The Claim That Herbal Medicine Has Not Been Scientifically Proven

"But herbal medicine has no scientific basis."

When I hear this, I do not start by refuting it. Because there is a correct part in that statement. But there is a mistaken part too. Today I will separate the two.

First, the correct part

You cannot say that herbal medicine as a whole has been verified by modern standards. This is true.

Confirming, one by one, the countless combinations of thousands of herbs through clinical trials has, realistically, not been done. Some prescriptions have a fair amount of research accumulated; some have almost none. So the statement "herbal medicine has all been verified" is not accurate either.

There is one more thing that must be admitted. Among the old explanations of Korean medicine, there are many that must be rewritten in today's language. Simply repeating old sayings is not enough. I regard that work as my own.

But "not proven" also has a trap

Having no research and having been researched and shown to have no effect are completely different.

These two are often mixed together. "There is no basis" is quietly swapped for "there is a basis that there is no effect." That is not logic.

And in reality, there is already a fair amount confirmed at the pharmacological level.

• That herbal compounds act on multiple targets at once (multi-target)
• That a good share of the components must be metabolized by gut bacteria to be activated
• That a low stimulus can, rather, raise the body's regulatory capacity (hormesis)
• That components of licorice inhibit a particular enzyme and act directly on an inflammatory alarm substance

These are things dealt with in pharmacology. Joining the fragments into a single picture is still in progress, and I regard that work as my share. (What Herbal Medicine Actually Does)

The real reason it is hard to verify

There are structural reasons why herbal medicine does not fit well into the modern clinical-trial frame.

First, herbal medicine is compounded differently for each person. For the same disease name, the prescription differs from person to person. But a clinical trial is designed on the premise of giving everyone the same drug. (Same Diagnosis, Why Is Each Person Treated Differently)

That said, the claim that "because it is individually tailored, the trial itself is impossible" is not true. There was a double-blind trial that divided 116 patients with irritable bowel syndrome into three groups — individually tailored prescription, standard prescription, and placebo — and the herbal medicine groups did better than the placebo group. The design was possible. It is only that trials like this take a great deal of work, so there are still few of them.

Second, the components are not just one. Within a single dose there are dozens, hundreds of components, and they influence one another. It is hard to say flatly "this component produced this effect."

Third, the target is different. The place where herbal medicine is often used is a state that shows no abnormality on tests. It is hard to take what is not captured in numbers as an outcome measure.

This is not an excuse but the nature of the problem. And the existence of these reasons does not make it "so there's no need to verify."

There are places where herbal medicine is not the answer

Herbal medicine is not the answer to every illness. There are cases where a part has broken badly, cases that are urgent, cases where surgery or a strong drug comes first. In those cases I recommend testing and other clinical care first.

In the consulting room I tell you in advance which direction we will go, what we will watch, and how long we will try before judging. We try it, and if it is not right, we change direction.

When you should go to a hospital first

If you have severe pain or paralysis that arose suddenly, or speech that has become slurred, if your weight is dropping for no reason, if a fever lasts a long time and night sweats come at night, or if blood is mixed in your phlegm, stool, or urine — hospital testing comes first. And if you are already in treatment for cancer or for heart or kidney disease, herbal medicine does not replace that treatment.

The question I keep holding on to

The question "is there scientific basis" does not make me uncomfortable. On the contrary, it is a question I keep holding onto.

There are things that set out from a clue left in an old text and became the medicine of today. Artemisinin was one; aspirin and metformin were others. Korean medicine is a medicine that still holds many such clues, and since the turn of the twenty-first century those grounds have been coming to light one by one.

I study that work, and I write it down here.

---

References

• A double-blind, placebo-controlled trial of a compound herbal prescription — the herbal medicine groups did better than the placebo group — JAMA, 1998
• Finding artemisinin from a clue in a classical text and establishing a malaria treatment — the 2015 Nobel Prize in Physiology or Medicine — NobelPrize.org
• The proportion of drugs approved since 1981 that originated in natural products — Journal of Natural Products, 2020

Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)