Recently, a colleague sent me the following question:

A friend in Canada tested positive for H. pylori bacteria. Of course, the Western doctor he goes to wanted to start heavy antibiotic treatment. Plus, he said he would need to be on some 'pill' for the rest of his life! He is refusing until he can seek out alternative answers to this. He is 70 yrs. old, does not have a hiatal hernia, just a bit of indigestion at times.

What is Helicobacter pylori?

Helicobacter pylori is a common bacterium that many have with or without any noticeable symptoms. Recently a study found that Otzi, the 5,300-year-old ice-mummy, was also infected with H. pylori. Today it is estimated that it is present in about half the population.

H. pylori is known to produce an enzyme, urease, that allows the bacteria to live in harsh acidic environments such as the stomach. Urease reacts with urea to form ammonia which can neutralize enough of the stomach acid to allow organisms to survive in tissues for years. It is highly contagious and is transmitted through saliva, fecal contamination in food or water, and poor hygienic practices in general. As stated, the good news is that most people do not exhibit any symptoms. However, if enough of the stomach acid is neutralized, it can be a factor behind many acute gastrointestinal problems such as gastritis and GI tract ulcers.

The Herbal Approach to GI Inflammation

I’ve been involved with the study and practice of herbal medicine since 1968. In all of that time, I focused on treating the patient more than the disease. This is because my model, traditional herbalism, does not focus on treating specific pathogens associated with a disease, but the whole disease complex itself.

In other words, a Western herbalist may treat gastrointestinal symptoms caused by H. pylori with herbs not specifically targeted to eradicating the bacterium, but with herbs that reliably treat ulcers, abdominal and acid reflux. An Ayurvedic herbalist might treat these conditions as a humoral imbalance of excess pitta. A traditional Chinese herbalist would treat it based on Eight Principles and pattern analysis. In all three models, there is no particular advantage in testing and discovering that the inflammation is caused by H. pylori.

Today, many complementary health practitioners seeking to impress their patients too often resort to describing their diseases based on a Western medical model. The problem is that herbs are more food-like than drugs, exerting a broader function on restoring homeostasis and health. Still, many herbs do have specific tropisms or indications. For the patient described above, look to herbs that treat symptoms of ulcers, acid reflux, belching, bloating, nausea, vomiting, and abdominal pain as symptoms of gastritis. All of these conditions are effectively treated with dietary and herbal treatment.

So while I’ve not treated H. pylori as a discrete entity, I have had a lot of experience successfully treating all the conditions previously mentioned. Because people have responded positively, I can only assume that the diet and herbs I prescribe regularly such as Triphala inhibit the growth of H. pylori.

Herbs for Gastritis, Acid Reflux, and GI Tract Ulcers

Bitters, triphala, goldenseal, and coptis are among the many botanical remedies taken singly or in a formula for treating gastritis, acid reflux, and gi tract ulcers. These herbs treat a broad range of gastric imbalances but have also substantiated research that they are effective for H. pylori. 

Berberine is a constituent of herbs such as goldenseal, coptis, barberry, Oregon grape and the Ayurvedic herb guduchi (Tinospora cordifolia).  All of these have been shown to have broad-spectrum antibiotic and antipathogenic properties. Studies in vitro have demonstrated that berberine can inhibit H pylori. While these may not be robust enough to eradicate the organism entirely (if that is even possible), when used in a compound herbal formulation for gastritis, or in bitters, along with probiotic foods and a balanced diet, they will certainly contribute to a multilayered comprehensive gut healing regime.

Triphala, an ancient Ayurvedic healing compound consisting of three fruits, Terminalia belerica, T. emblica, commonly known as “amla” and T. Chebula or black myrobalan (Chinese: he zi), also has broad spectrum antipathogenic properties.  Chebula or black myrobalan has been cited as effective against all harmful bacteria and specifically effective for inhibiting urease active of H. pylori.

The remaining two fruits in Triphala are also effective against H. pylori, especially amla (T. emblica). Amla fruit is one of the greatest antioxidants in the plant kingdom and is highly regarded both for its nutritional and for its medicinal benefits. It is claimed as one of the two or three highest known sources of natural tannins and Vitamin C which is impervious to both age and heating. Research confirms what native people of India have known for millennia, that Amla is good for the health of the whole body, especially the liver and GI tract. It is an effective treatment for gastritis, Crohn's, iBS, stomach and duodenal ulcers and to inhibit the growth of H. pylori in the stomach.

Tinospora cordifolia, called “guduchi” and “the body’s protector” is bitter, pungent and astringent with a post-digestive ‘sweet’ effect meaning that it is an antipathogenic herb with tonic-nutritive properties. It is one of the most powerful antipathogenic herbs of special benefit for inflammatory gastric disorders.

Deglycyrrhizinated licorice root (DGL) is a well-established anti-ulceration and mucosal healing agent. DGL can coat and soothe the intestinal lining and promote the healing of inflamed tissue and ulcers. Research suggests that flavonoids in licorice have impressive antimicrobial activity against H. pylori. The flavonoids have been shown to have antimicrobial activity against strains of H. pylori that were resistant to clarithromycin and amoxicillin, two of the primary antibiotics used in triple therapy. Some forms of licorice can elevate blood pressure but because DGL has low glycyrrhizin levels it is safe to take if you have high blood pressure.

Sulforaphane is a naturally occurring chemical found in cruciferous vegetables such as broccoli, cabbage and brussels sprouts. Some studies have demonstrated that it can inhibit H. pylori. Eating cruciferous vegetables, especially broccoli sprouts, will ensure that you get plenty of sulforaphane, but it is also available in capsule form from several supplement manufacturers, including a product called Broccomax.

Some studies have suggested that Vitamin C may inhibit and even kill H. pylori but more research is needed to determine the optimal dosing and program duration. Even if Vitamin C does not eradicate H. pylori, it is still worth taking a controlled dose because studies clearly show that Vitamin C levels in the stomach lining can be reduced when H. pylori is present, largely as a result of the inflammatory and oxidative stress caused by the infection. Vitamin C is also an excellent nutrient for assisting with gut healing.

Vitamin U – also known as MSM – is found in raw cabbage. In fact, Vitamin U is not a vitamin at all. Cabbage juice has been studied extensively in Russia and other Eastern European countries for the healing of damaged and eroded intestinal mucosa. It appears to enhance the healing of damaged tissue and may assist in healing ulcers.

When I consider what the most useful single herb I know with these same antiviral, antibacterial, antifungal – in fact, every ‘anti’ property we would need to fight off harmful  pathogens—is, it is Isatis tinctoria, an herb commonly known in old English as “woad,” meaning “weed.” As an ancient East - West cruciferous family medicinal herb, it happens to have all of the same antipathogenic sulfur compounds found in cruciferous vegetables and of course biologic MSM sulfur. Both the leaf and the root of Isatis are used in Traditional Chinese Medicine called da qing ye and ban lan gen respectively. These are classified as bitter and cold, which from an herbalist’s perspective means they are broadly antipathogenic and reserved for short-term use to treat the most stubborn pathogens such as viruses but are equally effective for bacteria and funguses as well.

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

The three fruits of Triphala.

My clinical experience using the Ayurvedic formula Triphala is extensive, based on literally thousands of cases over the course or 25 years. It is only within the last three years that I can proclaim it to be as near a specific for IBS, ulcerative colitis and Crohn’s disease as one can find.

I discovered this use for it quite by accident working with a patient with the worst case of ulcerative colitis I have ever encountered. Because this was a condition of extreme diarrhea, I initially never thought to prescribe Triphala because of its known laxative properties; Triphala is also a specific treatment for laxative-dependent constipation, so it seems counterintuitive to employ it in the treatment of ulcerative colitis, which is basically an intractable type of diarrhea. Even though I had read that Triphala was good for both constipation and diarrhea, I didn’t want to exacerbate an already bad inflammatory condition.

To step back for a moment, I’ve written about Triphala extensively before, but to briefly recap, I use Triphala as a foundation formula appropriate for all diseases. It is detoxifying, astringent, and laxative. Literally millions of people in India and now throughout the world use it, and there have been no serious adverse effects to its regular use, whether daily, or weekly. Triphala perfectly balances the chemistry of the entire GI tract so that healthy flora will flourish. Triphala helps us to eliminate all that we don’t need while retaining what we do.

A patient came to me who had suffered for years with the worse case of ulcerative colitis I’ve ever encountered clinically. I shared his full story on a blog here. I was only able to occasionally relieve his symptoms with Chinese herbs, health supplements and a severely restricted diet avoid all sugar, refined foods, dairy and grains.  Even with periods of surcease, his condition would recur and we’d have to come up with a completely different game plan to help him recover.

But after just three days on two “00” sized capsules every waking hour during the day, he was symptom-free!

It seemed that indeed, the ancient recommendations for Triphala being good for both constipation and diarrhea were correct. 

I shared this story with a number of colleagues and students and they all reported the same results. They were curing the incurables, IBS and Crohn’s disease. The only difference was that they were able to achieve these positive results with a far more modest disease level and regime. They simply gave 3 “00” capsules three times daily and they got the same results as I did giving 2 capsules hourly.

Most recently, I gave it to a woman who had medically diagnosed Crohn’s disease as well as rheumatoid arthritis for which I prescribed other herbs. In this case I only prescribed 3 “00” sized capsules of Triphala three times daily. This was enough to completely stop her Crohn’s disease symptoms within three days.

Her rheumatoid arthritis symptoms were resolved by her embarking on a 10-day kitchari fast and the Chinese formula Du Huo Ji Sheng Tang (Du huo angelica and loranthes combination) in pill form. However it was the Triphala that completely stopped all symptoms of Crohn’s disease which had plagued her for years previous.  While I am reluctant to use the word “cure,” she continues symptom-free for more than six months and continues to take Triphala now at the modest dose of only 2 “00” sized capsules 2 or 3 times daily, she claims that she is cured of her Crohn’s disease. 

With the exception of the occasional day or even week off of all supplements which is a good idea generally, she has not stopped taking Triphala. Why should she? In India, Triphala is considered safe for all young and old and is even given to infants. It is a regular household item. As the saying there goes, “No mother? No worry, so long as you have Triphala.”

IBS, Crohn’s and ulcerative colitis are such terrible diseases affecting 10 to 15% of the population in the US, which is anywhere from 25 to 45 million people. If only all these sufferers and their gastroenterologists knew about this single safe and most effective formula, consider how many might benefit.

I have no way of knowing whether it will work for everyone, but I do know it is safe based on my own and my colleagues’ and my many students’ experience. A bottle of Triphala powder or capsules doesn’t cost much; if there is a chance it can heal these inflammatory bowel conditions, it is worth a try with little sacrifice.

Elderberry Juice for IBS?

Besides Triphala for IBS, I recently came across a single case of an individual who suffered from severe symptoms of inflammatory bowel disease and cured himself with elderberry juice. This is a heretofore unknown use of the famous elderberry previously only considered as a treatment for colds and flu. What I found interesting about this was that like Triphala, elderberry is a fruit that contains both laxative and astringent properties. Perhaps this once sacred herb of the ancient Celts is a northern European counterpart as an effective herb for IBS. Let us know about your experiences with Triphala and/or elderberries for IBS.

 

 

 

It’s that season when many pin a bouquet of mistletoe in their doorway for that magical ritual of kissing underneath its bounty. While there’s wonderful lore behind this annual tradition, mistletoe is also a very useful medicinal herb.

Lore

Dating back to 16th century England, kissing under the mistletoe was probably an custom adopted by the Christians from other earlier rituals that honored this plant, although it was rarely alluded to until the 18th century. Customarily, a man and a woman who meet under the hanging mistletoe were obliged to kiss – and still are today.

Shakespeare called it “the baleful mistletoe” because in a Scandinavian legend, Balder, the god of peace, was slain with an arrow made of mistletoe. He was restored to life at the request of the other gods and goddesses and after mistletoe was given to Freya, the goddess of love, beauty and fertility, who proclaimed that everyone passing under it should receive a kiss so the branch would become an emblem of love, and not of hate.

This ritual probably sourced from the Celtic Druids who held that mistletoe possessed life-bestowing properties, protected against evil, was an antidote for  poisons, cured illnesses, and enhanced fertility, especially since it could blossom even in the winter. They especially esteemed mistletoe growing in oak trees because it was much rarer, and they would harvest it in ritual with a golden sickle at a particular phase of the moon at the beginning of the year (the winter solstice) if they had visions directing them to seek it.

Greek legends also associated mistletoe with peace as any enemy stepping under mistletoe was required to lay down their arms and declare a truce until the next day. The “golden bough” of Aeneas, ancestor of the romans, written about in the Aenid by Virgil is thought to be mistletoe.

A Parasite

Mistletoe is a parasitic plant that grows on the branches of trees and forms pendant bushes. It actually sends forth a thread-like root that pierces the bark and roots in the growing wood of its host tree, using its sap and so forth as its own food.

Mistletoe fruit – the red berries – are highly toxic and should not be eaten!

Western Mistletoe

There are more than 30 species of mistletoe and not all are safe.

Phoradendron flavescens, the mistletoe typically used in the U.S. during the holidays, contains a toxic protein, phoratoxin, which slows the heartbeat, weakens the heart muscle, and can cause contact dermatitis. It should only be used as a decoration (or by an experienced practitioner, if even then).

Viscum album (Loranthaceae family), the European mistletoe, however, has many wonderful uses. It is mainly employed as a nervine, antispasmodic and narcotic. It has been traditionally used for the “falling sickness,” or epilepsy, and other convulsive nervous disorders, including St. Vitus’ Dance, delirium, and hysteria, although it may also be used for sciatica, neuralgia, and nervous debility. It is also used to lower blood pressure and for this must be taken awhile to see results and is best combined with other herbs such as eucommia (Eucommia ulmoides, du zhong). For hypertension it treats the accompanying symptoms of headache and tinnitus.  All of these symptoms translate in Chinese medicine as Liver Wind and Liver Yang Rising.

Mistletoe has also been used for gout, rheumatism, tachyarrhythmia (it slows the heart down), angina, palpitations, and menorrhagia. As well, it is given homeopathically for epilepsy, sciatica, convulsions, tearing pains, asthma, and a feeling of suffocating when lying on the left side.

These uses of mistletoe match how the Chinese use it – to dispel Wind-Dampness as well as for hypertension – so it seems that the EuropeanViscum album could possibly be used similarly to the Chinese Taxillus chinensis (see below).

Today many use mistletoe for cancer, which originated with Rudolph Steiner who likened the parasitical aspect of mistletoe to cancer. There is no conclusive evidence at this point that mistletoe reduces cancer, however.

Western Mistletoe Contraindications: Pregnancy, lactation, diabetes as it can modify glucose regulation; some say to avoid it if taking antidepressants or if there’s hyperthyroidism; some say even Viscum album should only be used by experienced practitioners.

Dose: Fresh plant tincture : chronic - 1:5: 10-20 drops TID (60 drops mas/day); up to 75 drops/day short term for an acute crisis.

Chinese Mistletoe

Chinese medicine uses the species Taxillus chinensis (formerly Loranthus chinensis or sang ji sheng), the mistletoe growing on the mulberry tree. It is used to expel Wind-Dampness, tonify the Liver and Kidneys, nourish the Yin and Blood, and quiet the fetus in pregnancy. It treats low back and muscle pain, arthritis, rheumatism, and hypertension. It treats weakness and atrophy of the sinews and bones, and numbness,. Because it also tonifies Yin and Blood, it is used to nourished dry, scaly skin due to Blood Deficiency or stop uterine bleeding during pregnancy. It also promotes lactation.

The Chinese also use the species Viscum coloratum (hu ji sheng) or colored mistletoe, which is a parasite on a different kind of tree than taxilli. It is also used to expel Wind Dampness and also tonifies the Liver and Kidneys, strengthens the sinews and bones, and calms the fetus. It is stronger at expelling Wind-Damp and so used more for painful obstruction, although it also treats lower back and leg pain and weakness, and hypertension. 

Because of their similarities, it’s highly possible that Chinese mistletoe could be used for epilepsy and nervous debility, like Western mistletoe is used.

Chinese Mistletoe Contraindications: None noted

Dose: 9-15 g

 

One of my favorite movies, Where the Wild Lilies Bloom (1974), tells the story of a family of five Appalachian children who use herbal folk healing they learned from their widower father who recently passed away. Not wanting to be separated and adopted out, they developed a reputation of healers by relieving a neighbor’s bad case of pneumonia by immersing him in a tub of filled with hot water and chopped raw onions until the desperate fellow broke a sweat. After that, his fever passed and he got well.

The principle behind this depiction of true Appalachian folk medicine, to break a sweat, happens to be the best way to cure a cold or flu. The method was certainly espoused by the famous iconoclastic 19th-century doctor Samuel Thomson (1769-1843), whose popularity at the time earned him the title, ‘the father of American herbalism.’ He learned of the value of sweating for these seasonal afflictions from Northeastern Native Americans and their use of sweat lodges.

Thomson said “warming the vital force” was the key to health and freedom from disease. To accomplish this, he combined the following internal warming herbs into a formula we know as “Composition Powder”:

4 parts bayberry root bark powder

3 parts ginger powder

3 parts white poplar bark (inner bark) powder

3 parts pine bark (inner bark) powder

2 parts clove powder

1 part cayenne powder

Those afflicted with colds, flu, fever and even acute joint and back pains would be told to steep a teaspoon of these herbs in a covered cup of boiling water until cool enough to drink. Honey could be added to improve flavor, but the best results were effected if the patient also consumed the dregs.

This is only the first part of the treatment. After consuming the formula in the way described above, the patient was to quickly bundle up and lie perfectly still in a warm bed until a sweat is broken. If sweat does not occur the first time within an hour or two the process can be repeated once or twice more.

These old-fashioned sweating treatments were not only used for colds, flu, fever, and even pneumonia, but for any condition where circulation is weak and obstructed, for the aged who require a stimulating drink, and to relieve cold sensitive back and joint pains as well as urinary conditions.

This was the single most popular North American old-time remedy for over a century with famous doctors such as Dr. Nowell of Canada and the Dominion College of herbalism claiming that each year he would dispense hundreds of pounds of composition powder to his patients for a wide variety of conditions.

Most people who take Composition Powder today in capsules or pills don’t realize that the powder must dissolved in hot water as described above, followed by the sweat in bed; take note!

Composition Powder is available as a Planetary product called “Ginger Warming Compound.” It is my own proprietary formula and it consists of: Cassia Bark, Ginger Root Extract (5% gingerols), Cayenne Fruit, White Pine Bark, Cloves Fruit, Bayberry Bark, Marshmallow Root Extract, and Licorice Root Extract.

Back in the 1940’s, my mother would use a similar approach at the first sign of any cold or flu my younger brother or I developed: She would give a warm drink, perhaps hot lemon and honey tea, then slather on a thick coat of Vick’s Vapo Rub and camphorated oil on our chest and back (we hated it but it worked!) and then tuck us tightly under the covers with the admonition to lie perfectly still until we broke a sweat. After this, she’d quickly sponge us off with warm water, then get us into new pajamas and bedding for a comfortable night’s sleep. In most cases we were completely recovered by morning and could even return to school.

Western herbalists frequently recommend a tea made by steeping one or two teaspoons each of elderflower and peppermint in a cup of boiling water for 10 to 15 minutes. This can be taken with honey but the key always is to retire with some warm blankets and lie perfectly still until a sweat is broken.

In some rural areas of throughout Europe, people take a stiff shot of whiskey or brandy as the hot drink before retiring to sweat. Using a similar technique, my old Sicilian grandparents would eat several cloves of garlic again with hot water followed by sweating under the covers.

Many a time when coming down with a cold or flu while traveling all I could find was preferably raw ginger or dried ginger, which I would make into a tea with honey.

In Japan a drink of hot sake with garlic taken as a shot two or three times a day is used as an effective cold remedy.

In Mexico a tea is made with a stick of cinnamon, a handful of raisins and a teaspoon of oregano is used.

In all of the examples above, the hot drink is followed by lying still under the covers until one breaks a sweat. A hot water bottle or hot brick wrapped with a flannel applied to the feet greatly assists this process. It may not be easy for children to remain still until sweating occurs (nor for parents who must keep them still!), but the objective of all of these remedies is to induce diaphoresis.

One must induce sweating even if a fever is already causing perspiration. Spontaneous perspiration from fever or hot climate occurs because of exhaustion, but diaphoresis as a result of drinking certain herbal teas actually rallies the body’s internal defense to drive the invading pathogen out through the pores of the body. I know this idea of releasing the invader through the surface of the body may not be physiologically accurate, and what may be really occurring is that the herbs rally the body’s immune response to destroy the invading pathogen, be it bacterial or viral. But it serves as a strategically useful description of how herbal diaphoresis works when it is done correctly.

Due caution should be taken to not sweat too long or to the point of exhaustion. Only take enough herbs to induce perspiration and then stop taking the herbs.

For babies and small children who tend to run higher fevers, it is a good idea to apply frequent cool water compresses to the forehead during the sweating process which can take anywhere from 30 minutes to an hour. 

Traditional Chinese Medicine describe most acute cold-sensitive, external diseases with possible joint and muscle aches as a Tai Yang stage disease which is the first stage or layer of six described as the Shang Han Lun compiled by Zhang Zhong Jing around 200 AD. Without going into detail regarding the six stages, Tai Yang is the only stage where diaphoresis (sweating) is absolutely indicated. Diseases can affect many levels or layers of the body, but sweating should be induced is for anyone with an external disease (which includes colds, flu, fevers, coughs, joint and/or back pains, skin affections, anxiety, nervousness, fluid abnormalities (swelling, etc), jaundice,  and accompanying symptoms) so long as they exhibit the syndrome of aversion to cold and/or wind, floating pulse, and neck or upper back pain or stiffness which classifies it as an external Tai Yang Syndrome.

The Shang Han Lun describes hundreds of different Tai Yang formulas, each more or less specific for treating associated symptoms. Most of them are grouped under the category of cinnamon tea (Gui Zhi Tang) or Ma Huang tea formulas.

  1. Gui Zhi Tang consists of gui zhi (cassia cinnamon) 10g, bai shao (white peony) 10g, gan cao zhi (honey fried licorice) 6g, sheng jiang (fresh ginger) 15g, da zao (Jujube dates) 4pcs.

Gui Zhi Tang (pronounced: ‘gway jur tang’) is specifically indicated if someone has a Tai Yang condition with a tendency to sweat but the condition is not relieved.

  1. Ma Huang Tang consists of ma huang (Ephedra sinica) 9g, gui zhi (cinnamon twigs) 6g, zhi gan cao (honey-fried licorice root) 3g, xing ren (apricot seeds) 10g.

Ma Huang Tang is specifically indicated if an individual is stronger, and tends not to sweat.

There are dozens of variations of ma huang and gui zhi formulas based on other problems occurring other than a cold, flu or fever. Further, these formulas are used to treat a wide number of diseases with basic Tai Yang syndrome. However in most cases these need to be followed by diaphoresis.

Diaphoresis is a Qi-exhausting process and is contraindicated for individuals who are weak and generally deficient. If a tea were used for such individuals it should be Gui Zhi tang which is more nourishing.

After sweating, it is recommended that you have a bowl of thin, easily digested white rice cream or oatmeal to replenish energy that was lost during sweating.  Chicken soup is also a good food to use after or when recovering from colds or flu. 

Note: Because of the ban by the FDA of the retail sale of ma huang due to industry abuses of this valuable herb you may substitute 10 grams of fresh ginger or Composition Powder mentioned above (Planetary's “Ginger Warming Compound" available at stores around the country).

We’ve all heard of so many products such as zinc, Vitamin C, echinacea for colds and flu – these are really good to use if you want to get rid of your cold or flu in a week or two or three. However sweating therapy using Composition Powder tea, strong ginger and honey tea, or garlic and honey tea, followed by breaking a sweat, is the best way to get rid of a cold, flu or fever in one or two days.  

 

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.

As we continue this blog series on Yin Deficiency (with Heat), I want to make clear that the description of Heat hereby discussed is confined to the organic pattern of Heat and not the description of the external contraction of Heat in terms of communicable bacterial and viral diseases. This was developed by Ye Tian Xi (17th century) with the Four Levels of warm disease. There is a similarity between the two types of Heat but the greatest difference is that warm disease (Wen Bing) occurs as a result of an externally contracted pathogen while the category of Heat described here is one that develops from diet, stress and lifestyle. 

Linear or goal-oriented thought processes are usually the basis of Western thought and medical science, but Traditional Chinese Medicine is much more complex. It is based on a circular understanding of the universe where everything returns to its source before manifesting once again.

Yin and Yang, a nutshell description of what Western physiology calls “homeostasis,” is the basis for all manifestation. Yin Deficiency is a progression were an excess leads to deficiency and deficiency leads to excess.

Yin Deficiency in the body can occur for years before giving rise to Empty Heat. In my experience, many of the strange symptoms people sometimes have that can’t be explained by any known pathology, such as a strange itch or rash on one part of the body, a sensitivity to smell, foods, allergies, are possible signs of Yin Deficiency. Some of these symptoms may be Empty Heat signs and not receptive to the same kind of Heat-clearing and/or anti-inflammatories as Full or Excess Heat.

In fact, they are impossible to fully resolve without addressing the underlying Yin Deficiency, which must be treated with Yin-nourishing and Deficient Heat-clearing herbs.

Before one can treat Yin Deficiency with herbs, it is first necessary to identify which herbs ‘nourish Yin.’ Unfortunately thinking in terms of Western herbalism where such concepts are foreign makes it more difficult to identify an herb that can be used as a Yin Tonic. However, considering that Yin tonics are lubricating and cooling (anti-inflammatory), oils such as fish liver oils, olive oil, borage seed or evening primrose oil could be considered a Yin tonic in a treatment protocol. Or one might prescribe aloe vera gel. Perhaps herbs such as comfrey, slippery elm and marshmallow root would have some cooling demulcent Yin tonic properties. These would be combined with certain mild Heat-clearing herbs including dandelion and/or burdock root – that is, herbs that clear Heat but add substance.

Concomitantly we also need to know which herbs deplete Yin. Obviously if the body is over-amped and in burnout mode, coffee, cayenne pepper and other stimulants would be contraindicated. Herbs that actively promote detoxification and elimination such as all the laxative herbs and strong liver-detoxifying cholagogues would also be contraindicated. However, milk thistle seed containing 70% silymarin has some nutritive and nourishing properties so that it could definitely be indicated for Yin Deficiency.

In Ayurveda we look to herbs such as aloe vera and shatavari (wild asparagus root), Amla fruit, possibly shilajit (although warm) as Yin tonics combined with Heat-clearing detoxifying herbs such as guduchi (Tinospora cordifolia).

The major Chinese formula for Yin Deficiency is Zhi Bai di Huang (Anemarrhena and Phellodendron Combination, see formula below), which is available in pill or other forms. To nourish the weakened organ and clear Deficient Heat requires herbs such as Moutan peony (mu dan pi), anemarrhena (zhi mu), phellodendron tree bark (huang bai), and others that may be used.

In the body, there is a pattern of Yin Deficiency without Empty Heat, and one with Empty Heat for every organ which in Traditional Chinese Medicine means the Heart, Spleen, Stomach, Lungs, Kidneys and Liver. Herbs for treating Yin Deficiency are sweet, cool and moist while those that clear Empty Heat, which in excess would be called Yin Fire, are bitter and cold such as coptis and goldenseal. As previously described many times Yin Tonic and Deficiency Heat-clearing herbs are combined.

This is not the time and space to go more thoroughly describing all the different manifestations of Heat in Traditional Chinese Medicine but following is a list from Maciocia’s book “Clinical Pearls”:

  • Excess or Full Heat
  • Heat from Qi stagnation
  • Empty or Deficient Heat
  • A distinction between Heat and Fire
  • Damp-Heat
  • Phlegm-Heat
  • Latent Heat
  • Yin Fire

The inspiration for this article was derived from Maciocia’s book and for those who want a more in depth discussion based on TCM principles I highly recommend the article in his book. He also offers a number of wonderful formulas corresponding to each of the above imbalances.

The Causes of Heat

Excess or Full Heat is the same as “Wind Heat,” as opposed to Deficient or Empty Heat.

Yin Deficiency Heat

As stated, the major cause of Yin Deficiency is overwork without adequate rest. This burns out Yin and causes Yin Deficiency with symptoms of Dryness and Heat. This in turn gives rise to symptoms of Empty (or False) Heat.

Full or Wind Heat

All emotions lead to Heat. Thus a red-tipped tongue is the most reliable indicator of emotional stress.

Emotions, Stress and Qi Stagnation

Traditional Chinese Medicine posits seven emotions and each of these relates to one or more of the internal organs outlined in the Five Elements. Different exponents might describe these differently but the most important thing is to understand each emotion in excess can cause Qi Stagnation leading to Excess Heat and when this becomes more than our body can deal with, Yin Deficiency with Empty Heat symptoms occur.

Diet and Drinks

Excessive consumption of alcohol is a major source of Heat and the higher the alcohol content the more Heat it can cause. All kinds of meat are hot (or warm) but especially lamb and beef. All wild game with the exception of fish is hot. Finally, most spices are hot, including peppers, ginger, cumin, cloves, cinnamon, etc.

Environmental and Dietary Toxins

Toxins taken from food, drink and the environment which the body is unable to neutralize and discharge are a major cause of Heat. Symptoms corresponding to the internal organs leads us to what herbs to use to discharge or eliminate this Heat.

External Pathogenic factors penetrating to the Interior

Any external factor that is not expelled at the external stage and penetrates to the interior can change to Heat. Thus even Wind-Cold conditions not expelled from the surface through diaphoresis will change to Heat.

For example, a cold or flu not discharged via sweating can penetrate to the bronchioles or lungs causing bronchitis or pneumonia. This will happen if the symptoms are suppressed with fever-reducing drugs or antibiotics, for instance. We also might consider the phenomenon of Lyme disease or any feverish condition which starts out on the surface and penetrates and becomes internal Heat with a variety of debilitating symptoms manifesting in the joints and internal organs causing chronic fatigue and joint pains to be another example of this process.

The point to understand here is that pathogenic Heat, which in Western and Ayurvedic herbal medicine is largely considered a form of toxicity, is seen by Chinese medical theory as being caused by Qi Stagnation.

Yin Deficiency generates Heat caused by weakness and over taxation.  Yin Deficiency gives rise to “empty or false” Heat (true Heat being Excess Heat).

Following are two representative TCM formulas for Yin Deficiency and Yin Deficiency with Empty Heat:

Liu Wei Di Huang Wan – Rehmannia Six For Kidney Yin Deficiency

Prepared Rehmannia glutinosa (Shu di huang) – 20-25g

Cornus berries (Shan Zhu Yu) – 10-15g

Dioscorea batata (Shan Yao) 10-15g

Alisma (Zi Xie) – 9-12g

Moutan peony (Mu dan pi) – 6-9g

Poria mushroom (Fu ling)  - 9-12g

 

Explanation:

Prepared Rehmannia nourishes Yin, Jing and Blood

Cornus Berries nourish Liver and Kidney

Dioscorea tonifies the Spleen and Kidney

Alisma sedates the Kidney and causes turbidity to descend (diuretic)

Moutan sedates deficiency fire of the Liver

Fu Ling strengthens the Spleen and resolves dampness

 

The formula for Yin Deficiency with Heat (Zhi Bai Di Huang Wan) is the same with the addition of the Deficient Heat Clearing herbs

Anemarrhena (Zhi mu) – 6-9g

Phellodendron tree bark (Huang Bai) 6-9g

Both of these clear deficient Heat.

Portions or this article were inspired, extracted and paraphrased from Clinical Pearls by Giovanni Maciocia, one of the most highly respected practitioners of acupuncture and Chinese herbal medicine in Europe. Any errors uncovered in the text would be my own. Giovanni has an online education program here.

Heat is an extremely common condition in Traditional Chinese Medical Diagnosis.

In Ayurveda Heat can be described as pitta and there are two broad classifications: Pitta prakriti describes a constitutional predisposition of a normal pitta condition from birth. This is distinguished from Heat or inflammatory disease described as pitta vikruti which is an abnormal inflammatory or pitta condition.

Western herbalism doesn’t differentiate individuals from a constitutional predisposed state and describes only inflammation with little differentiation in terms of treatment, unless one delves into the older texts which describe excess heat as sthenic and deficient heat as asthenic.

In a personal correspondence with Giovanni Maciocia about this, he wanted to be sure that I emphasize that Heat is not the same as what is currently described as ‘inflammation.’ Inflammation is a kind of Heat, but the distinction is that while TCM “Heat” is caused by Qi Stagnation, it is broader in its implications while many types of inflammation such as those caused by bruising are caused by Blood Stagnation and is more confined to a specific area.

Today Western medicine and Western herbalists make much out of the notion of inflammation being an underlying cause of disease. Western medicine uses over the counter non-steroidal anti-inflammatory drugs (NSAIDs) along with more powerful drugs including antibiotics, antivirals and cortisone-type drugs. From the point of TCM, these may clear up the acute manifestation of inflammation but not the underlying condition of “Heat” in TCM terms. Thus one can have no inflammation but still have symptoms of TCM Heat or vice versa, symptoms of inflammation without TCM Heat and finally both inflammation and TCM Heat.

All of which begs the question, what is TCM “Heat”?

Any definition is bound to invite criticism but, let’s face it, while I practice Chinese medicine and regard it as the greatest gift of wisdom from the ancient world to contemporary society, I doubt whether I will ever be able to understand some of the TCM concepts of Chinese medicine with the same perspective and understanding that someone steeped in that culture from birth might have. So I’m a Western herbalist practicing Chinese Medicine as a part of a wider practice of herbal medicine which I call ‘Planetary.’ So here goes my definition of TCM “Heat:”

Heat according to Traditional Chinese Medicine is a general condition of hyperactivity that arises as a result of a fundamental Yin-Yang imbalance, which in Western terms would be an imbalance of homeostasis.

I know we don’t like to think of our bodies as an engine but I think mechanical engines were modeled after our body and the internal organs correspond to all of its internal parts. The basic idea is to take a small spark and amplify it so it moves a vehicle and that is what the gears, carburetor, motor cylinders, cooling system, etc. is designed to do.

So just as when we take a vehicle and run it on fast high gear using poor quality fuel, oil, lack of lubrication and cooling fluid, eventually depending on the integral strength of the material from which the engine parts are made, they will get hot, wear out and eventually break down altogether causing the engine to shut down.

Similarly, when we run the human body on poor quality food, air and water, and/or subject it to overwork and various forms of physical and emotional stress, the body will get hot, wear out and eventually break down.

The most vulnerable parts of our internal engine—the organs, hormones, etc.—go through a process first of Excess Heat, where ‘we give it all we’ve got’ so to speak. Then gradually the wear and tear begins to show on one or more of those internal organs until it begins to sputter out with heat generated from a weakening which is called Yin Deficiency first followed by symptoms of “empty Heat.”

Of course the engine or the body doesn’t shut down due to Heat alone, but as a result of the damage the Heat has done to the vulnerable internal organ(s).

The point to keep in mind here is that the cause of Heat and therefore the type of Heat in the last stages of Yin Deficiency is different from the Heat generated in the earlier stage of “Full or Excess” Heat.

Full or Excess Heat (tongue pictured at left) simply requires cooling everything down but Yin Deficient Heat requires lubrication and rebuilding. This is what Yin tonics in TCM do. While consuming herbs such as Echinacea or dandelion root, rhubarb, and cascara, more vegetables and fruits instead of red meat, and practicing quiet introspection will cool excess Heat, Yin Deficient Heat or Empty Heat requires nourishment, rest, oiling, and other things that will lubricate the dryness caused by prolonged excess.

To one who is not aware of this distinction, it would seem that Yin Deficient Heat is simply what arises as infections and inflammation and that the same old standbys (NSAIDs, antibiotics, cortisone) will do the trick but usually these don’t work in the long run, certainly not the same as they might if they were used to treat Excess Heat.

In extreme cases we recognize this type of Deficient Heat as any number of wasting diseases such as HIV, chronic hepatitis or TB. However one can be somewhat wasted from stress and overwork without having these or for that matter any clearly defined disease. Disease leading to death as a result of deficiency only occurs in the later stages of Yin Deficiency. Before this or during there are a number of other general symptoms of Yin Deficiency manifesting Empty Heat that a TCM doctor looks for such as:

  • a feeling of heat in the afternoon/evening
  • a dry mouth with a desire to drink in small sips
  • malar flush (red cheekbones)
  • dry throat at night
  • feeling of heat in the chest, palms and soles (called 5-palm heat).
  • Dry stools
  • Scanty dark urine
  • Floating and rapid pulse
  • Red tongue without a coat

An acknowledged ‘master’ of tongue diagnosis, Maciocia describes how a tongue that lacks a coating (pictured at right) and/or has scattered cracks is typical of Yin Deficiency. As described above, but requiring more experience to recognize, a Yin Deficiency pulse may be slightly rapid and thin or floating and empty. In other words, the pulse and tongue reflect Qi desperately struggling to maintain presence, or as some individuals suffering from nervous burn-out might describe it, just struggling to keep things together.

For practitioners who want to learn more about the different types of Heat in TCM and their respective treatment Chinese herbal and acupuncture treatments consult Giovanni’s excellent book, Clinical Pearls, published by Su Wen Press: http://www.giovanni-maciocia.com/books/english/clinicalpearls.html
 
Also check out Giovanni's online courses here: 

Stay tuned for Part 2 of this blog, which will discuss the etiology and herbal and other treatments for Heat and Yin Deficiency, published later this month!

"Tanacetum parthenium-Stueber0". Licensed under CC BY-SA 3.0 via Wikimedia Commons

When most people hear of the herb feverfew, they think migraines. While feverfew became popular in Great Britain in the ‘80s for treating this, it has been used far longer and for many more purposes than this. In fact, this herb is quite similar to the Chinese herb, wild chrysanthemum, and their common uses may make them somewhat interchangeable.

Feverfew (Tanacetum parthenium, Chrysanthemum parthenium, Pyrethrum parthenium; Asteraceae family) has a cool energy, bitter flavor and enters the Lungs, Liver, and Stomach. While the entire above-ground portion may be used, typically the leaves and flowers are given, especially the leaves for migraines. It has antipyretic, diaphoretic, carminative, purgative, bitter tonic, and anti-inflammatory properties.

In terms of treating migraines, the first feverfew treatment was chewing 2-3 of the fresh leaves daily. However, some reacted by developing mouth sores, or swelling of the tongue, mouth and lips. Today, many take the dried herb in capsule form instead and are able to reduce the frequency of their migraines.

Feverfew does not work for all types of migraines, however. I’ve seen it work best for those with Damp Heat in the Liver or Blood Stasis1, but not for those with deficient Blood or Yin.2 Overall, it works best for those with headache, heavy menstrual bleeding and pain, feeling hot, a bluish discoloration on the skin, or poor digestion.

According to Gazmend Skendiu in Herbal Vade Mecum (Herbacy Press, NJ, 2003), feverfew releases serotonin from blood platelets, which may in part explain its anti-migraine properties. Sharon Tilgner, N.D., in Medicines from the Earth (Wise Acre Press, Creswell, OR, 1999) states that feverfew decreases platelet aggregation, which could account for its Blood-moving properties that would also alleviate certain migraines.

Feverfew was traditionally used by the ancient Greeks to reduce inflammation and as an emmenagogue for menstrual cramps. The genus Chrysanthemum parthenium was employed and considered an important remedy for fevers. All the feverfew genuses have been used for colds, flu, digestive problems, headaches, nervous afflictions, pain due to poor circulation, coughs, wheezing, or difficult breathing. As well, the plant was applied topically to treat insect bites and its oil on arthritic pain.

Interestingly, the genus names of feverfew have changed many times but the common and species names haven’t. Note that one of the genus names is Chrysanthemum! In fact, Grieves in A Modern Herbal calls both Chrysanthemum suaveolens and C. maritime, “Sweet Feverfew.”

When you read about wild chrysanthemum below, you’ll see these traditional uses may well be applied now and that feverfew may still be a good choice for colds, fever, digestive problems, dizziness, nausea, vomiting, ringing in the ears (tinnitus), psoriasis, earaches, liver diseases, muscular tension, and more, especially in those with Liver Damp Heat or Blood Stasis (see footnote 1).

Dose: 3-9 g; infuse 1 tsp/cup water, drink 2-3 cups/day; 10-40 drops tincture 1-4 times/day

Precautions: pregnancy; do not use for migraines resulting from weakness or any deficiency); don’t take while on blood thinner medication or using any medications broken down by the liver; stop using before surgery. Those with an allergy to ragweed may have sensitivity to feverfew.

Joydeep [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Wild chrysanthemum flowers (C. indicum; ye ju hua) are white and daisy-like as are those of feverfew, however they have a slightly colder energy, and although also bitter, they have an acrid flavor, and yet they too enter the Lungs and Liver. They are used to treat sore throat, red eyes, and skin conditions since they resolve toxins and reduce swelling. As well, they move Blood, like feverfew.

In general, wild chrysanthemum is a strong detoxifier used to treat hypertension, skin ailments, eczema, scrofula, and inflammation of the throat, eyes, and cervix. The entire above ground plant is used for toxic boils and swollen abscesses.

Chrysanthemum flowers (Chrysanthemum morifolium, Asteraceae family; ju hua Chinese) have a cool energy and bitter flavor, but are also somewhat sweet. They enter the Lungs and Liver. The larger flowers are used to cool the Stomach, as does feverfew. They have diaphoretic, antipyretic, anti-inflammatory, and antihypertensive properties. The yellow flowers are considered best by the Chinese, probably because they are also slightly sweet, which would ameliorate the bitter flavor and so extend their use to deficient Yin and uprising Yang conditions.

Chrysanthemum is included in many cold and flu formulas, including the well-known Yin Chiao Chieh Tu Pien, for headaches, fevers, colds, flu, sore throat, and pneumonia. It also treats red, painful, dry eyes, excessive tearing, blurry vision, dizziness, and spots in front of the eyes. The Chinese regularly drink chrysanthemum tea as a summer beverage for its refreshing taste and cooling properties.

Chrysanthemum is also used to calm the Liver, treating anger, irritability, dizziness, headaches, hypertension, and deafness, by pulling down the rising energy (called uprising Liver Yang). In order to use feverfew as a possible substitute for the yellow chrysanthemum flowers, it would need to be combined with an herb that nourishes Liver and Kidney Yin, such as marshmallow, which clears Heat and moistens.

Dose: 4.5-15g

Contraindications: do not use large doses in those with weakness; avoid if there’s diarrhea or coldness.

Overall, feverfew is a good substitute for the Chinese herb, wild chrysanthemum (C. indicum; ye ju hua), expanding its uses to treating sore throat, red eyes, and skin conditions. As well, it may be a valuable substitute for yellow chrysanthemum, too, if combined with an herb like marshmallow. In general, however, this is one more Western herb we can reclaim and begin using again according to its ancient tradition, for this herb has many more valuable applications than just for migraines

[1] Symptoms of Blood Stasis include sharp stabbing pains, bluish or purplish discolorations, numbness, certain lumps, masses, dark colored blood, large blood clots, tremors, swelling of the organs, and traumatic swellings. Symptoms of Liver Damp Heat include nausea, fullness of the chest and hypochondrium, jaundice, vomiting, fever, scanty dark urine, burning on urination, bitter taste in the mouth, abdominal distention, redness and swelling of the scrotum, vaginal discharge and itching, and a sticky yellow tongue coat.

[2] Symptoms of deficient Blood include dizziness, blurry vision, numbness, restlessness, anxiety, slight irritability, insomnia, scanty menses or amenorrhea, thinness or emaciation, dark spots in the visual field, dry skin, hair or eyes, lusterless, pale face and lips, tiredness, easily startled or overwhelmed and poor memory. Symptoms of deficient Yin include night sweats, malar flush (redness and burning heat along the cheeks and nose), burning sensation in the palms of the hands, soles of the feet and in the chest, afternoon fever or feelings of heat, restless sleep, dry throat or thirst at night, agitation, mental restlessness, dry cough, dry stools, and scanty dark urine.

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.

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