Alternative Medicine Arrives

"Europe's Strong Herbal Brew" by Rebecca Rawls, in Chemical 6Engineering News (Sept. 23, 1996), 1155 16th St. N.W., Washington, D.C. 20036; "Trends in the Education and Practice of Alternative Medicine Clinicians" by Richard A. Cooper and Sandi J. Stoflet, in Health Affairs (Fall 1996), Ste. 600, 7600 Old Georgetown Road, Bethesda, Md. 20814-6133.

Herbal medicines have long seemed a fringe interest. No more. In the eyes of both middle-class consumers and physicians, reports Rawls, a senior correspondent for Chemical 6-Engineering News, such medi- cines have become increasingly respectable, and may now be on the verge of widespread acceptance and use.

Europe some time ago embraced herbal remedies, such as extract from Gingko bilo- ba, used to improve the flow of blood in capillaries and arteries. In Germany and France, many herbs and herbal extracts are sold as prescription drugs, and their use is covered by national health insurance. Regularly prescribed by 80 percent of German physicians, herbal medicines are always among the best-selling prescription drugs in the country.

Most of the research on herbal medicines has been done by companies in Europe (par- ticularly Germany). The reason, Rawls explains, is that it is far less costly to get a drug approved for use there than in the United States. "Because herbal medicines are usually not patentable, the profit margin on them is often much lower than for syn- thetic drugs," she notes.

In the United States, herbal remedies are generally sold in so-called natural food stores rather than drugstores. Extracts from the echinacea plant, used to prevent or treat colds and influenza by stimulating the immune system, are the best-selling herbal medicines here. Garlic is also widely used for medical purposes, such as the reduction of cholesterol levels and blood pressure. Many clinical studies indicate that garlic does cut cholesterol, Rawls notes, though just how it works is unclear.

Many other "alternative" therapies, from folk remedies to bioelectromagnetics, have been getting increased attention in recent years. Cooper, director of the Health Policy Institute at the Medical College of Wisconsin in Milwaukee, and Stoflet, a research assistant, report that in 1990 Americans spent $13.5 billion on alterna- tive therapies-equivalent to about half the out-of-pocket sum spent on physician ser-vices. Interest in such therapies is growing rapidly. The authors project that the num- ber of chiropractors, now about 50,000, will double by 2010. Also on the horizon: a tripling in the ranks of today's 1,800 natur- opaths and 7,200 practitioners of acupunc- ture and "oriental" medicine.

There are still plenty of skeptics, but Cooper and Stoflet say that "many physi- cians" now use acupuncture, herbal medi- cine, and other alternative measures. It no longer makes sense, the authors conclude, to discuss the future of America's health care system without giving consideration to medi- cine beyond the mainstream.