Medical Herbalism: Clinical Articles and Case Studies

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Pain - Specific medication for pain with toxic botanicals

by Paul Bergner

Medical Herbalism 10-31-94 6(3): 6-8

The term “specific medication” played an important part in the development of the Eclectic medical movement of the 1800s and early 1900s in the U.S. The concept is similar to homeopathy in that very specific symptom indications were compiled for single remedies. A primary source of information is John Milton Scudder’s Specific Medication and Specific Diagnosis. Specific medication is covered to a lesser extent in King’s American Dispensatory, and Harvey Felter’s Eclectic Materia Medica, Pharmacology, and Therapeutics. (These above books are available from Eclectic Medical Publications, in Portland OR.) Another compilation by symptom, in the model of a homeopathic repertory, is the Homeopathy Prescriber and Clinical Repertory of Medicinal Herbs, by F. Harper-Shove, from Jain Publishers, in New Delhi.

In Eclectic practice, the use of potentially toxic botanicals, such as Bryonia alba and Arnica montana was common. In fact, Anemone pulsatilla and Gelsemium sempervirens, two other toxic botanicals, were among the ten most-often prescribed herbs by the Eclectics in the 1920’s. These herbs were given in small doses for very specific symptomatic indications. A common method was to put from ten to thirty drops in four ounces of water, and prescribe it by the teaspoon. Modern Naturopathic physicians are also trained in the use of these botanicals. In practice, a modern ND may sometimes add a small amount of a toxic botanical to a tincture as a synergist, to add potency to it, matching the herb to the symptom picture of the patient.

The Eclectic literature and homeopathic literature do not always agree on guiding symptoms, so in this article I have favored the Eclectic literature over the homeopathic when they disagree. This seems reasonable, because the Eclectic literature grew out of direct clinical observation, and homeopathic literature is sometimes derived theoretically, or is not based on direct experience with crude dose medicines.

The use of potentially fatal medicines has been a controversy for a long time in Western herbalism. I only include them here because no discussion of the herbal treatment of severe pain would be complete without them. The Eclectics were well-trained in monitoring for symptoms of overdose, and modern practitioners should be cautious with these powerful healers. Because they are not usually available for sale to the unlicensed professional, a few words of caution are in order. If you are thinking of making your own tinctures, they must be prepared according to the guidelines in the U.S. Pharmacopoeia (the 1905 version has most of these in it.) If you inadvertently make a tincture that is double or triple strength, what seems to be a normal dose may in fact be toxic. When using these toxic botanicals, think of the same precautions you would use with a loaded gun. Like a gun, they may be illegal to use in your state. Like a firearm, you shouldn’t use them without proper training, and if you have them, keep them under lock and key or otherwise away from children or others who might take them inadvertently.
Copyright 2001 Paul Bergner    326


    Medical Herbalism: Clinical Articles and Case Studies    

Aconite napellus

Actions: Antipyretic, diaphoretic, depressant (both sensory and motor), anodyne, antirheumatic, promotes secretions, counterirritant.

Symptom picture: enfeebled, asthenic, with hot, dry skin, with either elevated or depressed temperature; chilly sensations.

Pulse: small, corded, feeble, frequent, pulse.

Conditions: neuralgia, trigeminal neuralgia, rheumatic conditions, arthritic our gouty pain, dental pain.

Contraindications: great debility

Toxicity: Aconite is considered by some to be too strong for internal use, because the difference between the effective and the toxic doses is small. It is used in Chinese medicine in a form that reduces toxic potential. It was used safely and effectively in Eclectic practice, however, and is used in naturopathic practice today; with proper caution. First signs of a toxic reaction are tingling and burning followed by numbness in the mouth and stomach. this can spread to the limbs. Poisonous doses result in profound sedation and death is possible from respiratory and cardiac paralysis four to five hours after a toxic overdose.

Dose: 1/30 to 1/2 drop. Drop of the tincture are added to a larger amount of water or other tincture to accomplish this small dose. Ten drops added to a tincture for pain may act as a synergist.

Anemone pulsatilla

Actions: sedative, analgesic, spasmolytic, skin irritant

Symptom picture: debility, pain after exposure to wind, neuralgic or rheumatic pain that shifts from place to place. Pains relieved by cold, worse from heat, demoralization of spirits. Left-sided. Patient is nervous, restless, but despondent and sad, disposed to look on the dark side of life, with active imagination for disease, a fear of impending danger, nervousness accompanying sexual or menstrual pain or worries. Suppressed menses with chilliness.

Pulse: soft and weak

Conditions: tension headache; frontal headache from nasal catarrh; bilious headache, menstrual headache, pain of male or female reproductive system; toothache from abscess, earache after exposure to cold, wet wind, nervous collapse due to overwork.

Toxicity: first sign is burning in the mouth and throat, gastric irritation, marked prostration, large doses may cause stupor, coma.

Dose: 1/10 to 10 drops (5-30 drops in 4 ounces of water, 1 teaspoon every 2-3 hours.)

Arnica montana

Actions: vulnerary, analgesic, antirheumatic, stimulates local circulation.
Copyright 2001 Paul Bergner    327


    Medical Herbalism: Clinical Articles and Case Studies

Symptom picture: deficient nervous response, sluggish vascular power, debility, depressed function, advanced stages of exhausting disease.

Conditions: muscle pain from injuries or overexertion, rheumatism with cold skin and debility. Backache when accompanied by nervous depression and poor circulation. Sore throat (gargle). Hemorrhoids (compress), bruises (internal and external use).

Toxicity: Nervous excitement and restlessness. Some herbalists use this only for external use, and only on unbroken skin.

Dose: 1/4 to 10 drops internally. 2 ounces can be lethal.

Atropa belladonna

Actions: antispasmodic, especially of gastrointestinal and involuntary muscle; secretory suppressor; bronchial dilator.

Symptom Picture: dull, expressionless face, dilated pupils, red face and extremities, sluggish circulation, slow, labored breathing, cold extremities, congestion impairs capillary, circulation.

Pulse: soft, oppressed, compressible

Conditions: Spasm of involuntary muscle, intestinal spasms: ulcers, gastritis, colitis, colic, acute cystitis, spasms of anus, uterus.

Toxicity: First signs are dry mouth and dilation of pupils, Blurred vision, hot, dry, flushed skin, inhibition of sweating. Excitement, headache, confusion, hallucination. three berries of the fresh plant can be fatal for children to eat.

Dose: 1-10 drops. A dose of ten drops, three times a day, may result in dry mouth within two days, at which time the dose should be reduced. Duration: 3-4 weeks if necessary for gastrointestinal conditions.

Bryonia alba

Actions: febrifuge, anodyne, antirheumatic, stimulant (of nerves), expectorant, diaphoretic.

Symptom picture: exudation stage of illness; bruised, sore feeling; cutting, tearing, stitching, pain, worse on movement, worse with pressure, worse at night; weary, apathetic, languid, too tired to think; dry skin, great thirst.

Pulse: hard, wiry, or moderately full.

Conditions: frontal headaches, irritated cough, joint pain, finger joints.

Toxicity: large doses may cause colic, vomiting, diarrhea, congestive headache, and collapse.
Copyright 2001 Paul Bergner    328


    Medical Herbalism: Clinical Articles and Case Studies    

Gelsemium sempervirens

Action: analgesic, sedative, and hypotensive.

Symptom picture: flushed face, bright eyes, contracted pupils, great heat, and nervous unrest; pain sharp, shooting, or stabbing, excitement, restlessness, stiffness, high muscular and nervous tension. Pain worse on commencing motion, but better on motion. Aggravated by warmth or rest.

Pulse: sharp and quick, not always hard.

Conditions: Inflammatory arthritis, lameness, stiffness and pain, conditions of the bowels, stomach, urinary organs, or cerebro-spinal; migraine, neuralgia, sciatica, acute cystitis (bladder infection).

Contraindications: avoid in debilitated cases with low blood pressure or depressed respiration.

Toxicity: first symptoms are visual disturbances (double vision), muscular weakness, dropping lower jaw, slow respiration and lowered blood pressure are intermediate symptoms. Death has occurred from respiratory paralysis.

Dose: 1-30 drops of tincture.

Hyoscyamus niger

Actions: Antispasmodic, hypnotic, nerve sedative, anodyne.

Symptom picture: Patient weakened from prolonged illness. nervous irritability. unrest and insomnia in the anemic, debilitated, the aged, infants. Choking sensations, spasms, nervous unrest in Conditions: muscular rheumatism, nervousness.

Contraindications: feeble pulse, depression, extreme exhaustion

Toxicity: rapid heart rate, salivation, dilated pupils, headache, hallucination, dizziness.
Copyright 2001 Paul Bergner    329