Sinopsis
In 1998, when I wrote the first edition of this
book, the Internet was very new; the world was a different place. A lot
has changed.
For one thing, the Internet has become the greatest reference
library human beings have ever known. A tiny part of that library, though
enormously huge compared to what was available in the past, has to do with
medicinal plants and the vast amount of research now being conducted on them.
This facilitated the revision of this book enormously. During my research for
the first edition, despite the size of my personal library (huge) and my access
to a great university library at the University of Colorado in Boulder, I had
access to only a tiny portion of the research and other material on medicinal
plants that existed in the world. Now I have access to a great deal more; it’s
as close as my office computer.
But that is only a small part of the changes that have taken
place over the past 15 years; something a great deal more interesting has been
happening. As I spent weeks on the Web, following the scent of medicinal plants
through the Internet forest, what struck home the most was a deep and visceral
impact of just how much the human world itself has changed.
It is a new world out there. And it is a world with which the
United States has an increasingly tenuous connection. The rest of the Western nations are nearly as lost. During the past 15 years nations
on the African continent, in Asia and South America, within the Russian sphere,
and in most of the old Eastern bloc have realized that the medical model used by
the West is unworkable, and to a great extent, they have begun abandoning it as
the dominant approach to their people’s health care.
Nations in those regions, especially in Africa, Asia, and South
America, have realized they can’t afford a pharmaceutical/technological
medical model as their primary approach to health care. They know that the
problems of antibiotic resistance, petroleum depletion (most pharmaceuticals and
all medical technology are made from or highly dependent on petroleum products),
population expansion, top-down care models, and most especially cost and cost
inflation cannot be solved and are only going to worsen over time. With that
realization, they have begun abandoning industrialized medicine as a legitimate
model for providing health care to their populations. (Industrialized medicine
will still play a part but a much smaller, more affordable, and considerably
less dangerous one.)
Unlike in the United States, researchers in those nations
aren’t exploring whether plant medicines work (nor are they spending
their time and money trying to discredit what they feel is “primitiveâ€
medicine or unscientific quackery); they are exploring which herbal medicines
work best and in what form and at what dosage. Their research and their journal
papers are looking for the herbs that can treat malaria most successfully (for
example) and how those plants, once identified, can be grown by the people who
need them so they can be used when, and where, and by whom they are needed.
Many non-Western researchers are actively addressing the health
problems of their populations with little if any profit motive. They have simply
realized that corporate profit making and human health are not compatible.
Shorthand: they are tired of seeing their cultures get screwed by international
corporations that make billions out of the misery of others. They want to solve
the problems facing them, simply, repeatedly, cheaply, ecologically, and with a
great deal of personal empowerment for the people who are most
directly affected. Reading the journal articles of U.S. researchers and
comparing them with those of other nations and cultures is an illuminating and
sobering experience.
The African and Asian journal articles tend to have titles like
this: “Antibacterial activity of guava (Psidium guajava L.) and neem
(Azadirachta indica A. Juss.) extracts against foodborne pathogens and
spoilage bacteria†or “Evaluation of antimicrobial activities of extracts of
five plants used in traditional medicine in Nigeria†or “Antimicrobial
activity of ethanolic and aqueous extracts of Sida acuta on
microorganisms from skin infections.â€
The U.S. journal articles are more along these lines: “Severe
hypernatremia and hyperosmolality exacerbated by an herbal preparation in a
patient with diabetic ketoacidosis†or “Metal content of ephedra-containing
dietary supplements and select botanicals†or “Hypereosinophilia associated
with echinacea use.â€
The abstract for that last study contains the kind of commentary
common to many Western researchers, especially in the United States:
Echinacea, believed by herbal practitioners to enhance the
immune system, is one of the most widely used herbal supplements in the United
States. Like most herbal products, it lacks strict FDA regulation and more
information is needed about its potential adverse reactions. Here, we report the
case of a patient with eosinophilia of unclear etiology whose condition resolved
after cessation of this supplement. We feel this likely represents an
IgE-mediated allergic process to echinacea.1
The article ignores the in-depth research on echinacea done in
Germany over decades and the fact that it is a part of primary care medicine in
that country. It uses words and phrases such as “believed by†and “we
feel†and “likely.†Its writers assume that the echinacea is the
cause of the eosinophilia even though they have conducted no research to make
sure of it. It’s not science, not research, but rather guesswork and opinion
that reflect the orientation, and bias, of the technologically focused,
pharmaceutically dominated medical world, especially in the United States.
The antimicrobial effect of the ethanolic and aqueous
extracts of Sida acuta was investigated. Phytochemical analysis
revealed the presence of saponins, tannins, cardiac glycosides, alkaloids and
anthraquinones. The test isolates from human skin infections were
Staphylococcus aureus, Bacillus subtilis, Pseudomonas
aeruginosa, Escherichia coli, Scopulariopsis candida,
Aspergillus niger and Aspergillus fumigatus. The zone of
inhibition for the ethanolic extract varied from 10 mm for P.
aeruginosa to 43 mm for S. aureus and from 4 mm for P.
aeruginosa to 29 mm for S. aureus in the aqueous extract. Though
the zone of inhibition increased with increase in the concentration of the
extract, the highest concentration of the ethanolic extract revealed a higher
significant (P. 0.05) inhibition against S. aureus and B.
subtilis compared to the inhibition effect on these organisms by gentamicin
used as control. The aqueous extract had no significant effect on the test
organisms. The extracts had no inhibitory effect on the fungi isolates. This
study has shown that the extract of S. acuta if properly harnessed
medically will enhance our health care delivery system.2
This herb “will enhance our health care delivery system.†I
have never seen that sentiment in a research article in the United States and
I’ve read thousands of them. (Gentamicin, by the way, is what is called an
aminoglycoside antibiotic, often used to treat Gram-negative bacteria. Sida
acuta at higher doses was more active against the test organisms than the
antibiotic was.)
The authors of this study tested both aqueous (water) and
ethanolic (alcohol) extracts of the plant—essentially infusions and
tinctures—to see which were most effective. Most plants are used by indigenous
cultures as water infusions (strong teas) or in whole form of one sort or
another, either eaten or placed directly on the affected area of the body. Some
cultures do use simple alcohol extractions. Of the active ingredients in plants,
some are soluble in water, some in alcohol, and the researchers clearly wanted
to find out which form of preparation was the most effective for this plant.
It’s usable information they were after. And they found it. They came
to Sida acuta by looking at what traditional healers and herbalists in
Nigeria were using in their practice and they decided to test it
for activity. If it was effective they wanted to find out how it was
most effective. And they planned then on supporting the use of that
plant widely throughout Nigeria to enhance their country’s health care system.
Nothing could be more alien to the medical establishment in the United
States.
To be fair, there are some good studies occurring in the United
States, but to be clear, virtually none of them support the use of
herbal medicines by the general populace or even by educated herbal
practitioners. Their focus, rather, is on the identification of an “activeâ€
constituent that can then be modified chemically, patented, and subsequently
produced by a pharmaceutical company for profit. U.S. researchers, in spite of
often being affiliated with universities, generally work for or in concert with
pharmaceutical companies. They are not looking for something the general
populace can use without a prescription; they are not working to empower
self-care. In most instances they don’t trust the general populace to be
intelligent enough to provide their own health care, nor do they want to
interrupt their own financial income stream.
We in the Western world, especially in the United States, are
being left behind in an outmoded model that has no effective place in the real
world. By the time we realize it, the rest of the world will be generations
ahead. The rest of the world has abandoned our approach; they understand the
problems they face and what lies ahead. In the meantime, we spend our time
making better and better buggy whips, not realizing the automobile really is
here to stay.
Some Comments on the Herbs Discussed in This Book
To find the top herbs that can be effectively used for
treating antibiotic-resistant organisms, I have relied on decades of my own
experience, the cumulative experience of a great many other practitioners, many
thousands of journal papers of very good research by committed
researchers from many countries around the world, and the history of use of
these plants by local peoples over centuries.
I have put the herbs in this book into three categories:
systemic antibacterials, localized antibacterials, and facilitative or
synergistic herbs.
Systemic antibacterials are herbal medicines
that are broadly systemic, that are spread by the bloodstream throughout the
body, thus affecting every cell and organ within the body, and that are active
against a range of bacteria. These herbs are good for treating infections such
as MRSA that have spread throughout the body and are not responding to multiple
antibiotic protocols.
Localized antibacterials are those that do not
spread easily throughout the body but are limited in their movement. Because
they don’t easily cross membranes, they are effective in the GI and urinary
tracts and for external infections. These kinds of herbs are useful for
infections such as E. coli O157:H7 or cholera or for infected skin
wounds that refuse to heal.
Facilitative or synergistic herbs are just
that: plants that facilitate the action of other plants or pharmaceuticals. They
either enhance the action of the antibacterial being used or affect the bacteria
so that the antibacterial is more effective. Most plants contain both antibiotic
substances and a potent synergist, quite often one or more efflux
inhibitors. Goldenseal, which contains berberine, is an example.
Berberine, a strong antibacterial, is very active against a
number of resistant organisms. It is considerably more active, however, in the
presence of another constituent in goldenseal, 5′-methoxyhydnocarpin
(5′-MHC), which is a multidrug efflux pump inhibitor. It reduces or eliminates
MRSA’s ability to eject antibiotic substances that might harm it from inside
its cellular membrane. 5′-MHC has no known function other than to do exactly
this, and it is one of the reasons goldenseal is so effective in the treatment
of resistant infections of the GI tract.
Compounds such as 5′-MHC are why plants are often more
effective than single constituents in treating disease conditions. Other compounds in plants do still other things; some have no known
function in the plant other than to reduce the side effects of the more
pharmacologically active constituents. This is one of the reasons plants tend to
be strange medicines in the minds of medical reductionists—they can’t
understand that kind of complexity or see the reason for its existence.
Nevertheless, newer generations of researchers have grasped that the old
paradigm is unworkable and they are looking toward plants with new eyes. They
are understanding that plant medicines are much more sophisticated than
pharmaceuticals (something those in older cultures innately understand).
As some specific examples: The anticonvulsant actions of
yangonin and desmethoxyyangonin, kavalactones found in Piper
methysticum, are much greater when the lactones are used in combination
with other kava constituents. Concentrations of yangonin and another lactone,
kavain, are much higher in the brain when the whole plant extract is used rather
than the purified lactones themselves. In other words, some of the other
constituents in kava help move the bioactive lactones across the blood-brain
barrier into the brain. Blood plasma concentration of kavain is 50 percent less
if the purified compound is used rather than an extract of the plant itself.
Plant compounds in Isatis tinctoria, a potent antiviral and
anti-inflammatory herb, are highly synergistic. Tryptanthrin, a strong
anti-inflammatory in the plant, possesses very poor skin penetration capacity.
However, when the whole plant extract is applied to the skin, penetration of
tryptanthrin is very good. In other words, applying a salve of pure tryptanthrin
to the skin, despite how anti-inflammatory that compound is, won’t do you much
good. But if you make the plant itself into a salve, the tryptanthrin moves
rapidly into the skin and helps reduce skin inflammation.
Artemisinin is much more active against malarial parasites if
administered with artemetin and casticin, flavonoids normally contained in the
artemisia plant. Additional flavones in the plant, chrysophlenetin and
chrysospenol-D, also act as potent synergists in this way. They are also
permeability glycoprotein (P-gp) inhibitors (see monograph on
piperine, page 236), thus
facilitating the movement of artemisinin and the plant’s other constituents
through the intestinal membrane and into the blood.
As a final example, side effects such as tinnitus and stomach
ulcers that can occur from the use of acetylsalicylic acid don’t occur if
whole extracts of willow bark are given rather than that purified constituent;
other compounds in the plant specifically ameliorate its side effects.
Combining Plants for Greater Effect
When it comes to plant combinations, things get even more
complex. For example, constituents from licorice (glycyrrhizin and its related
compounds) significantly enhance the solubility of other plant compounds, such
as the saikosaponins from Asian ginseng, in water. Thus, combining plants
during the medicine-making process—a field almost completely
unexamined in Western herbal approaches—can produce much stronger tinctures
than when they are produced singly.
Quercetin (an anti-inflammatory and moderate anticancer flavonol
found in many plants and vegetables) is poorly soluble in water, but that
solubility is strongly enhanced by complex mixtures of saponins if plants
containing them are added to the mix when the medicine is being made.
So … while some plants such as goldenseal are synergistic
within themselves from the presence of efflux inhibitors and potent
antibacterial constituents, other plants, such as Dalea spinosa, are
relatively mild as antibacterials but contain compounds that are multidrug
resistance (MDR) inhibitors, making them synergists for other plants. Adding
synergists to a systemic antibacterial when creating an herbal compound
increases the potency of the primary herb being used, sometimes considerably.
(This has long been recognized in the actions of such plants as licorice and
western red cedar, though the reasons why were not known.)
Synergists, while known throughout herbal history, have been
only mildly recognized for their actions, usually in the Chinese and Ayurvedic
systems, but they have not been accepted as a legitimate and
unique category of herbal medicines that should be studied in their own right.
Given the seriousness of emerging resistant pathogens, it is time to begin
developing this category of herbal medicines in more depth, to begin to
understand how to use them in practice, and to find the most potent ones that
can be used for healing. The material in this book is, I hope, the beginning of
that development.
The Importance of Preparation Methods
I remember, growing up, how often the physicians in my family
made fun of the old plant doctors and herbalists insisting that some plants must
be harvested only at such and such a time or they would be too weak to work or
their insistence that certain plants must be used together to work. Turns out
there is a great deal to those old assertions. So … considerable attention is
paid within this book to how and when the plants should be
harvested, prepared, and made into medicine.
Understanding these kinds of complexities in plants and the
medicines they become comes from long exposure to them, from the same kind of
intuitive sensing (holistic nonlinear perception) that all artisans use (in
things from writing to house building to making music), and, most importantly,
from a lack of intellectual hubris. If you understand up front
that plants are highly complex living beings that are a great deal older than
the human species, it is much more difficult to place an intellectually
reductionistic paradigm on them. You can’t see what you assume is not
there.
Herbalism is an art; it is, and always will remain, much too
complex to be approached from a reductionist and linear orientation with any
expectation of success. “Phytorationalism†is an oxymoron. A practitioner
with such an orientation will never grasp the essential nonlinearity of the
world, of healing, of plant medicines.
The synergy within and among plant medicines, a prime example of
the nonlinear complexity in this field, means that the combined effect
of different substances will be greater than that which can be expected from the
individual components alone. Combination produces outcomes beyond rational
expectation. To face the challenges before us, we ourselves have no choice but
to synergize within ourselves: to develop our abilities to feel and think
simultaneously, neither in competition with the other, and blend those
capacities together into a unique perceptual tool of tremendous elegance. I am
talking about developing forebrain elegance here, not just tentative
understandings of the hindbrain. As Erich Fromm once commented: “Reason flows
from the blending of rational thought and feeling. If the two functions are torn
apart, thinking deteriorates into schizoid intellectual activity and feeling
deteriorates into neurotic life-damaging passions.â€3
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