Efficacy Health Dictionary

Garlic (Allium sativum).

Plant Part Used: Bulb.

Dominican Medicinal Uses: The bulb is traditionally ingested raw for high blood pressure, upper-respiratory infection, common cold, flu-like symptoms and cough, and the alcohol extract is taken internally for sinusitis. The bulb skins are traditionally prepared as a tea and taken internally for indigestion and gastro-intestinal complaints.

Safety: The bulb is generally regarded as safe for human consumption. Reported adverse effects include skin burns due to topical application (especially in children with prolonged exposure). Adverse effects associated with internal use include halitosis, body odor, gastrointestinal irritation, constipation, headache, nausea, fatigue and vertigo.

Contraindications: Not to be taken at therapeutic doses for 10 days prior to surgery due to antiplatelet activity and risk of excessive bleeding. The bulb is contraindicated during lactation.

Drug Interactions: Chlorzoxazone: garlic may reduce drug metabolism. Indomethacin and NSAIDs: risk of excessive bleeding. Protease inhibitors: reduced blood levels. Drugs metabolized by cytochrome P450 2E1: garlic may inhibit efficacy. Forskilin: garlic may potentiate antiplatelet activity.

Clinical Data: The following effects have been investigated in human clinical trials: treatment of atherosclerosis, common cold, coronary artery disease, hyperlipidemia, hypertension and unstable angina pectoris.

Laboratory & Preclinical Data: The following biological activities have been investigated in laboratory and preclinical studies (in vitro or animal models): antibacterial, anticarcinogenic, antifungal, antihypertensive, antineoplastic, antinociceptive, antioxidant, anti-platelet-aggregant, antithrombic, antiviral and immune enhancing.... ajo

Assessment of the efficacy and persistence of an insecticidal treatment by exposing mosquitoes of known susceptibility to a treated surface or area for a standard period of time.... bioassay

Studies which test drug safety and efficacy prior to registration. 1. Phase I: a study in human volunteers to establish safety of a pharmaceutical agent. 2. Phase II: the first investigation of a new drug in patients to determine the preliminary evidence of efficacy and to confirm safety. 3. Phase III: trials designed to determine long term safety, efficacy and cost-effectiveness of a new drug in large numbers of patients.... clinical trial

Cimicifuga racemosa. N.O. Ranunculaceae.

Synonym: Known also as Black Snakeroot.

Habitat: The dried rhizome and roots are imported from the U.S.A., to which country and Canada the plant is indigenous.

Features ? Thick, hard and knotty, the root is bitter and acrid in taste, and gives off a rather nauseating smell.

Part used ? Rhizome and roots.

Action: Astringent, diuretic, emmenagogue and alterative.

The decoction of 1 ounce to 1 pint (reduced from 1 1/2 pints) of water, is administered in wineglassful doses. Its chief importance lies in the treatment of rheumatism, and the root figures frequently in herbal prescriptions for this complaint. In small doses it is useful in children's diarrhoea, and is reputed to be a remedy for St. Vitus' Dance (chorea), although its efficacy here is dubious.

Cimicifuga should be taken with care, as overdoses produce nausea and vomiting.... cohosh, black

The extent to which the specific resources used to provide a specific intervention, procedure, regimen or service of known efficacy and effectiveness are minimized.... efficient / efficiency

B. Br.

Family: Asclepiadaceae.

Habitat: Central and Peninsular India.

English: Australian Cow Plant, Ipecacuanha (Indian).

Ayurvedic: Meshashringi, Meshav- ishaanikaa, Meshavalli, Chhaagal- shrngi. Ajashringi (also equated with Dolichandrone falcata and Pergularia extensa).

Unani: Gurmaar Buuti.

Siddha/Tamil: Kannu Minnayam- kodi, Passaam, Shirukurinja.

Action: Leaf—antidiabetic. Stimulates the heart and circulatory system, activates the uterus. Used in parageusia and furunculosis. Plant—diuretic, antibilious. Root— emetic, expectorant, astringent, stomachic.

Gymnemagenin, the main sapoge- nin in the leaves, yielded 3.9-4.6% of total gymnemic acids.

Gymnemic acids are antisweet principles and exhibit inhibitory effect on levels of plasma glucose.

The extract of dried leaves, given to diabetic rats at a dose of 20 mg/day per rat for 8 weeks, was found to bring about blood glucose homoeostasis by increasing serum insulin levels. Increased glycoprotein level and the resultant nephropathy, retinopathy and micro-and macro-angiopathy were also controlled.

The leaf extract (25-100 mg/kg), when orally administered to experimentally induced hyperlipidaemic rats for 2 weeks, reduced the elevated serum triglyceride and total cholesterol in a dose-dependent manner. The efficacy and antiatherosclerotic potential of the extract (100 mg/kg) were comparable to that of a lipid lowering agent, clofibrate.

In homoeopathy, a drug obtained from the leaves and roots is prescribed for both diabetes mellitus and insipidus Gymnemic acid is reported to inhibit melanin formation in vitro. It also inhibits dental plaque formation.

Dosage: Root, leaf-3-5 g powder; 50-100 ml decoction. (CCRAS.)... gymnema sylvestre

A medicament, the efficacy of which has not been proved by convincing clinical investigation and double blind trials. To the scientific mind, the difference between fact and fiction depends upon satisfying the Medicines Control Agency with worthwhile evidence of efficacy before issue of a Product Licence. ... anecdotal medicine

One of the corticosteroid hormones produced by the outer layer (cortex) of the adrenal glands. Corticosteroid drugs are synthetic derivatives that have similar properties as those produced in the body. They are used in pharmacy for allergies, Addison’s disease, rheumatism and inflammatory conditions. Prolonged over-use is known to weaken response of the body’s immune system to invasion of bacteria and infection.

Alternatives of limited efficacy: see entry – CORTICOSTEROIDS. These are known to produce increased output of adrenal hormones by their cortisone-like effect. ... cortisone

Centaurea nigra. N.O. Compositae.

Synonym: Hard-head, Hard-hack, Ironweed (these due to its resistance to the mower's scythe), Black Ray Thistle, Star Thistle.

Habitat: Pastures and meadows.

Features ? Stem grows from one to two feet, angular, tough, very much branched on alternate sides. Leaves dull green, hard appearance, downy underneath, irregularly notched edges, upper sessile, lower stalked. Flowers thistle-shaped ; reddish-purple, hair-like petals grow from nearly black, scaly knob. Fruit without pappus, surrounded by bristles. Taste, slightly salty.

Part used ? Herb.

Action: Tonic, diaphoretic, diuretic.

As a general tonic for most of the purposes for which Gentian is used. Knapweed is held in some quarters to equal Gentian in all-round efficacy, but the latter is much more frequently prescribed. The ounce to pint infusion is taken in wineglass doses.... knapweed

Linn.

Family: Campanulaceae; Lobeli-

Habitat: Native to eastern United States; imported into India.

English: Indian Tabacco, Pukeweed.

Ayurvedic: Devanala (var.).

Action: Antiasthmatic, antispasmodic, broncho-dilator, expectorant, mild sedative and relaxant. Used as a tabacco deterrent (as a major ingredient in many antismoking mixtures).

Key application: In the treatment of asthma, bronchitis. (German Commission E.) As respiratory stimulant. (The British Herbal Pharmacopoeia.)

Lobelia contains piperidine alkaloids, mainly lobeline, with lobelanine, lobelanidine, norlobelanine, isolobi- nine. Lobeline stimulates respiration in animals by stimulating respiratory centre and at high doses stimulates the vomiting centre.

Lobeline has similar but less potent pharmacological properties to nicotine but 1/20-1/5 as potent.

Lobeline (0.5%) has also been used as an active ingredient in skin-lightening preparations.

Clinical research could not demonstrate lobeline efficacy greater than placebo in smoking cessation. It was disallowed as an ingredient in antismoking products in the US in 1993. (Natural Medicines Comprehensive Database, 2007.)

The leaves contain beta-amyrin pal- mitate which possesses sedative and antidepressant properties comparable to the antidepressant drug mianserin. Methanolic extract of leaves exhibited antidepressant activity.

The leaf powder is toxic at 0.6-1.0 , (Francis Brinker.)... lobelia inflata

Sarg.

Synonym: P. longifolia Roxb.

Family: Pinaceae.

Habitat: The Western and Eastern Himalayas.

English: Long-leaved Pine, Three- leaved Pine, Chir Pine.

Ayurvedic: Sarala, Pita-vriksha, Surabhidaaruka, Dhuupavriksha, Namasu. Oleo-resin—Shriveshtaka, Ghandh-Birojaa.

Unani: Sanobar-ul-Hindi. Oleoresin—Gandh-Bihrojaa, Qinn, Berzad.

Siddha/Tamil: Simaidevadaru.

Action: Needle, needle oil— decongestant, expectorant, antiseptic. Oil—used in cough and cold remedies, particularly inhalations and in rubefacients for rheumatism and muscle stiffness. Resin— expectorant, antiseptic, antipruritic.

The essential oil from oleoresin contains chiefly alpha-and beta-pinene; carene and longifoline.

Pinus pinaster Ait (Cluster Pine, Maritime Pine) has been successfully grown in Kulu, Manali and Rahini. German Commission E recognized the efficacy of the needle-oil in catarrhal diseases of the upper and lower respiratory tract (internally, as well as externally).

Dosage: Heartwood, root—1-3 g powder. (API, Vol. III.)... pinus roxburghii

Linn.

Family: Piperaceae.

Habitat: Warmer parts of India, from Central Himalayas to Assam, lower hills of West Bengal; Uttar Pradesh, Andhra Pradesh, Western

Ghats from Konkan southwards to Trivandrum. Often cultivated.

English: Indian Long Pepper, Joborandi.

Ayurvedic: Pippali, Maagadhi, Maagadha, Maagadhaa, Maagad- hikaa, Magadhodbhavaa, Vaidehi, Upkulyaa, Pippalikam, Chapalaa, Kanaa, Krishnaa. Uushnaa, Shaun- di, Kolaa, Tikshna-tandulaa.

Unani: Filfil Daraaz, Daarfilfil.

Siddha/Tamil: Thippili, Arisi thippili. Thippiliver (root).

Action: Fruits—used for diseases of the respiratory tract (cough, bronchitis, asthma); as sedative (in insomnia and epilepsy); as chola- gogue (in obstruction of bile duct and bladder), as emmenagogue, as digestive, appetizer and carminative (in indigestion); as general tonic and haematinic (in anaemia, chronic fevers and for improving intellect). Applied locally on muscular pains and inflammations.

Several aristolactams and dioxoa- porphines have been isolated from Indian long pepper. It also contains the long chain isobutyl amide, longamide, besides guineensine and the lignans, pluviatilol, methyl pluviatilol (farge- sin), sesamin and asarinine.

Piperine is the major alkaloid of peppers.

Piperine is antipyretic, hypotensive, analeptic, CNS stimulant. It has been reported to exert significant protection against CCl4-induced hepatotoxicity in mice. It improves drug availability in experimental animals, and is used for enhancing the efficacy of co- administered medicaments.

Piperine enhanced bioavailability of hexobarbital, phenytoin, propranolol and theophylline. (Sharon M. Herr.) (Piperine is also a component of Piper nigrum.)

N - isobutyl - deca - trans - 2 - trans - 4 - dienamide, isolated from the fruit, exhibited antitubercular property.

Milk extract of the fruit effectively reduced passive cutaneous anaphylaxis in rats. It protected guinea-pigs against antigen-induced bronchospasm.

In China, Piper longum oil constituents were reported to inhibit the increase in serum total cholesterol induced by triton in mice.

The root powder exhibited antifer- tility activity.

A related species, P. peepuloides Roxb., is known as Saamvali Peepal. It is used specifically against obstinate skin diseases and as a sialagogue.

Dosage: Fruit—1-3 mg (API, Vol. IV); root—1-3 g powder. (CCRAS.)... piper longum

Linn. (European BlackBerry, European Bramble, known as Vilaayati Anchhu) is cultivated in the valley of Kashmir and in Assam and Tamil Nadu up to 2,000 m. A decoction of the root is used for dysentery and whooping cough. The plant gave a triterpenic acid, rubitic acid, characterized as 7 alpha-hydroxyursolic acid.

Key application: Rubus fruticosus leaf—in nonspecific, acute diarrhoea, mild inflammation of the mucosa of oral cavity and throat. (German Commission E.)

Rubus rugosus Sm. synonym R. moluccanus auct non Linn., (known as Kalsol in Kumaon) is found in Central and Eastern tropical and temperate Himalaya from Nepal to Sikkim and in Assam. The plant contains triter- penes, also afforded rubusic acid and beta-sitosterol; leaves gave tormentic acid. Leaves exhibit astringent, emme- nagogue and abortifacient properties.

Rubus niveus Thunb. (Mysore Raspberry, Mahabaleshwar Raspberry) is common in evergreen forests of Ma- habaleshwar.

European Raspberry is equated with Rubus idaeus Linn. The leaves contain flavonoids, mainly glycosides of kaem- pferol, quercetin and tannins. Raspberry leaf tea has been used in Europe to facilitate child birth. Its uterine relaxant effects have been demonstrated in animals (the extract appears to effect only the pregnant uterus, no activity has been observed on the non- pregnant uterus).

The leaves of European Raspberry (Rubus idaeus) and other species exhibit astringent, carminative and spasmolytic activity. Leaves are used for painful and profuse menstruation and, as mentioned earlier, for making parturition easier. An infusion is used for bowel complains, also as a blood purifier. Leaves contain ascorbic acid (about 80 mg/100 g). Polyphenol content of the fruit (methanolic extract) exhibited scavenging and antilipo-peroxidant activities.

Rubus idaeus has been introduced into India and is cultivated on a small scale in South Indian hill stations.

The leaf of Rubus idaeus has been included among unapproved herbs by German Commission E, as its efficacy has not been documented.... rubus fruticosus

Miller.

Family: Liliaceae; Smilacaceae.

Habitat: Native to tropical America and the West Indies.

English: Sarsaparilla.

Unani: Ushbaa Maghrabi (Ushbaa Desi is equated with Decalepis hamiltonii.)

Action: Alterative, anti- inflammatory, antipruritic, blood purifier, antiseptic. (It was first introduced in 1563 as a drug for syphilis.)

In Western herbal, Sarsaparilla is equated with Smilax aristolochiaefo- lia (American, Mexican, Vera Cruz or Grey Sarsaparilla); S. medica, S. regelii (Jamaican, Honduras or Brown Sarsaparilla); S.febrifuga (Ecuadorian or Guayaquil Sarsaparilla). Hemides- mus indicus is equated with Indian Sarsaparilla.

Key application: Preparations of sarsaparilla root are used for skin diseases, psoriasis and its sequel, rheumatic complaints, kidney diseases, and as a diaphoretic and diuretic. (The claimed efficacy has not been established clinically.) Included among unapproved herbs by German Commission E.

The roots and rhizomes of sarsaparil- la contain saponins based on aglycones sarsapogenin and smilagenin, the major one being parillin (sarsaponin), with smilasaponin (smilacin) and sar- saparilloside; beta-sitosterol, stigmas- terol and their glucosides. Chief components of saponins (0.5-3%) are sar- saparilloside, along with parillin as a breakdown product. Parillin shows antibiotic activity.

Sarsaparilla root sterols are not anabolic steroids, nor are they converted in vivo to anabolic steroids. Testosterone, till now, has not been detected in any plant including sarsaparilla. Hemidesmus indicus contains none of the saponins or principal constituents found in sarsaparilla. (Natural Medicines Comprehensive Database, 2007.)... smilax aristolochiaefolia

Tanacetum vulgare. N.O. Compositae.

Habitat: This common English wild plant was formerly cultivated in gardens, but is now rarely seen away from the borders of fields and waysides.

Features ? The tough, slightly ribbed stems reach a height of two or three feet, terminating in the peculiar bunch of yellow, flat, button-like flowers by which the plant may be easily recognised in July and August; the flowers look, indeed, as if all the petals had been pulled off, leaving only the central florets. Leaf stalks grow on alternate sides of the stem, the leaves themselves being six to eight inches long by about four inches broad, deeply cut pinnately. The crushed leaves and flowers give a pronounced aromatic smell, and have a bitter taste.

Tansy herb is probably the best of all the media for getting rid of worms in children, and a dose according to age should be given night and morning fasting. The infusion of 1 ounce to 1 pint of boiling water is used.

The medicine is also esteemed in some quarters for the treatment of hysteria and certain other of the nervous disorders of women. For this purpose a wineglassful of the infusion should be taken frequently.

The old-time herbalists used Tansy as a stimulating tonic for a poor digestive apparatus, but to-day herbal compounds of greater efficacy are prescribed for dyspepsia.

TOAD FLAX.

Linaria vulgaris. N.O. Scrophulariaceae.

Synonym: Butter and Eggs, Flaxweed, Pennywort. The name "Toad Flax" because of a supposed similarity between the mouth of the flower and that of the toad.

Habitat: Hedgerows and cornfields.

Features ? Stem one to two feet higli, upright, only slightly branched. Leaves numerous, grass-like, tapering to a point. Stem and leaves are smooth, with a pale bluish hue. Flowers shaped like the snapdragon (antirrhinum), pale yellow, mouth closed by projecting orange-coloured lower lip ; clustered together at top of stem.

Part used ? Herb.

Action: Hepatic, alterative, astringent, detergent.

To some extent in prescriptions for jaundice, hepatic torpor and skin diseases. Is also sometimes included in pile ointments. The 1 ounce to 1 pint infusion is taken in doses of 2 fl. ounces.... tansy

n. a drug administered to break down mucus filaments in the eyes in the treatment of dry eyes (for example, in *Sjögren’s syndrome). It is also given to prevent liver damage in paracetamol overdosage. Acetylcysteine has been shown to have efficacy in treating idiopathic pulmonary fibrosis, but it is not licensed for this purpose.... acetylcysteine

Strychnos nux-vomica

Loganiaceae

San: Karaskara;

Hin: Kajra, Kuchila;

Mal: Kanjiram; ;

Tam: Itti, Kagodi, Kanjirai Mar:Jharkhatchura;

Kan: Hemmushti, Ittangi;

Tel: Mushti, Mushidi; Ori: Kora, Kachila

Importance: It is a large deciduous tree, with simple leaves and white fragrant flowers.

Strychnos is highly toxic to man and animals producing stiffness of muscles and convulsions, ultimately leading to death. However, in small doses it can also serve as efficacious cure forms of paralysis and other nervous disorders. The seeds are used as a remedy in intermittent fever, dyspepsia, chronic dysentery, paralytic and neuralgic affections, worms, epilepsy, chronic rheumatism, insomnia and colic. It is also useful in impotence, neuralgia of face, heart disease, spermatorrhoea, skin diseases, toxins, wounds, emaciation, cough and cholera. Leaves are applied as poultice in the treatment of chronic wounds and ulcers and the leaf decoction is useful in paralytic complaints. Root and root bark used in fever and dysentery (Nadkarni, 1982; Kurup et al, 1979).

Distribution: The plant is distributed throughout India in deciduous forests up to 1200m. It is also found in Sri Lanka, Siam, Indochina and Malaysia.

Botany: Strychnos nux-vomica Linn. is a large tree belonging to the family Loganiaceae. Leaves are simple, opposite, orbicular to ovate, 6-11.5x6-9.5cm, coriaceous, glabrous, 5 nerved, apex obtuse, acute or apiculate, transverse nerves irregular and inconspicuous. Inflorescence is many flowered terminal cymes, 2.5-5cm across. Bracts (5mm) and bracteoles (1.5mm) small. Flowers are white or greenish white and fragrant. Calyx 5 lobed, pubescent and small (2mm). Corolla salver shaped, tube cylindrical slightly hairy near the base within and greenish white, tube much elongate than the lobes. Tube 7mm and lobes 2.5mm long. Lobes 5 and valvate. Stamens 5, filaments short, 0.1mm long. Anthers 1.5mm subexerted, linear oblong. Ovary 1.5 mm, pubescent, 2 celled, ovules one to many. Style 9mm, stigma capitate. Fruit is a berry, 5-6cm diameter, globose, indehiscent, thick shelled, orange red when ripe with fleshy pulp enclosing the seeds. Seeds 1-many, discoid, compressed, coin like, concave on one side and convex on the other, covered with fine grey silky hairs.

The leaf fall is during December (do not shed all the leaves at a time) and new foliage appears in February. Flowering is during March - April and fruiting during May - December. Fruits take about 8-9 months to mature.

Properties and activity: Strychnine and brucine are the most important and toxic alkaloids present in the plant. They occur not only in the seeds but also in roots, wood, bark, fruit pulp and hard fruit shells. The minor alkaloids present in the plant are vomicine, -colubrine, -colubrine, pseudostrychnine and N-methyl-sec-pseudobrucine (novacine). Loganin a glycoside is also present (Warnat, 1932; Martin et al, 1953; Guggisberg et al, 1966; Bisset and Chaudhary, 1974). Chatterji and Basa (1967) reported vomicine as the major constituent alkaloid along with unidentified alkaloid in leaves and identified another alkaloid kajine (N-methyl pseudostrychnine) from the leaves of very young plants.

Root bark of S. nux-vomica yeilded 4-hydroxy-3-methoxy strychnine, 4 hydroxy strychine, nor-macusine, a new alkaloid 12 , 13 dihydro-12 -hydroxy isostrychnine named protostrychnine (Baser et al, 1979) methoxy strychnine, and mavacurine (Guggisberg et al, 1966). Leaves and root bark also yeilded 11 new alkaloids. 10-hydroxy strychnine, 3-12-dihydroxystrychnine, 12-hydroxy–11- methoxy strychnine, 3-12-dihydroxy- 11-methoxy strychnine,12-hydroxy strychnine-N- oxide 12-hydroxy-11-methoxy strychnine- N-oxide-19,20–dihydro isostrychnine, 16 , 17 dihydro-17 -hydroxy isostrychnine, O- methyl-macusine B, 16-epi-o-methyl–macusine B and normelinone B (Baser and Bisset, 1982).

De and Datta (1988) isolated 5 tertiary indole alkaloids viz. strychnine, brucine, vomicine, icajine and novacine from S.nux-vomica flowers. Bisset et al (1989) isolated and identified two phenolic glycosides salidroside and cuchiloside – a compound consisting of salidroside and an attached xylose unit, from the fruit of S.nux-vomica.

Rodriguez et al (1979) isolated an indole alkaloid from the seeds of S. nux- vomica and identified as a 3-methoxy icajine. A new alkaloid 15-hydroxy strychnine has been isolated from the seeds and the structure of the alkaloid established by spectroscopic data (Galeffi et al, 1979). Cai et al (1990a) isolated 4 new alkaloids isobrucine, isobrucine N-oxide, isostrychnine N-oxide and 2 hydroxy–3-methoxy strychnine from the heat treated seeds of S. nuxvomica and the structure of the alkaloids were determined by 13 CNMR (Cai et al, 1994). Cai et al (1990 b) studied the changes in the alkaloid composition of the seeds during drug processing. Saily et al (1994) determined the mineral elements in Strychnos nux-vomica. Corsaro et al (1995) reported polysaccharides from the seeds of Strychnos species.

Seeger and Neumann (1986) reviewed the physico-chemical characteristics, occurrence, identification, utilisation, poisoning, toxicity, kinetics, differential diagnosis and therapeutic uses of strychnine and brucine. Aspergillus niger, A. flavus and Pencillium citrinum showed regular association with Strychnos seeds and effectively deteriorated the alkaloid content of the seeds (Dutta, 1988; Dutta and Roy, 1992). Nicholson (1993) described the history, structure and synthesis of strychnine which occur in the seeds of S. nux-vomica. Rawal and Michoud (1991) developed a general solution for the synthesis of 2- azabicyclo (3.3.1) nonane substructure of Strychnos alkaloids.

Villar et al (1984) and Hayakawa et al (1984) developed HPLC method for the analysis of strychnine and brucine. Graf and Wittliner (1985), Kostennikova (1986) and Gaitonde and Joshi (1986) suggested different methods for the assay of strychnine and brucine. Biala et al, (1996) developed new method for the assay of alkaloids in S. nux- vomica.

The seeds are bitter, acrid, alexeteric, aphrodisiac, appetiser, antiperiodic, anthelmintic, digestive, febrifuge, emmenagogue, purgative, spinal, respiratory and cardiac stimulant and stomachic. The bark is bitter, and tonic and febrifuge (Nadkarni, 1954; Kurup et al, 1979; Warrier et al, 1996).

The quarternery alkaloid from the root bark of the Sri Lankan plant exhibited muscle-relaxant activity (Baser and Bisset, 1982). Antimicrobial activity of indole alkaloid isolated from the Strychnos nux-vomica was studied by Verpoorte et al, 1983. Shukla et al (1985) evaluated the efficacy of Rasnadigugglu compound consisting of S. nux-vomica, on rheumatoid arthritis and found to be effective in reducing inflammatory oedoma and rheumatoid arthritis. It also exhibited analgesic activity. A compound Unani formulation containing S. nux-vomica significantly attenuated withdrawal intensity in morphine dependent rats (Zatar et al, 1991). Shahana et al (1994) studied the effect of Unani drug combination (UDC) having Strychnos nux-vomica on the abstinence syndrome in moderately and severely morphine dependent rats. The UDC strikingly suppressed the abstinence syndrome was seen to possess central depressant and analgesic action.

Melone et al (1992) reported brucine-lethality in mice. Panda and Panda (1993) and Satyanarayanan et al (1994) reported antigastric ulcer activity of nux vomica in Shay rats. Banerjee and Pal (1994) reported the medicinal plants used by the tribals of plain land in India for hair and scalp preparation and S. nux-vomica being used to cure alopecia (baldness) by the tribals. Tripathi and Chaurasia (1996) studied the effect of S. nux-vomica alcohol extract on lipid peroxidation in rat liver.... strychnine tree

Linn.

Family: Compositae; Asteraceae.

Habitat: Western Himalayas from Kashmir to Nepal at 1,500-3,500 m.

English: Coughwort, Coltsfoot, Asses' Foot.

Unani: Fanjiyun.

Action: Leaves and flowers— anticatarrhal, antitussive, expectorant, antispasmodic, demulcent, anti-inflammatory. Used for dry, unproductive, irritative cough, smoker's cough, whooping cough, bronchial asthma (effect shortlived), laryngitis.

Key application: In acute catarrh of the respiratory tract with cough and hoarseness; acute, mild inflammation of the oral and pharyngeal mucosa. Contraindicated during pregnancy and nursing. (German Commission E.)

The leaves and flowers contain flavo- noids including rutin, hyperoside and isoquercetin; pyrrolizidine alkaloids including senkirkine and tussilagine (about 0.015%); mucilage (about 8%) consisting of polysaccharides based on glucose, galactose, fructose, arabinose and xylose; inulin, tannins.

Polysaccharides are antiinflammatory and immuno-stimulating, as well as demulcent. Flavonoids also have anti-inflammatory and antispasmod- ic action. Pyrrolizidine alkaloids have caused hepatotoxicity in rats fed daily on high doses, but not on daily low dose regimes. These are largely destroyed when the herb is boiled.

The leaf contains an inhibitor of platelet activating factor (PAF). The PAF inhibitor can account for Coltsfoot's efficacy in asthma. The constituent, tussilagone has respiratory stimulant and cardiovascular (including pressor) activities. In animal studies, Coltsfoot is reported to have a pres- soreffect similartodopaminebut without tachyphylasis. (Natural Medicines Comprehensive Database, 2007.)... tussilago farfara

The Government and health authorities of the UK and Europe express their desire that citizens take more responsibility for their own health. Also, the public’s disquiet towards some aspects of modern medicine leads them to seek alternatives elsewhere. As a generation of health-conscious people approach middle age, it is less inclined to visit the doctor but to seek over-the-counter products of proven quality, safety and efficacy for minor self-limiting conditions. This has the advantage of freeing the doctor for more serious cases. Intelligent self-medication has come to stay.

Prescriptions. While specimen combinations appear for each specific disease in this book, medicines from the dispensary may be varied many times during the course of treatment. The practitioner will adapt a prescription to a patient’s individual clinical picture by adding and subtracting agents according to the changing basic needs of the case. For instance, a first bottle of medicine or blend of powders may include a diuretic to clear the kidneys in preparation for the elimination of wastes and toxins unleashed by active ingredients.

The reader should never underestimate the capacity of herbal medicine to regenerate the human body, even from the brink of disaster.

Acknowledgements. I am indebted to my distinguished mentor, Edgar Gerald Jones, Mansfield, Nottinghamshire, England, to whom I owe more than I could ever repay. I am indebted also to the National Institute of Medical Herbalists, and to the British Herbal Medicine Association, both of which bodies have advanced the cause of herbal medicine. I have drawn heavily upon the British Herbal Pharmacopoeias 1983 and 1990, authentic publications of the BHMA, and have researched major works of ancient and modern herbalism including those pioneers of American Eclectic Medicine: Dr Samuel Thomson, Dr Wooster Beach, Dr Finlay Ellingwood and their British contemporaries. All made a vital contribution in their day and generation. I have endeavoured to keep abreast of the times, incorporating the latest scientific information at the time of going to press. For the purposes of this book I am especially indebted to my friend Dr John Cosh for checking accuracy of the medical material and for his many helpful suggestions.

A wealth of useful plants awaits further investigation. Arnica, Belladonna and Gelsemium are highly regarded by European physicians. It is believed that these plants, at present out of favour, still have an important role in medicine of the future. The wise and experienced clinician will wish to know how to harness their power to meet the challenge of tomorrow’s world.

Perhaps the real value of well-known alternative remedies lies in their comparative safety. Though largely unproven by elaborate clinical trials, the majority carry little risk or harm. Some have a great potential for good. The therapy is compatible with other forms of treatment.

The revival of herbal medicine is no passing cult due to sentimentality or superstition. It indicates, rather, a return to that deep devotion to nature that most of us have always possessed, and which seems in danger of being lost in the maze of modern pharmacy. It is an expression of loyalty to all that is best from

the past as we move forward into the 21st century with a better understanding of disease and its treatment. I believe the herbal profession has a distinguished and indispensible contribution to make towards the conquest of disease among peoples of the world, and that it should enjoy a place beside orthodox medicine.

Who are we to say that today’s antibiotics and high-tech medicine will always be available? In a world of increasing violence, war and disaster, a breakdown in the nation’s health service might happen at any time, thus curtailing production of insulin for the diabetic, steroids for the hormone-deficient, and anti-coagulants for the thrombotic. High-technology can do little without its specialised equipment. There may come a time when we shall have to reply on our own natural resources. It would be then that a knowledge of alternatives could be vital to survival. ... self medication

n. any substance used in conjunction with another to enhance its activity. Aluminium salts are used as adjuvants in the preparation of vaccines from the toxins of diphtheria and tetanus: by keeping the toxins in precipitated form, the salts increase the efficacy of the toxins as antigens.... adjuvant

n. the apparatus used for *defibrillation, which may be internal (see implantable cardiovertor defibrillator) or external. External defibrillators may be fully automated (see automated external defibrillator), semiautomated, or manual and usually deliver the electric current via two defibrillation paddles. They are now all manufactured to deliver a biphasic current waveform (until recently they were all monophasic). The efficacy of the first shock during *cardiac arrest is higher with biphasic systems, which also use less battery power per shock.... defibrillator

Recommendations are not intended to take the place of diagnosis and treatment by a medical practitioner or qualified consulting medical herbalist. All information has a record of efficacy, though treatment cannot be expected to be always successful. Any condition that persists for more than ten days should be referred to a doctor, especially if it is not in the nature of a cold or influenza. All reasonable care has been taken in the preparation of this book. The author does not imply any guarantee of cure and cannot accept responsibility for adverse effects arising from the use of thereof.

IN the case of a known serious condition a doctor should be consulted.

ALL medicines should be avoided during pregnancy unless prescribed by a doctor. ... warning

Acetylsalicylic acid. Widely used drug for relief of pain and to reduce fever. Preventative against stroke, cataract, heart attack. While aspirin has been a dramatic life-saver, unwanted side-effects include stomach bleeding, nervous irritability and personality change. Should not be given to children with influenza or chicken pox. A common source of allergies and infertility.

Herbal alternatives exist but may be of limited efficacy: menstrual pain (Helonias root), muscular rheumatism (Black Cohosh), tension headaches (Ginkgo), Angina pectoris (Cramp bark), eye-strain (Eyebright), facial neuralgia (German Chamomile), swollen glands (Poke root), chest pain (Elecampane), cough (Iceland Moss), simple abdominal pain (Fenugreek).

Cures for relief of painful limbs run into hundreds. Gentle massage to release endorphins which block pain waves offers an external approach. Arthritic knees are less painful on application of Castor oil packs or one of the many preparations commended under poultices, liniments, lotions, etc.

During trials at Long Island University, USA, 189 cases of rheumatic knees and elbows were rendered painless by pollen poultices. Dissolve one tablespoon bee pollen pellets in warm water; immerse small handtowel; squeeze out excess moisture; bind over affected joint.

Cold water packs are advised by hydrotherapists for headache, stiff neck, shoulders, back and legs. Sodium bicarbonate is the safest and most effective antidote for aspirin overdose.

Aspirin therapy almost halves the risk of venous thrombosis and pulmonary embolism in patients

undergoing surgery, according to a major study. (BMJ Jan 22 1994)

Studies show that deaths from heart attack can be halved by prescribing half tablet daily together with a clot-dissolving remedy (Nettles, Vitamin E, etc). As an anti-coagulant aspirin is matched by Garlic. In alternative medicine the use of aspirin is discouraged. ... aspirin

Company founded by Fred Pestalozzi, Herrliberg on Lake Zurich, Switzerland. Pioneered herbal preparations in a base of candida utilis yeast. Yeast is fed with wild herbs plasmolysed in a fermentation process. Efficacy of products demonstrated by scientific experiment. Under special growing conditions the principles are absorbed by the yeast cells in the process of multiplication or are bound to the cell surface. They are then metabolised, i.e., undergo chemical change.

Candida utilis is a highly active wild yeast able to synthesise its own vitamins. More than 90 selected plant species from 14 countries are used in Biostrath preparations. The Company has pioneered an important advance in the preparation of herbal medicines. Results have in some instances led to completely new discoveries. ... biostrath a. g.

May be scirrhus or epithelial.

Causes. Smoking, alcohol, jagged teeth, chemical irritants, septic toxins, sprayed fruit and vegetables, poisoning by lead, arsenic and other chemicals, additives, hot foods, spicy curries and peppers, chewing tobacco.

Over 80 per cent found to be present in old syphilitic cases. Charles Ryall, surgeon, Cancer Hospital, regarded the two as comparable with that between syphilis and tabes. Dr F. Foester, Surgeon, concluded that epithelioma of the tongue as far more frequently preceded by syphilis than any other form of cancer.

(Hastings Gilford FRCS, “Tumours and Cancers”)

The condition may arise from a gumma or patch of leucoplakia (white patches) – at one time known as smoker’s tongue.

Of possible value. Alternatives:– Many plants have been shown to produce neoplastic activity, as observed in discovery of anti-cancer alkaloids of the Vinca plant (Vinchristine) and Mistletoe. Dr Wm Boericke confirms clinical efficacy of Clivers, promoting healthy granulations in ulcers and tumour of the tongue. Dr W.H. Cook advises a mouthwash of Goldenseal. For scirrhous hardening, juice of fresh Houseleek has a traditional reputation.

Tinctures. Equal parts Condurango and Goldenseal. 30-60 drops before meals in water; drops increased according to tolerance.

Local paint. Thuja lotion.

Case record. Dr Brandini, Florence, had a patient, 71, with inoperable cancer of the tongue. In the midst of his pain he asked for a lemon which immediately assuaged the pain. The next day gave him even greater relief. The doctor tried it on a number of similar patients with the same results, soaking lint in lemon juice.

Diet. See: DIET – CANCER.

Treatment by a general medical practitioner or hospital oncologist. ... cancer – tongue

a drug used in the treatment of bipolar affective disorder to reduce the severity of manic and depressive episodes. Mood stabilizers include *lithium and antiepileptics. More recently antipsychotics have been marketed as mood stabilizers but evidence about their efficacy for this purpose is scarce and their clinical usefulness needs further evaluation.... mood stabilizer

n. sexual attraction to children (of either sex) that may cause deviant behaviour. Sexual activity with any children under the age of 16 is illegal in the UK for adults. Paedophiles who have been arrested may be forced to undergo treatment: *behaviour therapy can be used, although evidence of its efficacy is controversial. Occasionally, the offender’s sexual drive can be reduced by drug treatment. —paedophile n. —paedophilic adj.... paedophilia

the ratio of a dose of a therapeutic agent that produces damage to normal cells to the dose that is necessary to have a defined level of anticancer activity. It indicates the relative efficacy of a treatment against tumours.... therapeutic index

 Garden celandine. Chelidonium majus L. German: Scholkraut. French: Herbe aux hirondelles. Italian: Cheldonia maggiore. Spanish: Celidonia. Herb.

Constituents: alkaloids, saponins, carotene.

Action: cholagogue, bitter, antispasmodic, antifungal.

Analgesic (Pharmaceutical Journal 8/3/1986, p.304)

Diuretic, laxative, vesicant (fresh juice), antibacterial, antimycotic.

Constituents. Alkaloids Chelidonine, Chelerythrine and Sanguinarine. Yellow juice resembles bile. Uses. Gall stones, inflammation of the gall bladder, jaundice with yellowness of skin, mild hepatitis, bilious headaches, aching pain in right shoulder of liver origin, skin diseases. Gonorrhoeal ophthalmia, as an eyewash 3-5 times daily. (T.J. Lyle)

Eye infections: traditional use – infusion as an eyewash. Warts, papillomas, condylomas and colonic polyposis.

Juice of fresh plant injected locally into cancer lesions gained a reputation in the old school. (U.S. Dispensatory 25, 1923)

Combination: with Barberry and Dandelion for gall bladder disease BHP (1983).

Preparations: Maximum dosage, dried herb: 2g (30 grains) thrice daily, by infusion. Daily dose not to exceed 6g.

Tea. Quarter of a teaspoon to each cup boiling water. Infuse 10 minutes; half-1 cup. Liquid extract: 15-30 drops, thrice daily.

Tincture BHP (1983). 1 part to 10 parts 45 per cent alcohol: 2-4ml, thrice daily. Ointment, for leg ulcer and skin diseases.

Fresh juice: warts, corns.

Side-effects, none; but large doses avoided. Note. Herb loses its efficacy after a few months. ... celandine, greater

The world’s biggest killer of children. Inflammation of the bowel by production of too much mucous secretion.

Causes: faulty absorption of fats, bacterial or viral infection, nervous bowel, anxiety or psychosomatic disturbance, malfunction of the thyroid gland, etc.

Looseness of the bowels may sometimes occur as an acute cleansing eliminative effort by Nature to expel wastes and impurities. Dehydration can be serious in children. For presence of mucous or blood in the stool refer to DIFFERENTIAL DIAGNOSIS.

Differential diagnosis. Crohn’s disease, Gastroenteritis, Diverticulosis, Ulcerative colitis, Dysentery, Salmonella.

Travel diarrhoea: ‘blight of holiday and business trips abroad’ due to E. Coli. Acute, usually non- persistent self-limiting condition. Ginger, crystallised or powder in capsules or tablets is known to reduce the incidence in high risk areas.

Imported bloody diarrhoeas – salmonella, shigella or amoebic infections should receive special investigation by a competent authority, a consultant in infectious diseases. First-aid until the practitioner comes: 2-5 drops oil of Peppermint in water.

Children’s diarrhoea. Re-hydration after severe loss of fluids – glass of water containing 1 teaspoon salt and 2 teaspoons sugar.

Over 13,000 children die from this preventable disease every day, many in the developing countries. This simple combination of sugar and salt prevents dehydration, the most common cause of death from acute diarrhoea, and has helped save tens of thousands of lives.

Alternatives. Rest. Avoid caffeine and alcohol drinks. Plenty of astringent herb teas to reduce the associated hyperperistalsis. Children – half-dose.

Teas. Any one of the following: Agrimony, Avens, Burmarigold, Black Walnut leaves, Burnet (greater or garden), Ground Ivy, Ladysmantle, Hops (nervous bowel), Plantain, Peppermint, Periwinkle (vinca major), Meadowsweet, Silverweed, Shepherd’s Purse, Tormentil. Sage. Formulae: (1) equal parts; Raspberry leaves, Agrimony, Avens. Or (2) equal parts; Raspberry leaves, Plantain, Silverweed. 2 teaspoons to each cup boiling water; infuse 5-15 minutes. Half-1 cup freely. For nerve exhaustion: add a sprinkle of Valerian.

Seeds. Coriander, Caraway or Fenugreek. Half a teaspoon to each cup water, brought to boil; vessel removed as soon as boiling point is reached. Half-1 cup freely.

Decoctions. Any one of the following: Bayberry, Cranesbill (American), Rhatany root, Sweet Chestnut leaves, Oak bark, Wild Yam, Iceland Moss.

Powders. Any one: Calamus, Bayberry, Oak bark, Cinnamon, Black Catechu, Wild Yam. Add pinch of Ginger.

Tinctures. (1) Combine Bayberry 2; Ginger 1. Or (2) Combine Bayberry 1; Raspberry leaves 2. One to two 5ml teaspoons thrice daily after meals.

Tincture, or spirits of Camphor: 5-10 drops in water every 3-4 hours for severe depletion of body fluids. Adults only.

Aloe Vera. Scientific papers confirm efficacy.

Dr Finlay Ellingwood. Castor oil: 5 drops every 2 hours.

Bilberry juice. Half-1 cup freely.

Goldenseal. Antibacterial. 5-10 drops, tincture, 3-4 times daily. Adults only.

Diet. Avoid cow’s milk. 3-day fast on fruit juices and herb teas alone, followed by gruel made from Slippery Elm, Oatmeal or Arrowroot. Yoghurt. Bilberry fruit. Carob bean products: chocolate or other preparations. Ensure adequate fluid intake.

Supplementation. Vitamins A, B12, C, D. Minerals: Calcium, Iron, Magnesium, Potassium, Zinc. Preventative. 2 drops oil of Peppermint morning and evening. ... diarrhoea

(TMS) stimulation of the brain by strong magnetic fields that induce electric currents in the underlying brain tissue. Repetitive transcranial magnetic stimulation (rTMS), consisting of a series of TMS pulses, is used to treat depression. Its clinical utility is controversial, with inconsistent research results regarding its efficacy. Although there have been some small studies regarding its use with other conditions, such as OCD, rTMS is not currently used routinely in the treatment for any illness other than depression.... transcranial magnetic stimulation

 Sugar diabetes. Chronic disorder of fat, protein and carbohydrate metabolism. A decrease of insulin by the pancreas gives rise to high level blood sugar (glucose) which is eliminated in the urine by the kidneys. With low insulin production the body cannot convert food into energy. In Britain over 30,000 new cases are diagnosed each year. One in five people go blind because of diabetes. The genetic factor is important; it may run in families due to defect in the immune system. Women who have German measles during the first three months of pregnancy can have a child who develops diabetes during adolescence.

Etiology. The more severe form, in younger patients, needs insulin treatment, without which ketosis and diabetic coma are possible. The milder form in older patients can be managed with diet and hypoglycaemic agents. Now considered due to auto-immune attack on Islet of Langerhams cells in pancreas which secrete insulin. “The Pill” often raises blood sugar. Lack of trace minerals (chromium and zinc). Zinc is a component of insulin and Chromium produces enzymes to stimulate metabolism of sugars. Diabetes can cause heart attack, stroke, hardening of arteries, blindness. It is the leading cause of kidney failure and gangrene.

Symptoms. Great thirst. Urine of high specific gravity. Weakness, emaciation, skin ulcers, loss of tactile sensation in the fingertips (Vitamin B6). In men there may be inflammation of the glans penis and in women, itching of the vulvae. Boils are common. In spite of large appetite there may by severe weight loss. Magnesium deficiency.

Diabetics are subject to glaucoma and detachment of the retina. There is a high incidence of cataract of the eye. While surgery may be necessary, effective supportive herbal treatment can do much. Regular visits to the Hospital Specialist help detect in time future eye, kidney and circulation damage.

High fibre, low fat, high carbohydrate. To help control blood sugar a diabetic must avoid sweets.

Exercise lowers blood sugar.

Agents used with some success: Alfalfa, Damiana leaves, Fenugreek seeds, Aloe Vera juice, Dandelion, Fringe Tree, Guar gum, Garlic (anti-diabetic action shown by Dr Madaus, West Germany, 1967), Bilberry berries, Goat’s Rue (dried aerial parts reduce blood sugar BHP (1983), Olive leaves, onions, Nettles, Pipsissewa, White Horehound, Sweet Sumach, Jambul seeds rapidly reduce sugar in the urine. Karela. Gurmar, (Gymnema sylvestre) leaves are chewed in India to reduce sugar in the urine (mild cases). Balsam pear. Bitter melon (Momordica charastia).

Hypoglycaemic herbs can be effective where the pancreas still functions. Type 1 diabetes, suffered by children whose insulin-producing cells have been destroyed and who produce no insulin at all will always require administered insulin. Maturity-onset diabetes (Type 11) occurs in middle life, insulin- production being insufficient. This form is usually associated with obesity for which herbs are helpful.

Diabetics are specially prone to infections; a course of Echinacea at the onset of winter is beneficial. Coronary artery disease is common in diabetics (especially women) who may develop atherosclerosis at an early age. High blood pressure places undue strain upon kidneys which may excrete too much protein (Yarrow, Lime flowers, Hawthorn). Lack of sensation in the feet exposes the subject to unconscious bruising and injury from which septic ulceration may arise (Chamomile foot baths).

Alternatives. Liver herbs work positively on the pancreas. Diabetic cases should receive treatment for the liver also, Dandelion and Fringe Tree being a reliable combination. Dr John Fearn, California (Ellingwood) used Fringe Tree for all his cases of sugar in the urine: 10 drops, Liquid Extract, 4-5 times daily.

Tea. Equal parts: Peppermint leaves, Dandelion leaves, Goat’s Rue leaves. 1-2 teaspoons to each cup boiling water infuse 5-15 minutes. Cup 2-3 times daily.

Teas from any one of the following: Bilberry berries or leaves, Nettles, White Horehound, Alfalfa, Olive leaves.

Decoction. Fenugreek seeds. 2 teaspoons to each large cup water simmered gently 5 minutes. One cup daily, consuming the seeds.

Powders. Equal parts: Sweet Sumach, Jambul seeds, Dandelion. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.

Tinctures. Formula. Equal parts: Jambul, Fringe Tree, Goat’s Rue. Dose: 1 teaspoon thrice daily and at bedtime.

Tablets. Dr Alfred Vogel: tablet containing: Bilberry, Kidney Bean, Tormentil, English Walnut leaves, Alfalfa leaves, Cuckoo flowers.

Karela (Momordica Charantia) Hypoglycaemic action gave good results in clinical trials. Daily dose: 50/60ml fresh juice.

Evening Primrose. See entry.

Guar Gum. 5g unit dose sachets (Guarina) containing dispersible granules. This gum has shown beneficial effects for insulin-dependants.

Hypoglycaemics (second degree). Allspice, Bugleweed, Burdock, Ginseng, Lily of the Valley, Wormwood, Nettles.

Diabetic gangrene. Tinctures: equal parts, Echinacea, Thuja. Internally and externally. Internal dose: 30- 60 drops.

Diabetic neuralgia. Cayenne pepper (Capsicum). Frequently successful.

American traditional. It is claimed that 500mg Bayleaf, Cinnamon, Cloves and Turmeric halve the need for insulin in diabetics.

Diet. Dietary treatment has changed over the past few years. Patients are now advised by the British Diabetic Association to eat food rich in complex carbohydrates (starches) and high in fibre as in wholemeal bread, oats and wholegrain breakfast cereals, wholewheat pasta, brown rice, beans and lentils, vegetables and fruit. Fat intake should be carefully watched (lean meat); skimmed milk, polyunsaturated or low-fat cheeses and salad dressings. Certain foods are known to encourage the pancreas to produce more insulin: banana, barley, cabbage, lettuce, oats, olive, papaya, turnip, sweet potato.

Coffee intake should be limited to prevent hypoglycaemic symptoms.

Barley. A study has shown that the use of barley flour as a substitute for wheat in bread helps to control diabetes, in Iraq. (Naismith D, et al, ‘Therapeutic Value of Barley in Management of Diabetes’: Annals Nutr Metab, 35, 61-64 1991)

Supplementation. Vitamins A, B-complex, C, D, E, F. Vitamin B6. Brewer’s yeast. Minerals: Chromium 50mcg; Manganese 15mg; Magnesium 300mg; Zinc 25mg; to normalise glucose metabolism.

Note: Over 400 traditional plant medicines have been documented for diabetes, but few have been evaluated for efficacy. In the undeveloped countries they are chiefly used for non-insulin dependent diabetes. (Diabetes Care, 1989, Sept 12, p553)

Insulin dependents. Whether adults or children, insulin dependents should under no circumstances discontinue insulin injections.

Treatment by or in liaison with general medical practitioner.

Information. British Diabetic Association, 10 Queen Anne Street, London W1M 0BD, UK. Send SAE. ... diabetes, mellitus

 Oedema. Hydrops. Not a disease but a condition. An abnormal accumulation of fluid in a body cavity or beneath the skin. Due to weakened walls of capillaries caused by circulating toxins obstructing the flow of blood or lymph. Gross oedema of nephrotic syndrome associated with low plasma protein level and high proteinuria.

Renal dropsy is worse in the early morning, with loose tissues under the eyes.

Treatment. When fluid rapidly collects it may have to be aspirated (drawn off) but before this stage is reached herbal diuretics and cardiac tonics have much to offer. In acute conditions, sweat glands should be stimulated by suitable diaphoretics to assist elimination of excess fluid through the skin. Attention to the bowels is important; a timely copious bowel action greatly assisting elimination. A well-known diuretic for dropsy is Juniper, 3 to 5 drops taken in honey 2 or 3 times daily.

Alternatives. Teas. (Simple infusions): Agrimony, Bearberry, Boldo, Boneset, Borage, Buchu, Celery seed, Clivers, Corn Silk, Dandelion leaves, Parsley leaves, Elderflowers, Bogbean, Heartsease, Lime flowers, Parsley Piert, Pellitory, Plantain, Sea Holly, Wild Carrot, Yarrow.

Decoctions. Broom tops, Lovage, Burdock root, Couchgrass, Dandelion root, Juniper berries, Blue Flag root.

Bean Cure (Phaseolus vulgaris). 1 tablespoon kidney (haricot) bean pods, sliced, in cup water simmered gently for 5 minutes. 1 cup morning and mid-day.

Sassafras root. An old Swedish colonist of the late 18th century related how his mother cured many cases of dropsy with a decoction of Sassafras root. (American Indian Medicine. Virgil Vogel, p.363) Of historic interest only, this root is no longer used in herbal practice.

Tablets/capsules. Buchu. Dandelion. Juniper. Celery. Garlic. Blue Flag.

Powders. Equal parts: Buchu, Dandelion root, Stone root, Senna leaf. Mix. Dose: 500-750mg (2 × 3 × 00 capsules or one-third to half a teaspoon) thrice daily.

Liquid Extracts. Equal parts: Buchu, Clivers, Blue Flag. Mix. 30-60 drops, thrice daily.

Practitioner. Alternatives with a record of efficacy. Tinctures.

Formula 1. Burdock, 20ml; Buchu, 20ml; Bearberry, 20ml; Aqua to 100ml. Dose: 5ml 3 times daily in water.

Formula 2. Juniper, 10ml; Buchu, 20ml; Broom, 10ml; Dandelion, 10ml. Aqua to 100ml. Dose: 5ml, 3 times daily, in water.

Topical. Poultice over kidney area: quarter of an ounce Irish Moss gently simmered in half a pint water to a jellied mass and applied on linen or suitable material to the small of the back. Repeat 2 or 3 times with fresh hot poultices.

Diet. High protein, low salt. Fresh conservatively-cooked vegetables, polyunsaturated oils. Bottled or spring water.

Supplementation. Vitamin A, B-complex, B1, B6, C, E, Potassium.

General. Elevation of affected limbs above level of abdomen.

This condition should be treated by or in liaison with a qualified medical practitioner. ... dropsy, renal

Fever is a reaction of the immune system to (1) defend the body against attack from viral or bacterial infection, (2) trauma, or (3) to decompose morbid matter into simpler compounds suitable for elimination. It is also the result of toxins released by infective agents. It may be a healing crisis. Dr Samuel Thomson writes: “Fever should not be suppressed with drugs. The body’s increased heat is a sign that the body is engaged in an extraordinary effort to cleanse itself of a disease influence. We are to support it, but see that temperature does not get out of hand.”

“There is an increasing amount of evidence,” writes Dr D. Addy, Consulting Paediatrician, “that fevers may enhance the defence mechanism against infection. There is little evidence that fever itself is harmful except in 3 per cent of children who are prone to develop febrile convulsions.”

When a fever is identified (scarlet fever, measles, etc) specific treatment with agents of proven efficacy are required. See appropriate entries. For unidentified fever, before the doctor comes, diaphoretics (Yarrow, etc) may be given to induce sweating to relieve tension on lungs and other internal organs. Also, diuretics (Yarrow, etc) stimulate elimination of wastes through the kidneys. Two herbs, Elderflowers and Peppermint, given at the chill stage have probably saved lives of tens of thousands from fever. A timely laxative to clean out stomach and bowels may favourably reduce temperature.

Perseverance with strong Nettle tea may also assist the work of the awaited practitioner. Excellent for simple fevers is the formula: Liquid Extracts: Elderflowers 1oz; Peppermint quarter of an ounce; Cinnamon quarter of an ounce; Skullcap 1oz. One 5ml teaspoon in hot water every 2 hours until fever abates – patient in bed. Sponge down body with vinegar and water. Patient should not leave bed until temperature falls. Abundant Vitamin C drinks, fresh lemon, orange juice.

A fever may be accompanied by: flushed face, rapid breathing, headache, hot skin, shivering, thirst and sweating.

Discharges are often a necessary part of the cure. Once toxins are eliminated by skin, kidneys, bowel or by respiration, symptoms abate and a feeling of well-being appears. It is often a turning point towards recovery: the body is trying to throw off toxins and poisons. A fever is an effort of the system to fight back. ... fever

Two types – simple and ulcerative. Inflammation of the membrane lining of the heart with the appearance of small fibrin accumulations on the valves. These may form during a specific fever – rheumatic, scarlet, etc, due to bacterial infection. In Bacterial Endocarditis, fragments of tissue may be shed from the main seat of infection and borne to other parts of the body, promoting inflammation or ischaemia elsewhere.

Affects more women than men, ages 20 to 40 years. Most cases have a history of rheumatic fever as a child. Thickening of the valves renders them less efficient in regulating the flow of blood through the heart thus allowing leakage by improper closure. Increased effort is required from the heart muscle to pump blood through the narrowed valves giving rise to fatigue and possible heart failure.

Prolapsus of the mitral valve is now recognised as predisposing to bacterial endocarditis. It is concluded that herbal antibiotic prophylaxis is justified in heart patients undergoing dental extraction, or other surgery where there is exposure to infection.

Symptoms: Breathlessness on exertion. Swelling of legs and ankles, palpitations, fainting, blue tinge to the skin and a permanent pink flush over the cheek bones. Clubbing of fingers. Enlarged spleen. Stethoscope reveals valvular regurgitation. The most common organism remains streptococcus viridans, by mouth. It may reach the heart by teeth extraction, scaling and intensive cleaning which may draw blood, posing a risk by bacteria.

Treatment. Acute conditions should be under the authority of a heart specialist in an Intensive Care Unit.

Absolute bedrest to relieve stress on the heart’s valves. For acute infection: Penicillin (or other essential antibiotics). Alternatives, of limited efficacy: Echinacea, Myrrh, Wild Indigo, Nasturtium, Holy Thistle. Avoid: excitement, chills, colds, fatigue and anything requiring extra cardiac effort. Convalescence will be long (weeks to months) during which resumption to normal activity should be gradual.

Aconite. With full bounding pulse and restless fever. Five drops Tincture Aconite to half a glass (100ml) water. 2 teaspoons hourly until temperature falls.

To sustain heart. Tincture Convallaria (Lily of the Valley), 5-15 drops, thrice daily.

To stimulate secretion of urine. Tincture Bearberry, 1-2 teaspoons, thrice daily.

Rheumatic conditions. Tincture Colchicum, 10-15 drops, thrice daily.

Various conventional treatments of the past can still be used with good effect: Tincture Strophanthus, 5 to 15 drops. Liquid Extract Black Cohosh, 15 to 30 drops. Spirits of Camphor, 5 to 10 drops. Bugleweed (American), 10 to 30 drops. To increase body strength: Echinacea. To sustain heart muscle: Hawthorn. Endocarditis with severe headache: Black Cohosh.

Teas: single or in combination (equal parts) – Nettles, Motherwort, Red Clover flowers, Lime flowers. 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup 2-3 times daily.

Decoction: equal parts: Hawthorn berries, Echinacea root, Lily of the Valley leaves. Mix. 2 teaspoons to each 2 cups water in a non-aluminium vessel, gently simmer 10 minutes. Dose: 1 cup 2-3 times daily. Formula. Echinacea 20; Cactus 10; Hawthorn 10; Goldenseal 2. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Thrice daily.

Diet. See entry: DIET – HEART AND CIRCULATION. Pineapple juice. Treatment by or in liaison with general medical practitioner or cardiologist. ... endocarditis

Allium sativum L. German: Knoblauch. French: Ail. Italian: Aglio. Arabic: Som. Indian: Lashuna. Chinese: Swan. Iranian: Sir. Malayan: Bawang puteh. Bulb. Contains allicin, amino acids; iodine, selenium, sulphur and other minerals. Pliny, of ancient Rome, advised Garlic for more than 60 different health problems. A valued medicament to the civilisations of China, Egypt, Chaldea and Greece. Constituents: volatile oils, B group vitamins, minerals.

Action: antibiotic, bacteriostatic, anti-parasitic, anti-viral, anti-carcinogen, antispasmodic, antiseptic, fungicide, anti-thrombic, cholagogue, diaphoretic, hypoglycaemia, hypotensor, expectorant, anthelmintic. A wide range of anti-infection activity reported. Hypolipidaemic. Non-sedating antihistamine. Anticoagulant – reduces blood platelet clumping, raises HDL. Lowers total cholesterol after a fatty meal in normal subjects. As a vasodilator tends to reduce blood pressure. Bacteria do not become resistant to it. (Dr Stephen Fulder) Detoxifier.

Uses: Prevents build-up of cholesterol in the blood. Lowers a too high blood pressure and raises one too low. Beneficial in thrombosis and arteriosclerosis.

“Helps clear fat accumulating in blood vessels, reducing the tendency to heart disease: also can drastically reduce the level of sugar in the blood, which could help diabetics.” (Lancet i 607, 1979)

Bronchitis (loosening phlegm), asthma, cough, whooping cough and as a preventative of influenza and colds. Sinusitis; catarrh of the stomach, throat and nose. Catarrhal discharge from the eyes returning every night; catarrhal deafness. Intestinal worms. To stimulate bile for digestion of fats. Mucous colitis, allergies including hay fever, ear infections, paroxysmal sneezing, candida and some other fungus infections, vaginal trichomoniasis.

“Anti-tumour activity reported.” (Y. Kimura and K. Yamamoto, Gann, 55, 325 (1964); Chem. Abstra, 63, 1089d 919650)

The therapeutically active ingredients of Garlic are the smelly ones. Deodorised Garlic has not the efficacy of the odoriferous. (Dr Stephen Fulder, JAM Feb. 1986) Chewed Parsley may mask the odour of Garlic on the breath.

Preparations: Fresh clove: eaten at meals.

Fresh juice: half-1 teaspoon in honey or water.

Capsules: one before meals or three at night to prevent infection.

Powder: 300mg capsules; 5-10 capsules twice daily during meals.

Tincture BHP (1983): 1:5 in 45 per cent alcohol. Dose, 2-4ml in water.

Compress: mashed clove or oil on suitable material.

Ear or nasal drops: pierce Garlic capsule and squeeze oil into ear or nose for infection. Notes. Source of the important trace element, Germanium. Combines well with Echinacea. ... garlic

Older generations of herbalists attached great importance to the time of collection. The most auspicious hour may vary from herb to herb and is recorded in the old herbals. The kind of weather, with presence or absence of sunlight, are now known to affect the potency of a plant. Much herb lore of history has been vindicated by today’s scientific research, with the discovery that the quality of active ingredients depends upon such variables as season, location, and the time of day when gathered. Different parts of herbs are gathered at different times.

Herbs should be collected in dry weather after the dew has lifted. Where not possible to cull by hand, a sharp knife or scythe should be used. In general, aerial parts should be gathered before flowering. Rhizomes and roots are gathered in the autumn when the leaves decline for maximum therapeutic action. Wash and clean roots, and ensure they do not touch when drying. Flowers are picked just before breaking into full bloom. Barks and twigs are collected in the spring when the sap is rising.

Spread out fresh material to dry in a thin layer, without delay. Use trays, wire racks, even lengths of string netting. Packed into bundles without circulation of air encourages bruising, fermentation and mould that destroy medicinal properties.

Almost any shed can be adapted as a drying shed, provided there is adequate ventilation. Artificial heat may be required for complete drying. Leaves should not be dried to the point where they powder when rubbed between the palms. Most herbs and roots lose about four-fifths of their weight on drying. When the hand is plunged into a bag of well-dried herbs they should feel warm and crisp to the touch. Roots are dried to the point of brittleness, breaking easily.

Present-day growers achieve high standards of drying. Since passage of the Medicine’s Act, 1968, the quality of herbs on sale has been good. Dried herbs should be stored away from direct sunlight, or they will lose their colour and efficacy. ... harvesting of herbs

An accumulation of cerebrospinal fluid between the membranes of the brain or when fluid collects in the ventricles resulting in brain damage. Head abnormally large.

Causes. Injury, tumour, blood clot, meningitis, or congenital malformation obstructing the aqueduct. Symptoms. Headache on the crown of the head, enlarged pupils, double vision, eyes squint and appear abnormally small, convulsions, slow onset of fever, high blood pressure, delirium, flushed cheeks, patient shuns the light.

Treatment. As a supportive aid to conventional treatment by hospital specialist or general medical practitioner.

Formula. Yarrow 2; Lily of the Valley 2; Ginkgo 1. Dose: Powders – 750mg (three 00 capsules or half a teaspoon). Liquid extracts – 1 teaspoon. Tinctures – 1-2 teaspoons every 2 hours for acute cases, otherwise thrice daily.

Ivy. Dr John Clarke, homoeopathic physician, reports the case of a colleague, Dr L. Cooper, who cured a case with one single dose of 1 drop mother-tincture of Ivy (Hedera helix). “Clear fluid (cerebrospinal rhinorrhoea) dripped from his nostrils for three weeks; 20-30 handkerchiefs being used a day.” Evidence of efficacy of the traditional reputation of 1-2 drops Ivy juice for the condition is lacking.

Diet. 3-5 day fast on fruit juice only. Yarrow tea. No solid food until fever abates; then Slippery Elm and Complan.

Note: Pregnant mothers are advised by the Medical Research Council to take folic acid – part of the Vitamin B-group – to help protect against neural tube defects; severe birth defects of spina bifida and hydrocephalus. See: FOLIC ACID. ... hydrocephalus

Amygdalin. From apricot or peach kernels. Dramatic claims of cures of malignancy reported in 1950. In spite of extensive anecdotal efficacy, performance has not lived up to early promise. Powdered kernels are usually taken with additional vitamins and pancreatic enzymes. Purpose of the enzymes is to break down the muco-protein capsule which enables the cyanide in the remedy to penetrate the wall of the cancer cell and destroy its contents. Dr Ernest Krebs claimed the body’s own immune response broke down the cyanide content to produce a substance with an ability to destroy cancer cells. Apple pips are also said to be a good source of this property. ... laetrile

Fluid Extract (F.E.). The most concentrated form in which a herbal medicine can be prepared. Stronger than a tincture. Almost all liquid extracts contain alcohol. Made by a number of methods including cold percolation, evaporation by heat, or under pressure. A popular commercial form of administering herbs as a medicine. Usually taken in water.

Strength: “One part by volume of liquid is equal to 1 part by weight of herb.” Thus, one ounce of fluid is equal to one ounce of crude material. For instance, 1oz Stone root liquid extract would have the same therapeutic potency as 1oz Stone root.

In the making of liquid extracts there is often a loss of valuable volatile constituents which is believed to reduce efficacy of a plant. For this reason tinctures are becoming popular among practitioners. Dosage of L.E.s may vary from 5 to 60 drops according to the plant. For instance, the maximum dosage of Goldenseal is 15, Black Cohosh 30, and Yarrow 60 drops. A general average would appear to be 15-60 drops, though a practitioner would be more specific. The bottle should be shaken vigorously before use to remix any natural sediment.

One millilitre = 15 drops. One teaspoonful = 5ml (5 millilitres) or 75 drops liquid medicine. For liquid medicines, always use medicine glass graduated in millilitres, or standard dropper. ... liquid extract (l. e.)

“There is a large body of opinion to support the belief that a herb that has, without ill-effects, been used for centuries and capable of producing convincing results, is to be regarded as safe and effective.” (BHMA) Claims for efficacy are based on traditional use and inclusion in herbals and pharmacopoeias over many years. Their prescription may be prefixed by: “For symptomatic relief of . . .” or “An aid in the treatment of . . .”

To establish efficacy of treatment for a named specific disease by herbs, the DHSS requires scientific data presented to the Regulatory authorities for consideration and approval.

A product is not considered a herbal remedy if its active principle(s) have been isolated and concentrated, as in the case of digitalis from the Foxglove. (MAL 2. Guidance notes)

A herbal product is one in which all active ingredients are of herbal origin. Products that contain both herbal and non-vegetable substances are not considered herbal remedies: i.e. Yellow Dock combined with Potassium Iodide.

The British Government supports freedom of the individual to make an informed choice of the type of therapy he or she wishes to use and has affirmed its policy not to restrict the general availability of herbal remedies. Provided products are safe and are not promoted by exaggerated claims, the future of herbal products is not at risk. A doctor with knowledge and experience of herbal medicine may prescribe them if he considers that they are a necessary part of treatment for his patient.

Herbalism is aimed at gently activating the body’s defence mechanisms so as to enable it to heal itself. There is a strong emphasis on preventative treatment. In the main, herbal remedies are used to relieve symptoms of self-limiting conditions. They are usually regarded as safe, effective, well-tolerated and with no toxicity from normal use. Some herbal medicines are not advised for children under 12 years except as advised by a manufacturer on a label or under the supervision of a qualified practitioner.

World Health Organisation Guidelines

The assessment of Herbal Medicines are regarded as:–

Finished, labelled medicinal products that contain as active ingredients aerial or underground parts of plants, or other plant material, or combinations thereof, whether in the crude state or as plant preparations. Plant material includes juices, gums, fatty oils, essential oils, and any other substances of this nature. Herbal medicines may contain excipients in addition to the active ingredients. Medicines containing plant material combined with chemically defined active substances, including chemically defined, isolated constituents of plants, are not considered to be herbal medicines.

Exceptionally, in some countries herbal medicines may also contain, by tradition, natural organic or inorganic active ingredients which are not of plant origin.

The past decade has seen a significant increase in the use of herbal medicines. As a result of WHO’s promotion of traditional medicine, countries have been seeking the assistance of WHO in identifying safe and effective herbal medicines for use in national health care systems. In 1989, one of the many resolutions adopted by the World Health Assembly in support of national traditional medicine programmes drew attention to herbal medicines as being of great importance to the health of individuals and communities (WHA 42.43). There was also an earlier resolution (WHA 22.54) on pharmaceutical production in developing countries; this called on the Director-General to provide assistance to the health authorities of Member States to ensure that the drugs used are those most appropriate to local circumstances, that they are rationally used, and that the requirements for their use are assessed as accurately as possible. Moreover, the Declaration of Alma-Ata in 1978 provided for inter alia, the accommodation of proven traditional remedies in national drug policies and regulatory measures. In developed countries, the resurgence of interest in herbal medicines has been due to the preference of many consumers for products of natural origin. In addition, manufactured herbal medicines from their countries of origin often follow in the wake of migrants from countries where traditional medicines play an important role.

In both developed and developing countries, consumers and health care providers need to be supplied with up-to-date and authoritative information on the beneficial properties, and possible harmful effects, of all herbal medicines.

The Fourth International Conference of Drug Regulatory Authorities, held in Tokyo in 1986, organised a workshop on the regulation of herbal medicines moving in international commerce. Another workshop on the same subject was held as part of the Fifth International Conference of Drug Regulatory Authorities, held in Paris in 1989. Both workshops confined their considerations to the commercial exploitation of traditional medicines through over-the-counter labelled products. The Paris meeting concluded that the World Health Organisation should consider preparing model guidelines containing basic elements of legislation designed to assist those countries who might wish to develop appropriate legislation and registration.

The objective of these guidelines, therefore, is to define basic criteria for the evaluation of quality, safety, and efficacy of herbal medicines and thereby to assist national regulatory authorities, scientific organisations, and manufacturers to undertake an assessment of the documentation/submission/dossiers in respect of such products. As a general rule in this assessment, traditional experience means that long-term use as well as the medical, historical and ethnological background of those products shall be taken into account. Depending on the history of the country the definition of long-term use may vary but would be at least several decades. Therefore the assessment shall take into account a description in the medical/pharmaceutical literature or similar sources, or a documentation of knowledge on the application of a herbal medicine without a clearly defined time limitation. Marketing authorisations for similar products should be taken into account. (Report of Consultation; draft Guidelines for the Assessment of Herbal Medicines. World Health Organisation (WHO) Munich, Germany, June 1991) ... herbal medicine

Notifiable disease. The world’s No 1 public health enemy. Affects 108 nations. Still kills millions of people each year. Probably has claimed more lives than all the wars of history. In the 1960s was believed to have been eradicated but has made a dramatic reappearance due to the malaria-carrying mosquito’s resistance to insecticides. Few modern drugs have proved a match for malaria; quinine drugs of proven reliability still used. Quinine (Peruvian bark) has a history of safety and efficacy.

The disease is transmitted by the anopheles protozoa. Old cases present with fever, jaundice, diarrhoea and confusion.

Symptoms: incubation 2-5 weeks. Onset sudden, with shivering and high fever (104°F), headache, vomiting. Symptoms recur every 2-3 days. Blood sample examination confirms.

Treatment. Drugs once useful in the fight against malaria are losing their effectiveness. Drug resistance becomes a major problem; in which case the remedies of antiquity have something to offer.

Alternatives. Yarrow was once regarded as the Englishman’s Quinine. Nettle tea (Dr Compton Burnett). Prickly Ash (Ellingwood). Barberry, Chiretta, Peruvian bark BHP (1983). Mountain Grape (Berberis aquifolium) (Ellingwood). Wild Indigo, cases of extreme prostration (Dr Wm Boericke).

Sweet Wormwood. The Chinese Qing Hao (Artemisia annua) proved beneficial for millennia before Quinine arrived on the scene. Its re-discovery by Professor Nelson is declared ‘very effective’.

Formula. Liquid Extracts: Boneset 1; Yarrow 1; Barberry half; Valerian half. Few drops Tincture Capsicum. Dose: 1-2 teaspoons every 2 hours.

Malaria was rife in parts of America, especially Arkansus. During the Civil War it was difficult to obtain Quinine and various alternatives were tried. Where symptoms of chills and intermittent fever presented, Gelsemium gained considerable reputation as a substitute, also as a preventative. A favourite prescription was three drops tincture in a little brandy every 2-3 hours before the chill, and repeated every hour.

Dr M.H. Grannell, Sinaloa, Mexico. “I do not doubt that I treat more malaria than any other five physicians in the United States. My sole remedy, unless other indications present themselves, is Gelsemium. I give the following with never-failing results: 30 drops Tincture Gelsemium in 4oz water. Dose: 1 teaspoon hourly.” (Ellingwood, June 1920)

Thomas Nuttall, botanist. In 1819, when on tour in Arkansus, relieved a malarial attack with decoction of Boneset.

David Hoffman, MNIMH. 1 teaspoon Peruvian bark in each cup boiling water; infuse 30 minutes. Thrice daily.

Diet. 3-day fast.

Treatment by or in liaison with a general medical practitioner. ... malaria

Criteria for manufacture of herbal preparations are efficacy, safety and purity. To ensure Government requirement, manufacturers test all incoming crude material by first placing it in quarantine, an area specially set aside for quality control. Material is inspected against standard samples by sight, taste, touch and microscopic analysis. Samples are taken for chemical reaction in a laboratory equipped for this purpose.

Herbal preparations are required to meet the same high pharmaceutical standards as conventional medicine.

Today’s exacting standards ensure an absence of sugar, yeast, gluten, milk derivatives, cornstarch, wheat, artificial colours, flavours, and preservatives.

The Department of Health expects manufacturers to standardise active constituents where possible and to ensure purity by eliminating from crude material pesticide residues, aflatoxins and heavy metal contaminants. Chromotography, in one of its forms (thin-layer, gas or high-pressure liquid) are used to assess purity, potency, accurate identity and contamination by lead, cadmium, etc. A Geiger-counter reveals the presence or absence of radio-activity. Each plant has its own signature or ‘fingerprint’ showing density and other important characteristics.

Failure to meet Government requirements empowers a purchaser to return the whole consignment to the supplier. Thus, a high standard of manufacturing practice is maintained.

See: Medicines Act leaflet 39, Revised Guidelines DHSS Nov 1985 ... manufacturing

Recurring headache commencing with constriction of blood vessels of the brain, followed by expansion which allows engorgement of vessels. Single or double-sided. With nausea, vomiting, speech difficulties, visual disturbances, emotional stress, tension.

“Half of all migraine patients suffer from anxiety, and one in five experiences depression,” according to a study carried out at Manchester University. (Dr Jennifer Devlen)

Causes: many and varied. Alcohol, excess coffee and caffeine stimulants, gluten food allergies, dairy products, chocolate, citrus fruits. Related to carbohydrate metabolism. May be associated with menstruation or emotional disturbance, nervous or physical fatigue; liver, stomach or kidney disturbance, or The Pill.

Symptoms: temporary blindness, or sight may be only half the visual field. Flashing lights, throbbing headache, loud noises worsen, nausea, vomiting, depression.

Treatment. In the initial (constrictive) stage any of the following simple teas may resolve: German Chamomile, Betony, Skullcap, Wild Thyme, Valerian.

Where the condition has progressed to vasodilation (engorgement of cerebral blood vessels) give any of the following alternatives. Whilst the requirements of each individual case is observed, inclusion of a remedy for stomach and liver may enhance efficacy. Sometimes a timely diuretic to reduce volume of the blood aborts an attack.

Associated with menstrual disorders: Agnus Castus, Evening Primrose oil.

Tea: Formula. (1) Equal parts: Betony, Valerian, Dandelion root. (2) Alfalfa 1; Valerian half; Hops quarter. One heaped teaspoon to each cup boiling water; infuse 15 minutes. Half-1 cup 2-3 times daily. Formula. Skullcap 2; Mistletoe 1; Hops half. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon) 2-3 times daily.

Valerian. German traditional.

Feverfew. 2-3 fresh leaves on bread. Tincture (or essence) 5-10 drops.

Practitioner: Tincture Gelsemium, BPC (1963) 5 drops.

Diet: Fruit juice fast. Oily fish. Hay diet. Salt-free.

Vitamins. A. B-complex, B6, B12, C (up to 1000mg). E, Niacin.

Minerals. Manganese, Calcium, Magnesium, Zinc.

Rose-tinted glasses. Ophthalmology Department, Birmingham University.

Information. British Migraine Association, 178A High Road, West Byfleet, Surrey KT14 7ED. Send SAE. ... migraine

Nail loss. Paronychia. Clubbing. Brittle nails. Deformity (koilonychia). Spoon-shaped, as from iron-deficiency anaemia. A wide range of diseases affect the nails which, themselves, provide useful clues to underlying constitutional disturbance. Brittle and malformed nails are usually due to mineral deficiency. Ridging and grooving show altered nutrition and damage to the nail bed. Psoriasis nails are pitted.

Infections include candidiasis (monilia), ringworm, staphylococcal or streptococcal bacteria. Biting of fingernails reveals anxiety. Colour change and atrophy of nails may be caused by antibiotics, antimalarials, betablockers, gold and arsenic medicines, steroids, “The Pill”; requiring Eliminatives, liver, kidney and possibly Lymphatic agents.

For in-growing toenail – see entry.

Alternatives. General, internal. For antifungals, see: WHITLOW. Mineral-rich herbs for nutrition.

Teas: Alfalfa, Carragheen, Horsetail, Gotu Kola, Red Clover, Oats (for silicon salts), Plantain, Silverweed, Clivers, Dandelion.

Decoctions: Yellow Dock, Burdock, Sarsaparilla, Queen’s Delight.

Tablets or capsules: Alfalfa. Kelp. Bamboo gum.

Formula. Horsetail 2; Gotu Kola 1; Thuja quarter. Dose: Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Cider Vinegar, See entry. Efficacy recorded.

Topical. Alternatives:– Apply to the nail:

(1) Liquid Extract or Tincture Thuja. (Ellingwood)

(2) Blood root. (J.T Kent MD)

(3) Evening Primrose oil.

(4) Contents of a Vitamin E capsule.

(5) Tincture Myrrh.

Diet. Nails are almost wholly protein. High protein. Onions, Garlic, Soya products, Carrot juice, Cod Liver oil, Kelp.

Vitamins. A. B-complex. B6. B12. Folic acid.

Minerals. Calcium. Dolomite. Copper. Iron. Silica. Stannum, Zinc. ... nails

Oatstraw. Avena sativa L. Husks of oats. German: Evenhafer. French: Avoine. Spanish: Avena. Italian: Biada.

Constituents: glycosyl flavones, proteins, Vitamin E, oil, proteins.

Action: nerve restorative, antidepressant, tranquilliser, brain tonic. Cardiac tonic BHP (1983). Nutrient with selective action on brain and nerve cells. Source of minerals. Thymoleptic. Improves performance of athletes and stamina.

“Oats have the highest content of iron, zinc and manganese of all grain species.” (Dr A. Vogel)

Uses: Benzodiazepine, Valium or other drug addiction – with Valerian and Skullcap to assist withdrawal. Alcoholism. Nerve and physical weakness with depression and anxiety. Debility following illness; recovery from surgical operation. Neurasthenia. Tension and irritability through overwork. Headache with pain at back of the neck; sleeplessness, shingles, hyperactivity in children. Nerve tremor in the aged not caused by Parkinson’s or other nerve degenerative diseases. May be taken with benefit for general well-being in chronic nerve dyscrasies but with limited improvement in basic condition. Sometimes proves of benefit for schizophrenic tendency. Sexual weakness with night losses and impotence. Combines well with Saw Palmetto for spermatorrhoea. Combines with Valerian and Wood Betony for nerve weakness, to minimise attacks of petit mal, chorea and other convulsive states. Does not combine well with Passion flower or Cypripedium.

Contra-indicated in cases sensitive to gluten.

Preparations: Average dose, 1-2 grams or equivalent. Thrice daily. An older generation of herbalists prepared their tinctures and extracts from the green flowering unripe wild Oats as the effective constituent is unstable. Taken hot, effects are more immediate.

Tea: oatstraw: 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Drink freely.

Tincture BHP (1983) 1 part to 5 parts 45 per cent alcohol. Macerate and shake daily for 8 days; dose, 1- 5ml.

Extracts, groats and oatmeal products are all beneficial but are not of the same efficacy as the fresh green plant.

Oatstraw bath: 2-3 handfuls oatstraw. Simmer in 2-3 litres water for 5 minutes; strain; add to bathwater. Liquid Extract: dose: 1-2ml in water.

Traditional combination: equal parts – Oats, Passion flower, Hops and Valerian. Diet. Porridge, but not to be eaten by the gluten intolerant.

Side-effects: none known. ... oats

A group of small protein molecules produced in the brain and by nerve endings elsewhere in the body. Enkephalins have an analgesic effect and are also thought to affect mood. Enkephalins are similar to endorphins but have a slightly different chemical composition and are released by different nerve endings.enophthalmos A sinking inwards of the eyeball. Enophthalmos is most often caused by fracture of the eye socket or shrinkage of the eye due to the formation of scar tissue following injury.

enteric-coated tablet A tablet whose surface is covered with a substance that is resistant to the action of stomach juices. Enteric-coated tablets pass undissolved through the stomach into the small intestine, where the covering dissolves and the contents are absorbed. Such tablets are used either when the drug might harm the stomach lining or when the stomach juices may affect the efficacy of the drug.... enkephalins

n. a drug that prevents or reduces the severity and frequency of seizures in various types of epilepsy; the term antiepileptic drug is now preferred since not all epileptic seizures involve convulsions. The choice of drug is dictated by the type of seizure and the patient’s response, and the dosage must be adjusted carefully as individuals vary in their response to these drugs and side-effects may be troublesome. Commonly used antiepileptic drugs include *carbamazepine, *lamotrigine, *phenytoin, *sodium valproate, levetiracetem, topiramate, *gabapentin, pregabalin, and oxcarbazepine. Phenobarbital is no longer commonly prescribed.

Certain anticonvulsants have shown efficacy in treating bipolar disorder and chronic pain, as in postherpetic neuralgia or *peripheral neuropathy, and can be used to prevent migraine and other primary headache syndromes.... anticonvulsant

n. a drug designed to alleviate the symptoms of *depression. Most antidepressants act by altering the availability of *serotonin and *noradrenaline in the brain; they are also likely to influence synaptic transmission regulation and postsynaptic conduction. There are four main classes of antidepressants. The selective serotonin reuptake inhibitors, such as fluoxetine, sertraline, escitalopram, and citalopram (see SSRI), are recommended as first-line treatment for depression and anxiety by current NICE guidelines. Their mode of action is entirely on serotonin. Side-effects include gastrointestinal problems and nausea. Tricyclic antidepressants, such as *imipramine, *doxepin, *lofepramine, *clomipramine, and *amitriptyline, are also widely used. They act on noradrenaline as well as serotonin, although most of them primarily have a noradrenergic action. They are also used in chronic pain management. Their side-effect profile varies from that of SSRIs; on the whole they have more *antimuscarinic effects and are more sedative. They are more dangerous in overdose than SSRIs and cause more weight gain. Other side-effects include postural hypotension. Serotonin and noradrenaline reuptake inhibitors), such as venlafaxine and duloxetine (see SNRI), are a common second-line choice in the treatment of depression and anxiety. Monoamine oxidase inhibitors (MAOIs), such as the reversible moclobemide and the irreversible phenelzine (see MAO inhibitor), are older antidepressants. They are now less used because of significant side-effects and interactions with other drugs. The irreversible MAOIs also require certain dietary restrictions. Antidepressants are not addictive, but depending on their half-life they show a varying prevalence of *discontinuation syndrome. Antidepressants have consistently been shown to be more effective than placebo. Their efficacy is lower in mild depression but moderate to good in moderate and severe depression. They are part of the gold-standard treatment for depression and anxiety.... antidepressant

n. any one of a group of drugs used to treat severe mental disorders (psychoses), including schizophrenia and mania; some are administered in small doses to relieve anxiety and tic disorders or to treat impulsivity in *emotionally unstable personality disorder. Formerly called major tranquillizers, and later typical and atypical antipsychotics, they are now known as first- and second-generation antipsychotics. The first-generation (or typical) antipsychotics include the *phenothiazines (e.g. *chlorpromazine), *butyrophenones (e.g. *haloperidol), and thioxanthenes (e.g. *flupentixol). Side-effects of antipsychotic drugs can include *extrapyramidal effects, sedation, *antimuscarinic effects, weight gain, and *long QT syndrome. The second-generation (or atypical) antipsychotics are a group of more recently developed drugs that are in theory associated with fewer extrapyramidal effects than first-generation antipsychotics: they include *clozapine, *risperidone, amisulpride, aripiprazole, olanzapine, and quetiapine. Antipsychotics act on various neurotransmitter receptors in the brain, including dopamine, histamine, serotonin, and cholinergic receptors. Most of them block neurotransmitter activity, but some have partially agonistic effects. Recent evidence suggests that there are significant differences among the second-generation antipsychotics regarding their efficacy and side-effect profiles. Clozapine, amisulpride, and olanzapine were found to be the most effective antipsychotics. Clozapine, zotepine, and olanzapine caused the most weight gain; haloperidol, zotepine, and chlorpromazine caused the most extrapyramidal side-effects; sertindole, amisulpride, and ziprasidone caused the most QT-prolongation; and clozapine, zotepine, and chlorpromazine caused the most sedation.... antipsychotic

n. the subjective experience of abdominal fullness, often (but not always) accompanied by abdominal distension. Its many causes include air swallowing (*aerophagia), abnormal intestinal gas handling or abdominal wall reflexes, increased gas production, and organ hypersensitivity. Bloating may be associated with increased belching, excessive flatus, or changes in bowel habit, particularly constipation. It tends to be aggravated by meals, fluctuates in severity throughout the day (with particular discomfort in the evening), and is relieved at night. Treatment includes the removal of exacerbating factors (such as specific dietary products), avoidance of carbonated drinks and fat-rich diets, reduction in dietary fibre, and reassurance. Drug therapy has limited efficacy, but antispasmodics, laxatives, peppermint oil, simeticone, prokinetics (such as domperidone), nonabsorbable antibiotics (rifaximin), and tricyclic antidepressants (to reduce hypersensitivity) may be tried.... bloating

n. the presence of fragments of endometrial tissue at sites in the pelvis outside the uterus or, rarely, throughout the body (e.g. in the lung, rectum, or umbilicus). It is thought to be caused by retrograde *menstruation. When the tissue has infiltrated the wall of the uterus (myometrium) the condition is known as adenomyosis. Symptoms vary, but typically include pelvic pain, severe *dysmenorrhoea, *dyspareunia, infertility, and a pelvic mass (or any combination of these). Medical treatment is aimed at suppressing ovulation using *gonadorelin analogues, combined oral contraceptives, or the intrauterine system (see IUS). High-dose progestogens suppress *gonadotrophins (FSH and LH), shrink implanted endometrial tissue, and reduce retrograde menstruation. They have a similar efficacy to other medical treatments, are cheaper, and have fewer side-effects than gonadorelin analogues. Surgical treatment may also be necessary, usually by laser or ablative therapy via the laparoscope. More radical surgical treatment in the form of a total hysterectomy and bilateral salpingo-oophorectomy is sometimes required.... endometriosis

n. surgical treatment of *vault prolapse, which can be an abdominal or laparoscopic procedure. It involves suspending the prolapsed vaginal vault to the sacral promontory using a synthetic mesh or biological material; however, it is associated with a significant risk of haemorrhage and mesh erosion. Posterior intravaginal slingplasty (or infracoccygeal sacropexy) is a more recent technique in which a neo-uterosacral ligament (which supports the vagina) is formed. This helps to relocate the vaginal apex and restore the normal vaginal axis. The procedure appears to have similar efficacy to those currently in use but with minimal surgical morbidity.... sacrocolpopexy

a test carried out on a large number of apparently healthy people to separate those who may have a specified disease and could benefit from further testing from those who probably do not. Examples include newborn blood spot screening, cervical screening, and breast screening. The appropriateness of screening depends on the severity and *epidemiology of the disease and the efficacy and availability of treatment. Other factors to be taken into account are the safety, acceptability, cost, *sensitivity, and specificity of the test. No screening test is perfect, and all screening is associated with *false positives and *false negatives. See also genetic screening; UK National Screening.... screening test

Osmanthus fragrans

FAMILY: Oleaceae

SYNONYMS: Sweet osmanthus, sweet olive, tea olive, fragrant olive, silang, holly osmanthus, holly olive, kwai hwa.

GENERAL DESCRIPTION: An evergreen shrub or small tree growing up to 12 metres tall, with broad leaves and bearing purple-black fruits containing a single hard-shelled seed. The small flowers, which appear in clusters late in the season, can be white, pale yellow, gold, orange or reddish in colour, with a strong sweet fragrance much like fresh apricots or peaches.

DISTRIBUTION: This plant is native to Asia from the Himalayas through southern China to Taiwan and southern Japan. It is the ‘city flower’ of the cities of Hangzhou, Suzhou and Guilin in China. Today it is cultivated as an ornamental plant in gardens in Asia, Europe, North America, and elsewhere in the world, mainly for its deliciously fragrant flowers.

OTHER SPECIES: Osmanthus is a genus of about 30 species belonging to the olive family, which are mainly found growing in warm climates. While the flowers of O. fragrans range in colour from silver-white (O. fragrans Lour. var. latifolius) to gold-orange (O. fragrans Lour. var. thunbergii) to reddish (O. fragrans Lour. var. aurantiacus), the absolute is usually prepared from the gold-orange flowered species. A number of cultivars of this species have also been selected for garden use, with specific names: for example, in Japan, the white and orange-blossoming subspecies are distinguished as silver osmanthus and gold osmanthus respectively.

HERBAL/FOLK TRADITION: The exotic flowers from this plant have traditionally been cherished in the East for a range of purposes. Due to the time of its blossoming, sweet osmanthus is closely associated with the Chinese mid-autumn festival when osmanthus-flavoured wine and tea are traditionally served. The flowers are also used to produce a special osmanthus-scented jam, called guì huà jiàng. The tree is known as tea olive because in ancient times the Chinese used it to make a natural ‘de-tox’ herbal tea to flush out excessive nitric oxide from the system; the tisane was also recommended for menstrual irregularities. In some regions of North India, especially in the state of Uttarakhand, the flowers of sweet osmanthus are still used to protect clothes from insects.

Traditional Chinese medical literature describes the usefulness of the flowers of Osmanthus fragrans in the treatment of phlegm reduction, dysentery with blood in the bowel, indigestion and diarrhoea. The Chinese also used the flowers as a natural medicine to improve the complexion of the skin and today the absolute is still employed in cosmetic preparations. However, modern evidence regarding the therapeutic efficacy of the flowers has shown them to be somewhat limited, although studies have indicated they do have anti-oxidant properties, valuable for skincare. Findings also confirmed the ability of the O. fragrans flowers to reduce phlegm and suggest that they may be useful as an anti-allergic agent. Although little used in aromatherapy, since the aroma is relaxing and soothing, helping bring relief from mental stress and depression, it can make a valuable addition to floral-based blends.

ACTIONS: Anti-oxidant, anti-allergic, expectorant, depurative, insecticide, nervine, regulating, sedative.

EXTRACTION: A concrete and absolute by solvent extraction from the fresh flowers. Since the yield of absolute from concrete is only about one kilo per 3,000 kilos of flowers, the enfleurage method or the infusion process have also been applied to these flowers.

CHARACTERISTICS: A green to brown viscous liquid with a very strong sweet-honey, floral, fruity perfume with notes of peach and apricot. It blends well with lime, orange, sandalwood, rose, benzoin, violet, jasmine, mimosa and ylang ylang.

PRINCIPAL CONSTITUENTS: Main constituents include beta ionone, gamma-decanolid, palmitic acid, linoleic acid, linalool oxide, dihydro-beta-Ionone, trans-beta-Ionone and cis-jasmone.

SAFETY DATA: No recorded contraindications for external application: best avoided during pregnancy.

AROMATHERAPY/HOME: USE

Skin care: Dry or mature skin and general skin care.

Nervous system: Anxiety, depression, nervous debility and tension, mood swings, stress.

OTHER USES: Osmanthus absolute (although often adulterated) is used in high-class perfumes for its exquisite aroma, which is very pleasing to the senses. It is also used as a cosmetic ingredient.... osmanthus