Blog Transition

Since this blog is effective dead as a collaborative project, I am starting a new blog where I will be sharing my thoughts on integrative herbalism (with a little bit of acupuncture as well). The new blog will have a somewhat expanded scope, taking an interest in integrating Chinese, Anthroposophical, Biomedical, and Greek Medicine theories as well as integrating between herbal materia medicas. I will be reposting all my relevant posts from this blog at the new location: integrativeherbalism.blogspot.com. Its going to be exciting.

Graphing Gyn Herbs

I have a rough mental organization of gynecological herbs which arranges them in a spectrum running from blood tonic, through functional blood mover, to qi movers: Di Huang - Dang Gui - Bai Shao - Chuan Xiong - Chai Hu. (These are, of course, the herbs of Si Wu Tang, plus Chai Hu.) In this spectrum we move from the most materially nourishing to the most dry, and potentially harsh, movement. This spectrum also corresponds roughly to the periodicity of symptoms: Chai Hu as leading herb for symptoms which are maximal at ovulation, Chuan Xiong leading up to menstruation, Dang Gui at the cusp of menstruation, and Di Huang for depletion after menstruation. We would need to add extra dimensions to our graph to accommodate other gynecological herbs such as the material blood movers.

So, how to our western herbs fit into this chart? The order among the western herbs seems to be: Saw Palmetto - Black Haw - Black Cohosh - Agrimony. How does this spectrum interweave with the spectrum of Chinese Herbs? Quite tentatively I suggest a chart something like this: Di Huang - Saw Palmetto - Dang Gui - Black Haw - Bai Shao - Black Coshoh - Agrimony - Chai Hu. I would love to hear from people who have other ideas about how these should be arranged, or if there are reasons that we should not rely on this linear structure.

Extension: We can, at least conceptually, extend the spectum to the left by including the menopausal, Liver yin herbs: Er Zhi Wan from the Chinese pharmocopia and Blue Vervain, Vitex, and Borage from the Western.

Elecampane is no Banxia

The title mostly says it. Ive been trying to use Elecampane in situations where I would otherwise use Banxia. This has failed to produce the results that I'm used to from Banxia enough times that I will probably not try that approach any more. If anyone has ideas of other herbs that might work similarly to Banxia, I'd love to hear them.

Pleurisy Root as Mahuang ??

I was browsing in William Cook's The Physio-Medical Dispensatory, where I came upon his account of Pleurisy Root (asclepias tuberosa). Allow me to share a few passages: "The root of this plant is probably one of the most reliable and serviceable relaxing diaphoretics in the whole Materia Medica. ... Its principle action is upon the sweat glands ... The chief employment of this agent is in febrile and inflammatory affections, where the perspiration needs to be decidedly promoted ... It secures a slow, steady, and free perspiration, and the same time suitably diminishing excessive heat on the surface; which action renders it highly serviceable in [various fevers] and other forms of fever with hot skin and a rigid pulse ... Most commonly it is combined with some diffusive and more prompt stimulant, especially about one-fourth its own weight of ginger [and, I would add, guizhi]."

This seems to set us up perfectly to use Pleurisy Root in a Mahuang Tang type formula. But does it open the Lungs, for use in a Ma Xing Shi Gan Tang type formula? Ellingwood & Lloyd (1915), list Pleurisy Root in their chapter on "Agents Acting Upon the Respiratory Tract." They say: "It is of special service in the treatment of affections involving the serous membranes, as pleuritis, peritonitis, etc. ... It is beneficial in acute pleuritis specifically, also in bronchitis, pneumonitis, and peritonitis. It has distinct expectorant properties. In tight and painful coughs with difficult respiration, especially where there is a general suppression of secretion, with dry skin and mucous membranes, and in soreness of the chest from coughing, it is a most excellent remedy." That seems to line up pretty well, but I cannot tell whether it is working on the lungs through the same mechanism as Ma Huang. I have not yet seen wheezing mentioned specifically although "difficult respiration" comes pretty close. I'm not sure that I would rely on it in a case of whooping cough.

In terms of flavor, Holmes calls Pleurisy root bitter and pungent, which is how Bensky lists Mahuang. Holmes considers Pleurisy Root to be a cold herb, however, Matthew Wood (1997) notes that Pleurisy Root is called for in patients who are worse in the cold and damp.

A First Look at Wood

Laying the foundation for a systematic study of herbs which work on the Wood phase (Shaoyang and Jueyin, but mostly Shaoyang), I thought I would look at the different actions that the western traditions ascribe to herbs that we would regard as Wood herbs: anti-spasmodic, alterative, bitter, carminative, cholagogue, emenagogue, nervine, circulatory stimulant, lymph decongestant, blood tonic, and anti-inflammatory.

Not all of these categories belong entirely to Wood. Those nervines which relieve nervous tension belong to Wood, but others are Water or Earth tonics (when anxiety is due to depletion). Many circulatory stimulants work by moving qi, a Wood function. But those herbs which use a warming force to drive the blood, often called "diffusives," of which Prickly Ash is a strong example, work through the Taiyang. Of the anti-inflammatories, only those which relieve inflammation from stagnation belong to Wood, others we would ascribe to Yangming Metal.

Alteratives seem to straddle shaoyang and yangming functions: As downward, detoxifying agents they could be ascribed to yangming (they perform the function that some in Chinese Medicine seek to achieve with small doses of Da Huang). Indeed, most of the alteratives also promote bowel movements, however they are not purgatives like Da Huang, instead they encourage the the production and release of bile, which in turn drives the bowels, thus we could say that they use gallbladder energy to move the bowels. Finally, The alteratives work on the interstial fluids, a region that belongs to the Shaoyang Triple Burner. This is perhaps the strongest reason for regarding them as Wood herbs.

We can also note that many of the listed western functions can be regarded as specialized forms of qi-moving. I would include anti-spasmodic, carminative, cholagogue, nervine, emenagogue, and circulatory stimulant in this category. These different functions are moving the qi in different domains (perhaps we could use a five evils model to express this). Carminatives are moving qi in the digestion (Earth), Nervines are moving qi in the nerves (which belong to the Fire-Water axis), circulatory stimulants are moving qi in the vessels (belonging to Fire, but also possibly to Metal), Cholagogues move qi the gallbladder (Yang wood) Emenagogues are moving qi & blood in the reproductive organs (belonging to mostly to Yin Wood), Anti-spasmodics move qi in the muscles, often the smooth muscles (we should probably regard these as. tendons, belonging again to Wood.)

Three Prescribing Styles

As I learn more about practicing with western and local herbs, I think of myself as working toward precision in my prescribing. But precise means different things to different people. This writing is meant to help me think about what my goals are.

One style of precision is very precise about the actions and indications of each herb employed. This style tends toward single-herb prescribing, and, as this style reaches its apogee, it begins to develop bizarrely specific herbal profiles, with guidelines that might read: “the patient who needs this herb tends, while thinking, to stroke downward along his or her nose, especially with the left hand.” While such an indication would certainly be useful to remember if you happen to come across such a patient, it is hard to draw from such an indication any more general understanding of what the herb is doing, what its range of applicability might be, or how it will work with other herbs. Nevertheless, this style is quite valuable for clarifying the specificity of each herb, so that we aren’t stuck with vague understandings such as “oh, that’s qi tonic.” When used in its pure form, this style will depend on a large and ever-growing materia medica; As one makes finer and finer distinctions between the herbs, one needs more and more herbs to fill out the spectrum of effect, or, seen another way, since the aim is to perfectly match an herb to a patient, one will need at least one herb for each of the 6 trillion people on the planet.

A second style seeks precision in its diagnostic categories. The aim here is to understand and perceive the fundamental dynamics of human health. The hallmark of this approach is that it seeks to be systematic: organized, integrated, and simplifying, thus I name this the systematic style. One still needs a good refined understanding of particular herbs to use such a system, but the attention is not on the herbs in their individuality, but on the way they affect the fundamental dynamics identified by the diagnostic system. This style moves toward using fewer and fewer herbs. To the extent that one’s system is truly fundamental, one can recognize a few basic dynamics underlying a variety of clinical manifestations. Consequently one can seek to treat using only the handful of herbs needed to rectify those dynamics. This style risks clipping one’s awareness of the individuality of both herb and patients - seeing the ways that they fit in one’s system, but failing to see the ways that they do not fit. In other words, it is unclear whether one really can shoehorn the blooming, buzzing biological world into a tidy system with only 5, 10, or 25 variables.

There is a third style which is not precise in an obvious way. In this style, herbal actions are again understood in terms of diagnostic categories. (I will call this the categorical style.) The difference from the second style is that instead of preferring to use one specific herb for each action, there is a tendency to use lower doses of several herbs from the same category. Instead of trying to choose between dandelion, burdock, or oregon grape, one would just blend the three, and that blend would represent one function within a formula. The categorical style seems especially suited to long-term treatments, which cannot afford to have too many rough edges. Even if a formula is carefully balanced, the eccentricities of one’s preferred herbs may create problems if they are given for several years. Moreover, this prescribing style allows one to rotate individual herbs out of the formula without changing the direction of the formula. It does seem that the categories of thought used in this style are also less precise than in the systematic style. Perhaps this is because the body cannot be told to go to a particular point 20 miles away, rather you can point it in a general direction and begin to refine matters as the destination draws closer.

Rosemary

Morphology

Bushy growth is abundant and thick. I am always surprised how much herb is available from one plant, ie there is a dense abundance. The stem is woody with much branching. The leaves are fine, almost needles. New growth shows little distinction between leaf and stem, but with time the stem grows more woody. The leaves also dry and harden somewhat, but less dramatically. The flowers also are small and in the angles. The many small flowers all bloom together, but they remain only briefly.

It is clear that this plant places most of its emphasis on the vegetative growth process, and it focuses specifically on multiplication of the stem process, as opposed to any watery swelling of the leaf. Also, this is a dense growth, not a sprawling one. It is a steady, patient growth which does not over-extend itself. This principle of growth extends briefly to the leaves, which are abundant, but it does not fully enter into a leaf process. Instead, after forming each leaf, it quickly moves on. On the contrary, we can see the leafy vitality being usurped by stem process, being used there to promote its own growth.

The flowers are in the angles, further showing us that the growth principle does not extend itself far beyond the stem. This form also allows the stem to go on growing indefinitely. The plant does not allow the flower principle to establish itself as the final flowering, to cap the growth, to declare itself as the final cause of the plant.

 Compared to yarrow, which plays in the region between the leaf and flowering processes, rosemary keeps its vital force much closer to its center. This suggests an almost Fuzi-like storage of yang. 

Taste and Experience

I find two or three different tastes in rosemary. One is smooth, sweet, and light while also being deep and woody. There can also be an initial harshly pungent taste (this is especially noticeable in stronger tinctures). This flavor quickly dissipates, leaving the previously mentioned woody sweetness as the general impression. This harsher flavor seems to be doing some kind of cleansing, so that the lighter flavor may float forth. Concentrating on this harsh flavor also seems to pull my awareness deep within, quite as though it uses its cutting quality to sink toward the core. What is this cleasing? My sense is that it works on what we would call immaterial phlegm and turbidity.

 (Can we find this cleansing, opening, turbidity transforming quality in the plant morphology? It is not quite apparent to me. If I were interested in post-hoc mnemonics, I could say that a branch of rosemary together with its many needle-like leaves looks like a bottle brush, therefore it can be used for cleansing fine crannies, but this does not help me understand the language of plant morphology. Still, this might be a clue. Perhaps the watery life of the leaves, condensed by a drying force, have developed an inner intensity which allows them to be cutting in this way. It’s just an idea.)

 When the sweet, woody flavor is dominant, I felt nurturing, as through I wanted to hold that which is gentle through the fall and winter. I also experienced an inner image of a hearth fire. This corresponds well with the morphological theme of a contained yang.

 With time I felt a pleasant warmth in the chest. I also experienced an increased sense of alertness.

Authorities

 Culpeper states that by its “warming and comforting heat” it helps all cold diseases of head, liver, stomach, and belly - including drowsiness, mental dullness, and weak memory, windiness of stomach, bowels, and spleen, those that are “liver-grown by opening the obstructions thereof,” and can cure jaundice if it is followed by physical exercise. He says that it is good for women with leukorrhea, and can be used externally for cold, benumbed joints and limbs.

William Cook merely states that the leaves are stimulating, somewhat emmenagogue, useful in suppression of the menses from exposure, and for painful menstruation.

 Pelikan repeats Steiner’s idea that Rosemary strengthens the ‘I’ and its influence on the rest of the body. This includes both its mental acuity and blood stimulating properties. He says that it promotes digestion by “firing the metabolism,” can be used in the treatment of epilepsy, and used for diabetes.

 David Winston adds that it is a carminative cholagogue useful for flatulence, burping, and borbor. He uses it for “liver headaches and biliousness,” as well as headaches with impaired circulation. Although he also mentions that its circulatory tonic function is mild. He says that it is a powerful antioxidant, useful for preventing arterial sclerosis.

 Mills and Bone mention that, as an emenagogue, it should be avoided during pregnancy. 

 Holmes say that Rosemary is an arterial circulatory stimulant which warms the interior, treating for yang deficiency cold and damp, and says that it is one of the few remedies for HT and KD yang deficiency. Also good for conditions he attributes to zong qi deficiency: mental depression, palps, shallow breathing. Also warming to treat cold stagnation of digestion, liver, and uterus. Finally, he says that it is an adrenal restorative.

 Jeremy Ross defines its action as tonifying and moving HT, SP, and LV qi, calming and regulating intestine qi, and calming hyperactive LV yang.

 Matthew Wood says that it stimulates metabolism, enhances the burning of sugars and fats. He says that it warms and cleans through-out the body, and quotes Dr John Quincy: “[Rosemary leaves] abound with a subtile detergent oil which makes them universally deobstruent and opening.” He uses it for cardiac edema and congestive heart failure, saying that it has all three properties needed in a HT remedy: tonic, cleansing, and nervine. He finds that its influence extends to the extremities - opening capillaries and improving sensation. He also mentions that although classified as warming and drying, it is moistening to the gallbladder and bowels, so it can be used there for dryness and atrophy

Conclusions

 We can summarize these finding by saying that Rosemary: 1) Is a warming tonic to the shaoyin, with its warmth working also on the digestion and uterus. 2) Transforms some kind of turbidity or phlegm, although this sphere of action is underdefined. My sense is that it does not work well on copious or heavy phlegm but on micro-turbidity. Much of its awareness stimulating function can be ascribed to opening of the orifices through this cleansing. It is not clear what other aspects of physiology this might affect. 3) Has some wood affinities, working with jaundice and liver headaches.

Rosemary seems somewhat less activating than guizhi but somewhat more active than fuzi - with its circulatory stimulation and its center more on the HT rather than resting in the KD (although we should remember that Holmes mentions that it is an adrenal restorative and considers it a kidney yang tonic).

 Both rosemary and yarrow have some opening or moving properties, however yarrow seems to emphasize relieving qi constraint and has a significant upward and outward direction, while rosemary moves through warmth and by cleansing turbidity which might impede motion. Both herbs also have significant Wood phase connections. They might make a good combination for situations where we need both warmth and motion, and especially for situations involving chest stagnation.

 In the guizhi family of formulas, Rosemary seems less appropriate to a straight guizhi tang type formula, but well suited to Danggui Sini Tang and Ling Gui Zhu Gan tang type formulas. It seems appropriate to a Lizhong Wan type formula and perhaps even something like a Sini Tang. It will also be useful for any formulas addressing cold gynecological conditions (Wenjing Tang, etc). I have not finished working out its uses in the Wood sphere, and will address that in the future when I make a study of Wood-phase herbs.