Guido Mas

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Clinical Herbalism

• Guido Masé
• guido_at_grianherbs.com
• [phone]

http//www.grianherbs.com/herbalism.ppt
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Roots

• Traditional Chinese
• Traditional European
• Native American
• Eclectic
• Modern European

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Astragalus, Huang qi

• Astragalus membranaceus
• Member of the Fabaceae (Leguminosae). Composite
  leaf, delicate yellow-pink flowers that mature to
  small pods. Strong branching yellow root used for
  medicine.
• Warming Yang immune tonic, lung tonic

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Hawthorn

• Crategus species
• Member of the Rosaceae. A beautiful
  white-flowered tree, used in Europe for
  hedgerows. The berries are traditionally used.
• Warming, nutritive cardiovascular tonic and
  normalizer. Can be of support in depleted,
  depressive conditions.

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Echinacea

• E. purpurea, E. pallida, E. angustifolia
• Member of the Asteraceae (Compositae). A
  perennial favorite with prolific flowers, all
  parts of this plant are used for medicine. Root,
  seed and unopened green flower buds are
  strongest.
• Cooling, disperive, anti-infective, anti-poison
  herb. Powerful and effective in acute conditions.

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Therapeutic ideas

• Energetics Yin/Yang, Fluids, Spirit
• Physiological concepts
• Enhancing absorption/metabolism/elimination
• "Tonification"
• Empiricism
• Scope of practice

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Yin and Yang

• Cold/Hot
• Sedating/Stimulating
• Deep (Chronic)/ Superficial (Acute)

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Vital Fluids

• Humors
• Tissue states
• Hot
• Dry
• Wet
• Cold
• "Vital Force"

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Plant spirit medicine

• Meaning through experiential relationship
• Plants as archetypal symbols
• Connection with Homeopathy
• Long-term healing life-changing

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Physiological concepts

• Vis medicatrix naturae
• The healing power of Nature
• Holism
• Looking for broad, underlying pattern
• Extensive tissue/organ interconnection
• Feedback is everywhere homeostasis is subtle

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Holism

• Reflection of pattern at many levels of being
• Self-similarity exists at every level. All levels
  interact to form the whole.
• Intervention can be broadly effective when
  initiated at any level
• Broad-stroke physiology centered more on
  process/relationship
• Herbs are complex crude preparations understood
  holistically
• Essential role of nutrition in therapy
• herbs as "special foods"

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Nature of Herbalist / Client relationship is
crucial

• Intake process can take hours
• Emphasis on story, context and meaning
• Increasing clients connection to medicine
• A partnership that educates and empowers the
  client to take responsibility for wellness

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Extensive tissue/organ interconnection

• Autonomic nervous reflexes
• Immune / lymphatic
• Endocrine / Adrenal
• Shared characteristics
• Innervation
• Mucosa

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Enhancing elimination

• Liver function
• Digestive strength (helps absorption, too)
• Kidney function
• Expectoration
• Lymphatic function
• MILD IRRITANTS / TISSUE STIMULANTS
• WITH OVERALL COOLING FUNCTION

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TonificationA tonic brings a system towards
optimal homeostasis / efficiency

• Specific type
• Cardiovascular
• Digestive
• Endocrine
• Immune
• Systemic / broad type
• Ginseng, e.g.
• LONG-TERM, AKIN TO FOODS

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Scope of practice

• Acute treatment / limitations
• Chronic treatment / limitations
• Importance of inter-modality work
• Acupuncture
• Massage / bodywork
• Counseling
• Nutrition
• Modern Medicine

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Nature of the Materia Medica
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Archetypal herbal actions
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Enhancing Elimination / Counter-irritating

• Rubefacient
• Cholagogue
• Diuretic / Diaphoretic
• Expectorant
• Lymphatic

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Relaxing / Soothing

• Sedative
• Hypnotic
• Antispasmodic
• Anti-inflammatory
• Demulcent

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Countering pathogens

• Antifungal
• Antibiotic
• Antiviral
• Anthelmintic

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"Tonifying"

• Digestive bitter
• Immune tonic / modulator
• Cardiovascular tonic
• Endocrine tonic
• Nervine tonic

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Multi-function

• Multi-function tonic
• "Alterative"

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Phytochemistry

• Chemical classes
• Standardization
• Dosage and safety considerations
• Pharmakokinetics

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Astragalus, Huang qi

• Polysaccharides
• Phytosterols / Saponins
• Generally safe and mild ß-sitosterol gentle
  anti-inflammatory
• Polysaccharides important immune tonics1
• Mostly water-soluble

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Hawthorn

• Flavonoids
• Vitamin C (like most Rosaceae)
• Sugars
• Very mild, akin to food. Antioxidant value
  (flavonoids) reduces LDL oxidation and vascular
  damage2
• Mostly water-soluble

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Echinacea

• Alkyl amides
• Polysaccharides
• Inulin starches
• Strong effect from alkyl amides (immune
  activating, anti-inflammatory)3 plus
  polysaccharide effect
• Inulin starch beneficial for intestinal flora
• Generally safe, but more powerful in flavor and
  effect
• Better solubility in 50 ethanol

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"Energetics"

• Signatures
• Spirit / "Intelligence"
• Temperament
• Hot / Enhancing / Stimulating
• Cool / Eliminating / Sedating
• Taste
• System affinity
• Amphoteric

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Case 1 Recurrent Staphylococcus infection

• Male, age 34
• Original infection in foot, with extensive
  inflammation and lymphatic involvement. Left
  untreated for 2 weeks. Initial treatment with IV
  antibiotics, unknown type, resolved the dramatic
  symptoms fairly quickly.
• Herbal therapy sought for eruptions (few
  localized furuncles) six months after initial
  treatment. Furuncles tender but not itchy,
  appearing on R leg and hip, chest.
• First recommendations
• Drastically reduce sugar and refined starch
  consumption
• Echinacea tincture, 3ml every 2 hours as
  anti-inflammatory and antibiotic
• Calendula and Zingiber (Ginger) tea, 32 fl. oz.
  daily
• External applications Maleleuca (Tea tree) and
  Zingiber
• Based on trapped, stagnant heat and deficient
  circulatory energy
• i.e. latent infection, need for increased
  circulation and therefore immune response
• First results
• After 24 hours, client reports less tenderness
  and reduction in number of furuncles
• After 72 hours most furuncles have disappeared
• No recurrence for 3 months

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• Client returns with similar symptoms same
  treatment is repeated with good success (though
  improvement is not as rapid).
• Two months later, client returns. Symptoms began
  similarly, but now furuncles have become
  exacerbated (within 48 hours) and skin necrosis
  has begun in two areas. Client presents with two
  ulcerations, diameter approx. 2 cm, where the
  skin is completely gone and underlying tissue is
  revealed, surrounded by an inflamed area of 6-8
  cm in diameter. Beginnings of lymphatic
  involvement.
• Recommendations
• Same as initial protocol, but with the addition
  of Baptisia tinctoria (2 ml TID) as a more
  powerful antiseptic and lymphatic
• External applications of beeswax-based salve with
  Commiphora (Myrrh) and Maleleuca (Tea tree) under
  sterile bandages, along with suggestions on
  proper hygiene.
• Results
• Surrounding inflammation much reduced within 48
  hours. Salve modified to feature Symphytum
  (Comfrey) to speed growth of new dermis, along
  with nightly fresh Symphytum poultices.
• New skin forming within 1 week diameter of
  ulcerations down to 1 cm. Improvement continues
  over next week until fully resolved.
• Additional information
• In an attempt to arrive at the underlying
  imbalance that allows the infection to recur,
  client reveals emotional and personal trauma
  surrounding the initial presentation and first
  recurrence. Client is troubled by threats from an
  individual who hates him.
• Recurrences seem to occur around times of stress
  and tension with this individual.

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• Final Assessment
• Stagnant damp heat as a result of blockage in
  the flow of internal energy. This flow has been
  blocked as part of an emotional pattern which is
  disallowing proper immune function. Infections
  are recurring partly because of an immune
  response weakened by the underlying infection
  itself partly because of stress-related immune
  suppression and partly because of an
  unwillingness and a fear to confront an abusive
  situation.
• Long-term solution
• Traditional purification ritual involving
  Artemisia (Mugwort, Wormwood). These herbs are
  strewn about the dwelling burned as incense and
  taken internally as a tea for the day and night
  of the ritual. Emotional fear and anger are
  identified, acknowledged, externalized, and
  released through compassion-based imagery and
  meditation. The herbs used have both
  spiritual/emotional and somatic function all
  members of the Artemisia family contain
  powerfully antiseptic volatile oils (thujone,
  e.g.)
• Immune enhancing protocol is recommended for an
  additional 6 months daily tea of Astragalus and
  Ganoderma (Red Reishi polypore mushroom), 16
  fl.oz.
• Final Results
• Client has been free of infection to date.
  Immune-enhancing protocol slowly discontinued
  after 6 months.

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Case 2 Integrative treatment brain tumor

• Female, age 53
• Tumor in motor cortex, diagnosed from symptoms of
  Bells palsy (rt. side of face), arm weakness,
  difficult speech and fine motor movement.
  Confirmed by MRI, 9/04, when tumor size was
  assessed at 1.5 cm diameter. After initial
  courses of radiation and chemotherapy, surgery
  was attempted (Dana Farber Oncology) 3/05. Tumor
  had reached diameter of 4 cm. Surgery largely
  successful, with no complications (although
  impossible to remove entire tumor due to
  location).
• Client begins dietary regimen on the advice of a
  nutritionist. 9 servings of fresh fruit/veg per
  day 4 servings of whole grain and/or legumes
  daily fish as major protein source. Addition of
  yogurt and flax seed oil. Organic, hormone and
  antibiotic-free foods are stressed. Colorful
  (flavonoid-rich antioxidant) foods are
  emphasized.
• Follow-up visit 6/05 MRI shows no signs of
  tumor. Chemotherapy continues client WBC counts
  are very low, especially neutrophils. RBC
  borderline-low. Motor symptoms are not much
  improved anti-convulsants are prescribed.
• Client seeks herbal support 8/05, primarily to
  address low WBC counts but also to add another
  level of protection against tumor recurrence and
  perhaps an alternative to anti-convulsant
  medication

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• Initial assessment
• Vital, strong, motivated individual who is eating
  an incredibly healthy diet and wishes to pursue
  all available treatment strategies for her
  condition.
• Immune function / WBC count is low most probably
  as a result of chemotherapy treatment.
• Tumor was aggressive, but seems under control
  at the present moment from excellent,
  muti-modality care.
• Motor symptoms are distressing to an active,
  energized, professional woman. This may be
  related to trauma and resultant cerebral
  inflammation/oedema and may take time to resolve.
• Intake process reveals mild hypoglycemia, a
  lifelong concern
• Initial recommendations
• Tincture of Astragalus, 3ml BID
• Digestive bitters (Dandelion, Artichoke,
  Burdock), 3ml 15 min. before meals
• Supercritical CO2 extract of Maitake, Reishi,
  Chaga (medicinal mushrooms) 2ml BID
• Tincture of Verbascum (Mullein), 1ml BID
• Immune broth recipe using organic beef bones,
  Astragalus, Ganoderma. 8 fl.oz. daily.
• Silybum (Milk Thistle) standardized extract 240mg
  daily
• Astragalus, mushrooms and broth all help increase
  WBC and RBC counts. Digestive bitters are tonic,
  help elimination and liver function, and address
  hypoglycemia. Mullein root a specific for
  neuromotor symptoms. Milk thistle supports liver
  function (aids in processing chemotherapy).

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• Results
• After 6 weeks, WBC and neutrophil counts are
  within normal ranges, even with the same dosage
  of chemotherapy. RBC low end of normal. Liver and
  kidney enzymes are fine.
• Client, in consultation with oncologist, has
  halved the dose of anti-convulsant medication.
  Symptoms are slightly improved, esp. hand
  movement and speech.
• Client has noticed improvement in digestive
  function, especially bowel movement consistency
  and regularity (side-effect of digestive
  bitters).
• MRI reveals no tumor or re-growth of any kind.
• Treatment is modified to include Trifolium (Red
  Clover), Rosmarinus (Rosemary), and Crategus
  (Hawthorn) for anti-tumor, anti-oxidant, and
  cerebral vascular health. These are taken in tea
  form
• After an additional 6 weeks, motor symptoms
  continue to (very gradually) improve. CBC still
  completely within normal ranges. Chemotherapy and
  nutritional intervention continue.
• MRI still reveals nothing of note in the affected
  area. Liver enzyme levels are lower than before
  initiating herbal treatment. It has been 14
  months since diagnosis 9 months since surgery.
• Herbal therapy can provide a significant benefit
  when used alongside conventional tumor treatment.
  It encourages stronger immune function manages
  the side-effects of medication and can provide
  mild symptomatic relief. Communication between
  practitioners accomplished, for the most part,
  through the client.

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Case 3 Chronic bronchitis

• Female, age 57
• Complains of yearly recurrences of bronchial
  infection (diagnosed by MD). Antibiotic therapy
  temporarily effective, but respiratory infection
  usually recurs at least once in the season. Each
  bout can last 2 weeks, with protracted chest
  congestion for an additional 4-6 weeks. No fever.
• Non-smoker. No hazardous environmental conditions
  (chemicals, allergens, molds, etc) identified.
• Diet consists of refined wheat flour as main
  carbohydrate source much dairy few vegetables,
  mostly canned or frozen (not fresh).
• Assessment
• Long-term lung weakness, perhaps from overuse of
  antibiotics. Current acute presentation of
  bronchitis. Poor exercise regimen. Poor diet
  needs improvement.
• Initial Recommendations
• Tea of Glycyrrhiza (Licorice), Sambucus (Elder),
  and Zingiber (Ginger) to warm, soothe, and
  stimulate expectoration. 32 to 64 fl.oz. daily.
• Tincture of Echinacea, 3ml five times daily.
  Tincture of Inula (Elecampane) 3ml TID as an
  expectorant.
• Extensive dietary recommendations focus on whole
  foods, less dairy, and warming spices that
  stimulate circulation (Garlic, Cayenne, Ginger,
  etc)
• Follow-up visit scheduled in one week.

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• Results
• Respiratory infection resolved, mostly. Some
  expectoration continues but mucus production is
  easy, and the mucus is clear (no longer dark
  yellow). No antibiotics used.
• Treatment is altered to remove Echinacea and
  Inula, and focus instead on strengthening lung
  qi and rebuilding immunity. Immune broth of
  Astragalus, Ganoderma, and Urtica (Stinging
  Nettle) is recommended as a winter tonic. Brew by
  simmering for 8 hours strain freeze in ice cube
  trays and use two cubes daily in 8oz of hot
  water. Initial tea is still part of treatment for
  at least another week.
• Follow up this fall client reports no bronchitis
  this season, and has been taking Immune broth
  since mid-September. Diet has improved a bit,
  mostly by the addition of whole fresh vegetables

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Clinical Herbalism

• Guido Masé
• guido_at_grianherbs.com
• [phone]

http//www.grianherbs.com/herbalism.ppt
38
Notes

• 1) A study on the immune receptors for
  polysaccharides from the roots of Astragalus
  membranaceus, a Chinese medicinal herb. Biochem
  Biophys Res Commun. 2004 Aug 6320(4)1103-11
• 2) Flavonoids a review of probable mechanisms of
  action and potential applications. American
  Journal of Clinical Nutrition, Vol. 74, No. 4,
  418-425, October 2001 http//www.ajcn.org/cgi/cont
  ent/full/74/4/418
• 3) Macrophage activating effects of new alkamides
  from the roots of Echinacea species.J Nat Prod.
  2005 May68(5)773-6.
• Additional resources
• www.grianherbs.com
• http//www.herbalgram.org/
• http//ns2.rt66.com/hrbmoore/index.html/)
• http//www.henriettesherbal.com/
• http//www.americanherbalistsguild.com/