In most cases herbal remedies only relieved symptoms—it was not until the nineteenth and twentieth centuries that some diseases could be effectively treated. The herbs that are effective continue to be used. The World Health Organization (WHO) estimates that twenty-five per cent of modern drugs, and at least 7,000 medical compounds in the modern pharmacopoeia were originally derived from plants. Four-fifths of the one hundred and twenty active compounds isolated and widely used today show a positive correlation between their modern and traditional usage. Even today, nearly four-fifths of Asian and African populations rely on traditional medicines based on plants and their components.[xiv] Altogether the (WHO) estimates that four billion people use herbal medicine for some form of primary health care. Pre-scientific trial and error methods did produce some useful herbal remedies.
The debt the pharmaceutical industry owes to the explorers, monks and kings, as well as the traditional healers, peddlers and early Arab pharmacists is mostly forgotten. When modern pharmaceutical manufacturers explore traditional herbal remedies in the hope of developing new drugs for modern medicine, it is their chemical composition that is important. Although the advice of tribal users is sometimes sought, an herb’s exotic provenance no longer has the relevance it once had in medical circles. Nevertheless, for the pre-packaged self-medication industry, the advertisers know that the traditional and long use of herbs remains an important factor in their popularity as we will see in the next two chapters.
[i] Solecki, (1975) Shanidar IV, A Neanderthal Flower Burial in Northern Iraq. Science, 28: 880–1.
[ii] Economist (2015). The 2015 Nobel Prizes. 10 October, p. 72.
[iii] Griggs, B. (1997). The Medicine of Mankind, Chapter One. In Green pharmacy: the history and evolution of Western herbal medicine. Rochester, Vermont: Healing Art Press. p. 7.
[iv] Mez-Mangold, L. (c1971). A history of drugs. Carnsworth, Lancaster: Parthenon Publishing, p. 49.
[v] Wachtel-Galor, S. & Benzie, F.F. Herbal Medicine, Chapter 1. http://www.ncbi.nlm.nih.gov/books (accessed July 2015)]
[vi] Hsu, E. (1999). The transmission of Chinese medicine. Cambridge: Cambridge University Press. p. 2.
[vii] Unschuld, P.U. (1998). Chinese medicine. Brookline, Ms: Paradigm Publishing. pp. 75–7.
[viii] Mortimer, P. (1974). Only when it hurts: being a curious collection of old fashioned remedies and dissertations on matters of health and hygiene. London: Wolfe Publishing. pp. 7–8.
[ix] Porter, R. (1997). The greatest benefit to mankind: a medical history of humanity to the present. London: Fontana Press, p. 269.
[x] Cotta, John (1575?–1659?). A short discoverie of the vnobserved dangers of seueall sorts of ignorant and vnconsiderate practisers of physicke in England. London: Imprinted for W. Jones and R. Boyle, New York: Da Capo Press, 1972.
[xi] Jameson, M.J. (1961). The natural history of quackery. London: Michael Joseph Ltd, (Abstract of a quote attributed to a Dr Radcliffe).
[xii] Martyr, P. (2002). Paradise of quacks. Sydney: Macleay Press. p. 33.
[xiii] Pennsylvania Hospital Web pages: http://www.uphs.upenn.edu/paharc/timeline/1751/index.html . [Accessed 8 July 2015]
[xiv] American Medical Association (June 1997). Report 12 of the Council on Scientific Affairs: Alternative Medicine. http:// www.ama.assn.org/ama/pub/article/3036-2523.html [Accessed 15 October 2003].
Self-Administered Medicines
Self-administration of medicine started out with simple people turning to the green pharmacy growing in the fields where they lived and ended up being a global market trading in herbal remedies. Huge fortunes are made by the herbal industry which services today’s lifestyle. Throughout the western world health care consumers are hooked on self-medication. Popping pills to prevent illness or relieve symptoms has, for many of us, simply become a habitual part of our lives. Collectively these self-medications are known as patent medicines, over-the-counter (OTC) preparations, herbal or traditional medicines, dietary supplements or non-prescription pharmaceuticals. Most of these are not licensed as medicines; they are called dietary supplements because they are considered sufficiently harmless to take without any medical supervision. While these products are mild in their action, it will be demonstrated that, under certain circumstances, they are certainly not harmless. This highlights the need for consumer access to accurate information and strategies to improve health literacy about OTC medicine.
Servicing this propensity to self-diagnosis and self-medication really has become a big business. In the developed countries of the world the use of dietary and herbal supplements has grown dramatically in recent years and OTC pills and potions are a multi-billion-dollar industry. Americans are big spenders, according to the National Institutes of Health Office of Dietary Supplements. In 2012 they outlaid a total US$32.5 billion on dietary supplements and one fifth of this large sum was spent on multivitamin/mineral supplements (MVMs).[i] A Wall Street Journal article stated that expenditure was only $23 billion and the journalist found the lesser sum encouraging because it left plenty of room for market expansion.
Australians are great pill poppers and the advertisers and the media all know this and trade on it. We are consistently bombarded with advertisements for pills and potions and articles promoting health fads, while the media regularly portray scientific breakthroughs as if there is endless medical progress towards solving all our health problems. The result is that, even in our prime, we worry that we might fall ill, or we worry that we are not as well as we think we ought to be. Which raises the questions: who are the pill poppers, and will the industry encourage them to take more or will the industry try to attract a new section of the community?
Studies show that MVM use is more frequent among women, and their children, who live relatively healthy lifestyles and have good diets. Whether any health benefits for this segment of the market are due to MVMs intake or to their healthier lifestyle choices is difficult to untangle. Australian television networks are currently featuring male sportsmen to advertise an Australian brand of dietary supplements. These advertisements suggest men who play sport need more vitamins to be a success, like the man in the ad. As men currently take MVMs less frequently than women then pushing vitamins to this group would lead to a growth in sales.
MVMs only represent one section of dietary supplements. In 2007 the US expenditure on non-vitamin, non-mineral and so-called ‘natural’ products, such as fish oil, glucosamine, and echinacea was $14.8 billion. That is one-third of the sum Americans spend on prescription drugs. Over-the-counter medicines are a fast growth industry[ii] and research shows that current industry profit is expected to grow from $3.5 billion to $4.6 billion in 2017-2018. Other countries are experiencing a similar growth in self-medication. For example, in Australia, Canada, and the United Kingdom annual expenditure on herbal medicine is estimated to be US$80 million, US$1 billion, and US$2.3 billion respectively.[iii]
One Australian study found that more than eighty per cent of its participants took one or more OTC medicines daily, and of those two-fifths had taken five or more in the previous twenty-four hours. Prescription drugs are also part of many people’s daily routine, a survey in the UK found 43% of men and 50% of women had taken such a drug in the previous week and some had taken three.[iv] Interestingly, most participants used both dietary supplements and conventional remedies. The most commonly used medicines were antihypertensive agents, natural marine and animal products including fish oil and glucosamine, and lipid-lowering agents (for cholesterol control). The items on this list represent a growing tendency for packaged drugs (as well as those ordered by prescription) to aim at curtailing