About Herbal Antibiotics
Facts are subversive of lies, half-truths, myths; of all those easy speeches that comfort cruel men.
—Timothy Garton Ash
The Internet has become the greatest reference library human beings have ever known. A tiny part of that library, though enormously huge compared to what was available in the past, has to do with medicinal plants and the vast amount of research now being conducted on them.
But that is only a small part of the changes that have taken place over the past 15 years; something a great deal more interesting has been happening. As I spent weeks on the Web, following the scent of medicinal plants through the Internet forest, what struck home the most was a deep and visceral impact of just how much the human world itself has changed.
It is a new world out there. And it is a world with which the United States has an increasingly tenuous connection. The rest of the Western nations are nearly as lost. During the past 15 years nations on the African continent, in Asia and South America, within the Russian sphere, and in most of the old Eastern bloc have realized that the medical model used by the West is unworkable, and to a great extent, they have begun abandoning it as the dominant approach to their people’s health care.
Nations in those regions, especially in Africa, Asia, and South America, have realized they can’t afford a pharmaceutical/technological medical model as their primary approach to health care. They know that the problems of antibiotic resistance, petroleum depletion (most pharmaceuticals and all medical technology are made from or highly dependent on petroleum products), population expansion, top-down care models, and most especially cost and cost inflation cannot be solved and are only going to worsen over time. With that realization, they have begun abandoning industrialized medicine as a legitimate model for providing health care to their populations. (Industrialized medicine will still play a part but a much smaller, more affordable, and considerably less dangerous one.)
Unlike in the United States, researchers in those nations aren’t exploring whether plant medicines work (nor are they spending their time and money trying to discredit what they feel is “primitive” medicine or unscientific quackery); they are exploring which herbal medicines work best and in what form and at what dosage. Their research and their journal papers are looking for the herbs that can treat malaria most successfully (for example) and how those plants, once identified, can be grown by the people who need them so they can be used when, and where, and by whom they are needed.
Many non-Western researchers are actively addressing the health problems of their populations with little if any profit motive. They have simply realized that corporate profit making and human health are not compatible. Shorthand: they are tired of seeing their cultures get screwed by international corporations that make billions out of the misery of others. They want to solve the problems facing them, simply, repeatedly, cheaply, ecologically, and with a great deal of personal empowerment for the people who are most directly affected. Reading the journal articles of U.S. researchers and comparing them with those of other nations and cultures is an illuminating and sobering experience.
The African and Asian journal articles tend to have titles like this: “Antibacterial activity of guava (Psidium guajava L.) and neem (Azadirachta indica A. Juss.) extracts against foodborne pathogens and spoilage bacteria” or “Evaluation of antimicrobial activities of extracts of five plants used in traditional medicine in Nigeria” or “Antimicrobial activity of ethanolic and aqueous extracts of Sida acuta on microorganisms from skin infections.”
The U.S. journal articles are more along these lines: “Severe hypernatremia and hyperosmolality exacerbated by an herbal preparation in a patient with diabetic ketoacidosis” or “Metal content of ephedra-containing dietary supplements and select botanicals” or “Hypereosinophilia associated with echinacea use.”
The abstract for that last study contains the kind of commentary common to many Western researchers, especially in the United States:
Echinacea, believed by herbal practitioners to enhance the immune system, is one of the most widely used herbal supplements in the United States. Like most herbal products, it lacks strict FDA regulation and more information is needed about its potential adverse reactions. Here, we report the case of a patient with eosinophilia of unclear etiology whose condition resolved after cessation of this supplement. We feel this likely represents an IgE-mediated allergic process to echinacea.
The article ignores the in-depth research on echinacea done in Germany over decades and the fact that it is a part of primary care medicine in that country. It uses words and phrases such as “believed by” and “we feel” and “likely.” Its writers assume that the echinacea is the cause of the eosinophilia even though they have conducted no research to make sure of it. It’s not science, not research, but rather guesswork and opinion that reflect the orientation, and bias, of the technologically focused, pharmaceutically dominated medical world, especially in the United States.
Now compare that with this abstract from an article by Nigerian researchers, “Antimicrobial activity of ethanolic and aqueous extracts of Sida acuta of microorganisms from skin infections.”
The antimicrobial effect of the ethanolic and aqueous extracts of Sida acuta was investigated. Phytochemical analysis revealed the presence of saponins, tannins, cardiac glycosides, alkaloids and anthraquinones. The test isolates from human skin infections were Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Escherichia coli, Scopulariopsis candida, Aspergillus niger and Aspergillus fumigatus. The zone of inhibition for the ethanolic extract varied from 10 mm for P. aeruginosa to 43 mm forS. aureus and from 4 mm for P. aeruginosa to 29 mm for S. aureus in the aqueous extract. Though the zone of inhibition increased with increase in the concentration of the extract, the highest concentration of the ethanolic extract revealed a higher significant (P. 0.05) inhibition against S. aureus and B. subtilis compared to the inhibition effect on these organisms by gentamicin used as control. The aqueous extract had no significant effect on the test organisms. The extracts had no inhibitory effect on the fungi isolates. This study has shown that the extract of S. acuta if properly harnessed medically will enhance our health care delivery system.
This herb “will enhance our health care delivery system.” I have never seen that sentiment in a research article in the United States and I’ve read thousands of them. (Gentamicin, by the way, is what is called an aminoglycoside antibiotic, often used to treat Gram-negative bacteria. Sida acuta at higher doses was more active against the test organisms than the antibiotic was.)
The authors of this study tested both aqueous (water) and ethanolic (alcohol) extracts of the plant—essentially infusions and tinctures—to see which were most effective. Most plants are used by indigenous cultures as water infusions (strong teas) or in whole form of one sort or another, either eaten or placed directly on the affected area of the body. Some cultures do use simple alcohol extractions. Of the active ingredients in plants, some are soluble in water, some in alcohol, and the researchers clearly wanted to find out which form of preparation was the most effective for this plant. It’s usable information they were after. And they found it. They came to Sida acuta by looking at what traditional healers and herbalists in Nigeria were using in their practice and they decided to test it for activity. If it was effective they wanted to find out how it was most effective. And they planned then on supporting the use of that plant widely throughout Nigeria to enhance their country’s health care system. Nothing could be more alien to the medical establishment in the United States.
To be fair, there are some good studies occurring in the United States, but to be clear, virtually none of them support the use of herbal medicines by the general populace or even by educated herbal practitioners. Their focus, rather, is on the identification of an “active” constituent that can then be modified chemically, patented, and subsequently produced by a pharmaceutical company for profit. U.S. researchers, in spite of often being affiliated with universities, generally work for or in concert with pharmaceutical companies. They are not looking for something the general populace can use without a prescription; they are not working to empower self-care. In most instances they don’t trust the general populace to be intelligent enough to provide their own health care, nor do they want to interrupt their own financial income stream.
We in the Western world, especially in the United States, are being left behind in an outmoded model that has no effective place in the real world. By the time we realize it, the rest of the world will be generations ahead. The rest of the world has abandoned our approach; they understand the problems they face and what lies ahead. In the meantime, we spend our time making better and better buggy whips, not realizing the automobile really is here to stay.
Some Comments on the Herbs Discussed here
To find the top herbs that can be effectively used for treating antibiotic-resistant organisms, I have relied on decades of my own experience, the cumulative experience of a great many other practitioners, many thousands of journal papers of very good research by committed researchers from many countries around the world, and the history of use of these plants by local peoples over centuries.
I have put the herbs in this website into three categories: systemic antibacterials, localized antibacterials, and facilitative or synergistic herbs.
Systemic antibacterials are herbal medicines that are broadly systemic, that are spread by the bloodstream throughout the body, thus affecting every cell and organ within the body, and that are active against a range of bacteria. These herbs are good for treating infections such as MRSA that have spread throughout the body and are not responding to multiple antibiotic protocols.
Localized antibacterials are those that do not spread easily throughout the body but are limited in their movement. Because they don’t easily cross membranes, they are effective in the GI and urinary tracts and for external infections. These kinds of herbs are useful for infections such as E. coli O157:H7 or cholera or for infected skin wounds that refuse to heal.
Facilitative or synergistic herbs are just that: plants that facilitate the action of other plants or pharmaceuticals. They either enhance the action of the antibacterial being used or affect the bacteria so that the antibacterial is more effective. Most plants contain both antibiotic substances and a potent synergist, quite often one or more efflux inhibitors. Goldenseal, which contains berberine, is an example.
Berberine, a strong antibacterial, is very active against a number of resistant organisms. It is considerably more active, however, in the presence of another constituent in goldenseal, 5′-methoxyhydnocarpin (5′-MHC), which is a multidrug efflux pump inhibitor. It reduces or eliminates MRSA’s ability to eject antibiotic substances that might harm it from inside its cellular membrane. 5′-MHC has no known function other than to do exactly this, and it is one of the reasons goldenseal is so effective in the treatment of resistant infections of the GI tract.
Compounds such as 5′-MHC are why plants are often more effective than single constituents in treating disease conditions. Other compounds in plants do still other things; some have no known function in the plant other than to reduce the side effects of the more pharmacologically active constituents. This is one of the reasons plants tend to be strange medicines in the minds of medical reductionists—they can’t understand that kind of complexity or see the reason for its existence. Nevertheless, newer generations of researchers have grasped that the old paradigm is unworkable and they are looking toward plants with new eyes. They are understanding that plant medicines are much more sophisticated than pharmaceuticals (something those in older cultures innately understand).
As some specific examples: The anticonvulsant actions of yangonin and desmethoxyyangonin, kavalactones found in Piper methysticum, are much greater when the lactones are used in combination with other kava constituents. Concentrations of yangonin and another lactone, kavain, are much higher in the brain when the whole plant extract is used rather than the purified lactones themselves. In other words, some of the other constituents in kava help move the bioactive lactones across the blood-brain barrier into the brain. Blood plasma concentration of kavain is 50 percent less if the purified compound is used rather than an extract of the plant itself. Plant compounds in Isatis tinctoria, a potent antiviral and anti-inflammatory herb, are highly synergistic. Tryptanthrin, a strong anti-inflammatory in the plant, possesses very poor skin penetration capacity. However, when the whole plant extract is applied to the skin, penetration of tryptanthrin is very good. In other words, applying a salve of pure tryptanthrin to the skin, despite how anti-inflammatory that compound is, won’t do you much good. But if you make the plant itself into a salve, the tryptanthrin moves rapidly into the skin and helps reduce skin inflammation.
Artemisinin is much more active against malarial parasites if administered with artemetin and casticin, flavonoids normally contained in the artemisia plant. Additional flavones in the plant, chrysophlenetin and chrysospenol-D, also act as potent synergists in this way. They are also permeability glycoprotein (P-gp) inhibitors, thus facilitating the movement of artemisinin and the plant’s other constituents through the intestinal membrane and into the blood.
As a final example, side effects such as tinnitus and stomach ulcers that can occur from the use of acetylsalicylic acid don’t occur if whole extracts of willow bark are given rather than that purified constituent; other compounds in the plant specifically ameliorate its side effects.
Combining Plants for Greater Effect
When it comes to plant combinations, things get even more complex. For example, constituents from licorice (glycyrrhizin and its related compounds) significantly enhance the solubility of other plant compounds, such as the saikosaponins from Asian ginseng, in water. Thus, combining plants during the medicine-making process—a field almost completely unexamined in Western herbal approaches—can produce much stronger tinctures than when they are produced singly.
Quercetin (an anti-inflammatory and moderate anticancer flavonol found in many plants and vegetables) is poorly soluble in water, but that solubility is strongly enhanced by complex mixtures of saponins if plants containing them are added to the mix when the medicine is being made.
So … while some plants such as goldenseal are synergistic within themselves from the presence of efflux inhibitors and potent antibacterial constituents, other plants, such asDalea spinosa, are relatively mild as antibacterials but contain compounds that are multidrug resistance (MDR) inhibitors, making them synergists for other plants. Adding synergists to a systemic antibacterial when creating an herbal compound increases the potency of the primary herb being used, sometimes considerably. (This has long been recognized in the actions of such plants as licorice and western red cedar, though the reasons why were not known.)
Synergists, while known throughout herbal history, have been only mildly recognized for their actions, usually in the Chinese and Ayurvedic systems, but they have not been accepted as a legitimate and unique category of herbal medicines that should be studied in their own right. Given the seriousness of emerging resistant pathogens, it is time to begin developing this category of herbal medicines in more depth, to begin to understand how to use them in practice, and to find the most potent ones that can be used for healing.
The Importance of Preparation Methods
I remember, growing up, how often the physicians in my family made fun of the old plant doctors and herbalists insisting that some plants must be harvested only at such and such a time or they would be too weak to work or their insistence that certain plants must be used together to work. Turns out there is a great deal to those old assertions. So … considerable attention is paid within this post series to how and when the plants should be harvested, prepared, and made into medicine.
There are other complexities that come into play when it comes time to actually make your plants into medicine. There is a synergy between the plant and the medium in which it is extracted. Regrettably, there has been an unfortunate lack of attention paid to this in much of the world, especially among us American herbalists. For example: The word alkaloid means alkaline-like, a clue that has been overlooked in every herbal preparation manual I have read over the past 30 years. In practical terms: Plant alkaloids won’t extract easily in alkaline waters; they need more acidic waters to do so. Extracts of plants with highly bioactive alkaloids increase in strength if the plants are extracted in liquid mixtures that are at least minimally acidic. The water being used to make extracts (tinctures and infusions) needs to be “soft,” or else an acid such as vinegar needs to be added in minimal amounts to make it so.
Understanding these kinds of complexities in plants and the medicines they become comes from long exposure to them, from the same kind of intuitive sensing (holistic nonlinear perception) that all artisans use (in things from writing to house building to making music), and, most importantly, from a lack of intellectual hubris. If you understand up front that plants are highly complex living beings that are a great deal older than the human species, it is much more difficult to place an intellectually reductionistic paradigm on them. You can’t see what you assume is not there.
Herbalism is an art; it is, and always will remain, much too complex to be approached from a reductionist and linear orientation with any expectation of success. “Phytorationalism” is an oxymoron. A practitioner with such an orientation will never grasp the essential nonlinearity of the world, of healing, of plant medicines.
The synergy within and among plant medicines, a prime example of the nonlinear complexity in this field, means that the combined effect of different substances will be greater than that which can be expected from the individual components alone. Combination produces outcomes beyond rational expectation. To face the challenges before us, we ourselves have no choice but to synergize within ourselves: to develop our abilities to feel and think simultaneously, neither in competition with the other, and blend those capacities together into a unique perceptual tool of tremendous elegance. I am talking about developing forebrain elegance here, not just tentative understandings of the hindbrain. As Erich Fromm once commented: “Reason flows from the blending of rational thought and feeling. If the two functions are torn apart, thinking deteriorates into schizoid intellectual activity and feeling deteriorates into neurotic life-damaging passions.”