While many western-trained doctors and pharmacists continue to reject all alternative medical treatments, others are embracing a complementary approach, or even integrating their conventional training with other medical traditions.
Niamh Boden was not exposed to herbal medicine while growing up, but was fascinated by the science of how drugs work in the body and so chose to study pharmacy. "We did do a section in our course in Queen's on pharmacognosy, which is the science of plants, and I found that very interesting," she recalls.
Boden worked as a hospital pharmacist before moving into retail and finally establishing her own business, Dunville Pharmacy in Dublin's Ranelagh. Five years ago, she decided to enrol at the College of Naturopathic Medicine to study herbal medicine and naturopathy, believing that expanding into herbal medicines could help the business stand out from other pharmacies.
What she didn’t expect was how much the course would change her own lifestyle. “I saw this other side to healthcare which was about looking at your health and your well-being. It wasn’t about taking this herb to fix A or this herb to fix B, it was about finding balance in your life,” she says.
“It was really helpful for my own health and my family’s. When I started the course I would have got quite sick through the winter. I would have been on antibiotics, had chest infections, been very run down, feeling exhausted all the time. I realised I needed to take more time out for myself, to stop working 50 hours a week, to cook wholesome meals with good ingredients, and I started using the herbs. That first year, I had a really bad cough and my teacher gave me a mixture with myrrh in it and a few lung tonics, and literally within three days I was completely better. I was amazed and surprised at how well it worked. From that day on I haven’t touched an antibiotic.”
Herbal treatments
Boden says there is a place for herbal treatments alongside pharmaceutical medicines. “If somebody, for example, was on a high-tech medicine for rheumatoid arthritis, I’d be reluctant to give them herbs. I think there is a time in everybody’s life when they are grateful for the medicines that we have, for themselves or for their families. However, I think we reach for them too easily.
"When I started to take an interest in plant medicine I realised that a lot of the phytochemicals present in plants can have a similar reaction in the body to chemical medicines but are much gentler. The famous examples would be digoxen from the foxglove plant, and aspirin from the plant Salix alba, but when you take the whole plant you don't get the side effects that may be associated with the chemical. The way we were taught on the herbal medicine course is that when you use the whole plant it is balanced. They are singing the praises of turmeric now and what the pharmaceutical companies would love to do is isolate its most potent phytochemical, curcumin, license it and sell it. Whereas if you take it in its natural form you will have less side effects."
Boden has now begun to produce and dispense her own herbal remedies under the label BodeWell Botanicals. “I want to specialise in herbal medicine. We are only doing it in a small way at the minute, but the teas and the tinctures I am giving people seem to be really helping. The teas are very gentle and I find that they are really good, even for children. I have customers who give our Dream Tea to their children for sleep. It is chamomile-based with a few other herbs in there, such as lavender. It just helps you switch off. The tincture would be stronger, that would have valerian in it. Studies show that valerian modulates GABA receptors in the brain in the same way that benzodiazepines do, but without the side-effects, so it does make you drowsy.
“I wouldn’t say there’s a herb to fix everything but with the right changes in lifestyle, if you’re not too far gone you can bring your body back to balance. For example, I do a nice tea for gastric reflux, so instead of going on a proton pump inhibitor you can take the tea, which will have an anti-inflammatory effect on the stomach, but you will need to make changes in your diet as well. There will be cases – like with a hiatus hernia – where you may have to go on medication to protect yourself, but every case is individual.
‘Sinus tea’
“I’ve also got a sinus tea, and a tincture. It has some anti-bacterial and some decongestant herbs. It’s really good if you have a sinus infection, but you need to get it early, before it gets too engrained. It also works well synergistically, even if you were on antibiotics.
“A lot of herbs are safe to take. Only some interact with medication. That’s where I have the advantage as a pharmacist – I know how medicines work. Nothing I have pre-prepared would interact with other medications and it would all be sold by consultation. You can’t just pick them off the shelf.
“I do tinctures for coughs and an anti-viral blend for when you are coming down with a virus. I also have herbs for hot flushes and menopause but normally for those I would need to have a more in-depth consultation. I do see patients by consultation as well, but that’s when I’m not in the pharmacy, or I have extra cover.”
Boden knows that herbal medicine is “definitely not for everyone”. “I have a lot of customers who wouldn’t look at the herbal products. We’re not pushing it. However, we do have a certain number of customers who make it very clear that they only want the natural approach.”
Consultant obstetrician gynaecologist Prof Mary Wingfield is clinical director of the Merrion Fertility Clinic, where Chinese medical practitioner Celine Leonard holds a weekly clinic.
Wingfield, author of The Fertility Handbook, has worked with practitioners of acupuncture and traditional Chinese medicine for many years. Studies and trials of their methods are very difficult, she says, because unlike western medicine, treatments are not standardised, but individualised for each patient. "There is definitely a need for good-quality research in this area."
Wingfield, however, says that she has seen IVF patients do “really well with a combination of Chinese medicine and artificial reproductive technology (ART)”.
“Apart from its possible effect on IVF success rates, acupuncture has been shown to reduce stress in many women undergoing ART and may help them cope with the challenges of treatment,” she adds. “This has been shown in both randomised controlled trials and observational studies. This can only be beneficial.”
While she does not recommend the use of any herbs while undergoing IVF, Wingfield adds that: “TCM, including herbs, can be very useful for many patients with chronic period pain due to endometriosis and also women with heavy, difficult periods. The best results are when the practitioner works with the gynaecologist, and this is certainly my practice. My advice generally is that acupuncture and TCM seem to be safe – as long as they are administered by suitably trained practitioners. That is key.”
Acupuncture
Dr Vincent Carroll began practising acupuncture more than 20 years ago after training with the British Medical Acupuncture Society. At the time, he was working in public-health medicine, in what was then the North Eastern Health Board.
“Thankfully, in public-health medicine you are encouraged to have a broad approach so I did a business qualification, and it was natural for me too to get a complementary medical qualification,” he explains. “You have that freedom to explore within public-health medicine as opposed to perhaps when you are in a narrower specialty.”
He was so taken with the results achieved by acupuncture that he went on to found the Lansdowne College of Acupuncture and Complementary Medicine in Dublin. Though now retired from the HSE, he continues to train new acupuncturists. In addition, he works as a part-time GP, but finds that increasingly his practice is a complementary-care practice.
“Both models are based on observation, though we’re getting a little bit away from that now from the western point of view,” he notes. “When I started off, I would have ordered a blood test and told the lab what to expect, now they tell me what to expect. Your observation, your intuitiveness is no longer as important a part of your diagnostics, whereas it ought to be as we are all different as people. In acupuncture, we factor everything in to the medical mix. We observe and we listen. Listening is the most important, but again that’s a skill that’s being lost. It’s very easy to send someone for a MRI and look at the result, and order a blood test and look at the result, without engaging with the person, without getting to know the client. It’s also disrespectful.
“One of the strengths of western medicine is that it only incorporates measurable entities into the medical mix, for example your blood pressure, your cholesterol level or your thyroid function tests, and the reason for this is to exclude bias, but the problem is what you also exclude is that what is not amenable to measurement, for example your level of happiness or sadness. From an acupuncture point of view, this is all something that impinges upon health, though we adopt a line of questioning to try and avoid the creeping in of bias.”
He sees the beginnings of some engagement between both disciplines. “I’m very fortunate to be on the board of directors of ARC Cancer Support and we work hand-in-glove with the oncology departments, so people receive their chemotherapy and their radiotherapy and they come into our drop-in support clinics where acupuncture is one of the gangplank therapies that we offer. It’s very popular and very, very helpful.”
Greater acceptance
He also sees a far greater acceptance of the Chinese medical approach amongst medical peers. “I go on my GP training the same as everyone else. I was up at a training in the Bons [Secours hospital] the other day where acupuncture was mentioned as an add-on treatment for chronic pain. I’d agree completely, but years ago it would have been less likely to be mentioned. Nobody blinked an eye when it was mentioned, nor should they. It’s just standard.”
Carroll would like to see acupuncture incorporated within the hospital system. "When my late mother was in hospital in the French provincial town of Charleville-Mezieres, a city of about 50,000 people, the next ward was the acupuncture ward. That's normal in France. The difficulty in France is that only medical doctors can practise acupuncture, and that's the case in much of mainland Europe. In Ireland, anybody can practise acupuncture but the difficulty is there is no parliamentary legislation to regulate it.
“There are many people practising acupuncture within Irish hospitals,” he adds, “but they are practising as nurses or physiotherapists. What is needed is a standard qualification, and effectively that means some sort of parliamentary legislation about the title of acupuncturist.”
Carroll is keen to convince others of the benefits of traditional Chinese medicine in tandem with the western model. “I want to take as many people on board as I can. It’s a wonderful system. Nobody has a monopoly on all wisdom but you have extremists on both sides, those that totally and utterly embrace the western model and those that totally and utterly embrace the complementary model, whereas both should complement each other.”
