Western Herbal Medicine

Herbal medicine is a broad term that includes all forms of plant-based therapy.

According to the Merriam-Webster dictionary, there are two formal meanings to the noun herb.

In the strictest sense (i.e. as utilised in botany), it refers to a specific category of plants: seed-producing plants that do not develop persistent woody tissue, but rather die off at the end of the growing season. Many of the traditional medicinal plants are small, soft, and weedy; dandelion, yarrow, peppermint, and gotu kola come to mind.

But not all medicinal plants are botanically herbs! Herb has come to also indicate, in a broader sense, a plant or the specific part of a plant (i.e. the bark, root, flower, fruit etc) valued for medicinal, flavouring or aromatic qualities. When we refer to herbal medicine, we mean utilising any type of plants for their medicinal qualities specifically.

Further, it is worth mentioning for the literalists, that this definition is not strictly limited to plants as we understand them now. Before modern science, human beings did not clearly delineate between plants and fungi. These were classed together as vegetative (living, non-mobile), in contrast to animals (living, mobile) or minerals (non-living, non-mobile). Hence, while the term “herb”, in its most literal definition, refers exclusively to non-woody plants, in the context of herbal medicine we are talking about any medicinal part of a plant or fungus, or even algae (flower, seed, root, bark, mushroom, etc).

Botanical drawing of traditional medicinal herbs

Botanical drawing of traditional medicinal herbs

Ginseng Root

Krakow Museum Pharmacy

Differing systems of herbal medicine have arisen around the world. They are necessarily defined by the geographic region within which they developed (herbs available), in combination with the diseases that commonly afflicted the people of said region (medicine needed). The methods of application may also be influenced by the cultural understanding of health and disease in each system. As such, while all herbal medicine systems might be capable of treating the same disease, they may all approach it with a different solution. Examples of some of the most well-known systems include traditional Chinese medicine (TCM) and Ayurvedic medicine (Indian traditional medicine).

The term Western indicates a herbal medicine practice that is based in European tradition but is ever-expanding. As modern scientific research validates traditional practices from around the world, WHM incorporates this wisdom and adapts its approach to health accordingly. This makes WHM arguably the most progressive and option-laden method to modern natural health.

As a practitioner of WHM, I acknowledge and am guided in my approach to practice by the following fundamental tenets of natural medicine:

1. Vis medicatrix naturae

Literally, “the healing power of nature”, vis medicatrix naturae is the primary tenet of any approach to natural health, so rightfully guides the philosophy behind my practice. It has its roots with Hippocrates, who first developed the idea of medicine as a distinct profession, developing the first school to train the first dedicated physicians, in Classical Greece (circa 400 BCE). Hippocrates is famous today for laying down the foundations of medical understanding, revered by those who followed in his footsteps, including another master herbalist from Greece, Dioscorides, who wrote De Materia Medica, a foundational herbal pharmacopoeia for WHM.

This fundamental concept of health keeps us reverent to nature’s power, and both hopeful and humble in our approach as physicians or healers. It reminds us that our understanding of health and disease remains yet immature (even though we have come far from Hippocrates’ blood-letting legacy). Even today, the best medicinal intentions, when based on an incomplete understanding of the disease process, might only interfere with the body’s innate capacity to restore its own balance (homeostasis).

A simple example is seen whenever a mild temperature is interpreted as a threat in an otherwise healthy person, and the physician seeks only to reduce the fever. Such good intentions to improve the comfort of the diseased person may only serve to prolong the infection. The heat is generated as part of a healthy immune response to make the body less inhabitable to infectious agents. In this example, we do well to monitor the fever progression (only interfering if it reaches a dangerous level) and support the body during this process. This translates as encouraging the avoidance of exertion, the consumption of easily digestible but nutrient-rich meals, and good quality sleep, so that the body has what it needs to resolve the situation. Herbs with diaphoretic or pyretic activity are commonly employed to modulate fever temperature only if required. Recognising the healing power of nature is respecting the innate capacity for natural systems to return to homeostasis if given the appropriate opportunity.

hippocrates engraving 1584 CC BY 4.0 Wel

Hippocrates (b. 460 BCE)

Dioscorides's 1st century De materia med

An Arabic copy of De Materia Medica

Dioscorides (b.40 CE)

2. Tolle causam

Tolle causam is a direction that follows naturally on from the primary philosophy outlined above. It instructs the practitioner to remove or abolish the cause of disease in order to support vis medicatrix naturae. Of course, many symptoms can and should be relieved as part of supporting a healing journey, but tolle causam indicates that the body cannot initiate its true return to health if we do not identify and remove the cause.

3. Primum non nocere

From the Latin primum non nocere, we get the very obvious-seeming directive of “first do no harm”. Some consider it to be the first tenet, however we must first cultivate a philosophical approach that informs our health goals. Primum non nocere is the final directive that guides the physician’s approach before taking physical action. It implores us to find medicines without side effects; we are committed to always seek to reduce the overall disease burden, and never to add to it with our treatments.

Platearius, Matthaeus CC BY 4.0 Wellcome Library, London

4. Docere

Docere means “to teach” and refers to the passing on of knowledge as the first medicine offered by the physician. This is a particularly wild concept in the face of the paradigm of Western allopathic medicine currently. The idea is that health is largely the responsibility of the individual to preserve. The physician is charged with educating patients and empowering them with the best understanding of what is causing their disease and how they can support their body’s healing processes.

5. Tolle totum

Tolle totum is the holistic hallmark of a successful herbalist. It teaches that the application of medicine must align with consideration the whole being, and not simply the disease. The human body is extremely complex, in ways that elude our comprehension even today. Not all people with the same disease develop the same symptoms or comorbidities, and neither do they all thrive on the same medicines!

As such, I consider the broader picture of a patient’s health and individual needs when considering prescriptions. The art of being a good herbalist lies in being able to discern between a selection of indicated herbs and choose only those with the best affinity for the individual. Along with assessing the broader physical state, we also observe how the mental, emotional and spiritual bodies intersect to help inform this personalised treatment style.

6. Praevenire

Finally, it is part of my best practice as a herbalist to be aware of risk factors and disease trajectories, and predict increased susceptibility to disease. More than primum non nocere, this principle of prevention is about actively attempting to reduce future harm from developing. The ideal success means avoiding the need to intervene again!

Lee, Lecturing in Northern CA

Aesclepius, Greek god of medicine with the symbolic snake-entwined rod of healing associated with him.

I hold a firm belief that, in nature, all living things are connected and medicinal plants have a natural affinity for the human physiology, which can support the body’s return to balance/health. Beyond the nutrients (the essential components we ingest for energy, as cellular building materials, and for other essential processes) there is a vast world of chemicals that plants provide to our bodies (phytochemicals). Many of these interact directly with the body. Those plants that amplify the body’s healing via this communication are herbal medicines.

For example, mushrooms have compounds in them that talk directly to our immune system, and the message they deliver is to take care of internal and external defences. This may mean the body will increase specific white blood cell numbers or make them more vigilant in response to threats.

My experience is in having a broad understanding of human health and of the common human disease processes, and of how a herbal medicine can help bring about positive change in these.

While not all herbalists are, my practice is integrative in approach, because all forms of medicine have value and should be integrated appropriately for the best possible outcome for the patient. I maintain that, as part of minimising harm, the safest options should be explored so that unnecessary risk is always avoided.