EXPLOSIVE GROWTH OF HERBAL MEDICINES

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Viewed as a balanced and moderate approach to healing, herbal medicines have grown exponentially. This popularity is attributed to a preference for natural therapies and a greater interest in alternative medicines. Traditional medicinal practice involving herbs is an integral part of many communities, and the World Health Organization (WHO) estimates that 80% of the world’s population relies on herbal medicine as a primary source of healthcare. Strategic marketing by manufacturers of herbal medicines has expanded product visibility, and the continuous introduction of new herbal products into the market has led to public health issues and safety concerns.

CHALLENGES
All medicines must be safe and of suitable quality, yet a single herb plant may contain hundreds of natural constituents. Such complexity means that the control of raw herbal materials and finished herbal products is more involved than for conventional pharmaceuticals. A substantial proportion of the global drug market, herbal medicines require pharmacovigilance and safety monitoring. The WHO recommends national quality specifications and standards related to the manufacturing, import, and marketing of herbal materials; however, in most countries, herbal medicines arrive on the market without mandatory safety or toxicological evaluations and without evidence of quality and efficacy. The common misconception that natural products are nontoxic and devoid of adverse effects leads to improper use and unrestrained intake, along with the risk of severe poisoning and acute health problems. Herbal medicinal products have been implicated in cases of poisoning, with certain compounds capable of reacting with cellular macromolecules including DNA and inducing cellular toxicity and/or genotoxicity. 

SAFETY AND TOXICITY
The safety of traditional and herbal medicines is paramount to national health authorities and the general public, yet:

• There is limited knowledge of potential adverse reactions.
• Many herbal preparations remain untested and their use unmonitored.
• The safest and most effective therapies have not been identified, and rational use has not been promoted.
• Traditional health practitioners may not be certified or licensed.

Possible causes of adverse events resulting from the consumption of herbal medicines include
mistaken use of the wrong plant species, misidentification of medicinal plants, adulteration of herbal products with undeclared medicines, mislabeling of herbal medicinal products, contamination with toxic or hazardous substances, overdose, and misuse of herbal medicines by healthcare providers or consumers – including concomitant administration with other medicines. Predictably, adverse event analysis with herbal medicines is more complex than with conventional pharmaceuticals.

Evaluation of product safety is further complicated by geographical origin of the plant material, processing technique, route of administration, and compatibility with other medicines.

PROPERTIES OF SPECIFIC HERBS    

Aristolochic acids and Aristolochia species. After findings of potential nephrotoxicity and carcinogenicity of aristolochic acids, studies confirmed their genotoxic activity. Aristolochic acid-related DNA adducts have been found in the renal tissues of patients; these mutagenic adducts are usually poorly repaired and capable of persisting for years in DNA. All plants in the genus Aristolochia contain aristolochic acids and are banned in Europe and the United States. Intake of slimming pills containing the Chinese herb Aristolochia fangchi has been linked to Aristolochic acid nephropathy and the development of subacute interstitial fibrosis of the kidneys and urothelial malignancies.
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The tubers and roots of the Aconitum species have been used medicinally for centuries in herbal preparations for stroke, heart failure, diabetes, rheumatic fever, painful joints, gastroenteritis, edema, bronchial asthma, and other disorders. Aconitum carmichaeli and Aconitum kusnezoffii are used traditionally for pain relief.  The toxicity of these plants derives primarily from the presence of diester diterpene alkaloids. Severe cases of cardiotoxicity from consumption of aconitine-containing herbal preparations manifest as ventricular tachycardia and fibrillation and eventually death. Bradycardia and hypotension have also been observed. The toxicity of aconitine and related diterpene alkaloids can be denatured by special processing and in China only the processed (i.e., detoxified) tubers and roots of Aconitum can be administered orally. More than 70 techniques are applied to the processing of Aconitum roots in order to reduce levels of toxic alkaloids below a certain threshold; note that this principle is not accepted in Europe. 

​Traditionally, Tussilago farfara or coltsfoot has been used for thousands of years to treat pulmonary complaints, acute and chronic coughs, bronchitis, laryngitis, and asthma. The polysaccharides are anti-inflammatory and immuno-stimulating, as well as demulcent, and the flavonoids have anti-inflammatory and antispasmodic actions. Tussilago farfara is generally regarded as nontoxic, although total alkaloids isolated from this plant have demonstrated hepatotoxicity. Recently, the effects of the pyrrolizidine alkaloids found in Tussilago farfara were reviewed and hepatic veno-occlusive disease and cirrhosis suggested as potential disease outcomes in humans. Restricted intake of pyrrolizidine-containing herbs is recommended.

There are reports on the efficacy of Garlic (Allium sativum) for management of hypertension and hypercholesterolemia. The main compound in the fresh plant is alliin, which on crushing undergoes enzymatic hydrolysis by alliinase to produce allicin. Due to the antiplatelet effects of garlic, care should be taken if given in combination with antiplatelet drugs and warfarin. Adverse effects associated with garlic extract include burning sensation in the gastrointestinal tract, nausea, diaphoresis, and lightheadedness. 

The active compounds of St. John’s wort (Hypericum perforatum) include hypericin, hyperforin, and melatonin. The plant has clinically well-established effects for mild depressive symptoms, although allergic reactions, headache, dizziness, restlessness, fatigue, gastrointestinal symptoms, and photosensitivity have been reported, as well as hyperesthesia and a syndrome of dyspnea and hyperventilation with mydriasis, nausea, palpitations, and tremors. Interaction of St. John’s wort with antidepressants and anticoagulants has been demonstrated and use is not recommended in pregnancy because of the herb’s uterotonic activity.

RECOMMENDATIONS
It is vital to inform and protect the public by identifying risks associated with herbal medicines, incorporating herbal products into pharmacovigilance systems, linking safety monitoring to the regulatory status of herbal medicines, promoting safe use through adequate labeling and appropriate patient information, advancing knowledge of traditional, complementary, alternative, and herbal medicines within national drug regulatory authorities, and standardizing definitions and categorizations of herbal medicinal plants on an international level. Herbal medicines must be assessed for safety, toxicity, efficacy, and quality.

Providers of medicines – physicians, nurses, and pharmacists – need training to understand how herbal medicines affect the health of their patients. Healthcare professionals and medical communicators (translators and writers) must inform the public. The right knowledge base is crucial. 

Citation: Ekor M (2014) The growing use of herbal medicines: issues relating to
adverse reactions and challenges in monitoring safety. Front. Pharmacol. 4:177. doi:
10.3389/fphar.2013.00177

The Chinese-language newspaper Sing Tao (stnn.cc) reported earlier this year that 93.5% of COVID-19 patients in Guangdong had been treated with traditional Chinese medicine (TCM). Clinics encouraged the use of TCM as early intervention in mild cases of coronavirus infection. As of May 20th, 1481 of 1488 patients receiving TCM treatment were cured and subsequently discharged. 
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3000-YEAR HISTORY 
In traditional Chinese medicine, which is based on empirical observation and practical medical knowledge, the physician observes patterns in a multiplicity of clinical events to visualize a bodily landscape. Aspects of activity or illness in the body are corresponded to elements in nature and individual disharmonies are noted. A system of pre-technological medical thought, TCM has its own systems of the body and parallel notions of reharmonizing opposites. Diagnosis is based on recognizing and precisely describing patterns of disharmony and then reconciling hostile elements in the body. Extremes are balanced. The highly personalized diagnostic process attempts to capture the essence of the individual patient.
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Tools developed by Chinese medicine over 3000 years to diagnose, prevent, and cure disease: food as medicine, herbal remedies, acupuncture, moxibustion, tongue diagnosis, pulse diagnosis, and facial pallor. 

​DISEASE THEORIES
Historically, TCM has categorized infectious disease as Shanghan (damaged by cold) and Wenbing (warm disease).
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Shanghan (伤寒)
Shanghan refers generally to heat (febrile) disease caused by exogenous pathogenic factors and specifically to acute diseases caused by exogenous cold-evil or malicious cold.
Shanghan in later Han Dynasty medical references is a pathological condition described as externally contracted heat disease with absence of sweating, stiff neck, and a tight floating pulse. 

In Shanghan theory, all heat diseases are of the cold damage kind. Stage 1 starts at the exterior, the respiratory tract, and manifests as chills and sniffles. Stage 2 progresses inward to the lungs and the digestive tract and may manifest as cough and gastrointestinal symptoms.
Stage 3 moves deeper into the digestive tract and the kidneys.
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Wenbing (温病) 
Wenbing is defined as any of various heat diseases due to exogenous pathogenic warmth or heat, characterized by rapid onset and shifts, pronounced heat signs, and a tendency to form dryness and damage the yin. It is infectious and seasonal in nature. Originating in the Ming Dynasty 500 years ago, Wenbing theory builds on earlier Shanghan concepts to elucidate the spread of pathogens from person to person. 

​HOW DOES TRADITIONAL CHINESE MEDICINE CATEGORIZE COVID-19?
 
TCM views COVID-19 using concepts from Shanghan and Wenbing. In both theories, the disease progresses from the exterior to the interior. COVID-19 pneumonia is categorized as Wenbing. The main cause of this disease is damp heat with pestilent toxin, and the pathological features are “dampness, heat, stasis, toxin, and vacuity.”
 
In clinical practice, the COVID-19 patient may present with fever, fatigue, sore muscles, feeling of heaviness in the body, poor appetite, and greasy tongue coating – indicating that the pathogen is in the exterior. Most patients have cough, chest oppression, panting and/or urgent breathing. The fundamental pathogenic factors are dampness and heat. 

PATTERNS ASSOCIATED WITH COVID-19 DISEASE
 
COVID-19 manifests differently based on patient age, disease state, and geographic location. In assessing the patient, the TCM practitioner performs a thorough review of symptoms and selects the pattern that best describes the individual patient.

Pathogenic Damp Stagnation in the Lungs 邪湿郁肺型

Stagnation makes qi movement through this pivot difficult and interferes with the qi dynamic of the lungs. Early symptoms include low-grade fever or no fever, slight aversion to cold, sensation of heaviness and stuffiness in the head and body, muscle pain and soreness, fatigue, cough with scant phlegm, dry mouth with little intake of fluids, feeling of oppression in the chest, nausea, poor appetite, diarrhea, and thin stool. The tongue is pale red with a greasy white coating; the pulse is floating and slightly rapid.
 
Pathogenic Heat Obstructing the Lungs 邪热阻肺型

In this pattern, the lungs lose the ability to diffuse and descend. Symptoms include fever or high fever, cough, yellow or thick phlegm, fatigue, headache, pain and soreness throughout the body, dryness and bitter taste in the mouth, irritability, constipation, and reddish urine. Tongue is red with a greasy yellow coating. Pulse is slippery and rapid.
 
Damp-Warm Stagnation in the Lungs 湿温郁肺型

Symptoms include fever, strong or abnormal sensation of heat, slight aversion to cold, cough, yellow and thick phlegm, chest oppression, shortness of breath after exercise, lack of energy, dry mouth, lack of appetite, abdominal distention, dry and bound or sluggish stool, a sensation of incomplete defecation, and yellow urine. Pale red tongue with thin yellow greasy coating. Slippery and rapid pulse.

Pestilent Dampness Damaging the Lungs 疫湿伤肺型
Normal body temperature. Symptoms may include cough with little or no phlegm, chest oppression or shortness of breath after exertion, lethargy and fatigue, spontaneous sweating, palpitations, or poor appetite. Tongue is pale red with a white coating or slightly greasy. 

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​HOW DOES TRADITIONAL CHINESE MEDICINE TREAT COVID-19?

To treat COVID-19, TCM employs herbs that transform dampness and release toxins, as well as herbs that clear heat and resolve toxins. The goal is to diffuse the lungs to vent pathogens. TCM uses herbal formulas, moxibustion (mugwort burned at the skin over acupuncture points), and acupuncture in combination because the approaches act synergistically to improve symptoms. Treatment is tailored to the patient’s symptoms and based on the practitioner’s knowledge about local manifestations of the virus. ​
 
Guangdong Province The Chinese Medicine Protocol for Pneumonia Due to Novel Coronavirus released in Guangdong Province outlines the particular epidemiological features, clinical presentation, and clinical features of the progression of COVID-19 pneumonia in Guangdong.
The climate in southern China is damp and humid, and pestilent qi easily mixes with this dampness, first attacking the lung defenses, particularly in patients with a weak spleen and stomach. If the healthy qi is unable to defeat the pestilent unhealthy qi, then the pathogenic toxin moves to the interior and transforms into heat, harming the bodily fluids and depleting the humors, sometimes to the point of agitating the blood, which can create a critical situation.
 
Hubei Province The novel coronavirus first appeared in humans in the cold, damp winter of Wuhan, a central Chinese city situated on the Yangtze River. Clinical departments at Hubei Provincial Hospital of Traditional Chinese Medicine collaborated to investigate and formulate protocols for preventing and treating COVID-19-related pneumonia, which TCM practitioners termed “damp heat in the lungs.”

Critical viral respiratory disease formulas
Primary treatment strategies target latent heat and damage to qi and yin. TCM concludes that the cause of coronavirus is primarily dampness, which obstructs the spleen and blocks the lungs (湿困脾闭肺) and disrupts the bearing [rising and falling] of the qi dynamic (⽓机升降失司). Damp toxins are converted into heat, bowel repletion develops, damp toxins and stagnating heat are locked in, and the increasing heat leads to severe qi reversal and imbalance.
  
Next month: Overview of Herbal Formulas and the Properties of Individual Herbs
  

ROLE OF DIETARY SUPPLEMENTS IN MODERN LIFE   
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​Many people today take dietary supplements, herbal remedies, botanicals, and other “natural products” as part of their daily wellness regimen. Dietary supplements come in the form of pills, powders, or liquids and are widely available. Note that in the United States, herbs and herbal remedies are regulated as dietary supplements.

DO SUPPLEMENTS PREVENT OR TREAT DISEASE?
While there is a lot of evidence that dietary supplements help to prevent and treat nutrient deficiency, there is less evidence about the usefulness of dietary supplements in preventing or treating disease. In an evidence-based study of the links between nutritional supplements and mood and neurological disorders, antioxidants, omega-3 fatty acids, quercetin, folate, and zinc demonstrated benefit for depression. Elsewhere, research indicates that pomegranate may ward off infection, turmeric has been studied for Alzheimer disease, rheumatoid arthritis, and prostate and colon cancer, and ginger has proven effective for nausea and vomiting. 
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DOES MY SUPPLEMENT OR HERB INTERACT WITH MY PRESCRIPTION DRUG?
Although herbs and herbal remedies are regulated as dietary supplements and not as drugs, prescription drugs and herbs may interact in harmful ways. Some supplements decrease the effects of a drug. Others may increase a drug’s effects and produce unwanted side effects.

Significantly, there is extensive evidence that St. John's wort interacts in dangerous, sometimes life-threatening ways, with a variety of prescription drugs including birth control pills, antidepressants, and some HIV drugs. There is still a lot we don’t know.

TELL YOUR HEALTHCARE PROVIDER
It’s important to tell your healthcare provider about all dietary supplements and drugs you take so they can help you avoid harmful interactions. 

WHERE DO I LEARN MORE?

WEBSITES
National Center for Complementary and Integrative Health 
https://nccih.nih.gov/health/herbsataglance.htm
Fact sheets on specific herbs or botanicals 

MedlinePlus of the U.S. National Library of Medicine 
​https://medlineplus.gov/druginformation.html
Drugs, Herbs and Supplements page

BOOKS
Tarascon Pocket Pharmacopoeia 2020 Richard J. Hamilton, M.D., Editor-in-Chief. Ten pages detailing possible drug interactions with commonly used herbs.
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Herbal Contraindications and Drug Interactions 2010 Frances Brinker, N.D. Comprehensive guide to drug-herb interactions with additional extensive appendices addressing common conditions, medications and nutritional supplements, and influences on phase I, II, and III metabolism.

TRADITIONAL CHINESE HERBAL REMEDIES  
As evidenced by a February 18th tweet from China Xinhua News, healthcare practitioners across China are relying on centuries-old remedies to treat the novel coronavirus. In the absence of targeted drugs and vaccines, with continual updates to the national diagnosis and treatment program for novel coronavirus, the role of traditional Chinese medicine (TCM) is on the rise. More COVID-19 patients are being treated with Chinese medicine or integrated Western-Chinese medicine, and the role of TCM herbal prescription formulas is expanding. What formulas are they using? What do the properties of these herbs tell us about TCM approaches to the virus?

USE OF CHINESE HERBS TO TREAT THE CORONAVIRUS
With an array of treatment methods and a wealth of experience in its arsenal, Chinese medicine has been used to fight plagues and epidemics for thousands of years. The focus of TCM is not just the virus itself but also symptoms and changes to the body caused by the invasion of the virus. Treatment starts with the patient as a whole, to identify patterns and then dispel sickness and support health.

HERBAL FORMULA USAGE RATES 80% TO 95%
Reports from throughout China indicate TCM formula usage rates of 80% to 95% in confirmed cases of novel coronavirus. One specialist described isolation wards containing a mix of mild, typical, and severe cases of novel coronavirus. Typical cases are characterized as imaging findings in the lungs but the absence of disease progression to respiratory failure. In hospitals, traditional Chinese medicine plays a significant role in regulating diarrhea, constipation, and other gastrointestinal symptoms; in addition, intervention with Chinese medicine may stop the condition from progressing to the severe and critical stages.

WHAT FORMULAS ARE BEING USED? WHAT FORMULAS HAVE BEEN VALIDATED?
清肺排毒汤
The National Health Commission and the State Administration of Traditional Chinese Medicine recommend Qing Fei Pai Du decoction (清肺排毒汤); clinical observation and data analysis have been performed on the therapeutic efficacy of this classical TCM formula. One formula for Qing Fei Pai Du decoction appearing on multiple sites, including Baidu, listed 21 ingredients. The top ingredients in terms of quantity are calcium sulfate, Radix bupleuri (common name bupleurum, effective in the treatment of alternating chills and fever; may induce headache or nausea), Poria cocos (efficacy in draining dampness and transforming phlegm; concurrent administration of diuretics contraindicated), Radix dioscoreae (Chinese yam, known to tonify qi and yin of the lungs, spleen, and stomach; may have hypoglycemic effects, use with caution in comorbid hepatobiliary disease).

肺炎一号
Pneumonia Formula No. 1 (肺炎一号), developed by the Chinese Medicine Department at Guangzhou Eighth People's Hospital, and its variations Pneumonia Formula No. 2, Pneumonia Formula No. 3, Pneumonia Formula No. 4, and Pneumonia Formula No. 5 are also in use. Formula No. 1 has achieved favorable clinical results in Guangzhou. Formula No. 1 includes two herbs that clear heat and relieve toxicity, Flos lonicerae (honeysuckle flower) and Fructus forsythiae (forsythia fruit), along with 16 other ingredients.

VARIATIONS
In Chinese medicine, the treatment regimen adopted varies by person. If a patient is in poor physical condition, dispelling disease is not enough, treatment must focus on supporting health. For example, in those with poor appetite it is necessary to focus on spleen health; in patients with damp-heavy qi and thick tongue coating it is necessary to improve the flow of urine. Ear needling (acupuncture) may be used to treat the patient’s psychological state and resolve issues of insomnia, in order to restore the patient’s biological clock.

Just as treatment varies by individual patient, the virus varies by region. This too is a factor in treatment selection. It would not be appropriate to select one uniform formula for the entire nation.

NOT ADVOCATED FOR THE HEALTHY
NOT ADVOCATED FOR THE PREVENTION OF CORONAVIRUS
According to the head of a university of traditional Chinese medicine, the entire populace does not need to take this medicine. Healthy people need to improve resistance in order to avoid getting sick. High-risk populations, including healthcare providers, may take herbal remedies as appropriate.

Practitioners emphasized that these are treatment prescriptions and are not recommended as preventive prescriptions. The general public should not self-administer these prescriptions.
 

ASTRAGALUS  
Originating in northeastern China, central Mongolia, and Manchuria, the root of the herbaceous perennial Astragalus membranaceus or 黃芪 (huangqi) is a staple of traditional Chinese medicine. Mild in strength, with a sweet and slightly warm nature and an affinity for the spleen and lungs, astragalus is used as a general tonic to improve endurance, immune resistance, and energy, and to promote blood flow to the surface. ​Astragalus is useful for viral infections and increases the action of interferon alpha-1. It tonifies the spleen, the qi, and the blood. It is indicated for energy deficiency, fatigue, prolapse of rectum, womb, or other organs, profuse sweating due to external “empty” ailments, stubborn abscesses, facial swelling, and diabetes. ​

The use of astragalus root as a general tonic dates to the 28th century BCE and the mythical Chinese ruler Shennong, the legendary author of the first materia medica. Astragalus root has a long, cylindrical taproot, which is internally yellowish in color, but rootlets should be absent. The constituents of astragalus root include triterpenoid saponins, astragalosides I-VIII, astramembranins I and II, isoglavones including formononetin and kumatakenin, and polysaccharides known as astrogaloglucans. There is anecdotal but little clinical evidence that astragalus alone or in combination aids in the treatment of the common cold or impaired immunity. Clinical studies supported by data from over 1000 patients in China confirm the use of astragalus as an immunostimulant for use in colds and upper respiratory infections. It is also used prophylactically. In general, astragalus is well tolerated but should probably be avoided in autoimmune diseases. 

INGREDIENTS
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Root herbs astragalus, ginseng, eleuthero
Six cups low-salt soup broth
2 tablespoons olive oil
2 cloves garlic
​4 carrots
1 onion
1-2 pounds chicken (optional - for added immunity)
2 cups of chopped greens (spinach, chard, kale)
4 sprigs of parsley
2-3 sprigs of sage
6 slices of ginger root
 
Step 1: Soak root herbs in large pot with soup broth while preparing Steps 2 and 3. 
Step 2: Mince garlic, chop carrots and onion. Sauté  in olive oil over low heat until onions are translucent.
Step 3: Add chicken to above and brown on both sides.
Step 4: Add sautéed carrots, onions, and garlic, as well as chopped greens, sprigs of parsley and sage, slices of ginger, and chicken to soup broth.
Step 5: Simmer soup 3-4 hours, then remove root herbs, ginger slices, and sprigs of parsley and sage. 
Step 6: Season to taste with salt and pepper or soy sauce/hot oil/sesame oil. 

WILD STRAWBERRY   
​Wild strawberry runs along the trail. Tea of strawberry leaves and stems is valued for its mild astringent effects, and its antirheumatic, diuretic, antidiarrheal, tonic, and laxative properties. Strawberry is recommended in many traditions for intestinal sluggishness and for pregnancy, convalescence, and chronic stomach sensitivity when stronger herbs are contraindicated.

WORMWOOD 
Known variously as 艾叶 (aiye), artemisia, or mugwort, wormwood is an intense bitter that stimulates underactive digestion and aids anemia. An anti-inflammatory and antidepressant, wormwood can be added as a potentiating factor to other preparations. Its active substances include essential oils, sesquiterpene lactones, azulenes, flavonoids, phenolic acids, and lignans. The whole plant is used as an antimalarial. Wormwood herbal tea is administered as a stomach stimulator and orexigenic.
In Chinese medicine, wormwood warms the channels and stops bleeding. It dispels cold and alleviates pain, calms the fetus, resolves phlegm, and stops cough and asthma. As an aromatic, wormwood is used in sweat baths and saunas. Wormwood-juniper smudge sticks cleanse spaces and purge negativity.

VERBENA 
The constituents of verbena or 马鞭草 (mabiancao, literally, horsewhip herb) include volatile oils, bitters, iridoids, alkaloids, mucilage, and tannins. It is a restorative, helpful for tension and long-term stress and good for convalescence from a long illness. The entire plant has sedative, tonic, diaphoretic, and anti-inflammatory properties and it is used to treat early-stage depression, melancholia, stress, and fever. Chinese medicine employs the bitter and cool properties of verbena to clear heat and remove toxicity, activate blood, disperse nodules, promote diuresis, and resolve swelling. It is indicated for jaundice caused by damp-heat, for fever due to external pathogens, and for dysmenorrhea or amenorrhea from blood stasis and abdominal masses. Its heat-clearing properties are used for severe sore throat and other accumulations of heat toxin including breast abscesses and swollen and painful gums. Extracts of lemon verbena and its major compound acteoside (ACT) have a regulatory effect on abnormal liver lipid metabolism; furthermore, ACT promotes lipolysis and fatty acid oxidation by increasing messenger RNA expression of adipose triglyceride lipase and carnitine palmitoyltransferase. 

OAK TREE
The leaves, acorns, galls, and branches of oak trees contain tannin, quercetin, gallic acid, pectin, calcium, magnesium, and potassium. In various medical traditions, infusion of oak tree bark is administered internally to treat hemorrhoids, diarrhea, chronic dysentery, intestinal bleeding, and uterine bleeding, and, as a tea astringent, oak is applied externally to skin wounds, burns, mouth inflammation, toothaches, sore throats, and earaches.
Oak gall possesses astringent, anti-inflammatory, antiviral, antidiabetic, larvicidal, antibacterial, and gastroprotective effects. Gallnuts have been sourced to produce drug therapies for cancerous diseases in traditional and folk medicine systems through the centuries, and the literature indicates that gallnuts contain a number of bioactive metabolites, accounting for their anticancer effects. Further screening of bioactive compounds is expected to yield valuable anticancer agents.

​JUNIPER
​The medicinal evergreen juniper or 杜松子(dusongzi) is resinous and aromatic. Internally, the leaves or berries have been used as a urinary antiseptic and for cystitis and urethritis, although juniper is contraindicated in people with kidney infection or chronic kidney weakness as the oils may be irritating to kidney inflammations. Juniper berries have diaphoretic and emmenagogue properties and the leaves have diuretic properties. In Chinese medicine, juniper works at the heart, spleen, and lung meridians and its key actions and medicinal uses include promoting digestion, warming the middle burner, expelling phlegm, warming the lungs, and cleansing the kidneys and liver.
Topically, juniper is used to treat chronic skin irritations and as a relaxant. It relaxes the muscles and removes barriers to blood flow and energetic flow. Juniper is prized in many traditions for its ability to dispel tension and stagnation and the aromatic parts of the juniper plant have been employed as a protector against negativity.  Juniper is known to have a stabilizing presence for those in need of safety and protection. ​
Juniper's versatility extends to the culinary world and includes the flavoring of meat and sauerkraut and the distillation of gin.  

 
Please note: The herb information in this blog is presented for educational purposes only. The use of herbal preparations is not recommended without seeking the advice of a healthcare provider. Substances in herbal preparations may interact with prescription drugs to eliminate therapeutic efficacy or induce toxicity.

BEAR CORN
​​Bear corn or 肉苁蓉 (roucongrong) emerges from the soil under the oaks. A root parasite lacking chlorophyll, bear corn searches the dark soil to feed off the root system of the host tree. These New Mexico specimens are yellow and resemble ears of corn. In the words of Culpeper, “The juice or decoction of the young branches or seed, or the powder of the seed taken in drink, purgeth downwards and draweth phlegmatic and watery humors from the joints, whereby it helpeth the dropsy, gout, sciatica, and pains in the hips and joints.” Bear corn serves as an astringent, a poultice, a laxative, and a sedative. It restores strength, muscle tone, and balance after a long illness. In Chinese medicine, bear corn is a tonic to kidney-yang and a demulcent laxative; it tonifies yin as well as yang, lowers blood pressure, and is prized as an aphrodisiac and a uterine hemostatic. Modern research indicates that phenylethanoid glycosides isolated from bear corn may be effective in treating hot flashes and menopausal syndrome.

YARROW
The wet spring has produced a bumper crop of fernlike yarrow. Also known as thousand-leaf, yarrow is an important species in the traditional medicine of many cultures. It is antispasmodic, astringent, bitter, diaphoretic, and anti-inflammatory, and its constituents include coumarins, tannins, alkaloids, flavonoids, lactones, volatile oils, and triterpenes. Internally, yarrow is used to break fevers and to regulate the menstrual cycle, reduce heavy bleeding, and relieve menstrual pain. Externally, a salve or ointment of yarrow heals wounds and eases the pain of varicose veins. Yarrow has been used as a battlefield remedy for its ability to stanch bleeding and its antibacterial properties. Soldiers applied powdered yarrow or fresh yarrow leaves and flowers to stop wounds from bleeding. 

CLEMATIS
Clematis ​or 威灵仙 (weilingxian) grows vertically on rocky roots as a vine with sparse, four-petal, nodding mauve flowers. Clematis has analgesic, anti-inflammatory, diuretic, and antimicrobial properties and its synergistic nature increases the effectiveness of other herbs. Clematis tea both acts as a vasoconstrictor on brain lining and dilates blood vessels -- it is used to treat headaches and migraines. Externally, a poultice of clematis leaves treats rheumatic pain.  
Known as “the holy root of the temple” in Chinese medicine, clematis removes wind and dampness, facilitates passage of meridians, and relieves pain. Experimental studies have demonstrated the antirheumatic and analgesic effects of clematis and saponins isolated from clematis may induce apoptosis in breast cancer cells via the mitochondrial pathway. Triterpene saponins from the roots and rhizomes of Clematis mandshurica show inhibitory activity against human colon cancer cell lines.

VALERIAN
Valerian or 缬草 (xiecao) clings to the rocks nearby. Also known as all-heal, valerian's use as a medicinal herb was documented in ancient Greece. Pliny said that the powder of valerian root given in drink, or the decoction thereof taken, helps all stoppings and stranglings in any part of the body. And Culpeper recommended the root of valerian boiled with licorice, raisins, and aniseed as singularly good for those who are short-winded and for those who are troubled with the cough, to open passages and expectorate phlegm easily.
​We scratch the root and smell the pungent odor of its chemical constituent valerenic acid. Acting at the central nervous system, valerenic acid and its derivatives have soothing, sedative, spasmolytic, digestive, and hypnotic properties. Physiologically active iridoid valepotriates may cause the release of GABA from nerve endings and block its return to nerve cells, and valerenic acid is known to inhibit an enzyme that destroys GABA. Herbal tea from valerian root has been used for anxiety, tension, hysteria, insomnia, and pain. Valerian root is approved in Europe for mild anxiety and to aid sleep. 
In Chinese medicine, valerian possesses pungent, bitter, and warm properties and enters through the liver and heart meridians. It acts to induce tranquilization, stop bleeding, and alleviate pain. Valerian root is indicated for irregular menstruation, traumatic injury, back pain, neurasthenia, and indigestion. ​

CORYDALIS
​Corydalis, also known as golden smoke, scrambled egg, or 延胡索 (yanhusuo), is among the first herbs to flower in spring. An herbal tea of the fumewort corydalis has hypnotic and analgesic properties and is used for stomachache and headache. The Ojibwe people placed the root on coals and inhaled the smoke to clear the head and calm the patient. In Chinese medicine, corydalis invigorates the blood, moves qi, alleviates pain, and reduces masses; thus, it is indicated for pain due to blood stasis and qi stagnation such as epigastric pain and dysmenorrhea. Corydalis contains 20 alkaloids, among them corydaline, tetrahydropalmatine, protopine, and tetrahydrocoptisine, and in laboratory research has exhibited pharmacological action on the central nervous system, including analgesic and sedative effects. Corydalis may block certain receptor sites in the brain, inducing sedation. Its alkaloids may also have cardiovascular effects.

Please note: The herb information in this blog is presented for educational purposes only. The use of herbal preparations is not recommended without the advice of a healthcare provider. Substances in herbal preparations may interact with prescription drugs to eliminate therapeutic efficacy or induce toxicity.