Module 7 Review Questions and Answer Key

Transcription

1 Module 7 Review Questions and Answer Key Introduction to Module 7 1. Describe the immune system s role in maintaining our overall health. The immune system has a massive job that most of us don t think about as we go through our day. Its primary task starts with the ability to differentiate our cells from those of invaders. Our white blood cells (immune cells) need to sniff out any viruses or other pathogens that have snuck into our cells. The immune system also ascertains when our cells are out of control dividing madly or spreading to parts of the body where they aren t needed. A healthy immune system is constantly scavenging for cancer cells and destroying these cells that have gone berserk. 2. Describe a few examples in which the functioning of the immune system goes awry. As with all scenarios involving intricate coordination among millions of specialized cells, things can go awry. Immune cells can begin to see perfectly harmless substances, like a pollen grain or fleck of animal skin, as a dangerous force to reckon with. Allergies are the immune system spazzing out. Even more disconcerting is when immune cells can no longer effectively differentiate our cells from those of our foes. Autoimmune conditions, such as rheumatoid arthritis, type 1 diabetes, and inflammatory bowel disease, involve white blood cells attacking our own cells. Finally, when the immune system is worn down or overloaded, it can t properly deal with cancerous cells, which then divide uncontrollably, untethered by our body s checks and balances. 3. What are some possible explanations for the rise in immune system disorders? What are some practices that can help children develop strong immune systems? My belief is that there are multiple factors contributing to the prevalence of immune system dysfunction, including increased exposure to environmental chemicals (which can increase our risk for cancer and disrupt our hormone systems, which in turn creates dysregulation of the immune system); diets that increase overall inflammation in the body; and, finally, decreased exposure to pathogens in childhood, which ultimately disables proper priming of the immune system. The hygiene hypothesis addresses this last factor. The relationship between modernization (think, hot water and soap, and antibiotics) and the rise in autoimmune conditions and allergies is described by the hygiene hypothesis: Studies demonstrate a correlation between childhood exposure to microbes and prevention of allergies

2 (hay fever, asthma, and eczema) and autoimmune conditions. When children s immune systems are coddled with sanitizer and antibiotics, their white blood cells don t quite know what to do with themselves. Without any apparent enemies, they turn on harmless substances, such as pollen grains or dust mites. Reductions in beneficial flora (friendly bacteria), along with an absence of intestinal parasites, are other factors involved. We now know that the overuse of antibiotics can result in serious consequences, including diminished populations of healthy intestinal flora; an increase in antibiotic-resistant infections, like methicillin-resistant Staphylococcus aureus (MRSA); and dysregulation of the immune system. To build a healthy immune system, we can breastfeed if possible; reduce unnecessary antibiotic use; and feed our children live, fermented foods. And maybe a little dirt under the nails isn t such a bad thing. Introduction to Immunostimulants, Immunomodulators, and Antimicrobials 1. List the potentially serious symptoms that require emergency medical care. Pronounced lethargy, with or without a fever. If your child is totally disinterested in playing and/or food and just seems seriously off, call your doctor. Fever over F (38 C) in a young baby (under three months). High fever over F (39.7 C) or persistent fever (>3 days). Difficulty breathing, with rapid, shallow breathing and wheezing sounds. Persistent or extremely painful earache, sore throat, severe headache, or stomachache. A red streak emanating from a wound. Frequent vomiting or diarrhea: If your child hasn t urinated at least once every eight to twelve hours, she may be dehydrated. Other symptoms of dehydration include a lack of tears when crying, dry mouth, soft fontanel (soft spot on a baby s skull), and sunken eyes. Blood in the vomit or diarrhea is also cause for concern. Fever, stiff neck, and headache are symptoms of possible meningitis. A child with meningitis often exhibits only two out of the three previously listed symptoms in meningitis. In babies, a bulging fontanel (soft spot) can be an indicator of meningitis

3 or other potentially serious conditions. When an infant is crying, lying down, or vomiting, fontanels may bulge, but they should return to normal when the infant returns to a calm, head-up position. Immediate, emergency care is called for if any infant exhibits a bulging fontanel, especially with lethargy or fever. 2. What are immunostimulants? Should these herbs be taken long-term or for short periods? Do they have a quick or sustained effect? When would it be appropriate to take these herbs? What precautions are associated with this class of herbs? Give at least four examples of immunostimulants. This group of herbs is used on a short-term basis to address acute infections by stimulating white blood cell activity. Immunostimulants also called immune stimulants help the body to resist infection during the initial stages of a possible infection as well as throughout the duration of an infectious illness. You can also call on immunostimulating herbs when you re exposed to a contagious illness. A good number of these herbs also possess antimicrobial activity, pulling double duty through augmenting the body s immune response as well as directly inhibiting the pathogen. These herbs have an immediate but short-lived effect on white blood cells, and thus need to be readministered frequently to maintain their effectiveness. Every one of these herbs affects the immune system uniquely. However, general modes of action include increasing phagocytosis; moderating immune communication chemicals, such as cytokines; or increasing white blood cell division and activity. In general, immunostimulants have traditionally been used short term, as they re often overtly stimulating in nature and can result in imbalance if used for an extended period of time. Many are heating and dispersing and can be aggravating for people with hot constitutions (for example, people who run hot, are often hot-tempered or highly passionate, and prone to inflammation). Immunostimulants have the remote potential to increase autoimmunity, and although this is more the exception than the rule, they have at times caused flare-ups in people with autoimmune conditions. Examples of immunostimulants include boneset, Echinacea, garlic, Japanese honeysuckle, myrhh, spilanthes, prickly ash, usnea, and wild indigo. (See the chart in the lesson for these herbs scientific names.) 3. What are immunomodulators? Should these herbs be taken long-term or for short periods? Do they have a quick or sustained effect? When would it be appropriate to take these herbs? Give at least four examples of immunomodulators. These herbs are traditional tonics for supporting the immune system and are slower acting with a more prolonged effect as compared to immunostimulants. They are used for longer

4 periods of time and have a more balancing rather than stimulating effect on the body. As tonics, they aren t overtly heating or stimulating and match a wide variety of constitutions. Examine each herb for its traditional usage and constitutional picture to find the remedy with the greatest affinity for each person. Therapeutically, these herbs are used to address low immune resilience, for example, individuals who experience frequent infections. Herbal immunomodulators are also used when the immune system is overactive, as is the case in allergies and autoimmunity. Also, immunomodulators help to harmonize the endocrine and nervous systems, which, in turn, regulate immunity. Herbal immunomodulators can be taken on a daily basis during the fall and winter months to bolster immunity and lessen the chance of succumbing to common viral infections. This class of herbs also has a role in cancer prevention and treatment. Herbal immunomodulators covered in this course with their own herbal profiles include astragalus, ginseng, and holy basil. You can read about licorice, schisandra, reishi, and shiitake in the herbal glossary. See the chart in the lesson for a longer list of immunomodulators, along with their scientific names. 4. What is an herbal immune tonic? How are they different than immunomodulators? Give at least two examples of herbal immune tonics. These herbs have traditionally been used as long-term immune tonics and most likely also possess immunomodulating effects. They are suitable for long-term use in cases of poor immunity and in cancer therapy and prevention. You may be wondering about the difference between an immune tonic and an immunomodulator. By and large, most practitioners use herbal immune tonics just the same as herbal immunomodulators. Immune tonics simply don t have the scientific stamp of approval to be classified as immunomodulators, but they very well may have the same degree of regulating, or balancing, effects on the immune system. Herbal immune tonics covered in this course with their own herbal profile include calendula and elder. You can read more about chaga and maitake in the herbal glossary. See the chart in the lesson for a longer list of immune tonic herbs, along with their scientific names. 5. What is an herbal antimicrobial? Can any antimicrobial herb be used for any given infection? List at least three antimicrobial herbs. Antimicrobial herbs have compounds that directly deter pathogenic bacteria, fungi, viruses, and protozoans. They are a broad class of herbs and function in many ways. Many of the following herbs are active against several classes of pathogens. For example, an herb may be both antibacterial and antiprotozoan, and another herb may be antiviral and antibacterial. It

5 is helpful to know what kind of infection you are working with and the direct antimicrobial qualities of any herbs you are considering in the treatment of that infection. Antimicrobials covered in this course include goldenseal, Japanese honeysuckle, elderberry, bee balm, calendula, chamomile, lemon balm, spilanthes, rose, and yarrow. See the chart in the lesson for a longer list of antimicrobial herbs, along with their scientific names. Boneset (Eupatorium perfoliatum) 1. Describe an ideal habitat for boneset, and give at least one identifying characteristic of this plant. Why is proper identification extremely important with this plant? Boneset likes to grow in wet meadows, lakesides, riparian open forests, swamps, ditches, and floodplains. Boneset has quite the curious leaf arrangement: the stem appears to pierce the joined leaves a trait which botanists call perfoliate. It actually has opposite leaves that lack a petiole and instead are joined around the stem, giving the appearance of a piercing stem. The leaves and stems are extremely fuzzy with long white hairs. If you would like to harvest boneset in the wild, proper identification is extremely important, as some of boneset s look-alikes and relatives contain toxic pyrrolizidine alkaloids (commonly referred to as PAs), which can be fatal for some populations. 2. What are pyrrolizidine alkaloids (PAs) and what is the concern around ingesting harmful PAs? What are the symptoms of PA damage? What populations are most vulnerable? Pyrrolizidine alkaloids are a large class of compounds that can be harmful or benign. Harmful PAs can cause veno-occlusive disease of the liver, which resembles cirrhosis of the liver a serious condition that is often deadly. Symptoms typically don t appear until the damage is irreparable. The damage from harmful PAs relates to the concentration of the compound in the plant, the part of the plant that is used, the dosage of the medicine, and the duration of ingestion. Damage can happen quickly within a few weeks if consumption and concentration are high enough. Children, including fetuses, have livers that are more susceptible to damage from PAs. Therefore, children, pregnant and nursing women, and those with compromised liver health shouldn t ingest plants containing harmful PAs.

6 3. List at least three plants that contain harmful PAs, and give some examples of herbs you can use as a substitute. What look-alike of boneset contains harmful PAs? Does boneset contain harmful PAs? Common plants that contain harmful PAs include comfrey (Symphytum spp.), borage (Borago spp.), ragwort (Senecio spp.), and coltsfoot (Tussilago farfara and Petasites spp.). I rarely ever recommend the internal use of medicinals containing PAs, as the benefits do not outweigh the risks, and there are plenty of viable alternatives. I use gotu kola (Centella asiatica) and calendula (Calendula officinalis) internally to promote wound healing instead of comfrey (I still use it topically). You can purchase PA-free butterbur (Petasites hybridus) and use mullein (Verbascum thapsus) instead of coltsfoot (Tussilago farfara). White snakeroot (Ageratina altissima) grows near boneset and bears a superficial resemblance, except that white snakeroot does not possess a perfoliate leaf arrangement. White snakeroot is considered toxic, owing to a toxic constituent, tremetol, which caused tremors in livestock and milk sickness in humans who consumed tainted milk. Boneset does not produce tremetol. There are other species of Eupatorium that superficially resemble E. perfoliatum, but if you use the above characteristics, you should be able to properly identify it. The Eupatorium genus contains close to fifty species, primarily occurring in North America and eastern Asia. Many of these species contain harmful pyrrolizidine alkaloids. At the time of this writing, there is some scientific controversy over the presence or absence of toxic PAs in Eupatorium perfoliatum. Numerous studies have demonstrated the absence of these compounds in boneset; however, several recent biochemical assays demonstrated their presence. It is unknown if this is the result of adulteration (another Eupatorium species being sold as E. perfoliatum). Boneset is known to hybridize with at least four other members in its genus, which could perhaps account for some biochemical diversity (some plants containing harmful PAs and others not). Most contemporary herbalists believe boneset to be free of harmful PAs, but it is certainly in the realm of possibilities. Therefore, if you would like to play it supersafe and err on the side of caution, do not give high doses or prolonged doses (longer than two weeks). And definitely avoid the internal use during pregnancy, nursing, and with children. Hopefully, science will yield a definitive answer sometime soon! 4. List at least four of boneset s herbal actions. List two ways to prepare boneset for internal use, and two ways to prepare it for external use. Which preparation will optimize its diaphoretic effect? Boneset is antirheumatic, immunostimulant, vulnerary, diaphoretic, diuretic, anticatarrhal, antiviral, expectorant, and, in larger doses, emetic and laxative.

7 Boneset can be prepared as a tincture, tea, compress, or poultice. Drink the tea (or the tincture in hot water or tea) hot to increase its diaphoretic effects. 5. List at least three indications for the use of boneset, and include both internal and topical uses. Native Americans used boneset extensively, both topically and internally. Much of its use centers on fevers, respiratory congestion, arthritic complaints, colds, and flu. It was also used as a digestive stimulant in smaller doses and an emetic and laxative in higher doses. Topically, poultices of boneset were used to treat broken bones, rheumatic pain, and snake bites. Modern research has demonstrated an in vivo immune-stimulating activity, in the form of increased phagocytosis. Moreover, isolated constituents in boneset have shown to be antiprotozoan (malaria is caused by a protozoan) in vitro. Boneset was successfully used to treat over a thousand cases of flu during the Spanish flu epidemic of Boneset is helpful after surgery or injury, as it s anti-inflammatory and stimulates phagocytosis (cell eating). Our body responds to damaged tissue by calling in the cleanup crew: macrophages (big-eating white blood cells), who gobble up damaged debris, along with their usual fare pathogens. Given that boneset stimulates macrophages to become voracious eaters of dead cells, the injured area is cleaned up faster and subsequently replaced by healthy tissue. Boneset also helps with the pain and inflammation of injury. Spilanthes (Acmella oleracea) 1. Which parts of spilanthes are medicinal? Can it be used fresh or dried? What causes spilanthes unmistakable numbing quality? All the aboveground parts are medicinal and can be chewed fresh in moderation or made into a tincture. The flowers reign supreme in tingle land, but the leaves and stem are a close second, medicinally. The plant can be dried and used medicinally, but it is more bioactive and potent fresh. Be sure the dried plant is tingly when you nibble on it this is a good indicator of its strength. I truly prefer the fresh tincture as a medicinal. The unmistakable quiver and numbness of spilanthes are brought about by constituents named alkamides, also known as alkylamides.

8 2. List at least three of spilanthes herbal actions, and describe its energetics. List at least three medicinal preparations you can make with this plant. Spilanthes is a sialagogue, oral anodyne, immunostimulant, diuretic, antioxidant, antiinflammatory, antibacterial, antifungal, and anthelmintic. It is stimulating and dispersing, and slightly warming; it is mildly drying owing to its diuretic actions. Spilanthes can be made into a tincture, tea, poultice, compress, tooth powder, nibble, and cocktail fancier. 3. Describe how you would use spilanthes as an immune stimulant. At what point during an infectious illness is spilanthes indicated? Give a few examples of an infection that can be ameliorated by the use of this plant. One of the most common ways I use spilanthes is as an immune stimulant. I find that higher doses are often necessary to fight infection and avoid antibiotic use. I combine immunestimulating herbs, like spilanthes and echinacea, to augment the body s internal defenses against the common cold and flu. If infection takes hold, I add other antimicrobial herbs, such as usnea, goldenseal, and honeysuckle, to the formula. Immune stimulants like spilanthes are helpful to ward off infection after potential exposure, like flying on an airplane or caring for a sick family member. This class of herbs can also be called on to stimulate immune activity throughout the duration of infectious illness, which ultimately helps a person get over the sickness more quickly. Spilanthes can be called upon for a wide spectrum of infectious diseases, including sinus infections, urinary tract infections (UTIs), viral meningitis, ear infections, cold sores, and various bacterial infections of the skin. Spilanthes offers a numbing and soothing quality to sore throats and also seems to lessen lymphatic congestion. 4. How could you use spilanthes for tooth health? Toothache plant truly lives up to its name, as it can temporarily numb the mouth during tooth infections and abscesses. It can be combined with licorice root for this purpose, while someone waits for a dental procedure. Additionally, it is helpful for maintaining healthy gum tissue by increasing salivation and blood flow. The dried flowers can be added to tooth powders to address periodontal disease and prevent dental caries and cavities. Alternatively, after brushing with toothpaste, add the powdered flowers to a wetted toothbrush, and brush the gums and tongue. You can add cultivated goldenseal powder to increase the antimicrobial and astringent qualities. If you have fresh plants on hand, chewing on a smidgelet of the flower head is a fine substitute for the above methods.

9 5. List the precautions and contraindications that should be considered when using spilanthes. Immune-stimulating herbs, like spilanthes, have a potential to increase autoimmunity and have caused flare-ups in people with autoimmune conditions, although this is more the exception than the rule. As spilanthes is in the aster family, it may cause a reaction with people who are highly sensitive to plants like ragweed and chamomile; this possibility is rare, but sensitive individuals should proceed with caution when taking spilanthes for the first time (in fact, I could not find any documented adverse allergic reaction, despite its widespread international use). Take care not to squirt the tincture on the back of your throat or chew too large a wad of spilanthes, as the throat may take offense and clamp down not a fun exercise! Echinacea (Echinacea purpurea) 1. Are all species of Echinacea medicinal? E. angustifolia is way better than the other species, right? Can you use cultivars of this plant? Echinacea purpurea, E. angustifolia, and less commonly E. pallida are used as medicinal herbs. Although E. angustifolia is widely used, we recommend growing and using Echinacea purpurea for the following reasons: (1) The entire world's supply of E. purpurea is cultivated; thus, no sustainability or conservation issues are associated with its use, whereas there are conservation concerns for sustainable harvest of E. angustifolia and other wildcrafted Echinacea species. (2) Echinacea purpurea is by far the easiest Echinacea to grow. (3) The vast majority of pharmacological and clinical studies as well as clinical experience since the late 1930s have involved E. purpurea and its preparations, which now dominate the herb market. The herbalist must pay attention to selecting cultivated material that is as close to wild populations as possible. In recent years numerous hybrids and improved cultivars (cultivated varieties) have entered the horticultural trade. Cultivars are designated by a name in single quotation marks following the scientific name. These cultivars are bred and selected for characteristics such as spreading rather than drooping petals or differences in intensity or shade of flower color. In my opinion, those seeking to grow E. purpurea for medicinal use should avoid the new horticultural introductions of E. purpurea over the last thirty years and named cultivars in general. 2. Which parts of Echinacea are medicinal? Why might you consider using the flowering tops rather than the root? Can this plant be used fresh or dried? All of the following parts of Echinacea are medicinal: the aboveground parts harvested in full bloom, roots, flowering tops, and sometimes the seeds.

10 The fresh chopped flowering tops of Echinacea purpurea contain a mirror of the chemical constituents of the root, plus volatile oil components not found in the root, which speculatively may contribute to antioxidant and anti-inflammatory activity. If using the root, tincture only the fresh root (preferable) or the freshly dried root, as components in the roots tend to degrade relatively quickly, in as little as forty-eight hours. 3. List at least three of Echinacea s herbal actions, and list three of the many ways to prepare this plant medicinally. Echinacea is alterative, lymphagogue, anti-inflammatory, vulnerary, immunostimulant, antimicrobial, and sialagogue (stimulates salivation). It can be taken as a tea, tincture, powder, powdered root and/or aboveground parts or extracts in capsules, tablets, salves, compresses, and green smoothies (for the adventurous); and the expressed juice of the fresh flowering plant preserved in alcohol (succus). 4. Describe Echinacea s role during infectious illness. Is Echinacea a short- or long-term remedy? Echinacea helps the immune system to attack foreign invaders, such as cold or flu viruses. Echinacea products are best taken at the onset of cold or flu symptoms, when you first feel like you are coming down with something, or when a person has been exposed to infection. Some prime-time indications for echinacea include flying on a plane, visiting with a sick friend or coworker, or having someone sick in the home. Echinacea can also shorten the duration of an infectious illness. Many people stop taking it once they are sick, thinking it can t help anymore, but Echinacea stimulates many aspects of our immune system to help us fight the infection quicker, and thus should be taken throughout the duration of an infectious illness. Echinacea products are not recommended for continuous use as a preventative during the cold and flu season. Echinacea should be used only as needed. Goldenseal (Hydrastis canadensis) 1. What parts of goldenseal can be used for medicine? List at least four herbal actions and at least three possible medicinal preparations for goldenseal. Why might some preparations be more effective than others? The rhizomes, roots, leaves, and stems can all be used as medicine, although the rhizomes and roots are the most potent medicinal parts.

11 Goldenseal has many medicinal actions, including bitter, antimicrobial, mucosal tonic, alterative, astringent, anticatarrhal, anti-inflammatory, emmenagogue, and it s considered heat clearing in TCM. Goldenseal can be made into an infusion (leaves), decoction (rhizome and roots), tincture, capsules, poultice, wash, douche, sitz bath, eyewash, and gargle. To be most effective, goldenseal must come into direct contact with infected tissues. For instance, as a nasal flush to clear sinus infections or as a topical powder to remedy a festering wound. 2. Goldenseal contains several powerful alkaloids. Tell us about two of them. Goldenseal contains several powerful alkaloids (a class of bitter medicinal compounds that contain a nitrogen atom), including hydrastine and berberine. Clinical studies have shown berberine to be strongly antimicrobial against a range of bacterial, fungal, and protozoan pathogens. Hydrastine, on the other hand, is tonic to catarrhal (excessively mucus producing) conditions of the mucous membranes. Although hydrastine is unique to goldenseal, berberine is found in many other botanicals. 3. Give two reasons that goldenseal might not be the best herb to use at the onset of a cold. At what point during a cold is the use of goldenseal indicated? Goldenseal is one of the most purchased herbs in commerce today particularly as a systemic antibiotic and for addressing the onset of colds and flu. But that may not be the best use of the herb for several reasons. For starters, because of goldenseal s astringent and anticatarrhal qualities, it tends to counteract the beneficial flushing efforts of the immune system thin respiratory mucus literally ferries viruses out of the body when we sneeze or blow our nose. Thin mucus at the beginning of a cold or flu, though annoying, is actually helping our body rid itself of the infection. Secondly, to be most effective, goldenseal must come into direct contact with infected tissues. For instance, as a nasal flush to clear sinus infections or as a topical powder to remedy a festering wound. Goldenseal is appropriate, however, when the symptoms of a cold or flu move deeper into the body or become more serious; for instance, when a sinus infection develops or when pneumonia becomes a concern. The Eclectics used goldenseal specifically when thick yellowgreen mucus or discharge was present. Contemporary herbalists tend to use goldenseal when the mucous membranes are stagnant or bogged down the person may feel stuffy or stuck, with thick mucus, and no heat. This is more common in the later stages of infection.

12 4. Besides the respiratory system, list three other organ systems that can be supported by goldenseal, and at least three indications for each system. Digestive system: Goldenseal is classic for treating peptic ulcers, in combination with soothing medicinals that possess vulnerary and demulcent actions It can also be used for dysentery and severe diarrhea when taken as a tincture or encapsulated powder In small doses, goldenseal is a traditional bitter stimulant and digestive aid Its astringent and antimicrobial actions make goldenseal a wonderful herb for oral health as a mouthwash or tooth powder Genitourinary uses: A sitz bath can be used for tearing after childbirth and for leucorrhea, which is defined as excessive vaginal discharge (can be irritating and drying if not properly combined with soothing herbs) Yeast infections and cervical inflammation can benefit from a douche of goldenseal infusion (can be irritating and drying if not properly combined with soothing herbs) May be beneficial topically for genital warts associated with human papillomavirus (HPV) It can also have a beneficial effect on urinary tract infections Integumentary system (Skin system): Other: Can effectively clear up a number of skin conditions and ulcerations, such as eczema, psoriasis, impetigo, abscesses, itching, cracked nipples, and cuts, scrapes, and bites where infection is a concern (along with other herbs containing berberine) Fungal conditions of the skin such as ringworm and athlete s foot can be treated using goldenseal in combination with other anti-fungal herbs Apply as a wash, liniment, or dusting of powder Goldenseal is a traditional herb for healing eye infections such as conjunctivitis and pink eye. Do not let the powder come into contact with the eye because the girt can scratch the cornea. Instead, prepare a decoction and strain well or make a simple eyewash.

13 5. What are the concerns about harvesting goldenseal from the wild? List some sustainable analogues for goldenseal. Goldenseal is a woodland medicinal whose roots have been heavily overharvested in the past two centuries. Now on the United Plant Savers At-Risk List, goldenseal is a threatened species, which makes harvesting wild plants from public lands unethical. Please do not gather goldenseal from the wild or purchase wild roots. Grow your own if you can, purchase cultivated roots, or use other herbs in its stead. Keep in mind that many conditions that call for goldenseal can be treated with other, more plentiful berberine-rich herbs. Top choices for alternatives include yellowroot (Xanthorhiza simplicissima), abundant Oregon grape root species (Mahonia aquifolium and others), and barberry (Berberis vulgaris). Both yellowroot and Oregon grape root are easy to cultivate outside their native ranges (the southern Appalachians and northwest North America, respectively) and give a much higher yield than goldenseal. Various species of barberry are cultivated as ornamentals and also exist in the wild as garden escapees. Bee Balm (Monarda didyma or Monarda fistulosa) 1. What plant family does Monarda belong to? Why is it important to use scientific names with this group of plants? How does bee balm make Early Grey so very tasty? Monarda belongs to the mint family, or Lamiaceae. There are over twenty species in the Monarda genus, all of which are native to North America. It is important to use scientific names with this group, as common names are many and often used interchangeably. The species might be called wild bergamot, bee balm, Oswego tea, or horsemint, depending on where you live and whom you are talking with. The name wild bergamot is especially confusing, as bergamot is also applied to the essential oil from the similarly scented Citrus bergamia (which grows in Bergamo, Italy). It is the citrus oil, and not Monarda, that is used to flavor Earl Grey tea. 2. What precautions should you take when harvesting bee balm from the wild? What time of year should you harvest bee balm (particularly to avoid fungal diseases overtaking your medicine)? Until you re entirely chummy with all the Monarda species and similar mints in your area, we don t recommend harvesting plants from the wild in the early spring. Instead, harvest the shoots from gardens or familiar wild patches you identified during the previous flowering season. Smell the leaves throughout the season to familiarize yourself with the scent of the bee balm species you have on hand.

14 Use a field guide to identify local wild bee balm species when they re in flower it s impossible to identify the species when they aren t in flower. Once you become familiar with all your local Monarda species, and their signature aromas, you may be able to smellidentify them. But until then, you ll need a plant in flower. As most bee balms are susceptible to powdery mildew, the plants are generally peaked and unsavory after flowering. I usually cut them back at this time, and the vegetation regrows and fills in the bare area in a few weeks. If you live in an area where powdery mildew is a problem, you may want to harvest your Monarda in early summer, before the fungus gets ahold of the leaves. The plants will still flower, although the blooms will be lower down on the stem. Alternatively, you can take some stems here and there, and if your patch is large enough, it won t make a noticeable dent. 3. What parts of Monarda are medicinal? What parts are edible? List at least three ways to prepare this plant for food or medicine. What are Monarda s herbal actions? The leaves and flowers of Monarda are edible and medicinal. They can be prepared as a tea, tincture, douche, honey, steam inhalation, infused oil, herbed butter, infused vinegar, pesto, dressing, poultice, and compress. Monarda is diaphoretic, antibacterial, antifungal, emmenagogue, anticatarrhal, expectorant, carminative, nervine, antirheumatic, and diuretic. 4. How can bee balm be used to treat respiratory infections? List at least two medicinal preparations of bee balm that can relieve respiratory ailments. Many Native tribes use various Monarda species to treat fevers, colds, coughs, flu, and respiratory congestion of the lungs and sinuses. I like to use the dried leaves and flowers in a steam inhalation to help break up phlegm in respiratory congestion. Bergamot s essential oils released through the steam of a bath, sauna, or steam inhalation are antimicrobial and anti-inflammatory. I commonly include bergamot in my herbal soaks and compresses to treat bacterial and fungal infections. 5. Aside from respiratory support, describe at least three other indications for the use of bee balm. Are there any precautions or contraindications when using this medicinal? Wild bergamot is useful in colds and flu, as it is antimicrobial, anticatarrhal, and diaphoretic (brings on a sweat to break a fever). Make sure you drink the tea or the tincture (place a couple droppersful in hot tea or water) piping hot if you re attempting to break a fever.

15 Matthew Wood discusses using wild bergamot topically as a poultice for treating burns and internally for treating urinary tract infections (UTIs) and vaginal yeast infections. He also uses it for tinnitus and Meniere s disease. Kiva Rose frequently uses the leaves and flowers in salves and oils for wounds, sprains, bruises, burns, rashes and other external pains to bring down swelling, eliminate infection, reduce irritation, dull pain and stem excess bleeding. Bee balm is a gentle nervine sedative on par with chamomile (Matricaria recutita) and mint (Mentha spp.). Although, I will add, most folks especially children prefer the flavor of mint or chamomile to bee balm. Do not use Monarda in pregnancy, as it is a traditional menstrual stimulant. As with other spicy herbs, bee balm may aggravate heartburn. Calendula (Calendula officinalis) 1. Why is it preferable to use the whole flower head of calendula, rather than just the petals? Calendula is sometimes sold as petals, which is inferior medicinally to the whole flower head, because the petals alone lack the resinous bracts (from the green involucre, or the base of the flower head). The resin is an important part of calendula s healing properties and is a good indicator of a variety s medicinal strength. When purchasing calendula, make sure it has the green base of the flower head and the petals are a bright yellow or orange color, another good barometer of its freshness and medicinal quality. 2. Can you use any variety of calendula as food or medicine? What should you look for when purchasing Calendula seeds? You can use any of the Calendula officinalis cultivars as food or medicine, although the yellow and orange varieties are more common in medicinal preparations. There are multipetaled varieties for extra garden bling (and edible petals) and varieties with increased resin, purported to be more medicinally active. Let the aroma and stickiness of the flowers guide you in finding your personal favorite types of calendula. 3. List at least four of calendula s herbal actions. Describe two ways to prepare calendula for internal use, and two ways to prepare it for external use. Calendula is lymphagogue, antifungal, antibacterial, antiviral, antioxidant, antiinflammatory, emmenagogue, cholagogue, and vulnerary. Internally, calendula can be prepared as a tea or tincture. It can also be cooked into broths.

16 Externally, it can be prepared as an infused oil, salve, lotion, compress, poultice, vaginal douches and suppositories, and sitz baths. 4. List five body systems that can be supported by calendula, and provide at least one indication for each system. Integumentary/Skin system: External remedy for practically every manner of skin complaints: rashes, stings, wounds, burns, sunburns, abrasions, swellings, eczema, acne, surgical wounds, scrapes, chickenpox, cold sores, and genital herpes sores Common household remedy for healing sore, cracked nipples from nursing (it is safe for babies to ingest in small amounts) Genitourinary uses: Douche for bacterial vaginosis, yeast infections, and cervical dysplasia Can be prepared as a sitz bath to heal perineal tears and abrasions after childbirth Digestive system: Tea is commonly used to help ease peptic ulcers, gastroesophageal reflux disease (GERD), and inflammatory bowel disease Helps to heal gastric and intestinal inflammation from infection or irritation through its vulnerary, anti-inflammatory, and antimicrobial actions Lymphatic/Immune system: Stimulates the lymphatic system and relieves stagnation Used to treat acute or chronically swollen lymph nodes resulting from respiratory infections, localized infections, and tonsillitis Builds immunity by helping to prevent infection through stimulating the lymphatic system. Nervous system: Has an uplifting quality that may be called upon to help with grief and sadness, along with other cheering flowers

17 Elderberry (Sambucus nigra) 1. What toxic constituent is present in the elder plant? List the parts of the plant that contain this compound in order, from low to high levels of toxicity. The toxic compound in elder is a cyanogenic glycoside (CG). This same toxicity is present in varying degrees throughout the elder tree, including its flowers and berries, which we use commonly (and safely) for medicine. Concentrations by part range from nearly none to high (in this order): flowers, unripe berries, ripe berries, leaves, stems, bark, and roots. 2. Is there a way to prepare elder that will reduce or eliminate its toxicity? Which types of preparation can be used freely, and which require more caution? With proper preparation, dosage, and application, elder can be a valuable remedy from top to bottom (and has historically been used just so). Elder offers us far more medicine than poison, and when used correctly is wonderfully safe and one of our favorite remedies for children. Cooking or heating elder can minimize or eliminate CGs. The flowers and ripe berries (cooked or dried) can be used freely, but the internal use of the leaves, bark, roots, and fresh berry juice requires more caution they can be strongly emetic and purgative (strong laxative). We are recommending that only experienced herbalists use these parts internally, and even then with due care and proper dosage. 3. Describe an ideal natural habitat for elder (Sambucus nigra var. canadensis or S. nigra). List one identifying characteristic of the bark, leaf, flower, and berry (you can keep it broad, unless you really want to practice your botanical lingo!) Elder thrives in rich, moist soils in areas that receive generous sunlight; especially along rivers, lakes, streams, forest edges, ditches, fencerows, and farmland borders. Bark: Mature bark is gray-brown to red-brown in color and smooth, except for a sprinkling of raised, knobby lenticels. Leaf: The dark green leaves of American elder are opposite, pinnately compound, and quite large. Leaves contain five to eleven leaflets, including one larger terminal leaflet. Flowers: The flowers are a creamy white, and each gently rounded or flat-topped cluster can contain hundreds of tiny flowers, each one with five petals. The flower clusters are in cymes, and not umbels. Berry: Berries form in late summer to early fall. When ripe, the fruit of Sambucus nigra are a deep, juicy purple that can appear nearly black.

18 4. List at least four herbal actions for elderflower, and at least one indication associated with each action. Note: some indications are due to more than one action. For example, elder flowers do such a good job clearing up congestion because of a combination of three of their herbal actions. The flowers of elder are diaphoretic, antiviral, anticatarrhal, antispasmodic, astringent, alterative, anti-inflammatory, diuretic, and nervine Anti-cattarhal/ Astringent/ Anti-inflammatory: Dries up excessive catarrh (mucus) and helps mucus flow more freely from the sinuses, alleviating stuffy nose, headache, and earache The infusion is beneficial for alleviating sinus congestion in head colds, sinus infections, and allergic rhinitis It can help clear up hearing problems associated with congestion Diaphoretic: Antiviral: Diuretic: When taken hot, a tea or tincture of elder flower can help sweat out a cold or fever, especially when combined with other diaphoretic herbs An infusion of elder flower, combined with Saint John s wort flowers and soapwort root has demonstrated strong activity against influenza types A and B and against herpes simplex type 1 When prepared as a cold infusion, elder flowers are diuretic. They improve kidney function, relieve fluid retention, and help clear the body of toxins and heat. They are a traditional remedy for edema, or fluid retention, and bloating. Anti-inflammatory: An infusion can be used as a wash or compress for oily skin and acne, to improve skin tone, or to cleanse the eyes Beneficial for infectious skin conditions like chickenpox and measles A salve or poultice of the flowers is healing for eczema, psoriasis, burns, and swelling

19 5. List at least four herbal actions for elderberry, and at least one indication associated with each action. Elderberries are diaphoretic, antiviral, antibacterial, antioxidant, diuretic, antirheumatic, anticatarrhal, anti-inflammatory, cardiovascular tonic, immune stimulant, and nervine. Antiviral: Demonstrates antiviral effects against a broad spectrum of influenza strains, especially when taken at the first signs of illness Immune stimulant: Taken daily throughout the fall and winter months, elderberry syrup offers us protection against colds, flu, and other viral infections Anti-inflammatory: Beneficial for arthritic conditions Cardiovascular tonic/ Antioxidant: Blood building and iron rich and can be helpful in cases of anemia. The anthocyanins (a type of bioflavonoid) in the berries protect blood vessel walls from oxidative stress (preventing vascular disease) and lower cholesterol, which helps to prevent atherosclerosis. The antioxidant activity of the berries makes them a preventative for cancer 6. What precautions and contraindications are associated with elder? All parts of elder, with the exception of the flowers, can cause nausea, vomiting, and/or diarrhea. This occurs in individuals who are sensitive to the plant, when it s consumed in too-large doses (this can vary greatly from person to person), or when it s improperly prepared. 4 Once the plant has been purged from the system, there is no lasting illness. Some folks are able to eat handfuls of the raw berries or take large doses of the leaf tincture without any side effects, while others will suffer from even a small dose. In general, we suggest starting with small doses and working your way up to assess tolerance. The flowers and cooked or dried berries are unlikely to cause any side effects for almost everyone! The leaves, stems, bark, and roots can be more problematic to varying degrees. We recommend the internal use of ONLY the flowers and berries unless you are a highly experienced herbalist and understand their potential for toxicity.