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The Art & Science of Herbal Formulation: Western Herbal Medicine

Written by Sebastian Pole


Traditional medicine in the west did things rather differently. If we go back to Galen the acknowledged authority from Roman times, we see that in his world view the ‘power’ of the individual medicine (or ‘drug’) was foremost. Galen set out what was in effect a ‘research agenda’ for ‘proving’ these powers, based on eight conditions:

1.      the drug must be of good unadulterated quality;
2.      the illness must be simple, not complex;
3.      the illness must be appropriate to the action of the drug;
4.      the drug must be more powerful than the illness;
5.      one should make careful note of the course of illness and treatment;
6.      one must ensure that the effect of the drug is the same for everybody at every time;
7.      one must see that the effect of the drug is specific for human beings;
8.      one must distinguish the effect of drugs (working by their qualities) from foods (working by their substance).

In effect the physician’s role was to ‘prove’ the individual effect of each drug by direct experience. The fundamental principle in Galen’s work was that nature was an active dynamic force. Treatments engaged these forces, either in the case of drugs through their own dynamic ‘qualities’, or in the case of foods by the qualities of their substance. In classifying the dynamic qualities of medicines, Galen refined the widely established view that they had ‘temperaments’ reflecting well-understood climatic influences: hot, cold, dampness and dryness, each formed of paired combinations of the four elements that made up nature: earth, water, fire and air (heat is generated by fire and air, cold by earth and water and so on).

The elements were associated with four fluids or ‘humours’ in the body, black bile, phlegm, yellow bile and blood, with their associated personality types, the melancholic, phlegmatic, choleric and sanguine. The humours were the cornerstone of therapy and physicians moved to counteract excess (plethora) or deficiency (kenos) in any of them. For excess or toxic conditions remedies were antidota, primarily heating, cooling, drying and moistening as necessary, in degrees, with remedies in the ‘first degree’ milder than those in the third or fourth (which became increasingly dangerous). In deficiency conditions physic remedies were replenishing or supportive.

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