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Herbal medicine
Herbal medicine must be treated differently from CAM
From Professor P. J. Houghton, FRPharmS
I applaud the eirenic attitude of the Broad
spectrum piece by Chris
Brewer (PJ, 5 August, p158) in arguing for complementary and alternative
medicine-bashing to be less polemical.
It is easy for scientists to be as arrogant and dogmatic as anyone and
refuse to think outside the box. We should always bear in mind the quotation
from Hamlet: “There are more things in heaven and earth, Horatio,
than are dreamt of in your philosophy.” Indeed, it could be argued
that true scientific advance stems from keeping such an open mind and
the ease with which minds can become closed is exemplified in the struggle
to gain acceptance in scientific medicine for theories such as the link
between Helicobacter pylori infection and stomach ulcers.
I take some issue with Mr Brewer’s use of the term “alternative” rather
than “complementary”. The latter is more commonly used these
days. As a scientist, I would, however, stress that some forms of CAM
can be explained to a large extent by what is already accepted scientifically,
whereas others defy our presently accepted pharmacological theories.
I would particularly make the case that herbal products and medicine,
at their best, are at one end of a continuum with “orthodox” medicines.
The continued presence of senna tablets in the British National Formulary
would, otherwise, not make sense. The paucity of knowledge about and
complexity in ingredients and, therefore, pharmacology of herbal products
makes it difficult to interpret or predict what is happening, or likely
to happen. However, that surely also applies in many patients receiving
conventional medicines where several different drugs are taken every
day.
Interesting and exciting advances have been made over the past 20 years
in the analysis, interactions and synergy, mode of biochemical action
and evidence of scientifically acceptable clinical efficacy of many herbal
products and their constituents. Because of this I would make the case,
as is being recognised in recent EU regulatory schemes, that herbal medicine
should be viewed by the scientific community in a different way from
other forms of CAM.
Peter Houghton
Professor of Pharmacognosy
King’s College London
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