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by Paul Bergner

Medical Herbalism 2(5):1,4

Antibiotic drugs help to control serious infections, such as pneumonia, but their use in minor infections remains controversial. Medical writer Lynn Payer points out that U.S. doctors prescribe about twice as many antibiotics as English doctors, and about four times as many as German physicians. No class of antibiotics is found among the twenty most prescribed drug categories in Germany. One conventional European source says that, in general, if a person is sick enough to require antibiotics, they should be in the hospital (Payer). This is in contrast to the U.S. where antibiotics are often prescribed prophylactically with the common cold or a simple sore throat. The National Consumers Union reports that as many as ninety percent of antibiotic prescriptions in the U.S. are either prescribed inappropriately, or used inappropriately by patients who do not follow directions.

With informed and responsible care, herbal antibiotic formulas may be substituted for conventional antibiotics in minor infections. Some ground rules: the infection should show signs of improvement within a day or two, improvement should continue, and the infection should be resolved in seven to ten days.

Risks with strep throat

The case studies show the use of herbs in the treatment of sore throats and tonsillitis. Commentaries by clinical experts Cascade Anderson Geller and Dr. Wade Boyle help to clarify the finer points of treatment. The chief risk in using herbal treatments for sore throat is that a strep infection may progress to a more serious disease. In a few percent of cases, an improperly treated strep infection can cause kidney damage or heart disease.

The HEMP formula

The cases here all use some variation of the “HEMP” formula, the letters standing for Hydrastis (goldenseal), Echinacea, Myrrh, and Phytolacca (poke root).

Hydrastis has direct antibiotic properties, and should be used with some of the same cautions as conventional antibiotics, i.e. with long-term use (more than a few weeks) it may kill the “good guys” in the gut as well as the “bad guys” at the site of infection. Hydrastis also has direct immune-stimulating effects. It is drying and cooling, and is specific for excessive discharges from the mucous membranes (Felter). Without some mucous discharge, or a relaxed tone to the mucous membranes (such as swollen tonsils), its use is not warranted.

Echinacea is not directly antibiotic, but stimulates the body’s own immune response to bacteria. It is thus good complement to the direct antibiotic effects of hydrastis and myrrh. Echinacea is also anti-inflammatory.

Myrrh is also antimicrobial, and has a beneficial effect on mucous membranes. It has a heating energy, and balances the cooling properties of both hydrastis and echinacea.

Phytolacca has an effect on the lymph glands, and is specific for sore or swollen glands accompanying an infection. It is potentially toxic, emetic and purgative in large doses. Also with higher doses and longer periods of treatment, it may cause an increase in white blood cells mimicking leukemia.

In each of the four cases here, this basic formula has been modified to match the individual patient.

References

Felter, H.W. The Eclectic Materia Medica, Pharmacology, and Therapeutics. 1922. Eclectic Medical Publications.

Payer, L. Medicine and Culture. 1988. Henry Holt and Co.

Case I:

Sore throat; swollen lymph nodes; earache.

PATIENT: Thirty-nine-year-old female. Ht 5’7" Wt 140 lb.

HISTORY: Past history of Crohn’s disease (close relative of ulcerative colitis) and hysterectomy.

BOTANICAL TREATMENT

Echinacea tincture            2 parts

Myrrh tincture                1 part

Poke rt. Tincture                1 part

Water                    12 parts

Gargle 15 drops 4 times a day.

OTHER TREATMENT: High potency multiple vitamin; acidophilus yoghurt; high fiber vegetarian diet; enemas.

FOLLOW-UP: Two days later, sore throat was entirely gone, and ear pain and swollen glands reduced.

CASE II: Tonsillitis

PATIENT: Twenty-year-old female.

HISTORY: Frequent colds.

BOTANICAL TREATMENT:

Echinacea tincture            3 parts

Goldenseal tincture            2 parts

Myrrh tincture                2 parts

Thirty drops every hour until symptoms start to subside.

Then fifteen drops until bottle is finished.

OTHER TREATMENT: Homeopathic kali mur (6c); heating compress to throat (cold application, covered with warm wool for a few hours, or overnight); charcoal gargle.

FOLLOW-UP: Twenty-four hours. Symptoms worse overnight, but cleared during the day.

Case III

Influenza; sore throat, swollen glands.

PATIENT: thirty-year-old male. Ht 6’1" Wt 145 lb.

HISTORY: Sinus congestion and aching joints for two weeks. Lacto-ovo-vegetarian. Regular exercise. No tobacco or coffee.

OCCUPATION: restaurant chef.

BOTANICAL TREATMENT:

Echinacea tincture            4 parts

Poke rt tincture                4 parts

Gelsemium tincture            10 drops

(Five drops in a little water, six times a day)

Optibiotic (Eclectic Institute), daily dose for four days, in eight daily divided doses, equal to:

Echinacea powder            2 gr

Myrrh                    800 mg

Ginger                    400 mg

Cayenne                    260 mg

Garlic                    800 mg

Plus: 40,000 vit A; 2 gr vit C; 2 gr bioflavonoids; 60 mg vit B6; 60 mg magnesium; 60 mg zinc

OTHER TREATMENTS: Vit C, 7 gr/day; drink plenty of liquids, rest, and keep warm.

FOLLOW UP:

THREE DAYS: glands no longer swollen, throat not sore or red. Stopped taking Optibiotic.

FIVE DAYS: Patient discontinued tincture.

EIGHT DAYS: Sore throat and nasal drip returned.

Treatment: Start tincture again at 15 drops every three hours.

NINE DAYS: Relief of symptoms in 24 hours. Patient continued tincture for one more week at original dose.

CASE IV

Tonsillitis

PATIENT: Eight-year-old male. Enlarged, non-inflamed tonsils, slightly coated without tenderness. Lymph glands swollen. Thin, low energy, constipation, gas and occasional bed-wetting. No significant signs or symptoms of organ or glandular dysfunction. Weak pulses and pale, moist tongue. No spinal fixations.

HISTORY: Three recent episodes of strep throat.

BOTANICAL TREATMENT

Dandelion tincture            8 parts

Arctium (burdock)            8 parts

Phytolacca (poke rt.)            3 parts

Zingiber (ginger)                3 parts

Water                    10 parts

One tsp. 10-15 minutes at breakfast and dinner.

OTHER TREATMENTS: moxabustion (stimulation with heat on specific acupuncture points); mother instructed to continue this treatment at home.

FOLLOW UP: TWO WEEKS: Increase in energy; daily bowel movements; tonsils enlarged, but not coated. Lymph glands still swollen. Chinese evaluation reveals increase in heat. Treatment: continue with same.

FIVE WEEKS: Patient is more active and happy. Tonsils still enlarged and lymph glands swollen. Pulse/tongue the same.

Case Commentary

Cascade Anderson Geller, Herbalist

In all of these cases, I would recommend that the patients should gargle, swab the tincture directly on the throat area, or apply it with an atomizer. The direct applications are better than the gargle. This gets more of the medicine directly into contact with the inflamed tissue. The patient should not eat or drink for fifteen minutes after the application, to avoid washing the medicine away from the area. Compliance with this may be difficult with children. If using toxic botanicals, I usually give the patient two separate bottles—one for direct application to be spit out after gargle, and one to be taken internally. Another way of applying more directly to the throat is to massage the botanical directly to the neck or over swollen glands.

The cases show different results with different doses, but you never really know how a patient will respond to treatment. Dosing should really be based on the vital force of the patient. If the vital force is depleted or deficient, use a lower dose, less frequent application, or less potent herbs. This is one reason there is such a wide range of dosages in the Eclectic literature. Phytolacca, for instance, is recommended in dosages of one to thirty drops. (A good discussion of vital force appears in Herbal Medication by Priest and Priest).

I find that the frequency of the dose is more important than the size. Notice the hourly administrations in case two. Most important in acute cases, there should be some signs of improvement within twenty-four hours. Also, I always continue treatment for five to ten days after symptoms clear. Case three shows the importance of this.

Case four is not really an effective antibiotic formula. I would not give phytolacca for this long to a child, and only with caution even in adults. Phytolacca can cause elevated white blood counts, mimicking leukemia. It may also cause diarrhea (the most common side effect), nausea, vomiting, and headache.

The formula in case four fails because it is trying to do too much. It is expecting too much from the alterative herbs, and the phytolacca makes it too toxic for long-term use. I see three basic things in dosing and writing prescriptions for acute illnesses: 1) Judge the vital force (see brief discussion above) 2) Make an acute formula to use for two weeks or less. If an acute infection has not resolved within ten days, something is wrong 3) Give a broader-based formula and health program for addressing other constitutional issues.

Cascade Anderson Geller has been assistant professor of botanical medicine at National College of Naturopathic Medicine since 1979.

Case Commentary

Wade Boyle, ND

Case #1: This is a good formula, which could possibly be improved by the addition of hydrastis, which Frank Roberts (author of Robert’s formula) says, “has the strange property of being able to magnify the therapeutic activities of all the other remedies which are mixed with it.” A larger and/or more frequent dose may have cleared the ears and glands as dramatically as the throat. I would neither prescribe nor allow dairy products of any kind in such a case.

Case #2: If improperly applied, the heating compress to the throat may have accounted for the overnight worsening of symptoms and slowed the curative action of this excellent formula and dose.

Case #3: While gelsemium is a famous flu remedy, its primary indications, “persistent high temperature and headache, with great excitability,” (King) seem to be absent in this case. The herbs may have been suppressive, which may have prolonged the patient’s recovery, yet may also have made the recovery more comfortable.

Case #4: This looks more like a gastrointestinal tract (GI) formula than an upper respiratory tract (URT) formula, which may explain why the patient’s GI symptoms improved but not his URT symptoms. Ultimately such an alterative approach, if persisted in, would probably relieve the tonsils and the glands, but such persistence is not desirable in children. This formula suffers from the omission of echinacea, which is, again in the words of Roberts, “the one herbal remedy which stimulates the whole of the lymphatic system … (and) washes every cell of the body.” If, as I suspect, echinacea’s reputed “cool” properties kept it out of this formula for a patient who lacked heat, I would point out that phytolacca, arctium, and taraxacum are also classed as “cool” herbs. The ziniber and moxibustion, therefore, appear adequate to address the issue of “heat.” The substitution of echinacea for either arctium or taraxacum would, I believe, produce more satisfactory results.