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Reviving Lost Herbal Knowledge with Denis Stewart

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Reviving Lost Herbal Knowledge with Denis Stewart

How much has herbal medicine changed over the last 40 years? Is a loss of traditional herbal medicine applications coming at the expense of the pursuit of science?

Today we are joined by Denis Stewart, who shares with us some of the changes he has seen in herbal medicine throughout his four decades of practice and why it's so important to ensure we respect historical applications for herbs and continue to champion some of the lost herbs that have fallen out of favour in the modern-day quest for more 'scientifically validated' herbal preparations.

Covered in this episode

[01:05] Welcoming back Denis Stewart
[02:03] Changes to Australian herbal medicine over the years
[06:22] Who were the Eclectics?
[07:19] Discussing turmeric
[11:25] Discussing St. John’s Wort
[14:54] Discussing gelsmium
[17:29] Changes in the use of ginkgo and bilberry
[21:13] Discussing solvents
[27:09] Discussing rauvolfia
[30:22] The value of learning the history and use of herbs that are no longer available to us
[32:41] The roots of the herbal renaissance
[38:18] Teaching programs
[42:05] Establishing the National Herbalists Association of Australia 
[46:26] The future of the herbal renaissance
[49:41] Defending natural medicine against government bureaucracies 


Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. Joining us on the line again today is Denis Stewart, a clinical medical herbalist and naturopath who's been in continuous practice for over 40 years and currently conducts busy practices in Newcastle and Cessnock in New South Wales, Australia. Referred to as the godfather of Australian herbalism, Denis spearheaded a renaissance in Australian herbal medicine in the early 1970s and he established and taught at the New South Wales College of Naturopathic Sciences and then in the late 1970s, founded the Southern Cross Herbal School. He was also conjoint associate professor at the University of Newcastle from 2002 to 2007. I could go on and on, but let's hear from the man himself. I warmly welcome you back to a FX Medicine. Denis Stewart, how are you?

Denis: I'm very well, Andrew. Very nice to talk to you again.

Andrew: Now we're going to be indeed discussing today the Australian renaissance in herbal medicine. So I think we need to go back in history though. You've been in practice for 40 odd years. You would have seen some changes.

Denis: Yes. Look, Andrew, I have seen some remarkable changes and fortunately, I've had the real privilege of being able to be part of that change and to participate in that change. I was there at the beginning and I'm still here now observing the change going on.

Andrew: So, Denis, what about the types of herbs that you've seen from your early years to now? I mean, we've seen some herbs like comfrey and coltsfoot taken off the herbal register…

Denis: Yeah. Yeah.

Andrew: ….and we've seen a change in, I guess, the expectations of herbal medicine practitioners over the years as well with regards to the products that they have available to them.

Denis: Yes, I think that's a significant observation. When I was studying herbalism and indeed when I first started practice, practices were very much based on what was called the physio-medical or the Anglo-American system of herbalism that took its roots from the U.S. under the auspices of an American gentleman called Samuel Thompson and whose ideas and many of his herbs were subsequently transported back to Europe, particularly to the UK.

So the herbs characterised my practice in the early days were strongly physio-medical herbs, that is herbs associated with this significant development in herbal medicine, the development of a style of herbalism incorporating a significant number of American herbs, many American herbs indeed, as you would expect…

Andrew: Yep. Yep.

Denis: …but also being blended with the with the herbs of the old England and Europe generally. So my practice was very much taken up with the herbs that represented that system of herbalism at that time.

And in those days, we could use a like lobelia, we could use herbs like coltsfoot. We could use herbs like comfrey, many other herbs which were part and parcel of our practice, which these days, fortunately or unfortunately, are no longer available or no longer permitted to be prescribed by non-medical practitioners.

But moving from that era, we have seen a significant alteration in the style of herbalism. And look, that alteration has become fairly obvious in as much that many of the herbs that we use today and depend on today, many of the herbal remedies were largely not used when I started 40 years ago. And good examples of this would be the way in which herbs like the bilberry, herbs like the ginkgo, and some of the more modern remedies, the turmeric, etc, these herbs which now represent, if you like, a movement in medical herbalism to embrace a more modern and more eclectic selection of herbs.

Not that we've, in any way, departed entirely from the initial remedies, we couldn't practice without the remedies from the physio-medical tradition, but the herbs that we use today are different in many ways, are broadly based being drawn from many other traditions. Herbs like Dong Quai from the Chinese tradition, for instance, is a good example, herbs like Withania from the Ayurvedic tradition, these herbs now play a significant role in the practice of herbalism. So it's a move, if you like, from a strong Anglo-American base with all the remedies that went with that to a much more eclectic system of herbalism today.

Andrew: Now, you said the word “eclectic.” Does the physio-medicalism style come from the eclectic physicians in the early...?

Denis: Yes. Look, they were a good group of practitioners in the U.S. known as eclectics and these were practitioners that were essentially eclectic. They took on board herbal medicine certainly, but they also practised other modalities. Many of them were, in fact, medical practitioners...

Andrew: Yeah. Doctors, yeah.

Denis: ...who preferred to be known as eclectic in as much that they blended with their medical approaches and their medical remedies and medical procedures, the use of other modalities, particularly herbal medicine and from the eclectics, particularly people, I think Ellingwood was a great member of the eclectic team. We get some of the best monographs of the American selection, if you like.

Andrew: You were also mentioning about a different use, if you like, of gingko, of bilberry, and of turmeric. 

Denis: Yes.

Andrew: You know, turmeric is probably the biggest one for me. Now it's an anti-inflammatory, anticancer, if you like. But to me, it's been pigeonholed as an osteoarthritic or an alodine, if you like. But what are the other uses that we use to use turmeric for?

Denis: Well, I think we have to be cautious here when we're looking at any herb, that we don't just try to pigeonhole it and see it be only used for one condition based on only one active principle that's been located in the herb. My use of turmeric is broadly based. Certainly, I still would use some of the more modern preparations or modern forms of it, which do emphasise, if you like, the presence of an active principle, the curcuminoids in the herb.

But I also use the herb as proud of a routine, a dietary program, a recommendation that is based on my understanding that the crude herb, the crude herb in its unconcentrated form, has some ability, if you like, to work in the gastrointestinal tract, particularly as an agent to promote improved biliary flow and also, perhaps, to set up a healthy environment within the large bowel, which would seem to be providing some resistance to some of the pathologies that afflict that area. So I use turmeric in a number of ways, but certainly, I don't override its traditional use that is rooted in Ayurvedic medicine, which spilled over, of course, into our system of medicine.

Andrew: And you know, you make a really important point because I indeed, you know, the historical use was, as you say, as a cholagogue, but I hadn't even thought about, that it might be setting up a favourable gastrointestinal...

Denis: Environment.

Andrew: Thank you.

Denis: Yeah.

Andrew: Is the word.

Denis: There's a text that has helped me understand this fairly well by two Canadians that is called "Foods That Fight Cancer" by Béliveau and Gingras. That's a readily available text, which is a remarkable work. And I say remarkable, I hope I've pronounced the names of those gentlemen correctly. I think I'm right in the mentioning the name of the text, but in that book, there are select, I call them monographs or discussions on a range of foods, and I would say herbs in some cases, which have been shown to have significant chemistries and traditions which explain an ability to be able to resist cancer.

And with reference to the herb turmeric, there's a significant discussion in that text, which points out that in countries where turmeric is regularly taken as part of the diet, there does seem to be some lesser incidence, particularly of serious pathologies of the large bowel. And I'm pretty impressed with that and that would encourage me to believe that the herb has a wide area of use, perhaps, when regularly taken as part of the diet as it is in certain parts of all over South Asia. It has benefits in creating a healthy, or maybe a stronger resistance to certain pathologies of the large bowel as well as, of course, encouraging the whole mechanism of biliary production and biliary excretion.

Andrew: Yeah. What about St. John's Wort? You know, there's another herd that pigeonholed for depression and anxiety now, but indeed in the old days, it was used for neuralgias.

Denis: Yes. Look, there's a lot of...I think they call it a lot of discussion and a lot of opinions on the herb, St. John's Wort both in herbal and homeopathic medicine. The herb has had a history of being useful for mild nerve-based pain. In the homeopathic literature, it implies an indication or a possible activity even in subduing some levels of pain associated with what we call shingles. 

Andrew: Ah.

Denis: It has a history that is more than just what we see it being used for today. In our modern understanding or our modern usage of St. John's Wort, which is very much dependent upon the European information and the European usage of it, it is presented as a mild psychographic remedy what Dr. Rudolph Weiss mentions in his book as having, if you like, mood-stabilizing properties.

Andrew: Right.

Denis: And that's the term that I like, I resist the categorization of St. John's Wort as being an antidepressant because I think that's going a bit too far.

Andrew: Yeah.

Denis: I think Weiss's terminology is better. It elevates the mood. It makes one a little bit more euphoric rather than just being a conventional competitor for antidepressant pharmacology, it’s broader than that. And really, the multitude of its constituents together provide that benefit, in my opinion, rather than any one single active principle.

Andrew: Indeed. I mean, even with the German phytopharmaceuticals, you know, we've gone through this active principle change, if you like, over the years. You know, we first thought it was one thing, then another. Now it's one of the most studied products out there. The Ze 117 formula has been shown not to have any action on CYP liver enzymes. 

Denis: Yes, yes.

Andrew: So, therefore, as you say, it can be quite safely used with other antidepressants for a mood-stabilizing effect.

Denis: I think there's every likelihood that it could be a good companion and certainly, I have known patients that have used it as a means of coming down from stronger and more problematical antidepressant remedies. However, in situations like that, I always prefer that a patient work with their medical manager if they're going to append something like St. John's Wort to a treatment of coming down from a mainstream antidepressant, I think to do justice to the patient and to do justice to the management of his condition, which is usually primarily under the direction of a general practitioner, it's wise to have that relationship.

Andrew: Can I ask you, and I hope I'm not being rude here, but what about gelsemium? 

Denis: Yep.

Andrew: Like I was blessed in the days of the prescription-only herbs to be able to have access to that herb and use it with great effect, but in your day, it was freely available, wasn't it?

Denis: That was gelsemium?

Andrew: Yeah.

Denis: Yeah. Look, we could use in the early days, as I said earlier, a lot of remedies which now are prohibited to be used by persons other than a medical practitioner, and tincture gelsemium a remarkable remedy, wasn't it?

Andrew: Absolutely.

Denis: So things like trigeminal neuralgia, there are few remedies that could compete with it. We would use that, albeit to be fair, we did not use it very frequently because the conditions for which it's mainly used tend to be more medically managed and more medically profiled than what we were able to do, but certainly, we had access to it. These days, I think you'll find gelsemium is if not schedule 4, close to it. I think perhaps, if they might be tincture gelsemium which might be schedule 2, that is pharmacy dispensing and prescription only, but I stand contradiction on that, I do know that one of my graduates from the course, the provisional extension program that I conducted at Newcastle many years ago at a very, very successful pharmacy in Newcastle, and he was able to dispense tincture gelsemium particularly, to those patients that presented to me for whom I was unable to prescribe or supply tincture gelsemium…

Andrew: Yep.

Denis: …and he helped many patients by stocking that preparation tincture gelsemium and as a pharmacist being legally entitled to prescribe it with a very, very stipulated cautious dose that that remedy needs to be administered in. And that's the only thing that I would say about gelsemium. It's a very potentially toxic herb… 

Andrew: Yes.

Denis: …which if it is to be used, must be used in a very standardised form and in a strict adherence to the dosage. It's called up in the British Herbal Pharmacopoeia of 1983 with the particular dosage that it's to be prescribed in.

Andrew: So we've seen not just restriction of certain herbs, you know, ostensibly because they were poisonous or had some danger attributed to them, like for instance, respiratory depression with gelsemium. But what about, you were mentioning earlier about the change in the use of ginkgo and bilberry. How's that changed? How have they changed?

Denis: Well, these herbs were never used in the early days. I go back to what I said earlier. Going back to when I first started practice in the '70s, the herbs were used, as I emphasised, were essentially, physio-medical remedies, remedies that had been associated with a style and a practice of herbalism that came as a blend of U.S. herbs and philosophy with U.K. herbs and philosophy. So the remedies were strongly American-based and with many European herbs, particularly herbs that grew in the United Kingdom, herbs such as ginkgo and bilberry were never considered.

We probably didn't know even anything about them, but down the track, they emerged. And in the case of the ginkgo, as far as I'm aware, I was the first to give a lecture on ginkgo, and this was given at Blackmores Seminar, a particular seminar held at Balgowlah many, many years ago, when I gave what I think was the first dissertation on the emergence of ginkgo, its possibilities, its uses, and the way in which it was a popular remedy already in Europe.

And I mentioned on that occasion, and I will mention it ongoingly my introduction to it was observing one of my students doing a subject called “global therapeutics” with me many, many years ago, a German student using a preparation of ginkgo in a lecture. And I asked her what it was and she said it is a preparation she was using, was called Tebonin, which was a proprietary name for it, and it was a German product, and she said, "I can give you some information on it." So she gave me some information on it in German.

And my colleague, the good professor, Elliott from Newcastle University, lovely man who's now passed on, he had all the information translated about the way in which this particular product was a representation of the herb gingko, and that gingko was used popularly particularly in Germany as a means of addressing things like a memory, and recall, and focus and was used a lot in the management of ageing conditions as well as also as my student told me, popularly used by students to improve their performance as far as taking in information, etc.

So I was quite interested in this. And as far as I'm aware, I was the first to have a preparation of ginkgo manufactured in Australia, both a tableted preparation and also a liquid preparation. And that is a remedy that emerged, if you like, in time from the European tradition, perhaps, accidentally here, but now is part and parcel of professional herbal medicine practice.

Andrew: Now, you mentioned manufacture just then…

Denis: Yes.

Andrew: …and this is something that I...this must have changed dramatically over the decades that you've practised. I mean, you know, we've now got cold percolation and, you know, there's a lot of argy-bargy about the one to two, or one to one, or whatever concentration it is. But I don't know, I have misgivings that every herb should be made in one way. Don't herbs have different, not even actives, but even different attributes that they must be cared for and prepared in various differing ways. And even, you know, down to the solvent used or do you subscribe to just one solvent?

Denis: No, I don't. I think again here, you need to recognise that the literature, the pharmacopeias stipulate very, very frequently what solvents should be used in the extraction of particular herbal medications. Keep in mind that pharmacopeias were and many of them still are riddled with herbal preparations, probably the best one is the 1934 edition of the British Pharmacopeia. It's a remarkable text and a lot of its information is incorporated into the 1983 edition of the British Herbal Pharmacopeia for which I have great esteem.

So what these pieces of literature do is indicate to the manufacturer what solvent has been traditionally used, whether it be a 25% solvent, a 45% solvent, 60%, sometimes higher. And by that, I would infer that the literature is recognising traditional menstruums or solvents that have been used to give good results associated with the particular herbs that they've been developed for. For instance, I think if you're looking at goldenseal, which is a melchelloidal remedy…

Andrew: Yep.

Denis: …I’m pretty sure you'll find that it's got a 60% solvent or menstruum associated with it. Now, that is called up in the pharmacopeias and indicates that history has shown that that solvent is particularly effective in extracting the representative alkaloids from goldenseal. And, of course, those alkaloids, which play a very, very fundamental role, and as we know with many of the alkaloids, if you use very aqueous solvents, you may not get the same extraction of the alkaloid that you would get when you're using a menstruum that is much more tailored to dragging it out of the herb. 

So I subscribed to the idea that what is in the literature should be taken on board, that there's information there, which in my opinion, should govern the manufacture of liquid extracts and tinctures. And I feel that that should be pretty well seen as the yardstick for extracting many of the herbs which are the backbone of our profession, the solvents, the menstruum are already called up in various monographs and, in my opinion, should be used consequently in order to get the best extract from it.

Andrew: Right. Do you ever use say one extraction concentration or amount of menstruum solvent? Let's say I'm going to use calendula here, a 40% alcohol extract for let's say an inflamed gut where you don't want to use too much alcohol, versus a very high extract of alcohol, let's say 90%, where you get the resinous compounds coming out from the calendula that I might use for a topical application, let's say on herpes.

Denis: Okay. Well again there, I think you'll find that if you're looking at calendula, and I stand contradiction on this, I haven't got the pharmacopeia in front of me at present, I think you'll find that there is a tincture of calendula that has a very high alcohol solvent associated with it. 

Andrew: Right.

Denis: On the other hand, I think you'll find that there's a fluid extract of calendula which has a much less alcohol solvent. I think there's a case there for saying that both those preparations were targeting different treatment situations.

Andrew: Yeah.

Denis: I have never been too concerned about using fluid extract of calendula with its more attenuated level of alcohol because rarely is it prescribed on its own.

Andrew: Right.

Denis: It is usually prescribed with other remedies, many of them with a more aqueous solvent, which further attenuates the level of alcohol in the extract preparation. So, but again, I come back to the point that I have never really found that in the dosages we use, and my prescriptions are generally five mils of a compound three times daily, incorporating, usually, five herbs, I've never found that in the varying levels of solvents in each of the herbs in that compound, that there is ever been any significant gut irritation or inflammation.

Andrew: Okay. So what other herbs have we lost touch with or forgotten? I mean, I'm thinking things like rauvolfia, for instance.

Denis: Rauvolfia is a herb that, as far as I'm aware, has never been part and parcel of the herbal medicine camp…

Andrew: Right.

Denis:  …for very good reasons. What I mean, as you would know, it has a very reliable alkaloidal chemistry with very well defined alkaloids in it, particularly reserpine, and it is still, in my opinion, one of the gems for managing hypertensive conditions. And unfortunately, has been largely lost sight of here in Western or English-speaking medicine, in my opinion, largely because the herb, in its traditional form, has been bypassed and preparations based on the isolated alkaloids took its place. And as a result, side effects emerge…  

Andrew: Yeah.

Denis: …which made the remedy fall into disfavour. Those side effects were not as easily generated when galenical preparations, that is preparation of the whole herb was used or taken. And I can remember probably 20 years ago referring patients in my practice to pharmacy colleagues who would stock various pharmaceutical preparations of rauvolfia but were based on the entire plant and in certain parts of the world, those preparations are still available. I think a major drug company in India make a preparation, I think its called Subida, which is a galenical preparation dose-related which is used to manage hypertension.

We were never able to use that when I started because I think even...I'm not sure whether it was even in the medical procedure at that time. It must've been, because some pharmacies were stocking preparations, a few of them were stocking a couple of preparations of the whole herb. I would suspect that then that was schedule 4, a doctor could only dispense it and prescribe it and the pharmacist could only dispense it or issue it. It was never something that we had access to. And as such, has largely now fallen out of use as a result of the emergence of more medical antihypertensives.

Andrew: I never found this instability that was found with reserpine with rauvolfia.

Denis: That's correct. That's correct.

Andrew: I mean, admittedly, part of that goes with the responsible prescribing of this. So I guess my next question is to get into this herbal renaissance, and that is what have we lost along the way about what we study with herbs? Because now we're pigeonholed, if you like, to only what we can use, so we don't even learn about these historically available herbs.

Denis: Yeah. Look, I think this is a pity because, again, I go back, when I started practice, we were able to use without any problems convallaria, or Lily of the Valley. 

Andrew: Right.

Denis: It was a member of a trilogy of herbs that usually were taken into account by most medical herbalists at that time, hawthorn berry, cactus grandiflorus, and Lilly of the Valley. They were the three remedies that we frequently prescribed for various cardiovascular conditions.

A lot of the knowledge even associated with convallaria has been lost and even though we are not permitted to use it, my contention is that a medical herbalist should have an understanding of herbs that we have used in order to appreciate why they were used, something about their chemistry, and maybe their usefulness even in modern medicine today. I note when I read Rudolph Weiss's work, English translation, herbal medicine, he comes out very strongly in favour of the tincture convallaria for managing some levels of cardiovascular disease.

And I suspect that in Europe, it is much more popularly used there than what it is in Australia where even preparations of digitalis which is of the same team as convallaria, perhaps not used as popularly as they were. My contention is that even though we may have lost some herbs and we are not able to use some herbs, we still need to have an understanding of the history of those herbs, their usefulness, how they work, and not let a knowledge of them die, which is perhaps, already happening.

Andrew: Yes. So with regards to the herbal renaissance, what were the roots of it?

Denis: Well, look, I think if we're talking about the herbal renaissance, I think I talk about that great movement or how can you call it? That landslide of interest in herbal medicine that happened in the United States, in England, in Australia, particularly in the English-speaking world, and I reflect back on it. And I think a lot of it had to do with the social and political changes that were taking place, particularly in the U.S., and mainly associated with the Vietnam war, the emergence of the counter culture where a lot of different lifestyles, different philosophies, objection to certain, the class values, objection to the way in which a particular model of medicine that has been dominating in the West.

I think out of that social change, that massive political change had a bit to do with it and, you know, as much that I oppose the Vietnam War and marched against it, a lot of the era of that time, call it counter culture, if you like, in my opinion, fed the resurgence of interest because younger people at that time are interested in looking at things that have been bypassed, looking at different ways of looking at the human body, different ways of treatment. And so, from this, different lifestyles, different diets, different philosophies emerged an interest in different medicine, and herbal medicine being very much seen as part of the earth coincided with this incredible and dramatic social change that occurred at that time. The herbal renaissance, in my opinion, emerged from that. And even though the renaissance now, perhaps, has petered out, it nevertheless, came, in my opinion, from those events.

Andrew: Where was encouragement garnered along the way? Was it fed by, as you talk about, this social change, this... 

Denis: Yes.

Andrew: It was almost a revolution, really. There was a wholesale questioning of those in power. 

Denis: Yes, that’s a good point.

Andrew: Do you think it was fed by the public, therefore?

Denis: Look, I think it was, although interestingly without mentioning any names, some of the people that helped me most to take up the teaching, the lecturing on, the demonstrating on, on herbs were people from, if you like, very privileged backgrounds and some from the medical profession. What intrigued me at that time was that whilst there was this social change happening, there were a number of organisations and groups and individuals, particularly in Sydney, which was the heartland in my opinion of the herbal renaissance in Australia.

There were groups of people that paradoxically coming from a different background, a different class structure, were very, very interested in herbs and interested in the history of them, the philosophy of them. And some of them in particular gave me great encouragement because they saw that I had somewhat of a gift in being able to talk about them, and teach them, and give demonstrations on them. So along the way, I was privileged in as much that I came in contact with a number of people, it’s best not to mention names, but they were very well-known and organisations, particularly in Sydney, which provided platforms for me to talk, to lecture, and to encourage me eventually to end up getting into teaching.

So there was encouragement from that source, but you'll point out where the public became involved, I think at that stage, there was already the rumblings of discontent within ordinary people about the way in which medicine had become, in my opinion, very class-based structure and which was almost presented in a secretive way, and at that stage, there was a growing awareness of the limitations of modern Western medicine and many of the side effects associated with the medications and procedures.

So with this massive social change that took place, the emergence of the counter culture, there was also rumblings that took place in the ordinary public in the questioning of various ways of life, various class systems, and that also fed an interest in other healing modalities, acupuncture, osteopathy, chiropractic. They were always there, but they were fired by this change supported, as I've said, paradoxically by people in the medical profession in favoured positions, but also by the public that was becoming more and more aware of the need to criticise and analyse even the medical system at that stage.

Andrew: Right. Let's talk a little bit about the commencement of these teaching programs. It started with, was it the New South Wales College of Naturopathic Sciences? Is that right?

Denis: That's the college that I initially…

Andrew: Right.

Denis: …started teaching at and I had the privilege of teaching in that college and being responsible eventually as dean of the faculty of herbal medicine of that college in graduating what I believe was the first three-year program and graduated a group of students with a diploma in botanic medicine. That's how we referred to it in those days, the DBM. A group who had studied under me for three years as full-time and not part-time, but as full-time students at that college and a large cohort of them upon completing their diploma in botanic medicine, went on to form the backbone then of critical associations, which would have died without their coming into membership.

Andrew: And what about the breaking away, if you like, the formation of your school, the Southern Cross Herbal School?

Denis: Okay. Look, whilst I was very at the New South Wales College of Naturopathic Medicine, there were students who wanted to study outside of that who wanted to have a more intimate level of association who were not able to study full-time, and so I took on board the point that it was time for me to establish my own teaching platform, and as such, I formed Southern Cross Herbal School and began to teach a diploma of medical herbalism course. That's how we referred to it, the DipMedHerb, a diploma of medical herbalism course. Initially, interestingly, at Glebe where I taught it on a night-time part-time basis and very happily taught it there with Dorothy Hall down the road, teaching her style of herbal medicine at Balmain and me teaching my style at Glebe.

Southern Cross Herbal School graduated some of its first graduates with a DipMedHerb from our teaching program that was conducted at the Glebe Town Hall as a part-time program. Then from there, we moved the headquarters of the school to Gosford and began to teach the course at two levels. We began to teach the course on what might be called a part-time seminar basis where students would present for a full day of lectures once a month in various subjects. And at the same time, we also were teaching the program in conjunction with Nature Care College where Southern Cross Herbal School would present a herbal medicine component of their naturopathic diploma course.

And that was a very happy association with Nature Care, Southern Cross being responsible for teaching at that college in Sydney, a herbal medicine component of their naturopathic diploma course. And we also carrying on separately in our Gosford lecture venues, a seminar or part-time program presenting students with the DipMedHerb. That went on for very, very many, many, many years, happily.

Andrew: Denis, when did the NHAA commence in Australia? Was that before the Southern Cross Herbal School or after?

Denis: Yes, look, the NHAA of which I'm a life member, it was functioning very, very many years before what I'm talking about. It goes way back I think to about, don't hold me to it, to about '19 to '20. NHAA would have good records of the actual commencement, but I'd think it was roundabout 1920. And when I became associated with it, I think... I haven't got my membership diploma in front of me here, but it goes back to about the mid-'70s. When I became associated with it, it, unfortunately, had shrunk to a very, very small number of practitioners who met very irregularly at Paul Wheeler's rooms in King Street, Newtown. And I would attend there on those irregular meetings to display it in the business of the association, which in my opinion, wasn't much at all. When I became associated with it initially as a student member, it was a rump of very elderly men, many of whom were very successful practitioners, but a very small number of them, and in my recollection, not very keen to share some of the information that they had on which their were practices were built.

Andrew: So sad. Yeah.

Denis: It was sad, but I guess he could understand it in as much that in those days, herbalists were not, how can you call it, not that warmly welcomed by the mainstream and there were one or two herbalists who actually sustained litigations for doing things that apparently, there was no basis to, but had been frightened by charges and legal action that had been looted as being taken against them. So I think what was happening was that they played it close to their chest. They did not want to be seen out there as making waves.They had good, honourable and ethical practices, but they did not feel there's any great virtue in blowing the trumpet of herbalism. Whereas when I came on board, associated with renaissance, it was the very opposite I wanted and those associated with the renaissance, my graduates, etc, we wanted to see herbal medicine on the map and I would like to think that I had something to do with putting it on the map, initially via the National Herbalists Association of Australia and then, of course, subsequently with the Australian Traditional Medicine Society.

Andrew: That's right. Which Dorothy Hall established, yes?

Denis: That's correct. 

Andrew: Right.

Denis: Dorothy established the Australian Traditional Medicine Society, I think, because the style of herbal medicine that Dorothy was teaching was a style of medicine that didn't coincide with the examination requirements of the National Herbalists Association of Australia. The core structure that Dorothy was teaching, the great course that it was, incorporated subjects and ideas that were different to those in the NHAA's curriculum or membership curriculum and was not easy therefore for people doing Dorothy's course to come automatically into the NHAA without doing subjects that would fit them for the examination of curriculum requirements. So Dorothy, smart lady that she was, formed the Australian Traditional Medicine Society, which, of course, immediately became a home for her own herbal medicine graduates, and down the track also for even my own herbal medicine graduates.

Andrew: Moving into the future, Denis, what can we do to reinvigorate the herbal Renaissance? Does it entail a fight for registration or co-regulation? Or how hard do we fight for herbs that we've lost, like you said comfrey. We've recently lost uva ursi.

Denis: Yeah. Well, this is a difficult question to answer. The good thing about herbal medicine is the vast range and diversity of herbs that are available to us and the way in which in the modern world and with the interchange of ideas, and cultures, and people, what is lost is sometimes compensated for by other herbs which share many of the characteristics, if not better characteristics than say the herb that we have lost. So while I'm disappointed that we have lost herbs, although please don't hold me to this, but I understand that with uva ursi there might be some reconsideration of it. I'm not as down in the mouth about things…

Andrew: Right.

Denis: …because, again, here, my own style of herbalism incorporates remedies that compensate to a degree for the loss, say, of herbs like uva ursi, for instance. You mentioned uva ursi. Well, I used and would still use the herb uva ursi, but I have found, for instance, the herb that's known as java kidney tea popularly used throughout Southeast Asia has many of the possibilities on the kidney and the urinary tract that, say, uva ursi has, and I would be using, I would suspect more of that herb in my practice today than what I would be using as uva ursi. It was not uncommon...well, would still would still be very common for me to prescribe a combination of buchu and uva ursi, say, for the management of urinary tract conditions.

But in the absence of uva ursi I have been getting what I would consider to be pleasant feedback and results by using buchu in conjunction with java kidney tea, or orthosiphon stamineus being its botanical name. So I don't like the way in which here and there we seem to be losing this or that. But I come back to the point that herbal medicine is bigger than some bureaucrat, you know, saying “you can't use this herb or that herb.’ Things come into play and being an Australian today in herbal medicine, we have a lot more with our fingertips due to this cultural change, the interchange of ideas, what's happened in Australia in my 40 years, we have a lot more at our fingertips than we've ever had to compensate for these losses.

Andrew: Indeed, in your career, you've had a number of fights with governments who wished at that time to restrict the practice of herbal medicine. So you engage patients to contact their politicians, correct? Is that right?

Denis: I think that what I have done has been represented by most of the associations, that when we have been seemingly threatened by government bureaucracies, when bad press has emerged that we feel is unfounded, I together with the associations have encouraged my patients to put paper to pen and to express their dissent from intentions that would be against the best interests of ongoing natural or herbal medicine. I would come back and say that as a school, rather than an individual, as a school, Southern Cross Herbal School and as an executive member of some of the associations in that way, I would like to think, yes, I've contributed to arranging alarm bells, for getting people motivated, to take issue with those that make decisions about these things.

Andrew: Denis, there's so much, so, so much that has transpired in your career and that you've brought to other practitioners for other practitioners and indeed for the whole profession. I can't thank you enough for taking us through just a snippet of your mind today and I would urge, I mean, you have a course coming up and I would urge every practitioner who really wants to delve into not just the history, but the practice to enrol for that course. So 2019, so we'll put all the details up on the FX Medicine website so that people can enrol if they wish.

Denis: That's lovely.

Andrew: Thank you, Denis, for joining on FX Medicine today.

Denis: Thank you very much, Andrew. It's been very nice talking to you.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.

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