Herbal Medicine I Flashcards

1
Q

Where is the first archaeological evidence of herbal medicine?

A
  • Neanderthal graves in Iraq
  • Dating back 40,000 years
  • Herbs that still in use today
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2
Q

Where is the first recorded evidence of herbal medicine?

A
  • Egyptian hieroglyphics
  • Parchments from the Indus Valley
  • > 4,000 years
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3
Q

Who was “The Father of Medicine”?

A

Hippocrates of Kos
(460 BC–375 BC approx.)

Established the importance of:
* careful observation
* examination
* documentation of cases and treatments

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4
Q

Who wrote De Materia Medica in the first century AD?

A

Dioscorides
(30–90 AD approx.)

  • Greek physician during the Roman Empire
  • De Materia medica remained a key text in medical schools for the next 1,600 years!
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5
Q

Who was surgeon to the gladiators in the 2nd century AD?

A

Galen
(131–200 AD)
* Gladiators’ injuries allowed him to view the inner workings of the body
* Developed humoral medicine, (blood, phlegm, bile, black bile)
* Basis of Western medical thinking until the 18th century.

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6
Q

Who was “The mother of German botany” in the 12thC AD?

A

Hildegard of Bingen
Saint Hildegard (1098–1179)

  • German Benedictine abbess, healer, writer, composer and philosopher
  • Herbs formed an integral part of her healing work
  • Authored Physica and Causae et curae
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7
Q

Who created the Quack’s charter in the 15thC AD?

A

King Henry VIII
(1491–1547)
* Keen amateur herbalist.
* He brought legislation to protect herbalists
* Known as the ‘Quack’s charter’
* Gives the legal basis to practise herbal medicine freely to this day!
* ‘Quack’ is still used as a derogatory term to describe conventional medics

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8
Q

Who published The English Physician in the 17thC AD?

A

Nicholas Culpepper
(1616–1654):
* Served the poor of East London
* The English physician (1653), written in English (not Latin)
* Still in print today
* How herbs were understood and applied in Tudor England

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9
Q

Why are doseage levels in Western herbalism comparitively lower than other traditions?

A

Naturopaths such as Goethe and Steiner, developed therapies based on ‘nature cure’:
* They taught that healing is intrinsic to the body and that successful herbal therapy is based on mobilising the ‘Vital Force’.
* This required lower doses of herbs (higher doses suppress Vital Force).
* For this reason, dosage levels in Western herbal medicine are generally lower than in traditional Indian medicine (Ayurveda) and TCM.

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10
Q

Why are doseage levels in Western herbalism comparitively lower than other traditions?

A

Naturopaths such as Goethe and Steiner taught ‘nature cure’:
* healing is intrinsic to the body
* successful herbal therapy is based on mobilising the ‘Vital Force’
* this requires lower doses of herbs (higher doses suppress Vital Force - Arnaud-Schultz Law)

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11
Q

What are the four forms of traditional medicine

A
  1. Ayurveda (South Asia: India)
  2. Chinese medicine (East Asia: China)
  3. Galenic medicine (Ancient Greece and Rome)
  4. Unani Tibb (Arabic world)
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12
Q

What do the Four forms of traditional medicine share?

A
  • Broadly identical ‘energetic’ approaches to classify and treat diseases
  • Maintenance of good health using herbs, foods and lifestyle
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13
Q

What are Energetic Qualities?

A
  • Hot
  • Cold
  • Dry
  • Wet (Damp)
  • A balance of all qualities is important for good health
  • Imbalance leads to excesses and characteristic patterns of disease (physical and mental)
  • ‘Energetics’ fell out of favour in the West and was replaced by biomedicine
  • By contrast, in India, China and the Middle East, it is still very much alive
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14
Q

What are the signs of excess heat?

A
  • inflammation
  • redness
  • infections
  • burning sensations
  • high blood pressure
  • loose stool
  • stress
  • irritability
  • anger
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15
Q

What can cause excess heat?

A
  • Hot climates and seasons
  • Very hot food and drinks
  • Hot ‘pungent’ herbs (chilli, dry ginger, garlic)
  • Oily foods
  • Chemical food additives
  • Refined sugars
  • Stimulants (coffee, alcohol)
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16
Q

What are the signs of excess cold?

A
  • Chills
  • Poor circulation
  • Muscle spasm
  • Fatigue
  • Low mood
  • Weak digestion
  • Hypometabolic conditions (low thyroid function)
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17
Q

What can cause excess cold?

A
  • Cold climates and seasons
  • Cold, refrigerated, frozen foods
  • Iced drinks
  • Too much raw food, salad, bitter leaves e.g. chicory
  • Too much green smoothies
  • Too much ‘Bitter’ (detoxifying) herbs such as golden seal
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18
Q

What are the signs of excess dryness?

A
  • Weakness
  • Emaciation
  • Stiff joints
  • Dry skin and mucous membranes
  • Constipation, gas and bloating
  • Anxiety
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19
Q

What can cause excess dryness?

A
  • Dry, windy climates and seasons
  • Too much dry food e.g. popcorn
  • Low fluid intake
  • Gas-forming legumes
  • Drying ‘astringent’ herbs e.g. green tea
  • Excess hot spices and diuretic herbs
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20
Q

What are the signs of excess moisture?

A
  • Weight gain
  • Fluid retention
  • Lethargy
  • Mucus, watery discharges
  • Cysts
  • Lymphatic congestion
  • Over-emotional
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21
Q

What can cause excess moisture?

A
  • Wet climates and seasons
  • Too much dairy, gluten, sweet foods
  • High water-content fruit and veg. e.g. melon, cucumber
  • Slimy ‘mucilaginous’ foods and herbs such as okra and linseeds
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22
Q

Where should the Energetic Balance lean?

A

Slightly towards warmth and moisture
The opposite is cold and dry (dead!)

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23
Q

What is Organoleptic?

A

The traditional name for evaluating herbs using the senses

Organoleptic = ‘to stimulate a sense organ’.

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24
Q

What are the tastes used in Herb testing?

A
  • Astringent
  • Pungent
  • Bitter
  • Sweet
  • Aromatic
  • Demulcent
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25
Q

What are responsible for the Astringent effect?

A
  • Phytochemicals known as tannins
  • On contact with mucous membranes tannins crosslink proteins
  • This binds the mucosa more tightly (decreases permeability) and reduces secretions
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26
Q

What are the effects of Astringents?

A
  • Increases protection from microbes and noxious irritants
  • Decreases watery discharges (e.g. diarrhoea, runny nose)
  • Tones and heals skin and mucous membranes
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27
Q

What are the energetics of Astringent?

A
  • Drying
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28
Q

Astringent: Kitchen examples

A
  • Green tea
  • Cinnamon
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29
Q

Astringents

Agrimony leaf

A
  • Traditional remedy for diarrhoea, especially in children.
  • Protective layer formed by tannins on the gut mucosa
  • Decreases peristalsis by reducing stimulation of nerve endings by noxious agents
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30
Q

Astringents

Meadowsweet leaf

A
  • Forms a protective barrier
  • Heals the stomach lining in GORD, gastritis and stomach ulcers
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31
Q

Astringents

Witch-hazel leaf

A
  • A topical treatment for healing wounds
  • If wounds are bleeding, tannins have a styptic effect*

*Localised vasoconstriction to stem blood loss

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32
Q

What are responsible for the Bitter taste?

A

Wide range of chemicals known collectively ‘Bitter principles

Usually secondary metabolities (defensive/protective functions)

Primary metabolites = growth, reproduction

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33
Q

What are the effects of the Bitter taste?

A
  • Stimulate taste bud receptors
  • Increase vagal activity
  • Promotes gastric acid and pepsin secretion
  • Prime the pancreas and gallbladder
  • Small amounts increase digestive juices and digestive power (take a few drops before meals)
  • Larger amounts stimulate liver detoxification, bowel elimination, kill microbes (anti-microbial)
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34
Q

What are the energetics of Bitters?

A
  • Cooling
  • Drying
35
Q

Bitters

Gentian root

A
  • Small amounts before meals increases digestive power
  • Promotes release of bile from the gallbladder
36
Q

Bitters

Wormwood leaf

A
  • A bitter digestive in small amounts
  • In larger doses it is anthelmintic (kills intestinal worms) and anti-parasitic
37
Q

Bitters

Dandelion root

A
  • Bitter tonic
  • Promotes production and flow of bile
  • Supports gallbladder and liver health
38
Q

What are responsible for the Aromatic tastes?

A

‘Volatile’ (essential) oils

39
Q

What are the effects of aromatic?

A
  • Improve appetite and digestion
  • Relieve GI pain, nausea, bloating and flatulence by relaxing intestinal smooth muscle and sphincters
  • Take as teas after meals to settle digestion
  • Open the airways in asthma and coughs (relax smooth muscle of the bronchioles)
  • Have important anti-microbial properties (secondary metabolites)
40
Q

What are the energetics of Aromatics?

A
  • Warming
  • Drying
41
Q

Aromatics

Sage leaf

A
  • Antimicrobial and astringent
  • Use for infections and inflammation of the mouth and throat
  • Alleviates excess sweating associated with menopause
  • Supports mood and cognitive function*

*Volatile oils can cross the BBB

42
Q

Aromatics

Rosemary leaf

A
  • Circulatory stimulant, improving delivery of oxygen and nutrients to body tissues including the CNS
  • Improves memory and concentration
43
Q

Aromatics

Thyme leaf

A
  • Anti-microbial
  • Reduces bronchial spasm and assists in the removal of mucus (expectorant)
  • For respiratory issues including coughs, bronchitis and asthma
44
Q

What is responsible for the Pungent taste?

A

Phytochemicals such as volatile oils, oleo-resins and alkaloids

45
Q

What are the effects of the Pungent taste?

A
  • Stimulates digestion, promotes circulation, raises body temperature and metabolism
  • Promotes sweating (helps manage a fever)
  • Counteracts cold, mucus and ‘dampness
46
Q

What are the external uses of the Pungent taste?

A
  • Use externally as a rub for cold stiff joints
  • Warming effect, improves blood flow and nutrient supply
  • E.g., cayenne.
47
Q

What are the energetics of Pungent taste?

A
  • Heating
  • Drying
48
Q

Pungent

Ginger rhizome

A
  • Anti-emetic (reduces nausea and vomiting)
  • Anti-inflammatory (inhibits synthesis of inflammatory cytokines such as IL-1, TNF-α)
  • Commonly used for rheumatism and osteoarthritis
49
Q

Pungent

Cinnamon bark

A
  • Anti-diabetic
  • Increases insulin receptor sensitivity aiding the transport of glucose into the cells
50
Q

Pungent

Black pepper seed

A
  • Rich in the phytochemical piperine
  • Increases bioavailability of certain nutrients such as beta carotene and curcumin from turmeric
51
Q

What is responsible for the Sweet taste?

A
  • Phytochemicals including saponins and polysaccharides
  • Often found in higher concentrations in plant roots
52
Q

What are the effects of the Sweet taste?

A
  • Nourishing and building for tissues, increase energy and stamina, grounding
  • Many adaptogens (energising) tonics have a sweet taste
53
Q

What are the energetics of the Sweet taste?

A
  • Neutral
  • Moistening
54
Q

Sweet

Liquorice root

A
  • Heals mucous membranes
  • Anti-inflammatory
  • Expectorant (helps eliminate respiratory mucus)
  • Adrenal tonic (cooling)
55
Q

Sweet

Korean ginseng root

A
  • Stimulating adaptogen for exhaustion
  • For ‘Yang deficiency’
  • Heating
56
Q

Sweet

Ashwagandha root

A
  • Increases stamina
  • Relaxes the nerves in anxiety and insomnia
  • Increases weight gain in debilitated states
  • Warming
57
Q

What is responsible for the Demulcent texture?

A
  • Mucilage: indigestible sugar chains, gives ‘slimy’ texture in the mouth
  • Often found in roots and seed coatings
58
Q

What are the effects of Demulcent textures?

A
  • Used for irritated and inflamed tissues
  • Soothes, coats, protects and promotes healing of mucous membranes and skin
  • Some demulcents have gentle laxative properties (bulk & soften the stool)
59
Q

What are the energetics of Demulcents?

A
  • Moistening
  • Cooling
60
Q

Demulcent

Marshmallow root

A
  • For inflamed mucous membranes: dry coughs, pharyngitis, laryngitis, gastritis, GORD
  • Constipation
61
Q

Demulcent

Slippery elm bark

A
  • For inflamed mucous membranes, leaky gut, constipation / diarrhoea
  • Is also prebiotic and slightly astringent to support a healthy microbiome and digestive system
  • Endangered tree - use sparingly
62
Q

Demulcent

Comfrey leaf

A
  • Anti-inflammatory
  • Contains allantoin, a phytochemical that promotes cell proliferation to speed the healing of fractures, strains and sprains
  • External use
63
Q

What are the restrictions around Schedule 20 herbs?

A

A special group of herbs that are subject to usage and legal dosage restrictions:
* Only prescribed and dispensed by qualified herbalists
* Must be kept in a locked cupboard.
* At the correct dose they are completely safe, but at higher doses they are poisons!
* Don’t take Schedule 20 herbs unless prescribed to you by a qualified herbalist
* Do not recommend S20 herbs to anyone unless you are a qualified herbalist

64
Q

What are some examples of Schedule 20 herbs?

A
  • Aconite (pain) external use only
  • Arnica (pain, inflammation) external use only*
  • Deadly nightshade (gastro-intestinal pain)
  • Lily of the valley (heart failure)
  • Ephedra (allergy)
  • Gelsemium (pain)
  • Henbane (severe uterine pain)
  • Lobelia (bronchodilator)

*Do not apply to broken skin - toxic internally

65
Q

What herbs are contra-indicated to someone with a ‘ragwort’ allergy?

A

Chamomile
Feverfew

66
Q

How to proceed when allergy is possible?

A

With atopic patients (asthma, eczema, hay-fever)
* Test herb drops on the skin of inner wrist / elbow to check for sensitivity
* Avoid if there is a reaction
* If people report side effects from herbs, they should stop taking them, wait till effect passes, try again at ½ dose. If effect happens again —discontinue.

67
Q

How to proceed side effects are reported?

A
  • Stop taking herbs
  • Wait till effect passes
  • Try again at ½ dose
  • If effect repeats - discontinue
68
Q

What is the toxic compound in the comfrey and borage family?

A

Pyrrolizidine alkaloids (PAs)
Can damage the liver in high doses Comfrey root is banned for internal use

Borage and comfrey leaf tea / tincture is fine, but:
* Use small doses (½ - 1 teaspoon herb per cup).
* Use for short periods (one month maximum).
* Avoid in all pre-existing liver diseases.

69
Q

What is the main question to ask all female patients?

A

If they are pregnant, could be pregnant, or are breast feeding

70
Q

What herbal remedies are safe in moderation during pregnancy?

A
  • Simple teas such as peppermint and fresh ginger are traditional remedies for morning sickness
  • Fennel seed is good for breast milk production
  • In moderation (½ - 1 tsp infused 3 x daily), but not in higher doses!
71
Q

Which herbs may have a Teratogenic effect*?

*risk of birth defects

A

Herbs containing ‘thujone

  • Thuja
  • Wormwood
  • Sage, Rosemary, Thyme and Basil*

*OK in small culinary amounts

72
Q

Which herbs have an Emmenagogue effect*?

*Encourage menstruation

A

Agnus castus
Angelica
Motherwort
Yarrow

73
Q

What herbs may increase miscarriage risk?

A

Strong herbal laxatives (contain anthraquinone glycosides)

  • Senna
  • Rhubarb root
  • Cascara sagrada
  • Aloe root
74
Q

Examples of unsafe herbs during pregnancy and breastfeeding?

A

Celery seed
Berberis
Blue cohosh
Celandine
Black cohosh
Cinnamon
Myrrh
Golden seal
Juniper
Pennyroyal
Parsley root
Poke root
Turmeric
Feverfew
Mistletoe

75
Q

What precautions must be taken with herbs in cases of pregnancy and breastfeeding (for qualified herbalists)?

A
  • Check all herbs using texts and reputable databases
  • Avoid using herbs if there is any doubt
  • Focus instead on gentler naturopathic tools such as nutrition or homeopathy
76
Q

Why can herb drug interactions occur?

A

Because herbal medicines work on the same biochemical pathways as pharmaceuticals

77
Q

What is an Additive interaction?

A

‘Additive’ interactions occur when the effect of a herb is the same as a drug, leading to excessive effects

78
Q

What are some examples of Additive interactions?

A

Herbal sedative
e.g. valerian + prescription sedative may cause very strong sedation

Herbal blood thinner
e.g. garlic* + warfarin could lead to spontaneous bleeding

Herbal hypoglycaemia
e.g. gymnema + metformin or insulin could lead to extreme drop in blood sugar

*garlic has antiplatelet activity at therapeutic doses

79
Q

What is an Antagonistic interaction?

A

‘Antagonistic’ interactions can occur if herbs and drugs have opposite effects, potentially reducing herb or drug efficacy

80
Q

What examples are there of Antagonistic interaction?

A

Liquorice and Korean ginseng can raise blood pressure, which could potentially reduce or cancel out the effects of conventional blood-pressure-lowering medicines.

81
Q

What are the antagonistic interactions of St John’s Wort?

A

St John’s wort is antagonistic to many drugs because it speeds liver detoxification, so clears drugs from the system faster:

This is dangerous for patients taking ‘life-maintaining’ medicines such as:
* Immuno-suppressants following organ transplant
* Digoxin for heart failure
* Warfarin following stroke
* May also clear birth control pill out of the system resulting in unplanned pregnancy

82
Q

What is the herbal safety check list?

A

Check all herbs for safety issues:
* Always ask patients if they are pregnant, could be pregnant, or are breast feeding.
* Always check what medications they are taking.
* If there is a caution or interaction don’t proceed.
* There will be safe ways to support patients using different herbs or different approaches.
* The most up-to-date information is found on databases such as Medlineplus
http://www.nlm.nih.gov/medlineplus/druginformation.html

83
Q

Further reading

A

Essential:
* Chevallier, A. (2016). Encyclopaedia of herbal medicine. Dorling Kindersley.

Recommended:
* Green, J. (2000). The herbal medicine maker’s handbook: A home manual. Crossing Press.
* Griggs, B (1997). The history and evolution of Western herbal medicine. Inner Traditions Bear and Company.
* Tierra, M. (1989). Planetary herbology. Lotus Press.