The oldest and the newest

Herbal medicine is one of the oldest methods of healing on the planet with a history of over 100,000 years of continuous use. Every country has developed its own unique brand of healing according to their particular indigenous plants, and several of these systems have developed into widely regarded medical philosophies. Traditional Chinese medicine has a recorded history of almost 5000 years and the Ayurvedic medicine of India is even older.

Conversely the sales of natural health products in the US topped $12 billion in 1996 and the therapeutic applications of herbs and herbal extracts is one of fastest growing areas of medical research. There are daily more reports of health benefits being attributed to a variety of foods, herbs, vitamins, minerals etc. The WHO recently announced that over 80% of the worlds population still relies on herbs and crude botanicals as their primary medicine. The WHO have also pledged to support and encourage indigenous traditional medicines as a sustainable way to work towards their goal of "health for all by the year 2000"

The Vitalist Philosophy of Herbal Medicine

Many people these days are looking to the Oriental medicine systems for an understanding of the body based on energetic fluctuations and life force processes. While Traditional Chinese, Ayurvedic, Unani and other esoteric philosophies are often effective and valuable, people are forgetting that there is a strong Vitalist tradition which Western trained herbalists draw upon when integrating traditional principles with modern practices. Our intellectual roots go back several thousand years. Claudius Galen in first drew out the "cross of the four humours" - a simplistic but revolutionary pattern by which disease and treatment could be classified and correlated. Over the centuries this system was enlarged and developed, becoming quite sophisticated and lasting as the accepted mode of assessment until only a couple of hundred years ago. 

The Vitalist philosophy considers that the body has an inherent intelligence and that this manifests in humans as a life force or energy that drives us forward and that resonates with that of the planet itself. It is the role of the herbalists to aid the body in rebalancing itself, to bring it into alignment with its natural state. This is done through the application of four basic categories of assessment and treatment - hot, cold, wet and dry according to how far the body has veered from the centre point of balance and fallen into one of these opposing extremes. 

The Gaia Hypothesis was first proposed by James Lovelock of Cambridge University in the 1960s and suggests that the earth can be likened to a single organism. He likened the rivers to the arteries and veins, the trees to the lungs. Every event on one side of the world, he says, impacts people and events on the other side. Nothing is separate from another, we are all inter-connected and inter-related and ultimately dependent on each other for maintaining balance and harmony of the whole. This concept of wholeness and unity is named Gaia after the Greek goddess of the Earth. 

Herbalists have always believed that through the use of herbs for healing it is possible to contribute to the wellbeing of the individual client while also contributing to balance and harmony in the world around us. The practice of herbal medicine is founded on the principle "above all, do no harm". The underlying tenet of holistic herbalism is the treat the person, not the disease. 

Herbalists believe in the Holistic principle that "The whole is greater than the sum of the parts". Thus when we practice herbalism we attempt to treat the whole person, body, mind and spirit as well as operaing within the recognized influence of family, community and society. We address diet, exercise, stress management, lifestyle and relationship issues and other individual concerns as well as the general disease states and particular pathologies that people present with.

Herbal medicine in the current context

In 1990 The New England Journal of Medicine, one of the most prestigious medical journals in the world, published a report of a study carried out by Harvard University indicating that 34% of Americans had consulted with a natural health practitioner in the past year and had spent a total of $13.5 billion in out of pocket expenses for these services and products. Botanical therapies are one of the top 5 alternative medicine options chosen - along with chiropractic, acupuncture, homeopathy and massage. Herbal medicine has recently been mentioned in Macleans, Newsweek, Life, Chatelaine, Consumer Report and Homemaker magazines. Ginkgo biloba (a herbal extract) is the leading prescription drug in Germany, where prescribing herbalists are required to be medical doctors. France has hospitals and university chairs devoted to aromatherapy. Clearly, herbal medicine is an idea whose time has come, and the resurgence of demand for natural healing modalities has not even begun to crest yet.

Scope of Practice

Herbal medicine is proven effective in assisting the body to heal from an amazing variety of complaints and diseases. Professional Clinical Herbalists can be of assistance in many health concerns from simple coughs and colds to more serious conditions. Herbs may be especially effective in chronic conditions and in cases requiring tonic, nourishing and revitalising medicines. At the present time in North America herbalists are not permitted to practice medicine (make diagnoses or prescribe medicines) but they may make health assessments based on general criteria of wellness and recommend certain courses of action to be taken to elicit healing.

 

SOME COMMONLY ASKED QUESTIONS ABOUT HERBAL REMEDIES

How long will it take?
There is no single simple answer to this question. Really it depends very much on the individual and on the nature of the illness. Generally speaking, the longer you have been sick the longer it will take to regain your health. As a general guideline, you could expect to see some improvement within 2 to 3 weeks and to have significant results within 2 to 3 months. It is also important to recognize that herbs are only a part of the therapeutic protocol - attention to diet, exercise, lifestyle and so on is also usually essential and without this the herbs cannot be expected to work well. 

What form do the remedies take?
Herbal remedies are usually given in easy to take liquid form, as tinctures or syrups, or may be given dried to be made into a tea. Sometimes they are also given in powdered form as capsules or tablets, and essential oils creams and lotions may also be used.

Some herbs are best taken in the tincture (alcohol extract) form because not all constituents are readily soluble in water and a simple tea nay not extract adequately. Anything with a lot of resin (Ginger, Myrrh, Marigold, Poplar buds) may be best in an alcohol solution as strong as 90% for optimum extraction of the medicinal ingredients. Others like Goldenseal and Passionflower are best at around 65% to extract the alkaloids that are active. Still others need 45% to extract essential oils (Chamomile, Melissa). And then there are lots of herbs whose constituents are quite water soluble and they only need 25% alcohol for sterility. These low alcohol ones are the best ones to make into tea because they have the most water soluble ingredients. 

Do I have to stop taking medication from my doctor?
In general you should not stop current medication. The herbs will not usually interfere in any way with the efficacy of your prescription drugs but there is a possible danger of the herbs being so effective that your dose of prescription drugs becomes inappropriate and causes problems for you. If you are currently taking some prescription medication then it is recommended that you do not self medicate with herbs, but rather consult with a qualified practitioner who can monitor your progress and work in conjunction with your doctor.

Do I have to have my doctors permission to take herbs?
No, you are free to seek health care wherever you wish, but it is usually a good idea to let your doctor know what you are doing so that he/she and the herbalist can work together for the greater good of you, the patient.

Are the herbal remedies safe?
Given under the supervision of a trained herbal practitioner, the remedies are completely safe. They have no side effects and no cumulative effects. Herbs are natural, non-invasive, and work in harmony with the body's own healing powers. The Poisons Control Center in Atlanta recorded over 150,000 deaths due to adverse drug reactions in 1995 and not a single death due to herbs. Some herbs, if used inappropriately, can cause health problems so if in doubt ask a herbalist. 

What happens when I visit the herbalist?
In your first visit, which usually takes 60 - 90 minutes, a full medical history will be taken to determine your basic level of health as well as to find out about your specific health problems. It may also be necessary to carry out certain assessment procedures such as measuring your pulses, listening to your heart or feeling for your liver etc. Your diet and general lifestyle will also be discussed. In subsequent visits the changes and progress in your condition will be reviewed and your remedies will be adjusted accordingly. If blood tests are required the herbalists will usually refer to a cooperative MD who can do this for you. 

How often will I have to attend?
Your second visit is usually 2 or 3 weeks after the first, and following this, visits will be at 3, 4 or 6 week intervals depending on the needs of the individual.

How much does it cost?
Herbal remedies and visits to the herbalist are not covered by most health care plans. The first visit (90 minutes) will cost $185.00 which includes the time I spend afterwards to compile your protocol. Subsequent visits are typically half the time and half the price. The remedies are charged in addition to this and work out to around $30 - $50 per week or around $4 per day - about the price of a cappuccino and a newspaper!

HOW DOES HERBAL MEDICINE WORK?

The modern reductionist model of medicine, where it is thought that the whole can be understood by minutely examining the individual parts in isolation, places the emphasis of therapy on physiological compensation. If the immune system is under performing and frequent colds are occurring then antibiotics are given to compensate for the weakness and help the body fight infection. 

In contrast, holistic medicine places the emphasis on physiological support. The holistic practitioner looks for the reasons why the immune system is under performing and seeks to support the whole body is attaining optimum metabolic function so that all bodily processes and activities are improved. In extreme circumstances antibiotics, or herbal anti-microbials might be used, but they would be simply creating an opportunity or a space for the deeper healing to occur and would never be considered an end unto themselves. Ultimately the herbalist is attempting to teach the body how to function in harmony, balance and optimum health and to reduce or eliminate the need for any therapeutic support, whether herbal or drug. This approach harks back to the ancient Latin roots of the word ‘doctor’ which also meant ‘teacher’.

It was Hippocrates, 2500 years ago, who first stated that "It is more important to know what kind of person has a disease than to know what kind of disease a person has". This profound statement neatly sums up one of the abiding tenets of holistic medicine and is as applicable today, when the science of pathology is so well developed, as it was in the simpler times in which Hippocrates lived and worked. The individual patient is the single most important factor in determining the success or failure of a treatment and attention to the individual within the context of their whole life style and environment is one of the hallmarks of a good healer. 

For the herbalist, then, knowing the patient comes first and foremost. The skilled herbalist does not work with stock formulas, the same for each patient with a certain named condition, but will customize and personalize for specific individuals at specific times. Although the more interventionist approach is occasionally necessary, the herbalists real strength comes in knowing the strengthening, balancing and harmonizing herbs, for these are the herbs which will bring about real and lasting change in a persons health. 

The practice of herbalism as a clinical skill requires the application of both right and left brains - art and science. For example, while the chemists and pharmacists will speak in terms of tannins as a chemical class and assign astringent or cicatrizing properties to them, the trained and experienced herbalist will know that the tannins of Red raspberry are specific for the female reproductive organs while those of Horse chestnut are specific for the veins and those of Strawberry leaf for the stomach and lower bowel. There is no adequate scientific explanation for this tissue specificity but it is real and effective and can be attested to by many experienced practitioners over many generations

The herbs which bring about this balancing, strengthening and harmonizing are frequently called the adaptogens or the tonics. The adaptogens literally aid the body in adapting to various stressors, whether they may be physical or emotional, and are often referred to as harmonizers in Oriental medicine. The tonics act in a more generalized way, and typically over a longer time period, to reconfigure the inherently intelligent functioning of every cell, tissue and organ. They strengthen, nourish and rejuvenate the whole body, with various herbs and classes of herbs having specificity for various parts of the body. 

The tonics and adaptogens are inherently safe for prolonged use, with a couple of notable exceptions described below. If you are feeling run down, tired or lacking in that vital spark that makes life worth living then using tonics is a good idea for you. Tonics can also be used when you are convalescing from some more serious illness or are for any reason feeling debilitated, weak or depressed. 

The following is a list of my personal favorite tonic and adaptogenic herbs. There are, of course, many others which I could have included but these are ones that have stood the test of time and should always be included in your personal dispensary of herbal remedies. 

Tonics and adaptogens

Slippery Elm (Ulmus fulvus)

This tall and graceful tree, whose natural habitat in the eastern USA, is being steadily eroded by aggressive forestry practices, and is now succumbing to the depradations of a viral disease much like that which killed off millions of American elms many years ago. The Slippery elm has long been known for the medicinal properties of its inner bark. It is stripped off in long pieces from the branches and dried and powdered for sale. This powder is very rich in mucilage (a complex sugar molecule). When it is mixed with water it swells up and forms a thick, goopy gruel that coats and soothes the stomach lining, reducing irritation or burning. It has a similar action along the length of the digestive tract and also absorbs excess fluid in the gut so reducing diarrhoea. Additionally, it is rich in essential oils which are relaxing and anti-spasmodic to the whole length of the digestive tract. The powder is also rich in nutrients, providing a useful convalescent or baby food.

Slippery elm is used wherever there is indigestion with excess acidity, burning or cramping of the upper digestive system as well as in cases of nausea or diarrhoea and in inflammations of the large intestines. It is specific for stomach and duodenal ulcers, hyperacidity and gastritis, ulcerative colitis, Crohn’s disease, diverticulosis and diverticulitis. 

By a reflex action in the nervous system, Slippery elm is also soothing and relaxing in the respiratory system and thins the mucous so that it can be more easily expectorated. 

The freshly powdered herb is best taken one teaspoon two - four times a day stirred into a glass of warm water and drunk quickly before it starts to thicken and gel. It can also be mixed into herbal tea blends.

Hawthorn (Crataegus oxycanthoides)

This thorny, shrubby tree is traditionally used in England to form an impenetrable hedge and has been used in fertility rituals and harvest festivities for thousands of years. It is another member of the Rose family but with some very specific and particular attributes. The flower buds and leaf buds are harvested in the early spring then the berries are gathered in the fall. These all contain very simple molecules called anthocyanidins, related to the Tannins, which exert an astringent and tonic action upon the vasculature (arteries and veins) so aiding in the regulation of blood pressure and in improving the integrity of the vessel walls in cases of varicose veins, spider veins, easy bruising or hemorrhoids. 

This herb has gained particular prominence as a tonic for the heart. It serves to regulate the rhythm of the heart while increasing the force of the contractions, without increasing the need for more oxygen to generate this extra energy. Thus it is prescribed especially for tired, weak, failing hearts, arrhythmias and angina. 

Hawthorn works in such a gentle, tonic manner that it is completely safe to use even with other heart medications, and will not interfere with heart drugs such as digitalis or beta blockers. The flower and leaf buds can be added to herbal infusion blends but the berries should be decocted (simmered). It can also be made into a tincture preserved with 25% alcohol. 

Horsetail (Equisetum arvense)

This common herb is unusual because it has survived since the time of the dinosaurs. 250 million years ago giant Horsetails, the size of trees, grew in many parts of the world and when the fell they provided much of the carbon that now makes up coal and oil and diamonds. Their descendants now reach only 1 - 5 foot but it is still an immensely tenacious weed - any gardener battling with it begins to understand why it might have survived so long. The reproductive parts appear above ground early in the spring, pale spears breaking the surface of boggy or marshy areas, and they are followed later by the vegetation. It is the feathery green stalks that are harvested when young and tender to make a medicine that is excellent for all manner of conditions.

The fresh Horsetail is rich in silica which acts in the body as a tonic to all the connective tissues. These are packing and connecting tissues such as muscle, bone, cartilage, ligaments and tendons as well as skin and subcutaneous layers. 

It has traditionally been used internally as a skin, hair and nail strengthener, as a rebuilding tonic for gout, arthritis, tendinitis, ruptured ligaments, torn muscles, broken bones 

In the kidneys Horsetail has an interesting almost paradoxical effect. The fresh herb is a powerful diuretic at the same time as being quite strongly astringent and tonifying to the membranes of the nephron (the functional unit of the kidney). Is has a long history of use as a tonic and healing agent for the kidneys, especially where there is blood or protein leaking into the urine. Additionally Horsetail has been shown to have antibiotic properties especially against staphylococcus and streptococcus infections. 

Although often traded in a dried form, this herb is probably best in the fresh form to prevent to silica oxidizing and becoming less biologically available. You can readily harvest your own from a clean source and make tincture using vodka.

Plantain (Plantago lanceolata)

This is one of the lowliest wayside weeds and one of the most useful. Colloquially known as "White Man’s Footsteps" because it has followed all European colonizers to all corners of the globe and adapted to almost every climate. It has a basal rosette of leaves that can be as small 3 inches or as long as 24 inches under ideal circumstances. The flower is borne on a single, central stalk, pale and insignificant, pollinated by the wind. 

The leaf is the part used and it must be harvested with care because it is rich in enzymes which will bruise the leaf if it is damaged at all. 

Plantain contains numerous therapeutic agents. vitamin A, vitamin C and zinc speed up skin and tissue healing, aided by mucilage which is soothing and tannins which are astringing and reduce bleeding and act as antimicrobials. This makes Plantain ideal as a topical treatment for cuts, scrapes and wounds. The mucilage also helps to draw foreign objects to the surface and can be applied to dirty cuts to draw out particles. The easiest way to use the herb for these purposes is to mash up the fresh leaves and bind the resultant paste onto the affected part. Plantain is available fresh year round in temperate climates. If it is not available then the dried can be used. Liquid extracts made from the fresh plant are also effective. 

The mucilage also helps to loosen thick or sticky mucous in the lungs, this expectorant effect being useful in cases of chronic bronchitis, pleurisy or coughing of blood. The vitamin A & C, zinc and silica act as strengthening and tonic agents to the connective tissue of the lungs making it an effective treatment in emphysema, fibrosing alveolitis or tuberculosis.

The seeds of Indian Plantain (Plantago ovata) are better known as Psyllium. This is sued in much the same way as Slippery elm is used to coat the stomach lining with a thick protective coat. The ability of Psyllium to absorb water is extraordinary and as it progresses down the digestive, if you drink a couple more glasses f water after taking it then the powder will swell up to form a bulky, soft, slippery mass that facilitates easy bowel movements and effectively treats constipation. Conversely, if Psyllium is taken without the glasses of water to follow then it will absorb any excess fluid in the digestive tract and reduce diarrhoea.

Chaste berry (Vitex agnus castus)

This pretty purple flowering shrub is indigenous to the Mediterranean area and has a long tradition of use. In olden times it was also known as Monk’s Pepper and was given in copious quantities to reduce libido and sexual function in monks and nuns. It is the berry which is used and it does both resemble a peppercorn and have a peppery, pungent taste.

In more moderate doses the volatile or essential oil in Vitex regulates the pituitary gland in the brain. This gland is sometimes called the Master gland because it produces so many hormones and directs them into the various other glands where they in turn produce other hormones. Specifically, Vitex is given to increase the amount and efficacy of Luteinizing Hormone which promotes ovarian function and the production of Oestrogen and Progesterone. Thus Vitex supports hormone production and helps to correct imbalances. 

Vitex has traditionally been used to restore regularity and rhythm to the menstrual cycle and to treat symptoms of PMS, menopause, infertility due to hormone disruption and other female conditions. 

Additionally Vitex may be beneficial where there is weakness or dysfunction of other glands served by the pituitary such as thyroid and adrenal.

Because so much of the medicinal value of this plant is carried in the volatile oil, it is best extracted into alcohol at about 45%. It may also be decocted, the patency being improved by crushing the berries first. It may also be put in a pepper grinder and freshly ground onto food to taste.

Sarsaparilla (Smilax ornata)

This is a thorny vine, native to central America and Ecuador. The root and rhizome (underground stem) are the harvested for medicine. Sarsaparilla has long been used as a flavoring agent in soft drinks, especially root beer. 

The major active constituents are as a group of steroidal and saponin glycosides. These chemicals bear as a structural similarity to cholesterol and the molecular skeleton can be used by the body to support the production and activity of cortisol and testosterone. Thus Sarsaparilla has as a folklore reputation as as a remedy for arthritis and rheumatism and other inflammatory joint conditions as well as being widely used as a somewhat anabolic male tonic. It is particularly used where there is reduced testosterone as evidenced by blood work and may of use in treating infertility as well as sexual weakness or dysfunction. 

Additionally Sarsaparilla is an excellent blood cleanser, finding use in treating excema, psoriasis, acne, especially in young men, and other skin afflictions. There is also some antimicrobial activity and it has as a long history of use to treat syphilis. The tea is moderately effective but the tincture is as a better way to extract the active constituents. 

Oats (Avena sativa)

This grass is extensively cultivated in northern climates to provide a nutritious grain, rich in protein, soluble fibre, vitamins and minerals. The Latin name comes from avidus meaning sought after and sativum meaning grown as a crop. When eaten as a food the grain provides a range of B vitamins, vitamin E, silica, calcium, magnesium, boron and other essential trace elements. Part cooking then rolling the grain to produce oat flakes contributes to a rapid breakdown of the vitamins, denaturing of the protein structures and loss of anti-oxident properties. Oats as a food are best taken in the form of scotch oats or oat groats which is the chopped whole grain, uncooked. It is soaked overnight and simmered for 10 minutes before eating. 

The green stalks and leaves along with the immature grain are also used as a medicine, taken in the form of tea, tablet or tincture. It is considered one of the best remedies for ‘feeding’ the nervous system, especially whne under stress. It is a specific remedy for nervous debility, exhaustuion or depression and as a convalscent aid. Oats may be of value where there is any damage to the tissue of the brain such as after a blow to the head, a seizure or a stroke. It has proven to be of value when treating epilepsy, anxiety, insomnia, hyperactivity and chronic fatigue syndrome. 

Fine oatmeal in a muslin bag hung over the hot tap of a bath will soften the skin and makes an excellent remedy for dry or irritated skin. 

CHOOSING AND USING MEDICINAL HERBS

Using herbal remedies to treat your friends and families is a wonderful way to bring the magic of herbs into your own home. If you have access to a kettle , a teapot and a saucepan then you can make medicinal teas. Tinctures are readily available in health food and herbal stores across the country, or you can make your own using vodka. 

Herbal medicine has traditionally been ‘of the people, for the people, by the people’ , inherently democratic and available to all. This is one of its greatest strengths and the deeply rooted folkloric nature of herbalism has protected millennia of empirical knowledge from the ravages of the modern reductionist scientific paradigm. The modern clinical herbalist in the 21 st century integrates folklore and tradition with modern science, so creating an entirely new paradigm called holistic medicine. 

Most herbs are safe most of the time. Some certainly have a potential for toxicity though, and it is always advisable to seek the advice of a qualified herbalist when you first start out using herbs. Just as your ancestors consulted with the wise woman, healer or shaman for serious conditions, so you can use the services of a qualified herbalist when necessary or appropriate. 

At all times when treating yourself, it is essential that you have an accurate diagnosis. Misdiagnosis can be a dangerous thing e.g. an occasional headache may be due to stress or fatigue but persistent headaches may be from more serious conditions such as glaucoma, impaired circulation, hypertension or neoplasms (cancers). The general rule is that if you have a condition for which you might normally take an over the counter medication and would not bother the doctor, then you can probably treat it at home with herbs. Any persistent or severe symptoms require professional help.

There may be some risks in combining herbal remedies with certain prescription drugs and generally any patient taking prescription medication should consult with a qualified herbalist before taking herbs and should never cease taking the drugs without discussing the situation with the prescribing physician. 

Some conditions you can safely treat at home with herbs

• Colds and flu

• Sore throats

• Mouth ulcers

• Indigestion

• Constipation

• Bladder infections

• Yeast infections

• Scratches and scrapes

• Boils and pimples

• Minor skin infections

• Tension headaches

• Insomnia

• Anxiety

• Fatigue

• Menstrual cramps

• Muscle aching and joint stiffness

Some conditions which require professional assistance

• Severe persistent headache

• Severe pain in the limbs (joints or muscles)

• Severe pain in the abdomen or chest

• Blood in the stool

• Blood in the urine

• Shortness of breath without exertion

• Fainting

• Coughing of blood

• Excessive bruising

• Persistent weakness

• Persistent diarrhoea

• Difficulty swallowing

• Persistent cough

SELECTION CRITERIA - HOW TO CHOOSE YOUR HERBS

Medicinal herbs may be classified in several different ways according to need. They may be listed by

alphabet - anemone, birch, chamomile etc

botanical family - rosaceae, lamiaceae, apiaceae etc

plant parts - roots, leaves etc

therapeutic effect- astringent, tonic, sedative etc

constituents - tannins, alkaloids, mucilage etc

distribution - European, Asian, north American etc

When choosing herbs for medicine it is the therapeutic effect and the constituents which are of especial significance.

Energy based

There are numerous energy based systems of assessment and therapy, including traditional Chinese medicine, Ayurveda from India, Unani from the middle east, Physiomedical from Europe and earth-centered from the Native Americans. Each of these involves a complex assessment of the constitution and temprement of the person in relationship to their environment and may invoke etheric or intangible forces in healing process. Frequently an attempt is made to balance opposing energies such as hot or cold, light or dark, wet or dry, internal or external, and to create harmony and regularity where disease has disrupted the natural order of things. This way of using herbs requires years of study and practice as well as significant degree of sensitivity of the practitioner to be able to sense the subtle energies of patient and plant. 

Actions based

This is the easiest way for you to begin using herbs. All herbs have biochemical actions and effects in the body. Knowing what these are and understanding the specific pathology of the patient you are dealing with, will enable you to decide which actions and then which individual herbs are best suited to correcting the disease.

Some herbal actions include:

Antibacterial
Several herbs have a direct effect upon pathogenic microbes both topically for skin infections and also internally for lung, gastric or other systemic infection. E.g.. Lomatium (Lomatium dissesctum), Goldenseal (Hydrastis canadensis), Thyme (Thymus vulgaris)

Digestive stimulants
The bitter taste of some herbs initiates a nerve impulse from the taste buds to the brain then down the Vagus nerve to the entire digestive tract. This can stimulate everything from salivation to gastric acid and digestive enzyme production to peristalsis. E.g.. Wormwood (Artemisia absinthium), Centaury (Erythrea centaurea), Gentian (Gentiana lutea)

Circulatory stimulants
These are warming herbs that dilate blood vessels and strengthen the heart. They may direct blood to the head, limbs or through the central organs. E.g.. Cayenne (Capsicum minimum), Ginger (Zingiber officinalis), Prickly ash (Zanthoxylum spp.)

Expectorant
These herbs stimulate the cleansing activities of the lungs and aid the removal of thick or sticky mucous. E.g. Licorice (Glycyrrhiza glabra), Elecampane (Inula helenium), Marshmallow (Althea officinalis)

Anti-inflammatory
This group includes a wide variety of herbs and constituents and may be effective in many different parts of the body. E.g. White willow (Salix alba), Devil’s claw (Harpagophytum procumbens), Turmeric (Curcuma longa)

Anti-depressant
These herbs tend to be gentle strengthening agents, nourishing, tonifying and healing. They may be chosen for their invigorating or their sedative properties according to need. E.g.. St. John’s Wort (Hypericum peforatum), Vervain (Verbena officinalis), Lemon balm (Melissa officinalis)

Analgesic / anodyne
For mild to moderate pain herbs may offer a useful alternative to the harmful non-steroidal anti-inflammatory drugs . E.g. Jamaican dogwood (Piscidia erythrina), Wild lettuce (Lactuca virosa), California poppy (Eschscholzia californica)

Sedative nervine
Calming, soothing and relaxing herbs for anxiety, stress and sleep disturbance. E.g.. Passionflower (Passiflora incarnata), Skullcap (Scutalleria lateriflora), Chamomile (Chamomilla recutita)

Energy booster
Strengthening and tonic herbs that support the adrenal glands, thyroid and nervous tissue. They generally should not contain caffeine or other aggressive stimulants. E.g.. Siberian ginseng (Eleutherococcus senticosus), Gotu kola (Centella asiatica), Kelp (Fucus vesiculosis)

Immune stimulating 
Used to build immune strength and resistance to disease. E.g.. Echinacea (Echinacea spp), Wild indigo (Baptisia tinctoria), Usnea lichen (Usnea spp.)

Antispasmodic
For relaxing smooth and skeletal muscle and easing cramps, muscular tension and spasmodic conditions. E.g.. Cramp bark (Viburnum opulus), Lobelia (Lobelia inflata), Black cohosh (Cimicifuga racemosa)

Uterine tonic
Strengthening and tonifying to the uterine muscle and lining, useful in restoring normal menses. E.g.. Partridge berry (Mitchella repens), Yarrow (Achillea millefolium), Ladies mantle (Alchemilla vulgaris)

Diuretic
Gentle but effective remedies that will not cause potassium depletion or stress the kidneys. E.g. Dandelion leaf (Taraxacum off. folia), Celery (Apium graveolens), Corn silk (Zea mais)
 
BUILDING YOUR FORMULA

Remember that it usually more effective to give more quantity of a single herb than small amounts of many different things. Five or six herbs in significant quantities (which vary with each herb) is usually the most effective number - it gives you room for all the herbal actions you need and yet doesn't confuse the body with to many chemical combinations all at once.

You should start by listing all the herbal action that you think you need to use for this particular condition. Always try to seek the cause of the problem and don’t just treat the symptom. That doesn’t mean you should never treat symptoms, of course this can be a useful thing to do to give some relief while you take the time to try and understand the condition and its underlying or root causes. 

An example of formula building

A friend seek your advise for chronic mild asthma manifesting as frequent episodes of mild to moderate chest tightness, wheezing and shortness of breath. There is a frequent cough with thick sticky mucous which is hard to move. The symptoms are aggravated by contact with dairy products, animals and feathers. The patient is pale, weak, cold and lethargic. 

You might choose to utilize the following herbal actions:

antispasmodic

soothing 

immune boosting 

warming 

stimulating

Now list out all the herbs you know that have these actions. Any herb which appears in more than one category is a very likely candidate. Additionally within each category there will be some herbs with greater tissue specificity for the lungs and these are, of course, to be preferred over those with tissue specificity for other parts of the body. If possible you should also include the energetic properties of the herbs and the patient ion your choices. For example, in this case, you might choose Echinacea as the immune stimulant because it is warming as compared to Usnea which is cooling. 

A sample formula for asthma

Lobelia 5% A warming, stimulating antispasmodic, specific to lung tissue

Marshmallow 20% Soothing and relaxing 

Echinacea 20% Warming immune booster to reduce the allergic reactions that trigger the asthma

Ginger 10% A warming circulatory stimulant

Licorice 20% A warming, energizing and stimulating herb which supports the immune system and aids the removal of mucous from the lungs

Nettle 15% A nutritive and restorative herb that reduces response to inhalant or ingested allergens

Cramp bark 10% An antispasmodic that combines especially well with Lobelia to relax the lungs

The traditional and time - honored approach suggests that a formula should have within it:

* 2 or 3 parts specifically active against the particular components of the condition.

* 1 part soothing and relaxing to the affected area or to the nerves in general.

* 1 part nourishing & strengthening or tonic to the affected area or to the body in general.

* 1 part eliminative/alterative/depurative.

The proportions can also be adjusted to give additional potency to certain herbs, or an action may be enhanced by several herbs working in synergy. Additionally each herb may have several different activities and effects. In this way the formula can be layered and overlapped so as to give almost infinate adaptability. This enables the clinical herbalist to prescribe a very personalized formula, specific to an individual and their particular set of health concerns. 

HOW MUCH TO TAKE

When determining the dose of herbal formulas there are several criteria which must be taken into account. 

First and foremost is the question of the medicines themselves - exactly how powerful and potent are the herbs and is there any question of possible toxicity? The severity of the condition must also be considered. Generally, the worse or more acute the condition, the more medicine you will need to give, gradually tapering off as the condition abates.

The height, weight and overall body size is significant - you wouldn’t give the same dose to a frail, little 80 year old woman as you would to a 250 lb weight lifter. Also consider the absorption and elimination processes. If there is significant constipation or digestive sluggishness then lower doses might be required because the herb would remain in the system longer. Conversely, in cases of chronic diarrhoea a larger dose might be necessary. If a fever is present or if the general metabolic rate is high then higher doses might be required. 

The constitution of the patient should also be considered. The tongue, pulse, skin tone & color should be assessed as well as their personal and family health history. 

If you use teas then up to 1 oz (30 g) of herbal blend per day is a reasonable amount. If you use tinctures at a strength of 1:3 to 1:5 then up to 1 tsp. (5 mLs) three times a day is usual.