From: camilla@primenet.com (Camilla Cracchiolo)
Newsgroups: alt.folklore.herbs
Date: 11 Jan 1995 04:03:35 GMT

              CAUTIONS ABOUT HERBAL MEDICINE:

There is nothing about herbs that automatically makes them
non-toxic just because they are natural.  Ever hear of
deadly nightshade or poisonous mushrooms?  They are drugs,
like other drugs, and should be approached with the same caution.

This means, for example, that pregnant women should be as
careful about medicinal herbs as they are about conventional
medicines.  Some medicinal herbs are clearly linked to birth
defects. People on certain medications, like anti-coagulants or
psychiatric drugs, can have serious problems from interactions
between the herb and the medicine they're taking. In the US, herb
labels do not list information about side effects, dangers and
contraindications on the label (which I think they should).  Many
physicians are not well informed about herbs, and so you cannot
always rely on your doctor to know about potential problems. And
if you have or suspect you have a serious illness, it is very
important to be under a doctor's care.  Self diagnosis is not always
accurate and self treatment doesn't always work.

I believe it is vital for any person who wishes to try herbs to
be very well read before attempting them. I strongly recommend _The
Honest Herbal_ by Varro Tyler to anyone who is considering or using
herbal medicines.  It is the one herb book that I have ever found that
relies solely on scientific studies instead of anecdotes *and* which
provides references.  Tyler himself has impressive credentials, being a
tenured professor of pharmacognosy (the branch of pharmacy that deals
with herbal medicine) in the school of pharmacy at Purdue University.
The ISBN # is 1-56024-287-6 and it is published by the Haworth Press, 10
Alice Street, Binghamton NY 13904-1580.  It is in print, costs about $20
and I got mine through a regular bookstore which special ordered it for me.

I personally regard herbal medicine as useful primarily in two
situations:

1) when a basically healthy person uses an herbal compound
for a short, self limiting condition such as a cold or the
flu, where over the counter remedies would normally be
appropriate.

and

2) in the case of serious illness, where no effective standard
treatment exists and where there is some evidence from the
scientific literature that a particular herbal compound may help.
An example of this would be the use of silymarin (an extract from
milk thistle) in the treatment of chronic viral hepatitis.  In this
kind of situation, I regard it as extremely important that the
person be under the close supervision of a physician well versed
in the disease in question and who has reviewed the available studies
on the herb to be used.

Herbal medicine has some very big problems.  The most important is
probably that herbs often have not been subjected to thorough
testing.  Even when an herb has many studies published about it,
almost always the studies are on animals; human studies are quite
unusual.  Studies to determine whether the compound can cause birth
defects are vanishingly rare, as are studies to determine whether
the compound can cause cancer.  Relying on traditional folklore is
not much help; very obvious or dramatic adverse effects may be
caught this way, but it doesn't tell us much about either long
term effects or problems caused in only a small percentage of people.

Another major problem is that the amount of pharmacologically
active ingredient available varies widely from plant to plant, so
accurately regulating dosage is difficult. The pharmacologically active
ingredient may also occur in conjuction with other toxic compounds.
Examples of toxic agents often found in herbs include pyrrolizadine
alkaloids (very toxic to the liver and cause both benign and malignant
liver tumors); coumarins (which decrease the ability of the
blood to clot); and allergens.  The latter can be quite important
to people who are allergic to ragweed; some herbs  in the
ragweed family (chamomile and yarrow are examples) can cause
severe allergic reactions in these folks.)  Most companies do
not list the source of their herbs or how they were grown.  Pesticide
contamination is a possibility and heavy metal contamination of some
herbs has been reported in the scientific literature.

Because of the problems mentioned above, I believe it is often better
to rely on an extracted and standardized compound (conventional drugs)
when possible.  However, some of the active ingredients of herbs cannot
be found in this form.

Yet another problem is with herb labelling.  Very few herbal
medicines marketed in the US have both the Latin name of the
herb and an expiration date marked on the bottle.  Often,
this is deliberate: fraud is rampant among companies marketing
herbs.  One brand that does have good labelling is Nature's Way.
Alternatively, if you live in a city with a large Chinese, Japanese
or Korean population, you can try the herb sellers in that
district.  I've personally found the herb sellers in Chinatown
here in L.A. to be very honest and knowledgable (although language
is often a problem, alas.  Gotta learn to speak Chinese one of
these days.)  :)

If you decide, after your research, to try herbal medicines,
you may wish to consult a trained herbalist.  Unfortunately, in
the US anyone can hang out a shingle and call themselves an
herbalist. Lots of these people have no idea what they're doing.
I have found practitioners of traditional Chinese medicine to be
the best trained.  I don't accept the model that traditional Chinese
practitioners use to explain the effects of herbs (yin/yang,
hot/cold, damp/dry, etc.).  I also have problems with the
amount of unsupported anecdotal info mixed in with scientific
studies. But traditional Chinese doctors treat herbs with a lot of
respect and caution.  They are well up on the side effects
and counterindications.

And finally, very few herb books contain dosage information.
I have *a lot* of problems with Michael Tierra's herb books.  I
don't accept the medical models he endorses (traditional Chinese
medicine and Ayurveda).  I also don't like the fact that Tierra
doesn't distinguish between scientifically validated information
and folklore.  But Tierra's books are among the very few herbal
medicine books that discuss dosage.  Just making up a weak tea
is usually not enough to get a pharmacologically effective dose.
Tierra is the author of _The Way Of Herbs_ and _Planetary Herbology_.

Warning: Tierra's books should be used as supplemental sources
only and never as your primary source of information on herbs.  I
have spotted several places where he has left out important information
on toxicity.

Other references which may be of value:

A book which I have been told contains scientific references,
but which I have not read myself, is the _Encyclopedia of Natural
Medicine_ by Michael Murray and Joseph Pizzorno.  It's available
from Prima Publishing, P.O. Box 1260MP, Rocklin, California 95677.
The phone # is (916) 786-0426 and the price is $18.95.

A couple of other recommendations were sent to me by Jay Mann in New
Zealand:

"CRC Handbook of Medicinal Herbs",written by James A Duke, published 1985.
Dr Duke was Chief of Medicinal Plant Resources Lab, USDA for 25 years.  The
book covers 365 medicinal plants, one for every day of the year. The "CRC"
label on the cover ensures that the book will be thorough and exceedingly
expensive to buy.  There are nearly 700 largesize pages.

A nice feature is having a sketch of each plant.  At the back is a 7-page
summary of each herb, toxicity score, scientific and common names, and
estimated market price.  The toxicity scores are given in triplets: Duke's
own, Rose's, and Tyler's, (I don't know Rose's.)  He admits that his
scoring is ad hoc, all based on comparison with a cup of coffee!  3=safer
than coffee and wouldn't hesitate to drink 3 cups a day.  (He wouldn't
drink anything more than 3x /day.)  2=same as coffee, 2 cups.  1=more
dangerous, would accept 1 cup a day containing 10 g of steeped herb.
0=very dangerous, wouldn't drink anything.   He considers himself less
conservative than Tyler, more conservative than Rose.  The book, b the way,
also has proper scientific citations."

According to Jay, this book is quite expensive, but may be available
in some university libraries.

and

"Herbal Remedies: Harmful and beneficial effects", by S Talalaj
& A S Czechowicz.   Publisher is
             Hill of Content Publishing Pty Ltd
             86 Bourke Street
             Melbourne 3000
             AUSTRALIA

I don't have a fax number for them, nor a price, but from memory it cost
only something like $A20 in paperback form.  They were happy to accept a
VISA-card number.