Homeopathy Under Attack

In the last few years there has been a growing trend to discredit natural healing traditions. Always looking for a controversial subject to cash in on, the media has jumped in on this one with both feet. The primary target that has been in the crosshairs of all of this vitriol is homeopathy. Because the principles of homeopathy can not be explained by modern scientific theory it is an easy target. Although most of the skeptics will be satisfied if homeopathy is thoroughly discredited, the more extreme of the lot are hoping that they will be so successful making homeopathy look incredibly far fetched and ridiculous that it will be easy to extrapolate that sentiment to other systems of healing. In writing this post, I have no interest in debating with the skeptics because it is pointless. I'm putting this out there for those of you who are confused by all of the misinformation that has been propagated in the media. Hopefully it will help you to have a better understanding of the issues.

For my next post I was planning to write the second installment of my series on vaccinations, itself a very controversial subject these days. As we shall see, it is closely related to the homeopathy debate (or lack of it!). I had originally intended to steer clear of homeopathy because I have a limited amount of time for writing and there are other things I want to write about. I was hoping that with time people would just get bored of it and move on to something else. However, instead of fading away this issue has been building momentum and a couple of recent attacks that are relatively close to home grabbed my attention. Firstly, a group of scientists have attacked University of Toronto for proposing some good research on homeopathy. The chief researcher of the study, which is intended to examine homeopathy as a treatment for children with Attention Deficit Hyperactivity Disorder, is Heather Boon of the Department of Pharmacy. In proposing this study her credibility has also come under attack. I met Heather a few times quite awhile ago. I don't know her very well, but I am familiar with some of her work. She is someone who seems to me to be very committed to doing quality research on complementary and alternative medicine (CAM). The essence of the attack on Heather and U of T is that, although the proposed study is well-designed, since we already know that homeopathy doesn't work conducting this study is a waste of time and money.

That happened a few weeks ago. More recently the government of Ontario has come under attack for regulating homeopaths in this province. This has been in process since 2007 when the Homeopathy Act was tabled and finally came to completion a couple of weeks ago when the Act was passed. The provincial government is being condemned for legitimizing homeopathy.

Samuel Hahnemann, the founder of homeopathy.

This story begins at the end of the 18th century when purging, bleeding, high doses of mercury and poor hygiene were typical of the practices of mainstream medicine. At that time there was already a growing divide between the practices of orthodox medicine and more natural healing traditions, although there was a lot of grey in between. Enter Samuel Hahnemann. He was a medical doctor that wasn't happy with the practices of his time. He saw them as counter to the traditional healing principles that date back to Hippocrates and beyond. I'm not going to get into a detailed discussion of the principles of homeopathy because that would require a book, but what's important is that by the end of the 19th century the homeopaths were better organized and had better standards and hospitals throughout Europe and North America than their mainstream counterparts. As a result, they were perceived as a major threat by allopathic medical practitioners who used financial and political influence to gradually discredit or absorb most of the homeopaths. This was easier to do by the early 20th century because mainstream medical science was starting to mature and the public no longer perceived going to a doctor as such a scary prospect.

The influence of homeopathy may have been reduced but it never went away. In some parts of the world, such as India, it continued to flourish. Fast forward to the 1960s and we have the beginning of a renaissance of natural healing traditions that continues to this day. During this time homeopathy has prospered along with herbalism and many other natural healing modalities, and natural health products have become big business.

The growing popularity of natural healing has not been universally appreciated, as is always the case when money, influence and a clash of paradigms occurs. The four major antagonistic sectors are the pharmaceutical industry, medical doctors, pharmacists, medical researchers, and the associations that represent them. Although the growth of the natural health product industry has to some extent been at the expense of the profits of the pharmaceutical industry, the latter has chosen to adapt by diversifying. That primarily translates into buying up successful natural health products manufacturers.

Of course, not everyone who is a member of one of these groups is antagonistic to CAM. But many of them are. In spite of this, medical doctors and pharmacists are mostly too busy to care and pharmacists are happy to reap the profits of natural health product sales whether or not they believe in them. There are, however, a minority of extremists among the doctors and pharmacists who are very antagonistic to CAM.

The recent wave of attacks has to a significant extent been championed by medical researchers, supported by the professional skeptics who are always out their proselytizing. Although there is a definite clash of paradigms at the root of this, a big part of it is about money. In response to its growing popularity, many governments and universities have chosen to devote a small proportion of their research dollars to investigating CAM. For the most part this is a good thing because CAM research in the West is lagging way behind the research that is being done in Eastern countries such as China and India where traditional healing systems have continued to be appreciated.

The result of these changes is that it is now slightly more difficult for researchers who are doing mainstream medical research, many of whom are antagonistic to CAM, to get funding. As they see it, all of the research money rightfully belongs to them and it is being wasted funding research on what they see as pseudoscientific or completely unscientific healing modalities.

In laying out this background, what is not apparent is why the skeptics are particularly focusing on homeopathy. Basically it is this: in accordance with the principles of homeopathy, homeopathic remedies are subjected to a "potentization" process that involves diluting them in fixed ratios and shaking each dilution vigorously before diluting them again. Remedies are used at a variety of different dilutions, but they can potentially be diluted to the point where few, if any, of the molecules of the substance from which the remedy is derived are present. According to homeopathic theory and practice, the more times a remedy is subjected to this potentization process the more potent it becomes, even if on a chemical level it is becoming more dilute.

No one knows with absolute certainty how homeopathic remedies work.

From the perspective of the modern reductionistic, materialistic paradigm, this is absolute nonsense! How can something that has no molecular basis be more potent or have any therapeutic value at all? According to Hahnemann, the potentization process separates and intensifies the "vital force" or life force of the substance and it is this vital force that is primarily responsible for the therapeutic action of the remedy. More recently homeopaths, in an attempt to explain the actions of these remedies in more modern terms, have postulated mechanisms such as the transfer of this life force energy into the water in a way that alters the bonding angle or the electromagnetic field of water molecules, or possibly that they act within the realm of quantum mechanics. These are just hypotheses. The bottom line is that if homeopathic remedies work they operate in a way that can not currently be explained by the known laws of chemistry or physics. This is the crux of the matter.

The attack on homeopathy is fear-based. One of the unfortunate characteristics of human nature, at least how it is expressed in the modern world, is that when people invest a lot of energy into a belief system they (consciously or unconsciously) are afraid of alternative beliefs. Some people can just agree to disagree, but others are more zealous. Human history is full of examples of groups of people acting with violence against other groups of people who held different religious, political or other beliefs. Although scientists like to believe that they are beyond this and act on the basis of reason, the history of science says otherwise. The majority of scientists are dogmatists to varying degrees who do not question the reigning scientific paradigm of their era.

As anyone who has read a few of my posts knows, I'm actually a fan of science! However, for any field of inquiry to be useful we must recognize its limitations. Science, when practiced appropriately, is a very useful way to explore the world that we live in. However, it is only one of a number of different ways to explore the world. Each is legitimate within its field of reference and each has its strengths and limitations. Each also affects how we perceive the world. If we approach the world in a rationalistic, reductionistic, materialistic way, the world will appear to us as a rationalistic, reductionistic, materialistic place. This is one of the major mistakes that most scientists make. Objectivity is an illusion. The world will tend to appear in ways that conform to how we look at it. Even when it doesn't, we tend ignore, misinterpret or deny experiences that don't conform to our world view.

When science is done properly it is a beautiful thing. We approach the world as the big, beautiful, mysterious place that it is. We are humbled by it, knowing that it is infinitely bigger and more complex than we can every hope to comprehend with our rational mind. As soon as we fall into the trap that we have things figured out we are no longer doing science because our beliefs affect the kinds of questions that we ask and how we perceive and interpret the results. Our beliefs can even cause us to see things in the results that aren't there or to manipulate the results so that they conform to our expectations.

The mystery of Nature: the source of all healing!

Getting back to homeopathy, if we want to truly investigate it in a scientific way the first thing we need to do is separate the effect from the explanation of the effect. The most important thing to investigate is whether or not homeopathic remedies work. If we focus on the explanation, we risk throwing out the baby with the bathwater because if the explanation turns out to be false there is a tendency to assume that the effect is also false. As a healer, I subscribe to a particular paradigm because it is what best conforms to my experience and produces the best results. However, my goal is to heal. Healing is a beautiful and mysterious thing. It doesn't matter to me if my understanding of why what I do works is accurate. What matters most is that it helps people. Similarly, demonstrating whether or not homeopathic remedies work is the most important thing. If it turns out that they do, the appropriate response is not to reject the results because they don't conform to our theories, it is to re-examine our theories because clearly they are inadequate to explain our observations.

One of the major arguments against homeopathy is that it is not supported by research. In fact, one of the reasons that the attack on homeopathy has recently ramped up so intensely is because the Australian National Health and Medical Research Council (NHMRC) recently conducted a "review" of the available research on homeopathy and concluded that the research overwhelmingly demonstrates that homeopathic remedies do not work any better than a placebo. Although it is true that there aren't many good studies on homeopathy, this conclusion is not accurate for a number of reasons. Firstly, good quality human clinical studies are very expensive to conduct and, in general, it's difficult to get funding for studies on homeopathy. Consequently, there aren't very many studies out there on homeopathy and most of them aren't very good. Another issue is that homeopaths are not part of the mainstream research community. If they attempt to do studies, it is difficult for them to get sufficient funding and they, as a rule, don't have a lot of experience doing research. Conversely, most experienced researchers aren't interested in doing research on homeopathy, and even if they are, they don't understand homeopathy. This means that their research is likely to be conducted from a modern medical paradigm and is not accurately testing homeopathy the way it is actually practiced. Finally, many of the people who have done studies on homeopathy are really trying to disprove it. Thus their studies are significantly biased. The Australian NHMRC itself was also trying to disprove homeopathy, so their analysis is extremely suspect.

Personally, I can not speak to the quality of the studies on homeopathy out there because most of the people who are writing about them are biased one way or the other and I simply don't have time to review the actual studies myself. However, I am familiar with one study which illustrates my point. In the late 80s a French researcher, Jacques Benveniste, did a study which seemed to demonstrate the effectiveness of homeopathy. He submitted a paper to Nature magazine. Not surprisingly, they were skeptical of his findings. They told him that in order to publish it he would have to incorporate some additional controls in the study and also have it replicated at other labs. He made the suggested changes and his study was replicated by researchers at University of Toronto, University of Milano and Hebrew University. When he resubmitted the paper, Nature begrudgingly published it because they said that they would, but in an uncharacteristic move they also published an editorial attacking the study. They then sent a team of "experts" to examine Benveniste's methodology. This is completely unprecedented! They would never do this with researchers whose research conforms with the mainstream medical paradigm, even if the research was of a much poorer quality. In addition, none of the "experts" were actual researchers and only one of them was a scientist, but from a completely different field of study. Their sole intent was to discredit Benveniste. They had him repeatedly redo his experiment under more extreme controls even though the results remained consistent, until finally they got the results that they wanted and this is what was reported. From their perspective, that of Nature, and most of the scientific skeptics in the world, Benveniste's results were disproved and the positive results that he did get were due to some flaw in the design of the study that they were not able to determine. Benveniste later conducted even better designed studies and got consistent results but Nature refused to publish them. Shortly after, the French Institute of Health and Medical Research cut his funding after a routine evaluation of his lab. Although they acknowledged that his lab exceeded their standards, they cut his funding because he refused to stop doing research on microdoses.

Needless to say, the whole Benveniste affair has very little to do with real science and all of the characteristics of a witch hunt. Even some scientists who are skeptical of homeopathy have criticized the way it all went down.

When evaluating healing systems that are outside of the mainstream, "not supported by scientific evidence" is one of the common criticisms. What is interesting to me is how skeptics like to apply strict criteria to the evaluation of things that they don't believe in, but are willing to accept far lower standards for things that they support. For instance, many of the practices of modern medicine have little to no research backing them up and medical practitioners often continue to practice them even when the research clearly demonstrates that they are ineffective [see: http://www.scientificamerican.com/article/demand-better-health-care-book/ and http://well.blogs.nytimes.com/2009/04/02/the-ideology-of-health-care/?_r=0]. It is also quite common that things that initially seem to be backed up by research turn out to be false [see: http://www.huffingtonpost.com/alison-rose-levy/what-statins-transfats-and-gmos-tell-us-about-scientific-controversies_b_4385741.html and http://www.newyorker.com/magazine/2010/12/13/the-truth-wears-off]. To a large extent this is because of the biases of researchers, whether ideological or because the people conducting and funding the research have a vested interested in the results of the study [see: http://www.scientificamerican.com/article/trial-sans-error-how-pharma-funded-research-cherry-picks-positive-results/ and http://www.sciencedaily.com/releases/2015/04/150403073439.htm and http://www.sciencedaily.com/releases/2014/10/141021141746.htm and http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124].

Although there are many medical practitioners that genuinely want to find ways to help people who are sick or suffering, sadly, even those who are coming from a good place are largely barking up the wrong tree. Although mainstream medicine has made great progress when it comes to emergency interventions, it is largely unsuccessful when it comes to the treatment of chronic health conditions. In fact, it has actually contributed to the growing epidemic of chronic degenerative diseases, both as a result of its toxicity and side-effects [see my previous post The Vaccination Controversy, Part 1] and by promising magical cures that don't really work. This is because modern medicine is not really about healing. It is about palliative care - suppressing or neutralizing symptoms rather than understanding and addressing the underlying condition. A good example is the so-called "war on cancer". In spite of the billions of dollars that have been spent funding the cancer industry, with the exception of childhood leukemia a person's prognosis if they are diagnosed with some form of cancer is no better today than it was 60 years ago [see: http://blogs.scientificamerican.com/cross-check/2014/05/21/sorry-but-so-far-war-on-cancer-has-been-a-bust/]! Lots of new drugs have been developed and profits made, but the actual results speak for themselves.

Another comment that is interesting to me is that homeopathic remedies are "just placebos". They speak about placebos as if they are something to be written off, but the placebo effect is one of the most interesting things ever demonstrated by medical science. It is a demonstration of the healing power of the human mind! If anything, we should be doing a lot more research on the placebo effect. For one thing, so called "placebo controlled" studies aren't even properly designed to determine the magnitude of the placebo effect [see: http://www.sciencedaily.com/releases/2015/04/150413140906.htm]. Secondly, the placebo effect is a very powerful and important part of the healing process. It should be cultivated, not written off, because the beneficial affects of ALL treatments, conventional and natural, are partly due to the placebo effect [see: http://blogs.scientificamerican.com/cross-check/2013/03/12/psychiatrists-instead-of-being-embarrassed-by-placebo-effect-should-embrace-it-author-says/]. This is why it is a very dangerous thing to attempt to convince someone with a serious illness that they shouldn't follow a treatment that they really believe in. What this does is instill doubt and fear in people and it can significantly hinder the outcome of their treatment. Similarly, there is also a negative placebo effect. Just as a person's belief in the benefits of a treatment can significantly improve the effectiveness of the treatment, their disbelief in the benefits of a treatment can significantly hinder the effectiveness of the treatment. This is one of the reasons why there is usually no point attempting to convince someone to undergo a treatment that they don't believe in (the other reason is that they are less likely to properly follow instructions or continue the treatment long enough for it to be effective). As a practitioner, the best thing we can do is attempt to educate a person in as unbiased a way possible about the potential benefits and limitations of their treatment options and allow them to choose what they feel is best for them.

St. Johnswort (Hypericum perforatum) is an amazing herb for the treatment of nerve trauma and inflammation. For this purpose it works

both in crude form and in homeopathic potencies, but it works best when both are used concurrently.

Getting back to homeopathy, regardless of how difficult it is to understand from a scientific perspective, it is completely unrealistic to assume that the tens of thousands of practitioners that have prescribed homeopathic remedies and the millions of people who have used them over the last couple of centuries are completely deluded. I have used homeopathy for myself, my family and pets. Although it is not my primary modality, I sometimes recommend homeopathic remedies to my clients as well. I can say with absolute certainty that they work. Interestingly, they work even better for animals than humans because animals don't have any negative beliefs about them. Because of their lack of beliefs, when animals demonstrate positive results from homeopathic remedies it can not be attributed to the placebo effect.

It certainly wouldn't hurt to fund some good quality, unbiased human clinical studies that investigate homeopathy in the context of how it is actually used to put this issue to rest once and for all. Unfortunately, this is unlikely to convince most of the skeptics. They are too attached to their theories. How the world really works is secondary. If such studies were to be done, I have confidence that the results will be positive. Once it is clear that homeopathy does work, then we can attempt to figure out why. It may be that we do not have the right technology to figure that out at the moment, or that we will never be able to with absolute certainty. As far as I am concerned, that doesn't matter. What matters is that homeopathic remedies when used correctly have a tremendous potential to help people. Positive healing outcomes are the most important thing. Good theories and explanations are useful, but not necessary.

For those who have been patiently waiting, I will continue my series on vaccinations in my next post.

Harvesting Herbs: Dancing With Weather

OK, I'm back! I haven't posted anything since I returned from my back-to-back trips to Mexico and Lake Superior - and, yes, my leg is doing great! I'll provide more on that in a future post.

Unlike last year, during which the warm weather came very early in the spring and the spring and first half of summer were extremely hot and dry, so far this year it has been unusually cool and wet in the region where I live. This can have a significant influence on many plant species. Each plant has an ideal habitat that it prefers, including type of soil, moisture level, amount of sun, and climatic conditions. However, there will be a range of conditions in which it can do well and a wider range of conditions that it can tolerate. What these conditions are and how much variation it can tolerate will vary from plant to plant.

The plant life in my area can be pretty lush when there is lots of moisture like there is this year.

There is always a certain amount of climatic variation in any given region. The amount of variation in the Great Lakes region where I live is probably moderate compared to other regions. However, since around 1970 our climate has been noticeably changing - and the amount of change has been increasing with each successive decade. The kind of change is consistent with what we can expect given global trends: a progressive warming with greater extremes. This has had a noticeable impact on plant and animal species.

So, let's get back to the conditions this year. It is fortunate that, although it has been cooler and wetter, we have at least had one or two sunny days most weeks and even on some of the days that it has rained there have been sunny breaks at some point during the day. As a result, some plants that do very poorly if there has been very little sun are managing to stay relatively healthy.

Many plants that don't do well if there is too much rain and too little sunshine are still doing fairly well this year.

On the other hand, there are a few plants that are looking a bit stressed. This is particularly the case for plants, such as a few of the bedstraw (Galium) species, that grow in lower light areas that are relatively moist. Examples include cleavers (G. aparine) and rough bedstraw (G. asprellum). When there is as much rain as we have been getting this year, the typically moist areas where some of these species grow tend to be moist to the point where they are somewhat wet - and not all plants that grow in these areas necessarily like wet conditions.

Rough bedstraw (Galium asprellum) is finding many of the areas where it lives too wet this year.

As an herbalist that wild-harvests almost all of the medicines that I work with, years when it is very cloudy, rainy and cool can be challenging in a couple of ways. Firstly, most herbs need to be harvested on a sunny day and there needs to be at least one additional sunny day between the day they are harvested and the last rain. For some plants there needs to be two sunny days in between. This is because the plant tissues tend to otherwise be too wet and there are many important constituents, such the components of essential oils, that are produced in much lower quantities if there isn't much sunshine. If there are too few consistent periods of sufficient sunshine, there are also a lot fewer days when herbs can be harvested. If the timing of the sunnier periods doesn't line up with when the herbs are ready to be harvested, I may not get some herbs that year. Secondly, there are some plants, such as red clover (Trifolium pratense) and common St. Johnswort (Hypericum perforatum) that are significantly less potent during such conditions to the point where it isn't even worth harvesting them. In unusually wet (and dry!) years many plants will also be affected by mildew, making them unusable.

Red clover (Trifolium pratense) isn't happy when it's too cloudy and wet!

When the conditions are cooler, cloudier and/or wetter than usual, it is best to harvest herbs in the sunnier parts of their range where they will get maximum direct sun and the soil will be a little bit drier. In years when it is hotter, sunnier and/or drier than usual, it is best to harvest herbs in the shadier parts of their range where they are more protected from excessive sunshine and the soil will be more moist. This year, herbs such as stinging nettle (Urtica dioica), which can tolerate full sun but doesn't usually do well in it, is doing very well in more open areas.

Our native stinging nettle (Urtica dioica ssp. gracilis) is doing very well this year in more open areas.

I typically spend about one day per week harvesting the medicines from mid April to mid May; two days per week from mid May to mid June; three days per week from mid June to the end of July; two days per week in August; one day per week in September; I only harvest on two to three days in October; and then it's back up to two days per week in November. This means that during harvesting season I have to minimize the amount of days that I have a fixed schedule, such as clinic days and scheduled classes and workshops. Which days I need to harvest on depends on when the herbs reach the right stage in their life cycle for harvesting and, of course, the weather! During the peak harvesting season I do my best to allow four to five days per week when I have nothing in particular scheduled so that I can head out on a moments notice whenever the herbs and the weather align! Fortunately, a lot of the work that I do can be scheduled around my harvesting days.

This intensive harvesting schedule means that if I harvest almost all of the herbs I use and don't cut any corners to ensure that the medicines are harvested in a respectful and ecologically sustainable way, and are the highest quality possible, I can only harvest and prepare enough medicines to comfortably run clinics two days per week scheduling about five to seven clients per day. I could maybe do three days per week if I really push it, but I would rather not. These constraints are fine with me. Healing work is very intensive. If one gives oneself fully to the medicine it is very difficult to be completely present when seeing more than 15-20 clients per week. It is essential that any healer live a balanced life and look after their own health and well-being in order to be able to fully live the medicine and offer the most to those who need it.

In my practice I only run clinics one day per week. The rest of the time I do other related work such as teaching, writing, and dealing with the various responsibilities I have as a result of being on the board of directors of both our provincial and national herbalist associations. For almost two years a lot of my time has also been devoted to converting the content of courses to an online format. This will continue for a couple of years, but out of necessity it slows down during harvesting season. By nature I do best with diversity and flexibility. My work also requires that I spend regular time deepening my relationship with Nature and the medicines, whether I'm out there observing or just being.

In years where the weather conditions verge towards the extremes it can make harvesting difficult. For instance, of the sixteen herbs that I had intended to harvest this spring, I only managed to harvest ten of them. Fortunately, I didn't need as many herbs as usual. This is partly because I will often harvest enough to prepare a two year supply of tincture for herbs that I use in low to moderate quantities so that I don't have to harvest every herb that I use every year. For herbs that I use in larger quantities this isn't possible. Also, last year I used less of some of the spring herbs than usual.

 American black elder (Sambucus nigra ssp. canadensis) is right on schedule this year!

Another challenge associated with more extreme weather conditions is that it can significantly alter the life cycle of a plant. Although the timing of some species such as black elder (Sambucus nigra) and yarrow (Achillea millefolium) is pretty consistent from year to year, others can vary by as much as one to four weeks depending on the weather.

This year lance-leaved heal-all (Prunella vulgaris ssp. lanceolata) came into flower sixteen days later than last year.

Ultimately, all I can do is surrender! Herbalists have always had to learn to work with whatever Nature provides. Fortunately, I work with enough medicines that if I can't harvest a sufficient quantity (or any!) of a particular herb in any given year I usually have one or more herbs that are similar enough that I can use as a substitute. In the mean time, looking ahead at the coming weeks there is still lots of rain in the forecast. In terms of the rest of the harvesting season, I'll just have to wait and see how the summer is going to unfold. All I know for sure is it will be an adventure!

Healing Bone Fractures, Part 3 of 5

This is the third in a series of posts in which I am documenting the process of treating a serious fracture of my right leg. In Part 1 I discussed the details behind the injury and the initial protocols that I used with the remedies I had available while I was still away. In Part 2 I provided a detailed account of the protocols that I implemented when I returned home. In this post I am providing an update on how things are progressing four weeks after my surgery and any modifications that I have made to the protocols that I am using.

Systemic Herbal Formulation: On the fifth day after my surgery I was finally able to make a specific herbal formulation to treat my injury. I made up a 250 bottle, which lasts two weeks at the dose I am taking (for the details see Part 2). This formula ran out during the third week after my surgery. Although I was only taking it for two weeks and I could have just repeated the same formula, I decided to make a slight change to the formula. Since there is no evidence of nerve damage, I eliminated the St. Johnswort (Hypericum perforatum). I also substituted stinging nettle (Urtica dioica) for common horsetail (Equisetum arvense). The second version of the formulation contains turmeric rhizome (Curcuma longa) 18%, stinging nettle herb (Urtica dioica) 20%, boneset herb (Eupatorium perfoliatum) 20%, American plantain herb (Plantago rugelii) 20%, common comfrey herb (Symphytum officinale) 15%, wild ginger rhizome (Asarum canadense) 5%, white pine leaf/twig (Pinus strobus) 2%. I am continuing to take 6 ml three times per day on an empty stomach, 5-10 minutes before each meal.

St. Johnswort (Hypericum perforatum), topically, systemically and in homeopathic potencies,

is a very important herb for healing nerve damage.

Herbal Sleep Formulation: Due to the changes to my primary systemic formulation I made a slight adjustment to the sleep formulation as well so that the two formulations remain well coordinated. It now contains English lavender flowering spike (Lavandula angustifolia) 15%, St. Johnswort herb (Hypericum perforatum) 15%, catnip herb (Nepeta cataria) 15%, American plantain herb (Plantago rugelii) 15%, hop strobilus (Humulus lupulus) 15%, stinging nettle herb (Urtica dioica) 15%, turmeric rhizome (Curcuma longa) 9%, white pine leaf/twig (Pinus strobus) 1%. Once more this formula overlaps with and carries over some of the properties of my daytime formula while still maintaining its effectiveness as a sleep formula. Just as with plantain, it is rare for stinging nettle herb to be acknowledged as a sedative in the herbal literature. In fact, it is a very calming herb, especially when harvested a bit later in its life cycle when a some of the harvested portion includes the immature seeds. These are the most sedating part of the plant. I am continuing to take 6 ml immediately before bed and additional 3 ml doses through the night, as required.

More On Sleep: For reasons that I explained in Part 2, getting sufficient sleep has been a real challenge for me, even with the herbal sleep formula. By day 23 after my surgery I still had experienced only a slight improvement in my sleep, so I decided to go one step further and take melatonin as well. In the past I have found that clients with moderate to severe insomnia for whom an herbal sleep formula does not produce sufficient results usually respond well to the addition of a small amount of melatonin into the mix. Although I am not experiencing typical insomnia, my hope was that this will help me to sleep deeper and I won't wake up as much due to the discomfort and stiffness I have been experiencing as a result of having to lie on my back all night. I have to say, I was appalled at the poor selection of melatonin products even in a very well stocked health food store. Most of them had additional undesirable ingredients such as high doses of individual B vitamins or calcium. In addition, the doses of melatonin were way too high. Melatonin is a hormone and, although it is safe when used correctly, it is important to use only the minimum dose that will produce the desired results. The way I recommend people take it is to begin with a 0.5 mg dose for a few days. If that isn't strong enough I have them increase the dose in 0.5 mg increments (allowing a few days each time the dose is increased to determine its effectiveness) until they hit the ideal dose for them. One of the advantages of using melatonin in combination with a good herbal sedative is that they are mutually synergistic and, when taken concurrently with the herbs, the melatonin will usually produced the desired result at a very low dose. Although I did find a few products that had relatively low (1 mg) dose of melatonin, they all had other things in them that I didn't want to take. As a result, I ended up purchasing a 3 mg sublingual lozenge that I am able to cut into quarters so that each dose is approximately 0.75 mg. I take 0.75 mg of melatonin about 15 minutes before I go to bed and then take a 6 ml dose of my sleep formulation just before bed. When I wake up in the night and have difficulty falling back to sleep, if it seems that I won't have too much difficulty falling asleep I will take an additional 3 ml dose of the tincture. However, if it seems that I am going to have more difficulty, I will allow myself one more 0.75 mg dose of melatonin in addition to 3 ml of the tincture. If I wake up additional times through the night and have difficulty falling asleep I will only take the tincture. As it turns out, the first night I required two doses of melatonin but after that my sleep improved so much I only required one. I have found that I am waking up less often through the night and having less difficulty falling back to sleep when I wake up.

Homeopathics: On day 23 after my surgery, when I added the melatonin, I also diverged from the homeopathic protocols that I had intended to follow (as indicated in Part 2). I am continuing to take Symphytum 200C three times per day to support the healing of my bone. Since I was past the stage of the initial tissue trauma, I dropped the Arnica. As there seemed to be no major nerve damage, but there is a little bit of numbness of my skin along the major incision, I dropped the Hypericum 200C to one dose per day. To address the mild numbness I also kept Hypericum (St. Johnswort) in my sleep formulation even though I eliminated it from my daytime formulation. I also added Rhus 200C two doses per day. Rhus is for injuries or strains that stiffen up and feel worse when they are rested for periods of time, but feel better when we move around. These symptoms are typical for me whenever I have injuries or stiffness. I always feel better when I can move around and limber up. My hope was that the Rhus will help reduce the stiffness I am experiencing from lying on my back all night, since this stiffness is one of the things interfering with my sleep. It has helped somewhat and I have experienced a significant improvement in my sleep since adding the Rhus and melatonin to my protocols. It is my intention to continue taking these three homeopathic remedies in these doses for the next few weeks.

Eastern poison oak (Toxicodendron pubescens) was formerly classified as Rhus toxicodendron.

The names of homeopathic remedies are often based on obsolete botanical names

so as to maintain the continuity of the name with older homeopathic texts.

Topical Herbal Preparations: I have two incisions in my leg. A smaller one just below my knee and a larger one that runs down to my ankle which is the area where the plate was put in. On day 13 after my surgery all of the stitches in the smaller incision were removed, but the surgeon decided to remove only half of the stitches in my larger incision because the inflammation and edema were putting a lot of pressure on that area. He wanted me to come back in two more weeks to have the remainder of the stitches removed. On day 16 we began applying a poultice to the smaller incision from which all of the stitches had been removed (for more details about the poultice, see Part 2). We decided to use it as an opportunity to demonstrate how to apply a poultice during our Making Herbal Tinctures workshop. By day 18 it was apparent that the healing of the smaller incision was already much further along than the larger incision to which I was not yet able to apply a poultice because of the remaining stitches. I tried to get an appointment that week to see the surgeon and have the remaining stitches removed so that I could begin working on the longer incision, but there were no appointments available. As a result, I decided it was best if I removed the stitches before my appointment the following week. On day 23, herbalist (and my partner) Monika Ghent removed them for me in the morning. We allowed the holes to seal during the next few hours and began applying a poultice to the larger incision as well that night.

This photograph was taken of my leg just before we removed the remaining stitches from the larger incision.

Notice how much further along the healing is on the smaller incision which at this point I had been

poulticing for a week. The redness is in areas that were formerly covered by scabs.

Since then the protocol that I have been using is as follows:

• When I wake up I apply the liniment I am using (see Part 2) to my whole lower leg up to and including my knee, but not to the area of the incisions themselves. I apply an ointment to the incisions. The ointment is made from the same infused oil that I used as the base for my liniment (see Part 2) with a little bit of English lavender (Lavandula angustifolia) essential oil added to it (probably about 2 drops in each 25 ml jar). Both the infused oil and the ointment were made during our Herbal Field Studies field workshops.
• In the mid afternoon I apply a poultice to both incisions (for details see Part 2). I leave them on for 30-45 minutes and then remove them and allow the plant juices to dry on my leg. I do not apply anything else at that time.
• In the evening I apply a second poultice to both incisions. However, after I remove them and the plant juices dry on my leg I apply a comfrey (Symphytum officinale) ointment to my whole lower leg below the knee including the incisions. I had not prepared any comfrey ointment but fortunately my friend and fellow herbalist Rick DeSylva provided me with an jar of his excellent comfrey ointment.

This is what the protocols I am using look like at about 4 weeks after my surgery. There is no pain in my leg even when I touch the area where the incisions and fractures are. The surgeon was quite surprised at that. My leg feels strong and I am doing my best to stretch the tendons and ligaments in my ankle and knee so they don't tighten up too much while I'm not walking. There is some edema in my foot because I am spending a fair bit of time upright, which allows the blood and lymph to pool in my foot. This is has gone down somewhat but is still significant except when I wake up in the morning after I've been horizontal through the night. It is something I'm going to have to put up with until I start walking unless I want to spend the whole day sitting or lying with my leg raised, which is not an option.

I will continue provide updates on how things are progressing and any changes to my protocols in Part 4.

Healing Bone Fractures, Part 2 of 5

This is the second in a series of posts in which I am documenting the process of treating a serious fracture of my right leg. In Part 1 I discussed the details behind the injury and the initial protocols that I used with the remedies I had available while I was still away. In this post I am going to explain the protocol that I implemented when I returned home.

I returned home on evening of Sunday February 3rd, four days after my injury and three days after my surgery. On Monday we picked up some additional supplements that I needed and then on Tuesday I made up a couple of new formulations specifically formulated to address my injury. This is the protocol that I implemented at that time:

Homeopathics: I am taking Arnica 200C, Hypericum 200C and Symphytum 200C individually, four pellets per dose alternated throughout the day. The dosage of each remedy varies over time according to the following protocol:

• Week 1: Arnica 4 doses per day; Hypericum 4 doses per day; Symphytum 4 doses per day.
• Week 2: Arnica 3 doses per day; Hypericum 3 doses per day; Symphytum 3 doses per day.
• Week 3: Arnica 2 doses per day; Hypericum 2 doses per day; Symphytum 3 doses per day.
• Week 4: Arnica 1 dose per day; Hypericum 1 dose per day; Symphytum 3 doses per day.
• Week 5 and onwards (until my bones are completely healed): Symphytum 3 doses per day.

Herbs: I created three new formulations to address my specific needs:

• A systemic herbal formulation prepared from 1:5 fresh herb tinctures containing turmeric rhizome (Curcuma longa) 18%, common horsetail herb (Equisetum arvense) 15%, boneset herb (Eupatorium perfoliatum) 15%, St. Johnswort herb (Hypericum perforatum) 15%, American plantain herb (Plantago rugelii) 15%, common comfrey herb (Symphytum officinale) 15%, wild ginger rhizome (Asarum canadense) 5%, white pine leaf/twig (Pinus strobus) 2%. This formulation is a specific for healing damaged tissues and blood vessels, bone, and improving general circulation. Boneset and turmeric also have a significant tonic action on the liver which will help address any stress on my liver from the medications and other aspects of my hospital experience, as well as protect my liver from any toxicity from the pyrrolizidine alkaloids in the comfrey, which is the best herb I know for healing bones and well worth the very slight risk of toxicity. Given that the comfrey will not exceed the 15-20% range in any of the formulations that I use and will be combined with herbs that can mitigate its potential toxicity, the likelihood of any toxicity is almost nil. Boneset and horsetail are also specifics for healing bone tissue. This formulation is taken in 6 ml doses three times per day on an empty stomach, 5-10 minutes before each meal.

Boneset (Eupatorium perfoliatum) is an excellent healing herb that is very effective for the healing of bone tissue.

• A systemic herbal sleep formulation prepared from 1:5 fresh herb tinctures containing English lavender flowering spike (Lavandula angustifolia) 20%, St. Johnswort herb (Hypericum perforatum) 20%, catnip herb (Nepeta cataria) 20%, American plantain herb (Plantago rugelii) 15%, hop strobilus (Humulus lupulus) 15%, turmeric rhizome (Curcuma longa) 9%, white pine leaf/twig (Pinus strobus) 1%. The dosage of this formulation is 6 ml immediately before bed and additional 3 ml doses through the night, as required. Getting sufficient sleep is one of my greatest challenges. I tend to be a light sleeper. I sleep on my sides and wake up four or five times a night feeling a bit stiff and change my position, flipping from side to side and then falling back to sleep fairly quickly. With my broken leg I can only sleep on my back. This is difficult for me because as a general rule I can't sleep on my back, and it also doesn't allow me to shift my position sufficiently. By half way through the night my lower back is very stiff and sore. Most nights I'm only getting five to six hours sleep, and that's with the sleep formulation. Occasionally I get a bit more. Getting sufficient sleep is critical to the healing process, so I made this formulation to help me sleep better. Notice that it contains a few of the herbs that are in my daytime formulation. This is to help continue to support the healing process through the night. It is also important that the overlapping herbs contribute to the sleep formulation. You will find few, if any, references to plantain having sedative properties, but it does. As a general rule, whenever someone is taking more than one herbal formulation concurrently, it is usually preferable if there is some overlap between the herbs in the different formulations. As in this case, the overlapping herbs must contribute to the desired actions of both formulations.
• A topical liniment made up of a base containing 1:5 fresh herb infused oils of pot marigold flower head (Calendula officinalis), Canada goldenrod leaf (Solidago canadensis), wild bergamot herb (Monarda fistulosa), coltsfoot leaf (Tussilago farfara), St. Johnswort herb (Hypericum perforatum), northern white pine leaf (Pinus strobus) and American plantain herb (Plantago rugelii). This infuse oil was prepared last year. The herbs are in descending order based on proportion as I am not certain of the exact percentages. To the base oil I added the following essential oils at an overall potency of two drops per ml of base oil: rosemary leaf (Rosmarinus officinalis) 25%, English lavender flower (Lavandula angustifolia) 25%, black spruce leaf/twig (Picea mariana) 15%, marjoram herb (Origanum majorana) 10%, eastern hemlock leaf/twig (Tsuga canadensis) 10%, Roman chamomile flower head (Chamaemelum nobile) 5%, yarrow herb (Achillea millefolium) 5% and eastern white cedar (Thuja occidentalis) 5%. I apply this twice a day, immediately upon waking and just before bed, to the lower thigh, knee and half of the foot of my injured leg as my leg below my knee and half of my foot are covered by a tensor bandage. I also apply it to the hip, knee and ankle of my left leg, and my wrists, as these areas are being stressed in unusual ways due to using crutches.

In this photograph we have common plantain (Plantago major), an alien species that has naturalized throughout

North America, on the left, and American plantain (P. rugelii), our native species, on the right. Notice the

reddish colour at the base of the petioles (leaf stalks) of American plantain. Most people

(including herbalists) don't realize that these are two different species.

Two weeks after my surgery I went to the hospital to have my stitches removed. There was a lot of pressure on my stitches due to the edema in my leg that occurs whenever I am moving around in an upright position. The blood and lymph tends to pool in my leg because I am not using my leg to walk, which is necessary to efficiently pump the fluids out of my leg against the force of gravity. As a result, the doctor decided to leave every second stitch in my lower, longer incision for another two weeks. In the mean time, beginning a couple of days after I got my stitches out I started poulticing the shorter incision from which all of the stitches were removed. I am applying a poultice twice per day for 30-45 minutes. The primary herbs that I am using are common comfrey leaf (Symphytum officinale), stinging nettle leaf (Urtica dioica), pot marigold petals (Calendula officinalis), purple loosestrife herb (Lythrum salicaria), and a bit of whole flax seed (Linum usitatissimum) to increase the mucilage content. I use these herbs in roughly equal proportions (except for the flax seed) and each time add a sixth herb in a similar proportion. I have a lot of "ends" which are small quantities of herbs that are left over from when I harvest herbs to make tinctures. I dry these remainders and use them when the opportunity arises. This is one of those opportunities. Each time I make a poultice I use a different sixth herb. Some of the herbs that I have used so far include elecampane leaf (Inula helenium), wood nettle leaf (Laportea canadensis), Canada goldenrod herb (Solidago canadensis), blueweed herb (Echium vulgare), blue vervain herb (Verbena hastata), wormwood herb (Artemisia absinthium), yarrow herb (Achillea millefolium), yellow bedstraw herb (Galium verum) and pearly everlasting herb (Anaphalis margaritacea).

Supplements: I was able to obtain the additional supplements that I need over the course of the first week that I was back so that since about a week and a half after my injury I have been on the full complement of supplements that I need to help heal my leg. These supplements are very important whenever there is significant tissue damage, but they are particularly important for healing damaged bone, cartilage, tendons and ligaments, regardless of the cause of damage. I use a similar supplement regimen for the treatment of osteoarthritis and osteoporosis. Although there are a number of supplements available that are formulated for building bone tissue that contain some of these nutrients, I chose not to use any of them because I didn't like any of the formulations. All of them were missing important nutrients, had way too much calcium relative to the other ingredients, and most of them were compromised in some way by using cheaper, low quality ingredients such as magnesium oxide. As a result, I had to put this supplement regimen together using a fair number of products. Nevertheless, the importance of using all of these nutrients in the right balance can not be over emphasized. I have listed them here by nutrient instead of by which ones I am taking with each meal, as I did in the first post of this series, so that it is more clear what I am taking. All of these are taken with meals:

• Vitamin A: 3,500 IU with breakfast; 3,500 IU with dinner.
• Beta-carotene: 750 IU with breakfast; 750 IU with dinner.
• Vitamin C (calcium and magnesium ascorbate): 1,485 mg with breakfast; 1,360 mg with lunch; 1,485 mg with dinner.
• Vitamin D: 1,200 IU with breakfast; 1,000 IU with lunch; 1,400 IU with dinner.
• Vitamin E (mixed tocopherols, acetate): 115 IU with breakfast; 40 IU with lunch; 315 IU with dinner.
• Vitamin K: 60 mcg with breakfast; 80 mcg with dinner.
• Calcium (citrate, ascorbate, malate): 150 mg with breakfast; 135 mg with lunch; 450 mg with dinner.
• Magnesium (citrate, ascorbate, malate): 60 mg with breakfast; 60 mg with lunch; 260 mg with dinner.
• Zinc (citrate): 5 mg with breakfast; 25 mg with dinner.
• Silicon (aqueous horsetail extract): 4.7 mg with breakfast; 4.7 mg with lunch; 4.7 mg with dinner.
• Manganese (chelate, citrate): 0.5 mg with breakfast; 5.5 mg with dinner.
• Copper (citrate): 0.5 mg with breakfast; 1.5 mg with dinner.
• Boron (chelate): 350 mcg with breakfast; 350 mcg with dinner.
• Selenium (chelate): 50 mcg with breakfast; 150 mcg with dinner.
• Polyphenol complexes (flavonoids, anthocyanidins, proanthocyanidins and catechins from extracts of berries, citrus, grape seed and green tea): 325 mg with breakfast; 225 mg with lunch; 325 mg with dinner.
• Quercetin: 100 mg with breakfast; 100 mg with lunch; 100 mg with dinner.
• Lutein: 0.5 mg with breakfast; 0.5 mg with dinner.

Blueberries (Vaccinium spp.) are a very rich source of anthocyanins and flavonoids, including quercetin.

Some of these are ingredients from a multivitamin that I am taking with breakfast and dinner. It is a good quality low potency multi with an excellent trace mineral content. It does not contain iron. I did not list all of the ingredients of the multivitamin, only those that are important for bone repair. However, the full range of nutrients in the multi are important to support healing in general. Mostly what I haven't listed are the B vitamins and some of the other trace minerals. In addition, I am also taking omega-3 fatty acids in the form of organic flax seed oil, 2-3 teaspoons taken throughout the day mixed in food (but not heated).

In addition to the above supplements that I am taking with meals, I am also taking the following on an empty stomach three times per day 30 minutes before each meal:

• Methylsulfonylmethane (MSM) 400 mg.
• Glucosamine hydrochloride 300 mg.
• Betaine 80 mg.
• Hyaluronic acid 10 mg.

Probiotics: Another one of the challenges that I am dealing with is constipation. It started with fasting from food and water for 16 hours before my surgery and was further aggravated by the intravenous hydromorphone and three courses of intravenous antibiotics that I was given through the night after my surgery. However, the ongoing issue is that I am spending a lot more time sitting and can't walk or run, which is important for good bowel tone. I am addressing this by taking a high potency probiotic supplement that contains 25 billion active cells of a combination of eight active strains of bacteria. I take this first thing in the morning in a glass of warm water with a tablespoon of whole organic flax seed. My bowel movements gradually returned to normal during the first week that I took this and I am continuing to take it on an ongoing basis.

Lactobacillus rhamnosus: An important probiotic species.

Exercise: This is another of my major challenges. The surgeon wants me to spend most of my day sitting or laying with my injured leg raised. This is not an option. It's bad enough that the muscles in my right leg are getting weaker. I'm not going to sit around and let my whole body atrophy. Plus, I have clients and students that depend on me and lots of work to be done. My life has definitely slowed down and there are many things that are too difficult or impossible for me to do, but I'm not out of commission completely. I have sit stations all over my house where I work, eat and rest consisting of a padded chair to sit on and a second chair with a pillow on it that I can put my leg up on. I have found that there is a delicate balance between sitting and moving around upright. If I do either for too long, the edema in my lower right leg gets worse.

Aside from the exercise I get moving around on crutches, every morning before breakfast I do an upper body workout with light weights and lots of stretching. I'm also working my injured leg as best I can. Whenever I'm sitting for periods of time I periodically massage my thigh and knee. I also wiggle my toes a lot and gently stretch the tendons and ligaments in my ankle and knee. In addition, I'm doing my best to work out my right knee and hip as best I can without being able to walk. To maintain some level of strength in these joints I do leg lifts from my hip raising my whole leg, and from my knee raising my lower leg several times per day for a few minutes. I also "pump" my leg while I'm walking on crutches by raising my leg and bending my knee on one step and then lowering my leg on alternate steps. As before I also continue to do deep breathing exercises in which I "feel" the life force or qi energy flowing into and out of my leg.

Diet: My diet is pretty good in general. It is almost completely organic and I get a lot of variety. My only concern is getting a bit more good quality protein. I have been a vegetarian for 33 years. Contrary to what some people believe, it is very easy for vegetarians to consume sufficient protein. Nevertheless, a good supply of high quality protein is necessary to heal bone tissue. Rather than bump up some of the typical high protein vegetarian foods such as beans or nuts which are harder on the digestive system, I have decided to increase my protein somewhat by eating one or two organic, free-range eggs most days. I have to strike a balance here and not eat too many eggs because for me eggs tend to be constipating.

So there you have it! This is the regimen I am following at this time. It is very intensive. I probably spend about 10% of my waking hours engaged in some aspect of this healing protocol. However, that's not bad considering I am still working at about 60% capacity instead of laying around like the surgeon advised me to. Also, with the exception of the intravenous hydromorphone and three courses of intravenous antibiotics that I was given through the night immediately after my surgery, I did not fill the prescription for painkillers that the surgeon gave me and only had to take a single dose of acetaminophen about 24 hours after my surgery. When I had the stitches removed, the surgeon prescribed another course of antibiotics and some anti-inflammatories. I didn't fill those prescriptions either. My intent is not only to stay relatively functional through this process, but also to make sure that my bones heal well and are strong enough to allow me to continue doing what I've always done. I'm also hoping to be able to start putting some weight on my leg a fair bit earlier than the three to four months that the surgeon predicted.

Overall, I have to say that the biggest challenge for me has been not being able to walk the land. In my normal life, every day I take my dogs out for about an hour and a half and walk the trails through the fields and forest where I live. Aside from the obvious benefits of the exercise and fresh air for the dogs and myself, it provides me with an opportunity to deepen my ongoing relationship with the land; to observe what changes are taking place; to stop periodically at one or more of my favorite sit spots and just be. I'm also missing the winter. Last year was the warmest winter I can remember. There was pretty much no snow. This year we are having a somewhat more "normal" winter. I am missing walking through the snow; breathing the cold, crisp air; feeling the wind on my face; the calls of the chickadees, goldfinches and nuthatches. At best a couple of times a week when the conditions are good I can put the spiky snow things on the bottom of my crutches, go out and sit behind my house by our fire pit and gaze out over the landscape. I really do appreciate those moments.

"The Land" in winter.

Most of the details relating to the protocols that I am using have been covered in these first two parts of this series. From Part 3 of this series onwards I will discuss any changes that I make to these protocols and provide updates on how things are progressing.