What is depression?

Depression is popular, Signs will influence everyday living as well as will turn into extremely upsetting. Remedies involve emotional therapies and anti-depressant drugs. Treatment method requires time to deliver the results but has a great opportunity of good results. Some persons have repeating periods of depression and need long term cure to maintain signs out.

Your first move is to obtain acceptable treatment and go to a doctor. Particular prescription drugs, and some medical circumstances such as viruses or a thyroid condition, can trigger to the same signs as depression. In inclusion, it is vital to rule out depression that is related with a different emotional illness known as bipolar disorder. A physician can guideline these prospects by performing a physical assessment, interview, and lab tests, based upon on the health situation. If a health situation and bipolar disorder can be ruled out, the doctor need to perform a emotional assessment or recommend the individual to a mental health specialist.


The medical professional or mental health professional will perform a comprehensive analytic assessment. He or she must get a total history of symptoms, as well as when they began, how lengthy they have held up for, their severeness, if they have happened before, and if so, how they were handled. He or she must also seek advice from there is a family historical past of depression. In addition, he or she need to ask if the individual is utilizing liquor or medicines, and no matter if the particular person is pondering about loss of life or committing suicide.
As soon as clinically diagnosed, a individual with depression can be handled with a variety of procedures. The most typical therapy methods are drugs and psychiatric therapy.


Treatment for depressions:

Antidepressant medications operate to stabilize normally developing brain substances known as neurotransmitters, particularly serotonin and norepinephrine. Other anti-depressants perform on the neurotransmitter dopamine. Researchers examining depression have identified that these certain toxins are included in controlling feeling, but they are doubtful of the precise methods in which they execute.
The latest and most well-known kinds of antidepressant medications are known as selective serotonin reuptake inhibitors SSRIs and consist of:
fluoxetine "Prozac"
citalopram "Celexa"
sertraline "Zoloft"
paroxetine "Paxil"
escitalopram "Lexapro"
fluvoxamine "Luvox"
Serotonin and norepinephrine reuptake inhibitors SNRIs are similar to SSRIs and include:
venlafaxine "Effexor"
duloxetine "Cymbalta"

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What is Fracture?

A fracture is the medical term for a broken bone. Bone fractures are typical; the normal individual has two while in a life-time. They happen when the physical force applied on the bone is more powerful than the bone by itself. Your risk of fracture relies upon, in part, on your age. Fractured bones are very typical in childhood, though children at hospital with bone injuries are generally less complicated than fractures in adults. As you get older, your bones come to be more brittle and you are more likely to suffer bone injuries from falls that would not occur when you were young.


These are the some types of fractures, but the main types are:
1. displayed
2.non-displaced
3.open
4.closed

Displaced and non-displaced fractures pertain to the way of the bone breaks. In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight. If the bone is in many pieces, it is called a comminuted fracture. In a non-displaced fracture, the bone cracks either part or all of the way through, but does move and keep its proper alignment.


- Closed-fracture is when the bone damage but there is no cut or openwound in the skin.
- Open fracture is one in which the bone damage by the skin; it may then diminish back into the wound and not be seen through the skin. This is an significant distinction from a closed fracture because with an open fracture there is a possibility of a deep bone infections.


Greenstick fracture -  an incomplete fracture in which the bone is curved. This type occurs most often in children.

Transverse fracture - a break at a right position to the bone's axis.
Oblique fracture - a break in which the crack has a curved or sloped pattern.
Comminuted fracture - a fracture in which the bone pieces into several bits.

Impacted fracture - is one where ends are pushed into each other. This is generally seen in arm fractures in kids and is often known as a buckle fracture. Other varieties of fracture are pathologic fracture, induced by a disease that deteriorates the bones, and stress fracture a hairline crack.
some other types of fracture are pathologic fracture, induced by a disease that deteriorates the bones, and stress fracture.

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Dyspeptic Syndrome Natural Treatment

Clinical Considerations
➤ General comments
– Dyspeptic syndrome is the generic term for all types of upper abdominal and retrosternal pain, abdominal discomfort, heartburn, nausea, vomiting, and other gastrointestinal symptoms.
– It is characterized by prolonged upper abdominal problems due to an underlying functional disorder with or without an additional psychovegetative component. The symptoms occur in the intestinal lumen without significant intestinal wall involvement. The following types can be distinguished:
• Epigastric meteorism with distended abdomen (most common type): The stomach and intestine are often jointly involved.
• Arteriosclerosis of gastrointestinal arteries: Characterized by deficient absorption of intestinal gases and flatulence.
• Cholecystopathies (latent or manifest), food intolerance, the characteristic symptoms of which are distension of the stomachal region with bloating and belching.
• Dysmotility type: Abdominal distension and bloating, premature feeling of satiation, diffuse abdominal pain in daytime only, nausea, food intolerance, vomiting, aversion to food, and constant discomfort.

➤ Herbal treatment measures
– Herbal remedies can be used for trial treatment (for 14 days) or symptomatic treatment.
– Symptomatic herbal therapy
• Dyspepsia with motor disorders: Bitters can be used to counteract motor disorders of the upper gastrointestinal tract, e. g., a large flaccid stomach or motor disorders related to bile and pancreatic juice secretion. If the problem is already long-standing, treatment must usually be continued for several weeks before the preparations become effective. A high-fiber diet is also recommended.
• Meteorism: Carminatives are used to treat meteorism (see below). They are sometimes combined with bitters, antiphlogistics, and/or tannincontaining herbs, depending on the symptoms involved.

➤ Clinical value of herbal medicine
– Herbal remedies permit differentiated treatment according to the type and severity of the predominant symptoms.
– Synthetic drugs and chemical remedies (e. g., prokinetic drugs) are used when there is positive evidence of organic disease or if the patient fails to respond to trial herbal therapy.

Recommended Herbal Remedies (Overview)
Carminatives
➤ Caraway seed (Carvi fructus); fennel seed (Foeniculi fructus); aniseed (Anisi fructus).
– Action: When taken orally, carminatives induce a feeling of warmth and facilitate eructation and the passage of gas after meals. They contain essential oils that either induce spasmolysis or promote bowel motility and probably
also have antibacterial effects. They are not as potent as the specific anti-biotics or antispasmodics. The most potent carminative is caraway, followed by fennel and aniseed.
– Contraindications: Patients with gallstones should not use carminatives unless directed by a physician.
– Side effects: Carminatives reduce the pressure in the esophageal sphincter and can therefore cause heartburn. Bitters
➤ Wormwood (Absinthii herba); angelica root (Angelicae radix); gentian root (Gentianae radix); chicory herb and root (Cichorii herba et radix); bogbean leaf (Menyanthidis folium); dandelion root and herb (Taraxaci radix cum herba); blessed thistle (Cnici benedicti herba); yarrow herb (Millefolii herba).
– Action: Stimulate gastrointestinal motility.
– Contraindications: (cf. Anorexia):
• Patients prone to gallstones should not use bitters unless directed by a physician.
• Gentian root: Ulcer-related dyspepsia, acute gastritis.
• Yarrow: Known allergy to composite plants.
• Dandelion: Biliary tract obstruction, gallbladder empyema.
• Wormwood: Pregnancy.
– Side effects: See Anorexia.

Aromatic Herbs
➤ Aniseed (Anisi fructus); calamus root (Calami rhizoma); caraway seed and oil (Carvi fructus et aetheroleum); cinnamon bark (Cinnamomi cassiae cortex, C. zeylanici cortex); turmeric root (Curcumae longae rhizoma, C. xanthorrizae rhizoma); bitter orange peel (Aurantii pericarpium); coriander (Coriandri fructus); fennel seed (Foeniculi fructus); chamomile flower (Matricariae flos); balm leaf (Melissae folium); peppermint leaf (Menthae piperitae folium); rosemary leaf (Rosmarini folium).
– Action: Antispasmodic and antibacterial; increases peristalsis.
– Contraindications
• Turmeric: Should not be used by patients with biliary tract occlusion or gallstones.
• Anise: Known allergy to anise or anethole.
• Calamus: Should not be used by children under 12 years of age or during pregnancy or breast feeding.
• Chamomile: Known allergy to chamomile.
• Menthol: Biliary tract obstruction, gallstones, gallbladder inflammation, severe liver damage.
– Side effects: (Cf. Anorexia):
• Anise: Although rare, allergic reactions of the skin, respiratory tract, and gastrointestinal tract may occur.
• Turmeric: May irritate the gastric mucosa if used for extended periods or overdosed.

Other Herbs for Dyspeptic Syndrome
➤ Galangal root (Galangae rhizoma); papaya peel (Caricae papayae fructus); pineapple (Ananas comosus); artichoke leaf (Cynarae folium).
– Action: Used to treat enzyme deficiencies. Galangal bark stimulates the secretion of pancreatic enzymes. Papaya and pineapple contain digestive enzymes.

Range of Applications in Bloating and Meteorism
Mild Pain and Meteorism
➤ Caraway; aniseed; fennel; balm; peppermint; wormwood.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, aa 20.0; Menthae piperitae folium, Melissae folium, aa 30.0. Steep 1 teaspoon in 1 cup of boiled water for 15 minutes. Take 1 cup of the tea while hot, 3 to 6 times a day.
• Tincture Rx: Ol. Carvi 5.0, Tinct. Absinthii, Tinct. Foeniculi Compos., aa 20.0. Take 20 to 30 drops in water, 3 times a day.
• Aniseed: Pour 1 cup of boiled water onto 1 heaped teaspoon of the freshly crushed or coarsely powdered herb, then cover and steep for 10 to 15 minutes. Take 1 cup, 3 to 5 times a day.
• Anise oil: 3 drops on a cube of sugar, several times a day.
• Commercial products: Take as directed on the product label.
– Clinical value: All of these remedies are generally recognized in Europe as safe and effective. Hence, they can be selected according to the taste preference of the patient.

Mild Gastrointestinal Pain, Bloating, and Meteorism
➤ Caraway; fennel; wormwood; yarrow.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, Absinthii herba, Millefolii herba, aa 25.0. Steep 1 teaspoon in 1 cup of boiled water for 15 minutes. Take 1 cup of the hot tea before each meal.
– Clinical value: Effective and well-recommended tea formulation, owing to inclusion of wormwood, the duration of application should be limited.

Severely Distended and Painful Stomach
➤ Caraway; olive oil; fennel; aniseed.
– External remedies: Dosage and administration
• Liniment Rx: Ol. Carvi 10.0, Ol. Olivinarum ad 100.0. Apply 10 to 15 drops onto the stomach in a circular pattern, 2 to 3 times a day. Can also be used in small children.
– Internal remedies: Dosage and administration
• Tea Rx: Carvi fructus (crushed), Foeniculi fructus (crushed), Anisi fructus (crushed), aa 20.0. Steep 1 teaspoon in 1 cup of boiled water for 20 minutes. Drink a cup of the warm tea after each meal.
• Caraway oil: 2 to 3 drops in a small amount of water at meal time.
• Caraway seed: Pour 1 cup of boiled water onto 1 teaspoon of the freshly crushed seeds, then cover and steep for 5 minutes. Take 1 cup at or after meals.

– Clinical value: These herbal remedies, especially caraway oil, have good effects in this indication according to clinical experience in Europe. Postprandial Bloating and Meteorism
➤ Caraway; fennel; wormwood herb (see p. 129); yarrow herb; turmeric root; artichoke leaf.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, Absinthii herba, Millefolii herba, aa 25.0. Pour 1 cup of boiled water onto 1 teaspoon of the tea mixture, then cover and steep for 15 minutes. Take 1 cup of the hot tea before each meal.
• Turmeric root, artichoke leaf: Use commercially available preparations Meteorism and Cramping with Inflammation and Diarrhea

➤ Caraway; fennel; chamomile.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, aa 20.0; Matricariae flos, ad 100.0. Steep 1 to 2 teaspoons in 1 cup of boiled water for 10 minutes and sip slowly while hot.
– Clinical value: Effective and well-tolerated remedies. Bloating and Meteorism with Cramplike Gallbladder Pain

➤ Gentian root; wormwood herb; peppermint leaf; belladonna.
– Dosage and administration
• Tincture Rx 1: Tinct. Gentianae, Tinct. Absinthii, aa 20.0; Tinct. Menthae Piperitae 10.0. Take 30 drops in a glass of water, shortly before meals,
3 times a day.
• Tincture Rx 2: Tinct. Belladonnae 2.0, Tinct. Menthae Piperitae 10.0; Tinct. Gentianae 20.0. Take 10 to 15 drops in a glass of water shortly before meals, 3 times a day.
Note: Pharmacists are required to standardize belladonna tincture with respect to its alkaloid content. The use of belladonna tincture for more than 3 weeks is not recommended.
– Clinical value: Effective and safe for short-term use.

More Severe Colics and Meteorism
➤ Peppermint leaf; aniseed; calamus root; blessed thistle; wormwood.
– Dosage and administration
• Tea Rx 1: Menthae piperitae folium, Anisi fructus, Calami rhizoma, aa 20.0. Steep 1 tablespoon in 1 liter of water for 1 hour. Warm and drink 1 cup before each meal.
• Tea Rx 2: Cnici benedicti herba, Absinthii herba (see p. 129), Melissae folium, aa 20.0. Steep 1 teaspoon in 1 cup of boiled water for 20 minutes. Take 1 cup, 3 times a day.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Range of Applications in Functional Epigastric Complaints Spastic Functional Epigastric Syndrome
➤ Peppermint leaf; belladonna; wormwood; caraway seed; valerian root.
– Dosage and administration
• Peppermint leaf: Pour 1 cup of hot, not boiling water onto 1 to 2 teaspoons of the herb, then cover and steep for 10 to 15 minutes. Take 1 cup after or between meals. The tea should be drunk slowly while warm.
• Peppermint tincture: 5 drops in half a glass of water. Gives two doses daily. Preferably used for acute symptoms only.
• Tincture Rx: Ol. Carvi 3.0, Tinct. Belladonnae, Tinct. Absinthii, Tinct. Carminativa, aa 10.0; Tinct. Valerian. Aeth., ad 50.0. Take 30 drops in water, after meals, 3 times a day.

Warning: The latter formulation contains belladonna and should not be used for more than 3 weeks.
Note: Antacids can dissolve the enteric coating of some tablets, leading to stomach upset.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Roemheld’s Complex
(Spastic Functional Epigastric Syndrome with Severe Meteorism)

➤ Galangal root.
– Dosage and administration
• Dried herb: Pour 1 cup of boiled water onto 1 teaspoon of the finely chopped or coarsely powdered herb, then cover and steep for 5 to 10 minutes. Take 1 cup, 15 to 30 minutes before each meal.
• Tincture (1 : 10): Take 10 drops in lukewarm water, 15 minutes before meals, 3 times a day.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Roemheld’s Complex with Poor Evacuation of the Bowels
➤ Caraway; fennel; senna leaf.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, aa 20.0; Menthae piperitae folium, Sennae folium, aa 30.0. Steep 1 to 2 teaspoons in 1 cup of boiling water for 20 minutes. Take 1 cup in the morning and evening.
Warning: This formulation contains senna and should not be used for more than one month at a time.
– Clinical value: Effective, but duration of use is restricted.

Dyspepsia Associated with Enzyme Deficiencies
➤ Papaya peel; pineapple, or their derivatives, papain and bromelain.
– Dosage and administration
• Papain, bromelain, pancreatin, trypsin, chymotrypsin: Commercial tablets are widely used.
Warning: Allergic reactions, ranging from mild reactions to anaphylactic shock, can occur. Bloating, flatulence and occasional nausea can occur when administered at high doses.
Warning: Bromelain can increase the potency of antibiotics and anticoagulants. Other side effects include harmless changes in the consistency, color, and smell of stools.
– Contraindications: Severe congenital or acquired coagulopathies, known hypersensitivity to any of the ingredients. Should not be used before surgery.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

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What is Reflux disease, Gastritis, Gastroduodenal Ulcers, Dyspepsia Clinical Considerations?

What is Reflux disease?
-is acknowledged by the symptomatic in reverse movement of the stomach contents (particularly gastric acid) into the esophagus due to weakness or inadequacy of the gastroesophageal sphincter.

How do you get a stomach ache? (acute gastritis)
-can be induced by a variety of factors, like simple overeating, stress, alcohol, medications, acids, alkaline substances, and bacterial infections. Acute stomach diseases can become chronic. The superior layers of the gastric mucosa are affected.
– Indications: Upper abdominal pain, anorexia, nausea, vomiting, bleeding.
– Gastroduodenal ulcers develop when there is an imbalance of protective and aggressive factors. Erosions extending into the deep layers of the stomach wall can be found on the mucous membrane of the stomach and or duodenum.
– Functional stomach disorders (diagnosis of exclusion) play a very essential role, as they are found in 30–50 % of all patients with upper abdominal complaints.
– Nervous disorders are suspected if no natural variations can be discovered. It is hard to recognize nerve-related problems from typical upper abdominal problems pursuing meals (dyspeptic syndrome). The stomach and duodenum (nausea, belching, upper abdominal discomfort) as well as the small and large intestine (flatulence, cramplike abdominal pain, diarrhea) can be involved.
-Ulcer-like dyspepsia - Nocturnal pain, episodic pain, pinpoint pain.
-Dysmotility dyspepsia - Nausea or vomiting, premature satiation, belching, gas, upper abdominal tension, flatulence.
– Reflux dyspepsia or Heartburn.
– Aerophagia or Flatulence and belching

Clinical value of herbal medicine and herbal treatment measures
– Reflux: Herbal remedies are used for adjunctive treatment only.
– Gastritis
• The effectiveness of herbal remedies for autoimmune gastritis (type A) is still unclear.
• Treatment for Helicobacter pylori-related gastritis (type B) consists of eradicating the pathogen by way of acid blockade and antibiotic treatment.

Herbal remedies can be prescribed as adjuvant measures.
• Drug-induced gastritis (type C) caused by salicylates, nonsteroidal anti inflammatory drugs, and other medications responds well to mucoprotective herbal remedies. Their use is, however, limited to adjuvant therapy.
– Ulcers: Antacids, mucoprotective drugs, and antisecretory drugs (e. g., H2-antagonists and proton pump inhibitors) are normally used. In this case, herbal remedies are limited to adjuvant therapy.
– Non-ulcer-related dyspepsia: A variety of herbal remedies are used to treat
dyspeptic syndrome.

Recommended Herbal Remedies

Antiphlogistics
➤ Chamomile flower (Matricariae flos); peppermint leaf (Menthae piperitae folium); balm leaf (Melissae folium); licorice
root (Liquiritiae radix); fennel seed (Foeniculi fructus).
– Action: Anti-inflammatory. Aromatic herbs also have bacteriostatic effects and increase the local blood circulation.
• Chamomile flower: Chamomile alone is not a very effective ulcer treatment. Because of its general efficacy and virtual lack of side effects, it is still commonly recommended for adjunctive treatment at the onset of and during acute ulcer episodes. The greatest strength of chamomile lies in prevention.
• Licorice root: Because of its antiphlogistic effects, the herb is mainly prescribed for treating ulcer-related conditions, but is also indicated in gastritis and dyspeptic syndrome.
– Contraindications
• Licorice root: Cholestatic liver diseases, cirrhosis of the liver, hypertension, hypokalemia, severe liver failure, and pregnancy.
• Chamomile flower, dried and in alcoholic extracts: Known allergy to chamomile.
• Peppermint leaf and its preparations: Reflux.
– Dosage and administration: Licorice preparations should not be used for more than 4–6 weeks at a time unless directed by a physician. Standardized licorice root extracts made with diluted ethanol and containing no less than 4.0 % and no more than 6.0 % glycyrrhizin should preferably be used.
• Deglycyrrhinated licorice extract (DGL) is very commonly recommended and available in capsules or tablets in North America. The preparation is nearly as effective as whole licorice, but with fewer side effects. The daily dosage is based on the equivalent to 200–600 mg glycyrrhizin.
– Side effects: Undesirable mineralocorticoid effects occur after a weekly dose of ≥3.5 g glycyrrhizin (from licorice root). Rare cases of myoglobinuria have also been reported.

Demulcents
➤ Flaxseed (Lini semen).
– Action: Soothing.
– Contraindications: Bowel obstruction.
Important: Flaxseed may impair the absorption of other drugs. The patient using flaxseed should drink plenty of fluids, at least 150 ml after taking the herb.
Anticholinergics
➤ Belladonna (Atropa belladonna).
– Action: Parasympatholytic. Alkaloids of the atropine group inhibit vagus nerve activity, reduce gastric juice secretion, and diminish intestinal motility. They are therefore used to relieve spasms, gastrointestinal colic, and gallbladder colic.
– Contraindications: Narrow-angle glaucoma, mechanical gastrointestinal tract stenosis, benign prostatic hypertrophy with residual urine formation, acute pulmonary edema, and tachycardiac arrhythmias.
– Dosage and administration
• Belladonnae radix: Single dose 0.05 g; maximum single dose 0.1 g (equivalent to 0.5 mg total alkaloids). Maximum daily dose 0.3 g, equivalent to 1.5 mg total alkaloids calculated as L-hyoscyamin.
– Belladonna extract: Single dose 0.01 g; maximum single dose 0.05 g, equivalent to 0.73 mg total alkaloids calculated as L-hyoscyamin.

Note: Belladonna is dispensed by prescription only.
– Side effects: Dose-dependent side effects, such as dry mouth, blurring of vision, micturition disorders, headaches, and stupor.

Range of Applications in Acute Clinical Pictures
Acute Gastritis and Esophagitis (in viral infection)
➤ Chamomile.
– Dosage and administration
• Special chamomile therapy: The patient should drink 2 to 3 cups of fresh, hot chamomile tea (see p. 47), then lie on the back, left side, stomach, and right side for 5 minutes each. As an alternative to the tea, this therapy can also be performed using 30 to 50 drops of chamomile fluid extract or an appropriate commercial preparation, taken in a glass of hot water. The tea or diluted extract should be taken on an empty stomach in the morning.

Important
• This therapy should be continued for a few days after the symptoms have ceased.
• Recovering alcoholics should not use chamomile extract because it contains alcohol.
– Clinical value: Useful and effective treatment measure without side effects. Ulcers with Nocturnal Pain and Localized Epigastric Hunger Pain
➤ Chamomile; licorice root.
– Dosage and administration
• Chamomile: see Acute Gastritis and Esophagitis.
• Licorice root fluid extract (with 4–6 % glycyrrhizinic acid): 1 teaspoon diluted in a small quantity of water, up to 4 times daily.
• Deglycyrrhizinated licorice (DGL) chewable tablets. Take 2 to 4 380 mg chewable tablets before meals for acute symptoms, 1 to 2 tablets as a maintenance dose.
Note: Should be taken under medical supervision and for no more than a few weeks.
– Clinical value: For adjunctive treatment.

Gastric Colic (Ulcerlike Pain without an Organic Finding)
➤ Belladonna (Atropa belladonna).
– Dosage and administration
• Tincture Rx: Tinct. Belladonnae with 0.02–0.03 % total alkaloid content, Tinct. Valerianae, Spir. Menthae pip., aa ad 30.0. Take 8 to 10 drops in water, 3 times a day.
– Clinical value: Useful for alleviating pain. Range of Applications in Chronic Esophageal and Gastric Diseases Chronic Esophagitis
➤ Flaxseed.
– Dosage and administration: Grind flaxseed before use. Place 2 tablespoons of flax seed in 1⁄2 liter of water and bring to a boil. Strain and drink the liquid. The use of commercial products is recommended. Take 3 to 4 sips of the gruel, several times a day.
– Clinical value: For adjunctive treatment.

Chronic Gastritis
➤ Fennel seed; peppermint leaf; lemon balm leaf; calamus rhizome (Calami rhizoma).
➤ Tea Rx: Foeniculi fructus, Menthae piperitae folium, Melissae folium, Calami rhizoma, aa 20.0.
➤ Flaxseed (see p. 66).
– Dosage and administration
• Tea mixture: Steep 1 teaspoon in a cup of boiled water for 10 minutes. Take 1 cup, 2 to 3 times a day. Sip slowly while hot.
• Flaxseed gruel: Soak 1 to 2 tablespoons ground flaxseed (daily portion) in 1⁄4 to 1⁄2 liter of water overnight in the refrigerator. Drink lukewarm before breakfast or in portions distributed throughout the day.
– Clinical value: For adjunctive treatment.

Chronic Gastritis in Very Underweight or Weak Patients
➤ Olive oil; flaxseed.
– Dosage and administration
• Olive oil: Sip 1 tablespoon slowly each morning.
• Flaxseed: see above
– Clinical value: For adjunctive treatment. Non-Ulcer-Related Dyspepsia (cf. Dyspeptic Symptom Complex)
➤ Licorice root.
– Dosage and administration
• Dried licorice root: Chop and steep 1⁄2 teaspoon in 1 cup boiled water for 15 minutes. Take 1 cup, 3 to 4 times a day. Can be taken for several months because the glycyrrhizinic acid content is very low.
• Licorice fluid extract (4–6 % glycyrrhizinic acid): 1 teaspoon in 1 cup water, 3 to 4 times a day.
• Deglycyrrhizinated licorice (DGL) chewable tablets: take 1–2 before meals.
Note: The use of licorice fluid extract and commercial licorice products should be medically supervised. These preparations should not be taken for more than a few weeks at a time.
– Clinical value: For adjunctive treatment.

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Anorexia Nervosa Natural Treatments

Anorexia Nervosa Natural Treatments

Clinical Considerations of anorexia nervosa

Report General Comments

– Appetite is defined as an natural desire for food. It has a unique control mechanism that is mostly localized in the hypothalamus and an unspecific manage mechanism in the limbic system. Hence, appetite is basically subject to psychological command.

– The gustatory nerves (vagus nerve) in the mouth induce the production of saliva and gastric juices.

Herbal and general treatment measures: Pleasant-tasting bitters can be used to induce the appetite and the production of gastrointestinal juices. The patients usually become comfortable to the approved herbs or herb formulations within a few weeks, so the herbal remedies soon lose their initial efficiency. This makes it necessary to periodically replace to various natural formulations to keep treatment effectively.

➤ Medical benefit of natural treatment: Bitters used to activate the appetite are a best example of the effectiveness of natural and organic treatments simply because, in this case, no comparable man-made solutions are out there.

Natural Appetite Suppresant

Distinction: Bitters are separated into the following four groups: tonic bitters (tonic substances), astringent bitters (tannins), aromatic bitters (essential oils), and acrid bitters (pungent substances).

➤ Tonic bitters (amara tonica): Centaury leaf (Centaurii herba); artichoke leaf (Cynarae folium); cinchona bark; gentian root (Gentianae radix); horehound herb (Marrubii herba); bogbean leaf (Menyanthidis folium); dandelion root and herb (Taraxaci radix cum herba); chicory leaf and root (Cichorii herba et radix).

➤ Astringent bitters (amara adstringentia): Condurango bark (Condurango cortex—use only in combination with other herbal remedies); cinchona bark (Cinchona cortex).

➤ Aromatic bitters (amara aromatica): Wormwood herb (Absinthii herba); bitter orange peel (Aurantii pericarpium—use only in combination with other herbal remedies); calamus root (Calami rhizoma); angelica root (Angelicae radix); blessed thistle (Cnici benedicti herba); yarrow herb and flower (Millefolii herba et flos).

➤ Acrid bitters (amara acria): Cinnamon bark (Cinnamomi cassiae or ceylanicicortex); galangal root (Galangae rhizoma); ginger root (Zingiberis rhizoma).

➤ Contraindication to natural treatment

– Gentian: Must not be employed by persons with gastric or duodenal ulcers.

– Wormwood: Should not be used while in maternity.

– Calamus (sweetflag): Should not be used for the duration of maternity or by youngsters below 12 years old.

➤ Measures

– Bitters initially induce the release of saliva. Once they reach the stomach, they stimulate the release of gastrin, thus enhancing upper gastrointestinal mobility. Bitters also stimulate the release of bile, pancreatic juices, and pepsinogen.

– Bitters stimulate the appetite of patients who lack gastric juices (achylia) owing, for example, to chronic atrophic gastritis.

– Bitters do not stimulate the appetite of healthy individuals.

– Overdosage can lead to a digestion-suppressive effect.

– Bitters are usually not effective in treating cancer-related anorexia. However, one should try the different formulations.

➤ Adverse reactions

– Although rare, head aches may happen in vulnerable persons.

– Angelica root can trigger photosensitivity. Persons using it should prevent extensive sun exposure.

➤ Dosage and administration

– Bitters should be taken 15 to 30 minutes just before meals and implemented at doses large enough to be efficient.

– Bitters should be temporarily retained in the mouth before ingesting.

Variety of Applications

To Stimulate the Appetite in Useful Achylia (lack of gastric juices) Secondary to an Acute Infection

➤ Gentian root; centaury herb; bogbean.

– Dosage and administration

• Gentian root: Steep 1 teaspoon of the carefully sliced natural herb in 1 cup of water for 5 minutes.

• Centaury herb: Steep 1 to 2 tsp in 1 cup of boiled water for 15 minutes.

• Tea Rx: Centaurii herba, Menyanthidis folium, Calami rhizoma, aa 20.0. Simmer 1 tbsp in 1 litre of water for 15 mins. Single dose: 1 cupful. Heat before use.

• Gentian extract: 0.5–2.0 g herbal preparation , 2 times a day, e. g., in pill form.

• Centaury extract: 1–2 g, several times a day, e. g., in pill form.

• Bogbean leaf tincture: 20 to 40 drops in 1⁄2 glass of water; sip slowly.

• Gentian tincture: 20 to 40 drops in 1 glass of water before each meal (very potent).

Note: Bitter teas, extracts, and tinctures should be taken before each meal.

– Medical benefit: There are no man-made drugs with similar results. Bogbean tea has an particularly effective result. Swallowing bitter preparations in capsules is less efficient than use of preparations where the bitter taste is tasted in the mouth.

Anorexia in General Tiredness or Exhaustion

➤ Additional sign: For common roborant and stimulant effects after medical procedures.

– Tincture Rx: Tinct. Cinchonae comp. Tinct. Rhei vinosae, aa 25.0.

– Dosage and administration: 1 teaspoon, 30 minutes before meals, 3 times a day.

– Medical advantage: Comparably pleasant tastes, low-potency solution.

Anorexia in Vegetative and Constitutional Weakness

➤ Combined Cinchona Tincture containing 6 parts cinchona bark, 2 parts bitter orange peel, 2 parts gentian root, and 1 part cinnamon.

– Dosage and administration: 20 drops in a glass of lukewarm water, 30 minutes before each meal. Long-term use is recommended.

– Clinical value: Easy to use, comparatively good taste. Gastric Anacidity, Achylia, and Anorexia (in the elderly)

➤ Tea Rx: Absinthii herba, Menthae piperitae folium, aa 30.0.

– Dosage and administration: Steep 1 teaspoon in 1 cup of water for 10 minutes and strain. Take 1 cup, just before meals, 2 times a day. Sip slowly and gradually.

– Medical benefit: This is an alternatively efficient solution, but is soon rejected by many patients due to the fact of its bitter taste. Anorexia (early stages)

➤ Yarrow herb; peppermint leaf; centaury herb; calamus root.

– Dosage and administration: Take 30 mins just before meals.

– Tea Rx: Centaurii herba, Millefolii herba, Menthae piperitae folium, aa 20.0. Steep 1 tsp . in 1 cup of boiled water. Take in, cold or lukewarm, just before meals.

– Calamus tincture: 5 to 10 drops in a glass of water, thrice a day.

– Medical benefit: The efficiency of these uses has not been recorded in medical studies. Calamus tincture should not be administered to youngsters, or while in maternity. Lack of Appetite and Functional Upper Abdominal Problems (in situations where carminative, cholagogue, and mild antispasmodic results are desired.

Lack of Appetite and Insufficient Peristalsis

➤ Ginger root

– Dosage and administration: Ginger tea or tincture should be taken 15 to 30 mins just before meals.

– Dried ginger root: Pour 1 cup of hot water onto 1 tsp . of the coarsely powdered herb, then cover and steep for 5 to 10 mins.

– Ginger tincture (1 : 5): 10 to 20 drops in 1⁄2 to 1 glass of water. 

Helpful substitute solution.

Medical benefit: Instead of well accepted. Big inter individual differences in the effectiveness of these treatments can be noticed. Anorexia in Severe Organic Diseases (Cancer)

➤ Calamus root.

– Dosage and administration: Calamus tincture: 20 to 30 drops in a glass of water, 15 to 30 minutes before meals, 3 times a day.

– Clinical value: Herbs that induce the appetite are not very efficient for this sign.

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Diseases of the Mouth and Throat Natural Remedies

Clinical Considerations
➤ General comments: Mouth and throat diseases can be caused by bacteria, (e. g., Streptococcus or Staphylococcus species), viruses, mycoses (e. g., Candida albicans), allergies, pseudoallergies, and autoimmune diseases.
➤ Herbal and general treatment measures: Mouth washes and gargles are mechanical measures for cleansing the mouth and increasing the blood flow in the oral mucous membranes. Depending on which secondary herbal substances they contain, they can also relieve pain and speed up the healing process.
➤ Clinical value of herbal medicine
– Herbal preparations are effective in counteracting bacterial, viral or nonspecific mouth and throat diseases. They can be used alone or for adjunctive treatment parallel to established synthetic drugs.
– There are no known herbal remedies for fungal diseases of the mouth and throat.
– Astringents help to clear up drug-related oral eruptions, and bitters are used to counteract dryness of the mouth.

Diseases of the Mouth and Throat Recommended Herbal Remedies (Overview)
Demulcents
➤ Marshmallow root (Althaeae radix); mallow leaf (Malvae folium); ribwort plantain (Plantaginis lanceolatae folium); sage leaf (Salviae folium).
– Action: Antitussive.
– Contraindications: None known.
– Side effects: None known.

Astringents
➤ Myrrh (Myrrhae); dried bilberries (Myrtilli fructus); silverweed (Potentillae anserinae herba); rhatany root (Rhataniae radix); sage
leaf (Salviae officinalis folium); tormentil root (Tormentillae rhizoma).
– Action: Anti-inflammatory, antimicrobial, promotes wound healing.
– Side effects: None known.
Aromatic Herbs
➤ Clove oil (Caryophylli aetheroleum); chamomile flower (Matricariae flos) myrrh; lemon balm leaf (Melissae folium).
– Action: Bacteriostatic, bactericidal, virustatic. Some are antiphlogistic.
– Contraindications: Chamomile: Known allergy to chamomile.
– Side effects: None known.
Bitters
➤ Centaury herb (Centaurii herba); bogbean leaf (Menyanthidis folium); gentian root (Gentianae radix).
– Action: Increases the flow of saliva by stimulating bitter receptors on the tongue.
– Contraindications: Individuals with gastric or duodenal ulcers should not use gentian root.
– Side effects: Although rare, headaches may occur.

Range of Applications in Acute Mouth and Throat Diseases
Acute Stomatitis (with less severe pain)
➤ Mallow leaf, marshmallow root, and sage leaf, either alone or using equal parts of each, as an infusion.
– Dosage and administration: Use as a mouthwash or gargle, 3 to 6 times a day.
– Clinical value: Herbal treatment alone is usually sufficient in mild cases. Otherwise, the herbal remedies can be applied for adjunctive treatment. Acute Stomatitis (painful)
➤ Chamomile flower and sage leaf (1 : 1) for infusions.
– Alternative: Clove oil 5 % in water base.
– Suggested combination: Commercial slippery elm bark (Ulmus rubra) preparations.
– Dosage and administration: Place herbs in water, bring to a boil, then cover and steep for 14 minutes. Rinse mouth or gargle with 1 tablespoon infusion in a cup of warm milk, 3 to 10 times a day as needed.
– Clinical value: Can be used alone to treat mild or moderate disorders. Also combines well with synthetic drugs and chemical remedies (e. g., lidocaine or tetracaine). Isolated Mouth and Throat Ulcers (Aphthae)
➤ Myrrh tincture; sage leaf.
– Dosage and administration
• Apply a few drops of myrrh tincture 1 : 5 to the affected sites, 2 to 3 times a day.
• Gargle: Briefly boil sage leaves in water (1:1) and steep for 14 minutes.
– Clinical value: The effects of these herbs are comparable to those of their active constituents’ synthetic counterparts. Pharyngitis with Dry Cough and Problems in Swallowing
➤ Mallow leaf; sage leaf; marshmallow root.
– Dosage and administration: Prepare an infusion using one or more of these herbs. Gargle with the infusion several times a day.
– Clinical value: The effects of these herbs are comparable to those of their active constituents’ synthetic counterparts. Clinical studies to confirm this are, however, not available. Acute Glossitis and Aphthous Stomatitis
➤ Dried bilberry.
– Dosage and administration: Steep 1 to 3 tablespoons of dried bilberries in 1 liter of water for around 15 minutes. Gargle with the infusion several times a day.
– Clinical value: Studies comparing bilberry to its active constituents’ synthetic counterparts are not available.
• Bitters: Centaury herb, bogbean, and gentian root. Prepare an infusion using one or more of these herbs. Add 1 to 2 teaspoons of the tea mixture to 1 liter of water.
– Clinical value: Comparable treatment regimens with synthetic drugs do not exist. The elimination of harmful factors (e. g., cigarette smoking) can greatly improve the symptoms. Chronic Gingivitis and Periodontal Disease
➤ Undiluted rhatany (Krameria spp.) tincture.
– Tincture Rx: Tinct. Krameriae, Tinct. Arnicae, aa 20.0.
– Dosage and administration: Dilute 1 teaspoon in 1 glass of water and rinse or apply undiluted tincture to gums, 2 to 3 times a day.
– Clinical value: Useful alternative to synthetic drugs. No comparative studies are available. Inflammation and Mild Suppuration of the Gums
➤ Tincture Rx: Tinct. Sanguinariae 3.0,, Tinct. Myrrhae, 20.0.
– Dosage and administration: Apply 1 tsp of the mixture diluted in 4 ounces of water to the gums, 2 to 3 times a day.
– Clinical value: Good alternative to synthetic drugs. Persistent “Lump” in the Throat or Need to Clear the Throat
➤ Centaury herb, bogbean, and gentian root. Prepare an infusion using one or more (equal parts) of these herbal remedies, or use the following tincture. Tincture Rx: Tinct. Resina myrrhae 10.0.
– Dosage and administration: Add 1 teaspoon tincture to a glass of water, or
1 to 2 teaspoons tea mixture to 1 liter of water. Rinse the mouth or gargle, several times a day.
– Clinical value: Comparable treatment regimens with synthetic drugs and/ or chemical remedies do not exist. Dryness of the Mouth and Sicca Syndrome
➤ Same as for lump in throat sensation (above).
– Action: Bitters stimulate the remaining intact mucous glands.
– Clinical value: Alternative to artificial saliva. Herpes Simplex Labialis
➤ Apply externally on the lesions either lemon balm leaf dry extract in creme base, or St. John's wort oil.
– Dosage and administration
• Apply 10–20 mg of the creme per cm2 of affected skin, 2 to 4 times of day.
• St. John's wort oil: Apply 1–2 ml of the oil to the affected area, several times daily.
– Clinical value: Useful alternatives to the synthetic counterparts; however, no convincing clinical studies to test this have been published.
– St. John's wort oil has demonstrated anti-inflammatory and antiviral properties and may help reduce pain and inflammation.
Note: It is important to start treatment early, that is, as soon as the first signs appear.

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Symptomatic Cough

Clinical Considerations
➤ General comments
– Coughing clears foreign particles and accumulated mucus from the respiratory passages.
– Coughing is a response to foreign particles caused by stimulation of neuroreceptors located on the larynx and esophageal bifurcation at the opening of the stem bronchi. The stimulus is usually mechanical, but sometimes also chemical or thermal in nature. The cough reflex travels through the afferent nerve fibers to the cough center of the medulla oblongata. Additional cough receptors are located in the bronchi, alveoli, and throat. A smaller number of receptors can be found in the nose and paranasal sinuses. Connected to the cough center are receptors in the auditory canal, esophagus, and stomach. Coughing is induced when these receptors are stimulated.
– Coughing for reasons other than to eject mucous secretions and foreign particles places unnecessary strain on the respiratory tract and should therefore be treated. Expectoration should be boosted through appropriate measures.
– If the cough becomes chronic, a thorough work-up should be performed to determine the cause and to initiate the proper treatment measures. Apart from lung and heart disease, other common causes include medications, such as ACE inhibitors, and environmental factors, such as irritant gases, cigarette smoke, and solvents.

➤ Herbal and general treatment measures
– Herbal remedies that quiet coughing (antitussives) or promote the ejection of mucus (expectorants) are delivered either by inhalation or orally.
– Herbal antitussives with central effects: The essential oil in eucalyptus leaves (cineol) and licorice root may have central effects.
– Herbal antitussives with peripheral effects reduce the sensitivity of cough receptors in the mucous membranes of the mouth and throat as well as in the esophagus and stomach.
– Anticoughing teas can help to liquefy thick mucous secretions. The secretolytic and expectorant actions of certain essential oils develops more effectively when the preparations are inhaled or taken in extract form. Saponincontaining herbs, on the other hand, should be administered by mouth since they work by stimulating the sensitive fibers of the gastric mucosa. The reflex stimulus is then passed on to the bronchial mucosa.
– Some herbal remedies have an additional anti-inflammatory effect (e. g., licorice root and sundew herb) or bronchospasmolytic effect (e. g., sundew herb, peppermint oil, and licorice root).

➤ Clinical value of herbal medicine
– Herbal remedies that liquefy the mucus have antitussive efficacy.
– All the specified herbal preparations are used for symptomatic treatment of coughs.

Recommended Herbal Remedies (Overview)
Demulcents
– Action: Reduction of coughing. The active constituents in some herbal demulcents (e. g., marshmallow root, ribwort plantain herb, Iceland moss) are transported by the mucus to the receptors in the mucous membranes of the mouth and throat. Those of others (e. g., naphthoquinone derivatives in sundew herb) take effect in the bronchial mucosa. Iceland moss contains bitter principles that additionally stimulate the production of saliva and digestive juices, thereby triggering a swallowing reflex that decreases the cough reflex.

• Antitussives
• Secretolytics and expectorants
• Antispasmodics
• Antiphlogistics

Range of Applications in Unspecific Dry Cough
➤ General comments
– Symptomatic treatment is justifiable if the cause of coughing cannot be identified or if the environmental factors causing the coughing cannot be eliminated. Herbal remedies with primarily antitussive and anti-inflammatory effects should be used.
– Aromatic oils such as anise oil, eucalyptus oils, fennel oil, menthol, peppermint oil, and thyme oil are useful. When allowed to dissolve in the mouth, they not only have a pleasant taste but also stimulate the swallowing reflex, which can be further enhanced by adding sugar or other sweeteners.

• Demulcents
• Antitussives
• Antiphlogistics

➤ Tea Rx: Althaeae radix 25.0, Foeniculi fructus 10.0, Lichen islandicus 10.0, Plantaginis lanceolatae herba 15.0, Liquiritiae radix 10.0, Thymi herba 30.0. Steep 1 tablespoon in 1 cup of boiled water. Sweeten and drink the fresh tea slowly and as hot as tolerable. Take 1 cup, several times a day.
➤ Dosage and administration: Commercial preparations (e. g., capsules, cough drops, lozenges, cough syrup) should be taken several times a day, as directed on the product label.
➤ Clinical value: For adjunctive treatment.
➤ Differential diagnosis: Chronic bronchitis.

Range of Applications in Bronchial Asthma
➤ Preliminary remarks
– The chronic inflammatory process associated with bronchial asthma is controlled by T-helper cells and effector cells involved in the inflammatory response. Eosinophil granulocytes and other cells are typically found in inflamed bronchial tissues and bronchoalveolar fluids.
– The main goals of therapy are to reduce inflammation and eliminate bronchospasms.

➤ Recommended herbal preparations: Eucalyptus oil in various forms
– Eucalyptus oil is often used in steam inhalers, or as a rub. Small amounts can be found in cough lozenges or cough syrups.
– Eucalyptus oil is is only rarely availaible in capsule or tablet form in the United States and is little used in these forms.
– Clinical value: For adjunctive treatment. A cortisone-reducing effect has also been reported.
Warning: Asthma patients are often allergic to essential oils.

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Bronchitis Natural Cures

Clinical Considerations
➤ General comments
– Acute bronchitis
• Usually caused by an ascending viral infection. Irritant bronchitis is due to the inhalation of toxic or allergic substances.
• The disease is marked by abnormal mucus production and impaired ejection of mucus from the bronchi. The bronchial passages become obstructed owing to the thick mucous secretions and inflammation. Coughing and phlegm production, the hallmark symptoms of bronchitis, ultimately occur.
• The initial symptoms are dry cough accompanied by a burning sensation in the chest. The cough gradually becomes productive and increasingly troublesome. The viscosity of the mucus starts to decrease over the course of time (2 to 3 weeks).
• Yellowish-green mucus is indicative of secondary bacterial infection.

Note: If there is severe coughing (especially with a presumed lung involvement), frequent relapsing, or persistent coughing with expectoration, the patient should consult a physician to assess the need for antibiotic treatment.
• Complications: The primary complication is chronic bronchitis, which can cause irreversible damage to the mucous membranes. The damaged membranes provide a foundation for further complications, such as pulmonary emphysema, bronchiectasis, and bronchopneumonia.

– Chronic bronchitis
• Smoking is usually responsible for the persistence of bronchitis. Chronic adenovirus infection may be another cause.
• Increased quantities of CD8+ T lymphocytes can be found in the larger airways (beneath the basal membrane). The bronchial glands are swollen, and large quantities of neutrophil granulocytes and macrophages are present, even in the alveolar fluid.

➤ Herbal and general treatment measures of bronchitis
– Increasing the fluid intake is essential. In mild cases, the patient should drink large quantities of tea made from herbs selected according to the type of cough.
– Herbal preparations with soothing effects are to be applied first. Expectorants, preferably those with antispasmodic or immunostimulatory effects, can be prescribed later if necessary.

➤ Clinical value of herbal medicine
– The objective of herbal treatment is to prevent complications. Treatment should therefore be initiated in the early stages of disease.
– Herbal medicinal products containing single or multiple ingredients can decrease the viscosity of mucus, counteract inflammation, ease bronchospasms, and stimulate the immune system.
– In chronic bronchitis, herbal remedies are used for adjunctive treatment.

Recommended bronchitis Herbal Remedies (Overview)
Demulcents
➤ Marshmallow root (Althaeae radix); mallow leaf and flower (Malvae folium cum flores); ribwort plantain (Plantaginis herba)Iceland moss (Lichen islandicus); mullein (Verbasci flos).
– Action: Antitussive.
– Contraindications: None known.
– Dosage and administration: Oral dosage forms should be used. For dosage
recommendations, see the application in question.
– Side effects: None known.

Secretolytics and Expectorants
➤ Aromatic herbs and pure essential oils: Aniseed (Anisi fructus); fennel seed (Foeniculi fructus); thyme (Thymi herba); eucalyptus oil (cineol); camphor tree Cinnamomum camphorae aetheroleum); peppermint oil (menthol); pine needle oil (Piniaetheroleum).
➤ Saponin-containing herbs: Primula root (Primulae radix); mulleinflower (Verbasci flos); licorice (Liquiritiae radix).
– Action: Mucolytic and expectorant.
– Contraindications: Peppermint oil and preparations containing menthol and camphor as well as eucalyptus, pine, and spruce needle oils should never be applied to the face, especially the nose, of infants.
– Dosage and administration: See instructions for the specific application in question.
– Side effects
• Eucalyptus oil: Internal administration of large quantities of eucalyptus oil can lead to the passage of gallstones or kidney stones or to stomach irritation, cramps, tachycardia, and cyanosis. Eating large amounts of eucalyptus candy can induce nausea and vomiting in children.
• Licorice: Aldosterone-like side effects such as edema and hypokalemia, when larger quantities are consumed.
• Saponin-containing herbs: The consumption of large quantities can irritate the stomach.
• Cineol activates the hepatic enzyme system that metabolizes foreign substances, possibly weakening and/or shortening the therapeutic action of other active principles.
• Although rare, contact eczema may occur.

Bronchospasmolytics
➤ Thyme (Thymi herba); ivy leaf (Hederae helicis folium); primula root (Primulae radix); licorice root (Liquiritiae radix).
– Action: Relieve bronchial muscle spasms.
– Contraindications: None known.
– Dosage and administration: See instructions for the specific disease in question.
– Side effects
• Licorice.
• Ivy leaf and primula root: Large quantities of saponin-bearing herbs can irritate the stomach.

Antiphlogistics
➤ Ivy leaf (Hederae helicis folium); primula root (Primulae radix); ribwort plantain (Plantaginis herba); licorice (Liquiritiae radix); Iceland moss (Lichen islandicus).
– Action: Anti-inflammatory.
– Contraindications: None known.
– Dosage and administration: See instructions for the specific application in question.
– Side effects: Described above.

Antibiotics and Immunomodulators
➤ Thyme (Thymi herba); ivy leaf (Hederae helicis folium);nasturium (Tropaeoli herba); horseradish root (Amoraciae radix).
– Action: Reduces the likelihood of a secondary bacterial infection.
– Contraindications: Horseradish should not be used by individuals with peptic ulcers or nephritis, and should not be administered to children under 4 years of age.
– Dosage and administration: See instructions for the specific disease in question.
– Side effects: Those of ivy leaf are described above. Horseradish root can cause isolated allergic side effects; higher doses of the herbal remedy can cause gastrointestinal upsets.

Antitussives
➤ Sundew herb (Droserae herba).
– Action: Relieves dry cough by reducing the cough reflex.
– Contraindications: None known.
– Dosage and administration: See instructions for the specific disease in question.
– Side effects: None known.

Range of Applications in Acute Bronchitis
Internal Remedies
➤ Chest tea, Rx: Standard license: Anisi fructus (chopped) 15.0, Liquiritiae radix 25.0, Althaeae radix 35.0, Malvae folium 25.0.
➤ Cough and bronchial tea Rx: Anisi fructus 10 g, Plantaginis herba 30 g, Liquiritiae radix 30 g, Thymi herba 30 g.
– Dosage and administration: One teaspoon of either tea mixture per cup, 3 to 4 times a day. Commercial preparations should be used as directed on the product label.
– Clinical value: When treatment is initiated early, the combined administration of oral herbal remedies with topical remedies and inhalants can be sufficient treatment in many cases.

External Remedies of bronchitis
➤ Thyme; eucalyptus oil; dwarf pine oil; peppermint oil; spruce needle oil; camphor.
– Dosage and administration: Apply to the skin or use for inhalation several times a day. Should be used as directed on the product label.
– Clinical value: See internal remedies.

Range of Applications in Chronic Bronchitis
Immunostimulants
➤ Purple echinacea herb (Echinaceae purpureae herba) and paleflowered echinacea root (E. pallida radix).
– Dosage and administration: Liquid tinctures, 1:4, 2–4 mL are added to a little water and taken orally, 4 to 5 times daily.
– Clinical value: No comparable synthetic drug preparations exist. Echinacea’s immunostimulatory action takes effect within 24 hours. These products are safe to use, even by patients on concomitant antibiotic treatment. Symptomatic Treatment

➤ The purpose of symptomatic treatment is to promote the ejection of mucus in subacute or chronic bronchitis and to counteract inflammation.
➤ Thyme herb; primula root; ribwort plantain herb; ivy leaf (use commercial products only); cineol. See overview on p. 155.
– Tea Rx: Primulae radix, Thymi herba, Plantaginis herba, aa ad 100 g.
– Dosage and administration: 1 teaspoon per cup, 3 to 4 times a day. Commercial preparations should be used as directed on the product label.
– Clinical value: The specified herbal remedies are generally well tolerated and useful for adjunctive treatment.

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Colds and Flu Natural Treatments

Colds and Flu

Clinical Considerations
➤ General comments
– Colds and flu are the most common reasons for the loss of working hours.
– Around 90 % of all catarrhal disorders are caused by viruses, especially rhinoviruses. Secondary bacterial infection can also develop. Viral and secondary bacterial infections are especially common in individuals with temporary or permanent asthenia of the unspecific (congenital) or specific (acquired) immune system.
– Drafts, cold weather, excessive indoor heating, stress, and loss of sleep are factors that promote the development of colds. When the body (especially lower body) is subjected to hypothermia or ischemia, it responds by reducing the blood flow to the mucous membranes in the upper respiratory passages. This and the drying of the mucous membranes due to excessive room heating promote the growth of pathogens.

➤ Herbal and general treatment measures
– Once a cold has fully developed, treatment focuses on alleviating typical symptoms, such as a runny nose, sore throat, and hoarseness with or without fever. Nasal douches, throat wraps, inhalation, sweat-inducing agents (diaphoretics), and baths with aromatic herbs have proved to be effective. Cold remedies usually contain secretolytic and expectorant herbs with essential oils, mucilage, and saponins.
– Hot baths for colds and flu are prepared with aromatic oils, such as spruce oil, pine needle oil, eucalyptus oil, thyme oil, camphor and/or menthol.
– The administration of a diaphoretic tea after a hot bath can enhance the febrifuge effects of the treatment.

➤ Clinical value of herbal medicine in colds and flu: All measures that improve the natural function of the mucous membranes of the upper respiratory tract, alleviate cold symptoms, and strengthen the immune system, can be recommended for symptomatic treatment of all virally induced catarrhal disorders. There are no comparable synthetic drug preparations. Self-treatment measures should be coordinated with the help of a physician.

Recommended Herbal Remedies for cold and flu(Overview)

Immunostimulants
➤ Purple echinacea herb (Echinaceae purpureae herba); paleflowered echinacea root (Echinacea pallidae radix); wild indigo (Baptisiae tinctoriae radix); and arbor vitae tips (Thujae occidentalis stipites).

Note: The efficacy of other plant parts of the two Echinacea species has not been convincingly demonstrated, although the roots of E. purpurea, and especially E. angustifolia are frequently thought to be more potent in North America.
– Action
• Echinacea: Certain compounds in echinacea (arabinogalactans, arabinogalactan proteins) enhance the body’s nonspecific immune defenses by activating the granulocytes and macrophages, thereby improving the body’s capacity to phagocytose viruses and bacteria. Activated macrophages secrete interleukin-1, interleukin-6, and tumor necrosis factor,substances that stimulate the specific immune system and protect the cells from viral attacks. These mechanisms are activated when the pathogen comes in contact with the oral mucous membranes.
• Caffeic acid derivatives such as chicoric acid and alkylamides are responsible for the antiviral effect of purple echinacea juice.
• Echinacea juice inhibits hyaluronidase, thereby reducing the permeability of the blood vessels and inhibiting the spread of local infection.
• Clinical and postmarketing surveillance studies indicate that echinacea juice and alcoholic extracts of Echinacea pallida root increase the time until the occurrence of a new infection. In those who already have a cold, the course of the infection is less severe and the symptoms subside more quickly. Since many antibiotics can suppress the immune system, these herbal remedies should be helpful in patients with bacterial infections.
• Wild indigo promotes the release of interleukin 1 and stimulates the production of interferons.
• Arbor vitae stimulates the T cells, increases interleukin-2 secretion, and has a direct antiviral effect.
– Indications: Viral and bacterial infections of the upper respiratory passages.
– Contraindications: See cautions noted on labels of commercial products.
– Dosage and administration: Oral echinacea preparations are available. Based on the current data, combinations of Echinacea root (E. purpurea, E. pallida), wild indigo (Baptisia tinctoria), and arbor vitae tips (Thuja occidentalis) appear to be superior to preparations with Echinacea alone. Further in-depth studies are needed for final clarification.
• Flavored liquid products containing coneflower preparations that include glycerine instead of alcohol are popular for children.
– Side effects: None known for oral administration.

Diaphoretics (Sweat Inducers)
➤ Elder flower (Sambuci flos); yarrow flower and leaf (Millefolii herba); and linden flower (Tiliae flos).
– Action: Elder, yarrow, and linden flowers have febrifuge and anti-inflammatory effects due to the inhibition of prostaglandins by their flavonoid constituents. Prostaglandins play a role in fever development. Linden flower tea also induces nonspecific activation of the immune system. Yarrow has anti-inflammatory properties.
– Indications: Viral and bacterial infections of the upper respiratory passages.
– Contraindications: None known.
– Dosage and administration: Elder flower.
– Side effects: None known.

➤ Vitamin C Supplements
– Black currant (Ribes nigrae fructus); rose hip peel (Rosae pseudofructus).
– Action: Increases the stores of vitamin C, yielding unspecific enhancement of the immune system.
– Indications: For prevention and treatment of upper respiratory tract infections.
– Contraindications: None known.
– Dosage and administration:• Black currant juice: Dilute with hot water. Drink 1 glass with meals at noon and in the evening. Can be used by patients in all age groups.
• Rose hip tea: Steep 2–5 g of the herb in 1 cup of boiled water for 15 to 30 minutes. Take one cup, several times a day.
• Cold rose hips tea is an effective thirst quencher for patients with fever.
Note: These preparations have relatively low concentrations of vitamin C, and their beneficial action depends also on their flavonoid or anthocyanin content. Their effectiveness is not proven with clinical trials; they fall more into the realm of pleasant-tasting home remedies.
– Side effects: None known.

Remedies to Apply at the First Signs of a Cold
Circulatory Stimulants
➤ Powdered black mustard seed (Sinapis nigrae semen) or white mustard seed (Sinapis albae semen).
– Action: Mustard stimulates the blood flow in the mucous membranes of the mouth and nose by reflex mechanisms. It can prevent the outbreak of a cold if treatment by footbath is started early enough.
– Contraindications: Powdered mustard seed should not be used by patients with kidney diseases or by children under 6 years of age due to transdermal absorption of mustard oil.
– Dosage and administration: Powdered mustard seed should not be applied to mucous membranes. When used for footbaths, add enough warm water to cover the feet and ankles.
Warning: After treatment, all mustard particles should be removed by rinsing the skin with warm water. Prolonged exposure can cause skin irritation and blistering, especially in patients with sensitive skin.
– Side effects: Prolonged use (>2 weeks) of strongly heated preparations externally can lead to skin burns and nerve damage.

Diaphoretics (Sweat Inducers).
– Contraindications: None known.
– Dosage and administration: The tea should be taken as hot as tolerable during the early afternoon.
– Linden flower tea: 2 teaspoons per cup.
– Diaphoretic tea Rx: Sambuci flos 35.0, Tiliae flos 25.0, Liquiritiae radix 10.0, Rosae pseudofructus 30.0. Use 1 teaspoon per cup of boiled water.
Warning: Diaphoretic teas should not be taken on a full stomach.

Nonspecific Immunostimulants
➤ Vitamin C supplements.
➤ Immunomodulators.
– Dosage and administration: Oral dosage forms are used. Treatment should be continued for at least 5 to 6 days.
• Liquids: 20 to 40 drops (up to 2–4 mL [2 to 4 droppersful]), 3 to 4 times a day.
• Solids: 1 to 2 lozenges, tablets or capsules, 3 times a day, as directed on the product label.
Note: Echinacea should be taken at the first signs of a cold. The efficacy of the herbal remedy is questionable when treatment is started at the climax of the disease. The preventive effect of echinacea is still under investigation. Chronic Infections of the Upper Respiratory Tract

➤ Purple echinacea leaf juice, liquid extracts of the root of E. purpurea or E. angustifolia, or a combination of various parts of the two species can be very helpful in chronic upper respiratory tract infections and recurrent colds. Products manufactured from the fresh, or recently-dried plants are preferred by most herbalists.
➤ The usefulness of echinacea preparations past 2 weeks or so is still controversial and requires further clinical studies. Oral administration of alcoholic extracts and homeopathic tinctures (mother tinctures to D2 tinctures) is reported to be more effective than other preparations. The current data suggest that preparations combining echinacea with other herbs are more effective than echinacea alone.
➤ Siberian ginseng (Eleutherococcus senticosus) may also be useful.
Warning: The immune status of severely ill patients should be checked before starting immunostimulatory therapy. Supposed risks must be carefully weighed against the expected but unproven benefits of treatment.

Patients with Low Resistance to Infection
➤ Echinacea.
– Dosage and administration: Oral dosage forms are used. In the early phases of manifest disease, administer for a period of no less than 6 days and no more than 14 days.
• Liquids: 30 to 40 drops, 3 to 4 times a day.
• Solids: 1 to 2 lozenges, tablets of capsules, 3 times a day, as directed on the label.

Chronic Recurrent Respiratory Tract Infections
➤ Echinacea.
– Dosage and administration: Liquid oral preparations

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Diseases of the Nose and Nasal Sinuses and Herbal Remedies

Clinical Considerations

➤ General comments
– Acute catarrhal rhinitis (head cold)
• Head colds are most commonly caused by viruses, especially rhinoviruses.
• The preliminary stage is marked by nasal dryness, often with sneezing or severe itching.
• This is followed by a catarrhal stage with profuse discharge of watery mucus. Yellowish-green mucus is indicative of a secondary bacterial infection.
• After a few days, the viscosity of the nasal mucus increases, and the nasal membranes become inflamed, swollen, and congested. Drainage of mucus is impaired, and the local immune defenses are weakened. Sinusitis can develop if marked swelling of the paranasal sinuses occurs.
• The symptoms of a harmless head cold normally subside within a week.

– Acute sinusitis
• Acute sinusitis is characterized by congestion of the entire nasal sinus system. Individuals with congenitally narrow sinuses or narrowing of the sinuses due to chronic allergy-related inflammation are especially prone to sinusitis.
• Sinusitis often occurs secondary to rhinitis.
• The lack of sufficient drainage of mucus leads to an oxygen deficiency and inadequate mucous membrane function. The membranes start to produce a very thick discharge (dyscrinism) that is an ideal breeding ground for bacteria. The mucociliary clearance mechanisms responsible for transporting the discharge out of the mucous membranes become inactivated.
• Acute sinusitis is marked by a clear feeling of malaise, usually with fever and unpleasant sensations in the cheeks, eyes, or temples ranging from pressure sensations to severe pain. Earaches can also occur. The condition can become chronic if acute episodes do not fully subside before the next bout. Chronic sinusitis can lead to massive changes in the mucous membranes

➤ Herbal and general treatment measures
– All patients with respiratory tract infections should drink plenty of fluids.
– Nasal douches with isotonic saline solution are helpful, especially in the first two stages of acute rhinitis.
– The sooner herbal remedies are administered, the better the chance of successful treatment.
– Different herbal remedies have different effects. Some stimulate the immune system, whereas others counteract inflammation. Combinations of remedies can therefore be very useful.

➤ Clinical value of herbal medicine: Herbal remedies for acute rhinitis (head colds) are cheap and safe. They do not damage the mucous membranes of the nose, even when used for long periods of time, if administered at low doses. In the case of sinusitis, a qualified physician should determine whether antibiotic treatment is necessary. Herbal treatments are always useful adjunctive measures.
Recommended Herbal Remedies (Overview)
Antiphlogistics

➤ Chamomile flower (Matricariae flos, see p. 47).
– Indications: Acute rhinitis.
– Contraindications: Known allergy to plants from the Asteraceae (aster or daisy family).
– Action: The essential oil in chamomile is not irritating to the mucous membranes. Two of its constituents, β-bisabolol and chamazulene, counteract inflammation.
– Dosage and administration: Inhalation: Add 2 to 3 tablespoons dried chamomile flower, 1 teaspoon chamomile extract, or 5 drops of the essential oil to boiling water and inhale, several times daily (see p. 18). If this is not possible, administer chamomile nose drops or chamomile cream to each nostril, 3 to 4 times a day.
– Side effects: None known. Cold Receptor Stimulators

➤ Peppermint oil (from the leaves of Mentha piperita L. (see p. 103)); Mentha arvensis var. piperascens (mint oil; sometimes mislabeled as peppermint oil); menthol; camphor tree (see p. 45).
– Action: These preparations stimulate cold receptors in the nose, making it easier to breathe. They also have secretolytic, antimicrobial, and antiviral effects, but do not reduce swelling of the mucous membranes. The remedies are generally safe, except in the specified contraindications.
– Indications: Acute rhinitis.
– Contraindications: Exanthematous skin and childhood diseases, bronchial asthma. Infants and small children should not inhale peppermint oil or use nasal ointments containing menthol. Camphor should not be used during pregnancy or lactation. Individuals with hypertension or heart failure should use it with caution. Warning
• When administered to infants and small children, peppermint oil and preparations containing menthol and camphor can trigger respiratory problems ranging from shortness of breath and choking to laryngeal spasms or cardiovascular problems. These herbal remedies should never be applied to the face or to large areas of the chest or back of infants and small children.
• Do not apply peppermint oil, mentholated nasal ointments or camphor to the eyes or to broken skin. Camphor should not be allowed to come in contact with the mucous membranes.
– Dosage and administration: Peppermint oil: Add 2 to 4 drops of peppermint oil to boiling water and inhale, several times a day, or apply 1 drop of the oil directly below the nostrils (school-aged children and adults only). Camphor: Apply the ointment directly to the chest, several times a day, to inhale the vapors. Nasal ointment: Apply a pea-sized amount to the nostrils, 3 to 4 times daily.
– Side effects: Allergic skin reactions and unpleasant local sensations can occur in isolated cases (in conjunction with mentholated nasal ointments).Rare incidences of contact eczema (camphor) have also been reported.

Immunostimulants
➤ Purple echinacea herb (Echinaceae purpureae herba); Paleflowered echinacea root (Echinaceae pallidae radix).
– Action: Increases the ability of granulocytes and macrophages to ward off disease. The immunostimulatory effect of echinacea develops over a few days of oral administration. No comparable synthetic preparations exist.
– Indications: Chronic sinusitis.
– Contraindications: Chronic-progressive systemic diseases (e. g., tuberculosis), leukoses, inflammatory rheumatic diseases, multiple sclerosis, HIV infection, known hypersensitivity to composite plants, autoimmune diseases. Warning: In severely ill patients, the patient’s immune status should be checked before starting immunostimulatory therapy. The expected benefits of treatment must clearly outweigh the potential risks.
– Dosage and administration: Liquid tinctures are widely available that include either or both of E. purpurea and E. angustifolia. The roots, leaves, seeds, or flowers are included in many products, and are sometimes blended.
• Flavored liquid products that include glycerin instead of alcohol are popular, especially for children.
– Side effects: Rarely, allergic skin reactions, which disappear after use is discontinued.
– None of the available data confirms the efficacy of oral echinacea preparations for sinus infections. Compound Remedies for Acute Sinusitis

➤ We do not recommend single-component commercial preparations for this indication.
– Action: See those of the individual herbs contained in compound remedies. Herbal remedies are highly recommended for adjunctive treatment of acute sinusitis.
– Indications: Acute sinusitis; adjunctive treatment of chronic sinusitis.
– Contraindications: See cautions noted on labels of commercial products.
Warning: The patient should consult a physician if the symptoms persist for more than 7 to 14 days or re-occur periodically. Pregnant women should not use echinacea unless directed by a qualified health care practitioner.
– Dosage and administration: Oral preparations should be used as directed on the product label.
– Side effects: Occasionally allergic reactions in the skin, respiratory tract, and gastrointestinal tract. Although rare, stomach complaints, nausea, vomiting, and diarrhea can occur.
– Interactions: See cautions noted on labels of commercial products.

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Varicose Veins (Chronic Venous Insufficiency) Natural Treatment

Clinical Considerations
➤ General comments
– In a recent survey on the German population, 70 % of all females and 50 % of all males over 30 years of age were found to have some type of venous disease. Up to 86 % of the US population will have venous disease at some time in their lives.
– Lack of physical exercise, prolonged sitting or standing on the job, and obesity contribute to the development of venous insufficiency (varicose veins). The disease occurs when the supporting and stabilizing connective tissue structures around the veins weaken due to congenital factors, fat deposition, or hormonal changes, resulting in damage to the venous walls and incompetence of the valves.

➤ Symptoms: Venous insufficiency develops gradually, with the first signs being tired and heavy legs and swelling of the ankles (edema) in the evening. Increased venous pressure and oxygen free radicals render the venous walls increasingly permeable, allowing fluids, leukocytes, and proteins to escape into the adjacent tissues. This results in edema formation and a reduced supply of nutrients and oxygen to the surrounding tissues. In severe cases, necrotic leg ulceration can also develop.

➤ General treatment measures
– It is important to start treatment early, that is, as soon as the first symptoms develop, to delay the progression of the disease.
– Physical treatment measures can be very helpful: for example, regular leg elevation, leg exercises, short exercise breaks to interrupt prolonged sitting activity, treading cold water, losing weight, and endurance sports.
– Elastic stockings should be used regularly, but most patients refuse to wear them.
– In certain rare cases, short-term treatment with diuretics may be necessary. Loop diuretics are not suitable for this indication.

➤ Clinical value of herbal medicine
– The efficacy of “vein ointments” has not been conclusively demonstrated. Use of these preparations should be limited to adjuvant therapy of varicose veins parallel to physical therapy and treatment with oral preparations.
– Treatment with herbal medicinal compounds should be initiated in the early stages of chronic venous insufficiency to maintain the decongestant effects of treatment. The herbal measures combine well with physical treatment measures.

Recommended Herbal Remedies (Overview)
External Remedies
➤ Witch hazel bark (Hamamelidis cortex), horse chestnut seed (Hippocastani semen), red or white grape leaf (Vitis viniferae folium).
– Action: These herbs reduce leakage from the capillaries and have astringent, antiphlogistic, and antiedematous effects.
– Dosage and administration: These preparations are gently applied to the affected area, several times a day. Gels are suitable for long-term use with elastic bandages and stockings. Ointments penetrate into the deeper tissues and are therefore more suitable for inflammatory processes.

Warning: Inflamed areas of the skin should not be massaged, to avoid the potential detachment of blood clots. Topical remedies should never be applied to mucous membranes or broken skin.
– Side effects: Although rare, allergic skin reactions may occur.

Internal Remedies

➤ Horse chestnut seed (Hippocastani semen).
– Action: The therapeutic action of horse chestnut seed can mainly be attributed to β-aescin, a complex saponin with antiexudative, membrane-stabilizing, antiphlogistic, diuretic, and venotonic effects. Preparations containing aescin stabilize the lysosomal membrane. The therapeutic effects should develop within around 3 to 5 days of oral administration.
– Contraindications: Pregnant or nursing mothers should not use preparations containing alcohol. High-dose horse-chestnut formulations should not be used in the last two trimesters of pregnancy or when nursing a baby unless absolutely necessary.
– Dosage and administration: One oral 50 mg dose, twice daily.
– Side effects: Horse chestnut seed can irritate the stomach and should therefore be administered as an enteric-coated, slow-release dosage form.

➤ Melilot (Meliloti herba): The herb is derived from Melilotus alba or M. officinalis (sweet clover).
– Action: Melilot contains antiedemic flavonoids and coumarins with antioxidant, antiphlogistic, antiedematous, antispasmodic, and lymphokinetic effects. The herb does not affect coagulation of the blood.
– Dosage and administration: Up to 30 mg coumarin per day (oral).
– Side effects: Headache is a rare side effect. Preparations with a high coumarin content can also cause hepatitis.

➤ Butcher’s broom (Rusci aculeati rhizoma).
– Action: Contains steroid saponins with antiexudative, antiphlogistic, and venotonic effects.
– Contraindications: None known.
– Dosage and administration: Oral commercial preparations should be used as directed on the product label. Daily dose: 7–11 mg total ruscogenins.
– Side effects: Although rare, gastrointestinal complaints and skin rashes may occur.

➤ Grape leaf (Vitis viniferae folium)
– Action: The herbal remedy contains caffeic acid derivatives, tannins, organic acids, and flavonoids such as quercetin-3-glucuronide and isoquercetin, and has antiedemic and antiphlogistic effects.
– Dosage and administration: Oral commercial preparations should be used as directed on the product label.

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Natural Remedies to Atherosclerosis

Clinical Considerations
➤ General comments
– Half of all mortality in Germany is attributed to atherosclerosis, a disease in which the walls of the arteries degenerate progressively over the course of several decades. Free radicals of oxidized lipoproteins have been implicated as cofactors in the etiology of atherosclerosis.
– Individuals with high serum cholesterol levels and LDL : HDL ratios of more than 4.0 have a particularly high risk of developing atherosclerosis. This constellation is most prevalent in men of all ages and in postmenopausal women.

➤ General treatment measures: Dietary measures are the first and foremost treatment measures. The patient should be placed on a reduced fat diet and use dietary fats high in polyunsaturated or monosaturated fatty acids (e. g., olive oil, flaxseed oil), as well as fatty fish with DHA and EPA (salmon, halibut). Foods with both added refined sugar and saturated fatty acids should be strictly avoided. Therapy should be combined with regular aerobic exercise for best results, according to recent research.

➤ Clinical value of herbal medicine
– About herbs preparations play an especially important role in prevention. Their therapeutic action is directed against important mechanisms involved in the development of atherosclerosis.
– Synthetic antilipemic drugs clearly reduce cardiovascular mortality, but are expensive and sometimes highly prone to side effects. Moreover, they are not covered by most health care insurers when used primarily for prophylactic purposes.
– The herbal alternatives have a very low incidence of side effects and can be recommended for medically supervised self-treatment.

Recommended Herbal Remedies (Overview)
Antilipemic Herbs
➤ Artichoke leaf (Cynarae folium).
– Action: Standardized artichoke leaf extract inhibits cholesterol biosynthesis on various levels and increases the biliary elimination of cholesterol, resulting in an overall antilipemic effect. Antioxidant effects have also been observed in pharmacological experiments.
– Contraindications: Hypersensitivity to artichoke or other composite plants; biliary tract obstruction; cholelithiasis.
– Dosage and administration: 320–640 mg extract, 3 times a day, equivalent to 960–1920 mg per day. Antiatherosclerotic Herbs
➤ Garlic bulb (Allii sativi bulbus).

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Dementia Herbal Remedies

Dementia

Clinical Considerations
➤ General comments
– Mental functional disorders present with unspecific symptoms such as headaches, vertigo, insomnia, lack of concentration, and depression. The later reduction of cognitive and perceptive abilities as well as a loss of intellectual abilities, an impaired sense of time and space, and changes in personality develop as the disease progresses. In the final stages, these patients exhibit affective disorders, lack of motivation, impaired social behavior, and mental confusion.
– Primary dementia
• In around 80 % of cases, the death of nerve cells (usually cholinergic neurons in the basal forebrain) or the destruction of synaptic junctions (Alzheimer’s dementia) is the underlying cause of primary dementia. Multi-infarct dementia (10 %) and mixed types of dementia (10 %) are less common causes.
• Increased oxidative stress due to increased generation of oxygen radicals during ATP production from glucose is a possible cause of nerve cell loss. The radicals lead to lipid peroxidation and sodium-potassium-ATPase inhibition. This, in turn, causes pathological changes in the cell’s electrolyte distribution and, ultimately, cell death. In Alzheimer’s dementia, β-amyloid is deposited in nerve cells, the role of which is still discussed. At least 30 % of persons over 80 years are affected.
• Multi-infarct dementia is characterized by the increasing recurrence of lacunar infarcts and damage to the cerebral medulla near the lateral ventricle. The high level of platelet-activating factor (PAF) activity is of pathogenetic importance. The increased activity results in increased platelet aggregation, microcirculatory impairment, increased vessel permeability and, ultimately, edema formation.
– Secondary dementia occurs as a result of cardiovascular diseases, hormone changes, infections, and poisoning (e. g., drug poisoning).

➤ Clinical value of herbal medicine
– Acetylcholinesterase inhibitors have recently been adopted in the treatment of dementia. These herbal remedies should always be administered under the watchful eye of a physician. The effectiveness of so-called nootropic drugs such as piracetam is debated.
– The efficacy of ginkgo extract for symptomatic treatment of all types of primary dementia has been demonstrated in various clinical studies.
– Treatment of primary dementia must be started in the early stages in order to slow down the progression of the disease. A psychometric test should be conducted after 3 months of therapy to assess treatment success.
– In secondary dementia, eliminating the underlying cause is the primary goal of treatment.

Recommended Herbal Remedies on Dementia(Overview)

Symptomatic Treatment
➤ Ginkgo leaf (Ginkgo bilobae folium).
– Action, dosage, commercial products: Ginkgo bilobae folium.

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Vertigo and Tinnitus Alternatives

Vertigo and Tinnitus

Clinical Considerations
➤ General comments
– Systemic vertigo: Usually occurs as a result of microcirculatory and macrocirculatory disturbances in the inner ear and is often associated with tinnitus and other hearing problems.
– Nonsystemic vertigo: This form of vertigo is much more common and usually occurs as a result of hypertension, hypotension, cardiac arrhythmias, or decreased mental performance.
– Tinnitus: The subjective perception of sounds (whistling, rustling, or ringing noises) in one or both ears, often due to microcirculatory disturbances.

➤ Clinical value of herbal medicine: Combinations of physical therapy and herbal remedies that modify the cerebral metabolism have proved to be effective. The effectiveness of Ginkgo biloba on aural vertigo has been demonstrated in clinical studies. Benefit should be assessed after three months of application.
Note: Sudden hearing loss is characterized by a unilateral loss of hearing of rapid onset with or without tinnitus. The patient should receive immediate medical attention, because complete restoration of health is possible only if treatment is initiated within the first 24 hours. Herbal remedies are not recommended for causative treatment.

Recommended Herbal Remedies (Overview)
Symptomatic Treatment
➤ Ginkgo leaf (Ginkgo bilobae folium).
– Action, dosage, and administration: search Ginkgo bilobae folium.

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Hypotension Herbal Remedies

Hypotension

Clinical Considerations

➤ General comments
– Hypotension is defined as a chronic reduction in the systolic blood pressure to < 100 mmHg.
– Primary hypotension is common, but clinically significant only if the symptomsare severe. The causes of hypotension are unknown. Fatiguability and orthostasis are typical symptoms.
– Secondary hypotension is rare. It can occur secondary to cardiac or adrenal insufficiency, or as the result of liver disease or cancer. When possible, the causes of the disease should be treated. No clinical data on herbal treatment of hypotension are currently available.

➤ Clinical value of herbal medicine
– Primary hypotension can usually be managed by nonpharmaceutical measures, such as exercise and physical therapy. It does not appear wise to prescribe medications unless the patient is recovering from illness of surgery or is under great physical and mental stress.
– Herbal remedies for primary hypotension are low-side-effect alternatives to synthetic drugs and chemical remedies, which often fail to provide satisfactory results, especially in long-term treatment. The herbal remedies are safe to use for self-treatment. Clinical studies are not available.

Recommended Herbal Remedies (Overview)

External Remedies
➤ Rosemary leaf (Rosmarini folium).
– Action: The essential oil in rosemary leaves stimulates the blood flow and has central analeptic effects attributed to the constituents camphor and cineol.
A circulatory tonic effect of the herbal remedy has been empirically demonstrated.
– Contraindications: Heart failure. (See Herbal Hydrotherapy.
– Dosage and administration: Steep 50 g of rosemary leaf in 1 liter of boiled water for 30 minutes, then strain and add to full bath or hip bath. Bathe for 10 minutes at 34–36 °C after getting up in the morning and rest for 1 hour afterward.
Note: Rosemary baths are stimulating, they should not be taken before retiring at night.

Internal Remedies
➤ Rosemary leaf (Rosmarini folium, see p. 112).
– Action: See above.
– Dosage and administration: Take 5 drops of rosemary tincture (1: 5) in a little warm water, 15 minutes before meals, 3 times a day.

Clinical Considerations
➤ General comments
– The incidence of peripheral and/or cerebral circulatory disturbances is growing since the average age of the population is increasing in many states.
– Peripheral vascular disease (PVD) is characterized by the development of arteriosclerotic vessel changes, especially in the extremities. Low-density lipoprotein (LDL), elevated cholesterol levels, the coagulatory system, and platelet function play a decisive role in these changes. Their interactions are responsible for the deposition of arteriosclerotic plaques on blood vessel walls. This ultimately leads to narrowing and occlusion of the blood vessels. Since this is related to an oxygen deficiency, larger quantities of free radicals develop and damage the vessel walls by way of oxidized LDL.

➤ General treatment measures
– It is essential to eliminate the risk factors (e. g., smoking and lack of exercise) and to ensure optimal management of diabetes, elevated serum lipid levels, and arterial hypertension.
– Regular physical therapy and physical exercise are achieved in only onethird of all patients with peripheral vascular disease because of concomitant cardiological or orthopedic diseases and/or lack of motivation.
➤ Clinical value of herbal medicine: Ginkgo biloba extracts are useful alternatives to the corresponding synthetic drugs and chemical remedies.

Recommended Herbal Remedies (Overview)
Symptomatic Treatment
➤ Ginkgo leaf (Ginkgo bilobae folium).
– Action: The acetone-based dry ginkgo biloba leaf extract received a positive monograph rating. The therapeutic effects of ginkgo biloba extract (GBE) are largely determined by its flavone glycoside and sesquiterpene lactone components.
• Positive rheological effect (reduction of erythrocyte and platelet aggregation)
• Inhibits free radical production
• Increases prostacyclin synthesis
• Antagonizes platelet-activating factor (PAF)
• Neuroprotective
• Improves cellular energy metabolism
– Dosage and administration: Daily dose of 120–160 mg, taken orally in 2 or 3 divided doses, for a period of at least 6 weeks.
– Side effects: Although very rare, mild gastrointestinal complaints, headaches, and allergic reactions can occur.

Prophylactic Treatment
➤ Garlic (Allii sativi bulbus).
– Action, formulations, and dosage.

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