Introduction

Many of today's synthetic drugs originated from the plant kingdom but, historically, medicinal herbalism went into decline when pharmacology established itself as a leading and effective branch of medical therapeutics. In much of the English-speaking world, herbalism virtually vanished from the therapeutic map of medicine during the last part of the 19 th and early part of the 20th century. However, in many third world countries various forms of ethnic herbalism prevail to the present day (e.g., Ayurvedic medicine in India, Kampo medicine in Japan, and Chinese herbalism in China). In some developed countries, (e.g., Germany and France), medical herbalism continues to co-exist with modern pharmacology, albeit on an increasingly lower key.

More recently this situation has changed remarkably. The usage of medicinal herbals by the general U.S. population, for instance, has increased by a staggering 380% between 1990 and 1997 (Eisenberg et al., 1998). Medical herbalism was most commonly employed for allergies, insomnia, respiratory problems, and digestive

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problems. The out-of-pocket expenditure amounted in 1997 to $5.1 billion (Eisenberg et al., 1998).

Faced with this most remarkable revival of medical herbalism (also termed phytotherapy in Europe), mainstream healthcare professionals now ought to familiarize themselves with this subject. The way forward for clinicians might well be an evidence-based approach that is mainly concerned with the clinical effectiveness and safety of herbal medicinal products (HMPs).

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