by Paul Bergner
North American Institute of Medical Herbalism

Part I

I am convinced that Western medical herbalism is dying in North America and Britain. If we stop congratulating ourselves for a moment on the growing numbers of herbalists, or of schools, or of accredited degrees, or of more interest by scientists in herbs, and look honestly, we will see it is dying. If we look to a hundred years ago, the number of herbs in use, and the knowledge of those herbs, by professional herbalists, they greatly exceeded what we use today. Our medical herbal forebears mastered more herbs than we do today, and also knew more about each of them. If, say, an herbalist today, truly understands about a hundred herbs, and knows 2-3 clinical things about each of them, we can call that 250 data bits. If our ancestors learned 365 herbs (more on this below), and knew 6-8 things about each, then that is more than 2500 data bits, and 90% of our herbal knowledge has gone down the drain.

Much of this loss of knowledge in North America is because the the collapse of medical level herbal education early in the 20th century. The loss of direct clinical education has been most devastating. Another cause is the abandonment by herbalists of their own traditions in the later 20th century in favor of “scientific” herbalism, as the trend by herbalists to become defensive and “prove that herbs work” came to dominate the psychology of the herbal faculties. Herbal practice has become dominated by The Book rather than by Direct Clinical Observation, or even by Tasting. A scientific trial of an herb is like a serial killer. We have, for instance, a wonderful diffusive and diaphoretic, reliable emmenagogue, mucous membrane remedy for the stomach and lungs, and occasional remedy for certain kinds of headaches, in the herb feverfew. These properties can readily be experienced and confirmed by simply taking some of the herb and paying attention. But once a clinical trial establishes that feverfew is “good for migraines” it becomes The Migraine Remedy. Never mind that feverfew is not all that effective for migraines (it reduced episodes on average by about 25% in one trial, and for one segment provided no relief at all), in the absence of direct experience, or of clinically experienced faculty who know the herb from first hand use, or even an authenic clinically based text book, our serial killer scientific trial “murders” all the other uses of the herb, and they fall away, lost to posterity with no one even to mourn at their grave. Now the proud student administers standardized extracts of feverfew to the patient with a migraine, ignoring such factors as the hot or cold or deficient state of the patient, or her menstrual patterns, and tells them to take it every day forever to reduce migraine.

Now the weak and exhausted patient with a red face sweats profusely and her dehydration is aggravated. The women with normal menses suddenly is flooding, not to mention the patient with menorrhagia. Because of the scientific trial, and the devaluation of traditional experience and handson experience, the student is for practical purposes disabled for clinical practice. The “expert faculty” has become the one who knows all the clinical trials and plant constituents instead of the one who has decades of experience taking the herb personally and seeing its effects directly in clients and students. The epitaph on the tombstone of medical herbalism will read:

European Phytotherapy
finally was the death of me.
I had three-hundred-sixty-five;
they cut me down to twenty-five.

About those 365 herbs: I have a copy of Physio-Medical Therapeutics, Materia Medica and Pharmacy by T.J.Lyle. This book was used as the materia medica text at the Chicago Physiomedical College after its publication in 1897 until the college closed in 1913. (You can download an electronic version of this book at David Winston’s web site). The book later formed the basis for sections of the Dominion Herbal College course written by Dr Herbert Nowell in 1926 and still available today. My copy of the book is a reprint from 1932 by the the National Association of Medical Herbalists in Britain; the copy appears to have belonged to a student sometime mid-century when it was used as a text in a preclinical therapeutics course at school there. The student underlined, very carefully, with a fountain pen and a ruler, the material from the lectures for which he or she would be responsible on examination. The markings fairly well ruin the resale value of the book on the rare book market, but offer very valuable insight into mid-century British herbal education and entry level knowledge into the profession at that time. The book contains listings for about 430 herbs in the materia medica section, and about 85% of these are underlined. That comes to 365 herbs this student was required to learn. (This is, by the way, the same number of herbs in the oldest Chinese classical materia medica) The underlining itself is telling, because the student was not responsible for all the material in the book, but most often for the uses of the herb and the tissues it affects. And the fingerprints of the teacher in this class are also evident, because not all the uses were emphasized. It is the mark of an experienced clinician and experienced clinical educator to be able emphasize those things that will be most important clinically, according to his or her experience, from the larger amount that inevitably appears in books and can overwhelm the entry-level clinical student. And we also have the fingerprints there of Lyle, who was the protégé of Physiomedicalist master William Cook for decades, and who also interviewed many of his contemporary colleagues before completing his text; and of Cook himself, who practiced and taught diligently for more than fifty years. Which brings me to the topic of this article. Drs. Cook, Lyle, Nowell, and the unnamed faculty of the student who did the underlining in my book were all masters of herbalism. All studied and practiced with a diligence and rigor and a focus on hands-on experience which is for the most part lost from contemporary North American herbal education and practice. They all studied under masters of herbalism, either directly or indirectly. And without the reemergence of that level of rigor in study and practice, and that level of mastery, I think our profession will die.

Part II

Mastery of any topic is attained after years to decades of becoming fully engaged not only in the field, but being constantly engaged with a level of rigor and practice that steadily expands and also deepens understanding of the facts and principles of that field or topic. The master brings the subject completely alive in their own being and experience. Ultimately their career is characterized by various “threshhold events” of understanding and insight which contribute new understanding for the current generation and a legacy for future generations. Those thresholds are made possible by an intuitive synthesis of many facts and observations during the career leading up to them. This process is how a field stays current and alive throughout generations.

The 10,000 hour rule

A study of classical musicians at a Berlin academy of classical music investigated students in three tracks in the school: The Star track, headed for world fame in classical music; the middle track, headed for the St Louis Philharmonic; and the teacher track, less skilled and headed to teach music in high school. Researchers asked the simple question: How much weekly practice time have you put in year by year since your started playing your instrument? The results: star track musicians had put in at least 10,000 hours of practice. The middle track had put in 8,000 hours but none had put in 10,000 hours; and the teacher track had put in 4,000 hours, but none had put in 8,000 hours. This is now being called The Ten Thousand Hour Rule in popular culture, and people are claiming mastery for having showed up for work for 10,000 hours (about 20 hours a week for ten years.) There is a big
problem with this kind of thinking, however. Musicians put in practice time with rigor such as scales, mastering all keys, and chords within them, as well as developing progressively more difficult techniques and progressively more sophisticated pieces for performance, while at the same time keeping well practiced in the basics. They don’t just play what they already know, they grow constantly, in addition to constantly honing the basics. Just punching the clock is not enough. I am sure the a Rotor Rooter Man can claim 10,000 hours of snaking toilets, but this is not progressive development of ability and insight. Or to put it another way, one stand-up comic criticized a rival saying: “He says he’s been doing stand-up for twenty years; I say he only did it for 1 year and then repeated that year nineteen times.” In the herbal field, we have herbalists lecturing at conferences who are giving essentially the same lectures they were 20 years ago; herbalist-physicians practicing by rote administration of set formulas; herbalists writing books full of information they read in other books and which they have never demonstrated to be true in their own experience. So our questions for mastering herbalism are:

1) What kinds of activities or study count toward the 10,000 hours and progressively develop skill and insight in the practitioner?
2) How can we avoid becoming comedians who repeat their same jokes for twenty years without growing or developing new repertoire?

In this series of articles, I am not calling for standards for licensing or approval by any regulatory body or accrediting agency. I am an educator, with 36 years of clinical experience, 20 years teaching, and 15 years running a teaching clinic, supervising thousands of cases over that time in addition to my own clients. I’m now in my elder years, and at this stage I could care a fig whether the government or anyone else approves of me (other than that Social Security). And I am very much focused on how to train a younger generation of herbalists in the routines and practices and attitudes that will lead to mastery instead of decades of bad jokes. I believe the future of Western herbalism will depend on this kind of work to a much greater extent than reframing what and who we are for the sake of acceptance by authority, however necessary or valuable that may be in the short term.

I’ve thought about the above questions deeply, and will give my thoughts in the third and final part of this article. Meanwhile I thought I would put this out on the lists for discussion. Every herbalist, and especially every master of herbalism is not on the same track, in fact mastery implies to some extent uniqueness and being out-of-the-box. So there is not one answer to the above. A master of wildcrafting and medicine making is on a different track that a master of clinical herbalism, a clinical herbalist practicing in the physician-model will have a different set of “scales” to practice than a clinical herbalist practicing in the hygienist/nutritionist model. Teachers will have routines of practice and preparation that are unique to teachers. True mastery of botany is essential for a master of wildcrafting, it is not for a clinical herbalist, and so on. So I put the question for discussion: What are some of the routines, practices, disciplines, that can lead to progressive development of an herbal career and lead to mastery in the field?

Part III

to be continued…

Paul Bergner