Herbal medicine yesterday and today
Remedies made from plants have been known to mankind for thousands of years and are common in every culture. Until not very long ago, the use of medicinal plants as drugs (phytotherapy) was the only way to alleviate complaints and cure diseases. The time of chemical-synthetic drugs only began at the beginning of the 20th century. Until then physicians trusted remedies from nature. In the initial therapy at the doctor’s today, drugs from the evidence-based, rational phytotherapy (see Figure) are used as part of modern pharmacotherapy. Phytotherapeutics must have their efficacy, tolerability and safety confirmed in clinical trials. Accordingly, phytotherapeutics are used in different medical fields (e.g. general medicine, internal medicine, psychiatry, gynaecology, etc.) . In contrast to this, there are however still many herbal preparations, which are used due to their long tradition as remedies and have been proven in different areas of application. In this case, long tradition is considered as proof of efficacy. Herbal medicine is seen as separate from modern therapy as are alternative and complementary treatment methods such as homoeopathy and spagyric medicine or osteopathy and acupuncture. The therapeutic efficiency of many alternative medical treatments is disputed from a pharmacological point of view and the subject of many scientific discussions.
In recent decades, phytotherapy has developed in two directions: traditional and rational phytotherapy. While traditional phytotherapy is based exclusively on its many years of experience and tradition as a remedy, rational phytotherapy goes one step further. Strict official and scientific benchmarks are set for the efficacy, tolerability and safety of the medicine. In contrast to traditional medicines and similarly to chemical-synthetic drugs, rational phytopharmaceuticals must meet all requirements of pre-clinical/toxicological and clinical and efficacy trials of the health authorities. Their ingredient is frequently a standardised extract with precise adjustment of substantial marker substances. This means the extract is adjusted to a few substances (standardised), and unwanted materials are removed. This makes it very difficult to compare extracts from different manufacturers with one another. Typical examples of rational phytopharmaceuticals:
- St. John’s wort for the treatment of depressive moods
- Butterbur for hay fever
- Ginkgo for the treatment of decreased mental performance
- Black cohosh for the treatment of menopausal ailme