Herbal Medicine, Past and Present, for Women’s Health


The focus of this essay is the historical socio-political context of orthodox medicine and herbal medicine for women and by women. Herbal medicine has an important place in the majority of people’s health throughout history and throughout the world (Halberstein 2005). The historical socio-political context of medicine will aid our understanding of the role that biomedicine and herbal medicine have played in women’s health, in the 20th Century. Emerging interest in herbal medicine and complementary medicine (Patersons 1997) requires a model of health to enable much-needed research to be carried out, reflecting the proper true practice in herbal medicine. An honest research model is required to suit the practice of herbal medicine as well as, and satisfying, the rigors of science.

Historical perspective

Herbal medicine has been practised in many continents for thousands of years (Griggs 1981). It used to be the main form of medicine, and still is today over the entire world, where the majority of the world’s population uses herbal medicine (Akerele 1993). Pre-industrial England saw relatively few official medical practitioners in existence and they only served the social elite (Saks 1992). Most of the population could not afford the official medicine, had they been able to, they would often have preferred not to use it because the treatments offered were rather drastic, such as purging, blood letting and cauterising, which often left the patient more ill after treatment (Hughes 1943). When people were unwell they tended to go to wise women, who were the main providers of health care pre-industrialisation (Oakley 1992). Healthcare was part of the women’s role in the upper and the lower classes (Clark 1968), they did have knowledge of herbs used for different conditions (Hughes 1943). They had no formal training and did not get any economic rewards but treated more out of religious or neighbourly duty (Hurt-Mead 1938).

Care of children and women in childbirth were an important part of the female healing role and when a women was in labour, women in the neighbourhood would attend, so that they could learn and increase their understanding in midwifery (Clark 1968). Practising wise women / midwives were generally respectable and enjoyed high status among the people they served (Clark 1968). The practice of women’s medicine continued as an oral tradition (Griggs1981). The Royal College of Physicians was set up in 1518 in the city of London (Saks 1992) and the Church strictly controlled the early profesionalisation of medicine. It was considered that if a woman dared to cure without having studied she was a witch and must die (Hurt-Mead 1938), yet women were barred from the universities (Hughes 1943). Suppression of women healers followed directly from the association between church doctrine and university trained medical men, as well as the ruling classes (Griggs 1999). Over the following centuries the popular status and authority of the female healer was gradually eroded. A midwife was liable to be accused of being a witch (Parinder 1958), by the male dominated medieval church. The medieval wise women would have administered abortive herbs to women carrying unwanted babies, this was taboo in the church (Hughes 1943).

Further, in the seventeenth century, the learned professions monopolised learning by using Greek and Latin, the languages used by the university-educated clergy, physicians and lawyers (Poynter 1962). This made it inaccessible to women (Webster 1975) and further distanced them from the legitimate medical practise of the day. Throughout history medical theory had been restricted to the work of Galen written in AD130-200 (Saks 1992). Women practised empirically, using trial and error. Male medicine was theological, ‘antiempirical’ and acceptable to the Church (Oakley 1992). Medicine was practised by the official doctors for many centuries using Galen as their basic textbook as taught in the universities (Saks 1992). The way it was practised remained the same for many hundreds of years (Griggs 1981). Both the mainstream and unofficial medical practise used herbs.

The difference between licensed practitioners and the rest was essentially the fact that they were accredited members of organised professional groups with the legal authority to exclude others. It was this social power which distinguished them form the unlicensed. It is the social mechanism that leads to certain kinds of healing being regarded as legitimate or orthodox and others not. Such mechanisms may be shaped to a great extent by external factors that have little to do with the knowledge employed, or the proven effectiveness of the treatments concerned. In the middle of the nineteenth century, those who held that there were specific drugs for specific diseases were called ‘quacks’; a century later the herbal practitioners were called ‘quacks’ (Griggs1981). In the seventeenth century the herbalists accused the early ‘Chymists’ of using poisonous concoctions and in this century (Griggs 1981), it is herbal medicine that is being queried as a possible danger to the general public. 130 years ago, it was scientific medicine that was seen as irrational and irresponsible (Rosenberg 1977). Orthodox medicine achieved state registration with substantial powers of self-government in 1858 (Saks 1992). All other professions, such as midwives, dentists and nurses, were subject to medical control and, in effect, were licensed as secondary practitioners (Saks 1992). Doctors were thus given power over the patient and all other auxiliary or paramedical professions (such as nurses or pharmacists), part protection from the consequences of possible incompetence, and a virtual monopoly over health care decisions (Saks 1992). During the first half of the twentieth century complementary medicine was all but outlawed in this country. A doctor could be struck off the medical register for sending a patient to a practitioner who was not medically qualified (Griggs 1981). Modern medicine as it is today has only dominated medical practice for the last 150 years. Mainstream medicine in this day and age, if it is to be fully credible in the context of widely differing cultures, the globalisation of knowledge and its accessibility through the world wide web, where falsities easily spread, needs to encompass the socio-historical context of what it has grown out of. Some prejudices of the past may have been carried forward into the present day setting and will therefore need to be reviewed. Certain aspects of medical knowledge and practise of the past may be found to have been rejected wrongly, through prejudice rather than by scientific elimination. The development of the NHS offered orthodox treatment free, whereas before that, people chose to pay for an orthodox practitioner or other practitioners. People, naturally, choose to have their treatment for free and in so doing limit the possible therapies.

Medicine in Britain today

Orthodox medicine has been linked with modern, scientific ways of thinking. The result is that, in people’s minds, alternative medicine has been linked with unscientific thinking (Fulder 1996); equating scientific with effective medicine and anything else with a non-effective form of medicine (Fulder 1996). This bilateral distinction has not allowed much differentiation between alternative therapies. Medicine has developed into this century where, still, the majority of consultants are men and only very few women achieve this level, even in gynaecology (Weader Kelly 1995). People are becoming disillusioned with the present system (Fulder 1996) and question the autonomy of the medical profession. More women visit their GP and are concerned about their health as is the same is the case with the medical herbalist; more women than men attend as patients (Green 1999). With the HRT scare, an increasing number of women are looking towards herbal medicine to help them with menopausal symptoms. The increasing hazard of modern drugs contributes to the trend away from conventional medicine (Siahpush 1999). It has been estimated that two out of every five patients taking prescribed drugs are likely to suffer from the side effects of these drugs and some drugs produce dependence (Shitara and Sugiyama 2006). Over the centuries, improvement in people’s health has been brought about by improved standards of nutrition and sanitation (Dubos 1959) rather than as a consequence of new drugs. Antibiotics, steroids, continuous improvement with surgery, have led to dramatic improvement in conditions that were previously impossible or difficult to treat. Serious infection could now lead to survival and normal health, where herbal treatment would not have been able to provide and answer, such as in Tuberculosis, Syphilis, and other conditions. Surgeries such as appendectomy, cholecystectomy have rescued lives where no other treatment would have lead to survival. However some of today’s diseases are the result of behaviour and environmental changes associated with industrialisation (McKeown 1983). A past director of the World Health Organisation (WHO) said that most of the world’s medical schools prepare doctors for a medical practice that is blind to anything but disease and the technology for dealing with it (Mahler 1977). The attempt to diagnose and treat one illness may produce another, be it through side effects or iatrogenesis. ( Mahler 1977). The resources directed into health are increasing steadily, yet life span remains unchanged and we are getting sicker. In the last 20 years there has been a 300% increase in health expenditure and a 50% increase in the percentage of the Gross Domestic Product spent on health (Fulder 1996). Yet there is an increase of a third of the population suffering from long-term illness and a 64% increase in incapacity or days of certified illness (Fulder 1996). Today patients, women, and carers are becoming active participants in their form of care and self-help groups are empowering patients (Saks 1992). There has been an increase in the use of different complementary therapies, and more GPs recommend or endorse the use of complementary therapies (Paterson 1997). These changes are happening, partly due to the buying-in of services, which have to be cost-effective (Fulder 1996). This could lead to a reduction in the use of expensive drugs and in hospital bills (Kincheloe 1997). Self-help groups present a challenge to the traditional paternalistic and professional power base (Saks 1992). The sufferer or carer becomes an active participant and, with alternative systems of healing, this cuts across the orthodox doctor-patient relationship. These groups can be seen as opposing bureaucratic and hierarchical authority structures. They have been compared to the women’s movement, which intentionally opposed the typical authority structures of patriarchal society. Their strength lies in empowering its members (Saks 1992).

Looking at health

Herbal tradition has remained the cornerstone of medicine (Halberstein 2005). Some of the most effective drugs have their basis in herbal medicine and about 25% of the present day pharmacopoeia originate from the herbal world (Halberstein 2005). In Shropshire in 1775, there was a secret remedy for dropsy, used by a local healer, that led to the discovery of the use of foxglove, for the treatment of heart failure (Weiss 1960). Research led to the use of the isolated constituent and present day medicine of Digoxin. The development of aspirin from the willow bark, quinine from the cinchona tree, and opium derived from opium poppy has led to the discovery of drugs that led to important results (Halberstein 2005).

Where complementary medicine and orthodox medicine divide, is in the way they look at health; in the complementary field it is restoration to health, rather than the removal of sickness that is fundamental (St George 1995). The WHO stresses the importance of the state of physical and mental well being (Mahler 1977). Modern medicine defines health as absence of symptoms. Orthodox thinking is based on the model from Descartes’ thesis, treating the body and mind as separate entities, treatment is based on rational and objective observation without subjective influence. The body is conceived of as a machine (Nettleton 1995). Clinical signs are presented to the doctor objectively, and are not connected to the patient’s own experience. The cause of the disease could be narrowed down to one specific agent such as a germ, or a lack of a particular hormone. It has no place for multi-factorial effects of the broader social environment such as nutrition and stress. (Nettleton 1995).

With the desire to understand the processes within the body, specialisations developed, such as gynaecology and obstetrics in women’s health. The understanding of the body as a machine (Nettleton 1995) allows it to be dissected, and individual tools used, such as individual chemical components, to be able to fix the machine. To achieve this, one effective constituent of a plant is sought, or one chemical assuming that other constituents are irrelevant. This leads to isolating the active substances in the herbs, rather then having to cope with hundreds of other constituents that make more difficult an understanding of how the medicine works.


The pinnacle of clinical research is Randomised Controlled Trials (RCT), however by 1994 these constituted only 16% of the published trials in leading medical journals (St George 1994). RCT, research is reductionist and objective, trying to break down reality into manageable pieces. The emphasis is on standardisation, isolation, control, classification, quantification, and randomisation. Within this system there is an attempt to gain maximum control by stripping the therapy down to a single intervention. This will enable researchers to have minimal other influences on the condition studied, and enables them to draw the conclusion on the effects of one particular chemical on the condition.

Current research aspects illustrate the masculine, dominating, quantitative medical technology approach, in contrast with the female contribution which includes mystical, qualitative, intuitive and natural approaches (Aakster 1986, lecture notes Fox-Strangeways 2005). However there are certain limits to RCTs. RCT have not always been large enough to pick up adverse effects or outcomes. On occasions, drugs have had to be withdrawn, despite extensive RCT. For example the drug Opren in the 1980’s was withdrawn; despite trials, the drugs led to 3000 deaths and side effects (Robertson 1995). Or the trials are undertaken for too short a period. RCT can have difficulty in assessing prevention of rare events, such as sudden infant death syndrome as related to the position a baby sleeps in. RCT cannot always reveal problems with medication when used long term, e.g. the contraceptive pill, where the problem did not arise until decades later (Robertson 1995). By using RCT, treating the person as a whole person is not possible and classifying does not allow for the uniqueness of the patient (Aakster 1986). Surrogate endpoints are often used in preference to clinical outcome measures. With RCT research there can be no variables in treatment. With herbal medicine, treatment is highly individual, assessing different body systems and for the same condition in different people, the same herbs would not be used. Significant lifestyle advice is discussed per patient. RCTs of individual herbs, although of use, do not reflect treatment as would have been provided by a medical herbalist, therefore the therapy under question has not been truly evaluated. RCT generally offers an indication of the efficacy of an intervention rather than its effectiveness in everyday practice and provides evidence of what can be achieved in the most favourable circumstances (Black 1996). Analysis of only predefined ‘objective endpoints’ may lead to exclusion of important qualitative aspects of the intervention and publication bias.

Within the context of wholeness, RCT are of limited value. The effects of herbal medicines are the outcome of complex interacting variables, by eliminating the variables in RCT however, a major part of the treatment is taken away.

RCTs have contributed towards the recognising of herbal medicine as a valuable alternative in the case of Black Cohosh to HRT (Wuttke et al 2003) and Agnus Castus (Wuttke et al 2003) in women’s health. Research is needed to help in the clarification and development and professionalisation of the therapies. Proper investigation is needed. Without it neither conventional nor complementary medicine would exist beyond the folk remedy level. However there are difficulties in scientifically exploring systems of treatment that do not obey constructed scientific principles.

Complementary medicine involves individualised diagnosis and treatment of patients, an emphasis on maximising the body’s inherent healing ability, the treatment of the whole person by addressing their physical, mental and spiritual attributes, rather than focusing on a specific pathogenic process as emphasised in western medicine. At the centre is the patient, and not the disease. (Whitelegg 1995). So the alternative approach is ‘holistic’ rather than ‘reductive’, and the person is treated as a whole (Whitelegg 1995). Despite this emphasis on multimodality treatment regiments, most research investigating traditional systems of medicine have examined only one, or perhaps two, interventions taken from a whole treatment system. Empowering the patient to reflect on what contributed to the disease process and correct aspects that are feasible, and encourage healthy living, such as lifestyle, exercise, socialising and relaxing. Treatment involves the patient who is not just passively present. There is a need to no longer see a disease as a technical problem, but in essence as a human problem and research should reflect this. One needs to acknowledge uncertainty and subjectivity in medicine, which to orthodox medicine is inferior (Whitelegg 1995). However, to the complementary health system, personal evaluation is central; nature is a force, with which one works rather than fights against.

An alternative paradigm (see appendix) is needed to provide a human-centred science in which patient self-assessment is valued, other knowledge accepted and uncertainty and ignorance admitted (Whitelegg 1995). Acknowledging female contribution that may include mystical, qualitative, intuitive and natural approaches (Aakster 1986, lecture notes Fox-Strangway 2005) would also produce a more total scientific analysis. Investigators are either faced with designing a trial of a single intervention which contributes towards the credibility of individual herbs, but does not accurately reflect true clinical practice, or undertaking a multifaceted intervention trial that is complicated to design and implement.

Different studies that could be used

- Single intervention approaches to treat a conventionally diagnosed disease, as has been done with St Johns Wort for depression, Black Cohosh for menopause, and Agnus Castus in hyperpolactinaemia is possible. These have been done as RCTs, and continue to be a valuable contribution towards the understanding of herbal medicine.

- One could treat a specific disease, in which investigation of a whole system of medicine is investigated, so that both diagnosis and treatment can be individualised. The system as a whole is used instead of a single form of treatment. The system could be evaluated at the end of a trial through a validated measure of the condition, as the Hamilton scale for depression (Hamilton 1960), and Menopausal Rating Scale for menopause (Hilditch 1996).

- Comparative outcomes approaches examine the results in selected groups of patients of the entire therapy performed by the therapist, compared with conventional treatment by a doctor.

- Observational studies help with evaluation of rare adverse effects and are a viable research option when randomisation might be unethical or unacceptable.

- Person centred approaches should include the patient’s ownership of their treatment experience (Whittlegg 1995). It has been recognised that patients can make a reliable assessment of their symptoms, everyday limitations and functional impairment, provided they are asked relevant questions in a standard form, such as Measure Yourself Medical Outcome Profile (MYMOP) (Patterson 1996).


The history of medicine has shown a male dominated system, where women healers were dismissed as irrelevant. The distinction between orthodox and herbal medicine depends on particular circumstances of different societies. It is fashioned by factors, which include the nature of medical technology, the forms of organisation of medical practice and more general social values. A healer is likely to be very different if they think of the body as a machine. Many women choose herbal medicine for their healthcare, and good research needs to evaluate safety and effectiveness. Although there is some limited value in RCTs in herbal medicine, this does not reflect a true evaluation of herbal medicine as it is practiced today. Studies need to be done which reflect herbal medicine as practiced, with measurements allowing for the assessment of the benefit to the patient.


Akerele O 1993 Summary of WHO guidelines for the assesment of herbal medicine. Herbalgram 28:13-6

Black N. 1996 BMJ 1996;312:1215-1218

Chamberlain M. 1968 The Old Wife, Pregnancy and Birth Control. (London)

Clark A, 1968 Working Life of women in the seventeenth Century (London: Frank Cass, 1968)

R.Dubos 1959 Mirage of health : René Dubos. World Perspectives, Vol. XXII. New York, Harper and Brothers

Fox-Strangeways P. 2005 Lecture notes; Holism, Science and Women: the case of Complementary /Alternative therapies.

Fulder S.1996 The Handbook Of Alternative and Complementary Medicine, Oxford University Press

Ferguson M. 1980 The Aquarium conspiracy Pallidon, London p.270

Griggs 1981 Green Pharmacy; a history of herbal medicine.Jill Norman and Hobhouse Ltd. London

Green et al 1999 Gender, psychosocial factors and the use of medical services: a longitudinal analysis. Social Sciences and Medicine 48;10:1363-1372

Halberstein R 2005 Medicinal Plants: Historical and Cross-Cultural Usage Patterns. Ann Epidemiology 15:686-699

Hamilton M 1960 A rating scale for depression. Jounal of neurology, Neurosurgery, Psychiatry 23 :56-62

Hilditch JR et al 1996 A menopause-specific quality of life questionnaire: development and psychometric properties, Maturitas 24: 161–175.

Hughes M.J. Women Healers in Medieval Life and Literature (Morningside Heights, NY, 1943)

Hurt-Mead K.C. 1938, A history of women in medicine (London)

Joyce C 1994 Placebo and complementary medicine. The Lancet344,1279-81

Kincheloe 1997 Herbal medicine can reduce costs in HMO. Herbalgram 41;49

Lancet (1841) ‘State of the Medical Profession’ 655-6

Litovitz T.L. et al 1990. 1989 annual report of the American Association of Poison Control Centers national data collection system. Emergency Medicine 8,394

Mahler H. 1977 Editorial. WHO Chronicle, 31,60-62).

McCaleb R.S. 1992 Food ingredient safety evaluations. Food and Drug Law Journal 47,657-63

McKeown T.(1983)‘A Basis for Health Strategies: A Classification of Disease’ British Medical Journal august 1983; 287

Mintel Ltd 1993 Alternative medicine; Mintel Market Intelligence report, Mintel, Long Lane London.

Montgomery J 2005 Lecture, Diseases in the Seven Ages of women.

Nettleton,S 1995 The Sociology of Health and Illness, Cambridge: Polity Press

Oakley A. 1992 The wise women and the doctor in alternative medicine in Britain, (Oxford university press 1992)

Parinder G., Witchcraft: European and African (London: Faber. 1958)

Paterson C 1997 Complementary practitioners as part of the primary health care team: consulting patterns, patients characteristics and patient outcomes. Family Practice 14:347-354

Patersons C 1996 Measuring outcomes in primary care: a patient generated measure, MYMOP, compared with the SF-36. BMJ 312:1016-1020.

Paterson C et al 1996 Measure Yourself Concerns and Wellbeing (MYCaW): An individualised questionnaire for evaluating outcome in cancer support care that includes complementary therapies,Complementary Therapies in Medicine

Poynter F. 1962 , ‘Nicholas Culpeper and his books’, Journal of the History of Medicine 17 (1962), 152-67

Robertson M 1995 The European Journal of Herbal Medicine 1;3:31-35

Rosenberg C. 1977 The therapeutic revolution: medicine, meaning and social change in the nineteenth century. Perspectives in Biology and Medicine, 20, 485-506

Siahpush 1999 Post modern attitudes about health: a population-based exploratory study. Complementary therapies in medicine7:3;164-169

Saks M, 1992 Alternative medicine in Britain. Oxford university Press

Savage and Hutchings 1987 Poisoned by herbs. British Medical Journal 295, 1650-1

Y. Shitara and Y. Sugiyama 2006, Pharmacokinetic and pharmacodynamic alterations of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors: Drug–drug interactions and interindividual differences in transporter and metabolic enzyme functions , Pharmacology & Therapeutics

StGeorge D 1995 Research and development in herbal medicine; Biomedical research or new paradigm. European Journal of Herbal Medicine Vol1;1:38-40

StGeorge D. 1994 Research into complementary medicine; going beyond the limits of clinical trials. Advances, 10,59-61

The Independent 1992 9 September Chemical Marketing Reporter.

Valussi M 2001 Biochemical research methods and Herbalism, The European Journal of Herbal Medicine.Special Issue 25-32

Weader Kelly 1995 Gender influences on earnings of obstetricians and gynaecologists, Obstetrics & Gynaecology 86;1:112-118

Webster 1975 The Great Instauration: Science, Medicine and Reform, 1626-1660 (London: Duckworth, 1975)

Wegener T 2003 Proposals to enhance the quality of ovservational cohort studies. Phytomedicine; International Journal of Phytotherapy and Phytopharmacology 10;8:700-708

Weiss R 1960 Lehrbuch der Phytotherapy, Hippokrates Verlag

Whitelegg M1995 An Alternative Science for Herbal Medicine. The European Journal of Herbal medicine2;1:36-39

Wuttke et all 2003 Chaste tree (Vitex agnus castus) – pharmacology and clinical indications. Phytomedicine 10:348-357

Wuttke et al 2003 The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 44 Suppl. 1 S67-S77


Make a Free Website with Yola.