The History of Western Herbal Medicine
© Chanchal Cabrera MSc, MNIMH, AHG

Herbal medicine is the oldest form of healing known. Possibly massage is older because it is an instinctive response to rub ourselves when we hurt, but from archaeological and anthropological evidence it is certain that even our most primitive forbears made use of the abundance of plants around them to treat their many and varied ailments. Their intimate connection to the earth may have enabled these people to communicate in some way with the plants, through techniques such as deep contemplation, ritual and ceremony, and so to gain insight into their therapeutic uses. Native peoples today still claim that the plants talk to them. It is also likely that a certain amount was learned, or at least confirmed, by empirical evidence. The choice of plants in any given case would be influenced by the results of previous choices and this information would have been passed down from generation to generation. As populations grew and migrated to new lands so they experimented with newly discovered plants. If one was not helpful for a fever maybe it was tried against toothache instead, and if one was poisonous then they would know not to try it again.

In these 'primitive' societies the roles of shaman and healer were traditionally different. The shaman tended to be a male and was responsible for the spiritual health of the tribe or community. He intervened between mortals and deities and controlled the future well-being of the group. The healer, on the other hand, was often a woman, and she tended to the immediate, physical well being of the people. This role may have grown out that of the midwife and certainly utilized plants extensively with each indigenous group developing their own system of medicine based on the available plants.

It is not known exactly when the art of writing first developed but we do know that some of the earliest surviving texts are on plants. The Chinese herbal Pen Ts'ao of Shen Nung was written around 2800 BC and describes 366 medicinal plants. Much of Chinese medicine grew out of Ayurveda (Science of Life) from India and some people claim that some Indian texts on medicine are even older than the Pen Ts’ao.

By the time of the ancient Greeks, philosophy and medicine had reached a high level of sophistication. Many Gods were worshiped, none more so than those involved with health and healing.

Hygeia was revered as the goddess who watched over the health of the city of Athens. She was not involved in the treatment of disease but, rather, was the guardian of health and symbolized the belief that men would remain well so long a they adhered to a life of reason and balance. The metaphor for which she stands has evolved into the word 'hygiene' with its image of asepsis, antibacterials, and cleanliness. The worship of Hygeia was introduced to the ancient Romans in 239BC where she took the name Salus meaning health.

Asclepius was her father and the god of healing. He had the power to bestow healing on the weak and sick and was considered to be the first physician of the Greek tradition. He was credited with knowing the curative values of plants and his devotees promoted the belief that it was easier to rely on the powers of the healer than to attempt the more difficult task of living wisely. In Greek mythology Hygeia ended up serving Asclepius and being relegated to a lowly position.

Panacea was Hygeia's sister and was believed to have an omnipotent healing power that could only be accessed through divine intervention or extreme good luck.

Hygeia and Asclepius are symbolic of the modern dichotomy of medicine: health through lifestyle and attitude (preventative medicine) versus health through correction of disease (interventionist medicine).

In the ancient Greek traditions everything in the Universe comprised 4 elements fire, water, earth & air. It was thought that all the elements existed inside every living thing but in variable proportions which resulted in different characteristics being expressed. Two great forces, distinct and opposite, controlled and directed the elements: energy also called the life-force, spirit etc. which was thought to be a positive, non-material force that radiated outwards and matter which was thought to be a negative, material force that radiated inwards towards itself. The point at which the two opposing forces met was considered the beginning of life, with the combination of the two forces giving rise to the four elements.

Early healers whose names we still respect include several notable herbalists from Asia minor. Crataeus, the personal physician to Mithridates VI Eupator, King of Pontus, wrote a herbal in the first century BC in which he named Agrimonia eupatorium after the King. Dioscorides wrote his huge herbal (Peri hulas iatrikes - About Medicinal Trees) in the first century AD. It was later translated as De Materia Medica (The Medical Material) and remained a standard medical text for hundreds of years. Hippocrates lived from 468 - 377 BC and has been enshrined as 'the Father of Medicine'. He was of the Hygeian school and believed that health and disease were under the influence of natural laws and that the state of health or disease reflected the extent of the influence exerted by the environment. He wrote that we should 'let food be our medicine and medicine be our food' and he believed that health is a state of dynamic equilibrium among the various internal factors that govern the operations of the body and mind and which can be attained only when man lives in harmony with his external environment. Another famous quote from Hippocrates that our modern doctors would do well to remember is that "...it is more important to know what kind of person has a disease than to know what kind of disease a person has." Hippocrates promoted the idea of the four humors: blood, bile, phlegm and choler, each of which must be in balance and harmony with each of the other three in order for optimum health to be attained.

Of all the brilliant minds and insightful mysticism in the ancient times, the single most influential physician was probably Claudius Galen. He lived from 131 - 200 AD and studied medicine at the famous school in Alexandria. Starting as a physician to the gladiators, he rose to become personal physician to Marcus Aurelius. Galen believed strongly in the Humoral system of medicine and developed it further. He promoted the idea of a cross with each branch representing hot, cold, wet and dry respectively and with perfect balance (ie optimum health) being in the middle. He classified all diseases and all plants into these four categories and recommended the use of opposites to counterbalance. In this way, for example, psoriasis was classified as hot and dry and should therefore be treated with cool, wet herbs like plantain. His theories and dogmas were to become standard medical knowledge throughout Europe for several hundred years. In fact his writings were required reading in medical school up until just a few hundred years ago.

When the Romans invaded Celtic lands (Germany, France and especially Britain) they brought with them a sophisticated system of philosophy and medicine which ousted the well established and highly developed medicine of the Myddfai school. The druidic practitioners of traditional Celtic medicine were marginalized by the Romans but, although their influence waned, it continued to be practiced as a system of healing until only about 150 years ago.

When the Roman empire crumbled, a century after Galen died, it plunged Europe into the Dark Ages about which very little is known. Christianity had reached Ireland early on and was brought first to Scotland and thence on into the rest of Britain and Europe. The remaining druids were branded as witches and were actively discouraged. The Greek and Roman traditions of healing were kept alive by literate monks who were the only people trained to translate and transcribe Latin texts. Little new work was done at this time, merely the copying and recopying of older works. Thus we see the mistakes of one person repeating themselves in numerous later texts. The monks adhered to the Benedictine edict that it was the duty of the Church to care for the sick but they distinguished this from the pastoral duty of caring for the soul. Thus in their writing of herbals, monks removed much information that pertained to diseases of the spirit - possessions, demons and the like - because that was the domain of the Church and had no place in books on medicine. Thus they created a separation of the mind from the body, they took the soul out of healing.

For those who could not get to a monastery to be healed by the monks, there remained folk medicine as practiced by a village healer or sometimes a wandering healer mendicant. This was still influenced by the magical and mystical and there were many irrational beliefs about medicine. One which has survived to this day, and may not be without merit, is the doctrine of signatures. This suggests that a plant or a part of a plant will look like the disease it can treat. Thus, for example, Eyebright (Euphrasia spp.) with its white flower with a deep purple center, was believed to useful in treating eye complaints. Modern studies have confirmed this traditional use. Similarly Dandelion (Taraxacum off.) has a yellow flower that caused it is to ascribed properties of stimulating bile and urine. In modern trials it has been found to indeed be effective in these areas. Perhaps the most remarkable example of the doctrine of signatures lies in autumn crocus (Colichicum autumnale).This plant has a root which is twisted and gnarled like a foot afflicted with the gout for which it was traditionally used. Modern laboratory experiments have shown it to yield a chemical called colchicine which is presently recognized as being the drug of choice to treat gout.

While the Dark Ages continued in Europe, in the middle eastern and Arabian countries intellectual thought was reaching its zenith. Plundered Greek and Roman medical texts were stored for over two centuries in Baghdad before being translated into Arabic in the 9th. century AD. One of the greatest Arabian medical thinkers was Avicenna who lived from 980 - 1037 AD. Going on from where Galen left off, he codified the 'rationale of opposing forces' and solidified Galen’s theory of using opposite attributes of a plant to correct negative attributes of a disease. He also studied astrology extensively and wrote many treatises on the importance and relevance of astrology to medicine.

As Europe stepped out of the Dark Ages in the early 1400's and entered the age of the Renaissance so new ideas occurred in medicine. One of the most influential in the early Renaissance was Philippus Theophrastus Bombastus von Hohenheim or Paraselcus as he was more often known. The son of a poor but highly educated and literate physician, he was an early alchemist and was a great fan of tonic medicines to strengthen the patient. He refuted the ancient theories of Dioscorides, Galen and Hippocrates, publicly burning their books in the town square of Basel, and promoted the objective and empirical model of medicine. Paraselcus is often considered to be the originator of modern allopathic medicine.

Alchemy may have started with the search for the Philosophers stone which could transform base substances into gold, but in the search, many new chemicals were discovered and inevitably these were investigated for their potentially medicinal properties. Such things as lead, arsenic, vitriol and mercury were originally given to prisoners and patients in the asylums, those who were unable to say no, and the results observed. Of course there were many deaths but occasionally a positive effect would be noted and this served to encourage the alchemists in their investigations.

At this time syphilis was the scourge of Europe. It was not understood at all because it occurs in three distinct phases, the last one possibly 30 years after the initial sores, which made it almost impossible to track and monitor. Alchemical doctors considered that mercury would cure this dread disease if given in sufficiently high doses to cause the salivation of 5 buckets of fluid daily. This type of medicine has been called heroic medicine because it took a brave doctor to administer it and a very brave (or very desperate) patient to undergo such treatment. Over time, sufficient cures were effected to encourage the doctors who eventually came to be known as 'quacksilvers' from the old name 'quicksilver' for mercury. This is actually the origin of the word 'quack' which is used today much as it was then to denote a person experimenting with unproven therapies.

The early 'doctors' were still heavily influenced by the ancient Galenical theories and from this they developed an elegant model of disease. In it the four cardinal humors (hot, cold, wet and dry) were considered to act as energetic influences upon the four elements (fire, earth, water and air). The energetic and humoral influences within a body acted to produce the humors (yellow bile, black bile, blood and phlegm) and the temprements (choleric, melancholic, sanguine and phlegmatic).

The Air Element

This governs the humor called blood. It is of a sanguine (full-blooded) temprement. It is fine, light, hot and moist. It refines and purifies. It is associated with movement, speed and clarity. The air of the body is the seat of the soul.

The Earth Element

This governs the humor called black bile. It is of a melancholic temprement. It is rigid, firm, heavy, dry, cold, stationary and unyielding. It gives the body structure and form.

The Water Element

This governs the humor called phlegm. It is of a dull, phlegmatic temprement. It is liquid, heavy, wet, cold, has no fixed, form, is mobile and easily displaced. It binds and protects the body.

The Fire Element

This governs the humor called yellow bile. It is of a choleric, hot-tempered temprement. It is light, hot and dry. It is penetrating and purifying. It stands above all the other elements and balances the cold elements.

The horizontal axis (water and ) earth represents the physical body, the flesh and bones, which may be either relaxed or astringed. The vertical axis represents the energy of the body, the life-force, which may be either stimulated or sedated. The exact individual temprement is determined by the balancing of all the elements and may change subtly over time. Thus with youthfulness there is a tendency to heat and moisture eg. the child has soft bones, is very active and is prone to fevers and head colds. With increasing age coldness and dryness enter the body leading to hardening of the body eg. of the arteries or bones. Men also tend to be hotter while women tend to be colder.

Before an element can express itself as a temprement is must first exist as a humor in the body. Thus the humors are the mechanisms by which the four elements are kept in balance and in the correct proportions to one another.

Any imbalance in the elements, humors or temprements is called an intemperance. A simple intemperance may be hotter, colder, drier or wetter ie. an excess of any one element. A compound intemperance may be drier and colder, colder and wetter, hotter and drier or wetter and hotter. Perfect health is considered to lie in the very center of the cross and all healing measures were designed to bring the body back to this central mid-point.

In the reign of Henry VIII there was much dispute among the practitioners of the modern alchemical systems of healing and between them and the traditional botanical therapists. Eventually a Charter of Rights for Herbalists was proclaimed law and served to temporarily silence the critics of simple herbal medicine. It stated that "....it shall be lawful to every person being the King's subject, having knowledge and experience of the nature of Herbs, Roots and Waters, or of the operation of same, by speculation of practice within any part.... of the King's Dominions, to practice, use and minister in and to any outward sore, uncome, wound, apostumations, outward swelling or disease, according to their cunning, experience and knowledge in any of the diseases, sores and maladies before-said, and all other like to the same, or drinks for the Stone and Strangury, or Agues, without suit, vexation, trouble, penalty, or loss of their goods".

Encouraged by this protection in the eyes of the Law, herbal medicine flourished in England, alongside the developing alchemical systems. In 1597 John Gerard, an English Master-surgeon published his vast herbal, one of the first to contain any original material since Galen. He described over 3500 plants, many of them new arrivals from far away lands that the English explorers were just beginning to ‘discover’.

Nicholas Culpeper in the early 1600's was another enormously influential English herbalist. Trained at Cambridge and fluent in Latin, he harbored aspirations of being a doctor which were thwarted by his lack of social standing. A love affair with a woman of noble birth, far above his class, led to an elopement. The couple arranged to meet in Brighton, then several days ride from London where they both lived. He went on ahead to secure rooms and she was to follow him. On her way there, her carriage was struck by lightening and she was killed. After this disaster Culpeper decided to throw caution to the wind and start his own medical practice. First he trained as an apothecary so that he would "... really know and understand the medicines" and then he started seeing clients and writing. Initially he translated the London Pharmacopoeia from Latin into English which made such information available for the first time to many more people than classically trained scholars. He also edited greatly, most particularly in that he decried the standard practice of vastly complex and unrealistically expensive medicaments, preferring instead locally grown plants and simple formulations that were affordable and easily made. In 1652 Culpeper published his famous Herbal which he titled 'The English Physician or an Astrologo-physical Discourse of the Vulgar Herbs of this Nation, Being a Compleat Method of Physick Whereby a Man may Preserve his Body in Health, or Cure himself being Sick, for threepence charge, with such Things as onlie Grow in England, they being Most Fit for English Bodies' He associated each plant and each disease with a planet and ascribed astrological principles to healing. He also wrote from a wealth of practical knowledge and he wrote in a way which was clearly understood and easily followed. This made his books very successful and his herbal has gone through over 40 editions to date and is still a steady seller.

A hundred years after Culpeper, an English physician of the chemical school made a remarkable discovery. Dr. William Withering was a doctor and botanist who was the first to isolate an active constituent from a plant. A study into the beneficial effects of foxglove (Digitalis purpurea) on dropsy (cardiac oedema) led to the isolation of the 'cardio-active glycosides' which he found to contain "the potent active force". In time this came to be seen as so potent that only licensed practitioners were permitted to use it and foxglove thus became the first herb to be lost to the herbalists.

While the alchemists in Europe were experimenting with their cure or kill methodologies, on the other side of the Atlantic the picture was quite different. The early pioneers were unable to bring with them rare chemicals or fragile glass equipment. Instead they brought plant seeds and simple folk remedies. Initially the white settlers were distrustful of the natives and refused to learn from them. But slowly it was realized that the people of the land knew a great deal about the endemic diseases and the medicinal plants. little by little knowledge was gleaned and much of it is still prevalent in modern herbal medicine. Thus we learned of Echinacea, Goldenseal, Yellow Root and Wild Yam, among many others, from the native Americans. One person was particularly influential in accumulating and spreading this knowledge and this was Samuel Thomson.

He lived from 1769 - 1843 and was probably the most influential herbalist of his time. As a sickly child he received herbal treatments that were effective when the physic had failed. His healer was an old woman who had learned from the Natives. When Thomson’s own child was sick and was pronounced doomed by the doctors, Thomson, almost instinctively, decided to give her steam baths and she quickly recovered. Thomson never formally trained as a doctor but his practice grew as his success grew. He administered powerful emetics such as lobelia (Lobelia inflata), cathartics such like buckthorn (Rhamnus purshiana), stimulants such as cayenne (Capsicum minimum), as well as steam baths and cold showers. His treatments were unpleasant but often successful. He believed that all disease was a "derangement of the vital fluids" and a decrease in "animal warmth" of the affected part. This allowed the growth of what he called "canker" which clogged up the channels of elimination and caused congestion and stagnation in the body. His approach was to warm and stimulate the body and to open all the channels of elimination so that morbid materials could be removed.

Thomson’s fame as a healer became widespread and he began traveling from town to town in New England. He earned the wrath of the medical officials of his day and was vilified in the press as well as being taken to court on trumped up charges. He persisted never the less and in 1813 he took out a patent on his "Improved System of Botanic Practice of Medicine". He then set up what was possibly the first ever multi-level marketing program. He appointed agents in each town who made commissions selling memberships in the Friendly Botanic Society. The members received educational materials and seminars and were entitled to buy medicines from the agents who in turn bought them from Thomson. Some of the agents were also practitioners, working with the Thomsonian methods. By 1939 there were over 3,000,000 members and Thomson was a wealthy man.

However, Thomson’s downfall lay in his arrogance. He refused to have anything to do with the modern science of medicine, disdaining even the study of anatomy and physiology and believing that his system was complete unto itself. He likewise refused to allow his adherents to have anything to do with medicine and it soon alienated some of them who formed various breakaway groups. Thomson died a bitter man, alienated from those he had once held dear.

One of his early students who later became a medical doctor was Wooster Beach. He opened the United States Infirmary in New York in 1827 and this was followed by the Reformed Medical College in 1829. He practiced a skillful blend of the old and the new, using modern science to understand the body and herbs to treat the diseases he diagnosed. He called his discipline "Eclectic" and was the first of many wonderful pioneering herbal doctors in America.

John Scudder, John King, Finley Ellingwood, Harvey Wickes Felter, and perhaps especially John Uri Lloyd all helped to make Eclectic medicine popular throughout the latter part of the 1800s and even into the twentieth century. John Uri Lloyd was a brilliant chemist who, together with his brothers, devised new and improved methods of extraction for herbal products and who founded a herbal products company in Cincinnati. When the brothers died they endowed a library in their name which now houses one of the world’s largest collections of books on herbs.

The ‘regular’ doctors as the medical practitioners were then called were appalled at the success and popularity of the ‘irregulars’ or herbal healers, most especially the Thomsonians. In 1847 the American Medical Association was founded and it served as a focal point for the concerted effort to wipe out natural remedies in favor of the new drug remedies that were increasingly available. One way to do this was issue licences to practice medicine based upon achieving certain standards of competence. At the turn of the century the AMA initiated a study of the medical education establishments then available, including the herbal and eclectic schools. Their requirements for approval included laboratories and texts that were not used or needed by the herbalists. When the AMA ran out of funding, the Carnegie Foundation stepped in and appointed Abraham Flexner to complete the study. The Flexner Report was released in 1910 and it was devastating to the herbal and eclectic community. Within the next 4 years 29 schools closed down because they were not approved by the AMA, even though no-one in the AMA was actually qualified to properly assess the medicine they were teaching. Herbal and Eclectic medicine in the USA virtually died out for the next 60 years, preserved only in folk tradition and by Natives.