract and synthesize the active ingredients in plants, pharmaceutical laboratories took over from providers of medicinal herbs as the producers of drugs. The use of herbs, which for most of history had been mainstream medical practice, began to be considered unscientific, or at least unconventional, and to fall into relative obscurity.

Today, the U.S. Pharmacopoeia, with its reliance on herbal compounds, has been all but forgotten. Most modern physicians rely on the Physician's Desk Reference, an extensive listing of chemically manufactured drugs. It is important to note that each entry in this enormous volume, in addition to specifying the chemical compound and actions of a particular drug, also includes an extensive list of contraindications and possible side effects.

Rather than using a whole plant, pharmacologists identify, isolate, extract, and synthesize individual components, thus capturing the active properties. This can create problems, however. In addition to active ingredients, plants contain minerals, vitamins, volatile oils, glycosides, alkaloids, bioflavanoids, and other substances that are important in supporting a particular herb's medicinal properties. These elements also provide an important natural safeguard Isolated or synthesized active compounds can become toxic in relatively small doses; it usually takes a much greater amount of a whole herb, with all of its components, to reach a toxic level. Herbs are medicines, however, and they can have powerful effects. They should not tee taken lightly. The suggestions for herbal treatments in this book are not intended to substitute for consultation with a qualified health care practitioner, but rather to support and assist you in understanding and working with your physician's advice.

Substances derived from the plants remain the basis for a large proportion of the commercial medications used today for the treatment of heart disease, high blood pressure, pain, asthma, and other problems. For example, ephedra is an herb used in Traditional Chinese Medicine for more than two thousand years to treat asthma and other respiratory problems. Ephedrine, the active ingredient in ephedra, is used in the commercial pharmaceutical preparations for the relief of asthma symptoms and other respiratory problems. It helps the patient to breathe more easily.

Another example of the use of an herbal preparation in modern medicine is the foxglove plant. This herb had been in use since 1775. At present, the powdered leaf of this plant is known as the cardiac stimulant digitalis to the millions of heart patients it keeps alive worldwide.

There are over 750,000 plants on earth. Relatively speaking, only a very few of the healing herbs have been studied scientifically. And because modern pharmacology looks for one active ingredient and seeks to isolate it to the exclusion of all the others, most of the research that is done on plants continues to focus on identifying and isolating active ingredients, rather than studying the medicinal properties of whole plants. Herbalists, however, consider that the power of a plant lies in the interaction of all its ingredients. Plants used as medicines offer synergistic interactions between ingredients both known and unknown.

The efficacy of many medicinal plants has been validated by scientists abroad, from Europe to the Orient. Thanks to modern technology, science can now identify some of the specific properties and interactions of botanical constituents. With this scientific documentation, we now know why certain herbs are effective against certain conditions. However, almost all of the current research validating herbal medicine has been done in Germany, Japan, China, Taiwan, and Russia. And for the most part, the United States Food and Drug Administration (FDA), which is responsible for licensing all new drugs (or any substances for which medicinal properties are claimed) for use in the United States, does not recognize or accept findings from across the sea. Doctors and government agencies want to see American scientific studies before recognizing the effectiveness of a plant as medicine. Yet even though substantial research is being done in other countries, drug companies and laboratories in the United States so far have not chosen to put much money or resources into botanical research. The result is that herbal medicine does not have the same place of importance or level of acceptance in this country as it does in other countries.

Generally, herbs fall into two categories: wild-grown and farm-grown. A wild-grown herb is one that grows naturally, without human intervention. As a result of natural selection, plants tend to be found in places with conditions that optimize their growth. For example, horsetail grows best in moist, swampy areas, while arnica thrives at high altitudes in alpine meadows. The process of gathering herbs from their natural habitats is called wildcrafting.

The disadvantage of wild-grown herbs is that there is no guarantee the plants haven't been exposed to chemicals and pesticides. Herbs harvested from a meadow, for example, may have been exposed to chemical drift from a crop-dusted farm nearby. Exhaust fumes from passing traffic may have settled invisibly on plants growing near a country road. Water-loving plants, like horsetail, may be rooted in the bank of a polluted stream.

Because of the possibility of contamination, unless you are very sure of the source of wildcrafted herbs, organic herbs grown commercially may be a better choice. Organic farm-grown herbs are becoming increasingly available, as more and more herb farms are being established. With careful management, organic herb farms can provide a steady supply of quality herbs to the consumer.

To produce top-quality products, herb farmers require a great deal of specialized knowledge. For maximum potency, it is important that particular herbs be harvested at the optimum moment. For example, echinacea is gathered in the spring, winter, and fall, but not in summer, when the plant's energies are concentrated on growth and flowering.

Responsible farmers use compost and organic matter to fertilize and replenish the health of the soil. For obvious reasons, we favor the use of certified organically grown herbs, produced without the use of synthetic fertilizers or chemical pesticides. As of this writing, not all states have agencies inspecting and certifying organic growers, so to be sure you are getting pure, pesticide-free herbs grown without chemical contamination, check the label for the words "certified organic" before you make a purchase. The name of the certifying agency should be specified on the label. Two reliable organizations that certify organic products are the Organic Growers and Buyers Association and California Certified Organic Farmers. Organic products grown in the states of Washington and Texas should be certified organic by the Department of Agriculture of the relevant state. As of this writing, federal legislation on requirements for labeling a product "organic" has been passed, but is not yet being fully implemented. Once it is, it should be easier to be sure that you are buying a genuine organic product. Hopefully this will take place in the next few years.

Another concern when using tinctures is the presence of the alcohol. If you wish to lessen the amount of alcohol in a tincture before giving it to your child, mix the appropriate dose with one-quarter cup of very hot water. After about five minutes, most of the taste of the alcohol will have evaporated away, and the mixture should be cool enough to drink.

Homeopathy, also known as homeopathic medicine, is a whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like"). It is a form of health care that developed in Germany and has been practiced in the United States since the early 19th century.

Homeopathic practitioners are commonly called homeopaths. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like") and reviews scientific research on its use and effectiveness.

Hans Burch Gram, a Boston-born doctor, studied homeopathy in Europe and introduced it into the United States in 1825. European immigrants trained in homeopathy also made the treatment increasingly available in America. In 1835, the first homeopathic medical college was established in Allentown, Pennsylvania. By the turn of the 20th century, 8 percent of all American medical practitioners were homeopaths, and there were 20 homeopathic medical colleges and more than 100 homeopathic hospitals in the United States.

In the late 19th and early 20th centuries, numerous medical advances were made, such as the recognition of the mechanisms of disease; Pasteur's germ theory; the development of antiseptic techniques; and the discovery of ether anesthesia. In addition, a report (the so-called "Flexner Report") was released that triggered major changes in American medical education. Homeopathy was among the disciplines negatively affected by these developments. Most homeopathic medical schools closed down, and by the 1930s others had converted to conventional medical schools.

In the 1960s, homeopathy's popularity began to revive in the United States. According to a 1999 survey of Americans and their health, over 6 million Americans had used homeopathy in the preceding 12 months. The World Health Organization noted in 1994 that homeopathy had been integrated into the national health care systems of numerous countries, including Germany, the United Kingdom, India, Pakistan, Sri Lanka, and Mexico. Several schools of practice exist within homeopathy.

Persons using homeopathy do so to address a range of health concerns, from wellness and prevention to treatment of injuries, diseases, and conditions. Studies have found that many people who seek homeopathic care seek it for help with a chronic medical condition. Many users of homeopathy treat themselves with homeopathic products and do not consult a professional.

Most homeopathic remedies are derived from natural substances that come from plants, minerals, or animals. A remedy is prepared by diluting the substance in a series of steps. Homeopathy asserts that this process can maintain a substance's healing properties regardless of how many times it has been diluted. Many homeopathic remedies are so highly diluted that not one molecule of the original natural substance remains. Remedies are sold in liquid, pellet, and tablet forms.

Because of these characteristics, it is illegal for homeo­pathic medicines or any other OTC drug to be marketed for serious medical conditions, such as heart disease, diabetes, multiple sclerosis, or similarly dangerous conditions. Whereas these conditions are not self-limiting, there are other conditions that are self-limiting but need a doctor's diagnosis. An OTC indication must have both of these characteristics. An OTC product must not only fit these characteristics, it also must be in a dosage form that is non-toxic.

It is certainly true that the raw materials for many homeo­pathic medicines are known poisons. And yet, every toxicologist knows that a substance is poisonous only in a certain dose.

Actually, virtually everything is poisonous in certain doses. Too much oxygen can impede respiration, and too much calcium will lead to brittle bones.

Homeopathic medicines are manufactured through a specific pharmaceutical process called "potentization" in which the sub­stance is serially diluted, that is, it is diluted in a 1:10 or 1:100 solution of distilled water, vigorously shaken, diluted again, shaken again, and this process is continued many times. Homeopathic medicines are commonly diluted so many times that there are very few, if any, of the molecules of the original substance. As a result of the small doses used, there is general consensus that homeopathic medicines that are presently avail­able for OTC use are basically safe.

The small doses used in homeopathy make its nearly impossi­ble to elicit a poisonous effect. As famed violinist and philan­thropist Yehudi Menuhin once said, "Homeopathy is one of the few medical specialties which carries no penalties--only benefits."

Although skeptics assume that these medicines are simply placeboes, 200 years of experience by hundreds of thousands of physicians and by tens of millions of patients confirm that these small, specially prepared doses do, in fact, have clinical ef­fect. Further, a small but growing body of research also con­firms this.

The Homeopathic Pharmacopeia Convention of the United States (HPCUS) is a non-profit organization with board consisting of representatives from homeopathic pharmacists and homeopathic physicians. Drawing from research in conventional toxicology and clinical medicine, the HPCUS makes its determination on what dose is appropriate for consumer use (OTC), what dose is available via a doctor's prescription, and what doses cannot and should not be made available.

The manual for how to manufacture make homeopathic medicines is the Homeopathic Pharmacopeia of the United States (HPUS). It is presently being revised and is available on a subscription basis. Although it is very expensive to subscribe (it costs $1,000+ for all past issues). A summary listing of the official homeopathic medicines is available as HPUS Abstracts. These Abstracts provide a listing of official homeopathic medicines, the precise dose in which a medicine is either an OTC or Rx drug, the criteria for inclusion in the HPUS, the guidelines for homeo­pathic combination medicines, and the legal requirements for labeling homeopathic medicines.  Source: Homeopathic Pharmacopoeia of the United States

From a strictly pharmacological perspective, there are no such things as "side effects," either of conventional drugs or of homeopathic medicines. Drugs simply have "effects," and we arbitrarily differentiate those effects that we like from those that we don't. The symptoms that conventional drugs cause are not side effects but are the direct effect of a specific drugs inhibiting the body's inherent reaction to a stress or infective agent. Although the effects of the drug may reduce the main complaint of the sick person, the new symptoms are sometimes more and some­times less bothersome than the original. The consumer must decide which aggravation he or she prefers. Homeopathic medicines, in contrast, are not known to create side effects.

The basic tenet of homeopathy, the principle of similars, assumes that a medicine is good for the specific pattern of symptoms that it is known to cause if given in large dose. In order to find out what a medicine is effective in treating, homeopaths perform experiments called "provings" (derived from the German word pruefung, meaning test) in which healthy people are given continual doses of a potentized medicine. Although not everyone is sensitive to potentized doses of each substance, some people will develop symptoms of this particular substance. These symptoms can and will disappear if: after the person stops taking this medicine; if a higher potency of this medicine is given to them; if the person is prescribed a potentized remedy that causes the similar symptoms to those that the person is experiencing; if the person is prescribed a potentized remedy which is known to antedote the action of the first remedy; or if the person takes crude doses of a substance, such as coffee or camphor, which sometimes is known the antedote the effects of the remedy.

In summary, you can develop symptoms from taking a homeo­pathic medicine, though these symptoms rarely last very long and will usually go away shortly after the person stops taking the remedy.

Just as one can drink too much carrot juice and develop orange skin, one can take homeopathic medicines too frequently. And just as carrot juice should not be considered dangerous in its common dose, neither are homeopathic medicines. It is, however, important for manufacturers to educate both consumers and retailers that homeopathic medicines are medicines; they are not supplements that people can and should be taking every day. They should be used for treating specific complaints and should not simply be taken unendingly.

Other information that consumers and retailers should know is that people should be taking a homeopathic medicine for a limited time and only when the person is experiencing a specific set of symptoms for which the medicine is indicated. If these symptoms disappear, it is not necessary to take the medicine any longer. If the symptoms change, it may be necessary to take a different remedy or formula that most accurately fits the new set of symptoms.

Homeopaths commonly use substances that are known poisons. However, the HPUS provides strict definitions of doses that are known to be dangerous. These more dangerous dose forms either require a physician's prescription or are simply not available.

At the other extreme, most homeopathic pharmacies do not encourage the retail sale of high potency homeopathic medicines (such as 200x, 1m, 10m, 50m, or CM; "M" stands for 1,000) unless the consumer has some knowledge of homeopathic medicines. Homeo­pathic manufacturers may sell these medicines to natural food stores, but they encourage retailers to have them behind the counter and to sell them only when a customer is knowledgeable or when a physician has prescribed that particular potency.

These high potency medicines are not dangerous in the tradi­tional sense of toxicology. They are simply deeper-acting medi­cines which have the potential to create a healing crisis, that is, an increase in certain superficial symptoms (often skin symptoms) as the homeopathic medicine stimulates the deeper internal health of the person.

If a homeopathically uneducated person experiences a healing crisis, he or she may not realize that these new symptoms are actually benefiting their health, and this person may become anxious or even seek conventional medical treatment for these new symptoms. Such a medical intervention may significantly reduce the healing benefit of the homeopathic medicine that may not be easily re-established.

A healing crisis is an exacerbation of certain symptoms in the body's efforts to heal a deeper condition. It is, for in­stance, relatively common for people with chronic ailments to experience an externalization of symptoms in the process of cure, that is, a person with a recurrent respiratory condition may develop a skin rash in the healing process. The body always seeks to protect its deepest and most vital functions, and it always tries to externalize stress and discharge infective agents.

The basic assumption underlying homeopathy is that symptoms are defenses and that one should seek to aid the body's efforts in completing and externalizing them, rather than simply sup­pressing them. Homeopaths observe that there are three determi­nants that distinguish a healing crisis from a worsening of symptoms. Called Hering's laws of cure, homeopaths find that a true healing is occurring when: symptoms are moving from the person's vital internal functions to more external, less vital functions; symptoms are moving from the top of the body to the bottom of the body; symptoms are moving in reverse order of experience, that is, a person may shortly re-experience old symptoms in the process of cure.

Although a person may experience some new or old symptoms after taking a homeopathic medicine, they are thought to be part of the healing process when they are following Hering's laws. When they are not, it is generally assumed that the homeopathic medicine is not working and the person's condition is getting worse. In rare instances it has been known for a person to experi­ence an exacerbation of symptoms without subsequent relief on a deeper level. Homeopaths have found that people who experience this are thought to have a deep pathology that may not be cura­ble with homeopathy or other known therapies.

No homeopathic medicines are actually dangerous, but there are certain remedies which are known to be more "reactive" than others. By reactive, I mean, that people are known to experience healing crisis more frequently with this remedy than with others. Although this healing crisis is beneficial, it is recom­mended that people experiencing a healing crisis be supervised by someone with a professional level of understanding of homeopathy.

The most reactive homeopathic medicines are called "nosodes," which are a class of substances made from pathological tissue or organisms. Syphilinum (made from pus in a syphilis chancre), Medhorrinum (from gonorrhea), and Tuberculinum (taken from the sputum of a person with tuberculosis).

These medicines are prescription homeopathic medicines and are available only by prescription from a physician.

Several known "quackbusters" have made reference to a Lancet letter that noted that a homeopathic medicine was found to be contaminated with a steroid. However, true to the bias that they bring to their assessment of homeopathy, they always neglect to mention that this single incidence took place in Pakistan. Intentional contamination of a homeopathic medicine is possible; however, except for this single incidence in Pakistan, it has never been known to happen anywhere else.

Modern botanical, biochemical, and pharmacological methods allow manufacturers to properly identify medicinal substances used, and the use of double- and triple-distilled water for the process of dilution assures a high level of purity to homeopathic products. Contamination after manufacture of a homeopathic product is highly unlikely due to the various protective seals that manufac­turers use on their bottles and boxes.

In sum, homeopathic medicines are OTC drugs that are very safe. It is, however, important for consumers to know that homeopathic medicines are not vitamins or supplements that are taken daily. Homeopathic medicines are medicinal agents that can and should be used when there are proper indications for them.

At present, skeptics of homeopathy assert that the medicines are simply placebos. In the coming years when more research confirms that efficacy of homeopathic medicines, I predict that skeptics of homeopathy will take a new tact in their attack on the field. Instead of recognizing them as placebos, they will probably assert that they are indeed powerful medicines, but they are so powerful that consumers cannot and should not have access to them, except under the care of a physician. The skeptics' efforts to make homeopathic medicines prescription drugs will probably be aided by conventional medical organizations, by certain medical professors (most likely those who are funded by major drug companies), and even by small factions of homeopathic medical doctors.

I predict that there will be pressure for strong regulation on the sale and marketing of homeopathic medicines from conven­tional drug manufacturers. The drug companies will insist that homeopathic products are given preferential treatment and will demand greater proof of efficacy. Whether the FDA bows to such pressure or not will depend on the unity and organization of the homeopathic and natural products community.

Because homeopathic medicines are generic products that are not presently patentable, there is no incentive for any company to test the efficacy of its products. However, as homeopathy achieves more popularity and greater profitability, there will probably be significant pressure on the American Homeopathic Pharmaceutical Association to develop cooperative studies. It is also quite possible that homeopathic medicines will be patentable at some time in the near future. Such changes in the legal status of homeopathic medicines will provide significant incen­tive to homeopathic manufacturers to develop and test new homeo­pathic medicines.

Needless to say, it is essential that the homeopathic and natural products community do all that is possible to resist the movement of homeopathic medicines from OTC drugs to prescription drugs. It is likewise essential that the FDA recognize that homeopathic medicine cannot and should not be regulated in the same way as conventional drugs. At the same time, we must encourage the homeopathic industry to devote increasing monies to efforts to evaluate the safety and efficacy of its products. With these tangible investments, homeopathy can and will become an integral part of the American medicine chest.

In the meantime, there has been and there will continue to be increasing efforts by homeopathic organizations and companies to teach people how to use homeopathic medicines for themselves and their families. We are empowering people to take care of themselves. Not only is such care effective, the empowering of individuals and families is healing in its own right.

Homeopathy is here to stay, and hopefully it will stay in the rightful hands: in everybody's hands, both doctors and patients.