When it comes to research in herbal medicine on one end of the spectrum is the pillar of experimental research and on the other is properly conceived empiricism to make up the continuum of scientific philosophy. Traditional knowledge and empiricism are the ongoing flow of medical wisdom for thousands of years. Traditional herbalists might follow practices like Western herbalism, Traditional Chinese Medicine or Ayurveda. In sharp contrast, scientifically driven herbalists focus on using plant phytochemistry to guide their practice. These are two equally stable and valuable poles. No one disputes the scientific validation of a herb to encourage a deeper understanding and appreciation of its complex healing properties. It can empower herbalists to treat new conditions with ancient remedies. Used properly, and in context, good science has much to offer phytotherapy. The challenge herbal medicine faces today is how to integrate science with the traditional knowledge that is at the foundation of its practice and respect the mysteries that science has yet to uncover.
To set the scene there are four main types of scientific research including chemical analysis, in vitro, in vivo and clinical research. As the name suggests, chemical analysis helps us understand the chemical profile of herbs. In vitro is Latin for ‘in glass’ and in vivo is Latin for ‘within the living’. In vitro studies describe experiments that researchers perform outside a living organism in petri dishes and test tubes. In contrast, in vivo studies typically involve live animals (which some herbalists condemn), especially rodents, or people. Clinical research involves conducting well-structured studies where people are given herbs and the outcomes are measured. For herbalists, clinical research is the most applicable and valuable form of scientific study, offering us insights that can help potentially find novel (not previously identified) uses of herbal medicine. Even though clinical research is the most reliable source of scientific information on herbs there can be flaws such as bias, poor design and administration (i.e. was it isolated compounds rather than whole plant).
Sometimes animal research can begin to pave the way for novel uses of herbs, which would warrant further study, however caution must be taken in extrapolating results to humans as it can be misleading and counterproductive because of species differences. While in vitro studies are interesting, they do not accurately represent the complexity of the human body. Much of this research looks at the antimicrobial (including antiviral and antibacterial effects of herbs), based on their interactions with microorganisms in a controlled environment, and can commonly be misinterpreted. Although these herbs might be effective when applied to the skin, things become far more complicated when ingested because the body’s organs, organ systems, tissues, biochemical interactions and metabolic transformations add dimensions that a simple petri dish experiment cannot replicate. For example, cancer cells can be killed in a petri dish by everything from fire to bleach but preclinical studies must always be followed by clinical studies in humans before we can make any recommendations to patients.
Clinical herbalist, herbal medicine industry leader and prolific author Kerry Bone has pontificated about the herbalists’ pun in vitro non veritas which means ‘test tube research, on herbs in particular, has a limited capacity to lead to the truth’. The pun is derived from the ancient adage in vino veritas, which is a Latin phrase that means 'in wine, there is truth', suggesting a person under the influence of alcohol is more likely to speak their hidden thoughts and desires. The phrase is sometimes continued as, in vino veritas, in aqua sanitas, 'in wine there is truth, in water there is good sense (or good health)'. In vivo veritas is a pun on in vino veritas and means ‘in a living thing [there is] truth’. This is an expression used by biologists to express the fact that laboratory findings from testing an organism in vitro are not always reflected when applied to an organism in vivo. In a 2023 seminar Bone said: “People are extrapolating activities inappropriately from herbal research and the herbal world is rife with it.” In his book Functional Herbal Therapy he says: “in general we should be highly cautious about extrapolating the findings of in vitro herbal research to clinical situations.” In an earlier paper he says: “I have attended several talks by herbalists or natural therapists where they might list many hypothetical activities for herbs derived from in vitro or in vivo research as if they were absolute facts. Moreover, they often do not clarify in their presentations which information comes from pharmacological models and which has been proven in clinical trials. Extrapolation from pharmacological studies should be clearly stated and the information regarded as only of tentative relevance to a clinical situation… The treatment of the patient as an individual can never be outweighed by results of double-blind clinical trials. In any examination of the worth and future potential of herbal medicines, their traditional therapeutic context should not be discarded. To do so will limit the value of herbs and make them subservient to modern reductionist thinking and superficial symptom control.” Something to ponder next time you are mixing your herbs.
References
Stewart D. Personal communication. Southern Cross Herbal School. Ourimbah. 2005.
Niemeyer K, Bell IR, Koithan M. Traditional Knowledge of Western Herbal Medicine and Complex Systems Science. Journal of herbal medicine. 2013;3(3):112-119. doi:10.1016/j.hermed.2013.03.001.
Popham S. Is All Herbal Research Trustworthy? The School of Evolutionary Herbalism. c2014 – 2024 (accessed 21 Aug 2024) Available from https://www.evolutionaryherbalism.com/2024/04/24/is-all-herbal-research-trustworthy/
Popham S. Is All Herbal Research Trustworthy? The School of Evolutionary Herbalism. c2014 – 2024 (accessed 21 Aug 2024) Available from https://www.evolutionaryherbalism.com/2024/04/24/is-all-herbal-research-trustworthy/
Popham S. Is All Herbal Research Trustworthy? The School of Evolutionary Herbalism. c2014 – 2024 (accessed 21 Aug 2024) Available from https://www.evolutionaryherbalism.com/2024/04/24/is-all-herbal-research-trustworthy/
Bone K. The role of herbs and phytonutrients in acute and long Covid: An update. NHAA Naturopathic Symposium 27-28 May 2023.
Bone K. Functional Herbal Therapy. London:Aeon. 2021. p215
Bone K. Phytotherapy: Challenges for the 21st Century. Mediherb: A Phytotherapist’s Perspective. 1999 Dec;5:9.
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