Mastering the Actions of Herbs

The first step to using medicinal herbs successfully is understanding the actions of each herb and how they work to treat an individual patient’s symptoms. Remember: It’s not a question of what herbs will treat a specific ailment but rather a question of how the actions of each herb will perform to treat the identified symptoms.

The following excerpt is from Herbal Formularies for Health Professionals, Volume 2  by Dr. Jill Stansbury. It has been adapted for the web.

Mastering the Actions of Herbs

Herbal clinicians should have an excellent grasp of primary actions while gaining a solid knowledge of materia medica and specific indications. Clinicians should know which herbs are the best antispasmodics for a variety of situations, the best anti-inflammatories, the best vulneraries, the best nervines, the best antimicrobials, and so on. Such actions of herbs are also foundational considerations when creating an herbal formula or when considering which herbs to select as a tonic base, synergist, and specific of a formula triangle.

Actions include antispasmodics, antimicrobials, carminitives, alteratives, adaptogens, demulcents, vulneraries, and so on.  For example, individual antispasmodic herbs might be categorized as having an affinity for a certain organ system or being best suited for a particular quality of spasm. Consider the following antispasmodics: Lobelia is especially indicated for respiratory smooth muscle and cardiac muscle spasms, Dioscorea is specific for twisting and boring muscle spasms about the umbilicus, Piper methysticum can allay acute musculoskeletal pain and urinary spasms, and Viburnum opulus or prunifolium is especially effective for spasms of the uterine muscle.

It is best to avoid a “What herbs are good for bronchitis?” or “What herbs are good for hypertension?” style of creating herbal formulas. When treating bronchitis, for example, be it a dry hacking cough or a cough with abundant free expectoration, rather than asking what herbs are “good for bronchitis,” I encourage clinicians to ask themselves, “What actions do I need this formula to perform?” In this case, we need to tailor the formula to the individual and select herbs with specific desired actions—expectorant action for a wet cough or a demulcent action for a dry cough. We may want herbs with an antispasmodic action on respiratory smooth muscle, and we may want herbs with strong antimicrobial actions for bronchitis due to respiratory viruses and other microbes. Throughout this text, the comments that accompany each formula mention actions we are attempting to accomplish with the recipe. For example, “Lobelia is included here as a reliable bronchodilator and respiratory antispasmodic,” or “Lomatium is one of the most well-known respiratory antiviral herbs.”

When thinking through an herbal formula, especially for difficult or complex cases, it is useful to write down what actions you wish the formula to perform and then list several herbs that perform this action. The next step is to consider any specific indications for the listed herbs to help narrow in on the best choices. And finally, the most nourishing herbs may be chosen as supporting the foundation of the triangle, a base on which the formula may rest. Other herbs from the action lists may then be chosen as specifics or synergists to best offer all the needed actions, while creating energetically specific, finely tuned formulas.

Energetic Fine-Tuning

Using the triangle method and an awareness of the actions of herbs, as detailed above, will assist you in selecting three or more herbs that address a case in its entirety, and as such, the formulas are likely to be effective and successful. To fine-tune your formulas even further, an added tier of specificity is the energetic state of your patient. TCM philosophy often depicts the energetic state as a mixture of polar opposites in keeping with the Taoist philosophy of yin and yang polarities. For example, is your patient hot or cold? Tight and constricted or loose and atrophic? Excessively damp in the tissues or excessively dry? Tired and lethargic or energized and manic—and so on. Ayurveda, the traditional medical system of ancient India, sets up a three-pronged system of doshas—vata, pitta, and kapha—rather than the two-pronged polar opposites of Taoism but is similarly aimed at addressing differing constitutions and energetic presentations. The four-elements theory of ancient Western herbalism looks for symptoms or presentations categorized into earth-, air-, fire-, and water-related symptoms, with herbal therapies being chosen accordingly. Again, the precise system, vernacular, and approach do not matter, as long as you are aware of some sort of energetic presentation. Whether or not you take it upon yourself to learn the doshas, TCM, or four-elements thinking and prescribing, you can still begin to notice whether a patient is hot or cold, damp or dry, for example, and choose herbs based on the specific clues or symptoms that you discern through thorough questioning and from simple and obvious physical exam findings.

For example, a hypertension patient may present with episodes of elevated blood pressure related to ongoing job and family stress. The person also suffers from insomnia, frequent muscle tension headaches, and mild digestive upset, also stress related. A hypertension formula for this case might be based on the nervine vasodilators, such as Passiflora, Tilia, or Rauvolfia, resting on a base of Avena as a nervous system trophorestorative. The actions desired for stress-related hypertension are vasodilators with anxiolytic and calmative effects. If, on the other hand, hypertension is unrelated to stress, but rather has slowly progressed over a decade related to worsening diabetes and long-term smoking, improving blood vessel tone and elasticity would be desired actions, as well as offering antioxidant and hypoglycemic effects to help protect the blood vessels from high blood sugar and the toxic effects of smoking. In this case, Ginkgo and Angelica might offer mild vasodilating effects while helping to protect blood vessel walls. Salvia miltiorrhiza might be capable of improving circulation damaged by smoking and diabetes, and the formula might rest on a nourishing base of Crataegus, whose procyanidins might improve the integrity of vein and artery walls. With these examples, it is easy to see how herbal formulas for hypertension might be very different when the underlying causes are considered and herbs with specific actions are selected.

The Use of “Toxic” Herbs in Formulas

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