Plant medicine is bunk, says medicinal plant expert

The Irish Times has an interview with the delightful crotchety doctor who is the garden fellow at London's Royal College of Physicians. Basically, he manages the College's collection of plants that have been historically used for medicinal purposes. Ironically, the job has convinced him that most herbal medicine is complete bunk. And he is not shy about saying so.

PLANTS HAVE been trying to kill us, not cure us," says Dr Henry Oakeley, the garden fellow at London's Royal College of Physicians.

But if plants are, for the most part, as medicinally useless as he believes, how does he explain their centrality to the beliefs and practices of medical practitioners for centuries?

"Because they believed in the tooth fairy," he says matter of factly. "They had no concept of illness or of chemistry or biochemistry. They believed all plants had been put on the earth by the creator for mankind's use. So if the plant had a particular shape, it indicated that the creator had put it on the planet for a particular use."

Citing as an example the use of blue liverwort, Hepatica nobilis , once cultivated as a liver tonic because its three-lobed leaf form mirrored the shape of the liver, he says, "It was absolute rubbish. They had no idea how the body worked." In the 1880s, at the height of its popularity, those taking it to cure feelings of "liverishness" were stuck down by jaundice because the plant was in fact toxic to the liver.

"The basic concept that most people have missed is that [many] plants are poisonous," he says. "We just have to find a way of using the poisons in plants to our advantage."

Oakeley doesn't deny that some plants have been useful, with plant-based chemicals leading to the development of important medicines. And, sometimes, ancient people guessed right, using those plants to treat the very things the plant-derived prescriptions treat today. His argument is simply that you can't just trust the ancients' opinion on a plant's medicinal value without first proving that it is effective and safe. In most cases, he says, the traditionally-used plants don't turn out to be effective. And the ones that are effective aren't as 100% safe as they're made out to be.

Via Tim Lloyd

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  1. “The basic concept that most people have missed is that [many] plants are poisonous,” he says. “We just have to find a way of using the poisons in plants to our advantage.”

    No shit, Sherlock.

  2. So… Oakeley is arguing that plants didn’t *intentionally evolve* to have healing properties?

    Next up: Water is wet!

    1. No, he’s trying to inform a willfully ignorant population that plants were not designed for our benefit.

      Sometimes, the only way to get a point across is with a club.

    2. When the prevailing wisdom used to be just that proposition you’re saying is obvious, pointing out that it’s bunk isn’t the “water is wet” statement you’re making it seem to be.

  3. “His argument is simply that you can’t just trust the ancients’ opinion on a plant’s medicinal value without first proving that it is effective and safe.”

    Of course… that seems kind of obvious to me. That doesn’t mean the plants are useless, just that some of the leads are dodgy! All those stories and traditions are a place to start, not proof in and of themselves.

  4. I ate some magic mushrooms once that I swear were trying to kill me by filling my head full of insects.

  5. Actually, there is quite of bit of evidence that plants that have great benefit to us tend to get selected by us, cultivated, and therefore thrive. Take cannabis for example.

    1. Yes, terribly obvious. On a related note, have you ever been to a grocery store? Ours are so wonderful they set aside space for these comedy aisles, stocked with products like Echinacea and Ginkgo biloba, even though it’s obvious nobody would ever buy such a thing.

      1. why is everyone posting that this is terribly obvious… it isn’t to me. Just because its posted on Boing Boing doesn’t mean you have to unswervingly agree with it. Common sense would tell you that a majority of pharmaceutical drugs are ineffective. many drugs are based on plant compounds… and natives have been using plants as medicine for thousands of years.

  6. Can’t find the cite, but I saw recently that of all the commonly sold herbal supplements, there is academic research showing the efficacy of around in 1 in 3. That’s pretty good, I doubt that non-herbal medicines as a whole are much better than that.

  7. I dunno, I still feel like he’s making a fairly overbroad pronouncement.

    Yes, many of the plant-derived chemicals we know and love come from poisons (I actually happen to work in a field of medicine that makes very heavy use of phytotoxins and their derivitives, and even uses them *for* their toxic properties), but not all physiologically interesting plant chemicals are employed as poisons, and even amongst the ones that do, not all of them target animals. Just as one example, Salicylic acid is predominantly a hormone that regulates growth in the Willow tree, not a phytotoxin.

    1. But the medicinal ingredient in willow trees isn’t salicylic acid, it’s the related form salicin, and the reason it’s accumulated in large amounts is mainly as a phenolic defense against insects. We merely turn into salicylic acid once we digest it.

  8. The other side of this is that many times when scientists believe they have synthesized the active chemical ingredient in a plant they find that their pharmaceutical is less effective than the plant because the active chemical ingredient was working in concert with other chemical compounds.

    1. But please do keep in mind that the opposite happens a lot, it simply doesn’t get as much press. Willow bark, for instance, isn’t actually very useful medicinally; by the time you’ve gotten a noticeable dose, you’ve taken in a lot more tannins than you should. Aspirin is actually much better for you.

  9. QUOTE “His argument is simply that you can’t just trust the ancients’ opinion on a plant’s medicinal value without first proving that it is effective and safe. In most cases, he says, the traditionally-used plants don’t turn out to be effective. And the ones that are effective aren’t as 100% safe as they’re made out to be.”

    And medication that IS derived from plants, such as Digitalis, Are? NOTHING in plant and pharmaceutical poisons is 100%!

    Shill

    1. And medication that IS derived from plants, such as Digitalis, Are? NOTHING in plant and pharmaceutical poisons is 100%!

      Shill

      Ah, the old “you’re claiming the opposite of the negative point you’re making!” fallacy …

      Not Maggie, not me, not the drug companies, and certainly not the FDA, are claiming that pharmaceuticals are 100% safe.

    2. “And medication that IS derived from plants, such as Digitalis, Are? NOTHING in plant and pharmaceutical poisons is 100%!

      Shill”

      Medicine that is derived from plants is *medicine*.

      The problem with herbal medicine is this:

      “Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety.”

      Digitalis is a good example. It derives from the foxglove plant. It is highly poisonous, but in *just the right dosage* it can be used as an antiarrhythmic agent. The efficacious dosage is close to the toxic dosage, so identifying identifying the bioactive agent, separating it, refining it and making standardized dosages is what makes it useful. That’s pharmacology, not herbal medicine.

        1. Really? You are linking to a **press release**, from 2001?

          Fine…

          I’ll up your press release with a nice science blog article:

          https://sciencebasedpharmacy.wordpress.com/2009/03/27/oil-of-oregano/

          “3. Does [Oregano Oil] actually work for the condition? There is no published evidence to demonstrate that that oil of oregano is effective for any medical condition or illness. “

          The fact is that plants can and do have useful bioactive agents. Isolating those agents so that they can be studied, tested and understood is what pharmacology is all about–but herbalists reject that. Herbalists reject science, and want herbalism to be un-regulated. They want to be able to prescribe unproven drugs of unknow effectiveness and unknown safety.

          1. Herbalists reject science, and want herbalism to be un-regulated. They want to be able to prescribe unproven drugs of unknow effectiveness and unknown safety.

            I was agreeing with you until you got to that part. I’m sure there’s herbalists who would embrace better testing and regulation. That is, as long as the regulation body could be trusted and was open and not merely a corporatist front for big pharma to stunt competition.

          2. “Cowicide in reply to Skep

            “Herbalists reject science, and want herbalism to be un-regulated. They want to be able to prescribe unproven drugs of unknow effectiveness and unknown safety.”

            I was agreeing with you until you got to that part. I’m sure there’s herbalists who would embrace better testing and regulation. That is, as long as the regulation body could be trusted and was open and not merely a corporatist front for big pharma to stunt competition.”

            Better testing and regulation would eliminate herbalism. There are only a few herbs that have been tested for safety and efficacy–the vast majority have not been. And even for those herbs for which testing has been done, when it comes to the actual product in a store or herbalists shop, you don’t actually know what is in medicinal herbs–not the dose or purity–since they aren’t regulated the way scientific medicine is.

            And Herbalists, as with pretty much all other CAM practitioners, generally reject science, claiming to be “untestable” by science, or invoke some other exemption whereby they don’t believe they should be held to scientific standards of efficacy or safety.

          3. Better testing and regulation would eliminate herbalism. There are only a few herbs that have been tested for safety and efficacy–the vast majority have not been.

            Again, don’t really agree. How do you know better testing and (open) regulation would eliminate it? It seems to me it would actually be quite a boon to the industry if that happened. Would it get rid of some quacks, yes, but the rest of the industry would improve as more people would gravitate to the products that pass muster.

          4. 3. Does [Oregano Oil] actually work for the condition? There is no published evidence to demonstrate that that oil of oregano is effective for any medical condition or illness.

            Actually, there is. It’s from 2004, published in FEMS Microbiology Letters (impact factor 2.199):

            “Susceptibility of methicillin-resistant staphylococci to oregano essential oil, carvacrol and thymol”, Nostro et al (FEMS Microbiology Letters 230 (2004) 191-195)

            The moral here is: go for the primary sources.

          5. “Actually, there is. It’s from 2004, published in FEMS Microbiology Letters (impact factor 2.199):”

            Actually, there isn’t. The moral here is that you should understand what you are citing before claiming it is proof of your thesis.

            What you cited is an in vitro study, not a clinical study proving that oregano oil has any medical benefit in humans. This statement still stands: “There is no published evidence to demonstrate that that oil of oregano is effective for any medical condition or illness. “

          6. Come on. “Evidence” does not only come from clinical trials. You don’t get to clinical trials in medchem, let alone preclinical, unless you’ve got solid – and repeated – results from lab bench experiments conducted by reputable researchers, and preferably published in reputable journals. That’s especially true for anti-infectives. And this paper is rock-solid support for the idea that oregano oil actually does have an antibiotic effect.

            Look, I don’t have a dog in the fight here. I work in medchem and biotech, not herbalism, but I know that a lot of the eureka moments blindside you – never rule anything out if it’s supported by reliable literature.

          7. It’s not surprising oregano oil has an antibiotic effect – these sorts of phenols have been used as antiseptics for a long time. But he did specify it was an in vitro study; surely that’s different enough from in vivo that you’d need a separate study before you can say there’s solid evidence it can be used that way in people?

          8. Here’s the studies. It was better described in the press release, and I don’t have access to the original article. Sorry your internet is broken so you couldn’t find it yourself:
            http://www.ncbi.nlm.nih.gov/pubmed/20021093
            http://www.ncbi.nlm.nih.gov/pubmed/16010969

            No, not clinical trials yet, but promising. It’s about a billion dollars to bring a drug to market, which is why he likely hasn’t gotten around to doing sufficient clinical trials.

            My point is this is what the garden fellow should be doing.
            Single compounds do not neccessarily trump a gamish, the example being the HIV cocktail. Or an orange vs. Sunny D.

            “Isolating those agents so that they can be studied, tested and understood is what pharmacology is all about–but herbalists reject that. Herbalists reject science, and want herbalism to be un-regulated. They want to be able to prescribe unproven drugs of unknow effectiveness and unknown safety.”

            Some things should be available with a prescription, some shouldn’t. Herbs and conventional meds are all just chemicals, it’s unscientific to think that one is inherently better. He should be doing studies, and if they debunk a suggested therapeutic approach, then he gets to do his happy dance. Until then, spouting off is just crotchety whinging.

          9. Herbs and conventional meds are all just chemicals

            Exactly. And, in the same way as some conventional meds will kill you or make you very ill in the wrong dose, so will some herbs. Which is why the FDA should insist on the same safety and efficacy studies for herbal remedies as for conventional meds.

          10. The FDA really should do studies like that, but no one wants to pay for them. Pharm companies do these studies for drugs, they’ve no interest in something that’s problematic to patent. Herb farms and herb companies have no way of recouping the expenses like the pharmaceutical industry does. Anyway, there’s no real interest in antibiotics (!) because there’s more money in boner pills. But if the MRSA plague is coming through and decimating us, I may stockpile some oregano oil while I’m waiting for the pharm companies and the FDA to save us. Call me quacky.

          11. There’s a huge interest in novel classes of antibiotics. It’s not only MRSA that’s a problem, there’s also vancomycin-resistant enterococcus (VRE) and fluoroquinolone-resistant Pseudomonas aeruginosa (FQRP) on the horizon, but the problem is that there’s a declining investment in pharma R&D in general, not that pharma is making most of its money from ‘boner pills’ (it isn’t).

          12. “daen in reply to Snig

            There’s a huge interest in novel classes of antibiotics…but the problem is that there’s a declining investment in pharma R&D in general, not that pharma is making most of its money from ‘boner pills’ (it isn’t).

            Even so, the pharmaceutical industry is complicit in the overuse of antibiotics that has lead to resistance, as we’ve seen with industry lobbying against restrictions on the indiscriminate use of antibiotics such as Cipro to make livestock grow faster. Selling Cipro for such purposes is big business for the pharmaceutical industry.

          13. The main culprit in the MRSA story is the medical profession prescribing antibiotics as a panacea, not the pharmaceutical industry itself.

            Incidentally, Ciprofloxacin sales are lower than aspirin ($242mn vs $324mn, Q1-3 2008 figures), so, no, I really wouldn’t class it as ‘big business’.

          14. “daen in reply to Skep

            The main culprit in the MRSA story is the medical profession prescribing antibiotics as a panacea, not the pharmaceutical industry itself.”

            Indeed, anti-biotics are over prescribed. That doesn’t excuse lobbying efforts in favor of indiscriminate use of antibiotics to make livestock grow faster.

            Incidentally, Ciprofloxacin sales are lower than aspirin ($242mn vs $324mn, Q1-3 2008 figures), so, no, I really wouldn’t class it as ‘big business’.

            What? Only 1/3 of a billion dollars? Why I guess that really is nothing. However, from the same link you provided:

            “Ciprofloxacin has proven to be a blockbuster drug for Bayer A. G., generating billions of dollars in additional revenue. “In 1999, Cipro was the eleventh most prescribed drug in the United States based on new prescriptions, and ranked twentieth in total United States sales. In 1999, Bayer’s gross sales of Cipro in the United States were approximately $1.04 billion.”[9] “

            I’d call that big business for sure. Cipro remains one of Bayer’s top sellers.

          15. Indeed, anti-biotics are over prescribed. That doesn’t excuse lobbying efforts in favor of indiscriminate use of antibiotics to make livestock grow faster.

            Maybe, but it’s an almost entirely irrelevant point with respect to antibiotic resistance.

            I’d call that big business for sure. Cipro remains one of Bayer’s top sellers.

            It isn’t now. And as large as $300mn per annum might seem to us, it wasn’t enough to get Cipro into the top 100 drugs in 2009. The top 10 drugs alone sold more than 100 times that amount in 2009 (approx $30 billion).

          16. True that. Agricultural overuse of antibiotics is one of the worst public health failures in existance.

          17. There’s a huge clinical need and interest, but as noted here:
            http://www.ncbi.nlm.nih.gov/pubmed/18465675
            http://www.mja.com.au/public/issues/181_10_151104/cha10412_fm.pdf
            the pharm companies are less interested. Companies that can generate a product that is chronically needed will likely be more financially successful than companies that produce something that’s needed a handful of times over your life time. Also, when the new “vancomycin” comes out, it’ll only be used for emergencies, which will mean less money. I’m not pharm bashing, that’s the way the system is set up.

          18. “The fact is that plants can and do have useful bio-active agents. Isolating those agents so that they can be studied, tested and understood is what pharmacology is all about–but herbalists reject that. Herbalists reject science, and want herbalism to be unregulated. They want to be able to prescribe unproven drugs of unknown effectiveness and unknown safety.”

            More importantly the woo doctors do not close the loop in any systematic way. The fundamental break through with science was to realize that you need to close the loop, to verify in an impartial and systematic way that the results you expect are the ones you are actually getting.

            Herbalists and what not emphatically reject that, thus all the psychological bugaboo’s and logical fallacies that lead people astray are in full force. Magical thinking, confirmation bias, mindless appeal to some authorities and emphatic rejection of other authorities are all at work.

        2. The actual study that’s referring to is available here. The exact quote is:

          The daily administration of equivalent
          amounts (8.66 and 17.33 mg/kg body weight) of carvacrol
          was found to confer similar therapeutic properties (data
          not shown). However, the overall clinical appearance of the
          mice receiving origanum oil was cosmetically better than
          those receiving carvacrol, as evidenced by the improved coat
          luster and minimal scruffiness.

          This is not the difference between working and not working you paint it is. There are cases where natural products have multiple components working synergistically, which take extra work to recover, but this is not one of them.

          And of course, I’d like to reiterate that there are lots of cases where single or modified compounds work better than the natural product, such as aspirin, penicillins, and so on.

  10. Eat a salad of rhubarb leaves and then get back to us. Send the stalks on though, they’re yummy!

  11. I less than a year, Traditional Medicines Will Become Illegal in Europe, further shoring up the lack of competition for Big Pharma. I can only assume that this interview article was done to help bolster public opinion favorably toward the pharmaceutical industries.
    As someone who has praciced herbalism and helped send hios own remission of esophageal cancer partially through use of very affordable herbs, I too had to ignore the Sympathetic Magic veins of thought and ignorance in much of the herbal literature, and to concentrate instead on the thousands of scientific studies proving the efficacy of herbs in healing, largely through and abundance of phyto chemicals that are often the conceptual precursors of more modern medical chemists’ “discoveries.”
    I found the interview and the presentation of the interview to be condescending and kind of ignorant to a fault; most herbalists already ignore the physical appearance of the herbs they would choose.

    1. As someone who has praciced herbalism and helped send hios own remission of esophageal cancer partially through use of very affordable herbs, I too had to ignore the Sympathetic Magic veins of thought and ignorance in much of the herbal literature, and to concentrate instead on the thousands of scientific studies proving the efficacy of herbs in healing, largely through and abundance of phyto chemicals that are often the conceptual precursors of more modern medical chemists’ “discoveries.”

      Two words: Clinical trials.

      Another two words: Primary references.

      Also: Research and development.

      Look, “conceptual precursors” is NOT the same as “biologically effective” which is NOT the same as “lead compound” which is NOT the same as “pharmaceutical product”.

      You obviously have no idea how hard it is to do real medicinal chemistry, so go back to your pestle and mortar, thank you.

    2. most herbalists already ignore the physical appearance of the herbs they would choose.

      That’s certainly very reassuring.

      /sarcasm

    3. no they wont they just have to go through the similar testing processes O(i.e double blind)as normal medicine. the problem is that this means that homeopathic medicines will have to show more than a placebo effect.

  12. One of my favorite plant medicine fallacies is the ancient belief that aconite seeds cured eye diseases and walnuts cured headaches — so that’s why God made aconite seeds look like eyeballs, and why walnuts resemble the human head with a nut that resembles a brain. If only it were true! It’s a lovely idea … h/t Michel Foucault

  13. So far half the posts say this is too obviously correct to bother with, and the other half claim it’s incorrect or at least misleading. Hm.

  14. I despise “what our ancestors did wrong” articles, we’re still here Dr. Oakeley.

    BTW, I was able to locate some reference to is medical profession: He’s a retired Psychiatrist.

    1. We’re still here. And yet the four humors are still wrong, mental illness is still not caused by possession, and liverwort still isn’t good for you. I guess you’re saying it’s impolitic to point that out?

    2. Brilliant! I love it when a “Dr.” makes sweeping claims about fields they really have little business talking about.

      If we want a professional opinion on the matter, shouldn’t we listen to ethnobotanists, anthropologists, plant biologists, chemists…etc. I would think psychiatrist would be pretty far down that list.

      1. Obviously people on this forum haven’t bothered to look up the difference between a psychologist and psychiatrist. A psychiatrist gets a MD. He is most likely perfectly qualified to speak about the various drugs and their effects on a human being.

    3. I despise “what our ancestors did wrong” articles, we’re still here Dr. Oakeley.

      I must have missed the part where he said everything our ancestors did was wrong, and also completely lethal. Some of our ancestors performed human sacrifice, the fact that “we’re still here” doesn’t mean that the practice was an effective way of appeasing the sun god.

      BTW, I was able to locate some reference to is medical profession: He’s a retired Psychiatrist.

      A Psychiatrist has to spend as much time in medical school as any other medical doctor. That’s why they can prescribe medications (unlike, say, a psychologist).

  15. When my friend was in medical school, he studied a case where a girl died from taking waaay too much Tylenol. I was shocked that something as “safe” as Tylenol killed her, but he told me “All medicines are just poison in very controlled amounts.” I have no doubt that medicinal plants are the same way. If they’re going to be useful to us, we have to figure out what the balance of cure/poison is.

    1. That’s my point: there’s a large disconnect between what most people think about medicine, and what’s “obvious” to those who have studied it.

  16. This doctor is not so delightful to me. It was these kinds of ethnocentric, my-knowledge-is-science-yours-is-superstition type of people who destroyed the traditional system of knowing in colonized countries. And now pharmas patent what was already recorded as traditional knowledge as their own discovery, limit the access to use and make millions. No, not delightful.

    1. Couldn’t agree more, aninsomniac. But Boing Boing has always showed a strong bias towards corporate medicine; I see it as an over-reaction to the perceived hokum of homeopathy. If one of the base principles of homeopathy (dilution) is disproved, then all of homeopathy is disproved, therefore all of chiropractery is disproved, therefore all of any system unrelated to large western mega-corporations is false. It’s a very slippery slope… but one that L. Ron Hubbard liked to sled down.

        1. Only better! I appreciate your vote of confidence.

          These threads always devolve into one group refusing to accept any evidence that doesn’t fit into their narrow preconceived worldview and… oh, wait, that describes both groups! I guess there’s a few outliers, and they get beat up by both sides. How you feeling, Antinous? A little bruised?

          My favorite claim is that something personally experienced is less valid than hearsay, apparently because of magical science-magazine fonts or something. “My refereed paper says gravity is illusory, therefore you are floating towards the sun! Don’t you believe your lying eyes!”

          Almost as good is the claim that because your cousin’s friend’s Aunt cured her dropsy by taking the waters, all scientific research that shows no therapeutic connection is necessarily flawed. Those scientists don’t know anything! Yeah, right.

          madhyamā-pratipad leads to liberation…

    2. Evidently, we have a lot of Michin’s “Storm”s in real life here. And I thought the argument was that she was a straw-(wo)man. Guess not.

      1. Are you serious? I decry the hegemony of a singular way of doing science which is largely controlled by market-driven pharma companies and assisted by the destruction of scientific knowledge and ways of knowing of non-western countries. Your response is that I’m a Western stereotype of the vegan-hippie-anti-science-Caucasian?

        Nice ethnocentrism there too!

        1. As a biologist, I work with lots of people from other countries, including China and India. Funny thing though — while many newage Westerners idealize the traditional mythology of those countries, the actual people whom I work from those countries with don’t. They know perfectly well that the the way out of poverty and disease in their native lands is going to be based on scientific principles, not chakras and qi.

        2. Wait a minute – you complain:

          a) that:

          these kinds of ethnocentric, my-knowledge-is-science-yours-is-superstition type of people … destroyed the traditional system of knowing in colonized countries

          b) and then that:

          And now pharmas patent what was already recorded as traditional knowledge as their own discovery, limit the access to use and make millions.

          To answer:

          a) First of all, Oakeley has given no indication that he has any ethnocentric perspective on this, merely that early medical practitioners in the Western tradition were misguided, and that future medical practitioners are as likely to see our efforts as being equally laughable. Sounds pretty balanced to me.

          b) No, not really. Salicylic acid? A derivative product from willowbark. Artemisinin? Again, the natural form is not the best – artemether has an IC50 which is more than 3 times better than artemisinin (0.1 vs 0.35 nM respectively – from here)

          As I pointed out earlier, it’s not just a question of pharma execs skipping through the forest (or jungle) plucking leaves for their magic brews. There’s actually, usually, a good deal of work involved to turn a folk remedy into a viable potent drug.

  17. People say obvious but to the majority of the population this isn’t. I’m a doctor and honestly i once had a patient who refused to take any ‘chemical’ medications but swore by his willow bark tea for headaches (for anyone who doesn’t know this is basically aspirin tea)

  18. Seriously? “Scientists have been wrong before, so how can we ever consider any ancient knowledge wrong?” “People didn’t get wiped out in the past, so traditional stuff must be good enough?” Is that the level of reasoning people are going with?

  19. “His argument is simply that you can’t just trust the ancients’ opinion on a plant’s medicinal value without first proving that it is effective and safe. In most cases, he says, the traditionally-used plants don’t turn out to be effective. And the ones that are effective aren’t as 100% safe as they’re made out to be.”

    It’s pretty obvious that you can’t just trust anyone’s opinion on a drug’s medicinal value without first proving that it is effective and safe. In most cases, I says, the medications don’t turn out to be effective. And the ones that are effective aren’t as 100% safe as they’re made out to be.

    Whining about someone else’s lack of science doesn’t enhance yours. He should use his office to lead some damn studies and stop whinging.

  20. It looks like some people are reacting to what’s in Maggie’s post, rather than the actual article. The good doctor’s opinions are much more nuanced than his blanket dismissal of herbal medicine as being of the same ilk as belief in the tooth fairy. His point about what practitioners of medicine fifty years from now will think of our current practices is telling.

    What he’s saying, it seems to me, is not ‘our ancestors were dumb’ or even ‘herbal medicines don’t, on the whole, work.’ His key points seem to be ‘just because we’ve believed things for a long time doesn’t mean they are true’ and ‘science is real.’ This does not mean that that ‘traditional’ medicine of any strain is always wrong, or that ‘science’ is always right (an obvious point, but I think it bears repeating.)

    The question of ethnocentricity is thornier. I’m inclined to let each participant in the cultures at large decide for themselves. Keeping the benefits of scientific research away from them on the assumption that their culture isn’t strong enough to assimilate it is itself a kind of paternalism.

    1. I did read the article. The example given is St. John’s wort having side effects. In clinical practice for mild to moderate depressions, MD’s often try a course of a couple anti-depressants, at a couple different dosages. St. John’s wort might be one of the ones that helps some people. Yes it has side effects, and like all other meds, is not a cure all or a cure everyone. But to say “gee, look it has all these problems and should be restricted” is a problem. The side effects, based on the studies, are comparable or less than other meds used. Because it’s an herb, it seems as if it’s being held to higher standards.

      This is another way of looking at it, excuse the long copypasta:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240543/?tool=pmcentrez

      In this review we describe and discuss several approaches to selecting higher plants as candidates for drug development with the greatest possibility of success. We emphasize the role of information derived from various systems of traditional medicine (ethnomedicine) and its utility for drug discovery purposes. We have identified 122 compounds of defined structure, obtained from only 94 species of plants, that are used globally as drugs and demonstrate that 80% of these have had an ethnomedical use identical or related to the current use of the active elements of the plant. We identify and discuss advantages and disadvantages of using plants as starting points for drug development, specifically those used in traditional medicine.

      So, maybe the toothfairy was giving the shamans some good advice as well.

      1. With respect to St. John’s Wort, if it is indeed powerful medicine with side effects comparable to other treatments, then I fully agree with Dr. Oakeley that it should be restricted. There may indeed be a bias against it; I’ve no doubt it many doctors don’t consider it because its provenance is not the one they are used to, i.e., big pharmaceutical companies.

        I took the time to read the article (well, not the technical bits, I confess) and I thank you for the interesting link. I had heard the general consensus was that on the whole traditional medical treatments (n.b. – not the same thing as the use of plants in traditional medicine) were on the whole as likely to harm as help, and were on the whole no better than guesswork. I am unqualified to judge the import of the paper, but neither am I going to let some half-remembered headline colour my view of ethnobotanic medicine.

        I’m inclined, then, to believe that traditional medicine is a good starting point for research, but when I’m not going to trust a claim about the world whose chief support is that it’s been around a long time when scientific study is available. (Scientists may as a class be remiss in studying the claims of ancient medicine, but that is a whole separate kettle of herbs.)

        1. Thanks for the measured response. The studies that I’ve read on St. John’s wort lead me to believe it’s side effects are likely less than Prozac. And it may be milder in efficacy. I believe it’s likely appropriate as an OTC, but that’s just my belief. People self-medicating with alcohol is likely more dangerous. St. John’s wort also has the benefit that overdose leads to instant emesis, which is a great safety valve. A professor I know tested that, he said he couldn’t even make it to the sink.

          I’m likely in agreement with you, I don’t believe in any herb or drug without reading studies. “Food” herbs that have long been in the diet I’m willing to try much more freely.

          My distaste at the original article is the bias in the doc’s statements. If someone in charge of a gene therapy institute said gene therapy largely doesn’t work, original premises were overly optimistic and he’s personally pessimistic about its future, I’d kind of wonder if maybe someone else with a little more enthusiasm might be better qualified for the job.

  21. It takes many years to be a good herbalist. I’ve had very good results from Chinese Herbal treatments. A good herbalist will say that plants are not absolute in their treatment usage. Pharmaceuticals are intended to be, for the most part, a one-size-fits-all solution, which is absurd in itself. Herbalists realized centuries ago that doesn’t work. Plants don’t treat that way. Often they are placed in combination with numerous other herbs to achieve a certain effect. And again, it all depends upon the unique condition of the patient. How many MDs are equipped to judge the unique condition of a patient with all its subtlety? From personal experience I’ve met perhaps 2 in 50 years. Although Dr Henry makes a good point, as a precaution, he is also trained in the view of absolutes rather than relatives. Herbal medicine, like acupuncture, is a science of relativity. In fact, it is more comparable to an art, then our traditional sense of science. But that doesn’t make it any less likely to produce actual results.

  22. I agree with dccarles here, I don’t really think it was meant at a jab at traditional societies (would he be scolding them for not having invented the scientific method a few thousand years early?), more at modern folks who think that because something is “traditional” or “herbal” it’s likely to be superior to bad ol’ “chemicals”.

  23. If plant medicine is all bunk, why then do pharmaceutical companies send researchers to villages in the rainforest to find out what plants the healers use to break fevers, stomachaches, etc, and then collect those very plants to discover what their active ingredients are?

    Not all plant medicine is accurate, but I doubt humans would have been alive as long as we have been if there wasn’t a good amount of medicinal experimentation going on through the millenia.

    1. If plant medicine is all bunk…

      Forget reading the first article, just read the first paragraph of the post. “MOST” ≠ “ALL”

    2. Pharmaceutical companies are trying to check everything. Yes, they’re going through tropical plants, and asking villagers what to try first is better than picking at random. But at least as far as treating cancer, AIDS, and antibiotic-resistant bacteria go, the types of compounds plants produce are relatively well-known. Instead the most promising sources seem to be organisms that haven’t been looked at so much – sponges, protozoa, seaweeds, new marine bacteria, and so on.

  24. It takes many years to be a good herbalist, longer than it takes to be an MD. The number I get from most Chinese Doctors is about 10 years of actual practice. This would be on top of other related education, such as Chi Kung, and the philosophy/science of Yin/Yang, and Five Elements. I’ve had very good results from Chinese Herbal treatments. A good herbalist will say that plants are not absolute in their treatment usage. Pharmaceuticals are intended to be, for the most part, a one-size-fits-all solution, which is absurd in itself. Herbalists realized centuries ago that rarely works. Plants don’t treat that way. Often they are placed in combination with numerous other herbs to achieve a certain effect. And again, it all depends upon the unique condition of the patient. How many MDs are equipped to judge the unique condition of a patient with all its subtlety? From personal experience I’ve met perhaps 2 or 3 in 50 years. Although Dr Henry makes a good point, as a precaution, he is also trained in the view of absolutes rather than relatives. Herbal medicine, like acupuncture, is a science of relativity. In fact, it is more comparable to an art, than our traditional sense of science. But that doesn’t make it any less likely to produce actual results.

    1. he is also trained in the view of absolutes rather than relatives.

      Well, he seems to be bucking that training. Maybe you missed that part? Observe:

      Oakeley doesn’t deny that some plants have been useful, with plant-based chemicals leading to the development of important medicines. And, sometimes, ancient people guessed right, using those plants to treat the very things the plant-derived prescriptions treat today. His argument is simply that you can’t just trust the ancients’ opinion on a plant’s medicinal value without first proving that it is effective and safe.

      1. Actually, he is speaking in absolutes there. He says, “ancient peoples guessed right,” implying a non-relative criterion of which he is aware but not they. Also, (pharmaceutical) chemicals are, by definition, quantifiable entities with (assumed) constant effects — not like plants. It may be possible, with some as yet unknown science, to define the effects of plants in a way similar to the way the effects of chemicals are defined, assuming one had the ability to completely articulate the condition of a patient and all the possible activities of a plant. I don’t think that is practical, however. The approach has to be holistic (uh, oh — there’s that word. I’m damned now!)

        I certainly agree that superstition and tradition poison all sciences, including Herbology. Especially now when few people have the time to take up the practice of Herbology in the proper way, with lengthy apprenticeships. It’s a science that must be “caught” rather than “taught,” if you see my meaning. It’s too complex to lend itself to a syllogistic analytic. Even if one were developed, I don’t think any mind would be able to retain it and use it correctly or practically. And I’m not sure a computer could be programmed because it evolves over time and involves a degree of intuition (which is sometimes effective, sometimes not). That’s how Herbology evolved.

        Please don’t attack me for using the concept of holism or intuition. These concepts are not alien to our western tradition of science, and are in fact inherent to its progress. Einstein’s relativity started as an intuition and took a long time to formulate. Holism is a common enough term in science these days as well — the idea and observation that systems function in synergistic ways, beyond the mere definable qualities of their components. Chaos theory and Wolfram’s NKS allude to that kind of thing.

  25. I did go back and read TFA, and the biggest bunk here is the title and tone of this article.

    The original interview, while somewhat sensationalized, does eventually touch on his original premise. The BB article above makes Dr Oakeley look like an idiot.

    I agree that the medicional use of plant material began long before scientific methods developed, our (still) primitive understanding of health has been largely replaced by deception and greed of the pharmaceutical industry. While there is some good reserch going on, the vast majority of effort is spent trying to create a patentable version of a natural substance. If the patent system were not so primitive (or the companies were not so greedy), we would be much farther along the path of understanding.

  26. “ktrammel
    It takes many years to be a good herbalist, longer than it takes to be an MD. The number I get from most Chinese Doctors is about 10 years of actual practice. This would be on top of other related education, such as Chi Kung, and the philosophy/science of Yin/Yang, and Five Elements.”

    The issue is not how long someone has studied an alternative medical practice but whether it actually works. You can study the “Yin/Yang, and Five Elements,” or how many angels can dance on the head of a pin, for decades but that doesn’t prove the efficacy of the treatment.

    “I’ve had very good results from Chinese Herbal treatments.”

    Personal annecdotes are not proof of efficacy. People used to think they had “very good results” from the poultices, purging and bloodletting of Medieval humorism, but humorism is nonsense of the same appeal to tradition that herbalism comes from.

    “Pharmaceuticals are intended to be, for the most part, a one-size-fits-all solution, which is absurd in itself. Herbalists realized centuries ago that rarely works. Plants don’t treat that way. “

    Plants don’t “treat that way”? Now it sounds like you are appealing to magic.

    Often they are placed in combination with numerous other herbs to achieve a certain effect. And again, it all depends upon the unique condition of the patient. How many MDs are equipped to judge the unique condition of a patient with all its subtlety?

    Ah, the appeal to “individualized” treatments. Individualized treatment is a way for every treatment to be an anecdote. However, individualized treatment can be studied, and it fails.

    Conclusions
    There is a sparsity of evidence regarding the effectiveness of individualised herbal medicine and no convincing evidence to support the use of individualised herbal medicine in any indication.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600130/

    1. Dear Skep… I apologize I missed the rest of your critique. It would take a very long time to reply to it. It’s taken me years to gain what little understanding I do have about this subject. But, it’s quite clear you haven’t taken it upon yourself to study the topic seriously or you would have gained new insights beyond those which now limit your thinking. You’re understanding is confined to the “studies” which often produce different results depending upon the assumptions made when the study is designed and when the data are interpreted. Your thinking is also conditioned by a faith in absolutes, which simply don’t exist in the sense you believe them to exist. No concept is perfect, or complete, because a concept is a fragment. If you could study that last statement, investigate other references to that idea, I think you’d find you wouldn’t be such an automatic skeptic. I’m not being judgmental or condemning you. I was the same way when young. I’m also not trying to put myself above you. These are just the things that have worked for me. What can anyone share but their own point of you, just as you have done? My personal experience with Herbology would be meaningless if it were not something shared by many, for thousands of years (but again, one has to study this extensively to come to that conclusion). Our tradition of understanding things here in the US must expand itself and become more capable of recognizing holism and subtle causes that lead to unexpected effects. If you’re really interested in going beyond your current understanding, you’re going to have to take some “risks in thought.” If you’re content with where you are, then there’s nothing more to be said.

      1. “ktrammel in reply to Skep

        Dear Skep… I apologize I missed the rest of your critique. It would take a very long time to reply to it. It’s taken me years to gain what little understanding I do have about this subject. But, it’s quite clear you haven’t taken it upon yourself to study the topic seriously…. Our tradition of understanding things here in the US must expand itself and become more capable of recognizing holism and subtle causes that lead to unexpected effects.”

        Do you see what is missing from your long response? Any proof of efficacy.

        I don’t really care if you want to invoke decades-long training, or holism, or whatnot. Just cut to the chase. Prove in large scale studies that are properly designed to compensate for bias that your treatment works. Until then all of your other comments are moot.

        Keep in mind what Rchard Feynman noted, “Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.” The extent to which you, ktrammel, reject the scientific method is the extent to which you leave yourself open to fooling yourself.

        1. Skep, you need to prove it for yourself. The “experts” can’t do your homework for you. See my last post.

          1. Skep, you need to prove it for yourself. The “experts” can’t do your homework for you.

            That’s why I’ll refuse to accept that Plutonium is a dangerous material to use for dental fillings until I personally develop acute radiation poisoning.

          2. And will you also refuse to agree that stepping out in front of a gravel-pit-truck full of rock is deadly until you actually do it? Of course you would not rely on direct experience for proof that that would probably kill you. Children past a certain age know this. There are subtle and not-so-subtle things. There are complex systems, and simple systems. Trucks and plutonium are not subtle. Health and healing is.

            Would you assume that having a 4 foot 1″ diameter rod of iron driven through your skull would kill you? Although I don’t remember the exact dimensions of the rod, this happened to a man many years ago while tamping dynamite into a hole drilled in a rock — he lived. There were other factors in play than might be apparent from the mere description of the event.

            There are always exceptions and things are much more involved than the illusions of analysis imply. Then again, analysis is useful, too. It’s not so black and white as you indicate. There are illusions all around. There are truths all around. Between them is the gray area of personal investigation and discovery. When you were 2, you may not have known that plutonium would kill you, and would have happily chewed on a chunk of it. After undertaking your own course of education, you understand that it will.

          3. When you were 2, you may not have known that plutonium would kill you, and would have happily chewed on a chunk of it. After undertaking your own course of education, you understand that it will.

            But only because my “system of education” included information from experts on the effects of Plutonium. I’ve never even seen the stuff myself, let alone witnessed and evaluated the effects of long-term exposure. The health effects are only “obvious” today because they have been so well documented.

            My point being that it’s silly to imply we should test all medical claims ourselves instead of relying on experts. It’s not feasible or wise to do so, which is why, when evaluating claims, it’s generally a good idea to go with whichever group of experts has the best track record and system of peer review.

            (Note to Antinous: this does not mean that think that group of experts must be directly associated with “Big Pharma.” The discipline of medical science and the business of medicine are two different things which, sadly, do not always go together.)

          4. But you’ve investigated things enough to feel confident in your agreement with the conclusions of your chosen experts? You don’t accept everything simply because they say it? You at least maintain a place for reasonable doubt?

            May I ask how involved one’s been in verifying the claims of these experts with regard to herbology? Have you read about or experienced first hand the work of experienced herbologists?

          5. I don’t have absolute confidence in either group, but if I have to put stock in the claims of one expert over another it’s going to be whichever one has the most compelling collection of tested data to back up their claims.

            The reason I’m skeptical of herbology as a substitute/supplement for evidence-based medicine is that I worry anyone who can’t or won’t submit their claims to controlled tests is either ignorant of the scientific process, self-deluded, or hiding something.

          6. anyone who can’t or won’t submit their claims to controlled tests is either ignorant of the scientific process, self-deluded, or hiding something

            You do realize someone could actually be in all three categories … ;-)

  27. The “many plants are poisonous” part is bunk already. “Poisonous” is a relative term. It’s the dose that defines what is toxic and what isn’t. Try ingesting a gallon of pure Vitamin C.

    And I can’t believe this shit really gets posted with that shamefully misleading “Plant medicine is bunk” bait. Where did you learn this fine style of journalism that enables you to post articles here? At Tabloid University?

  28. I think the real problem here is that the Indignant Herbalists and Defenders of Our Ancestors’ Way Of Doing Things don’t realize how hard it is, even given a really, really good candidate from a natural source, to turn that into a viable pharmaceutical product.

    Medicinally useful compounds tend to fall into three categories of structural complexity:

    1. low – no unusual elements (C, N, O and H only) or ring structures and low molecular weight (500 Daltons-ish) – eg salicylic acid

    2. medium – some unusual elements (Cl, F, S etc) and/or medium weight (>500 Daltons) and/or unusual ring structures, or polymeric structures – eg the macrolides, lupeol etc

    3. insane – proteins such as antibodies, or multi-ringed beasties – the lignans and neolignans such as helicterin B, and compounds such as chamaecypanone C, for example, which are plant derived – although most of these weirdos come from marine organisms for some reason (consider palau’amine and “the thing” known only as TP-1161) …

    But the problem is that the (relatively) easily synthesizable compounds are likely to already have been stumbled upon by evolution, so you have to be careful not to disrupt an important metabolic pathway by slinging a metaphorical chemical spanner in it. This is why simple compounds like salicylic acid are a medicinal chemist’s dream – not part of the human biological pathway, but with a useful and largely non-fatal effect (although they are a broad-range COX inhibitor, which is what led to COX II inhibitors like Celebrex and Vioxx, which have unfortunate side effects because of their suppression of parts of the arachidonic acid cascade relating to production of prostaglandins, which are part of the pain pathway, but also influence blood pressure regulation by the kidneys… but I digress …)

    Small, lightweight, easy to synthesize, cheap, non-polar, non-greasy, rigid, biologically relevant, safe, effective … these are a few adjectives used to describe the ideal drug.

    Unfortunately, such compounds are very rare (although they still turn up in the recent literature) and much effort is dedicated to creating them, both in actual laboratories and in computers. There are a lot of candidates – some estimates have it as 10E+60 biologically relevant small molecule compounds, of which the FDA has approved around 1,500 …

    The medium-to-high complexity compounds are hard (or impossible) to synthesize, so are usually harvested – taxol, for example, is usually extracted from yew trees, or penicillin is grown in vats. Finding new ones is a bit of a treasure hunt – medicinal biochemists will sample dung and sewer outlets for unusual fungi or bacteria, also plants, trees, marine organisms. Anything with an unusual or tough ecological niche is good.

    So, no, it’s not good enough to just skip through the forest plucking leaves to dry for your magic brew …

  29. A lot of woo in this thread.

    If you think that chemical compounds that come from corporations are inherently good or evil, you are stupid.

    If you think that chemical compounds that come from plants are inherently good or evil, you are stupid.

    The origins of chemical compounds are unrelated to their efficacy, m’kay?

    Skep uses circular logic; if herbalism works (digitalis, aspirin, thousands of other compounds) then it’s not herbalism, it’s medicine. His opponents are nearly as bad; just because a corporation has duplicated an efficacious compound, it isn’t suddenly evil. Both arguments are faith-based woo, and have no scientific component at all.

    Herbalists and corporate medicine are economic rivals and will always slag each other. The fact is, there are healers in the ranks of both armies, and total quacks as well. Asking a retired physician to sit judgement on herbalism has the expected outcome.

  30. I realize that my last post is probably going to seem like an attempt to “cut and run.” I apologize for that, and I will agree that it is incomplete and could probably be better stated. But I just want to leave this particular thread with the thought that this topic cannot be briefly or succinctly treated. It doesn’t lend itself to easy quantification. And, really, it’s an injustice to all of us to try to treat it that way.

    I’d like to be able to say more about it, to respond to Skep’s remarks more thoroughly, but I simply don’t have time. That’s why I’m attempting to suggest further study. There are two very good books on Chinese Herbology:

    The Way of Chinese Herbs
    Michael Tierra (Author)

    The Complete Book of Chinese Health & Healing: Guarding the Three Treasures
    Daniel Reid (Author)

    Lobsang Dhondup, a Tibetan Physician, is doing research with UC Santa Barbara on herbs that exhibit the ability to restore damaged nerves. See http://www.tibetanacademy.org/lobstaff.html

    The Institute for Functional Medicine is also doing good work: http://www.functionalmedicine.org/about/mission.asp

  31. And yet, magically, a glass of red wine per day is still the best heart attack prevention. If it were produced by the pharmaceutical industry, we would have little vials of diluted ethanol. Which wouldn’t work. In wine, it’s most likely the congeners that produce the health effects and counter the negative effects of pure alcohol.

    As long as the pharmaceutical industry operates on the idea of isolating and synthesizing that one super-duper special compound and delivering it without its naturally-occurring ‘congeners’, they’re the ones who are employing magical thinking. The idea of a miracle drug is woo. It works in vitro and only the studies that support it working in vivo ever see the light of day.

    1. That’s a terrible example – ethanol wouldn’t work because it’s not the medicinal ingredient in wine. If you figured out exactly which antioxidants and other active compounds contains, you might very well get a pill that works better, and that’s what clinical studies are about.

    2. 1. Actually the evidence on the red wine is a bit mixed, as is typical in studies that are basically based on statistical data-mining of links between behavior and disease rather than mechanism. Not that such studies aren’t useful; many discoveries (such as the link between lung cancer and smoking) were originally just statistics. But many more purported links were later discovered to be artifacts, and it doesn’t help the publics’ understanding of science to be constantly bombarded with “red wine (coffee, chocolate, etc) is good for you/no it isn’t” without details of the study.

      2) You can say many negative things about the pharmaceutical industry, but the idea that they can get something on the market with only in vitro results is complete bollocks. Clinical trials in people are required before anything gets delivered. This is what stops university scientists from just turning their discoveries (typically in vitro, or maybe with a mouse model) into drugs without industrial help.

      1. Clinical trials in people are required before anything gets delivered.

        I’m not suggesting that you could go to market without clinical trials. Just that clinical trials frequently return quite different results and the company that’s funding them will attempt to bury the negative ones if its at all feasible. And unfavorable post-market data gets sucked straight into an alternate universe. Anti-depressants, in particular, have been the source of some pretty horrifying manipulation.

        1. Just that clinical trials frequently return quite different results and the company that’s funding them will attempt to bury the negative ones if its at all feasible. And unfavorable post-market data gets sucked straight into an alternate universe. Anti-depressants, in particular, have been the source of some pretty horrifying manipulation.

          But, still, what has this got to do with actual R&D? So, pharmaceutical companies’ senior management are a bunch of money grubbing sociopaths? Yes. And? What does that have to do with research and development? Actually, it turns out that – surprise – aspirin is an excellent preventative medicine for heart disease – one single super-duper special compound!

          Sorry, the woo with regard to the medicinal chemistry is most definitely coming from your side today.

          1. But, still, what has this got to do with actual R&D?

            You don’t think that the fact that the researchers and their labs are paid for by what you call “a bunch of money grubbing sociopaths” might have just the teensiest effect on the results of the research? Did you forget to take your Gulliblexâ„¢ this morning?

          2. Industry effects cut both ways, though. The herbal industry might not be quite as big as the pharmaceutical industry, but it has exactly the same motivation to lie about what it does.

          3. You don’t think that the fact that the researchers and their labs are paid for by what you call “a bunch of money grubbing sociopaths” might have just the teensiest effect on the results of the research?

            No.

            Drug discovery R&D departments are populated with people whose reputations are based on intellectual property and publication. Yes, of course these goals are driven by the broad commercial focus of the company (so you’ll get papers on 5-HT receptors published by Lundbeck and Neurosearch, and papers on vitamin D analogues published by LEO Pharma, for example), but overall, the researchers are given considerable leeway to start new research projects. It has to be that way, given the unpredictability of chemical biology.

            Or, rather, that’s how it used to be …

            Nearly all pharma company senior management views R&D as an irritating and expensive barrier to profit these days. For goodness sake, look at Merck, Pfizer, GSK, Sanofi, J&J … the list goes on … and tell me how many are actively building their R&D departments year on year? R&D people have no time for senior management in these companies.

            The genius sociopaths are planning on effectively out-sourcing their drug discovery programs because R&D is very expensive, and has not been terribly effective in the last few decades.

        2. Of course there have been manipulations of clinical trials, largely encouraged by the Reagan-era defanging of the FDA, and unwittingly helped by cancer and HIV activists who demonize needed regulatory oversight as “red tape” in drug development. But just like faulty criminal trials doesn’t mean that we shouldn’t try to figure out if people are guilty or not, the solution to faulty clinical trials is better clinical trials.

    3. Antinous, it’s clear that you actually don’t understand how drug discovery works (or organic chemistry, it seems), and your red wine argument is an obvious straw man. There are hundreds of chemical compounds in red wine, most of which have not been analysed in any details because of the difficulty of, for example, teasing out a single polyphenol from maybe dozens of other almost identical compounds in sufficient quantities to do NMR on it, then figuring out the actual stereochemistry and whether it’s a bioactive isostere, and then either getting enough red wine to concentrate it (expensive) or synthesizing it from scratch (also expensive).

      It’s hard enough to try to find and develop one biologically relevant compound for a well-understood disease model in vitro, let alone starting off on random fishing trips into medical oenoculture. Come back and lecture us when you have a better idea.

      1. Antinous, it’s clear that you actually don’t understand how drug discovery works (or organic chemistry, it seems), and your red wine argument is an obvious straw man.

        I understand the issue perfectly: you just drink the wine because it works. My point is that the pharmaceutical industry is based on the idea that, if you can’t isolate a single magic substance, then taking the source material is woo.

        1. My point is that the pharmaceutical industry is based on the idea that, if you can’t isolate a single magic substance, then taking the source material is woo.

          Which is why clavulanic acid, which is only effective when taken with other drugs, was never produced?

        2. the pharmaceutical industry is based on the idea that, if you can’t isolate a single magic substance, then taking the source material is woo.

          Yeah, because there’s that small thing called “safety and efficacy” which people seem to get hung up on. Red wine, as lovely and tasty as it is, has its problems. It’s got lots of lovely antioxidants to scavenge those free radicals – and is full of stuff that gives you a headache, red teeth and liver cancer if you’re not careful. It probably shouldn’t be taken if you’re flying a plane, or driving, operating heavy machinery, pregnant or an infant. Some people object to it on religious or ethical grounds. And so on and so forth.

          Aaaaand there’s no clear evidence, yet, that it works, anyway. Who knows? Maybe. There’s some tantalising clues, based on the polyphenolic content, but really, it isn’t even close to a cure for anything.

    4. This is the absolute truth! This is why I daily imbibe both medicinal Guinness (Guinness For Strength!) and the more than occasional bottle of Shiraz. My wife won’t hear of it, but I say, the more preventative, the merrier.

  32. “ktrammel
    It doesn’t lend itself to easy quantification. And, really, it’s an injustice to all of us to try to treat it that way.

    Blah, blah, blah, our methods can’t be tested by reductionist science, blah, blah, blah.

    That is the common excuse of CAM proponents. Why? Because CAM constantly fails properly designed tests. And since Individualized Herbalism can’t possibly be wrong, the tests and all of science must be wrong!!!

    Sorry, ktrammel, but that isn’t how science, or real knowledge, works. If individualized herbalism has an effect it can be tested and measured, but in science you have to follow where the sound and tested evidence leads, even if it means having to update your beliefs and reject what you once thought to be true.

    This anecdote (which I offer as an illustration no as proof :-) ) reminds me of your claims.

    http://www.quackwatch.org/01QuackeryRelatedTopics/ideomotor.html

    A group of Chiropractors was demonstrating their claim that the body reacts differently to sucrose and fructose. They put the substance on a person’s tongue and pushed down on the person’s outstretched arm. It was easy to push down the arms of those given sucrose but not those given fructose! Proof. Case closed.

    Then the Chiropractors were challenged to do the test without knowing who was given what substance:

    When these results were announced, the head chiropractor turned to me and said, “You see, that is why we never do double-blind testing anymore. It never works!” At first I thought he was joking. It turned it out he was quite serious. Since he “knew” that applied kinesiology works, and the best scientific method shows that it does not work, then — in his mind — there must be something wrong with the scientific method. This is both a form of loopholism as well as an illustration of what I call the plea for special dispensation. Many pseudo- and fringe-scientists often react to the failure of science to confirm their prized beliefs, not by gracefully accepting the possibility that they were wrong, but by arguing that science is defective.”

    I’d say that is you. You ‘know’ that individualized herbalism works. Cognitive dissonance theory suggests that since you’ve dedicated much of your life to this idea that your brain will automatically filter out contrary evidence, as you are doing now. All too often it is CAM proponents who are the closed minded ones. I’m open to evidence. Are you open to evidence that individualized herbalism is not efficacious?

    1. I’m open to evidence.

      Your blanket statement should probably be revised somewhat to indicate your rigorous definition of what evidence actually is.

      I have a friend who insists that all evidence must be referenced by the King James version of the Christian Bible. Because he’s honest about this, it is possible to have an honest argument with him, even if you think Christianity is bunk.

      What is your definition of evidence? You’ve made it clear that you do not accept personal observation as valid evidence, but I can’t figure out what you do believe in. You’ve rejected several printed sources. Are there specific institutions or practices you find worthy? Is there a time limit?

  33. “and natives have been using plants as medicine for thousands of years.”

    This is what gets me, and its gets under my skin because its racism.

    There are no “Magic Natives”. They are just people like anyone else, and there culture is no more advanced than any other historical culture without the scientific method.

    You know what else was proscribed by various native groups for thousands of years? What is still proscribed?

    Leeches, blood letting, raping a virgin to cure diseases, CANNIBALISM (even to this day in P.N.G.), anointing with oils, prayer

    Just because its been done for thousands of years doesn’t mean it works. In case you have forgotten, most groups one would classify as natives died off from disease in a hurry precisely because their ‘medicine’ was bunk.

    1. In case you have forgotten, most groups one would classify as natives died off from disease in a hurry precisely because their ‘medicine’ was bunk.

      Let’s be fair… the state of medical science in Europe wasn’t anything to brag about at the time either. The native inhabitants of places that Europeans colonized didn’t die off because they had inferior medicine, they died off because their immune systems weren’t adapted to handle the diseases that Europeans brought with them as a result of living in close contact with domestic livestock for thousands of years.

  34. Oh gee, I am so surprised that Indians and Chinese people who were educated in a system of educated founded by and based off of the British would believe that capitalism and western science are the only narrative.

    A little something I’ve learnt: Institutions hegemonize! Even schools! I know, it’s shocking. Foucault who?

    Another something you might learn from: I’m from India. Born and brought up. Does that blow your mind?
    Here’s another: I am not anti-western science! Yet another shock! I’m simply very aware of the relationship between power, knowledge and legitimacy.

    1. I am so surprised that Indians and Chinese people who were educated in a system of educated founded by and based off of the British would believe that capitalism and western science are the only narrative.

      Which is why Buddhism, yoga, acupuncture, ayurvedic medicine, qi balancers, feng shui and the like are unheard of today, right?

      1. Of course they’re heard of, but not as “science”. They used to be at one point of time. But they’re not now, because “science” is synonymous with Western science.

        As for the ethnocentrism, my comment was geared more towards, the tendency to see the science-alternative medicine debate as a purely Western phenomenon. Oakeley is quite balanced on the point of how time proves one wrong over and over again. But we’re ignoring the matter of space.

        As for plucking leaves, I’m glad the EPO did not take your stand:
        http://en.wikipedia.org/wiki/Azadirachta_indica#Patent_Controversy

          1. How is it different that a pharma company attempted to secure exclusive rights to the process that would have made use of a plant’s medicinal properties? We are arguing about how pharmas control knowledge for the sake of profit, aren’t we?

          2. How is it different that a pharma company attempted to secure exclusive rights to the process that would have made use of a plant’s medicinal properties? We are arguing about how pharmas control knowledge for the sake of profit, aren’t we?

            No. The patent was overturned (quite rightly) because of prior art claims.

            “Work” meaning process.

            No. Work meaning intellectual pursuit with absolutely no guarantee of success.

          3. The prior art claims here are books of traditional medicine that were thousands of years old. Ayurveda, in other words. And the pharma company was still trying to pull one over traditional medicine because it had its privileged notion of “science” and monetary support.

            And I think you might need to look into what “privileged” means if you think it is presumptuous of me to use it. Everyone is privileged. Including me. Which I am aware of. You, however, consider it to be insulting when someone points out that you have privilege.

          4. Also, the privileged part was cut off from my response to that other poster. So I typed it in with my response to you.

    2. Well, to be fair, you seem to be influenced by postmodernist obscurantism (buzzword check: narrative, Foucault, hegemonize), which is a Western product as worthless as any ayurvedic potion, so at least it’s nice to know there is free trade of nonsense going from, as well as to, the West.

      1. Nice! I am not worth listening to, because
        a. I employ language that you don’t consider as having value
        b. possess views that do not conform to the rationalist-capitalist model

        That’s a nice combination of liberal-snobbery and republican-nearsightedness.

        Are these worthless because you don’t agree with them or because you have tested their productivity and found them lacking?

        Anyways, no point in arguing with the privileged (<- also a buzzword used in feminist, anti-racism circles. They're also worthless, no?).

  35. Anyways, no point in arguing with the privileged ( <- buzzword used in feminist circles; also a product of postmodernism. Worthless, no?)

  36. Ok, London has produced another nut. That’s not news.

    Please explain the “delightful” part.

  37. In your own words, “There’s actually, usually, a good deal of work involved to turn a folk remedy into a viable potent drug.”
    “Work” meaning process.

    And for some reason my last line in the other comment keeps getting cut off. sigh.

    Again:
    Anyways, no point in arguing with the privileged – also a buzzword usually employed in feminist circles, which incidentally is also a product of postmodernism (the current form). That’s also worthless, no?

    1. no point in arguing with the privileged

      How arrogant, how presumptuous, how contemptuous, and yet how vapid that statement is. Itself positively rotten with privilege, and yet how faux-humble it appears to be.

      Leave the hyperbole and rhetoric out. It doesn’t suit the subject matter one jot.

  38. This is simply not true. I personally have used nothing but herbal remedies for the past ten years (with one exception for AB), and…they work. I’ve had a great record of them.

    There was this kindly older gentleman who sold Chinese herbs at the public market in Jeju, Korea. He was pushing 80, with crisp silver hair. First time I ever saw him, he was wearing a neon orange shag vest – like a raver vest. He was absolutely he was strong and fit as could be, as he showed me once. It felt like he was going to snap my arm off!

    He had about 40 or 50 styrofoam bins, each one holding a different plant. I would pantomime my symptoms for him. He had this ancient wrinkled book, half Korean and half Chinese, and he would spend about ten minutes puttering around with all of his herbs and putting together a mixture, which I drank as tea.

    I think I must have gone to him five or six times while I was there, a couple times really quite sick. I can attest – his crazy teas worked. EVERY time I visited him (also taking for instance oregano and ‘wellness formula’), I was well within 24-36 hours. Without exception. He also helped a few of my friends.

    The total price of his mixes was never more than $5 or $10.

    Contrast this to two or three of my friends in Korea. They went to a hospital, paid a reasonably low (state subsidized) fee, and were given large doses of antibiotics and other pills for a couple weeks. During the three years I was there, two or three of my friends got so sick after all the pills the doctor gave them that they had to leave the country.

    They give AB to people in Korea like we give to cows in America. At the first symptom!

    It’s interesting to note that the vendor operated in what was very effectively a truly free and voluntary market, with no particular authority overseeing his actions other than his personal reputation within the ‘O-Il-Jang’ (Five Day Market).

    Sadly he wasn’t there the last several months I was in Korea. It’s really a shame.

    What are most pharmaceuticals other than organic plant compounds extracted and refined?

    No matter what the may feel, I for one hope that others continue to study his path and replace him at the market. In terms of affordability, safety, and effectiveness..I believe herbs will play a much more significant part in the health system of the future.

    A future built on maintaining health, instead of maintaining illness.

    1. What are most pharmaceuticals other than organic plant compounds extracted and refined?

      You are joking, right?

      Good grief.

  39. What are most pharmaceuticals other than organic plant compounds extracted and refined?

    This statement is simply not true. I personally have used almost nothing but herbal remedies for the past ten years , and…they work. I’ve had a great record with them.

    Let me tell a little story:

    There was this kindly older gentleman who sold Chinese herbs at the public market in Jeju, Korea. He was pushing 80, with crisp silver hair. First time I ever saw him, he was wearing a neon orange shag vest – like a raver vest. He was absolutely he was strong and fit as could be, as he showed me once. It felt like he was going to snap my arm off!

    He had about 40 or 50 styrofoam bins, each one holding a different plant. Each totally lacking the others’ language, I would pantomime my symptoms for him. He had this ancient wrinkled book, half Korean and half Chinese, and he would spend about ten minutes puttering around with all of his herbs and putting together a mixture, which I drank as tea.

    I think I must have gone to him five or six times while I was there, a couple times really quite sick. I can attest – his crazy teas worked. EVERY time I visited him (also taking for instance oregano and ‘wellness formula’), I was well within 24-36 hours. Without exception. He also helped a few of my friends.

    The total price of his mixes was never more than $5 or $10.

    Contrast this to two or three of my friends in Korea. They went to the shiny modern hospital, paid a reasonably low (state subsidized) fee, and were given large doses of antibiotics and other pills to take for a couple weeks. During the three years I was there, two or three of my friends got so sick after all the pills the doctor gave them that they had to leave the country.

    They give AB to people in Korea like we give to cows in America. At the first symptom!

    It’s interesting to note that the vendor operated in what was very effectively a truly free and voluntary market, with no particular authority overseeing his actions other than his personal reputation within the ‘O-Il-Jang’ (Five Day Market).

    Sadly he wasn’t there the last several months I was in Korea. It’s really a shame. His 50 little bins (he also sold sea weed and delicious fresh pine nuts) were replaced by a lady selling hog’s heads. :'(

    No matter what the may feel, I for one hope that others continue to study his path and replace him at the market. In terms of affordability, safety, and effectiveness..I believe herbs will play a much more significant part in the health system of the future.

    A future built on maintaining health, instead of maintaining illness.

    1. What are most pharmaceuticals other than organic plant compounds extracted and refined?

      Organic plant and animal compounds extracted, refined, tested, and selected; and more often chemically altered to form different compounds with similar of improved effectiveness, and less undesirable effects. Even aspirin, mentioned many times here as a plant-derived pharmaceutical, does not actually occur in willow bark.

      Most times I’m sick I get better within a few days, even in the absence of medicine and tea. Sometimes I don’t, and for those times I’m glad someone went to the trouble of weeding out the many factors that confound results from personal experience.

  40. Most drugs today are derivatives of plant products. The comments by the doctor on plants wanting to poison us are weird – of course they do. Nearly all medicines are poisons in large enough quantities, and nearly all poisons have medicinal uses. That’s the whole point: they have metabolic activity. Too much = death. Lesser = metabolic regulation. It’s precisely because plants want to kill us that we find so many useful products.

    The derivative process (chemical alteration of side chains) has two primary effects that are sought: to increase the desired metabolic activity while reducing effects on other paths, and to make the product patentable (which natural products are not). There are a number of cases where the second effect is the primary result, there are a number of cases where the first effect is realised, and there are a number of cases where the first effect has only mixed results (increasing potency but also triggering new metabolic paths, …).

    Indigenous uses of plants had many reasons. Some were for things like the doctrine of signatures (similar form = benefit that organ) and other mythologies, but many were just for trial and effect. Which is why they had a fairly good record of finding medicinal plants, which is the heart of modern medicine. Ethnobotany is a science too, and much of the debate here seems to assume that indigenous people’s choices could not have scientific origins or that natural plants and science are opposed. Not all use of synthetic medicines are better, nor are they all worse.

  41. medical condition: scurvy
    cause: lack of vitamin c
    cure: eat plants with high vitamin c content
    ????
    plant medicine

    1. “Anon

      medical condition: scurvy
      cause: lack of vitamin c
      cure: eat plants with high vitamin c content
      ????
      plant medicine”

      No, that is **nutrition**. Scurvy is caused by a nutritional deficiency. Proper nutrition is not medicine per se.

  42. Let’s remember conventional pharmaceuticals are synthesizations of plant compounds and once you’ve synthesize them the curative properties are lost and you’re left with side effects and temporary relief. Most of the time you’re left open to further infection. Also, since the average person rarely consumes raw foods or minimally processed foods along with usually growing up with conventional medicines, their bodies aren’t as quick to respond to the natural alternative. Over time after the chemicals are broken down the body can revert back to accepting the natural. Plus, anything in large quantaties can be fatal, hell drink too much water and you’ll drown yourself. Most poisonous plants are known by the doctors who prescribe the use of herbs or which parts are unusable. In a world where anasthetics contain cocaine and cigarettes are filled with arsenic, who would want to believe a plant would have any medicinal use?

    1. Wonderful excursion into fantasy chemistry. Now go and do some reading about what medicinal chemistry really is.

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