1. Featured new link at http://medherb.com
2. Discussion board feature at http://medherb.com
3. Clinical Herbalism: Herbal treatments of ulcer-related H. pylori infection
4. Eclectic Materia Medica: Horsetail

1. FEATURED LINK

King’s American Dispensatory is probably the most substantial (by volume) herbal materia
medica in the history of Western herbalism. Published in 1898, it contains accumulated
information from the nineteenth century medical level herbal practice of all schools of medicine.
King’s represents a turning point in Eclectic medicine, and was published about the time that the
Eclectics began weeding out anecdotal reports and unsubstantiated claims for herbs, a process
that would continue for several decades until the publication of Felter’s and Ellingwood’s
separate materia medicas, which combined are less than half the size of King’s. All the extra
volume in King’s is not anecdotal -- it contains lengthy sections on description, history, and
pharmacy that are not contained in the later works. Thus King’s contains much valuable clinical
information not found elsewhere, and which would probably be lost to history were the book to
vanish. Hard copies of King’s may be available from the American Botanical Council in Austin
Texas. Herbalist Henriette Kress of Finland has begin putting King’s online, with 212  herbal
listings already posted. You can find them at
http://metalab.unc.edu/herbmed/eclectic/kings/main.html
Kress also publishes other herbal classics, at http://metalab.unc.edu/herbmed/eclectic/main.html
You may also find portions of Felter’s and of Ellingwood’s later writings at Michael Moore’s site
at http://chili.rt66.com/hrbmoore/HOMEPAGE/HomePage.html

2. DISCUSSION BOARD at http://medherb.com
For those who have not seen it, we now have a discussion board at http://medherb.com. The
initial weeks’ action has been a little slow. Come post a question or (better) post a reply.

3. HERBS, HELICOBACTER PYLORI, and ULCERS
by Paul Bergner
Medical Herbalism, Volume 10, Number 3

Within the last decade, researchers discovered that most upper gastrointestinal tract ulcers are
accompanied by infection by the organism Helicobacter pylori. Whether the organism causes the
ulcers or hitchhikes on ulcers already formed, getting rid of the infection now appears to be
essential for ulcer healing. Researchers recently conducted a meta-analysis review of 60 studies
on H. pylori eradication involving more than 4300 patients (Treiber and Lambert). The results
showed that healing was dramatically improved by eliminating H. pylori. If the elimination was
not complete, other treatments alone did not reach the effectiveness of eradication. In fact,
eradication alone produced healing in some instances with no other treatment.
 Even if an infectious organism was only recently discovered in ulcers, naturopathic herbal
treatments for ulcers have traditionally included antibiotic and immune-stimulating herbs, in
addition to demulcent and astringent agents. Tables 1 and 2 show, respectively, Robert’s Formula
and Bastyr’s Formula, as taught in naturopathic medical schools for at least the last twenty years.
Note that both formulas contain goldenseal. The plant contains the alkaloid berberine, which has
broad spectrum antibiotic action against a wide variety of organisms. At least one clinical trial
showed that berberine sulfate was in the same range of effectiveness as the drugs gentamicin;
terramycin, and furazolidone for eradicating or reducing H. pylori infection. (Hu). Constituents of
echinacea, baptisia, and althea have all been demonstrated to have immunostimulating properties
as measured by various parameters, although they have not been tested specifically in ulcers.
 
Table 1
Robert’s formula for ulcers

Hydrastis canadensis (goldenseal) 1 part
Echinacea angustifolia (echinacea) 1 part
Althea officinalis (marshmallow)  1 part
Phytolacca americana (poke root)  1 part
Geranium maculatum (spotted cranesbill) 1 part (2 parts if hemorrhaging)

If painful, add okra or slippery elm

Sig:  tincture: 10 min qid pc and hs
 powder: 2 00 capsules qid

(Sherman)

Table 2
Bastyr’s formula for chronic ulcers

Hydrastis canadensis 1 part
Althea officinalis 1 part
Geranium maculatum 1 part
Zingiber officinalis 1 part
Baptisia tinctoria 1 part
Duodenal substance 1 part
Vitamin b3  1 part
Okra   1 part
Slippery elm  1 part

Sig: 2 00 capsules qid

(Sherman)

 Another traditional treatment for gastrointestinal infection is garlic. A group of scientists,
noting the connection between H. pylori and gastric cancer, and the lower incidence of gastric
cancer among people who eat garlic, tested the hypothesis that garlic might kill H. pylori. They
made a simple water extract of garlic, and then standardized it for thiosulfinate content.
Thiosulfinate content of garlic -- allicin being the most abundant member of the group -- is
variable, ranging from 2 to about 9 mg per gram of crushed garlic( Koch and Lawson). Forty
micrograms of thiosuflinate per ml of the garlic extract was the minimum dose to inhibit H. pylori
in the trial. That translates to 40 mg of thiosulfiantes per liter of water, or 4.5 to 20 grams of garlic,
or about 1.5 to 6.5 garlic cloves in a liter of water. Thiosulfinate content is maximized by crushing
or blending the cloves fresh, and is greatly reduced in dried products or garlic oils. The authors
suggested that such a mixture might make an effective treatment for H pylori infection.

References

Hu FL. Comparison of acid and Helicobacter pylori in ulcerogenesis of duodenal ulcer
disease. [Article in Chinese] Chung Hua I Hsueh Tsa Chih 1993 Apr;73(4):217-9, 253

Koch HP and Lawson LD Garlic: The Science and Therapeutic Application of Allium sativum L.
and related species. Baltimore: Williams and Wilkins, 1996

Sivam GP, Lampe JW, Ulness B, Swanzy SR, Potter JD. Helicobacter pylori--in vitro
susceptibility to garlic (Allium sativum) extract. Nutr Cancer 1997;27(2):118-121

Treiber G, Lambert JR  The impact of Helicobacter pylori eradication on peptic ulcer healing. Am
J Gastroenterol 1998;93(7):1080-1084
 

4. ECLECTIC MATERIA MEDICA
by William Bloyer, M.D.
Medical Herbalism, Volume 10, Number 4

We continue our reprint of excerpts of the comments on Materia Medica of Professor William
Bloyer of the Eclectic Medical Institute in Cincinnati, in the 1900 volume of the Eclectic Medical
Journal.

Equisetum spp.
Scouring rush -- Horsetail

The specific medicine equisetum is the standard preparation among Eclectics, and is used in from
5-30 drops eery 2-6 hours. In the old classification of drugs we find this remedy among the
astringent diuretics. In proper doses the action is simple and mild; in overdoses it is sufficiently
active to produce hematuria.
Equisetum is an invaluable remedy in the so called “gravel”of the laity. Commonly this term
covers a great number of nephritic and vesical affections, and this drug relieves many of them in a
very satisfactory way. It is indicated when there is dysuria – an irritation of the urinary organs,
expressed by a constant desire to urinate. The flow is neither free nor copious, the color of the
urine is dark, even to a brown, and there is usually more or less of a mucous deposit. There is
pain after urination, and tenderness, and feeling of distension over the bladder. In some cases of
suppression of urine, and generally where there is tenesmus,  equisetum is an excellent
medicament. Many cases of dropsy are benefitted in a short time by equisetum, especially where
the above symptoms or indications are present, and in hematuria, in small doses, I will frequently
relieve when Triticum repens fails. It may be useful in chronic gonorrhea, bedwetting in children
etc, when the above indications are present.

Bloyer, W.E. Eclectic Medical Journal Volume LX January to December 1900 p 63-64

Editorial Comment

Bloyer positive statement that horsetail can cause blood in the urine in overdose is a caution not
listed in modern herbals. German phytotherapist R.F. Weiss, for instance, states that no adverse
reactions have been reported (Weiss). Bloyer does not does not suggest a toxic dose. It is
conceivable, if speculative,  that kidney toxicity could develop from excess amounts of silicon in
a large overdose of horsetail or its persistent use. (See below on Silicon in Horsetail and
Comfrey.) Some authors recommend that daily doses of dietary silicon – much of that bound by
fiber – not exceed 50 mg per day (Brown), and it is possible to greatly exceed this amount with
decoctions of horsetial. An ounce of horsetail decocted in a liter of water, for instance, might
yield as much as 15 times the upper limit of the recommended safe intake of silicon, in a form
more readily assimilable that that customary in food sources. Silicon, usually in the form of
inhaled silica has been shown to cause kidney damage (Hotz et al; Giles et al.), and silicic acid
itself as also viewed as a possible toxic contaminant of drinking water (Suslikov et al.)

Silicon in horsetail and comfrey.
Horsetail is most famous to herbalists as a source of silicon, present in the plant in various forms
including the water soluble silicic acid. The plant contains between 5% and 8% silicic acid
(Duke). Experiments by Piekos and Paslawaska demonstrated that 55 mg of silicon, as soluble
silicon dioxide, may be extracted in 200 ml of water in which 2.0 grams of Equisetum arvense
plant is boiled for 3 hours,  for a total yield of 2.75% soluble silicic acid by weight of the original
horsetail.  A small amount of sugar added to the water increases the extraction even further.

Silicon has no officially recommended dietary intake, but estimates of the requirement for
humans range from 5-20 mg per day (Groff et al).  Silicon was found to be essential in the 1970s
for normal development of connective tissue, mucopolysacchardies, cartilage, elastin, and bone
(Carlisle). It is an important rate-limiting enzyme cofactor in the formation of the collagen matrix
of bone, and its presence facilitates bone repair and the uptake of other minerals into bone.
Estimated requirements are based on average dietary intakes rather than on observed effects in
humans, which are difficult to measure.  Most dietary silicon comes from grains and other plant
foods in which it is frequently bound in poorly assimilable forms. Up to 97% of the silicon in a
high fiber diet remains undigested and is excreted in the stool. Silicic acid, one form in which
silicon exists in equisetum and some other plant species, is readily soluble in water, readily
absorbed in the digestive tract once dissolved, and readily diffuses to the extracellular fluid
reservoir and connective tissues. Thus a small amount of infused herbal material containing
soluble silicic acid may provide more physiologically available silicon than much larger amounts
of food in which the silicon is bound by fiber or fails to be extracted into solution in the small
volume of fluid in the stomach and intestine.  The physiological role of silicon, especially in the
assimilable form of silicic acid, may explain the persistent traditional use of horsetail for bone and
connective tissue health, and also that of comfrey (Symphytum officinale) which contains from
50-80% of the silicic acid content of horsetail. Those who want to use comfrey to promote
connective tissue healing might follow the method of Piekos and Pasklawaska above and make a
long decoction of the leaves. Such a method, using mature leaves, would also minimize the
exposure to the potentially hepatotoxic pyrrolizidine alkaloids in comfrey.

References

Beckstrom-Sternberg, S.M. and Duke, J. “the Phytochemical Database.”
http://www.ars-grin.gov/duke/

Brown, M.L. (Ed) Present Knowledge in Nutrition, 6ht Editionh. Washington D.C.. International
Life Sciences Institute 1990, Cited in Murray M Encyclopedia of Nutritional Supplements,
Rocklin, California, Prima Publishing, 1996

Carlisle, E.M. Silicon. In: Frieden, E, ed., biochemistry of the essential trace elements. New York:
Plenum Press, 1984; 257-291

Felter, H. The Eclectic Materia Medica, Pharmacology, and Therapeutics. Portland, Oregon:
Eclectic Medical Publications, 1985 [Reprinted from the 1925 original].

Giles RD, Sturgill BC, Suratt PM, Bolton WK. Massive proteinuria and acute renal failure in a
patient with acute silicoproteinosis. Am J Med 1978 Feb;64(2):336-42

Groff, J.L. Gropper, S.G., Hunt, Sara M. Advanced Nutrition and Human Metabolism, Second
Edition. Minneapolis: West Publishing Company, 1995

Hotz P, Gonzalez-Lorenzo J, Siles E, Trujillano G, Lauwerys R, Bernard A. Subclinical signs of
kidney dysfunction following short exposure to silica in the absence of silicosis. Nephron
1995;70(4):438-42

Piekos R, Paslawska S.  Studies on the optimum conditions of extraction of silicon species from
plants with water. I. Equisetum arvense L. Herb. Planta Med 1975 Mar;27(2):145-50

Suslikov VL, Semenov VD, Liashko LS.  Establishment of the maximum permissible
concentration of silicic acid in drinking water. [Russian language] Gig Sanit 1979 Nov;(11):17-22

Weiss, R.F. Herbal Medicine. Beaconsfield, England: Beaconsfield Publishers, 1988