A Clinical Materia Medica - verlag-systemische-medizin.de · Introduction XV Why I wrote this book THE TOPIC Since I started combining Western herbs and Chinese med-icine twenty years

COMBINING WESTERN HERBS AND

CHINESE MEDICINE

Jeremy Ross

A Clinical Materia Medica

– 120 Herbs in Western Use –

Foreword by Dr. Andreas Höll

Illustrations by Inken Toepffer

Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH,

Bad Kötzting / Bayer. Wald, Germany

Copyright © 2012 Verlag Systemische Medizin AG

Jeremy Ross, A Clinical Materia Medica

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ISBN 978-3-927344-92-1

© 2010 Jeremy Ross, Greenfields Press. www.jeremyross.com and

Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH, D-93444 Bad Kötzting/Bayer. Wald

© Illustrations

2010 Jeremy Ross, Greenfields Press. www.jeremyross.com and

Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH, D-93444 Bad Kötzting/Bayer. Wald and

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Caution

All persons involved in the preparation and publication of this book have, as far as it is possible, taken care to ensure that

the information given in this text is accurate and up-to-date. However, medical knowledge is constantly changing, and

readers are strongly advised to consult all the available data to confirm that the information given in this text complies

with the latest legislation and standards of practice, especially with regard to drug usage. Internet medical research

resources such as PubMed can be used to help update some of the information in the text.

The author and the publisher welcome notifications from readers on the need to change information in this book and can

be contacted via the address of the publisher. Relevant alterations to the text will be included in the next edition of this

book, and in the meantime will be cited in the author’s website (www.jeremyross.com) and the publisher’s website

(www.vgm-portal.de) under the heading of Text updates.

Before using any of the herbs listed in this book, practitioners should study the data on dose and contraindications given

in the relevant chapters on those herbs. In addition, practitioners are strongly advised to read the chapters on Principles

of herb combination, Practical herb combination, Dose, and Safety in Combining Western Herbs and Chinese Medicine:

Principles, Practice, and Materia Medica by Jeremy Ross. Where the author is aware of differing opinions, for example, on

dosage and contraindications, references for these different opinions have been given. Practitioners should consult these

references and weigh the available evidence themselves to come to their own conclusions before using this information to

treat a patient.

The information given for treatment in this book is meant as a guide only. It is the responsibility of the practitioner to

decide whether a herb or herb combination is appropriate for a specific patient at a particular time. It should also be

pointed out that herbal therapy is not proposed as an alternative to conventional medical diagnosis and treatment when

this is necessary for the patient.



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Foreword _______________________________XI

Sources _______________________________ XIII

Introduction XV

Why I wrote this book ___________________ XV

Where to find things in this book __________ XV

How to use the herb chapters ____________ XVI

Principles and practice of herb combination XVIII

Dose and dispensing ____________________ XIX

Safety _________________________________ XX

Materia Medica

Achillea millefolium ______________________ 2

Acorus calamus ___________________________ 4

Aesculus hippocastanum ___________________ 6

Agrimonia eupatoria _______________________ 8

Agropyron repens ________________________ 10

Aloe vera _______________________________ 12

Althea officinalis _________________________ 14

Anemone pulsatilla _______________________ 16

Angelica archangelica _____________________ 18

Apium graveolens ________________________22

Arctium lappa ___________________________24

Arctostaphylos uva-ursi ___________________26

Arnica montana _________________________28

Artemisia absinthium _____________________30

Asclepias tuberosa ________________________34

Astragalus membranaceus ________________36

Avena sativa ____________________________38

Ballota nigra ____________________________40

Berberis vulgaris _________________________42

Calendula officinalis ______________________46

Capsella bursa-pastoris ____________________48

Capsicum species ________________________50

Chamaelirium luteum ____________________54

Chamomilla recutita ______________________56

Chelidonium majus _______________________58

Cimicifuga racemosa _____________________60

Table of Contents




Cinchona species _________________________64

Cinnamomum cassia _____________________66

Citrus aurantium _________________________68

Commiphora molmol _____________________ 70

Convallaria majalis _______________________72

Crataegus species ________________________ 74

Curcuma longa __________________________ 78

Echinacea species ________________________80

Elettaria cardamomum ____________________84

Ephedra sinica ___________________________86

Equisetum arvense _______________________90

Eucalyptus globulus ______________________ 92

Euphorbia hirta __________________________94

Euphrasia officinalis ______________________96

Filipendula ulmaria _______________________98

Foeniculum vulgare _____________________100

Fucus vesiculosus _______________________ 102

Galium aparine _________________________104

Gentiana lutea __________________________106

Glechoma hederacea _____________________ 108

Glycyrrhiza glabra _______________________ 110

Grindelia species ________________________ 114

Hamamelis virginiana ___________________ 116

Harpagophytum ________________________ 118

Hedera helix ____________________________120

Humulus lupulus ________________________122

Hydrangea arborescens __________________124

Hydrastis canadensis ____________________126

Hypericum perforatum __________________128

Hyssopus officinalis _____________________ 132

Iris versicolor ___________________________134

Isatis indigotica _________________________136

Juglans species __________________________138

Juniperus communis _____________________ 140

Lavandula angustifolia ___________________ 144

Leonurus cardiaca _______________________ 146

Lobelia inflata __________________________150

Lycium chinensis ________________________154

Marrubium vulgare ______________________156

Melissa officinalis _______________________158

Mentha piperita _________________________ 160

Mentha pulegium _______________________ 162

Myrica cerifera _________________________ 164

Nepeta cataria __________________________ 168

Ophiopogon japonicus ___________________ 170

Panax ginseng __________________________ 172

Passiflora incarnata ______________________ 176

Petroselinum crispum ___________________ 178

Phytolacca Americana ___________________ 180

Pimpinella anisum ______________________ 182

Piscidia erythrina _______________________ 184

Plantago major __________________________ 186

Polygala senega _________________________ 188

Polygonum bistorta ______________________190




Populus tremuloides _____________________ 192

Potentilla erecta _________________________194

Prunus serotina _________________________ 198

Quercus robur __________________________200

Rhamnus purshiana _____________________202

Rheum palmatum _______________________204

Rosmarinus officinalis ___________________208

Rubus idaeus ___________________________ 210

Rumex crispus __________________________ 212

Ruta graveolens _________________________ 214

Salvia officinalis _________________________ 216

Sambucus nigra _________________________220

Sanguinaria canadensis __________________222

Sanguisorba officinalis ___________________226

Sarothamnus scoparius __________________228

Schisandra chinensis ____________________230

Scrofularia nodosa ______________________232

Scutellaria species _______________________234

Serenoa serrulata ________________________238

Silybum marianum ______________________240

Smilax species __________________________242

Solidago virgaurea _______________________244

Stellaria media __________________________246

Syzygium aromaticum ___________________248

Tanecetum parthenium __________________250

Taraxacum officinale ____________________ 252

Thuja occidentalis _______________________256

Thymus vulgaris ________________________260

Tilia species ____________________________262

Trigonella foenum- ______________________264

Turnera diffusa _________________________266

Urtica dioica ___________________________268

Valeriana officinalis _____________________ 270

Verbena officinalis _______________________ 274

Viburnum prunifolium ___________________ 276

Viola tricolor ___________________________ 278

Vitex agnus-castus ______________________280

Zanthoxylum species ____________________282

Zea mays ______________________________284

Zingiber officinale _______________________286

Comparison of herb action groups

… six Blood tonic herbs ___________________20

… six bitter herbs ________________________ 32

… seven circulatory stimulants _____________ 52

… five cardioregulatory herbs ______________ 76

… seven antimicrobial herbs and antibiotics __ 82

… five antiasthmatic herbs _________________88

… seven antidepressant herbs _____________130

… four diuretic herbs ____________________ 141

… five uteroregulatory herbs ______________ 148

… four anticatarrhal herbs ________________ 166

… ten sweet tonics_______________________ 175

… seven astringent herbs _________________196




… laxative and purgative herbs ____________206

… four aromatic herbs ___________________ 218

… six herbs with isoquinoline alkaloids _____224

… four nervine herbs ____________________236

… alterative herbs _______________________254

… five bitter calming herbs _______________272

Appendices

References ____________________________ 291

Glossary _____________________________333

Chinese Organs and Syndromes:

Terminology __________________________ 337

Herbs for Chinese Syndromes __________339

Herb Properties ______________________365

Herb Names ___________________________369

Cross References

English – botanical name _____________ 375

Botanical name– family ______________ 379

Family – botanical name ______________383

Pharmaceutical name – English ________385

Botanical name – Mandarin __________389

Mandarin – botanical name ___________ 393

Western Indications – Herb (pairs) ______397

Herb (pairs) – Western Indications ______ 417




Introduction XV

Why I wrote this book

THE TOPIC

Since I started combining Western herbs and Chinese med-

icine twenty years ago, there has been a great increase in

interest in this topic in many countries.

A BASIC TEXT

My first book on this topic was Combining Western Herbs

and Chinese Medicine: Principles, Practice, and Materia

Medica. This 970-page book was written to provide the ba-

sic theory and practical techniques, and to give detail on 50

herbs and 150 herb combinations.

TEXTS ON SPECIFIC TOPICS

While teaching many courses on ‘Combining’ after the

book was written, students and practitioners have request-

ed books on specific aspects of this topic. As a consequence,

a series of books on Combining Western herbs and Chinese

medicine is now planned.

A CLINICAL MATERIA MEDICA

From discussion, the most urgent need of the majority of

course participants was for more herbs, and for a flash card-

style presentation of the key data for each herb.

This book, A Clinical Materia Medica – 120 Herbs in West-

ern Use, was written in answer to their requests.

KEY DATA TABLES

Each herb in this book has a specially designed key data ta-

ble, equivalent to a flash card, clearly showing the Chinese

actions, Western actions, Western uses, and examples of

herb pairs for that herb.

COMBINING THREE TRADITIONS

What has become increasingly clear during my work with

this topic over the years is that the range of use of a herb

can be greatly expanded by combining information from

the three traditions: Chinese medicine, Western herbal tra-

dition, and modern pharmacological and clinical research.

For some herbs, this opens up a remarkable panorama of

potential future uses. Crataegus is an excellent example of

this.

EVIDENCE FOR STATEMENTS MADE

In books on Western herbal medicine written over the last

fifty years, authors often simply made statements or claims

about herbs without giving supporting references from

eith er traditional texts or modern research. As a result, the

reader did not know whether a statement made by the author

was anything other than their unsubstantiated opinion.

In more recent books, such as the ESCOP monographs, the

British Herbal Compendia, or the works of Mills and Bone,

references are given for statements made. In modern books

on Western herbs, citing references is essential if the work

is to be regarded as a serious medical rather than a popular

text.

TRADITIONAL AND RESEARCH DATA

Each herb in this book has one section on Traditional use

and another section on Constituents and pharmacology.

In these sections, a selection of material from traditional

texts and from modern research studies is presented with

references. Approximately 1,200 references are cited in this

book.

LIST OF HERBS FOR CHINESE SYNDROMES

Many practitioners have requested a list of herbs for Chinese

syndromes, with signs and symptoms, pulse and tongue

given for each syndrome.

Such a list with all the main Chinese syndromes plus 125

common combinations of syndromes is given as an appen-

dix in this book.

WESTERN INDICATIONS

This book meets also the needs of those who want to look up

the main Western indications for each single herb and dou-

ble. See appendices “Western Indications and herb pairs”.

Where to find things in this book

COMPANION TEXTS

This book was designed to be a companion text to Combin-

ing Western Herbs and Chinese Medicine: Principles, Prac-

tice, and Materia Medica (PPMM).

It provides a quick reference clinical materia medica for 120

herbs, whilst PPMM provides the theoretical basis, practi-

cal instructions, great detail of 50 herbs, and discussion of

150 herb combinations.

THIS BOOK

Apart from the 120 herb chapters, this book contains the

following information:

Introduction




XVI Introduction

PRINCIPLES OF COMBINATION, DOSE, SAFETY

There is a brief summary of these topics toward the end of

this Introduction. These topics are discussed in much great-

er detail in PPMM.

SOURCES

A number of basic texts are referred to so frequently in this

book, that an abbreviation is used when citing them, often

the names of the authors or editors. These abbreviations are

explained in the beginning of the book in the Sources chap-

ter.

REFERENCES

Approximately 1,200 references are cited in this book. Since

the aim was to keep each herb chapter to two pages, the ref-

erences are listed in the References appendix.

GLOSSARY

A Glossary at the back of this book explains some of the

terms used in the text.

The Actions glossary in PPMM will further help with the

definition of Western herbal action categories and the dis-

cussion of their nearest Chinese equivalents.

CHINESE ORGANS AND SYNDROMES: TERMINOLOGY

This section at the back of this book describes non-standard

Chinese syndromes that I encounter in my practice.

HERBS FOR CHINESE SYNDROMES

One appendix contains all the main Chinese syndromes and

about 125 common syndrome combinations with details of

signs and symptoms, pulse and tongue, and suitable herbs.

HERB PROPERTIES, HERB NAMES, AND CROSS

REFERENCE LISTS

These useful tables provide a cross reference for botanical,

English, pharmaceutical, and Mandarin names, and give

groupings of the herbs into families.

PRINCIPLES, PRACTICE, AND MATERIA MEDICA

The reader is referred to PPMM for background material,

and specifically to the following chapters:

Although there are fewer herb chapters in PPMM, these

herb chapters provide greater detail on:

- herb pairs

- herb combinations

- comparison of herb combinations

- discussion of research data

- toxicology

- dose discussion

- comparison of Western and Chinese use

How to use the herb chapters

Each of the 120 herb chapters in this book is organized

in the following way:

Names and botanical detail

Names, part used, family

Botanical description

Botanical illustration

Use of different types and plant parts (where applicable)

Key herb data

Temperature, tastes, organs

Actions, uses, and herb pairs table

Traditional use

Traditional use in China

Traditional use in the West

Comparison with a similar herb

Comparison with another single herb

Comparison within a herb group

Constituents and pharmacology

Types of constituents

Actions supported by research

Actions linked to a constituent

Dose and dispensing

Dried herb

Liquid extract

Tincture

Initial dose

Duration




Introduction XVII

Cautions

General contraindications

Chinese contraindications

Pregnancy and lactation

Side effects

Overdose

Drug interactions

Names and botanical detail

NAMES, PART USED, FAMILY

The English, botanical, and pharmaceutical names of the

herb are given, together with the parts used, and family

name.

The Mandarin name and Chinese characters are given

where applicable.

BOTANICAL DESCRIPTION AND BOTANICAL

ILLUSTRATION

These are given to help create a mental picture and give a

feel for the herb and to aid in identification.

USE OF DIFFERENT TYPES AND PLANT PARTS

For some of the herbs, specific data on the use of different

species, subspecies, varieties, or plant parts is given in a sep-

arate section. This section, which may also include a brief

description on differences of tradition in different coun-

tries, is found directly underneath the main table.

Key herb data

TEMPERATURE, TASTES, ORGANS

Temperature Some herbs are classified with a range of

potential temperatures, e.g., Achillea is classified as warm-

cool. For discussion of the concept of variable-temperature

herbs, please see the Temperature chapter in PPMM.

Taste properties The aromatic property is included with

the taste properties in this book. For a detailed discussion of

the taste properties, please see the Taste chapter in PPMM.

Organs entered This is equivalent to the concept of merid-

ians entered in other texts. Please see the appendix Chinese

organs and syndromes: terminology in this book for explana-

tion of organ concepts, such as Intestines or Uterus.

ACTIONS, USES, AND HERB PAIRS TABLE

Organization by Chinese actions This table uses the main

Chinese actions for the herb as the coordinating theme to

link Chinese actions, Western actions, and Western uses.

For each of the main Chinese actions, an example of a herb

pair is given to treat a specific disorder.

Flash card or basis for detailed study This table shows

the key data on the specific herb, and it summarizes an

enormous amount of information.

The table can be used like a flash card that assists with learn-

ing the essentials of a herb. Alternatively, each Chinese ac-

tion in the table can be used as a starting point for detailed

study.

Traditional useTRADITIONAL USE IN CHINA

Whenever a herb is also commonly used in China, this sec-

tion gives available herb data, including properties, actions,

and uses.

TRADITIONAL USE IN THE WEST

Material from masters of the past, such as Dioscorides,

Lonicerus, Tabernaemontanus, Gerard, and Culpeper, is in-

cluded where space allows. The material is often condensed

or paraphrased, with antique terminology converted to

modern English. Readers are strongly encouraged to study

these texts, which represent the rich heritage of our West-

ern materia medica.


COMPARISON WITH ANOTHER SINGLE HERB

Sometimes the herb of the chapter is compared with a simi-

lar herb, for example, Angelica archangelica is compared

with Angelica sinensis. The similarities and differences of

the herbs are discussed in terms of properties, actions, and

uses, so that the practitioner can get a clearer idea of when

to use each herb in practice.

COMPARISON WITHIN A HERB GROUP

Sometimes the herb of the chapter is compared with other

herbs in an action group. For example, the end of the An-

gelica chapter has a Comparison of six Blood tonic herbs,

which compares Angelica sinensis with molasses, Lycium,

Gentiana, Rosmarinus, and Salvia.


TYPES OF CONSTITUENTS

The main types of constituents are listed, organized by

chemical type, e.g., essential oils, flavonoids, alkaloids, tan-

nins. The list mainly focuses on the constituents that give

the herb its characteristic actions.

ACTIONS SUPPORTED BY RESEARCH

This section lists the actions that are supported by one or

more research studies, including in vitro, in vivo, human

pharmacological, or clinical studies.

ACTIONS LINKED TO A CONSTITUENT

This section shows which constituents are responsible for

which actions, when there is data available. This section is

sometimes organized by constituent and sometimes by ac-

tion, as appropriate.

Dose and dispensing

DRIED HERB, LIQUID EXTRACT, TINCTURE

Dosage is usually given as three individual doses per day. If

the daily amount was given as a single dose in the source

text, this was usually converted to an amount for three in-

dividual doses.

In this book, the most frequently used source text for dose

levels was the British Herbal Pharmacopoeia of 1983, see

Dose and dispensing at the end of this chapter.

INITIAL DOSE, DURATION

These sections indicate whether there is a restriction on the in-

itial dose or on the length of time that the herb can be taken.




XVIII Introduction

CautionsIt is absolutely essential that practitioners read this section

before using any herb in this book.

GENERAL CONTRAINDICATIONS

This section lists known contraindications or cautions from

Western tradition or modern research.

Where space permits, contraindications based on adverse

reaction reports are differentiated from theoretical con-

cerns based on the presence of a potentially toxic constitu-

ent. This differentiation is discussed in detail in PPMM.

CHINESE CONTRAINDICATIONS

This section lists traditional contraindications from texts

on Chinese medicine. It may also list contraindications that

are not given in these texts, but that have occurred clinically

due the nature of the herb’s actions. For example, Rosmari-

nus may aggravate Heart Spirit Disturbance in susceptible

persons due to its stimulant action.

PREGNANCY AND LACTATION

This section gives data on safety concerns during pregnancy

and lactation. Please see The Essential Guide to Herbal Safe-

ty by Mills and Bone for more detail.

SIDE EFFECTS, OVERDOSE

These sections include data on adverse reactions within and

above the therapeutic dose range, respectively.

DRUG INTERACTIONS

This section gives data on adverse herb-drug reactions,

when available.

Principles and practice of herb

combination

This book is a clinical materia medica, in which there is no

space for a detailed discussion of the principles and practice

of herb combinations. Only a very brief outline is given here

and the reader is referred to PPMM.

ChecklistTo create a balanced, effective, and safe herb combination in

Chinese medicine, it is important to consider the following

principles. These principles apply whether the herbs used

are Chinese or Western.

ACCURATE DIFFERENTIAL DIAGNOSIS

The foundation for creating an effective

herb combination is accurate diagnosis.

In herbal treatment, accurate diagnosis is important. With-

out it, the consequences to the patient may be unpleasant

or even dangerous. The practitioner needs to determine

the Chinese syndromes underlying the patient’s signs and

symptoms in order to choose appropriate herbs to treat

these syndromes. This can be summarized by the phrase:

Wrong diagnosis means wrong herbs!

PRIORITIZATION OF CHINESE SYNDROMES

The next step consists of prioritizing the patient’s Chinese

syndromes into those of primary and those of secondary

importance.

How to decide The decision as to which syndromes are

primary and which are secondary is made partly according

to which disorders are most important to the patient, and

partly according to medical principles, such as the optimum

sequence for treating ‘root’ and ‘branch’ in the given case.

Importance of prioritization Primary syndromes re-

quire more herbs in the combination than do secondary

syndromes. If the practitioner gets the syndromes right, but

the prioritization of the syndromes wrong, the patient may

get worse not better. See An example with mistakes in the

Practical herb combination chapter in PPMM.

BALANCING TEMPERATURE

In the traditions of Western and Chinese herbal medicine,

both patient and herbs were classified in terms of temper-

ature (hot, warm, neutral, cool, or cold). Herbs were then

matched to patients on the basis of this classification.

For example, a cool pathology would generally be treated

with a herb combination that was warm in its overall tem-

perature balance. To treat a cool pathology with a hot com-

bination would be seen as a potentially damaging overcor-

rection.

Incorrect temperature balance is one of the most common

mistakes in herb combination.

BALANCING TASTE PROPERTIES

Taste balance is a relatively sophisticated level of herb com-

bination, but the practitioners should at least be aware of

the contraindications for the different taste properties.

Each taste property has its specific range of uses and its

specific disadvantages. Tastes can be combined so that one

taste can enhance the beneficial effects of another or moder-

ate its potential adverse effects.

Tables showing taste contraindications and how to balance

the tastes are included in the Taste chapter in PPMM.

BALANCING HERB ACTIONS

It is important to balance the actions of the individual herbs

in a herb combination.

For example, a purgative like Rheum is commonly given

with a carminative like Foeniculum to reduce the potential

purgative side effect of intestinal colic.

As another example, an alterative like Taraxacum is often

combined with a detoxicant and anti-inflammatory like

Glycyrrhiza to reduce the potential alterative side effect of

aggravating skin and arthritic conditions.

A table showing how to balance herb actions is included in

the Actions chapter of PPMM.




Introduction XIX

CHECKING FOR POTENTIAL CONTRAINDICATIONS

It is essential that the practitioner check for each herb in the

proposed combination whether it can cause side effects in a

specific patient.

Some obvious examples of questions are:

stimulant herbs should be avoided?

loose stools, so that cooling, bitter, downward draining

herbs should be avoided?

herbs are contraindicated?

-

tions to any of the herbs?

or a specific herb, so that only low doses should be used?

so that treatment with alterative herbs may cause an ag-

gravation of symptoms?

herbs may interact?

Four different approaches to herb

combinationThree of these approaches involve using a preexisting com-

bination, and the fourth involves creating a new combina-

tion by using the basic principles of herb combination.

USING A PREEXISTING COMBINATION

There are three main possibilities:

-

tions

Note for beginners Creating a new combination by com-

bining elements of different preexisting combinations is an

advanced technique. If the technique is used by those who

are inexperienced in herbal medicine, it can easily result

in an assortment of ill-matched fragments rather than in a

carefully balanced and harmonious combination.

It is recommended that beginners first become thoroughly

familiar with the properties of the individual herbs and with

the principles of herb combination. They can then develop

their skills by using preexisting combinations, with simple

modifications where appropriate, and by learning to create

simple new combinations from first principles.

CREATING A NEW COMBINATION

When creating a new combination that matches the specific

Chinese syndromes and life situation of the patient, it is

necessary to work through the stages in the checklist above.

See examples in PPMM.

Dose and dispensing

Dose levels

THERAPEUTIC DOSE RANGE

Each herb has a therapeutic dose range, within which a suit-

able dose for most adults will be found.

Minimum therapeutic dose This is the smallest dose that

will have a therapeutic result. Below this is the subtherapeu-

tic dose, which is too small to have a therapeutic effect.

Maximum dose In the case of herbs with potential adverse

effects, this is the largest dose that is safe to administer. The

toxic dose is the dose, at and above which adverse reactions

due to toxic effects are likely to occur. In the case of herbs

like Althaea, for which there are no reports of adverse ef-

fects even at overdose levels, the maximum dose can be de-

fined as the largest dose that is generally necessary to obtain

a therapeutic effect.

DIFFERENCES OF OPINION

The statement on dose above sounds clear and definite. The

problem is that there are often differences of opinion as to

what constitutes the minimum and maximum therapeutic

dose for a specific herb.

Common sense dosing The author of this book recommends

using the least dose required to get the desired therapeutic

effect. He takes the middle road between what may be called

the higher dose approach and the lower dose approach. This

topic is discussed in detail in PPMM, where alternative

doses are often given for each herb and where the appropri-

ate use in different situations is described.

BHP AS A BASIS

For dried herbs and for herb tinctures, this book generally

adopts the dose levels of the British Herbal Pharmacopoeia

of 1983.

Recent research on dose In cases where subsequent re-

search has indicated that lower doses should be used for

safety reasons or that higher doses are more clinically ef-

fective, these are the doses that are included in the current

text. For example, the BHP recommended 3-6 ml of a 1:5

tincture of Crataegus per day, whilst The Essential Guide to

Herbal Safety by Mills and Bone recommended 3.5-17.5 ml

per day. The latter amount is recommended in the current

text, and is an example of the higher dose approach.

A GENERAL GUIDE

Very approximately, the dose for the average herb is 1-2 g of

dried herb or 2.5-5 ml of 1:5 tincture, three times per day,

for an adult.

However, some herbs are more potent, and their doses may

be much less. For example, the maximum permitted dose in

the UK of Lobelia inflata is 0.2 g of dried herb or 1 ml of 1:5

tincture, three times per day.

Dose and age

Infants, children, and the elderly are given smaller doses

than people of other age groups, as shown in the table. These

are individual doses to be taken three per day.




XX Introduction

Age Individual dose of 1:5 tincture in ml

Individual dose of 1:5 tincture in drops*

infants 6-12 months

0.05-0.5 ml 1-10 drops

infants 1-2 years

0.1-1 ml 2-20 drops

children 2-5 years

1-2.5 ml 20-50 drops

children 5-10 years

2-3.75 ml 40-75 drops

teens 10-18 years

2-5 ml 40-100 drops

adults 2.5-5 ml 50-100 drops

elderly 2-3.75 ml 40-75 drops

* The figures are based on the assumption of 20 drops per ml

Dose formHerbs can be taken orally as powdered dried herbs to be

taken with water, infusions, decoctions, tinctures, liquid

extracts, or concentrates. Each dose form has its advantages

and disadvantages, summarized in the table below. For a de-

tailed discussion, see the Dose chapter in PPMM.

Safety

Please do not use any of the herbs in this book without first

studying their properties, actions, use, dose, and contrain-

dications.

ChecklistPractitioners can use the following checklist to minimize

adverse reactions due to herb use.

For detailed discussion of safety, see:

Safety, Safety and the organ systems,

and Safety in clinical practice in PPMM

by Mills and Bone

Monitoring

HERBS NEEDING MONITORING

For some of the herbs in this book, it is suggested that the

patient be monitored for side effects during the course of

treatment.

These herbs include: Capsicum, Cinchona, Convallaria,

Ephedra, Lobelia, and Sarothamnus.

Monitoring may also be appropriate for some of the altera-

tive herbs, specifically Arctium seeds and Taraxacum root,

which have the potential for aggravating skin rashes and

arthritis, especially in patients with high levels of accumu-

lated toxins.

MONITORING BY PRACTITIONER AND PATIENT

Practitioner The practitioner should check for signs and

symptoms of any potential side effects that are to be expect-

ed with the specific herbs and the specific patient. Moni-

toring is essential for herbs with the possibility of severe

adverse reactions.

Advantages Disadvantages

Infusions and decoctions

cheapness and accessibility

link to the natural world

ble constituents, such as resins

-tituents

decoctions suitable for water-solu-ble constituents, such as polysac-charides and tannins

treatment of patterns of Cold

treatment of patterns of Dryness

diaphoretic treatments

Tinctures and liquid extracts

tastesoluble constituents, such as polysaccharides and tannins

treatments

Advantages Disadvantages

suitable for ethanol-soluble constituents, such as essential oils, alkaloids, resins, and saponins

treatments

treatment of patterns of Cold and Damp, Deficiency, and Stagnation of herbs in a combination

Powders

constituents

Pills and capsules

possible to match them to the specific needs of the

-tuents




Patient The patient can be asked to keep a record of the

following:

-

tions: noting such details as severity and the time and

date the symptoms occurred

medication, herbs, or food supplements

responsible for the symptoms

Rechallenge If it is appropriate and if the patient agrees,

the herbs can be taken again, at a lower dose and/or in a

different form if preferred, to determine if the symptoms

recur. The patient should be asked to keep in contact with

the practitioner during this process and to stop the herbs

immediately if the adverse effect recurs.

Rechallenge may not be appropriate for herbs with poten-

tially severe adverse effects, even if the dose is greatly re-

duced.

General

1. take a full medical history

2. make an accurate differential diagnosis

3. prioritize Chinese syndromes

4. decide if further specialist diagnosis is required

5. decide if herbal treatment is appropriate

6. allow informed patient choice

Herb combining

7. balance temperature

8. balance taste properties

9. balance herb actions

10. check for potential contraindications

11. choose appropriate dose level, dose form, timing of

dose, and duration of prescription for the patient

After prescribing

12. monitor for adverse reactions, if appropriate

13. manage adverse reactions, if appropriate

14. report adverse reactions, if any

Introduction XXICopyright © 2012 Verlag Systemische Medizin AG



2 Achillea

AchilleaEnglish yarrow

Botanical name Achillea millefolium L., s. l.

Pharmaceutical name Achilleae millefolii herba cum

flore (= Millefolii herba cum flore)

Part herb and flowers

Mandarin yáng shī căo ( ), the aerial parts of A.

millefolium, is not a main herb in Chinese medicine

Family Asteraceae (Compositae)

An aromatic stoloniferous perennial with erect, usually un-

branched stems, 0.2-1 m tall. Leaves are feathery, lanceolate,

and 2-3-pinnate. Flowers are small and white or occasion-

ally pink, borne in dense flat-topped clusters. Native to the

Northern hemisphere, where it grows in grassy habitats, road

verges, and lawns. Achillea prefers well-drained soil.

Temperature warm-cool

Tastes acrid, bitter, aromatic

Organs LU, SP, HT, UT

Please see the chapter on this herb in Principles, Practice

and Materia Medica for herb combinations and for further

information1.

USE OF DIFFERENT TYPES AND PLANT PARTS

A. millefolium is a complex of barely distinguishable species or subspecies,

which have evolved by polyploidy (changes in chromosome number)2. Dif-

ferences in chromosome number between the A. millefolium subspecies

are often accompanied by important chemical differences, which in their

turn, may lead to differences in temperature, actions, and uses1.

Actions, uses, and herb pairs

Chinese actions (Western actions)

Western uses Pair examples (disorders)

I. clear Wind Heat (diaphoretic, antipyretic, alterative)

acute respiratory disorders with feverish-ness dominant to chills

Achillea + Mentha piperita (common cold + sore throat)

II. clear Wind Cold (diaphoretic, antipyretic, alterative)

acute respiratory disorders with chills dominant to feverishness

Achillea + Zingiber (fresh) (influenza + cold sensation)

III. clear Lung Phlegm Heat (diaphoretic, antipyretic, alterative)

acute respiratory disorders with fever, cough, bronchial phlegm

Achillea + Asclepias (pleurisy + fever)

IV. clear Lung Phlegm Cold Damp (anticatarrhal, alterative)

acute respiratory disorders with nasal or bronchial phlegm and cold sensations

Achillea + Angelica archangelica (influenza + sinusitis)

V. clear Retained Pathogen, tonify Defensive Qi (diaphoretic, alterative, tonic)

recurring respiratory infections, with low-grade fever and fatigue

Achillea + Echinacea (recurring respiratory infections)

VI. tonify Spleen Qi and Blood (bitter digestive tonic)

digestive weakness with exhaustion (and anemia), postfebrile convalescence

Achillea + Artemisia absinthium (postfebrile exhaustion)

VII. tonify Spleen Qi and Heart Qi (digestive and cardiac tonic)

(postfebrile) exhaustion with digestive and cardiac weakness

Achillea + Cinchona (some cases of chronic fatigue)

VIII. reduce leakages, reduce bleeding (astringent, anticatarrhal, hemostatic)

nosebleeds, hemoptysis, diarrhea, leukor-rhea, menorrhagia, wounds

Achillea + Urtica (menorrhagia)




Traditional use in the West

DIOSCORIDES 1ST CENTURY AD3

and heal the wound, clear it from heat and inflammation,

and congeal the blood

herb with wool and put in the vagina

LYLE 18974

It stimulates the appetite and tones the digestive organs. It

is important as a tonic to the general system. In cold infu-

sions, it acts as a tonic in convalescence from fevers, from

nervous prostration, and in pulmonary tuberculosis and

night sweats.

CHRISTOPHER 19765

equalizes the circulation, and purifies the blood of morbid

waste material

-

cluding typhoid fever), eruptive diseases (including mea-

-

der discharges

urine, enuresis

BHP 19836

This text gave the specific indication of thrombotic condi-

tions with hypertension, including cerebral and coronary

thromboses.


ACHILLEA AND HYSSOPUS See Hyssopus.

ACHILLEA AND TILIA See Tilia.


TYPES OF CONSTITUENTS2

(0.2-1%) composition of essential oil varies

greatly with chromosome number, for example:

- hexaploid plants have no chamazulene, but mainly

oxygenated monoterpenes, especially linalool (26%) and

camphor (18%), with some borneol and 1,8-cineole

- tetraploid plants contain mainly sesquiterpenes, es-

pecially chamazulene (about 25%) and β-caryophyllene

(11-22%)

achillicin (= 8-acetoxyartab-

sin) is the main prochamazulene

including apigenin, luteolin and their gluco-

sides

mainly achilleine (= betonicine = L-4-hy-

droxy-stachydrine) as well as stachydrine, betaine, and

choline

tannins (3-4%), polyacetylenes, triterpenes, ster-

ols (including beta-sitosterol), coumarins, phenolic acids

(including salicylic and caffeic acids)

ACTIONS SUPPORTED BY RESEARCH

The following actions have been reported for Achillea plant

material or for its isolated constituents:

antibacterial7, anti-inflammatory8, antiulcer9, spasmolytic8,

choleretic8, hepatoprotective10, antihypertensive and antili-

pidemic (A. wilhelmsii)11, hemostatic12, antitumor13

ACTIONS LINKED TO A CONSTITUENT

essential oil (including linalool)7

flavonoids, dicaffeoylquinic acids8

flavonoids8

dicaffeoylquinic acids8

12

achimillic acids (sesquiterpenoids)13

Dose and dispensing

DRIED HERB 2-4 g of dried herb, as powder or as infusion, three times

per day (BHP)6.

TINCTURE 2-4 ml of 1:5 tincture in 45% alcohol, three to four times

per day (BHP).

INITIAL DOSE Can start at the standard dose (JR).

DURATION

Achillea infusions are generally for acute conditions and for short-term

use only (JR).

Cautions

GENERAL CONTRAINDICATIONS Sensitivity to Asteraceae (M&B

Safety)14.

CHINESE CONTRAINDICATIONS Not widely used in Chinese

medicine.

PREGNANCY AND LACTATION No adverse effects in humans repor-

ted, but see M&B Safety for animal research. No restrictions on breast-

feeding listed by BSH15.

SIDE EFFECTS See General contraindications.

OVERDOSE No adverse effects reported (M&B Safety).

DRUG INTERACTIONS No adverse effects reported (M&B Safety).

Achillea 3Copyright © 2012 Verlag Systemische Medizin AG



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A Clinical Materia Medica - verlag-systemische-medizin.de · Introduction XV Why I wrote this book THE TOPIC Since I started combining Western herbs and Chinese med-icine twenty years