Thursday, April 28, 2011
In this age of the Internet when high-quality information is readily available, the consumer is perfectly able to satisfy him- or herself about the standard of quality controls and efficacy of a particular herbal remedy. For example, hundreds of clinical studies on herbal medicines are available online.
The main motivation for this draconian European Directive is the European political and administrative class’s pathological need to regulate. In the European mindset, anything that is not “regulated” is assimilated to “illegal”. The European bureaucracy needs to regulate to justify their existence and paradoxically, we, the victims of this legislation, are even paying their salaries through taxation. Have you heard that the European Commission has asked for an increase of 5% in their annual budget? At a time when all over Europe (and especially in Ireland, Greece and Portugal) populations are suffering under a regime of economic “austerity” and drastic cuts!
The second reason for the ban is, sadly the lobbying by the powerful drug companies. Hannan says: “Whenever an apparently absurd law of this kind emanates from the EU, ask yourself cui bono — whose interest does it serve? In this case, there is no mystery: the directive was openly lobbied for by large pharmaceutical companies, which saw an opportunity to put their smaller rivals out of business. Not for the first time, big corporations have used the EU to push through rules which national assemblies would never have countenanced. MPs were left in no doubt about how their constituents viewed the proposal. But Brussels fonctionnaires are invulnerable to the ballot box: the EU was designed, in the aftermath of the second world war, precisely to shield them from public opinion”.1
When asked why we need this Directive, regulators churn out always the same trite things: some Chinese herbal remedies contain undeclared medicinal drugs, some have high levels of heavy metals, etc. This is true (although the percentage of above remedies is a tiny proportion of the total), but there are already existing laws against such practices. Such practices could easily be stamped out using existing legislation without this draconian European legislation. In fact, the result of this legislation will be the exact opposite of what it purports to do. A tiny minority of companies will probably continue selling remedies that are already illegal while many reputable herbal companies who do not, and never have, used such practices will be driven out of business. Moreover, as in usual European style, each country will do what they want, we will have the absurd situation that consumers in one country will be able to buy unlicensed herbal remedies online from another European country: hardly a desirable outcome.
By the way, do you know that the long delay (7 years) in the implementation of this Directive was deliberate? Hannan says: “The ban was voted through the European Parliament seven years ago but, as so often, Eurocrats built in a delay, knowing that national ministers were far more likely to agree to an unpopular measure that would blow up in the laps of their successors”. Indeed, in the UK, the Directive was approved by the Blair Labour Government and it has now blown up in the face of Cameron’s Coalition Government.
Why do we need such Directive?
• Six million people in Britain have visited a herbalist at some point in the past two years
• Two million regularly use alternative treatments as a first resort
• Herbal remedies account for just 0.4% of reported adverse reactions.
In theory, the EU Directive sounds reasonable. It is not “banning” herbal medicines: it is “merely” establishing rules for their “licensing”. In practice however, the licensing requirements are such that no remedy with multiple ingredients (such as Chinese or Ayurvedic medicines) can get a licence because it is impossible to meet the criteria for registration.
Secondly, cost. The licensing of each remedy would cost about between € 50,000 and € 100,000 Euro ($ 74,000-148,000) which is therefore impossible to bear for the overwhelming majority of herbal suppliers. Therefore, the practical effect of this legislation is indeed to ban herbal remedies (and, by the way, increase unemployment).
The result of this Directive is that:
• A third-party dispensary service (Product Supplier) can no longer make up individualised raw and powdered prescriptions, batches of pills or capsules
• Patent herbs will no longer be available to any practitioners, whether state regulated or not and will disappear from the UK/ European market. Over-the-counter herbal remedies also will not be available to consumers
• Only health professionals who are statutorily regulated can prescribe or sell “finished” unlicensed medicines and even that is up in the air in the UK
It is ironic that such restrictions on the use of herbal medicines are being introduced at the same time as more and more powerful and dangerous previously prescription medicinal drugs are being de-regulated and sold over the counter without prescription. Such drugs cause a 100 times more side effects and adverse reaction than herbal remedies. This proves that the European Directive has nothing to do with protection of the consumer.
In my opinion, we should fight this European Directive tooth and nail on political rather than medical grounds because that is what this Directive is inspired by. We can argue for the next 10 years that herbal remedies are intrinsically safe but the regulatory authorities will always come back with the same old excuses: undeclared drug ingredients, heavy metals, the one patient who got liver failure years ago, St John's Wort induces cytochrome P450, etc.
It is also a losing battle to argue the medical case with regulatory authorities (although necessary and we should continue doing that) because they are not elected and have a vested interest in “regulating” and “licensing”. By contrast, politicians are elected and all they are interested in is being re-elected. They are therefore more sensitive to the political case: we should tell them en mass that we are not going to vote for them if they do not scrap this Directive.
Why should Eurocrats decide what I can and cannot take for my health? It is a fundamental issue of freedom and we should demand our freedom!
It is ironic that this freedom-killing European Directive is coming into force on 1 May, the day when traditionally the peoples of Europe celebrate freedom and workers’ rights…
1. Daniel Hannan: www.spectator.co.uk Allergic to Freedom Why is Europe taking up arms against herbal remedies? (12.03.2011)
2. Daniel Hannan: www.spectator.co.uk Allergic to Freedom Why is Europe taking up arms against herbal remedies? (12.03.2011)
Tuesday, April 19, 2011
Sunday, April 17, 2011
Since the previous Clinical Tip was about guilt as an emotional cause of disease, it makes sense to discuss now shame as an emotional cause of disease. I think that shame is as common as guilt in Western patients while it could be argued that Eastern societies are more prone to shame than guilt.
Shame may be caused by a feeling of shame about one's behaviour in breaking society’s rules or customs; more commonly, it is an in-born feeling of shame due to one's upbringing. It is a feeling of blame which often makes one feels “dirty”; with shame, one feels that one has to hide from the frowning look of society. One feels observed all the time.
According to Solomon, in small doses, shame is an affirmation of one's autonomy, a confirmation that one will live by one's standards and accept responsibility. In small doses, shame is conducive to self-esteem. However, in larger doses, shame is overwhelming and it is self-demeaning, making one extremely defensive and impotent.
As a cause of disease, we consider the shame that is overwhelming, that is due to one's upbringing and that is not related to one's actions or to have done anything wrong. A person suffering from this shame will always feel as if they had done something wrong and will want to hide.
It is often said that Western societies are “guilt-based” and Eastern ones “shame-based”, so it is useful to explore the differences between shame and guilt. Shame is related more to one's place in society, what people think of us, the feeling that one has to hide because one has done something wrong, something that society frowns upon, something “dirty”.
In other words, as long as we do not do anything that society disapproves of or, most importantly, we are not seen, not found out to be doing something “wrong”, we do not feel shame. By contrast, in such situations we would feel guilty even if nobody sees us doing something “wrong”.
It is certainly true that Eastern societies are shame-based probably due to the strong Confucian influence. As the Confucian ethics is all about social relationships, and about one's “place” in society and conforming to strict rules of conduct and social hierarchy, it is natural that shame ensues from contravening the established rules of society. Thus, people are worried about not being seen to be doing anything that society would frown upon.
What is paramount in shame, is how one appears to the other members of the community, not how one feels inside. Guilt, is a “darker” emotion, more inner-directed, an emotion from which there is no escape, the judgement is there, whether anyone sees us or not. The big difference between guilt and shame is that guilt has no redemption, it “eats” one inside for ever; shame has redemption and repair.
With shame, we have a feeling of being seen doing something wrong (by implication, if we are not seen, we do not feel shame). With guilt, we hear an inner voice condemning us and we cannot escape it.
Wollheim explores the differences between shame and guilt and I have summrized them in this Table.
The term “guilt” (zui) occurs very infrequently in the Analects of Confucius. By contrast, shame (chi) is mentioned in many passages. It is always used with reference to a lapse of responsibility, often accompanied by insult, estrangement and humiliation at the hands of others.
Shame is very ingrained in Confucianist ethics. It is even something that is considered a beneficial “tool” to keep people in line. Consider this passage from the Analects of Confucius:
“The Master said: ‘Lead the people with administrative injunctions and keep them orderly with penal law, and they will avoid punishments but will be without a sense of shame. Lead them with morality (de) and keep them orderly through observing ritual propriety (li) and they will develop a sense of shame; and, moreover, will order themselves”.
This passage is an attack on the Legalists who advocated keeping people in order with strict laws and harsh punishments. In other words, Confucius is saying that laws and punishments may keep social order, but even better is to lead by example so that people will regulate themselves due to the sense of shame from not following the social order.
The importance of shame in Chinese society is also apparent from a study of the penal system and amnesties in ancient China: there is evidence that the ancient courts acted harshly in cases of serious crimes but relied on shame entailed in the process of litigation to discipline the more minor offenders and restore their commitment to social responsibility.
In terms of the effects on Qi by shame, I think that this emotion makes Qi stagnate but also possibly in some cases, sink. Indeed, sinking of Qi is, in my experience, a common result of shame; Dampness also frequently accompanies shame.
When one feels shame, one feels “dirty” and “dirty” is characteristic of Dampness. Thus, shame often manifests with sinking of Qi and Dampness: for example, prolapses, very chronic and stubborn vaginal discharge, excessive menstrual bleeding from sinking of Spleen- and Kidney-Qi, slight urinary incontinence.
1. Solomon R The Passions, Hackett Publishing Company, Indianapolis, 1993, p. 245. 2. R Wollheim, On the Emotions, Yale University Press, 1999, pp. 155-6.