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COMBINING WESTERN HERBS AND
CHINESE MEDICINE
Jeremy Ross
A Clinical Materia Medica
– 120 Herbs in Western Use –
Foreword by Dr. Andreas Höll
Illustrations by Inken Toepffer
Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH,
Bad Kötzting / Bayer. Wald, Germany
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Bibliographic information published by the Deutsche Nationalbibliothek
The Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data
are available in the Internet at http://dnb.d-nb.de.
ISBN 978-3-927344-92-1
© 2010 Jeremy Ross, Greenfields Press. www.jeremyross.com and
Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH, D-93444 Bad Kötzting/Bayer. Wald
© Illustrations
2010 Jeremy Ross, Greenfields Press. www.jeremyross.com and
Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH, D-93444 Bad Kötzting/Bayer. Wald and
Inken Toepffer, D-93059 Regensburg
Type-setting: modern ART, Vilshofener Str. 12, D-93055 Regensburg
Production: TYPOS, CZ -30537 Plzeň/Pilsen
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, recording, or by any information or retrieval system, without the prior written
permission of the copyright holder, except where permitted by law.
Caution
All persons involved in the preparation and publication of this book have, as far as it is possible, taken care to ensure that
the information given in this text is accurate and up-to-date. However, medical knowledge is constantly changing, and
readers are strongly advised to consult all the available data to confirm that the information given in this text complies
with the latest legislation and standards of practice, especially with regard to drug usage. Internet medical research
resources such as PubMed can be used to help update some of the information in the text.
The author and the publisher welcome notifications from readers on the need to change information in this book and can
be contacted via the address of the publisher. Relevant alterations to the text will be included in the next edition of this
book, and in the meantime will be cited in the author’s website (www.jeremyross.com) and the publisher’s website
(www.vgm-portal.de) under the heading of Text updates.
Before using any of the herbs listed in this book, practitioners should study the data on dose and contraindications given
in the relevant chapters on those herbs. In addition, practitioners are strongly advised to read the chapters on Principles
of herb combination, Practical herb combination, Dose, and Safety in Combining Western Herbs and Chinese Medicine:
Principles, Practice, and Materia Medica by Jeremy Ross. Where the author is aware of differing opinions, for example, on
dosage and contraindications, references for these different opinions have been given. Practitioners should consult these
references and weigh the available evidence themselves to come to their own conclusions before using this information to
treat a patient.
The information given for treatment in this book is meant as a guide only. It is the responsibility of the practitioner to
decide whether a herb or herb combination is appropriate for a specific patient at a particular time. It should also be
pointed out that herbal therapy is not proposed as an alternative to conventional medical diagnosis and treatment when
this is necessary for the patient.
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Foreword _______________________________XI
Sources _______________________________ XIII
Introduction XV
Why I wrote this book ___________________ XV
Where to find things in this book __________ XV
How to use the herb chapters ____________ XVI
Principles and practice of herb combination XVIII
Dose and dispensing ____________________ XIX
Safety _________________________________ XX
Materia Medica
Achillea millefolium ______________________ 2
Acorus calamus ___________________________ 4
Aesculus hippocastanum ___________________ 6
Agrimonia eupatoria _______________________ 8
Agropyron repens ________________________ 10
Aloe vera _______________________________ 12
Althea officinalis _________________________ 14
Anemone pulsatilla _______________________ 16
Angelica archangelica _____________________ 18
Apium graveolens ________________________22
Arctium lappa ___________________________24
Arctostaphylos uva-ursi ___________________26
Arnica montana _________________________28
Artemisia absinthium _____________________30
Asclepias tuberosa ________________________34
Astragalus membranaceus ________________36
Avena sativa ____________________________38
Ballota nigra ____________________________40
Berberis vulgaris _________________________42
Calendula officinalis ______________________46
Capsella bursa-pastoris ____________________48
Capsicum species ________________________50
Chamaelirium luteum ____________________54
Chamomilla recutita ______________________56
Chelidonium majus _______________________58
Cimicifuga racemosa _____________________60
Table of Contents
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Cinchona species _________________________64
Cinnamomum cassia _____________________66
Citrus aurantium _________________________68
Commiphora molmol _____________________ 70
Convallaria majalis _______________________72
Crataegus species ________________________ 74
Curcuma longa __________________________ 78
Echinacea species ________________________80
Elettaria cardamomum ____________________84
Ephedra sinica ___________________________86
Equisetum arvense _______________________90
Eucalyptus globulus ______________________ 92
Euphorbia hirta __________________________94
Euphrasia officinalis ______________________96
Filipendula ulmaria _______________________98
Foeniculum vulgare _____________________100
Fucus vesiculosus _______________________ 102
Galium aparine _________________________104
Gentiana lutea __________________________106
Glechoma hederacea _____________________ 108
Glycyrrhiza glabra _______________________ 110
Grindelia species ________________________ 114
Hamamelis virginiana ___________________ 116
Harpagophytum ________________________ 118
Hedera helix ____________________________120
Humulus lupulus ________________________122
Hydrangea arborescens __________________124
Hydrastis canadensis ____________________126
Hypericum perforatum __________________128
Hyssopus officinalis _____________________ 132
Iris versicolor ___________________________134
Isatis indigotica _________________________136
Juglans species __________________________138
Juniperus communis _____________________ 140
Lavandula angustifolia ___________________ 144
Leonurus cardiaca _______________________ 146
Lobelia inflata __________________________150
Lycium chinensis ________________________154
Marrubium vulgare ______________________156
Melissa officinalis _______________________158
Mentha piperita _________________________ 160
Mentha pulegium _______________________ 162
Myrica cerifera _________________________ 164
Nepeta cataria __________________________ 168
Ophiopogon japonicus ___________________ 170
Panax ginseng __________________________ 172
Passiflora incarnata ______________________ 176
Petroselinum crispum ___________________ 178
Phytolacca Americana ___________________ 180
Pimpinella anisum ______________________ 182
Piscidia erythrina _______________________ 184
Plantago major __________________________ 186
Polygala senega _________________________ 188
Polygonum bistorta ______________________190
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Populus tremuloides _____________________ 192
Potentilla erecta _________________________194
Prunus serotina _________________________ 198
Quercus robur __________________________200
Rhamnus purshiana _____________________202
Rheum palmatum _______________________204
Rosmarinus officinalis ___________________208
Rubus idaeus ___________________________ 210
Rumex crispus __________________________ 212
Ruta graveolens _________________________ 214
Salvia officinalis _________________________ 216
Sambucus nigra _________________________220
Sanguinaria canadensis __________________222
Sanguisorba officinalis ___________________226
Sarothamnus scoparius __________________228
Schisandra chinensis ____________________230
Scrofularia nodosa ______________________232
Scutellaria species _______________________234
Serenoa serrulata ________________________238
Silybum marianum ______________________240
Smilax species __________________________242
Solidago virgaurea _______________________244
Stellaria media __________________________246
Syzygium aromaticum ___________________248
Tanecetum parthenium __________________250
Taraxacum officinale ____________________ 252
Thuja occidentalis _______________________256
Thymus vulgaris ________________________260
Tilia species ____________________________262
Trigonella foenum- ______________________264
Turnera diffusa _________________________266
Urtica dioica ___________________________268
Valeriana officinalis _____________________ 270
Verbena officinalis _______________________ 274
Viburnum prunifolium ___________________ 276
Viola tricolor ___________________________ 278
Vitex agnus-castus ______________________280
Zanthoxylum species ____________________282
Zea mays ______________________________284
Zingiber officinale _______________________286
Comparison of herb action groups
… six Blood tonic herbs ___________________20
… six bitter herbs ________________________ 32
… seven circulatory stimulants _____________ 52
… five cardioregulatory herbs ______________ 76
… seven antimicrobial herbs and antibiotics __ 82
… five antiasthmatic herbs _________________88
… seven antidepressant herbs _____________130
… four diuretic herbs ____________________ 141
… five uteroregulatory herbs ______________ 148
… four anticatarrhal herbs ________________ 166
… ten sweet tonics_______________________ 175
… seven astringent herbs _________________196
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
… laxative and purgative herbs ____________206
… four aromatic herbs ___________________ 218
… six herbs with isoquinoline alkaloids _____224
… four nervine herbs ____________________236
… alterative herbs _______________________254
… five bitter calming herbs _______________272
Appendices
References ____________________________ 291
Glossary _____________________________333
Chinese Organs and Syndromes:
Terminology __________________________ 337
Herbs for Chinese Syndromes __________339
Herb Properties ______________________365
Herb Names ___________________________369
Cross References
English – botanical name _____________ 375
Botanical name– family ______________ 379
Family – botanical name ______________383
Pharmaceutical name – English ________385
Botanical name – Mandarin __________389
Mandarin – botanical name ___________ 393
Western Indications – Herb (pairs) ______397
Herb (pairs) – Western Indications ______ 417
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Introduction XV
Why I wrote this book
THE TOPIC
Since I started combining Western herbs and Chinese med-
icine twenty years ago, there has been a great increase in
interest in this topic in many countries.
A BASIC TEXT
My first book on this topic was Combining Western Herbs
and Chinese Medicine: Principles, Practice, and Materia
Medica. This 970-page book was written to provide the ba-
sic theory and practical techniques, and to give detail on 50
herbs and 150 herb combinations.
TEXTS ON SPECIFIC TOPICS
While teaching many courses on ‘Combining’ after the
book was written, students and practitioners have request-
ed books on specific aspects of this topic. As a consequence,
a series of books on Combining Western herbs and Chinese
medicine is now planned.
A CLINICAL MATERIA MEDICA
From discussion, the most urgent need of the majority of
course participants was for more herbs, and for a flash card-
style presentation of the key data for each herb.
This book, A Clinical Materia Medica – 120 Herbs in West-
ern Use, was written in answer to their requests.
KEY DATA TABLES
Each herb in this book has a specially designed key data ta-
ble, equivalent to a flash card, clearly showing the Chinese
actions, Western actions, Western uses, and examples of
herb pairs for that herb.
COMBINING THREE TRADITIONS
What has become increasingly clear during my work with
this topic over the years is that the range of use of a herb
can be greatly expanded by combining information from
the three traditions: Chinese medicine, Western herbal tra-
dition, and modern pharmacological and clinical research.
For some herbs, this opens up a remarkable panorama of
potential future uses. Crataegus is an excellent example of
this.
EVIDENCE FOR STATEMENTS MADE
In books on Western herbal medicine written over the last
fifty years, authors often simply made statements or claims
about herbs without giving supporting references from
eith er traditional texts or modern research. As a result, the
reader did not know whether a statement made by the author
was anything other than their unsubstantiated opinion.
In more recent books, such as the ESCOP monographs, the
British Herbal Compendia, or the works of Mills and Bone,
references are given for statements made. In modern books
on Western herbs, citing references is essential if the work
is to be regarded as a serious medical rather than a popular
text.
TRADITIONAL AND RESEARCH DATA
Each herb in this book has one section on Traditional use
and another section on Constituents and pharmacology.
In these sections, a selection of material from traditional
texts and from modern research studies is presented with
references. Approximately 1,200 references are cited in this
book.
LIST OF HERBS FOR CHINESE SYNDROMES
Many practitioners have requested a list of herbs for Chinese
syndromes, with signs and symptoms, pulse and tongue
given for each syndrome.
Such a list with all the main Chinese syndromes plus 125
common combinations of syndromes is given as an appen-
dix in this book.
WESTERN INDICATIONS
This book meets also the needs of those who want to look up
the main Western indications for each single herb and dou-
ble. See appendices “Western Indications and herb pairs”.
Where to find things in this book
COMPANION TEXTS
This book was designed to be a companion text to Combin-
ing Western Herbs and Chinese Medicine: Principles, Prac-
tice, and Materia Medica (PPMM).
It provides a quick reference clinical materia medica for 120
herbs, whilst PPMM provides the theoretical basis, practi-
cal instructions, great detail of 50 herbs, and discussion of
150 herb combinations.
THIS BOOK
Apart from the 120 herb chapters, this book contains the
following information:
Introduction
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
XVI Introduction
PRINCIPLES OF COMBINATION, DOSE, SAFETY
There is a brief summary of these topics toward the end of
this Introduction. These topics are discussed in much great-
er detail in PPMM.
SOURCES
A number of basic texts are referred to so frequently in this
book, that an abbreviation is used when citing them, often
the names of the authors or editors. These abbreviations are
explained in the beginning of the book in the Sources chap-
ter.
REFERENCES
Approximately 1,200 references are cited in this book. Since
the aim was to keep each herb chapter to two pages, the ref-
erences are listed in the References appendix.
GLOSSARY
A Glossary at the back of this book explains some of the
terms used in the text.
The Actions glossary in PPMM will further help with the
definition of Western herbal action categories and the dis-
cussion of their nearest Chinese equivalents.
CHINESE ORGANS AND SYNDROMES: TERMINOLOGY
This section at the back of this book describes non-standard
Chinese syndromes that I encounter in my practice.
HERBS FOR CHINESE SYNDROMES
One appendix contains all the main Chinese syndromes and
about 125 common syndrome combinations with details of
signs and symptoms, pulse and tongue, and suitable herbs.
HERB PROPERTIES, HERB NAMES, AND CROSS
REFERENCE LISTS
These useful tables provide a cross reference for botanical,
English, pharmaceutical, and Mandarin names, and give
groupings of the herbs into families.
PRINCIPLES, PRACTICE, AND MATERIA MEDICA
The reader is referred to PPMM for background material,
and specifically to the following chapters:
Although there are fewer herb chapters in PPMM, these
herb chapters provide greater detail on:
- herb pairs
- herb combinations
- comparison of herb combinations
- discussion of research data
- toxicology
- dose discussion
- comparison of Western and Chinese use
How to use the herb chapters
Each of the 120 herb chapters in this book is organized
in the following way:
Names and botanical detail
Names, part used, family
Botanical description
Botanical illustration
Use of different types and plant parts (where applicable)
Key herb data
Temperature, tastes, organs
Actions, uses, and herb pairs table
Traditional use
Traditional use in China
Traditional use in the West
Comparison with a similar herb
Comparison with another single herb
Comparison within a herb group
Constituents and pharmacology
Types of constituents
Actions supported by research
Actions linked to a constituent
Dose and dispensing
Dried herb
Liquid extract
Tincture
Initial dose
Duration
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Introduction XVII
Cautions
General contraindications
Chinese contraindications
Pregnancy and lactation
Side effects
Overdose
Drug interactions
Names and botanical detail
NAMES, PART USED, FAMILY
The English, botanical, and pharmaceutical names of the
herb are given, together with the parts used, and family
name.
The Mandarin name and Chinese characters are given
where applicable.
BOTANICAL DESCRIPTION AND BOTANICAL
ILLUSTRATION
These are given to help create a mental picture and give a
feel for the herb and to aid in identification.
USE OF DIFFERENT TYPES AND PLANT PARTS
For some of the herbs, specific data on the use of different
species, subspecies, varieties, or plant parts is given in a sep-
arate section. This section, which may also include a brief
description on differences of tradition in different coun-
tries, is found directly underneath the main table.
Key herb data
TEMPERATURE, TASTES, ORGANS
Temperature Some herbs are classified with a range of
potential temperatures, e.g., Achillea is classified as warm-
cool. For discussion of the concept of variable-temperature
herbs, please see the Temperature chapter in PPMM.
Taste properties The aromatic property is included with
the taste properties in this book. For a detailed discussion of
the taste properties, please see the Taste chapter in PPMM.
Organs entered This is equivalent to the concept of merid-
ians entered in other texts. Please see the appendix Chinese
organs and syndromes: terminology in this book for explana-
tion of organ concepts, such as Intestines or Uterus.
ACTIONS, USES, AND HERB PAIRS TABLE
Organization by Chinese actions This table uses the main
Chinese actions for the herb as the coordinating theme to
link Chinese actions, Western actions, and Western uses.
For each of the main Chinese actions, an example of a herb
pair is given to treat a specific disorder.
Flash card or basis for detailed study This table shows
the key data on the specific herb, and it summarizes an
enormous amount of information.
The table can be used like a flash card that assists with learn-
ing the essentials of a herb. Alternatively, each Chinese ac-
tion in the table can be used as a starting point for detailed
study.
Traditional useTRADITIONAL USE IN CHINA
Whenever a herb is also commonly used in China, this sec-
tion gives available herb data, including properties, actions,
and uses.
TRADITIONAL USE IN THE WEST
Material from masters of the past, such as Dioscorides,
Lonicerus, Tabernaemontanus, Gerard, and Culpeper, is in-
cluded where space allows. The material is often condensed
or paraphrased, with antique terminology converted to
modern English. Readers are strongly encouraged to study
these texts, which represent the rich heritage of our West-
ern materia medica.
Comparison with a similar herb
COMPARISON WITH ANOTHER SINGLE HERB
Sometimes the herb of the chapter is compared with a simi-
lar herb, for example, Angelica archangelica is compared
with Angelica sinensis. The similarities and differences of
the herbs are discussed in terms of properties, actions, and
uses, so that the practitioner can get a clearer idea of when
to use each herb in practice.
COMPARISON WITHIN A HERB GROUP
Sometimes the herb of the chapter is compared with other
herbs in an action group. For example, the end of the An-
gelica chapter has a Comparison of six Blood tonic herbs,
which compares Angelica sinensis with molasses, Lycium,
Gentiana, Rosmarinus, and Salvia.
Constituents and pharmacology
TYPES OF CONSTITUENTS
The main types of constituents are listed, organized by
chemical type, e.g., essential oils, flavonoids, alkaloids, tan-
nins. The list mainly focuses on the constituents that give
the herb its characteristic actions.
ACTIONS SUPPORTED BY RESEARCH
This section lists the actions that are supported by one or
more research studies, including in vitro, in vivo, human
pharmacological, or clinical studies.
ACTIONS LINKED TO A CONSTITUENT
This section shows which constituents are responsible for
which actions, when there is data available. This section is
sometimes organized by constituent and sometimes by ac-
tion, as appropriate.
Dose and dispensing
DRIED HERB, LIQUID EXTRACT, TINCTURE
Dosage is usually given as three individual doses per day. If
the daily amount was given as a single dose in the source
text, this was usually converted to an amount for three in-
dividual doses.
In this book, the most frequently used source text for dose
levels was the British Herbal Pharmacopoeia of 1983, see
Dose and dispensing at the end of this chapter.
INITIAL DOSE, DURATION
These sections indicate whether there is a restriction on the in-
itial dose or on the length of time that the herb can be taken.
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
XVIII Introduction
CautionsIt is absolutely essential that practitioners read this section
before using any herb in this book.
GENERAL CONTRAINDICATIONS
This section lists known contraindications or cautions from
Western tradition or modern research.
Where space permits, contraindications based on adverse
reaction reports are differentiated from theoretical con-
cerns based on the presence of a potentially toxic constitu-
ent. This differentiation is discussed in detail in PPMM.
CHINESE CONTRAINDICATIONS
This section lists traditional contraindications from texts
on Chinese medicine. It may also list contraindications that
are not given in these texts, but that have occurred clinically
due the nature of the herb’s actions. For example, Rosmari-
nus may aggravate Heart Spirit Disturbance in susceptible
persons due to its stimulant action.
PREGNANCY AND LACTATION
This section gives data on safety concerns during pregnancy
and lactation. Please see The Essential Guide to Herbal Safe-
ty by Mills and Bone for more detail.
SIDE EFFECTS, OVERDOSE
These sections include data on adverse reactions within and
above the therapeutic dose range, respectively.
DRUG INTERACTIONS
This section gives data on adverse herb-drug reactions,
when available.
Principles and practice of herb
combination
This book is a clinical materia medica, in which there is no
space for a detailed discussion of the principles and practice
of herb combinations. Only a very brief outline is given here
and the reader is referred to PPMM.
ChecklistTo create a balanced, effective, and safe herb combination in
Chinese medicine, it is important to consider the following
principles. These principles apply whether the herbs used
are Chinese or Western.
ACCURATE DIFFERENTIAL DIAGNOSIS
The foundation for creating an effective
herb combination is accurate diagnosis.
In herbal treatment, accurate diagnosis is important. With-
out it, the consequences to the patient may be unpleasant
or even dangerous. The practitioner needs to determine
the Chinese syndromes underlying the patient’s signs and
symptoms in order to choose appropriate herbs to treat
these syndromes. This can be summarized by the phrase:
Wrong diagnosis means wrong herbs!
PRIORITIZATION OF CHINESE SYNDROMES
The next step consists of prioritizing the patient’s Chinese
syndromes into those of primary and those of secondary
importance.
How to decide The decision as to which syndromes are
primary and which are secondary is made partly according
to which disorders are most important to the patient, and
partly according to medical principles, such as the optimum
sequence for treating ‘root’ and ‘branch’ in the given case.
Importance of prioritization Primary syndromes re-
quire more herbs in the combination than do secondary
syndromes. If the practitioner gets the syndromes right, but
the prioritization of the syndromes wrong, the patient may
get worse not better. See An example with mistakes in the
Practical herb combination chapter in PPMM.
BALANCING TEMPERATURE
In the traditions of Western and Chinese herbal medicine,
both patient and herbs were classified in terms of temper-
ature (hot, warm, neutral, cool, or cold). Herbs were then
matched to patients on the basis of this classification.
For example, a cool pathology would generally be treated
with a herb combination that was warm in its overall tem-
perature balance. To treat a cool pathology with a hot com-
bination would be seen as a potentially damaging overcor-
rection.
Incorrect temperature balance is one of the most common
mistakes in herb combination.
BALANCING TASTE PROPERTIES
Taste balance is a relatively sophisticated level of herb com-
bination, but the practitioners should at least be aware of
the contraindications for the different taste properties.
Each taste property has its specific range of uses and its
specific disadvantages. Tastes can be combined so that one
taste can enhance the beneficial effects of another or moder-
ate its potential adverse effects.
Tables showing taste contraindications and how to balance
the tastes are included in the Taste chapter in PPMM.
BALANCING HERB ACTIONS
It is important to balance the actions of the individual herbs
in a herb combination.
For example, a purgative like Rheum is commonly given
with a carminative like Foeniculum to reduce the potential
purgative side effect of intestinal colic.
As another example, an alterative like Taraxacum is often
combined with a detoxicant and anti-inflammatory like
Glycyrrhiza to reduce the potential alterative side effect of
aggravating skin and arthritic conditions.
A table showing how to balance herb actions is included in
the Actions chapter of PPMM.
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Introduction XIX
CHECKING FOR POTENTIAL CONTRAINDICATIONS
It is essential that the practitioner check for each herb in the
proposed combination whether it can cause side effects in a
specific patient.
Some obvious examples of questions are:
stimulant herbs should be avoided?
loose stools, so that cooling, bitter, downward draining
herbs should be avoided?
herbs are contraindicated?
-
tions to any of the herbs?
or a specific herb, so that only low doses should be used?
so that treatment with alterative herbs may cause an ag-
gravation of symptoms?
herbs may interact?
Four different approaches to herb
combinationThree of these approaches involve using a preexisting com-
bination, and the fourth involves creating a new combina-
tion by using the basic principles of herb combination.
USING A PREEXISTING COMBINATION
There are three main possibilities:
-
tions
Note for beginners Creating a new combination by com-
bining elements of different preexisting combinations is an
advanced technique. If the technique is used by those who
are inexperienced in herbal medicine, it can easily result
in an assortment of ill-matched fragments rather than in a
carefully balanced and harmonious combination.
It is recommended that beginners first become thoroughly
familiar with the properties of the individual herbs and with
the principles of herb combination. They can then develop
their skills by using preexisting combinations, with simple
modifications where appropriate, and by learning to create
simple new combinations from first principles.
CREATING A NEW COMBINATION
When creating a new combination that matches the specific
Chinese syndromes and life situation of the patient, it is
necessary to work through the stages in the checklist above.
See examples in PPMM.
Dose and dispensing
Dose levels
THERAPEUTIC DOSE RANGE
Each herb has a therapeutic dose range, within which a suit-
able dose for most adults will be found.
Minimum therapeutic dose This is the smallest dose that
will have a therapeutic result. Below this is the subtherapeu-
tic dose, which is too small to have a therapeutic effect.
Maximum dose In the case of herbs with potential adverse
effects, this is the largest dose that is safe to administer. The
toxic dose is the dose, at and above which adverse reactions
due to toxic effects are likely to occur. In the case of herbs
like Althaea, for which there are no reports of adverse ef-
fects even at overdose levels, the maximum dose can be de-
fined as the largest dose that is generally necessary to obtain
a therapeutic effect.
DIFFERENCES OF OPINION
The statement on dose above sounds clear and definite. The
problem is that there are often differences of opinion as to
what constitutes the minimum and maximum therapeutic
dose for a specific herb.
Common sense dosing The author of this book recommends
using the least dose required to get the desired therapeutic
effect. He takes the middle road between what may be called
the higher dose approach and the lower dose approach. This
topic is discussed in detail in PPMM, where alternative
doses are often given for each herb and where the appropri-
ate use in different situations is described.
BHP AS A BASIS
For dried herbs and for herb tinctures, this book generally
adopts the dose levels of the British Herbal Pharmacopoeia
of 1983.
Recent research on dose In cases where subsequent re-
search has indicated that lower doses should be used for
safety reasons or that higher doses are more clinically ef-
fective, these are the doses that are included in the current
text. For example, the BHP recommended 3-6 ml of a 1:5
tincture of Crataegus per day, whilst The Essential Guide to
Herbal Safety by Mills and Bone recommended 3.5-17.5 ml
per day. The latter amount is recommended in the current
text, and is an example of the higher dose approach.
A GENERAL GUIDE
Very approximately, the dose for the average herb is 1-2 g of
dried herb or 2.5-5 ml of 1:5 tincture, three times per day,
for an adult.
However, some herbs are more potent, and their doses may
be much less. For example, the maximum permitted dose in
the UK of Lobelia inflata is 0.2 g of dried herb or 1 ml of 1:5
tincture, three times per day.
Dose and age
Infants, children, and the elderly are given smaller doses
than people of other age groups, as shown in the table. These
are individual doses to be taken three per day.
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
XX Introduction
Age Individual dose of 1:5 tincture in ml
Individual dose of 1:5 tincture in drops*
infants 6-12 months
0.05-0.5 ml 1-10 drops
infants 1-2 years
0.1-1 ml 2-20 drops
children 2-5 years
1-2.5 ml 20-50 drops
children 5-10 years
2-3.75 ml 40-75 drops
teens 10-18 years
2-5 ml 40-100 drops
adults 2.5-5 ml 50-100 drops
elderly 2-3.75 ml 40-75 drops
* The figures are based on the assumption of 20 drops per ml
Dose formHerbs can be taken orally as powdered dried herbs to be
taken with water, infusions, decoctions, tinctures, liquid
extracts, or concentrates. Each dose form has its advantages
and disadvantages, summarized in the table below. For a de-
tailed discussion, see the Dose chapter in PPMM.
Safety
Please do not use any of the herbs in this book without first
studying their properties, actions, use, dose, and contrain-
dications.
ChecklistPractitioners can use the following checklist to minimize
adverse reactions due to herb use.
For detailed discussion of safety, see:
Safety, Safety and the organ systems,
and Safety in clinical practice in PPMM
by Mills and Bone
Monitoring
HERBS NEEDING MONITORING
For some of the herbs in this book, it is suggested that the
patient be monitored for side effects during the course of
treatment.
These herbs include: Capsicum, Cinchona, Convallaria,
Ephedra, Lobelia, and Sarothamnus.
Monitoring may also be appropriate for some of the altera-
tive herbs, specifically Arctium seeds and Taraxacum root,
which have the potential for aggravating skin rashes and
arthritis, especially in patients with high levels of accumu-
lated toxins.
MONITORING BY PRACTITIONER AND PATIENT
Practitioner The practitioner should check for signs and
symptoms of any potential side effects that are to be expect-
ed with the specific herbs and the specific patient. Moni-
toring is essential for herbs with the possibility of severe
adverse reactions.
Advantages Disadvantages
Infusions and decoctions
cheapness and accessibility
link to the natural world
ble constituents, such as resins
-tituents
decoctions suitable for water-solu-ble constituents, such as polysac-charides and tannins
treatment of patterns of Cold
treatment of patterns of Dryness
diaphoretic treatments
Tinctures and liquid extracts
tastesoluble constituents, such as polysaccharides and tannins
treatments
Advantages Disadvantages
suitable for ethanol-soluble constituents, such as essential oils, alkaloids, resins, and saponins
treatments
treatment of patterns of Cold and Damp, Deficiency, and Stagnation of herbs in a combination
Powders
constituents
Pills and capsules
possible to match them to the specific needs of the
-tuents
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Patient The patient can be asked to keep a record of the
following:
-
tions: noting such details as severity and the time and
date the symptoms occurred
medication, herbs, or food supplements
responsible for the symptoms
Rechallenge If it is appropriate and if the patient agrees,
the herbs can be taken again, at a lower dose and/or in a
different form if preferred, to determine if the symptoms
recur. The patient should be asked to keep in contact with
the practitioner during this process and to stop the herbs
immediately if the adverse effect recurs.
Rechallenge may not be appropriate for herbs with poten-
tially severe adverse effects, even if the dose is greatly re-
duced.
General
1. take a full medical history
2. make an accurate differential diagnosis
3. prioritize Chinese syndromes
4. decide if further specialist diagnosis is required
5. decide if herbal treatment is appropriate
6. allow informed patient choice
Herb combining
7. balance temperature
8. balance taste properties
9. balance herb actions
10. check for potential contraindications
11. choose appropriate dose level, dose form, timing of
dose, and duration of prescription for the patient
After prescribing
12. monitor for adverse reactions, if appropriate
13. manage adverse reactions, if appropriate
14. report adverse reactions, if any
Introduction XXICopyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
2 Achillea
AchilleaEnglish yarrow
Botanical name Achillea millefolium L., s. l.
Pharmaceutical name Achilleae millefolii herba cum
flore (= Millefolii herba cum flore)
Part herb and flowers
Mandarin yáng shī căo ( ), the aerial parts of A.
millefolium, is not a main herb in Chinese medicine
Family Asteraceae (Compositae)
An aromatic stoloniferous perennial with erect, usually un-
branched stems, 0.2-1 m tall. Leaves are feathery, lanceolate,
and 2-3-pinnate. Flowers are small and white or occasion-
ally pink, borne in dense flat-topped clusters. Native to the
Northern hemisphere, where it grows in grassy habitats, road
verges, and lawns. Achillea prefers well-drained soil.
Temperature warm-cool
Tastes acrid, bitter, aromatic
Organs LU, SP, HT, UT
Please see the chapter on this herb in Principles, Practice
and Materia Medica for herb combinations and for further
information1.
USE OF DIFFERENT TYPES AND PLANT PARTS
A. millefolium is a complex of barely distinguishable species or subspecies,
which have evolved by polyploidy (changes in chromosome number)2. Dif-
ferences in chromosome number between the A. millefolium subspecies
are often accompanied by important chemical differences, which in their
turn, may lead to differences in temperature, actions, and uses1.
Actions, uses, and herb pairs
Chinese actions (Western actions)
Western uses Pair examples (disorders)
I. clear Wind Heat (diaphoretic, antipyretic, alterative)
acute respiratory disorders with feverish-ness dominant to chills
Achillea + Mentha piperita (common cold + sore throat)
II. clear Wind Cold (diaphoretic, antipyretic, alterative)
acute respiratory disorders with chills dominant to feverishness
Achillea + Zingiber (fresh) (influenza + cold sensation)
III. clear Lung Phlegm Heat (diaphoretic, antipyretic, alterative)
acute respiratory disorders with fever, cough, bronchial phlegm
Achillea + Asclepias (pleurisy + fever)
IV. clear Lung Phlegm Cold Damp (anticatarrhal, alterative)
acute respiratory disorders with nasal or bronchial phlegm and cold sensations
Achillea + Angelica archangelica (influenza + sinusitis)
V. clear Retained Pathogen, tonify Defensive Qi (diaphoretic, alterative, tonic)
recurring respiratory infections, with low-grade fever and fatigue
Achillea + Echinacea (recurring respiratory infections)
VI. tonify Spleen Qi and Blood (bitter digestive tonic)
digestive weakness with exhaustion (and anemia), postfebrile convalescence
Achillea + Artemisia absinthium (postfebrile exhaustion)
VII. tonify Spleen Qi and Heart Qi (digestive and cardiac tonic)
(postfebrile) exhaustion with digestive and cardiac weakness
Achillea + Cinchona (some cases of chronic fatigue)
VIII. reduce leakages, reduce bleeding (astringent, anticatarrhal, hemostatic)
nosebleeds, hemoptysis, diarrhea, leukor-rhea, menorrhagia, wounds
Achillea + Urtica (menorrhagia)
Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica
Traditional use in the West
DIOSCORIDES 1ST CENTURY AD3
and heal the wound, clear it from heat and inflammation,
and congeal the blood
herb with wool and put in the vagina
LYLE 18974
It stimulates the appetite and tones the digestive organs. It
is important as a tonic to the general system. In cold infu-
sions, it acts as a tonic in convalescence from fevers, from
nervous prostration, and in pulmonary tuberculosis and
night sweats.
CHRISTOPHER 19765
equalizes the circulation, and purifies the blood of morbid
waste material
-
cluding typhoid fever), eruptive diseases (including mea-
-
der discharges
urine, enuresis
BHP 19836
This text gave the specific indication of thrombotic condi-
tions with hypertension, including cerebral and coronary
thromboses.
Comparison with a similar herb
ACHILLEA AND HYSSOPUS See Hyssopus.
ACHILLEA AND TILIA See Tilia.
Constituents and pharmacology
TYPES OF CONSTITUENTS2
(0.2-1%) composition of essential oil varies
greatly with chromosome number, for example:
- hexaploid plants have no chamazulene, but mainly
oxygenated monoterpenes, especially linalool (26%) and
camphor (18%), with some borneol and 1,8-cineole
- tetraploid plants contain mainly sesquiterpenes, es-
pecially chamazulene (about 25%) and β-caryophyllene
(11-22%)
achillicin (= 8-acetoxyartab-
sin) is the main prochamazulene
including apigenin, luteolin and their gluco-
sides
mainly achilleine (= betonicine = L-4-hy-
droxy-stachydrine) as well as stachydrine, betaine, and
choline
tannins (3-4%), polyacetylenes, triterpenes, ster-
ols (including beta-sitosterol), coumarins, phenolic acids
(including salicylic and caffeic acids)
ACTIONS SUPPORTED BY RESEARCH
The following actions have been reported for Achillea plant
material or for its isolated constituents:
antibacterial7, anti-inflammatory8, antiulcer9, spasmolytic8,
choleretic8, hepatoprotective10, antihypertensive and antili-
pidemic (A. wilhelmsii)11, hemostatic12, antitumor13
ACTIONS LINKED TO A CONSTITUENT
essential oil (including linalool)7
flavonoids, dicaffeoylquinic acids8
flavonoids8
dicaffeoylquinic acids8
12
achimillic acids (sesquiterpenoids)13
Dose and dispensing
DRIED HERB 2-4 g of dried herb, as powder or as infusion, three times
per day (BHP)6.
TINCTURE 2-4 ml of 1:5 tincture in 45% alcohol, three to four times
per day (BHP).
INITIAL DOSE Can start at the standard dose (JR).
DURATION
Achillea infusions are generally for acute conditions and for short-term
use only (JR).
Cautions
GENERAL CONTRAINDICATIONS Sensitivity to Asteraceae (M&B
Safety)14.
CHINESE CONTRAINDICATIONS Not widely used in Chinese
medicine.
PREGNANCY AND LACTATION No adverse effects in humans repor-
ted, but see M&B Safety for animal research. No restrictions on breast-
feeding listed by BSH15.
SIDE EFFECTS See General contraindications.
OVERDOSE No adverse effects reported (M&B Safety).
DRUG INTERACTIONS No adverse effects reported (M&B Safety).
Achillea 3Copyright © 2012 Verlag Systemische Medizin AG
Jeremy Ross, A Clinical Materia Medica