The first written accounts of the medicinal uses of plants were found in ancient scripts from China, Egypt and India. Hippocrates (486-377 BC) is well known for his contribution to such literature and his principles of wholism and balance. Diocles (4th Century BC) was a gatherer of herbal supplies and wrote his own herbal. Crataeus (1st Century BC) wrote the first illustrated herbal.

One of the most well known documents was De Materia Medica, written by Dioscorides (1st Century AD). He was a Roman army surgeon, and he put together a comprehensive book on plant drawings and descriptions, ways of preparing the herbs, parts used and their medicinal applications. Trading routes opened up with the advance of the Roman army and herbs from the Mediterranean became widely available – particularly since the Romans planted their own physic gardens wherever they were based.

In AD 597, Christianity came to the UK and with it a tradition of monastic medicine. The monks grew extensive physic gardens and wrote volumes of herbal knowledge and traded these together with plants, with networks of monks and travellers. King Alfred (870 – 899) ordered medical texts to be translated into English (from Latin) so that they were more readily available. The most famous Anglo Saxon book is “The Bald Book of Leech” written in the 10th Century and was a compilation of the best of the Roman and Greek literature.

From the 7th century; the Arab nations began over running Europe and northern Africa. They collected all the Greek and Roman texts they could and had them translated into Arabic. The Arabs avidly studied these texts and experimented, amended and improved the medical knowledge available. They set up teaching hospitals and practical investigative medicine principles based on the work of Hippocrates. Main areas of study were in prevention and the environmental influences on health. Ar-Razi (869 – 925 AD) emphasised the importance of diet and hygiene on health rather than the over use of drugs.

It was at the point of the introduction of the works of Galen (131 - 200 AD), a gladiator surgeon and later surgeon to the Emperor Marcus Aurelius that traditional herbalism and the seeds of modern medicine began to diverge. He adopted the four humours teachings of Hippocrates, together with astronomy, and developed them into a rigid classified system of medicine and medicine thus became theory based rather than observation and practice based. Galen’s works were carried on by Avennica, who wrote As-Qanum (the Canon of Medicine). The Arabs also experimented with mineral preparations, in particular, mercury. As a result of their uses of medicines, a separate profession emerged: that of the pharmacist who gathered and prepared the various medicinal products used by the medics. This had an effect on the prescribing habits of European medics and led to commercialism in herbal drugs. In medieval times, medicine became theory and university based.

Paracelus 1493 – 1541 believed in the doctrine of signatures: that medicinal plants grew where they were needed and they were marked in some way that indicated the part of the body on which they would be effective. Like cured like. He applied alchemical principles to medicine and was the founder of chemical pharmacology. He used metallic medicines as well as extracting the “active principles” of plants and said that these were stronger and safer than the whole plant. He taught his students to always be open minded enough to learn from “old women, Egyptians and such like persons; for they have greater experience in such things than all the Academians”. This suggests that behind the growing medical universities, there was a background extensively used wise and ancient knowledge.

During the reign of Henry VIII (1491-1547) a decisive turn of events took place that sealed the directions of modern medicine and traditional herbalism. The population of London exploded and Londoners were vulnerable to the many diseases of overcrowding, poor hygiene and poor nutrition. There was a corresponding explosion in dubious medical preparations and quack’s potions. Several acts were passed during this time, originally to protect the public from unscrupulous traders, that restricted the practice of medicine in London, to Oxbridge graduates under license by the Bishop of London (1512). In 1518, the College of Physicians set up a formal regulatory body and in 1523, the authority of physicians extended over the whole country. However, far from protecting the public, they became victims to the fashionable and dangerous treatments of the doctors. The physicians, surgeons and apothecaries used the acts to establish a pecking order to protect their financial interests. The physicians had authority and power over surgeons, surgeons over apothecaries and apothecaries over traditional healers. The traditional healers being at the bottom of the pecking order were treated as charlatans and quacks. The root of all this was, of course, money and power. Eventually, Henry VIII, a keen herbalist himself, passed a famous charter in 1548 that legalized a new class of practitioner- that of the traditional healers and herbalists.

“..it shall be lawfull to every person being the King’s subject, having knowledge and experience of the nature of Herbs, Roots and Waters, or in the operation of same, by speculation or practice within any part… of the King’s dominions, to practise, use and minister in and to any outward sore, uncome, wound, apostemations, outward swelling or disease, any herb or herbs, ointments, baths, pultes and amplaisters, according to their cunning, experience and knowledge in any of the diseases, sores and maladies before-said, and all other like to the same, or drinks for the Stone and Strangury, or Agues, without suit, vexation, trouble, penalty, or loss of their goods.”

In 1597, John Gerard published his “Herbal or General Historie of Plantes". His style of herbalism was that of the traditional, his practice enhanced with his intimate knowledge of plants as a gardener. Publications of his book became a “must have” for every lady of the house. He had even described the use of scurvy grass as a treatment for scurvy in the 16th century. The disease was thought of as a new disease by the medics of the 17th century.

Nicholas Culpeper was an educated apothecary, who practiced medicine and gave of his services freely to the poor. He aimed to raise the educational standard of the apothecaries, who were often the only medics for London’s poor, as they could not afford the high fees and expensive, exotic treatments prescribed by the physicians. He translated the London Pharmacopoeia in 1649 amending the text, using cheap, local herbs in place of expensive imported ones and throughout criticised the medical treatments, and highhanded attitudes of the physicians. He later published, in 1651, the English Physician, a “Compleat Method or Practice of Physic, whereby a Man may preserve his Body in Health, or cure himself when sick, with such things one-ly as grow in England, they being most fit for English Bodies”. He considered himself as much an astrologer as a doctor and the herbs he used had their own astrological influences, as did each disease. Culpeper was trying to maintain the traditional ways of healing with local herbs in a climate of the medical establishment trying to gain control of medicine and discarding traditional uses of plants.

In 1665, the Plague swept across Europe. The physicians of the day floundered trying out their mercury and other highly poisonous treatments, bleedings and blisterings. In the background, it seems that the traditional healers carried on using the many herbs as they had always used. This is hinted at in the story of the 4 thieves caught plundering the belongings and houses of plague victims without succumbing to the disease. They used combinations of herbs containing strong, volatile oils and thus protected themselves far more successfully than the poor patients who were bled, purged or poisoned by the physicians!

In the USA, the newly arrived settlers had little in the way of medicine. Many of them learned directly from the Native Americans and their uses of local herbs. Once physicians came over, however, they depended on imported herbs from Europe and used many of the fashionable preparations of the time: mercury, bleedings, purgings and blisterings. The American War of Independence (1776-1783) made the Americans turn to local herbs as supplies from Europe became scarce and implied their dependence. Samuel Thompson (1769-1843) learned herbs from folk healers and personal experimentation and is credited with discovering lobelia. He became a root and herb doctor and challenged the American medical establishment. His theories were based on clinical observation and he brought back the Hippocratic vix medicatrix naturae.

In the UK, William Withering (1741-1799) wrote a Botanical Arrangement of all the vegetables Naturally Growing in Great Britain with Descriptions of the Genera and Species according to Linnaeus. He disregarded the teachings of Galen and started afresh with observation and practice. He is particularly known for his investigations using the foxglove (Digitalis purpurea).

In 1813, Hahnemann’s homeopathy had become established practice in the US. This was based on the principles of like cures like and used very dilute medicines to encourage the body to heal itself. Unfortunately, in Britain, medical treatment became a victim of fashion, and beautifully crafted home apothecary chests became the vogue. They had mercury, antimony and laudanum preparations in them. Herbal traditions in families were dying out in favour of the “active” chemical treatments. Homeopathy eventually arrived in London in 1822.

In 1838, Albert Isaiah Coffin came to the UK. He had learned his medicine for the Seneca Indians and French shepherds. He wrote a Botanic Guide to Health, established agents to sell the rights to householders to use the book and its remedies, built herbal depots to make his preparations and recruited male and female practitioners. Coffin criticised the adulteration of food with chemicals, the long hours of employment and conditions for mothers, poor industrial safety records, industrial diseases, poor sanitation and vaccination. During the early years of the industrial revolution, only 43-50% of infants survived to their 5th birthday. The vast numbers of people moving into towns and cities meant that huge portions of the population had little or no access to fresh food and clean, uncramped living conditions. They were required to work long hours doing dangerous and dirty jobs for very little pay. Their cramped living conditions and poor state of nutrition left them wide open to disease. John Skelton was a practicing herbalist and worked with Coffin in the 1830s. However, the two men went their separate ways as Coffin’s closed mindedness and refusal to develop his theories caused an irreparable rift.

In 1803, Frederick Seturner isolated 2 alkaloids from opium – morphine and narcotine. In 1818 other alkaloids were isolated using his techniques and in 1852, salisylic acid was produced synthetically. These early experiments heralded a rapid development of modern chemical medicine.

In 1854, Mr Brady’s Medical Reform bill was presented to parliament to outlaw all the “quacks” for once and for all. The Sick and Burial Society protested against the attempted monopoly of medicine and organised a deluge of petitions to parliament and the bill was defeated. The following year, the Cholera Report was published as a White Paper. This did not mention homeopathic or botanic medicine, which had been more effective than the physicians’ treatments. The homeopathic hospital produced records, proving their case, but the botanic doctors did not have the organisation to produce any such evidence in answer to the omissions in the paper.

The chemical “revolution” in medicine continued in the search for more convenient super drugs. John King discovered methods of extracting out constituents of plants, such as resin, mucilage and very soon the drug suppliers jumped on the bandwagon, flooding the market with such substances, many of which were inert once separated from the whole plant. John Scudder and John King broke away from this and studied the direct action of single drugs on the body. They left behind the purging, bleeding and other violent treatments, and instead prescribed specific drugs in small doses based on ultra careful observation of their patients. They copyrighted their medicines to keep them under their control.

In the mid-1800’s bloodletting had been discredited. In 1865 it was discovered that the general health of the population, in particular the women, was poor among the Americans and the English as compared to the Europeans, whose treatments consisted mainly of herbal preparations. This was because American and English people (particularly the women) were dosed regularly with mercury since early infancy. so much so that having an invalid woman in the house became almost the norm.

The herbalists had organised themselves into various professional bodies, though their general educational level was far below that of the physicians. The latter used this as proof that the herbalists were ignorant lay people interfering with the business of medicine. By the late 1800’s synthetic pharmacology had become the normal practice of physicians.

In 1881, Lord Champerdown headed a Royal Commission on the Medical Acts. The NAMH (National Association of Medcial Herbalits) complained officially about their exclusion, and Francis Crick gave evidence to the House of Commons, ensuring the defeat of a bill that would have outlawed herbalists and which would have put the herb lobelia on a new poisons schedule. However, the NAMH was denied the status of registered practitioners and instead, had to settle on being a limited company. They were strongly opposed by the medical establishment who brought legal and political pressure to bear on them many times in attempts to outlaw them.

In 1911, Lloyd George refused to include their contribution when the National Insurance Act was written and passed and insurance companies began to refuse contracts to herbalists. In 1913 only one insurance company allowed its members to consult a herbalist. Local doctors prosecuted this particular herbal doctor and he lost a subsequent appeal. He wrote to PM Asquith and protested that this had set a precedent that would deny people the choice of practitioner and monopolise medicine. However, before this was dealt with satisfactorily, war broke out and public protests could not be arranged. The poor organisation, splintering of groups and the poverty of herbalists ensured their lack of financial and political clout and as a result, they were marginalized often hanging on to their right to practice by a thread.

Pasteur’s work on bacteria had opened the way for experimentation on vaccines and serums, and medical chemical experimentation continued in earnest. In 1917, it became illegal for anyone other than a registered medical practitioner to treat syphilis. The NAMH again protested to the government but to no avail, as they couldn’t back up their herbal claims with written clinical material and research. Drug companies were unable to patent herbal remedies and herbs, so they concentrated on chemical drugs.

In 1927, Hilda Leyle founded the Society of Herbalists and allied with the NAMH and together, they fought for recognition of the qualified herbal practitioner. Leyle published A Modern Herbal based on Maude Grieve’s educational herbal pamphlets. In 1922 NAMH lobbied the new Labour government to a Medical Herbalists Registration, but the Bill was dropped.

In 1941, the Pharmacy and Medicines Act was passed quickly and made herbalists illegal overnight as they had no right to supply herbal medicines directly to their patients. It was contested vigorously, but there was no change. Bevin did not consult herbalists when he draughted plans for the NHS. In response the general Council and Register of Consultant Herbalists was set up in 1960 to address the training question for the British Herbal Union. It set up a course, clinical training and examination and later set up a 4 year course, much of it correspondence. Bevan, in response the NIMH’s (NAMH name change) protest, offered them participation in the NHS giving them the smallest income possible from NHS prescriptions and subordinating them to the medical profession. The NIMH opted to remain outside the NHS.

Unfortunately, the history of herbal institutions has been dogged with internal disagreements, competitiveness and divisionsonly uniting in times of crisis. This has weakened their political clout. One such crisis was in 1964 when the new Medicines Bill was draughted. As a result of the unified protest, the British Herbal Medical Association was formed from representatives of all the groups of herbalists and an historic declaration was made that stated “...a herb for which a monograph appeared in any standard reference book and was not poisonous would be acceptable” ensuring a place for herbs as medicines. The BHMA wrote the British Herbal Pharmacopoeia that contained monographs of every medicinal herb in use. To add to its credibility, it was written by well-respected botanists, chemists, pharmacists and herbalists.

The bill was produced and though legally secure, herbalists were no longer permitted to make house calls and could only prescribe for patients who called in person – even if they were very ill and should have been in bed. Only crude or powdered herbs could be used, either with or without water. No concentrated extracts, solid extracts, tinctures or tablets, ointments, distilled lotions, pills or suppositories were allowed. The herbalists could use no non-herbal ingredient in the preparation of medicines. The number of herbs allowed was curtailed.

In response to this, the BHMA lobbied MPs and informed the public and 50 thousand letters of protest were printed and sent to all consulting herbalists, herbal shops and health food stores, for clients and customers to sign and send to their MPs.

In 1978, after 15 years of negotiation, orders were written under the 1968 Medicines Act, which distinguished herbs that could only be prescribed by licensed practitioners; those, which could only be used externally, and those which may not be used. In addition, a 10% VAT charge was levied on fees for services and prescriptions in 1973, which caused a huge increase in prices. Herbal suppliers had to obtain a manufacturer’s license and in the eyes of the law, they were treated like a pharmaceutical company.

In spite of its huge curtails, the 1968 Medicines Act did secure the legal existence of herbalists. The Threshold Survey in 1981 showed that 10 million British people had consulted an alternative practitioner and 9/10 would do so again. In 1983, the Prince of Wales told the BMA during an after dinner speech that they should look at complementary medicine. The BMA did just this, but their report was negative and incomplete as they did not consult experts in the various fields, but did highlight the age-old problem of lack of training and practice regulation.

In 1985 the Department of Health issued a directive that stated that natural medicines for which a license was sought would face the same tests for safety and efficacy as a new drug. This would be prohibitively expensive, so the manufacturers set up the Natural Medicines Group to mobilise public opinion and political support. The government stated in response, that herbal medicines would be acceptable for self-limiting conditions such as rheumatic pain, coughs, and colds etc., where there was bibliographic reference proving traditional use. For serious problems, such as liver and kidney disease, hypertension, cardiac conditions and so on, full clinical trials and pharmacy only sales route would apply. In 1988 the NMS set up the Medicines Advisory Research Committee. In 1990 MAFF (Ministry for Agriculture Fisheries and Food) withdrew licenses for all products containing herbs.

In 1989 the European Scientific Cooperative for Phytotherapy (ESCOP) was set up to represent the herbal medicine associations of Holland, Germany, France,Belgium, Switzerland and the UK. No other EC country recognised herbalists and in France, Spain and Italy, they are illegal and face fierce opposition from their medical establishments.

In 1995 the Medicines Control Agency harmonised its 1968 Medicines Act to the new European Medicines Evaluation Agency. There was no mention that herbal medicines were exempt from licensing requirements and therefore under EC law all medicines that were manufactured in the UK must now be licensed. At the time only 1:5 herbal medicines were licensed and under the new regime, herbalists would only be able to use crushed or dried herbs or home made tinctures.

The BHMA and other organisations met with the MCA in 1994 but there was no solution. The only recourse being to mobilise public support and protest. Two months later, the directive (65/65EEC) required herbal medicines to be licensed if they are industrially produced, but this term in not defined. “…the Government believes that those herbal medicines currently exempt under UK law are made according to a number of traditional processes that fall outside the interpretation of industrial process. As a result they can be exempted fro the new legislation”.

A Code of Practice for unlicensed herbal medicines was set up and members of the BHMA making herbal medicines would be bound by it. The labelling, quality control, standards of manufacture and so on were laid down in accordance with existing government regulations. Adverse reactions would be reported promptly and accurately. The list of prohibited substances included heavy metals, synthetic drugs and substances derived from endangered animal species. In addition the BHMA report adverse drug reactions to the MCA for action.

It seems that the only way forward for herbalists is to unite their efforts for high standards of education and practice regulation and to join as one voice. Its history has shown that the medical establishment has always used these very issues against them. The latter now have so much power and monopoly over medicine that herbalists need bodies such as the BHMA more than ever.The whole profession is currently undergoing a statutory self regulation procedure, whereby all schools are reviewing their teaching materials and upgrading them to a core syllabus that respects the various tradition and all practitioners will, in future, have to meet minimum requirements of training and practice, post graduate training and registration. Those interested in natural medicines would do well to be vigilant as the power and money the drug companies wield is a massive weapon. They are constantly trying to find ways into the herbal market, changing herbs into patentable products and controlling their use and distribution.