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3. Case Study: Pre- and post-surgical care for recovered alcoholic undergoing hip replacement
4. Materia medica: Fringe tree bark
 

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Culpeper’s Herbal is a classic in Western herbalism. First published in 1653, the book shocked
both the public and the medical establishment in London, because Culpeper had the audacity to
translate the current Latin medical books into English, making the information available to the
general public. Culpeper worked as an herbal pharmacist with extensive clinical experience in
herbalism, and soundly criticized the medical elite for practicing on the basis of theoretical book
learning rather than hands-on experience. His insights into the clinical use of many of the herbs
remain valuable today. The information can be difficult to access, however, because the book is
arranged by seventeenth century common plant names, and some of the astrological language of
the book, understandable as a code for plant activity and organ affinity at the time, has been lost
to the modern generations. Link directly to Culpeper’s Herbal at
http://www.bibliomania.com/NonFiction/Culpeper/Herbal or access it through the materia
medica or therapeutics sections of http://medherb.com in the future.
 

>>>Updates at http://medherb.com<<<
We have uploaded a number of articles to the http://medherb.com site, and installed a search
engine so you can search all the directories of the site by keyword. Enjoy.
 
 

>>>Case Study: Pre- and post-surgical care for recovered alcoholic undergoing hip
replacement<<<

The following case is from the teaching clinic at Rocky Mountain Center for Botanical Studies in
Boulder, CO.   http://herbschool.com

Although this case deals with a specific patient and a specific type of surgery, the strategies it
describes might be relevant to many patient and surgery types. Consult your phycisian or
qualified alternative practitioner before attempting to self treat in preparation for surgery.
Especially risky is any therapy that might thin the blood.

March 28th
A 58 year-old male, 6'3", 200 lbs, asked a student in our clinic for a consultation for preparation
for hip replacement surgery. He had a similar operation on the other hip one year previously, with
no complications and a satisfactory result. The patient was scheduled to give a pint of his blood
on each of May 18, May 25, and June 1 for transfusion during surgery scheduled on June 8.
Patient is a recovered alcoholic, and wants no alcohol tinctures.

Strategy prior to surgery
1) enhance immune system
2) protect liver during anesthesia
3) promote tissue integrity and wound-healing capacity
4) fortify and nourish the blood in preparation for transfusion
5) avoid blood-thinning effects
6) minimize traumatic pain
7) minimize adverse effects of antibiotics
8) Support natural anti-inflammatory mechanisms

Strategy after surgery
1) assist with post-anesthesia detoxification
2) promote wound healing
3) deal with pain as needed
4) avoid interactions with a blood-thinning medication to be given in the days after the procedure.

Recommended to implement immediately
1) A nutritional formula to build the blood (Metagenics Hemagenics) containing iron, folic acid,
B6, B12, and other nutrients. 4 tablets daily until 3 weeks after surgery.
2) 3 grams vitamin C per day, in divided doses. Boosts immunity, enhances white blood cell
formation, increases antibody production and interferon activity, cofactor for production of stress
hormones, enhances wound healing.
3) Essential fatty acid supplementation. Patient already takes flax seed oil, and a fish oil. Up
dosage to 4 capsules of each per day.
4) Proanthocyanidins (grape seed extract) 400 mg/day therapeutic dose. Increases intracellular
vitamin C levels, decreases capillary fragility, antioxidant, inhibits collagen destruction.
5) Discontinue vitamin E supplementation (patient was taking 200-400 mg) to prevent blood
thinning effects.
6) Discontinue aspirin use to prevent blood-thinning effects.
7) Discontinue NSAIDs. Block collagen synthesis and wound healing.

Note: Patient discontinued aspirin and reduced NSAID use from 4-6 per day to one per day most
days (some days used none).

8) L-Phenylalanine, 200-400 mg day, for pain relief

9) Herbal pain formula:

Cimicifuga racemosa (black cohosh)      35 ml     Nervine, antispasmodic, analgesic
Eschscholtzia californicum   (California poppy) 35 Sedative, antianxiety, analgesic
Pedicularis spp   (betony) 20 muscle relaxant
Lobelia inflata     (lobelia) 10 antispasmodic
Leonurus cardiaca (motherwort) 10 sedative, nervine, anodyne

Sig: 60 drops four times a day. in warm water

8) Avoid nightshade family vegetables
9) Avoid simple sugars. Client had difficulty doing this, but dramatically reduced sugar intake.
Had previously consumed large amounts of candy, a habit acquired after stopping alcohol.
10) Increase consumption of onions and garlic (in dietary amounts only, no garlic capsules).
11) Reduce coffee and substitute green tea. Client did reduce the coffee, but only occasionally
drank green tea.
12) Introduce shiitake mushrooms into diet on a regular basis. Client did not comply.

To start two weeks prior to surgery
1) Commercial probiotic (acidophilus plus fructooligosaccharides), as directed on bottle.
Continue for two weeks after discontinuation of scheduled antibiotics.
2) Standardized milk thistle seed extract for liver support. Continue until two weeks after
anesthesia.

Stop five days before surgery
Onions and garlic in the diet
Grape seed extract

Start five days before surgery
1)Echinacea angustifolia capsules (Nature’s Way standardized product). Avoiding tincture
because of alcoholism. 2 capsules twice a day. Continue for ten days after surgery
2) Homeopathic arnica. 30c. 5 pellets tid under tongue. Continue 5 days after surgery
3) Start diathermy. Heat from heating pad applied to hip for 20-30 minutes per day.

Two days before
Professional massage, to relax muscles.

Post-Surgery
(On day of arrival home)
Standardized gotu kola Centella asiatica product (avoiding alcohol). Promotes wound healing.
120 mg/day
Massage oil into incision: rose hip seed oil with calendula extract and essential oils of carrot seed
and geranium added.

Outcomes
1) Client lost more blood. 3 pints of transfusion blood was used by end of the first day; last year
not all used until 3rd day. Dr. attributed this to “better physical condition”
2) Client went home one day earlier.
3) Was on coumadin post-surgically for five days instead of ten.
4) Was on morphine prescription as needed for two days instead of three.
5) See photos of wound healing, comparing the two incisions at day eight. Visibly less bruising,
less inflammation, and more complete healing after recent procedure compared to previous year.
6) Three months post surgery, client is in best health in years, exercising regularly in gym. Started
active skiing and snowboarding after not being able to do so for more than five years.
 

>>>Materia medica<<<

>Eclectic Materia Medica: Chionanthus virginiana - Fringe Tree.<
By William E. Bloyer

This article is reprinted from the 1898 volume of the Eclectic Medical Journal. Bloyer was
professor of materia medica at the Eclectic Institute in Cincinnati, Ohio. Editorial comments
follow the article.

 There is no more prompt and positive medicine in the materia medica than chionanthus.
When given in functional liver difficulties due to some wrong of the mucous surface of its ducts,
it seldom fails.  It will not cure all cases of jaundice, but it will cure nearly all in which there is no
structural disease of the liver.  It may be said to be specifically indicated by clay-colored stools,
yellowness of the skin and conjunctiva, high colored, even brown urine, with uneasiness or pain
in the right hypochondrium of the liver, or with abdominal pain or colic, and great prostration.  It
is another remedy that acts dynamically.  Under older classification, chionanthus was said to be
aperient, alterative, diuretic, narcotic, tonic to the stomach and bowels, and particularly
emphasized as a cholagogue.
 We believe that it does stimulate the liver to more and better work, and that it awakens
and tones up the digestive tract generally.  It is the remedy for jaundice due to functional
disorders of the liver.  It may be given alone or in combination with podophyllin, nux, leptandrin,
or dioscorea, all of which are closely related to chionanthus when judged by their actions on
hepatic functions.  They are all antitorpor liver remedies - liver stirrers.  Chionanthus will
materially assist in the prevention of the formation of gall stones, and is of undoubted benefit in
their expulsion. Acute dyspepsia is frequently relieved by chionanthus.  It is of great work in
hepatitis, both acute and chronic, but is not a specific in the jaundice of hepatitis.  It often settles
the irritable or refractory liver of the dipsomaniac.
 Chionanthus has few qualms in many cases of bilious, remittent and obstinate
intermittent fever.  It is very beneficial in overcoming the slow convalescence that frequently
follows exhausting disease.  Bilious colic has a conqueror in specific chionanthus.  It relieves
many cases of hypertrophic liver due to obstruction of its ducts and of a malarial character.  The
dose of specific medicine chionanthus is from five to ten drops well diluted and frequently
repeated.  Chionanthus has strong recommendations for efficiency as a local application in the
form of cataplasms of poultices in inflammations, in severe ulcers, and we rely upon it in certain
lines, and we are not disappointed.
 Specific chionanthus has a very rank odor, a dark amber color, and although it
occasionally precipitated a heavy sediment, it does not deteriorate.    W.E.B.

>Commentary<
 Chionanthus is a largely forgotten remedy in modern North American herbal practice,
failing to earn even a mention in most modern herbals. By comparison, the Lloyd Brothers
pharmacy reported in the year 1921 that chionanthus was second only to echinacea products in
sales by that company, which supplied the Eclectic medical profession. It was used primarily as a
liver remedy, with some broader uses described above. Liver conditions might be classified along
a polarity of sluggishness on one pole to inflammation on the other, with a different therapeutic
approach necessary at the extremes. Bloyer, when stating that chionanthus is not a specific for
the jaundice of hepatitis, is placing it among the remedies best used for sluggishness without
inflammation. Thus it might be useful in conditions such as hepatitis C during remissions, but
might be avoided during inflammatory exacerbations, when its stimulating effects might further
injure the swollen and inflamed liver.  That condition call for a modification of general liver
therapy to emphasize hepatoprotective or anti-inflammatory herbs such as milk thistle seed or
turmeric. – Paul Bergner