Medical Herbalism: Clinical Articles and Case Studies

Search entire site by keyword(s)
Free electronic MH newsletter
Information on Distance Learning in Herbalism
Back to articles index page
Back to

Respiratory - Acute and chronic case studies

by Paul Bergner

Medical Herbalism 2(6):1,4-5

Herbal practitioners report that they most often see two kinds of patients—those who come at the first sign of illness, hoping to avoid a visit to the doctor, and the chronically ill who have given up on conventional medicine. The case studies here show the successful treatment of both types, for an acute and a chronic cough. The first case is a common cold with a cough. We selected this case because it employs five different formulas or techniques using herbs. Patients won’t always comply with this many treatments, especially the more labor-intensive hydrotherapy treatments, but the practitioner will probably get at least one good new idea from the case. The second case is a patient with a serious chronic disease who has been severely injured by drug treatments and surgery.

Case 1: Acute cold with cough

Patient: 37 year old male. Fever 102.5, with body pains and slightly labored breathing; stuffy sinuses.

History: cold and cough for one day.

Botanial Treatment:

    Formula LA #1

    Wild cherry bark            4 parts

    Licorice root                6 parts

    Comfrey root                4 parts

    Lobelia                2 parts

    Elecampagne root            4 parts

    Anise seed                6 parts

    Lungwort (Lobaria p.)        6 parts

    Mix together and place a teaspoonful into a cupful of boiling water. Allow to steep for twenty minutes, and drink. Take a cup in the morning and a cup at night.

    Formula #2
Copyright 2001 Paul Bergner    356


    Medical Herbalism: Clinical Articles and Case Studies    

    Take a handful of dried mullein leaves, crush into a powder, place into a pipe and smoke, inhaling deeply.


Fill a tub half full of hot water and add a teaspoonful of dry mustard powder. Place feet in water, every so often adding more hot water. Stay wrapped warmly in a bathrobe and sip a hot drink like lemon juice with honey, or mint tea. After ten minutes dip one towel into the hot water, wring it out, and wrap it around the chest. Keep it in place for several minutes until the heat dissipates, then replace it with a second towel which has been soaking in readiness. Continue fomentations for at least three applications. After treatment is complete, dry with a rough towel, bundle up, and go to bed, preferably for the night.

Vitamin Therapy

    Vitamin A        5000 iu daily

    Vitamin E        400 iu daily

    Vitamin C        3000-5000 mg daily.

Follow-up: Two days

The patient felt much better. His temperature was normal, his body aches less severe. Still had some stuffiness in the sinuses. He was advised to continue his above treatment and was further advised the following:

Treatement: Boil a pot of water and add 15-30 drops of oil of eucalyptus, oil of camphor, and menthol. Place a towel over the head and over the pot, forming a relatively steamtight tent, then lean over the steam (not too close!) and inhale the vapors for five minutes.

Follow-up: Five days

The patient was greatly improved of all symptoms.

Treatment: make a mixture of fresh-squeezed lemon juice mixed with equal amounts of honey. Take as a cough syrup whenever necessary.

Case 2: Chronic cough for seven months.

Patient: 57 year old male

History: Ulcerative colitis for 25 years. Colon removed two years ago. Idiopathic Thrombocytopenic Purpura (ITP). Treated with steroid drugs and removal of spleen. ITP is a serious systemic illness characterized by blood disorders, bleeding from the mucous membranes, and collapse. In most cases, the body has developed antibodies to its own blood platelets. Six incidents of diabetes mellitus following steroid treatments. Recovers spontaneously after drug withdrawal. Colon removal left him with urinary incontinence and completely impotent.
Copyright 2001 Paul Bergner    357


    Medical Herbalism: Clinical Articles and Case Studies

History of current illness: The cough was originally productive, with yellow sputum. This lasted for five months when he had an acute attack of ITP and was treated with steroids (80 mg four times a day) for two weeks. The cough went away during this time. The steroids caused him to enter an acute episode of rebound diabetes mellitus and he is still suffering some signs of that. After the steroids were discontinued, the cough returned but was non-productive, constant and spasmodic hacking. He has been running a fever of approximately 101 degrees F throughout the course of the illness. He also reports feeling rundown. He has used Robitussen, Tylenol II and Novafed with no success.

First visit. August 19, 1986.

Physical observations: Blood Pressure 138/98; pulse 108; Temperature 100 degrees F (oral). Decreased breath sounds in all lower lung fields. No indications of lung congestion.

Botanical treatment:

Formula #1

Ligusticum        8 parts

Verbascum        8 parts

Echinacea            4 parts

Taracum            4 parts

Cloves elixir        2 parts

Aspidosperma        6 parts

In a four ounce dropper bottle. Take 20 drops four times a day.

Formula #2

Usnea (in live oil)

Take 5 drops four times a day.


Constitutional hydrotherapy: 15 treatments. Constitutional hydrotherapy is a naturopathic technique using alternating hot and cold towels to both the front and back of the trunk, in conjunction with gentle pulsing electrical stimulation over the spine and the internal organs. The treatment takes about an hour. Three treatments a week is necessary for a good outcome in chronic disease.
Copyright 2001 Paul Bergner    358


    Medical Herbalism: Clinical Articles and Case Studies    

FOLLOW-UP: 8/28/86 (ten days).

Has had four hydrotherapy treatments. Reports that cough is 75% better than prior to treatment. Frequency has been cut to 25%, cough is looser and productive (white thick mucous), intensity of spasms has decreased greatly. Is no longer awakening at night with coughing attacks. Energy levels have risen. Slight lung sounds indicating congestion in right lower lung fields.

Follow-up: 9/23/86 (thirty-five days)

In general all symptoms have improved by 85% to 90%. The force of the cough has decreased by approximately 95%, now only coughs in the morning upon awakening for about five minutes. The cough is still productive (about two tablespoons of white to clear mucous). No more cough upon exertion. Has reduced tincture to twice a day. All lung fields are clear.

Respiratory botanicals

Anise seed, the common cooking spice, is warming and expectorant.

Aspidosperma The common name is Quebracho. It contains at least six alkaloids, and is used for shortness of breath. It reportedly increases the depth of respiration, useful in emphysema, asthma, or chronic bronchitis. The dose according to the Eclectics was 5 to 60 drops of the fluid extract.

Cloves elixir. Cloves are warming, and also have antiseptic and antispasmodic properties.

Comfrey root. This is included for its soothing, demulcent properties. Potentially toxic pyrrolizidine alkaloids in comfrey make it the subject of controversy for long-term use. A few days to a week treatment for an acute condition is safe only in generally healthy adults, and outside of pregnancy.

Echinacea. Included for its enhancement of general immunity.

Elecampagne root. This is a classic lung herb, being warming, drying, expectorant, nutritive and tonic.

Licorice root. Another classic lung herb, Licorice is expectorant, antitussive, demulcent, and antispasmodic.

Ligusticum. Common name: Osha root. Osha root is specific to lungs and upper respiratory tract. It is warming, drying, expectorant, immune stimulating and antiviral.

Lobelia. Lobelia is a respiratory stimulant, antispasmodic, and expectorant. Large doses are emetic. Use in larger doses with caution in patients with low energy.
Copyright 2001 Paul Bergner    359


    Medical Herbalism: Clinical Articles and Case Studies

Lungwort leaves. The common name lungwort can refer to either Lobaria pulmonaria (formerly called Sticta pulmonaria) or Pulmonaria officinalis, plants belonging to entirely different genuses, with entirely different actions.

Taraxacum. Dandelion root. Included here as an alterative to improve general function of liver and digestion.

Usnea. Usnea species are lichens with direct antibiotic effects.

Verbascum. Common name: Mullein. Taken internally it is expectorant and demulcent. Native Americans included it in pipe mixes with tobacco, and also inhaled the vapors of the tea for colds and lung problems. See the accompanying commentary on smoking it.

Wild cherry bark. This is antitussive, sedative and astringent. It is classically used for irritable and persistent coughs. It is not appropriate used alone for dry coughs.

Case commentary: notes on respiratory herbs

Sharol Tilgner, ND.

In acute conditions with red mucosa, I think of using soothing plants like comfrey or marshmallow. The mucilage in these plants helps to soothe and regenerate the tissues and also break up the mucous. In general anything that is mucilaginous will also act as an expectorant in this way.

In more chronic or subacute conditions, when the tissues are more pale and boggy, I prefer a resinous “irritating” expectorant like grindelia or propolis.

In general, plants with volatile oils are all somewhat antispasmodic. They promote expectoration by relaxing the tissues.

For smoking mullein, you don’t want very hot smoke to go directly on inflamed tissues. It might be better to make a cloud of the smoke, like incense, and inhale that.

The usnea used in case two would have been better in the form of a tincture than the oil.

Elecampagne is a wonderful herb that should be used more in respiratory formulas. Recent research shows that it has immune-stimulating properties. It is especially suitable for chronic conditions with excessive mucous.

You will see every possible respiratory action mentioned for wild cherry bark if you read through the herbal books. I tend to think of it as a tonic and slight sedative.

It is easy to confuse the names for Lungwort, Lobaria pulmonaria and Sticta Pulmonaria are the same plant, and both names are often used. This is a lichen (a cross between a fungus and an algae) and not a moss, even though one common name is lungmoss. This is the stronger of the two Lungworts. Pulmonaria officinalis is a member of the Borage family, and is a perennial herb. Personally I have not found it to be beneficial for respiratory tract problems. I’ve seen it described in some old books as a gentle respiratory tonic. It may very well have a place in formulas for chronic conditions as a tonifying, nourishing herb.
Copyright 2001 Paul Bergner    360


    Medical Herbalism: Clinical Articles and Case Studies    

Sharol Tilgner, ND is an associate editor of Medical Herbalism. She manages the pharmacy at National College of Naturopathic Medicine, and is owner of Wise Woman Herbals in Portland, OR.
Copyright 2001 Paul Bergner    361