Last month's announcement of the awarding of a $4.3 million grant to Duke for a multicenter study of St. John's wort in the treatment of depression heralds the beginning of a new era of scientific investigation into herbal remedies. As summarized in psychiatrist Harold Bloomfield's recent book, "Hypericum and Depression," the serious research into St. John's wort started in Europe in the 1980s. Now after the completion of over 20 randomized, double-blind clinical trials there, the scientific community in this country is finally starting to pay attention.
The popular appeal of inexpensive herbal remedies with few side effects also deserves the attention of the Research Triangle pharmaceutical industry. This phenomenon is particularly threatening as herbs are sold over the counter at health food stores unregulated by the Food and Drug Administration, and these companies do not profit from natural substances that cannot be patented or synthesized. Evidence of this threat can be seen in Germany where St. John's wort makes up more than half of the anti-depressant market compared to 2 percent for Prozac.
Ironically this apparent paradigm shift is an artificial creation of modern medicine's recent fascination with synthetic drugs, since the use of St. John's wort dates back several thousand years. In "The Healing Power of Herbs" naturopath Michael Murray notes that "St. John's wort has a long history of folk use ... Hippocrates (the father of medicine) administered St. John's wort in the treatment of many illnesses. Its Latin name, Hypericum perforatum, is derived from Greek and means "over an apparition," a reference to the belief that the herb was so obnoxious to evil spirits that a whiff of it would cause them to depart."
The folk name derives from the fact that the yellow flowers bloom just after the longest day of the year around St. John's Eve which is June 24. Metaphorically, the red spots on the petals are thought to represent the blood shed at the beheading of John the Baptist, while the tears are represented by translucent spots on the leaves which give them a "perforated" appearance. John's chief function in the New Testament was to prepare for the coming of "The Light of the World," in the human form of Jesus. Fittingly, St. John's wort has also been shown to be useful for the treatment of Seasonal Affective Disorder, a particular form of depression associated with a lack of sunlight during winter when the days are shortest.
Another neurological condition which has recently been scientifically documented to respond to treatment with an herbal remedy is Alzheimer's Disease. A special October issue of Journal of the American Medical Association devoted entirely to a discussion of this illness featured a randomized double-blind trial of ginkgo biloba that demonstrated improvement in the cognitive performance and the social functioning of demented patients-Interesting results considering how much time and money is being spent searching for the genetic roots of the disorder in hopes of designing a successful drug therapy.
Many other herbs are being validated by science for uses that have been known for centuries to traditional herbalists. Valerian is a useful sedative for anxiety and insomnia with Valium-like properties. Hawthorn is a cardiotonic remedy which has been shown in numerous European studies to boost the effects of digitalis in heart failure. Echinacea is widely recognized for its immunosupportive benefits in Germany and is becoming a popular cold remedy in this country.
Our pharmaceutical industry is obsessed with finding the active ingredients of these plant substances in the hope of creating a new and improved "magic bullet." In most cases, it seems, while they succeed in making a more potent drug, they also create unnatural side effects when the active agent is administered out of the context of the plant of origin. Quantification of activity and quality control for proper dosage are important issues in the emerging herbal field, but perhaps the most important concept is to respect the natural wholeness of the herbs themselves.
In "Herbs: The Magic Healers," spiritual teacher Paul Twitchell notes that "Common sense tells us that nature supplies most of our foods from the vegetable and herb kingdom and that it supplies the remedies for most illnesses. Every animal has an inborn instinct and, when sick, will seek out certain grasses, weeds or plants to eat. We owe a great deal to the Native Americans and natives of other countries, who, through the centuries, learned how to cure their ailments with herbs."
The herbalists teach that the most important herbs are those that grow wild locally, such as St. John's wort and hawthorn. Wander over to the North Carolina Botanical Gardens some weekend and stroll through the medicinal herb section where many of these plants are growing. The importance of rediscovering this nurturing feminine character of Mother Nature is reflected in "The Heart of Matter" by ecospiritual priest Pierre Teilhard de Chardin. "Every day supplies more irrefutable evidence that no man at all can dispense with the Feminine, anymore than he can dispense with light or water or vitamins."
Dr. Larry Burk is an associate professor in the Department of Radiology.