In every culture, in every age, there are different theories of disease and different fashions in medicine, but botanical remedies are universal. Civilized societies have bequeathed us myths and compendiums of healing herbs, and the medicine men and women of preliterate societies continue to surprise us with their extensive green pharmacy. Today, from forty to fifty percent of pharmaceutical drugs are plant-derived, and pharmaceutical houses are beating the bushes in South America and Africa in search of botanicals they can analyze chemically, for a current Western theory of disease is chemical imbalance.
The most popular theory of disease worldwide is demonology. Sacred books of all the major religions include rituals for casting out evil spirits, so it's no wonder that in the twenty-first century a sneezer is often saluted with "God bless you" to mark the expulsion of a demon. Demon-expelling rites die hard. Shamans in traditional societies continue to use anti-demonic rites, sometimes in conjunction with antibiotic Western drugs.
Throughout the Middle Ages ordinary folk believed that demons were the cause of most maladies, which they treated with prayers and herbs. Even St. Hildegard's great twelfth-century works on medicinal plants include a theory of disease which is pure demonology. A few obscure doctors and scholars kept the Greek medical tradition on life support until it was revived in the Renaissance.
The Greek physician Hippocrates (circa. 460-377 B.C.E.) or members of his school promoted a theory of humors that challenged the demonic theory of disease. The theory that prevailed well into the nineteenth century assumed that the human body was a balance of four elements, or humors: yellow bile, black bile, blood, and phlegm. It was this theory that inspired Western physicians to induce vomiting in their patients and to bleed, blister and purge them to eliminate their excess humors. Choler is the now obsolete Latin term for yellow bile. In excess, yellow bile made for a choleric or angry temperament and black bile made for a melancholy temperament. Shakespeare's audiences recognized that Hamlet, with an excess of black bile, was melancholic. An excess of blood (Latin sanguis) made for a rosy-cheeked patient with a sanguine disposition. Phlegm made for a phlegmatic disposition.
Although the theory of humors retreated with the advance of modern medicine, the fashion for blood-letting endured into the twentieth century. Earnest practitioners believed they were ridding their patients of "bad blood," which, they insisted, was the cause of all symptoms. (Doctors no longer attach leeches to patients to bleed them--they currently apply these blood-sucking worms to morbid wounds, with excellent results.) Both George Washington and Lord Byron were bled to death by attending physicians, and in the nineteenth century Flaubert wrote in Madame Bovary of Emma Bovary's physician husband as a dolt who bled an anemic patient when bleeding was still in vogue for every disorder except anemia.
The fictional Charles Bovary was unaware of the real sleuths with microscopes who were observing heretofore invisible organisms, connecting them to specific diseases, and discovering substances to counter them. A great ferment of experimentation with pathogens, symptoms, and medicaments was well underway.
While researching classical Greek medicine, a German physician, Samuel Hahnemann (1755-1843), rediscovered the theory of homeopathy in the 2400 year-old teachings of Hippocrates. Hahnemann and his medical students at Leipzig University ingested small doses of substances from the animal, mineral, and vegetable kingdoms and carefully recorded the results of their experiments. Not content with introducing empirical pharmacology into medicine, Hahnemann formulated a grand theory to explain his findings: A substance that causes symptoms in a healthy person can cure a patient suffering from those same symptoms. The more often the substance is shaken and diluted, the more powerful the remedy becomes. After assessing the patient's mental, emotional, and physical condition, the homeopath administers a remedy designed to provoke the "vital force," the organizing energy that maintains healthy functioning.
Hahnemann upset the orthodox European and American medical establishments and made many converts among practitioners. Hahnemann coined a name for the medicine being practiced in his day from Greek roots: allopathy. Allopathy treats disease with remedies that produce effects opposite to those produced by the disease. The name stuck, and to this day, practitioners of mainstream medicine are called allopaths.
Unlike the orthodox allopathic model, a homeopathic remedy does not attack a pathogen. Theoretically; it arouses the body to exert its own healing energies. Despite the evidence for its usefulness in some disorders, and despite publication of controlled studies in such prestigious journals as The Lancet and The British Medical Journal, conventional allopaths refuse to believe that substances in such infinitesimal amounts can have any physical effects. They do not acknowledge the existence of vital forces or energy fields associated with the human body.
Contemporary medicine has discarded demonology along with the theories that were its justification, but the prevailing nineteenth-century chemical-mechanical model, with all its inadequacies, is not so easily dislodged.
The contention that humans are chemically-fueled machines looks more and more like a beautiful theory succumbing to ugly facts. Until the 1960s, the medical establishment dismissed as trickery and superstition all accounts of Indian yogis and Zen monks with extraordinary powers. In fact, the establishment categorically denied the possibility that these thaumaturgists could, without damaging their bodies, control their heartbeat, body temperature, and respiration while they were buried alive for days. In the nineteen-sixties, after yogis and monks repeatedly demonstrated their voluntary control of "reflex reactions" under laboratory conditions, the establishment revised its description of the autonomic nervous system but retained the chemical-mechanical paradigm.
The Chinese practice of acupuncture met with the same impatient dismissal until President Nixon made his surprise visit to China. When a journalist in Nixon's entourage underwent an emergency appendectomy and lauded Chinese acupuncture for pain relief, the few curious American doctors who actually investigated the ancient treatment reported positive results. In the presence of Western doctors, Chinese doctors anesthetized a woman with acupuncture and then performed surgery on the patient while she was awake and at ease. (Unfortunately, the Chinese say that only 20% of their patients react to acupuncture with deep anesthesia.) The amazed doctors' observations were anathema to the American medical establishment. Acupuncture? Inserting hair-thin needles under the skin? Stimulating specific points along meridians, meridians where channels of vital energy flow? Stimulating these points to unblock and harmonize the energy flow? "Nonsense," responded the establishment. "There is nothing mechanical or chemical in the treatment that could cure disease or relieve pain and symptoms. Patients are experiencing the placebo effect."
The placebo effect is the single concession orthodox practitioners make to the mind's power to heal the body. A placebo, a harmless substance given as medicine to humor a patient or for purposes of comparison in an experiment, appears to heal some patients who believe they are taking a powerful medicine. In other words, a patient's mind-set can alter the course of disease. "It is the patient's belief in the procedure that makes acupuncture effective, " the orthodox medical establishment proclaimed.
A decade after Nixon visited China, veterinarians reported they had successfully treated animals with acupuncture. So much for the placebo effect.
On November 5, 1997, sponsored by the establishment-oriented National Institutes of Health, a federal advisory panel of non-governmental medical experts announced its strong support for acupuncture. The twelve-member committee was enthusiastic about acupuncture's ability to relieve pain and nausea with minimal side-effects. According to the World Health Organization, about 10,000 acupuncturists practice in the United States. With the official approval of the American Medical Association, the number will doubtless increase.
Official approval from the American Medical Association translates into big profits for vendors of synthetic drugs. Because chemists cannot patent natural plant remedies, the drug companies' strong lobbies have prevented Americans from obtaining cheap, effective generic drugs as well as herbal preparations. In their war against generic drugs, the big drug companies offer at discount their name-brands to all health maintenance organizations who agree to prescribe them exclusively.
As for herbs, the protocols for certifying drugs in America are so expensive that no for-profit organization will do the necessary testing to certify non-patentable plant remedies. As it is, most of our information about effective botanical medicines comes from Europe. In Germany, an expert committee, Commission E, evaluated and approved herbal medicines until it disbanded in 1991. Today, German consumers can buy standardized over-the-counter herbal preparations that are often cheaper and more effective than synthetics. Thanks to the Germans, we know that Echinacea augustifolia, a valued remedy of Amerindians from the western plains, has antifungal, antibacterial, and antiviral properties, unlike synthetic antibiotics, which are only antibacterial. Experiments with root extracts demonstrated that echinacea is an immune stimulant as well. Early in the twentieth century, echinacea was listed in the American Formulary, but was dropped later when the medical profession got caught up in the fashion for synthetic drugs.
Medical fashions aside, the news about the American health care system is generally bad. Urbanization, globalization, and environmental pollution continually introduce new pathogens into our midst. Medical costs are rising while consumer confidence in the system is declining. Prescription drugs are often dangerous and always overpriced. At the same time politicians claim the Medicare system must be cut back, patients become paupers after a single hospitalization, and health maintenance organizations become the focus of scandals and remedial legislation. If for no other reason than economics, at least a third of American citizens use some form of alternative medicine.
All over the United States, sales of herbs are booming in health food stores, and pharmacists are slowly compiling a data base of interactions of these and other powerful herbs with synthetics.
Hundreds of European studies demonstrated that a preparation from ginko tree leaves increases blood supply to the brain. Israeli scientists developed a preparation from the elderberry bush, Sambucol, that tames influenza and its accompanying cough. Researchers proved that milk thistle extract improves liver function and actually regenerates damaged liver cells. Studies from the former Soviet Union and Germany rate St. John's Wort high on the scale of antidepressants.
Fads for treating mental and emotional disorders wax and wane. Freudian psychology is much less esteemed than it was earlier in the twentieth century, and tranquilizers are back, as the book title Prozac Nation so bluntly puts it. No matter what the treatment, orthodox practitioners have difficulty fitting psychological diseases neatly into the chemical-mechanical paradigm, although their attempts are sometimes drastic..
Egas Moniz, a Portuguese neurologist who believed that the mind is an epiphenomenon of the brain, deduced that some psychoses would be relieved if he cut into or across the frontal lobe of a patient's cerebellum. He touted this surgery, frontal lobotomy, as a cure for schizophrenia. Both his fame and the vogue for the operation spread across continents. In 1949, Moniz shared the Nobel Prize for Physiology and Medicine. By 1960, an estimated 25,000 patients in the United States and perhaps 100,000 worldwide had been lobotomized. If the surgery cured or alleviated psychoses, and most critics say it did not, it did create brain-impaired zombies. Another beautiful theory was slain outright by ugly facts.
A few Western physicians who have practiced alongside healers from other traditions are less concerned about the theoretical aspects of medicine. When the great Dr. Albert Schweitzer established a medical mission in Gabon early in the twentieth century, Western visitors were astonished at Schweitzer's deference to the local witch doctor, whom Schweitzer addressed as "mon chère collègue." Schweitzer explained that he admired the witch doctor's ability to deal with mental illness, so he sent him patients, just as the witch doctor routinely sent Schweitzer patients who would benefit from Western medicine. In neither case did the two doctors understand the therapeutic system of the other, but both doctors respected results.
The time has come for the World Health Organization to bring together the traditions, insights, and skills of practitioners from the four corners of the earth. Their very languages and cultures embody different concepts, assumptions, and practices they can share. All nations, great and small, can make a contribution to the health of humanity. Let the healing begin.