Recently, Michael and I taught in England, and as we generally do when teaching there we also traveled to other countries. And of course we just had to investigate the herbal scene wherever we went, too. This month we are both blogging about different aspects of what we found about the general state of herbal medicine in Europe.
Older generations of most cultures have long complained how their youth detach from traditional ways in favor of modern Western living. The same can be said of herbalism. In Russia, we learned that herbalism is alive and well, although mainly with the elderly population. Unfortunately, this is also the case in Mexico (as we learned while there earlier this year) as well as in other countries.
Ever since Western conventional medicine came to the forefront in the early 20th century, it has swept the world as the only medicine to use. The herbal renaissance in America that began during the 1970’s (well, 1960’s if you count marijuana!) created an impression that herbs are alive and well and growing. They are in the United States, but the European Common Union (EU) is crushing herbalism in most parts of Europe (particularly in the UK; see Michael’s blog). This is especially true in the UK, which used to be the last bastion of freedom for herbs and natural healing. While there are still many people using and teaching herbs there, they do so under increasingly stringent regulations and smothered resources. while the UK matches the EU’s regulation of only medical doctors prescribing herbs.
Given this sad state of herbal affairs, imagine Michael’s and my surprise when we strolled through the stone-paved ancient Gothic district in Barcelona (near La Rambla) only to stumble across the Herbolari (or Herboristeria) del Rei, self-proclaimed oldest herb shop in all of Spain. Established in 1818 (and moved to this location in 1823), is still fully stocked and operational. It immediately took me back in time to the "olde-time shoppes" in England and the States. Imagine standing in an herbal Ollivander's Wand Shop in Harry Potter’s Diagon Alley and you've got the idea!
To give you an idea of the almost 200-year history of this place, supposedly, Queen Isabel II shopped there for lavender for her baths! Thankfully, many more customers have come and gone so the store has stayed in full operation these last two centuries, recognized by a pavement plaque in 1999 when it was declared a site of culture and interest for tourists.
When we entered the store and breathed in its history, we met one of the proprietors along with his English-speaking nephew. They happily gave us a tour and we gazed upon cabinets of wooden drawers, much like those found in traditional Chinese herb stores, and a store room stuffed with sturdy cardboard boxes, all holding hundreds of plants (I believe he told me 263?).
Other shelves held bottles of syrups, elixirs, tinctures, wines, olive oils, beauty products, candies and to Michael’s delight, chunks of pure licorice extract, which is very hard to find. The shop itself is exquisite with its Elizabethan style decorations, statues, oil and watercolor paintings, wooden panels, hand-painted tiles, glass cabinets, and central marble fountain.
Since Aunt Trinidad Sabates, honored as a master of medicinal plants by the Generalitat de Catalunya, was not in, we didn’t get to ask specific questions. She offered to come down but as we had another engagement right then, we settled on returning two days later. Unfortunately, when I did come back it was raining and the shop was closed. I understand that although there are normal Tues-Fri hours (4-8 pm), it’s not unusual for them to close like this, similar to other stores in fun-loving Barcelona. As we had to fly to England the next day, we never did get to meet Trinidad, so someday we’ll have to return.
I did learn, however, that the shop is much visited and people still request herbal solutions for their health conditions, a rarity in the EU these days. Unlike other countries in the EU, Spain doesn't suffer the same restrictions such as Germany and France where herbs can only be prescribed by licensed medical doctors. So if any of you plan to visit Barcelona, be sure to stop by this incredible landmark that is keeping herbalism alive and well for Catalonia, Spain!
Herboristeria del Rei (Herbolari del Rei): located through a side passage near the Royal Square/Plaza Real in the Street of Glass # 1, or Carrer del Vidre, 1, 08002, or through the street Carrer de Ferran.
"Be it ordained established and enacted by authority of this present parliament, that at all time from henceforth, it shall be lawful to every person being the King’s subject, having knowledge and experience of the nature of Herbs, Roots and Waters… to practise, use and minister in, and to any outward swelling or Disease, any Herbs, Ointments, Baths, Pulters and Emplaisters, according to their Cunning, Experience and Knowledge … without suit, vexation, trouble, penalty or loss of their goods."
-- The Herbalists’ Charter ordained by Henry VIII, 1543
Lesley and I just completed teaching for the annual United Register of Herbal Practitioners (URHP) conference, held at a typically bucolic English countryside conference center in Warwickshire about an hour or so by train south of London. We were gratified to learn that the herbalists in this organization were indeed Planetary herbalists, not confined to a single ethnic herbal tradition. For a dozen years, we used to travel yearly to England to teach Planetary Herbology there, and on this return visit, we met some dear old friends and former students, now respected herbalists in the UK. We could converse easily about Western, Chinese, and Ayurvedic herbs and everyone was able to follow along.
Despite this happy meeting and the invitation for us to teach, the fact is that herbal medicine in the UK is in a state of confusion and repression compared to its present state in the US. I was somewhat dismayed by how things seem to have taken a few steps backward the last 10 or 15 years. The problem seems to have arisen after integration of the UK with the European Union (EU).
Calling around and seeking once familiar herb sources, I found practically no herbal formulas or supplements available to the general public. I learned that one of the mandates of the EU was that herbal formulas and products had to go through a prohibitively expensive licensing process in order to be made available to the public. That means that products sold by such popular companies as Planetary, Source Naturals, Herb Pharm, Kan and GMP (good manufacturing practice) standard Chinese patents are no longer sold, (including ones regularly referred to in our URHP classes). Some flagship Chinese patent formulas are not available even to registered herbalists because they contain substances derived from animal sources (like oyster shell).
Walk-in herb shops in London were rare or virtually non-existent -- stores such as Mayway, Neal's Yard and others have either moved out of the city, shut down or converted to selling mostly trivial potpourri-type items such as herbal bath and toiletry articles.
Ever since the herbalist charter of Henry VIII (a portion of which is quoted above), herbalists throughout the UK have enjoyed a remarkable degree of protection of their right to practice and dispense herbal medicine throughout the UK and all of its present and former territories.
As countries including England faced the prospect of uniting with the newly envisioned European Union (EU), the European Herbal and Traditional Practitioner Association (EHTPA) was set up in 1993 to achieve a secure regulatory basis for herbal practice in the EU. The EHTPA has taken on other important work that would create more uniform standards for their registered herbal practitioners, such as developing standards for practice and accreditation, documenting research as published evidence of the efficacy of herbal medicine, and developing a dispensing code of practice that would ensure the traceability of herbal ingredients.
But where the contention lies is that EHTPA mandated that for the sake of public safety, all herbal formulas and products needed to be licensed along prescribed parameters or they could not be traded on the open market. This applies to all supplements including herbs.
Timelines were set forth for companies to comply. For most, the cost of having even a single product licensed was far too prohibitive, costing several thousands of dollars for each formula or product. Not doing so meant that they forfeited their right to sell their products throughout the EU, including the UK. However, herbalists who are registered would have privileged access and right to dispense unlicensed products to their clients. The problem is that becoming a registered herbalist is a complicated and expensive matter especially since the UK government who proposed and sponsored legislation has been dragging its feet in the final approval process.
What was and continues to be at jeopardy is access to herbs needed to operate an herbal medical practice. On Feb. 16, 2011, the UK government proposed and drafted legislation for statutory regulation of herbal medicine. Strangely, this gave the impression that the UK was more concerned with herbal products rather than the public safety concerns flaunted by the EU generally, and as a result it appeared that the UK was deliberately circumventing EU medicines law. (For more about this issue, see this article.)
URHP Vice President Lloyd Gee writes:
The Herbal Medicine Working Group has been formed to advise the Deputy Chief Medical Officer of Health on the future legislative arrangements for the practice of herbal medicine in the UK. This met twice and there is division within this working group with Association of Master Herbalists (AMH), Association of Naturopathic Practitioners (ANP) and homeopaths generally against statutory regulation (SR).
SR would bring a protected title to herbalists meaning that only properly qualified herbalists could prescribe unlicensed medical herbs which is seen to be important for public safety. This would also mean that naturopaths and homeopaths who are not qualified herbalists would lose their access to dispensing herbs. Schedule 20 herbs (previously schedule 3) have been under threat and several times EHTPA has had to negotiate on the basis that SR will ensure only competent herbalists will be able to use them. With voluntary registration (VR), we are more likely to lose these.
This is where the UK and the EU cross swords. If the UK government’s current legal advice is that SR-registered herbalists would have access to unlicensed herbal products, this would be seen by the EU as the UK deliberately circumventing the directive. The result would be the European Commission imposing hefty fines on the UK government. If that happened, registered UK herbalists would lose access to these products in any case and a big reason for joining an herbal registry would be moot.
As if things were not complex enough, the EHTPA as the umbrella pro-registry organization for the EU, for various reasons would not accredit certain herbal registers. Furthermore, some registers withdrew from the EHTPA because of the delay in getting government support for statutory regulation. Statutory regulation was eventually what the government insisted upon, but not before major herbal suppliers ran out of stock in 2011 and were told that they could not replenish their stores until statutory regulation of herbalists was legally established.
Another factor justifying many herbal organizations' decision to withdraw from the entire process of creating a body of registered herbalists is the required annual fee to support EHTPA activities while the UK government dragged its feet in creating clear legislation. Many withdrew from EHTPA as they felt that they didn't want to pay for something that wasn't going to happen.
To sum up, where things stand at the moment is that English herbalists are awaiting registration approval from a government that seems to be delaying the completion of a process which they first proposed several years ago and have not yet finalized. (This registration of professional clinical herbalists would be equivalent to ‘licensed herbalists’ in the US, if such a thing existed – which it doesn't.)
UK herbalists are stuck in this holding pattern until the government sorts out its own registration process. In the meantime, herbalists not only have limited access to herbal products, but in many instances they also have a difficult time finding sources for them. For now, they are allowed to formulate on the spot for individual clients. This makes aspects of herbal medical practice cumbersome and difficult.
Most herbalists I spoke with would prefer to continue with as little government interference as possible. At best, some of them are willing to forfeit some of their individual freedom of practice to assure the evolution and ongoing practice of herbal medicine especially in the wake of possible EU compliance.
Living in a global community, too often we see how the socio-political concerns and problems of other countries, especially those of Western European nations, eventually become our own.
Present matters in the UK has resulted in discord between herbalists in favor of saving the profession by becoming part of a new herbalists registry and those who staunchly resist any and all government interference with the practice of herbal medicine. Similarly, in the US today and within the ranks of the American Herbalists Guild, there are those who seek to evolve and preserve the profession of medical herbalism by licensing and those who vehemently resist it. Just as in the UK, at times this struggle has engendered fierce hostility between the two sides.
I hope this brief discussion of the complex issues of herbalism in the UK offers some enlightenment and clarification for herbalists in the US, where the pros and cons of licensing in this country are certainly an issue. It is my personal belief that licensing of medical herbalists in the US is a good idea for the safety of the public and to ensure trained herbalists’ access to now restricted herbs such as Ephedra (withdrawn from sale because of opportunistic misuse of the herb as a metabolic stimulant for weight loss). Most herbalists that I know would agree that certain herbs are too dangerous for unrestricted public access. Licensing is a trade-off where certain liberties are exchanged for greater privileges and freedoms.
I also firmly do not want licensing to occur that would in any way prohibit individuals and small community and family groups to not maintain their God-given right to prescribe and use herbs. Where I draw the line is when it comes to setting up a professional medical herbalist practice for pay.
Everything seemed to be going just fine for the few of us herbal pioneers when we freely practiced herbal medicine and prepared our potions in our home kitchens with ideals of bringing the blessing of herbal medicine to people in all walks of life. Funny thing is that we may have succeeded, but now we have to cope with the changing and ever greater responsibilities of more publicly accessible herbs. Now we must prepare our medicines in regulated facilities outfitted with paraphernalia and safeguards mandated by the present GMP codes.
In the same way, if herbal practitioners are to come of age, they face similar demands and must conform to minimum standards of education and practice that will justify the trust that we are asking from the public.
I recommend reading Giovanni Maciocia’s blog of 2010 entitled "Appeal to European Herbal Practitioners"