So, I always imagine that I will have time free in the summer to get on with lots of ongoing projects. In semester time, I blithely pictured myself updating this blog weekly, in between long afternoons of lazing around in the garden, occasionally doing a spot of weeding. Sadly, it never happens like that.
Back in reality, my only chance to update the blog is when, like now, I’m on a train. This time, I’m coming back from the final summer school at the Scottish School of Herbal medicine, where I was attending some of their Research methods classes. I came away with lots of problems to mull over.
For example…like many herbal practitioners, I consider my practice to be part art, part science. In herbal medicine, there is usually a multitude of choices of herb for any one patient. If greater blood flow to the skin seems desirable, there is reasonable scientific evidence to back up the prescription of Capsicum minimum or Zingiber officinale, or maybe Tilia spp., or any number of others. The art comes into the choice of which one. Some of the reasons why I might pick one, rather than another, are easily explained and could be formalised – the soothing relaxing actions of Tilia spp. are clearly going to be more appropriate for an anxious stressed patient, whereas the stimulating effects of Capsicum will be better for others. But some reasons are less clear-cut.
For example, certain herbs, such as Rosa spp. (Rose) or the Crataegus spp. (Hawthorn), have strong symbolic value, and may be chosen for this. This would usually be considered a placebo effect, as for any medicinal treatment that works via an alteration in the way that the mind and body interact. But if you accept that mind and body are inextricably interlinked, as is suggested by both traditional medicine and by the newer sciences of psychoneuroimmunoendocrinology, then to call a treatment a placebo is roughly as useless and meaningless as calling a disease psychosomatic. You do not need to believe that the ‘spirit of Rose’ comes over in an ethanolic extract to appreciate that connecting with such powerful symbolism on a regular basis whilst taking medicine might facilitate a different attitude to your body. And that the better chosen the symbol, the more powerful the ‘placebo’ effect. (Please note that I am not suggesting that this is the only, or even a major, route by which herbal medicines exert their effects).,
However, an approach that includes such artistic and intuitive aspects does not lend itself to codification and generalisation in a way that can be easily researched and used to inform the practice of others. One of the fine and noble purposes of medical research is to find out what works and enable others to use it. For herbalists, this requires methods of research that allow for the art as well as the science. Qualitative methods used by social scientists may enable an approach to exploring the art, and standard quantitative methods can survey the science. Herbalists need to find a blend of both.