Sunnyfield Herb Farm

The Three Basic Principles of

Traditional Western Herbalism

Matthew Wood M.Sc. (Herbal Medicine)

Registered Herbalist (AHG)

One theory has it that we should abandon the herbalism of the past, instead binding our destiny to modern medicine. According to this view, herbs should be used like mild drugs, suited to the treatment of molecular changes in the body, completely independent of the holistic context within which the disease developed. This, however, is not holistic medicine, and it is not the best way to use herbs.

Drugs are suited to specific molecular changes in the body because they are isolated molecules themselves, but each herb contains a slurry of chemicals – dilute, synergistic and gentle in action – which instead of operating on a single specific site in the body nudges many different sites and through them, different tissues, functions, and organs. In this way herbs achieve a synergistic effect throughout the body. This effect is also holistic because the herb stimulates whole functions rather than isolated molecular sites.

In order to use medicinal plants effectively we therefore need to understand how the body works in a holistic fashion, with numerous functions integrated together, rather than tinkering about with isolated molecular changes. This is really a more sophisticated way of thinking than is prevalent in modern medicine, because it requires an understanding of integrated processes rather than isolated ones. At the same time, this is a return to traditional knowledge, because this is the way doctors thought in the past, when all they could perceive and understand were the broad patterns of behavior of the organs and systems of the body. Thus, we need to recover the rich knowledge of the past and bring it up to date with recent medical discoveries.

Instead of thinking of diseases as precise germ entities or molecular lesions observable in isolated tissue samples, we need to understand disease in terms of patterns of imbalance. This is not new knowledge. Plato described it perfectly twenty five centuries ago in a passage in the Timaeus (Longrigg, Greek Medicine, 1998, 160):

Diseases, except where they are very dangerous, should not be irritated by drugs. For every disease has a structure that resembles in a certain manner the nature of living creatures. For the composition of these living creatures has prescribed periods of life for the species as a whole. . . . It is the same with the constitution of diseases; whenever anyone destroys this by drugs, contrary to the allotted period of time, many serious diseases are wont to arise from those that are few and slight. Consequently, so far as leisure permits, one should control all such diseases by regimen, instead of irritating a troublesome evil by administering drugs.

The meaning is even clearer in the Greek, where “living creature” [zoion] means both an animal and a symbol or pattern, as in zodiak. At any rate, as Plato says, it is dangerous to thwart and pervert disease processes. They will only be driven deeper in the system and pop up somewhere else, more unpleasant and dangerous than before.

The Three Basic Principles of Herbal Treatment

In order to practice herbalism holistically, we need to understand three basic principles: (1) the affinity of the herb to a pattern of disease, (2) the affinity of the herb to an organ or system, and (3) the affinity of the herb to the basic pattern of self-governance in the organism (from center to circumference). This basic plan was set out by Galen, a Roman physician in the third century CE, in his Ars medica. Nicholas Culpeper, the colorful Reformation London herbalist, translated this as A Key to Galen’s Art of Physick (1652). No one has ever stated the principles of herbalism more succinctly.

I. Energetics or Patterns of Disease

Aristotle broke the natural world up into four basic qualities, hot, cold, damp, and dry. These were used in Greek medicine to define the basic patterns of imbalance and the properties of plants. Thus, by hot to cold, or damp to dry, the Greeks envisioned the treatment of disease. For instance, cayenne is warming and stimulating, increasing the circulation of the blood when it is tending to coagulate and the action of the heart to push it. Lavender is cooling, and thus stops a headache from a surfeit of blood and heat to the head – the blood carries the heat, and both are in excess. Marshmallow, which is moist, is used for dry coughs and mucous membranes. Astringents such as blackberry leaf are drying; they are used for stopping the discharge of fluids, as in diarrhea.

Galen acknowledged only the four qualities of Aristotle, but for the sake of completion, and better clinical work, we need also to include the two basic conditions described by his opponents, the methodist physicians: too much tension (status strictus) or too much relaxation (status laxus). The four qualities represent fixed, oppositional imbalances, while the two states represent dynamic imbalances due to change or exhaustion. Putting them altogether we have a system of six types, which corresponds to the system of six “tissue states” introduced by the physiomedicalists, or botanical physicians (the descendants of Samuel Thomson) in the early twentieth century. Putting these two systems together we have the following six conditions of imbalance.

Heat/Excitation. This corresponds to the symptoms of inflammation: heat, redness, swelling, and tenderness. The tongue is usually elongated, red, and pointed – like a flame, pulse rapid or raised to the surface or both. This state does not correspond to the source of all inflammation, which can be from drying out, blockage, rotting of tissue, bacteria, etc., but only to that which arises from an excess in the organism. Thus, there are greater tendencies to over excitability of the tissues, to excess immune reactions, and to heat and inflammation generated through excessive activity or stimulation. Heat corresponds to is oxidation in chemistry, so this is an overly oxidized condition, and the remedies here are cooling, sedating, or – as they say today – antioxidant. That includes the cooling remedies we like to eat and drink in the summer derived from fruits and berries. Hence, the great cooling remedies are rose, hawthorn, peach, wild cherry (rose family), lemon, lime (citrus), yellow dock root, rhubarb (rhubarb family), elder and honeysuckle (honeysuckle family). There are also some exceptional coolants such as lemon balm (mint family) and yarrow (asteraceae). Elder and yarrow are both stimulating (warming) and sedative (cooling), making them particularly effective in fevers, chills, and intermittent chills and fever. The hyperthyroid remedies can also be mentioned here: lemon balm, motherwort, bugleweed.

Wind/Constriction. This is the status strictus of the methodists; we can adopt the concept of “wind” from Chinese medicine. It corresponds to tension or constriction. The characteristic symptoms are sudden changes and onsets, alternating or changeable symptoms (like the wind), and tension of the mind or body. The pulse is resistant, wiry, or hard. This condition usually involves the nervous system, though it is possible for blockage of the pores, fluids or blood to cause tension. In fact, one of the most characteristic symptoms is blockage of the pores of the skin, cessation of perspiration, due to wind, chill, or fever. The old theory of treating fevers and colds was to open the pores of the skin, not to “kill germs.” The condition of the skin (see below under government from center to circumference) is the first line of defense which is disordered before the appearance of germs, or the need to kill them. Thus, the remedies for constriction are relaxants, antispasmodics, and diaphoretics. The Chinese discovered that most of the remedies for wind or opening the pores are “acrid” in flavor (like bile in the back of the throat) or bitter/acrid. Thus, relaxants and diaphoretics include catnip, valerian, viburnum, hops, wild lettuce, lobelia, blue vervain, boneset, and others. A good remedy here is agrimony, though it is more astringent than acrid.

Dry/Atrophy. There are two kinds of fluids in the body: water and oils. It takes fluids to move food from the digestion to the cell, so if there is dryness there will also be lack of nutrition and eventually wasting or atrophy. Thus, the symptoms of dry/atrophy are dryness of the tongue, digestive tract (gas, constipation), and skin (flakey, irritable, skin outbreaks). In severe cases there will be lenification (weight loss) and weakness. The tongue is dry; in severe cases withered. The pulse is usually weak on one side (usually the left). These people need fluids, both water and oil, or herbs that carry in water and oil with the special intelligence herbs have to reestablish pathways and functions that the body has forgotten or lost. They also need foods to rebuild. Many types of substances are useful. Because water follows salt, salty plants are needed to break up hardness (emollients) and because bitters cause salivation, bitters can sometimes be used in this tissue state (also in others). The following are the most important remedies: Marshmallow, slippery elm, comfrey, fenugreek (mucilaginous, or moistening), plantain, chickweed, cleavers (moist), burdock, sage, angelica, psyllium seed, fenugreek (oily), marshmallow (salty), slippery elm, American ginseng, burdock, codonopsis, rehmannia root (sweet/nutritious), mushrooms, nettles (meaty, proteinaceous), nettles, slippery elm (minerals, earthen salts), burdock, American ginseng, Oregon grape root, poplar bark (bitters), plantain, psyllium seed husks, cleavers (fibrous). Aging processes are usually associated with dry and atrophy.

Damp/Relaxation. Relaxed tissues have open pores that lose fluids or secretions, thus this is both a relaxed and a damp tissue state. Here the fluids are flowing over and out of the tissues. The tissues, in turn, are likely to lose their tone or elasticity, and to become saggy or prolapsed. The major symptoms are loss of fluids through one or more of the channels of elimination (skin, lungs, bowels, kidneys, menses), leading to profuse sweating, expectoration, diarrhea, urination, or watery, excess menses. The electrolytes are also lost, including potassium, so that it is hard to concentrate the urine – urine pale and copious. Tissues tend to prolapse: hemorrhoids, varicose veins, uterus. Tongue is moist as shown in streamers running down the sides. Pulse is nonresistant or relaxed. Skin pale, with prominent blue veins, tendencies to anemia. This is the state that needs astringents: sumach, oak bark, raspberry leaf, blackberry, alum root, bayberry bark, plantain, etc. Some of the mineralizing plants can also help, like oak, plantain, and nettles.

Damp/Stagnation. This is a second kind of dampness, in which the fluids do not run off, but get stagnant and build up in the tissues. When fluids build up they tend to precipitate into mucopolysaccharides, which gum up the internal works. These were called “humors” in the old days. Also, undelivered food and waste materials build up in the fluids, causing what used to be called “bad blood” or “toxic blood.” The liver is overworked, the channels of elimination are stressed to carry off the toxins, leading to skin eruptions and lesions, and the thyroid is usually low – hence a low metabolism, too low to move the fluids and burn off the toxins and consume all the food. “Bad blood” is treated with the alteratives or blood cleansers such as dandelion, burdock, Oregon grape root, red clover, nettles, yellow dock root, black walnut, and the laxatives, such as yellow dock, rhubarb, cascara sagrada, black walnut, and butternut. Blackened hulls of black walnut are a superlative remedy for hypothyroidism – I learned this from herbalist Phyllis Light, of Arab, AL.

Cold/Depression. This condition is the opposite of heat. The cells and tissues are deficient of energy. As a consequence there is an internal cold (not an acquired cold from chill, though the person is more prone to chilliness). Nor is the skin cool and damp, as in relaxation, from the passage of fluids out of the body. Skin cold, inactive, pale or dark, complexion pale, dark, blue (from coagulated blood), black. Activities of the body are suppressed, inviting in the presence of bacteria, viri, and parasites, which live off the foods the cells can’t use, or which impose themselves on the body, suppressing function with their exotoxins, and causing subpar vital functions. Tendencies to sepsis, necrosis, putrefaction. Pulse low or slow. Tongue dark. Spirits often depressed. Remedies here are the numerous warming stimulants of herbalism: thyme, rosemary, sage, angelica, cabbage, mustard, shepherd’s purse, cayenne, sassafras, echinacea, prickly ash, bayberry bark, etc. Stimulants are often combined with astringents or alterative or laxatives.

II. Organ Systems

This is a subject which is too grand to take up in a short lecture or paper, but the main point is that we want to understand how the entire organ system works, not just the parts in their isolated molecular glory. Thus, for instance, we want to know that a lack of saliva and dry mouth will be associated with poor secretion in the stomach, tension, food sitting and rotting, gas, intestinal colic, poor digestion, and weight loss. If the urine is concentrated and dark we think of coolants and relaxants, if copious and pale, we think of astringents and sometimes stimulants. We do not think of the specific pathways in the liver, but of the general function of detoxification and rebuilding of food/toxins, and so we use metabolic stimulants or alteratives – the Greek word for metabolism was “alteration.”

To give an example of differentiation in the treatment of a single organ: we do not just understand high blood pressure in isolation, but in relationship to general wrongs in the organism. Thus, the BP associated with beta-blockers calls for relaxants to the nervous system. When associated with ACE inhibitors and diuretics we need salt-balancing remedies that retain potassium and strengthen the kidneys. When statins are prescribed there is an indication, not only need for exercise and dietary restraint, but for better oils, prostaglandins, and herbal blood thinners.

The following is just a short list of organ-affinities:

Brain (wood betony)
Neck and spine (blue vervain, black cohosh)
Throat glands/lymphatics (cleavers, calendula, scrophularia, poke, ceanothus)

Ears (lady’s mantle, ground ivy, pulsatilla)
Eyes (eyebright, goldenrod, pulsatilla)
Throat passages (marshmallow, elecampane, sage, propolis)
Trachea (calamus)
Bronchial tubes (garlic, Easter lily, elecampane)
Lungs (elecampane, coltsfoot, mullein, pine, usnea, white hoarhound)
Heart (hawthorn, cayenne, linden flower)
Vasculature (collinsonia, horse chestnut, oak bark, black walnut)
Blood (cayenne, sassafras, yarrow)
Stomach (meadowsweet, wood betony, lemon balm)
Intestines (yellow dock root, rhubarb, plantain, butternut)
Kidneys (sumach, pipsissewa, nettles, string beans)
Bladder (monarda, corn silk, yarrow, buchu)
Adrenal cortex (burdock, licorice, Siberian ginseng, spikenard)
Thyroid (lemon balm, black walnut, cleavers, chickweed)
Pituitary (pulsatilla, vitex)
Sex glands and hormones (white peony, black cohosh, angelica, shepherd’s purse, blue vervain, raspberry, mitchella, blessed thistle, mugwort, Easter lily, white hoarhound)
Nerves (lemon balm, oatseed, skullcap)
Muscles (lady’s mantle, shepherd’s purse)
Connective tissue (true and false Solomon’s seal, horsetail)
Bone (boneset, comfrey, true Solomon’s seal, nettles, horsetail)

III. Government from Center to Circumference

The hypothalamus is the “master gland” of the endocrine system. It regulates the internal temperature and fluid levels through sensors, the autonomic nervous system, hormones, and feedback loops. It also regulates the periphery in the same manner – the “vents” of the exterior open and shut to keep the internal temperature constant. This includes the sweat glands, capillaries, sebaceous glands, and “shivering mechanism.” When the body is overheated the sweat glands open up to release sweat, which cools the body as it vaporizes off the surface; it opens the peripheral capillaries to release heat to the surface. When the body is overcooled it elicits the shivering mechanism to generate heat, and if the body is cold and damp the oily sweat is poured out to coat the skin and retain heat. The healthy surface temperature is slightly lower (98.6º) than the interior (100º) so there is always a gentle flow from interior to exterior.

Samuel Thomson realized that the organism was like a “fountain” and that it flowed from interior to exterior, bringing in a sense nutriment, heat, and life to all corners of the body, while it was protected from the cold and exterior by the skin or periphery. If the internal heat died down the organism was not able to defend the periphery and cold, blockage, and disease crept in. Likewise, if the exterior was too weak cold and blockage burst there way in forcefully and attacked the internal heat. Thus, the object of medicine was to maintain the heat in the center, the flow to the periphery, and the integrity of the defensive system at the perimeter. This gives us a model to understand the self-regulation and orderliness of the organism.

Galen classified herbs according to whether they opened, closed, moved up or down, thinned or thickened. Here are a few pointers.

Opening. Hyssop, pleurisy root, elder.
Closing. Sweet leaf (Monarda fistulosa), sumach.
Open and Close. Burdock, blue vervain, sage.
Thins. Elecampane, dandelion, sassafras, parsley.
Thickens. Slippery elm, marshmallow, comfrey.