In my previous blog on treating H. pylori-induced stomach inflammation with herbs, I touch briefly on a fundamental difference between conventional and complementary medicine: namely, that conventional medicine prefers to identify an isolated pathogen or discrete named diagnosis which it aims to treat singularly; whereas complementary or traditional medicine relies on signs and symptoms, within the unique individual and their personal conformation, and how these elements fit into a time-tested model of healing.

Being an herbalist means learning to think like a herbalist, which apart from a special knowledge of the therapeutic properties of plants also means to not overly focus on the symptoms of a disease but also the particular unique physiological ‘terrain’ from which the disease and its symptoms arise. With Chinese medicine, this means treating ‘root (cause) and branch (symptom) based on principles of yin and yang. In Ayurveda, it means differentiating the individual’s underlying prakriti (doshic or humoral imbalance) from the vikruti (doshic disease imbalance).

There are several layers of healing. One is to disguise the symptom, another is to deal with the microbiological cause of the symptoms. Still another is to treat the “cause of the cause” which is the imbalances in the body that predispose one to develop such things as infections (like H. pylori overgrowth). Still another cause beyond these physical ones are the psycho-spiritual reasons one develops a disease.

Relief or “cure” can be achieved at any of these levels. The first treatment principle should be to relieve the symptoms, which is the most superficial level of healing; second, treat the “cause of the cause” being the most physiologically beneficial level overall: and then attention must be paid to the third, psycho-spiritual level, which is the most profound.

Only masking the symptoms, which is the usual approach in Western medicine such as when antibiotics and anti-inflammatory drugs such as cortisone are given, is fraught with possibly damaging side effects. This is why many people seek the herbalist or acupuncturist for the second and third levels of healing. Every healer has some facility to work on each of these levels but the herbalist and acupuncturist uniquely specialize on second “cause-of-cause” level.

The third, psycho-spiritual level may either be all encompassing or may provide other levels of relief beyond the physical.

Addressing all three of these levels, with respect to the individual patient’s particular physiology, history of illness and mental or emotional disposition, is the definition of “wholistic” healing to which most herbalists and traditional practitioners aspire. It is an approach which, in my opinion, is most likely to bring about the sort of transformation that leads to deep and lasting healing.

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

"Be it ordained established and enacted by authority of this present parliament, that at all time from henceforth, it shall be lawful to every person being the King’s subject, having knowledge and experience of the nature of Herbs, Roots and Waters… to practise, use and minister in, and to any outward swelling or Disease, any Herbs, Ointments, Baths, Pulters and Emplaisters, according to their Cunning, Experience and Knowledge … without suit, vexation, trouble, penalty or loss of their goods."

-- The Herbalists’ Charter ordained by Henry VIII, 1543

Lesley and I just completed teaching for the annual United Register of Herbal Practitioners (URHP) conference, held at a typically bucolic English countryside conference center in Warwickshire about an hour or so by train south of London. We were gratified to learn that the herbalists in this organization were indeed Planetary herbalists, not confined to a single ethnic herbal tradition. For a dozen years, we used to travel yearly to England to teach Planetary Herbology there, and on this return visit, we met some dear old friends and former students, now respected herbalists in the UK. We could converse easily about Western, Chinese, and Ayurvedic herbs and everyone was able to follow along.

Despite this happy meeting and the invitation for us to teach, the fact is that herbal medicine in the UK is in a state of confusion and repression compared to its present state in the US. I was somewhat dismayed by how things seem to have taken a few steps backward the last 10 or 15 years. The problem seems to have arisen after integration of the UK with the European Union (EU). 

Herbs Disappearing from Stores in the UK

Calling around and seeking once familiar herb sources, I found practically no herbal formulas or supplements available to the general public. I learned that one of the mandates of the EU was that herbal formulas and products had to go through a prohibitively expensive licensing process in order to be made available to the public. That means that products sold by such popular companies as Planetary, Source Naturals, Herb Pharm, Kan and GMP (good manufacturing practice) standard Chinese patents are no longer sold, (including ones regularly referred to in our URHP classes). Some flagship Chinese patent formulas are not available even to registered herbalists because they contain substances derived from animal sources (like oyster shell).

Walk-in herb shops in London were rare or virtually non-existent -- stores such as Mayway, Neal's Yard and others have either moved out of the city, shut down or converted to selling mostly trivial potpourri-type items such as herbal bath and toiletry articles.

Stalled Legal Status for Herbalists in the UK

Ever since the herbalist charter of Henry VIII (a portion of which is quoted above), herbalists throughout the UK have enjoyed a remarkable degree of protection of their right to practice and dispense herbal medicine throughout the UK and all of its present and former territories.

As countries including England faced the prospect of uniting with the newly envisioned European Union (EU), the European Herbal and Traditional Practitioner Association (EHTPA) was set up in 1993 to achieve a secure regulatory basis for herbal practice in the EU. The EHTPA has taken on other important work that would create more uniform standards for their registered herbal practitioners, such as developing standards for practice and accreditation, documenting research as published evidence of the efficacy of herbal medicine, and developing a dispensing code of practice that would ensure the traceability of herbal ingredients.

But where the contention lies is that EHTPA mandated that for the sake of public safety, all herbal formulas and products needed to be licensed along prescribed parameters or they could not be traded on the open market. This applies to all supplements including herbs.

Timelines were set forth for companies to comply. For most, the cost of having even a single product licensed was far too prohibitive, costing several thousands of dollars for each formula or product. Not doing so meant that they forfeited their right to sell their products throughout the EU, including the UK. However, herbalists who are registered would have privileged access and right to dispense unlicensed products to their clients. The problem is that becoming a registered herbalist is a complicated and expensive matter especially since the UK government who proposed and sponsored legislation has been dragging its feet in the final approval process.

What was and continues to be at jeopardy is access to herbs needed to operate an herbal medical practice. On Feb. 16, 2011, the UK government proposed and drafted legislation for statutory regulation of herbal medicine. Strangely, this gave the impression that the UK was more concerned with herbal products rather than the public safety concerns flaunted by the EU generally, and as a result it appeared that the UK was deliberately circumventing EU medicines law. (For more about this issue, see this article.)

URHP Vice President Lloyd Gee writes:

The Herbal Medicine Working Group has been formed to advise the Deputy Chief Medical Officer of Health on the future legislative arrangements for the practice of herbal medicine in the UK. This met twice and there is division within this working group with Association of Master Herbalists (AMH), Association of Naturopathic Practitioners (ANP) and homeopaths generally against statutory regulation (SR).

SR would bring a protected title to herbalists meaning that only properly qualified herbalists could prescribe unlicensed medical herbs which is seen to be important for public safety. This would also mean that naturopaths and homeopaths who are not qualified herbalists would lose their access to dispensing herbs. Schedule 20 herbs (previously schedule 3) have been under threat and several times EHTPA has had to negotiate on the basis that SR will ensure only competent herbalists will be able to use them. With voluntary registration (VR), we are more likely to lose these.

This is where the UK and the EU cross swords. If the UK government’s current legal advice is that SR-registered herbalists would have access to unlicensed herbal products, this would be seen by the EU as the UK deliberately circumventing the directive. The result would be the European Commission imposing hefty fines on the UK government. If that happened, registered UK herbalists would lose access to these products in any case and a big reason for joining an herbal registry would be moot.

As if things were not complex enough, the EHTPA as the umbrella pro-registry organization for the EU, for various reasons would not accredit certain herbal registers. Furthermore, some registers withdrew from the EHTPA because of the delay in getting government support for statutory regulation. Statutory regulation was eventually what the government insisted upon, but not before major herbal suppliers ran out of stock in 2011 and were told that they could not replenish their stores until statutory regulation of herbalists was legally established.

Another factor justifying many herbal organizations' decision to withdraw from the entire process of creating a body of registered herbalists is the required annual fee to support EHTPA activities while the UK government dragged its feet in creating clear legislation. Many withdrew from EHTPA as they felt that they didn't want to pay for something that wasn't going to happen.

To sum up, where things stand at the moment is that English herbalists are awaiting registration approval from a government that seems to be delaying the completion of a process which they first proposed several years ago and have not yet finalized. (This registration of professional clinical herbalists would be equivalent to ‘licensed herbalists’ in the US, if such a thing existed – which it doesn't.)

UK herbalists are stuck in this holding pattern until the government sorts out its own registration process. In the meantime, herbalists not only have limited access to herbal products, but in many instances they also have a difficult time finding sources for them. For now, they are allowed to formulate on the spot for individual clients. This makes aspects of herbal medical practice cumbersome and difficult.

Most herbalists I spoke with would prefer to continue with as little government interference as possible. At best, some of them are willing to forfeit some of their individual freedom of practice to assure the evolution and ongoing practice of herbal medicine especially in the wake of possible EU compliance.

An Object Lesson from Across the Pond?

Living in a global community, too often we see how the socio-political concerns and problems of other countries, especially those of Western European nations, eventually become our own.

Present matters in the UK has resulted in discord between herbalists in favor of saving the profession by becoming part of a new herbalists registry and those who staunchly resist any and all government interference with the practice of herbal medicine. Similarly, in the US today and within the ranks of the American Herbalists Guild, there are those who seek to evolve and preserve the profession of medical herbalism by licensing and those who vehemently resist it. Just as in the UK, at times this struggle has engendered fierce hostility between the two sides.

I hope this brief discussion of the complex issues of herbalism in the UK offers some enlightenment and clarification for herbalists in the US, where the pros and cons of licensing in this country are certainly an issue. It is my personal belief that licensing of medical herbalists in the US is a good idea for the safety of the public and to ensure trained herbalists’ access to now restricted herbs such as Ephedra (withdrawn from sale because of opportunistic misuse of the herb as a metabolic stimulant for weight loss). Most herbalists that I know would agree that certain herbs are too dangerous for unrestricted public access. Licensing is a trade-off where certain liberties are exchanged for greater privileges and freedoms.

I also firmly do not want licensing to occur that would in any way prohibit individuals and small community and family groups to not maintain their God-given right to prescribe and use herbs. Where I draw the line is when it comes to setting up a professional medical herbalist practice for pay.

The Price of Success

Everything seemed to be going just fine for the few of us herbal pioneers when we freely practiced herbal medicine and prepared our potions in our home kitchens with ideals of bringing the blessing of herbal medicine to people in all walks of life. Funny thing is that we may have succeeded, but now we have to cope with the changing and ever greater responsibilities of more publicly accessible herbs. Now we must prepare our medicines in regulated facilities outfitted with paraphernalia and safeguards mandated by the present GMP codes.

In the same way, if herbal practitioners are to come of age, they face similar demands and must conform to minimum standards of education and practice that will justify the trust that we are asking from the public.

----------

I recommend reading Giovanni Maciocia’s blog of 2010 entitled "Appeal to European Herbal Practitioners"

http://maciociaonline.blogspot.com/2010/12/appeal-to-european-herbal-practitioners.html

Botany300HMany years ago, Montana resident Thomas J. Elpel dropped off a manuscript entitled Botany in a Day at my office. Over the years many people have submitted manuscript copies of their book to me in the hopes that I would provide some sort of endorsement that could be used for future marketing. Unfortunately, not all were worthy of my endorsement, but this one caught my eye for several reasons.

As the founder and director of the most successful herb course in North America – in terms of numbers of enrolled students and numbers of students who have distinguished themselves professionally in the growing field of herbal medicine, I immediately recognized that Botany in a Day was perfect for herbalists and new students of herbalism.

I contacted Elpel and told him so, and further, that I wanted to make it one of the core textbooks of the East West Herb Course. I think it was 1996-98 or so when this occurred and the first edition of this remarkable book was published. Since that time to the present the book has gone through a total of six editions and has sold over 50,000 copies. Not bad for a self-published and self-distributed book, I’d say. While this is impressive it hardly reflects the true value of such a book to anyone who has an interest in plant identification. The book covers a comprehensive description of plant families of the northern latitudes, especially North America and Canada, but is applicable to most parts of the world above the equator as well as plants on every continent.

It starts out identifying the various parts and patterns of plants with a tutorial on plant names and a section on the evolution of plants that allows one to understand the big picture of plant botany. Following is a segment on "Learning Plants by Families" that teaches the reader to recognize the basic characteristics of the eight most common plant families (Mint, Mustard, Parsley, Pea, Lily, Grass, Rose, and Aster). This covers 45,000 common medicinal herbs and plants one is likely to encounter most frequently. With a basic understanding of these, one is ready to go on to learn the many other families one is likely to encounter.

While not intended as a medicinal herb book, perhaps it is my bias to see it as preeminently a book intended for herbalists, herb students and wild food foragers. As such, it references common biochemical, medicinal and nutritional characteristics.

For most of us, a lengthier and more formal training in botany would promise a long, perhaps dull study with no intended practical application other than learning to identify and classify plants. But Thomas Elpel’s book is a painless approach to the same subject specially tailored to the needs of herbalists and lovers of plants. It approaches the otherwise heady subject of botany on a somewhat limited but totally useful scale with the same sense of satisfaction and fun one might expect from working and solving a crossword puzzle. The end result is a deeper relationship with the plants we know and the possibility of making new plant friends.

Earlier editions of this book were printed in black and white. For the same price, the newly expanded sixth edition has a colorful cover and color depictions of the plants throughout the book.

Click here to purchase the new edition on the Botany in a Day page on Elpel’s website, and don’t forget to check out his other works.

chartingRecently I read an article in Acupuncture Today titled "The Devil is in the Details" written by acupuncturist Douglas Briggs, who is frequently called upon to give his opinion on standard care in depositions for malpractice cases. Briggs has experience with the legal demands that determine standard patient care, including proper case documentation.

In a recent case where he was called for his opinion, Briggs listed various questions asked to determine proper patient care, which gave insight into how the legal realm looks at patient records. Apparently during a deposition an attorney can ask anything about your care of a patient, whether you wrote it down or not. What you "think" or "remember" is not credible. If it’s not written down, it’s not part of the record!

While this deals with licensed practitioners, it also applies to all health care providers including those who practice complementary medicine. As these modalities become more mainstream and integrate with conventional ones, our practice methods are also scrutinized and are expected to come into line with highly recognized practices. This will eventually include herbalists as they become more acknowledged. This means herbalists not only need to include proper referrals to other practitioners, but also keep adequate documentation.

Good case notes are obviously helpful for treating your patient. If it’s been weeks, months or even years since you’ve last seen someone, of course you treat what presents in the moment. However, thorough notations provide important reminders of the patient’s history, background, prior assessment and treatment, and other factors that are helpful for choosing your current procedures.

While at the East West School of Planetary Herbology we have long stressed the importance of charting TCM/Ayurvedic/Western assessment, treatment strategy and remedies/protocols, there are several other factors that must be documented. Doing so not only helps your treatment of the patient but also prepares you for unforeseen future needs. When you record such information as patient name, contact information, history, symptom/signs, lifestyle habits, and diet, keep these additions and considerations in mind:

  • Not only is good record-keeping legally viewed as providing good care but also NOT providing good documentation could be seen as potentially harming the patient. In other words, good documentation is seen as necessary for the patient’s safety.
  • Keep your own notes and don’t depend on other people’s, even if from another respected practitioner.
  • Document when you referred someone and to whom, including full names and dates. If you request information from another practitioner, note when and from whom. This protects you, the patient, and the other practitioner.
  • Be specific about your recommendations and treatments. If you do any form of bodywork, record what you did, including any points you held or body areas treated with adjunct therapies such as cupping or moxibustion. Do not just state "massage" or "full body care."
  • List your treatments and recommendations in the order performed as this shows a flow of care and not just a list of procedures.
  • When you record a follow-up session, your comments about the patient's progress must be specific. Rather than write that a patient is "better" or "worse," note what specifically has changed since your last session. For example, record how their range of motion is different or what their pain level is now on a scale of one to 10 as opposed to what they reported last time.
  • Give a straightforward rationale for your treatment. This is the basis for doing a TCM/Ayurvedic/Western assessment, which also then determines your treatment strategy.

These are the kinds of micro-details that can make a difference. While it may seem nit-picky and time-consuming, it actually takes very little extra effort to comprehensively record what you are doing. In the end, this not only serves you but also gives your patient better care.

Breitenbush 2011 portrait: 
Leaning on the rail: (unknown). Left to right, top row: Ken Collins, Autumn Summers Spelman, Kevin Spelman, Daniel Pinney. Next row: Cassandra (organizer), (unknown). Third row: Jane Bothwell, Rob Menzies, Gabriel Howearth. Fourth row: Leslie Gardner, Jim Green, Svevo Brooks, Cascade Anderson Geller. Fifth row: (unknown), Michael Tierra, Ryan Drum, Mindy Green, Christopher Hobbs. Last row: Tim Blakeley, Kathi Keville, Rosemary Gladstar, Heather McNeil Blakeley

 

Breitenbush Hot Springs, located in the Willamette National Forest of the Oregon Cascades, was the place where North American herbalists met for the first time about 30 years ago. The September 2011 conference was billed as a 25-year reunion, but many of us joked about our aging memories and were really not so sure of the date. Upon consideration, it was probably more like a 30-year reunion.

Many of us young herbalists met for the first time at Breitenbush in the nude, steaming in the wonderful sauna or soaking the in the many wonderful hot mineral springs. Most of us felt then as we do now that Breitenbush, tucked away in the wilderness of southeast Oregon, with wild herbs like Oregon grape and others growing everywhere, is in all the ways that count a veritable herbalist's paradise. We saw ourselves as mavericks and revolutionaries of a sort. The revolution we were fomenting was the entire alternative medicine movement that began with herbs.

It's perhaps a bit of a cliché to say that most revolutionaries have been part of a youth movement and could hardly ever imagine themselves aging. The Breitenbush reunion consisted of a number of us now in our late 60s and early 70s, having spawned a $3.5 billion alternative health and herb industry in the United States and Europe. Here we were, hanging once again warming our tired old bones in the Breitenbush hot mineral baths, bunking together in the same rustic cabins in the woods, and sharing delicious vegetarian meals on the deck of the main lodge. We capped off the event by sharing anecdotes about each other and our past together during the Saturday evening keynote address which given by all of us sitting in a row in front of the nearly 200 attendees.

When we first met 30 years ago, those of us herbalists in the Pacific Northwest had already taken classes with famed itinerant herbalist Dr. Raymond Christopher, and Norma Meiers, an eccentric hyperbolic herbalist living and working in and around Vancouver, B.C. They were among the scant few who were left from earlier days when all medical doctors learned and implemented herbs as part of their practice. By the 1960s, these two were probably the only herbalists in all of North America who were willing to pass along the torch of herbal medicine, essentially banned since the 1930s throughout the continent.

Another forerunner was herbal pharmacist Nathan Pothurst, who along with his assistant Emma, owned and operated the last surviving herbal pharmacy, Nature's Herbs, in the United States. At that time, what herbalism remained was supported by an older conservative set who remembered the "good old days" when illnesses were better attended without the risk of dangerous side effects by their parents, grandparents, and benign doctors who healed common diseases using herbs.

The mid-20th century herbal renaissance occurred concomitantly with San Francisco hippies' use of marijuana and their search for an alternative lifestyle apart from what was felt to be an inhuman, violent and corrupt mainstream. At first, when some of us like myself, Ed Smith and Rob Menzies descended on Pothurst's pharmacy on Ellis Street, he was not impressed with our unkempt, bearded hippie appearance. Nathan even asked me once to leave because I presented a frightening appearance to his prim and proper elderly patrons. I left but kept coming back with money to buy herbs for the Haight community and hunger for herbal knowledge. It was from Nathan that I first received what must have been the last eight ounces of commercially available echinacea forgotten in the bottom of a jar in his basement.

Today, the continued availability of herbs for study and practice is more fragile and endangered than many think. This is nothing new. I remember Nathan describing how in the late 1940s the FBI stormed into Nature's Herbs and confiscated thousands of herb books containing formulas sold in the store and took them out on the street for a public book burning. Fortunately that excellent book written by Otto Mausert N.D., simply entitled HERBS was bootlegged and reprinted by Elaine M. Muhr and is once again available today.

Breitenbush 2011's core teachers were representative of only some of us who were together for the first time 30 years ago, people whom I deeply respect and was overjoyed to renew soul contact with. Some 30 years later, our bodies may show a bit of age but our spirit was the same as when we first met:

I first met East Coast Cherokee-trained herbalist David Winston at Breitenbush all those years ago. We were both delighted and astonished to discover that there were a few others like ourselves scattered throughout the country who were interested in herbal medicine. He is now one of the most sought after and beloved herb teachers in the country.

Cascade Anderson Geller is another great herbalist held in high esteem by naturopathic and herb students who have studied with her throughout Oregon and Washington state. Cascade and I enjoyed a wonderful walk along the Breitenbush River that runs through the property talking about the past, present and future of herbal medicine and the legacy we want to leave our beloved students "" as if, in fact, we really have any control over that!

Kathi Keville, an herbalist from the Lake Tahoe California Sierra region, one of the founders of the American Herbalists Association, is an author with the most joyous personality.

breithobbsMy close friends Christopher Hobbs (shown with me at left), as well as James and Mindy Green, no longer a married couple but close friends and respected colleagues, were there.

One of the most amazing faces from the past for all of us was Rob Menzies, the founder of Star Herbs, a Vietnam vet, keeper of the biggest heart you can imagine and a deep wealth of all aspects of herbal medicine. He, his wife Mary Po (a former student of mine from Santa Cruz), and I shared a cabin and enjoyed some intimate conversation together. He told me to check out his website to see what he's up to these days. If you've ever wondered, as I did, "Whatever happened to the Wild man of the West, Rob Menzies?", do check out his fabulous website at http://www.menziesnatives.com/school.html.

Notably absent were some like Ed and Sarah Smith, the founders of Herb Pharm, arguably the most enduring and one of the finest herb companies in the country. Ed and Sarah got their start by selling their tinctures and wares at the first Breitenbush gatherings. 

Also absent was Roy Upton, to whom I gifted my herb course on a hillside in Breitenbush because he made and continues to make such a deep impression of his compassionate caring, love and devotion to humanity, was also at our "reunion." Without even one iota of university credentials, Roy went on to write several books, formulate great products, become the line director for Planetary Herbals, and most impressive of all, found and create the American Herbal Pharmacopoeia, which consists of a series of scientifically peer-reviewed monographs on herbs. These are considered the academic standard of the herbal industry worldwide.

breitrosemaryLast but certainly not least, the person who brought us together in those early years, first in classes taught in the barn of a ranch where she lived called Rainbow's End and later at Breitenbush Hot Springs, was the beautiful granddame of North American herbalism, Rosemary Gladstar (pictured at right with me). It is impossible to consider a North American herbalist reunion without her presence. Rosemary now lives with her husband in Vermont and continues to invigorate the herbal movement with her teaching and the annual International Herbal Symposium, where herbalists from throughout the world attend and teach. Rosemary pays their expenses and treats them like honored royalty, keepers of the sacred knowledge and wisdom of herbal medicine.

Throughout the Breitenbush reunion, whenever we needed a spokesperson or someone to bring us together or send us on our way with a heartfelt invocation or closing circle, Rosemary, with all of her beauty and grace, was there. It was like old times, forever.

I can't begin to mention all the people and events of the Breitenbush 25 year-but-really-closer-to-30-year reunion but four more deserve mention:

Gabriel Howearth is one of the founders and promoters of the permaculture movement in America, herbalist and founder of Seeds of Change. Gabriel was there, happily recovering from a severe years-long struggle with the crippling effects of spinal meningitis he contracted by accidentally swimming in sewage polluted oceans off the coast of Mexico. He was completed paralyzed, in a coma for a year, couldn't walk or talk. We were all so happy to see him miraculously recovering, though he still needed a lot of assistance.

Ryan Drum is an herbalist whose specialty is the many healing benefits and uses of seaweed. During the keynote speech Ryan, who looks like an herbal leprechaun, gave a hilarious description of when we was assigned to a cabin where he almost crawled into bed with a giant man with a snore to match (probably Michael Moore).

Svevo Brooks, an herbalist whose emphasis is on practical wisdom and simplicity, is deeply revered throughout the community of friends and colleagues. He taught his workshop at 4 a.m., inviting those who joined him for a walk and icy plunge in the Breitenbush River. Svevo believes in the most ancient and fundamental principles of good living. Rosemary tells of hiring Svevo to teach at one of her East Coast symposiums; he taught, amongst other things, the art of napping. She was utterly shocked when she dropped in on his class and found the entire class napping on the floor! On Saturday evening, there was a talent show and Svevo read the following poem, entitled "The Nap," which he composed for this event:

Passing years are not as great
When reckoned by the score
Half again is after all
Not a great deal more

Counting is an exercise
That jumbles up the brain
Age is better tallied
By measuring drops of rain

Or even ice cream sodas
Chocolate mints and lollipops
Children, flowers, barefoot walks
Random draughts of schnapps

At least these do bring pleasure
And fix upon the mind
Memories of former days
When life was more sublime

I therefore raise an empty glass
To whatever age you choose
That half again be just enough
More to gain than lose

An now if you'll excuse me
The mid-day bell has tolled
I'm of the age when courtesy
Gives way to being old

What's that I hear
A snicker and a laugh?
I suppose you're one of those
Who stopped at 3 1/2

2.
As though a nap is infantile
Unbecoming one my age
Closer to dementia
Decidedly less sage

I don't deny penchant
For prepubescent times
When milk and ginger cookies
Were served with nursery rhymes

Or that my mind does wander
To places yet unknown
And that I dream of bubbles
Not yet fully blown

But these are useful assets
In my field of expertise
Matters of repose
Rest, supine, and ease

For napping is an art
Like painting and croquet
Those who would excel
Must practice every day

So please, my friend, forgive me
I really must depart
The muse of sleep is calling
Tugging at my heart

A journey to vacuity
A voyage to unknown parts
Villages above the clouds
Life with endless tarts

All of this awaits me
Wind beneath my kite
For age and time do dissipate
As day gives way to night.

Copyright Svevo Brooks http://www.botanicalmedicine.org/Tapes/Bios/Brooks.htmks

Another talent show star was Vicki Dodds, an empath who can embody and express the energy of anyone or anything. She did this through sound and I later learned that she teaches workshops in Sacred Sound Energy to lay people as well as accomplished musicians. I'm happy that I'm a skeptic of so many things because being associated with alternative medicine, one is inundated by a lot of half baked notions and ideas. But what Vicki Dodds evoked with her short performance singing the energy of the plants in Breitenbush was very powerful. She was able to completely alter her voice, tone vowel sounds that reminded me of Hawaiian language and she was a master of overtone singing causing her voice to intone arpeggios like an Aeolian harp.

Speaking of which, my own artistic contribution throughout the conference was to play on piano the music of Chopin including his nocturnes and Aeolian harp etude.

The highlight of this event was Saturday evening when the Breitenbush Conference organizers had all the reunion herbalists sit in a line facing the attendees and reminisce about each other and our amazingly accidental wondrous life journey together. Despite moments between the sublime and high humor, these were our stories, sacred stories if you will, lived and told by us, the founders of the herbal renaissance. Like music, it is a thing of the moment and you needed to be there to appreciate it.

This lighthearted but profoundly moving evening was completed with Rosemary leading us in a ritual honoring all of those who played a profound role in carrying forth the herbal tradition through the dark ages of the early 20th century, who were beloved by us but have moved on from this earthly life, including Michael Moore, Dr. Christopher, Norma Meiers, Silena Heron, Jeanine Parvati, and many others. For these herbal teachers, friends and colleagues, we lit a candle of gratitude and remembrance.

While the event certainly was a reunion, it was also an educational opportunity; we taught nearly 200 wonderful and enthusiastic Breitenbush herb conference attendees. Two hundred is actually a good number for a seminar held in this wonderfully remote location, a two-hour drive into the wilderness from the Portland airport. Kudos to organizers Catherine, Sue, Cassandra, Tracy, and Trudy, who somehow arranged for most of us to be taken back and forth from the airport by conference attendees. There was also so much more that they did to provide for us and make us feel welcome and comfortable at our advertised 25-but-actually-30-year-reunion.

Breitenbush may have been the first, but now there are herbalist conferences and symposiums happening throughout the year all over the country. The American Herbalists Guild Symposium will take place on October 21-23 with preconference intensives happening on the 20th at TradeWinds Island Resort on St. Pete Beach, St. Petersburg, Fla. For more information go to http://www.americanherbalistsguild.com/.

In the marketplace, it is often more difficult to sell the general public on an herbal formula as opposed to a single herb. This is understandable, because people are usually driven to single herbs when they hear of some sensational effect associated with it.

For example, Ligusticum porteri (now available as a Planetary Herbals extract), commonly known as "osha," has been found to lower viral count in chronic hepatitis C patients. Traditionally, the herb is considered "big medicine" by southwestern natives who widely utilize this herb in ceremonies and as treatment for a wide variety of conditions including sore throat, and all viral diseases including the flu.

In the marketplace, a typical consumer presented with the choice of capsules of pure lomatium versus capsules of lomatium blended with other herbs would most likely choose the former.

Are formulations better than singles?

Assuming that it is well crafted by an experienced herbalist, a formula consisting of two or more herbs can often more effective than a single herb. The operative word here is 'can' not always.

Strange how often the first things you hear on your learning path often prove to hold the greatest weight in life. My first Chinese herb teacher, a Taoist named Foon Lee Wong who operates a curio shop on the outskirts of San Francisco's Golden Gate Park, once off-handedly said that herbs used together represent more than anything we find in nature -- in other words, herbal formulations are 'unnatural' or perhaps 'supernatural,' as in beyond nature.

In a very real sense an herbalist uses herbs as a musician uses individual notes or an artist uses colors and shapes to create something unique and hopefully therapeutically effective.

Herbs are combined in formulas with particular objectives in mind. For example:

To complement or augment a primary intended therapeutic action: For instance, we might use more than one antiviral herb together to have a wider range of effect in treating viruses. Or we might use several complementary tonics together for a wider range of tonification.

Or, we might add some herbs because we can see the need to support an internal organic function in order to help the body achieve relief of a specific symptom. In other words, extra support for the digestive or urinary systems will help more effectively treat the underlying cause.

We might add in a smaller amount of an herb that slows down the liver's ability to neutralize any strange substance that enters its portals. Usually this would be a small amount of a spicy herb to bypass the liver P450 enzymes. This allows the active principles of an herb to remain in circulation longer than if it were used alone.

Or we might add a small amount of an antispasmodic herb to relieve any physiological resistance to the unique qualities (taste, texture, etc.) of an herb.

However one of the most fascinating phenomena around herbal formulation is how a particular combination, even a ratio of two or more herbs can biochemically optimize the primary ingredients in the herbs themselves.

Traditional Chinese and Ayurvedic medicine includes thousands of preparations, sometimes in exact prescribed rations and amounts that have been passed down over millennia because of some unique experientially proven benefit.

Given today's research capabilities, it is difficult enough to try to understand biochemically why some herbs do what they do. Each herb contains thousands of unique compounds. Compound this with trying to analyze an ancient traditional herbal formula containing two or more herbs, and you can see what a challenge this would be! (And that's assuming that there is a will and funding for such research - which by and large in the West there is scant little of either.)

Over 50% of all pharmaceutical drugs were or are derived from plants. Are there miracle cures in the vast but dwindling Amazon rain forest? Absolutely, but thus far only a handful of drugs have made it to market (including quinine, codeine, morphine, and cocaine). While visiting the Amazon, I spoke with one of the leading Western ethnobotanists whose job it is to discover and send back plants to pharmaceutical companies that may have a value in medicine. He said he's sent them hundreds but because they are unable to isolate, synthesize and therefore patent a single active constituent, all of this traditional knowledge of therapeutic plant usage goes to waste.

In the case of herbal formulas, the challenge to isolate and synthesize is exponentially greater.

Finally, research that supports formula synergy

So given all of the above, you can imagine how excited I get when I find a research paper that substantiates the value of an herbal formula over a single plant, in this case where the herbs work on each other to optimize certain therapeutic properties and effects.

While researching the effects of the Chinese herb dang gui (Angelica sinensis) as a blood tonic especially for women, I accidentally came upon a study of a famous ancient Chinese two-herb formula Dang gui bu xue tang (DBT) which consists of one part dang gui and five parts huang qi (astragalus root). This formula has a wide range of use and is traditionally prescribed alone with other herbs or in soups for anemia, uterine bleeding, post-partum bleeding, fatigue, and symptoms due to hormonal deficiency including osteoporosis.

The odd thing is that the formula is for blood deficiency but dang gui, the herb regarded as the sovereign blood tonic in Traditional Chinese Medicine, is used in a much smaller amount than astragalus root, an herb used as a qi tonic. Why?

The study "Verification of the formulation and efficacy of Danggui Buxue Tang (a decoction of Radix Astragali and Radix Angelicae Sinensis): an exemplifying systematic approach to revealing the complexity of Chinese herbal medicine formulae" demonstrated the higher therapeutic efficacy of the two herbs together with the primary herb being a one fifth the ratio to its secondary counterpart.

The researchers speculated as follows:

"The saponins may liquefy and make the primary properties of ferulic acid and ligustilde in dang gui more bio-available. When boiled it seems that the ferulic acid and ligustilide in dang gui are oxidized and degraded which is far less when astragalus is combined in the 5:1 ratio with dang gui. Finally it's possible that the stability of the active constituents are improved by having the different plant chemicals together."

While none of this is conclusive, it sure supports Foon's notion that an herbal formula is more than the sum of its parts.

Students and clients often ask me, "When the best time is to take my herbs?" This is a very good question, and there are several different answers. (However, in truth, the best time to take herbs is when you remember to take them.)  

Often, when people try to follow rules, they invariably can't comply, or they forget, or some other thing happens and then before you know it, the time has passed and the time to take the herbs was missed. Then it's on to the next required time and if this is also missed, the day soon passes and the herbs are never taken at all.  

Taking herbs this way can be hit or miss. With such infrequent ingestion, they help very little or are entirely ineffective. This is why I say, take the herbs when you remember them! 

But if you want to know the real 'rules' for taking herbs '"- what will make them most effective in their use '"- here they are (and they are given in Lesson 9 of the East West Herb Course). Keep in mind that these 'rules' are not necessarily agreed upon by everyone, so you'll find herbalists who have other ideas instead. But these are generally the ones most acceptable. 

In general, the time herbs are taken has to do with efficiently getting them to the part of the body they most affect. Thus:  

  • Herbs treating the upper part of the body (heart/lungs/head) should be taken after meals so the food in the middle of the body slows their descent, and they stay in the upper part of the body longer.
  • Herbs treating conditions in the middle part of the body  (spleen/pancreas/stomach/liver/gallbladder) should be taken just before or during the early part of meals, so they stay in the middle part of the body for a longer time, along with the food being digested.
  • Herbal formulas targeted toward the lower part of the body (kidneys/bladder/intestines/genitals) should be taken between meals, when the stomach is empty, so they have a free passage to the lower part of the body.  

Of course, if the disease is urgent, herbs may '"- and should '"- be taken at any time and, in fact, they should generally be taken more frequently anyway. 

Further, if digestion is weak, herbs are best taken with meals, as this is when the digestive juices most strongly flow. 

If people continuously forget to take their herbs, even if told they can be taken anytime, help set a convenient location and schedule. Put the herbs in the kitchen by spice jars or some other obvious place, or put them in the bathroom by the toothbrush, or put them on the bedside table, wherever they will be easily seen at the appropriate times. 

Generally, when people are eating they can remember to take herbs. Most can take them with breakfast and dinner, but often miss lunch since they're gone all day. If this happens, the third dose can be taken at bedtime.  

If none of this works, and the person (or you!) keeps forgetting to take the herbs, remember that the herbs can be taken anytime!

At the recent American Herbalists Guild conference, I met various people who felt inadequate about their herbal knowledge '"- that they were somehow inferior to teachers or to other AHG professional members -- and so wondered if they'd ever learn enough about herbs to 'get there.'

I guess I felt that once, when I just opened the door to the huge world of herbal medicine. But that quickly evaporated in the process of learning, studying and experimenting. And 30 years after opening that door one of the main things I've learned is that 'the more I know, the more I know I don't know.'

To me this is one of the attractions of herbalism: there is so much to learn, so many different possibilities and avenues to explore, that I can study my whole life and never get bored, never be done; there is always more to learn. As a result, I quickly learned to steer clear and beware of people who seem bored with herbalism, who feel they know it all. They obviously had stopped learning and growing.

Besides, herbalism is not just a science; it's also an art. To me the art part is the most important because this is where experience is developed '" the application of knowledge '" and thus is the spring from which wisdom blooms. It is also where time and practice come in, which is only accomplished by doing. I guess that's why working as a medical practitioner is called 'practicing' medicine '" it's about constantly learning, applying what you've learned and learning from your mistakes and successes in an ongoing, life-long process.

So there is no 'getting there' place to achieve in herbal medicine. You are always 'there' wherever that may be, whatever knowledge you might hold. Today you know more than you did yesterday and yesterday you knew more than a year ago. Stack a bunch of these years together and you've got stores of knowledge. But those stores only matter if they're applied in some way; only then is it true wisdom.

As Ansel Adams once said, 'The perfect is the enemy of the good.' When we hold other people up as 'knowing' and ourselves as 'not knowing,' then we can get paralyzed, stall, and not explore or make mistakes. So avoid comparing yourself with other herbalists and instead, keep applying what you do know. Soon enough you'll realize that 'being there' is actually 'here!'

cranberriesRecently a friend of mine called to say that she had a terrible bladder infection. Her doctor prescribed an antibiotic, but it had no effect; in fact, the infection worsened. She also said she tried drinking cranberry juice, but that had no effect on the condition either.

Women's bladder infections are one of the most common complaints in the health world, and they probably account for the brisk sales for cranberry (Vaccinium macrocarpon, pictured above) supplements. An article that described 10 randomized controlled trials published by Cochrane Collaboration in January of 2008 concluded that cranberry products may prevent recurrent urinary tract infections in women. I'm sure this helped boost cranberry sales as well as the belief that it can help a woman with a UTI.

I wouldn't disparage the proven value of unsweetened cranberry juice, but I remember the study only seemed to indicate that it prevented recurrent urinary tract infections. By implication, the public and marketers read "cure" and that is an entire different realm to consider.

There are flagrant misrepresentations in the marketplace for the use of herbs and various nutritional supplements, but the public also knows that these things, when used appropriately, can work for situations like my friend's antibiotic-resistant cystitis, when no standard medical procedure or tested natural therapy such as cranberries, do.

(Most studies, even preliminary trials, are expensive. We need to ask ourselves how they were funded, and naturally, this leads us to question who is likely to gain from the study. Given this, I would not be surprised that just as studies of pharmaceutical drugs are funded by the manufacturer, the same could be true, and that studies of the medicinal value of cranberries could be funded by cranberry growers.)

But, as I stated above, cranberry didn't work for my friend, and I bet it doesn't work for a lot of women who've had the same problem. She turned to me and asked what she might do.

uva ursiI told her about a few other herbs which I know are more powerful for treating bladder infections. I directed her to an uva ursi-based formulation (generally herbal formulas are more effective for more people than are single herbs). Uva ursi (Arctostaphylos uva ursi, pictured at left) is not as strong as pharmaceutical-grade antibiotics and does not cause the same side effects. It works locally, purely with the body fluids, as a urinary antiseptic. It also enhances the liver's powerful role in treating inflammations. These actions, combined with other herbs in the formula, make for a more positive outcome. I also suggested the use of parsley tea which is an old time remedy for urinary tract infections, and cherry stems in the specific treatment of urinary tract infections.

CherriesCherry stems are high in potassium, salts and tannin. Traditionally, when women in Europe were troubled with bladder infections, they would steep a handful of the stems in one or two cups of boiling water and drink the strange-tasting brew. Lesley and I have found that cherry stems work for bladder infections when antibiotics and even most herbs may not.

I think my friend wound up doing a combination of cherry stem tea and the uva ursi formula and within a couple of days her intractable urinary tract infection was gone.

In conclusion, it's good for the herbal consumer to look to the use of herbs as a first line treatment for most diseases. However, it's also important that they learn the value of different herbs and supplements in the event that one may not be enough, that if possible they educate themselves on the wise use of herbs singly and especially in formulations.

To that end I and my wife, Lesley, have published several books on herbal medicine, including the top-selling herb book in the world today, The Way of Herbs, published by Pocket Books, and Lesley's book, Healing with the Herbs of Life, now published by Random House.

It's also obvious there is a need for qualified and skilled professional herbalists. Lesley and I personally make an effort to fulfill this need with the East West Herb Course. It is partially correspondence and partially online, and one can complete it at his or her own pace. Students learn Planetary Herbology, which is a combination of the best global herbal systems from the Western, Ayurvedic and Chinese traditions. Check these and our other herbal products out elsewhere on this site.

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