NEWS & ARTICLES

HERBAL MEDECINE,

RETURN TO THE FUTURE

By Drs C. DURAFFOURD and J.C. LAPRAZ

Our interest for Herbal Medecine is not a matter of desire to answer to a temporary come back to nature or of a mythical belief saying that plants have "miraculous powers". Fruit of an attentive observation of the real needs that the patient presents to the doctor and of the solutions that medicinal plants can bring to them, it was being born out of a daily practising. By putting it against an alternative more physiological, it fits in a basic will to protect the patient in his destiny, to prevent him from the aggressiveness of therapies which are officially imposed. It relies on a different approach which brings the patient to make him much more aware of his responsabilities and to implicate consciously himself in his own health care.

It appeals to the possibilities that the various florastics may offer us in the doctor's willing to preserve or to recover the physiological order which every human being can arrange, within or without disease.
Whatever is the pathology he is suffering from, even badly, a man has always the means to go against it, even if he is not at this moment in position to use them. By their intrinsic properties due partly to the judicious distribution of the positive principles that they convey at various unitary dose, medicinal plants give the possibility to the therapist to appeal to these physiological workings.

This continuous medical care of the patient faced with the dangers which are threatening him in fighting against disease, requires from the doctor a thorough knowledge of the physiological human being machinery and of the therapeutic material. He must know how to fit it into the body without creating further problems. To answer to such requirements, medicinal plants constitute a huge basic tank. They provide a very large range of possibilities in all pharmacological activity.

Real tank in which we are starting to hand over the chemioterapic drug, herbal medicine is also the best intermediary between classical medicine and others, while waiting to be recognized as being fully a part of Medicine. In pathology, all parts of it are answerable of herbal medicine treatments, but we still have to describe of what use medicinal plants are about.

Classical use of herbal medicine relies on the fact that the limited effect of each medicine is proportional to the dose. Such an use, as for every medicine, presents the disadvantage of the coexistence of side-effects, and medicinal plants do not escape to this rule. The multiplicity of positive principles of each plant makes the health risk heavy. As well as the chemical medicine, medicinal plant then has a too high specific misdemeanour that it gives it no advantage over the chemical drug.

The clinical use of herbal medicine, as we "SOCIETE FRANCAISE DE PHYTOTHERAPIE ET D'AROMATHERAPIE", since 1992, put it forward within the framework of endocrinal theory area, consists in using only doses being very far away from toxicity areas and even from misdemeanour areas. The therapeutic effect wanted must not be obtain in increasing the doses but in inflecting the relative proportion of several plants making up the recommended association, according to the reactions that the doctor want to obtain, the quickness of the wanted therapeutic effect, its term and the stability of the results.

But herbal medicine used in this way cannot hope to be of a real efficacy, only if the doctor can take advantage of a precise valuation of the patient's state of health, of a well known knowledge of physology and a complementary knowledge of the effect's repercussions, and this for entire pathology. That is the way of use we actually record in our works.

It cannot be no more restricted to be only an artificial bringing up to date of galenic packaging which have being set on former data which became dangerous because of the apporximately informations joint to the ignorance of the working of plants and men.

The potential future of the herbal medicine drug can only be conceived through a guided research by innovating medical principles which are based on dynamics and physiology of humain being. It is also from them that all protocole of estimation should be defined concerning the activity of the medicinal plant.

Only a perfect knowledge of the real proprieties and of the true level of pharmacological activiy of each of medicinal plants used can elaborate an active treatment with a removed noxiousness.

By the setting up of a synergy of fact it allows a true strategic use. This one consists to gather on the same prescrition plants with similar or complementary activity, being liable to associate their positive effects in order to trigger off the wished effect sufficiently moderate doses not to infer the symptoms of uncontrollable side-effects. This is the reason why, in general rule, a prescription includes between 6 to 10 plants which work and interwork on several points, and set up to two levels this synergy of action.

It is only after laying down a diagnosis, or the confirmation of a diagnosis done in accordance with the usual forms for all graduated doctors, using all classical means of investigation and some specifics ones, that a distinctive clinical reflection put back the ailment into its general context.

Herbal medicine recourses to the maximum of modern medical knowledges, including the endocrinology field, as well as in all works done on different compositions of plants. The adaptibility of herbal medicine (included aromatherapy) allows to fit the treatment according to the specific reaction of the patient.

This complicated therapeutic strategy is far away from the old symptomatic "recipes". Appealing to a particular person, the prescription is different from one patient to another. The determinism of this only strategy makes that this approach is worthwhile for everybody, and every human being, even unwell, will benificiate of this treatment, apart from the moment of great distress confining to resuscitation. Herbal medicine will be applied alone faced to ailments which have not acquired their autonomy, and jointly faced to those of which the organization sets up problems to the organism that cannot be ignored.

Used at non poisonous doses by a well-formed doctor, herbal medicine may (it depends of the case) cure the ailment and replace the chemiotherapic drug when this one is required, shorten its time of application limit its side-effects, and avoid an escalation of chemical associations.

One of our prioritary axis of research in the use of medicinal plants grows for more than 5 years within a parisian hospital in general surgery and oncology. Medicinal plants constitute one of priviliged means of therapeutic action of a new science called oncobiology, which consists to study the development of biological perioncological phenomenons, their proper noxiousness, their modifications under the influence of therapies established. The phytotherapical treatment operates together with chemiotherapics, radiotherapics and surgical treatments.

The results obtained are an encouragement to carry on with such a use and generalize it to all patients suffering from cancer. We observe an improvement of the patient's general allowance to several chemiotherapics drugs imposed by his cancer, and to the one which is particular to each of its organs, particularly concerned. When the achievement of this first objective will be reached the first consequence is a better consistency in the administration of chemical drugs, which alone allows to guarantee the optimal action. Studies are carried out to value in the long term the future of a person with cancer and of his disease.

As far as Aromatherapy is concerned more specifically, certain therapists doctors, or even none doctors, try to correlate plants traditionnal indications to the essential oils, then to their chemistry. Under the pretext of analogy, they are allowing themselves to connect chemical structures to particular virtues that they set up in new therapeutics indications. In combining them often, willingly or not, to those which are finding themselves rigged or enriched since Antiquity, they permanently in this way making worse the multiple confusions in which they still are the subject. This embarrassment to all the levels of their use justifies a rigorous adjustment and a constant and permanent checking regarding to the attributions of their real properties.

For over 25 years we have been carrying on a spadework of bibliography and of clinical verification, which had required an extreme rigour and a trifling details without weakness. It has allowed us to set up a new methodology of aromatherapy for external use which increase its efficiency in a remarkable manner going from medical basis the most up to date confronted with the endocrinous theory field, aromatherapy describes new mode of enforcement of the essential oils through the skin which give to them an efficiency of action not only for minor symptoms but also in general ailments which are sometimes very serious.

Three essential reasons are threatening the future of herbal medicine and those are : commercial, esoteric and political. Some practices which would be based, apart from a real ethic will mean serious distortions wich will stop the scientific development and the objectivity of its education.

For us the only logical way is to maintain the herbal medicine education inside medicine and its integration into the progressive data of medical science. Herbal medicine is a therapeutic tool given to the general practionner disposal and to any specialist who can recourse to it inside his practising. An official education would be imperatively and strictly medical, that means it would be released from the recourse to tradition which is held as the main explanation and justification of medicinal plants properties. This education will lean on the most recent data of science and on the reflection of a particular approach which relies on a thorough knowledge of physiopathological works. It should bring out to doctors the essential knowledges in Medical Matters, Botany, Galenic which refer to the Pharmacology and Pharmacognosy.

If numerous researchs are actually in course in the world, concerning medicinal plants : ethnobotonical, pharmacognosical, pharmacological etc..., they do not however lead on a real medical use of them. It appears to us as a priority that the necessity of reintroducing herbal medicine in therapy and as well as an international harmonization of clinical researches in this area which is entirely ignored by the actual medicine.

This is why we have organized in May 1993, in Tunis, with the Faculty of Pharmacology in Monastir, an Intercontinental Congres, which had gathered five hundred participants, all doctors, chemists, researchers, university's professors and manufacturers, coming from 49 different countries. The final conclusion has clearly put in evidence the essential role which will be devolved upon medicinal plants in medicine in the immediate years. In fact, medicinal plants gather a great number of required qualities to be one of the possible keys to the serious problems that meet the minimal health for everybody in the entire world.

They give a key to the blow up of expenses for health due to sickness in industrialized countries. Drugs increase and improve but they reach some astronomical prices. This escalation of prices makes the Social Welfare "plunge" and leads medicine to give up the health field to take only in charge the sickness. As for the countries in emergence, they cannot in any case financially endure such cares. Therefore the controlled use of medicinal plants, in many fields, can offer cheaper possibilies of treatment.

Thus, far from being only a tank of modern drugs, medicinal plants are a fundamental stake for the future of medicine and is without any doubt the essential key of the crisis in actual therapy.

President and General Secretary of the "Société Française de Phytothérapie et d'Aromathérapie" (S.F.P.A.) "Attachés de Consultations des Hopitaux de Paris" (General surgery and oncological department, Hopital Boucicaut) the doctors C. DURAFFOURD and J.C. LAPRAZ are involved in clinical phytotherapy since 1972.

Writers of the "Cahiers de Phytothérapie Clinique" (Editions Masson) they devoted themselves in the diffusion of really medical herbal medicine in taking part in it, in creating education, in France as in foreign countries : Belgium, Spain, United-States, Greece, Italy, Mexico, Switzerland, Tunisia, in cooperation with the universities and learned societies of each of those countries.

President and General Secretary of the "Fédération Internationale des Associations de Défense, de Recherche et d'Enseignement de la Phytothérapie" (F.I.A.D.R.E.P) they are carrying along experimental studies, in general medicine as well as in hospitals, to precise the real therapeutic capacities of medicinal plants in their strictly clinical use.

Being closely in touch with official organisms since 1977 : Ministry of Health, Doctors Association, Chemists Association, the European Parliament, etc...., they took part in several ministerial commissions (AMM Qualité des Huiles Essentielles, Transparence, Evaluation) and established a report on Herbal Medicine in France to the intention of the Ministry of Health (1985).


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