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[midwifemedicine]

Milk thistle: Silybum marianum

• Family: Asterceae family (daisy/ “first aid” family) • Native habitat: Most milk thistle is sourced from the Pacific Northwest, though it’s native to the Mediterranean region and southwestern Europe.

Milk thistle is considered a noxious weed in several states, particularly in the Pacific Northwest. 

• Preparations/dose: The seed is the medicinal part of the plant. When dried, the seeds can be eaten, extracted into a tincture or tea, or powdered and encapsulated. Capsules: Depends on the concentration. If standardized, 200-300mg 1-2X per day.  If not standardized (whole seed powdered), 350mg 1-3X per day.  // Tincture: 30-60 gtt 2-3 X per day. 

For daily use as a liver protectant, dosage is 175 mg a day of 30:1 seed extract standardized to 80% silymarin. For therapeutic and restorative effects, up to 600 mg/day of extract standardized to 80% silymarin may be used (Hoffman, 2003).”

• Herbal actions: hepatic, galactagogue, demulcent, cholagogue, and antihepatotoxic

• Indications: For postpartum, it may be used as a safe liver tonic, such as in hepatitis positive clients or those with preeclamptic symptoms, but more often it would be used as a galactagogue, indicated when a mother may be struggling with adequate milk supply (Hoffman, 2003). 

• Other notes: Milk thistle is safe for lactation, and according to Hoffmann (2003) there is no side effects or drug interactions reported. Mills and Bones (2005) give it a B1 for pregnancy, stating that is is safe to use and a C in lactation, stating it is compatible with breastfeeding.  Energetics: Cold, oily, smooth, soft, heavy, stable.  Helpful for those experiencing the opposite of this, those with too much warm, dry, rough, light, mobile.  This is one of the more grounding liver herbs (we will go over liver herbs next quarter), which can be something you’re looking for. 

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Organoleptic notes: The most beautiful seed yet. Deep chestnut brown as if perfectly roasted, larger in size, buttery smooth and oddly satisfying to rub together. Like a prettier sunflower seed. Rich, fatty seed. Nibbled on a few and it tasted like plain flax seed. Did not notice any effect, but was not taking a therapeutic effect. I plan to cook with milk thistle for postpartum lactation support cookies. 

Class discussion: Clearing. Wet, fibrous, gelatinous, bland. Used as a food. Head clearing, nourishing. Strong, immediate action on hepatocytes. Could be used for hepatic nourishment in instances of choleostasis or PUPS. 

_ BMMC 2: Postpartum March 2018

[midwifemedicine]

Fennel: Foeniculum vulgare

• Family: Apiaceae family. This family has carminative, antispasmodic, antimicrobial, and diaphoretic actions, and their energetics are generally warming, stimulating, and clearing.  Regarding safety, this family has a lot of food plants and so many that are very safe, but there are also extremely toxic members of this family, such as hemlock. 

• Native habitat: Fennel originates from the shores of the Mediterranean but also grows through parts of temperate Europe. Fennel now grows throughout the world particularly in dry soil and near the coast or river banks.

• Preparations/dose:  Infusion according to Hoffman (2003) is 1-2 teaspoon of crushed seeds to 1 cup of boiling water infused for more than 10 minutes taken 3x day. Tincture recommendations is 1:5 tincture but can vary from 1-2 ml 3x/day to 7-14ml/day (Mills & Bone, 2005).

• Herbal actions: Carminative, aromatic, antispasmodic, anti-inflammatory, galactagogue, hepatic

• Indications: Supporting milk supply in lactating individuals, stomach and intestine remedy for gas/ bloating, helps calm coughs/ bronchitis. Used externally, fennel can help with muscle pain, and can also be used externally on the eyes to help treat conjunctivitis and inflamed eyelids.

• Contraindications: Sensitivity to Umbelliferae species

• Other notes: Fennel whole herb is more often used, and it is beneficial as a galactagogue. It helps with digestive issues, and respiratory issues (Rather, 2012). Essential oil is less often used and seems to be more effective when comparing to the whole herb as an antimicrobial agent. It is known to treat anxiety and depression, and may help with  muscular and rheumatic pains (Rather, 2012).

For pregnancy, fennel is a B3 category (Mills & Bones, 2005). There is not an increase in malformation effects when studied on animals (Mills & Bones, 2005). This is unknown for humans.

It is an uplifting plant, it’s helpful in pregnancy and postpartum for common concerns like gas, infections, or low milk supply but is especially specific when these are accompanied by mild depression.

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Organoleptic notes: Crescent shaped seeds, in a lovely array of greens, browns, and tans. Oblong, slightly curved, each seed about the size of a grain of rice. Firm, sharp, grating against each other. Highly aromatic, very unpleasant taste when plain, like bitter anise.  Attempted to drink an infusion of this and was so put off by the anise-y nature of it, I couldn’t choke down more than a couple sips. Next time will mask the taste by co-steeping with mint, or perhaps will stick to using fennel bulb when cooking. Would love to use this more often for the carminative effects.  Class discussion: Very neutral.  Energetics: moving. Antispasmodic in the gut. Moves milk, depression, liver stagnation. Mobile and static ... *amphoteric*. Liquid/dense.  

_ BMMC 2: Postpartum March 2018

[midwifemedicine]

Fenugreek: Trigonella foenum-graecum

• Family: Leguminosae (subfamily Papilionaceae).  This is a very large and diverse family of flowering plants and is commonly known as the legume, pea or bean family.  A symbiotic relationship with nitrogen fixing bacteria is common within this family.

• Native habitat: Fenugreek is an annual herb that is native to the Mediterranean region, Ukraine, India, China and Northern Africa. It grows well in open areas/semi-arid plains. Today, fenugreek is widely cultivated in many areas with most of the cultivated commercial products in the US sourced primarily from Morocco, Turkey, India and China. (American Botanical Council, 2000)

• Preparations/dose: 

Tea: infuse 0.5g of cut seed in 150 ml of cold water for 3 hours, strain, and drink several cups a day // 

Capsules: powdered, cut or crushed in capsule form, 6g per day // 

Tinctures: 1:5 (g/ml): 30 ml. 

• Herbal actions: stimulant, galactogogue, nervine, expectorant, diuretic, secretolytic, hyperemic, antiseptic, demulcent, emmenagogue, hypoglycemic/antidiabetic

• Indications: Internal use for loss of appetite/anorexia, indigestion, gastritis, and topically for boils, muscle pain, inflamed lymph nodes, gout, wounds, eczema, chronic cough, allergies, influenza, bronchitis, toothache, sciatica, arthritis. • Contraindications: May cause vaginal bleeding and abortion - do not use in pregnancy or in someone with high Pitta tendencies (Frawley & Lad, P.118).

• Other notes: Fenugreek is the most commonly used galactogogue around the world. It stimulates milk production through phytoestrogens and diosgenin activity, and increases sweat and mammary glandular output.

Whole vs. “de-fatted” fenugreek:  Whole fenugreek seed is used for various reasons medicinally such as: “hypocholesterolemic, lactation aid, antibacterial, gastric stimulant, for anorexia, antidiabetic agent, galactogogue, hepatoprotective effect and anticancer” (Wani & Kumar, 2015). The de-fatted fenugreek seeds can lower blood sugar levels, “plasma glucagons and somatostatin levels; carbohydrate-induced hyperglycemia also was found to be reduced” (Wani & Kumar, 2015). The whole fenugreek seed is used as a galactogogue and de-fatted fenugreek seeds are used to lower blood glucose levels because of their phytochemistry properties.

Hypoglycemic action:  Fenugreek exerts its hypoglycaemic effect by delaying glucose absorption and enhancing its utilization.The active component responsible for this activity is associated with a defatted part (non-lipid extract), rich in fiber and proteins. Fenugreek seeds contain 45.4% dietary fiber, the gum is composed galactose and mannose which are associated with reduced glycemic effects. The results suggest that insulin synthesis and/or secretion from the beta pancreatic cells increases the glycemic effects. It is also believed that fenugreek lowers lipids because it contains saponins that can also slow the rate of postprandial glucose absorption (Wani & Kumar, 2016).

Carminative action:  Fenugreek has been used to improve digestion, irritable bowel syndrome, and has been shown to enhance the pancreatic and intestinal activity. Digestion, respiratory problems and lactation are the more common uses for this herb. The Chinese traditionally use fenugreek for abdominal pain.The non-starchy polysaccharides increase bowel movements and assists in the smooth digestion where the high

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Organoleptic notes: Beautiful caramel colored little seeds. From far away, they almost look like Grape Nuts. Up close, they’re smooth and toasted golden and remind me of tiny flower teeth. Hard, gritty, like fine gravel. Smells beautiful, full, savory, warm and familiar. 

Declined to use in pregnancy due to potential cause for vaginal bleeding and not wanting to experience the diuretic effect.  Class discussion: Liquid/heavy/oily/stable/warm/stable/big. Works as a galactogogue by acting as a gland and increasing production. Some instances of indigestion or gas in babies, could be a result of gulping more air with increased supply.  _

BMMC 2: Postpartum March 2018

[midwifemedicine]

Usnea: Usnea spp.

Usnea is a lichen, which is a combination of fungi and algae that have grown together in a symbiotic partnership. Like all lichens, Usnea is not technically a plant. It does not have roots, stems or leaves, and the chloroplasts are only found in the algal component of the organism.

• Family: Parmeliaceae family, the largest group of lichen-forming fungi 

• Native habitat: Worldwide, on the bark and wood of conifers and deciduous hardwood trees in orchards and damp forests. 

• Preparations/dose: 

Tincture: 30-60 drops; up to 4x/day. For acute condition increase to ½-1 tsp, 3-6 x /day

/  Douche or skin wash dosage: Add ½ oz tincture to 1 pint water, mix well. Use twice a day, morning and night, for 3 days.

/ 

Wash: for impetigo, staph, or strep infections 

Undiluted: Use tincture directly on site of infection using cotton ball or cloth. Use twice a day, morning and night. Diluted: make a dilution of 1:1 with water

/ 

Nasal spray: Combine 10 drops of tincture in water in a 1oz nasal spray bottle. Use as needed for nasal and sinuses bacterial infections. 

• Herbal actions: Immune stimulating, antibacterial, antifungal, antiparasitic, antiviral, analgesic, anti-inflammatory, antioxidant, antineoplastic, antimitotic, antiprotozoal, antiseptic, antiproliferative, inhibitor of biofilm formation, synergistic with clindamycin tx (for H. pylori)

• Indications: Due to the multiple herbal actions of Usnea, there is a large list of indication in which Usnea would be beneficial. Some of these indications include: Gram-positive skin infections, vaginal infections, GI tract infections, throat infections, fungal skin infections, resistant bronchial and pulmonary infections ,TB, conjunctivitis, superficial skin wounds. 

• Contraindications: Usnea should not be used internally during pregnancy. Usnea may cause atopic dermatitis when used externally. According to the AHPA, there are no known contraindications, and no available information on the safety of Usnea use during pregnancy and lactation. 

• Other notes: Acetone extraction is the ideal method of extraction for stictic and usnic acid for most types of lichens. Rich in usnic acid; antimitotic, antiprolifitive, and inhibitor of biofilm; benefits = many actions, including analgesic activity and particularly effective at Candida and Resistant Gram positive bacteria (potentially more so than gram negative bacteria).  

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Organoleptic notes: Strange, beautiful, quirky Usnea. A celery green, definitely green but with hints of yellow and grey. Very dry and scratchy, like an organic steel wool. Dense, but airy. Difficult to pull apart. Smells like the forest brought indoors. 

Currently brewing as a tincture, folk method. After four more weeks, will have tincture available for future home pharmacy use for sinus infections, would like to also try on acne. 

Class discussion: Comforting. Hyperlocal to the PNW. Drying, clearing, rough, mobile. Used for acute situations.  

_ BMMC 2: Postpartum March 2018

[midwifemedicine]

Tea Tree: Melaleuca alternifolia

• Family: Myrtacea (myrtle family) 

• Native habitat: Tea tree is indigenous to Australia, New Zealand, Malaysia, Cambodia, New Guinea, Indonesia, Thailand, and Vietnam. The plant grows favorably on coastland near wetlands. The Melaleuca plant can be cultivated in many climates but favors an environment with moist soil in full sun. These plants are tolerable in both drought and flood conditions and can also withstand fires, but do not tolerate climates with low temperature. 

• Preparations/dose: Used topically as an essential oil. Dilute with carrier oil. 

• Herbal actions: Anti-microbial, anti-inflammatory

• Indications: Treatment of wounds and infections. Antifungal and antimicrobial to many antibiotic-resistant microbes. 

• Contraindications:  Internal use is not recommended for most applications. High cineole content may cause local adverse reactions, contact allergy, and dermatitis. Liver toxicity has also been demonstrated.

Other notes: rich in terpinene-4-ol; works via cell membrane disruption; benefits include = very broad spectrum, effective for antibiotic resistant bacteria (MRSA and MSSA), and is particularly effective at treating persistent or chronic infections.

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Organoleptic notes: Pungent and sharp in the nose. Very distinctive smell, almost like eucalyptus, but still very much its own scent. Earthy, familiar to me.

Cooling and drying. Less drying with a good carrier oil. I like jojoba, for just feeling a little lighter.  

I’ve used tea tree intermittently for years now, mostly in an attempt to spot treat acne and blemishes. I’ve had mixes success with it; it will seem to work well for a short time before it doesn’t, or on certain blemishes but not others. In hindsight, this is likely because my acne is primarily hormonal, and so a topical antimicrobial was going to have a limited effect. Have also used to treat bumps from previous nose piercings. 

Class discussion: Great for diffusing, kills large percentage of microbes in air. Strong, cooling. Can work well in combination with calendula. 

_ BMMC 2: Postpartum March 2018

[midwifemedicine]

Calendula: Calendula officinalis

• Family: Asteraceae (daisy/”first aid kit” family)

• Preparations/dose: 

Tincture:  Fresh Flowers -  weight:vol - 1:2, 100% alcohol in menstruum, dose: 1-2mL, 3-4x a day //  Dried Flowers weight:vol - 1:5  60-80% alcohol in menstruum, dose: 1-2mL 3-4x a day //  Infusion (Folk Method): Grind the dried herb into a fine powder. Place the herb into a jar and add a fixed oil of choice; olive, sesame, almond, etc. Leave an additional ¼ inch so the herb may absorb the extra oil. Cap jar and leave it out in the sun for 7-10d. Shake or stir every couple hours or at several times a day. When it is ready, strain out the leaves and sediment.  Allow the infusion to sit in a glass jar in a cool dark place with proper labelling. Salve: Measure out the dried powdered herb, add equal parts by volume of 190 proof ethyl alcohol (about 120ml). Mix herb with alcohol and stir until moist then place the sealed container safe overnight.  Pour the oil into blender and add moist herbs, strain with a cheesecloth. Pour liquid into a double boiler and heat over low flame for a few hours until the alcohol is evaporated.  You can check to see if there is any alcohol present by lighting the match to the surface of the mixture.   Add beeswax to create the salve. Bring to boil and tightly cap (Green, 2000) 

• Herbal actions: vulnerary, anti-inflammatory, lymphatic, hemostatic, antimicrobial, antifungal, antispasmodic, astringent, emmenagogue, cholagogue

• Indications: Calendula may be used externally to treat inflammation of the skin, bruising, strains, bleeding, minor burns and skin ulcers. Internally, calendula is also anti-inflammatory and can help treat gastric and duodenal ulcers, relieve gallbladder problems, treat swollen lymph glands, and ease indigestion (soothes digestive and mucous membranes). Calendula can also be used internally and externally to combat fungal infections. Calendula may stimulate the immune system (via bone marrow) and may help normalize menses and ease painful periods.

• Contraindications: Known allergy to Calendula or other members of the Asteraceae family. 

• System affinities: Integumentary, lymph/immune, and hepatic

• Other notes: 

Calendula could be beneficial for a mother wishing to reduce localized swelling and inflammation at the perineum after birth, as well as helping to heal wounds such as a perineal laceration or cesarean incision site. Since calendula reduces bruising, it could be used on a newborn’s skin for birth injuries. Calendula could also be helpful in taming yeast flare-ups on a mom’s nipples, and internally for the newborn’s mouth (thrush).

Energetics: warm and dry

No known contraindications at this time for Calendula.  Avoid oral consumption during pregnancy due to potential to cause contractions. Calendula has been recognized as safe while breastfeeding.

Calendula is famous for its vulnerary properties, it’s been known to treat minor inflammations of the skin and mucosa and helps with healing minor wounds. It can be used in oil extracts or salve for treatments for inflamed, irritated, sore, or cracked nipples; an excellent resource as an anti inflammatory. There are also antimicrobial and antifungal benefits from the hydroethanolic extracts that may be used topically for treatment of infection (Romm, 2010). Commission E (2000) reports that it also possesses pain reduction properties, antifungal, antiviral, antiparasitic, and antibacterial activity with the presence of ethanol in addition to the increase of glycoprotein, nucleoprotein and collagen metabolism at the wound site.  

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Organoleptic notes: Such a lovely plant - the color is so striking. Gives me a new appreciation for marigolds. Distinctive, voluminous dried flower heads. Smells sweet, like caramelized honey. 

Used the calendula salve regularly to soothe itchy razor bumps on my arm pits with great success. Applied a few times to belly stretch marks with less obvious success.  Plan is to infuse calendula oil to have on hand for postpartum healing. 

[midwifemedicine]

Horsetail: Equisetum spp.

• Family: Equisetaceae family (horsetail family)

• Native habitat: Horsetail is a perennial plant that is found in or near watery areas such as marshes, streams, or rivers. Horsetail grows in temperate northern hemisphere areas of Asia, Europe, North America, and North Africa. It flourishes where it can root in water or clay soil. Horsetail has been found to act as a sort of filter in riparian and wetland ecosystems, absorbing insecticides and general contaminants and promoting the general health and resilience of an ecosystem. This is very similar to horsetail’s action in the human body, where it has anti-inflammatory, astringent, diuretic, tissue tonic, and vulnerary properties. In both natural and human ecosystems, horsetail filters and soothes.

• Preparations/dose: Horsetail can be prepared as an infusion, decoction, tincture, or liquid extract in capsule form. According to Mills & Bone (2005) the typical adult dosage is:

3-12g per day of dried aerial parts //

3-12g per day of a 1:1 liquid extract // 

2-6mL per day of a 1:2 liquid extract or equivalent in tablet or capsule form // 

6-8mL per day of a 1:5 tincture

The dosage and preparation according to Hoffman (2003):Tincture (1:5 in 25%) 2-4mL. TID //

Infusion: 2tsp of dried plant, 1 cup of boiling water - infuse for 15-20min, TID.

A horsetail infusion can also be added to bathwater to help with rheumatic pain.

• Herbal actions: Anti-inflammatory, anti-rheumatic, astringent, connective tissue tonic, diuretic, vulnerary 

• Indications: To promote repair, improve strength of connective tissues (collagen & bone), rheumatic & genitourinary complaints 

• Contraindications:  Use caution with impaired cardiac and kidney function, edema from cardiac origin, prostate cancer, children under 2, and long term use.

• System affinities: Urinary, respiratory 

• Other notes:

Energetics: bitter, sweet, cooling, pungent.

Can be used prenatally for acute cystitis (not to take place of antibiotics) for its diuretic, anti-inflammatory actions which can work on an overactive bladder.

Postpartum use includes pelvic edema and mucosa irritation as it can increase connective tissue tone and healing due to vulnerary action and anti-inflammatory properties.

Pregnancy category B2. According to Mills & Bone (2005) there have been no increases in frequency of fetal malformation, or harmful effects seen with limited used during pregnancy.

Lactation category C: Compatible with breastfeeding and lactation (Mills & Bone, 2005).

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Organoleptic notes: Dried plant matter is dry, crispy, almost insect-shell like. Whispery crackles as the bits move against each other. Looks strange, primordial, like a leek and conifer hybrid ... tubular with needles. The dry smell is unexpectedly savory, like the generically distinctive smell of a spice shop, a perfume of a hundred different scents all compiled together. 

Decided to try as a daily infusion for what relief from what felt like pending UTI symptoms.

Infusion recipe:  2 tsp horsetail + 1 tsp aech of Echinacea purpuera aerial parts and roots. Steep in boiling water for 15 minutes. Steep with raspberry tea leaf bag or other preferred tea for more palatable taste. 

This seemed almost immediately effective. After having my first cup before bed, I already had less frequent urination and dysuria. Will continue two cups/day, complemented with horsetail tincture and D-Mannose. 

Class discussion: Connective tissue, nerve, muscle tissue tonic. Cooling, dry, light, liquid. Can be useful for a lung tonic when harvested young. 

_ BMMC 2: Postpartum Feb 2018

[midwifemedicine]

Echinacea

• Family: Asteraceae(daisy/first aid kit family)

• Preparations/dose: Root: As hydroethanolic extract or hydroethanolic extract (tincture). Helpful for acute stage of infections. Immunostimulating: increases inflammatory response, prepares initial immune response. 

Aerial parts: Water extracts, infusions and decoctions. Hydroethanolic extracts also effective as immunostimulant.

Immunomodulating: Modifies and regulates immune function. Decrease when overactive and increase when deficient.

• Herbal actions: immunomodulator, anti-catarrhal, alterative, general tonic, immuno-stimulator, antimicrobial (antibacterial & antiviral), anti-inflammatory, diaphoretic, detoxifer, peripheral vasodilator, mild lymphatic stimulant.

• Indications: Echinacea is “indicated primarily for the prevention and treatment of acute infections, particularly colds, influenza, and other acute respiratory tract infections, in which it reduces both the duration and severity of symptoms” (Hoffman, 2003, p. 545). It has been used to treat variety of both bacterial and viral infections, including boils, sepsis, upper respiratory tract infections, tonsillitis, as a mouthwash for gingivitis, or applied topically to sores and cuts (Hoffman, 2003). Postpartum indications for internal use of root: infections, esp mastitis, perineal infections, uterine infections, URI.    Indications for internal use of aerial parts: frequent infections, immune dysfunction In the postpartum time, it can be applied topically as a tincture to the umbilical stump “to encourage rapid healing, discourage bacteria, and eliminate mild infections” (Weed, 1986, p. 97). It can also be useful for reducing maternal fever, topical application to any perineal lacerations, and preventing and curing postpartum infections such as mastitis or endometritis (Weed, 1986).

• Contraindications: Echinacea is contraindicated for immunocompromised people or people on immunosuppressant medication. Those with severe seasonal or pollen allergies may be at greater risk for an allergic reaction to the aerial parts of Echinacea (Mills & Bone, 2005).

• System affinities: respiratory, digestive, immune 

• Energetics: Bitter, pungent/cooling. 

• Other notes:

Traditional ethnobotanical use of Echinacea: Echinacea is a plant native to North America and the root was used medicinally by Native Americans in the Midwest. The past medicinal uses of the plant were for snakebites, stings, coughs, sore throats, toothaches, and rheumatism, to name a few. Echinacea was also used internally to help treat typhoid, septic fevers, and puerperal. The E. purpurea aerial parts were introduced in Europe when homeopathic doctors introduced the benefits for healing wounds, antiseptic benefits, and antiphlogistic benefits. When the E. angustifolia roots were hard to obtain, seeds were brought over to Europe from the U.S. Though, mistakenly E. purpurea seeds were brought over. Studies on the use of E. purpurea began in the 1930s. In addition, traditional use of Echinacea was for bowel pain, skin disorders, arthritis, seizures, and cancer.

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Safety Class: 1 Interaction Class: A Contradictions: none known Side Effects: Allergic reactions Safety: There is limited human data on echinacea; there is no indication of any safety concerns for use during pregnancy and lactation, however, safety has not been conclusively established due to lack of data. A survey of dietary supplement use by pregnant women in CA indicated that Echinacea was the most commonly used supplement during pregnancy.

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Organoleptic notes:

Ech. purpurea aerial parts - green crumbled bits with woodier, fibrous pieces mixed it. Smells grassy, warm, with a hint of cinnamon. Tastes pleasant, dry, sweet, raisin-like notes. 

Ech. purpurea root - Same, but brown and grey firm crushed bits, woody and fibrous. 

Combined root/aerial part decoction (1.5 tsp each/3 tsp total) in 8 oz hot water, once daily for 5 days. Did not directly affect my day-to-day experience nor relieve my lingering cough, but may have prevented my cough from getting any worse. Would like to make tincture to have on hand for more convenient future immune support. 

_ BMMC 2: Postpartum Feb 2018

[midwifemedicine]

Skullcap: Scutellaria lateriflora

• Family: Lamiaceae (the mint family). Plants from the Lamiaceae family are high in volatile oils, so they are generally very aromatic, the stems are square, and the leaves are opposite of each other with a serrated edge. However, skullcap itself is not aromatic!

• Native habitat: Skullcap is native to North America and is domestically cultivated and harvested in the Pacific Northwest & the Midwest: Minnesota, Missouri, Oregon, Washington, as well as North Carolina; it is also widespread throughout Central and South America. The native habitat of Skullcap is riparian wetlands - marshes, stream banks and wet meadows.

• Preparations/dose: hot or cold infusion, powder, tincture

• Energetics: cool, slightly dry, sweet and mildly bitter, slow, heavy, dull 

• Herbal actions: nervine tonic, antispasmodic, hypotensive, mild nervine sedative, alterative, astringent, nervine anxiolytic

• Indications: nervous tension, petit mal seizures, exhaustion and depression, premenstrual tension

• System affinities: nervous system, circulatory system, muscular-skeletal system

• Other notes: Most useful for people who constantly need to take charge, make plans/back up plans, and feel insulted when things don’t go as they hoped. May have insomnia due to overthinking the day. Tendency to worry about their performance and are very good at criticizing themselves. Client may be experiencing acute or chronic pain, and/or have emotional attachment to this pain/injury. 

Safety: According to the Botanical Safety Handbook (2013), Skullcap has a general safety class of 1 (herbs that can be safely consumed when used appropriately) and it’s interaction class is A (herbs for which no clinically relevant interactions are expected).

“No information on the safety of skullcap in pregnancy or lactation was identified in the scientific or traditional literature” (AHPA, 2013, p.801).

Combine w/ gotu kola for improving awareness and perception. Take with ashwaghanda as nerve tonic in 1:4 ratio. 

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Organoleptic notes:

Light and voluminous, large dark green rolled leaves, dry and crinkly, generic “herb” smell - not as aromatic as other families. 

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future plans - daily infusion: 

Skullcap25gms Lemon Balm 25gms Chamomile25gms Passionflower  15gms Lavender flower10gms

The dosage to have a pronounced effect is about 2-3 heaped tsps. to one large cup of boiling water. Cover the cup or whatever you are using for a good 10 minutes, then strain and drink. Adding some honey may be welcome

Skullcap combines perfectly with Passionflower for tension and anxiety, with Chamomile for digestive upsets and with Lemon Balm for moody or depressed spirits.

Class discussion: Soothing, calming, mild. Sweet smell, strong taste as an infusion. Antispasmodic. Slow/heavy/dull. Great in formulas for sleep/relaxation. 

_ BMMC 2: Postpartum Feb 2018

[midwifemedicine]

St. John’s Wort: Hypericum perforatum

• Family: Hypericaceae (St. John’s Wort family)

• Preparations/dose: 

Aerial parts are used medicinally. 

Tincture - 1:2 or 1:5: 40-60 drops, three to four time per day // 

Tea - Add 2 tsp. dried flowers/buds to 8oz. hot water, steep 30-40 minutes. Take 4oz. three to four times per day // 

Capsules - take a capsule containing 350mg of standardized extracted three times per day // 

Infused oil - applied topically as needed.

• Herbal actions: antidepressant, nervine tonic, antiviral, vulnerary, antimicrobial (topically), antiinflammatory, astringent

• System affinities: nervous system (depression, anxiety, nervousness), immune system (antiviral, antibacterial), integumentary system (wound healing).

• Safety: Pregnancy Category B1: No increased risk of teratogenic effects noted with limited use during pregnancy; minor adverse effects/teratogenic effects noted with high dose use in mice, however how this translates to effects on human fetus’ is unknown (Mills & Bone, 2005).

Lactation Category CC: may be used during breastfeeding, however it should be used cautiously and under the supervision of a healthcare provider. Mills and Bone (2005) state because SJW  penetrates  through the blood-brain barrier poorly, it is likely that it would cross the breast milk compartment poorly as well.

• Other notes:

The common name “St. John’s wort” comes from the traditional flowering and harvesting on St. John’s Day. The translation from Greek of Hypericum is above (hyper) and picture (eikon). This name originated from the tradition of warding off evil with this plant by hanging plants over religious icons on St. John’s Day.

Though modern herbalism projects it as the “depression” herb, it is useful for other things as well historically. It has been described as the arnica for nerves. The aerial flowering parts of SJW have been used in traditional European medicine for centuries  to treat neuralgia, anxiety, neurosis, and depression, 

How to positively identify Hypericum perforatum:

When the leaves are viewed up close (held up towards light) they have many tiny little spots on them like pinholes (“perforated” like the name perforatum).  These spots are actually translucent glands, not holes.

When the flower heads are pinched and squeezed in the fingers, a red pigment can be seen left on the fingers.  This has a very distinct SJW fragrance.  When making SJW tincture, the tincture almost immediately turns red once alcohol is poured over the plant.  This is in part due to the compound hypericin.

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Organoleptic notes:

Have used SJW extensively in the past for mental health/SADD support, with mixed results. It seemed to help somewhat, but perhaps not more than the placebo effect after a few months of use. In hindsight, this may be because I don’t make enough serotonin without supplementation, and without adequate levels of serotonin, I won’t benefit from SJW’s SSRI effect. Would like to try SJW again after some more time regularly supplementing with nettle. 

Class discussion: helps balance depleted neurotransmitters. Feeds into 5-HTP substrate > serotonin > melatonin. Helps with focus, insomnia. Supports metabolism (cytochrome P450). Mobile, clearing. 

– 

BMMC 2: Postpartum  Feb 2018

[midwifemedicine]

Lemon balm: Melissa officinalis

• Family: Lamiaceae (mint family)

•Preparations/dose:  Topical HSV therapy -  topical cream containing 1% dried herb applied as early as possible in infection //

Infusion -  In a covered contained, infuse 2-3 tsp dried herb in 1 cup boiling water for 10-15 minutes. Drink twice daily, once each in morning and evening

//

Tincture - 2-6 mL 3 times per day, 1:5 in 40% 

• Herbal actions: antioxidant, hypoglycemic, hypolipidemic, antimicrobial, anticancer, antidepressant, anxiolytic, antinociceptive, anti-inflammatory and spasmolytic properties, carminative, cardiac tonic, diaphoretic, thyroid stimulating hormone (TSH) antagonist, hepatic, vasodilatory

• Indications: HSV lesions, neuralgia, anxiety, insomnia, migraine, high blood pressure, depression, postpartum depression, digestive spasms

• Contraindications: No known contraindications, but those with thyroiditis should avoid as it may interfere with thyroid hormone • Other notes:

Dried or fresh arial parts are those used for medicine. 

When the plant is in flower, it is trying to attract beneficial pollinators to it, and thus it increases the synthesis of these types of volatile oils.  Plants synthesize these compounds also to prevent predation, we see that the “protective” oils are more often synthesized when the plant goes to seed.  The scent of lemon balm will be slightly different between the flowering and seeding stages, for this reason.  We find more of the types of volatile oil compounds that are balancing to our nervous system when the plant is in flower, and more of the antimicrobial types of compounds when it’s in seed.  This is a subtle difference.

Some traditional uses include: nervine tonic (insomnia, memory enhancer), antidote to toxic mushrooms, wound disinfectant (scorpion bites, dog bites, spider bites), carminative, cardiac tonic, intestinal ulcers, toothache, earache, morning sickness, sleeplessness (caused by heart break, melancholy and sadness), depression, anxiety, obsession, psychosis, and mild sedative.

//

Organoleptic notes: Finely ground softer green leaves mixed with woodier bits. Smells earthy, hay-like, pleasant. Did not try due to my thyroiditis.

Class discussion: mobile ~ uplifting, energizing, may move away digestive discomfort, constipation, or anxiety, lemon-y, aromatic. Childlike. Prolific self-seeded perennial. Can reduce blood pressure (use w/ hawthorne for trending BP). Synergizes with skullcap, passionflower. 

_ BMMC 2: Postpartum Feb 2018

[midwifemedicine]

Witch hazel: Hamamelis virginiana

• Family: Hamamelidaceae (Witch hazel family)

• Native habitat: Witch hazel is found primarily in damp woods in Eastern North America. Witch hazel grows as a deciduous shrub that flowers in the fall. It can be cultivated also in Europe and Canada. Being from a damp woodland environment, the aqueous bark of witch hazel was traditionally used to treat hemorrhage, inflammation, and hemorrhoids.  There are four species of witch hazel found in North America, and one in Japan. Witch hazel grows naturally in cooler climates with defined seasons such as along the eastern coast of the United States and in the high, cold terrain of the Ozark Mountains. Witch hazel tolerates a range of light levels, from full sun to heavy shade. Full sun is best for most cultivated witch hazels because it produces a more compact shape with more spectacular blooming, although light shade is beneficial in hotter climates where drought it common.

• Preparations/dose: Witch hazel is commonly prepared as a distillate, infusion, tincture or ointment.  It can be found in many households/drugstores in the distilled form and is one of the easiest-to-use astringents for external use. Can be made into/used as an active component in topical ointments and suppositories or as a mouthwash to treat inflammation of gums and mucous membranes of the mouth. 

• Herbal actions: astringent, anti-inflammatory. Bark and leaf are the therapeutic parts. The main constituent in witch hazel is tannins; witch hazel leaf contains 3-10% tannins and witch hazel bark contains 8-12% tannins. 

• Indications:  Minor skin injuries, local inflammation of skin and mucous membranes (including eye irritation), hemorrhoids, and varicose veins. Can also be used for oral hygiene.  

• Contraindications: There are no contraindications for witch hazel, no drug interactions known, and no safety issues in regards to pregnancy and lactation.

//

Organoleptic notes:

Extract sample we received from class: classic witch hazel! Light in color, a little more impressionable in smell: like half alcoholic/half vinegar but somehow something more organically occurring.  Applied to back of hand, felt gentle tingling. Will tuck this away for future use as indicated. 

Class discussion: Cooling, astringent, healing for skin. Can be too drying for some people. 

-- 

BMMC 2: Postpartum  Jan 2018

[midwifemedicine]

Poplar buds: Populus candicans

• Family: Salicaceae (willow family) • Native habitat: Poplar thrives in flood plains. It grows primarily in the northernmost America and grows transcontinentally.

• Preparations/dose:  Aquaeous infusion for oral gargling with preparations may relieve laryngitis, external preparations for topical treatment. 

• Herbal actions: Stimulating expectorant, antimicrobial, vulnerary. 

Poplar buds contain a therapeutically active exudate that is used in topical treatments for skin injury, hemorrhoids, frostbite, and sunburn. Topically, the volatile oils offer therapeutic properties while the flavonoids offer anti-inflammatory agents to provide the vulnerary actions and efficacy of the poplar buds.  Both buds and bark are effective when used topically.

The antibacterial properties are due mainly to the caffeates and the expectorant action of the volatile oils which have been used for  expectorant, antiseptic and anti-inflammatories. In addition to the volatile oils, the flavonoids in poplar buds attribute to the antimicrobial properties.

Poplars are used topically for encouraging wound healing, taken orally as a stimulant and expectorant, and have a foliar chemistry. Due to their immune stimulating, anticatarrhals, and diaphoretics properties, they can be useful in healing upper respiratory tract infections. 

• Indications: superficial skin injuries, external hemorrhoids, frostbites, sunburn, skin injuries (sores, bruises, cuts, pimples), sore throat, cough, laryngitis, chronic bronchitis, rheumatism, arthritis, psoriasis, dry eczema

• Contraindications: sensitivity to popular buds, propolis, Peruvian balsam, salicylate

• Other notes: Collect unopened buds in fall-winter, dry, and store in glass jars. aka Balm of Gilead 

//

Organoleptic notes:

Poplar-infused olive oil: smells very medicinal, reminds me of cherry cough syrup from my childhood. The smell is strong; a tiny drop rubbed into my hand lingers. 

Beeswax salve ~ recipe adapted from James Green’s The Herbal Medicine-Maker’s Handbook. ~ .78 oz poplar-infused olive oil  (sample received in class) ~ 1/3 oz beeswax chips Consistency is too hard! Use less beeswax in future. Need to re-heat and add more coconut oil. 

Therapeutic effect: used three consecutive nights as topical ointment on my neck and chest to treat a lingering cough (like a homemade Vick’s Vapo rub) ...cough definitely subsided some, especially immediately, but hard to tell if it was on the way out anyway or if the poplar did the trick. Regardless, it was a very pleasant experience to make and use, and it smells/feels potent enough that I think there is some therapeutic benefit. 

– BMMC II: Postpartum. Jan 2018

[midwifemedicine]

Comfrey: Symphytum officinale

• Family: Boraginaceae (Forget-me-not family)

• Native habitat: Native to Europe and temperate Asia. It can be found along rivers, banks, and general wet-places.

•Preparations/dose: 

For leaf ointments and other external preparations = contains 5-20% dried leaf; Commision E recommends that “the daily applied dosage not exceed 100 mcg of pyrrolizidine alkaloids with 1,2-unsaturated necine structure, including their N-oxides”; duration of administration is < 4-6 wks/yr. 

For root ointments and other external preparations = crushed root/extracts can be made into semi-solid preparations and poultices for external use; contains 5-20% dried root; similar recommendations to not exceed 100 mcg of daily applied dosage; duration of administration is < 4-6 wks/yr. 

• Herbal actions: Vulnerary, demulcent, anti-inflammatory, astringent, expectorant. Comfrey is used in acute wound healing (it’s not recommended to use comfrey for long periods of time). It boosts skin cell production to help heal wounds faster.  Comfrey has also been known to help treat inflammation to muscles, skin, and joints.  Comfrey root is a mucilage and acts as a demulcent.  Comfrey is mildly astringent and an expectorant and can be used to treat lung problems and whooping cough. 

• Indications: Herb & leaf - bruises, sprains. Root - bruising, pulled muscles and ligaments, sprains.

• Contraindications: Apply only to intact skin. No contraindications or drug interactions known for comfrey. No safety issues known in pregnancy and lactation.

• System affinities: Integumentary, respiratory 

• Other notes:

Comfrey is a commonly used plant for healing damaged tissue from wounds - it is indicated for minor cuts but you would want to use caution for deep wounds in the initial healing phase. For very deep wounds, since this is a very effective herb for stimulating cell proliferation it may close off the surface tissue leaving an abscess deeper down.  It’s ideal for the secondary healing phase of deep wounds though, once the tissue has knit together deeply then comfrey can be applied topically to help with the surface healing and to prevent scarring (like with Cesarean incision healing)

//

Organoleptic notes:

Dried comfrey leaves: rich green, pretty curled edges, not prickly to the touch, but almost so. Smells sweet, subtly medicinal, almost resinous. 

Beeswax salve ~ recipe adapted from James Green’s The Herbal Medicine-Maker’s Handbook.  ~ 5tablespoons coconut oil (1/3 cup) ~ 0.2 oz dried comfrey (sample received in class)  ~ 1/3 oz beeswax chips Simmer comfrey in coconut oil over medium-high heat for 2-3 minutes. After oil turns green and becomes fragrant, reduce to medium heat for an additional 10 minutes. 

Remove from heat, strain out comfrey leaves, and stir in beeswax chips until melted. Set in fridge to harden and cool.  Applied twice/day to a cut on the pad of my thumb that had been reluctant to heal due to it being a high-exposure part of the body! Looking forward to seeing how it expedites (fingers crossed) the healing process. 

Update (2/13) -- Consistency is too hard! Use less beeswax in future. Need to re-heat and add more coconut oil. Also take care not to burn comfrey in future. 

Have had success with applying salve to face overnight - makes a temporary but remarkable reduction in acne, inflammation, redness. 

Class discussion: Reduction in redness/acne, excellent for sunburn as a hydrosol. Soft/dull/smooth/heavy/stable.

– BMMC II: Postpartum. Jan 2018

[midwifemedicine]

Gotu kola: Centella asiatica

• Family: Apiaceae (parsley or carrot family) 

• Native habitat: Native to SE Asia including: India, Sri Lanka, China, Indonesia and Malaysia, South Africa and Madagascar. Has now been found in Turkey, South America and West Indies,Iran, Pakistan, Australia and Southern USA.  Grows well in warmer regions of north and south hemispheres up to altitudes of 7000 ft. It prefers swampy and damp areas of fields, shady places and along river beds, streams and ponds. It has been found along stone walls and rocky areas at 2000 ft in India and Sri Lanka.

• Preparations/dose:  Tincture 1:2: 20-40 drops, three times per day // Tea: Add 1 tsp dried herb to 8 oz hot water, steep 30-40 minutes. Take up to 4oz. four times per day. 

• Herbal actions: Adaptogen, sedative, antidepressant, anxiolytic, nervine, antispasmodic, nootropic, stimulant, vulnerary

• Indications: Poor memory, head trauma injuries, anxiety, mental fatigue, and irritability, depression, anxiety, stress, memory, and mental fatigue, connective tissue repair, keloid formation or hypertrophy of scars, burns.

• Contraindications: allergy to the Apiaceae family.

• System affinities:  Nervous system, integumentary system

• Other notes:

It’s a nice adaptogen for recovering from a cesarean birth, when there is so much connective tissue and nerve tissue undergoing repair, possible birth trauma being processed, and the increased stress of recovering from surgery while also initiating lactation and dealing with sleep deprivation. 

Lactation Safety: Category C: “Compatible with breastfeeding” (Mills & Bone, 2005). Pregnancy Safety: Category B1: “No increase in frequency of malformation or other harmful effects on the foetus from limited us in women. No evidence of increased foetal damage in animal studies” (Mills & Bone, 2005). History of use as a contraceptive agent in Bengal. 

//

Organoleptic notes:

Dried plant is dark green with small amounts of brown pieces, not soft nor firm, smells pleasantly grassy, reminds me of matcha.  Infusion: 1 tsp of gotu kola steeped in 8 oz hot water for 35 minutes. After straining, the color is a light golden-green. Smells and tastes lightly musty, in a pleasant, palatable way. Feels slightly drying in the mouth. Earthy and easy to drink. Drank this at 8:30pm as I was facing several more hours of homework, and I think it definitely helped me power through. Physically I felt about the same, but was able to focus and stay awake until midnight a little more easily than I had expected. Looking forward to continuing to use gotu kola as a late night coffee replacement.

Class discussion: Good for formulating - mask taste with something else! Excellent for people who need support healing connective tissue (c/s incisions). Focus. Works for all people, energetically. Peppery/culinary herb. 

// 

BMMC II: Postpartum. Jan 2018

[midwifemedicine]

Ashwagandha: Withania somnifera

• Family: Solanaceae (nightshades) ~ warming, stimulating, drying. Roots of ashwagandha are less irritable to people with nightshade sensitivities. 

• Native habitat: drier subtropics, adapts well to dry conditions. Grown as an annual in temperate climates. Needs well-drained soil and full sun. Sourced from India, Pakistan, Sri Lanka, parts of Africa or cultivated like tomato plants (planted inside, set outside in full sun after frost risk ends). Harvest roots in fall/winter. 

•Preparations/dose: tincture of fresh or dried root (1:5) ~ 30-40 drops, t.i.d. //  decoction ~ 1/2 tsp dried root in 8 oz water and decocted for 10 min and steeped for 30 min, t.i.d. //  capsules ~ one 400-500 mg capsules 2x/day // powder ~ 1/2 - 1 tsp mixed into milk, water, honey, food, t.i.d. 

• Herbal actions: adaptogen, anti-inflammatory, antioxidant, immune amphoteric/modulator, anti-tumor, hepatic support, nervine (anxiolytic and antidepressant), antispasmodic, mild astringent, diuretic, neuroprotective 

• Indications: anemia, anxiety, depression, diuretic, edema, exhaustion, chronic fatigue, hypothyroidism, immune dysfunction, infertility, insomnia, glycemic dysfunction, recurrent miscarriage, memory loss, cardiovascular protection, nervous system exhaustion due to stress, infertility, lactation problems 

• Contraindications: hemochromatosis, hyperthyroidism, PCOS or androgen excess 

• System affinities: nervous system (calming, stress reduction), immune system (inhibits inflammation and increases lymphocytes/T cells), reproductive system (strengthens semen and tones uterus), endocrine system (regulates thyroid) 

• Other notes: Energetic qualities are bitter, sweet, and dry. Indicated for nerve pain, insomnia, weakness of mind, calming for all constitutions. Combine with milk, honey, or ghee for traditional method of consumption. For pregnancy: low doses likely safe, avoid large doses, not the ideal herb for adrenal support. Conflicting ethnobotanical support - some cultures used for miscarriage support and prevention, others as abortifacient. 

// 

Organoleptic notes: 

Dried root looks like miniature wood chips. Tan and dark brown in color. Firm, sharp. Sounds crinkly. Smells quite pleasant ... earthy, sweet, subtle. Tastes rough, unpleasant, and dry. 

Decoction: 1 tsp in 8 oz water decocted for 10 minutes. Smells sweeter, like a subtle licorice. Looked weak and light in color - found in personally unpalatable (reminded me of dish water...) and managed to drink only half a cup. 

Soothing, calming. Noticed no other significant effect. Would like to try powdered as a miele. 

-- BMMC II: Postpartum.  Jan 2018

[midwifemedicine]

Rhodiola: Rhodiola rosea

• Family: Crassulaceae (succulents)

• Native habitat: cold climates, high altitudes, and seaside cliffs originally in Asia and now throughout the Northern Hemisphere. Traditionally used as an adaptogen for coping in cold, high-altitude, stressful, or difficult places, and to increase energy and focus.

• Sourcing: organic cultivation in North American and small amounts of wild-harvested herb from certified wild lands in China 

• Indications: fatigue, anxiety, depression, unstable mood, desire for enhanced physical performance, stress, infertility, insomnia/sleep disturbance, anemia of pregnancy clouded or slow mental capacity, desire to increase memory and/or productivity 

• Herbal actions: Adaptogen, antidepressant, antioxidant, antiviral, immune system stimulant, nervine, mild CNS stimulant, anti-arrhythmic, cardioprotective, neuroprotective, tonic 

• Dosing: tincture (1:4) ~ 40-60 drops, t.i.d. // decoction ~ 1-2 tsp roots decocted in 8-10 oz of water for 15 minutes, steep for additional 45 minutes and take 1-3 cups/day // capsules ~ standardized to 3-5% rosavins and 1% salidroside. Take 2-4/day.

• Safety: Very safe. Avoid if bipolar, manic, or paranoid. 

• Energetic qualities: Cooling to acute stress and pain, warming and stimulating long-term. Drying and good for those with wetter constitutions. 

• Other notes: Short onset of action, great for acute stress. May prevent or ameliorate age-related memory dysfunction. Very astringent - use with milky oat or coconut oil or ghee for people with dryer constitutions.  // Organoleptic notes: 

Dried root is tan and light brown, firm like fibrous pebbles (or Grape Nuts cereal!) and roughly cut. Smells subtly sweet, hay-like or dry fall leaves. Sound is crinkly when rubbed together. Taste of dry root is very bitter, with subtle floral undernotes. 

Decoction: 2 tbsp in 10 oz water, boiled and simmered. Smells overwhelmingly sweet, like herbal licorice. Taste is overwhelmingly astringent!! Very full-bodied mouth feel ... technically a neutral taste that then turns instantly astringent.  Quelled my headache and settled stomach. Smells sweet, tastes bitter. 

Next time: try more often in situations of acute stress. Try as a tincture instead, perhaps.  _

BMMC II: Postpartum. Jan 2018