A Radicle

A brief and practical introduction to pulse and tongue assessment

2012-01-30T14:58:00.002-05:00

Any assessment ordiagnostic technique that seeks to make sense of what’s happening inside thehuman system is inherently pretty complex – be it a modern tool such as a CTscanner, or a traditional device such as the stethoscope. Interpretation istricky, and the background knowledge required can often be intimidating. Whileusing the tongue and pulse to get a glimpse inside the human body is not anexception, one can nevertheless glean really useful, actionable informationwith even a basic understanding of the technique. This basic understanding canbecome richer and deeper with ongoing practice. The complexity evidenced intraditional texts on the subject should not be a reason to keep you fromexperimenting!

Basics: Excess /deficient. Hot / cold. Dry / moist. The polarities!

Pick two people and look at their faces. Feel their skin.Who is more red? Whose skin more dry? Who speaks more loudly and often? Who ismore reserved and shy? The answers to these questions are clinically relevant,and it is in these basic categories that we will try to fit our observations ofpulse and tongue. They have been universally recognized in traditional healingsystems, from Chinese yin/yang theory to the Western humors.

The Pulse: Neuromusculartension and tone

When feeling the pulse, set your fingers on theradial artery. It can be found on the palm side of the wrist, right where thehand (thumb side) ends. You can often find a pair of strong tendons here; feelfor the pulse in the little “trench” just above these.

What we can learn from pulses: relative state of anxiety,tension, stress. Underactivity in the heart, vessels, and spirit (or,conversely, overactivity).

Herbs we can use to rebalance pulse: aromatic plants, andsometimes rooty, nourishing adaptogens. Archetypal plant for the pulse: HolyBasil (Tulsi – ocimum sanctum).

Polarities to observe:

- The pulse has a depth. It is right on the surface,somewhere in the middle, or deep down. This is determined by the amount ofpressure required to find it. Surface pulse with no depth indicates “paperfire” (quick burnout, moody and changeable, hyper then crashing. Consider lavender,linden). Deep pulse that’s hard to find can mean depletion (hard to get going,tends to depression, fatigued. Consider ashwagandha, ginger, cayenne, greentea).

- The pulse has a width. Think of the artery as a river,ideally flowing through the middle channel of depth. If it’s full andnoticeable at all depths, it might be called “flooding” (excess function, highblood pressure, over-intensity. Consider motherwort, rose). If it’s thin andfeels like a string, it might be called “tight” (high tension, excesssympathetic discharge. Consider motherwort again, lemon balm, scullcap). Ifit’s just thin, it might be a sign of deficiency and we would turn to thenourishing herbs (ashwagandha, oat, licorice, American ginseng).

- The pulse has a speed. This is a pretty classicassessment: greater physical activity usually raises the pulse rate. Whensitting, speedy pulses usually indicate anxiety or poor physical conditioning.Aromatic plants and exercise are called for. In extreme situations (requiringhospitalization: shock, toxicity, severe dehydration) you can see rapid, thinpulses too – but hopefully you won’t ever run in to these as they are emergencysituations.

- The pulse should respond to breath. Feeling the pulse, havethe person take a deep, full breath slowly. The pulse should quicken on inhale,and slow down noticeably on exhale. Failure to do so indicates poor heart ratevariability: if the pulse has low depth, feels thin or absent, considernourishing and building here (ashwagandha, oat, licorice, American ginseng). Ifthe pulse is of surface depth, flooding, or tight consider aromatherapy, andany aromatic plants (chamomile, linden, lemon balm, scullcap, mint, rose,yarrow).

- The pulse should come back well after being completelyblocked. Occlude the artery by pressing hard, then feel for the return ofblood. Slow return to the “normal” state (taking more than 1 second) mayindicate blood stagnation (purple color, cold, areas of chronic pain. Consideryarrow, elderflower, Salvia milthiorrhiza)

Basically, aromatic nervines make great teas andare often just the ticket for an imbalance in the pulse. This is because theradial pulse reflects the degree of sympathetic, or fight-flight, tone reallywell, and these plants are supremely useful for those who have either excessiveor deficient tension in their systems. They modulate how we respond to changein the world within and without – and if we’re not doing a great job of it, thepulse tells us. If the pulse truly seems weak, sunken, and/or thin, you mightwant to add nourishing adaptogens as well to provide a literal foundation forstress hormone production, not just a way to balance response.

The Tongue: state of themucous membranes

When looking at the tongue, ask the person to really openwide and stick their tongue out completely. Then, tell them to relax it (oftenthe “sticking out” causes the tongue to get really tight and weirdly-shaped).

What we can learn from the tongue: relative state ofactivity and moisture of the membranes that line the GI tract, but also therespiratory passages by reflex. Degree of inflammation. Degree of swelling /moisture.

Herbs we can use to rebalance the tongue: bitter andastringent plants. Archetypal plant for the tongue: Agrimony (Agrimoniaeupatoria).

Polarities to observe:

- The tongue has a body color. This is the general hue ofthe tongue itself, not its coating, and indicates the degree of blood flow andactivity in the mucous membranes. Pale tongue can indicate anemia, poornutrition (consider yellowdock, rehmannia, protein). Red tongue indicatesinflammation and irritation (consider dandelion and also slippery elm ormeadowsweet depending on dry vs moist below). Purple: blood stagnation (seeabove).

- The tongue has a coat. It should be whitish/gray, andrelatively thin. Absent coat calls for soothing, especially with a red body(consider slippery elm, licorice, flax seed meal). Thick coat calls forbitters, especially if the coat has any signs of yellow in it – though watchfor coffee stains! (consider dandelion, yellowdock, burdock)

- The tongue has a shape, largely determined by itsmoisture (though the coat can tell us about moisture, too). Wider, thicker,glistening tongues indicate a swollen, boggy gastric mucous membrane. Oftenthere will even be the scallops of tooth marks on the side (consider specificbitters such as goldenseal or barberry, but also meadowsweet, cleavers). Thin,wrinkly tongues indicate an atrophied, dry gastric mucous membrane (considerdietary oils such as sesame, bitters, and potentially soothers such as slipperyelm especially with redness).

Basically, bitters are often a great choice for anytongue signs, except maybe in cases where the tongue is really pale and wet andthere are symptoms of looseness in the bowel. This is because bitter herbsstimulate and awaken digestive function, and tone the mucous membranes in theprocess. They help us deal well with what comes to us from the world outside(most often food) by making sure that the interface (the mucous membrane) isfunctioning well. The tongue is a convenient piece of mucous membrane we canalways observe!

Conclusion

None of the diagnostic signs are infallible, of course –and should always be read in the context of symptoms and case presentation. Theassessment of pulse and tongue can precede the oral interview, and guide it:for instance, feeling a tight and rising pulse with poor response to breath,you might want to ask about tension, anxiety, and a difficult response tolife’s changes and stresses. Or noticing a dry and red tongue, you might askabout heartburn and/or constipation. Conversely, the assessment can come at theend of the oral interview, and be used to corroborate information obtainedthrough conversation. Finally, the maxim: treat the person, not the tongue(or pulse)!

Plant allies for winter health

2011-12-12T15:06:00.003-05:00

Enhancing immune activity

Why: Herbal allies to combat respiratory infection as it begins.

Echinacea, Andrographis, Elderberry, Hyssop, Garlic, Osha

These agents provide an immediate “boost” to immune function, particularly the body’s ability to produce antibodies against viral infections. Will shorten the duration of common winter infections, and can also be used longer-term as preventative agents particularly for those more at risk.

How to take: most acute-use antiviral herbs can be taken whole, or with minimal processing. I often will simply nibble on a small (1”) piece of Echinacea root, or an even smaller piece of Osha root, when the first warning signs of illness begin. Stored in a glass mason jar in a cool cabinet, they will keep at least a year.

Elderberry seems best taken as a syrup. These preparations are pretty widely available, or you can make your own by mixing an equal volume of fresh berry juice with raw honey, and storing in the fridge. The honey is really medicinal too! 2 TBS three to five times daily is typical.

Andrographis is extremely bitter and hard to take straight. Often, we recommend a tablet or capsule of this plant, at a dose of 400mg three times a day, again at the first signs of trouble.

Hyssop makes an excellent though somewhat biting tea, and Garlic can be included with food (though the more raw, the better).

“Deep” immunity

Why: Enhancement of our own immune function, to clear infection more quickly if it does begin, and help get rid of lingering problems or break the pattern of repeated illnesses.

Astragalus, Medicinal mushrooms, Spikenard, Tulsi

Good policy for anyone, these tonics are most indicated in conditions of convalescence, to rebuild strength, or in cases of repeated infection every season. Taken consistently, they will also improve immune activity, helping to shorten lingering colds and flus, and prevent them to begin with.

How to take: these herbs are an easy addition to your regular stock-making routine. If you’re not making stock regularly (once a week or so), consider doing it! Save your vegetable scraps and peels and any animal bones, and simmer them with Astragalus root ( ½ cup per gallon), dried mushrooms (Reishi, Turkey Tail, about ½ cup total per gallon) and some spikenard root (Aralia racemosa, about 2 TBS per gallon). This last one is especially indicated to help bring up vitality and kick out lingering congestion. Also, see a specific recipe variant in the “recipes” below.

Tulsi (aka Holy Basil) is a wonderful tea herb. Start it up in September if there are concerns about the coming season.

Adjusting mucous membrane function

Why: Our respiratory mucosa is our first line of defense. Ensuring it is not swollen, stuck, and/or inflamed not only improves symptoms immediately, but also improves defense.

Reducing swelling: Goldenseal, Barberry, Osha
Reducing thick secretions: Echinacea, Horseradish
Reducing dryness and irritation: Propolis, Licorice

How to take: These strong herbs usually don’t require a high dosage to accomplish their goals. Part of this may be due to the fact that reflex action mediates their effects – horseradish makes your eyes water, for instance, even though none is ever put in your eyes. So I usually suggest tinctures, good to have on hand and already picked out depending on what your respiratory passages tend to feel like when you get sick. Of these liquid extracts, try taking 15 drops or so every couple of hours and seeing how it makes you feel.

Protecting and toning the respiratory tract

Why: If lungs are consistently affected. This isn’t an issue for everyone, but if it tends to be, best to include these herbs right away before the illness gets there.

Thyme, Garlic, Usnea

These herbs are especially useful for those whose lungs are prone to weakness (history of pneumonia, repeated bouts of bronchitis or bacterial infection, or smokers).

How to take: Thyme can be inhaled as a steam by brewing strong tea and breathing deeply. After that, go ahead and drink the tea too! With a little raw honey. Usnea lichen is eaten whole, or taken as a capsule – though I really like the effect of the raw herb as it goes down the throat. It kills viruses and bacteria that contribute to sore throat, and enhances lung immunity once you absorb it internally. 1-2 grams of Usnea twice daily is usually plenty.

Encouraging lymphatic activity

Calendula, Cleavers

Useful in the latter phases of an illness, after the fever or acute symptoms have abated, to clear lingering inflammation and hasten recovery. Can also be used right at first if there is a history of lymph node (gland) tenderness.

How to take: Most often as teas. The extra fluid is really helpful too. 4-6 TBS per quart of water.

Encouraging circulatory activity

Ginger, Garlic, Cayenne

This often is all you’ll need for a common cold in those of strong constitution. Helpful for all to stimulate warmth, encourage perspiration and speed recovery, but particularly indicated in a colder person.

How to take: Special hot sauce? Or a home-made version thereof where the above three herbs are blended, to taste, with apple cider vinegar. Try ½ teaspoon twice a day to start.

Herbal Recipes for Winter Health

Remember that, when using herbs for healing and wellness, it is important to bring their powers into your life from many different angles – use a tea, tincture, and/or an aromatherapy steam to reinvigorate a weak constitution, and think preventatively to strengthen immunity during times of good health.

Immune ‘soup’:

This simple blend can serve as a base for any soup, or can be taken ‘as is’. It strengtens the immune system and can help prevent weakness during the winter months. It is quite powerful, but as with any herbal tonics (blends designed to strengthen over the long term) it is best used on a regular, daily basis.

Astragalus (Astragalus membranaceus) root 1 cup of dry root

Ashwagandha (Withania somnifera) root ½ cup dry root

Red Reishi (Ganoderma lucidum) mushroom ½ cup dry mushrooms

Burdock (Actium lappa) root ½ cup dry or fresh root

Garlic (Allium sativum) bulb 4 minced cloves

Take the above ingredients, and simmer them, covered, in a pot with 2 quarts of spring or well water (this process is called a decoction). Simmer on very, very low heat for at least one hour (in China, these types of tonics are often simmered for a whole day – a crock pot can be helpful. Be sure to keep an eye on the soup, and add water as needed. Don’t scorch the pot!). Strain and serve, perhaps with a little honey, or freeze for storage. The daily dose is 8 fluid ounces (1 cup).

Get creative with this soup! Add onions, carrots, seaweed (dulse, arame for example) and salt to taste. You can also add cabbage, potatoes, and cooked beans to make it more of a hearty meal. Or herbs and spices like Cayenne, Thyme, and Parsley. These soups remind us that our daily food is our best medicine!

Tea #1 – For lung congestion

Sometimes a cold can ‘go down’ into the lungs, making it difficult to breathe and producing a deep and sometimes painful cough. In these cases, this blend can help.

Mullein (Verbascum thapsus) leaves 3 Tablespoons dry leaves

Thyme (Thymus vulgaris) leaves 1 Tablespoon dry leaves

Licorice (Glycyrrhiza glabra) root 1 Tablespoon dry root

Ginger (Zingiber officinalis) root powder 2 Teaspoons dry powder

Place all the ingredients in a teapot or mason jar, add 1 Quart of boiling-hot water, cover, and steep for 15 to 20 minutes (this process is called an infusion), then strain. Drink the whole quart over the course of a day. You can prepare this tea the night before, and let it steep all night if you’d like, but I have found that teas for colds and flus work better if you drink them hot.

Add honey to taste.

Tea #2 – For nose and sinus congestion

Often times the worst part of a cold is a stuffy nose. This blend can help relieve that congestion, drying up the nasal passages a bit. It is also useful, I’ve found, after the worst of a cold or flu is done, to help relieve lingering symptoms of congestion.

Elder (Sambucus nigra) flowers 2 Tablespoons dry flowers

Red Clover (Trifolium praetense) flowers 2 Tablespoons dry flowers

Catnip (Nepeta cataria) leaves 1 Tablespoon dry leaves

Ginger (Zingiber officinalis) dry root powder 1 Teaspoon dry powder

Place all the ingredients in a teapot or mason jar, add 1 Quart of boiling-hot water, cover, and steep for 15 to 20 minutes (this process is called an infusion), then strain. Drink this quart of tea over the course of 4 hours, then repeat if necessary. You can add a little honey to taste if desired, although I’ve found too much sweetness can make nasal congestion worse.

Tincture – Echinacea purpurea

Tinctures are alcohol-based extracts of herbs. Usually quite potent and concentrated, they require a solvent such as Vodka to create. The dose is usually much, much smaller than that of a tea.

Echinacea (Echinacea purpurea) root 2 or 3 Tablespoons fresh or dry

Vodka (100 proof) 8 fluid ounces (1 cup)

Chop the root as finely as is possible, and place it in a jar you can close securely (mason jars work well, I’ve found). Pour the vodka over the chopped root, close the jar, and shake it really well for at least 30 seconds. Label your tincture (name of herb and date are the mimimum requirements) and put it in a cool, dark place. Shake it well at least every other day.

After two weeks (better yet, wait four weeks if you can), strain your tincture, discard the spent roots, wash out the jar, and put the tincture back in. It should have turned a nice reddish-brown color, and is ready to use!

Echinacea tincture is taken 1 teaspoon at a time, in a little water, once every hour when you feel the first signs of a cold or a sore throat.

Aromatherapy steam

This process is very useful to help relieve congestion in the nose and lungs. Usually best to do at night, before bed, to clear the breathing passages and encourage restful sleep.
Boil a pot of water. When the water is hot, remove from heat and place it on a safe surface (a stone or trivet works well).
Add 2 drops each of these essential oils (highly concentrated plant essences – use only a few drops, never internally, and be careful because, undiluted, they can irritate the skin):
Rosemary
Thyme
Eucalyptus
Cover your head with a towel and breathe in the steam for 5-10 minutes.

Plant medicine heals more than just people

2011-11-26T08:39:00.003-05:00

We often discuss how effective plants can be at supporting and gently bringing human beings back to a state of "wellness" (meaning that resiliency, vibrancy, passion are maximized). I've spent a lot of time exploring how this happens, reading through the historical record and perusing modern research, and on balance it seems pretty clear that medicinal herbs, trees, mushrooms and more are good at helping folks in need. But that's not what I want to discuss today.
Rather, I'd like to posit the idea that working intimately with the botanical world alters our lives in ways that transcend individual health. Of course, this is not a surprising idea: reality mirrors itself, and the skin is barely more than an illusory boundary. Nevertheless, as a person whose life was redirected, and perhaps saved, by trees and herbs, I want to share three ways in which these allies can have powerful effects beyond the individual.

First, the people. Herbalists, gardeners, and other plant folk are consistently the most cooperative and compassionate people with whom I've had the pleasure of working. They share knowledge freely, contributing to a vibrant living oral (and now digital) tradition. They are often excellent communicators, speaking easily in language of metaphor and myth, forest and field. Even the most "beginning" herbalists have taught me amazing lessons and come up with amazing insights - which is why I avoid ranking plant people based on experience, training, or whatever else. Nature's gifts aren't reserved for the well-learned - and those of us who have spent a lot of time studying may find that, in the end, we return to the simple source of life for lasting truth, and books fall away in the light of the green world. This engenders gratitude, and may be the reason plant people are generally gentle, compassionate, and giving. They are often amazingly creative, too - coming up with new pictures, herbal formulae, and solutions where science falls short. I don't mean to disparage any way of "knowing", as all ways are necessary. I simply feel that knowing through plants is so very beautiful, and makes its people beautiful, too.

Next, herbal medicine has a way of reconnecting our species to nature. Clearly a no-brainer: we get outside more, we tend to eat differently, we appreciate a woodland walk differently when we have an intimate knowledge of the green folk living all around us. This gets into our heads slowly, insidiously, and deliciously. Before we know it, we may find ourselves kneeling on a city sidewalk looking at plantain (the horror)! But I feel like the gift of reconnecting to nature that herbal medicine offers us is most clearly evident in what happens when nature and wild plants are removed from human life: this is what, in Western culture, we've been working on for a few hundred years. The results are dramatic: epidemics of chronic disease affect the population, not because of the rise technological medicine, but because of a removal of traditional medicine! Additionally, to support homogenized, un-wild, unchallenging food systems we are also creating epidemics of chronic disease in the environment: new chemical signals that affect fertility, waste material that alters climate and ecosystem balance, disorganized living arrangements that sprawl over the landscape. I may be overly optimistic, but I believe that we don't need to remove technology to fix these issues: we simply need to bring plants back in to daily life. Once we develop the botanical habit, herbs begin to mess with our heads (where we all too often live). As we lose our heads, we save our spirit - and spirit being all-encompassing and transcending the human species, we participate in a more sustainable dance with the rest of nature.

Which leads me to my final point of appreciation for herbal medicine: mystery. Anyone who has seen a plant effect a cure knows that there is something magical about this process, as it may never be able to be replicated again. The herbalist, plant, and client have somehow managed to work together, in that one timeless moment, and the feeling all (plant included!) are left with is similar to what you feel when you run in to a random friend in a random place at just the right moment. It is synchronicity beyond coincidence, and we glimpse for an instant what it is like to be the immortal Universe. A healing modality that respects and welcomes mystery is my kind of medicine: because in the end, no matter how much we dress it up or understand its details, a human physiology brought back in to balance always reveals an awe-inspiring mystery. All good scientists know this. Einsten, for instance, tells us:

The most beautiful experience we can have is the mysterious. It is the fundamental emotion that stands at the cradle of true art and true science. Whoever does not know it and can no longer wonder, no longer marvel, is as good as dead, and his eyes are dimmed.

I have great faith in the power of herbal medicine to heal not only people, but also culture, species, and ecology. It's really pretty simple: we really need plants in our lives. Even only a little bit. And once their green tendrils begin to grow in our hearts, like the first pea vines of spring, there is no turning back. Thank goodness - thank greenness.
In gratitude, I leave you with the words of Peter Conway, English herbalist, philosopher, and erstwhile humorist.

The future of herbal medicine is the past of herbal medicine - self care & psychedelics - serious...

Joyful herbs for the darker days

2011-11-14T14:44:00.000-05:00

All of us feel the loss of daylight to a certain extent. For some, it may be occasional sluggishness, less motivation to get outside and exercise, or less of a desire to spend time with friends and family. Others may feel even deeper withdrawal, or experience less control over anxiety and the sometimes overwhelming responsibilities of daily life. To a certain extent, the culture has tried to address this by consistently packing in times of remembrance, celebration, and family during the darkest months of the year – but by the time it’s all over (or even during the often stressful holidays), there are still many months of darker days left and it is usually at this time that folks express the desire for more fun, more joy, more light.

Aside from creating internal tension by working the same schedule regardless of season every single week of the year, darkness literally affects our mood, in a pattern that has been fairly well characterized and is known as seasonal affective disorder, or SAD. This pattern can carry a significant depression along with it, though most often it is a period of withdrawal, sadness, and perhaps increased anxiety whose chief feature is that it occurs as the daylight wanes.

So what can be done? Naturally, being outside is extremely important. Feeling sunlight directly on the skin, for even 30 minutes a day, can have substantial benefits! Some choose to install and operate full-spectrum lighting in their homes. As an extension of this, folks also supplement with between 1,000 and 4,000 IUs of vitamin D daily. This important nutrient is essential for those who suffer from a seasonal sadness pattern. But there are some specific medicinal plants that can reinforce these sun-seeking impulses, while at the same time buffering the symptoms of sluggishness, sadness, anxiety and withdrawal. All of this put together helps us not only feel better during the winter months, but also perform better at work, play, and family gatherings.

Pulling out of the “hole”: stronger botanicals for SAD

St. Johnswort (Hypericum perforatum) has a well-deserved reputation as a good herb for mild to moderate depression, and clinical research has confirmed its effectiveness for this condition. SAD, usually a moderate case, responds extremely well to this plant, which not coincidentally has a long history of solar mythology tied to it. Though also useful for anxious conditions, it is better suited to the depressive side of the winter blues, where it warms, enlivens, and improves circulation.

Consider between ½ tsp and 1 tsp (3-5ml) of a good, fresh tincture prepared from the whole buds and flowering tops. This extract can be taken up to 5 times a day – though it should never be consumed alongside conventional medication without checking with an herbalist first.

Mimosa (Albizia julibrissin) is perhaps a bit less well-known, but is a stellar and powerful plant for supporting darker, sadder moods characterized by apathy and withdrawal. It comes from the flower and bark of a medium-sized tree, and has an astringent and somewhat acrid flavor. The tincture is usually taken at a dose of 30 drops all the way up to 1 tsp (1-5ml) twice a day.

Rhodiola (R. rosea) is an anti-stress, energy-enhancing tonic. As such, it lessens the pressures our psyches may feel when we are also sluggish or anxious from the changes in daylight. And of all the “stronger” herbs, it has the greatest affinity for the overwhelmed and frazzled type, where it also serves the purpose of enhancing and evening out energy throughout the day. ½ tsp once, or sometimes twice, a day usually suffices to add spark back into a tired life – and sometimes enough spark to start back in to an exercise program, a snowshoe adventure, or that wintertime project you were putting off…

Aromatic plants: a daily habit to keep us happy, focused, and “in the flow”

Plants with strong smells, rich in volatile essential oils, have been used throughout history as ways to facilitate ceremony, mark momentous (large or small) events, reduce the effects of stress on the human system, and spark creative focus. They accomplish this by quite literally balancing the level of internal tension we experience: tension in our internal organs, along our nerves, in our skeletal muscle. Though probably best to consume them daily, they make a more frequent appearance in my life from about mid-September to mid-March – the darker half of the year. All of the plants below can be combined together, are very safe to use alone or in concert with conventional medication, and are perhaps somewhat interchangeable. Find a few that you like, and try to start consuming them regularly before mood becomes an issue: it’s always easier to prevent a downslide than it is to climb back out of a dark hole.

Holy Basil (Ocimum sanctum, aka Tulsi) reduces inflammation in the body, buffers the effects of stress, calms anxiety and gladdens the heart – all while tasting delicious as a simple cup of tea! Various teabags prepared with Tulsi are available today, and almost all are delicious, safe, and effective when used habitually (2-3 cups of tea a day). The tincture too can help, when at least ½ tsp is taken twice a day, perhaps alongside other herbs.

Frankincense (Boswellia species) is a resin from an east African / Arabian tree. It is traditionally burned as incense, but its internal use is also storied and has been receiving a lot of attention over the last decade. It seems very useful at controlling inflammation, especially in nervous system and cardiovascular tissue, but has important mood-balancing effects as well. It is a rich and sensuous ally for the darker days. Typically ¼ tsp to ½ tsp of the “tears” (amber-like resin chunks) are eaten daily.

Lemon Balm (Melissa officinalis) has a delightful scent that is enlivening and makes for a happy heart. It brews a delicious tea, and its aromatic constituents are antidepressant and very, very useful in anxiety. Clinical research shows that consuming a strong cup of Lemon Balm tea (2TBS of leaf per cup) or its extract (1tsp per dose) lessens anxiety and uplifts the frazzled, overwhelmed person for up to six hours! That said, I usually recommend at least 3 cups or doses a day.

Rose (various Rosa species, the stronger scented the better) holds a sad heart and nourishes it. In clinic, its specific use centers around trauma, physical or emotional, and the withdrawal and closed-heartedness that can result. But it is also quite applicable in any context where sadness is overwhelming the ability to enjoy and engage life. Typically not used alone, Rose makes an amazing addition to tea blends and extract formulas for sadness and apathy. Use about 1tsp of petals per cup of tea, or 30-60 drops of tincture. If you can find a “rose elixir” (Avena Botanicals makes an amazing one), 5-50 drops can be used as needed to mend a broken heart.

Pine (Pinus species, often P. alba or white pine), along with spruce and fir, is an evergreen that has always been associated with the darker winter months. It’s for reasons that are more than celebratory that its fronds are brought indoors to decorate the home when the light is waning: the smell is uplifting, antidepressant, and energizing. It is also a great source of vitamin C and very good for the lungs. I’ve only ever used a tea of the fresh needles, regardless of species: about 1TBS of chopped needles steeped in a cup of hot water, taken 2-3 times a day.

Finally, Oats (Avena sativa) is the most nourishing of the bunch. It may be needed for folks who have experienced a SAD pattern for years, or who are perhaps getting worse and worse with every dark season’s passing. It also makes a good tonic for those used to burning the candle at both ends – all in all, not the strongest and immediately relieving anxiety and depression, but the secret ingredient for building resistance to stress and weathering the lack of sunlight with greater grace. Typically a tea is made with 2TBS of unripe, dried oat seedheads per cup of hot water – and 3-4 cups are consumed every day.

There is extensive research correlating the use of highly scented plants (think lavender, for example, or peppermint) to less tension, stress, anxiety and sadness. People have consumed these plants in a range of ways: as teas and extracts, but also as aromatherapy essential oil blends, in room diffusers, as incense, or in bath sachets. Other plants, such as white sage, pine, and citrus fruits, are brought into the home for decoration (and their noticeable medicinal effects). One way or another, it does us all a lot of good to share our space and lives with these sweet-smelling herbs: and it may be that the rise in patterns such as SAD in our culture parallels the loss of these allies in our environment. Many of the scented candles used for the holidays are artificially aromatic nowadays, their medicinal effects unclear (and perhaps even detrimental, as they might lead to hypersensitivity symptoms). So consider real plants, wreaths of evergreen fronds, and true potpourri and mulling spices as part of your seasonal rituals: there are good reasons for these customs, and a happy heart may be the most important!

The bitter flavor and the bitter herbs: trust and embrace!

2011-05-14T06:57:00.000-04:00

I had the opportunity recently to spend some time talking with Jovial, whom I've known for a while but who recently started the excellent herbal bitters company Urban Moonshine. The focus was often on the bitter extracts themselves (the tincture blend she makes is actually pretty tasty and mellow compared to some of the wormwood / artichoke / mahonia combinations I've made up for clients in the past), but we ranged off into more philosophical realms pretty quickly.
The discussion kept coming back to a few key points: the bitter flavor, when obtained through whole plants (and yes, I consider crude tinctures to be whole plant products), has a historical grounding in the culture of eating itself, and thus consuming it is a "well-connected" (relationship-rich) practice; it enables optimal digestion (and beyond) by relying on the physiology's innate wisdom and regulatory mechanisms; and it provides an essential challenge and avenue for growth for the human being. When habitually used, the bitter flavor turns the gut on, without second-guessing what it needs. And a happy belly, as any herbalist can tell you, is perhaps the most crucial element for overall vibrancy and health.
Bitter herbs and roots have myriad impacts on digestion and beyond. To review those was not the purpose of our discussions; for that, I refer you to Danielle's excellent article, published by the Weston Price Foundation. Right now, I simply ask you to take a step back, recognize that individuals are actually pieces of cultural and ecological webs, and think a little bigger.

As Michael Pollan astutely observed, the American culture lacks a rooted cuisine, a context in which meals are prepared and shared. This is evident in the food choices most commonly available: processed grains, proteins and fats with few vegetables and fewer whole ingredients, where both flavor and nutrition are reintroduced after the fact based on currently available nutrition science. It is no wonder therefore that the bitter flavor, most often found in whole plant ingredients and in the spices added to meals that are a part of a culinary context, is entirely absent from the American food offering: it is neither useful nor pleasureable to the typical food industry manufacturer, nor to the typical palate. Additionally, it is usually the secondary plant metabolites - such as flavonoids and iridoids - that are responsible for bitterness. These are, unfortunately, still seen as inconveniences to be removed (until they're labeled as "nutrients" or "vitamins", at least).
In all traditional cuisines, bitterness features as both a part of the basic menu choices and also as the separate mealtime ritual of the aperitif or digestif. In the former case, we see the use of bitter greens, whole grains, and even spice selections that use the bitter flavor to complement and highlight the sweeter and saltier components of the meal. In the latter case, bitter is given its own starring role based on the consistent cultural awareness that it is important to spend some time before and/or after eating being mindful of the meal and of one's company, and that a digestif encourages these important connections through a shared ritual with a very real pharmacological basis. I remember this growing up in Italy. Definitely not too fond of the stuff at the time...

That pharmacological basis is rooted in the herbal bitter's ability to increase digestive and hepatic secretions at just the right time, i.e., when strong digestion is most important. For thousands of years humans have known this to be true (which is why we see it in all traditional cuisines); in fact, the use of bitters predates the arrival of the human species (witness the bear's springtime Osha ritual)! The fact that bitterness is essential in maintaining optimal digestive health and ameliorating all the inflammatory conditions associated with flagging digestion seems, however, lost on the American supplement industry: we are seeing an increased reliance on digestive enzymes and increasingly complex probiotic cocktails. This is not surprising, and simply another manifestation of the same "nutritionism" (quoting Pollan) that seeks to enrich white flour after the fact instead of advocating for a whole grain to begin with. Every year a new combination of these products appears on the market, purportedly based on the latest science; and while this may be the case, we are deluding ourselves if we ever believe that an artificial source of digestive secretions or flora will function with the wisdom and flexibility of our bodies' own juices. Time and time again this point has been driven home (just last year, for instance, we had no idea that gut flora falls into three distinct ecological "biomes" that vary person to person), but rather than turning to whole plants to balance our physiological responses, we keep pursuing supplementation from external sources without any trust in our bodies' innate abilities.

Why is this? Ultimately, since industrialization, humankind has pursued the goals of ease, comfort, and convenience with the idea that activities such as manual labor and foods such as coarse, whole-wheat bread are undesirable. These goals may, perhaps, be rooted in some misguided desire to achieve a species-wide "aristocracy", or at least the trappings thereof. This obviously hasn't worked, and food security is still a major (and growing) issue even in so-called "first world" countries such as the US. In the end, these pursuits have netted us one thing: they have removed the challenge from our daily physical lives. Intellectual challenge may still exist (though others might argue that television and media largely remove this, as well) - but some of the key daily challenges all animals must endure, such as physical exertion and the consumption of the bitter flavor, are all but gone. They have been purposefully removed, and we are only now beginning to see what that means for our culture and our species. Without challenge, life ceases to expand, to improve, to creatively build. And while the importance of exercise is beginning to be recognized, the crucial role of the bitter flavor as a "workout for your digestion" has been largely neglected. How can we use a digestive enzyme to supplement an unchallenging diet and an atrophied digestion? It is like using an anabolic steroid instead of exercise. Recent research is showing how, in conditions of diabetes and pancreatic insufficiency, external enzyme supplementation actually does more harm than good by disrupting the physiology's attempts to seek balance in an imbalanced world. This comes back yet again to the lack of trust in our bodies' innate ability to thrive when well connected to Nature.

Interestingly, when thinking about the balance of energy in the ecosystem we call Gaia, it is useful to pause and consider the lack of challenge to the average American's palate through the absence of bitterness. If a challenge is removed from one piece of the web of life, it is likely to show up elsewhere! When you stop to look at this fact, as Jovial pointed out to me, you can see that the pursuit of comfort and sweetness in our diets has shifted the costs our species should be enduring daily onto the rest of the ecosystem: a corn and soy based industrial agriculture is relentlessly polluting and depleting the ecology for a goal that, in the end, actually leaves both humanity and Gaia much weaker.

So, can the addition of bitters into the American diet on a daily basis provide a reconnection to Nature, sabotage the industrial food machine by shifting the palate away from flavorless simple sweet and salty, and re-enliven our tongues and stagnant, unchallenged bellies? It is certainly more complex than that - but the maligned Dandelion, with its unrelenting yellow flag, offers itself yet again as a catalyst for healing not only individual imbalances, but the wider ecological rifts we've seen develop over the last century. Perhaps it's time to start listening.

Herbs for Athletes

2011-04-11T15:58:00.001-04:00

Lots of folks are getting back outside and becoming more active as Spring (finally!) moves forward. When we stop to consider how much our physical frame and physiological systems endure for even a moderate walk around town (coordination, tendon stretching, impact buffering, blood sugar changes, and more), it’s remarkable that human beings perform so well when engaged in physical activity! Good pre- and post-workout nutrition is crucial, as quality fuels provide a lot more than just energy to our bodies, but beyond eating well, herbal support can address three key areas that are important for athletic types and for anyone who is even moderately active: preventing problems, enhancing stamina and endurance, and treating any injuries that might sideline us. Usually herbs are used internally for the first two areas of focus, and in treating injuries external and internal therapies can play a role.

Prevention: strong blood, good circulation, supple connective tissue.

The areas that tend to get the most abuse in many athletic disciplines (even walking) are the joints, ligaments that surround them, and the tendons that attach muscle to bone and joints. Muscles themselves can also experience strains and tears, but these usually heal more quickly than those in joints or connective tissue.

Stretching and listening to your body are, obviously, crucial. Beyond this there are some key preventive strategies where herbs can really help.

· First, it is important to build and maintain “strong blood”. This really means that the blood should have excellent oxygen-carrying capacity and plenty of red blood cells and hemoglobin, so that muscle tissue receives all the oxygen it requires for healthy aerobic activity. When starved and forced to work anaerobically (without oxygen) for any length of time, muscles are more susceptible to injury. Additionally, “strong blood” usually includes the idea of “clean blood”, a somewhat mysterious herbal concept, which usually means that there are fewer reactive free radicals present in the bloodstream. The blood itself is therefore less pro-inflammatory. Inflammation is, of course, at the root of much joint pain, chronic fascia, tendon, and ligament pain, and more.

Astragalus builds the oxygen-carrying capacity of the blood. It also is a preventive agent for common viral infections, often the bane of athletes. You can simmer a few tablespoons of the root with vegetables and/or bones when making a soup stock, or take about 500-1,000mg twice a day in capsule form.

Ginkgo is not that useful to strengthen blood, unless you’re moving to higher altidude (over 5,000 ft or more) and you aren’t used to the lower levels of oxygen one finds up there. 240mg daily of the standardized extract for 3-5 days prevents altitude sickness and speeds the blood’s adaptation to the new environment.

Curcumin form Turmeric has a host of beneficial functions in the body, but for athletes one of its most important is the ability to reduce inflammation overall by acting as an antioxidant and liver balancer. It is used for chronic joint pain and injury, but is an excellent preventive agent as well. To this end, we usually use about 1,000mg of curcumin daily, taken with a little black pepper in the middle of a meal.

Fish oil and other omega-3 fatty acid sources (lots of greens, flax seed for example) are another class of nutrients essential for keeping overall inflammatory burden in check. We suggest 2g daily for maintenance, and up to 4-6g daily during peak, intensive training.

One final nutrient is related to the side effect of a commonly prescribed class of medication. Statin drugs (lipitor, zocor, et. al.) are used to treat high cholesterol, but have the unfortunate side effect of depleting Co-Q10 from cells. I recommend this supplement for athletes who are taking statin drugs and notice an increase in fatigue.

· Blood with a good capacity to carry oxygen and control the production of inflammatory chemicals is a great start, but beyond this we also need to ensure adequate circulation. This is for the muscles again, but even more crucial for tendons and ligaments where circulation is notoriously poor to begin with.

Gotu Kola is a water-loving ground cover plant that grows quite well as an annual in Vermont. It is a tonic for connective tissue and also improves circulation and oxygenation of all organs of the body. The daily dose is 3-5 fresh leaves, or about that many droppers full of a liquid extract (tincture). 3 capsules a day is ok if nothing else can be found.

Hawthorn berries, Blueberries, and other colorful berry fruits are fantastic sources of bioflavonoids which improve circulation, reduce inflammation, and protect the heart and capillaries so they can continue to perform as efficiently as possible. Aim for ¼ to ½ cup a day of mixed berries, fresh or (even better) frozen. Jam preparations are also acceptable.

Caffeine should be used with caution. While a little seems to boost performance somewhat, it can also restrict circulation to the heart and muscles when overconsumed, leading to premature fatigue. Play it by ear – I typically find that 1-2 cups of coffee is fine. Black tea has less caffeine and way more circulatory-enhancing and anti-inflammatory antioxidants, too.

Performance: herbs that improve speed and endurance and enhance recovery

Most athletes are interested in ways, beyond training, that they can support themselves as they push the body further in distance, speed, intensity, or all of the above. Usually, one reaches a limit where the physiology’s ability to absorb more training and improve hits a plateau, and continued exertion can lead to burnout, injury, or both. Generally speaking, the “adaptogenic” herbs can push that limit back, allowing for more exertion, improvement, and therefore greater performance. Here are three excellent and effective adaptogens to help us bounce back faster from hard training and also improve performance in the short term.

Rhodiola rosea is the root of an Arctic plant traditionally used to support stress and counteract fatigue. Exercise is perhaps the “purest” embodiment of physical stress on the system, and Rhodiola can help both in the short term (before a race, e.g.) and long term by pushing back the threshold of fatigue and getting us quickly ready for the next workout. Try a liquid extract, using about ½ teaspoon once or twice a day during training, or ½ to 1 teaspoon before a challenging workout or race.

Eleuthero (a.k.a. Siberian Ginseng) is a classic athlete’s tonic. It was first researched in Russia to enhance the stamina of its soldiers and cosmonauts, but quickly found its way into the athletic programs as well because it is effective. 2-3g of the root are consumed daily.

Cordyceps is actually a mushroom, not an herb, and there is some conflicting research showing that it may increase performance and endurance when taken regularly. Some of the recent clinical evidence did not show much effect; my feeling is that it helps individuals who might be already in a depleted state (i.e. coming back from an injury, or following a taxing race). Typically between 500 and 1000mg are consumed daily.

Treating common injuries: anti-inflammatory herbs and connective tissue repair

In working with active people, it seems that the issues that come up over and over again either involve connective tissue (sprains, tendonitis, fasciitis) or joints and articulations (arthritis, bone spurs). The preventive health strategies discussed above are important, of course, as is a concerted program of rest and physical therapy to rehabilitate the injury. Beyond this, we have a lot of great herbs to use both topically (on the site of pain) and internally that are a great alternative to ibuprofen.

Arnica is used topically as an oil or gel, and internally as a homeopathic remedy (usually the latter is at a 30C potency). It reduces inflammation, prevents bruising, and just greatly speeds the recovery process for almost any injury, but especially sprains (twisted ankle, e.g.) and trauma (bashes, falls, etc). For more nagging, chronic injuries such as tendonitis, runner’s knee, IT band syndrome, fasciitis and more, Arnica is less useful but can still be helpful, especially if combined with Horsechestnut (see below).

Ginger makes an excellent compress for sore muscles or for specific areas of inflammation around a joint or tendon. Brew a strong tea by steeping 1 TBS of powder in a cup of hot water for 5 minutes, then soak a cloth with the tea and apply to the affected area a few times a day.

Wintergreen essential oil is another excellent liniment, more for arthritic and other chronic joint complaints. It’s a bit too strong to use “neat”, or undiluted, so use about 10-15 drops of oil in 1 ounce of a carrier oil such as olive or grapeseed oil. It has a very cooling quality, and works well in alternation with the ginger compress.

Horsechestnut is a remedy often used internally for varicose veins and chronic inflammation throughout the body. In Europe, it is also used topically for any type of connective tissue injury or chronic inflammation – sprains, and tendon/ligament/fascia injuries. The liquid extract is a great way to use this plant both ways: 45 drops twice a day internally, and rubbed directly onto the affected area topically twice a day. It reduces not only inflammation but also the swelling associated with it.

Final note: often many of these herbs are employed at the same time, depending on the situation at hand. For instance, a combination liquid formula made with Hawthorn, Gotu Kola, and Horsechestnut could be used to speed recovery from a twisted knee and prevent recurrence at the same time. Additionally, the concomitant use of internal and external herbs along with physical therapy that strengthens the muscles and connective tissues around the injured area yields the best results.

Some sping tonic formulas for extraction

2011-03-28T12:58:00.005-04:00

You can reference these herbs in a previous entry, which goes in to Spring roots, leaves, tonics and cleansing at length. Below are just some ideas on combinations.

1 ounce is almost 30 grams

extract in a pint / quart jar with about 15 ounces of alcohol

Dandelion root 30g

Burdock root 30g

Sarsaparilla 30g

Nettle 15g

Gentle revitalizer, especially if the skin gets dry and bothersome by the end of Winter

Dandelion root 15g

Spikendard root 15g

Echinacea root 40g

Wintergreen 7g

Mustard 13g

Enhance immunity and protect/reawaken the respiratory system

Dandelion root 30g

Yellowdock root 30g

Goldthread root and leaf 7g

Cleavers 13g

Enhance liver function and correct feelings of being “swollen”, sluggish

Sarsaparilla 30g

Wild Sarsaparilla 30g

Dwarf Ginseng (fresh) 30g

Dandelion root 30g

Overall hormone and adrenal tonic; reawakens, counteracts fatigue

Love, Fertility and Reproductive Health

2011-02-14T13:53:00.003-05:00

The traditional strategies for enhancing libido and improving lovemaking usually involve two components: stimulate circulation and good blood flow to the erogenous zones of the body, and relax the mind so it can shed the cares of the day. Many of the traditional aphrodisiac plants hit either one or both of these bases!

For a really healthy love life, consider a shared exercise program as well. Men who exercise regularly have much lower incidence of erectile dysfunction – and the same goes for women whose libido may be suffering.

Finally, if fertility for men or women is an issue, consider adding some simple and safe herbal adaptogens with affinity to the reproductive organs into your daily habits. Shatavari for women, rich in plant estrogens, can support healthy ovulation and encourage conception. And Maca for men can increase sperm counts and motility. Taken daily, these plants can make a difference if part of a comprehensive fertility protocol.

Aphrodisiac “Bliss Balls” Recipe:

Mix together:

1 ½ cup almond butter

1 cup honey

Blend together and slowly add to the honey/butter mix:

2 cups cacao powder

2TBS Ashwagandha root powder

4TBS Maca root powder

2TBS Muira Puama bark powder

2TBS Shatavari root powder

Roll into balls about 2 inches in diameter. You can then dust them in cocoa powder or roll them in dried shredded coconut or dehydrated crushed raspberries

Valentine's Hot Cocoa

Prepare an infusion (tea) with:

About 1 teaspoon of Damiana leaves

About 1 teaspoon of crushed Rose petals

A trace of Cayenne if desired

Steep for about 5 minutes, then strain. Add:

1 TBS Cocoa powder

1 teaspoon (or more to taste) of Honey

Stir well and enjoy warm!

The above amounts are for 1 cup. Scale up for multiple cups.

Maca, Lepidium meyenii

The root of this perennial plant comes to us from the Andes of South America, where its extremely nutritious tuberous taproot serves as a food and general tonic. Recently, it has gained a reputation as an aphrodisiac for men and women, enhancing circulation, improving the quality of spermatic fluid, and positively affecting the central nervous system with its relaxing yet invigorating qualities.

Muira puama, Ptychopetalum spp.

Also known as “potency wood”, the bark of this Amazonian shrub has a stimulant and aphrodisiac quality, which increases circulation and enhances libido in both sexes.

Shatavari, Asparagus racemosus

The root of this cousin of garden Asparagus comes to us from the Indian subcontinent. It is juicy and demulcent in quality, increasing lubrication and quality of sexual fluids for men and women, though it’s traditionally thought of as a woman’s herb. It is also known as “she of a hundred lovers”, but its powers are not limited to improved sexual function: it also functions as an adaptogen, lessening the effects of stress and tension on the human system.

Ashwagandha, Withania somniferum

Another plant from the Indian Ayurvedic tradition, this root of the nightshade family is also known as “horse root”, a reference to stamina and perhaps to sexual function as well. It is another excellent adaptogen that leaves the system more resistant to stressors of many types, though it has a specific affinity to help those who are having trouble relaxing into sleep or lovemaking.

Cacao, Theobroma cacao

Theobroma means “food of the gods”, and chocolate fits the bill more than anything else on earth. Its uplifting and gently stimulating quaility is due to a precise cocktail of alkaloids that bring about a gentle euphoria and relaxation. Additionally, it enhances circulation and protects the cardiovascular system, increasing blood flow to the sexual organs while it enlivens and thrills the mind. Plus, with a little sweetness, it’s delicious!

Damiana, Turnera diffusa

Another herb from that magical cradle of power in Central America, Damiana has a totally unique flavor that is minty, spicy, and slightly bitter. It invigorates the circulation and improves sexual function while lessening the effects of the anxieties and tensions of the day.

Spring Tonics!

2010-04-28T06:30:00.001-04:00

Traditionally, the days around the Vernal Equinox (mid to late March) and the month(s) after it were seen as a time of intense, rushing energy: days get longer and the sunlight more intense, the first signs of green growth emerge, and wildlife stirs again. Herbalists still consider this a time when the more inward, ‘congealing’ energies of Winter begin to transition into the more outward, ‘expansive’ energies of Summer – and when a little attention paid to the process can improve vitality, strengthen digestion and immunity, and keep us in tune with the changing seasons.
There are specific herbal allies that have gained a deserved reputation for aiding in this transition, and each has its own peculiar “virtues” and affinities. All, however, rely somewhat on two basic strategies: either enhancing digestive and eliminative function, or bolstering the power of the body’s immune and hormonal systems. Some do both! And generally, it was (and still is) considered a good idea to start with enhancing absorption and elimination, and then proceed with strengthening the underlying physiology.
The old recipes for “root beers” can be somewhat instructive in this regard: they often feature a combination of bitter roots (which enhance elimination) coupled with aromatic, sometimes pungent ingredients (which improve digestion) and hormonal tonics (to enhance energy and vitality). Many of the herbs and botanicals listed below can be combined along these lines to make a customized spring tonic for yourself or your friends and family, helping to ride along the tides of Spring and get ready for Summer.
The last detail in the herbalists’ crafting of vernal concoctions is an attention to the constitution and physiological peculiarities of the individual using the tonic. Generally, these are pretty obvious considerations – but one point to remember is to try to add “cooling” herbs for those expressing signs of overactivity, heat, and inflammation; and “warming” herbs for those showing signs of sluggishness, depression, chill, and frequent infections. Often eliminative herbs are more cooling, and tonic herbs more warm. Botanicals listed below have their traditional energetic value added as a start in this process.

Tree sap
Often from maples (Acer saccharum, and other species), the sap of Birches (Betula spp.) can also be used. I like to use the unheated, unfiltered sap as a tonic all by itself: this “tree juice” provides unaltered enzymes as well as sugars and minerals ready for optimal absorption. It can also be used as a base for decocting (simmering) some of the roots and barks described below. Usually, a pint to a quart daily is consumed – though more is not necessarily a bad thing! Alternatively, you can reconstitute a similar liquid by using about a tablespoon of maple syrup per pint of spring water.

Burdock (Arctium lappa)
This root, generally cooling in energy though somewhat tonic too, can be eaten as one would a carrot, or simmered into a tonic brew. It is best suited for those with dryer skin, and perhaps an underactive appetite. Its chief traditional use is for acne and other skin complaints. Use about 2 TBS per pint of water, along with other herbs.

Dandelion (Taraxacum officinale)
A true remedy that synergizes well with herbs for almost any ailment, Dandelion is a catalyst for change that gently and safely enhances digestive and eliminative function. When in doubt, this is the root to pick! Its yellow flowers remind us early on that it’s time to pay a little attention to our bodies this time of year. The root’s energy is somewhat cooling, and it enhances detoxification through the liver, helping to resolve gassiness and sluggishness that may have accumulated after a winter of congestive, thick foods. Use about 2 TBS of chopped root per pint of water.

Yellowdock (Rumex crispus)
These roots are more bitter, and are best for those who might have a tendency toward constipation. They combine well with any of the other cooling, bitter roots and improve liver function and elimination. Generally, I suggest using Yellowdock for shorter (1-2 weeks) periods than Dandelion or Burdock, but it is still quite a safe plant. 1 TBS of chopped root per pint is usually adequate to relieve somewhat sluggish digestion.

Echinacea (E. purpurea, E. angustifolia, and others)
This is a cooling, dispersive root that posesses a good degree of pungency as well. Its chief use as a springtime tonic is to help boost immunity, especially if there are or have been any swollen glands or recurrent respiratory infections associated with winter illness. It can also help dry, scratchy throats that sometimes linger into spring. While I often recommend an extract, the roots are excellent too provided they are simmered for a little while (10-15 minutes). This time of year the plants are just starting to poke up from the soil, making it easy to find and dig out of the garden. Use 2 TBS of chopped root per pint of water.

Wild Sarsaparilla (Aralia nudicaulis)
An abundant relative of Ginseng, this plant posesses starches and bitter saponins that counteract fatigue and gently warm the system to enhance vitality and elimination at the same time. It also has hormone-balancing effects, especially in relation to stress hormones, making it a good adjunct for those who have intense work or personal lives, or who rely heavily on stimulants. It is a little difficult to recognize and find early in the season, before the greens emerge, so marking it out in the fall can help with digging the long rhizomes in the spring. Use a piece or pieces of rhizome about the length of your index finger in a pint of water.

Spikenard (Aralia racemosa)
Another Ginseng relative, this is a sweet, spicy and warming root that is most indicated as a tonic for hormonal and respiratory function, particularly for those with chronic lung congestion. Use only 1 TBS per pint – it is a potent ally.

Dwarf Ginseng (Panax trifolius)
Also called groundnut, this is a nourishing and rebuilding tonic that is somewhat rare in the wild, so it should be used judiciously. It flowers early in the spring, and though only a few inches tall, packs a flavor and power that is quite excellent for warming deficient constitutions that have become sluggish and undernourished over winter. If you find a good stand of it (make sure you have the correct plant ID!), you can have one corymb (a round, underground “bulb” attached to a delicate white root) two or three times a week eaten raw, straight from the forest floor, or simmered into your tonic brew.

Goldthread (Coptis canadensis)
This is a very bitter, cooling, detoxifying and anti-inflammatory plant that you really don’t need a lot of. It chief indication is chronic inflammation, perhaps also involving the skin, and a more “oily” skin pattern that could benefit from drying. It enhances digestive function when taken before meals, improves sluggish bowels, and clears heat that settled into joints and muscles over the winter months. Some have reported an improvement in allergies and sensitivities. It is also evergreen, which makes it easy to find even under a little snow cover! Its thin rhizome is bright yellow, and the above-ground greens are useful too. Use one to two plants (4-5 inches of root total) per pint of tonic brew.

Sarsaparilla (various Smilax species)
Not a local Vermont plant, the root bark from this vine is still such a classic spring tonic that it bears mention. It has a distinctive, warming and spicy flavor that, while enhancing digestion, is most powerful at adjusting hormonal balance (thyroid, adrenal, and reproductive hormones) and I have always found it useful for stubborn skin conditions such as eczema and psoriasis (often worse after the dry indoor heat of winter). Sarsaparilla has a strong flavor, so experiment with taste until you find what you like. It is usually available at the herbs store; start with ½ to 1 TBS per pint.

Sassafrass (S. albidum)
The FDA doesn’t appreciate the use of this bark anymore, due to its safrole content, which is considered carcinogenic. Its distinctive spicy/sweet and warming flavor and energy make it perhaps the most classic “root beer” ingredient, evoking memories of times when there brews were actually made from plants… And, for a few weeks each spring, consuming sassafrass provides such a negligible amount of safrole that, truly, doesn’t compare to pumping gasoline in terms of cancer risk. I would use about 2 TBS of dry bark per pint of brew, but I really like the flavor. Experiment and add to taste.

Cleavers (Galium aparine)
This green, as well as its cousin sweet woodruff, comes out a bit later in the spring but makes an invaluable cooling tonic for folks who are prone to swelling from chronic inflammation, edema, or water retention. They can be juiced and an ounce of juice taken as a daily tonic, or steeped into a more complex tonic after roots have been taken off the fire. Use about 2 TBS of chopped herb.

Nettles (Urtica dioica)
Though green, this herb is actually a bit warming and drying. It is great for those who show signs of water retention (sometimes evidenced by a swollen, “scalloped” tongue), or those in need of iron and other nutritive minerals. Finally, its mildly detoxifying qualities can help in seasonal allergies. Herbalists use the young, fresh leaves in soups or steeped into an herbal brew after the roots are done simmering – about 2 TBS or more of chopped leaves per day.

Dandelion greens (Taraxacum officinale)
We would walk through the meadows, before they fully became green with grass, looking for the young rosettes of dandelions and collecting them whole, along with the crown of the root. Back home, my aunt would dress them with olive oil and wine vinegar, for an abundant (though bitter) spring salad. These greens improve digestion, enhance elimination through the kidneys, and are loaded with important minerals. Their reputation for cooling overheated constitutions extends to the cardiovascular system. They are excellent eaten fresh as part of salads or wilted in soups or stir-fry; alternatively, steep 2 TBS of chopped leaves into an herbal brew after the roots are done simmering.

Mustard greens (Brassica species)
There are a wide range of mustards that come up quick in springtime, since they are so tolerant of late frosts. They are warm and spicy, wake up the digestion and liver, and additionally contain compounds that show much promise in preventing and treating cancer. Of course, they are best as part of a wild food salad, or cooked in soups (though they lose a lot of pungency if cooked). I don’t normally brew these into tea.

Wintergreen (Gaultheria procumbens)
This is a very aromatic and cooling plant, rich in anti-inflammatory salicylates and endowed with wonderful flavor, another aroma often found in classic root beer preparations. It is a good digestive normalizer, especially if there is a lot of gas, bloating, and irritation; it can also help with chronic inflammatory conditions of the joints and back especially if these get worse over the more sedentary winter months. Steep 5 or 6 fresh leaves in 8oz of herbal brew, covered so as to not lose the volatile aroma, and do not boil!

Birch bark (Betula species)
The black birch is perhaps the most flavorful, but the bark of any species yields a wintergreen-like essence that is similarly cooling, and much more readily available. Use a good handful of crushed bark (perhaps a cupful) per pint of water, and add it to your brew for the last two or three minutes of simmering.

A note on preparation
Many of the plants mentioned above release their medicinal constituents during a process of light simmering, known as “decocting”. The resulting brew is often called a “decoction”. It is best accomplished by simmering the herbs in a stainless steel container, covered, for 15 minutes or so on low heat. Afterwards, the brew can be removed from the heat and more delicate greens added and left in the pot, covered, for another 10-15 minutes or so. Finally, strain the brew and drink immediately, or bottle for 1-2 days.

Soy (and phytoestrogens) are safe and helpful in breast cancer

2009-12-09T06:12:00.003-05:00

December 9th's JAMA has an interesting study in it which is receiving a lot of press already. An analysis of over 5,000 Chinese women who survived breast cancer was conducted at Vanderbilt University. Dr. Xiao Ou Shu (and others) reviewed the women's intake of soy alone and in combination with Tamoxifen, and found significant evidence that consumption of soy at levels of about 1/4 cup of tofu daily is actually quite protective and lessens the chance of breast cancer recurring. There were over 30% fewer cases of recurrence in the women who consumed about 11 grams of soy protein daily.
This is excellent news and should serve as yet another piece of corroborating evidence that phytoestrogens are safe, useful adjuncts to both menopausal symptom treatment and cancer support, even in cases of estrogen-positive tumors.
The researchers at Vanderbilt postulated that the phytoestrogens "blocked" human estrogen from stimulating the estrogen receptor. A more sophisticated understanding includes an awareness of the two different estrogen receptor subtypes, and how phytoestrogens specifically activate the beta subtype. Estrogen-receptor beta seems to counteract the growth and division that human estrogen normally stimulates. It is very probable that phytoestrogens work at least in part by this mechanism in protecting against breast cancer.
One final note: the researchers in this current study kindly point out that soy from protein isolate or candy bars is probably not as good, and that the women in the study really ate whole-soy products like tofu and tempeh. To quote Gina Villani, director of heme/onc at the Brooklyn Medical Center:

"The take-home lesson is that whole foods are what we need to eat more of. Try to stay away from the processed stuff. Don't bulk up on soy milk or soy candy bars."

Ya think?

Safety of phytoestrogens reviewed

2009-11-03T14:05:00.000-05:00

Am J Med. 2009 Oct;122(10):939-46.e9.

Side effects of phytoestrogens: a meta-analysis of randomized trials.

Tempfer CB, Froese G, Heinze G, Bentz EK, Hefler LA, Huber JC.

Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria. clemens.tempfer@meduniwien.ac.at

BACKGROUND: Phytoestrogens are widely used by postmenopausal women for the treatment of the climacteric syndrome. The risk of adverse effects of this treatment, however, is unknown. METHODS: Using a fixed-effects model, we performed a meta-analysis of side effects comparing phytoestrogen treatment with placebo or no treatment in randomized controlled trials. RESULTS: We identified 174 randomized controlled trials. Side effects were reported in 92/174 randomized controlled trials with 9629 participants. The overall incidence of side effects in the phytoestrogen and control groups was 2019/5502 (36.7%) and 1824/4806 (38.0%), respectively (P=.2; incidence rate ratio [IRR] 1.01; 95% confidence interval [CI], 0.95-1.08). Comparing various side effect categories, we found significantly higher rates of gastrointestinal side effects among phytoestrogen users (P=.003; IRR 1.28; 95% CI, 1.08-1.50). Gynecological (IRR 0.94; 95% CI, 0.74-1.20), musculoskeletal (IRR 1.20; 95% CI, 0.94-1.53), neurological (IRR 0.91; 95% CI, 0.70-1.19), and unspecific side effects (IRR 0.95; 95% CI, 0.88-1.03) were not significantly different between groups. Within side effect categories, we found no significantly higher rates of side effects in women using phytoestrogens. Specifically, the rates of hormone-related side effects such as endometrial hyperplasia, endometrial cancer, and breast cancer were not significantly different between groups. CONCLUSIONS: Based on the available evidence, phytoestrogen supplements have a safe side-effect profile with moderately elevated rates of gastrointestinal side effects. Rates of vaginal bleeding, endometrial hyperplasia, endometrial cancer, and breast cancer were not significantly increased among phytoestrogen users in the investigated studies.

Statin drugs and muscle weakness in exercise

2009-10-09T16:06:00.005-04:00

"It is well known that exercise is an important disease management strategy for patients with dyslipidemia. It may be less well known that these individuals, if taking a statin and participating in strenuous activity, may be at a greater risk for muscle pain and discomfort, which can potentially lead to nonadherence to medications, physical activity, or both."

So concludes pharmacist Thomas L. Lenz who reviewed the literature on clinical trials of exercisers on statins. These drugs (Lipitor, Crestor, etc...) are by far the best-selling brand-name medications globally. They're for reducing cholesterol (though it's debatable whether they actually reduce cardiovascular mortality), so it's a shame that they seem to be mutually exclusive with exercise, one of the best (non-medical) ways to reduce LDL cholesterol, raise HDL cholesterol, and decrease death from heart disease. Reason being, they can cause long-term damage to muscle fibers that results in weakness and injury. In severe cases, widespread muscle damage can occur and can be life-threatening. Most athletes to whom they were prescribed could not tolerate their weakening effects.

What does statin-induced myopathy (muscle weakness) feel like as compared to just good-old-fashioned soreness? Lenz gives some information:

...muscle pain and discomfort that is most significant about 2 days following strenuous activity and subsides after a few days without other symptoms is most likely exercise-induced muscle soreness. If, however, the discomfort does not subside after a few days and is accompanied by flulike symptoms, patients should be advised to see their physician.

Herbal support for Influenza

2009-09-30T06:16:00.006-04:00

By popular demand, here is a copy of some notes on the upcoming flu season. Looking at the flu trend reports from Google, it seems we're already seeing a national spike in H1N1 cases - and it's not (quite) even October yet! Not to be alarmist, but herbalists can play an important role now and in the future, given the issues with vaccination and the relatively ineffectual drugs like Tamiflu.

Influenza is an acute respiratory illness caused by an RNA virus from the Orthrosynovitic family, of which three serotypes are known (A, B and C). Influenza causes an acute febrile illness with myalgia, headache and cough. Uncomplicated influenza generally resolves over a two to five day period. However, in a significant minority, symptoms of weakness and malaise may persist for several weeks, particularly in the elderly. Complications of influenza include otitis media, pneumonia, exacerbation of chronic respiratory disease, croup and bronchiolitis. Additionally, influenza can cause a range
of non-respiratory complications including febrile convulsions, Reyes’s syndrome and myocarditis. The influenza virus is transmitted primarily via virus-laden large droplets from sneezing, coughing or talking. Transmission may also occur by direct
(for example, person-to-person) or indirect (person-to-person) contact and accounts for 30,000 deaths per annum, US.

H1N1 flu (“swine flu”) is an A subtype, generally affecting the upper respiratory passages and the lungs less so, though can be characterized by a spasmodic, dry cough esp. in the initial stages. Those over 65 appear to be at lower risk because of exposure to the H1N1 type, which is the same as the 1918 flu. This serotype has been largely absent for some time. Most at risk are pregnant mothers and infants under 6 months. H1N1’s most troubling characteristic seems that it spreads 2-3x more readily that most seasonal influenzas.

H5N1 flu (“bird flu”) is also an A subtype, but appears to be much more focused on the lungs for invasion, replication, and symptoms. This serotype has been implicated with the “cytokine storm” (see below), making it more dangerous to those with health immune systems.

H1N1, which caused Spanish flu in 1918, and the 2009 flu pandemic

H2N2, which caused Asian Flu in 1957

H3N2, which caused Hong Kong Flu in 1968

H5N1, a current pandemic threat

Serotypes are determined by the Hemagglutin and Neuraminidase surface markers on the viral capsule. These markers also serve to trigger immune reactions in respiratory epithelial cells.

The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1 and have respiratory symptoms without a fever.

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Flu-like symptoms improve but then return with fever and worse cough

• 104 °F: up per range at which most bodily functions are not altered.
• 106 °F: threshold for possible seizure activity. Normally human body temperature does not rise above this.
• 108 °F: brain damage may occur due to protein destruction.
• 110 °F: human cells begin to die.
In infants aged 1 month, 101.4 °F may be a critical temperature. This rises to 102 °F at 2 months of age.

Clinically, this H1N1 strain seems to require management in 3 general phases:

Cool, clammy skin with weak (relatively) pulse requires warming herbs that are also immunomodulants. Ginger, Turmeric, Garlic. Avoid foods.
Warm, dry skin and perhaps facial flushing with strong pulse and development of spasmodic cough. Cooling diaphoretics like Peppermint, Bonest are traditionally indicated, along with respiratory antispasmodics. Cooling bitters, esp. Andrographis, can play a role here too.
Demulcents and restoratives are important for the final period which can last 2-3 weeks. Consider Licorice, Slippery Elm, Pleurisy Root.

Prevention is, of course, the best medicine. Consistently use Astragalus and Garlic, as well as assessing Vitamin D levels and supplementing as necessary. Modest, plant-rich diet and abundant sleep are also crucial. Finally, limit spread through hygiene and limited contact.

The cytokine storm does not seem to be a crucial component to the 2009 H1N1 flu, but remains a concern nonetheless. This is a severe inflammatory reaction which usually occurs in the bronchiopulmonary system and causes excessive destruction of healthy tissue. It may have been a contributing factor in the deaths related to H5N1 bird flu, as well as the US epidemics of 1957 and 1968.

This inflammatory reaction is set in motion by the immune system and involves cellular players such as helper T-cells, as well as chemicals (“cytokines”) such as interleukin-6 (IL-6), tumor-necrosis-factor-alpha (TNF), and mitogen-activated protein kinases (MAPK, specifically of the p38 variety. This latter agent seems to be a major initiating player and is overexpressed as part of the reaction to certain flu strains). Additionally, if exposed to strains that show evidence of initiating a cytokine storm, virus-infected cells seem to exhibit increased resistance to the inflammatory chemicals that would normally hurt them.

Caution may be advisable with herbal agents such as Echinacea and Elderberry which may stimulate TNF and other cytokines. However, this danger is unclear. More important is the addition of herbs that down-regulate dangerous cytokines while also exhibiting antiviral effects (for instance, St. John’s wort, Baikal Scullcap, Salvia milthiorrhiza, Ginger, Turmeric).

The role of vitamin D in the seasonal nature of the flu bears mention. It has been postulated (Bergner et.al.) that the crucial role of D in promoting healthy immunity.

The crucial role of vitamin D in the innate immune system was discovered only very recently. Both epithelial cells and macrophages increase expression of the antimicrobial cathelicidin upon exposure to microbes, an expression that is dependent upon the presence of vitamin D. Pathogenic microbes stimulate the production of an enzyme that converts 25(OH)D to 1,25(OH)2D, a seco-steroid hormone. This in turn rapidly activates a suite of genes involved in pulmonary defense. In the macrophage, the presence of vitamin D also appears to suppress the pro-inflammatory cytokines. Thus, vitamin D appears to both enhance the local capacity of the epithelium to produce endogenous antibiotics and at the same time dampen certain destructive arms of the immune response, especially those responsible for the signs and symptoms of acute inflammation, such as the cytokine storms operative when influenza kills quickly.

While it is unlikely that the increased deaths in healthy, young adults in the 1918 flu pandemic were entirely due to D deficiency, it is important to ensure adequate immunity esp. in the at-risk populations through testing (if necessary) and supplementation.

Herbal support and supplementation notes:

· Preventative health:

Vitamin D

The only supplement I recommend adding if your diet is adequately plant based. Recommended blood test levels are around 35 ng/mL, but that’s just for adequate calcium metabolism. For immune function, required levels are closer to 50 ng/mL. Supplementation with 5,000 IU daily is necessary.

Astragalus

As a preventative, it should be withdrawn once symptoms begin. Take 3-5 grams of root daily in capsule, or simmer 2-3 TBS in a pint of water and drink through the day. Tinctures are taken at 1 tsp doses once or twice daily.

Garlic

Directly antiviral, ameliorates influenza symptoms, and its pungent compounds have been found to reduce cytokine storm. 3-4 cloves daily is ideal, as close to freshly cut as possible (chop first).

· Herbs that are directly anti-influenza:

Note: for most antiviral herbs, frequent dosing is relatively important in order to maintain physiological levels of herbal medicine ahead of the viral replication curves. Viral populations can easily more than double in an 8 hour period, so it is beneficial to work with antiviral and anti-inflammatory herbs on a 6-8 dose/day schedule. This is a dose roughly every 3-4 hours.

Boneset

Infusion, 1 TBS per pint along with other herbs, sipped every hour or so. Tinctures can also be used, 45-60 drops in warm water every hour or so.

Elderberry

Amazing clinical results against most influenza strains. Safe for H1N1, perhaps caution in H5N1 or other cytokine-storm-inducing strains due to potential TNF stimulation.

Use syrups (1TBS 3-5 times daily) or a fresh preserved succus / juice at the rate of 1tsp every 2-3 hours.

Elder flower tea is useful also, as a cooling way to induce sweating in the latter phases.

Echinacea

There is evidence of activity against influenza viruses, especially when combined with Thuja and Wild Indigo (Esberitox). It is potentially contraindicated in cytokine-storm influenza. Use Esberitox, or a good fresh tincture at doses of 1tsp. every 3-4 hours. Usually best at the first signs of imbalance – fatigue, sore throat, headache.

· Herbs that reduce cytokine storm activity and buffer “hot” influenza symptoms:

Baikal Scullcap root

Reduces cytokine storm and acts as an inhibitor of influenza symptoms. Take 60-90 drops three times a day of a good tincture. Avoid in cases of diarrhea.

Salvia milthiorrhiza root

Immunomodulant for cytokine storm, esp. with a constricted, wiry pulse. Take ½ tsp. of a good tincture three times daily.

Ginger and Turmeric

Both rhizomes are anti-inflammatory and inhibit inflammatory cytokines. This protects respiratory tissue as well as relieving symptoms. Most indicated in the initial phases of the flu as warming agents. Add fresh ginger to teas, or use powders of both at doses of 1-3 grams 2-3 times daily (about ¼ to ½ tsp.).

St. John’s wort

This is a potent antiviral herb, prized as a restorative in deficient, depleted constitutions. Modern evidence points not only to its pharmacological effect on dampening the cytokine storm by suppressing IL-6 and MAPK, but also to its targeted and specific antiviral effect against the H5N1 strains of bird flu, both in the petri dish and in infected poultry. The dose of tincture is 90-120 drops three times daily.

Cannabis?

This herb is potentially a down-regulator of TNF in certain situations, and may have a role to play in especially “hot” influenza strains. It is also an activator of the endogenous cannabinoid system, which stimulates immunoglobulin production in the respiratory epithelium. Not for smoking – low doses of oil-based preparations are best.

Adjuvant herbs (beyond the virus and inflammation):

Dry, spasmodic cough:

A very intense and painful cough can accompany H1N1 2009 influenza. It usually appears after the first 24 hours or so, and affects the beginning of the bronchial tree causing violent coughing with whole-body spasms. The warm drying expectorants (such as Elecampane, Mullein, and Aster) are probably best avoided in favor of the soothing, demulcent expectorants listed below.

Licorice

Its antiviral action may be due in part to the inhibition of virulence factors such as the hemagglutin proteins on the viral capsule. While it is still unclear if it has specific inhibitory effect on H1N1 or H5N1 strains, it remains an excellent demulcent for people of all ages and reliably loosens the dry cough within a day or at most two. This is especially important to help with disturbed sleep. Tincture, 2 droppers in a little water every 2-4 hours. Infusion, 1 TBS of root per cup. 1-2 TBS of infusion every 2-4 hours.

Pleurisy root, Butterfly weed

This demulcent expectorant is particularly indicated if the re is a burning sensation in the chest wall that accompanies the cough. Any spitting of blood, while perhaps a clear sign of cytokine storm and certainly of the need for immediate treatment, was traditionally an indication for this herb. It is also relaxing and mildly diaphoretic. Take 30-60 drops of the tincture 3 times a day.

Lobelia

Strongly antispasmodic, it relieves the whole-body paroxysms associated with the dry bronchial cough and is also a gentle expectorant. Use 10-30 drops of tincture every 3 hours or so, depending on tolerance because it is quite nauseating if given in excess.

Wild Cherry, Peach pit

These herbs contain glycosides of hydrogen cyanide (HCN), which in small doses is calmative and strongly antispasmodic to the lungs. They are valuable as part of a comprehensive protocol that also includes expectorants and antiviral herbs. Cold-infusion is best. Heating dissipates HCN readily tincture is dosed 5-30 drops bid. Wild Cherry bark syrup: 1 pint overnight cold infusion of 1 oz bark; strain, add 2 lbs honey.

Diaphoretic herbs not previously mentioned:

Honeysuckle flower

This remedy from the Chinese pharmacopoeia helps to cool and break a fever. Best during the first and early second stages of the flu to release internal heat and bring warmth to the surface. Usually infused, along with Platycodon for the lungs, Catnip as another antiviral diaphoretic, peach pit as a pulmonary antispasmodic, and Licorice.

Catnip herb

Especially useful as a mildly calmative antiviral diaphoretic for kids. Usually added to tea blends, perhaps with a little Ginger and/or Licorice.

Peppermint

Has some mild antiviral quality, and certainly is cooling and helps break a fever, as well as improve the flavor of herbs such as Boneset. A classic formula: equal parts of Peppermint, Boneset, Elderflower, and Yarrow in the late first / early second stage of the flu, when heat is manifest but the skin still dry and the body still achy, with a tense, tight pulse.

Bitter tonic herbs with antiviral / mucosal tonic effect:

Goldenseal

Not antiviral, but astringent and tonifying to the upper respiratory mucosa. Can alleviate congestion and improve appetite in the second or third stages of the flu.

Andrographis

Also called the “king of bitters”, this herb has shown excellent results when combined with Siberian Ginseng in large trials for the flu. It has antiviral effect and also improves GI tract function and may help regulate cytokine activity and prevent the cytokine storm.

dried herb - 1.5- 5 g/day; tea- 1/2- 1 teasp. steeped in 8 oz water, drink 4oz 3 X day
tincture- 20-60 drops 3 X day. standardized tablets- 100mg. w/ 5mg andrographolide and deoxyandrographolide, take 4 tablets 3Xday

Adaptogenic herbs not previously listed:

Panax quinquefolium

This is the American ginseng root, and while most of the evidence in humans pertains to the cold rather than the flu, it has good immune-enhancing (modulating) effect. It is especially indicated if there is severe stress and/or recurrent infections of all types related to deficient immunity. Take ½ tsp. of tincture 3 times daily, or 2-7 grams daily as whole root or capsule.

Siberian ginseng, though a very different plant, can be used similarly.

Specific pulmonary anti-inflammatory herbs not previously listed:

Platycodon

The balloonflower is used in Chinese medicine to clear heat from the lungs. As such, it seems more specific for the dry, painful and recurrent bronchitis than for moist, low-grade symptoms. It makes a good addition to tincture formulas for those who always have “every cold go to the lungs”. 30-90 drops of tincture 2-3 times daily.

Hyssop

Yet another effective antiviral herb that is gaining more attention in modern times, it is an excellent herb for lung afflictions of the more moist / hot variety. As such, it perhaps has a role to play in the later phases of influenza and to help with recovery. Infusion is excellent, about 1 TBS / cup steeped with a lid 3 times a day.

Top 200 drugs in the US - 2008

2009-07-17T06:22:00.002-04:00

Jón T. Njarðarson's team at the University of Cornell has put together an interesting poster listing the top 200 pharmaceuticals used last year, ranked in order of sales dollars. Ostensibly there to "educate students about how chemistry positively impacts our lives" (debatable, I guess), it is a useful list because it gives the brand names, chemical structures, and general uses of these drugs we so commonly run in to in practice. A useful quick-reference (and an alarming amount of money spent).

Integrative mental health - an herbalist's ideas

2009-07-02T20:57:00.002-04:00

Just a quick note for those interested in the outline for some general approaches / suggestions for the herbalist seeking to provide support in the management of mental health issues. This document includes suggestions on assessment process, goal-setting, general tonification approaches, and specific herbs for mental health symptom profiles.
My feeling is that disease labels are not helpful in approaching this aspect of health. Rather, I like to focus on symptoms - highs, lows, fluctuations - and the constitution in which they are presenting. Herbal suggestions are presented from this point of view.

Integrative student clinic at Johns Hopkins

2008-11-01T09:35:00.003-04:00

Allegra Hamman has just been hired as a clinical herbalist to complement the care provider team at Johns Hopkins' Student Health and Wellness Center. She is a nurse practitioner (advanced training, similar to that received by a physician's assistant) with years of experience in the conventional medicine field. This June she received her Master's Degree in herbal sciences from Tai Sophia Institute, making her eminently qualified for her new position.
Though I don't know Allegra or her professional style, I am encouraged to see prestigious institutions such as Johns Hopkins responding to the demand they see in their clinics. As Alan Joffe, clinic director, put it: "There is clearly a group of students at Hopkins who prefer approaching health from a perspective other than what traditional Western medicine has to offer; I want to provide those students with some of those services."
Finally, I believe herbalists, as "generalists" well-equipped to handle a variety of complaints commonly seen in the "family practice" setting, can do a lot meet the needs created by a nationwide physician shortage. We represent an effective treatment modality, with a long historical record and excellent safety. Of course, there will always be those at institutions such as Hopkins who have to push back hard against these changes - largely, I might add, out of ignorance of the herbalists' skills and qualifications.

The benefits of Nature for children with ADD / ADHD

2008-10-19T08:54:00.006-04:00

File this one under the "let's spend grant money to research the obvious" category: it seems that walking for about 20 minutes in a park, surrounded by trees and Nature, is as effective as Ritalin for managing some of the symptoms commonly classified under the "attention deficit" umbrella.
Researchers recruited 15 boys and 2 girls and walked them for 20 minutes in one of three settings, on different days: an urban park, a residential neighborhood, and a downtown area. Those who walked in the park showed significant, powerful improvements in their ability to concentrate and perform after their walk. The others did not. While these results may seem obvious to us, we can at least gain some measure of comfort in knowing that the mainstream medical community feels like "doses of nature might serve as a safe, inexpensive, widelyaccessible new tool in the tool kit for managing ADHD symptoms" as Dr. Andrea Taylor, head researcher for the study, wisely commented.
Now, I might feel that a walk in the Vermont woods, as they turn from green to fiery red, might give an even better experience to nurture biophilia, provide renewal and inspiration, and calm a scattered mind. But even a manicured park can do the trick! So finding time to spend outside, away from television, houses, and buildings, is a good idea for our kids. And "nature deficit disorder" might soon be recognized as a legitimate concern. Imagine that...

Bacterial resistance update

2008-05-14T06:01:00.006-04:00

Triclosan, a chlorinated polyphenolic compound found in a range of consumer products, has been touted as "antibacterial" and somehow linked, by extension, to providing safety and reducing infection in hospitals and homes. Thus, it's found its way over the last twenty years into soaps and cleansers, and more recently toothpaste (scary).
Scientist at the University of Michigan in Ann Arbor reviewed relevant research on this chemical and the products that contain it, and came to the inevitable conclusion: it doesn't really work at reducing infection rates in hospitals, nor is it any better than regular soap at reducing bacterial levels on hands. And, of course, they tracked and documented cross-resistance amongst bacteria exposed to Triclosan and those who've never tasted the stuff: these ubiquitous antibacterial preparations are contributing to bacterial adaptation and resistance. Our environment is awash in these types of substances already, and bacterial resistance is increasing. Antibiotics, which can be lifesavers in emergency situations, are one thing (overused, granted). But no one should be purchasing these Triclosan-containing products which are ineffective and dangerous to the environmental balance.

Spring in Italy - pt. 1

2008-05-12T07:05:00.006-04:00

We returned to Italy in the last two weeks in April (mud season up here in Vermont), and got an amazing jump on Spring. For me it was a chance to see all my family again - it had been way too long! - and reconnect with old friends. Along the way, of course, we found many old friends of a different sort, like this flowering pink peony (Paeonia spp.)

Wild Clary Sage (Salvia sclarea)

Flowering Hawthorn (Crategus spp.)

Figs (Ficus carica)

Flowering Rosemary (Rosmarinus officinalis)

Hawthorn for a failing heart

2008-05-12T06:08:00.006-04:00

Hawthorn (various Crategus species) received an endorsement in another Ernst-and-friends metareview. The review included 14 trials, and focused on hawthorn's ability to improve the maximum workload of the heart, and improve various cardiovascular markers during exercise-induced strain. The bottom line: hawthorn leaf and flower extract helps. A lot. Even if added to existing medication regimens.
Just to be clear, no new clinical research is coming out of this review. Rather, it attempts to collate existing studies and compare them using a common denominator. Further details on the data are below, but for now my opinion continues to be that hawthorn, either as a berry, a tasty jam, or as a leaf-and-flower extract (or tea), should always be considered as part of the protocol for cardiovascular weakness or imbalance. In fact, I might go further to say that most colorful berries would accomplish similar effects and that, in fact, a nice cocktail of all sorts of berry fruits is probably the best way to go for managing blood pressure, improving capillary integrity, and increasing the efficiency of the heart muscle. Eat well!

Canadian herbal product regulation

2008-05-10T07:16:00.002-04:00

There's a somewhat alarming development afoot in Canada relating to the sale, use and dispensation of herbal medicines and "natural" supplements. We've been following the discussion on herbal product regulation here in the United States, and looked briefly at the impact that Canadian legislation passed in 2004 (very similar to the FDA's current rules) and the impact it's had on herbalists.
Now, the Canadian Ministry of Health is attempting to pass a bill that would radically step up enforcement of the new, stringent rules. These regulations are largely based on the framework of the Codex Alimentarius, a global agreement designed to 'harmonize' the preparation and dosing of various medicinal substances, from vitamins to herbs. Therefore, herbal products would have to be of ineffective potency and completely divorced from any health claims to be able to skirt this new legislation. No longer interested in regulating only drugs, the Canadian government wants to broaden its scope of oversight to all 'therapeutic substances' with this new law. Oh, and it steps up resources for enforcement and lowers the requirements for search and seizure (beware the herb police).
Many are showing righteous concern (here's a good legal summary from a concerned perspective). If the trends continue, we could see this coming in the United States soon.

Echinacea as a common cold preventative - again

2008-04-28T01:58:00.003-04:00

We've been over in Italy for the last few weeks, and updates here are difficult. I'll be posting some photos of wild springtime herbs soon, but for now a little tidbit that will surely make news (because it shows a negative result for an herbal intervention): another study tells us that Echinacea doesn't prevent the common cold.
90 volunteers received 3 caps pf Echinacea purpurea tops twice a day for 8 weeks, and reported 8 sick days vs. 12 for placebo. This is an 'insignificant' result. I'm not sure when the research community will figure out that this is a) an inappropriate dose and delivery system and that b) it is an inappropriate application of the herbal remedy.
Perhaps that's not the point. Perhaps media articles that say "Echinacea fails" are more enticing than actual helpful research. I just wish someone would send me the funding that researchers get for conducting these trials so I could buy more compost for my garden...

Devil's Claw and rheumatic inflammation

2008-04-08T06:24:00.008-04:00

Devil's Claw (Harpagophytum procumbens) is native to South Africa, lives in dry soils, and produces large underground tubers that are a source of both food and medicine.
The tubers are rich in flavonoids, phytosterols, and a particular type of bitter iridoids (one of which, extensively researched, is known as harpagoside and usually serves as the 'marker compound'). It is traditionally used as a tonic for the digestion, helping to improve appetite and assimilation while also being very nourishing. It has also served as a general depurative and diuretic.
More recently interest has focused on its analgesic and anti-inflammatory qualities, with a range of human trials in the literature that expand on lots of pharmacological data (Doloteffin, the standardized aqueous extract of the whole tuber used in many trials, yields about 50mg of harpagoside per dose). Seems best for back pain, osteoarthitis, and muscular pain -- or generally, most chronic conditions involving structural inflammation.
A new study for the first time looks at Devil's Claw in chronic inflammation of autoimmune origin. It's not placebo-controlled, but rather focuses on qualitative impressions from the clinicians and the patients regarding long-term rheumatic inflammation of the knee, hip, and various other joints. Over 200 people were included in the study, though folks taking H2 and proton-pump inhibitors (two varieties of heartburn drugs) were turned away because of the potential for herb-drug interactions. Patients were followed for 8 weeks (with a mid-course checkup at week 4) and, with an eye to safety, were also evaluated through a blood analysis that looked at comprehensive blood counts and liver enzyme levels.
Bottom line: the only adverse events reported weer occasional mild GI upset. Over 50% of participants rated the results as "good" or "excellent", with assessment criteria showing a reduction in pain and stiffness, and improved joint function across the board. Additionally, no changes were seen in any blood values, showing that Devil's Claw is well-tolerated, has no liver toxicity, and works quite well for rheumatic joint pain.
A final note: the authors recorded that a majority of NSAID (aspirin, ibuprofen) users scaled back or eliminated the use of these painkillers during the study, because they no longer were necessary. They go on to point out that, since rheumatic complaints are chronic but have 'flare-ups', the Devil's Claw could be used for long-term management and the NSAIDs added only as needed. This would reduce the chance of side-effects from the medication, and improve patient well-being overall.

Late winter lichens

2008-03-28T16:38:00.001-04:00

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.

Sage improves memory and attention

2008-03-24T09:33:00.004-04:00

'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?

2008-03-19T07:33:00.003-04:00

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

2008-03-11T07:22:00.004-04:00

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

2008-03-10T08:19:00.004-04:00

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

2008-03-10T07:49:00.007-04:00

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

Current Herbal

Herb Med Pro
www.gaiaherbs.com/herbs.php

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
www.who.int/medicinedocs/index.fcgi?a=d&d=Js2200e

WHO Monographs on Selected Medicinal Plants - Volume 2
www.who.int/medicinedocs/index.fcgi?a=d&d=Js4927e

WHO Monographs on Selected Medicinal Plants - Volume 3

http://www.who.int/medicinedocs/collect/medicinedocs/index/assoc/s14213e/s14213e.pdf

Plants-for-a-future Database Search
www.ibiblio.org/pfaf/D_search.html#NAME

Select from a wide range of plants, based on edible, medicinal, and agricultural uses. Extensively referenced.

Materia Medica Articles Index

www.medherb.com/Materia_Medica/materia_medica.htm

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

Jim Duke's Phytochemical and Ethnobotanical Databases
www.ars-grin.gov/duke/

A searchable database of plants providing chemical
constituents, cross-linked with the actions of said chemicals. An
interesting exploration of phytochemistry.

PLANTS Database | USDA PLANTS

plants.usda.gov/index.html

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

www.henriettesherbal.com/

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
www.herbaltherapeutics.net/herbal_therapeutics_lib...

David Winston's Online library

Maude Grieve's "A Modern Herbal"
www.botanical.com/botanical/mgmh/comindx.html

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
www.med.yale.edu/library/historical/siderits.htm

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

www.illustratedgarden.org/mobot/rarebooks/

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
www.merck.com/mmpe/index.html

Professional version of the manual of human disease, including mainline conventional treatment and medications used.

eMedicine The Continually Updated Clinical Reference
www.emedicine.com/

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
www.nutritiondata.com/

Specific nutritional information on almost any food or prepared product. Portion sizes, conversions, and cross-references.

Plant People

2008-03-08T10:12:00.004-05:00

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

2008-03-07T06:33:00.003-05:00

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'.

Large study finds association between headaches and digestive symptoms

2008-02-28T08:05:00.002-05:00

A large study conducted in Norway points at some definite links between headaches and GI tract complaints like acid reflux (see figure on the left), nausea, constipation, and diarrhea. Over 60,000 people participated, and the results were adjusted for sex, age, education, depression, anxiety and use of medication. The clearest connection was between headache frequency and GI symptoms (rather than severity, or simple headache occurrence). All reported symptoms were evaluated clinically (quite a feat!) and so there is some measure of objectivity to the data as well.
The authors rightly point out that, while there's been a decent smattering of research on migraines and GI complaints (esp. nausea), none has been conducted on headaches in general. This is interesting because to me a non-migraine headache is more indicative of generalized neuromuscular tension and inflammation, and thus we might speculate that this study shows that GI tract irritation is linked to inflammation in other parts of the body. Which came first is not as important to me as the fact that an intervention in the gut may be able to help inflammation in areas far from the gut. In the author's words,

"There is anatomical and functional evidence of convergence between nociceptive and viscerosensory systems involved in reflexes and homeostatic and behavioural control of autonomic outflow".

Now of course, this is not news to herbalists. Demulcent herbs (like Flax) have long been used to alleviate not only GI tract inflammation (most directly), but also respiratory, urinary tract, and neuromuscular inflammation. Simon Mills' concept of acupharmacology (an excellent overview on page 11 of this newsletter) does a lot to explain these mechanisms in more detail. But I am heartened to see this trend in modern medicine (see the now mainstream asthma/reflux connection): perhaps there are linkages between different functional processes in the physiology... perhaps dietary influences on the GI tract can actually help issues elsewhere... maybe human beings need a more broad approach, one that encompasses their bellies, their spirits, and their individual constitutions. Or, at least, as the authors conclude:

"It is important to consider the total burden of discomfort in these patients in order to provide for the best treatment, and the prognosis as to overall function may be determined not only by headache, but also by the comorbid conditions".

So careful with high-dose NSAIDs for those chronic headaches - it might upset an already upset belly. Well, at least it's a start...

HerbMed Pro

2008-02-20T07:07:00.008-05:00

Thank you to Larken for picking up on a new, free location for accessing HerbMed Pro. You can visit Gaia Herbs for the full list of over 200 referenced herbs, or enter a search below.
This database is a great place to start for contextualized research on the properties and applications of medicinal plants. Be wary of modern studies: please read Henriette's quick primer before delving into PubMed abstracts...

Search HerbMed Pro:

Herbal research often of 'higher quality'

2008-01-27T08:02:00.000-05:00

A study published last yea r in the Journal of Clinical Epidemiology looked at over 80 clinical trials in Western phytotherapy and compared them to similar trials (matched in size, power, scope, and results) in conventional medicine. It's often believed that trials focused on herbal medicine are of inferior quality, relying on poor methodology, and therefore less trustworthy. Of the studies analyzed in this review, over 20% of those focused on herbal medicine were deemed of 'higher quality', while only 5% of those for conventional medicine met the same standard.
While this is not conclusive proof that studies on herbal remedies always have better methodology (see this correspondence for an good opposing viewpoint), it does at least make us question the validity of the mainstream rhetoric that always portrays herbal science research as inferior and therefore unreliable.

Cordyceps video

2007-12-27T09:43:00.000-05:00

Best wishes for a happy New Light and New Year to everyone!
I'd like to share an amazing video of the Cordyceps fungus (many different species are shown) parasitizing an ant. The time-lapse effect is incredible, and gave me a very visceral connection to these mushrooms I often use and recommend for their ability to enhance life, energy, and stamina in human beings. As always, many sides to every story and many strands in the ecological web.
Via the wonders of MetaFilter.

Cannabinoids may modulate the spread of cancer cells

2007-12-27T09:35:00.001-05:00

Matrix metalloproteinases (MMPs) are a family of enzymes that are involved in many physiological processes, helping to balance inflammatory signals; regulate cell growth, division, death, and cleanup; and model new tissues and blood vessels. They seem to play a central role in tumor metastasis and survival in many cases.
New research out of Germany looks at the role of anandamide and THC in reducing the invasiveness of cervical cancer cells, and seems to indicate that invasion is reduced through the cannabinoids' inhibitory effect on MMPs. The results look promising, even though they are still in vitro, and give us another insight into the immune- and inflammation-regulating power of Cannabis in the human physiology.

Chemically modified curcumin

2007-11-09T06:49:00.000-05:00

Curcumin, one of the polyphenols present in Turmeric, has a long track record of positive research relating to its anti-inflammatory, anti-cancer, and liver-protective effects. It is a mild and generally well-tolerated addition to the diet, and even concentrated extracts of the Turmeric rhizome (like New Chapter's TurmericForce) work well without having to take multiple daily tablespoons of the spice (see here for my articles on this spice).
Now, Japanese researchers have gone in and chemically modified curcumin, which is already an isolated constituent of Turmeric and contains none of its beneficial mucilage and fewer aromatic constituents, and given these modified chemicals to rats with colorectal cancer. The results: the new chemicals seem to work better.
My main comment on this research, other than the fact that it was performed on rats, is that it continues the misguided trend of taking botanical substances, refining them, and modifying them for an 'enhanced' effect in the human physiology. Historically, my favorite example of this trend is the opium -> morphine -> heroin chain, which has certainly done wonders for the human race. The problem with this approach is that we have no understanding of, and therefore no way to predict, the effects of long-term supplementation with substances our physiology hasn't ever seen. This is in contrast with unaltered, whole-plant preparations, which are not only familiar to our metabolic pathways, but probably created those pathways to begin with.
In the long run, many modified chemicals, while potent in the short term, leave the body with unwanted side-effects and often further weaken the system. I am fully in support of ongoing research into the chemistry and effects of plant constituents, but please, let's wait a little until applying them to humans in refined, or modified, forms.

AHG Symposium - Part 3

2007-11-02T06:43:00.000-04:00

This is the third and final post in a series reporting on this year's Herbalists' Guild convention. Part 1, Part 2.

Simon Mills, author of some of my favorite herb books such as Out of the Earth, lectured on his idea of acupharmacology. The basic concept is that part of herbal medicine's effects can be understood by observing their effects on the gastric mucosa, an internal second skin, and the reflex pathways between the gut wall and the rest of the physiology as modulated by the central nervous system. This is just one of the ways herbs do their thing - but if you've ever seen the effects of a demulcent on anxiety, you know what I mean.
Simon went on to discuss the relationship of gut tissue not only with neurons, but also with the immune cells and tissues embedded in the gastric lymphatic system. The endocrine / immune secretions from these tissues serve as another channel of systemic effect, modulating stimuli received from herbs. He continued with a fascinating exploration of the role of the immune system in many pathological states. Some highlights:
- Pierre Graber, old-school immunologist, described a different understanding of the immune system in a 1974 paper in the Lancet (not much info available online). Rather than a "police squad", he viewed the immune system as a clean-up crew to support digestive processes (by removing any antigenic protein chains left undigested) and to support tissue autolysis (help clean up old pieces of tissue to make way for the new). Additionally, antibodies seem, in Grabar's view, to be more like transport proteins than markers of certain doom. They attach to these incompletely digested proteins and pieces of old "self" to make sure they don't interfere with cell-to-cell signaling as they get escorted to phagocytosis.
- Protein sequences on bacterial cell walls can be very similar to sequences found on our own cells. This has led to the identification of initial "insults" by bacteria which activate the immune response and lead it to attack self: for instance, Kelibsella and ankylosing spondylitis; Proteus bacteria and Parvovirus in rheumatoid arthritis; Mycobacteria and E. coli in Crohn's disease. This is not only interesting in terms of understanding autoimmunity, but reinforces the idea that herbs can modulate these inflammatory processes by acting through the immune system (and thus across the whole physiology) without their metabolites ever needing to leave the gut.

Along these lines, Kevin Spellman went into a fascinating discussion, including the presentation of his original research, on the role of Echinacea and Dandelion roots in treating an allergic reaction. The details:
- three cases involving rashes, hives and anxiety following the ingestion of an unknown Chinese herbal formula (different in each case, I presume).
- treatment with high doses (1tsp every 30 minues, roughly) or Echinacea and Dandelion root tinctures, which helped almost immediately (after the second dose).
- Kevin proposed that Echinacea (and Dandelion, though differently -- perhaps through inulin and its acupharmacological effects) helped diminish the acute allergic Type-4 hypersensitivity in the three cases.
- Echinacea modulates the expression of pro-inflammatory cytokines by acting on cannabinoid receptors on the surface of immune cells, and lessening the production of NF-kappaB and therefore the transcription and expression of inflammatory proteins.
- Kevin (and Nadja Cech, amongst others) showed that Echinacea alkylamides suppress IL-2 production, a pro-inflammatory cell-to-cell signaling molecule. This build on previous research showing similar results.
- Coupling these new results with Echinacea's history of use as an immune booster, we see a complex emerging picture of this plant as a true immunomodulator. Regardless, it gives us an interesting hypothesis for understanding how and why this plant might have helped in an allergic reaction! And, it continues to debunk the idea that Echinacea shouldn't be used in autoimmune conditions.

Robert Duggan, President of Tai Sophia, gave the keynote lecture at the banquet (love that Sheraton, guys!). He offered some beautifully iconoclastic pearls of wisdom:
- Don't let people off the hook by telling them you will "treat" their disease. Illness is an ally!
- Natural healing modalities function as ways to increase perception and consciousness, thereby allowing one to listen to and act upon the messages illness brings.
- Don't let herbalism become what acupuncture has - licensed, squabbling over recognition, standardizing treatment. And this from a man who, though he regrets it, spearheaded the original licensing push by acupuncturists.

Chris Hobbs talked about herbs for the respiratory tract. (His powerpoint for the lecture should be available soon). Some new info for me:
- Useful expectorants: young fresh tips of English ivy; Maidenhair ferns; Smilacina (False Solomon's seal) roots.
- Willow bark should be collected in the spring, well before leaves appear, and only from small, juicy branches. Its aromatic, wintergreen-like smell should be clear and strong. Higher elevation sources seem more potent.
- Honeysuckle (Lonicera japonica) for fevers - cooling and delicious!

There was an infectious disease round-table in which I participated. We talked about the emerging problem of antibiotic resistance (esp. MRSA in clinical herbal practice) and herbal approaches to treatment: Echinacea, Baptisia, Cryptolepsis, Artemisia, and topical preparations. We also discussed the threat of pandemic influenza, and divided its risk into two main categories: the pathogen itself, which can kill people with weak immunity (young and old, especially); and the inflammatory cytokine storm that accompanies the infection in those with strong immunities, basically liquefying their lungs. In the latter case, immunomodulants like Scutellaria baicalensis (and perhaps high doses of Echinacea alkylamides, see above) might be more useful than actual antivirals.

Finally, it was great to see old friends and make new ones. Mischa is getting a study together on the use of Wild Carrot seed in contraception. I got to meet Maria, of Dirt Under My Nails fame. Check out her symposium post for info on lectures I didn't attend. And many thanks to Jillian, who was kind enough to host us, join in some late-night music making, and expose us to some interesting Aguardiente combos from the Amazon. I came home inspired with new ideas, and excited about the new herb school we're starting in Montpelier.

AHG Symposium - Part 2

2007-11-01T06:25:00.000-04:00

This is a continuation of the conference report for this year's gathering of the American Herbalists' Guild.
Pam Fischer, from Berkeley, CA, discussed the free clinics she's set up and been involved with for over 7 years. It was an interesting discussion, and I enjoyed looking at diverse models of herbal care accessibility, hearing 7Song talk about the Ithaca Free Clinic, and mentioning my own work. Pam had some interesting models to discuss, and some pearls of wisdom from her own experience:
- herbalists have been joining up with pot clubs in the Berkeley area to offer their help with medicinal herbs other than Cannabis. Great idea! Tough here in Vermont.
- echoing my own experience, Pam recommends hiring a paid administrator / staff person to prevent volunteer burnout. I highly recommend this.
- running a clinic that is completely "free" can be politically correct, but it can also shut out folks who might want to contribute financially. Pam's clinic is entirely by donation; she calls it a "community herbal clinic", and focuses on its role in supporting the herbal community rather than its "freeness". This is an interesting point; I'm still not sure where I stand on this issue (having generally seen good compliance rates, good followup, and plenty of donations even when advertising as "free").
- compensation for the herbalists is derived from a pool of funds. This pool is fed by individual private practice sessions, donations, apothecary sales, and student tuitions.

Paul Bergner, of Medical Herbalism fame, gave a nice introduction on energetic assessment and its importance in the herbal consultation and in formulating a treatment plan. After all, if we can't tailor our recommendations to individual constitutions, we're just treating disease! Generally, herbs work a heck of a lot better if they're matched to individual constitutions. This also is the basis of one of my complaints with the double blind, placebo-controlled trial: almost none have a way of dividing populations based on simple constitutional profiles: diaphoretics may help improve circulation in a 'hot' constitution with cold hands and feet, but will do little for a 'cold' constitution with the same issues. Some interesting points:
- Three polarities: vitality / deficiency; hot / cold; moist / dry. You can figure these out with just a little common sense and good observation!
- If there is low vitality, there are usually three potential reasons why: low rest, low digestive fire, or poor food. To this I'd add an assessment of exercise and movement, too.
- As vitality is restored and the physiology becomes more capable of producing an inflammatory reaction, it will. This is the 'healing crisis', and follows Hering's Law of Direction of Cure.
- Healing crises show up in personal relationships (plateau -> conflict -> higher level) and in society as a whole. If fact, Paul made the case that our society is very deficient in vitality, because it doesn't react violently anymore. There are few protests, and little activism, compared to 45 years ago. His assessment: an acute illness that flared in the 1960s was generally suppressed. Emotional symptoms followed, and were expressed in the 1980s with its greed, corruption, and societal stratification. This was also suppressed, and now in the 21st century our illness has become spiritual...
- The rest of the lecture was a review of pulse and tongue assessment and its role in determining relative degrees of heat and moisture. Paul was clear to say, and I agree, that pulse and tongue are merely corroborating signs, and not definitive diagnostic tools.

...more to come, including Simon Mills and acupharmacology; Robert Duggan and some amazing philosophy of healing; infectious disease clinical roundtable; some herbs for the respiratory tract as suggested by Chris Hobbs; and original research by Kevin Spellman on Echinacea, Dandelion, and autoimmune inflammation.

AHG Symposium - Part 1

2007-10-31T08:18:00.000-04:00

Well, this year the American Herbalists' Guild conference is being held in Columbia, MD at a big Sheraton in the middle of a corporate office park. Certainly not my favorite setting -- but some excellent people nevertheless.
The session began on Friday morning with the annual meeting of guild members. It was led by Aviva and Tracy Romm, President and office manager for the Guild (Tracy also organizes the conference). Some highlights from the conversation:
- Aviva is interested in growing the Guild, recruiting more members, gathering more funds. She also lamented the fact that the grassroots, volunteer-based flavor that shaped the Guild ten to fifteen years ago has fallen away as full-time staff has taken on greater responsibility. My feeling is that putting money into a national organization might not be as effective as mobilizing the grassroots again. And, as K.P. Khalsa (herbalist and finance guy) pointed out in his report, the Guild makes between $2,000 and $5,000 a year in profit, which it's put in the bank and is just sitting on.
- We talked for a while about a national certification exam for clinical herbalists. The general consensus: not a good idea. This reassured me. Certification usually, historically, leads to assimilation. In the case of herbalism, this would not only hurt our discipline, but also cut off the potential for rebalancing the modern healthcare paradigm that herbalism offers.
- Lupo, a young herbalist currently living in Connecticut, was elected to the Guild Council as a general member. I think she will bring an excellent voice to the Council -- and those of you who may know her would probably agree.

Jonathan Treasure, whose personal philosophy I resonate with and whose writing I thoroughly enjoy, gave a talk later on Friday called "Herbs don't work". The point, of course, is that the inherent vitality of the physiology does most of the work, and that herbs and herbalists are catalysts and helpers for the process. Other interesting tidbits:
- Part of magic is the ability to manipulate human consciousness. Our current culture seems to be an expression of a massive 'spell' cast upon millions.
- When a magician comes to believe his/her own spells, a dangerous fanaticism can ensue. To me, this means that the wholesale acceptance of any model that describes reality is risky and leads to inflexibility, a lack of adaptive power, and a tendency to reject those who do not share your world-view. This seems to be what has happened to our modern medical paradigm - a seductive spell, to be sure, but the resultant fundamentalism is all too apparent when we look at obsessions like 'evidence-based medicine'.
- The idea of 'integrative medicine' can mean many different things. Today, some MDs and medical clinics practice what they call 'integration' - but in many cases, this simply means using meditation, biofeedback, and occasional standardized herbs as adjuncts to practice. There is no shift in philosophy, no shift in belief. This is simply co-opting, not integrating! JT recommended Ken Wilber for his work on defining true integration and holism. Check out Integral Psychology and Integral Spirituality for more.
- Once we accept magical flexibility and integrate ourselves into whole beings, the distinction between hero (healer / herbalist / doctor), villain (disease / doctor / herbalist), and innocent (patient / herb / drug) disappears as we see the trinity synthesize into oneness. Practically speaking: herbalists must talk to the modern medical community, with compassion, with friendship. It comes back to what I've always maintained: no personal philosophy should take precedence over client well-being!

Antibiotic resistance update

2007-10-17T06:54:00.001-04:00

Bacteria are getting better at eluding technological medicine's open attacks. I've been following the mainstream media's reports on this subject for a while now, and especially in this last year things seem to have begun an exponential rise.
Of chief concern is a variety of Staph bacteria, known as MRSA, that is highly resistant to powerful antibiotics, as well as being way more virulent. And now some numbers are in: MRSA has killed an estimated 19,000 Americans in 2005 and made 94,000 seriously ill.
Additionally, a strain of bacteria sometimes involved in middle ear infections (Streptococcus pneumoniae) is evolving antibiotic resistance that may have come as a response to increased vaccination rates and the overuse of drugs for ear infections.
Folks around the country are getting worried as these bugs spread from the hospital to the community. Dallas, where a teenager died from MRSA in March, is monitoring local schools. Bedford, VA has shut down all its schools after a student died of MRSA today.
This is getting scarier, and it seems to me that a moratorium on antibiotic use (unthinkable to mention even 10 years ago) for all but the most dire emergencies is almost in order. But if we can't use antibiotics, what on earth can we use to treat ear, skin, and lung infections? We are powerless!

Coca-cola gets into Chinese herbs

2007-10-16T08:39:00.000-04:00

"This collaboration will ultimately help us bring the insights and benefits of traditional Chinese medicine to consumers all over the world."

Thus spoke Coke, in reference to its collaboration with the China Academy of Chinese Medial Sciences. The company hopes to develop a line of drinks featuring Chinese herbs, and probably a whole range of health benefits. And corn syrup.
Does this mark a return, full-circle, to Coke's roots as a tonic herbal beverage? Or perhaps a new positioning scheme to be well-placed for production and distribution of herbal products once the FDA regs kick in? The prospects could be scary, especially if the multinational company (or companies) can claim patent rights for beverage "formulas".
Another successful step in the long road of corporate cultural appropriation.

Spilanthes and malaria

2007-10-11T05:29:00.001-04:00

Research from India highlights this amazing plant, usually used as a carminative, immune stimulant, antifungal and "toothache plant". Members of the Spilanthes genus, but in particular S. acmella (my favorite garden variety) seem to kill the larvae of mosquitoes at concentrations of 9ppm (9/1000ths of 1%), which seems really low (about 3 drops of their extract for a full 5-gallon bucket). The researchers used hexane to extract pungent alkylamides from the flower heads, then removed the hexane to leave what was probably a very concentrated (up to 20:1) fraction. Still, a more reasonable 1:5 weigh-to-volume ratio would still mean that 10ml to 15ml of tincture (of high alcohol percentage!) could provide the adequate concentration to kill all mosquito larvae in a 5-gallon bucket.
This research is geared towards containing the spread of malaria and filaria, carried by mosquitos which then infect humans. Considering the increase in the incidence of mosquito-borne disease here in the US (West Nile, e.g.), and the toxic chemicals used to control them in places like New York City, we might all want to consider some Spilanthes extract instead...

Custom herbal formulas just don't work

2007-10-10T06:16:00.001-04:00

There's new research out that attempts to answer the question of whether individualized herbal blends, as formulated by a practitioner, are better than single standardized herbs. I'll just skip right to the editorializing bit, because it's so well-reasoned and balanced:

This study sets a new benchmark for the tailored approach: not only must herbalists demonstrate that individualised treatment is superior to placebo, they must also
show, for reasons of cost and safety, that it is superior to standardised treatment. Claims by herbalists who use the individualised approach that their practice is evidence based are disingenuous; this is because evidence supporting the use of herbs for any indication has come almost entirely from the study of single, standardised herbal extracts, not from studies of individualised herbal medicine using combinations of several or many different herbs prepared from inherently variable raw plant materials. The paucity of data supporting the effectiveness of individualised herbal medicine, and the important safety concerns associated with this particular form of phytomedicine, should be taken into account by policymakers
concerned with the regulation of practitioners using this modality.

Overall, the results of the three studies included in this review do not provide support for the use of individualised herbal medicine in any indication.

So there you have it. Custom blending of herbal formulas just doesn't work.
This study is really just a research project where the authors selected 3 randomized, controlled trials from over 1,300 pubmed results. The trials covered Western herbs for osteoarthritis of the knee, Chinese herbs for irritable bowel, and Chinese herbs for chemotherapy support (this last one was terminated early due to difficulty recruiting subjects). With such limited results, why do the authors choose to call for increased regulation of herbal practitioners, rather than more, better, research?
Perhaps because Ed Ernst is at the helm. Jonathan Treasure has been following this man's career for the last little while, and the history is pretty interesting (his herblog reviews this latest study fully for your pleasure, although it comes with an 'adult language' warning). To me, it's just another fairly immature and certainly non-productive use of research time and money. In this climate of diversification, increased government worry and oversight, and the grassroots integration of effective, individualized herbalism into the modern medical system, Ernst's editorials may actually be irresponsible, too. I wish someone paid me a lot of cash to tool around pubmed with an agenda.

2007 Herbal Convergence report

2007-10-08T16:02:00.000-04:00

The Northeast Radical Healthcare Network hosted its second annual Herbal Convergence at Seven Arrows farm this past weekend. This gathering has been amazing so far - low cost, community organized, non-hierarchical, inclusive, conscious, accessible. I can't say enough about the organizers and the people there.
Lots was going on. It is a tumultuous time in the herbal world, and I think the discussions reflected that.

Wendy gave us an update from the herbal care unit of the Common Ground Free Clinic in New Orleans. A non-profit, the Clinic's board of directors felt that unlicensed herbalists should not be practicing in the clinic the way they'd been doing since Katrina left most of the city's healthcare network crippled. While this might have seemed the end of an experiment in truly integrative free healthcare, the herbalists in New Orleans turned things around. They enlisted Phyllis Light, a professional AHG member, to supervise their work, and created defined protocols for herbal treatment in specific situations. Integrative practice continues!

Chris Monteiro of Providence, RI spoke about her acupuncture practice where low-cost and sliding-scale treatments are given to many people at once, reducing overhead and engendering a sense of 'peaceful community' for those relaxing in the treatment room.

I talked a little about the free clinics we run up here in Montpelier, now through the VCIH, and how coupling educational opportunities and community-grown medicines with the free clinic can help make it sustainable.

Rebecca Hartman talked live about her herbal philosophy, with a special focus on seeing the human physiology as an ecological system. She described insights for practice from a relational, ecological, and network-based vantage point (definitely good stuff, summarized here on her blog).

We heard reports from Just Food, where folks are organizing communities and local farmers in and around New York City to encourage community food production, fresh food availability, urban chicken and bee keeping, and networks of distribution and barter.

The Rhizome Collective in Austin, TX has been continuing with its urban sustainability work, organizing efforts, and ecological preservation. We heard about how they got a $200,000 grant to clean up and preserve a ten acre brownfield they now own. I was especially impressed by the construction of a floating island of plastic in a stormwater collection pond: anchored to this structure are wetland plants that help purify and control the water.

Mischa Schuler talked about her practice and work as a community herbalist in Cambridge, MA. I missed her class on herbal support for eating disorders, because my workshop on herbs and psych med use was at the same time, and was very disappointed about that. Mischa is a thoughtful herbalist who shared with us many of the practicalities of an herbal practice: making a comfortable space, finding the right place to work in and the right people to share space with, creating methods of recordkeeping, accessibility, and more. Living in Boston has strengths and weaknesses - but this place called the Fells sounds pretty awesome...

During and after my talk on the history of medicine in the US over the last 200 years, a lot of crucial issues were brought up. I feel that we are at a similar juncture in the history of herbal medicine to the one the Eclectics (and everyone else) faced in the mid-1800s: unregulated, diverse healthcare practices with a central government threatening (an imposing ) regulation. Onerous regs might create a two-tiered system: licensed and lay herbalists, 'professional' and 'kitchen' healers. How to avoid this split, avoid assimilation, and avoid 'banishment'? Some ideas, such as 'community-shared herbalism' where a collective group makes tinctures for itself, came out of the mix. This is something we want to try to build in Montpelier; I know others are working on it as well. But licensure will continue to be a hot debate!

I spoke with Kale (I believe that was the name) about research on the role of neuronal myelination in disorders such as bipolar depression and schizophrenia. This research seems to point at low mylelination levels for the former and higher levels for the latter, both in the brain's while matter and in the corpus callosum. Kale, if you can keep in touch about your research, I'd love to hear more!

Mary Blue, who is one of the organizers and a hostess for the gathering, also talked about her community living and farming project, called Farmacy, that involves urban sustainability, a farm and herb garden, composting toilets and graywater processing, and a kid's camp -- all from a small lot in Providence, RI. She makes tinctures and other medicines for local distribution. I commented to her how interesting, from a semantic and philosophical point of view, her choice of the name 'Farmacy' is: in the 70s, herbalists were moving out of the underground, and the tincture company was called 'Herb Pharm' (and still is - great company!). This name puts the 'Ph' into an earthy, farmlike concept: it injects science into nature's grounding force. Now, in the 21st century, herbalists create an organization like 'Farmacy'. This name puts the 'F' into a scientific concept: it injects nature's grounding force into science. I guess we've had a few years to think about it, but I do like the latter way of doing things quite a lot. And the Convergence is doing a good job of distilling this new, radical herbal instinct and bringing it into the light.

Wild Carrot seed

2007-10-08T15:43:00.000-04:00

At last weekend's Convergence, Robin Rose Bennett gave an informative talk on wild carrot and its use as part of conscious birth control. She's made available a copy of her work on Daucus carota online.
This member of the parsley family has historical uses that range from abortifacient to diuretic. Here are some of my notes from Robin's discussion:

. the seed dose is approximately 1tsp. daily, varied for weight and constitution (sensitivity to inputs)
. the first dose should be taken 8-12 hours after sex, then repeated once or twice more with 12-24hrs between doses
. intermittency of dosage allows for most effective birth control action, and also fertility enhancing: take breaks at the right times!
. if there are hormonal imbalances (pharmaceuticals, cycle disturbances, post-partum if cycle hasn't returned, e.g.) it is less trustworthy
. if there are assimilation issues from dysbiosis, it is less trustworthy
. its volatile oil, and to a certain extent its fixed oil, are key to its action. Harvest not when bone-dry, not when old, first days of flowers, seedhead still greenish-brown
. it is extracted in 50% to 70% alcohol, 2:1 ratio of greenish-brown seed to brown seed, bruised
. tea can be made with 1TBS bruised seed, steeped covered for 20-30 min
. flowers can be used too, as a tea, at twice the doses of the seed
. only reported side effect has been vaginal irritation, relieved by switching from seed to tincture of the seed
. combination: ginger, pennyroyal, mugwort, wild carrot
. in a case of ectopic pregnancy, it helped eliminate the fetus without surgery (I heard this last part second-hand).

Robin's got 20+ years of experience working with wild carrot, both for herself and her clients.

Fungal mycorrhizae: ecosystem modulators

2007-09-14T07:42:00.000-04:00

A nice article from Nature magazine shares some interesting research on the mycelia of mushrooms (the main growing part, usually underground, which produce the spore-bearing fruiting bodies we harvest and eat). We've known for a long time that mycelia are everywhere, almost saturating soil and contributing to the ecological balance of forest and field alike. We've even studied how some plants, like orchids for example, engage in a delicate balance with the root-like tendrils of fungal mycelia (known as mycorrhizae), benefiting in both nourishment and protection. Recent research has focused on how the web of fungal roots in the soil of the forest acts as a literal 'network', sharing and balancing resources between itself and different species of green plants. It seems quite likely, in fact, that many plants could not exist without their fungal symbiotes: but the story goes deeper than that.
Mushroom mycelia can take nutrients, especially sugars, from the roots of strong, green plants (like established trees) and "feed" them to weaker understory herbs and seedlings who have less access to light for photosynthesis. A neat example: in the spring, mycorrhizae shunt nutrients from the early trout lily to feed new maple seedlings, while the reverse occurs in the fall. Inter-species nutrient balance is maintained by these fungal networks!
This research continues to increase my respect for the Kingdom Fungi, and I am beginning to suspect that these organisms are the great modulators and networkers of the living world. It is no wonder to me that they are so effective in modulating the function of human physiologies as well, helping to balance immunity and inflammation so effectively. Hopefully more research on this subject will be forthcoming -- it is a field we know woefully little about.
In the meanwhile, Paul Stamets is the man.

Hyperactivity linked to food additives

2007-09-06T09:08:00.000-04:00

A British study published in the Lancet has documented the effects of certain specific food coloring agents (sunset yellow coloring, also known as E110; carmoisine, or E122; tartrazine, or E102; ponceau 4R, or E124; the preservative sodium benzoate, or E211; and other colors) and preservatives (primarily sodium benzoate) in kid's drinks. Over 300 children, roughly split between three and eight year olds, underwent the blinded trial. The results were striking: the drinks with additives were linked with higher rates of impulsivity, inattention, and general hyperactivity.
Critics of the study were quick to point out that this is simply an association, not a "cause-and-effect" phenomenon. True enough, but many variables were controlled in this research: drinks, which were given to children in a double-blind fashion, were the only sources of additives. Assignment of the laced drinks was random. And this study builds on previous data gathered by the British government (which is why it awarded over $1 million for this recent research).
So, in my opinion, we are beginning to get scientific backing to the herbalist's idea that synthetic food additives are not only damaging to the liver and metabolism, but also interfere with the psyche. In fact, as many herbalists might tell you, the link between the liver and the spirit is a very real one, and the metabolism of toxic synthetics can lead to inflammatory processes all over the physiology, not just in the nervous system. Back to whole, local foods!

Herbal medicine commentary: are we 'chasing fairies'?

2007-08-30T07:52:00.000-04:00

"By proper Herbalism, I mean the variety practiced by Herbalists who have devoted many years of study to the application of herbs for medical purposes, as opposed to the fairy chasing brigade who hijack any therapy that they can practice with minimal effort..."

This quote is part of an interesting piece I was reading on ProgressiveU.org. The author comes down pretty hard on therapeutic ideas like "hot stones placed on (the) body, or ... mystical energy massages from Maori tribesmen", attempting to differentiate more modern, unsubstantiated modalities from traditional Herbalism as a valid, ancient art.
Let me clarify two points at the outset:
-first off, I work with fairies everyday in my garden. They help me out a lot, and the spirits that inhabit plants have broad-ranging powers and may be responsible for much of nature's medicine. In making this statement I am being very grounded and scientific: in my experience, 'fairies' are real, and have observable and testable effects.
-secondly, I deeply value thought processes that transcend reason and rationality, and I believe these processes are a vital part of the herbal tradition. Nevertheless, they cannot function alone. Throughout history, human beings (and animals) have evolved systems for understanding nature and functioning more efficiently as part of her. These systems rely on rationality, at least on a temporary basis, and greatly facilitate learning. Herbalism employs many such systems (energetics, herbal actions, physiology, phytochemistry, direction of cure, doctrine of signatures, and many more) and I love them all. In my opinion, it is a balance between intuitive, acausal, non-linear feeling and creative, pattern-based, rational thinking that makes an effective human. Herbalism teaches both!

That said, the author of the piece has some very valid opinions that made me stop and think. For instance:

"When somebody introduces certain herbs and plants into the body they have a tangible and explainable effect. Herbalism does not rely on some magical explanation, despite the fluffiness of some of the people who practice the tradition and their assertions to the contrary".

Not all effects can be 'explainable'. Modern doctors will be the first to agree with this! Besides that, what does 'explainable' mean? You can provide meaning to any set of circumstances. I think the point here is that herbalism does have a grounded component to its therapy, and that phytochemistry and biochemistry have danced together a bit and come up with some nice stories to tell. But, just because the effect of Rose elixir taken on the tongue is best explained magically, doesn't mean there is no effect.

Where Herbalism gets the short end of the stick scientifically, is in the fact that many herbal preparations have not been scientifically tested in controlled clinical trials. As a result preparations which have a history of effectiveness in treating ailments don’t have official scientific verification, not because they have failed scientific testing, but because they haven’t received it. Quacks and other alternative therapists exploit this to make a case for their remedies.

Two important points: a long history of traditional use is somehow not seen as evidence of validity, while scientific trials are. Couple this with the inability to patent crude plant preparations, and you have and perennial inadequacy set up for herbal medicines. The answer isn't necessarily just more trials (though this is great, too). It's to change the system that defines validity.
I can't argue that some 'quacks' exploit my attitude. And I hadn't really thought about that so much until I read this article.

Personally, I believe that legitimate Herbalists need to take a stand and speak out against suspect therapies in an effort to protect consumers and distance their discipline from the quacks. Herbalists should make greater efforts to safe-guard their patients from exploitation rather than just fighting with Western doctors. As an advocate of integrated medicine, I see the constant bickering between much of the Herbalist and Western Medical community as just tiresome and regressive.

This, to me, makes a whole lot of sense. We just have to be really careful in defining a 'suspect therapy': I can see that issue becoming a slippery slope all the way back to 'evidence-based medicine' and its exclusive reliance on the double-blind, placebo-controlled study.

I feel, from a deep, non-rational place inside me, that these issues (and others) are going to come swiftly to the fore of herbalist's discussions as the community evolves and interfaces with the American culture in all its craziness. I only ask that we try to be aware of the forces and ideas that are shaping our philosophies and worldviews, and stop briefly to ponder them. And that's the rational place coming out, right where it belongs.

Sparkly Comfrey Powder

2007-08-29T09:46:00.001-04:00

It's late August, the sun is still hot, the evening light is orange, and the Comfrey is still going crazy.
This unyieldingly generous plant keeps coming back, and spreading, no matter how often you harvest its leaves for improvised poultices, throw its long hollow stalks into the compost, or even dig away at its root. And regardless of what you think of the pyrrolizidine alkaloid content of this bristly Boraginacea, you can't deny that its topical use is very safe and effective.
I love chewing a Comfrey leaf to put on a bad scrape or superficial wound, you can feel its texture going from almost spiny to green to slimy. And the gel that is created is some of the best medicine for the skin, rich in allantoin, soothing and healing.
My problem was that, during the winter, it gets very difficult to recreate that smooth green gel without access to a fresh plant. The dry leaf approximates it, but isn't nearly as pleasant to chew and simply re-hydrating it doesn't come even close. So for this month's blog party, here's what I came up with for those bushels of Comfrey leaves you've got growing in some corner:

Sparkly Comfrey Powder:

You will need a good, strong blender. A Vitamix is good, but any commercial blender with a sturdy motor will do.
Harvest lots of Comfrey leaves.
Stuff the blender, not too tight, with coarsely chopped leaves.
Add 1 cup of water (for a half-gallon blender)

Blend, pulsing and stirring from time to time, until the mixture is a homogenous mass of green goo.

Press the mass through muslin, so that all the fiber is removed, saving the juice. This stuff should be very dark green and frothy.

Evaporate the moisture from the juice in a slow (150 degree) oven, or in strong sunlight. I use Pyrex pans for this purpose. Depending on how much juice you made, and the size of your pan, this could take all day (or more).

Using a metal spatula, knife, or spoon, scrape the dehydrated juice from the pan once all the water is gone.

Place the scrapings in a smaller container, and dry for another hour at 150 degrees.

Grind the dried Comfrey in a mortar and pestle.

Voila! You're done. This powder, which does seem to sparkle when in direct light, re-hydrates quickly to a slimy mass. Try 4-5 drops of water on a 1/4 tsp. dab of the powder. It also quickly colors pale oils, like sweet almond oil, a nice green color and makes a very good addition to salve recipes. Finally, I like to sprinkle it directly on bad scrapes I get during the winter months, where it quickly stops light bleeding and gets nice and mucilaginous, unlike the dry leaf.

Just remember: don't use Comfrey preparations on deeper wounds, puncture wounds, etc... as it will very likely cause an abscess to form.

The final product, infused for 15 minutes into sweet almond oil. On the right is a heaping spoonful of the re-hydrated powder, ready for use!

Antibiotic resistance update

2007-08-28T08:26:00.000-04:00

Reuters brings news from China that many bacterial lung infections that cause pneumonia are resistant to antibiotics. We've been following the reports of drug-resistant pathogens, mostly bacteria, and the response that government and healthcare establishments are considering.
Resistance seems to spread from centers of antibiotic use, with hospitals acting as 'universities' for bacteria to swap information and reduce their sensitivity to drugs (by altering metabolic pathways, structures in their cell walls, or both). While 70% of pneumonia cases were resistant in the Chinese 'countryside', that number reached 90% at major hospitals in cities like Beijing.
What's troubling is that, unlike poor manufacturing processes that lead to product recalls, antibiotic resistance is much like carbon emission: it has global reach and impact. Pneumonia can indeed be deadly, especially in weakened constitutions; and we do have drugs that the bacteria still aren't resistant to. But the trend in the last ten years is undeniable: let's not wait until all modern antibiotics are ineffective, and start incorporating more crude botanical preparations into the treatment protocols, especially for stronger folks, especially in hospitals!

Some herbs for active, moist pulmonary infections:

Warming expectorants: elecampane, lobelia
Antibacterials: garlic, thyme, eucalyptus, usnea
Diaphoretics: boneset, elderflower, ginger, cayenne
Antiinfectives: echinacea, osha

...and for convalescence: astragalus, red reishi

Of course, the sooner you begin addressing any lung distress, the better the final outcome. Still, I see no reason why some of these plants couldn't be incorporated into hospital regimens -- and it will happen, probably sooner than we think.

Datura inoxia

2007-08-27T06:40:00.000-04:00

Known as Toloache by the Aztecs (and probably used by most Mesoamerican cultures before them), this beautiful representative of the Datura genus just recently began opening its flowers in my garden. It blooms in the evening, pollinated by night-flying moths, with huge (8"+) flowers and a sweet aroma that sets it apart from its cousin, the Jimson weed (D. stramonium).
Many members of the Solanaceae (Nightshade family, perhaps my favorite plant family though the Araliae are right up there) possess alkaloids like scopolamine and hyoscyamine which have the ability to limit the action of the parasympathetic nervous system (they are so-called parasympatholytics). This yin-like side of our nerve networks promotes rest, digestion, and reproduction, and actively counterbalances the more yang-like sympathetics continuously.
By taking a plant like Datura, you can effectively inhibit yin function for a time, starting first at the physiological level and eventually at the level of the mental and energetic bodies. Small doses relax muscles, open airways, and provide a gentle warmth. As the dose is raised, heart rate increases; there is a loss of motor function; and convulsions, delirium, hallucinations, and finally death ensue. Internal use is generally not a good idea - the yang demons that are called into the human are generally unpleasant, and can be downright dangerous. Topical use, however, is a different story.
Of the parts of this plant, the seed is certainly the strongest. Leaves are next, and the root is milder. So to make a salve from D. stramonium, we recently took the black seeds from three of the thorny, opened pods and crushed them in a mortar and pestle. Keep in mind, there were enough seeds to kill all seven of us, had we taken them orally.

Datura salve:
Crushed ripe seeds from 3 seedpods (about 2 TBS)
Seven fluid ounces of oil: olive, almond, or grapeseed
soak the seeds in the oil, while heating in a double boiler
after an hour (or more), strain and return to the double boiler
add:
8/10ths of an ounce, by weight, of beeswax (about 23 grams)
when the beeswax is melted, add:
1 fluid ounce of the infused oil of Arnica [optional]
1/4 tsp. of Rosemary essential oil [optional]
stir quickly and pour into jars

The last two ingredients enhance the pain-relieving power of this salve, by reducing swelling and stimulating circulation. Datura was always traditionally used as a topical pain reliever for rheumatism, "bone aches", sprains, and wounds. This version is quite effective - but use only a little bit, and some sensitive individuals may feel a disturbance in their personal fields by even a small brush with this powerful plant. More flowers are set to bloom - I look forward to admiring this moonflower under the Full Moon!

Wikipedia

Maude Grieve
Erowid

The medicine of berries

2007-08-21T09:42:00.000-04:00

Colorful, small fruits - commonly known as berries - are essential for human health. We've been eating them since before we were human, and owe much of what we are to these little delicacies. Red wine, a berry product, has been in the news for a long time. More recently, the goji (a variety of lycii berry) has gotten a lot of attention. Elderberries, which also make a delicious wine, can boost immunity and have been used as antivirals for centuries.
Some of the medicinal value of berries relates to their content of polyphenolic compounds from the flavonoid class. These chemicals are responsible for much of the color of plants in general, but are most concentrated in small fruits. Though their specific physiological effects vary, they all play an important role in protecting and balancing the cardiovascular system, DNA and its reproductive pathways, the liver, and the immune system. When you consider how crucial these deep physiological functions are to our overall wellbeing and longevity, you can see why folks get so enthusiastic about the health benefits of berries!
It's a wrap for the berry season up here in Vermont, but while we're on the subject:

Molecular Nutrition and Food Research has a recent issue entirely devoted to the medicine of common berries, in conditions such as infection, heart disease, urinary problems, and more.
The Herbwife's Kitchen hosted a blog party that featured summer berries and some excellent recipes.
Rose hips are berries, too. But every part of the rose is rich in the same chemistry that makes berries great (as is blueberry leaf, for example).

Fresh blueberries soaked in rose syrup, with a little dab of cream, anyone?

Bush dictates terms for state healtcare coverage

2007-08-21T09:27:00.000-04:00

In a not-too-surprising move, the federal government has issues strict guidelines making it virtually impossible for states to offer health insurance to those over 200% of the poverty line. This is all done in the name of "returning focus to low-income children": but for a single mom with one child, 200% of the poverty level is just over $25,000 a year. Rent and utilities can easily take away more than half that income, and you can quickly begin to see why states might want to extend health care to families who make a bit more.
The article in the New York Times gives more details:

...states must demonstrate that they have “enrolled at least 95 percent of children in the state below 200 percent of the federal poverty level” who are eligible for either Medicaid or the child health program.
Deborah S. Bachrach, a deputy commissioner in the New York State Health Department, said, “No state in the nation has a participation rate of 95 percent.”
And Cindy Mann, a research professor at the Health Policy Institute of Georgetown University, said, “No state would ever achieve that level of participation under the president’s budget proposals.”

Antifungal activity of orchids

2007-08-11T06:18:00.000-04:00

In a fascinating description of a "love-and-hate" relationship between orchid rootlets and their fungal symbiotes, Phytochemistry shows us yet again why many plants evolved the medicinal constituents we find and use. The study involved a species of Cypripedium, our local Northeast ladyslipper orchid.

Germination of orchid seeds fully depends on a symbiotic association with soil-borne fungi, usually Rhizoctonia spp. In contrast to the peaceful symbiotic associations between many other terrestrial plants and mycorrhizal fungi, this association is a life-and-death struggle. The fungi always try to invade the cytoplasm of orchid cells to obtain nutritional compounds. On the other hand, the orchid cells restrict the growth of the infecting hyphae and obtain nutrition by digesting them. It is likely that antifungal compounds are involved in the restriction of fungal growth. Two antifungal compounds, lusianthrin and chrysin, were isolated from the seedlings of Cypripedium macranthos var. rebunense that had developed shoots. The former had a slightly stronger antifungal activity than the latter, and the antifungal spectra of these compounds were relatively specific to the nonpathogenic Rhizoctonia spp. The level of lusianthrin, which was very low in aseptic protocorm-like bodies, dramatically increased following infection with the symbiotic fungus. In contrast, chrysin was not detected in infected protocorm-like bodies. These results suggest that orchid plants equip multiple antifungal compounds and use them at specific developmental stages; lusianthrin maintains the perilous symbiotic association for germination and chrysin helps to protect adult plants.

FDA supplement regulation update

2007-08-07T14:00:00.001-04:00

The herbal community has been avidly analyzing the most recent FDA regulations on herbal / supplement manufacturing. It is becoming more and more evident that: 1. this is a very burdensome set of rules, most especially for small manufacturers and herbal practitioners (I find myself a member of both groups...); and 2. the regulations themselves are so complex and far-reaching that enforcement will be almost impossible.
The Integrator Blog has posted a nice, brief discussion on these topics from the point of view of big industry experts (good people, generally). I think it's worth the two minute read.

Black Cohosh beats Prozac for hot flashes

2007-08-06T06:27:00.002-04:00

After lots of back-and-forth concerning Black Cohosh (Actaea racemosa) and its effects on the hot flashes associated with peri-menopause, we have a study that examines 120 women over the course of 6 months. They were given either Black Cohosh extract, or a nice dose of Prozac.
While both treatments were effective, the herbal extract was much better at reducing hot flashes and improving subjective quality of life. Prozac didn't fare as well -- though it did seem to have a positive impact on subjective markers of depression.
I hope this study will continue to add to the positive evidence for the use of this excellent herb in managing peri-menopausal symptoms. Of course, I haven't heard anything about this in the mainstream news -- they much prefer poorly designed studies that show negative results -- but if good research keeps coming out validating Black Cohosh, that may change.

Stress, inflammation, and chronic disease: new links

2007-08-03T10:31:00.001-04:00

Sure, we all know that stress, tension and the anger that sometimes accompany them don't make us feel too good. A study from researchers at Duke, using data obtained by the Air Force, reveals just how linked these aspects of life are to crucial markers of cardiovascular inflammation. Elements (part of the complement family of proteins) in the blood that are involved in regulating inflammation in the heart and blood vessels seem to get overproduced by significant factors in men who feel more anger, hostility, and depression. This puts them at elevated risk for diseases such as heart attacks, strokes, and diabetes. To my knowledge this is one of the only pieces of research identifying a direct link between these emotional states and the cardiovascular system. It looked at over 300 men through the course of 10 years.
In another bit of research, scientists at the University of Grenada followed 45 patients who suffer from Lupus, a chronic autoimmune disease characterized by body-wide inflammation and fatigue (amongst many other symptoms). Relaxation and stress-management techniques made significant impacts on the day-to-day symptoms and levels of inflammation these patients experienced, leading to the conclusion that stress has a profound effect on increasing inflammation in chronic disease, and that managing this stress has wonderful benefits that are free from side effects.

This is not news to herbalists: I have always maintained that chronic inflammation is involved in most all states of imbalance, and that stress (without physical exertion) always aggravates it. Those who love plants have always added gentle tonics to most recommended treatment plans, and this makes good sense: address the disease, sure -- but manage the stress response as well!
Generally, the herbs used fall into two broad categories:
1. The "adaptogens", with somewhat of an "adrenal-tonic" effect:
Schizandra
Rhodiola
Holy Basil
Licorice (caution in hypertension)
Siberian Ginseng a.k.a. Eleuthero (caution in hypertension)
American Ginseng
etc...
2. The "nervine tonics", non-sedating yet calmative:
Oats ("milky", unripe oat tops or oatstraw)
Scullcap a.k.a. Skullcap
Lemon Balm
Passionflower
Linden
Chamomile
St. John's Wort (consult an herbalist before using)
Vervain
Lemon Verbena
etc...

Not surprisingly, there's some good therapeutic crossover between these two categories in terms of controlling stress and relieving inflammation, fatigue, and lack of focus. But let's not forget my favorite medicine for stress, anger, hostility and depression: good, regular, aerobic exercise. It's what we're built for, and the reason we secrete stress hormones to begin with!

Coffee, running, and skin cancer

2007-08-01T07:56:00.000-04:00

Good news for runners who enjoy a cup of coffee before morning exercise: new research in mice seems to point towards caffeine combined with exercise as protective against skin cancer and the deposition of subcutaneous fat. The study involved caffeine-laced water, which arguably has no flavonoid content compared to coffee and thus is even less protective, but nevertheless the mice who consumed it and exercised had about 4 times more cell death in UV-damaged skin cells. Death (apoptosis) here is good - it sure beats growth and division (a.k.a. cancer)! Interestingly, exercise or coffee, by themselves, were much less effective against melanomas.
This is an animal study, and thus largely theoretical, and I would be the first to volunteer for a logitudinal study in humans. Nevertheless, it balances earlier news that marathon runners have a higher incidence of melanoma (I wonder if they were controlling for coffee intake?), and continues to bolster the idea that good quality coffee, at about 1-2 cups a day, has a wide range of protective effects similar to those of chocolate. Tropical herbal medicine.

Diagnosing by smell

2007-07-31T07:59:00.000-04:00

Smelling the breath and body odor of a sick person has long been considered an important part of the herbalist's examination, regardless of your tradition and approach. Modern scientists have also been aware for a while that "bad breath" is not simply a condition of overgrowth of oral bacteria, but that it can also be linked to a variety of unbalanced internal processes (see this review for a summary). Now, a machine that analyzes volatile compounds in a patient's breath has been shown to detect the presence of lung cancer pretty reliably (3/4 of the time, with a misdiagnosis rate of about 25%). Neat idea -- but it's interesting to note that folks trained in Traditional Chinese Medicine started using the ultra-sensitive noses of cute poodles to do the exact same thing a few years ago.
Though our olfactory apparatus isn't as sharp as a dog's, we may still have some capacity to use information garnered from the breath and body odor of sick folks to understand what's going on. I recall a brief conversation I had at the last International Herb Symposium, while sipping Kava punch at the herbalist's Ball, where a gentleman whose name I can't remember was discussing olfactory diagnosis. An expert in the process had apparently teamed up with a perfumist and created a whole kit of scents, each of which exactly mimicked the "scent" of an individual disease. If anyone knows more about this, please let me know! I'd love to look, or smell, a little deeper...

Database of diabetes herbs

2007-07-31T07:52:00.001-04:00

ProGene Bio, an Indian company, has put together lots of recent research on medicinal plants used in diabetes and the management of blood sugar. The database is extensive, covering over 380 botanical species, but is a bit difficult to navigate unless you know the exact Latin binomial of the plant you're looking for. Nevertheless, browsing is always an option, and if you are looking for "scientific evidence" of an herb's use in diabetes control, this option might be a bit easier than a straight PubMed search...
(see Cinnamon, for example).

Cinnamon and blood sugar

2007-07-29T12:09:00.000-04:00

Swedish researchers published a small but interesting trial of Cinnamon (Cinnamonum verum) in the American Journal of Clinical Nutrition. Fourteen non-diabetics were in the group, and half received cinnamon powder at a dose of 6 grams in their rice pudding (clearly, not a blinded trial and much less tasty for the control group).
Then, starting 15 minutes after the pudding and continuing for an hour and a half, they measured both the rate of gastric emptying and the blood sugar rise. Cinnamon slowed both down, but the effect was much greater for the blood sugar itself.
It seems to me that we are watching the synergy of crude plant preparations here: the gut is slowing down, relaxing due to the carminative volatile oils in the ground cinnamon bark. At the same time, mucilage present in the powder is binding the sugars from the meal, slowing their release into the bloodstream. Finally, there are biochemical reasons, at the level of the cell surface and the cytoplasm, why Cinnamon seems to control postprandial blood sugar very well (see additional recent studies below), but this basic idea works well for any volatile / mucilage (carminative / demulcent) combination. I hope we stay away from the idea of refining and patenting a constituent from cinnamon to treat diabetes.
The other interesting point from a clinical perspective is that this trial uses a nice (6g) dose of cinnamon for a single meal. As the studies below show, lower doses (1g to 2g per day) don't seem to do very much. This makes sense, as you need some bulk of mucilage and 1 gram of powder is a very small amount; additionally, a dose of 6g to 12g a day is much more in line with traditional usage.

Related research, via PubMed:

	Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM.
	The effect of cinnamon on A1C among adolescents with type 1 diabetes. Diabetes Care. 2007 Apr;30(4):813-6. PMID: 17392542 [PubMed - indexed for MEDLINE]

	Pham AQ, Kourlas H, Pham DQ.
	Cinnamon supplementation in patients with type 2 diabetes mellitus. Pharmacotherapy. 2007 Apr;27(4):595-9. PMID: 17381386 [PubMed - in process]

	Cao H, Polansky MM, Anderson RA.
	Cinnamon extract and polyphenols affect the expression of tristetraprolin, insulin receptor, and glucose transporter 4 in mouse 3T3-L1 adipocytes. Arch Biochem Biophys. 2007 Mar 15;459(2):214-22. Epub 2007 Jan 25. PMID: 17316549 [PubMed - indexed for MEDLINE]

	Subash Babu P, Prabuseenivasan S, Ignacimuthu S.
	Cinnamaldehyde--a potential antidiabetic agent. Phytomedicine. 2007 Jan;14(1):15-22. Epub 2006 Nov 30. PMID: 17140783 [PubMed - indexed for MEDLINE]

	Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A.

	Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 2006 May;36(5):340-4. PMID: 16634838 [PubMed - indexed for MEDLINE]

	Vanschoonbeek K, Thomassen BJ, Senden JM, Wodzig WK, van Loon LJ.
	Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients. J Nutr. 2006 Apr;136(4):977-80. PMID: 16549460 [PubMed - indexed for MEDLINE]

	Kim SH, Hyun SH, Choung SY.
	Anti-diabetic effect of cinnamon extract on blood glucose in db/db mice. J Ethnopharmacol. 2006 Mar 8;104(1-2):119-23. Epub 2005 Oct 5. PMID: 16213119 [PubMed - indexed for MEDLINE]

	Verspohl EJ, Bauer K, Neddermann E.
	Antidiabetic effect of Cinnamomum cassia and Cinnamomum zeylanicum in vivo and in vitro. Phytother Res. 2005 Mar;19(3):203-6. PMID: 15934022 [PubMed - indexed for MEDLINE]

Cannabis and psychosis

2007-07-29T11:50:00.000-04:00

The current issue of the Lancet published a meta-analysis of multiple trials concerning the use of cannabis and its association with mental illness. There were 35 longitudinal studies selected for the analysis. All of them followed patients starting before any mental illness, and included cannabis use as a variable along with many other factors, such as personality, background, use of other drugs. 7 out of 35 trials concerned "psychosis" (ranging from 'mild symptoms' to 'schizophrenia') and were the only ones that showed any connection with cannabis use. Conditions of mental illness such as depression, mood disturbances, or others did not have any connection.
The study's authors rightly point out that there can be no way to say for certain that there is a direct causal link between smoking pot and experiencing at least one major psychotic episode (and the definitions are a bit of a problem for me here as well), but that caution, especially in folks with a personal or family history, is warranted. In the end, I would have to agree -- but this is true of any medicine, really...
There is a brief (6-minute) interview with the study's author here.

Docs and nurses use "alternative medicine"

2007-07-19T08:43:00.000-04:00

An interesting report details the uses of herbs and dietary supplements by doctors, nurses, and other mainstream health care providers. Although it focuses on clinicians enrolled in an online course about alternative medicine and supplements, the study still gives some interesting tidbits: first off, over 80% of the practitioners used some form of herb or supplement. The top choices are things like multivitamins and specific vits; but herbs such as green tea, chamomile, flax, cinnamon and Echinacea are right up there. I keep saying that things are changing with the new batches of allopaths coming out of the medical and nursing schools: I hope the positive attitudes can translate to good education, both of the care providers and their patients!

Salacia oblonga for type 2 diabetes

2007-07-19T08:34:00.001-04:00

A tropical shrub used in Ayurveda for controlling obesity and its associated health complications, Salacia oblonga (a.k.a. Saptrangi) has shown promise in some limited trials that looked at its ability to reduce high blood sugar in diabetes. A new trial goes into more detail: the extract of the root and stems of this plant lowered post-meal blood glucose by about 25%, while also reducing the amount of circulating insulin in the blood. Thus, it seems to sensitize the physiology to insulin, which reverses the trend of insulin resistance seen in type 2 diabetes. A 25% reduction is significant: it could bring a diabetic patient with postprandial blood glucose levels over 150 down to the "normal" range of 120.

Curcumin and Alzheimer's

2007-07-18T06:05:00.001-04:00

Though these findings come from a test tube, the results are nonetheless pretty interesting: a study carried out at UCLA reveals that immune cells are much more active against the amyloid plaques thought to contribute to Alzheimer's disease when treated with curcumin, one of the many compounds in turmeric.
This delicious rhizome in the ginger family has been conclusively shown to have anti-inflammatory power, and now this in-vitro research seems to hint at power beyond simple reduction of inflammation.
Amyloid plaques, which are tangles of protein thought to interfere with neuronal function in Alzheimer's disease, have a close link to inflammatory processes. Perhaps ongoing ingestion of turmeric in the diet can have a protective effect if initiated early on in life. I'd be interested in epidemiological reviews of the incidence of Alzheimer's in cultures who use a lot of curry (rich in turmeric) versus those who use none...

Solarfest 2007 - green buildings!

2007-07-14T06:28:00.001-04:00

This summer festival highlights sustainable energy and building technologies. I've been asked to talk about the laboratory and apothecary here at Grian Herbs, and share a slideshow that documents the construction of this straw-bale passive-solar building we've been using to host classes, do tincture production, and grow tropical botanicals year-round. Here are a few pictures:

The hemlock timber frame

The bale walls going up

A first coat of clay plaster...

Done!

Vitex and Gotu Kola in the greenhouse.

Inside, the classroom and processing spaces.

And a peek inside the apothecary...

Red Reishi - safety update

2007-07-13T06:52:00.000-04:00

Ganoderma lucidum, the Red Reishi shelf mushroom, and its closely allied species Ganoderma tsugae (native to the Northeast U.S.), are some of my favorites for rebalancing immune function and harmonizing liver metabolism. Excellent for allergies, autoimmune conditions, and cancer, this mushroom has always enjoyed a traditional reputation for safety. Now, a small in-vivo trial published in the American Journal of Chinese Medicine confirms its general safety by looking at markers of immunity and inflammation in healthy subjects receiving 2 grams of Reishi extract twice a day for ten days. Perfectly safe, are the conclusions.
I use a double-extraction process for most medicinal mushrooms, in order to obtain both the alcohol-soluble phenolic compounds and the more traditional water-soluble polysaccharides. With the addition of a little gylcerin in the menstruum, the extract stays well-emulsified and isn't quite so bitter.

Chocolate in hypertension

2007-07-10T05:58:00.001-04:00

A new, in-vivo German trial shows that even modest amounts of dark chocolate, consumed daily two hours after dinner, has positive effects on reducing high blood pressure. In comparing the consumption of dark vs. white chocolate (the latter not being chocolate at all), blood pressure was effectively lowered in the treatment arm of 44 adults aged 56-73.
I've written about chocolate before, and this new research just confirms that even tiny doses of cocoa flavonoids (under 30 calories /day!) benefit the circulatory system in many ways. Of course, I would recommend a bit more -- but as the study's authors comment, don't blow your calorie budget!

Jumping to conclusions

2007-07-08T20:32:00.000-04:00

For your enjoyment, the conclusions of a pilot study on warfarin / herb interactions:

The present survey highlights the potential risk of confidence with the 'natural world', the lack of discussion on this argument among health care providers and patients on warfarin therapy and the need to monitor strictly the INR value.

To this I would add (especially in the wake of recent experience): increased levels of physician education on the effects of the 'natural world' might help increase their confidence (heresy, I know). Many botanicals are perfectly safe to use in conjunction with anticoagulant therapy; others are not. A clear understanding of the underlying pharmacology and physiology is the best place to start.

I just couldn't get over how the first conclusion of this study, which rightly identifies poor communication between docs and patients and highlights the dangers that result, was to lay the blame at the feet of the 'natural world'. Fortunately, I think this kind of attitude is waning (eternal optimist).

Some plants from Cape Breton

2007-07-08T11:13:00.000-04:00

Our camping excursion to the Highlands National Park on Cape Breton island offered a wide diversity of environments to explore. Lots of terrain had poor, thin soils and supported acidic "barrens", covered in heaths and moss.
The few black spruces are probably over 100 years old, and though barely 10 feet tall are covered in Usnea.

Heath groundcover

Reindeer moss

In places where the barrens got more soggy, fens developed and more specialized plants thrived, like this Sundew (Drosera intermedia, the spoonleaf sundew).

Pitcher plant (Sarracenia purpurea)

Dragon's mouth (Arethusa) orchid

Labrador tea (Ledum palustre)

Bogbean (Menyanthes trifoliata) a.k.a. Buckbean

Local Larch (Larix)

Out by the coast, we find familiar friends.

Yarrow (Achillea millefolium)

Red Clover (Trifolium pratense)

A Campanula (C. rotundifolia, perhaps)

And, a bit further into the woods, a white bog orchid (Habenaria dilatata)

Echinacea effective (we knew that)

2007-06-26T07:13:00.000-04:00

A meta-analysis of multiple trials covering over 1,500 people and published in the Lancet not only revealed that Echinacea helps avert and shorten colds and flus, but also got substantial press coverage in the mainstream media. Nothing new for herbalists - merely a vindication of what we have known for a while: when taken at adequate doses in the real world, Echinacea species really are effective. Beyond colds and flus, I often use this plant for topical bacterial (e.g. Staph) infections, to excellent effect -- and considering drug-resistant staph may be much more widespread than we thought, Echinacea will become much more important than it already is.
As far as the new meta-analysis goes, HerbalGram wrote a review, and USA Today gave mass media's take.

New FDA rules for herbal preparations, practitioners

2007-06-25T16:04:00.001-04:00

The final rule on good manufacturing practices for herbal / nutritional supplements just got handed down this weekend. While it leaves some leeway for self-regulation, it does mandate some very difficult requirements, especially for practitioners who are essentially "manufacturing" a product each time they blend a tincture. These rules have been a long time coming, and will be phased in for small companies by 2011...
We need to dissect the full document and consider it with the advancing Traditional Medicines Congress (and its opposition) in an attempt to understand the very real changes herbalism will face in the coming years. Let's stay informed and keep our voices heard.

High-dose Ginkgo extract helps control anxiety

2007-06-25T08:12:00.000-04:00

The standardized extract of Ginkgo biloba, used for managing cardiovascular disease, improving blood oxygenation, reducing inflammation in colitis, and slowing the decline of brain function as we get older, seems now to reduce anxiety in people of all ages.
A new study (107 subjects) showed very significant improvement in the symptoms associated with "generalized anxiety disorder". The product used was EGb 761, the usual extract standardized to 24% ginkgo-flavone glycosides and 6% terpenoids. The dose was higher than what I often suggest, and the authors noticed a dose-dependent reduction in symptoms (they were giving 480mg and 240mg of extract daily).

Perhaps a bad idea?

2007-06-25T07:55:00.000-04:00

Trying to stimulate the immune system into producing antibodies to the active form of angiotensin, an enzyme involved in the complex balance of chemicals that regulate blood pressure, might not be the safest point of intervention for this disease. Considering the prevalence of autoimmune conditions, I would be concerned about the possibility of long-term effects. Nevertheless, according to the New Scientist, Cytos Biotechnology in Zurich seems to be trying out such a "vaccine".

Perhaps we should start training the immune system to attack a variety of other targets as well! Neurotransmitters for "mood disorders"? Hormones? I'm sure the resulting inflammation would be negligible.

Soy isoflavone helps bone density

2007-06-19T08:09:00.000-04:00

Research from the University of Messina in Italy points to genistein, and isoflavone from soy (Glycine max), as a possible treatment for poor bone density and osteopenia in post-menopausal women. While the scientists didn't track fractures or other negative outcomes of poor bone density, they did document an increase in BMD in the treatment arm of the study (the whole study included 389 women). The general conclusions indicate that soy contains phytoestrogenic isoflavones that reverse the trend of bone loss that occurs in post-menopausal women.
The researchers caution that, genistein being a phytoestrogen, the use of soy is dangerous for those with a history of endometrial or breast cancer (considered to often be estrogen-dependent). In response, I offer two considerations: first, no research has even indicated conclusively that phytoestrogens stimulate cancer in vivo, and additional research points to the possible cancer-preventive role of these chemicals. Second, ethnic and geographic groups that traditionally use an abundance of soy in their diet generally show lower rates of breast cancer.
As with many plant chemicals taken in their unadulterated states (and especially as crude, whole preparations), I suspect soy isoflavones play an amphoteric role in the human physiology, increasing what is deficient and reducing the effects of that which is excessive -- in this case, helping to modulate the effects of estradiol.

Plants recognize their siblings

2007-06-18T08:03:00.001-04:00

We already know that the rhizosphere, the zone of soil around the roots of plants, is teeming with chemical signals from the plants themselves as well as from symbiotic bacteria, fungi, and other life. This chemical crosstalk is akin to the air-based communication accomplished through pheromones (in humans, other mammals, insects, etc...), and undoubtedly provides a rich, stimulating and ongoing dialogue for the plants.
In many cases, chemicals secreted from plant roots contribute to survival: witness allelopathy, the ability of some plants such as wormwood, goldenrod, or many cover crops to inhibit the growth of other species in their rhizospheres. It has always fascinated me that the plants can recognize members of their own species and selectively inhibit the growth of everything else -- but after all, they are different species, and a genetic resistance to a poison is not difficult to imagine.
Now, in a beautiful study published in Biology Letters, we learn that members of the same species alter their competitive behavior based on whether or not they are growing next to their siblings (plants grown from seed that came from a single parent). Seedlings of Cakile edentula, a variety of wild mustard, grow much more dense and aggressive root structures when next to members of their own species that come from different parents. This is a remarkable level of sensitivity to a very slight variation in genetic structure -- but should come as no surprise to herbalists who are quite familiar with plants' ability to sense, perceive, process, and alter their behavior in concert with their environments.

Trouble for antibiotics

2007-06-12T07:43:00.000-04:00

Antibiotic resistance has been all over the news lately, with the media spotlight focused on the case of a man with extensively-drug-resistant tuberculosis who somehow eluded border checkpoints across Europe, Canada and the U.S.
We thought we had TB "licked", right? But the pesky little bug has somehow adapted to changing environmental conditions, and now modern medicine is left in a global panic when faced with the possible spread of a TB strain resistant to most available dugs. Treatment is expensive, long, and not always effective - and the specter of an even more powerful "superbug" looms large.

Hospitals, with their ubiquitous use of antibiotics, have long been havens for some ultra-potent, resistant strains of common bacteria like staph (Staphylococcus aureus). This bug can cause skin infections and systemic sepsis in the worst cases, but our immune systems usually take care of it pretty well (especially with a little Echinacea, an excellent remedy for this pathogen). In hospitals, a strain called MRSA (methycillin-resistant-staph-aureus) has been giving doctors headaches for a good while, ever since methycillin was extensively prescribed to kill bacteria that had become immune to penicillin. Now, they use vancomycin (ultra-strong antibiotic) to treat MRSA, but VRSA has already evolved and modern science has NO treatment available for this new bug. Things don't look too hopeful for the wonderdrugs that, in the 1950s, were heralded as the "end of infectious disease".

If this weren't enough, it turns out that MRSA has been spreading outside hospitals as well. A recent study showed a seven-fold increase in these cases over the period from 2000 to 2005, and this is just in the Chicago area. This is a concern because not only are these bacteria resistant to antibiotics, but they are generally more aggressive in the physiology as well, and can become lethal more quickly and easily than their original counterparts. Nevertheless, they still respond well to herbal treatment, especially if detected early.

In the wake of these types of reports (which have been ongoing), along with analyses that show how widely overused antibiotics are, modern medicine has been urging a less liberal prescription strategy so we can have these powerful drugs available when we really need them (i.e., not for your common cold)! And here's another reason: last month a broad analysis of over 13,000 children in Manitoba, Canada showed that antibiotic use in the first year of life substantially increases asthma later on, presumably by confusing and weakening the kids' immunity. The more frequent and more powerful the antibiotics, the greater the risk for asthma.

So, in the end, antibiotics seem to be less effective as time goes on, and actually quite harmful in some cases. More and more, it will be up to herbalists to pick up the pieces of our short and misguided love affair with these drugs. If you want to learn more, here's a good place to start.

Vermont Center for Integrative Herbalism

2007-06-11T08:47:00.000-04:00

We've started a new non-profit venture in Montpelier, focused on providing free herbal services (including access to a well-stocked apothecary) and a comprehensive herbalist training program. I've been personally involved in this work for over 7 years, and the momentum my friends and I have generated seems to be coalescing this Summer into what I hope will be a useful and powerful new resource for the Central Vermont community.
Read more from the Times Argus; or visit the website of the Vermont Center for Integrative Herbalism. And, if you're in Montpelier, Vermont this Friday evening, you can come visit at our benefit dinner and silent auction.