13/08/2008 - Mrs Hamilton
'We treat the person, not the disease'
Medical Herbalists approach diagnosis and treatment of diseases differently to Doctors. This is often summed up by the rather inadequate catch phrase 'we treat the person, not the disease'. Of course we do treat the disease, only differently.
Firstly, we spend much more time ascertaining the background causes of a condition. For example, when someone presents with a headache, we consider their medical history and family traits, when the headaches start, what aggrevates them, other medical problems they have - cold fingers and toes for example - all of which helps us understand why this particular patient gets these particular headaches. It might be poor circulation, damaged to the skull in a fall, eye strain, tension in muscles, hormonal disfunction, fear or stress.
We then make a prescription to suit that particular patient - to support their particular anatomical and physiological needs. It may contain any one of a number of herbs, or a mixture of several, chosen to address the headache and the background aggrevating factors.
At the follow up consultation we consider how the treatment has worked. Adjustments are made to the medicine from this information, and, hopefully, we can bring about a resolution.
Doctors, by contrast, have very little time to consider all of the background causes. This is not a criticism - afterall, even if they did investigate the background or secondary symptoms it would be of little benefit as they do not have drugs to address those biological weaknesses, physiological insufficencies and past traumas that a Herbalist will try to identify. They really have very few therapeutic options. So for headaches they tend to give pain killers. At the risk of over simplifying it, for a GP 'headaches = painkillers'. Because of this few doctors ever really use the anatomy and physiology they studied at medical school. They have handed all that over to the drugs companies who also look for a single drug for a single condition. In that sense they treat the disease not the person.
Unlike the drug company model, herbal medicine cannot simply reach for a single herbal solution for each disease. We treat the underlying causes which are slightly (or greatly) different in each patient. This requires a real application of diagnostic skill and a good understanding of anatomy and physiology. Having established an idea of what may be causeing this patients condition we have to then create a prescription that may contain one, two, three or more different herbs to address the different factors we have identified. It takes a great deal more medical skill than your average GP uses, but can lead to remarkable results that many doctors would not believe possible.
A surprising observation in my experience is that most GPs find it easier to understand aromatherapy, reflexology, acupuncture or homeopathy than they do herbal medicine. Why is this? After all, herbal medicine is in many ways comparable to the way in which GPs work - similar length training, standard diagnostic techniques and medical terminology - nothing esoteric, no weird and wonderful un-scientific systems of 'energy flow' or 'miasms'. So why is it so difficult for them to grasp how we herbalists work?
Could it be that doctors have become de-skilled? Have their therapeutic decisions been so limited by procedure and drugs profiles that they rarely get to think about the underlying physiology in the patient in front of them? I believe so. Worse still their pharmacopia (list of drugs) reads as a list of diseases - 'this drug treats this disease'. They do not have drugs with general therapeutic actions so they cannot even set out to treat these more subtle aspects of ill-health.
Herbs on the other hand provide us with a very wide range of pharmocological actions such as 'improves liver function' (dandelion root), 'increases blood flow to the peripheries' (ginger), 'strengthens the blood vessel wall' (buckwheat), to name but a few of the hundreds of subtle pharmacological actions available to us. Mention these to a doctor and he looks bemused or dismisses them. Why? Worryingly, the more one asks this question, the more it becomes clear, that doctors have lost the use of the medical expertise that we assume they aquire in medical school - all that anatomy, physiology and biochemistry - surely they use it on a daily basis don't they? No. It has all been handed over to the pharmaceutical companies to do the thinking for them, and regulatory bodies such as NICE to tell them it is OK to prescribe them. All GPs do now is diagnose 'It's this disease, not that disease' and then prescribe 'so I give this approach or drug'. And we pay them £70000 per year for that?
De-skilling of doctors has been going on for at least fifty years, perhaps longer. Incredibly, they have lost their ability to consider the individual symptoms, conditions and secondary factors in front of them and think through an intelligent approach to treatment that takes these into account. You may have noticed this. Does your GP really take any notice of those secondary symptoms and aggrevating factors you assume are important or does he just murmer 'hmm, yes...' while he's already writing out the prescription? Ask them what is meant by 'treating the patient not the condition' and they will look awkward or bluster and make you feel foolish. Try explaining to them how a medical herbalist approached your condition - they simply can't imagine how it is done!
