Old skills and gratitude

In the hills north of Montpelier, Vermont a small group of folks (some of them are herbalists too, studying at our school) are teaching skills humans have possessed for a long, long time. The Roots School instructors have been mastering tracking, tool-making, weapon-crafting, fire-summoning, fiber-spinning, hide-tanning and more (see it all here: http://www.rootsvt.com/skills).

Many people are interested in these traditional approaches to meet the basic needs of life. Why is this? Does learning this stuff have any inherent value?

First off, taking the example of stone knives and spears, it would seem that we've had these skills for a very, very long time. Most recently, Jayne Wilkins of the University of Toronto dated spear tips from South Africa to 500,000 years ago. Along with running (I'm biased) and cooking (so reliant on fire-making magic), these skills might actually be a defining element of what makes us human.

Stone knife - ROOTS School

Stone-tipped spears, South Africa. Photo: Jayne Wilkins

While these technologies are definitely more environmentally conscious, it is not a given that they don't have consequences on our ecology. Take, for instance, the plight of the woolly mammoths and their feelings about these spears. Or look at Ireland - humans deforested the island, and may also have created a fossil fuel reserve - peat - thereby. So I don't think we can clearly state that these skills are somehow valuable because they don't "adversely" impact the world around us. Very often, they do - and this impact can locally rival that of our modern technologies.

So maybe a clear line can't be drawn: technology is simply technology. Or is it?

Before getting a litter deeper into the value of primitive technologies, it's worth thinking about why, at the very least, we shouldn't abandon them completely. There is obvious historical and anthropological value to retaining some of these abilities - it would be a shame, for instance, if we forgot how to track animals through the wilderness (even though, ostensibly, we don't actually need to do that anymore). But beyond this, there is another reasons why institutions such as the Roots School are useful: primarily, the tools work. Pants made from tanned leather last a really long time and protect really well. Stone knives are super-sharp and useful for a variety of jobs. Bows make excellent hunting and fishing tools. Additionally, all these crafts are not somehow less "sophisticated" than gore-tex, metal carbide, or rifles. It often takes more skill and know-how to make a really excellent primitive tool than it does a modern one, and it can take a lifetime to learn all the intricacies. An expert flint-knapper has spent more time on her craft than a Ph.D. has spent on theoretical physics. So at the very least, I am grateful that someone has gone to the trouble to preserve these skills for us as a species.

But I'd have to go further, and say that traditional skills have their own inherent value as stand-alone disciplines, not simply as historical artifacts. It's interesting to me that this older tech uses an interface between our human "wetware" and its surrounding ecology that is straightforward, minimally processed, and manual-labor-intensive. That is to say, primitive skills rely on natural materials and human hands, and are based (by necessity) on a broad understanding of the ecology and its patterns to be successful. Modern technologies often rely on refined materials transported over long distances and the use of intermediate machinery. So the big difference, I think, is the degree to which the tools we use are abstracted from our daily experience: children quickly grasp how a stone knife is made (though actually making it is a lot tougher), whereas understanding a circular saw is trickier. Again, this doesn't mean the knife is less sophisticated. It simply has a more direct story. Its complexity lies in skill depth, rather than theoretical specificity. I am very grateful that someone still knows how to take a simple process and spend a long, long time exploring it with their hands and bodies.

If you compare a martial art and a gun, the distinction becomes unarguably clear. They are both complicated tools, but in very different ways. Both can kill - but it takes a lot longer to learn how by studying a martial art than it does by studying firearms. This is the tradeoff. What you sacrifice in time to learn the skill you gain in ethos, which is part of depth. It seems that we value technology differently when it is directly understandable, minimally processed, and labor-intensive. That different valuation connects to greater involvement, empowerment, and responsibility. We stop doing things by proxy. The process associated with the use of a technology becomes as important as the tool it creates, or the outcome it engenders. It's about the journey, not the destination. It's about how you play the game.
Herbalism, of course, represents the primitive skill of medicine. It has all the qualities we've explored: it's something a child can quickly understand, uses crude natural materials, and relies on individual labor (even if you're using ready-made tinctures or teas, the process of choosing them takes a long time. And the client has to do a lot of work to use them - relatively speaking). It changes our environmental ethos (shifting the perception of what to do with weeds, for instance). It is focused on process at all levels, though it still provides useful outcomes. For all these reasons, it is a valuable technology in the context of human health and, as with other primitive skills, cannot be dismissed as obsolete. I am most grateful to be a part of the tribe that has held and cultivated herbal medicine, and that I get to use this skill in my life every day. What a blessing.

Ultimately, old tech is different, and for some interesting (though not immediately obvious) reasons. When dealing directly with the messy, organic system of the human being and her surrounding environment, old tech might actually still be the better choice. When considering abstraction, verbal communication, neocortex-intensive-applications (which are by definition a bit more removed from the wet organic mess around and inside us), modern tech seems to shine. But when we approach old processes, like the workings of vital organs, the key to optimal, meaningful function is turned by old tech. Musicians (and vinyl enthusiasts) know this. Stonemasons know this. Many visual artists do as well. I am hopeful that our culture will take the lessons of primitive skills, including herbal medicine, as directions on our trail towards the future, towards progress. And I am grateful that any such trail will most likely be lined with dandelions.

Excerpts from Carmina Gadelica

Around the turn of the 20th century, Alexander Carmichael collected poems, hymns and incantations from the Scottish highlands into a six-volume compendium that includes both (extensive) Christian and Pagan verses. The digitized edition of Volume II includes a number of gems, with facing text in the original Gaelic. Here are some excerpts:


THE YARROW
I will pluck the yarrow fair
That more benign shall be my face
That more warm shall be my lips
That more chaste shall be my speech
Be my speech the beams of the sun
Be my lips the sap of the strawberry

May I be an isle in the sea
May I be a hill on the shore
May I be a star in the dark time
May I be a staff to the weak

Wound can I every man
Wound can no man me



SAINT JOHN'S WORT
Saint John's wort Saint John's wort
My envy whosoever has thee
I will pluck thee with my right hand
I will preserve thee with my left hand
Whoso findeth thee in the cattle fold
Shall never be without kine


THE CLUB MOSS
The club moss is on my person
No harm nor mishap can me befall
No sprite shall slay me no arrow shall wound me
No fay nor dun water nymph shall tear me


THE SHAMROCK OF LUCK
Thou shamrock of good omens
Beneath the bank growing
Whereon stood the gracious Mary.
The seven joys are,
Without evil trace,
On thee peerless one
Of the sunbeams:
  Joy of health
  Joy of friends
  Joy of kine
  Joy of sheep
  Joy of sons and Daughters fair
  Joy of peace
  Joy of God

The four leaves of the straight stem
Of the straight stem from the root of the hundred rootlets
Thou shamrock of promise on Mary's Day,
Bounty and blessing thou art at all times.

Kevin Spelman - molecular bio of immunomodulators

From the AHG symposium

Immunomodulators: botanical medicines that through the dynamical regulation of informational molecules alter the activity of the immune systems.

Cytokines and the cytokine theory of disease (Czura, CJ 2005): overproduction of cytokines can cause the clinical manifestations of disease. But it can begin on an emotional level (anger/shame as opposed to medidative states) - then as cytokines levels increase, disease manifests: first depression, pain, anorexia. Then, psoriasis, colitis. Then, tissue damage and arthritis. Finally, shock and organ failure.

Tumor necrosis factor (TNF) and other cytokines like Epidermal Growth Factor stimulate a series of intracellular changes that ultimately have effects in the nucleus - on genetic expression. When, in researching botanicals, we look at the nucleus, we're getting somewhere.

Paul Ridker MD 2002: "It may be possible that having a high cytokine response in our evolutionary past served us well, when our lifespan was 35-40 years. Insulin resistance might have been useful (to prevent starvation). Not so anymore."

The effect of cytokines depends on the cell secreting it (lymphocytes, monocytes, etc) and the physiological context in which they are secreted. They are "immune hormones". Subtypes:
-interleukins, which have profound effects on inflammation, immunity, central nervous systems, hormone secretions (esp. ACTH, corticoids), they drive antibody response.
-interferons, which are the first line of defense against viruses. They are also cytotoxic, disrupt sleep and HPA axis, stimulate fever-like response.
-colony stimulation factors, which affect cell motility and proliferation, wound healing, inflammation, and hematopoiesis
-chemokines, which stimulate chemotaxis, immune function, inflammation.

Cytokines are versatile. They have different roles, redundancy, synergy and antagonism, and can be autocrine, paracrine, or systemic in their actions. Cytokine receptors are membrane bound, though some are freely floating and act as an activating complex. They are secreted and produced for short periods of time, with little storage and tight regulation of production, and super-short half-lives - "like fireflies".
Normal physiologic functions that induce cytokine production are sleep (to repair/renew) and ovulation. Production in healthy tissue is minimal. Microbial infection, other cytokines, stress, corticoids, histamine all stimulate cytokines as well. "This is why hayfever can actually make you feel really sick".

We are attempting to exploit cytokines pharmacologically. Stimulate, inhibit, block, activate. Herbal medicines have been doing this for a long time. For example, now we use interferon for hepatitis, melanoma, lymphoma. TNF-alpha inhibitors are used for rheumatoid arthritis. Interleukins and interleukin inhibitors are used for asthma modulation, to reduce the risk of Alzheimers.

What about further, bigger thinking on cytokine use? They're implicated in all chronic, age-related, inflammatory diseases. They travel broadly throughout the body. They may also have huge behavioral effects (if we buy in to the psycho-neuro-immunology - PNI - model). Why do we get grumpy when we have the flu? Cytokines. But the behavior also isolates us, separating us from the herd, to protect our peers from infection.
Liver, heart, vessel walls, and adipose tissue all produce cytokines, and may contribute to the etiology of cardiovascular disease. The liver is dear to herbalists - for so many good reasons.
Diseases such as anorexia, schizophrenia, depression, Alzheimer's all show high plasma levels of cytokines. These can be directly measured (though the tests are expensive right now). What we still need clarity on is defining the normal range (which right now is super-wide). Maybe we can get there through genetic medicine, by refining the "normal" depending on genome. Herbalists, however, have always had a good differentiating tool: the constitution. Perhaps pitta people, for instance, exhibit higher "normal" ranges of cytokines.

Adhesion molecules (cellular adhesion molecules - CAMs) are immunoglobulin superfamily CAMs (IgSF - CD-x cell surface receptors), integrins, cadherins, selectins. They are involved in embryonic development, neuro development, tissue adhesion, and expressed by leukocytes, platelets, epithelial and endothelial cells. They maintain tissue integrity, and recruit cells to tissues. They have a critical role to play in pathology, cancer. There are higher levels in those at risk for heart attacks. They may also be involved in behavior - though the research is preliminary (Walzog, B 2000).
The conformation of adhesion molecules - extended versus bent - has an important role to play in the ability of adhesion molecules to function.
Adhesion molecules are important in inflammation - for example, p-selectins expressed on the endothelium sticks to sugars on white blood cell membranes and get snagged there. Then, integrins on white blood cells actually cause the WBC to stop, so it can engage in diapedesis (move across the vessel wall). In the wrong conditions, with too much inflammation, this leads to plaque formation in the vessel wall - atherosclerosis. It may also be important in perpetuating inflammation in autoimmune disease.

Next, nitric oxide (NO) starts to be produced. It is a free radical, second messenger, paracrine, vasodilative, neurotransmitter, and hormone. Signal molecule in the vasculature, neurons and immune system. It can act within the cell, moves through water and fat, and readily diffuses. It's synthesized from arginine (sister amino acid to lysine - they are in counterbalance to each other) using nitric-oxide-synthases. Interestingly, arginine levels are high in veg protein (peanuts, e.g.) and lysine high in animal protein.
The enzyme nitric-oxide-synthase is the key intervention point. It needs cofactors: NADPH, FAD, FMN (all based on B-vits) all linked by a calmodulin binding site [note from Guido: calmodulin found in, and stimulated by, milky oats]. Eventually, NO activates smooth muscle cAMP which relaxes the muscle.
Another important NO stimulating factor (through eNOS activation) is shear stress on the endothelium: often caused by high blood pressure.
NO not only leads to vasorelaxation, but also decreases platelet aggregation.
iNOS, which is created on an as-needed basis, often comes from macrophages when they are activated. So extra NO is produced when needed by immune cells! This vasodilates, sure, but NO is also a free radical that the immune players "shoot out" to damage invaders. Unfortunately, though, it can also damage us. Interferon is often the cytokine that gets iNOS going by activating iNOS gene expression.
nNOS (neuronal-nitric-oxide-synthase) is stimulated through a glutamate-sensitive NMDA receptor. The nitric oxide produced as a result enhances memory and learning. It's crucial for this purpose.

When NO is broken down, it produces superoxide ions, nitrates, and perhaps also peroxinitrites (ONOO-) which has been implicated as a cause of chronic fatigue syndrome (cf. Pall). It's extremely toxic, and will uncouple oxydative phosphorylation in the mitochondria - you can't make ATP anymore! If we remember that, because inflammation can come from infection, inflammation, or emotion, NO can come from a variety of causes, chronically elevated levels can lead to profound fatigue.
"We should be looking at the common molecular basis for disease, rather that all these different disease labels. This is part of the future of medicine".

THE HERBS:
Angelica sinensis: inhibits adhesion molecules, reduces iNOS
Curcuma spp.: modulates adhesion molecules, reduces iNOS. Very pleiotropic. A variety of constituents with multiple countervalent effects - depending on cell type and physiological context.
Echinacea purpurea: countervalent effects on cytokines (TNF), interleukins, selectins and iNOS. It has a lot to do with the dose and research model (in vitro) presenting different conditions. Also, extraction has a huge role to play: European products, for instance, often have low alkylamide content.
Ginkgo biloba: inhibits adhesion molecules, reduces iNOS.

Spelman - 2008: Modulation of Cytokine Expression by Traditional Medicines

Lisa Ganora - synergy in botanical medicines

From the AHG Symposium

The scientific research process makes it difficult to research more than a small handful of chemicals at a time. Considering that, by some estimates, botanicals contain up to 10,000 active constituents, scientific research runs up against a limit very quickly. Fortunately, we have a practical use history to turn to: we've been eating these plants for a long time with no harm.

Polymolecular approaches, which rely on synergy, have a unique ability to interface with the complex biological system of the human being. Plants provide this. Huge difference compared to pharmaceutical agents. Additionally, pharmaceuticals are very new on the scene. And most aren't cheap (whereas plants...)

Vitalism: boiled down by Paul Bergner, "Nature is Smarter". Case in point: digoxin in foxglove. When consumed alongside other foxglove chemicals, overdoses cause nausea and vomiting. When digoxin is purified, it loses that "warning sign". Molecules are like people: we behave differently in different situations. You're not going to behave in the same way at church with grandma as you do at the corner bar. Another example: "when embedded in a phytochemical matrix with companion molecules, ascorbic acid can behave differently ... this is antioxidant synergy". Ascorbic acid + Iron, on the other hand, is a strong oxidative agent.

Plants are chemistry's dynamic matrix. Dynamic is key. Always changing, always adapting, always efficient! This variability can seem to be a source of difficulty, of confusion. But herbalists can get a handle on the overall balance of botanical chemistry through organoleptic (sense-based) assays. [Guido's note: I really feel that human intuition is an expression of an interaction between complex living systems. That is to say, when we intuit that a plant is ready to harvest and will be useful, we are drawing on the sum total of our organoleptic assay, environmental awareness, memory, and need and coming up with a synthesis that determines usefulness. Our physiology (brain included) is a great pattern-recognition system that can be drawn upon to do complex, "fuzzy" calculations in near-real time... but only if we let the rational side go].

Co-evolutionary theory underlies the development of complex phytochemical matrices - and extends to humans as well. As people develop relationships with plants, we select for each other.

Types of synergy: potentiating (enhanced activity), stabilization (protect certain constituents), modification (attenuation of toxicity). Side note - "just because there's a known toxic constituent in a plant doesn't mean that plant will be toxic. I ate comfrey as a vegetable when I was pregnant. Modification synergy at work".

St. Johnswort is a great example of a plant that only works through potentiating synergy. Isolation of an active ingredient has consistently failed. Hyperforin, hypericin, xanthones, hyperoside, melationin and more all work together [Guido's note: Ginseng is another great example. We still can't point out an active constituent].
Clinical note: consider mixing your concentrated extract (St. Johnswort, Ginkgo, Milk Thistle, Turmeric, etc...) with a little powdered whole herb, tea, tincture or other crude prep. Take advatage of synergy.

Potentiating synergy types: affecting stability / reactivity of different constituents; increasing bioavailability; chemicals can be co-ligands of a receptor; one compound might inhibit enzymatic breakdown of another chemical.

An example of stabilizing synergy is the process of "redox cycling": botanical antioxidants re-activate one another and prevent pro-oxidant activity. Way more effective than eating isolated, single antioxidants (vitamin c, or quercetin, e.g.). There are well over 60 types of citrus bioflavonoids in a fruit, along with carotenoids or vitamin c.
This might underlie an interesting observation about carotenoids: 20mg/day trans-beta-carotene over 5-8 years to 29K smokers / drinkers actually led to 18% more lung cancer. When taken with Vit. E, no change in lung cancer rates. If they simply ate a high-carotenoid diet, there was less lung cancer (NEJM 1994; 330:1029-35).

Dandelion flowers are a great example of phytochemical synergy. They contain a cocktail of carotenes (beta and other). Also xanthophylls (lutein, cryptoxanthin). Flavonoids (luteolin, quercetin and their glycosides). Phenylpropanoids  - simple plant acids such as caffeic and chlorogenic acids. Triterpenes such as taraxasterol. Bitter sesquiterpene lactones. Some are oily, some watery. Taken together, they are anti-cancer, antioxidant, anti-inflammatory, and neuroprotective - but only when eaten as WHOLE dandelion flowers.

Black pepper (and its alkaloid piperine) is another example of synergy, but one where synergy relies on affecting endogenous (inside us) processes and thereby potentiating the activity of other phytochemicals. Piperine increases absorption and delays breakdown of many oil-based plant constituents. This has long been known in Ayurveda, where Trikatu is added to lots of formulas.

Oregon grape root is a great story of synergy. Its root contains lots of berberine, which is antibacterial and strongly inhibits Staph aureus. However, Staph uses a multi-drug-resistance pump (P-glycoprotein) that ejects the berberine to try to counteract its toxicity. But in the leaf of Oregon grape has 5'-MHC-D and pheophorbide-A which inhibit the multi-drug-resistance pump. Moral of the story: great synergy, but take a whole-plant preparation! (Stermitz, 1999)

Attenuation of toxicity is often seen in traditional polyherbal preparations. For example, Licorice markedly buffers the toxicity of prepared Aconite (monkshood) root.

The need for long-term thinking in medicine: Cinnamon as a case study

Here in Vermont, we are approaching the first anniversary of a storm that, over less than a day, poured an incredible amount of rain over the mountains, down the streams, and into narrow river valleys. The hill towns were quickly overwhelmed and literally swept away on huge torrents of water. These types of events are outliers, “hundred-year” floods. We tend not to think about them until they happen. If a river floods one spring, and washes away our garden, we could just build a retaining wall and be fine for years. But in Vermont, it seems that sort of thought process may have contributed to the severity of last summer’s event: narrower valleys, more constrained riverbeds, actually increased the torrent’s force and destructive power. As we rebuild, civil engineers are taking this into account.

In fact, there is a growing realization in many professions and disciplines that we need to approach the world with much more long-term thinking. Perhaps pumping out wetlands and building cities isn’t the best idea. It might be smart to consider sources of energy that aren’t going to run out fairly soon. When educating, connection to long-term curiosity might be better than passing the next test. Social and ecological concerns in market-based economies might trump the need to make a buck.

I dare say that medicine is beginning to embrace this trend, too – or at least people are. People who are interested in real food that may not require contaminating the water supply to cultivate, and who feel like this food might be better for their long-term health (though missing the tasty nacho cheese). People who consider a fever the sign of a healthy reactive response, and watch it for a bit rather than immediately suppresing it. People who are beginning to think that diabetes may be connected as much to ubiquitous, unregulated sugar in the food supply as it is to increased weight, lack of exercise, or “poor self-control”.

Which brings me to cinnamon. A recent meta-review found a small but significant effect from the powdered bark of this fragrant member of the Laurel family in treating the elevated blood sugar levels associated with Type 2 diabetes. I recommend this plant to clients concerned about this disease, either as part of breakfast or – my favorite – mixed with stevia, almond butter and cacao and rolled into “bliss balls”. It is best to take it regularly, as part of a long-term habit that includes real, bitter food and lots of movement. In this context it’s delicious, easy to take (doses are in the teaspoon range), and effective. 

The effect is, indeed, small when observed in isolation and for short periods of time. But diabetes (at epidemic levels) isn’t a problem that develops overnight, folks. I doubt anyone in the food industry, somewhere between the middle of the 19^th century and the middle of the 20^th, was saying “whoa - wait a sec, guys. I think that all this tasty sweet stuff (and elimination of all botanical biodiversity in the diet) might actually lead to epidemic levels of a sugar-metabolism disease in the next century!” No, that would have required seriously long-term thinking in matters of public health. And a little more knowledge of the human body.

Well, today we have a little more of  both. But research still looks at botanicals for three to four months most of the time – and this is partly because research is still beginning. When more time and interest are devoted to certain plants, such as the 2012 analysis that showed soy food consumption leads to lower recurrence of estrogen-positive breast cancer, striking results are revealed. But even this research only followed ten thousand women for seven years. Would that we had multi-generational followup data for cinnamon, endive, and dandelion roots! We might see a reversal of the grand experiment in carbohydrate refinement that gave us the current diabetes epidemic.

Short-term thinking gives us a need for dramatic, immediate results that might fit within the constraints of our current research model. This is great for many acute and chronic diseases, but not as great for matters of public health or for analyzing cultural patterns that lead to the diseases themselves.  Often, we learn about these matters from retrospective studies – discovering a problem after it’s already well-established. Long-term thinking takes a break and asks “if left alone, what might this situation look like?” Long-term thinking wonders how the river might handle a hundred-year flood if we hadn’t intervened to alter its course, how a population’s blood sugar might look if we hadn’t altered its food supply. 

Type 2 diabetes is a long-term effect of short-term thinking (satisfy my hunger now, and in a way that can be easily produced, stored, transported and packaged!) Its solution has to be based in long-term thinking, and part of that might very well include herbs such as cinnamon. The reason they are important is that, unlike a pharmaceutical solution, they provide an inroad to self-care based on whole plants and food – elements of life which, along with movement, end up being the keys to successful prevention of diabetes. If your mother started making cinnamon bliss balls when you were little, you might grow up eating them and eventually making them for your friends and family. Who knows what other bizarre plants you might consume along the way. Lo and behold, two generations later population levels of diabetes, obesity and heart disease are lower. I’d give you a rose to celebrate, but we all know there’s no research showing roses are effective as mood-lifters.

Some argue that, since the effect of a botanical such as cinnamon is small compared to conventional drugs, it should be rejected as part of our approach to diabetes. Ironically, the argument is that using cinnamon perpetuates a pill-driven, not lifestyle-driven, mentality for handling the disease. Call me crazy, but I’d respectfully argue that it’s probably pharmaceuticals that are driving this mentality, and that the search for a cinnamon capsule as an “alternative” is a first baby-step towards a different way. In the hands of an herbalist, baby steps turn into hikes in the forest. That could be a good thing – and a complex, multi-layered approach to diabetes that includes cinnamon most certainly is. 

Say what you will about an over-reliance on short-term clinical trials to drive therapy (or just read the British Medical Journal). Aside from the caveats (some of which I mention above), the approach is often a good one. But the offhand rejection of botanicals such as cinnamon, especially when they show promise, is actually harmful to public health. It is also a product of very short-term thinking. This is a problem that we need to resolve if we want to advance the cause of medicine and improve global quality of life – and herbalists, as those who, across the world, know what local plants do, are well placed to be part of the solution. Herbalists know the plants, but they also know that moving your vegetables over a little and supporting the community of cattail and calamus by the riverbank might be a better choice than a retaining wall, though it requires a (small) sacrifice in the short-term. Herbalists know that a bouquet of flowers makes you happy even though there’s not a single study out there to prove it. And they are usually inspiring teachers, too – the perfect choice for a diabetic patient. 

All this requires a change in thinking about medicine. We need to be looking further over the horizon, at a future where the advancement of our species sometimes includes a return to older technologies – not because they’re old, but because they’re damn smart in a long-term context. A future where we observe and mimic nature in designing our systems not because it’s “natural” but because, in the end, it’s in our own self-interest (global warming? Hundred year flood?). Herbal medicine fits in perfectly here. It is the precise modality that offers cultural connection, self-empowerment, ecological awareness, and effective remedies! It is both a blueprint for the future and a safety net for the present. As a design element for the next century of medicine, it can bring long-term thinking into a branch of science struggling with its own pressing challenges, helping it to harness the tools of complexity and deep ecology that are driving other industries. Long-term, complex herbal therapy won’t look as flashy in the short term – but that does not mean it has no value. Give it time, and skilled hands – a garden takes a season to come to fruit.

Urban Moonshine's herbal conference report

The recent week of warmth and humidity has taken a turn towards cooler weather today, and the south winds are freshening up and blowing in across the lake from the northwest now. But the full height of Summer’s glory was on display this Saturday, when over one hundred people from across Vermont and beyond attended Urban Moonshine’s first annual herb conference and the evening festivities that followed. I had an amazing time.

Rosemary Gladstar, our friend and ongoing source of inspiration, kicked off the event by describing the success herbal medicine has enjoyed – in our communities and on the national stage – but also by exhorting us to keep up the momentum and find new, creative ways to bring the plants into the lives (and kitchens) of those who need them most. Then we broke into class sessions held in yurts, out in green fields with sweeping views, or on the trail in the forest. Larken shared thoughts on differentiating and applying the nervine herbs; Betzy toured a huge group around the gardens and fields; Jeff shared his knowledge of medicinal herb cultivation; Melanie set loose the herb spirits by crafting flower essences on a truly perfect, sunny day; Mary gave a case-based overview of some herbal strategies for kids; Layla was the diva of essential oils; and Brendan taught how to fit Western herbs into the energetic and spiritual framework defined by classical Taoist Chinese medicine.

Throughout the day, Jovial and the Urban Moonshine crew took complete care of every detail, making sure there was plenty of water, energy tonic, and, of course, herbal bitters. They coordinated classes, showed folks to the pond for a refreshing afternoon swim, and prepared our dinner (along with Woodbelly Pizza, who trucked in their wood-fired oven and baked pies non-stop). And after browsing the herbal products marketplace, Colleen and Peter planted themselves behind the bar and served a range of  home-created cocktails to the assembly of herbalists: drinks such as the “Dreamer”, featuring crushed mugwort leaves, as well as more classic mixes (a great negroni, for instance). A fiery-orange moon came up over the Eastern ridge and the music got turned up.

As is so often the case for me at these types of gatherings, I loved my side-conversations with folks in the in-between times. I especially enjoyed talking with Brendan and his wife Liz, who are acupuncturists practicing at Jade Mountain Wellness and study medicine and philosophy in an ancient Taoist lineage. We mostly discussed how “wood” (as in the phase of change associated with spring) dominates our culture: we are immature, impulsive, infatuated with our newest technological marvels (fortunately, I had just finished swimming so my smartphone was far, far away). While there is nothing wrong with the pursuit of new things, we tend to discard our older ways much too quickly – and, of course, medicine is a great example of this pattern. Nothing wrong with antibiotics, I love the stuff when it’s needed: but do we really have to use them for every little infection? Probably not. You could make the same case for steroids, narcotics, anti-inflammatories – you name it. Brendan’s point was that, in being so “wood”-centered, we are overtaxing “metal”, which is charged with keeping the sprouting wood under control. Metal connects to ancestor wisdom. It connects to wild, animal nature. It connects to bonfires and howling to the moon. Too focused on wood we are, and metal suffers. If we fed our wild side a bit more, if we could learn to retain a measure of ancestor-wisdom, we might not be turning to our internet devices every thirty seconds. Just sayin’.

Of course, that is precisely what this gathering of fine herb-folk is promoting. And while the conference and party were a success, I am also extremely grateful to Urban Moonshine who is donating all the profits to our community clinic, where we work with folks who often have no money and provide them with long-term access to experienced practitioners, along with teas, powders and tinctures as needed, for as long as is needed. You can learn more about this work at the Vermont Center for Integrative Herbalism.

I taught a little class on herbal extraction and the distillation of herbal spirits. It was fun. Here’s the handout if you are interested.

Aromatic plants – cultivating the scented garden within.

It is legend that, some twenty-five hundred years ago, a ruler of  Babylon (or was it Niniveh?) commissioned a wondrous garden, terraced up from the flat plains between the rivers of the Fertile Crescent. Its levels were built of huge slabs of stone, elaborately carved and supported by high vaulted colonnades. Huge amounts of soil were transported to create hills and fields in this garden many, many feet above street level. Sundry species of trees, shrubs, flowers and herbs were brought in to plant its winding paths. Using giant corkscrew pumps, thousands of gallons of water were moved against gravity on a daily basis to keep the garden lush and green. The ancient historians named it one of the seven wonders of the world, and marveled at this oasis, high above the incessant bustle of the city, smoothed with endless marble and steeped in a deep, seductive fragrance from the constant bloom of aromatic plants. 

 It is also said that it was in fact the queen who, longing for her homeland in the rich, flowering hills of the north, had pleaded with her husband for a retreat that could remind her of her younger days, of her family, and of what brought her joy. Watching her languish in the hot, humid, noisy city at the heart of his kindgom, he met her request in grand style - and her Hanging Gardens have been the stuff of myth ever since. But while some may wonder at the choice of such a garden to appease the restless spirit, it makes perfect sense to me: a retreat of roses and jasmine, lavender and linden is the perfect prescription not only for bringing a quiet respite in the middle of a hectic life, but also for re-inspiring and re-awakening the joy and creativity of childhood. Furthermore, the fact that it was literally floating above the day-to-day activity of the city serves as a fitting metaphor for the scented garden itself: a time apart, uplifted, serene.

Think of the last time you received a bouquet of flowers, or brushed past a patch of mint in a field, or simply stood in the deep part of a forest and smelled, just smelled, the earth, the spruce, the moss. Chances are you experienced a moment where you lost track of your responsibilities, your desires, your plans and just existed in the fragrance. If even for a second, you tapped into a very primeval state of being: it is childlike, flowing, and free. In such a state, it is difficult to be judgemental, anxious, rigid, sad, or angry - and this may be why we so often give gifts of scented flowers when we want to nurture an atmosphere of love, understanding, and joy. 

 This fact may also underlie the nearly universal practice of burning scented plants, resins, and oils to alter the "energy" of a room or space: it clears the mind, sets the stage for creative, spiritual work, and attunes us to the present moment. Cultural rituals have harnessed the power aromatic plants hold over us and have embedded their use into the peak times of our lives: at birth and death; during marriage celebrations; as a cornerstone of purification ceremonies; during the dark, wintry months when the light is low; as part of meditative practice. Perfumery and aromatherapy have long recognized the power scent has on the human spirit - even real estate marketing suggests that a home, when appropriately scented, may put prospective buyers in a relaxed, comfortable mindset. In the ancient world, a thousand years before the Hanging Gardens were built, priests in the old stone temples along the Nile were mixing kyphi, the sweet and spicy incense sacred to the pharaos. 

 But the Egyptian ceremonies didn't only involve smoke and scent. Often, the priests leading the rituals would also ingest a good amount of kyphi, powdered and dissolved in wine, as a sort of primitive herbal extract. Here the truest power of scented herbs is revealed: when they are ingested, their action is magnified and lasts much longer. The smell may awaken us, bring us into the present moment, and help us flow through change more gracefully: but once the aromatic plants enter our bodies, their volatile constituents first relax our bellies, then disslove into our bloodstream and reach all of our internal organs. If there is underactivity in an organ or tissue, fragrant plants can "wake it up" (think of ginger, or peppermint). Conversely, if a tissue is overly tense, aromatic herbs "loosen the knot" (like fennel seeds after a huge meal, or lavender oil during a massage). Net result: a more balanced state of internal tension. Since forever, herbalists have called many of these plants “nervines”, loved the scented brews they yield, and prized them as stress-tamers, tonics for the nerves. 

 More modern research gives us two interesting pieces of information to help understand how this works: first, the chemicals in highly scented plants (specifically, their volatile oils) have the ability to alter the way smooth muscle contracts, depending on its current state of tension. Smooth muscle is found in the lining of all our hollow organs - lungs, gut, bladder, and uterus - as well as in the heart and blood vessels. Plants that affect smooth muscle can thereby affect how we perceive our internal state - and anyone who has experienced a spasming, crampy belly knows what a dramatic impact this can have. It is fascinating to note, however, that the place in the brain tasked with assessing this "internal state" is exactly the same place most affected by the perception of smell itself! The limbic system, a complex of brain structures known for its processing of emotion and its ability to guide "executive function" (our ability to flow through tasks efficiently and productively), is where all of this information is integrated. Aromatic plants thus have a dual effect: their smell immediately awakens and engages the limbic system, and if consumed, their chemistry helps adjust internal tension, removing the distractions that keep us from the present moment. When they are ingested, clinical research always shows the same results: more balanced mood, more restorative sleep, better attention, and an ability to move through challenging tasks more smoothly (and joyfully).

If you are seeking respite from the demands of the modern world and the bustle of the city, the scented garden and incense-filled temple may well be the answer. But fragrant herbs are the way to take your garden with you, to suffumigate your own internal temple. There are so many options available to help with the milder cases of restless or despondent spirit: sedatives for anxiety and insomnia, stimulants for apathy and sluggishness, narcotics to escape, concentrated extracts of botanicals like kava or St. Johnswort, and designer drugs for depression and the mental malaise of today's life. Unlike all of these, aromatic herbs are not strongly mind-altering, are safe and non-habit-forming, and quite easy to grow and use! They are part of a very old toolkit available to humans, and many animals before us, to enter more fully into the flow of life. When led by scent, we follow a path through a garden where intuition and emotion, more than analysis and control, dominate the landscape. 

For now, happy Full Moon, happy First Harvest. Our gardens are in fullest bloom. But since I so often turn to these gifts during the darker months of the year, when night is deep and one can't often see the path to brighter days, I leave you with the words of Margared McKenny, recalling her own garden on a January dawn:

                "The snow still lies upon the ground,

                And yet I feel

                The shadow of the scent of flowers;

                Breathless the firs against the gray -

                So still the air

                That hung upon a bare rose spray

                Are drops of rain

                Left there by midnight showers -

                (.....)

                Black head atilt

                A chickadee

                Whistles the first love-notes of the year."

               

The Natural Products Industry that Isn’t.

                A few evenings ago I was sitting on a rough cedar deck, watching sunlight orange across the tops of the poplar and maple canopy, and thinking how nice it was to be visiting my friend’s house in the forest: the nestled feeling, the total privacy, the familiar smells. He confessed  that, sometimes, he too liked to imagine his house from the perspective of a guest, walking through his gardens, up the wooden steps, and into the kitchen with the eye of an outsider, taking the time to appreciate it without the preconceptions and perceptual habits that develop after living in a place for an extended period of time. Perhaps it was the effects of the mixture of Schisandra kombucha, gin, and tonic water we were drinking, but this short exercise in mindfulness seemed to me as both a useful habit to practice and also a profoundly important skill for the modern human. We are so entrenched in our politics, our communities, our niches and worldviews that, without occasionally looking at life from outside the fences, we might run the risk of missing out on an important and useful perspective.

                I have also been thinking a lot about the Food and Drug Administration recently. Don’t get me wrong – there are serious issues around funding, connections to the food and pharma lobbies, and separation from nature that continue to concern me about this regulatory body’s work. But I have been trying to walk these familiar corridors (herbalists versus the FDA) with an outsider’s eye. In the last year, there have been more and more inspections of natural product manufacturing facilities. The government is trying to identify “new” dietary ingredients and regulate their use. There is both clamor and confusion rising up from those who make and sell products that are used under the umbrella of “complementary and alternative medicine”.  What is going on here, and why? What might we learn by observing the situation?

                Since 1994, when the US Congress passed the Dietary Supplements Health and Education Act (DSHEA), we have seen many, many new “dietary supplements” on the shelves of our food stores and pharmacies. Many of these products have come on to the market because DSHEA allows a fuzzy “gray zone” between food and medicine: while recognizing that supplements are more than vegetables, it doesn’t require that they be tested for safety and efficacy the way prescription and over-the-counter drugs are. This has allowed a profitable industry to grow in the United States, where annual sales of products labeled as “natural” and falling under the legal aegis of DSHEA top $28 billion, according to the Nutrition Business Journal. (http://newhope360.com/2010-supplement-business-report-0)

                Out of these annual sales, herbal products account for about five billion annual dollars, or just under 18% of the total. Within this five billion, it is hard to assess what percentage of products are made from refined, concentrated botanical constituents (such as curcuminoids, or silymarin) versus crude whole-plant encapsulations, tea blends, and tinctures – but suffice it to say, the bulk of that five billion annual dollars is not finding its way into the pockets of small-scale, heart-centered local herbalists! So, in sum, at least 82% and probably over 90% of what makes up the “natural products” industry isn’t “natural” at all: it is either a cocktail of vitamins and minerals, a sports nutrition or meal replacement product built up from processed constituents, or some other mixture of naturally-derived, refined, or outright synthetic ingredients. We may have encountered pieces of these products in nature at some point, but never at these doses. In certain cases, they are completely new to our physiologies.

                Take the case of grapefruit seed extract. The FDA has been warning manufacturers of this “natural” antiseptic and antibiotic agent that their products may contain triclosan (an antiseptic linked with bacterial resistance and toxicity); the American Botanical Council suspects that these extracts are adulterated purposefully to increase their antibiotic power (http://cms.herbalgram.org/herbalgram/issue94/QUALCONTROL_gfse.html). Others feel that the extensive processing that the original grapefruit seed slurry undergoes actually generates triclosan-like compounds (http://herbsandinfluenza.com/blog/2006/12/22/grapeseed-extract-explained/). Regardless, you either have an adulterated product (falsely labeled!), or a product that has undergone extensive chemical alteration, resembling grapefruit seeds less than high fructose corn syrup resembles an ear of corn. This isn’t a natural product at all.

                So whether it be an antibiotic derived from chemical manipulation, a mega-dose vitamin, a solvent-extracted slurry of connective tissue from a shark, or a digestive enzyme obtained from a genetically-modified Aspergillus fungus, I fear that our “natural” products bear little resemblance to those found on the shelves of natural food stores in the 1980s.  Even more disturbingly, most of what’s out there (with a few rare exceptions, like folic acid) shows very little evidence of helping for any problem whatsoever. Where do we see a consistent body of research and a rich depth of traditional use? It’s in herbal medicine – less than 1/5 of what’s on the shelves. Most of these other “natural” products are marketed on the basis of petri dish experiments, fruit fly studies from fifty years ago, anecdotal testimonials, or in some cases, just snazzy packaging. Some of them contain toxic, drug-like ingredients. It is no wonder the FDA is trying to get a handle on this situation (as it already has with the amphetamine-like additive DMAA http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm302133.htm). It is also no wonder that we are starting to see more and more reports of vitamins, minerals, and other supplements potentially doing us more harm than good: they are at best weak drugs, and at worst untested, potentially unsafe, chemical additives.

                What put this over the top for me was a discussion I had when I recently visited Bastyr University, the premier training ground for naturopathic physicians in the United States. Out of the 299 credits required for graduation, there are five credits devoted specifically to botanical medicine. Over seventeen are assigned to physical medicine (somatic therapies involving touch, manipulation, etc), and over eight for homeopathy (http://www.bastyr.edu/academics/areas-study/study-naturopathic-medicine/naturopathic-doctor-degree-program#Curriculum). Where are the herbal materia medica classes? Where are the topics on complexity in medicine, the study of interactions between multilayered living botanicals and multilayered living humans? These are the roots of naturopathic medicine, but they seem to be nourishing less and less of the Bastyr curriculum these days. So can we really be surprised that some practitioners recommend abstracted, drug-like “natural” products to their patients instead of teaching them to brew tea and walk in the forest?

                Natural products aren’t real, folks – but fortunately,  herbal medicine is. Herbal medicine is traditional medicine – for over 80% of the world, but for us in the “developed” world, too. Along with ancient somatic and energetic therapies like massage and acupuncture, all tied together by a rich and meaningful mythology, herbal medicine makes up this tradition. Modern alternatives – be they the mainstream technological medicine, or “CAM” technological medicine – are just that: a different choice, some of which is well validated for use in health care, some of which lacks any validation whatsoever. But neither prescription drugs, over-the-counter pills, or that 80% of “natural” dietary supplements can come close to providing the breadth, depth, and accessibility of true traditional medicine. 

                It is time for herbalists to affirm that our plants are not “complementary and alternative” to technological medicine. Our medicine is real, and just as real vegetables are not a complement to frozen dinners and meal replacement shakes, true botanical medicine is not some kind of extra adjunct to pharmaceuticals and surgical interventions. It is a birthright. It is a daily gift. Its memory is visibly encoded in our genetic material. And it is being practiced everywhere, in kitchens and apothecaries, in modern production facilities and improvised forest clinics. We as herbalists – the growers, the clinicians, the wildcrafters, the medicine-makers, the keepers of wortcunning, the storytellers – have been sinking our roots back into the tradition over the last few decades. Now, having moved well past the embryonic stage, and our cotyledons fully unfurled, it is time to rise up and proclaim what makes us unique: we are traditional medicine, we are integrated ecology, we are plants. Argue all you want about what is “mainstream” and what is “alternative” – we as herbalists are neither. We are tradition, we hold the roots. Now let’s stand up and let others know the deal.  As Rima Staines simply put it (http://intothehermitage.blogspot.com/2012/01/rise-root.html): rise and root. Think as a plant does: up, up! and down, down! One movement in many directions, many directions with one focus.