Dr Johannes G. Mayer is the head of the research group “Medical Knowledge in Monasteries” at the Institute for History of Medicine at the University of Würzburg, Germany. The research group focuses on the history of medical plants in Europe. The main objective is to document the entire range of applications of medicinal plants over the last 2000 years. The knowledge gained is passed on in lectures, articles and books and is also used to inspire the creation of new pharmaceuticals. This research group is unique in this form in Germany.

In some cases are medicinal plants more effective than synthetically produced medicines?

In some application fields, medicinal plants are more effective than synthetic medicine. Medicinal plants are a mixture of active substances; these special mixtures are the hallmarks of medicinal plants. In contrast, synthetic medicine is solely based on single active substances, which has its upsides and downsides. Synthetic medicine works faster and more directly. On the other hand, it regularly leads to undesirable side-effects. Medicinal plants, such as St. John's Wort or balm, work on the basis of a variety of active substances. Although in same cases it is possible to ascribe certain
effects to certain substances, unfortunately, for the majority of plants, it is almost impossible to scientifically explore a correlation between effects and substances. One can only explore that a special mixture of substances is working. Therefore it would be senseless to try to produce these substances synthetically.

Can you envision any major wild cards that may occur in the next 20 years?

We might discover a completely new pain reliever based on medicinal plants without any undesirable side-effects. Further, it might be possible to discover a pharmaceutical against enteritis. This would revolutionize treatment of this disease, as there does not even exist synthetic medicine against it. This point also proves that synthetic medicine is not always at an advantage. For example, the only existing effective medicine against hepatitis is based on medicinal plants.

Could you for example imagine that pharmaceutical companies might discover monastery medicine or other kinds of naturopathy, and that this might eventually lead to a "breakthrough" of monastery medicine?

It is imaginable, but rather improbable. Regarding such a wild card, called "Breakthrough in Monastery Medicine", you could further consider an extension and call it "Breakthrough in Traditional European Medicine (TEM)", as the usage of European (and Asian) medical plants in Europe goes back 2000 years. TEM also has much more to offer than Traditional Chinese Medicine.

What would be both positive and negative impacts of a wild card called "Breakthrough in Monastery Medicine"?

Awareness of one's own health and self-prophylaxis would increase if this wild card emerged, particularly concerning widespread diseases such as diabetes mellitus. This is partly due to a higher awareness of healthy nutrition. Important questions such as "what do I eat, how do eat and when do I eat" are essential in monastery medicine. These questions might have dramatic impacts on the food sector, in particular negative ones on "producers" of mammals such as cattle and pigs - in contrast to fish-farming, organic poultry farming and especially wheat cropping, which is the basis of nutrition in monastery medicine.
There could be further negative impacts on classic pharmacies, which only sell synthetically produced pharmaceuticals, on internet pharmacies and even on doctors. In the past, the majority of pharmacies produced their own pharmaceutical compounds and offered a broad range of consulting services supplemental to doctors. The number of such pharmacies would certainly increase if the wild card emerges. Additionally, ordinary doctors would have to reorientate, e.g. they would have to increasingly write individual prescriptions for specific pharmaceuticals, which are mixed from the required plants by the patients themselves at home. This task requires specific knowledge related to medical plants and their active substances.

You mentioned prophylactic actions, such as healthy nutrition, and reactive actions, such as remedies and medicines. Are these actions considered to be the two basic pillars of medical knowledge in monasteries?

It is always a difficult matter when a disease has already broken out. Interestingly, between 800 and 1300, when monastery medicine was the predominant therapy in Europe, no epidemics existed. It is likely that this was a remarkable coincidence. There had always been long phases in history without any epidemics, maybe because of low densities of populations and low international exchange.


So pharmaceuticals based on medicinal plants are not effective against serious diseases?

Some natural pharmaceuticals can be used against serious diseases. But developing new remedies very quickly against new bacteria is not possible, or to be more precise, in such cases monastery medicine is not the appropriate treatment approach. I do not claim that medicinal plants are a cure-all or a universal remedy. But I do consider monastery medicine as an important supplement to conventional medicine. It will never replace conventional medicine completely.

Are there any weak signals that could hint at a growing likelihood of this wild card?

Yes, take the example of GlaxoSmithKline, the world's second largest pharmaceutical company. They are supporting us in our work, and are trying to benefit from medical knowledge in monasteries. Further, there has been an enormous increase in external requests at our research group lately. Another important signal might be
a research group in Austria, which focuses on exploring a kind of traditional European medicine. They have already registered this research area at UNESCO as an intellectual heritage and are also trying to establish this area as an official medicine. They are already conducting training seminars, which we also plan to do in 2011. Last but not least, our research group in Wuerzburg, and the fact that we are given money for our research activities, can be considered as an important signal.

Can you identify any causal relationships between the wild cards and weak signals you mentioned?

All the wild cards mentioned are single findings. If new pain relievers or pharmaceuticals against enteritis are developed, these findings are mainly based on research on specific plants or active substances. We work intensively on specific plants, but this research is being conducted completely independently from the concept of medical knowledge in monasteries as a whole. Research on new pharmaceuticals and active substances and research on medical knowledge in monasteries are two aspects, two strands, which have a specific relationship, but not a causal one. The discovery of new pain relievers or pharmaceuticals against enteritis will have a positive impact on general interest in medical knowledge in monasteries. But we are not trying to discover active substances in specific plants in order to foster a "breakthrough" in monastery medicine.

How should this wild card be addressed in future research? In which fields?

Research on medical knowledge in monasteries should be intensified in the European Union, as we are the only research group dealing with traditional European medicine, except for a small group in London, which focuses on ethno medicine. Their work is an enrichment of our knowledge, and the working results of our research group in Wuerzburg are helping them at their work.
It would be desirable if such research on alternative forms of medicine was conducted in all major European states, particularly because every country has distinct characteristics concerning therapies and usage of different medicinal plants, primarily due to climate conditions. Specific national research does not even necessarily require high personal capacities.
Perhaps the most interesting contributions and insights in this field can be found in the Slavic countries, where there is a continuous tradition of medical knowledge in monasteries. Unfortunately, we only have a very few sources in such countries, except for the Czech Republic. Most applied knowledge in Slavic countries is not available in written form and only obtainable through interviews. And written documents are hard to get. But this is a matter of financial and personal resources.

Are there any legislations or administrative aspects in the European Union that might impede the emergence of this wild card?

Yes, the current European approval procedures for pharmaceuticals are an enormous problem, particularly for small companies dealing with naturopathy. Those companies cannot afford respective approvals, as these procedures are extremely time- and cost- intensive.
In some cases are medicinal plants more effective than synthetically produced medicines?

In some application fields, medicinal plants are more effective than synthetic medicine. Medicinal plants are a mixture of active substances; these special mixtures are the hallmarks of medicinal plants. In contrast, synthetic medicine is solely based on single active substances, which has its upsides and downsides. Synthetic medicine works faster and more directly. On the other hand, it regularly leads to undesirable side-effects. Medicinal plants, such as St. John's Wort or balm, work on the basis of a variety of active substances. Although in same cases it is possible to ascribe certain
effects to certain substances, unfortunately, for the majority of plants, it is almost impossible to scientifically explore a correlation between effects and substances. One can only explore that a special mixture of substances is working. Therefore it would be senseless to try to produce these substances synthetically.

Can you envision any major wild cards that may occur in the next 20 years?

We might discover a completely new pain reliever based on medicinal plants without any undesirable side-effects. Further, it might be possible to discover a pharmaceutical against enteritis. This would revolutionize treatment of this disease, as there does not even exist synthetic medicine against it. This point also proves that synthetic medicine is not always at an advantage. For example, the only existing effective medicine against hepatitis is based on medicinal plants.

Could you for example imagine that pharmaceutical companies might discover monastery medicine or other kinds of naturopathy, and that this might eventually lead to a "breakthrough" of monastery medicine?

It is imaginable, but rather improbable. Regarding such a wild card, called "Breakthrough in Monastery Medicine", you could further consider an extension and call it "Breakthrough in Traditional European Medicine (TEM)", as the usage of European (and Asian) medical plants in Europe goes back 2000 years. TEM also has much more to offer than Traditional Chinese Medicine.

What would be both positive and negative impacts of a wild card called "Breakthrough in Monastery Medicine"?

Awareness of one's own health and self-prophylaxis would increase if this wild card emerged, particularly concerning widespread diseases such as diabetes mellitus. This is partly due to a higher awareness of healthy nutrition. Important questions such as "what do I eat, how do eat and when do I eat" are essential in monastery medicine. These questions might have dramatic impacts on the food sector, in particular negative ones on "producers" of mammals such as cattle and pigs - in contrast to fish-farming, organic poultry farming and especially wheat cropping, which is the basis of nutrition in monastery medicine.
There could be further negative impacts on classic pharmacies, which only sell synthetically produced pharmaceuticals, on internet pharmacies and even on doctors. In the past, the majority of pharmacies produced their own pharmaceutical compounds and offered a broad range of consulting services supplemental to doctors. The number of such pharmacies would certainly increase if the wild card emerges. Additionally, ordinary doctors would have to reorientate, e.g. they would have to increasingly write individual prescriptions for specific pharmaceuticals, which are mixed from the required plants by the patients themselves at home. This task requires specific knowledge related to medical plants and their active substances.

You mentioned prophylactic actions, such as healthy nutrition, and reactive actions, such as remedies and medicines. Are these actions considered to be the two basic pillars of medical knowledge in monasteries?

It is always a difficult matter when a disease has already broken out. Interestingly, between 800 and 1300, when monastery medicine was the predominant therapy in Europe, no epidemics existed. It is likely that this was a remarkable coincidence. There had always been long phases in history without any epidemics, maybe because of low densities of populations and low international exchange.


So pharmaceuticals based on medicinal plants are not effective against serious diseases?

Some natural pharmaceuticals can be used against serious diseases. But developing new remedies very quickly against new bacteria is not possible, or to be more precise, in such cases monastery medicine is not the appropriate treatment approach. I do not claim that medicinal plants are a cure-all or a universal remedy. But I do consider monastery medicine as an important supplement to conventional medicine. It will never replace conventional medicine completely.

Are there any weak signals that could hint at a growing likelihood of this wild card?

Yes, take the example of GlaxoSmithKline, the world's second largest pharmaceutical company. They are supporting us in our work, and are trying to benefit from medical knowledge in monasteries. Further, there has been an enormous increase in external requests at our research group lately. Another important signal might be
a research group in Austria, which focuses on exploring a kind of traditional European medicine. They have already registered this research area at UNESCO as an intellectual heritage and are also trying to establish this area as an official medicine. They are already conducting training seminars, which we also plan to do in 2011. Last but not least, our research group in Wuerzburg, and the fact that we are given money for our research activities, can be considered as an important signal.

Can you identify any causal relationships between the wild cards and weak signals you mentioned?

All the wild cards mentioned are single findings. If new pain relievers or pharmaceuticals against enteritis are developed, these findings are mainly based on research on specific plants or active substances. We work intensively on specific plants, but this research is being conducted completely independently from the concept of medical knowledge in monasteries as a whole. Research on new pharmaceuticals and active substances and research on medical knowledge in monasteries are two aspects, two strands, which have a specific relationship, but not a causal one. The discovery of new pain relievers or pharmaceuticals against enteritis will have a positive impact on general interest in medical knowledge in monasteries. But we are not trying to discover active substances in specific plants in order to foster a "breakthrough" in monastery medicine.

How should this wild card be addressed in future research? In which fields?

Research on medical knowledge in monasteries should be intensified in the European Union, as we are the only research group dealing with traditional European medicine, except for a small group in London, which focuses on ethno medicine. Their work is an enrichment of our knowledge, and the working results of our research group in Wuerzburg are helping them at their work.
It would be desirable if such research on alternative forms of medicine was conducted in all major European states, particularly because every country has distinct characteristics concerning therapies and usage of different medicinal plants, primarily due to climate conditions. Specific national research does not even necessarily require high personal capacities.
Perhaps the most interesting contributions and insights in this field can be found in the Slavic countries, where there is a continuous tradition of medical knowledge in monasteries. Unfortunately, we only have a very few sources in such countries, except for the Czech Republic. Most applied knowledge in Slavic countries is not available in written form and only obtainable through interviews. And written documents are hard to get. But this is a matter of financial and personal resources.

Are there any legislations or administrative aspects in the European Union that might impede the emergence of this wild card?

Yes, the current European approval procedures for pharmaceuticals are an enormous problem, particularly for small companies dealing with naturopathy. Those companies cannot afford respective approvals, as these procedures are extremely time- and cost- intensive.