Herbal Medicine - Comparing traditions and overarching philosophy:
Origins of herbal medicine:
- The earliest medicine was thought to be Ayurveda (India) est. to be established around 4500-1600 B.C. Also, Chinese Medicine was getting more established around the same time- 3700 B.C.
- Western Medicine originated from the indigenous herbal practices in the British Isles rooted in European/Greek/Roman/Arabic traditions.
- Documents written on herbs and herbal medicine began with Shen Nung (Chinese Emperor) in 2800 BC, the Sumerians in 2500B.C, Egyptians in 1550 B.C, “Materia Medica” (by Greek Dioscorides) in 100 A.D and Galen’s writing “De Simplicibus” in 180 A.D.
Philosophy and guiding principles of herbal medicine:
As it originated, the guiding principle of Western Herbal medicine involved balancing the 4 humors. The humors represented the elements of the body and each had their own energetic quality and effects. Herbs were used to offset/rebalance any humoral disturbance. The major traditions include the Greek origins and have evolved into modern Western Herbal traditions including scientific (isolated study of herbs from a phytotherapeutic, isolated and molecular perspective), Heroic (focusing on detoxification) and Wise woman (more holistic therapy which includes looking at food, lifestyle, emotional and herbal supports to disease in the body)
In comparison, Ayruvedic and Chinese Medicine are very ancient and complex systems of medicine. They use a holistic approach to restoring health and balance within each of their models of disease. They have both been practiced for thousands of years and have contributed vast knowledge in terms of establishing the practice of herbal medicine. These systems of medicine have explored and categorized many plants/herbs in regards to their energetics and their use in restoring balance in the body. This approach to using plant medicine has certainly been a huge part of the foundation of Western herbal medicine both in the use of the crossover herbs like cordyceps, ginseng and ashwaghanda, turmeric etc.. and also in establishing a sophisticated approach to using and studying herbs in general.
While Western herbal medicine is a bit simpler in terms of characterizing the imbalances in the body that lead to disease/pathology, the approach to restoring balance is the same in all three disciplines. Fundamentally, all the disciplines come back to using herbs, food and lifestyle changes to holistically support and strengthen individuals while restoring harmony and balance to the body.
Why herbal medicine should be seriously considered to have an important role to play in animal health:
- More and more people are seeking out herbal medicines for themselves and as a result are seeking that type of care for their pets.
- Herbal medicines offer a uniquely broad scope of therapy especially in treatment of chronic diseases.
- Given their complex composition, nutritional components and multiple pharmacological elements within a single plant, herbs can offer clinical effects that are far more profound and effective than pharmacologic drugs.
- The approach to care within an herbal medical model is more holistic and supportive to true healing and involves treating more than just the symptoms.
How and why does herbal medicine work? The idea of holism and vital force:
Herbal medicine works to assist healing in the body by enhancing normal physiological processes. This is essentially healing patients from within and on deeper levels so that they have the greatest opportunity to prevent and fight disease and maintain good health over time. This way of approaching heath and healing draws on the traditional idea of ‘vitality’ or the innate energy of a being, and seeks to enhance this through physiological means. This may involve correcting underlying disharmony within the patient, by restoring harmony to parts of the body that are excessive/deficient or in some other way out of balance.
The concept of holism is central to the practice of herbal medicine in that it focuses on treating the whole individual, taking into account emotional/psychological factors, lifestyle, diet etc… rather than just the physical symptoms/signs of an illness or disease.
How do conventional medicine and herbal medicine compare and integrate with one another?
One of the main differences between conventional and herbal medicine is that conventional medicine focuses on and seeks out general/common causes of a given illness in patients (e.g. a pathogen), while herbal medicine looks for unique or more individualized causes of illness/disease (e.g. the immune system's inability to fight off infection). Conventional veterinary medicine focuses on killing/eradicating the pathogen (e.g. with antibiotics), while herbal medicine focuses on enhancing the individual's innate ability to fight the infection (e.g. boosting vitality by optimizing body chemistry, improving nutrition, enhancing detoxification and raising vitality.)
One key advantage of herbal medicine is that it does not rely on single chemicals or drugs like conventional medicine does. Herbal formulas, and even individual herbs, contain dozens of active ingredients that work synergistically on multiple aspects of a problem simultaneously. This approach is aligned with the natural intelligence in plants and more effectively addresses the multi-factorial aspects of chronic disease.
How long do herbs take to work?
An integrative approach using multiple modalities working in different ways along with an accurate diagnosis certainly improve the chances for a faster improvement in any illness. If the treatment is appropriate, improvements will often be seen in the first few weeks. How long the patient will take to resolve their condition and the level of resolution that can be achieved are less predictable. Typically, the longer and more chronic the disease process, the longer it takes to restore balance in the body.
It is important to re-evaluate the patient and treatment plan every few weeks tracking the symptoms and signs that supported the initial diagnoses. If the majority of them have been addressed and improved, the treatment is considered effective and should be continued. If not, the treatment plan needs to be adjusted.
Example of how herbs work therapeutically:
Chamomile- Matricaria chamomilla, recutitia
Chamomile is a slightly bitter plant and is pungent and neutral energetically. It is listed as a carminative, spasmolytic, mild sedative, antiallergic, anti-inflammatory, bitter tonic. The uses of chamomile both historic/traditional and those supported by current literature are incredibly broad. This lovely, gentle and soothing plant offers a range of anti-inflammatory, antispasmotic, anxiolytic, antioxidant, and probable antibacterial and immune-stimulating properties.
Research supports the anti-inflammatory effects of chamomile extract, it’s essential oil and other isolated constituents. The main anti-inflammatory constituents in the plant are the terpenes (matricin, chamazulene and alpha-bisaboloxides A and B as well as alpha-bisabolol). The essential oil of chamomile flowers in particular contains the sequiterpenes and flavones. Chamomile tea is a great antioxidant as well.
A note on constitution:
Many of my families notice that I refer to a patient’s constitution when developing a care plan. The constitution of an individual is defined as the whole of an individual’s inherited and acquired characteristics. In general, animals with a strong constitution have little illness, while certain breeds are prone to multiple disorders. They may be more sensitive to foods, stress or weather changes and are frequently visiting the vet. Note that genetics can be influenced somewhat through diet and environment (ex. hip dysplasia can be minimized through limit feeding and proper surfaces and avoiding activity that can damage growing joints.) Thus, assessing the constitution and inherent tendencies of an individual can provide a deeper insight into ways to sculpt a more effectively supportive care plan and ideally mitigate tendencies early on before they turn into significant imbalances later.
Addressing safety, side effects and herb-drug interactions:
Herbs that are known to be safe in one species are not necessarily safe in another species. Studies in humans do not reliably predict possible effects/outcomes in dogs, cats or horses. Species differences in metabolism may result in very different effects of chemicals in herbal medicines. For example, cats lack the ability to effectively reduce oxidative substrates and thus certain herbs that are safe in other species can cause oxidative damage in cats. Also, MDR1 mutations in Collie breeds can affect the p-glycoprotein system and alter metabolism.
It also of utmost importance that the purity of all herbs used be scrutinized. There are many adulterated herbal products on the market. Ideally, we would like to know with confidence that any herbal therapy being used has been manufactured to a high level of quality with checks and balances at every step of the manufacturing process. For herbal therapies, this should include information about where and how the herb was cultivated, how it was extracted and processed, how and when it was tested for contaminants, and ideally clinical trials supporting its safety and efficacy. Trust in the reputation of the manufacturer and sustainable company practices are also important criteria to evaluate. Unfortunately, much of the time, this information is not available, even from many well-known and reputable manufacturers.
There are times when a patient is reported to be worse following a treatment. In this case, a careful review of any other factors and treatments being used needs to be revisited to assess for their possible role in the decline. Even when there are no other treatments being used, some declines are unrelated to the herbal prescription, but merely coincidental. To better evaluate this situation, the first step is to stop administration of the herbal formula and wait for the new symptoms to resolve. Typically, resolution of side effects will only take a few hours, at which point the prescription can be re-started. If the symptom does not recur, it was unrelated to the herbal prescription and the therapy may be continued. If the side effects do reappear, but improvements have also been identified, the next step is to try a lower dose to see if it maintains the improvements but eliminates side effects.
Even if an adverse effect is confirmed to be due to the herbal prescription, it can essentially be considered a symptom of the patient’s condition. Like all other markers of heath in a patient, the response to an herbal stimulus is just one more way that the body expresses its energetic state and dynamic. Side effects that result from herbal prescriptions can clarify and exposing previously hidden tendencies within an individual. Once these tendencies have been brought to light, it allows us to better see the true state of the patient thus allowing for a more effective treatment plan.
Side effects of treatments should not be denied or negated, but fully explored, so the original diagnosis can be revised and a new more appropriate formula prescribed. In some cases, an entirely new formula may be prescribed in place of the original one. In cases where the original formula produced substantial improvements, the best course may be to continue the original formula but add in another formula or herbs to mitigate the dynamic in the body causing the side effect.
Herb -Drug interactions:
Herb-drug interactions refer to the possibility of a herbal medicine/herbal constituent altering the pharmacologic effects of a conventional drug given at the same time or vice versa. The result may be either enhanced or diminished effects of the drug or herb, or the appearance of a new, unexpected effect.
There are several ways to categorize herb-drug interactions. The most helpful and usable are those which look at the interactions from a pharmacodynamic (ex. interactions at receptor sites) or pharmacokinetic perspective (ex. interactions that alter the absorption, metabolism, distribution or elimination of drug/herb.)
Herb-drug interactions primarily concern blood coagulation/clotting, drug metabolism and the central nervous system.
There are three basic types of herb-drug interactions:
- Interactions that increase the toxicity of other drugs in the body.
- Interactions that decrease the therapeutic effect/benefit of other drugs being used.
- Interactions that enhance, ignite or complicate an existing disease process.
Scientific studies, in terms of drug interactions, are performed in the thousands each year. However, there has been relatively little scientific investigation into interactions between drugs and herbal medicines. Certainly, some insights can be gleaned regarding possible mechanisms of herb-drug interactions from research conducted with pharmaceutical medicines, but it is hard to effectively apply those predictions/comparisons in regards to clinical significance. Herbs, unlike conventional pharmaceuticals, are incredibly complex and contain vast chemical constituents which undoubtedly contribute to the overall effect of the herb as a medicine. Furthermore, the chemicals within each plant vary widely depending on many factors such as which part of the plant is being used, how the plant was cultivated, the growing conditions, the season and method of harvesting, how it was stored, processed and manufactured etc…
A note on synergy: In practice, herbalists use inter-herbal interactions to produce better outcomes. This practice is much the same as that of employing multi-target drug therapy in the treatment of cancer, hypertension, kidney disease etc... The chemical complexity of herbs contributes to the synergistic actions that are being identified in these plant medicines. This phenomenon of inter-herbal interactions is in large part the reason that whole herbal drug extracts are superior over single constituents isolated from the same herbal extracts.
Clearly, an in-depth knowledge of all herbs/plant medicines being put to use in a formula is essential so as to be aware of any documented toxicity/contraindications/known drug interactions. Beyond that though, careful history taking and awareness of other medicines being employed (especially pharmaceutical), regular re-evaluation of patients and good communication are of utmost importance in the practice of herbal medicine.
~Kelly Keeney, DVM