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Vitalist Herbalism in the 21 st Century

The Gathering 2011 Toronto, Ontario. Vitalist Herbalism in the 21 st Century. Paul Bergner Director, North American Institute of Medical Herbalism Editor, Medical Herbalism. Supplementary notes, readings, texts. Powerpoint and supplemental materials at http://medherb.com/gathering.

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Vitalist Herbalism in the 21 st Century

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  1. The Gathering 2011 Toronto, Ontario VitalistHerbalism in the 21st Century Paul Bergner Director, North American Institute of Medical Herbalism Editor, Medical Herbalism

  2. Supplementary notes, readings, texts • Powerpoint and supplemental materials at • http://medherb.com/gathering

  3. Clinical Experience at NAIMH • January 1996 to present. More than 3000 cases from a sliding scale public clinic • Therapeutics include medical herbalism, clinical nutrition, flower essences, and lifestyle modification delivered in a Vitalist model. • Each patient visit becomes case-based learning • 3 hour intake with 1 hr followup, averages. • Case writeup is studied in-depth collectively by clinical faculty and herbalists • “Community learning” among 250 students.

  4. Conditions routinely cured or greatly improved • --Connective tissue autoimmunity. Multiple lupus cases • --Insulin resistance/NIDDM • --Chronic URI (sinus, sore throat, bronchitis). • --Chronic inhalant allergies/asthma • --Chronic upper GI (GERD) • --Chronic lower bowel (UC, Crohn's, IBS) • --Chronic UTI: (secondary to dysbiosis) • --Chronic musculoskeletal pain: • --Vague neurological complaints. • --Chronic anxiety/panic disorder • --Chronic fatigue/depression • (from a review of 3000+ case files)

  5. Vitalism: A recurring principle • The same principles of Vitalism emerge in Egyptian, Mesopotamian, Chinese, Ayurvedic, Unani, Physiomedicalist, Eclectic, and Naturopathic medicines without apparent linear transmission. • “If you reinvent the wheel, it will probably be round” • Medicine on the model of Agriculture

  6. Vitalism • Modification of Regimen to maximize the healing expression of Nature • The primacy of food as medicine • The primacy of the digestive tract as a target for therapeutics • Use of herbs and foods to optimize the vital expression, remove obstacles to cure, and support Regimen • Reliance on the Power of Nature rather than the power of the drug • Avoidance of suppressive agents and strategies

  7. The Classical Regimen • Food • Drink • Rest • Exercise • Air • Emotions • Water (hydrotherapy) • Physical Medicine

  8. The Physician in History • Principles of Medicine • Humoral Diagnosis • Prognosis • Regimen • Dietetics • Medical Herbalism • Attending the critically ill • Attending the dying.

  9. Polarity of Vital Force and Regimen Any concept of Vital Force or Life Power separate from the patterns of Regimen necessary for its expression is a divergence from the principles of medicine

  10. Baghdad Medical Qualification (800 AD) • “Any physician found to have given a strong herb when a mild herb would suffice, or a mild herb when a food would suffice, or a food when a lifestyle change would suffice will be disqualified from practicing in the marketplace”

  11. Regimen in Homeopathy “The physician must know the things that derange health and cause disease, and how to remove them. . . . he must know the obstacles to recovery in each case and is aware how to remove them . . . he must know the most significant points in the whole history of a chronic disease . . . he must take into consideration the physical constitution of the patients, the character, the occupation, mode of living, habits, social and domestic relations, age, sexual function., etc.  ” Hahnemann, Organon

  12. Regimen in Homeopathy and Specific Medication “Of all the schools of medicine in existence today, it is the Homeopaths who are strictest in insistence on the avoidance of those foods which irritate the stomach or oppress the system. ” John Scudder, Eclectic herbal physician, 1898

  13. Henry Lindlahr In response to the challenge "If your system is so effective, why don't more people engage in it?"  Lindlahr’s reply "Because it requires a degree of self-mastery?"  

  14. Medicine as invitation to self-mastery The task of the physician is to cooperatively assess the uniqueness of the relationship between the Life Force and the Regimen of the patient, to educate them, and to invite them to a higher level of self-mastery.

  15. What happened to medicine? • With the advent of chemical medicine in the 1800s, the medical profession dropped Regimen and humoral analysis in favor of strong suppressive drugs. Today Regimen is fragmented, treated superficially, ignored in conventional training, and relegated to a subsidiary legal status. Only NDs study the range of traditional regimen. • In the later twentieth century many Western herbal and naturopathic institutions, seeking social and scientific approval, followed the same pattern, with Regimen poorly defined.

  16. How will you practice? Will your practice, in a cooperative manner, invite the patient to a higher level of self mastery, or will it burn itself out in pursuit of the next shiny bauble or magic bullet which will let both patient and practitioner evade the task of their own self-mastery.

  17. Vitalist Regimen in the 21st Century • Food: Provide basic nutrition for endemic deficiencies • Food: Review metabolic effects of macronutrients, evaluate for insulin resistance. • Food: Review immunologic effects of foods • Food: Review adverse effects of non-foods. • Food: Prepare food from scratch • Activity: 60-90 minutes of activity per day; mixed low aerobic walking, short resistance, and high-lactate short burst, 6 days per week. • Rest: 8.5 hours average; 9.5 x 3 days = short therapeutic dose; weekend bed rest • Evaluate for Leaky Gut and impaired digestion • Optimize vitamin D status • Emotions: flower essences, talk therapy, affirmations, other • Non-suppressive and supportive medical herbalism as indicated • Time in Nature

  18. Wade Boyle, ND “Medical Herbalism is using herbs as medicine. Naturopathic Medical Herbalism is using herbs in support of Nature Cure.”

  19. Herbs and Nutrition • Critical deficiencies in contemporary life: Minerals and trace elements • One ounce of most herbs contain nutritionally significant amounts of calcium, magnesium, and trace elements • Significant amounts of these nutrients are contained either dissolved or suspended in long decoctions/infusions of herbs • Model at NAIMH: Goal for each patient to take about a liter of herbal tea a day.

  20. Calc Iron Mag Mang Pot Sel Sil Alfalfa 299 0.87 76 0.08 400 0.00 0.00 Burdock 244 4.9 1 79 0.20 560 50 0.75 Catnip 205 4.6 69 1.25 783 41 0.00 Stellaria 403 8.4 176 0.18 280 140 0.19 Symp lf 600 0.4 23 0.19 566 40 0.30 Equiset. 630 4.1 145 0.23 520 40 1.29 Kelp 1013 0.5 289 0.25 703 60 0.03 Licorice 292 2.9 321 0.16 380 0.00 0.53 Althea 272 3.8 172 0.15 403 110 0.10 Urtica 966 1.4 286 0.26 583 70 0.34 Avena 476 0.4 400 0.02 90 40 0.61 Mentha 540 2.0 220 0.02 753 40 0.00 Trifol. 436 0.0 116 0.20 666 30 0.04 Rubus 403 3.3 106 4.8 446 80 0.04 Skullcap 151 0.8 37 0.16 726 30 0.16 Mg per ounce; for Sel mcg per ounce

  21. Herbal regimen for mineral nutrition • Increase nutrient density of the diet • Take 500 to 1000mL of a nutritional herbal decoction most days.  • Most nutritious herbs are Urtica and Avena (straw)  • Almost any herb offers mineral nutrition at a dose of 1-3 ounces in strong decoction.  • Use seaweeds for supplemental food most days. • Typical results: rapid increase in sense of well-being, within 4-7 days. Longer term improvement in tissue tone and hair quality.  

  22. Evening-to-morning bloating pattern before dairy removal Resolved chronic headaches, chronic yeast infections, constant nausea, and chronic fatigue

  23. Abdominal lymphadenopathy after exposure to chicken-egg antigens Bloating resolved within a week of return to avoidance of eggs. Patient eventually was cured of long-standing MRSA infection

  24. Abdominal swelling before and after elimination of dairy and gluten Migraine headaches completely absent after withdrawal

  25. Severe eczema due to covert buttermilk solids in gluten-free mix

  26. Herbalism and the Leaky Gut • “What is good for the skin is good for the gut” • Vulneraries useful in restoring gut integrity • Plantago, Calendula, Aloe vera, Symphytum leaf in decoction (PA caution), Althea spp., Ulmus • Abdominal lymphatic engorgement • Plantago, Ceanothus, Galium, Scrophularia, etc. • Combine with bitters, carminatives, astringents, demulcents, etc as indicated • Herbal anodyne formulas as substitutes for NSAID

  27. Herbal support for probiotic therapy • Many herbs in the composite family contain various quantities of the prebioticinulin. • Arctiumlappart (50% by weight) • Inulaheleniumrt (40%) • Taraxacumrt (25%) • May be administered as powder or as long decoction (inulin highly soluble in hot water)

  28. Formulae for acute pain Portions may be composed of simples or compounds of the herbs below. Portions are added as parts of the formula along with 1-2 chief herbs. Anodyne portion Eschscholtzia, Corydalis, Piscidia, Lactuca, Pulsatilla Antispasmodic portion Viburnumopulus, Dioscorea, Paeonia, Peducularis Sedative Portion Scutellaria, passiflora, Valeriana, Humulus(as indicated)

  29. Formulae for chronic pain • Build formula around the therapeutic pair of Curcuma and Glycyrrhiza • Deliver in larger quantities as powder. • Add modifying portions from acute formula if appropriate • A medium of lemon and honey (traditional corrigent for curcuma in Unani medicine) • Honey decoction. Heat a quantity of honey gently to just below its boiling point. For a brief period it will become as thin as water. Shortly therafter it will foam up. Before foaming, add 1/8 part lemon juice and then freshly ground powder of Curcuma (3), Glycyrrhiza (3), Rosaflos (1), and Pimpinella seed (1) until a thick consistency

  30. Vitamin D and the junction proteins

  31. The Pathophysiology of Sleep Debt • For some individuals, sleep debt occurs with less than 9 hours sleep. For the majority of individuals, it occurs with less than 8 hours sleep. • Sleep debt induces hypercortisolemia, disturbed cortisol rhythm, insulin resistance, immunodeficiency, and cognitive dysfuntion. Individual may meet diagnostic criteria for depression. • The neuro-endocrine effects are largely corrected with 3 successive night of sleep of 9.5 hours or more • Sleep coaching is necessary to re-establish sleep – effects of light, temperature, activity, daylight sun exposure, etc. • Herbs may help to induce or support sleep and restoration.

  32. Herbs and Sleep Debt • May be given is context of sleep-coaching: effects of light, activity, etc on circadian rhythm • Non-hypnotic nervine tonics by day • Mild relaxants at transition to home, to support intentional efforts to relax. • Hypnotics, sedatives, anodynes by night • Pulsed dosing along with relaxation efforts • Doses at 90 and 30 min prior to bedtime, and at bedtime. Extra dose at bedside if waking up.

  33. Wild Cards for Vitalism in the Future • Future shock/social and economic dislocation • Post Traumatic Stress Disorder (PTSD) • Mild Traumatic Brain injury • Jet lag, Climate lag, Season lag. • Electronic fields • Common forgotten remedy: Time in Nature

  34. Supplementary notes, readings, texts • Powerpoint and supplemental materials at • http://medherb.com/gathering • See also: http://naimh.com • Educational courses and CEU. Free copy of Scudder’s American Eclectic MateriaMedica and Therapeutics. • http://medherb.com • Free searchable Medical Herbalism back issue article database (free). Free copy of Cook’s Physiomedical Dispensatory

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