Transcript Document

Clinical Herbalism
http://www.grianherbs.com/herbalism.ppt
Guido Masé
[email protected]
(802) 229-5895
Roots
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Traditional Chinese
Traditional European
Native American
Eclectic
Modern European
Astragalus,
Huang qi
• Astragalus membranaceus
• Member of the Fabaceae
(Leguminosae). Composite
leaf, delicate yellow-pink
flowers that mature to small
pods. Strong branching
yellow root used for
medicine.
• Warming Yang immune
tonic, lung tonic
Hawthorn
• Crategus species
• Member of the
Rosaceae. A beautiful
white-flowered tree,
used in Europe for
hedgerows. The berries
are traditionally used.
• Warming, nutritive
cardiovascular tonic
and normalizer. Can be
of support in depleted,
depressive conditions.
Echinacea
• E. purpurea, E. pallida,
E. angustifolia
• Member of the Asteraceae
(Compositae). A perennial
favorite with prolific
flowers, all parts of this
plant are used for medicine.
Root, seed and unopened
green flower buds are
strongest.
• Cooling, disperive, antiinfective, anti-poison herb.
Powerful and effective in
acute conditions.
Therapeutic ideas
• “Energetics”: Yin/Yang, Fluids, Spirit
• Physiological concepts
• Enhancing
absorption/metabolism/elimination
• "Tonification"
• Empiricism
• Scope of practice
Yin and Yang
• Cold/Hot
• Sedating/Stimulating
• Deep (Chronic)/ Superficial (Acute)
Vital Fluids
• Humors
• Tissue states
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Hot
Dry
Wet
Cold
• "Vital Force"
Plant spirit medicine
• Meaning through experiential relationship
• Plants as archetypal symbols
• Connection with Homeopathy
• Long-term healing: “life-changing”
Physiological concepts
• Vis medicatrix naturae
– The healing power of Nature
• Holism
– Looking for broad, underlying pattern
• Extensive tissue/organ interconnection
– Feedback is everywhere – homeostasis is subtle
Holism
• Reflection of pattern at many levels of being
– Self-similarity exists at every level. All levels
interact to form the whole.
• Intervention can be broadly effective when
initiated at any level
– Broad-stroke physiology centered more on
process/relationship
– Herbs are complex crude preparations
understood holistically
– Essential role of nutrition in therapy;
herbs as "special foods"
Nature of Herbalist / Client
relationship is crucial
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Intake process can take hours
Emphasis on story, context and meaning
Increasing client’s connection to medicine
A partnership that educates and empowers
the client to take responsibility for wellness
Extensive tissue/organ
interconnection
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Autonomic nervous reflexes
Immune / lymphatic
Endocrine / Adrenal
Shared characteristics
– Innervation
– Mucosa
Enhancing elimination
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Liver function
Digestive strength (helps absorption, too)
Kidney function
Expectoration
Lymphatic function
MILD IRRITANTS / TISSUE STIMULANTS
WITH OVERALL COOLING FUNCTION
“Tonification”
A tonic brings a system towards optimal
homeostasis / efficiency
• Specific type
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Cardiovascular
Digestive
Endocrine
Immune
• Systemic / broad type
– Ginseng, e.g.
LONG-TERM, AKIN TO FOODS
Scope of practice
• Acute treatment / limitations
• Chronic treatment / limitations
• Importance of inter-modality work
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Acupuncture
Massage / bodywork
Counseling
Nutrition
Modern Medicine
Nature of the
Materia
Medica
Archetypal
herbal actions
Enhancing Elimination / Counterirritating
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Rubefacient
Cholagogue
Diuretic / Diaphoretic
Expectorant
Lymphatic
Relaxing / Soothing
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Sedative
Hypnotic
Antispasmodic
Anti-inflammatory
Demulcent
Countering pathogens
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Antifungal
Antibiotic
Antiviral
Anthelmintic
"Tonifying"
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Digestive bitter
Immune tonic / modulator
Cardiovascular tonic
Endocrine tonic
Nervine tonic
Multi-function
• Multi-function tonic
• "Alterative"
Phytochemistry
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Chemical classes
Standardization
Dosage and safety considerations
Pharmakokinetics
Astragalus,
Huang qi
• Polysaccharides
• Phytosterols / Saponins
• Generally safe and mild;
β-sitosterol gentle antiinflammatory
• Polysaccharides important
immune tonics1
• Mostly water-soluble
Hawthorn
• Flavonoids
• Vitamin C (like most
Rosaceae)
• Sugars
• Very mild, akin to food.
Antioxidant value
(flavonoids); reduces
LDL oxidation and
vascular damage2
• Mostly water-soluble
Echinacea
• Alkyl amides
• Polysaccharides
• Inulin & starches
• Strong effect from alkyl
amides (immune activating,
anti-inflammatory)3 plus
polysaccharide effect
• Inulin starch beneficial for
intestinal flora
• Generally safe, but more
powerful in flavor and effect
• Better solubility in 50%
ethanol
"Energetics"
• Signatures
• Spirit / "Intelligence"
• Temperament
– Hot / Enhancing / Stimulating
– Cool / Eliminating / Sedating
• Taste
• System affinity
• Amphoteric
Case 1:
Recurrent Staphylococcus infection
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Male, age 34
Original infection in foot, with extensive inflammation and lymphatic involvement. Left untreated for
2 weeks. Initial treatment with IV antibiotics, unknown type, resolved the dramatic symptoms fairly
quickly.
Herbal therapy sought for eruptions (few localized furuncles) six months after initial treatment.
Furuncles tender but not itchy, appearing on R leg and hip, chest.
First recommendations:
– Drastically reduce sugar and refined starch consumption
– Echinacea tincture, 3ml every 2 hours as anti-inflammatory and antibiotic
– Calendula and Zingiber (Ginger) tea, 32 fl. oz. daily
– External applications: Maleleuca (Tea tree) and Zingiber
Based on: “trapped, stagnant heat” and “deficient circulatory energy”
i.e. latent infection, need for increased circulation and therefore immune response
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First results:
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After 24 hours, client reports less tenderness and reduction in number of furuncles
After 72 hours most furuncles have disappeared
No recurrence for 3 months
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Client returns with similar symptoms; same treatment is repeated with good success (though
improvement is not as rapid).
Two months later, client returns. Symptoms began similarly, but now furuncles have become
exacerbated (within 48 hours) and skin necrosis has begun in two areas. Client presents with two
ulcerations, diameter approx. 2 cm, where the skin is completely gone and underlying tissue is
revealed, surrounded by an inflamed area of 6-8 cm in diameter. Beginnings of lymphatic
involvement.
Recommendations:
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Results:
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Same as initial protocol, but with the addition of Baptisia tinctoria (2 ml TID) as a more powerful antiseptic
and lymphatic
External applications of beeswax-based salve with Commiphora (Myrrh) and Maleleuca (Tea tree) under sterile
bandages, along with suggestions on proper hygiene.
Surrounding inflammation much reduced within 48 hours. Salve modified to feature Symphytum (Comfrey) to
speed growth of new dermis, along with nightly fresh Symphytum poultices.
New skin forming within 1 week; diameter of ulcerations down to 1 cm. Improvement continues over next
week until fully resolved.
Additional information:
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In an attempt to arrive at the underlying imbalance that allows the infection to recur, client reveals emotional
and personal trauma surrounding the initial presentation and first recurrence. Client is troubled by threats from
an individual who “hates him”.
Recurrences seem to occur around times of stress and tension with this individual.
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Final Assessment:
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Long-term solution:
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Stagnant “damp heat” as a result of blockage in the flow of internal energy. This flow has been blocked as part of
an emotional pattern which is disallowing proper immune function. Infections are recurring partly because of an
immune response weakened by the underlying infection itself; partly because of stress-related immune
suppression; and partly because of an unwillingness and a fear to confront an abusive situation.
Traditional purification ritual involving Artemisia (Mugwort, Wormwood). These herbs are strewn about the
dwelling; burned as incense; and taken internally as a tea for the day and night of the ritual. Emotional fear and
anger are identified, acknowledged, externalized, and released through compassion-based imagery and
meditation. The herbs used have both spiritual/emotional and somatic function: all members of the Artemisia
family contain powerfully antiseptic volatile oils (thujone, e.g.)
Immune enhancing protocol is recommended for an additional 6 months: daily tea of Astragalus and Ganoderma
(Red Reishi polypore mushroom), 16 fl.oz.
Final Results:
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Client has been free of infection to date. Immune-enhancing protocol slowly discontinued after 6 months.
Case 2:
Integrative treatment: brain tumor
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Female, age 53
Tumor in motor cortex, diagnosed from symptoms of Bell’s palsy (rt. side of face), arm weakness,
difficult speech and fine motor movement. Confirmed by MRI, 9/04, when tumor size was assessed
at 1.5 cm diameter. After initial courses of radiation and chemotherapy, surgery was attempted (Dana
Farber Oncology) 3/05. Tumor had reached diameter of 4 cm. Surgery largely successful, with no
complications (although impossible to remove entire tumor due to location).
Client begins dietary regimen on the advice of a nutritionist. 9 servings of fresh fruit/veg per day; 4
servings of whole grain and/or legumes daily; fish as major protein source. Addition of yogurt and
flax seed oil. Organic, hormone and antibiotic-free foods are stressed. Colorful (flavonoid-rich
antioxidant) foods are emphasized.
Follow-up visit 6/05: MRI shows no signs of tumor. Chemotherapy continues; client WBC counts are
very low, especially neutrophils. RBC borderline-low. Motor symptoms are not much improved; anticonvulsants are prescribed.
Client seeks herbal support 8/05, primarily to address low WBC counts but also to add another level
of protection against tumor recurrence and perhaps an alternative to anti-convulsant medication
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Initial assessment:
• Vital, strong, motivated individual who is eating an incredibly healthy diet and wishes to pursue
all available treatment strategies for her condition.
• Immune function / WBC count is low most probably as a result of chemotherapy treatment.
• Tumor was aggressive, but seems “under control” at the present moment from excellent, mutimodality care.
• Motor symptoms are distressing to an active, energized, professional woman. This may be
related to trauma and resultant cerebral inflammation/oedema and may take time to resolve.
• Intake process reveals mild hypoglycemia, a lifelong “concern”
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Initial recommendations:
• Tincture of Astragalus, 3ml BID
• Digestive bitters (Dandelion, Artichoke, Burdock), 3ml 15 min. before meals
• Supercritical CO2 extract of Maitake, Reishi, Chaga (medicinal mushrooms) 2ml BID
• Tincture of Verbascum (Mullein), 1ml BID
• “Immune broth” recipe using organic beef bones, Astragalus, Ganoderma. 8 fl.oz. daily.
• Silybum (Milk Thistle) standardized extract 240mg daily
Astragalus, mushrooms and broth all help increase WBC and RBC counts. Digestive bitters are
tonic, help elimination and liver function, and address hypoglycemia. Mullein root a specific
for neuromotor symptoms. Milk thistle supports liver function (aids in processing
chemotherapy).
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Results:
• After 6 weeks, WBC and neutrophil counts are within normal ranges, even with the same
dosage of chemotherapy. RBC low end of normal. Liver and kidney enzymes are fine.
• Client, in consultation with oncologist, has halved the dose of anti-convulsant medication.
Symptoms are slightly improved, esp. hand movement and speech.
• Client has noticed improvement in digestive function, especially bowel movement consistency
and regularity (side-effect of digestive bitters).
• MRI reveals no tumor or re-growth of any kind.
• Treatment is modified to include Trifolium (Red Clover), Rosmarinus (Rosemary), and
Crategus (Hawthorn) for anti-tumor, anti-oxidant, and cerebral vascular health. These are taken
in tea form
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After an additional 6 weeks, motor symptoms continue to (very gradually) improve. CBC still
completely within normal ranges. Chemotherapy and nutritional intervention continue.
MRI still reveals nothing of note in the affected area. Liver enzyme levels are lower than before
initiating herbal treatment. It has been 14 months since diagnosis; 9 months since surgery.
Herbal therapy can provide a significant benefit when used alongside conventional tumor
treatment. It encourages stronger immune function; manages the side-effects of medication;
and can provide mild symptomatic relief. Communication between practitioners accomplished,
for the most part, through the client.
Case 3: Chronic bronchitis
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Female, age 57
Complains of yearly recurrences of bronchial infection (diagnosed by MD). Antibiotic therapy
temporarily effective, but respiratory infection usually recurs at least once in the season. Each bout
can last 2 weeks, with protracted chest congestion for an additional 4-6 weeks. No fever.
Non-smoker. No hazardous environmental conditions (chemicals, allergens, molds, etc…) identified.
Diet consists of refined wheat flour as main carbohydrate source; much dairy; few vegetables, mostly
canned or frozen (not fresh).
Assessment:
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Long-term lung weakness, perhaps from overuse of antibiotics. Current acute presentation of bronchitis. Poor
exercise regimen. Poor diet needs improvement.
Initial Recommendations:
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Tea of Glycyrrhiza (Licorice), Sambucus (Elder), and Zingiber (Ginger) to warm, soothe, and stimulate
expectoration. 32 to 64 fl.oz. daily.
Tincture of Echinacea, 3ml five times daily. Tincture of Inula (Elecampane) 3ml TID as an expectorant.
Extensive dietary recommendations focus on whole foods, less dairy, and warming spices that stimulate
circulation (Garlic, Cayenne, Ginger, etc…)
Follow-up visit scheduled in one week.
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Results:
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Respiratory infection resolved, mostly. Some expectoration continues but mucus production is easy, and the
mucus is clear (no longer dark yellow). No antibiotics used.
Treatment is altered to remove Echinacea and Inula, and focus instead on strengthening “lung qi” and
rebuilding immunity. “Immune broth” of Astragalus, Ganoderma, and Urtica (Stinging Nettle) is
recommended as a winter tonic. Brew by simmering for 8 hours; strain; freeze in ice cube trays and use two
cubes daily in 8oz of hot water. Initial tea is still part of treatment for at least another week.
Follow up this fall: client reports no bronchitis this season, and has been taking “Immune broth” since midSeptember. Diet has improved a bit, mostly by the addition of whole fresh vegetables
Clinical Herbalism
http://www.grianherbs.com/herbalism.ppt
Guido Masé
[email protected]
(802) 229-5895
Notes
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1) A study on the immune receptors for polysaccharides from the roots of Astragalus
membranaceus, a Chinese medicinal herb. Biochem Biophys Res Commun. 2004 Aug
6;320(4):1103-11
2) Flavonoids: a review of probable mechanisms of action and potential applications. American
Journal of Clinical Nutrition, Vol. 74, No. 4, 418-425, October 2001
http://www.ajcn.org/cgi/content/full/74/4/418
3) Macrophage activating effects of new alkamides from the roots of Echinacea species.
J Nat Prod. 2005 May;68(5):773-6.
Additional resources:
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www.grianherbs.com
http://www.herbalgram.org/
http://ns2.rt66.com/hrbmoore/index.html/)
http://www.henriettesherbal.com/
http://www.americanherbalistsguild.com/