Late winter lichens

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

Sage improves memory and attention

'He that would live for aye,
Must eat Sage in May.'

The old English proverb, quoted by venerable herbalists from Gerard to Maude Grieve, refers to the virtues of the common garden sage (Salvia officinalis). This gracious aromatic herb, of a dry and warming energy, was long considered to confer immortality, a quickness of wit and eye, and protection from disease.
Previous research has shown evidence for sage's ability to enhance mood, reduce anxiety, and improve performance in healthy young volunteers (lemon balm, too), and the in-vitro research on the herb's ability to exert anti-cholinesterase activity (prolonging the activity of the neurotransmitter acetylcholine) has made it a target for research in aging and dementia. Acetylcholine is involved in transmitting signal in an area of the brain called the basal forebrain (amongst others), and there is evidence that this region of the central nervous system degrades as we age, leading to memory loss and cognitive impairment (as in Alzheimer's, for instance). Acetylcholine also provides the connection between the nervous system and musculature, and deficiencies are associated with conditions such as myasthenia gravis.
In this most recent study, 20 healthy older volunteers aged 65 to 90 were given various doses of a sage extract, and the results indicate an improvement in a variety of cognitive markers, along with a reduction in the score dropoff over the course of the day (the volunteers stayed sharper, longer). Some details:

• the extract was made with 70% alcohol, then concentrated and freeze-dried to a final weight-to-volume ratio of 7.5:1. This is pretty darn concentrated. Researchers were going for the volatile terpenes primarily (well-soluble in alcohol). They found 333mg to be the most effective dose; this is about 2.5 grams of leaf, or about 7.5 ml (1 and 1/2 tsp.) of a 1:3 tincture of sage.
• the extract was compared to placebo, in a variety of categories including word recognition and recall; vigilance; reaction time; spatial and numeric memory; and delayed picture recognition tests. Below are graphs of the changes in (a)secondary memory and (b)accuracy of attention:

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

Herbs regulated as drugs?

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

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

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

It will be interesting to see what eventually happens in the United States, since the regulation of herbal medicine has been in a virtual state of 'limbo' compared to Europe, Australia, and the rest of the world. If we had a crystal ball, we might be able to see how heightened regulations and 'professionalization' of herbalists and herbal products might affect our ability to practice our art in the future. Oh, but wait -- we have Canada (which works almost as well):

So many of us are afraid we’re going to go out business. Some people plan to go underground, some people plan to go defiant and see if they’re actually willing to put us in jail . . . we are like the weeds and will never be eradicated.

So spoke an unidentified Canadian herbalist in response to the new regulations that govern natural health products (NHPs). Here is a brief summary of the historical context:

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

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

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

Michael Pollan and Real Food

Food - our basic sustenance, one of our most primal interfaces with the natural world - plays a crucial role in the ongoing creation of ourselves, and in the maintenance of the all-important "internal balance". So, when we begin to lose our balance with the food we consume, it is no wonder that "disease" sets in. And it is no wonder that these "diseases" are slow to progress, leaving us in a state of chronically deteriorating health.
So, to re-enliven the body, mind, and spirit, herbalists have always been strong advocates for an old-time, whole-food, plant-rich diet - with some extra punch now and again in the form of herbs and spices. I've read some excellent thoughts on this subject over at The Herbwife's Kitchen, and have become quite suspicious of any larger company (witness Kashi / General Mills) trying to sell me something in a box.
So it was with great pleasure that I listened for a little while to Michael Pollan, author of The Botany of Desire (one of my favorite modern descriptions of the human/plant bond). Amy Goodman interviewed him on Democracy Now! and his comments clearly articulate the perils of overthinking and overprocessing the food we eat. The wide-ranging interview discusses the history of the food-industrial complex in the USA; 'nutritionism'; chronic disease and its link with food; whole foods, local foods; biotechnology; and more. Some comments:

And, in fact, one of my tips is, don’t eat any food that’s incapable of rotting. If the food can’t rot eventually, there’s something wrong. (...)

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

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

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

and, in conclusion:

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

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

Pharmaceuticals in tap water

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

Herbal Internet Resources

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

Current Herbal

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

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

FDA supplement regulation update

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

'We are not going to be enforcing the GMP for practitioners in
one-on-one consultations'.


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

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

Large study finds association between headaches and digestive symptoms

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

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'

A study published last year 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

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

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

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

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

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

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

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

"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

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...