by Matthew Wood
High-grade remedies—the most useful because they occur most frequently—are indicated in CAPITAL letters. Low-grade remedy names are not capitalized. While I have confidence that the high-grade remedies are very useful, many remedies listed as low-grade might also be considered high-grade as well. In the homeopathic repertory italics are used to indicate a middle grade; that is why the Latin herbs names in this repertory are not italicized, as would be customary in botanical literature.
Some herbalists will be surprised by the high grades assigned to some herbs. This may be because some of them are extensively used in some local region and less well known on a national or international scale. For instance, herbalists in Minnesota use Polygonum persicaria a great deal, so it ranks high for many fertility and sexual issues; yet it is comparatively unknown elsewhere. (This excellent remedy was introduced by Lise Wolff.)
Dosage
As I am a practitioner long known for recommending small doses, the reader might assume that I advocate small doses in the use of the herbs in this book. Nothing could be further from the truth; I frankly don’t care what dosage my readers choose to use, unless the dosage is required to be small to minimize toxicity, or because the herb acts differently in small and large doses.
Readers may use the remedies in The Earthwise Herbal Repertory in any responsible dosage. However, “responsible dosages” are not often given in the text. That level has to be defined on a case-by-case basis, and may require further research. Generally, a minute dose means one drop or less, a small dose would be 1–10 drops, medium 10–25 drops, and large 20–35 drops. My preferred dose is 1–3 or 3–5 drops.
Contraindications and Safety
I have not included information about herbal contraindications, toxicities, drug interactions, side effects, or other problematic responses. I use small doses, and consequently encounter less of these effects, and I also do not consider myself an expert in this field. Therefore, I will leave this to others.
Please refer to other texts for information on this subject. Many fine books are available, as well as much information online—though a great deal of that may be untrue. A reliable source is Merrily A. Kuhn and David Winston’s Herbal Therapy and Supplements: A Scientific and Traditional Approach.
Considerations on Two Sister Arts
Herbalism and homeopathy are “sister arts”—they share a common origin in Western alternative medicine, and use many of the same medicinal substances. Yet they are also quite different. Homeopathy is based on the “law of similars” (like treats like), while herbalism is primarily founded on the “law of contraries” (imbalances are addressed with opposing qualities), as we saw in the discussion of taste.
Herbalists may want to know whether indications in The Earthwise Herbal Repertory are different from those of other sources, since I use small doses: does the small dose make a remedy homeopathic? Homeopaths may want to know whether the Herbal Repertory can be applied in a homeopathic practice: if herbs act primarily by contraries, they must not be compatible with the homeopathic maxim.
These questions can be settled empirically. Almost all of the nontoxic herbs used in homeopathy (Chamomilla, Eupatorium perfoliatum, Eupatorium purpureum, Sambucus, Hypericum, Calendula, Carduus or Silybum marianum, Cnicus benedictus, Arnica, Cimicifuga, Caulophyllum, Phytolacca, Urtica, Chimaphila, Solidago, Ceanothus, Chionanthus, Quercus, Valeriana, etc.) are used essentially the same way by herbalists. I can think of only two exceptions, though there are undoubtedly others: Rumex crispus is used to treat cough in homeopathy but is primarily a mild laxative in herbalism, while Gnaphalium obtusifolium is used for sciatica in homeopathy and for respiratory problems in Southern folk medicine. Herbs have many uses, and different traditions overlap but also differ, so even the exceptions do not constitute a serious contradiction.
All the plants above were adopted into homeopathy from herbal medicine. A few that had been forgotten by herbalists, such as Hypericum, Calendula, Arnica, and Ceanothus, were picked up by homeopaths and then adopted back into herbalism. So we see an interplay between the two in terms of a common pharmacopeia. Still, a suspicion remains that these agents are being used differently. Therefore, to fully satisfy the questions of our readers, we will move beyond the study of these herbs and their properties into what can only be called the “pharmacological principles” of opposite reaction. While homeopaths and herbalists have been imagining differences, modern pharmacology has actually been studying this subject.
Similars and Contraries
Ancient and traditional medicine defined this debate in terms of “similars” and “contraries.” By “similarity,” the homeopath means that a substance causes the same symptoms it cures. In order to gain information about medicinal agents, therefore, substances are given to healthy people until they produce symptoms. This is called a “homeopathic proving.” Many of the substances used in homeopathy are poisons, and need to be given in minute doses. Homeopaths observed that they produced one set of symptoms as they entered the body as a poison, and another set of symptoms as the body reacted against the poison and restored itself to health. These were named the “primary” and “secondary” symptoms. It has long been accepted in homeopathy that both types of symptoms can be used to select a remedy.
Homeopaths have long recognized that foods do not easily produce a proving. (If they did, the organism would get sick every time it consumed food.) Because foods have a low level of toxicity, “proving” them would require giving them in large and prolonged doses, or giving them to particularly food-sensitive people. Foods follow the law of contraries: when we are hungry, we eat.
What about the nontoxic herbs? In every major system of herbal medicine (Chinese, Ayurvedic, Greek, Tibetan, and some Native American) these are defined by tastes, as foods are; many herbs are even used as foods. Only a few herbal powerhouses such as Lobelia, Phytolacca, Convallaria, and Podophyllum are strong enough to be considered toxic. These are easily “proven” or, in the case of Lobelia (and Valeriana), readily produce contrary actions even in herbal use.
What this means is that the homeopathic model is better suited to poisons than to foods or herbs. Some nontoxic herbs have produced a lot of symptoms in provings, while others have not. Poisons, on the other hand, always produce symptoms because that is the nature of toxicity. They contain large amounts of toxins, while nontoxic herbs contain only small amounts of mildly irritating material. These are called “secondary metabolites”; their purpose is to help the plant survive by overcoming environmental stresses. They even include poisons that kill insects and other plants. Secondary metabolites are often bound up in plants with other, antidotal substances that modify and reduce their effect, preventing the living herb from “hurting itself” with its small dose of poison. This “gentle” effect is transferred from the living plant to the medicine.
Opposite Reactions
It was homeopathy that first established the fact that substances could produce opposite effects. Since homeopathic dosages are highly diluted, it was long believed that this was a function of dosage—small amounts produced the opposite effects of large amounts.
In 1876, Hugh Schulz, a pharmacist and phytotherapist in Germany, showed in a series of experiments that small doses of heavy metals had the opposite effects of large doses on yeast colonies. At about the same time, a German psychiatrist named Rudolf Arndt independently observed that “weak stimuli slightly accelerate the vital activity; moderate and strong stimuli raise it; and very strong ones halt it” (Bastide 1998, 3). Schulz realized he had found some evidence for Arndt’s assertion, and it became known as the “Arndt-Schulz Law.” Both admitted there were exceptions to this “law,” so it was sometimes called a “principle.”
For over a hundred years, it was supposed that the homeopathic principle was based on Arndt/Schulz. However, decades of research have finally shown that (1) opposite actions are much more complicated than originally believed; (2) Schulz misinterpreted his experiments; and (3) the homeopa
thic principle is not based on Arndt/Schulz at all.
Extensive modern research by pharmacologists has now shown that there are three kinds of opposite actions (Bastide 1998):
Regulatory. Hormones, minerals, and other physiologically active substances can produce opposite metabolic reactions in large and small doses; this is called the “regulatory effect.” In the case of Schulz’s experiments, retrospective study showed that the yeast colonies were metabolically stimulated by small doses of heavy metals, while in large doses the metals killed the yeast. However, further research showed that some substances produced opposite results in large and small doses due to toxicology. This was termed the “reverse effect” and was eventually untangled from the regulatory effect.
Reverse. In medical practice it is often observed that two people, given the same dose, experience opposite reactions. It is also found that the same person, given a large and small dose can have opposite reactions. A classic example of the reverse effect in pharmacology is peppermint (Mentha piperita), which produces opposite effects—stimulation and depression—in different people. Research has shown that opposite reactions occur due to shifts in dilution as slight as 1:10. This has been called the reverse effect, or “hormesis.” It is not considered a law but a widely observable and often unpredictable phenomenon. It is a very real concern in pharmacological medicine, but so far no way to control or predict this reaction has been found.
The reverse effect is explained as an immunological response; repetition of the small dose stimulates immunity to the large dose. If the exposure is repeated, increasing immune tolerance will often result. This method was used by King Mithridates, who was said to have developed immunity to all the common poisons of his era by building up from small doses to large ones until he no longer reacted to them. (He was eventually killed by a sword.)
Rebound. A third type of oppositional reaction was eventually untangled from the other two. The “rebound effect” occurs due to the passage of time, not to concentration levels.
It has been found that poisonous substances produce an immediate toxicological effect as they impact the system. This is followed by a self-healing response caused by the appropriate reaction of injured bodily systems reacting against the substance. This reaction includes many physiological changes, which are not wholly or even primarily immunological.
The rebound effect is seen in the homeopathic provings, and is the true basis of homeopathy. It accounts for both the primary and secondary symptoms. Because homeopathy also dilutes the substance, the modus operandi of the provings became confused with the “reverse effect.” It is possible, however, that the dilution of the substance causes a shift so that the primary effect is enhanced by large doses, the secondary by small ones. This would seem to fit with experience—homeopathic and otherwise—but as far as I could tell, this oppositional action is not addressed by the regulatory, reverse, or rebound effect.
The rebound effect has proven to be important in the arena of addiction counseling and medicine because addictive substances cause a “rebound” as the system responds against them and eliminates them. When addiction is maintained, however, there is no rebound effect because of the suppressive effect of the addictive substance. This is undoubtedly how a lot of pharmaceutical drugs (many of which are also physiologically addictive) operate—by suppressing secondary, self-healing effects, interpreted as disease symptoms.
The rebound effect therefore explains a certain amount of drug activity. The reverse effect explains the efficacy of therapeutic applications such as vaccinations, and the regulatory effect explains drugs that are supplementary in action, like thyroxine.
Ironically, it took the reverse effect over fifty years to be taken seriously because of its association with homeopathy—an association that was incorrectly made in the first place. On the other hand, it took almost no time at all for the rebound effect, which does explain homeopathy, to be adopted because of its obvious importance in the assessment and treatment of addiction.
Here is a detailed description of the rebound effect, from M. Bastide (1998, 5):
Self-recovery is also called the rebound effect and is the consequence of the immunosuppressive effect [of the stressor]. It is a biological phenomenon which exists as a function of time after a strong pharmacological or toxic effect.… The organism presents the opposite manifestations as a dynamic reaction against poisoning. It is not related to a general immunological mechanism (except in an immunosuppressive effect), and has no relationship with the placebo. This self-recovery is the reaction of the living body to aggression, and self-recovery uses the appropriate and specific tools to reach a new equilibrium after the aggression.
The rebound effect is a universal phenomenon that explains sickness and recovery. It has been recognized for some time. The primary and secondary phases of the rebound effect were termed the “disease crisis” and the “healing crisis” by Henry Lindlahr, “the philosopher of naturopathy” (Wood 2000). The disease crisis occurs during the invasion from outside the organism. The “healing crisis” occurs when the organism is recovering. For instance, in an acute fever we often experience a night sweat, after which we feel better and on the road to recovery. In a chronic illness, if we are fortunate enough to recover, we may get a fever or a seemingly acute manifestation of disease, after which we return to health.
The term “healing crisis” goes back to Hippocrates. Both Lindlahr and Hippocrates would induce the healing crisis by a restricted diet (not a full fast) to remove foods difficult for the organism to digest or metabolize. Freed from this burden, the body can rally its resources and more effectively fight the illness. We may say, therefore, that an intuitive understanding of the rebound effect has been a part of medicine since remote periods.
The homeopathic idea is that the remedy reproduces the trauma of the disease as it passed into the organism—the primary effect—and that it unleashes the secondary or healing reaction. Does the rebound effect prove the law of similars? In a strict sense, the answer is yes, because the remedy causes what it cures. However, the rebound effect causes opposing reactions. One could just as well say that homeopathic agents act by the law of contraries, because the secondary symptoms oppose the primary. In other words, homeopathy works by both laws!
If both foods and poisons (including homeopathic remedies) can induce or influence the rebound effect, then herbs must too. However, compared to poisons, most herbs produce a much less noticeable rebound effect because they are not very toxic.
The medicinally active substances in herbs are labeled “secondary metabolites” because they are made by the plant secondary to its primary purpose—eat, drink, procreate. The “primary metabolites” are carbohydrates, lipids, and proteins that we use for food, which do not produce the rebound effect in either the plant or a person. The purpose of the secondary metabolite is to help the herb survive in some way. For instance, cyanogenic glycosides change to cyanide when a deer or beetle bites into the inner bark of a cherry, peach, or apple. This protects the tree. On the other hand, flavonal glycosides give the fruit of these trees strong coloring so that the deer or human will see and eat the fruit and spread the seed.
Secondary metabolites are not only diluted but are usually combined with other substances so that they do not cause the living plant to suffer from their effects. For instance, cyanide is not actually present in the peach bark; it is manufactured only when the bark is injured. If a secondary metabolite were concentrated, it would cause a toxic effect. Apple seeds, for instance, high in cyanide, are eaten by everyone in small amounts. However, if collected and eaten a cup at a time they would kill a person—as happened in one case (Kingsbury 1969).
While herbs usually need to be concentrated to become toxic, toxins have to be diluted in order to make them safe for use as homeopathic remedies. This suggests that while both herbs and homeopathic remedies produce the rebound effect, they act in opposite ways. The herb only gently provokes the primary and secondary responses. Fur
thermore, because it contains secondary metabolites mixed with naturally occurring dilutants and antidotes, the nontoxic herbal remedy probably provokes elements of the primary and secondary response simultaneously. This explains why some herbs “normalize” or find the middle ground between two opposite activities.
A good example of the opposite actions of an herb are given in the discussion of rhubarb (Rheum spp.) in Part II. Here we see the plant recommended for two very opposite constitutions, which we might call the “glutton” and “starvation” types. Rhubarb normalizes between these two opposite poles.
One of the hallmarks of a nontoxic herb is that it operates without producing a strong toxic or rebound effect, yet it eliminates or reduces primary and secondary extremes. A poison, on the other hand, produces a powerful rebound effect. Harnessed as a biomedical drug and given repeatedly, it controls the body and suppresses the symptoms it is directed against. It does not cure or normalize or eliminate primary or secondary symptoms, but forces a continuous response. It is, in fact, just like an addictive drug. It produces effects until it is stopped.
The homeopathic remedy is obviously not able to suppress symptoms—even when a recognized allopathic drug is being used. Pharmaceutical Atropa belladonna causes dilation of the sphincter in the eye, while homeopathic Belladonna is used to overcome excess dilation. It does not force the organism to respond but sends it through the primary and secondary reactions and back to balanced self-governance. It may normalize between extremes like a nontoxic herb.