ABSTRACT
Herbal, botanical, or phytomedicines are medicinal products containing active ingredients of exclusively plant origin. These medicines may be consumed as comminuted powders or as decoctions. Their production may involve concentration or purification processes resulting in extracts, tinctures, fatty or essential oils, or expressed plant juices. This review of herbal medicines excludes products that consist primarily of chemically defined constituents. The demand for herbal remedies is rising in many countries. This resurgence in the use of medicinal herbs may be due to various reasons. First, there is much disillusionment of the public with conventional medicine and its cost and inherent nonholistic approach (1-3). More important, there exists a perception among consumers that “natural” alternatives are safer than conventional medicine (2). In the United States, passage of the 1994 Dietary Supplementary Health and Education Act left the Food and Drug Administration (FDA) with limited jurisdiction over herbal products, resulting in a surge in the availability of herbal remedies to consumers. This may easily satisfy the consumers’ increasing desire for convenience and personal control over their own health (2). Also, the mass media, by providing reports of the “miraculous” healing effects of herbs, are fueling this trend, increasing the awareness of the consumer of the availability of various herbal remedy options (1). Since 1990, the U.S. market for herbal supplements has grown exponentially, to more than $2 billion a year in 1997, with no signs of leveling off (2, 4-6). The U.S. herbal industry, now numbering more than 1300 companies, is expected to grow at a double-digit rate annually. In 1993 it was estimated that the Australians, too, were spending almost twice as much on complementary medicines (more than $600 million per year) as on pharmaceuticals (7). This trend is seen too not only in Europe but also in Asian countries (8). Singapore’s health care services are based mainly on Western medical science. However, with the development of traditional chinese medicine (TCM) particularly in China over the past two to three decades, and increasing interest in complementary medicine, Singapore’s public expenditure in TCM has also risen (8). TCM practice in Singapore is confined mainly to outpatient care. More than 10% of daily outpatient attendance is estimated to be seen by TCM practitioners, the majority of whom are trained locally by TCM schools (8).
