Late winter lichens

Yes, the Equinox has passed, but here in the mountains of Vermont we still have two feet of snow in the fields. I've been jealous lately looking at the pictures of spring greens everyone is starting to harvest!
Well, short of digging for goldthread and wintergreen, we decided to visit with the thriving local lichen population. The first stones to emerge from the feet and feet of snow we had this winter were in the graveyard.
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Sage improves memory and attention

'He that would live for aye,
Must eat Sage in May.'
The old English proverb, quoted by venerable herbalists from Gerard to Maude Grieve, refers to the virtues of the common garden sage (Salvia officinalis). This gracious aromatic herb, of a dry and warming energy, was long considered to confer immortality, a quickness of wit and eye, and protection from disease.
Previous research has shown evidence for sage's ability to enhance mood, reduce anxiety, and improve performance in healthy young volunteers (lemon balm, too), and the in-vitro research on the herb's ability to exert anti-cholinesterase activity (prolonging the activity of the neurotransmitter acetylcholine) has made it a target for research in aging and dementia. Acetylcholine is involved in transmitting signal in an area of the brain called the basal forebrain (amongst others), and there is evidence that this region of the central nervous system degrades as we age, leading to memory loss and cognitive impairment (as in Alzheimer's, for instance). Acetylcholine also provides the connection between the nervous system and musculature, and deficiencies are associated with conditions such as myasthenia gravis.
In this most recent study, 20 healthy older volunteers aged 65 to 90 were given various doses of a sage extract, and the results indicate an improvement in a variety of cognitive markers, along with a reduction in the score dropoff over the course of the day (the volunteers stayed sharper, longer). Some details:
  • the extract was made with 70% alcohol, then concentrated and freeze-dried to a final weight-to-volume ratio of 7.5:1. This is pretty darn concentrated. Researchers were going for the volatile terpenes primarily (well-soluble in alcohol). They found 333mg to be the most effective dose; this is about 2.5 grams of leaf, or about 7.5 ml (1 and 1/2 tsp.) of a 1:3 tincture of sage.
  • the extract was compared to placebo, in a variety of categories including word recognition and recall; vigilance; reaction time; spatial and numeric memory; and delayed picture recognition tests. Below are graphs of the changes in (a)secondary memory and (b)accuracy of attention:

So, sage is definitely worth considering in the context of other herbs such as Ginkgo and Rhodiola in helping buffer the effects of aging on otherwise healthy minds. Perhaps there is indeed some wisdom in the old Latin proverb, Cur moriatur homo cui Salvia crescit in horto? ('Why should a man die as long as sage grows in his garden?'). Or at least, why should he (or she) grow old and forgetful?


Herbs regulated as drugs?

Michael McGuffin, President of the American Herbal Products Association wrote an interesting counterpoint in response to an editorial in the journal Clinical Pharmacology and Therapeutics (full text for both should be available for all starting in April 08). J.D. Morrow, a pharmacologist from Vanderbilt University, essentially argued that the FDA has had way too little authority under DSHEA, the act passed in 1994 that classes herbal supplements as 'foods' and regulates them as such. His concerns:
. "A major problem with the DSHEA is that the FDA bears the burden of proof if it decides to assert that a supplement is unsafe".
. "Many supplements contain active ingredients with the potential for serious adverse pharmacological effects if administered in excessive—or, in some cases, even recommended—dosages".
. "The sheer amount of usage and number of products available make adequate oversight of dietary supplements extremely difficult and provide the potential for agents with significant toxicity to enter the marketplace".
Well, thankfully, in order to safeguard us from certain doom, the FDA issued its final rule last summer to help address some of these concerns. Indeed, J.D. Morrow was involved in the commission that pushed for the approval of tighter standards. Nevertheless, he continues:
. "These needed regulations have been a long time in coming but are clearly designed to make more uniform the quality of products sold to the American public".
. "Again of concern, however, is the ability of an understaffed and underfunded FDA to enforce these regulations without additional support".
As I have always suspected, the FDA will require an armed enforcement unit! Only then can we ensure adequate product uniformity.
Morrow concludes that "there is little, if any, evidence that most agents are medically efficacious" (really?) and that therefore "enhanced regulation of the dietary supplement industry (...) must be done immediately".

McGuffin provides some needed clarification in the description of the current regulatory framework. Under DSHEA,
. "a statement for a dietary supplement may be made if…the manufacturer of the dietary supplement has substantiation that such statement is truthful and not misleading".
. "[Starting on] 22 December 2007, all marketers of supplements (and nonprescription drugs) must submit reports of serious adverse events that they receive. The FDA’s role in regulating dietary supplements has thus been expanded significantly".
. "Criticisms of herbal supplements tend to focus on areas in which federal regulatory agencies fail to enforce the current laws. (...) But these are not failures in the law; these are examples of
the need for more active enforcement of existing law".
As for the new GMP (Good Manufacturing Practices) rules in last summer's FDA pronouncement,
. "These regulations are much more extensive than the standard cGMP rules for conventional foods. The FDA acknowledged that some provisions of the new cGMP rule “may be similar to
the existing drug CGMP regulations,” and many sections of this new rule are borrowed directly from the cGMPs for drugs".
. "In addition, the FDA has assigned itself records-inspection powers that greatly exceed its authority in the conventional food sector".
And, McGuffin concludes,
. "An “herbs as drugs” option could only be seriously considered for the United States marketplace if there is also a willingness to allow claims for the use of these products in the treatment, cure, and prevention of disease and if legitimate historical records are accepted to support claims for traditional use".

That is, the 'gold standard' of the double-blind, placebo-controlled trial would need to be altered for substances that have a long, substantiated track record of historical use.

It will be interesting to see what eventually happens in the United States, since the regulation of herbal medicine has been in a virtual state of 'limbo' compared to Europe, Australia, and the rest of the world. If we had a crystal ball, we might be able to see how heightened regulations and 'professionalization' of herbalists and herbal products might affect our ability to practice our art in the future. Oh, but wait -- we have Canada (which works almost as well):
So many of us are afraid we’re going to go out business. Some people plan to go underground, some people plan to go defiant and see if they’re actually willing to put us in jail . . . we are like the weeds and will never be eradicated.

So spoke an unidentified Canadian herbalist in response to the new regulations that govern natural health products (NHPs). Here is a brief summary of the historical context:
"Until recently, NHPs in Canada were regulated as either foods or as drugs, as stipulated by the Food and Drugs Act. A major impetus for the creation of new NHP regulations was widespread concern that the Food and Drug regulations were inappropriate for NHPs (...) A new regulatory framework came into law January 1, 2004, with a transition period of 6-year. NHPs, including herbs, vitamins, minerals, essential fatty acids and homeopathics which are used to prevent, diagnose or treat disease, restore or correct function or maintain or promote health are now classified as drugs at the level of the Food and Drugs Act".

Very much like the progression we're seeing folks like Morrow advocate. For Canadian herbalists, these new regulations are much more difficult and may well force many underground. As American herbalists have oft lamented,
"smaller companies tend to be run by people who are herbalists, and herbs are their life, and they are very fussy about the quality of the herb and the manufacturing of the herb (...) They're going to make it very difficult for small manufacturers to continue to operate. I really think that they’re treating NHPs as if the risks associated with them were equal to the risks associated with drugs".

We need to think deeply about the costs and benefits associated with increased regulation in a framework that relies on conventional approaches to research, manufacturing, and delivery of medicines. All the components of such a network are extremely different in American herbalism (and, in fact, a unified framework is very difficult to pin down). But if we can be flexible and examine the effects of substances based on their historical context, modern research, and current folk wisdom, then perhaps we can learn to alter our entire approach to health care. After all, form follows intention, and as long as we advocate abstracted, culturally disconnected research as the only way to 'truth', we will continue to experience increased costs, side effects, adverse events, and chronic disease.


Michael Pollan and Real Food

Food - our basic sustenance, one of our most primal interfaces with the natural world - plays a crucial role in the ongoing creation of ourselves, and in the maintenance of the all-important "internal balance". So, when we begin to lose our balance with the food we consume, it is no wonder that "disease" sets in. And it is no wonder that these "diseases" are slow to progress, leaving us in a state of chronically deteriorating health.
So, to re-enliven the body, mind, and spirit, herbalists have always been strong advocates for an old-time, whole-food, plant-rich diet - with some extra punch now and again in the form of herbs and spices. I've read some excellent thoughts on this subject over at The Herbwife's Kitchen, and have become quite suspicious of any larger company (witness Kashi / General Mills) trying to sell me something in a box.
So it was with great pleasure that I listened for a little while to Michael Pollan, author of The Botany of Desire (one of my favorite modern descriptions of the human/plant bond). Amy Goodman interviewed him on Democracy Now! and his comments clearly articulate the perils of overthinking and overprocessing the food we eat. The wide-ranging interview discusses the history of the food-industrial complex in the USA; 'nutritionism'; chronic disease and its link with food; whole foods, local foods; biotechnology; and more. Some comments:
And, in fact, one of my tips is, don’t eat any food that’s incapable of rotting. If the food can’t rot eventually, there’s something wrong. (...)

And the last premise of nutritionism is that the whole point of eating is to advance your physical health and that that’s what we go to the store for, that’s what we’re buying. And that’s also a very dubious idea. If you go around the world, people eat for a great many reasons besides, you know, the medicinal reason. I mean, they eat for pleasure, they eat for community and family and identity and all these things. But we’ve put that aside with this obsession with nutrition. And I basically think it’s a pernicious ideology. I mean, I don’t think it’s really helping us. If there was a trade-off, if looking at food this way made us so much healthier, great. But in fact, since we’ve been looking at food this way, our health has gotten worse and worse. (...)

Cholesterol in the diet is actually only very mildly related to cholesterol in the blood. It was a—that was a scientific error, basically. We were sold a bill of goods. (...)

We learned how to grow food with lots of synthetic fertilizers made from natural gas, pesticides made from petroleum, and then started moving it around the world. So now we take about ten calories of fossil fuel to produce one calorie of food energy. Very unsustainable system. (...)

and, in conclusion:
Well, the interesting thing is that most traditional cuisines are very healthy, that people—that the human body has done very well on the Mediterranean diet, on the Japanese diet, on the peasant South American diet. It’s really interesting how many different foods we can do well on. The one diet we seem poorly adapted to happens to be the one we’re eating, the Western diet. So whatever traditional diet suits you—you like eating that way—you know, follow it. And that—you know, that’s a good rule of thumb.

There’s an enormous amount of wisdom contained in a cuisine. And, you know, we privilege scientific information and authority in this country, but, of course, there’s cultural authority and information, too. And whoever figured out that olive oil and tomatoes was a really great combination was actually, we’re now learning, onto something scientifically. If you want to use that nutrient vocabulary, the lycopene in the tomato, which we think is the good thing, is basically made available to your body through the olive oil. So there was a wisdom in those combinations. And you see it throughout.


Pharmaceuticals in tap water

An investigation by the Associated Press reveals some disturbing facts about the presence of a variety of medications in the public water supply of at least 41 million Americans. Major metropolitan areas were sampled along with representative rural communities from all 50 states.
The array of pharmaceuticals includes seizure medications, antibiotics, mood stabilizers, steroids and other hormones, and more. While it may be in the best interest (of someone) to over-medicate the American psyche with antidepressants and muscle relaxants, it is of immediate concern to see high levels of antibiotics entering the environment and registering appreciable quantities in water. It is no wonder antibiotic resistance is so prevalent amongst pathogenic bacteria.

Herbal Internet Resources

Some links to excellent free online material for herbal research, historical exploration, or just hours of gazing at full-resolution botanical illustrations...

Current Herbal

Free access to a database of over 200 medicinal herbs with complete links to relevant research, categorized by pharmacological, in-vivo, and human trials. Extensive referencing and links.

WHO Monographs on Selected Medicinal Plants - Volume 1

WHO Monographs on Selected Medicinal Plants - Volume 2

WHO Monographs on Selected Medicinal Plants - Volume 3

Plants-for-a-future Database Search
Select from a wide range of plants, based on edible, medicinal, and agricultural uses. Extensively referenced.

Materia Medica Articles Index
Paul Bergner's searchable online archive of newsletter articles pertaining to specific items in the Materia Medica.

Jim Duke's Phytochemical and Ethnobotanical Databases
A searchable database of plants providing chemical
constituents, cross-linked with the actions of said chemicals. An
interesting exploration of phytochemistry.

Extensive database providing information on plant distribution and taxonomy. Also describes commercial and ecological uses, and reports on endangered status. Extensive links and photos for most plants.

Classic Herbal

Henriette's Herbal Homepage
Massive online library that includes many older N. American texts, but also an extensive collection of the best of online herbal questions posted to Usenet, and thousands of pictures by Henriette.

Herbal Therapeutics Research Library
David Winston's Online library

Maude Grieve's "A Modern Herbal"
The classic 1931 text that covers a wide array of medicinal plants, includes rudimentary chemical analysis, extensive preparation notes, and medicinal activity for each plant.

Medical Historical Library: Electronic Texts in the History of Medicine
A variety of classic European texts scanned into images, usually with browsable indexes. Includes a full copy of Fuch's 1544 herbal, extensively illustrated.

MBG Library: Rare Books
Over 130 rare and classic herbal and botanical works. Incredible full-resolution pages, many containing stunning botanical illustrations.

Medical Reference

THE MERCK MANUAL MEDICAL LIBRARY: The Merck Manual of Diagnosis and Therapy
Professional version of the manual of human disease, including mainline conventional treatment and medications used.

eMedicine The Continually Updated Clinical Reference
Professional reference, most extensive and up-to-date, for conventional medicine, diseases and diagnoses, and medications used.

Nutrition facts, calories in food, labels, nutritional information and analysis – NutritionData.com
Specific nutritional information on almost any food or prepared product. Portion sizes, conversions, and cross-references.


Plant People

A new collection from photographer Hans Silvester documents the incredible plant-based ceremonial and celebratory outfits of he Surma and Mursi tribes of East Africa's Omo Valley. This region, which borders Kenya, Ethiopia, and the Sudan, is certainly not one of the least troubled areas of the globe. Yet people there, as everywhere, find time to continue old traditions that glorify and celebrate humankind's connection to Nature. A rich, beautiful, and heartening display.
Some selections below.


FDA supplement regulation update

Ever since the Food and Drug Administration released its 'final rule' on the manufacture of dietary and herbal supplements, herbalists have been wondering exactly how some of the byzantine record-keeping requirements might be enforced, and whether small-scale or one-time batches of custom formulas might be exempted, or at least overlooked.
This is a special concern for practitioners who, despite Ernst's protestations, continue to blend individual formulas for individual clients. There has been concern that these formulas might be subject to the same rules of production (not in your kitchen - unless you just installed that negative pressure fan and have no pets or food in there) and record-keeping (samples of batches for years) that large supplement companies now have to follow.
Well, apparently Vasilios Frankos, Ph.D. (Director of FDA's Division of Dietary Supplements) clarified the situation a little at a recent workshop in Washington, D.C. on Traditional Chinese Medicine. He was speaking in reference to a direct question on the requirements for practitioners of herbal medicine working in one-on-one consultations. Here are some quotes:
'We are not going to be enforcing the GMP for practitioners in
one-on-one consultations'.

'We are going to stay out of the individual practitioner relationship'.

Seems like a decent turn of events: we're still breaking the rules, but they promise to leave us alone (for now). Because, of course, the FDA still retains 'enforcement discretion'.