Herbal medicine commentary: are we 'chasing fairies'?

"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

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

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

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
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!

Maude Grieve


The medicine of berries

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

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

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

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

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

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:
Holy Basil
Licorice (caution in hypertension)
Siberian Ginseng a.k.a. Eleuthero (caution in hypertension)
American Ginseng
2. The "nervine tonics", non-sedating yet calmative:
Oats ("milky", unripe oat tops or oatstraw)
Scullcap a.k.a. Skullcap
Lemon Balm
St. John's Wort (consult an herbalist before using)
Lemon Verbena

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

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.