Ronan Gleeson is a Cork doctor who has spent many years researching the value of herbal medicines. He continues to be involved in conventional medicine but is convinced that herbal medicine as practised in China for thousands of years has benefits to offer.
Now the Irish Medicines Board has intervened directly in the conduct of the Irish herbal remedies market. Practitioners such as Dr Gleeson are unhappy about this and consider it to be unnecessary interference. Typically, he prescribes herbs such as St John's Wort, Hypericum Perforatum, which is used to treat patients with mild to moderate depression.
And in his own Cork practice, both on the south and north sides of the city, he says he has found the various herbs he uses to be an ally in the fight against conditions and illnesses as diverse as asthma and depression.
His medical training and his background work on herbal medicine have left him in no doubt about this. When this column reported some months ago that he had produced a female, herbal version of the male potency drug Viagra - he called his capsule Femagro - he was inundated with requests for more information.
But it wasn't just about Femagro. Dr Gleeson has treated many asthma sufferers in Cork using herbal remedies. People have come into his clinics and told him their condition has shown a marked improvement. He has logged these details and is quite certain that the evidence he has accrued verifies his belief in herbal medicine.
There are, of course, health shops throughout the State doing a significant amount of business. Ordinary people who prefer not to take antibiotics and pills have chosen this form of medicine as their preferred one.
In China a few years ago I went to a herbal remedy market. I was stunned by the number of people who were poring over the different stalls. Thousands of people were buying various roots and herbs. The tradition of practising this brand of medicine goes back almost 5,000 years in China.
ROOTS and herbs can be bought over the counter in health shops as can many other natural remedies. What do the pharmaceutical companies do? They extract the essential ingredients from such herbs, says Dr Gleeson, and then patent what the Good Lord had made available free in the first place.
Chinese peasants and native Americans, long before the arrival of the white man from Europe, did so, too. The irony, he insists, is that if herbal remedies are made prescription-only by law, doctors in his position will still be able to prescribe. The patient, though, will be paying more.
Those who take an interest in herbal medicine have been mounting a campaign to prevent the board having its way. In one well-known health shop in Cork last weekend, a petition was signed by a huge number of customers who wanted things to remain as they are.
As things stand, however, the Irish Medicines Board has persuaded the Government that as and from January 1st St John's Wort will not be a walk-in-and-buy product any more.
Dr Gleeson believes in its intrinsic value. The board argues from a different perspective. Its reasoning goes like this. It has suggested, and the Department of Health and Children has agreed, that St John's Wort will be a prescription-only drug once the new year dawns.
First of all, the board is of the opinion that patients with mild to moderate depression should be under medical supervision. I would have thought that, except for the cost, nothing would therefore change.
But the board said: "Self-diagnosis and self-medication (non-prescription sale) are inappropriate. There are currently no products available in Ireland for the treatment of mild to moderate depression which can be purchased without prescription.
"Consequently, the medicines board recommended to the Department of Health and Children that it should consider making products containing Hypericum Perforatum subject to prescription."
And the board went further. It said that how the herb worked was unclear. This is where its judgment on the issue becomes somewhat technical. St John's Wort, it said, was "reported to act as a monoamine oxidase inhibitor (MAOI). Prescription MAOIs must be used with care because there is a risk of hypertensive crisis when they are taken with over-the-counter sympsthomimetics (e.g. cough mixtures), anti-depressants or foods containing tryamine (e.g. red wine, cheese).
`THE medicines board is concerned that similar interactions may occur with Hypericum Perforatum. Advertising literature used in the promotion of Hypericum Perforatum in pharmacies and health food stores states the product can be taken with `no side-effects', and the product has been referred to as the `sunshine supplement'.
"These statements are not consistent with the published literature, which reports side-effects such as photosensitivity (sensitivity to sunlight), gastrointestinal disturbances, fatigue and nervousness."
In its press release, the medicines board spoke about unauthorised medicines and a "clampdown" on the distribution of such products. And it left the health shop industry in no doubt where it would be heading next.
It said: "We will also be taking into account the packaging, the pharmaceutical form, the promotional material, and the intended audience when determining the medicinal status of of each product."
The board's new guidelines were intended to clarify its position, its chief executive, Dr Frank Hallinan, said in a press release. The board has taken pains to point out that it is a statutory body which came in to being when it was established by the Oireachtas in 1995. It began to operate in January 1996.
It has been said that it has too cosy a relationship with the pharmaceutical industry. Does it? The board says: "In relation to income, the IMB is a statutory body, although it is not Government-funded. Its income comes from fees charged to companies for the IMB's services. These may be product authorisation fees (licence fees), or clinical trial fees."