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The evidence house of Herbal Medicine: A holistic approach to contemporary research

Written by Danny O’Rawe, ND MSc FIRH

Introduction

Critics of herbal medicine sometimes lead the public to believe that they should avoid herbal remedies because there is a lack of evidence about the safety or efficacy of medicinal herbs. They often resort to the somewhat exhausted mantra that “just because something is natural does not mean it is safe” (2,3,14, 28). This is on the face of it an accurate assessment, but it may also be a half-truth. It could equally be suggested that because something is natural it is more likely to be safe (due to its longevity of use without incident for example) rather than something which is unnatural, such as a synthetic drug made in a laboratory with all its inherent risks and unwanted side effects. Indeed, it is because of the latter, that the general public often seek a ‘natural alternative’ in the first place.

The general longevity of use in traditional practice over many centuries suggests the vast majority of herbal medicines when used appropriately by practicing herbalists are as safe as fruit and vegetables (indeed many of them are fruits and vegetables), with only a few stronger herbs employed in limited dosages. Part of the problem is that some researchers chose to ignore the existence of the professional herbalist who is trained to flag any potential contraindications which might assuage at least some of the perennial concerns they raise. Instead, some prefer to put across their conflated concerns of an unsuspecting public stepping into the mire, and rather than suggest that the public consults with a professional herbalist; they play on fears and generate uncertainty (13; 16). The objective of this type of criticism is to create a sense of doubt in the public eye, but is it all just smoke and mirrors?

While it’s true to say that some herbs such as Atropa belladonna are dangerous in the wrong hands, access to such plants is legally controlled and these herbs are unavailable to the general public. And while unsuspecting amateurs harvesting from incorrectly-identified species in the wild may cause problems for themselves, such misadventure is not in any way connected to professional herbal medicine. By and large, the majority of herbs used by herbal practitioners are tried and true over long periods of time. A small selection of herbal medicines may be considered more medicinally “potent”, but the discerning herbal practitioner uses restricted doses and fixed durations of use for such herbal preparations and is trained to be aware of any potential toxicity.

The deconstruction of semantics aside, we are still left with the question – is there a lack of evidence for herbal medicine? In order to put this question into context, we might begin by examining the term “evidence” itself. Critics of herbal medicine believe that herbal medicine can only be understood through certain types of evidence.

In a court of law the defendant or prosecution presents corroborating evidence for particular statements to establish the foundations of their arguments. This corroborating evidence may come from diverse sources. The origins of evidence are less important than the strength of such evidence to convince a judge and jury. But what if the judge demanded that only evidence gathered from the City of London could be considered, even if the events around the case occurred outside the City of London? You would be correct to think that such a hypothetical situation would be ludicrous.

I have been involved with herbal medicine for more than 30 years. I hold a Master of Science (MSc) degree in herbal medicine and I am an Honorary Fellow and former president of the Irish Register of Herbalists (IRH).

I am also a Registered Naturopath (ND) and member of the General Naturopathic Council (GNC) and was formerly Senior Lecturer in Nutrition for the College of Naturopathic Medicine. I also hold a Diploma in Aromatherapy. I co-authored with Keith Robertson FNIMH of Celtic Herbal Medicine (2018).

Danny O'Rawe

I have been involved with herbal medicine for more than 30 years. I hold a Master of Science (MSc) degree in herbal medicine and I am an Honorary Fellow and former president of the Irish Register of Herbalists (IRH).

I am also a Registered Naturopath (ND) and member of the General Naturopathic Council (GNC) and was formerly Senior Lecturer in Nutrition for the College of Naturopathic Medicine. I also hold a Diploma in Aromatherapy. I co-authored with Keith Robertson FNIMH of Celtic Herbal Medicine (2018).

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