Herbalism In The United States

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Herbal remedies were an important component of American medicine right up until the early years of the twentieth century. Medical historians believe that upon their arrival in North America in the sixteenth century, early European explorers began trading information about herbal remedies with the Native Americans they encountered. According to Medicinal Plants of Native North America, the various indigenous tribes had over 18,000 uses for herbs.1 Several of these herbs, such as seneca snakeroot (Polygala senega L.), wild cherry (Prunus virginiana L.), and balm of Gilead (Populus candicans Ait.), actually found their way into some editions of the United States Pharmacopeia (USP) or the National Formulary (NF). Some herbs sold today, such as echinacea, were originally used by Native Americans for the same purposes they are used for today.

During the nineteenth century, American medical movements, such as American eclecticism, introduced a range of herbs into common use, including purple coneflower (Echinacea spp.), goldenseal (Hydrastis canadensis), and black cohosh (Cimicifuga racemosa).2 In the early part of the twentieth century, approximately 170 herbal drugs were still listed in the USP and Nf.3 Preparations containing many of today's most popular herbs were being manufactured by large pharmaceutical companies, and in pharmacy schools, pharmacognosy (the study of the properties of drugs of natural origin) was an important part of the curricula. Some herbal materials, such as the dried roots and rhizome of echinacea, remained in the National Formulary right up to the 1950s.3

Several factors contributed to the general disappearance of herbal medicines from pharmacy shelves. The end of the nineteenth century saw the rise of scientific medicine and the growth of new disciplines, such as experimental physiology and physiological chemistry. The germ theory of disease revolutionized the treatment of infectious diseases. Major advances in organic chemistry led to the introduction of synthetic chemical drugs, such as the sulfonamide antimicrobials, and the rise of the modern pharmaceutical industry. Pharmacologically based chemical therapeutics with a biochemical emphasis began to displace other types of healing systems. In 1910, Abraham Flexner published his famous report Medical Education in the United States and Canada, which recommended that the quality of medical education should be improved by integrating scientific principles and techniques into treatment methods and medical school curricula. The Flexner Report had enormous influence and resulted in the closing of many medical schools that did not subscribe to the biochemical theory of medical treatment.4 Prior to Flexner, approximately 150 medical schools existed in the United States and Canada, but his report was sufficiently damning that more than half of those schools, which he considered "trade schools," closed. Alternative systems of healing, such as homeopathic medicine and eclecticism, disappeared from center stage.

After the Flexner Report, and with the rise in the belief that pharmaceutical drugs could eliminate all disease, the use of herbal remedies experienced a dramatic decline. Plant extracts did not disappear completely from the American materia medica, however, for around one-quarter of all conventional drugs on pharmacy shelves are still derived one way or another from plants—aspirin, for example, was originally extracted from the bark of willow trees (Salix spp.); a heart drug called atropine, from deadly nightshade (Atropa belladonna); and the anticancer drug paclitaxel, from the Pacific yew tree (Taxus brevifolia).5 Up until the mid-1990s, herbal preparations such as valerian and echinacea continued to be available to consumers, but they were largely confined to health food stores. It seemed that with the advent of computers and molecular biology, scientific medicine in Western industrialized societies was about to enter a new Golden Age. Many American health care providers were therefore rather startled when surveys published in 1990 and 1997, by Eisenberg and his colleagues, reported that 42.1 percent of all American adults had used at least one form of alternative therapy in 1997, up from 30 percent in 1990, and that four out of ten Americans had used alternative medicine therapies in 1997, including herbs, megavitamins, massage, self-help groups, and homeopathy.6,7 Most astonishing was the revelation that the total number of visits to alternative medicine practitioners exceeded visits to all U.S. primary care physicians. Additional surveys, such as that conducted by Prevention magazine in 1997, indicated that 32 percent of U.S. adults were using herbal remedies.8

The explosion of interest in herbs and other areas of Complementary and Alternative Medicine (CAM) continues unabated. Many practitioners of conventional medicine have become more familiar with CAM therapies or are trying to learn more about them: a 1997 issue of Nature Medicine reported that 80 percent of contemporary U.S. medical students now want more training in CAM.9 There is a burgeoning herbal market, and more than 300 companies now market herbal remedies, including such pharmaceutical giants as American Home Products (AHP) and Bayer Corporation.10 Herbal preparations are being sold not only in health food stores but in supermarkets, in pharmacies, and on the Internet.

The Web sites and resources in this chapter include online catalogs for prominent libraries with important herbal book and periodical collections as well as bibliographic databases focusing on the history of medicine. Also included are Web sites providing the full text of classic herbal monographs that are still regularly referred to by traditional herbalists. Many classic herbals are a rich source of information that cannot be readily found elsewhere.

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