Michael Tierra applies cups to a patient
with severe back pain at the East West Free
Clinic in Santa Cruz.

We have encountered many extreme acute chronic conditions among the homeless population that we’ve treated. The most common involve pain due to trauma or metabolic imbalance. Naturally enough, other common conditions perhaps just as prevalent are depression, anxiety and manic, bipolar disturbance.

Rheumatic and arthritic conditions are described in Traditional Chinese Medicine as Bi Zheng disease which includes a wide variety of back and joint pains. While diet and herbal therapy provide nutrients and healing at a deep level and ultimately provide the most lasting results, various physical therapies such as needling, bleeding, scraping, cupping, moxibustion and medicated oil massage  offer the most immediate relief.

This case was that of a homeless man, who had several laminectomies and possibly a disk fusion over a portion of his lower back in the area of L3 to L5. This man appeared to be in his late 30s and claimed to suffer from acute, disabling back pain for over 14 years. Laminectomy is a surgical procedure that removes a portion of the vertebral bone, called lamina. The muscles are pushed aside without cutting with the intention of leaving parts of the lamina intact. Disk fusions are performed when there is a problem with the disc space between the vertebrae causing painful pressure on the adjacent nerves.

I was not sure which of these or perhaps both procedures were performed on this man but it was obvious that he had at least three surgeries all in approximately the same area. Unfortunately he had no pain relief and more than likely a severe exacerbation of pain.

The man was married to a woman who loved and cared for him as best she could. Both lived on a small monthly disability and had temporary residence at the Santa Cruz Homeless Shelter. This is one of many cases where an individual suffering from such incapacitating health problems had little hope of being able to hold a job and better their living standard.

This man was taking and probably hooked on several severely addicting pain killers including oxycodone. Still, the pain throughout his body, especially his back, was constant and excruciating. He could barely move, let alone get on the table where we might try to relieve some of his suffering. With the assistance of three of us we finally got him lying face down. He was moaning and crying with every more. I palpated different areas of his back to determine where the pain was most severe and where the inflammation and blockage emanated. Again, he exhibited great sensitivity to pressure point palpitation.

I decided to use the most powerful method to relieve such conditions that I know: bleeding and cupping. Both are traditional ancient methods employed in many traditional cultures including Traditional Chinese Medicine dating back thousands of years.

Many people don’t realize that before the invention of small stainless steel needles, small sharp stones were used to extract a small amount of blood from precise areas of the body. Cupping used by creating a vacuum in a small cup applied to suck the skin and blood to the surface is used in diverse cultures ranging from throughout Asia, Greek and Central America. These were formerly considered folk traditions and are now part of the practice employed by some acupuncturists around the world.

I used small sterile diabetic needles, beginning with two points behind the knees called Weizhong or Bladder 40. These points treat lumbar pain and spasm of the lower back and extremities. They are powerfully anti-inflammatory and relieve pain. Translation of the name “weizhong” means “support the middle” because they also treat abdominal pain, vomiting and diarrhea. They are the most effective points for treating all lower back pains and for severe cases, they are most effective if they are caused to bleed. You may wonder if this was painful to this man. In fact his pain was so severe that he didn’t feel any of the quick tiny pricks which I then proceeded to do at particularly sensitive areas through his entire back, each time applying a cup and drawing out anywhere from a half to a teaspoon full of blood from each point.

After applying wan hua oil to the region, a special medicated oil to relieve pain and promote blood circulation, removing the blockage causing pain in the area, I pricked the two most painful areas near the areas where the surgery scars were evident and then applied two cups.

After 15 to 20 minutes I removed the cups, carefully wiping off the coagulated blood on the skin and inside each cup using as sterile measure as were available under the circumstances. This man’s pain was so severe, I considered this an emergency procedure. After removing the cups I lathered Ayurvedic Mahanarayana oil, the most powerful of all rejuvenative, anti-inflammatory and healing oils the world has ever known. “With a sesame seed oil base, this massage oil has some widely known homeopathic constituents like clove, camphor, turmeric, cow's milk, cedar bark, sandalwood, ginger and licorice. It also contains several historic Ayurvedic herbal tinctures known primarily in India, such as the herb blend dashmula, an asparagus extract called shatavari, the country mallow plant known as bala, and a mild sedative called tagar,” (http://www.wisegeekhealth.com/what-are-the-benefits-of-mahanarayan-oil.htm)  and these are about half of the total ingredients. This oil is available online. I use so much of it in my practice that I purchase a gallon at a time from Banyan Botanicals. http://www.banyanbotanicals.com/mahanarayan-oil/

After the cups were removed that man was reluctant to move and sit up for fear of experiencing the old pains he had before and during the process of getting on the table.

As you can see from the final picture, for the first time since our first encounter, the man was sitting up and specifically said “I feel good,” exclaiming that he hadn’t felt so much relief from pain in over 14 years of multiple and costly medical procedures and physical therapy.

I also prescribed an ancient traditional Chinese herbal formula for back and joint pains and both osteo- and rheumatoid arthritis called Du Huo Ji Sheng Pian (Wan) to be taken as pills three times daily. This formula contains up to 14 herbs and when taken over a period of weeks to 3 months is remarkably effective in treating back and joint pains especially of the lower body.

Among the powerfully anti-inflammatory, analgesic, blood-moving herbs in the formula are a species of angelica (Angelica pubescentis) and Loranthes, a particular species of mistletoe found growing on mulberry trees (do not use American mistletoe as it is toxic).

It is moments such as this that provide me with the most satisfaction and joy. 

East West Free Clinic herbalists Maureen Flash, Erin Massengale, Michael McEvoy, Beverly Jennings

I have always had the desire to be of service to the poor and indigent in our community, but was never quite sure how to incorporate that into my life, given all my other commitments as both an herbalist, acupuncturist, author, teacher, formulator, gardener, and musician. I was afraid of beginning something that I might not be willing, or able, to follow through with. Then, at the American Herbalists Guild annual herbal symposium, I met some friends and colleagues who I respect; 7Song and Lorna Mauney-Brodek of www.herbalista.org, who inspired me to try to create such an offering with my students in our local community.

In July 2014, Lesley and I began providing free monthly herb classes for local East West students. Most of these students were at the foundation or intermediate level when we started. We began with an in-depth study of pulse diagnosis, then tongue diagnosis, the 10 questions, TCM theory, and other important facets of Planetary Herbalism. By design, these classes were to prepare them for practice in a free clinic where they would not only serve the health needs of the poor and underprivileged in our community, but also gain valuable clinical skills and experience – a win-win situation for sure.

The result is the East West Herbal Free Clinic, headed up by myself and Lesley as teachers and mentors, made up of a number of inspired and great local East West Herb Students living in near proximity. So far, with two Saturday morning sessions under our belts, a group of 10 or 12 of us saw 26 patients within a two-and-a-half-hour time period. We are quickly learning how to work together as a choir of herbalist-healers. So far it seems that everyone who came to work with us on a one-on-one basis received the healing that was possible and that they were ready for.

I’m very proud of each and every one of my local Santa Cruz herb students and colleagues, and I want to honor, mention and introduce them to you each by name as founders of this noble collective endeavor. We are:

My wife, Lesley Tierra, without whom I don’t think I would be able to have done even half of what we’ve accomplished together; professional AHG members and East West School of Planetary Herbology graduates Beverly Jennings and Linda Vaughan; and foundation student Dee Lewis, who stepped up to reorganize the California Greater Bay Area chapter of the American Herbalists Guild. The team of students currently attending the classes and clinic also include Michael McEvoy, Maureen Flash, Kathryn Grant, Erin Massengale, Larry Nakanashi, Michelle Schurig, Evan Small, and Shelley Swapp. 

We have quickly bonded together.  If there is a need, such as filling gelatin capsules with Triphala powder the night before, we all soon learn that it’s already done or in process. The same occurs when we are working together in a relatively small space with patients at the homeless center; individuals just step up and do whatever is needed.

We operate together in a spirit of respect, friendly camaraderie and gratitude for each other as we learn to accept and appreciate who we each really are. Our dynamic bears out my experience that the best part of being an herbalist, for me, has always been to hang out and be with other herbalists. Herbalists come in all sorts of unique styles, political and religious persuasions. Bridges of mutual respect can transcend any differences, and these people can be brother and sister herbalists. As my fellow herbalist sister Rosemary Gladstar has said repeatedly, ‘It is the plants that unite us all.’

On a Wing and a Prayer: The Clinic is Launched

I set Saturday, Jan. 31, 2015, as our “ready or not” launch of the East West Herbal Free Clinic at the Homeless Services Center in Santa Cruz, hopefully establishing a model that will be duplicated by hundreds of enrolled students and graduates scattered throughout the United States and some foreign countries.

To seed our free clinic pharmacy, I gathered expired herbal patents that I had accumulated from years of over-purchasing products for my clinic – little did I know how useful these would prove to be. These products were perfectly good and potent, but carried an expiration date based on legal requirements. Shelley Swapp tirelessly encapsulated over a thousand capsules of several powdered herbal mixtures and simples I provided. I gave a ‘lead sheet’ describing briefly the uses and indications of each herbal product to Maureen Flash, who, after a whirlwind evening of sorting and categorizing with Beverly Jennings and Dee Lewis, carefully took on the job of researching and listing indications for added and current products, cataloguing and organizing them all into portable plastic boxes so thoughtfully and generously donated by Beverly, so that we could easily transport them back and forth from the homeless center.

How miraculous it seems that all the crucial details worked themselves out!

When January 31 arrived, I was up at 4 a.m. worrying about how the whole thing would go, wondering if I was about to throw a group of lambs into the lion’s den. With only five Saturday classes I gave as preparation, was it reasonable to expect that we could we pull this off? Would these students be ready to actually start seeing clients – especially people with such tremendous physical, mental and spiritual health handicaps? Could we really help people who barely have shelter and food to feel better?  I wondered how responsive our clients would be to such care.

All those feelings dissipated within the first hour as I breathed a sigh of relief and quietly said to myself, “Thank God, it’s happening and it really seems to be working.” Within the first five minutes, one problem was solved – there was no lack of clients who signed up to work one-on-one with members of our team.

We started out with one or two of us walking out onto the homeless center grounds to introduce ourselves. We offered to sit and listen to their health complaints, and assist with herbal, dietary, bodywork and other healing therapies. These were given free of charge, as well as free homemade bowls of delicious soup and warm tea. People responded positively.

As an aside, it is appalling to see the number of meds that many of these people have been given. Considering that alone, it is a wonder that any of them could ever get well!  However, it is also amazing that despite this, even the simplest, most common herbs and healing can make such a difference for some at least.

We held our second East West Herbal Free Clinic on February 28 and, despite the rain, everything went even more smoothly. It feels like we might have hit our stride. Everyone showed up on time, with food, tea, freshly capsuled organic herbal powders, an organized pharmacy of donated patent herbal formulas, tinctures and salves. Since I’m looking to use pre-made herbal formulas and herbal combinations with the broadest application, I brought tinctures of Swedish bitters, which I made for the center. Swedish bitters seemed to me to be a good contribution, along with Triphala, and capsules of dandelion, burdock, turmeric and ginger. These kinds of ready-made formulas with broad applicability work really well in such a setting.

Dee got a kick out of my referring to what we we’re doing as ‘guerilla herbalists,’ because, like a small squadron of revolutionaries, we are try to move in, get set up as quickly as possible, do our fun work and then, just as quickly, tear it all down and leave the place as if we were never there.

The Gifts of Giving

I discovered my calling as an herbalist and healer while living in a commune called Black Bear in the remote mountains of Northern California. This was an amazing collective, including a group of students learning and practicing acupuncture and herbs.  It was then that I learned two important lessons: that we learn best while doing, and that it is in giving responsibly that we receive.

Even after only two Saturday mornings at the free clinic, we’re definitely gaining a greater perspective on life and healing, and a respect for the power and benefit for what we have to offer to relieve even some of the misery and suffering of our community brethren. It may be a cliché, but I’m sure we experience true benefit and gratitude as we come face to face with individuals who for various reasons are less fortunate than ourselves. It is gratifying to experience how we make these people ‘almost’ happy, given their pitiable circumstances, with our gifts of healing presence, herbs and food.

I hope to set to rest the all too familiar complaint of students that “there are no patients.”  The ‘Way of Herbs’ is first and foremost a spiritual calling before it should ever be considered as a profession. If you are looking for patients, do as the great 16th century herbalist Nicholas Culpeper did: take to the streets.

Going Forward

We are presently expanding our pharmacy, making tinctures and other preparations, all projects I require students who enroll in the course to do within the first 12 lessons. Soon we will have a pharmacy housing about 60 herbs and formulas. It is the student’s job to learn about each of these herbs as much on their own as possible. Then they will acquire the skill of composing custom blends for each patient while drawing on an assortment of foundational products and formulas such as Triphala, guggul and Swedish bitters.

We are happy to gratefully accept any contributions, whether they be of herbs and products, money, or other material and spiritual gifts so we can thrive and carry on with our work. For details, please contact This email address is being protected from spambots. You need JavaScript enabled to view it..

I told our team that as we get more organized, and grow individually, we could look to the future to setting ourselves up in other venues such as farmer’s markets and fairs during the warmer seasons, and perhaps have weekly clinics where we all don’t need to be present at every session.

Thanks to the opportunity for practice presented by the free clinic, before they know it, by darn, my students will be full-fledged herbalists in no time at all. After all, as herbalists and healers, we are only ever reconnecting with our ancestral roots – ‘remembering’ as it were, ancient ways of healing and care that I believe exist within our own DNA code and that of the plants we work with.

Find the joy in herbal healing!


Are you interested in starting an herbal free clinic in your community? We are happy to share whatever we learn as we pioneer this worthy project. I also suggest you look into the work of Lorna Mauney-Brodek, herbalist 7Song at the Northeast School of Botanical Medicine and the Occupy Medical Clinic in Eugene, Oregon.

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