A serious look at herbs: Dr. James A. Duke campaigns for herbs vs. pharmaceutical clinical trials.

Many Americans are starting to wonder if there's "something natural" they can take to address their health issues instead of their expensive, side-effect-laden medicines. Those who have plenty of money often create their own Integrative Medicine microcosm by paying for various alternative treatments, often including herbs, while humoring their physician by looking to him for diagnosis and checkups. The poor with no insurance often seek whatever free advice they can gather to obtain the right herbal extracts for their ills, avoiding the doctor's office altogether. But these methods seem backward. The time has come for herbs to take a central position in the American health care system, sharing equal ground with pharmaceutical drugs.

True, modern American medicine has placed us quantum leaps beyond "superstitious ceremony" and "'primitive herbal remedies" of days past. High-tech research facilities, advanced chemistry, and a sophisticated, profitable pharmaceutical industry provide hundreds of powerful solutions to the symptoms of disease. Why bother with messy natural herbs when Americans are already getting the best medicines in the world? Or are we? Herbal medicine expert Jim Duke challenges that, saying, "With pharmaceuticals killing more than 100,000 Americans a year, I doubt that we are getting the best, cheapest, and safest medicines."

In the late 1960's, Jim investigated the people and plant life in a portion of Panama and Colombia. He spent weeks at a time living closely with ethnic groups such as the Choco and Kuna Indians in the jungle, experiencing and sharing their deep dependence on forest products. In two and a hall years, Duke and his team collected nearly 15,000 plant specimens, by the end of which time he confesses he "fell madly in love with Latin America, particularly Panama, ethnobotany, and medicinal herbs."

Ethnobotany, the study of the relationship of plants and people in primitive cultures, was born around this time as a description of what Duke and other scientists were doing. In 1995, he retired from his career as an ethnobotanist with the USDA. Since then, the globetrotting "Duke of Herbs" has carried a torch in the growing movement to reverse the American disdain for alternative medicine.

In the Nineteenth and early Twentieth Centuries, the United States Pharmacopoeia, the nation's official drug reference book, was filled with herbs, reflecting their widespread use in America. When drug manufacturers realized, around the time of World War II, that patentable synthetic molecules promised much bigger profits, herbal research diminished, and medicinal plants were all but forgotten.

But not in Europe. According to Edzard Ernst, a Munich native and professor of complementary medicine at the University of Exeter in England, the affinity Third Reich Nazis had for herbal medicine assured the preservation of the German botanical tradition. Germany now sets the global standard for herbal research and quality products.

Standardization is used in Europe and in America to provide a reliable dosage of the most important active phytochemicals in an herb. To do this, extra of the one or two main active compounds are added to the whole herb or extract. To have consistency, herbal supplements must also be grown and produced in a uniform way.

After his time in the jungles of Panama and years of interacting with other primitive cultures, Dr. Duke understands that plants and the human body are connected by nature's innate intelligence, having evolved together for millions of years. His belief is that man evolved in and radiated out from Africa. Most of the herbs mentioned in the Bible would have been encountered and utilized over time as people passed through the Middle Eastern Fertile Crescent into Europe and Asia, and finally Australia, Polynesia. and America.

According to Duke, "Biblical herbs each contain hundreds of biologically active phytochemicals with which the human body has genetically co-evolved, for 2000 if not 2 million years. Synthetic pharmaceuticals have been known to my genes less than 200 years, not enough time to become familiar. For that reason, one can expect more dramatic effects and side effects from new pharmaceuticals, the most heavily advertised." But when these side effects lead to over 100,000 American deaths a year. Congress should be investigating other less dangerous options, like botanicals.

Pharmaceuticals generally have one active chemical or compound. Herbs contain multiple synergistic compounds, described by Dr. Duke as "a Menu of Chemicals from which the body selects what it needs." Herbs also address vitamin and mineral deficiencies, providing a synergistic complex of hundreds of nutrients, in the easy-to-utilize natural state. Given a soup and salad and herbal tea containing these nutrients and chemicals, the body mines them for the needed nutrients, excreting the rest.

Dr. Duke bets that the common weed milk thistle is better and cheaper than the drug Interferon for hepatitis. But because the pharmaceutical company that makes Interferon doesn't want everyone to stop using its drug for an herbal alternative, he says we won't get the third arm trial. He also cites Rosemary's Eight Compounds that combat the breakdown of acetylcholine, asking for a clinical comparison of Rosemary shampoo against Alzheimer's drugs. "But," says Duke, "it costs $1.7 million for a pharmaceutical company to prove a new drug safe and effective. No herbs company grosses that in a year."

We will not know how drugs and herbs compare until they are included in the same clinical studies. For at least fifteen years, Duke has been campaigning Congress to get a Third Herbal Arm required for pharmaceutical vs. placebo trials, comparing herbs thought to be effective for a given complaint with the new drug in question. Duke says he has seen no progress on this, noting that Congress members are supported by the rich and powerful pharmaceutical lobbies, representing the highest profit margins in the Fortune 500.

Even with airwaves saturated with drug ads, public demand for the integration of herbs into our mainstream health care system is rising. Says Duke, "In the six minutes you get with the doctor, a physician can't determine what's wrong with you. Basically, if you ask about all the drugs you saw on TV--if they're right for you--your sex minutes would be up. And then there's the problem that nearly 25 percent of North Americans cannot afford the pharmaceutical prescription and/ or the doctor to prescribe it.

The health care system in the US is ripe for a change, shifting as necessary to accommodate the Twenty-First century reincarnation of American herbal medicine. The old money. based hierarchical paradigm is wobbling as its foundation is revealed to be nothing but dust. Dissatisfaction with the highly frustrating status quo is rising, building towards a tipping point of demand for more balanced, service-oriented medical care, where drugs and herbs can coexist. How shall we harness this demand to overcome the corrupt deal-making that protects the pharmaceuticals' monopoly on health care? Maybe an internet-based non-profit organization or network of non-profits dedicated to promoting herbal and alternative medicine can become, through donations, a rival for the pharmaceutical lobbies in Congress. It would support political candidates that will work toward the changes we need. Isn't democracy wonderful? How long will it be before we can look back on the past few decades, amazed at the absurdity of the denial of our connection with the earth?

James A. "Jim" Duke graduated from the University of North Carolina in 1961, with a Phi Beta Kappa PhD in botany. In 1995 he retired from a colorful thirty-year career as an ethnobotanist with the USDA, the author of over thirty books about medicinal herbs, including The Green Pharmacy. Eva Knox Morin is a member of the South Carolina Native Plant Society and works at Garner's Natural Market in the Wellness Department. She lives in Greenville, SC with her husband, two dogs, and a cat.

Resources:

Duke, J A, The Green Pharmacy. 1997 Rodale Press, Emaus PA

Duke, J A "A Third Arm for the First World?" Essay on his website: www.arsgrin.gov/duke He provides a full bibliography at the end of it, composed entirely of eight of his own books.

Stolberg, Sheryl Gay, "The Estrogen Alternative--Black Coshosh" by New York Times Magazine May 6, 2001

For additional information on Ethnobotany:

Arvigo Rosita, Sastun

Cunningham, Anthony, Applied Ethnobotany: People, Wild Plant Use and Conservation Ethnobotany:

Moerman, Daniel E, Native American Ethnobotany

Pollan, Michael, The Botany of Desire: A Plant's-Eye View of the World

Schultes, Richard Evans, and von Reis, Siri, Evolution of a Discipline