Herbal medicine has a long history of use in many cultures throughout the world for prevention and treatment of disease. From Traditional Chinese Medicine and Indian Ayurveda, to Traditional European Medicine and Unani, herbs and spices have been utilized as a medical resource for centuries. The World Health Organization defines traditional medicine as ‘’the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness.’’¹

In ancient Mesopotamia, the birthplace of modern civilization, asu physicians applied dressings with medicinal herbs to treat wounds and open sores.² As far back as the 3000 BC, the Sumerians utilized all plant parts: branches, roots, seeds, bark, and sap in preparation of herbal medicine. Current traditional medicine approaches vary based on the geographic area where they are practiced, but have a few things in common: a focus on the connection between the mind, body and the environment, and an emphasis on preserving one’s health instead of treating disease.³

The use of herbs and spices is an integral part of all forms of traditional medicine. The World Health Organization estimates that 3.5 billion people worldwide (approximately 65% of the total population) use medicinal plants for their basic healthcare needs.⁴ There are multiple reasons why patients turn to herbal and traditional medicine for solutions:  affordability, poor access to modern medicine, dissatisfaction with the results of mainstream medical treatment or its adverse effects, and the belief that herbal medicine is natural. In addition, the patients appreciate the extra time allocated by a traditional medicine practitioner, as well as a holistic approach to treatment.

While herbal medicine dominates in underdeveloped and developing countries of Africa, Asia and in India, a growing interest in natural therapies and ethnobotanicals has also been observed in industrialized countries. According to a CDC report published in 2007, about 38% of adults and 12% of children in the United States used some form of traditional medicine.⁵ The same report indicates that, besides vitamins and minerals, herbal therapy and natural products were the most common alternative medicine treatments utilized. The results of the National Health Interview Survey conducted in 2012 confirmed again that, aside from vitamins and minerals, dietary supplements are the most common complementary health approach used by US adults (17.9%).⁶ The worldwide annual market for herbal medicine has been estimated at US$ 60 billion.⁷

Medicinal plants are important sources of modern-day lifesaving medications, and a converging point between traditional and mainstream medicine. Some examples of plant-derived drugs include the potent anticancer medications vincristine, isolated from the periwinkle flower tree (Catharanthus roseus), and taxol, extracted from the bark of the Pacific yew tree (Taxus brevifolia). Another good example is digoxin, isolated from foxglove (Digitalis sp.) and used in the treatment of congestive heart failure and atrial fibrillation.

Unfortunately, the search for effective natural drug candidates is laborious, costly, time-consuming, and often not very efficient. Similar to the development of synthetic drugs, the development of plant-derived medicines is a step-by-step process that includes elucidating the mechanism of action of the active principle, efficacy and safety testing, and quality control of the final formulation. Often, active principles are derived from rare or slow-growing plants, which imposes limits on the quantities of available material and impedes the drug development process.

Herbal medicine will continue to play an important role in both developing and industrialized countries, owing in part to increasing patient demand for natural treatments. In ancient times, therapists had to rely on trial and error approaches and were often guided by spiritual beliefs in identifying effective treatments. With modern-day tools, objective scientific criteria, and advanced research practices, scientists and medical practitioners will continue to play an instrumental role in the development of plant-derived drugs for the benefit of future generations.

References

1. World Health Organization. http://www.who.int/topics/traditional_medicine/en/
2. Teall EK. Medicine and Doctoring in Ancient Mesopotamia. Grand Valley Journal of History. 2013; 3(1): 1-8.
3. Wachtel-Galor, Benzie FF. Chapter 1: Herbal Medicine: An Introduction to Its History, Usage, Regulation, Current Trends, and Research Needs. In: Benzie IFF, Wachtel-Galor S, eds. Herbal Medicine Biomolecular and Clinical Aspects. 2nd ed. Boca Raton, FL: CRC Press; 2011:1-10.
4. World Health Organization, 2007. WHO guidelines for assessing quality of herbal medicines with reference to contaminants and residues. WHO Press, Geneva, Switzerland.
5. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. National health statistics reports; no 12. Hyattsville, MD: National Center for Health Statistics. 2008.
6. Peregoy, JA, Clarke, TA, Jones, LI, et al. Regional Variation in Use of Complementary Health Approaches by U.S. Adults. NCHS Data Brief no. 146. Atlanta, GA: Centers for Disease Control and Prevention, 2014.
7. Tilburt, JC, Kaptchuk TJ. Herbal medicine research and global health: An ethical analysis. Bull World Health Organ. 2008; 86(8):594–9.

Jasenka Piljac Zegarac is a scientist and freelance writer. She holds a PhD in biology and a BS degree in biochemistry, and contributes on a regular basis to several health and science blogs. Her scientific publications have gathered more than 1100 citations. She may be contacted for assistance with a variety of science and medical writing projects.