Kratom leaves

 

See Part 1 of my series on kratom here.

I work at a local free clinic alongside other students and colleagues dispensing healing advice, free herbs and acupuncture. One of our regular clients is a woman who had been famous for her constant irritability and violent outbursts of anger. One day, unkempt, dirty, toothless, friendless, homeless, “crabby Judy” as I lovingly dubbed her, appeared in her customary angry and fitful self (though less so than as in previous months, thanks to our steady work with her). This time, she complained of chronic migraine headache and pain throughout her body. I decided to try giving her a teaspoon of the more uplifting white-veined kratom and administered some acupuncture on a bench outside of our clinic area. When I came back to her a half hour or so later, she specifically commented how her headache was nearly gone, her pains were greatly relieved, and in her own words she described how she felt “somewhat more uplifted.” Having treated her several times before, I could easily differentiate the beneficial difference kratom had on her psyche.

A wise man once told me that the most important aim of a healer is to instill hope in their patients. It is difficult to do this if a patient experiences the same complaints and pain as when they first came. My experience treating Judy that morning inspired hope in both of us; not that all of her life problems could be resolved but that with the help of a near-miraculous herb, kratom, we could each part with a sense of hope because she felt better.

I’m sure if you cut through the confusion and hype, you will see that kratom is not a cure-all, but many suffering people would find it useful.

Clinical Classification and Uses of Kratom

Mitragyna speciosa (Kratom)

Family: Rubiaceae (same family as coffee)

Energy and flavors: Warm and stimulating in small amounts; cool and sedating in large doses. Bitter.

Organs and channels affected: Liver, Lung, Heart, Large intestine

Chemical constituents: Over 40 alkaloids, especially mitragynine and 7-hydroxymitragynine. These are both opioid receptor cell agonists, occupying all but one of the opium receptor sites in the body. This is considered the reason that it can be used as an alternative to opioid drugs with none or few adverse side effects.  

Properties and actions: TCM: Relieves pain, Calms Shen, astringes Lung Qi, astringes the Large Intestine. Western: Analgesic, sedative, anti-anxiety, mild anti-depressive, anti-inflammatory, anti-diarrheal. Ayurvedic: pro-vata dominant because of its cooling and drying properties; anti-pitta because it is cooling; anti-kapha mainly because of its bitter flavor.

Uses and Indications:

  1. Pain
  2. Opiate withdrawal
  3. Alcohol withdrawal
  4. Speed-type drug withdrawal
  5. PTSD
  6. Anxiety
  7. Depression
  8. Insomnia
  9. Inflammation
  10. Diarrhea
  11. Cough

Note: Of the many indications described above, I have had particularly good results from individuals who suffer from PTSD with related severe bouts of anxiety and depression.

Dosage: Of the powder, 3 to 9 grams once to three times daily. Dosing is highly variable depending on the individual, the severity of the condition to be treated, the strain and strength of the kratom powder.

A widely published dosage recommendation is as follows:

  • 2 - 4 grams= mild stimulating effects (a teaspoon of powder is three grams)
  • 4 - 6 grams= medium effects (Stimulant or Sedative effects / Analgesic Effects)
  • 6 - 8 grams= strong effects (Sedative / Analgesic Effects; Too strong for most people)
  • 8 grams or Higher= very strong effects (Sedative / Analgesic Effects; NOT RECOMMENDED)

Note: The dosages above are not per-day doses but a dose taken at one time, once, twice or three times a day.

Always begin with the low to medium dose, usually about a teaspoonful. Its pain-relieving effects last anywhere from 4 to 6 hours. The dose can be repeated, increased or decreased as needed with the general rule that one should take as low of a dose necessary. The dose can be increased gradually based on and as needed basis according to the above dosage guidelines.

To reiterate: only take the minimum dose necessary. (I don’t recommend using it recreationally – it is actually just not that much fun!)

The Three Predominant Strains of Kratom Are Classified as Follows:

Red-veined

Green-veined “maeng da

White-veined

Considered the most sedative and pain relieving

Medium potency, most useful clinically

More stimulating, rather than sedating and pain relieving


All three strains share the same basic properties with various strengths and potencies as described above.

Since the powder is the form most commonly used, I usually recommend ingesting a teaspoon of the powder and quickly washing it down with water. Because the properties of kratom are based on its alkaloids, it is most powerfully absorbed when it is taken with a little apple cider vinegar mixed in water or lemon juice. Some people have trouble tolerating its bitter flavor; to offset this, some take kratom mixed with chocolate milk or chocolate.

Can You Build up a Tolerance to Kratom?

Though I have not witnessed this personally, some who need to use concentrated high doses for severe problems may find themselves building up a tolerance. This can lead to increased dependency. If possible, use it on an as-needed basis and to refrain from taking it every third day or so. If after using kratom for a while, you find yourself craving it, stop using it altogether for several days.

Much like caffeine withdrawal experienced by coffee quitters, after stopping kratom, some people may experience a few days of mild discomfort, which range from headaches, jittery feelings, nausea, etc. These symptoms are relieved as kratom is cleared from the system.  (see https://www.kratomscience.com/dosage-conversion-chart/)

Contraindications, Possible Adverse Reactions and Adulteration Issues

Kratom is generally safe and its effects are similar to the effects of Kava (Piper methysticum) in its anti-anxiety and calming effects. It is much stronger than kava for pain. Use with caution for symptoms associated with Yin Deficiency such as night sweats, dryness, constipation, unusual thirst, and itchiness. However, if it is still needed for its pain-relieving, anxiety-dispelling, and opiate-withdrawal properties, it would be best to take it with a Yin tonic. These are herbs with tonic, demulcent properties that help balance the drying effects of kratom, such as mai men dong (Ophiopogon japonica tuber) and/or marshmallow root.

Because it is sold as a recreational drug, some distributors have taken to spiking their kratom powder with substances to intensify its effects. Some kratom products (see Krypton Kratom) were found to be spiked with the opioid tramadol that is addictive. Deaths and severe reactions were associated with these adulterated products. Avoid this at all costs; find a reliable source of pure, unadulterated kratom. In general, avoid buying kratom from outlets specializing in dispensing cannabis and other intoxicating substances for private use. The exception to this may be the various “kava bars” which have sprung up around the country.  These bars sell mild psychoactive herbal drinks which are consumed in a public setting.

Is Kratom Addictive?

I’m sure that any herb that is a potent pain reliever, antidepressant, anti-anxiety agent and has a long-time reputation responsible for helping thousands of people throughout the world overcome addiction to far more dangerous drugs and alcohol, has itself the potential to be addictive to some. This is especially true since kratom is also widely used and abused recreationally. Kratom is controversial because some choose to abuse it by taking high doses (over 10 to 15 grams or more of the powder one or more times daily); these people are bound to develop a dependency or addiction to it. I once knew a man who regularly drank 15 cups of coffee each day. He, like many others who use coffee on a regular basis, or the highly caffeinated so-called “power drinks” widely sold throughout the country would have difficulty withdrawing from these substances.

While caution from overuse of any substance should be implemented, in the words of one of the many thousands who have found benefit from kratom said in a letter on drugabuse.com: “Making a substance illegal because there's potential for a fraction of the population to have trouble with it does not seem to me to be a logical approach.”

I’m mainly an advocate for the responsible clinical use of kratom as an effective non-addictive alternative to other psychoactive drugs with well-known adverse health effects. Even those who claim that it is addictive will say that it is mild compared to highly addictive drugs such as opiates, alcohol, speed, etc.

The opiate drug oxycontin was created because its pain-relieving effects are longer-lasting that morphine and other opiates. The company who first brought it to market in the 1990s, Purdue Pharmaceuticals, convinced and enticed hospitals and doctors to use it even for mild or moderate pain conditions. As a result, it was widely prescribed even to children and that was the beginning of the present opioid epidemic.

With kratom, we have an herb that has offered hope for thousands to help wean themselves off of these deadly drugs, but even so, some government agencies want to suppress it. Even if one were to concede that there can be some problems with people abusing kratom, those problems have no comparison to the already existing problem of opioid addiction.

Making Kratom Tincture

Kratom is widely sold as leaf powder. Powders have a limited shelf life (about 3-4 months for full potency), and ingestion can be challenging because of its flavor. Making a tincture assures potency for many years, and are convenient to take because the drops can be diluted in water or another liquid to mask the flavor.

The downside of kratom tincture is that it is alcohol-based and therefore not suitable for individuals who have a history of alcohol addiction. Also, it is too easy to consume more than is needed when it is a liquid as opposed to the limitation of taking it as leaf powder. With both of these considerations in mind, the following tincture recipe is given from KratomGuides.com.

Ingredients:

  • 1 quart vodka or diluted ethanol measuring 40 to 50% alcohol
  • 8 oz. (about 227 grams) of pure high quality Kratom leaf powder
  • About ½ ounce apple cider or white wine vinegar (which aids in the assimilation of the important kratom alkaloids)

Combine these ingredients in a wide-mouthed jar. Shake or stir daily for at least two weeks (although an extract made in this way could be used after a day or two).

When completed, carefully strain through fine mesh cloth. Bottle in 2- or 4-oz. amber dropper bottles at this point or allow to stand in a clear glass container for a day or so to allow any powder particulates remaining to settle to the bottom. Carefully decant the pure extract and bottle for use.

This is approximately a one to four ounce tincture, meaning that 1 part of the tincture is equal to 4 parts of the powder. One may have to experiment with the tincture dose but on average one might start with a dose of 30 to 60 drops which is approximately a half to one teaspoon.

Feel free to experiment with flavoring agents to make it more palatable. The most common is pure anise or fennel seed oil. One may only need a few drops to flavor. (Use caution when using pure essential oils for flavoring; consult a qualified practitioner and use food-grade oils from a reputable company. –M.T.)

2017 Reputable Sources for Kratom Leaf Powder

1.      BuyKratom.us – www.buykratom.us
This is the company I’ve been purchasing my Kratom from. I find them to be reliable, good quality and reasonably priced

2.      http://kratomguides.com/recommends/kratom-spot/

3.      http://kratomguides.com/recommends/pure-kratom/

4.      http://www.phytoextractum.com/?referrer=REF327161478868859


Read more about these companies at KratomGuides.com

Conclusion

Matt Wright, the general manager at Low Tide Kava Bar in Gulfport, Florida, described some of the signs held by demonstrators at a pro-Kratom rally held in Washington D.C. last year: “In support of keeping kratom legal there was a sign that read, ‘Death statistics of other illegal drugs from 2014: Heroin: 11,000; Cocaine: 5,000; Alcohol: 88,000; Opioid Pain Relievers: 20,000; Kratom: 0.’ There were also numerous other signs saying ‘Kratom Saves Lives,’ ‘Plants Not Pills,’ ‘Farm Not Pharma,’ and one heart-wrenching sign held by a young boy who appeared to be between 6 and 9 reading ‘Kratom Saved My Mom.’

This says it all.

Please at least go to https://www.americankratom.org/petition and sign the petition to the DEA to keep kratom legal.

 

 

Mitragyna speciosa by Uomo vitruviano

As of the beginning of August 2017, the National Institutes of Health (NIH) published notice of the state of the opioid epidemic in America. They estimated that of the 91.8 million people who were prescribed opiate pain killers, 2 million are addicted with an average of 142 dying from overdose daily. This means that every three weeks the same number of Americans die from opioids as died in 9/11.

Up to now, opioids and related compounds all derived from the poppy (Papaver somniferum) are the most reliable pain-relieving drugs since the American Civil war. Unfortunately, there is a price to pay when these drugs are too heavily used. That price is addiction, accompanied with the need to obtain more and stronger drugs to achieve similar pain relief. The problem for the addict is compounded, for as the drugs wear off there is even more intense pain and mental discomfort that acts as a disincentive to detoxification. Yet, another genre of pain-relieving drugs sold as over-the-counter anti-inflammatories includes acetaminophen, which are known to cause liver damage.

Most doctors agree that there is a need for another drug or substance to relieve pain; a few doctors even encourage their suffering and addicted patients to try the pain-relieving herb Mitragyna speciosa, commonly known as kratom. Herbalists, acupuncturists and naturopaths, however, have been overly wary of promoting yet another fad in the form of an herb that they have not heard of before. In the case of kratom, it is known to be widely used as a recreational drug and it has been the object of legal scrutiny. Its clinical value yet to be appreciated. 

The medicinal properties of all herbs were first discovered through trial and error. Kratom is no different. It has been used for thousands of years by natives of southeastern Asian islands for various health purposes, among them pain relief. Eventually, millions of individuals in America and Europe and throughout the world, seeking yet another drug with which to get ‘high,’ tried kratom. Kratom in normal low to medium dose is feeble compared to other drugs like cannabis but since the late 1800’s people have increasingly used it to withdraw from opiate and alcohol addiction and to relieve pain. On this note, consider how long it has taken for cannabis, once vilified as a dangerous recreational drug, to be found in recent years to offer potent health and medicinal benefits.

I’m a strong advocate for the use of kratom clinically and have had considerable personal experience using kratom leaf powder for the relief of chronic, intractable pain. In fact, I can’t think of any herb other than opioid drugs derived from poppies that provides such immediate pain relief and overall sense of well-being. 

How does kratom relieve pain?

There are more than 40 compounds in kratom leaves, including 25 alkaloids besides mitragynine which is the most abundant, occupying 1.2-2.1% of the total. Mitragynine is believed to be principally responsible for its pain-killing effects. Mitragynine is considered the main psychoactive constituent and functions as an opioid agonist, meaning that it has a special affinity for the opioid receptors in the brain.

Most people who take a sufficient amount of kratom internally will experience pain relief in less than a half hour.  Kratom is usually taken as a powder. Dosage is variable depending on the strength of the kratom, the severity of the condition for which it is intended, and the size of the person who takes it. Further, kratom is known to have both stimulant and sedating properties. Stimulant properties are associated with lower doses and sedation with higher doses. I will describe dosage guidelines next week, but clinically the goal is to use as low an effective dose as possible. Discounting whether it will act as either a stimulant like coffee to which it is related or a sedative like opium, I recommend beginning with a teaspoon (about 3 grams) of the powder swallowed and chased down with water once or twice a day. Regardless of its sedative or stimulant properties in an individual, kratom will relieve pain.

It’s taken me some time to complete this article because I first wanted to scour and interview patients, stores and others who have recommended or used kratom with great benefit to themselves and others. I took it myself for a minor shoulder sprain and was amazed at how benign it seemed; I had no adverse reactions, no disorientation, no grogginess, and my pain was relieved within 30 minutes. Even several hours later when the effects of kratom surely would have subsided, I realized that the pain did not come back. I know it doesn’t work for everyone that way but my experience suggested that the alkaloids in kratom were not only analgesic but anti-inflammatory as well.

Since then I have recommended kratom to several patients suffering severe chronic pain and depression. Their respective pain and discomfort was well managed and with no adverse reaction.

Cases

Cases 1 and 2 are from my own clinical experience. Case 3 was reported to me.

  1. A woman in her mid-70s had advanced osteoporosis of the spine that caused constant pain making it difficult for her to sleep at night. Acupuncture and carefully prescribed herbal treatments were of limited benefit. Realizing how important sleep is for healing, I decided to try kratom. That night she took only one teaspoon of green-veined maeng da kratom. She gratefully reported that it was the first night she could get 6 continuous hours of uninterrupted sleep.
  2. Another patient was a woman diagnosed with rheumatoid arthritis. She had severe and constant pains in all of her joints especially her fingers. Again the pain inhibited her ability to relax and get much needed sleep. At first she was suspicious of taking any substance to relieve pain. Perhaps she vaguely heard that kratom was being used as a recreational drug and she might get hooked. While she was still in my clinic, I was able to convince her to take a teaspoon of the powdered leaf followed by a glass of water. She predictably objected to the taste but I heard from her the next day that she had such tremendous relief from the single dose, but she was trepidatious of taking it daily. I convinced her that she should not be afraid to use as much as she needed. It turned out that she only needed to take one or two teaspoons of kratom for a week, during which time diet changes and deeper-acting herbs I gave her helped eliminate her pain completely, and she had no further need for kratom.
  3. It was personally reported to me by a saleswoman working at a local store specializing in selling cannabis and other psychoactive herbs that she has dozens of clients who purchase kratom strictly for its pain-relieving therapeutic value. According this saleswoman, these are people who have tried everything; many were already heavily drugged and addicted to doctor-prescribed opiates. Among the many cases she mentioned, the one that seemed most amazing to me was a woman with cystic fibrosis who had for a long time been on several different prescribed pain-killing opioid drugs and a number of different antidepressants. With great determination, she wanted to “get her life back” and decided to use kratom to wean herself off of all her drugs. (I don’t know what dose she needed to take, but generally speaking, the more severe the condition, the higher the dose of kratom.) Years later, this woman, still with cystic fibrosis, is able to completely manage her pain with red-veined kratom. Red-veined is the variety that has stronger sedative and pain-killing properties.

Interviewing other patients and practitioners, I learned how kratom is the only thing some have found to manage the pain associated with chronic fatigue syndrome, fibromyalgia and Lyme disease.

Not Just for Pain

Kratom also relieves depression, and unlike opiates, it can promote a sense of mental clarity with no grogginess when used in the above described doses. Further, as an alternative to antidepressants, kratom does not interfere with selective serotonin reuptake inhibitor drugs (SSRIs or antidepressants) so they can be used concurrently. By so doing, many have been able to withdraw from antidepressants by gradually replacing them with kratom. However, I strongly caution against this without the advice and guidance of their medical doctor.

Kratom and Opioid Addiction

One of the most important uses of kratom is to ease physical and psychological pain associated with opiates, including morphine and heroin and alcohol addiction. The use of kratom for opium addiction was first employed in Thailand around the end of the 1800s at a time when opium was proliferating throughout China and eventually spread to the islands of Indonesia and Thailand. It was so effective for that purpose that the Thai government made kratom illegal. The reason was not that it was harmful to the people or addicting but because the government was being denied a then important part of its revenue based on the taxes levied on the sale of opium. To this day, kratom is illegal in its native habitat where people had been using it medicinally for centuries. However, with the rise in heroin and alcohol addiction, there is a movement to get the government to rescind its kratom ban.

Legal Issues

How effective kratom has and continues to be for pain relief and drug addiction was shown when the US Drug Enforcement Administration (DEA) on August 30, 2016, proposed to place kratom into a Schedule I category of Controlled Substances. This is the same category in which the most addictive drugs such as heroin and methamphetamine are classified: completely illegal. This met with a widespread groundswell of protests, mostly by people who were using it for pain management or opioid withdrawal. Approximately 140,000 protesters signed an online petition and were able to enlist 51 members of the US House of Representatives with nine senators on their side in protest of the DEAs proposed ruling. As a result, the DEA temporarily withdrew its notice of intent and for the last year it has been inviting public comment. See the document Assessment of Kratom under the CSA Eight Factors and Scheduling Recommendation submitted to the DEA here.

At present, kratom is legal in all but six states (Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin). Kratom is also illegal for use by the US military.  It could still be banned and we would lose access to one of the most valuable herbs in the world. According to the American Kratom Association, currently 26,000 Americans have asked President Trump to keep kratom legal. Over 1,000 doctors, scientists and law officers told the DEA they don’t want a kratom ban. In fact there have been no deaths reported from pure kratom. Unfortunately, some companies decided to spike their kratom with an illegal opioid called tramadol. The resultant product called “kryptom” did result in some deaths and is now banned from sale.

The risk of dying from pure kratom overdose (whatever that may be) is nil. In fact high dosage of kratom is self-limiting as people who do so experience temporary gastric discomfort, nausea, and vomiting.

I’ve never personally seen or heard of kratom addiction and to the extent that it may exist it is quite rare. Individuals can form a dependency, which some may describe as ‘addiction’ but this is described as mild and comparable to withdrawal from coffee.

At present, these are the facts:

  • 100 million Americans suffer from chronic pain;
  • Of these, 21 million are also dealing with substance abuse;
  • Of these, 2 million abuse prescription pain drugs.
  • Drug overdose, which has gone up 4 times, has become the leading cause of accidental death.

Why would the federal government or states rush to ban an opioid replacement that’s hundreds of times less deadly than synthetic opioids?

I recommend visiting some of the online kratom support sites such as the American Kratom Association to read more about kratom’s history, biochemistry and the many anecdotal cases attesting to the positive effects of kratom for pain control and opioid and alcohol addiction. If you visit the AKA link above, be sure to sign the petition to keep kratom legal. In my estimation, it is one of the most important medicinal herbs for pain management other than opium.

Next week, I’ll post the clinical classification, uses, dosage, and preferred administrations of kratom, along with some reputable sources. (See Part 2 of my series on kratom here.)

Kratom may be enjoying a lot of press these days in light of current events, but the benefits of a whole world of herbs is diverse and mighty. Thinking of studying the art and science of herbalism at East West? Mention this kratom blog and receive an extra $100 off enrollment on our already low-priced sale of the herb course. Offer valid through August 18.

 

 

Christopher Hobbs

Christopher Hobbs needs no introduction to the herb world. If you have even the faintest spark of interest in herbs, you should know of him. I can’t even begin to count his many achievements, the number of books he’s written on herbal healing, yet he remains one of the humblest, most likable people I know and I’m proud to say, one of my closest and dearest friends. It seems like we have shadowed, competed, shared and walked this wondrous way of herbs with each other for decades. He is one of only a few colleagues I turn to when I have a question about a plant, founding the American Herbalists Guild, sharing our love of Mahler, art music, jazz, or life. I count the two or three years that I spent working with him side by side in my clinic, on patients together, as one of the happiest of my clinical  career – and I could hardly feel more honored than to have served as a vehicle for his becoming a California State licensed acupuncturist.

So, this is not the first time that I found myself searching the Internet on a subject that one of his brilliant articles popped up on my screen. I am grateful that he so graciously has allowed me to feature his especially wonderful article on the quintessential European herb, Gentian lutea, and the quintessential traditional European formulation – bitters.


The English, and subsequently the Americans, are not fond of bitter foods or herbs. In fact, bitter has often been spoken of disparagingly in the English language for example in the statement, “a bitter pill to swallow,” meaning, in a wider sense, that a person found something very difficult to accept. Such events as paying taxes or being forced, as a child, to eat some food we found particularly revolting fall into this category.

It is no wonder then, that the druggist was often called upon to disguise drugs or herbal preparations that tasted bitter. For this purpose, a person trained in pharmacy would have many tricks, sugar coating, encapsulation, or the addition of sickeningly sweet syrups to bitter liquids to make an elixir. For what adult, or especially child, would take their medicine for long if it was very bitter?

Many Europeans would. For instance, in modern Germany, it is estimated that over 40 million doses of bitters are consumed every day, and not just because people think that it’s good for them; they actually enjoy them.

In the European tradition, exposure to a bitter flavor is said to give the digestive system strength and tone, much in the same way that cold water is applied in Russia. It is said that Russian people cut a hole in the ice and dip their babies in the icy water for a second or two, in order to give the baby vigor. Those who survive should indeed be the hearty ones. Referring to this effect, it was Parkinson who quoted Galen as saying, “if our stomackes could brooke (tolerate) this and other bitter medicines, and were not so nice and daintie to refuse whatsoever is not pleasing to the palate, it would worke admirable effects in the curing of many desperate and inveterate diseases inwardly…”

One could speculate that people in the English-speaking countries have become so accustomed to the flavor of salt and sweet that the bitter flavor (as well as its benefits) has been completely forgotten. This may be a pity, for modern scientific research shows that some of the bitter herbs used in soft drinks, liquors, tonic waters, and even candies may have marked healing properties. For instance, modern German research shows that bitter tonic herbal formulas (called bitters) may activate digestive substances, such as bile and hydrochloric acid, enabling us to digest our food more efficiently and effortlessly. Bitters have been shown to stimulate and heighten nervous system function, as well as the immune system, helping people recover more quickly from various chronic illnesses. Bitters are often prescribed by physicians and natural health practitioners alike in many parts of Europe for mild to moderate digestive problems, such as irritable bowel syndrome, colic, gas, and constipation. Rudolf Weiss, a respected German herbalist, physician, and author of Herbal Medicine, says of bitters, “…pharmacological studies provide the explanation for something which has been known for a long time and which any careful observer is able to confirm for himself: that bitter plant principles have marked general stimulant effects that are far from limited to the stomach….generally [benefitting] physical and mental exhaustion.”

Gentiana lutea flower

Probably the best-known and studied pure bitter herb in the world is called gentian. Gentian is one of any number of species from the genus Gentiana in the family Gentianaceae. Some works list 40 or 50 different species; all of them seem to contain the bitter principle and sweet, aromatic taste that has made these herbs so popular. Although several ancient kinds of gentian will be mentioned below, the author has used several species that grow wild in the mountains of California completely unknown to Europeans, the Chinese, or Indians, in making home digestive tonics. These species seem to be even more bitter than the famous official species, Gentiana lutea L. In fact, it was the well-known English physician-botanist John Lindley who said in his Flora Medica (1838), “There is scarcely a plant of this natural order in which the bitter principle does not exist in considerable intensity.” Lindley considered all species of gentian as potentially useful in medicine.

Just how long have the benefits of bitter herbs been known? In Traditional Chinese Medicine, an intact system of medicine that is more than 5,000 years old, gentian was called lung tan, meaning dragon’s gall because of its exceedingly bitter taste. Bretschneider, physician to the Russian Legation at Peking in the late 19th century, wrote in his Botanicon Sinicum that gentian was first recorded from around the time of Christ in the Shen nung Pen ts’ao king, one of China’s oldest and most revered works on materia medica. Traditionally, the Chinese did not usually differentiate individual species of a genus, and thus lung tan could have been any number of Gentiana species, although the most important species used today is Gentiana scabra, known as Lung-tan. Since the days of the Pen King, and probably before the beginning of recorded history, this herb has been used in China to help ease a variety of ailments.

Read more at Chris’ website

 

CLOVE (Eugenia caryophyllata, E. aromaticum, Syzygium aromaticum)

Family: Myrtaceae

Also called: caryophylli or ding xian (Chinese)

Parts used: flower bud

Energy and flavors: warm, acrid, aromoatic

Organs and channels affected: Stomach, Spleen, Kidney

Chemical constituents: essential oils, especially eugenol, tannins, phenolic acids, methyl salicylate (painkiller), the flavonoids eugenin, kaempferol, rhamnetin, and eugenitin, triterpenoids such as oleanolic acid, stigmasterol, and campesterol, and several sesquiterpenes

Properties: stimulant, carminative, antiemetic, anthelmintic, antiseptic, antispasmodic, analgesic

Dosage: 1-3g

Contraindications for clove: Do not use if there’s Internal heat; caution with Deficient Yin, hypertension, or pregnancy; do not give the essential oil internally to children or pregnancy women as eugenol is toxic in relatively small quantities.

 

When many people think of cloves, they might remember it in sachets to scent closets or drawers, or stuck in hams and baked to imbue flavor. Today, clove is mainly used as a spice, especially for holiday meals. Still, it has many valuable uses outside the spice cabinet, some of which may even be the perfect remedy for you.

Clove is an evergreen tree that grows to about 30 feet and is native to Indonesia and the Malacca Islands (the Spice Islands). It is commercially harvested primarily in Indonesia, India, Madagascar, Zanzibar, Pakistan, Sri Lanka, and Tanzania. Very important in the spice trade, it was – and sill is – used in perfumes, mulled wines and liqueurs, dental products, and insect repellents.

Not too long ago, oranges were littered with cloves to create the Victorian English pomander, used for not only for its scent but to indicate “warmth of feeling.” And many may remember clove cigarettes where cloves were blended with tobacco (the Indonesian kretek) and smoked throughout Asia, Europe, and the United States until 2009 when they were banned in the U.S. (and sold as “cigars” ever since).

Despite all of this historical use as a spice, clove has also been widely used in Chinese and Ayurvedic traditional medicine.

In Chinese medicine, clove is classified as an internal warming herb, helping to dispel Cold and warm the body. It is especially used as a digestive aid and for sexual problems. Because it “brings the Qi down,” it alleviates uprising energy with symptoms of hiccough, vomiting, reflux or nausea. As well, it treats cholera, diarrhea, abdominal pain, poor appetite, stomachache, hernia pain in the uterus, chronic indigestion, and fullness in the stomach and intestines. It is also given for morning sickness (often with ginseng and pogosteme, or patchouli) and for vomiting and diarrhea due to Cold in the Spleen and Stomach.

The Chinese also use cloves for painful abdominal masses, impotence and clear vaginal discharge due to Coldness (Deficient Kidney Yang). One may actually feel coldness in the “womb” (uterus) or vagina and weakness in the legs when clove is indicated.

Ayurvedic medicine uses the dried flower buds as an energizer, carminative, expectorant, analgesic, and aphrodisiac to treat colds, cough, asthma, indigestion, vomiting, toothache, laryngitis, pharyngitis, low blood pressure and impotence. As well, it promotes the flow of fluids in the lymphatic system. For bronchitis and asthma, it is used as an inhalant. Further, clove in animal studies has been shown to lower triglycerides and blood sugar.

Western herbalists use clove as a carminative to increase hydrochloric acid in the stomach and to improve peristalsis. It is also a natural anthelmintic and is applied externally to treat scabies and fungal infections. It is taken for inflammatory and spastic conditions of the gastrointestinal and respiratory tracts, cramps, gas, diarrhea, ulcers, nausea, bronchitis, hoarseness, colds, flu, vomiting,  hypotension, hiccups, colic, and parasites.

Eugeneol, the compound oil in clove, is responsible for most of its aroma. Used in its essential oil form, clove oil may either inhaled for asthma and cough or else a couple of drops topically rubbed over the stomach or abdomen to alleviate pain and indigestion. It also helps muscle fibers contract, making it useful to relieve muscle pain, arthritis, rheumatism and muscle numbness. As a mouthwash, gargle (or else the clove itself chewed), it treats toothache, laryngitis, pharyngitis and halitosis. It is used in dentistry as a topical anesthesia and antiseptic.

And if that’s not enough, clove may be used as an ant repellent!

Avipatakar

Despite all these great applications for cloves, I discovered another fabulous use the last several years – as a powerful remedy tor acid regurgitation (GERD). I’ve treated many cases of acid reflux and while most responded well, there were some cases that I found to be particularly stubborn. Yet, even these responded to the use of clove in the Ayurvedic formula, Avipatikar. This formula is hands down the best remedy I found for the treatment of GERD.

Avipatikar churna is a traditional Ayurvedic formula used to  treat digestion. This blend both balances the digestive fire and detoxifies. It soothes the stomach tissues and promotes normal, comfortable levels of acidity during digestion. It also helps direct energy downwards helping to promote post-meal esophageal comfort and healthy elimination.

Avipatikar contains the following herbs:

Triphala:

amla (Emblica officinalis)

  • behada (Terminalia belerica)
  • haritaki (Terminalia chebula)

Trikatu:

  • black pepper (Piper nigrum)
  • ginger (Zingiber officinale)
  • long pepper (Piper longum)

green cardamom (Elettaria cardamomum

clove (Syzygium aromatica)

Indian bay leaf (Cinnamomum tamala) – patra

nut grass (Cyperus rotundus) – musta

turpeth (Operculina turpethum) – trivrit

sugar

Avipatikar helps many other conditions than heartburn, acid reflux, or GERD; it also treats constipation, diarrhea, gastritis, indigestion and ulcers.

In fact, one study published in the Journal of Clinical and Diagnostic Research in 2013 suggests that Avipatikar shows promise in the treatment of peptic ulcers (a condition marked by sores in the lining of the stomach or the first part of the small intestine). In tests on rats, the study's authors determined that Avipatikar helped thwart the development of peptic ulcers by reducing secretion of gastric acid. According to the study's authors, Avipatikar's ulcer-fighting effects may be similar to those of ranitidine (a medication commonly used in the treatment of ulcers).

Of course you’ve got all the benefits of Triphala added into the formula and that’s an entire blog on its own! (See Michael’s blog on Triphala for more details.)

One Ayurvedic doctor told me that clove was the main ingredient in Avipatikar, which got me thinking about using just clove power and sugar together as a simple acute remedy if one didn’t have the formula on hand. Make it by mixing honey or barley malt with clove powder and eating in small 1/8 – ¼  tsp. doses with meals.

Note that the honey, or sugar, is an important part of this remedy. This makes sense to me because in Chinese medicine small amounts of sugar (mainly barley malt or maltose) tonifies the Spleen and Stomach, helping digestion and increasing energy. The same goes here with its addition to clove as a simple remedy.

Another great way to take Avipatikar is the Planetary Formula, Avi-Pro, which is Avipatikar in tablet form! Take the indicated dose on the bottle with a teaspoon of honey or barley malt to enhance its effectiveness.

Cook with Clove

As you prepare your meals, remember to include clove in some form or another. Pinches added to pumpkin or apple pies or given after meals as a digestive electuary (mixed with a little honey and taken in 1/8 – ¼ tsp. doses), will definitely help alleviate the indigestion, reflux, gas, bloating, burping, and fullness so often experienced after big meals.

See Part 1 here.

"Actaea racemosa 002" by H. Zell - Own work. Licensed under CC BY-SA 3.0

Black cohosh has long been used throughout the world, but today its many uses have been mostly forgotten in the face of its powerful effects on menopause. Here are many more of its traditional uses that expand its effectiveness far beyond menopause.

Native American women have long used black cohosh to relieve childbirth pains (it stimulates uterine contractions during labor), afterbirth pains and menstrual pain. To facilitate childbirth, combine with raspberry leaves and blue cohosh, and take daily for the last two weeks of pregnancy. If needed, it may be used in the last trimester of pregnancy to relax spasmodic uterine activity (combine with black haw and wild yam). The Native Americans also used black cohosh for rheumatism and arthritis.

According to Steven Foster, the Oklahoma Delaware used black cohosh with elecampane and stoneroot (probably Collinsonia canadensis) together as a general tonic for the body while the Iroquois used it to promote lactation and treat rheumatism and babies’ sore backs. The Cherokee also used black cohosh for rheumatism as well as a tonic, diuretic, anodyne, and emmenagogue to treat colds, cough, consumption, constipation, fatigue, hives, backache, and help babies sleep. Further, the northeastern Algonquians used it for kidney troubles.

The Eclectic herbalists used it similarly to treat menstrual disorders, childbirth preparation, and rheumatism (once called “rheumatism week”), and yet they also employed it as a wonderful antispasmodic and nervine for arthritic disorders, including rheumatoid arthritis, osteoarthritis, joint inflammation, muscle problems, lumbago, stiff neck, cramps, nerve pains, tics, convulsions, epilepsy, and nervous excitability. It’s long been used in Europe for all of these conditions as well.

Overall, black cohosh treats pain characterized by tension and a dragging sensation. Consider it good for achy muscle and nerve pains, especially if there’s a bearing-down sensation. It is also used for unpleasant sensations in the uterus during the last months of pregnancy and false pains. I have successfully used black cohosh with white peony to treat epilepsy, lessening the frequency and severity of seizures.

In more recent times, Dr. Christopher has used it with lung herbs to ease whooping cough, asthma and bronchitis (supposedly it helps dilate the bronchioles).

While Chinese herbalists use a different species of black cohosh, C. foetida, it is used somewhat similarly. Mainly known as a cooling diaphoretic, it treats the initial stages of colds, flu, fever, headache, and sore throat. As well, it treats swollen or painful gums, ulcerated lips or gums, canker sores, toothache, and bad breath. It also ripens and brings out skin rashes such as measles in their early stages. 

The Chinese also consider black cohosh an important herb to raise the Yang and lift sunken Qi with symptoms of shortness of breath, mood swings, fatigue and prolapsed stomach, intestines, bladder, uterus, rectum, or veins.

While we don’t know if the different uses of the Western and Chinese species of black cohosh is due to their constituents or to different traditions, there is enough similarity in both that either tradition can benefit from the experience of the other and expand our use of this important herb. The Chinese could expand their use to rheumatism and menopausal symptoms while Western herbalists could use it for colds and flu along with their accompanying symptoms, ripening early rashes, and for prolapse. Since Western black cohosh already “lifts the spirits” in terms of treating menopausal mood swings, it could well have this raising effect on the organs.

Dose: Decoct 1 tsp. dried root/1 cup water, take 2-3 cups/day; 2 "00" caps 3 times/day; tincture, 10-40 drops, 1-4 times/day; 3-9 g in formulas; prepare C. foetida with wine or stir-fry to increase its ascending action; stir-fry with honey to nourish the lungs and relieve cough.

Precaution: Higher than recommended doses causes nausea, dizziness, vomiting, light headedness, headaches, low blood pressure, dilated pupils and dimness of vision; Yin Deficiency with Heat signs, fully erupted measles, in those with breathing difficulty and in those with excess above and deficiency below.

Biochemical constituents: Various glycosides such as triterpine and actein, salicylic acid, ferulic acid, woferulic acid, cimicifugoside, formononelin, bitter principles, racemosin, triterpenes, isoferulic acid, salicylic acid, tannin.

Sweet flag (Acorus calamus; A. americanus) has been one of those on-again/off-again herbs where it’s safe to use it, then it’s not, and then it is again. Well good news for North Americans – its native calamus is safe and very effective for many conditions.

While known by many names – acorus, calamus, sweet flag, sweet sedge, bitterroot, myrtle grass, and grassleaf – the root is used in Western, Chinese and Ayurvedic medicines. In the West its strongly scented rhizomes have traditionally been used to make fragrances and as a spice, particularly to substitute for ginger and cinnamon. It is eaten candied, and is also used for thatching and strewing (as in on the floor).

Bitter, spicy, and aromatic, calamus is a warming carminative, antimicrobial, Phlegm-dissolving herb that also opens the mental and sensory orifices. Because of these qualities, it’s long been used medicinally for digestive problems such as dyspepsia, gas, heartburn, ulcers, nausea, motion sickness, poor appetite and peristalsis, damp-heat diarrhea and dysentery, and inflammation of the stomach lining and stomach tension.

Traditional tribes used it to increase vitality and ensure long life. It is also useful for colds, sore throat, hoarseness, laryngitis, and sinus infections. According to Chanchal Cabrera, the British herbal tradition uses calamus root as a stomach acid balancer.

Currently, calamus is used for anxiety. Many who chew on the roots find that it helps their daily emotional balance, but it also alleviates full-blown anxiety and panic attacks as well as PTSD, particularly if chewed at the beginning of an attack to forestall its occurrence. As well, it helps attention and focus for those having to pull all-nighters or who study a lot, as its aromatic oils clear perception. Jim McDonald likens it to increasing one’s “perceptual depth of field,” i.e., helping one to focus in on the details better and increasing mental clarity.

There’s a reason for these latter effects on anxiety and mental clarity. In Traditional Chinese Medicine (TCM), calamus root is an herb used to clear Phlegm misting the Heart orifices. Now whatever does that mean you might ask? Basically, the fragrance gently opens the mental and physical senses, meaning it acts like mild smelling salts. In TCM, the mind and Heart are intimately connected and clearing the heart of Phlegm blockage aids blood flow through the brain to nourish the mind so one thinks and speaks more clearly (and appropriately – as opposed to mania and withdrawal).

Dosage of American calamus:

Start with little bits, chewing 1 tsp.-1 Tbsp of the fresh or dried root;

1-4 g/day;

1 drop of essential oil under the nose;

15-60 drops tincture 3 times/day;

Uas medicated ghee, oil or milk decoction, paste and powder.

Contraindications:

Avoid with bleeding disorders. Use caution in pregnancy.  Larger doses are emetic.

The Chinese have other uses for Acori calami (shui cheng pu) rhizome. They also consider it a warm, acrid, bitter herb that enters the Heart, Liver, and Stomach, and yet they use it to extinguish Wind as well as open the sensory orifices and transform phlegm. They use calamus (acorus is their common name) specifically to treat tremors, seizures, and loss of consciousness, As well, it moves Qi, strengthens the stomach and clears dampness obstructing digestion for treating epigastrc pain, abdominal distension, poor appetite, cough, gout, diarrhea, dysentery, scabies, wind-damp bi obstruction pain (arthritis, rheumatism and joint pain), palpitations, forgetfulness, and a greasy tongue coat, and to stop itching.

As well, the Chinese use the rhizome of Acori tatarenowii (shi chang pu), which has a similar warm energy with aromatic, acrid, and bitter flavors and enters the Heart and Stomach. Dispersing, it is used to transform damp, dissolve phlegm, open the sensory orifices, wake the Spleen and Stomach, improve digestion, and dredge congealed phlegm from the chest and diaphragm. Interestingly, calamus grows in watery areas – called “watery flourished reed” by the Chinese – and it effectively clears dampness from the body. It also moves Qi and Blood, reduces swelling, and improves overall healing. It is used for coma, mania, withdrawal, impaired mental function, deafness, forgetfulness, dysentery with inability to eat or drink, dizziness, and dulled senses. It can be taken internally and topically for wind-cold-damp bi painful obstruction, trauma, and sores.

Now here’s the important thing to remember about calamus: Chinese calamus is rich in asarone, a substance that’s carcinogenic, metagenic, chromosome damaging, and liver toxic. The Russian and European species are also high in asarone, while interestingly the central European variety has less than 10% and so doesn’t seem to have the psychoactive properties. All of these varieties can be hallucinogenic as well. For this reason, the Chinese only use acorus in acute conditions and for short periods.

However, American calamus is free of asarone and so is fine to use regularly. On the other hand, if the mind-activating properties of calamus are due to its asarones, then it may also not be as effective for these conditions. All of this needs examination as calamus has been widely used for thousands of years as medicine and food. Is this another case of an herbal witch hunt or something to be cautious of?

Ayurveda medicine is a case in point. Calamus is one of their major herbs and has been used in India for millennia. Called vacha, which means “speaking” (referring to its effects on clearing the throat), it’s been employed as a mental rejuvenative, decongestant, expectorant, nervine, antispasmodic, emetic, and energizer to treat colds, cough, asthma, sinusitis, loss of memory, and to increase mental cognition.

Interestingly, Ayurveda also uses calamus similarly as the Chinese to treat seizures, epilepsy, coma, shock, and hysteria, all Wind disorders in TCM. As well, its use for sharpening memory, enhancing awareness, and increasing communication all refer to its action on the TCM Heart and mind connection, too. As such, it can be used for autism, attention deficit disorders, and scattered thinking/awareness. All of these applications aren’t used in the West and so can expand our uses of it.

Further, calamus clears the head of kapha, a way of saying it dislodges mucus, which may result in a drippy nose as it leaves. Typically it is applied as an oil, essential oil, or medicated ghee under the nose or into the nostrils (a nasya to enter the nose’s gateway to the head, sinuses and deep lungs). And yet, taking too much or too frequently can be over-stimulating because of its warming stimulant properties. For this reason, it’s often combined with gotu kola, a cooling herb with complementary effects.  

Large doses of calamus are emetic and may also be “hallucinatory,” meaning it can cause unusual thoughts that aren’t necessarily pleasant. Overall, if one sticks to the low dose of calamus, one should be fine regarding its asarones and potentially mind-altering effects.

Lastly, powdered calamus root has been used as a vermifuge and insecticide for fleas, ants and other insects.

Too often we find Western herbs pigeon-holed into convenient commercialized boxes. While this expands people’s interest in natural healing, it also limits herbs to one particular application such as echinacea for colds, hawthorn for the heart, St. John’s wort for depression, and black cohosh for menopause. Each of these herbs has an array of other important healing uses that are overlooked at best and lost at worst. By incorporating other cultural traditions through Planetary Herbalism, we can broaden our understanding and use of commonly known western herbs.

It is no different with the easily grown and majestic-looking elecampane (Inula helenium, Asteraceae family), or scabwort (so called because it healed scabs on sheep!). Known as an expectorant for coughs, bronchitis, and asthma with white phlegm, this herb also does much more as it also treats digestive ailments and alleviates pain.

Used throughout the world for thousands of years, Westerners have traditionally used elecampane both as a medicine and a condiment or cordial for digestion, loss of appetite, and non-ulcer dyspepsia (it was an ingredient in absinthe). It’s considered not only expectorant but also carminative, diuretic, stomachic, antimicrobial, anthelmintic, anti-asthmatic, vulnerary, a gentle stimulant, and in large doses, emetic.

While elecampane root is brilliant for inflammatory lung complaints with white sputum or phlegm such as cough, bronchitis, asthma, whooping cough, and pleurisy, especially in those with depletion, it has also been used for cholecystitis, gallstones, intestinal worms, rheumatic complaints, genitourinary problems, and consumption (tuberculosis) as well as skin diseases (humans and animals taken both internally and externally) and venomous bites. It has been applied externally for sciatica and other neuralgic complaints as well.

As if these additional uses don’t add enough to your medicine bag over its lung condition applications, consider that the Chinese use I. helenium, too, as well as the species I. racemosa (both called tu mu xiang in pinyin). They consider that it has a warm energy, acrid and bitter flavor, and affects the lungs, liver, spleen, and stomach.

The Chinese use elecampane root to strengthen the Spleen and Stomach, promote the flow of energy, and alleviate pain for symptoms of fullness, distention, and pain of the chest and abdomen, as well as for nausea, vomiting, and diarrhea. In other words, this herb not only clears the lungs of phlegm but also cleans and dissolves mucoid matter from the liver and digestive organs. The Chinese prepare elecampane by dry-frying or baking it until yellow and sifting out the bran. This moderates its acrid flavor and ability to move energy so it’s better for diarrhea and nausea.

Ayurvedic medicine uses the same two species of elecampane root (Inula helenium and I. racemosa; pushkaramula), not only to clear the lungs but also as a lung rejuvenative tonic since it promotes the longevity of lung tissue. Reducing kapha and vata and increasing pitta, it is expectorant, antispasmodic, carminative, analgesic and rejuvenative. Ayurveda uses Inula helenium for chronic bronchitis, asthma, cardiac asthma, pleurisy, dyspepsia, cough, rheumatism, skin eruptions, all kinds of pain, especially that arising from chill, and animal bites. They use I. racemosa in veterinary medicine as a tonic and stomachic.

Now to expand our uses of elecampane even more, elecampane flowers are also employed but from the different species, Inula japonica and I. britannica (although several other local species of Inula are used both by traditional Western practitioners as well as the Chinese). Western herbalists used elecampane flowers for loss of appetite, cramps, and vomiting and in higher doses, cystitis, as well as for coughs, bronchitis, and pharyngitis.

The Chinese consider elecampane flowers (xuan fu hua) to have a slightly warm energy, bitter, acrid, and salty flavor, and affect the Liver, Lung, Stomach, and Spleen. The flowers were traditionally steamed and dried, although today they are fried in honey (soak in thin honey then bake or fry over moderate heat until no longer sticky) so they aren’t too drying or deplete the energy.

The Chinese use mobilizing and dispersing elecampane flowers to direct energy downward and clear thin or lacquer-like phlegm from the lungs and stomach. They stop coughs, soften hardened phlegm, break up clumped accumulations, dissipate pathogenic fluids, and open areas of stagnation. They treat cough from phlegm and fluids clogging the lungs and thin mucus in the lungs, stomach, or diaphragm causing bronchitis, coughing, asthma, wheezing, shortness of breath, pleurisy, vomiting, hiccough, belching, burping, epigastric obstruction, food stagnation, flank pain, or palpitations with anxiety. The flowers are particularly good for nausea after chemotherapy and may be useful for upper respiratory allergies.

And what about elecampane leaves and their bitter, aromatic stalks? The Chinese use these, too (from the same species as the flowers). They are considered a stronger diuretic (moving pathogenic water down and out of the body) while the flowers are better at expectorating phlegm and relieving cough.

Dose:

Elecampane root: decoct ½ -1 oz (about 1 tsp. per pint water and drink 1 cup weak tea 2 times/day or 1 Tablespoon strong decoction 3-4 X/day; 1 teaspoon to 1 tablespoon bitters 2-3 X/day; 10-40 drops tincture 2-3X/day; also eat candied or as lozenge

Elecampane flowers: 3-12 g, infuse 1 Tblsp./cup water; d1 "00" cap, 3 times/day; take with honey to moisten the lungs and relieve cough.

Precautions:

Elecampane root: High doses can cause nausea, vomiting, diarrhea, or gastric spasms.

Western: Avoid during pregnancy and lactation  (some say it treats delayed menses); a very warming and drying herb, avoid if there’s heat in other parts of the body or combine with cooling herbs as appropriate.

Chinese: Avoid if in coughs with yellow phlegm or gastric spasms.

Elecampane flowers:

Western: Best not to use during pregnancy and lactation.

Chinese: Avoid if there’s a dry cough or in debilitated patients with loose stools.

I recently decided to give elecampane the acid test when I had some phlegm in my lungs. Michael had just dug up a big root so I chopped it up and made a tea. I had 3 cups of varying strengths and quantities and learned a great deal. Elecampane definitely has an acrid flavor with sweet overtones and is slightly aromatic. I could feel its warming energy enter my lungs, stomach, spleen, and liver. After the first weak cup of tea I started clearing my lungs while after the second strong cup I was dislodging deeper stomach stagnation that impaired digestion.

As an added benefit, an hour after I drank the strong cup of elecampane tea, I felt renewed energy. It was not a caffeine surge but gentle and supportive. In fact, I needed to exercise and didn’t want to but after the elecampane, I not only worked out but also finished several projects. Furthermore, the next day I discovered a tiny cyst I had was nearly gone!

Both of these benefits made sense to me. The improved energy meant elecampane is also a Qi (energy) tonic, which assists its ability to expectorate phlegm in those with low energy. This function can be likened to improving and increasing the mitochondria, which not only energizes but also improves digestion and muscle strength and tone – you can read about this comparison in my blog: A Short Comparison of the Spleen in TCM and Western Medicine published in 2009 at planetherbs.com).

In terms of the cyst-reducing action of elecampane, I’ve had experience using phlegm-clearing herbs to eliminate cysts in clients and so knew it was the elecampane that worked here. Phlegm not only congests the lungs and sinuses but can also create internal blockage causing many other conditions such as cysts, tumors, food stagnation, joint aches and pains, paralysis, hemiplegia, wind-stroke, Bell’s Palsy, and vertigo.

As well, I would use elecampane for snoring and sleep apnea in those with a white tongue coat or white mucus/phlegm.

As if all of this doesn’t expand your medicinal uses of elecampane enough, it may also be used as a substitute for not just one but two Chinese herbs. 

Like garlic, cayenne pepper (Capsicum annum) is one of those rude, crude herbs that has staunch friends and enemies. Regarded as a virtual panacea by many, others find themselves irritated and annoyed by its hot spiciness. Among herbalists there are “cayenne doctors” who extol its benefits for just about every disease known to man and still others who turn their irritated noses up at it, deeming it unworthy for serious consideration as a healing agent.

I became aware of the healing power of cayenne pepper when attending my first ever lecture on herbal medicine in 1970, given by the late great herbalist John Raymond Christopher. In those days, Dr. Christopher was like the lone voice for herbal medicine on the North American continent that had all but completely abandoned its deep herbal medicine roots.

It was the first of a weekend series of classes that Dr. Christopher happened to be offering under the aegis of the great Canadian herbalist Norma Meyers in Vancouver, British Columbia. Dr. Christopher was a Tony Robbins-type motivational speaker and a worthy representative of old-time herbal medicine, especially cayenne, the hot spicy herb that he loved and extolled as a virtual cure-all. 

To demonstrate cayenne's safety he would – and this is no exaggeration - begin his lecture presentations by downing as much as three heaping tablespoons of the hottest African bird cayenne pepper with a pinch for good luck, in a glass of water in front of a room full of students, young and old who came to learn about herbs. We could hardly believe what we saw, but the point was indelibly impressed upon us that cayenne is safe to take. He then went on to encourage us to take a more modest amount of cayenne pepper with a little olive oil and water three or more times a day. From there we would gradually increase the dose until we could tolerate a teaspoon at a time with no inconvenience or adverse reaction.

I did this for at least two or three years, and found that indeed, cayenne was a strong enough herb to relieve most sore throats, colds, and flu, simultaneously promoting cardiovascular health and blood circulation by warming up the entire body inside and out. As such, we learned that cayenne pepper could be used along with any other herbal therapy to focus and intensify the healing effects of any herb with which it is combined.

“Cayenne Doctors”: A Bit of History

There is so much lore associated with the discovery of cayenne as a South and Central American herb of the Mayans and Aztecs, being first presented to Christopher Columbus by the native Arawak people he encountered when alighting on an island in the Bahamas Archipelago off the coast of North America. His trip was financed by European venture capitalists to find a more direct route to the spices of India. To appease his financiers, his accompanying physician, Diego Alvarez Chanca, encouraged him to bring back cayenne pepper. At first the herb was condemned by European physicians as ‘noxious,’ a conclusion with which many today who find themselves adversely affected by it would concur. It would take another few decades before cayenne would gain more acceptance in Europe, when we find it described in the famous 17th-century herbalist Nicholas Culpeper’s materia medica.

Indeed, many indigenous peoples in South and Central America, Africa and Asia have a high regard for the healing benefits of cayenne pepper. It seems that some people have ‘the stomach’ for it but others (especially of Northern European descent as I’ve noticed) have moderate to extreme adverse reactions to cayenne.

It could be said that the granddaddy of all North American “cayenne doctors” was the self-styled farmer-physician Samuel Thomson (1769-1843) of New Hampshire, a maverick reformer who spawned a huge wave of followers throughout the 19th century. From an early childhood, Thomson showed an avid interest in herbal healing. Like most herbalists today, this received powerful impetus as he witnessed the ravages that mainstream medicine of his time brought upon its unfortunate patients. Perhaps the most famous case of this was our nation’s first president, George Washington, who, contracting a relatively simple fever, was subjected to extreme blood-letting that history now accedes was probably his cause of death. How many today, who have submitted unnecessarily under the knife or other extremely toxic and invasive treatments, have only found their health worsened, if not extinguished, by the ordeal?

Dr. Thomson formulated a completely new theory for the cause and treatment of disease equating life energy with heat, and death with cold. He worked on the premise that disease was the result of coldness and healing occurred by restoring heat to the core of the body and thus promoting energy and life.

He learned medicine from nearby native healers, as well as from a woman simply called “the widow Benton,” famous in the area for her herbal healing.  Armed with his homespun theory of healing diseases caused by cold and cured by heat, he looked around for the perfect herbs to accomplish the task. One day while visiting a New Hampshire cabin, he discovered a string of cayenne chili peppers hanging up to dry. Then and there, he realized that this was precisely the herb he was looking for to burn off all “cankers” (pathogens) from the body.

From these beginnings, Thompson’s method attracted thousands of followers throughout the world. Dr. Christopher was certainly among this group, infamously known by the “regulars” (regular doctors) as “cayenne doctors.”

As my first herb teacher, Dr. Christopher definitely had a profound effect on my budding herbal career dating back to the late ‘60s. In those early days, I easily corroborated in my own practice the healing virtues of cayenne pepper especially when the focus of healing centered around a cold-natured vegetarian diet along with frequent four-day apple juice fasts. Here you can see that it was the use of cayenne within the context of Dr. Christopher’s system based on detoxification with raw foods and fruit juices that made it such an effective herb.

Too Much of a Good Thing

Traditions such as TCM or Ayurveda describe a Yang or heating element in the body; within the cold-detoxification system advocated by Dr. Christopher, cayenne pepper used as a primary or adjunctive tool for healing represented the heating or Yang element that was otherwise totally missing.

So that’s my theory, but no matter what one may call Thomson’s or Dr. Christopher’s cayenne pepper-based healing, it is certainly not about balance. If there is a flaw in this approach to healing, it is its tendency to let cayenne’s already assertive personality dominate, even to the point of overcoming fire with fire. This may work in some instances, but there is no consideration for nurturing the cooling element or Yin aspect equally essential to health.

According to TCM, cayenne would be contraindicated for those who have symptom of Yin Deficiency with Fire, a pattern most strongly associated with inflammatory conditions such as wasting diseases like tuberculosis or AIDS. Ayurveda would view cayenne as a Pitta or Fire-predominant herb useful for individuals with cold Vata (nerve-oriented) or Kapha (mucus- or dampness-oriented) individuals, contraindicated for those with a dominant Pitta constitution.

Despite this, cayenne pepper is still a great healing herb so long as there are no signs of Yin deficient parasympathetic exhaustion. As Thompson predicates, diseases caused by coldness, congestion and poor circulation can all be benefitted with the use of cayenne. Adding a small amount of cayenne to most herbal formulas definitely focuses, intensifies and prolongs the healing effect of other herbs with which it is combined.

The Three Primary Ways Cayenne Heals

Cayenne does this through three broad approaches, considered to be the pillars of health and well being:

1. boosting metabolism (yang Qi)

2. promoting digestion

3. promoting circulation

It just so happens that these three constitute the core ways by which herbs help the body overcome disease.

Nutritionally besides capsaicin, which is the most characteristic and therapeutic constituent in cayenne, cayenne pepper is high in Vitamin C, beta-carotene and a wide range of bioflavonoids which are particularly good for the cardiovascular system.

The range of conditions for which cayenne pepper is effective is extensively explored in Dr. Christopher and Dr. Patrick Quillin’s book, The Healing Power of Cayenne. In it, one might correctly get the impression that cayenne is good for virtually all diseases.

Christopher and Quillin offer some common sense warnings of some problems encountered from taking too much cayenne, including the following:

  • it should be used more sparingly by those suffering from hemorrhoids
  • too much cayenne can cause minor gastric irritation, nausea, indigestion and possibly diarrhea
  • even though it is anti-hemorrhagic, it may burn too much if applied to an open wound
  • despite its benefit as an eyewash, getting it in the eyes can cause irritation

Dr. Quillin, a world renowned nutritionist, goes on to list over 55 major diseases for which cayenne has been beneficial, including the following:

  • allergies
  • arthritis
  • asthma
  • cancer prevention
  • cataracts
  • colds and flu
  • constipation
  • cough
  • diabetes
  • diabetic neuropathy
  • fatigue and depression
  • fat reduction
  • gas
  • headache including cluster headaches
  • low libido
  • mouth sores
  • motion sickness
  • psoriasis (as an ointment)
  • shingles (topically applied)
  • sore throat
  • low thyroid
  • toothache
  • worms and parasites

Further, Dr. Christopher described at least two counterintuitive uses for cayenne that seem to be true: one involves its use along with other herbs as an eyewash, and another is its use for healing stomach ulcers.

I deliberately left out the two most important uses for cayenne: its beneficial effect for all diseases involving the cardiovascular system, and its now widely recognized value topically for the elimination or reduction of pain, which I will focus on separately.

Cayenne and Pain Relief

One can find cayenne plasters sold at most drug stores. These provide long-lasting pain relief over any part of the body to which they are easily applied.

Numerous scientific studies have found that capsaicin reduces the amount of substance “P” which is a chemical that carries pain messages to the brain. When substance P is blocked, pain messages no longer reach the brain and one feels relief. This makes cayenne plasters, ointment or cream effective over any painful area will providing deep, and long-lasting relief.

According to the University of Maryland, capsaicin is effective for the following conditions:

  • Osteoarthritis, rheumatoid arthritis, as well as joint or muscle pain from fibromyalgia or other causes
  • Nerve pain from shingles and other painful skin conditions (postherpetic neuralgia) that happens even after the skin blisters have gone away. Research is mixed, and it may be that it works for some people and not others. Check with your doctor to see if trying capsaicin ointment is right for you.
  • Pain after surgery, such as mastectomy or an amputation.
  • Pain from nerve damage to the feet or legs from diabetes, called diabetic peripheral neuropathy. However, capsaicin doesn’t seem to work for peripheral neuropathy from HIV.
  • Low back pain. Several studies suggest capsaicin cream can reduce lower back pain.

Additionally, capsaicin cream can reduce itching and inflammation from psoriasis, a long-standing skin disease that generally appears as patches of raised red skin covered by a flaky white buildup. [1]

Cayenne and Cardiovascular Disease

Cayenne is very beneficial for those who are suffering from, or are at risk for, cardiovascular disease. As such it can be taken as a powder or in capsules, singly or combined with other heart herbs such as hawthorn for the treatment and prevention of stroke, heart attacks, high blood pressure, angina, and arrhythmia.

Many with cardiovascular disease have found benefit from the inclusion of cayenne in their healing regime. Because there is absolutely no reason that Big Pharma would invest millions of dollars to discover that a common herb such as cayenne chili pepper could be used to replace the many high profit cardiovascular drugs on the market, few clinical trials exist on cayenne. Nevertheless, following are studies worth considering:

  • The anti-fibrin, blood-thinning properties of cayenne make it especially valuable for healthy cardiovascular circulation, preventing and relieving clots that could lead to strokes. This was confirmed in a research project by Sukon Visudhiphan, MD, PhD and colleagues in 1981 when he tested the viscosity of the blood of Americans living in Thailand compared with the native Thais, who consumed quantities of hot chilis. The fibrinolytic (breaking of fibrin) activity of the native Thais eating spicy chilis was much higher. [2][3]
  • A 2010 study published in Cell Metabolism found that a receptor called TRPV-1 was activated in mice when they consumed capsaicin, which lowered the blood pressure. [4]
  • Another study published in Current Medicinal Chemistry Cardiovascular Hematological Agents in 2003 found that capsaicin affects sensory nerves that work with neurohormonal systems to help lower blood pressure. [5]

The Thermogenic Effect of Cayenne for Weight Loss

Cayenne is popularly used as a thermogenic, i.e. calorie burning, substance. A study supported by the National Institutes of Health and the McCormick Spice company found that taking a half teaspoon of cayenne pepper either mixed with food or swallowed in a capsule and consumed with a meal helped normal-weight young adults burn about 10 more calories over a four-hour period, compared to eating the same meal without cayenne pepper. Pepper was found to further decrease the appetite especially in people who didn’t already eat spicy foods. [6]

It has been my personal experience and the experience I’ve noticed with many who regularly take cayenne as a supplement that because of the metabolic stimulating effect of cayenne, it is easier to lose weight if one includes cayenne in the diet or as a supplement.

Other Uses for Cayenne

Recently on a Viking river tour through Russia, I was introduced to a wonderful cayenne-honey vodka made in the Ukraine called Nemiroff Vodka.[7] Besides being delicious, it served as a powerful treatment to ward off a bad cold or flu that was circulating towards the end of our two-week cruise.

Besides its use as a spice and medicine, cayenne is of course used in pepper spray to ward off possibly aggressive attackers. It can also be applied to a small patch of adhesive applied to acupuncture points on the body.

Both cayenne and garlic are potentially rude and crude herbs that tend to dominate anything with which they are combined. This makes it difficult to incorporate these herbs in a comprehensive herbal healing system based on creating harmony and balance. Keeping this in mind, there is no reason that either of these heroic herbal ‘bullies’ could not play a role in health and healing.

 

[1] http://umm.edu/health/medical/altmed/herb/cayenne

[2] Visudhiphan, S. et al., American Journal of Clinical Nutrition, vol 35, p. 1452, June, 1982

[3] The Healing Power of Cayenne Pepper, Dr. Patrick Quillin pub. By the Leader Company.

[4] http://www.ncbi.nlm.nih.gov/pubmed/20674858

[5]  http://science.naturalnews.com/2003/5601844_Capsaicin_sensitive_sensory_nerves_and_blood_pressure_regulation.html

[6] http://www.webmd.com/diet/news/20110427/cayenne-pepper-may-burn-calories-curb-appetite?page=2

[7]  http://therumhowlerblog.wordpress.com/vodka-reviews/nemiroff-honey-pepper-vodka/

 

hawthorn fruitIn my search for western substitutions for Chinese herbs, it’s hard to ignore the easy ones. Since we’re at the end of the Spleen time of the Spleen time of year – deficient Spleen symptoms being poor digestion, difficulty losing weight, diarrhea, low appetite, fatigue, and slow metabolism – choosing hawthorn seems a perfect start to my herbal substitution blogs.

Technically, this is not really an herbal substitution but rather teaching Western herbalists to use an old favorite in a new way, although this is a type of substitute of sorts, isn’t it? The question is, can an old herb (or herbalist) learn new tricks? I hope so, because this one is really worth it!

Western hawthorn (Crataegus oxyacantha), the herb much beloved for treating heart conditions, is cherished indeed because cardiovascular diseases are the leading cause of death not only in the US but also the entire world. Hawthorn is perfect for this because it’s a cardiac tonic, regulates blood pressure, lowers cholesterol, and protects the heart all in one.

Chinese hawthorn fruits (Crataegus pinnatifida – shan zha) have another powerful use that Western hawthorn could "learn" and this one actually relates to heart problems – as a digestive aid. (I know the Chinese variety is a different species,[1] but stick with me here as all will become clear in the end.) Chinese hawthorn has long been used as a digestive to transform blockages in the stomach and intestines. In particular, it helps the body digest meat, fats, and greasy foods, alleviating symptoms of abdominal distention, pain, and watery diarrhea or dysentery (especially for the latter two when the herb is charred). It has been so widely used for this that hawthorn wafers are sold in Chinese pharmacies and markets as a tasty after-meal digestive for all ages.

And yet, the Chinese have also used their hawthorn species to circulate the blood and transform blood stasis, particularly for postpartum or lower abdominal pain and clumps, or pain in the chest. In recent years, however, the Chinese have begun to also use it for hypertension, coronary artery disease, and elevated serum cholesterol. Sound familiar?

This is why: the Chinese tested their species of hawthorn with anesthetized rabbits and found it lowered blood pressure for up to three hours. In other experiments it caused systemic vasodilation, while further experiments in China and other countries showed that various species of hawthorn grown in different parts of the world were useful in preventing and treating atherosclerosis. Lastly, other animal experiments with hawthorn showed changes in both serum cholesterol levels and coronary arteries and aorta.[2] And what underscores the similar uses of both the western and Chinese species of hawthorn? Both have the same flavors and actions – sour and sweet flavors and slightly warm energy!

What I find especially interesting about this herbal usage cross-over is that after eating a big meal or poor food combinations, many people experience pain in the chest and so fear they are having a heart attack. When they go to the hospital, one of the very first treatments for this often given in emergency rooms is a digestive such as Pepto-Bismol, which more often than not alleviates the symptoms. The doctors then know their patient’s pain was not from a heart attack but from blocked digestion. Many of us know what this feels like – just think back to the physical aftermath of a heavy meal and you’ve got the idea.

While the Chinese have researched and adopted the Western usage of hawthorn, it’s now time for Western herbalists to do the same and try hawthorn for digestion. And this is the perfect time of year to use hawthorn for digestion of meat and fats, stuffiness, abdominal distention, or pain, and watery diarrhea, or for postpartum or lower abdominal pain and clumps. Try it and watch your hawthorn horizons expand!

If you experience blurry vision, tiredness, dizziness, numbness, black spots in the visual field, dry skin, hair or eyes, and/or are easily startled or overwhelmed, then combine dang gui or gou ji berries with the hawthorn to protect your blood.

Pull out your hawthorn tincture (or wine!), take it with meals, and feel your digestion improve while your herbal skills grow!


 

[1] The same herb but different species may have completely different actions. For example, western black cohosh (Actaea racemosa) has a cool energy, sweet, acrid and slightly bitter flavors and enters the Liver, Spleen, Stomach and Large Intestine meridians. It has traditionally been used as an antispasmodic for rheumatic and arthritic complaints, skin rashes, and delayed and painful menstruation. Today it is used for menopausal hot flashes since it contains estrogenic substances. Chinese black cohosh (Cimicifuga heracleifolia, C. dahurica, C. foetida – sheng ma) has a cold energy with sweet and acrid flavors and enters the Lung, Spleen, Stomach, and Large Intestine channels. It is specifically used to vent measles and headaches, clear heat and toxins, treat canker sores and swollen throat, and lift the yang in prolapse.

[2] Bensky, Dan, and Gamble, Andrew, Chinese Herbal Medicine Materia Medica, (Revised Edition 1993), Eastland Press, Inc., Seattle, WA, p. 224.

Ever wonder why you never hear mention of certain well-known herbs in the higher echelons of herbal medicine? Garlic is one such unsung herb. I once asked my prominent TCM and Ayurvedic herbalist cohorts why garlic is not included in any of the classical texts and higher level discussions of herbal medicine in these respective systems. Both provided a similar response: essentially, garlic is just too common and crude. In this blog, I want to reaffirm my high regard for garlic.

Whole books have been written about its healing properties, but you need go no further than herbalist Christopher Hobbs’ article on garlic. According to Hobbs, Ayurvedic herbal theory considers garlic, called lasuna in Sanskrit, "tonic, hot, digestive, aperient, cholagogue and alterative." Various simple Ayurvedic practices used to administer garlic are not all that different from some of those used in Europe and the US. One is to crush garlic in honey and take it to relieve coughs, flu, fever, parasites, and other infectious diseases. Strong herbs like garlic often require ingenious vehicles of administration in order to lessen their harshness. In Ayurveda, it is crushed and taken in boiled milk with the addition of honey.

In traditional Chinese medicine, garlic is called suan. It is described as having a pungent taste, warm nature and acts on the Spleen, Stomach and Lung. Its spicy property is used to promote the circulation of Qi and Blood, remove masses from the abdomen, eliminate toxic substances, destroy parasites (internally and externally) and treat a wide variety of diseases including: feeling of cold, swollen abdomen, diarrhea, dysentery, malaria, cough, boils and pyogenic infections, tinea capitis, and snake or other venomous bites and stings. I’ve never found it as part of a TCM classical formula, perhaps because it is so strong and the flavor is overwhelming. For medicinal use, the Chinese do recommend crushing it and eating it raw, mashed, decocted, or with food.

Western herbalists are great believers in Allium sativum. The use of garlic in the West is well known and especially widely used in countries surrounding the Mediterranean Sea. Garlic is so highly respected that many herbalists quip, "It can be used to cure every disease except the one it causes (bad breath)!" For this I recommend taking some parsley after eating garlic.

The Antibiotic Power of Raw Garlic

Today, garlic is appreciated as an herb to help the cardiovascular system and lower blood pressure. But Hobbs and I both agree that garlic is probably the single most potent antibiotic herb there is.

Perhaps the most important chemical constituent found in garlic is the organosulfur compound allicin. When fresh garlic is chopped or crushed, the enzyme alliinase converts alliin into allicin. This is responsible for the strong aroma of fresh garlic, which travels throughout the body very quickly from direct contact through the blood stream. (If you want to prove this, try rolling and crushing a clove of fresh garlic with the sole of your foot and count the seconds before the smell is emitted through the breath of your mouth. This is what makes garlic so particularly effective for the lungs and bronchioles.)

Further enzymatic changes of allicin quickly occur producing other sulfur compounds such as diallyl disulfide. These are all known to have antibacterial, antiviral, antifungal, antiprotozoal and antiyeast activity making garlic both a powerful treatment as well as preventive of infectious diseases.

At the first sign of an upper respiratory infection of any kind, I recommend taking garlic in my favorite preparation: mash several raw cloves into some olive oil and take a hefty dose (about a teaspoonful) hourly when needed by dipping a bit of bread into the olive oil and garlic mix. This can help cure the disease but for certain, it prevents its progression.

Aged and fermented garlic is widely promoted in the market. This is a Japanese method to enable one to benefit from the positive effects of garlic especially for the immune and cardiovascular system without the strong smell.

Cooking or fermenting garlic largely destroys the antibacterial sulfuric compounds mentioned above, but again the many other health benefits of garlic especially for digestion, cardiovascular and immune system will still be present. However, if you are looking to use garlic for its more acute antibacterial and antiviral properties and benefits for the lungs and respiratory system you need the odor which carries these properties to those parts of the body.

A Delicious Way to Prevent Cold or Flu

I’d like to share a very special, delicious garlic food remedy given to me by one of my students and neighbor, Kathryn Grant. It is her ‘go-to’ first line treatment for acute colds or flu and I can attest that it really works.

Garlic Fettuccine

3 ounces fettuccine, cooked al dente

1 whole garlic bulb, sliced

2 tablespoons olive oil

2 to 3 tablespoons half and half

2 to 3 tablespoons Parmesan cheese

Cayenne pepper

Gently heat olive oil over a low/medium flame. Add garlic and sauté until fragrant (30 seconds).

Add fettuccine, half and half, and toss. Sprinkle with Parmesan and a little cayenne (next month’s crude, rude herb!), and toss until creamy and pasta is coated.

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