Nothing ever changes…

I was recently doing some routine housekeeping on my computer when I came across these two files from 13 and 12 years ago – and having copied them to the Herbarium team for interest, was asked to post them here, along with some explanatory notes.

During 2001 Michael McIntyre, Chair of the European Herbal Practitioner Association (EHPA), had fronted a series of regional meetings called the ‘EHPA Roadshow’ – to promote the notion of Statutory Self Regulation (SSR) to herbal practitioners, mostly members of the National Institute of Medical Herbalists (NIMH). There were subsequent complaints to the NIMH Council that its members felt they were simply being lectured – there was no balance of arguments and little opportunity for open discussion. With some reticence, NIMH Council organised a meeting in London in December 2001 to address this problem. I say ‘reticence’ advisedly – the event was notified to NIMH members with only a few days notice, the date and venue but no time was given, and thankfully the attempts by ‘Michael and his team’ to stage-manage the proceedings were successfully countered. Subsequently NIMH disowned the event, declaring that it was not an ‘official’ NIMH meeting: both the audio-tape and the Hon. Gen. Sec’s written minutes went missing, and it was never reported to the NIMH membership. Therefore you will have to rely on my own recall of the occasion. About sixty practitioners and students attended: speaking for SSR were Michael McIntyre, Andrew Chevallier and Alison Denham (NIMH president) – in opposition, Christopher Hedley, Susan Allshorn, Susan Tosoni and myself. This took up most of the morning, the afternoon being devoted to an open discussion from the floor. 

I believe this was the only occasion that SSR (now simply SR) was ever properly debated, and it’s not surprising that the outcome embarrassed the EHPA (now EHTPA) as the majority of those attending held against regulation. Below is a transcript of my own submission to the meeting. What fascinated both myself and my peers was to see how little has changed in terms of argument or context in the ensuing years.

Stephen Church

***

‘First and foremost, I’m here to represent the interests of Carol’s & my patients – and they do not want us to be registered!

We live and work in the middle of what are officially the three worst Health Authorities in the country and most of our patients, (we calculate about 70%), have been injured, betrayed or simply abandoned by state-controlled medicine. Part of their choice in coming to see us is for the very reason that we are not controlled by the state.

They don’t want us to be hobbled by bureaucracy, they don’t want us to become more expensive, they don’t want any more tampering with our materia medica or our freedom to make medicines for them, they don’t want our good work to be meddled with in any respect – they just want us to be left alone to get on with treating them in the fashion they have come to love and trust.

So this is a human rights issue, relating to freedom of choice, and it’s a good and just choice, because like all our colleagues we do a great deal of good, but never any harm.

However, this principle of freedom of choice extends beyond our relationship with our patients. Herbal Medicine is the indigenous traditional healing system of the British Isles – the Folk Medicine, the medicine of the people. The National Institute of Medical Herbalists is not that tradition, nor even is professional herbal medicine at large – we’re just a part of it.

Herbal medicine happens on many other levels between ourselves and basic home self-help. Good professionals have always nurtured, supported and taught to all these other levels – but now we’re seemingly set on a course that will destroy much of the rest.

Seven years ago we stood hand in hand with our patients and the public to protest against legislation that would have removed a huge raft of herbal remedies from public access – and between us we won the day – in fact, my information is that we broke the British public’s lobbying record in doing so.

Now it seems that part of the SSR package is to nominate a great many herbs for “practitioner use only” – once again denying the public a freedom of choice. They will most certainly campaign again, but this time I’m expected to stand in opposition to them. That, I’m afraid, I cannot do.

We also have to consider the freedom of choice of future generations. I don’t know how long the Empire of the Capitalist West can sustain itself, but it’s already shown itself to be vulnerable and one day, (if we have learnt anything from history), fall it certainly will. Quite what use are we going to be then – if we have developed our own grinding bureaucracy, have all but merged with the orthodox model and become dependent on the phytopharmaceutical industry?

Carol & I are truly blessed to have the resources to grow and make most of our own medicines, and through this we can give witness to the fact that you could all but cut our practice off from the outside world and our patients would hardly notice the difference. Herbal Medicine’s great and enduring strength is that it can function to a high degree of sophistication on spectacularly low technology. Of course, Carol & I are not the only custodians of this priceless knowledge and together we are all determined to protect it and keep it safe, come what may. Where your own personal choices regarding SSR are concerned, you’re going to have to decide which way to go – to remain part of this timeless tradition, or to try something dangerously different – surely it must be clear that you can’t do both.

I just used the term, “personal choice”, and advisedly.  Many of you may not have realised that although the Institute has been a key player in the move towards SSR, when it comes to registration each and every one of you will be applying to be registered personally. So where we put our hands up at Institute AGMs and the like, we may have some small influence on the process – but ultimately each of us has our own very private decision to make – do I want to be a state-controlled herbalist or not?  I believe that if the answer is not, then no harm will come to you, because our patients and the public will defend you – as indeed I believe your own professional body should, SSR or no SSR.

Short of a miracle – and that miracle will have to start happening here today – Carol & I will be leaving the Institute shortly – it would be hypocritical to remain part of an organisation that continues to act contrary to our own fundamental principles.

But of course we’re concerned for the fate of herbal medicine as a whole – and we’re convinced that what we have here is already a runaway train careering towards disaster. SSR is too expensive and herbal medicine is too humble and too diverse. We’re also ignoring the fact that herbalists are by nature people who choose freedom – we don’t like being organised. But if we turn aside from SSR at the eleventh hour, (or heaven forbid the thirteenth hour when our registration papers arrive and we don’t fill them in), then disaster it will be.

Meanwhile, right now, herbalists out there are suffering – they’re not doing well and their plight is in great part due to neglect of their real needs by their own professional body. We’re also pouring out graduates from the various universities to get the numbers up, but again, we’re doing precious little to help them gain a living either. Instead all we have is the fond hope that once we’re registered, doctors will find work for us. You must be joking!

I’d like to reiterate that the last four speakers [opposing SSR] have elected to speak more briefly than we were invited to so that this meeting can be something that we’ve never had since the term SSR was first heard – a consultation with you, the present and future membership of the Institute, to find out what you think about it all.

By all means ask questions, but don’t accept any politician’s answers. There is clearly great unrest, which I think arises from the sense that our political helm is not representing our interests to the state, but are instead representing the interests of the state to us. We want answers to questions, but if Michael and his team can’t provide them, perhaps it’s not too late for us to start providing answers ourselves.

So an even greater priority is for us to place a hand on the reins and express openly what we do and don’t want from SSR, what we are prepared to sacrifice, what must not be sacrificed at any cost, and what we hope to gain – which so far as I can make out, is too little to even consider. If you don’t take courage and grasp the nettle now, there may never be another opportunity.

Good luck to you all, and thank you for listening so patiently. Now it’s over to you.’

***

Despite the clear message of dissent voiced at this meeting, it was ruthlessly ignored, so a few months later in the spring of 2002, (and in the midst of a great deal of unpleasantness), Carol and I did indeed leave NIMH. However, to our surprise, the editor of ‘Herbal Thymes’ (NIMH’s own internal newsletter) accepted and published this article from us in the February edition: –

WHY YOU SHOULD SAY ‘NO’ TO SSR

Carol & I informed the Council of the Institute earlier this year that we would not be submitting to SSR and therefore must expect to leave the Institute shortly. We thought we were a voice in the wilderness when everybody else was in favour, or at least accepting of its inevitability. We’ve learnt a lot since then. We’ve found ourselves in surprisingly good company. If we’re used to being blanketed with motivational rhetoric from the Institute’s pro-SSR core then at least the present Council acknowledges the need for more information and a fair balance of opinion if we are all to be properly informed. In particular, we’ve found a culture of fear, based on the main political platform of SSR – that we must do or be done unto, and our only hope is to hide behind the skirts of the bullies. SSR is not inevitable. If there are enough people who really want it with their hearts, why should they not – but we can and must still insist on a safe haven for the tradition of herbal medicine. Clearly two heads cannot sit on the same shoulders. Here are some reasons why:-

What’s wrong with SSR?

Firstly, the ‘self regulation’ bit is just a smoke-screen – it’s ‘statutory’ that counts, and beware! Our understanding is that you will only be voting for a General Herbal Council to be set up – it will decide what it’s going to do later when we’ll have precious little influence. Herbalists will apparently not be in the majority on this Council, and the rest, the so-called ‘lay representation’ will be government appointees. So despite all the fine words, we’re looking at state registration & state control.

Why on earth should we choose to submit to state control at a time when the state concerned is so manifestly out of control?  Why should we become part of a process that one senior NHS worker referred to as ‘another example of re-arranging the deck chairs on the Titanic?’  Why, instead of the dream of ‘free herbal medicine for all’ are we willing to accept punitive charges for the privilege of being registered?  It’s our patients who will inevitably foot the bill.

Read any newspaper these days for increasing evidence that state registered medicine is not a guarantee of safe & ethical practice – whilst the Institute’s own matchless record will be sacrificed. Moving ever-closer to the orthodox model may amuse allopaths & academics but will not improve our effectiveness in practice. The promises of more doctor referrals or jobs within the NHS are ridiculous – such is their disappointment in this respect that Osteopaths are de-registering in droves – and allopaths feel even less kindly disposed towards herbal medicine!

The Principle of Freedom

As in most parts of the world herbal medicine is the indigenous traditional healing system of the British Isles – the folk medicine, the medicine of the people. Over the centuries we’ve proved particularly good at resisting attempts to persecute, hamper and legislate herbal medicine because ordinary people will fight for their innate right to reach out and pluck a plant for their nourishment and healing – and to seek sources of supply and the advice of experts if needs be.

Herbal medicine is practised at a continuum of levels from the humblest home self-help to the headiest heights of professional practice. Good practitioners have always nurtured and supported these different levels – and yet an inevitable consequence of state control is that much of the middle ground will be lost. Isn’t it telling that the only ‘perk’ of SSR on offer to date is that there will be more practitioner-only herbal remedies!

The key issue is not to do with the profession, or the state, or even the general public, but our patients. Freedom of choice! A substantial proportion of our patients have been injured, betrayed or abandoned by state-controlled medicine (or for other reasons are simply mistrustful of it) and a powerful motive for seeking our help is that we are not state-controlled. Ultimately everything we have solemnly sworn to is for the benefit of our patients – are we to abandon or betray them ourselves?

What’s the alternative?

One of the curiosities is that traditional herbal medicine, real herbal medicine is in amazing good shape at the moment. With the growing availability of organics, the proliferation of small fresh-herb manufacturers and more in-house medicine making, we have herbal remedies of a quality unimaginable even a few years ago. We have been able to access global ideas and resources with ease and have been enriched by the experience. Our contact with other traditional healing systems and their (often oppressed) practitioners continues to grow, and we link these inextricably with the concepts of ethnobotany, ecology & conservation, for which we take increasing responsibility. Holism has progressed from theoretical re-invention to a well-practised and highly effective model in which intuitive techniques, the concepts of energetics and an insistence on the indivisibility of body/mind/spirit have become routine to our work. We are no longer frightened of magic. A folk tradition is not an antique artifact, it’s a living thing that adapts to and is sustained by the times it finds itself in. We and our patients have something to be proud of and we will not relinquish it gladly.

SSR was never inevitable – one of the prerequisites is that a “substantial majority” of us must be in favour (in Civil Service terms this usually means over 70%). That would be hard to achieve within the Institute, let alone amongst the other herbalist bodies. The question now is, having considered the full implications, will we turn aside from it in unity, or are we facing another of herbal medicine’s famous schisms?  Either way, we have nothing to fear – as always, our patients and the public will protect themselves by protecting us if needs be.

A final thought: of late the world has been dominated not by western democracy but by western capitalism – and now the world economy is teetering on the brink of quite a precipice. In the face of such uncertainty gaining a top-heavy official structure, moving towards the allopathic model and increasing our dependency on the phytopharmaceutical industry sounds like entirely the wrong direction. Being the last drop of oil on a machine belching blue smoke is not a place in history to be savoured. Instead we must re-affirm herbal medicine’s unique value as a cheap and effective medical therapy that can function to a high degree of sophistication on remarkably low technology and with very little call on external structures or resources. Was there ever a greater need for the custodians of this extraordinary knowledge to keep its flame burning bright?

That is our determination, as we hope it may be yours.

Stephen & Carol Church

***

 Looking back, some of the language has changed (professional bodies rather than professional associations, for instance), and there are a few technical differences between SSR and the current proposals for SR: but the main tenet of the principled objections could have been written yesterday. In point of fact, the current ‘big push’ to achieve state sanction dates back a further 10 years to 1991, and the arguments were just the same then.

All that the latest round of lobbying has achieved is an undertaking from the Department of Health that a new working group will be set up (a working party is the start of a process, not the end-game!) Meanwhile, copying the ‘herbalists exemption’ piecemeal from the 1968 Medicines Act to the new Human Medicines Regulations 2012 doesn’t give a signal that change is imminent. Do you see a pattern developing here? Any committee work, any new public consultations, will doubtless carry through past the next general election, when the whole thing will start from the bottom again, if anybody still has the stamina for it. Whatever fate befalls the EHTPA, NIMH will surely carry on – its own history of petitioning for official recognition is now in its 150th year. 

If the context and the arguments have changed so little, the micro-environment of herbal medicine has changed quite a lot. The failed experiment of the BSc courses has come and largely gone again. Those manufacturers who opted to invest in pharmaceutical-style processes have not profited from it, or at least not from the practitioner market. For the PAs, their members probably account for less hours of herbal practice in the UK than at any other time in post-industrial history: the recession is blamed, rather than acknowledging the huge mistakes made, or the neglect of the real needs of their members for an entire generation. But the worst thing of all is the current political gambit of the pro-SR lobby, declaring that herbal medicine is inherently dangerous (on the grounds that only highly trained BSc graduates, subject to rigorous state control, can be trusted to handle this hazardous medium). This affects all of us, and it may take decades to restore public confidence.

To end on a positive note, there are not huge numbers around of the custodians of traditional herbal practice to which I referred 12 years ago, but they are able, busy and resilient, and there is plenty of fresh blood joining in. Then there is another unanticipated change – to which the Herbarium has contributed but is only a small part – the sudden expansion of the ‘middle ground’, (what PA members would no doubt dismiss scornfully as ‘lay practitioners’). This is a wonderfully colourful and expansive environment, proliferating through a huge network of personal blogs and websites. Whilst PAs and their executives still bleat on about standards, conformity and control, the middle ground, I am quite convinced, will provide the motive force for traditional herbal medicine’s future, and it is there, I would respectfully suggest, that anybody who loves it as I do should turn their attention.      

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Competence & Proficiency

This was a difficult article to write, partly because of the exceptionally high level of feedback from the rest of the Herbarium team, but mostly because it tried so hard to turn itself into a small book. I’ve confined myself to a single but telling aspect of the dialogue that the times demand. With the apparent mothballing of the Statutory Regulation process, the ongoing demise of the educational system created to serve it, and the meltdown of the herb trade in the wake of the THMPD, herbalists in the UK must pause to consider who and what we are, and where we’re going. Are the ‘professional’ herbalists of the last two centuries about to die out, and should we really mind? What sort of herbalists might replace them, and with what ethos? How would they learn their craft?

Stephen Church

In the early 1990s when I was working for NIMH and exploring what might have been a more inspiring model for professional development than is manifested these days, I spent some time with Crosby Chacksfield, an extraordinarily able educator who, amongst many useful things provided me with these two definitions: –

• Competence: the ability to function satisfactorily in familiar circumstances.
• Proficiency: the ability to function satisfactorily in both familiar and unfamiliar circumstances.

Let’s flesh this out a bit. Competence is about applying established solutions to pre-defined problems. Competence can therefore be measured, so it is easy to document, easy to teach, and easy to assess. Competence is based on vertical thinking. Competence is also the territory of risk management, evidence-based processes and centralised control.

Proficiency, by contrast, is about having abilities both more profound and broad-based – acumen, skill, flair, and audacity – to work in unknown territory and still be able to move towards a positive outcome. Lateral thinking is required. Proficiency is hard to measure, teach or assess, although it can be exemplified, recognised, and ultimately approved (or, of course, disapproved when it doesn’t go well). Proficiency used to be the territory of the professional – individuals sufficiently highly educated, conditioned and motivated in their chosen field (teaching, law, medicine, etc) that they could be trusted to act according to the best of their ability with a high degree of autonomy. There was a framework of competencies, of course, but also clearly plenty of headroom for individual talent and experimentation.

In a way, my discussions 20 years ago might seem to have very little relevance now, as proficiency (and professionalism) have been thrust aside in favour of an almost fetish-like demand for competence. Why has this happened? My own guess at the reason is two-fold. It’s partly because we now live in a world where human organisation is based on central control, and you can only control what can be measured and assessed. At the same time, the computer/interweb environment is the modern way to administer these control systems – and computers cope brilliantly with the yes/no environment of competencies, but very poorly with the ‘it depends’ environment of proficiencies.  Which chicken came before which egg is hard to know, but one can easily see how much of the modern world of occupational and social order (or disorder!) is defined by competency-based systems, and how badly it has all gone wrong: it has caused the dumbing down of just about everything, and has contributed to the creation of pyramidal, over-bureaucratised systems that are now creaking under their own weight.  On a more parochial level, one observes that workers in those fields that touch closely on herbal medicine – teachers, midwives, nurses, even doctors themselves, have had their status insidiously eroded by a process of de-professionalisation as proficiency has been sacrificed on the altar of competence. One also notices how much the demand for ever more detailed definition and evidence of competency has been done in the name of safety, and yet this process has manifestly failed to make the world a safer place.

Vitalism

Vitalism – some philosophers speak.

This is an adapted extract from my PhD thesis: Evans, S. (2009). Challenge, tension and possibility: and exploration into contemporary Western herbal medicine in Australia. Southern Cross University, Lismore. http://works.bepress.com/sue_evans

Vitalism, traditionally a central philosophical concept of herbal medicine, has more recently become an idea surrounded by controversy, not least because it can appear incompatible with a scientific worldview.  Some, like Smuts (1926) who is credited with coining the concept, suggest that the concept of vitalism is outdated and is usefully replaced by holism. However the French philosopher Georges Canguilhem (Delaporte, 1994) argues vitalism should be understood as a moral position rather than a scientific fact: a position  completely in accordance with traditional herbal practice.

In this article, I provide a brief outline of historical approaches to vitalism before discussing the contribution of Canguilhem to this debate. I will restrict the discussion to concepts and approaches to vitalism in European thought, omitting discussion of similar concepts found in indigenous traditions, or in scholarly approaches to herbal medicine such Traditional Chinese Medicine and Ayurveda.

The problem

Vitalism can be linked to a commonsense understanding of the world as being interconnected and alive, an idea which was widespread in Europe prior to the scientific revolution of the 17th century  (Larner, 1992; Sheldrake, 1990; Thomas, 1971). Since the early twentieth century, it has been soundly rejected in scientific circles, with scientists arguing that all biological processes can be explained by the laws of physics and chemistry. Consequently, well-respected chemistry texts suggest that the discrediting of vitalism was necessary to allow for the development of modern organic chemistry (Hart, Craine, Hart, & Hadad, 2007), and Greco (2004, p. 680) states ‘Many biologists today tend to use “vitalism” as a derogatory term associated with lack of intellectual rigor, anti-scientific attitudes, and superstition.’

Within the discipline of herbal medicine, a pre-modern understanding of the world as alive causes discomfort to those who feel it is important for herbalists to adopt the discourse and rhetoric of science. Mills, a leading British herbalist over the last twenty-five years, rejects its religious overtones, stating that ‘the lack of any criterion even to define a vital causal force has meant that vitalism itself has taken retreat into the bunker of modern religion’ (Mills, 1991, p. 120).

Wohlmuth draws attention to the divide between traditional herbalists and those who see herbal medicine as a science.

Many proponents of traditional herbal medicine argue that vitalism and its concept of a ‘vital force’ are fundamental parts of the theoretical and philosophical framework of herbal practice. In contrast, many others, who view herbal medicine as an essentially scientific practice employing medicinal plants as pharmacologically active therapeutic agents, see vitalistic concepts as irrelevant, antiquated and unhelpful to the promotion of herbal medicine as a valuable part of healthcare (Wohlmuth, 2003, pp. 198-199).

However, this emphasis on the science of herbal medicine and rejection of vitalism is not universally accepted. Baer (2004), VanMarie (2002) and Singer and Fisher (2007) draw attention to a developing rift, termed an ‘epistemological bifurcation’ by Singer and Fisher (2007), between those herbal practitioners who consciously support traditional herbal medicine and give centrality to the idea of vitalism, and those, like Mills (1991) and Wohlmuth (2003) above, who reject it.

Holism

Holism

It’s often quipped that Holism is something that others say, but only herbalists do. There is some truth in this – herbal medicine is the broadest and most versatile of therapies, whilst close observation of the plant world tends to lead us towards a more open and inclusive world-view. Holism is the ideal context in which to practise herbal medicine – formalised paradigms ultimately limit potential and ‘lower the ceiling’ on what can be achieved with herbs. It’s amusing to note how often holism is quoted as the antithesis of reductionism (the prime methodology of western material science). This is not true: reductionism is an aspect of holism, albeit a small one, that in the grand scale of things needs to be kept firmly in its place.

Holism is not a paradigm, it’s a philosophy – albeit the most all-embracing of philosophies – embodied in the disarmingly simple statement, ‘everything is connected to everything else’. Nevertheless what follows is one of a number of versions of the ‘Paradigm of Holism’, having its origins in the 1970s when work first started to reestablish holistic principles in western healing traditions. This said, as a series of affirmations, characteristic of holism and of critical interest to practitioners of all sorts, it serves as a tremendous source of guidance and inspiration: –

• Each patient is treated as a unique whole person – body, mind and spirit, – and in the context of family, community, culture and environment.

• Holistic medicine emphasises the responsibility of each individual for his or her own health. Good therapy promotes understanding and self-care rather than treatment and dependence. Holistic medicine uses therapeutic approaches that mobilise the individual’s innate capacity for healing.

• Holistic medicine promotes health as a positive state, not just an absence of disease. Likewise illness is seen as an opportunity for discovery as well as a misfortune.

• Holistic medicine acknowledges that the cornerstones of health are good nutrition, good exercise, good relaxation and good sleep.

• Holistic medicine makes use of perceptions and diagnostic systems additional to those validated by western material science.

• Holistic medicine emphasises the potential therapeutic value of the setting in which health care takes place.

• Holistic medicine demands an understanding of and a commitment to change those social, economic and environmental conditions that perpetuate ill health.

• Holistic practitioners are not judgmental – rather they assist their patients in pursuing their own life choices according to their own beliefs.

• Holistic medicine transforms its practitioners as well as its patients.

The Endless Knot

A Modern History of Herbal Medicine by Stephen Church

Introduction

This is a personal history, written quickly, relying in part on distant memories, anecdote and hearsay. Some of the myths and legends are impossible to substantiate, though their existence is often more telling than fact. It is anyway offered by way of a discussion document – I’m more than willing to stand corrected and, hopefully, learn more.

Some readers may need to be informed of the context – I have practised Herbal Medicine in partnership with my wife, Carol, at our home in Surrey for over 25 years. During most of this we were members of the National Institute of Medical Herbalists (NIMH), at times serving on its Council and various committees. If I seem over-concentrated on the NIMH, it is partly because it represents the lion’s share of my own experience, but equally because in most matters concerning the regulation of herbal medicine, it has lead where others have followed. Since 2002 Carol & I have practised independently, which surely in turn will colour how I organise my thoughts on the subject. Organising my own thoughts was the main motivation for undertaking this task, trying to make sense of all the tangled threads that draw us all, for better or for worse, towards a new era in Herbal Medicine.

I refer constantly to “Herbal Medicine” and “Herbalists.” Once upon a time we just had watches, until digital timepieces came along and we had to learn a new term, analogue watches, in order to differentiate. For most of my working life I was just a herbalist. Then the foreign invasions of Traditional Chinese Medicine and Ayurvedic Medicine arrived on our shores, so now I gather I’m to be known as a Traditional Western Herbal Medicine practitioner. This doesn’t sit well with me as it gives no hint that I’m part of the indigenous and unique healing system of the British Peoples, a folk tradition, which like all folk traditions only survives if it adapts and remains relevant. Like all folk traditions, it borrows from and lends to perceptions and resources from the known world of each era. It’s learnt from empirical knowledge and illuminated by anecdote. It is neither complementary nor alternative. It’s just always been there. It’s Herbal Medicine, and I’m a Herbalist!

Part of the uniqueness of British herbal medicine resides in the uniqueness of the experience of being British: if, like a good wine, we have travelled well, we have also always formed the vessel for an extraordinary admixture of races and cultures. My own working life has coincided with an era of rapid adaptation, where the “known world” has become the whole world, and in which sudden and perplexing changes in patterns of health and illness have required great consideration and invention. The tradition is, I believe, alive and well, and never more relevant. But despite this good and healing work, the custodians of the living tradition find themselves beleaguered and concerned for their future. The mainstream of Herbal Medicine is once again clamouring for recognition and status, once again in a legislative environment that is overbearing and hostile. This time, it seems, it’s prepared to sacrifice all sense of itself, to become science-orientated, doctor-like in the radically new way that doctors themselves have become, and using phytopharmaceuticals in which any sense of nature, botanical or human, is submerged. Proponents of this brave new experiment even deny that a indigenous tradition exists.

Anyone interested in the history of herbal medicine should read Barbara Griggs’ “Green Pharmacy.” It’s a history of eight centuries of “penury & persecution”. The last two centuries mark the growth of what we would recognise as “professional” herbal medicine – this in particular is a history of near-constant battles over regulation, of rivalling paradigms, of alliances and splinter-groups, of vainglorious enterprises and missed opportunities. Much of what went wrong arises from the poverty of herbalists, who on the basis that money is power, have so often found themselves powerless. Much of what went right was down to sheer bloody-mindedness. Much the same as now, in fact.

Why has herbal medicine had such an unsettled history? Partly because its own child, allopathic medicine, now in its rather naughty adolescence, has proved something of a bully. Partly because of the ebb and flow of fashion and competition. Partly because herbalists as collectives, despite the pomp and the fine words, are a bit of a rabble. But mostly one returns again and again to the same dichotomy. On the one hand, professional herbalists have yearned for official recognition and status. On the other, they are fiercely resistant to interference and control. If it’s worth listening to history, it’s to avoid making the same mistakes incessantly, and to seek new solutions to old problems.