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Clinical Skills Part with Paul Bergner, RH (AHG)Part Two: Formulation for the Clinical Herbalist

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Week 4

Modular formulation

See supplemental materials athttp://naimh.com/ahg/clinical-skills-II

See: Bergner Clinical Skills Formulation Week IV.pdf

Bitter cool and dry alteratives

– Arctium Arctium + Trifolium. Classic alterative pair in cancer formulas

– Taraxacum

– Mahonia

– Rumex

Warming alteratives

– Allium

– Juniperus Pair with Taraxacum for complementary effects

– Solanum dulcamara

Immune alteratives

– Eupatorium perfoliatum Use pair for influenza

– Sambucus

– Echinacea with Eupatorium for complementary actions: Echinacea broadly stimulates immune components, Eupatorium reinforces anti-viral components, but also

moderates cytokine responses.

Cold cholagogue laxative tonicsCombine with warming and/or carminative herbsor bitter tonics

– Berberis vulgaris with Eugenia and sugar (Unani)

– Rheum off With Mentha. Basis of neutralizing cordial

– Rhamnus purshiana with Foeniculum, Elletaria, or Coriandrum

– Rhamnus frangula Rhamnus species paired in Hoxseyformula

– Senna with honey and and anise to modify cold dry effect

With Zingiber or Coriandrum

Or Glycyrrhiza = pt, Foeniculum ½ part and sugar 6 parts (Ellingwood)

Neutralizing Cordial

Basis of formula is the traditional triplet (from Germany) of Rheum, Mentha, and Potassium bicarbonate. This is the formula of Wm Cook.

– Rheum 4 oz

– Mentha pip 8 oz

– Hydrastis 1

– Cinnamomum 1

– 1.5 oz potassium bicarbonate

– Macerate in 1 qt of 40% alcohol. Add potassium after filtering. Add 4 lbs of sugar for basic simple syrup.

– For almost any condition of the GI tract.

– Excellent delivery medium for tinctures

Hot and dry anti-inflammatories

– Zingiber

– Curcuma Formula = 2:2:1

– Boswellia as powder or tincture

– Cassia Cinnamon Cinnamon 2 Eugenia 1

Pelvic warmer, sexual stimulant

– Eugenia

– Capsicum Myrrh 16:Capsicum 1

= Thomson #6

Blood movers

– Angelica archangelica

– Angelica sinensis Pair with Ligusticum

– Levisticum off. Sub for Angelica sin.

– Ligusticum spp. Correct with licorice or honey

Pair with Myrrh

– Myrrh Pair with Capsicum 16:1

Bitter mintsAll are cooling, dry, varying degrees of bitter and pungent, diffusive diaphoretic taken hot, diuretic taken cold, emmenagogue, and bitter tonics

– Leonurus

– Lycopus classic pair for palpitations in hyperthyroid

– Marrubium

– Verbena pairs well, reinforces and broadens nervine actions of Leonurus

– Nepeta

Cardiovascular

– Crataegus Heart tonic. Add small part of capsicum

– Tilia Hypotensive, nervine

– Viscum album Hypotensive

– Olea Europa Hypotensive (may surprise some users who think it is antiviral)

Crataegus + Viscum + tilia + small capsicum + modifying herbs specific to case.

Spiritual heartThe Exhilirants of Avicenna“Gladden and delight the vital heart”

– Basil (Ocimum basilicum, O. sanctum)– Cassia (Cinnamomum cassia)– Cinnamon (Cinnamomum zeylanicum, syn: verum)– Coriander (Coriandrum sativum)– Frankincense (Boswellia glabra)– Lavender (Lavandula officinalis)– Lemon Balm (Melissa officinalis)– Mint (Mentha arvensis)– Rose (Rose damascena)– Saffron (Crocus sativa)– Sandalwood (Santalum alba)

Sample exhilarant formula

A sample exhilarant tincture formula:

– Centella asiatica 2 parts

– Ocimum basilicum or sanctum 2 parts

– Coriandrum sativum 2 parts

– Cinnamomum cassia 1 part

– Viola odorata 1 part

Centella/Ocimum 1:1 or Coriandrum/Cinnamomum 2:1 may be used as modules in larger formulas

Spiritual Heart

Heart protector

– Crataegus

– Rosa

– Oplopanax

Spiritual heart

Heart protector

– Crataegus

– Rosa

– Oplopanax

Heart Centering

Leonurus

Lycopus

Paeonia

Verbena spp.

Pulsatilla spp.

Succinum resin (amber, as small doses of powder)

Heart perception/wisdom

– Stachys

– Scutellaria (tincture)

– Ocimum

– Centella

Spiritual heart formulas

– May include herbs or modules from each category

Example:

– Exhilirant Cinnamomum/Coriandrum

– Heart Protecting Crataegus/Oplopanax

– Heart Centering Leonurus, Anemone

– Heart Wisdom. Sculellaria

Modular formulationComplex action-based formula

Formula modules

– These are pre-mixed pairs, triplets, or more complex formulas on the shelf. We will name them “Compounds”

– Example: Antispasmodic Compound = viburnum opulus 2 + Dioscorea 2 + lobelia 1.

– Example: Immune Compound = Echinacea + Eupatorium perfoliatum + Ligusticum porteri + Ceanothus

– Example: Tonic Adaptogen Compound = Eleutherococcus(RP), Avena (milky), Glycyrrhiza, Turnera

– Modules may make the basis of a formula, with individualized modifying herbs added, or proportions changes with additions.

– For example: Immune compound 6 + Zingiber 1 + Glycyrrhiza 1 for humoral correction.

– OR Immune compound 6 plus Myrrh 2 plus Phytolacca 1 to enhance blood moving, immune, and lymphatic effects

– OR Immune compound delivered in = part of elderberry syrup for influenza.

– Modules may be added as parts of larger formulas

– For example, my patient has a fever and I want to give a diaphoretic tea. The formula might be equal parts of Mentha, Achillea, and Sambucus as a tea, taken in 4 ounce doses, with two dropper of Immune Compound added to each dose.

– Or my patient has a cough, and I am giving the formula of Tussilago + Verbascum + Marrubium + Lobelia (A possible Expectorant Compound) and I can add one part of the Immune Compound to 2 part of the Expectorant Compound.

– Modules may be easily modified, herbs added or omitted, depending what is on hand, without changing the net effects of the module for its function in a formula

– Relevance in a fast moving clinic, street medic work, etc.

– For example the Antispasmodic Compound would be effective as the antispasmodic portion of a formula without one of its components. If you were out of one of the components, you could add Paeonia root or Pedicularis in its place, make a note on the label, and use it as before.

Some useful Compounds

– Demulcent Compound: Althaea 3, Ulmus 2, Glycyrrhiza 1

– Antispasmodic Compound: Viburnum opulus 2, Dioscorea 2, Lobelia 1

– Anodyne compound: Eschscholtzia 1, Piscidia 1, Corydalis 1

– Anti-inflammatory Compound: curcuma 2, Zingiber 2, Boswellia 1

– Immune Compound: Echinacea, Ligusticum, eupatorium perf., Ceanothus

– Basic Nervine Compound: Scutellaria, Avena (milky), Hypericum

– Hypnotic Compound: Scutellaria, Passiflora, Hypericum, Valeriana, Humulus

– Tonic/Adaptogen: Avena (milky), Eleuthero (RP), Glycyrrhiza, Turnera

– Liver chi relaxant: Lavandula 4, Foeniculum 3, Paeonia 3, Rosa 3, Mentha arv. 3, Rosmarinus 1

Complex formula modules

– Thomson’s Composition Powder (hot stimulating diaphoretic)

– Myrica 4 oz., Zingiber 2, Pinus 1, Eugenia 1 dram, Capsicum 1 dram

– May be used as the warming portion of another formula

Relaxant Diaphoretic Compound

– Eupatorium perfoliatum 2

– Sambucus 2

– Asclepias 2

– Zingiber 2

– Lobelia 1

Basic Alterative Module

– Arctium

– Trifolium

– Echinacea

– Taraxacum

– Juniperus

– Equal parts. Deliver in Neutralizing Cordial.

Two adjuvant compounds

– Vital force: Hydrastis 3, Myrrh 3, Lobelia 3, Capsicum 1 Add glycerine to prevent precipitation of alkaloids.

– Exhilirant adjuvant: Ocimum species 2 Coriandrum 2 Cassia cinnamon 1

Formulation processA formula for allergic rhinitis

– Category 1: Relaxant herbs that relieve “constrained liver chi”.

– Category 2: Drying astringents

– Category 3: Relaxant diffusives (“surface relieving”)

– Category 4: Mucous membrane tonics

– Catagory 5: Lymphatic alteratives

– Catagory 6: Harmonizers

– Catagory 1: Lavandula 4, Rosmarinus 1

– Category 2: Solidago 3, Achilla 2

– Category 3: Monarda 2, Pimpinella 1

– Category 4: Hydrastis 1 Ceanothus 1

– Category 5: Echinacea 3

– Category 6: Glycyrrhiza 3

Many other herbs could be substituted in each category, depending on availability, desirability, etc.

Digestive formula

– Bitter: Gentian OR Taraxacum, Mahonia, Matricaria

– Carminative: Zingiber OR Disosorea, Angelica, Coriandrum, Anise

– Demulcent: Glycyrrhiza OR Demulcent Compound

– Vulnerary: Plantago OR Plantago, Calendula

Sleep formula

– Mild sedative: Passiflora OR Scutellaria, Avena, Passiflora

– Stronger hypnotic Valerian OR Valerian and Hops

– Relaxant/antispasmodic Pedicularis OR Antispasmodic compound

– Anodyne Eschscholtzia OR Anodyne compound.

Pain formulation

– Anodyne portion Anodyne Compound

– Antispasmodic portion Antispasmodic Compound

– Sedative portion Scutallaria, Passiflora

Add Hypnotic Compound if at bedtime.

See supplemental materials athttp://naimh.com/ahg/clinical-skills-II