The "Best Of The Best" Herbs

2001 Alan Keith Tillotson

Understanding Herbs

 "The eye sees only what the mind is prepared to comprehend."

-          Henri Bergson –

Congratulations. Now that you've read section one, you have enough contextual background in the history of herbal medicine and the language of herbs to go to the nextlevel of understanding. If you are like most of us, the next thing you want to know is what the "best" herbs are for treating your particular health condition. I have to laugh at myself when I try to define the word "best" for use in this book, as the field of herbal medicine is so vast. At our clinic, my wife Nai-shing and I keep over 1,000 herbs from all parts of the world in stock. This stock includes herbs from the three systems of herbal medicine we have both studied, TAM (Traditional Ayurvedic Medicine) from India and Nepal, TCM (Traditional Chinese Medicine) from China, and Western herbal medicine.

Nonetheless, when you watch doctors from each of these systems at work, as I have, you notice very quickly that they choose certain herbs most frequently, based on their high levels of safety and effectiveness. Many of these herbs are already famous. One cannot imagine TCM without ginseng root and astragalus root, TAM without ashwagandha root and guggul gum or Western herbalism without echinacea and dandelion root. These are the herbs I will discuss. I have chosen more than 80 herbs that Nai-shing and I consider to be among the most useful available to us in effectively treating the common diseases we see every day. About a dozen or so less commonly used herbs have also been put in for illustrative purposes. Remember, different herbalists use different herbs like different artists use different colors.

How do you know which herbs are best?

 I draw my knowledge of herbal use from numerous sources:

• Traditional teachings (the wisdom handed down from the past)

 • Scientific reports from around the world

• My personal experience • Clinical experiences of my patients

• Reports from other professional herbalists and their patients

• Intuition

Of these, the traditional teachings of the past and the clinical results experienced by my patients have the greatest influence on my herbal choices. However, scientific finding often bring fascinating new insights into sharp focus, and I rely on them as well.

What are the premier herbs used by Ayurvedic doctors?

In Traditional Ayurvedic Medicine (TAM), the Sanskrit word rasayana is assigned to herbs that, although powerful in their results, can be used safely and indefinitely with complete confidence and without side effects. Rasayana describes an herbal preparation that promotes a youthful state of physical and mental health and expands happiness. Rasayana herbs have high levels of both safety and effectiveness. They are given to small children in India as tonics by their parents, and are also taken by the middle-aged and elderly to increase longevity. Several of these herbs have been administered to animals to determine toxicity, and in some cases no toxicity is seen even when the herb comprises very high percentages of the fortunate mammal’s diet. Such herbs do indeed exist. You may have heard of many of them already, as they are quite popular. They are as safe to consume as ordinary vegetables such as carrots and beets. I hope to expand your knowledge of some of these herbs, and introduce you to a few jewels you have not encountered yet.

Are these the herbs used most often by Ayurvedic doctors to treat diseases?

Yes and no. Rasayana herbs can be found everywhere in India and Nepal, and can be and are used by people of all ages and states of health. Ayurvedic doctors rely on them heavily in their tonic formulas for longevity and to treat chronic diseases. However, these herbs only form a moderate part of the expert herb doctor’s repertoire. A good doctor from any tradition must know how to use many, many other herbs. For example, niche herbs are uncommon herbs that only do one thing well, but are essential for treating certain conditions. I have included some of the more important ones, such as ephedra. Some herbs, as simple as black pepper or ginger root, are indispensable for helping to make an herbal formula work properly.

What are the premier herbs used by Western and European herbalists?

The premier herbs used by Western and European herbalists generally fall into a category known as adaptogens, herbs that bring balance back to the body no matter what the direction of imbalance. Some adaptogens will bring your blood pressure down if it is high, or bring it up if it is low. Others will regulate your thyroid whether its function is high or low (Rege et al. 1999). Soy products are good examples of these substances because they can be used beneficially whether estrogen levels are high or low. If the body’s estrogen levels are low, the mild concentration of plant estrogens in soy will stimulate cell receptor sites (the on/off switches for cellular function). Conversely, if the body’s estrogen levels are high, the same mild plant estrogens will block the more powerful human estrogens from reaching the same sites. Thus, soybeans are hormonal adaptogens.

The word adaptogen describes an agent that:

1. Has a normalizing effect on a wide range of body functions

2. Has a non-specific action that helps the body overcome stress regardless of the direction of stress

3. Is non-toxic when used in normal dosage.

What are the best Chinese herbs?

You must remember that even the best Chinese herbs, such as ginseng root and dang gui root, cannot be used without some basic diagnostic information. Herbal choices must be made based upon individual needs. Following the Taoist philosophy of Yin and Yang-- the balance and union of opposites--health is a means by which we balance and harmonize the conflicts we hold within ourselves.

Over a thousand years ago, the ancient Shennong Bencao Jing (pharmacopoeia of herbs) included a category of herbs suggested for use every day to strengthen vitality, increase energy and lengthen lifespan (reported in Dharmananda, 1988). Traditionally, such herbs are established tonics that are safe to use over a long period of time because they are balanced in terms of Yin and Yang. Many of them improve digestive function. Such herbs are commonly used for fu zheng (immune tonification) therapy, discussed in chapter 19.

You’ve said that some herbs are very safe for long-term use, but what about all the others?

Truthfully, few herbs can meet the highest standard of an adaptogen or a rasayana herb, scoring high on scales of both safety and effectiveness for general daily use. In this book I will classify such herbs as Gold Standard.

There are many other herbs that are of great importance but must be used with a certain level of knowledge and caution. These herbs, which have excellent results with no side effects when used properly, still harbor a slight potential for misuse. Some are very safe, but are not particularly powerful or broad in effect. Some herbs are very useful and very safe, but should not be used all the time. Throughout the book, I will classify such herbs as Silver standard.

There are other herbs that, although extremely beneficial and important in the treatment of certain conditions, have a limited range of action or must be used with caution. Mild or moderate diuretics, for example, may be very useful for a few weeks or months, but I do not see the sense in taking them for long periods of time. I will classify these herbs as Yellow standard.

The final group of herbs will be classified as Red standard. These Red standard herbs have certain essential properties that make them beneficial to many patients in states of poor health, but they also pose clearly defined dangers which must be known. Such herbs should be used only under the guidance of a trained professional.

There’s one more thing. I’m not sure any particular herb should be used continuously without a break, unless dictated by medical necessity. The constant intake of the same foods is, I believe, a major cause of food allergy and other problems such as nutrient overload or deficiency. TAM doctors place strong emphasis on eating foods during the correct season, which causes a natural change in dietary items during the year. By the same token, I think it makes more sense to rotate even the best tonic herbs. Don’t get stuck in the philosophy of using one herb for everything or using one herb forever. 

Important Herbs from around the World

"Knowledge is one. Its division into subjects is a concession to human weakness.

- Halford John Mackinder –

I have more than 900 books in my herbal library, and I've learned that any fact you find about an herb may be somehow useful. However, the way a writer selects, filters and presents information sometimes reveals more about the writer than the herb. As a clinician, there are certain books that I have always found myself going back to again and again. It took me a while to figure out why they stood out from the rest. The best ones are not all the same, because describing herbs is an art, unique to each plant and its characteristics. In many ways an herb is like a person. Descriptions are useful, but you have to get more intimate to really know the deeper truth. With people this means meeting them to see if your personalities are compatible, and with herbs it means taking them to see if they "work for you." I am going to offer the herbs from a variety of angles here, while at the same time trying to present the essence of each herb's usefulness in clinical situations.

Let’s take a look at the layout I have chosen for the herbal descriptions that follow.

COMMON NAME        Latin: Genus species

WHAT IT DOES: Here I will give the broad properties of the herb including it's taste, it's heating and cooling properties, an specifically what it does to the body.

RATING: Here you will find the “color” categories explained on page __.

SAFETY ISSUES: Any warnings about contraindications; possible adverse effects caused by misuse, overuse or use by persons with certain medical conditions, etc.

STARTING DOSAGE: Recommended starting adult dosage and preferred form.

DISCUSSION: (One or more paragraphs)

As discussed in chapter 6, Latin names are the most exact identification method, pretty much assuring that we know which herb we are talking about. For our purposes, however, I will provide the common name first, in CAPITALIZED BOLD LETTERS, This will be followed by the Latin name, and subsequently the name of herb as it is known in Chinese, Sanskrit or another foreign language, indicating that the herb is used by those cultures. This is important to avoid misidentification.

In the section called "WHAT IT DOES," I will explain my understanding of the essence of the herb's action. Here I rely on traditional energetic descriptions that, in my opinion, are essential to realistic understanding. Years ago, I received quite a shock when reading an early British author’s writings about Ayurvedic herbs. This chap decided to leave out all references to Vata, Pitta and Kapha, which he decided had nothing to do with the "scientific" actions of the herbs. I’m here to tell you that nothing could be further from the truth. The energetic attributes of each herb are time-tested global descriptions that are among the most important tools we have in herbal medicine. It is these descriptions, more than anything else, that allow herbalists to select appropriate treatments in clinical situations.

Each herb’s "RATING" provides a designated color value for each herb, determined according to values of safety and usefulness, as discussed on page __. This results in a color value for each herb—gold, silver, yellow or red. Following the safety rating you will find “SAFETY ISSUES,” highlighting any warnings, contraindications or special precautions. Contraindications are specific cautions that provide reasons why certain people, such as pregnant women or persons taking certain drugs, should not use the herb. Note that it is possible to have a gold standard herb which, while safe for use by most people, may still be contraindicated for some, such as pregnant women or people taking certain drugs.

I have also provided a "STARTING DOSAGE" for each herb. This offers the suggested starting dosage for an adult, as well as different available forms of preparation for the herb. Some herbs can be used in several different forms, while some work only as tinctures or in dry form or after undergoing special preparation. Remember that the dosages listed are the approximate starting dosage when using the herb by itself. When the herbs is used as part of a combination, the dosage will always be reduced. In formulas, a single herb typically represents from about 5 percent up to as much as 50 percent or more of a formula.

Children's dosages can be calculated using Clark's Rule. Divide the child's weight in pounds by 150 to give the approximate fraction of the adult dose to be used by that child. For example, for a 75- pound child, use 75/150 or one half of the adult dosage to start.

My final section in each herbal description is the “DISCUSSION,” consisting of one or more paragraphs intended to provide you with additional details, research findings, and any other information which can round our your understanding of the herb. For more information about any of the products, manufacturers or distributors mentioned in this section, refer to the resource guide .

AGASTACHE

Latin: Agastache rugosa， Pogstemon cablin

Chinese: Huo xiang

English: Patchouli

WHAT IT DOES: Agastache is aromatic, pungent in taste, and slightly warming in action. It stops nausea and vomiting by dissolving mucus in the stomach.

RATING: Yellow, due to limitations in use

SAFETY ISSUES: Avoid contact with eyes due to volatile oil content.

STARTING DOSAGE:

• Dried powder: four and-a-half to nine grams per day

• Concentrated powder: one to three grams per day

Agastache is the botanical source of patchouli oil, used as an aromatic perfume ingredient because it is said to give lasting qualities to other agents (Felter and Lloyd, 1898). It is used in India as a diuretic, and to keep insects away from clothing (Nadkarni, 1954). TCM doctors discovered that the real medicinal value of agastache is its ability to stop nausea and vomiting. This anti-emetic activity of agastache was demonstrated in a recent experiment on young chicks (Yang et al., 1999).

We use it in our clinic to treat cases of nausea that do not respond to the milder ginger root. In addition, this herb inhibits the actions of common fungi and bacteria that cause nausea and intestinal problems. You can find it in Chinese grocery stores as a major ingredient in various anti-nausea medicines, available in both pill and liquid forms. It is very valuable for treating the nausea of pregnancy or chemotherapy.

Research highlights

• Bacteroides is a strain of bacteria that ferments carbohydrates in the intestinal, respiratory and uro-genital tracts and oral cavity linings, causing toxic gas formation. In a study of several pathogenic bacteria, terpenoids isolated from agastache exhibited marked antibacterial activity. This activity proved strongest against Bacteroides (Osawa et al., 1990).

AGURU WOOD

Latin: Aquilaria agollocha

Sanskrit: Aguru / Agaru

English: Aloewood Eaglewood

WHAT IT DOES: Aguru wood is bitter in taste and hot in action. It increases blood circulation to the lungs and head area, and tonifies and warms the entire body.

RATING: Silver, due to minor limitations in usage

SAFETY ISSUES: None known

STARTING DOSAGE:

• Crude powder: two grams two times per day

Aguru is a large tropical and sub-tropical, fragrant evergreen tree. The resinous wood strongly catalyzes circulation in the cranial organs and chest. This makes it a very effective treatment for bronchial asthma. It warms the lungs, causing a reduction in the spasms and mucus exudation (Vata and Kapha). It also relaxes tension in the muscles surrounding the lungs, so it is indicated specifically for spasmodic asthma. Aguru wood is also used as a tonic for improving mental function. It is often prescribed for this purpose in the form of incense, or as an herbal cigarette.

Research highlights

• Aguru wood has been shown to reduce allergy reactions by inhibiting histamine release from mast cells (Kim et al., 1997).

• Studies in mice show that extracts of aguru wood possess potent central nervous system depressant activities (Okugawa. et al., 1993). Since it doesn’t contain any ephedrine, this herb can be used when ma huang is contraindicated.

ALFALFA

Latin: Medicago sativa

 WHAT IT DOES: Alfalfa is sweet and slightly bitter in taste and cooling in action. It nourishes the blood.

RATING: Gold

SAFETY ISSUES: Alfalfa seeds and alfalfa sprouts have induced lupus in primates and should be avoided by everyone due to the presence of an amino acid, L-canavanine. Patients with lupus or other connective tissue diseases should not ingest alfalfa in any form (Alcocer-Varela et al., 1985).

STARTING DOSAGE:

• 1:5 tincture (with minerals retained): 20-40 drops two to three times per day

• Capsules or tablets: one to four 500-mg. pills two to three times per day

Alfalfa is a classic nutritive tonic herb, rich in chlorophyll, protein, calcium, trace minerals, folic acid, and vitamins B6, E and K. The strong nutrient effects seen with clinical use may be credited to either of two attributes unique to this paricular herb. First, the plant has an extraordinarily strong root system that penetrates up to sixty feet into the soil, allowing the herb to mine out precious nutrients. Second, the herb contains specified plant enzymes which enhance nutrient assimilation (Heinerman, 1980). Alfalfa is also a rich source of plant phytoestrogens, useful in balancing the hormones during menopause (De Leo et al., 1998). The vitamin K content may also be useful for maintaining bone density.

I use alfalfa in a sweet liquid extract form as a nutrient tonic to stimulate gentle healing of the digestive tract membranes. The tonic effects become apparent after one or two weeks of use, often causing a sense of mild euphoria in the weakened. I frequently prescribe it for children and the elderly, especially when there are signs of emaciation and weakness. The tincture has a distinct root beer flavor, so I tell parents to add a tablespoon of it to cola-flavored natural sodas (actually made with juice and mineral water) from their local health food store. This is usually the easiest way to get kids to take it. Several weeks of use often imparts a general feeling of well being in such cases. It is also a good tonic base for other herbs.

Several companies make alfalfa in tablets, although I prefer to use it in tincture form when possible. Boericke & Tafel offers a good, inexpensive product—Alfalco—in 32-ounce bottles. Herbalists & Alchemists offers a superior product that undergoes an extra step before packaging to add back the minerals usually lost during tincturing.

ALOE VERA GEL

Latin: Aloe barbadensis Aloe vera

Sanskrit: Kumari

Chinese: Lu hui

WHAT IT DOES: Aloe vera gel is bitter in taste, cold in action and mucilaginous. It heals and soothes skin irritations

RATING: Gold (external use)

SAFETY ISSUES: Not for internal use when pregnant, if suffering from any intestinal or kidney disease, or during menstruation. Do not use in children under the age of 12, and internal use is not recommended in excess of 8-10 consecutive days. Completely safe when used externally.

STARTING DOSAGE:

 • External use: apply liberal quantities of fresh gel from plant leaves topically

I will only be talking here about the external use of aloe vera gel. (I believe there are other safer, more effective herbs that have the same internal applications as aloe.) Aloe vera is a plant that should be kept in every home, affording instant access to the fresh gel from its leaves for treating sunburn, minor burns, skin wounds, insect bites, acne and bruises. It is one of the best household items for parents to keep on-hand to educate children about using plants safely as medicine.

Aloe vera gel can benefit patients suffering from severe skin disorders such as psoriasis, frostbite and radiation burns (Miller et al., 1995; Klein et al., 1988). The healing effects of this plant result from a complex set of anti-oxidant, anti-inflammatory, moisturizing, emollient, and anti-bacterial properties.

AMERICAN GINSENG ROOT

Latin: Panax quinquefolium

Chinese: Xi yang shen

WHAT IT DOES: American ginseng root is sweet and slightly bitter in taste, and cooling in action. It is an adaptogenic (balancing) tonic that nourishes, moistens and cools the body; strengthens the lungs; reduces weakness and fatigue; and strengthens and calms the nervous system. 

RATING: Gold

SAFETY ISSUES: None known. Use cautiously with nausea and weak digestion.

STARTING DOSAGE:

• Dried powder: three to six grams per day

• 4:1 concentrated dried decoction extract: one to two grams per day

• 1:5 tincture: 30-60 drops 20 times per day

TCM doctors use American ginseng root as a Yin tonic and a Qi tonic. To see the benefits for yourself, use it after you've endured a severely weakening bout of fever or food poisoning, followed by signs of irritability and heat. It will greatly speed your recovery time. Though not as immediately energizing as Chinese ginseng root, American ginseng root gradually strengthens neurological force, and is effective in slowly fighting off chronic fatigue, colds, coughs and bronchitis. In our clinic we frequently add it to formulas where the patient has signs of fatigue and dryness in addition to their primary problem. I've noticed it often seems to strengthen the effects of other herbs. Perhaps this is due to the herb’s numerous effects on the gut and the brain. Some scientists discount differences between Chinese and American ginseng root, noting they differ little in the lab. It is clear, however, that both are strongly tonic.

Research findings

• Animal studies show that component found in American ginseng root facilitates the uptake of choline into nerve endings, which suggests benefit for memory deficits (Salim, 1997). It also alters brain chemistry in a way that may improve sexual performance in animals (Murphy et al., 1998).

 • Pharmacological studies done in China on animals have shown heart strengthening (cardiotonic) benefits of American ginseng root, as well as a calming effect on the cerebral cortex of the brain while simultaneously stimulating the central nervous system.

AMLA FRUIT

Latin: Emblica officinalis

Sanskrit: Amalaki

English: Indian gooseberry

WHAT IT DOES: Amla fruit is sour, sweet and astringent in taste, and cooling in action. It is a rasayana tonic that promotes longevity, and is especially good for the heart. It fights upper respiratory infections.

RATING: Gold

SAFETY ISSUES: None known

STARTING DOSAGE:

• Dried powder: two grams two times per day

• 4:1 Concentrated powder extract: one gram two times per day

Amla fruit comes from Emblica officinalis, a tropical and sub-tropical medium sized tree that grows in arid areas. It is very highly regarded for traditional use as a heart tonic and as a rasayana for long life. Its tonic qualities are very strong, lending it medicinal value in the treatment of numerous diseases, including fever, cough, asthma, anemia, hemorrhage, and alcoholism. Amla is one of three ingredients in the famous Ayurvedic balancing tonic formula called triphala (three-fruit compound). It also comprises about 80% of the famous medicine called Chyvanaprasha, an ancient l tonic made in the form of a jam that improves mental and physical well-being in people of all ages.

Modern research shows amla to contain an extremely high concentration of bioflavonoids and a stable form of Vitamin C, and this may partially account for its reputation. TAM doctors called this herb " tridosaghna," meaning "an agent that stimulates the brain to subdue over-balance in the three controlling systems called Vata, Pitta and Kapha." At our clinic we often add amla fruit to formulas when a gentle cleansing action is needed, especially in sensitive and weakened patients.

Research highlights

• Tannin compounds found in amla fruit were tested for their effects in the brains of rats on three important free radical scavenging enzymes. Levels of all three increased, and there was a parallel decrease of oxidative stress (Bhattacharya et al. 1999). This illustrates that the antioxidant activity of amla is due to more than its high vitamin C content, a common misconception.

• Daily administration of a water extract of amla fruit protected laboratory mice from arsenic damage (Biswas et al., 1999), while another study confirmed that amla fruit strengthened bodily defense mechanisms against stress-induced free radical damage. The researchers reported that the amla appeared to cause an increase in the ability of target tissues to synthesize prostaglandins, which are essential to a host of important regulatory health functions (Rege et al., 1999).

• Amla may also possess cancer-fighting properties, as illustrated by several studies. Extracts of three Ayurvedic herbs, amla fruit, tamalaki (Phyllanthus amarus) and katuki rhizome (Picrorrhiza kurroa) significantly inhibited the ability of carcinogenic chemicals to induce liver cancer. Without the herbs, the incidence of tumors was 100% (Jeena et al., 1999).

• In another study, a group of mice that received dietary supplementation of amla fruit along with a known carcinogen experienced a significant reduction in cell poisoning when compared to mice that received only the carcinogen (Nandi et al., 1997).

• Studies have also indicated an ability to protect against elevated cholesterol levels and the resultant arterial damage. Fresh juice of amla fruit reduced the atherosclerotic effects of a high-fat, high-cholesterol diet in rabbits, as illustrates by the regression of aortic plaques (Mathur et al., 1996). An earlier human study also showed a decrease in cholesterol with amla. However, two weeks after discontinuing amla fruit, cholesterol levels rose again (Jacob et al., 1988). Also, all three fruits in triphala were shown to lower cholesterol significantly, although vibhitaki fruit (Terminalia belerica) proved slightly stronger than amla (Thakur et al., 1988).

ARJUNA BARK

Latin: Terminalia arjuna

 Sanskrit: Arjuna

WHAT IT DOES: Arjuna bark is astringent in taste, cooling in action, and light and dry in property. It is an anti-poison agent that tonifies, strengthens and protects the heart and musculo-skeletal system.

RATING: Gold

SAFETY ISSUES: None known

STARTING DOSAGE:

• Dried powder: two grams two to three times per day

• 4:1 concentrated powder extract: one gram two times per day

• 1:2 tincture: 20-40 drops two to three times per day

Arjuna bark is one of the most important heart tonics in Ayurvedic medicine, used to treat all forms of heart disease. It reduces the heart-damaging culprits of inflammation (Pitta) and mucus (Kapha), and is strong enough to protect against scorpion stings. Arjuna bark contains a fair amount of triterpenoid saponins, and cooking tends to activate these chemicals (which is why saponin-rich Chinese ginseng root is always cooked). Looking at the traditional literature, we see that for more than 1,500 years TAM doctors have boiled arjuna bark in milk or ghee to make medicine, having patients ingest it daily for up to a year.

I read an interesting report in the Journal of Ethnopharmacology about the tribes of the Maasai and Batemi in East Africa. It seems these people had the world's highest-cholesterol diet, consisting of basically nothing but milk and animal blood, yet they exhibited low incidences of heart disease and elevated cholesterol. Scientists finally figured out the reason. They prepared their blood and milk as a mouth-watering soup containing tree barks known to be rich in saponins (Johns et al., 1999).

Research highlights

• The Indian Central Council for Research on Ayurveda and Siddha, citing 20 studies, reported that arjuna bark is valuable in treating angina pectoris, hypercholesterolemia, cardiac artery disease (CAD), and hypertension (Pandley et al., eds, 1996; Dwivedi and Jauhari, 1997).

• Animal studies have also demonstrated its ability to improve liver mitochondrial function (Pandley et al., eds, 1996).

• According to long-term outpatient evaluation, 500 mg. of arjuna bark, taken three times per day in addition to standard medicines (diuretics, vasodilators and digitalis) for 20-28 months (mean 24 months), contributed to improvement in symptoms, signs, effort, tolerance and New York Heart Association Class, with improvement in quality of life (Bharani, 1995).

ASHWAGANDHA ROOT

Latin: Convolvulus arvensis Withania somnifera

Sanskrit: Ashwagandha

WHAT IT DOES: Ashwagandha root is bitter in taste, warming in action, and a strong rasayana tonic. It calms and strengthens the nervous system (Vata); reduces stress; strengthens immunity and vitality; increases sexual energy; and improves cognition and memory.

RATING: Gold SAFETY ISSUES: Not to be used during pregnancy. Do not use Withania somnifera with barbiturates due to potentiation effects. The Nepalese Convolvulus arvensis variety has no known safety issues, but Western relatives such as bindweeds are associated with severe toxicity in animals (Todd FG et al., 1995).

STARTING DOSAGE:

• Dried powder: two grams two to three times per day

• 4:1 concentrated powder extract: one gram two to three times per day

• 1:5 tincture: 20-40 drops two to three times per day

There are two different plants known by the Sanskrit name ashwagandha. Both are effective. It is almost certain that the Convolvulus arvensis Himalayan mountain variety found in Nepal is the original one described in Sanskrit texts, and that Withaniaa somnifera was discovered and used later by doctors in India. In our clinic we use both of these plants to strengthen the immunity and vital force of weakened patients showing signs of anxiety or nervousness. Ginseng root, commonly used as a tonic, would not be a good choice in such case due to its excitatory action.

The Convolvulus arbensis variety of ashwagandha root is a perennial bushy plant with white roots that is usually found in tropical areas. It commonly grows at the base of wheat, spiraling around the stems, and Dr. Mana and I located specimens within minutes when we searched wheat farms in Nepal. The root is an aphrodisiac, and can be used to treat any nervous system disease. It is used to treat nervous exhaustion, poor memory, muscle weakness and impotence. The strength of ashwagandha root seems to penetrate into the core of one's being.

Andrew Weil, MD, reported in a Public Broadcasting System (PBS) special the case of a woman with multiple sclerosis who saw marked improvement in her overall health using this herb.

Withania somnifera has now taken over the common name of ashwagandha root throughout the world. Also an excellent plant, it seems to impart overall energy to the system, with a marked calming effect. It is commonly called the ginseng of India. The traditional way of preparing it for nerve diseases (Vataja) is to mix it into an approximate 50/50 ratio with ghee, and take one teaspoon two to three times per day. This tonic can be given to feeble children to increase their weight. It imparts a sense of well being and strength, as well as improved memory. In the interest of comparison, I have taken both forms of the herb. They are very similar in their calming effects, but the Nepalese variety has a much stronger aphrodisiac effect similar to that of Muira puama balsam.

Research highlights

• A true adaptogen, investigators have demonstrated ashwagandha root's effectiveness in animal models against a wide variety of biological, physical and chemical stressors (Pandley et al., eds, 1996; Rege et al., 1999; Archana et al., 1999; Dhuley, 1998).

• Pharmacological studies show it can prevent immunosuppression caused by exposure to strong chemical agents, and may be valuable in restoring immunity after exposure to or treatment with such drugs (Ziauddin M et al., 1996). It also provides protection against some side effects of chemotherapy (Pandley et al., eds, 1996).

• The alcohol extract of ashwagandha root has significant anti-inflammatory action in both acute and chronic types of inflammation, as demonstrated in rabbit, guinea pig, rat and frog animal models (Pandley et al., eds, 1996).

 • Citing a total of 31 studies, the Indian Central Council for Research on Ayurveda and Siddha tells us that ashwaganda root exerts its most powerful pharmacological influence on the reproductive system, neuropharmacological disorders, cardiovascular system, respiratory system, bacteria, fungi, inflammation and gastric acidity (Pandley et al., eds, 1996).

ASTRAGALUS ROOT

Latin: Astragalus membranicus

Chinese: Huang qi

WHAT IT DOES: Astragalus root is sweet in taste and slightly warming in action, It strengthens the vital force (Qi), nourishes the immune system, and strengthens the heart and lungs.

RATING: Yellow, due to limitations in usage.

SAFETY ISSUES: Should not be used to treat acute infections. Use cautiously in patients with hypertension or heat signs.

STARTING DOSAGE: dried powder

• Dried powder: 1-3 grams per day for long-term use

Astragalus root is a very important vital energy (Qi) in TCM, as important as ginseng root. It has long been used to treat immune deficiency and fatigue, to heal wounds, and to improve digestion and reduce edema caused by cardiac weakness. It is also very useful for chronic or acute low blood pressure. Astragalus root and rehmannia root are key herbs in most TCM prescriptions for treating chronic nephritis (Su et al., 1993, Zhang et al., 1986, Zhao, 1983). Astragalus is noticeably stimulating, and its action is described as being able to "push the blood," and "bring energy up to the head." I wholeheartedly agree with the latter statement--I get a headache if I take it myself.

To determine if a patient should take astragalus for immune tonification, the simple key sign I look for is weakness. It is also useful for patients who complain of catching every bug that comes around. It is best used in small doses over a long period of time for prevention of infections, in contradistinction to echinacea or chrysanthemum flowers, which are best used with acute infections.

TCM doctors also use astragalus root for treating prolapse syndromes of the uterus, stomach and anus, and to help stop uterine bleeding. I urge caution when using astragalus unless under the care of a qualified health care practitioner, because while it works really well in weak patients with signs of coldness, it can create nervousness, headache and even raise blood pressure in patients with heat signs or hypertension.

Research highlights

• In a study of the effects of astragalus on strength and endurance in mice, the group that received astragalus decoction exhibited greater weight gain and greater endurance in swimming tests in comparison to the control group (reported in Bensky and Gamble, 1986).

• In various pharmacological and animal studies, astragalus root shows considerable immune-enhancing activity. Oral doses of the whole root or root extracts have been shown to increase phagocytic activity (cellular debris gobbling), enhance production of interferon (an important immune chemical) and activate natural killer (NK) cell activity.

• Astragalus also excites the central nervous system, strengthens heart contraction in fatigued patients, decreases protein in the urine, and conserves liver glycogen (Ma et al., 1998; Liang et al., 1995; Hong et al., 1994; Hong et al., 1992; Zhao et al., 1990; reported in Yeung, 1983).

• Astragalus has been studied in vitro for its effects on ischemic heart disease, heart failure, angina pain and liver protection against poisonous agents (endotoxin). In one study of patients with ischemic heart disease, astragalus root relieved angina symptoms and improved EKG results (Li et al., 1995).

• A review of live animal research has indicated that it affords a cardio-protective benefit in cases of ischemic heart disease, heart failure, angina pain, and liver poisoning by endotoxin. It is an in vitro antioxidant mechanism that allows the herb to offer this protection. (Miller, 1998). Other researchers have come to the same conclusion with regard to liver protection (Wang and Han, 1992).

• In one interesting study that tested the ability of astragalus root to increase vital energy (Qi), researchers inserted microcomputers inserted into the stomachs of healthy dogs after they received a concentrated astragalus solution. The readings indicated that the solution strengthened the movement and muscle tone in the intestine, especially the jejunum (Yang, 1993).

• Several studies have confirmed the ability of astragalus root to prevent heart damage caused by viral myocarditis. Researchers used a formula composed primarily of astragalus root, ophiopogon root and honeysuckle flower in a randomized controlled cross-over clinical study of viral myocarditis in mice. They compared left ventricular function in the test group to the same function in a control group that received Coenzyme Q10. The researchers concluded that the formula could directly inactivate the Coxsackie B3 virus, protect the heart cells, and increase interferon and NK immune cell activity (Yan, 1991).

• Another group concluded, "it is a rational choice to treat patients with astragalus in viral myocarditis” (Guo et al., 1995; Peng et al., 1995).

• Two weeks after receiving injections of astragalus fraction, 15 of 19 patients with congestive heart failure experienced relief from chest distress and dispnea, and improved capability to exercise (Luo et al., 1995).

• In a study of rats with acute brain edema caused by pertussis vaccine, a TCM formula called bu yang huan wu tang that contains 84% astragalus root was shown to raise declining levels of the important cellular antioxidants SOD and glutathione peroxidase. Researchers concluded that the formula protected the blood-brain barrier and certain brain cells from damage (Zhou et al., 1994).

• A controlled study to test the ability of TCM formulas to improve the quality of life of persons with chronic renal failure treated 36 patients with a decoction containing ginseng root, astragalus root, licorice root, rhubarb root and cinnamon twigs. Researchers studied the effects on six symptoms: fatigue, lassitude in loin and legs, aversion to cold, anorexia, sexual dysfunction and mental depression. Five patients improved markedly in symptom scores, and their creatine levels approached normal readings (Sheng et al., 1994).

BALA

Latin: Sida cordifolia

Sanskrit: Bala English: Country Mallow

WHAT IT DOES: Bala is sweet in taste and hot in action. It nourishes and strengthens immunity, heals the nerves, reduces pain and stimulates formation of healthy new tissue. RATING: Silver, due to minor limitations in usage SAFETY ISSUES: Contains small amounts of ephedrine alkaloids. The amount of total alkaloids in bala plant by average dry weight is 1/15th of that found in ephedra. Bala seeds, usually not commercially available, contain about four times as much of the alkaloids, about 1/4 of that found in ephedra, and so should not be used unless under the care of a professional health care provider (reported in Kapoor, 1990; reported in Huang, 1999).

STARTING DOSAGE:

• Dried powder: two grams two times per day

• 4:1 concentrated powder extract: one gram two times per day

Bala is used as a tonic and to activate the function of the nervous system (Vata) by increasing blood circulation. As a tonic, it increases the vital properties of the serum (plasma), which is very important for the nourishment of the cells, the strength of thehealing power and the maintenance of immunity. Following this effect, it has medicinal value in treating neuropathy related to any organ including the heart, brain, spinal cord, facial nerves and inner ear. There is a gradual tissue-strengthening effect, most noticeable with increased wound healing after injury. It is used to stimulate healing of dry painful joints in osteoarthritis. TAM doctors also use it to heal the lung in tuberculosis, as well as for chronic bronchitis and chronic hemoptysis (spitting of blood).

The low level of ephedrine in bala does not warrant its substitution for ephedra in over-the-counter weight loss formulas, though it probably lowers risk factors. It is possible that unscrupulous manufacturers may attempt to hide the presence of ephedra alkaloids by adding bala to their weight-loss products.

TAM doctors use bala root to make various complex oil preparations. These oils are used as external applications for various nervous sytem diseases, such neuropathies, facial paralysis, spasmodic coughing or asthma, vertigo, seizures, and menstrual cramps. The oils are also used for rheumatic and arthritis pain. Bala root is a major ingredient is the famous medicinal oil called narayana taila.

Research highlights:

• Though a major Ayurvedic herb, there is still little scientific research available on bala. Test tube research has confirmed the presence of analgesic and antiinflammatory activities in the aerial portions and roots (Kanth and Diwan, 1999).

• Pharmacological studies have shown the presence of mucins, fatty oils and resins, as well as plant sterols, which may partially account for the tonic actions of the herb (reported in Kapoor, 1990).

BEET ROOT

Latin: Beta vulgaris

 WHAT IT DOES: Beet root is sweet in taste and detoxifying in action. It nourishes the liver, intestines and other internal organs and protects them from toxins.

RATING: Silver, due to limitations of medicinal potency

SAFETY ISSUES: None known STARTING DOSAGE:

• Vegetable: ingest freely

• Dried powder: two to three grams two times per day

A news report from Czechoslovakia reported that villagers who ate beets along with their sausages were able to lower the usual increases in colon cancer found in that country due to diet. Research seems seems to be backing this up and giving us the reasons why. (Filiberti R et al., 1995, Manousos et al., 1983).

Beets are cultivated worldwide both as a food and a source of sugar. I personally think they are also a very effective herbal medicine. Remember all fresh foods are medicinal, but only those with a unique composition that creates a higher-than-normal activity level qualify as medicines. The dark red color of the beet root is due to an intensly crimson pigment called betanin, which bleeds out if the skin is pierced before cooking. For this reason experienced cooks usually bake, steam or boil them with the skins intact. It also contains sugars (up to 22%), valuable fiber, anthocyans, and betaine etc. All byproducts of beet production are sold for use in livestock feeds. Betaine is important because it can help the body regenerate a key cellular antioxidant enzyme(methionine reductase), which in turn is used by the body to prevent the buildup of homocysteine, a very harmful chemical. Toxins like alcohol and environmental chemicals work in the opposite direction, damaging our liver, blood vessels, kidneys and intestines if we are low this protective enzyme (Barak, 1996). Although medical research on beet root is sparse, I suspect that more evidence of it's medicinal powers will emerge. I often mix beet root powder into herbal formulas to make them more palatable, especially to children.

Research highlights

• Researchers tested the inhibitory effect of beet root extract against both the Epstein- Barr virus and mouse skin and lung cancers, revealing a higher order of activity compared to other red-pigment vegetables and fruits such as cranberry, red onion skin and short and long red bell peppers. Researchers concluded that " The combined findings suggest that beetroot ingestion can be one of the useful means to prevent cancer." (Kapadia et al., 1996).

• A controlled study done in Greece of patients with colorectal cancer showed they ate significantly more lamb and beef, and less beets, spinach, lettuce and cabbage (Manousos et al., 1983).

• A rat study suggested that beet fiber could help eliminate abnormal cells from an irradiated colon by initiating apoptosis (programmed cell death) (Ishizuka et al., 1999).

BILBERRY & BLUEBERRY

Latin: Vaccinium myrtillus Vaccinium myrtilloides

WHAT THEY DO: Bilberries and blueberries are sour in taste and cooling in action. They remove inflammation and congestion from tiny blood vessels, strengthening vessel integrity and microcirculation; they prevent oxidative stress damage to the eye and to neuronal cells.

RATING: gold

SAFETY ISSUES: None known

STARTING DOSAGE:

• Blueberries: eat fresh berries freely in season, use frozen berries during the off-season

• Bilberry extract: 60-180 mg anthocyanosides per day.

A one-pound bag of frozen blueberries eaten over a week’s time provides approximately 400 mg of anthocyanosides, or about 60 mg. per day.

The colorful anthocyanoside pigment compounds in bilberries and [to a slightly lesser extent] blueberries find their way to the capillary vessel basement membranes and the surrounding collagen structures, where they neutralize free radicals which can weaken these tiny structures. Healthy and resilient capillary vessels are able to maintain their shape and function for normal, efficient microcirculation to prevent swelling in the surrounding tissues. This is very useful in the prevention of vascular complications of diabetes, and the improvement of night vision and overall visual acuity. For the same reasons, bilberries or blueberries can be used to treat intestinal inflammation, hemorrhoids, macular degeneration, rheumatoid arthiritis and varicose veins.

High doses of bilberry extract (and other flavonoids) act to strengthen the bloodbrain barrier by acting on collagen fibers to protect sensitive peptide bonds from attack and actually restoring degraded basement membranes (Robert et al., 1977, 1997). Since weakness of the blood-brain barrier is a suspected component in many serious diseases such as multiple sclerosis and chronic fatigue syndrome, I often tell patients with nervous system weakness to use blueberries in fairly large quantities over a long period of time. Typically, I suggest that they eat one bag of frozen blueberries (this form seems to be the most convenient to obtain year-round) once or twice per week, pretty much forever. Most patients love this prescription. The stronger concentrated bilberry extracts are needed with more serious diseases such as MS and macular degeneration, unless your love to eat blueberries. The best thing about them is that, like raspberries and blackberries, they contain less sugar than most other fruit.

Research highlights

• The antioxidant action of bilberry extracts can help prevent the problems caused by elevated LDL (bad) cholesterol levels (Laplaud et al., 1997). • Other reported benefits based upon pharmacological studies include wound healing, anti-ulcer action (Martin A et al., 1998), protection against damage to tendons, ligaments and cartilage (Monboisse et al., 1984),

• Of great interest to me was a 1997 study showing that bilberry extract in high dosage (equivalent to 180 mg. anthocyanosides per day) helped animals maintain normal permeability of the blood-brain barrier during induced hypertension. The same research group was able to demonstrate this over a series of experiments done over the next two decades (Robert et al., 1977; Robert et al., 1997).

BOSWELLIA GUM

Latin: Boswellia serrata Boswellia carterii

Sanskrit: Shallaki Hindi: Salai guggul (B. serrata)

Chinese: Ru xiang (B. carterii) English: Frankincense

WHAT IT DOES: Boswellia gum is pungent and bitter in taste, and warm in action. It reduces pain, swelling and inflammation in the lungs, intestines and joints.

RATING: Yellow, due to limitations in usage due to strong cooling action.

SAFETY ISSUES: None known. Long-term use may dampen appetite.

STARTING DOSAGE:

• Dried powder: two to three grams two to three times per day

• 4:1 concentrated powder extract: 250-750 mg two to three times per day

Boswellia gum is used as an effective pain-relieving anti-inflammatory in the treatment of osteoarthritis, rheumatoid arthritis, diarrhea, lung diseases (including asthma), boils, edema, pain, psoriasis, ulcerative colitis, bronchial asthma, and Crohn's disease. It works by affecting one of two classes of mediators of inflammation along the leukotreine pathway. Prostaglandins and leukotrienes are known collectively as eicosanoids, and they mediate pain and edema. TCM doctors use the related B. carterii species to remove blood stasis and reduce pain. What makes this herb stand out is its specificity and strength of effect.

Boswellia gum can often (but not always) be used as an alternative to NSAIDs and steroids, causing none of the common side effects such as stomach bleeding, ulceration, weakened heart and even death seen with these Western remedies. At our clinic we usually use boswellia gum in formulas for pain and inflammation. I have also used it successfully to reduce asthma symptoms in many patients. No plant works for all types of inflammation, so the best thing to do is test it out for a few weeks if using it by itself. Studies of Boswellia toxicity in rats, mice, and monkeys have shown it to be safe, even at high doses.

Research highlights

• A double blind, placebo-controlled study done on 40 asthma patients in Germany showed marked improvement in the treated patients compared to the control group (Gupta et al., 1998). Another study, done on ulcerative colitis patients using a standardized extract for six weeks, reported improvement in 82% of patients (Gupta et al.,1997).

• Boswellia may even be useful in treating leukemia, with one Chinese study showing that it stimulated leukemic cells to kill themselves, a phenomenon known as programmed cell death (Jing et al., 1999).

Note: The Chinese Boswellia carterii is sometimes called mastic, and should not be confused with Pistacia lentiscus, also called mastic, which is used to treat ulcers.

BROMELAIN

Latin: Ananas comusus (source)

WHAT IT DOES: Bromelain is pungent and slightly sweet in taste, with a strong longlasting penetrating quality. It reduces inflammation and mucus, improves digestion and absorption, speeds wound healing, and helps fight tumors.

RATING: Silver, due to minor limitations in usage

SAFETY ISSUES: Do not use if taking anti-coagulant (blood-thinning) medicines. Do not exceed suggested dosage unless prescribed by a physician. Overuse may weaken intestinal membranes.

STARTING DOSAGE:

• Enzyme pill: one to two 500 mg. pills (standardized to 2000 GDU's (a measure of protein-digesting capacity) twice per day between meals

Bromelain is an herbal compound of digestive-enhancing enzymes, derived from the stem of pineapple, and has been used as a medicine since 1957. Several hundred scientific papers have appeared in the medical literature supporting its use for various problems (Murray and Pizzorno 1989). It is important to understand that bromelain's digestive action takes place both in the digestive system and the blood.

Your blood coagulates when a special protein named fibrinogen converts to the more elastic fibrin. Bromelain inhibits blood coagulation by both inhibiting fibrinogen and breaking down fibrin (Lotz-Winter H, 1990). It also blocks the formation of several inflammatory compounds, and exhibits strong mucolytic (mucus-reducing) activity (Taussig & Batkin 1988). When I see patients who cannot overcome chronic infections and are on antibiotics continuously, I give them bromelain to enhance the antibiotic’s effectiveness and cross this impasse.

Because of its unique group of actions, we use bromelain at our clinic as an allpurpose anti-inflammatory and to speed wound healing, especially in patients with poor digestion or those recovering from recent trauma, surgical or otherwise. It is useful in angina, arthritis, athletic injury, connective tissue inflammation, bronchitis, burns, cellulitis, dysmenorrhea, edema, bruising, poor digestion, pancreatic insufficiency, pancreatitis, pneumonia, scleroderma, sinusitis, staph infections, post-surgical trauma, and thrombophlebitis. I consider bromelain second only to tian chi root for speeding recovery from trauma. Both can be used together as an effective combination.

Research highlights

• Bromelain reduces edema, bruising, wound-healing time and pain following surgery (Howat RC et al., 1972, Murray and Pizzorno, 1989).

• Bromelain has direct anti-cancer effects, originally attributed to its ability to digest the protein coatings surrounding tumors. However, recent evidence indicates it may also strengthen the ability of monocytes to attack target cancer cells (Eckert K et al., 1999).

• Bromelain's digestion-enhancing quality increases the serum levels and effectiveness of several antibiotics (Smyth RD et al., 1968, Zimmermann I et al., 1978), and is almost as effective by itself as an antibiotic treatment for sinusitis, bronchitis, pneumonia, and staph infections (Seltzer 1967, Weiss S et al., 1972).

BUPLEURUM ROOT

Latin: Bupleurum chinensis, Bupleurum falcatum

Chinese: Chai hu

English: Chinese thoroughwax

WHAT IT DOES: Bupleurum root is bitter and pungent in taste, and cooling (antiinflammatory) in action. It releases internal tension and lowers mental stress and anxiety; reduces dizziness and vertigo; warms cold hands and feet caused by tension; stimulates the immune system; reduces fever and liver inflammation; stimulates bile flow; protects the liver; and improves digestion.

RATING: Silver, due to minor limitations in usage (can generate wind)

SAFETY ISSUES: None known

STARTING DOSAGE:

• Crude herb: three to twelve grams per day

• Concentrated powder: one to four grams per day

Bupleurum is a very important silver standard herb, critically useful for some patients. Its scientifically investigated actions are as diverse as our Chinese animal example in the text box. TCM doctors note that when you look at this plant, its branches splay outward in a free and unrestricted manner. This is the "Doctrine of Signatures" or traditional way of seeing the plant’s main action--in this case, the removal of blockages from the free flow of the body’s vital energy. (The “Doctrine of signatures,” or "Signature of God," is the idea that the shape, form or color of a plant can tell you how to use it.) All the TCM clinical uses for this herb flow from this idea, because as the energy flows without blockage, the hands warm, the digestion eases, the mind calms and irritation and heat decrease. Once when I took this herb myself, I was amazed to feel my hands and begin to warm until they were actually buzzing in a pleasant way for over an hour. (Don't tell the government.)

Bupleurum root is a main ingredient in a formula called "Rambling without a destination," which is a great formula name, isn't it? The formula is used to treat the same conditions as the root, but in persons with additional signs of weakness and nutrient deficiency. Drs. Dan Bensky and Randall Barolet, in their excellent 1990 professional TCM textbook Formulas and Strategies, quote an ancient text that recommends this formula for "girls with weak blood and Yin deficiency."

Bupleurum is a good illustration of the problems we face when trying to translate Chinese thinking into Western words. We remember the story of the ancient Chinese dictionary, when a Westerner looked up the word "animal" and found the following definition: There are eight types of animals: 1) Cows 2) Pigs 3) Big animals 4) Animals that bite 5) Animals that live in holes 6) Animals that float 7) Mythical animals 8) Animals that belong to the emperor. Thought this seems funny at first, it is actually a quite practical if not logical grouping. In ancient times, cows and pigs were the most important domesticated food sources, large animals and animals that bit were dangerous, animals that lived in holes and floated were good secondary food sources, mythical animals were a necessary part of religious observances, and messing with the emperor’s animals got you killed.

Research highlights:

• Numerous components of bupleurum root have shown anti-inflammatory activity in a wide variety of animal models (Just et al., 1998, Bergema et al., 1998, Tagaki et al., 1969).

• In a screening of 232 plants for anti-cell adhesiveness activity, important for tumor cell and cancer metastasis inhibition, researchers found bupleurum root saponins to be one of the six most active (Ahn et al., 1998).

• Bupleurum root extracts protected rat livers from chemical insults, leading researchers to conclude that members of this species “have potential as broad spectrum antihepatic agents” (Chin et al., 1996).

• Bupleurum root saponins, like other saponin-rich herbs, show potent heart and blood vessel protective effects. They have been shown to “inhibit the formation of lipid peroxides in the cardiac muscle or in the liver, influence the function of enzymes contained in them, decrease blood coagulation, cholesterol and sugar levels in blood, (and) stimulate the immunity system” (Purmova et al., 1995).

• In a series of experiments to determine the mechanism by which bupleurum root saponins inhibit kidney inflammation, researchers concluded that they reduced platelet sticking (blood stickiness,), protected against loss of antioxidant capacity, and enhanced blood and kidney corticosterone levels (Hattori et al., 1991).

• Researchers have also determined that bupleurum root enhances macrophage cell activity (Matsumoto et al., 1995).

• Various clinical studies on humans have shown liver enzyme reduction in hepatitis, fever reduction in infection, and diuretic effects (reported in Bone, 1996).

• One of the most famous bupleurum root-based formulas is minor bupleurum decoction, which contains bupleurum root, scute root, pinellia tuber, ginger root, ginseng root, honey-fried licorice root and ziziphus fruit. This formula was able to promote clearance of hepatitis B antigen from the blood of 14 chronically ill children (reported in Bone, 1996).