NMT100 Bot Med Review Notes - Weeks 1-4.docx

NMT100 – Summary and Review Notes WEEK 2: BOTANICAL MEDICINE HISTORY AND HERBAL PHARMACY Botanical Medicine Botanical medicine: oldest form of therapy; based on Vital Force and relationship between plants, humans and the planet (linked to broader context of “planetary wholeness” Biophilia: innate f...

NMT100 – Summary and Review Notes WEEK 2: BOTANICAL MEDICINE HISTORY AND HERBAL PHARMACY Botanical Medicine Botanical medicine: oldest form of therapy; based on Vital Force and relationship between plants, humans and the planet (linked to broader context of “planetary wholeness” Biophilia: innate feeling or emotion for all living forms and systems; activated through relationship and experiences with nature Accepts that other species are our kin Lost language of plants – we used to know: What was dangerous or effective (what form was most effective), what part of the plant was to be used, what dose, which season/time of day/phase of moon is most active History of Herbal Medicine Earliest known records of therapeutic use of plants – Sumerian tablets (3000 BCE) followed by Ebers papyrus (1500 BCE) in Ancient Egypt Herbal medicine practice 60,000 years ago in Iraq and 8000 years ago in China Ancient herbal practices include: Ayurvedic Medicine (3000 BC) Traditional Chinese Medicine (2800 BC) African Traditional Medicine Ancient Egyptian Medicine (3000 BC) First Nation Traditional Medicine Arabic/Sumerian Medicine (3000 BC) Persian/Iranian Medicine (1500 BC) Greco-Roman Medicine (400 BC) Greco-Roman Roots Humoral Medical Theory – developed by Hippocrates and Aristotle; first European medical theoretical system Symbolic elements air, earth, fire, water Qualities cold, hot, wet, dry 4 fluid states in the body blood, choler (yellow bile), phlegm, black bile Temperaments sanguine, choleric, phlegmatic, melancholic Galen – surgeon to make humoral medicine the cornerstone of medicine in Europe for the next 1500 years Greco-Roman medicine integrated with Persian, Indian and Arabic practices by Ibn-Sina into the book The Canon of Medicine in 1000 AD Element Quality Humor Temperament Fire Hot Stimulating, cayenne Choler (yellow bile) Exc: Tingling, burning, itching, jaundice, flushing, redness Def: Ingestion, bloating, loss of drive Choleric Argumentative, angry, restless, decisive, hard-working Air Dry Toning, witch hazel Blood Exc: nervous, indigestion, mania, headaches Def: atrophy, fatigue Sanguine Socialable, talkative, playful, happy, impulsive, courageous Water Damp Relaxing, Labelia Phlegm Exc: lung infection, bloat, loose stool Def: constipation, dry skin Phlegmatic Lethargic, passive, loyal, calm, adaptable Earth Cold Sedating, valerian Black Bile Exc: insomnia, depression, weak digestion Def: impulsiveness, lack of focus Melancholic Moody, somber, worried, pessimistic, artistic, idealistic Historical herbal texts: Hippocrates (468-377 BC) – “Father of Medicine” wrote Hippocratic Corpus (300 plants) Dioscorides (50-70 AD) – doctor to the Roman Armies; wrote De Materia Medica (600 plants); remained key reference The Dawn of Chemical Pharmacology Paracelsus (1493-1541) German-Swiss physician and alchemist – considered founder of chemical pharmacology Believed specific medicinal action of each plant depends on its active principle Arcana: meant getting to the pure chemical part of the plant; isolating it thought to be more effective and powerful while being safe Doctrine of signatures: concept supported by Paracelsus that plants contain visible clues to their usefulness including colour, form, place of growth, resemblance to human organs Ex. yellow plants good for liver, fruit shaped like reproductive organs good for fertility, etc. Nicholas Culpeper (1616-1654) English herbalist, apothecary and astrologist known for providing cheap and readily available health care to the poor Translated Latin herbal pharmacopeia to English = English Physician – which made its way to North America and integrated Early American Naturopaths Samuel Thomson (1769-1843) Travelling physician using hydrotherapy and herbs; knowledge came from Indigenous peoples Thompsonian movement (The Friendly Botanical Society) Eclectic medicine – 20th century Blending old and new theories of medicine – science to understand the body and herbs to treat Ellingwood and Felter helped to publish Eclectic Materia Medicas Suppression of biophilia in medicine – 1906-1928 Attacking use of plant medicines – dangerous, unscientific, wild and unpredictable American Medical Association (AMA) founded in 1847 – licences to practice medicine based on achieving standards; steered away from traditional herbal practices 1936 – many botanicals, eclectic, Thomsonian schools had closed Western Herbal Medicine Inferred by our understanding of herbal nomenclature, constituents, actions, and energetics Naming of plants – genus, species (ex. Melissa officinalis) Herbal constituents: “active ingredients” or chemicals of plant; one plant can have hundreds and there can be primary or secondary constituents ex. flavonoids, mucilage, tannins Herbal actions: describes the effect an herb and its constituents have on the body ex. antioxidant, bitter, nervine relaxant Herbal energetics: used to describe the way herbs and the body interact; can fine tune herbal selection for formulation Four qualities Hot – stimulating, warm Cold – sedating, cooling, relaxing Damp – moistening, demulcent Dry – astringent, drying Six tissue states: Excitation Depression Stagnation Atrophy Laxity Constriction Energetic Description Helpful to oppose Heat-excitation Increased tissue function, overproduction, “hyper” conditions Red, swollen, tender, hot tissues, itching, burning, bleeding – inflammation Anxiety, irritability, restlessness Tongue – red, yellow coat Pulse – rapid, bounding Cooling, sedating, moistening Cold-depression Lack of stimulation, insufficient tissue function, “hypo” conditions Poor circulation, cold, easy bruising, wounds slow to heal, dull or throbbing pain, sluggish digestions, constipation Cloudy thinking, depression, lethargy Tongue - purple/blue with no coat or thick coat Pulse – deep and slow Stimulating, warming, aromatic Damp-laxity Tissues lack tone, unable to hold fluid, run freely, mucus, diarrhea, saliva and sweat Prolapsed organs, pale, cool, moist skin and mucosa Tongue – moist, foam or streamers on sides Pulse – full, non-resistant (floppy) Dryness, astringent Damp-stagnation Hold excess fluid, improper assimilation of nutrients, swollen, weak, inactive tissues, thick/sticky/yellow mucous Poor waste excretion, constipation, infrequent sweat/urine Poor liver/metabolic function, sluggishness, dullness and fatigue Tongue – thick, floppy Pulse – dull, slow Stimulating, detoxification, bitters, hepatics Dry-atrophy Dry tissues, skin and mucosa (itchy), craves fluids, chronic constipation Nervous exhaustion, poor memory and focus Tongue – dry, narrow Moistening, demulcent, nutritive herbs Tense-constriction Tension or spasm in tissues, rigid muscles, tension, digestive spasm or cramping Feeling anxious or high strung, unable to relax, irregular or changing symptoms Tongue – quivering Pulse – wiry, tense Relaxants, antispasmodics, nervines, aromatics, diaphoretics Parts of Herbal Plants Choosing herbs – factors to consider include: Environmental, sociological, ethnobotanical impact Time of year Quality How to dry, process and store the herb Parts of Plants Aerial parts When: spring to late summer when herb flowers How: pick petals or whole flowers/leaves Processing: dry herbs on rack or tie bunches to hang; wait until crunchy to store Storage: air-tight containers out of direct light; keep for ~1 year Roots When: autumn as nutrients settle downwards How: roots after 1 year of growth; replant crown just below stem Processing: wash/scrub root and peel off outer layer; cut and dry Storage: up to 2 years in air-tight containers in cool/dark place Bark When: early spring when sap rises; autumn when sap settles How: collect from branches or saplings that are at least 2 years old pruning them in long stripes; never harvest bark from main trunk or ring Processing: strip with knife/peeler; cut into pieces and dry Storage: up to 2 years in air-tight container in a cool/dark place Fruit and seed When: summer to autumn (when ripe) How: pick when fruit and seeds are ripe; some gathered when fresh and green Processing: slice larger fruits; lay out in single layers to dry Storage: up to 2 years in air-tight container in a cool/dark place Herbal Preparations Tincture Herbs steeped in alcohol or vinegar; alcohol better at extracting most constituents and acts as a preservative (strong) Method: Folk Method – uses 40% alcohol and stored for 4-6 weeks Maceration (mathematical) method - identify herb material to liquid ratio and percentage of alcohol required (ex. 1:5 in 40%) Percolation – moving alcohol (solvent) through powdered herb material slowly, letting the solvent drip through a container Benefits = faster processing (1-2 days), more concentrated product Drawbacks = requires special equipment, fresh plants and plants with high mucilage or resin content cannot be used Approx. shelf-life: 2+ years Liniment Alcohol or vinegar tincture applied directly to skin (external use only; 2 parts tincture with 1 part oil or alcohol) Muscular use – only apply to unbroken skin Usually contains anodyne and rubefacient herbs in oil or alcohol; applied with friction Glycerite Herbs steeped in glycerine Approx. shelf-life: 1 year Infusion Water-based - non-woody herbs steeped in water Approx. shelf-life: 24 hours, refrigerate Examples: chamomile, peppermint, lemon balm, nettle, dandelion leaf, lavender, raspberry leaf Decoction Woody herbs simmered in water (more heat and time needed than infusion) Approx. shelf-life: 48 hours, refrigerated Examples: licorice, dandelion root, astragalus, ashwagandha, ginseng Inhalation Infusion or decoction is inhaled as steam; delivers constituents right into respiratory tract Bath Strong infusion or decoction is added to bath water; skin, genital/anal use Poultice Applying fresh, dried or powdered herb directly to the body; skin irritation/damage, muscle pain/strain and inflammation (infection) use Can be hot or cold Examples: comfry leaf and root, chickweed, plantain, calendula, witch hazel Compress Infusion or decoction applied to skin with a soaked cloth; use for skin, muscle and inflammation Can be warming or cooling; often contain vulneraries, astringents, rubefacients and circulatory stimulants Infused Oil Herbs steeped in warm or cold oil; can be used topically or internally via cooking Carrier oil options include: olive, almond, coconut, shea butter, sunflower, castor, grapeseed Approx. shelf-life: 6-12 months Salve Beeswax or thickening agent is added to herbal oil to produce a solid product to apply to skin Occlusive and protective Suitable herbs would be vulnerary and emollients Approx. shelf-life: 6-12 months Creams and lotions Emulsions of oil and water with medicinal phases being in either or both bases – absorbed into body and work on surface of skin Powders, capsules and tablets Powdered herbs can be stirred into food and drinks, encapsulated or pressed into tablets (standardized) Vinegars, oxymels and honey, syrups Vinegars – for promoting digestion and support liver health; 4% acetic acid = extract certain amount of fat-soluble constituents Useful for no alcohol use – but does not keep as long Oxymel – when honey is added; can also infuse honey directly Herbal syrups – saturated solutions of sugar or honey in water (sugar is preservative component) and water used is a strong infusion or decoction) – can help absorption/effect of medicines and act as CHO for body Lozenges and pastilles Used to treat mucous membranes; often actions such as demulcents, soothing expectorant or antimicrobial Often contain finely powdered herbs Posology Considerations When to take it: Empty stomach – cleansing and detoxifying; best for most internal herbs Before a meal – nervous conditions and to help stimulate digestion After a meal – for indigestion and gas Taken with food – to lower the strength of preparation General dosing guidelines for adults Higher and more frequent dosing for acute conditions and/or stronger vitality Lower and less frequent dosing for chronic conditions and lower vitality WEEK 3: HERBAL MONOGRAPHS, PHYTOCHEMISTRY AND HERBAL ACTIONS Monograph structure: Picture of plant Latin name, common name and family name Part used Constituents and actions Pharmacology: Medicinal uses/indications Pharmacy and posology Contraindications, cautions, toxicity concerns and interactions Optional: energetics, taste, folklore Phytochemistry Primary metabolites: fundamental to the life of the plant (ex. protein, lipid, chlorophyll) Secondary metabolites: do not appear to be fundamental to sustain life but serve functions within the plant; referred to as plant constituents Can be made for protection, interactions with other species, fragrance, colour, structure Constituent classifications Carbohydrates – inulin, arabinogalactans, beta-glucans, gum, mucilage Lipids - alkamides, fatty acids Phenolics – salicylic acid, coumarins, flavonoids, isoflavones, lignans, quinones, tannins Terpenoids – volatile oils, resins, saponins, phytosterols, carotenoids, cardiac glycosides, iridoids Alkaloids – isoquinoline, pyrrolizidine Glycosides Two molecules attached via glycosidic bond – glycone (sugar unit) and aglycone (any compound) Phenolic glycosides – sugar unit attached to phenolic compound; typically, aglycone is active component and the sugar unit helps make them more water soluble Need 25-60% solvent Constituent solubility Water-based solutions extract water soluble constituents like mucilage, polysaccharides and tannins Fat-based solutions extract fat-soluble constituents like alkaloids, resins, volatile oils Influences of constituent solubility: Structure and size of phytochemical molecule Polarity and functional groups Synergistic and companion compound content Temperature of extraction solvents Plant matrix Type of solvent and solution pH (ionization) Constituents and solvent required Alkaloids – 45-60% alcohol Flavonoids – water or 35-50% alcohol (varies depending on glycoside) Mucilage – water; may form sludge in alcohol Salicylates – water or 25% alcohol; readily soluble in both Saponins – water + 40% alcohol; partially soluble in both water and alcohol Resins – 90% alcohol or oil; insoluble in water Tannins – water or 25-60% alcohol; readily soluble in both Volatile oils – volatize in hot water, 40% alcohol or oil; soluble in alcohol and fixed oils; slightly soluble in water (steam and heat) Alcohol only Water only Water and/or alcohol Alcohol and oil Alkaloids (45-60%) Mucilage Flavonoids (25-50%) Salicylates (25%) Saponins (40%) Tannins (25%) Resins (90%) *Volatile oils – hot water, alcohol (40%) and oil Herbal Actions Can have systemic effect on whole body or specific effect on tissue/organ system Categorized as either: tonics (normalizers) or effectors Actions can be further classified Actions for Body Systems Respiratory system: expectorants, anticatarrhals, antitussives Digestive system: cholagogue, choleretic, bitters, demulcents, carminatives, antiemetics, emetics Adrenals and nervous system: adaptogens, nervine tonics, nervines relaxants, sedatives, hypnotics, nervine stimulants, antidepressants, anxiolytics, nootropics Cardiovascular system: cardiotonic, hypotensives, blood vessel tonics, antioxidants, hypolipidemics, hypoglycemics, circulatory stimulants Urinary system: diuretics, antilithics Reproductive system: emmenagogues, galactogogues, uterine tonics, female reproductive tonics, male reproductive tonics Immune system: antimicrobials, antibacterial, antivirals, antifungals, anthelmintics, deep immune tonics MSK system and connective tissue: connective tissue tonics, rubefacients, vulneraries, analgesics, antispasmodics, anti-inflammatories, antirheumatics Skin and mucus membranes: emollients, demulcents, astringents, styptics, vulneraries, rubefacients Herbal cleansers: alteratives, diuretics, laxatives/aperients, lymphatics, diaphoretics Tissue Affinities and Specificities Herb can have affinity for certain tissues; can help deliver a formula to the affected area that needs to be treated WEEK 4: HERBAL ETHICS AND SAFETY Considerations for herbal ethics and safety: Social and environmental impact Unsustainable harvesting methods – can lead to extinction Biopiracy and corporatization of traditional medicine Commercial exploitation of wild plants without compensation to Indigenous peoples or countries of origin Cultural appropriation – use without ancestral connection to that culture; practices that have been passed down through generational knowledge systems Cultural sensitivity and patient autonomy Respecting different worldviews – local customs and beliefs about workings of body, nature of health and disease and use of herbal medicine Quality and sourcing Contaminants on herbal products (ex. dust, pollen, parasites, etc.) Adulterated with prescription drugs to enhance efficacy Reduced quality due to poor soil quality, growing conditions, production-focused harvesting Toxicity, allergy and contradictions Depends on: Dose applied Time of exposure Susceptibility of tissues and body metabolism Re-generative, elimination and spare capacity of tissues or organs The herb and the person Allergies – can be to whole plant or plant family Contraindications – some herbs must not be used in certain health conditions, reduced organ function, stages of life Herb-drug and herb-herb interactions Herb-drug interactions Additive effects – same effects (ex. gingko with anticoagulant medications) Counteracting effects – opposing effects (ex. stimulant herbs with sedative medications) Changes in the way a substance is absorbed in the GI tract (ex. tannins and mucilage) Changes in the way a substance is metabolized and excreted (ex. grapefruit, SJW) Herb-herb interactions Bitter and pungent herbs can enhance absorption and assimilation of other herbs Ex. bitter herbs – gentian, Oregon grape, dandelion Ex. pungent herbs – ginger, black pepper, horseradish Tannins may reduce absorption of other constituents (particularly alkaloids) via precipitation Ex. tannin-rich herbs – raspberry leaf, green tea, oak bark, meadowsweet Energetic interactions – ex. warming, cooling, drying, moistening