The problem with herbal remedies, part 2

Yesterday we pointed out that herbal remedies do not make a proper substitute for real medicine. Some plants do have an effect on the body, but their active compounds were long ago isolated in a laboratory and standardised, and we no longer call them “herbal medicine” – because they work, they are called medicine.

It’s not that most herbal remedy pills have never been tested in laboratories, however – it’s that they have been tested, and proven not to work. A landmark ten-year study by the U.S. National Centre for Complementary and Alternative Medicine tested a wide variety of common herbal cures and found that none of them performed any better than sugar-pill placebos at alleviating the conditions they were supposed to cure. Specifically:

• Gingko had no effect on memory.
• Saw palmetto did nothing for prostate problems. 
• Shark cartilage was useless against cancer.
• Black cohosh was useless for menopausal hot flashes. Echinacea, at least in their experiments, did not help with colds. 

Alternative medicine is an industry, just like the mainstream pharmaceutical industry, run by executives in suits, making pills in mechanised factories. Their packaging might have pictures of sunbeams and rainforests, but they were made by corporations just like conventional remedies; the only difference is that the alternative medicine market, in many countries, doesn’t have to follow as many rules about what’s in their products.

This is one of the most important things to take away: Most herbal pills don’t necessarily contain any of the substance they advertise on the package. A 2005 study published in the American Journal of Medicine, to use one example, found “high content variability” in herbal pills sold, with most companies not even testing how much gingko, say, is in the gingko pills. A 2003 study published in the Archives of Internal Medicine found that only half the Echinacea pills purchased contained the amount they were supposed to, and 10 per cent contained no Echinacea whatsoever.

In addition, remember that “holistic” medicines don’t just come from Chinese monks or Amazonian Indians; “holistic” refers to the idea that the body has essential elements that need to be kept in balance, like yin and yang in Chinese medicine or chakras in India. Western tradition has the four humours, used from Polybus in the fifth century BC to the beginning of the 19th century AD, and which we still invoke when we refer to someone as melancholy or sanguine. Western writers came up with some creative cures using this method – when 11th-century Arabic physician Ibn Butlan saw a patient who felt cold and clammy, for example, he recommended eating a rooster, an animal that was hot and dry. It might sound ridiculous, but all other holistic medicines work on the same principle.

Holistic theory was used because no one really understood how the body worked. Why did humours continue to be invoked for 2,400 years if their recommendations were so ridiculous -- she-goat urine poured into the ears for a stiff neck, to use an example from Pliny the Elder? Perhaps for the same reason many modern alternative medicines appear to work; people use them to treat problems like a cold or injury that eventually get better on their own anyway, leading the patient to think that the prescribed remedy was responsible. In cases where a patient gets measurably worse, perhaps, a certain anthropic principle comes into play; those patients who die aren’t around to complain that the cures didn’t work. Or – again, like modern alternative therapies – they treated symptoms that are particularly hard to measure, like “fatigue.”

If someone were to open a storefront today selling she-goat urine or literal snake oil, though, they would get few customers and might be shut down by the authorities. Nor, if your appendix bursts in China, will surgeons give you such treatments – they have modern medicine and pharmaceuticals, and use them. Why, then, do these now-disproven folk cures thrive in countries far removed from their origin?

I suspect that the reason has little to do with the remedies themselves, and everything to do with the Sixties counterculture, which criticised anything mainstream, modern, or Western, and suspended such scepticism when it came to Native Americans, Chinese, Africans or any other culture too far removed in time and space for most Westerners to consult.

Then, since we live in a society that a.) takes pills to solve problems and b.) markets new products to the public, an industry arose to take advantage of this new consumer demographic, one that replaced factory-made pharmaceuticals willing to buy factory-made placebos advertised with words like “natural,” holistic” or “essence.”

None of this, of course, means that local plants and herbal treatments have no value in keeping yourself healthy; quite the contrary, they are the first and last line of defence. They have value as the first and best way of staying healthy – say, getting enough vitamins to stave off illness – and we could consider that medicine, although most people prefer to consider it “food.” They are also your last resort if no medical help is available, and knowing plants that can be used as emergency medicine could save someone’s life.

What will not save lives, however, are pills that contain little or none of the substance they claim to have, substances that wouldn’t work even if they were present. The only difference such pills will make is to cheat money out of people who are already sick and struggling.

Photo: Dried shark fins used in Asian folk medicine.

The problem with herbal remedies - part 1

A few decades ago “alternative” medicines mainly came from fringe outlets that catered to the then-marginal counterculture. Today every health food store, pharmacist and supermarket sells a range of “natural” pills, juices, salves, teas and powders that promise to cure your cold, detoxify your body, sleep soundly, stave off illness, brighten your mood, remember your anniversary and return to the size you were when you were a teenager. In short, our poor health, dissatisfaction and desire to return to nature has created whole new fields of enthusiastic capitalism.
It’s not difficult to see the reason; we’re getting sicker across the industrialised world, as illnesses like heart disease, cancer, strokes and diabetes have created ever-greater medical costs. Many things cause this: We live sedentary lives, eat too much unhealthy food, work longer and more stressful hours. People also live longer, so they spend more time in an age when people get sick a lot. Even those Westerners who can afford treatment don’t always get it; the number of parents who refuse to give their children vaccinations, for example, increased by 77 per cent from 2003 to 2008.

Part of this might be because modern medicine has done its job so well, wiping out almost all major diseases in a mere century; if you’ve never heard of anyone getting polio, tuberculosis or measles, you might not be motivated to protect yourself against them. We have quickly forgotten what it was like many generations ago, when most children did not survive into adulthood and everyone knew someone who died or were crippled by these diseases. Part of it, however, might stem from an increasing scepticism of a medical establishment that seems so distant and costs so much, the same sentiment that makes pharmaceutical companies a reliable villain in Hollywood movies.

Unsurprisingly, then, more people spend money on herbal remedies – and at first, that might seem a sensible alternative. After all, you might think, if we value a more traditional way of life, shouldn’t we be exploring more traditional cures, and rediscover how to heal ourselves with a field of wildflowers?

Let’s get a few things straight. Firstly, words like “alternative” or “natural” cover a lot of ground, and will encompass methods that work and those that don’t. All foods affect the body – they’re food, after all – and some have long-noticed effects beyond mere nutrition; dandelions, for example, are famous diuretics. Almost all humans in history knew a great deal about the plants all around them from the time they were children, and knew them as intimately as we do the sexual lives of celebrities. As much local knowledge as those practitioners of herbal medicine had, their patients still died, often at young ages, until science brought microscopes, sterilisation, clean water, trial and error and peer review into the medical world in the 19th century.

Secondly, most herbal medicines that actually work were isolated chemically long ago and sold in pure form – aspirin, for example, from willow bark. We still use them, but have stopped calling them herbal medicine; we call them medicine. In order to become medicine, however, they had to stand up to scientific tests, and that’s where most alternative therapies fall apart. If we are less likely to be able to afford conventional medicine in the future, we might want to know what plants work as a backup; for example, to boil willow bark to make a headache cure. This should be backup knowledge for an emergency, though, for sterilised and standardised amounts are surely preferable to unknown combinations and qualities.

Thirdly, companies have an interest in patenting and selling cures that work, and pharmaceutical companies must follow public law to prove their products work. If such companies could spare themselves the trouble of manufacturing antidepressants and just patent an herb instead, they would save themselves money. The herbal cures that work were patented long ago; if an herbal cure has never been patented to make a profit, it probably doesn’t work.

Tomorrow we’ll look at an even more important reason not to rely on herbal cures – most of them are not, in fact, the substance labelled on the package.

Photo: A jar of dried sea horse.

Away from it all

I was standing on the bank above my house, and Sean Seamais went by in his boat.

"Why are you hoisting sail for now, in God's name?" I asked.

"That's more than I can tell you," he called back, "Except I have the seven cares of the mountain on my shoulders, with no end of things to do, and I'm making a start on none of them."

"It is often before now that a man pitched away his last and his awls when he had too much to face," said I.

"I'm in the same case," Sean answered. "There are people gathering seaweed.* I need turf. I have sheep to dip. I need flour. I have a wall to repair. I have a shed to rebuild. I have a trawl-line to see to and a net to prepare. I left the house now to have a day away from it all, for I couldn't decide which should be tackled first."

-- from the journals of Tomas O'Crohan of Blasket Island, February 1920, as reprinted in Island Cross-Talk.

* Seaweed was spread over fields as fertiliser.

Tea

To be published next week in the Kildare Nationalist. 

When I and several others were helping build the cob house in County Clare a few years ago, some of us took a break for tea. As we walked back to the shelter across the wildflower fields, though, some of the other workers started picking various flowers along the way and piling them into baskets.  The containers were full by the time they arrived at the kettle, and the workers quickly rinsed the plants, dropped them into a pitcher and poured boiling water over them, and in a few minutes had instant herbal tea.

You can do this yourself at home with any number of local plants, but some are particularly well-suited and easy to identify:

 • Mint grows wild in forests and hedgerows, and is one of the easiest crops for amateurs – as the saying goes, you drop the seeds in soil and jump back. Its cooling tea is much used in warmer climates like Morocco, helping people without air conditioning stay as cool as possible.
• Clover: The white and purple flowers are ubiquitous across the summer fields of Europe and America, and the flowers and leaves can be gathered for a delicious tea.
• Dandelion makes a good, nutritious tea without the bitter flavor of dandelion leaves. It also acts as a diuretic, as you can tell from “piss-a-bed” and other folk names for the herb.
• Bramble: Our hedgerows and fences are covered in thorny brambles, and not only do they offer natural barbed-wire security all year long and blackberries in autumn, but the spring shoots make a blackberry-scented tea loaded with vitamin C.
 • Nettles: I have several plastic bins filled with nettle tea, which I make by picking nettle shoots and drying them – you can do it the old-fashioned way, over a stove or fire, or the modern lazy way with a microwave.
• Chamomile flowers create a famously relaxing tea, as does valerian. • Fennel, dill and anise – all liquorice-flavoured plants – make teas that help upset stomachs.
• Sage, oregano, thyme and many other herbs can all be made into strongly-flavoured teas, and we have used them a great deal lately for colds and coughs.
• Linden or lime leaves make great tea in spring, when they are shoots.

You don’t need to make just one kind of tea – take a variety of herbs and mix them together, perhaps with a bit of honey or fruit juice. Remember that you generally need a lot of leaves to give boiling water taste and colour – black tea comes from a particularly strong-tasting plant, further strengthened by being smoked, dried and powdered. With living leaves fresh off the vine or stalk, pack them into a jar or container almost to the rim before pouring boiling water over them.

Do be careful never to take plants from a field unless you know that it has never been sprayed with any pesticides. Most of these, of course, make a slightly green tea that tastes very different than black tea, and would not take milk. One exception is rooibos or redbush, which tastes and looks very like black tea, takes milk and is naturally caffeine-free. It’s available in most stores in tea bags, so try it if you feel like tea in the evenings.

You can make your own tea blends out of conventional black tea, of course. Earl Grey, for example, is black tea with a bit of bergamot oil. If you feel experimentitive, add different kinds of juice or plants to regular tea and see what you like. Whatever you make, it will probably be nearly free and better for you than soda or any of the varieties of fake juice on the market.

Photo: The Girl flying a kite in a field of tea. 

Haymaking

"Haymaking started when the meadows were ripe, and the men used scythes. They would help each other, in a co-operative effort called a meitheal (mee-hall) and were given porter and potatoes, bacon and cabbage and bread or boxty for tea.

The oats were ripe around this time and ready for cutting. Oats were important – like potatoes, the main food of the people. When the corn (oats) was ripe the men cut it with hooks and tied it into sheaves, long enough to handle.

It was then stoked, six to eight sheaves standing on end, supporting each other. The stooks were left in the field for a time before they were brought into the haggard and stores in stacks and covered.

 Threshing was an unbelievable feat of endurance. The barn was cleared and the flagged floor scrubbed clean. Neighbours who knew the art of wielding a flail commenced. The flail was made of two strong sticks tied together at one end with leather. The sheaves were put into the centre of the floor in bundles of five or six. Each man wielded the flail in turn until the oats were separated from the straw.

The oats went into sacks and the straw for thatching. It was the work of a few nights. Next came the winnowing – getting rid of the chaff. It would have to be a special sort of day for this work with the wind blowing."

-- Memories of Kathleen Sheehan, growing up in County Cavan circa 1920. Recorded in the book No Shoes in Summer.

Waterfall

Photo taken in Glenariff, County Antrim, circa 1914.