Clinical Review ABC of complementary medicine

Herbal medicine

BMJ 1999; 319 doi: (Published 16 October 1999) Cite this as: BMJ 1999;319:1050
  1. Andrew Vickers,
  2. Catherine Zollman


    The use of plants for healing purposes predates human history and forms the origin of much modern medicine. Many conventional drugs originate from plant sources: a century ago, most of the few effective drugs were plant based. Examples include aspirin (from willow bark), digoxin (from foxglove), quinine (from cinchona bark), and morphine (from the opium poppy). The development of drugs from plants continues, with drug companies engaged in large scale pharmacological screening of herbs.

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    Until a century ago most effective medicines were plant based

    Chinese herbalism is the most prevalent of the ancient herbal traditions currently practised in Britain. It is based on concepts of yin and yang and of Qi energy. Chinese herbs are ascribed qualities such as “cooling” (yin) or “stimulating” (yang) and used, often in combination, according to the deficiencies or excesses of these qualities in the patient.

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    Chinese herbalism is the most prevalent of the traditional herbal practices in Britain

    Modern Western herbalism emphasises the effects of herbs on individual body systems. For example, herbs may be used for their supposed anti-inflammatory, haemostatic, expectorant, antispasmodic, or immunostimulatory properties.

    Spending on herbal products in the United Kingdom is over £40m a year, mainly from self prescription of over the counter products. This type of herbal drug use is typically based on a simple matching of a particular herb to particular diseases or symptoms—such as valerian (Valeriana officinalis) for sleep disturbance. Originally confined to health food shops, herbal remedies are now marketed in many conventional pharmacies.

    Differences from conventional drug use

    Although superficially similar, herbal medicine and conventional pharmacotherapy have three important differences:

    Use of whole plants—Herbalists generally use unpurified plant extracts containing several different constituents. They claim that these can work together synergistically so that the effect of the whole herb is greater than the summed effects of its components. They …

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