Week 9: Vulneraries Flashcards
What is a vulnerary?
An agent that helps tissue heal
- Used for lacerations, abrasions, ulcers, burns, or otherwise inflamed and disrupted tissue
- Many (but not all) can be used externally or internally
Inflammatory Phase
After hemostasis is achieved, blood vessels dilate, call junctions become more permeable as macrophages infiltrate the area.
Exudate increases , edema, heat, erythema and pain increase
If this process is exuberant, maceration of the tissue occurs
Proliferation Phase
Granulation tissue fills in the wound
Made up of collagen and extracellular matrix
Angiogenesis – new blood vessels form in the granulation tissue to supply nutrients and oxygen to the fibroblasts and other growing tissue.
Epithelialization – resurfacing of the wound
Maturation Phase
Remodeling of collagen from type III to type I
Blood vessels regress
Actions related to Vulnerary Herbs
Increased cell proliferation, angiogenesis, collagen formation, rate of epithelialization, contraction of wounds, tensile strength, and control of inflammation
Calendula officinalis
Family: Asteraceae
Energetics: drying
Constituents: terpene glycosides, flavonol glycosides, saponins, triterpene alcohols, sterols, carotenes, xanthophylls, polysaccharides, tannins
Part Used: flower
Calendula officinalis
Actions
vulnerary, anti-inflammatory, diuretic, antiseptic
Calendula officinalis
Indications and CIs
Indications: Lacerations, abrasions, excoriations, ulcers, eczema, rashes
Specific Indications and Uses.—Locally, to wounds and injuries to prevent suppuration and promote rapid healing. Internally, to aid local action, and in chronic suppuration, capillary engorgement, varicose veins, old ulcers, splenic and hepatic congestion. King’s American Dispensatory, 1898, Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.
Contraindications: pregnancy (internal)
Caution: Allergy to Asteraceae family
Anti-inflammatory activity of flower extract of Calendula officinalis Linn. and its possible mechanism of action.
The results showed that potent anti-inflammatory response of C. officinalis extract may be mediated by the inhibition of proinflammatory cytokines and Cox-2 and subsequent prostaglandin synthesis.
What is thought to be the most potent anti-inflammatory constituent in Calendula officinalis?
Faradiol
Echinacea spp.
Family: Asteraceae
Part Used: root and rhizome, whole plant
Energetics: Cooling, Drying, Stimulating
Constituents: Caffeic acid ester – echinacoside, polysaccharides, alkylamides, volitile oil, echinolone, caffeic acid. E. purpurea root contains traces of pyrrolizidine alkaloids.
Echinacea spp.
Actions
Actions: immunomodulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, lymphagogue, vulnerary
Echinacea spp.
Indications and CIs
Indications: Infection, sepsis, pharyngitis, snake bites, ulcers
Contraindications: some practitioners avoid use with inflammatory autoimmune diseases.
Echinacea angustifolia
It stimulates retrograde metabolism, or tissue waste, more markedly than any other single remedy known. It influences the entire lymphatic system, and the condition of the blood suggests that the patient has been taking stimulants. Its influence upon the capillary circulation is not comparable with that of any other known remedy, for while it is a stimulant to the circulation in these vessels, it also seems to endow them with a certain amount of recuperative power or formative force by which it is constituted, not only a general stimulant and tonic to the circulation, but also peculiarly so, to local inflammations of a debilitating character, as when administering liver and iron remedies in abundance. Sallow, pallid and dingy conditions of the skin of the face quickly disappear, and the rosy hue of health is apparent. Anemic conditions improve with increased nerve tone. There are but few subjective symptoms from large doses of this agent. It is apparently non-toxic, and to any unpleasant extent non-irritant. The agent certainly has a marked effect upon the nervous system, but its specific influence upon the central organs has not yet been determined.
The American Materia Medica, Therapeutics and Pharmacognosy, 1919, Finley Ellingwood, M.D.
Alcohol extract of Echinacea pallida reverses stress-delayed wound healing in mice.
Healing of open skin wounds begins with an inflammatory response. Restraint stress has been well documented to delay wound closure, partially via glucocorticoid (GC)-mediated immunosuppression of inflammation. Echinacea, a popular herbal immunomodulator, is purported to be beneficial for wound healing. To test the hypothesis, an alcohol extract of E. pallida was administrated orally to mice for 3 days prior to, and 4 days post wounding with a dermal biopsy on the dorsum. Concomitantly, mice were exposed to 3 cycles of daily restraint stress prior to, and 4 cycles post wounding. Echinacea accelerated wound closure in the stressed mice, but had no apparent wound healing effect for the non-stressed mice when compared to their respective controls. To test if the positive healing effect is through modulation of GC release, plasma corticosterone concentrations were measured in unwounded mice treated with restraint stress and the herbal extract for 4 days. Plasma GC in restraint stressed mice gavaged with Echinacea was not different from mice treated with restraint only, but was increased compared to the vehicle control. This data suggests that the improved wound healing effect of Echinacea in stressed mice is not mediated through modulation of GC signaling.
Centella asiatica (Gotu Kola)
Family: Apiaceae
Part Used: whole plant
Energetics: Cooling
Constituents: triterpenoid saponins: asiaticoside, brahmoside; brahmic acid, centelose, carotenoids, madecassoside
Centella asiatica (Gotu Kola) Actions
Actions: nutritive, vulnerary, nervine, anti-inflammatory, circulatory tonic, alterative, decreases excessive scarring, hepatoprotective
Centella asiatica (Gotu Kola) Indications
Indications: chronic venous insufficiency, memory and cognitive support, anxiety, scleroderma, longevity
Hypericum perforatum (St. John’s Wort)
Family: Hypericaceae
Part Used: Fresh aerial parts
Energetics: mildly warming and enlightening
Constituents: hypericin, hyperforin, bioflavones
Hypericum perforatum (St. John’s Wort) Actions
Actions: Anti-inflammatory, antidepressant, antispasmodic, anti-viral, astringent, detoxifying, nervine, vulnerary, sedative
Hypericum perforatum (St. John’s Wort) Indications and CIs
Indications: wound healing, mild-moderate depression, neuralgia, nerve injury, burns
Contraindications: induces CYP 3A4 and can cause increased clearance of pharmaceutical drugs.
Stellaria media (Chickweed)
Family: Caryophylaceae
Part Used: fresh aerial parts
Energetics: Cooling
Constituents:
Stellaria media (Chickweed) Actions
Actions: nutritive, vulnerary, demulcent
Stellaria media (Chickweed) Indications
Indications: Lacerations, abrasions, excoriations, ulcers, eczema, rashes, burns
Stellaria media (Chickweed) Action, Medical Uses, and Dosage.
—Chickweed appears to be a cooling demulcent. Ɣ I have seen the fresh leaves bruised and applied as a poultice to indolent, intractable ulcers on the leg, of many years’ standing, with the most decided and immediately beneficial results; to be changed 2 or 3 times a day. In acute ophthalmia, the bruised leaves will likewise be found a valuable application. An ointment, made by bruising the recent leaves in fresh lard, may be used as a cooling application to erysipelatous and other forms of ulceration, as well as in many forms of cutaneous disease (J. King). A tincture of Stellaria media has been extolled in some quarters as a remedy for rheumatic pains of a fugitive and shifting character.
King’s American Dispensatory, 1898, Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.
Plantago spp. - Plantain
Family: Plantaginaceae
Part Used: leaf
Energetics: Cooling
Constituents: volatile oils, carotenoids, saponins,
flavonoids, organic acids, vitamins and minerals
Plantago spp. - Plantain
Actions
Actions: nutritive, vulnerary, anti-inflammatory, demulcent
Plantago spp. - Plantain
Indications
Indications: Lacerations, abrasions, excoriations, ulcers, eczema, rashes, burns, used to soothe insect bites and bee and wasp stings, also used to draw out splinters
Matricaria recutita (Chamomile)
Family: Asteraceae
Part Used: Flower
Energetics: cooling
Constituents: anti-inflammatory sesquiterpenes – alpha-bisabolol and chamazulene
Matricaria recutita (Chamomile) Actions
Actions: nervine, anxiolytic, antidepressant, stomachic, vulnerary
Matricaria recutita (Chamomile) Indications and CIs
Indication: nervousness, impatience, discontent, insomnia, particularly useful in children
Contraindications/Cautions: high doses can cause vomiting and diarrhea
Aloe vera, Aloe barbadensis
Aloe Gel
Family: Aloaceae
Part used: Inner leaf gel
Energetics: cool and moist
Constituents: many polysaccharides – glucomannan, acemannan; phytosterols, chromones, enzymes, tiny amounts of anthraquinone glycosides
Aloe vera, Aloe barbadensis
Aloe Gel
Actions
Actions: soothing to mucous membranes, vulnerary, anti-inflammatory, immunomodulating
Aloe vera, Aloe barbadensis
Aloe Gel
Indications
Indications: Peptic ulcers, IBS, inflamed mucous membranes, burns
Arnica spp.
Family: Asteraceae
Part Used: flower heads, or whole fresh plant
Energetics: stimulating
Constituents: volitile oils, resins, flavonoids
Arnica spp.
Actions
Actions: stimulates circulation and macrophage activity, helps resolve edema and echymosis
Arnica spp.
Indications and CIs
Indications: tissue trauma – sprains, strains, bruises, arthritic joints
Caution: Arnica is a low-dose herb internally and externally due to its ability to act as an irritant (very small doses are stimulant)
Some tissue inflammation may be exacerbated by repeated topical applications of arnica, particularly rheumatoid arthritis. This is thought to be due to the stimulation of macrophages in an already overstimulated condition. Do not apply to broken skin
Arnica spp.
Specific Indications and Uses.
Muscular soreness and pain from strains or over-exertion; advanced stage of disease, with marked enfeeblement, weak circulation, and impaired spinal innervation; embarrassed respiration; lack of control over urine and feces; sleeplessness from impeded respiration, and dull praecordial pain from “heart-strain;” muscular pain and soreness when the limbs are moved; tensive backache, as if bruised or strained; cystitis, with bruised feeling in bladder, or from a fall or blow; headache, with tensive, bruised feeling and pain on movement; hematuria, with dull, aching lumbar pain, or from over-exertion. All cases of debility with enfeebled circulation.
King’s American Dispensatory, 1898, Harvey Wickes Felter, M.D., and John Uri Lloyd, Phr. M., Ph. D.
Symphytum officinale (Comfrey)
Family: Boraginaceae
Part Used: leaves, root
Energetics: cooling
Constituents: allantoin
Symphytum officinale (Comfrey) Actions
Actions: vulnerary, reduces edema
Symphytum officinale (Comfrey) Indications and CIs
Indication: sprains and fractures
Contraindications/Cautions: Due to pyrrolizidine alkaloid content, this herb should be avoided internally. There is little available data on topical application, but one 1982 study in rats showed that only 0.1-0.4% of the applied dose of PAs was detectable in the urine.
