The immune system has become an increasingly crucial issue in all branches of medicine in recent years, especially because of the AIDS epidemic and the statistical explosion of a wide range of autoimmune diseases. To consider the possibilities of holistic approaches, it is important to have a grasp of the biological basis of immunity, but at least as important is a comprehension of the role the immune system plays in human life. The new—though still incomplete—understanding that immunology grants us illuminates much on the physical level, but much more is involved, and herbal medicine is as limited as allopathic medicine if it is used only in terms of blood chemistry without the benefit of a broader holistic context.
The immune system is one of the first body systems to experience a functional decline with age, and this reduction in efficiency may trigger several problems. For example, the degenerative diseases associated with aging usually develop only after the immune system begins to show signs of aging. One major function of this system is the cleansing of dead or defective cells from the body, and as its efficiency diminishes the subsequent buildup of what might be called “cellular garbage,” in turn, contributes to the aging process in other body tissues. Infections and potentially fatal complications are more common in people as they age than in younger adults. Advancing age is accompanied by a gradual decline in the ability of the body to synthesize antibodies in response to antigens and to manifest cellular immunity.
Some important insights emerge when immune system functioning is placed in an ecological perspective and not simply a biochemical/medical one. It becomes clear that human immunity is a vital component of the interface between the individual and the world. Human activity is not simply resistance to a dangerous environment; it is a complex, beautiful dance flowing to and fro within the world.
The whole complex of human immunity has certain characteristics. Seen within the context of ecology, both human and environmental, immunity is about harmony, not simply resistance. It is a dynamic dance with the environment and not merely a series of barriers to it. This viewpoint leads to some insights that suggest exciting possibilities for the whole field of health care.
This ecological approach emphasizes that—as with all aspects of holistic healing—the approach to whole body immunity must address the following aspects of human life:
The diverse herbal traditions of the world, with their unique cultural roots and expressions, have valuable insights into the many ways to use herbs to enhance immunological vitality. In fact, the field of herbal immune system support provides a good example of the confirmation of traditional knowledge by modern pharmacology. A growing number of remedies are now being shown in laboratory and clinical studies to have marked immunological effects. Some are stimulants to immunity, but most can best be described as “modulators”—that is, they enable the body’s natural responses to be more flexible in the face of disease. But rather than focus on the plant, here again we shall look at the whole treatment process.
In the following sections, I shall present ideas that bridge a traditional European American approach and various insights offered by both oriental medicine and pharmacological research. Naturally, it is too soon in the process of crosscultural synergy to say that the theories presented here are “the way it is,” but the therapeutic suggestions are based upon clinical experience and historical precedence.
The Californian medical herbalist Christopher Hobbs has identified three levels of herbal activity. He describes these levels as deep immune activation, surface immune activation, and “adaptogenic” or hormonal modulation.
Increasing interest is being shown in plants that impact the immunological process within the tissue that mediates its work, termed deep immune activation. Pharmacology points to plant constituents such as saponins and complex polysaccharides as key components in the immunological role of herbs, but always remember that herbs act as biological wholes, not simply as vehicles for “active ingredients.” Important immunomodulators now being introduced into Western herbal practice from China and Japan include Astragalus membranaceous (huang-qi), Ligustrum lucidum (Chinese privet), Schizandra chinensis (wu-wei-zi), Ganoderma lucidum (from the reishi mushroom), and Codonopsis tangshen (dang shen).
In addition to specific remedies that directly impact immunochemistry, herbal support of general well-being will help homeostasis and so the immune system. Herbal actions and processes to take into account include the use of bitter tonics and alteratives. It is important to note that deep immune work involves support of the normal body functions of elimination and detoxification, discussed on page 218.
BITTER TONICS
It is becoming increasingly apparent that the bitter remedies have a major role to play in holistic herbal treatment and especially in preventive medicine. Because of their wide effect on the body’s physiology, they help in treatment of the body as an integrated whole.
Bitters apparently work by triggering a sensory response in the mouth. The sensation of bitterness, probably along with many subtleties of which we are still unaware, is directed by the nerves to the central nervous system, setting off other responses in turn:
Bitters also affect the activity of heart and circulation in general. There can be a marked antidepressive action in some cases as well as a tonic effect with remedies such as mugwort and gentian. Moreover, as digestion and assimilation of food are fundamental to health, bitter stimulation can often fundamentally influence a medical picture that has nothing pathologically to do with the digestive process.
ALTERATIVES
They have not attracted the attention of researchers as the oriental remedies have, yet the herbs we know as alteratives bring about changes in the body that suggest they may work on the deep immune level. Important gentle alteratives include:
burdock |
nettle |
yellow dock |
cleavers |
sarsaparilla |
Surface Immune Activation
Surface immune activation is facilitated by herbs that promote the immune response to microbial infection. These are the many plants known as anlimicrobials. These herbs, discussed in more depth below in the section on infection, include:
calendula |
myrrh |
western hemlock |
echinacea |
old man’s beard |
wild indigo |
garlic |
onion |
Hormonal Modulation
Remedies in this group work through some hormonal modulation of immune response. The feelings, thoughts, and dreams we have in response to daily life affect us in many ways, one of which is an immunological response. Most people, for example, have experienced getting a cold when work pressure is too great. Using adaptogens can help the body deal with such stress-related immunological problems. Please refer to the section on stress, where Siberian ginseng and ginseng are discussed (pages 118–21). Other endocrinological issues can be addressed herbally, as discussed below.
Helping the body to deal with removal of pollutants and potentially toxic metabolic waste produced internally is at the core of support for the immune system. One herbal approach to detoxification springs from the premise that the human body is a self-healing and homeostatic organism, and that the therapist simply has to support normal processes. The body has wonderfully effective mechanisms for ridding itself of waste and poisons, and this can be supported by using simple and safe herbs as long as the eliminative processes are addressed as a whole. This means that whenever such a program is undertaken, all the organs of elimination are supported at the same time. In addition, tonic help is given to the specific area of the body that has been most under toxic pressure. Examples would be the lungs in a tobacco smoker or the liver in a patient with alcohol-related problems. At the same time, symptomatic discomfort can be alleviated.
The key to detoxification is support of all the pathways with gentle herbs, not an attack with herbal Drano! The first step is to identify the appropriate herbs by considering what actions will gently support elimination in each pathway. If overly active plants are used, the effect may be unpleasant and uncomfortable and of no added therapeutic benefit. The herbal remedies listed below are effective, yet safe and mild.
Target System |
Herbal Action |
Remedy |
Kidneys and urinary system |
Diuretic |
Dandelion leaf |
Liver and blood |
Hepatic, alterative |
Dandelion root, milk thistle |
Lymphatic system |
Alterative, lymphatic tonic |
Nettles, cleavers |
Skin |
Diaphoretic, alterative |
Yarrow |
Respiratory system |
Expectorant, pulmonary, anticatarrhal |
Mullein, coltsfoot |
Systemic support |
Tonic |
Choose a remedy with relevant system affinity |
|
Adaptogen |
Siberian ginseng |
|
Antimicrobial |
Garlic |
The range of information now available concerning the immune system and herbal approaches to treatments can be truly daunting! Since the approach I use throughout this book does not focus on isolated plant research but rather is people-based, the therapeutic suggestions that follow are based upon my own training and clinical experience in Wales.
As pharmacology has begun to newly explore the possibilities offered by the plant kingdom, new words have been coined to describe how the plants work:
From the allopathic perspective, a number of therapeutic possibilities may be recognized, hinting at the changes in perspective that are underway within orthodox medicine today.
As more research is done, the range of plant species and constituents that seem to be involved grows. There is still far too little research to make generalizations, but the excellent studies being undertaken by Chinese and Japanese scientists on their traditional remedies is revealing much of importance to immunology. However, the same attention is rarely given to traditional European or North American herbs. This is because of a lack of research grants, not because of an inherent lack of value in the plants. (Perhaps if nettle were given the same quality of attention that the East Asian remedy Astragalus has received, we might soon have the immunological “proof” of its profound effects!)
A number of immune system conditions may readily be addressed herbally. Immunological problems are grouped into the following categories:
Immunodeficiency diseases: Associated with some deficiency or malfunction of one or more of the major aspects of the immune response, such diseases are usually divided into two groups:
Hypersensitivity reactions: These are normal immunity processes that become damaging rather than protective. The pathological processes result from specific interactions between an antigen and components of the immune system.
Autoimmune disease: A condition in which lymphocytes produce antibodies that attack the body’s own cells and tissues as if they were the foreign substances, thus causing pathological damage. Any organ or tissue may be involved.
Tumors and “cancer”: There is a direct immunological relationship between the body and tumors. This fact highlights the possibilities of prevention and treatment through working with immunity.
Transplant problems: Transplant rejection is immunologically based.
When considering the possibilities offered by herbal therapy in this area, please remember that appropriate remedies for immune system problems must be selected based upon individual need, which can only be identified by careful diagnosis; thus the practitioner must be aware of the complexities of the process in play. Stimulating immunological activity may be inappropriate in some conditions and vital in others. In an attempt to clarify this for myself, I have established provisional guidelines for distinguishing between therapeutic situations calling for immunostimulation, and those where it may be contraindicated.
As a generalization, it seems safe to say that in conditions involving inappropriate activity of some aspect of the whole immunological complex, immunostimulant plants should be avoided. Thus, immunostimulants are probably contraindicated in autoimmune conditions, hypersensitivity reactions, and transplantation problems.
Conversely, in conditions involving inadequate or compromised activity of immunity, immunostimulant plants are fundamentally important in herbal treatment. In other words, immunostimulants are probably indicated in cases of infections, cancer, or immunodeficiency disease.
Why have I used the term probably? The experienced herbalist, who is completely at home with the multifactorial effects of plants, as well as the diversity of human beings, will never see a plant simply as “an immunostimulant.” For example, a remedy may have specific value in the treatment of rheumatoid arthritis and may also be found to have immunostimulating activity. The long-standing experience of generations of practitioners and patients will have more value than the theoretical insights raised by in vitro or animal studies.
Infection
The risk of infection seems to be a natural consequence of life in the earth’s biosphere. Humanity lives in constant ecological dialogue with vast numbers of bacteria, viruses, and fungi, yet our immune systems have evolved in such a way that this interaction only occasionally gives rise to health problems. In fact, our well-being is dependent on our healthy and positive relationships with a range of organisms that live within and on our body: two examples are the bacterial flora of the intestines and the microorganisms on the skin.
Infection occurs when the body is exposed either to pathogens or to organisms that are usually nonpathogenic but for some reason become a threat. If the immune response is compromised in some way, the ecological balance between host and microbe will change, allowing the microbe to thrive. Whichever the type of organism, an herbal treatment must focus on supporting immunity.
The herbal traditions of the world abound in plants reputed for their antimicrobial activities, but it must be borne in mind that they do not always achieve the results desired. Antibiotics are life-saving medicines when used appropriately. They have largely removed the scourge of epidemic infectious disease from the Western world. Thanks to systematic vaccination programs, smallpox is extinct. These are truly miraculous achievements. Herbalism cannot always deal adequately or quickly enough with severe acute infection, especially in patients with a weakened immune response. Such infections (meningitis, for example) necessitate the use of antibiotic therapy. As a dedicated herbalist who recognizes the limitations of my chosen therapy, I celebrate the existence of these medicines, for the role of the healer is the alleviation of suffering, not the promotion of a belief system. Still, much can be contributed by herbal treatment, including the following effects:
Antimicrobials widely used in British and American herbal therapy include:
aniseed |
eucalyptus |
rosemary |
bearberry |
garlic |
St. John’s wort |
caraway |
gentian |
sage |
calendula |
goldenseal |
thyme |
cayenne |
juniper |
wild indigo |
clove |
marjoram |
yarrow |
coriander |
myrrh |
wormwood |
echinacea |
peppermint |
|
elecampane |
rue |
|
All herbs rich in aromatic essential oils are antimicrobial. At one time, indeed, various essential oils were used in orthodox medicine to combat infection, particularly those of the bronchial and urinary tracts, and in preventing infection of burns and wounds. Some of these oils still find extensive use as disinfectants, as their antiseptic activity often exceeds that of phenol. Much clinical work is now under way with these oils in France, but, unfortunately, little has been translated into English thus far.
AN HERBALIST’S APPROACH TO INFECTION
Because of the similarity in the immune system’s involvement in bodily response to one infection or another, it is possible to make certain generalizations regarding herbal treatment of infection. Of course, the details will vary according to the nature of the disease, the specific individual, and any medication the patient may be taking. Thus, the guidelines given here are only general suggestions.
First, select the appropriate antimicrobial remedy. Choice is based upon the most suitable herbs for:
Always use antimicrobials along with tonic remedies. These may be selected based upon the following criteria:
Support the body by dealing with any fever that may accompany the infection. Also, alleviate symptomatic discomfort as necessary.
HERBAL SUPPORT OF ANTIBIOTIC THERAPY
There is no reason why the benefits of herbalism should not be utilized even when antibiotic treatment is under way. Here the herbal focus must be on tonics, helping the body cope with the intense biochemical battle raging within it. Selection of the tonic can be based upon these criteria:
Immune support is appropriate, but don’t try to duplicate the work of the antibiotics by using excessive amounts of echinacea. Provide symptomatic support if appropriate.
RECUPERATION FOLLOWING ANTIBIOTIC THERAPY
Once a course of antibiotics has been completed, herbs may be used to speed convalescence, to help avoid any recurrence of infection, and to prevent secondary problems that might arise because of the temporarily weakened immune response.
Focus on general nutrition as well as herbal tonics:
Immune support is important. This may be both deep and surface work. Focus on deep immune support with the immunostimulant herbs if:
Herbs have a long and honorable history in the treatment of cancer, and it may surprise many readers to lean that herbs are still at the core of modern medicine’s response to this disease.
Cancer is a term applied to a range of malignant diseases that may affect many different parts of the body. All are characterized by a rapid and uncontrolled formation of abnormal cells that may either mass together to form a growth (tumor) or proliferate throughout the body, initiating abnormal growth at other sites. If the process is not arrested, it may progress until it causes the death of the organism. Cancer is encountered in all higher animals, and plants also develop growths that resemble cancer.
The search among Western research scientists for a chemical anticancer “magic bullet” or a specific cytotoxic plant is predicated upon a rationale that is inherently flawed. To be sure, Western medicine has made great strides for a suffering humanity. Our pharmacology has furnished medicine with powerful tools for the treatment of life-threatening acute diseases and the alleviation of much suffering through speedy and effective amelioration of symptoms. Yet the major cause of death in the Western world is no longer acute infection but rather degenerative disease. On one hand, this change is a reflection of the successes of the allopathic approach: smallpox has been eradicated, polio no longer occurs in epidemic proportion, and tuberculosis is no longer the scourge it once was. On the other hand, these very successes serve to highlight the inadequacy of our approach to the degenerative diseases.
To use the unfortunately militaristic imagery of allopathic advocacy groups, acute infection has been “conquered,” yet our investment of vast sums and resources into “conquering” cancer has not produced the results expected. The lobbyists of the “cancer industry” might conclude from this the need for more research funds—or the dearth of dramatic “breakthroughs” might suggest that the allopathic perspective has not perceived and addressed the complexity of factors at play. Multifactorial interactions are the strong suit of holistic medicine. This statement says nothing about specific techniques but emphasizes the need for a context that embraces far more than oncogenes, tumor pathology, and carcinogens.
From the perspective of holistic medicine, any approach to cancer must take into account the whole of a person’s life; it is not simply a matter of destroying a tumor. A deep process of healing and reevaluation is essential, perhaps involving all of the following elements:
HERBAL CANCER THERAPY
We all would like to find the magical herb to cure every possible disease, including cancer. But the term anticancer herb, promising as it sounds, is therapeutically meaningless. The National Cancer Institute has provided the following clear and useful definitions:
Anticancer is a term that is reserved for materials that are toxic to tumor cells in clinical trials with humans.
Antitumor activity occurs if this toxicity affects tumor cells in living animals.
A cytotoxic agent is a substance that is toxic to tumors in laboratory cultures.
Various cytotoxic herbs, such as American mandrake, are known, but just because we know about powerful poisons, powerful narcotics, and powerful purgatives does not mean that we use them. The selection of remedies in any therapeutic regimen is dictated by the practitioner’s interpretation of need, which in turn will be an expression of the therapeutic philosophy that he or she espouses. The holistic practitioner’s use of such powerful remedies would only be considered in the context of a treatment program that works in the broad way I have discussed earlier.
In fact, holistically orientated herbalists tend to minimize the role of cytotoxic plants in their approach to cancer because of the problems inherent in such remedies. For one thing, a common argument put forward by pharmacologists against the use of herbal medicines—that the variable amounts of active constituents in natural plants prevents accurate prescribing of standardized dosages—becomes relevant when considering cancer therapy. In most cases the herbal approach is based upon the use of normalizers, or, at most, effectors that do not contain potent constituents; but in the case of cytotoxic plants, the inherent variability of plant constituent levels makes the establishment of appropriate dosage extremely problematic. Thus, after experienced consideration of this therapeutic dilemma, I have been led to conclude that chemotherapy may in fact well be safer than therapy based on the use of cytotoxic plants. This may offend natural medicine purists, but the needs of my patients always outweigh any philosophical dogma I may be attached to. I believe that a holistic perspective combined with an approach based on immunostimulation and immunomodulation can provide a context of treatment that does not depend on the use of potentially poisonous plants. If extreme measures are needed, I do not hesitate to turn to the experts on poison—the allopaths.
Why are no prescriptions or treatment protocols suggested in this section? First, simply because each individual must be treated as just that: a unique individual, not a site for a tumor. As this approach proposes the avoidance of cytotoxic remedies, the factors to address will be fundamentally the same as those for general immune support, with possibly greater emphasis on the use of alteratives and lymphatics.
Another reason is a personal one. The herbal literature is replete with treatments and “cures” that sound wonderful but have no basis in reality. My own clinical experience in the treatment of cancer is not extensive enough for me to draw widely applicable conclusions beyond the following broad supportive guidelines:
blue flag |
mistletoe (European) |
sweet violet |
calendula |
poke |
western hemlock |
chapparal |
queen’s delight |
yellow dock |
cleavers |
red clover |