Clinical Skills Part with Paul Bergner, RH (AHG) Part Two: Formulation for the Clinical Herbalist

Transcription

1 AHG Advanced Webinar Intensives Presents: Clinical Skills Part with Paul Bergner, RH (AHG) Part Two: Formulation for the Clinical Herbalist Hosted by Michele Marlow

2 The American Herbalists Guild promotes clinical herbalism as a viable profession rooted in ethics, competency, diversity, and freedom of practice. The American Herbalists Guild supports access to herbal medicine for all and advocates excellence in herbal education.

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4 Formulation for the Clinical Herbalist Week 2 Patient-specific formulation

5 See supplemental materials at

6 Principles of herbal pairing Add a carminative circulatory stimulant. Add an herb to a simple to correct dryness Amplification with two herbs that do the same thing but in different ways or through different constituents Steering an herb through reinforcement of one of its actions Steering an herb by directing its affects to a specific tissue or organ. Pairing to balance energetics Complementary herbs for total physiological effect

7 Pair with a carminative stimulant Many simple herbs will benefit from pairing with a circulatory stimulant which also has carminative effects The added herb may increase absorption, circulation to the tissues and general vital stimulation The classic in Thomsonian/Physiomedicalism is Capsicum More than small amounts may overwhelm the pair. Also classic in all schools of medicine is Zingiber Another possibility is Zanthoxylum

8 Examples Myrrh and Capsicum 16:1 (Thompson #6) Hydrastis and capsicum Avena (milky) and Capsicum or Zanthoxylum (Ellingwood) Berberis vulgaris and Eugenia Actaea and Zanthoxylum for neurological conditions In most cases, may substitute Zingiber in the more fragile patient.

9 Correcting dryness Most medicinal herbs are dry. When taken persistently longer than a few days may create uncomfortable humoral dryness. Dryness can be corrected by pairing or by media Best pair for a tincture is Glycyrrhiza For a tea, Glycyrrhiza, Althaea, or Ulmus.

10 Examples Ligusticum and Glycyrrhiza Urtica and Althaea Glycyrrhiza is very common for this purpose in Chinese medicine, and is a component in a small portion of a majority of Chinese formulas. Also common in Chinese formulas is a small amount of Zingiber. Consider the pair Zingiber and Glycyrrhiza for addition to other formulas as an adjuvant and corrective.

11 Amplification by pairing herbs with similar effects Broader Total actions on system Herb #1 Herb #2 Unique actions Unique constituents Potent synergy Unique actions Unique constituents Broader constituent effects

12 Hydrastis Myrrh Temperature cold warm Humidity dry dry Tone tonic/astringent tonic/astringent Taste/action bitter bitter Tissues mucous membranes, venous system mucous membranes, capillaries, immune cells, lymphatics Clinical actions antiseptic, bitter tonic, alterative, venous tonic antiseptic, immune alterative, blood mover

13 Taraxacum and Mahonia Astragalus plus Reishi mushroom Gentian and ginger Eupatorium perf plus Sambucus Cactus and Crataegus Hydrastis plus Mahonia and/or Berberis

14 Scutellaria Passiflora Temperature cool cool Humidity dry dry Tone relaxant relaxant Taste/action bitter, slightly acrid sweet, slightly bitter Tissues nervous, digestive, muscles nerves Clinical actions nervine tonic, sedative, hypnotic, antispasmodic nervine relaxant, sedative, hypnotic

15 Valeriana Humulus Temperature warm cold Humidity dry dry Tone relaxant, diffusive tonic/astringent Taste/action bitter, sweet, pungent very bitter, somewhat aromatic Tissues nervous, circulatory, digestive, muscles nervous, digestive Clinical actions cerebral stimulant, sedative, hypnotic, antispasmodic, carminative sedative, hypnotic, nervine, bitter alterative tonic

16 Pairing to emphasize an action or tissue The first herb has multiple actions or potential tissue targets The second reinforces one of the actions or tissue targets The reinforced effect of the first herb is increased while its other effects are decreased.

17 Agrimonia spp Warming astringent to mucous membranes Upper GI GI Filipendula and or Cardamom for dyspepsia (BHP) With Rubus and Yarrow for diarrhea Rheum for gastroenteritis (BHP) with Artemisia for leaky gut (Ross) Respiratory tract Marrubium for excessive mucous Lycopus for bloody sputum Liver Urinary tract Uterus. Taraxacum and/or Mahonia Capsella (Priest); with Capsella and Zea for enuresis (BHP) Rubus for leucorrhea (Lyle)

18 Actaea racemosa Nervine which may affect different tissues Nerves with Zanthoxylum for neuralgia, sciatica, or tinnitus with Stachys for deficiency type headache with Scutellaria for convulsions Depression Cough reflex with Hypericum and Myrrh for nervous depression with Lobelia in syrup for dry spasmodic cough (Cook) with Lobelia, Inula, and Glycyrrhiza (Cook) Muscles Uterus. with Phytolacca for rheumatic muscular pains with Eupatorium perfoliatum for aching muscles in fever with Caulophyllum for atonic uterus with Viburnum opulus and Dioscorea for dysmenorrhea

19 More pairing to direct action Grindelia with Euphrasia to direct to sinuses Grindelia with Osha to direct to bronchial tract Grindelia with Elecampane to direct to intestine Eupatorium perfoliatum and Mahonia for the liver Eupatorium with Verbascum for the lungs Eupatorium with Taraxacum leaf for urinary tract

20 Steering to specific tissues A diffusive to bring effects outward toward skin. Turnera to bring effects toward the pelvis Ligusticum to steer effects toward the lungs Centella or Ocimum to steer effects to the head Crataegus to steer effects toward the heart. Actaea to steer energy upward, or to head.

21 Pairing to balance energetics Gentiana (cold and dry) with Zingiber (warm and dry) Valeriana (warm and dry) and Humulus (cold and dry) Ligusticum warm and dry with Glycyrrhiza (neutral and moist) Mentha (warm/cool and dry) with Althaea (cool, moist)

22 Humoral properties of corrective media ghee warm 2 moist 2 honey warm 2 moist 2 almond oil warm 2 moist 1 salt water warm 2 dry 2 wine warm 2 dry 2 sugar warm 1 moist 2 milk warm 1 moist 1 olive oil warm 1 moist 1 citrus juice cold 1 moist 1 vinegar cold 1 dry 1 warm water cold 2 moist 2 yoghurt cold 2 moist 2 cold water cold 4 moist 4 From Unani Tibb

23 Unani Corrigents from Latin corrigere to set right, improve Achillea millefolium Allium sativum Althea officinalis Berberis vulgaris Cannabis sativa Capsicum spp Centella asiatica Citrus spp. Commiphora myrrha Coptis spp. Pimpinella anisum fried in almond oil with coriander honey and Foeniculum sugar and cloves butter and ghee milk, ghee coriander sugar and honey honey and cold items honey

24 Coriandrum Curcuma longa Foeniculum vulgare Glycyrrhiza glabra Juniperus communis lemon and honey citrus juice celery seed Rosa spp honey and butter Lavandula lemon juice, sour articles Linum usitatissimum Coriander, caraway, and sugar with citrus juice Malva Matricaria Mentha honey and fennel honey honey, rose, violet

25 Ocimum spp viola, sugar, lemon Paeonia rose petals with sugar, fresh milk Pimpinella anisum lime juice and fennel Plantago Rosa Salix Valeriana honey and lemon anise Rosa spp Rosa spp Viola Nymphaea and marjoram Zingiber almond oil, honey

26 Using corrigents in formulation Herb Corrigent Curcuma citrus juice Glycyrrhiza Rosa Plantago Honey, lemon Formula Plantago 4 Take as powder Curcuma 3 in syrup of honey Glycyrrhiza 2 and lemon juice Rosa 1 Pimpinella 1

27 Complex formula modified by corrigents Herb Mentha Matricaria Foeniculum Glycyrrhiza Althaea Corrigent honey, rose, violet honey Celery Seed Rosa Fennel, honey

28 Complex formula modified by corrigents Mentha 4 Matricaria 4 Foeniculum 4 Glycyrrhiza 2 Althaea 2 Rosa 2 Viola 2 Celery 1 Anise 1 Take as powder in honey. About ¼ of the formula is composed of corrigents

29 Complementary Herbs for total physiological effect Two otherwise unrelated herbs may have complementary effects on the physiology The two together might accomplish what neither could do on their own.

30 Lobelia Capcisum Temperature neutral very hot Humidity slightly dry very dry Tone relaxant, diffusive stimulant Taste/action acrid, bitter pungent Tissues circulatory, nerves, muscles, mucous membranes Circulation, nerves Clinical actions antispasmodic, expectorant, diaphoretic Circulatory stimulant, carminative, diaphoretic, emmenagogue, anodyne Lobelia relaxes resistance to the circulation of the vital force Capsicum stimulates vital circulation

31 Echinacea Uva-ursi Temperature cool cold Humidity slightly dry very dry Tone slightly tonic tonic/astringent Taste/action bitter, pungent, bitter. Astringent Tissues Clinical actions immune cells, lymphatics immune enhancing alterative, topical vulnerary urinary tract, digestive tract urinary antiseptic, astringent to pelvic and digestive tissues Echinacea enhances host resistance from the system in a bladder infection Uva ursi has antimicrobial properties against bacteria from the urinary tract side.

32 Astragalus Ganoderma Temperature Somewhat warm Neutral Humidity Somewhat dry Nautral Tone slightly tonic Slightly tnic Taste/action sweet bitter Tissues immune cells Immune cells Clinical actions Stimulates production and activity of immune cells Inceases immune surveillance. Stimulates and balances immune cells.

33 More Herbal Affinity Groups For combinations and substitutions

34 Topical, anti-inflammatory, vulnerary Calendula Plantago Althaea Symphytum Aloe vera Calendula, Plantago, Althaea is a powerful GI antiinflammatory

35 Topical, antiseptic, immune more famous for internal use Allium sativum Echinacea Myrrh Baptisia Larrea Echinacea + Myrrh = proposed substitution for Thompson #6 Echinacea + Baptisia tea poultice for chronic wounds; spray for sore throat.

36 Topical antiseptic, membranes Hydrastis Cooling Anemopsis Warming Myrica Hot, dry. Classical eclectic sinus spray drops Anemopsis 1 dram glycerine Fill to 2 oz with water in nasal spray bottle This is improved by using 15 drops anemopsis + 15 Hydrastis

37 Nutritive, drying Correct with a demulcent Urtica Rubus Avena straw universal donor at add nutrition to any herbal tea formula Fucus lower dose. Excessive iodine is possible with higher amounts or regular use. Equisetum lower dose. 3 grams, per day for a few weeks.

38 Sweet cool demulcents Althaea Ulmus Glycyrrhiza Demulcent combination for constitutional tea. Althaea 4 Ulmus 2 Glycyrrhiza 1

39 Bitter cold demulcents Asparagus/Shatavari Viola (root is cold) Oenothera The bitter adds a colder temperature, and a draining effect and a broader systemic movement and effect. Heat signs should be present.

40 Bitter tonics Cooling, drying, draining Combine with carminatives Gentiana Classic pair with Zingiber Populus bark Classic in spiced bitters with hot herbs Taraxacum Mahonia Eupatorium perfoliatum Filipendula

41 Carminatives Warm and dry Combine with a bitter or a demulcent Zingiber Foeniculum Trigonella Carum carvi Citrus both bitter and carminative. Zingiber + Foeniculum + Cinnamomum = interior warming Zingiber plus Glycyrrhiza = universal corrector in TCM

42 See supplemental materials at