AHG Symposium - Part 3

This is the third and final post in a series reporting on this year's Herbalists' Guild convention. Part 1, Part 2.

Simon Mills, author of some of my favorite herb books such as Out of the Earth, lectured on his idea of acupharmacology. The basic concept is that part of herbal medicine's effects can be understood by observing their effects on the gastric mucosa, an internal second skin, and the reflex pathways between the gut wall and the rest of the physiology as modulated by the central nervous system. This is just one of the ways herbs do their thing - but if you've ever seen the effects of a demulcent on anxiety, you know what I mean.
Simon went on to discuss the relationship of gut tissue not only with neurons, but also with the immune cells and tissues embedded in the gastric lymphatic system. The endocrine / immune secretions from these tissues serve as another channel of systemic effect, modulating stimuli received from herbs. He continued with a fascinating exploration of the role of the immune system in many pathological states. Some highlights:
- Pierre Graber, old-school immunologist, described a different understanding of the immune system in a 1974 paper in the Lancet (not much info available online). Rather than a "police squad", he viewed the immune system as a clean-up crew to support digestive processes (by removing any antigenic protein chains left undigested) and to support tissue autolysis (help clean up old pieces of tissue to make way for the new). Additionally, antibodies seem, in Grabar's view, to be more like transport proteins than markers of certain doom. They attach to these incompletely digested proteins and pieces of old "self" to make sure they don't interfere with cell-to-cell signaling as they get escorted to phagocytosis.
- Protein sequences on bacterial cell walls can be very similar to sequences found on our own cells. This has led to the identification of initial "insults" by bacteria which activate the immune response and lead it to attack self: for instance, Kelibsella and ankylosing spondylitis; Proteus bacteria and Parvovirus in rheumatoid arthritis; Mycobacteria and E. coli in Crohn's disease. This is not only interesting in terms of understanding autoimmunity, but reinforces the idea that herbs can modulate these inflammatory processes by acting through the immune system (and thus across the whole physiology) without their metabolites ever needing to leave the gut.

Along these lines, Kevin Spellman went into a fascinating discussion, including the presentation of his original research, on the role of Echinacea and Dandelion roots in treating an allergic reaction. The details:
- three cases involving rashes, hives and anxiety following the ingestion of an unknown Chinese herbal formula (different in each case, I presume).
- treatment with high doses (1tsp every 30 minues, roughly) or Echinacea and Dandelion root tinctures, which helped almost immediately (after the second dose).
- Kevin proposed that Echinacea (and Dandelion, though differently -- perhaps through inulin and its acupharmacological effects) helped diminish the acute allergic Type-4 hypersensitivity in the three cases.
- Echinacea modulates the expression of pro-inflammatory cytokines by acting on cannabinoid receptors on the surface of immune cells, and lessening the production of NF-kappaB and therefore the transcription and expression of inflammatory proteins.
- Kevin (and Nadja Cech, amongst others) showed that Echinacea alkylamides suppress IL-2 production, a pro-inflammatory cell-to-cell signaling molecule. This build on previous research showing similar results.
- Coupling these new results with Echinacea's history of use as an immune booster, we see a complex emerging picture of this plant as a true immunomodulator. Regardless, it gives us an interesting hypothesis for understanding how and why this plant might have helped in an allergic reaction! And, it continues to debunk the idea that Echinacea shouldn't be used in autoimmune conditions.

Robert Duggan, President of Tai Sophia, gave the keynote lecture at the banquet (love that Sheraton, guys!). He offered some beautifully iconoclastic pearls of wisdom:
- Don't let people off the hook by telling them you will "treat" their disease. Illness is an ally!
- Natural healing modalities function as ways to increase perception and consciousness, thereby allowing one to listen to and act upon the messages illness brings.
- Don't let herbalism become what acupuncture has - licensed, squabbling over recognition, standardizing treatment. And this from a man who, though he regrets it, spearheaded the original licensing push by acupuncturists.

Chris Hobbs talked about herbs for the respiratory tract. (His powerpoint for the lecture should be available soon). Some new info for me:
- Useful expectorants: young fresh tips of English ivy; Maidenhair ferns; Smilacina (False Solomon's seal) roots.
- Willow bark should be collected in the spring, well before leaves appear, and only from small, juicy branches. Its aromatic, wintergreen-like smell should be clear and strong. Higher elevation sources seem more potent.
- Honeysuckle (Lonicera japonica) for fevers - cooling and delicious!

There was an infectious disease round-table in which I participated. We talked about the emerging problem of antibiotic resistance (esp. MRSA in clinical herbal practice) and herbal approaches to treatment: Echinacea, Baptisia, Cryptolepsis, Artemisia, and topical preparations. We also discussed the threat of pandemic influenza, and divided its risk into two main categories: the pathogen itself, which can kill people with weak immunity (young and old, especially); and the inflammatory cytokine storm that accompanies the infection in those with strong immunities, basically liquefying their lungs. In the latter case, immunomodulants like Scutellaria baicalensis (and perhaps high doses of Echinacea alkylamides, see above) might be more useful than actual antivirals.

Finally, it was great to see old friends and make new ones. Mischa is getting a study together on the use of Wild Carrot seed in contraception. I got to meet Maria, of Dirt Under My Nails fame. Check out her symposium post for info on lectures I didn't attend. And many thanks to Jillian, who was kind enough to host us, join in some late-night music making, and expose us to some interesting Aguardiente combos from the Amazon. I came home inspired with new ideas, and excited about the new herb school we're starting in Montpelier.

AHG Symposium - Part 2

This is a continuation of the conference report for this year's gathering of the American Herbalists' Guild.
Pam Fischer, from Berkeley, CA, discussed the free clinics she's set up and been involved with for over 7 years. It was an interesting discussion, and I enjoyed looking at diverse models of herbal care accessibility, hearing 7Song talk about the Ithaca Free Clinic, and mentioning my own work. Pam had some interesting models to discuss, and some pearls of wisdom from her own experience:
- herbalists have been joining up with pot clubs in the Berkeley area to offer their help with medicinal herbs other than Cannabis. Great idea! Tough here in Vermont.
- echoing my own experience, Pam recommends hiring a paid administrator / staff person to prevent volunteer burnout. I highly recommend this.
- running a clinic that is completely "free" can be politically correct, but it can also shut out folks who might want to contribute financially. Pam's clinic is entirely by donation; she calls it a "community herbal clinic", and focuses on its role in supporting the herbal community rather than its "freeness". This is an interesting point; I'm still not sure where I stand on this issue (having generally seen good compliance rates, good followup, and plenty of donations even when advertising as "free").
- compensation for the herbalists is derived from a pool of funds. This pool is fed by individual private practice sessions, donations, apothecary sales, and student tuitions.

Paul Bergner, of Medical Herbalism fame, gave a nice introduction on energetic assessment and its importance in the herbal consultation and in formulating a treatment plan. After all, if we can't tailor our recommendations to individual constitutions, we're just treating disease! Generally, herbs work a heck of a lot better if they're matched to individual constitutions. This also is the basis of one of my complaints with the double blind, placebo-controlled trial: almost none have a way of dividing populations based on simple constitutional profiles: diaphoretics may help improve circulation in a 'hot' constitution with cold hands and feet, but will do little for a 'cold' constitution with the same issues. Some interesting points:
- Three polarities: vitality / deficiency; hot / cold; moist / dry. You can figure these out with just a little common sense and good observation!
- If there is low vitality, there are usually three potential reasons why: low rest, low digestive fire, or poor food. To this I'd add an assessment of exercise and movement, too.
- As vitality is restored and the physiology becomes more capable of producing an inflammatory reaction, it will. This is the 'healing crisis', and follows Hering's Law of Direction of Cure.
- Healing crises show up in personal relationships (plateau -> conflict -> higher level) and in society as a whole. If fact, Paul made the case that our society is very deficient in vitality, because it doesn't react violently anymore. There are few protests, and little activism, compared to 45 years ago. His assessment: an acute illness that flared in the 1960s was generally suppressed. Emotional symptoms followed, and were expressed in the 1980s with its greed, corruption, and societal stratification. This was also suppressed, and now in the 21st century our illness has become spiritual...
- The rest of the lecture was a review of pulse and tongue assessment and its role in determining relative degrees of heat and moisture. Paul was clear to say, and I agree, that pulse and tongue are merely corroborating signs, and not definitive diagnostic tools.

...more to come, including Simon Mills and acupharmacology; Robert Duggan and some amazing philosophy of healing; infectious disease clinical roundtable; some herbs for the respiratory tract as suggested by Chris Hobbs; and original research by Kevin Spellman on Echinacea, Dandelion, and autoimmune inflammation.

AHG Symposium - Part 1

Well, this year the American Herbalists' Guild conference is being held in Columbia, MD at a big Sheraton in the middle of a corporate office park. Certainly not my favorite setting -- but some excellent people nevertheless.
The session began on Friday morning with the annual meeting of guild members. It was led by Aviva and Tracy Romm, President and office manager for the Guild (Tracy also organizes the conference). Some highlights from the conversation:
- Aviva is interested in growing the Guild, recruiting more members, gathering more funds. She also lamented the fact that the grassroots, volunteer-based flavor that shaped the Guild ten to fifteen years ago has fallen away as full-time staff has taken on greater responsibility. My feeling is that putting money into a national organization might not be as effective as mobilizing the grassroots again. And, as K.P. Khalsa (herbalist and finance guy) pointed out in his report, the Guild makes between $2,000 and $5,000 a year in profit, which it's put in the bank and is just sitting on.
- We talked for a while about a national certification exam for clinical herbalists. The general consensus: not a good idea. This reassured me. Certification usually, historically, leads to assimilation. In the case of herbalism, this would not only hurt our discipline, but also cut off the potential for rebalancing the modern healthcare paradigm that herbalism offers.
- Lupo, a young herbalist currently living in Connecticut, was elected to the Guild Council as a general member. I think she will bring an excellent voice to the Council -- and those of you who may know her would probably agree.

Jonathan Treasure, whose personal philosophy I resonate with and whose writing I thoroughly enjoy, gave a talk later on Friday called "Herbs don't work". The point, of course, is that the inherent vitality of the physiology does most of the work, and that herbs and herbalists are catalysts and helpers for the process. Other interesting tidbits:
- Part of magic is the ability to manipulate human consciousness. Our current culture seems to be an expression of a massive 'spell' cast upon millions.
- When a magician comes to believe his/her own spells, a dangerous fanaticism can ensue. To me, this means that the wholesale acceptance of any model that describes reality is risky and leads to inflexibility, a lack of adaptive power, and a tendency to reject those who do not share your world-view. This seems to be what has happened to our modern medical paradigm - a seductive spell, to be sure, but the resultant fundamentalism is all too apparent when we look at obsessions like 'evidence-based medicine'.
- The idea of 'integrative medicine' can mean many different things. Today, some MDs and medical clinics practice what they call 'integration' - but in many cases, this simply means using meditation, biofeedback, and occasional standardized herbs as adjuncts to practice. There is no shift in philosophy, no shift in belief. This is simply co-opting, not integrating! JT recommended Ken Wilber for his work on defining true integration and holism. Check out Integral Psychology and Integral Spirituality for more.
- Once we accept magical flexibility and integrate ourselves into whole beings, the distinction between hero (healer / herbalist / doctor), villain (disease / doctor / herbalist), and innocent (patient / herb / drug) disappears as we see the trinity synthesize into oneness. Practically speaking: herbalists must talk to the modern medical community, with compassion, with friendship. It comes back to what I've always maintained: no personal philosophy should take precedence over client well-being!

2007 Herbal Convergence report

The Northeast Radical Healthcare Network hosted its second annual Herbal Convergence at Seven Arrows farm this past weekend. This gathering has been amazing so far - low cost, community organized, non-hierarchical, inclusive, conscious, accessible. I can't say enough about the organizers and the people there.
Lots was going on. It is a tumultuous time in the herbal world, and I think the discussions reflected that.

Wendy gave us an update from the herbal care unit of the Common Ground Free Clinic in New Orleans. A non-profit, the Clinic's board of directors felt that unlicensed herbalists should not be practicing in the clinic the way they'd been doing since Katrina left most of the city's healthcare network crippled. While this might have seemed the end of an experiment in truly integrative free healthcare, the herbalists in New Orleans turned things around. They enlisted Phyllis Light, a professional AHG member, to supervise their work, and created defined protocols for herbal treatment in specific situations. Integrative practice continues!

Chris Monteiro of Providence, RI spoke about her acupuncture practice where low-cost and sliding-scale treatments are given to many people at once, reducing overhead and engendering a sense of 'peaceful community' for those relaxing in the treatment room.

I talked a little about the free clinics we run up here in Montpelier, now through the VCIH, and how coupling educational opportunities and community-grown medicines with the free clinic can help make it sustainable.

Rebecca Hartman talked live about her herbal philosophy, with a special focus on seeing the human physiology as an ecological system. She described insights for practice from a relational, ecological, and network-based vantage point (definitely good stuff, summarized here on her blog).

We heard reports from Just Food, where folks are organizing communities and local farmers in and around New York City to encourage community food production, fresh food availability, urban chicken and bee keeping, and networks of distribution and barter.

The Rhizome Collective in Austin, TX has been continuing with its urban sustainability work, organizing efforts, and ecological preservation. We heard about how they got a $200,000 grant to clean up and preserve a ten acre brownfield they now own. I was especially impressed by the construction of a floating island of plastic in a stormwater collection pond: anchored to this structure are wetland plants that help purify and control the water.

Mischa Schuler talked about her practice and work as a community herbalist in Cambridge, MA. I missed her class on herbal support for eating disorders, because my workshop on herbs and psych med use was at the same time, and was very disappointed about that. Mischa is a thoughtful herbalist who shared with us many of the practicalities of an herbal practice: making a comfortable space, finding the right place to work in and the right people to share space with, creating methods of recordkeeping, accessibility, and more. Living in Boston has strengths and weaknesses - but this place called the Fells sounds pretty awesome...

During and after my talk on the history of medicine in the US over the last 200 years, a lot of crucial issues were brought up. I feel that we are at a similar juncture in the history of herbal medicine to the one the Eclectics (and everyone else) faced in the mid-1800s: unregulated, diverse healthcare practices with a central government threatening (an imposing ) regulation. Onerous regs might create a two-tiered system: licensed and lay herbalists, 'professional' and 'kitchen' healers. How to avoid this split, avoid assimilation, and avoid 'banishment'? Some ideas, such as 'community-shared herbalism' where a collective group makes tinctures for itself, came out of the mix. This is something we want to try to build in Montpelier; I know others are working on it as well. But licensure will continue to be a hot debate!

I spoke with Kale (I believe that was the name) about research on the role of neuronal myelination in disorders such as bipolar depression and schizophrenia. This research seems to point at low mylelination levels for the former and higher levels for the latter, both in the brain's while matter and in the corpus callosum. Kale, if you can keep in touch about your research, I'd love to hear more!

Mary Blue, who is one of the organizers and a hostess for the gathering, also talked about her community living and farming project, called Farmacy, that involves urban sustainability, a farm and herb garden, composting toilets and graywater processing, and a kid's camp -- all from a small lot in Providence, RI. She makes tinctures and other medicines for local distribution. I commented to her how interesting, from a semantic and philosophical point of view, her choice of the name 'Farmacy' is: in the 70s, herbalists were moving out of the underground, and the tincture company was called 'Herb Pharm' (and still is - great company!). This name puts the 'Ph' into an earthy, farmlike concept: it injects science into nature's grounding force. Now, in the 21st century, herbalists create an organization like 'Farmacy'. This name puts the 'F' into a scientific concept: it injects nature's grounding force into science. I guess we've had a few years to think about it, but I do like the latter way of doing things quite a lot. And the Convergence is doing a good job of distilling this new, radical herbal instinct and bringing it into the light.