Changes
/* Differences from conventional drug use */
*Use of whole plants : Practitioners of herbal medicine generally use unpurified plant extracts containing several different constituents. Typically, they claim that these can work together synergistically so that the effect of the whole herb is greater than the sum total of the effects of its components. They also claim that toxicity is reduced when whole herbs are used instead of isolated active ingredients (“buffering”). Although 2 samples of a particular herbal drug may contain constituent compounds in different proportions, practitioners claim that this does not generally cause clinical problems. Some experiments have yielded evidence of synergy and buffering in certain whole plant preparations, but how far this is generalizable to all herbal products is not known.
*Herb combining : Several different herbs often are used together. Practitioners say that the principles of synergy and buffering apply to combinations of plants and claim that combining herbs improves efficacy and reduces adverse effects. Herb combining contrasts with conventional practice, in which polypharmacy is generally avoided whenever possible.
* Diagnosis : Herbal practitioners use diagnostic principles that differ from those used by conventional practitioners. For example, when treating arthritis (see box), herbal practitioners might observe “underfunctioning of a patient's systems of elimination” and decide that the arthritis results from “an accumulation of metabolic waste products.” A diuretic, choleretic, or laxative combination of herbs might then be prescribed alongside herbs with anti-inflammatory properties.
