COMBINING WESTERN HERBS AND

CHINESE MEDICINE

Jeremy Ross

A Clinical Materia Medica

– 120 Herbs in Western Use –

Foreword by Dr. Andreas Höll

Illustrations by Inken Toepffer

Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH,

Bad Kötzting / Bayer. Wald, Germany

Jeremy Ross, Copyright © 2012

A Clinical Materia Medica Verlag Systemische Medizin AG
Bibliographic information published by the Deutsche Nationalbibliothek

The Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data
are available in the Internet at http://dnb.d-nb.de.

ISBN 978-3-927344-92-1

© 2010 Jeremy Ross, Greenfields Press. www.jeremyross.com and

Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH, D-93444 Bad Kötzting/Bayer. Wald

© Illustrations
2010 Jeremy Ross, Greenfields Press. www.jeremyross.com and
Verlag für Ganzheitliche Medizin Dr. Erich Wühr GmbH, D-93444 Bad Kötzting/Bayer. Wald and
Inken Toepffer, D-93059 Regensburg

Type-setting: modern ART, Vilshofener Str. 12, D-93055 Regensburg

Production: TYPOS, CZ -30537 Plzeň/Pilsen

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, recording, or by any information or retrieval system, without the prior written
permission of the copyright holder, except where permitted by law.

Caution
All persons involved in the preparation and publication of this book have, as far as it is possible, taken care to ensure that
the information given in this text is accurate and up-to-date. However, medical knowledge is constantly changing, and
readers are strongly advised to consult all the available data to confirm that the information given in this text complies
with the latest legislation and standards of practice, especially with regard to drug usage. Internet medical research
resources such as PubMed can be used to help update some of the information in the text.
The author and the publisher welcome notifications from readers on the need to change information in this book and can
be contacted via the address of the publisher. Relevant alterations to the text will be included in the next edition of this
book, and in the meantime will be cited in the author’s website (www.jeremyross.com) and the publisher’s website
(www.vgm-portal.de) under the heading of Text updates.
Before using any of the herbs listed in this book, practitioners should study the data on dose and contraindications given
in the relevant chapters on those herbs. In addition, practitioners are strongly advised to read the chapters on Principles
of herb combination, Practical herb combination, Dose, and Safety in Combining Western Herbs and Chinese Medicine:
Principles, Practice, and Materia Medica by Jeremy Ross. Where the author is aware of differing opinions, for example, on
dosage and contraindications, references for these different opinions have been given. Practitioners should consult these
references and weigh the available evidence themselves to come to their own conclusions before using this information to
treat a patient.
The information given for treatment in this book is meant as a guide only. It is the responsibility of the practitioner to
decide whether a herb or herb combination is appropriate for a specific patient at a particular time. It should also be
pointed out that herbal therapy is not proposed as an alternative to conventional medical diagnosis and treatment when
this is necessary for the patient.

Jeremy Ross, Copyright © 2012

A Clinical Materia Medica Verlag Systemische Medizin AG
 Table of Contents

Foreword _______________________________XI Anemone pulsatilla _______________________ 16

Sources _______________________________ XIII Angelica archangelica _____________________ 18

Apium graveolens ________________________ 22

Introduction XV Arctium lappa ___________________________ 24

Why I wrote this book ___________________ XV Arctostaphylos uva-ursi ___________________ 26

Where to find things in this book __________ XV Arnica montana _________________________ 28

How to use the herb chapters ____________ XVI Artemisia absinthium _____________________30

Principles and practice of herb combinationXVIII Asclepias tuberosa________________________34

Dose and dispensing ____________________ XIX Astragalus membranaceus ________________ 36

Safety _________________________________ XX Avena sativa ____________________________ 38

Ballota nigra ____________________________40

Materia Medica Berberis vulgaris _________________________ 42

Achillea millefolium ______________________ 2 Calendula officinalis ______________________46

Acorus calamus ___________________________ 4 Capsella bursa-pastoris ____________________ 48

Aesculus hippocastanum ___________________ 6 Capsicum species ________________________ 50

Agrimonia eupatoria _______________________ 8 Chamaelirium luteum ____________________54

Agropyron repens ________________________ 10 Chamomilla recutita ______________________ 56

Aloe vera _______________________________ 12 Chelidonium majus _______________________ 58

Althea officinalis _________________________ 14 Cimicifuga racemosa _____________________ 60

Jeremy Ross, Copyright © 2012
A Clinical Materia Medica Verlag Systemische Medizin AG
Cinchona species _________________________64 Hydrastis canadensis ____________________ 126

Cinnamomum cassia _____________________ 66 Hypericum perforatum __________________128

Citrus aurantium_________________________ 68 Hyssopus officinalis _____________________ 132

Commiphora molmol _____________________ 70 Iris versicolor ___________________________134

Convallaria majalis _______________________ 72 Isatis indigotica _________________________ 136

Crataegus species ________________________ 74 Juglans species __________________________ 138

Curcuma longa __________________________ 78 Juniperus communis _____________________ 140

Echinacea species ________________________80 Lavandula angustifolia ___________________ 144

Elettaria cardamomum ____________________84 Leonurus cardiaca _______________________ 146

Ephedra sinica ___________________________ 86 Lobelia inflata __________________________ 150

Equisetum arvense _______________________90 Lycium chinensis ________________________154

Eucalyptus globulus ______________________ 92 Marrubium vulgare______________________ 156

Euphorbia hirta __________________________ 94 Melissa officinalis _______________________ 158

Euphrasia officinalis ______________________ 96 Mentha piperita _________________________ 160

Filipendula ulmaria _______________________ 98 Mentha pulegium _______________________ 162

Foeniculum vulgare _____________________ 100 Myrica cerifera _________________________ 164

Fucus vesiculosus _______________________ 102 Nepeta cataria __________________________ 168

Galium aparine _________________________ 104 Ophiopogon japonicus ___________________ 170

Gentiana lutea __________________________ 106 Panax ginseng __________________________ 172

Glechoma hederacea _____________________ 108 Passiflora incarnata ______________________ 176

Glycyrrhiza glabra _______________________ 110 Petroselinum crispum ___________________ 178

Grindelia species ________________________ 114 Phytolacca Americana ___________________ 180

Hamamelis virginiana ___________________ 116 Pimpinella anisum ______________________ 182

Harpagophytum ________________________ 118 Piscidia erythrina _______________________ 184

Hedera helix____________________________120 Plantago major __________________________ 186

Humulus lupulus ________________________ 122 Polygala senega _________________________ 188

Hydrangea arborescens __________________ 124 Polygonum bistorta ______________________ 190

Jeremy Ross, Copyright © 2012
A Clinical Materia Medica Verlag Systemische Medizin AG
Populus tremuloides _____________________ 192 Thymus vulgaris ________________________260

Potentilla erecta_________________________ 194 Tilia species ____________________________ 262

Prunus serotina _________________________ 198 Trigonella foenum- ______________________264

Quercus robur __________________________200 Turnera diffusa _________________________266

Rhamnus purshiana _____________________202 Urtica dioica ___________________________268

Rheum palmatum _______________________204 Valeriana officinalis _____________________ 270

Rosmarinus officinalis ___________________208 Verbena officinalis _______________________ 274

Rubus idaeus ___________________________ 210 Viburnum prunifolium ___________________ 276

Rumex crispus __________________________ 212 Viola tricolor ___________________________ 278

Ruta graveolens _________________________ 214 Vitex agnus-castus ______________________280

Salvia officinalis_________________________ 216 Zanthoxylum species ____________________ 282

Sambucus nigra _________________________220 Zea mays ______________________________284

Sanguinaria canadensis __________________ 222 Zingiber officinale _______________________286

Sanguisorba officinalis ___________________226

Sarothamnus scoparius __________________228 Comparison of herb action groups

Schisandra chinensis ____________________230 … six Blood tonic herbs ___________________20

Scrofularia nodosa ______________________ 232 … six bitter herbs ________________________ 32

Scutellaria species _______________________234 … seven circulatory stimulants _____________ 52

Serenoa serrulata ________________________238 … five cardioregulatory herbs ______________ 76

Silybum marianum ______________________240 … seven antimicrobial herbs and antibiotics __ 82

Smilax species __________________________242 … five antiasthmatic herbs _________________ 88

Solidago virgaurea _______________________244 … seven antidepressant herbs _____________130

Stellaria media __________________________246 … four diuretic herbs ____________________ 141

Syzygium aromaticum ___________________248 … five uteroregulatory herbs ______________ 148

Tanecetum parthenium __________________250 … four anticatarrhal herbs ________________ 166

Taraxacum officinale ____________________ 252 … ten sweet tonics_______________________ 175

Thuja occidentalis _______________________256 … seven astringent herbs _________________ 196

Jeremy Ross, Copyright © 2012
A Clinical Materia Medica Verlag Systemische Medizin AG
… laxative and purgative herbs ____________206 Herb Properties ______________________365

… four aromatic herbs ___________________ 218 Herb Names ___________________________ 369

… six herbs with isoquinoline alkaloids _____ 224

… four nervine herbs ____________________236

… alterative herbs _______________________254 Cross References

… five bitter calming herbs _______________ 272 English – botanical name _____________ 375

Botanical name– family ______________ 379

Family – botanical name ______________383

Appendices
Pharmaceutical name – English ________385
References ____________________________ 291
Botanical name – Mandarin __________ 389
Glossary _____________________________ 333
Mandarin – botanical name ___________ 393
Chinese Organs and Syndromes:
Terminology __________________________ 337 Western Indications – Herb (pairs) ______ 397

Herbs for Chinese Syndromes __________ 339 Herb (pairs) – Western Indications ______ 417

Jeremy Ross, Copyright © 2012

A Clinical Materia Medica Verlag Systemische Medizin AG
 Introduction
Why I wrote this book
THE TOPIC
Since I started combining Western herbs and Chinese med-
icine twenty years ago, there has been a great increase in
interest in this topic in many countries.
A BASIC TEXT
My first book on this topic was Combining Western Herbs
and Chinese Medicine: Principles, Practice, and Materia
Medica. This 970-page book was written to provide the ba-
sic theory and practical techniques, and to give detail on 50
herbs and 150 herb combinations.
TEXTS ON SPECIFIC TOPICS
While teaching many courses on ‘Combining’ after the
book was written, students and practitioners have request-
ed books on specific aspects of this topic. As a consequence,
a series of books on Combining Western herbs and Chinese
medicine is now planned.
A CLINICAL MATERIA MEDICA
From discussion, the most urgent need of the majority of
course participants was for more herbs, and for a flash card-
style presentation of the key data for each herb.
This book, A Clinical Materia Medica – 120 Herbs in West-
ern Use, was written in answer to their requests.
KEY DATA TABLES
Each herb in this book has a specially designed key data ta-
ble, equivalent to a flash card, clearly showing the Chinese
actions, Western actions, Western uses, and examples of
herb pairs for that herb.
COMBINING THREE TRADITIONS
What has become increasingly clear during my work with
this topic over the years is that the range of use of a herb
can be greatly expanded by combining information from
the three traditions: Chinese medicine, Western herbal tra-
dition, and modern pharmacological and clinical research.
For some herbs, this opens up a remarkable panorama of
potential future uses. Crataegus is an excellent example of
this.
EVIDENCE FOR STATEMENTS MADE
In books on Western herbal medicine written over the last
fifty years, authors often simply made statements or claims
Jeremy Ross,
A Clinical Materia Medica
about herbs without giving supporting references from
either traditional texts or modern research. As a result, the
reader did not know whether a statement made by the author
was anything other than their unsubstantiated opinion.
In more recent books, such as the ESCOP monographs, the
British Herbal Compendia, or the works of Mills and Bone,
references are given for statements made. In modern books
on Western herbs, citing references is essential if the work
is to be regarded as a serious medical rather than a popular
text.
TRADITIONAL AND RESEARCH DATA
Each herb in this book has one section on Traditional use
and another section on Constituents and pharmacology.
In these sections, a selection of material from traditional
texts and from modern research studies is presented with
references. Approximately 1,200 references are cited in this
book.
LIST OF HERBS FOR CHINESE SYNDROMES
Many practitioners have requested a list of herbs for Chinese
syndromes, with signs and symptoms, pulse and tongue
given for each syndrome.
Such a list with all the main Chinese syndromes plus 125
common combinations of syndromes is given as an appen-
dix in this book.
WESTERN INDICATIONS
This book meets also the needs of those who want to look up
the main Western indications for each single herb and dou-
ble. See appendices “Western Indications and herb pairs”.
Where to find things in this book
COMPANION TEXTS
This book was designed to be a companion text to Combin-
ing Western Herbs and Chinese Medicine: Principles, Prac-
tice, and Materia Medica (PPMM).
It provides a quick reference clinical materia medica for 120
herbs, whilst PPMM provides the theoretical basis, practi-
cal instructions, great detail of 50 herbs, and discussion of
150 herb combinations.
THIS BOOK
Apart from the 120 herb chapters, this book contains the
following information:
Copyright © 2012
Verlag Systemische Medizin AG
Introduction XV
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PRINCIPLES OF COMBINATION, DOSE, SAFETY - toxicology
There is a brief summary of these topics toward the end of
this Introduction. These topics are discussed in much great- - dose discussion
er detail in PPMM. - comparison of Western and Chinese use
SOURCES
A number of basic texts are referred to so frequently in this
book, that an abbreviation is used when citing them, often
the names of the authors or editors. These abbreviations are
explained in the beginning of the book in the Sources chap- How to use the herb chapters
ter.
Each of the 120 herb chapters in this book is organized
REFERENCES
in the following way:
Approximately 1,200 references are cited in this book. Since
Names and botanical detail
the aim was to keep each herb chapter to two pages, the ref-
Names, part used, family
erences are listed in the References appendix.
Botanical description
GLOSSARY Botanical illustration
A Glossary at the back of this book explains some of the Use of different types and plant parts (where applicable)
terms used in the text.
The Actions glossary in PPMM will further help with the Key herb data
definition of Western herbal action categories and the dis- Temperature, tastes, organs
cussion of their nearest Chinese equivalents. Actions, uses, and herb pairs table
CHINESE ORGANS AND SYNDROMES: TERMINOLOGY
Traditional use
This section at the back of this book describes non-standard
Traditional use in China
Chinese syndromes that I encounter in my practice.
Traditional use in the West
HERBS FOR CHINESE SYNDROMES
One appendix contains all the main Chinese syndromes and Comparison with a similar herb
about 125 common syndrome combinations with details of Comparison with another single herb
signs and symptoms, pulse and tongue, and suitable herbs. Comparison within a herb group
HERB PROPERTIES, HERB NAMES, AND CROSS
Constituents and pharmacology
REFERENCE LISTS
Types of constituents
These useful tables provide a cross reference for botanical,
Actions supported by research
English, pharmaceutical, and Mandarin names, and give
Actions linked to a constituent
groupings of the herbs into families.
PRINCIPLES, PRACTICE, AND MATERIA MEDICA Dose and dispensing
The reader is referred to PPMM for background material, Dried herb
and specifically to the following chapters: Liquid extract
Tincture
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Jeremy Ross, Copyright © 2012

XVI AIntroduction
Clinical Materia Medica Verlag Systemische Medizin AG
Cautions
General contraindications
Chinese contraindications
Pregnancy and lactation
Side effects
Overdose
Drug interactions
Names and botanical detail
NAMES, PART USED, FAMILY
The English, botanical, and pharmaceutical names of the
herb are given, together with the parts used, and family
name.
The Mandarin name and Chinese characters are given
where applicable.
BOTANICAL DESCRIPTION AND BOTANICAL
ILLUSTRATION
These are given to help create a mental picture and give a
feel for the herb and to aid in identification.
USE OF DIFFERENT TYPES AND PLANT PARTS
For some of the herbs, specific data on the use of different
species, subspecies, varieties, or plant parts is given in a sep-
arate section. This section, which may also include a brief
description on differences of tradition in different coun-
tries, is found directly underneath the main table.
Key herb data
TEMPERATURE, TASTES, ORGANS
Temperature Some herbs are classified with a range of
potential temperatures, e.g., Achillea is classified as warm-
cool. For discussion of the concept of variable-temperature
herbs, please see the Temperature chapter in PPMM.
Taste properties The aromatic property is included with
the taste properties in this book. For a detailed discussion of
the taste properties, please see the Taste chapter in PPMM.
Organs entered This is equivalent to the concept of merid-
ians entered in other texts. Please see the appendix Chinese
organs and syndromes: terminology in this book for explana-
tion of organ concepts, such as Intestines or Uterus.
ACTIONS, USES, AND HERB PAIRS TABLE
Organization by Chinese actions This table uses the main
Chinese actions for the herb as the coordinating theme to
link Chinese actions, Western actions, and Western uses.
For each of the main Chinese actions, an example of a herb
pair is given to treat a specific disorder.
Flash card or basis for detailed study This table shows
the key data on the specific herb, and it summarizes an
enormous amount of information.
The table can be used like a flash card that assists with learn-
ing the essentials of a herb. Alternatively, each Chinese ac-
tion in the table can be used as a starting point for detailed
study.
Traditional use
TRADITIONAL USE IN CHINA
Whenever a herb is also commonly used in China, this sec-
Jeremy Ross,
A Clinical Materia Medica
tion gives available herb data, including properties, actions,
and uses.
TRADITIONAL USE IN THE WEST
Material from masters of the past, such as Dioscorides,
Lonicerus, Tabernaemontanus, Gerard, and Culpeper, is in-
cluded where space allows. The material is often condensed
or paraphrased, with antique terminology converted to
modern English. Readers are strongly encouraged to study
these texts, which represent the rich heritage of our West-
ern materia medica.
Comparison with a similar herb
COMPARISON WITH ANOTHER SINGLE HERB
Sometimes the herb of the chapter is compared with a simi-
lar herb, for example, Angelica archangelica is compared
with Angelica sinensis. The similarities and differences of
the herbs are discussed in terms of properties, actions, and
uses, so that the practitioner can get a clearer idea of when
to use each herb in practice.
COMPARISON WITHIN A HERB GROUP
Sometimes the herb of the chapter is compared with other
herbs in an action group. For example, the end of the An-
gelica chapter has a Comparison of six Blood tonic herbs,
which compares Angelica sinensis with molasses, Lycium,
Gentiana, Rosmarinus, and Salvia.
Constituents and pharmacology
TYPES OF CONSTITUENTS
The main types of constituents are listed, organized by
chemical type, e.g., essential oils, flavonoids, alkaloids, tan-
nins. The list mainly focuses on the constituents that give
the herb its characteristic actions.
ACTIONS SUPPORTED BY RESEARCH
This section lists the actions that are supported by one or
more research studies, including in vitro, in vivo, human
pharmacological, or clinical studies.
ACTIONS LINKED TO A CONSTITUENT
This section shows which constituents are responsible for
which actions, when there is data available. This section is
sometimes organized by constituent and sometimes by ac-
tion, as appropriate.
Dose and dispensing
DRIED HERB, LIQUID EXTRACT, TINCTURE
Dosage is usually given as three individual doses per day. If
the daily amount was given as a single dose in the source
text, this was usually converted to an amount for three in-
dividual doses.
In this book, the most frequently used source text for dose
levels was the British Herbal Pharmacopoeia of 1983, see
Dose and dispensing at the end of this chapter.
INITIAL DOSE, DURATION
These sections indicate whether there is a restriction on the in-
itial dose or on the length of time that the herb can be taken.
Copyright © 2012
Verlag Systemische Medizin AG
Introduction XVII
Cautions
It is absolutely essential that practitioners read this section
before using any herb in this book.
GENERAL CONTRAINDICATIONS
This section lists known contraindications or cautions from
Western tradition or modern research.
Where space permits, contraindications based on adverse
reaction reports are differentiated from theoretical con-
cerns based on the presence of a potentially toxic constitu-
ent. This differentiation is discussed in detail in PPMM.
CHINESE CONTRAINDICATIONS
This section lists traditional contraindications from texts
on Chinese medicine. It may also list contraindications that
are not given in these texts, but that have occurred clinically
due the nature of the herb’s actions. For example, Rosmari-
nus may aggravate Heart Spirit Disturbance in susceptible
persons due to its stimulant action.
PREGNANCY AND LACTATION
This section gives data on safety concerns during pregnancy
and lactation. Please see The Essential Guide to Herbal Safe-
ty by Mills and Bone for more detail.
SIDE EFFECTS, OVERDOSE
These sections include data on adverse reactions within and
above the therapeutic dose range, respectively.
DRUG INTERACTIONS
This section gives data on adverse herb-drug reactions,
when available.
Principles and practice of herb
combination
This book is a clinical materia medica, in which there is no
space for a detailed discussion of the principles and practice
of herb combinations. Only a very brief outline is given here
and the reader is referred to PPMM.
Checklist
To create a balanced, effective, and safe herb combination in
Chinese medicine, it is important to consider the following
principles. These principles apply whether the herbs used
are Chinese or Western.
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ACCURATE DIFFERENTIAL DIAGNOSIS
The foundation for creating an effective
herb combination is accurate diagnosis.
Jeremy Ross,
XVIII Introduction
A Clinical Materia Medica
In herbal treatment, accurate diagnosis is important. With-
out it, the consequences to the patient may be unpleasant
or even dangerous. The practitioner needs to determine
the Chinese syndromes underlying the patient’s signs and
symptoms in order to choose appropriate herbs to treat
these syndromes. This can be summarized by the phrase:
Wrong diagnosis means wrong herbs!
PRIORITIZATION OF CHINESE SYNDROMES
The next step consists of prioritizing the patient’s Chinese
syndromes into those of primary and those of secondary
importance.
How to decide The decision as to which syndromes are
primary and which are secondary is made partly according
to which disorders are most important to the patient, and
partly according to medical principles, such as the optimum
sequence for treating ‘root’ and ‘branch’ in the given case.
Importance of prioritization Primary syndromes re-
quire more herbs in the combination than do secondary
syndromes. If the practitioner gets the syndromes right, but
the prioritization of the syndromes wrong, the patient may
get worse not better. See An example with mistakes in the
Practical herb combination chapter in PPMM.
BALANCING TEMPERATURE
In the traditions of Western and Chinese herbal medicine,
both patient and herbs were classified in terms of temper-
ature (hot, warm, neutral, cool, or cold). Herbs were then
matched to patients on the basis of this classification.
For example, a cool pathology would generally be treated
with a herb combination that was warm in its overall tem-
perature balance. To treat a cool pathology with a hot com-
bination would be seen as a potentially damaging overcor-
rection.
Incorrect temperature balance is one of the most common
mistakes in herb combination.
BALANCING TASTE PROPERTIES
Taste balance is a relatively sophisticated level of herb com-
bination, but the practitioners should at least be aware of
the contraindications for the different taste properties.
Each taste property has its specific range of uses and its
specific disadvantages. Tastes can be combined so that one
taste can enhance the beneficial effects of another or moder-
ate its potential adverse effects.
Tables showing taste contraindications and how to balance
the tastes are included in the Taste chapter in PPMM.
BALANCING HERB ACTIONS
It is important to balance the actions of the individual herbs
in a herb combination.
For example, a purgative like Rheum is commonly given
with a carminative like Foeniculum to reduce the potential
purgative side effect of intestinal colic.
As another example, an alterative like Taraxacum is often
combined with a detoxicant and anti-inflammatory like
Glycyrrhiza to reduce the potential alterative side effect of
aggravating skin and arthritic conditions.
A table showing how to balance herb actions is included in
the Actions chapter of PPMM.
Copyright © 2012
Verlag Systemische Medizin AG
CHECKING FOR POTENTIAL CONTRAINDICATIONS
It is essential that the practitioner check for each herb in the
proposed combination whether it can cause side effects in a
specific patient.
Some obvious examples of questions are:
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herbs may interact?
Four different approaches to herb
combination
Three of these approaches involve using a preexisting com-
bination, and the fourth involves creating a new combina-
tion by using the basic principles of herb combination.
USING A PREEXISTING COMBINATION
There are three main possibilities:
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Note for beginners Creating a new combination by com-
bining elements of different preexisting combinations is an
advanced technique. If the technique is used by those who
are inexperienced in herbal medicine, it can easily result
in an assortment of ill-matched fragments rather than in a
carefully balanced and harmonious combination.
It is recommended that beginners first become thoroughly
familiar with the properties of the individual herbs and with
the principles of herb combination. They can then develop
their skills by using preexisting combinations, with simple
modifications where appropriate, and by learning to create
simple new combinations from first principles.
CREATING A NEW COMBINATION
When creating a new combination that matches the specific
Chinese syndromes and life situation of the patient, it is
necessary to work through the stages in the checklist above.
See examples in PPMM.
Jeremy Ross,
A Clinical Materia Medica
Dose and dispensing
Dose levels
THERAPEUTIC DOSE RANGE
Each herb has a therapeutic dose range, within which a suit-
Minimum therapeutic dose This is the smallest dose that
will have a therapeutic result. Below this is the subtherapeu-
tic dose, which is too small to have a therapeutic effect.
Maximum dose In the case of herbs with potential adverse
effects, this is the largest dose that is safe to administer. The
due to toxic effects are likely to occur. In the case of herbs
like Althaea, for which there are no reports of adverse ef-
fects even at overdose levels, the maximum dose can be de-
fined as the largest dose that is generally necessary to obtain
a therapeutic effect.
DIFFERENCES OF OPINION
problem is that there are often differences of opinion as to
what constitutes the minimum and maximum therapeutic
Common sense dosing The author of this book recommends
using the least dose required to get the desired therapeutic
effect. He takes the middle road between what may be called
the higher dose approach and the lower dose approach. This
topic is discussed in detail in PPMM, where alternative
doses are often given for each herb and where the appropri-
ate use in different situations is described.
BHP AS A BASIS
For dried herbs and for herb tinctures, this book generally
adopts the dose levels of the British Herbal Pharmacopoeia
of 1983.
Recent research on dose In cases where subsequent re-
search has indicated that lower doses should be used for
safety reasons or that higher doses are more clinically ef-
fective, these are the doses that are included in the current
text. For example, the BHP recommended 3-6 ml of a 1:5
tincture of Crataegus per day, whilst The Essential Guide to
Herbal Safety by Mills and Bone recommended 3.5-17.5 ml
per day. The latter amount is recommended in the current
text, and is an example of the higher dose approach.
A GENERAL GUIDE
Very approximately, the dose for the average herb is 1-2 g of
dried herb or 2.5-5 ml of 1:5 tincture, three times per day,
for an adult.
However, some herbs are more potent, and their doses may
be much less. For example, the maximum permitted dose in
the UK of Lobelia inflata is 0.2 g of dried herb or 1 ml of 1:5
tincture, three times per day.
Dose and age
Infants, children, and the elderly are given smaller doses
than people of other age groups, as shown in the table. These
are individual doses to be taken three per day.
Copyright © 2012
Verlag Systemische Medizin AG
Introduction XIX
 Age Individual dose Individual dose Advantages Disadvantages
of 1:5 tincture of 1:5 tincture
in ml in drops* t suitable for ethanol-soluble t
MFTT
TVJUBCMF
GPS
BMUFSBUJWF

constituents, such as essential oils, treatments
infants 0.05-0.5 ml 1-10 drops alkaloids, resins, and saponins
6-12 months
t treatment of patterns of Cold and t
MJNJUBUJPOT
PO
UIF
OVNCFS

infants 0.1-1 ml 2-20 drops Damp, Deficiency, and Stagnation of herbs in a combination
1-2 years
Powders
children 1-2.5 ml 20-50 drops
2-5 years t DPOWFOJFODF t
VOTVJUBCMF
GPS
QBUJFOUT
XJUI

EJHFTUJWF
EJTPSEFST
children 2-3.75 ml 40-75 drops
5-10 years t TMPX
SFMFBTF
PG
BDUJWF
DPOTUJUVFOUT t
MFTT
TVJUBCMF
GPS
WPMBUJMF

constituents
teens 2-5 ml 40-100 drops
10-18 years Pills and capsules
adults 2.5-5 ml 50-100 drops t DPOWFOJFODF t
MBDL
PG
nFYJCJMJUZ
JU
JT
OPU

possible to match them to
elderly 2-3.75 ml 40-75 drops the specific needs of the
* The figures are based on the assumption of 20 drops per ml JOEJWJEVBM
QBUJFOU
t TMPX
SFMFBTF
PG
BDUJWF
DPOTUJUVFOUT t
EJHFTUJWF
EJTPSEFST
MFTT

TVJUBCMF
GPS
WPMBUJMF
DPOTUJ-
Dose form tuents
Herbs can be taken orally as powdered dried herbs to be
taken with water, infusions, decoctions, tinctures, liquid
extracts, or concentrates. Each dose form has its advantages Safety
and disadvantages, summarized in the table below. For a de- Please do not use any of the herbs in this book without first
tailed discussion, see the Dose chapter in PPMM. studying their properties, actions, use, dose, and contrain-
dications.
Advantages Disadvantages
Infusions and decoctions Checklist
t cheapness and accessibility t
UBTUF Practitioners can use the following checklist to minimize
adverse reactions due to herb use.
t link to the natural world t
MBDL
PG
DPOWFOJFODF
For detailed discussion of safety, see:
t UIFSBQFVUJD
WBMVF
PG
XBUFS t
VOTVJUBCMF
GPS
XBUFSJOTPMV
ble constituents, such as t
UIF
UISFF
DIBQUFST
Safety, Safety and the organ systems,
resins and Safety in clinical practice in PPMM
t JOGVTJPOT
TVJUBCMF
GPS
WPMBUJMF
DPOT- t
QSFTFSWBUJPO t
ͷF
&TTFOUJBM
(VJEF
UP
)FSCBM
4BGFUZ by Mills and Bone
tituents
t decoctions suitable for water-solu- Monitoring
ble constituents, such as polysac-
charides and tannins HERBS NEEDING MONITORING
t treatment of patterns of Cold
For some of the herbs in this book, it is suggested that the
patient be monitored for side effects during the course of
t treatment of patterns of Dryness treatment.
t diaphoretic treatments These herbs include: Capsicum, Cinchona, Convallaria,
Ephedra, Lobelia, and Sarothamnus.
t BMUFSBUJWF
USFBUNFOUT Monitoring may also be appropriate for some of the altera-
Tinctures and liquid extracts tive herbs, specifically Arctium seeds and Taraxacum root,
which have the potential for aggravating skin rashes and
t DPOWFOJFODF t
VOTVJUBCMF
GPS
QBUJFOUT
XIP

arthritis, especially in patients with high levels of accumu-
IBWF
QSPCMFNT
XJUI
BMDPIPM
lated toxins.
t taste t
MFTT
TVJUBCMF
GPS
XBUFS
soluble constituents, such MONITORING BY PRACTITIONER AND PATIENT
as polysaccharides and Practitioner The practitioner should check for signs and
tannins symptoms of any potential side effects that are to be expect-
ed with the specific herbs and the specific patient. Moni-
t QSFTFSWBUJPO t
MFTT
TVJUBCMF
GPS
EJBQIPSFUJD

toring is essential for herbs with the possibility of severe
treatments
adverse reactions.

Jeremy Ross, Copyright © 2012

XX AIntroduction
Clinical Materia Medica Verlag Systemische Medizin AG
Patient The patient can be asked to keep a record of the
General
following:
1. take a full medical history
t
BOZ
TVTQFDUFE
TJEF
FĉFDUT
PS
BEWFSTF
IFSCESVH
JOUFSBD- 2. make an accurate differential diagnosis
tions: noting such details as severity and the time and 3. prioritize Chinese syndromes
date the symptoms occurred 4. decide if further specialist diagnosis is required
5. decide if herbal treatment is appropriate
t
BOZ
DIBOHFT
JO
QSFTDSJCFE
PS
TFMGQSFTDSJCFE
DPOWFOUJPOBM

6. allow informed patient choice
medication, herbs, or food supplements
t
BOZ
DIBOHFT
JO
MFWFM
PG
MJGF
TUSFTTFT
UIBU
NBZ
IBWF
CFFO
Herb combining
responsible for the symptoms 7. balance temperature
8. balance taste properties
Rechallenge If it is appropriate and if the patient agrees, 9. balance herb actions
the herbs can be taken again, at a lower dose and/or in a 10. check for potential contraindications
different form if preferred, to determine if the symptoms 11. choose appropriate dose level, dose form, timing of
recur. The patient should be asked to keep in contact with dose, and duration of prescription for the patient
the practitioner during this process and to stop the herbs
immediately if the adverse effect recurs. After prescribing
Rechallenge may not be appropriate for herbs with poten- 12. monitor for adverse reactions, if appropriate
tially severe adverse effects, even if the dose is greatly re- 13. manage adverse reactions, if appropriate
duced. 14. report adverse reactions, if any

Jeremy Ross, Copyright © 2012

A Clinical Materia Medica Verlag Systemische Medizin AG
Introduction XXI
Achillea
English yarrow
Botanical name Achillea millefolium L., s. l.
Pharmaceutical name Achilleae millefolii herba cum
flore (= Millefolii herba cum flore)
Part herb and flowers
Mandarin yáng shī căo (⌻㫽㥹), the aerial parts of A.
millefolium, is not a main herb in Chinese medicine
Family Asteraceae (Compositae)

An aromatic stoloniferous perennial with erect, usually un-

branched stems, 0.2-1 m tall. Leaves are feathery, lanceolate,
and 2-3-pinnate. Flowers are small and white or occasion-
ally pink, borne in dense flat-topped clusters. Native to the
Northern hemisphere, where it grows in grassy habitats, road
verges, and lawns. Achillea prefers well-drained soil.

Temperature warm-cool Please see the chapter on this herb in Principles, Practice
Tastes acrid, bitter, aromatic and Materia Medica for herb combinations and for further
Organs LU, SP, HT, UT information1.

Actions, uses, and herb pairs

Chinese actions Western uses Pair examples
(Western actions) (disorders)
I. clear Wind Heat acute respiratory disorders with feverish- Achillea + Mentha piperita
(diaphoretic, antipyretic, alterative) ness dominant to chills (common cold + sore throat)

II. clear Wind Cold acute respiratory disorders with chills Achillea + Zingiber (fresh)
(diaphoretic, antipyretic, alterative) dominant to feverishness (influenza + cold sensation)

III. clear Lung Phlegm Heat acute respiratory disorders with fever, Achillea + Asclepias
(diaphoretic, antipyretic, alterative) cough, bronchial phlegm (pleurisy + fever)

IV. clear Lung Phlegm Cold Damp acute respiratory disorders with nasal or Achillea + Angelica archangelica
(anticatarrhal, alterative) bronchial phlegm and cold sensations (influenza + sinusitis)

V. clear Retained Pathogen, tonify Defensive Qi recurring respiratory infections, with low- Achillea + Echinacea
(diaphoretic, alterative, tonic) grade fever and fatigue (recurring respiratory infections)

VI. tonify Spleen Qi and Blood digestive weakness with exhaustion (and Achillea + Artemisia absinthium
(bitter digestive tonic) anemia), postfebrile convalescence (postfebrile exhaustion)

VII. tonify Spleen Qi and Heart Qi (postfebrile) exhaustion with digestive and Achillea + Cinchona
(digestive and cardiac tonic) cardiac weakness (some cases of chronic fatigue)

VIII. reduce leakages, reduce bleeding nosebleeds, hemoptysis, diarrhea, leukor- Achillea + Urtica
(astringent, anticatarrhal, hemostatic) rhea, menorrhagia, wounds (menorrhagia)

USE OF DIFFERENT TYPES AND PLANT PARTS ferences in chromosome number between the A. millefolium subspecies
A. millefolium is a complex of barely distinguishable species or subspecies, are often accompanied by important chemical differences, which in their
which have evolved by polyploidy (changes in chromosome number)2. Dif- turn, may lead to differences in temperature, actions, and uses1.

Jeremy Ross, Copyright © 2012

2 AAchillea
Clinical Materia Medica Verlag Systemische Medizin AG
Traditional use in the West t
nBWPOPJET including apigenin, luteolin and their gluco-
sides
DIOSCORIDES 1ST CENTURY AD3
t
QPVOE
UIF
MFBWFT
BOE
QVU
UIFN
PO
B
GSFTI
XPVOE
UP
DMPTF
t
BMLBMPJET mainly achilleine (= betonicine = L-4-hy-
and heal the wound, clear it from heat and inflammation, droxy-stachydrine) as well as stachydrine, betaine, and
and congeal the blood choline

t
UP
TUPQ
IFBWZ
NFOTUSVBM
nPX
NBLF
B
TVQQPTJUPSZ
PG
UIJT
t
PUIFS tannins (3-4%), polyacetylenes, triterpenes, ster-

herb with wool and put in the vagina ols (including beta-sitosterol), coumarins, phenolic acids
(including salicylic and caffeic acids)
t
NBLF
B
EFDPDUJPO
PG
UIF
MFBWFT
UP
DVSF
EZTFOUFSZ
ACTIONS SUPPORTED BY RESEARCH
LYLE 18974 The following actions have been reported for Achillea plant
It stimulates the appetite and tones the digestive organs. It material or for its isolated constituents:
is important as a tonic to the general system. In cold infu-
antibacterial7, anti-inflammatory8, antiulcer9, spasmolytic8,
sions, it acts as a tonic in convalescence from fevers, from
choleretic8, hepatoprotective10, antihypertensive and antili-
nervous prostration, and in pulmonary tuberculosis and
pidemic (A. wilhelmsii)11, hemostatic12, antitumor13
night sweats.
ACTIONS LINKED TO A CONSTITUENT
CHRISTOPHER 19765
t
BOUJNJDSPCJBM essential oil (including linalool)7
t
XIFO
UBLFO
IPU
BOE
DPQJPVTMZ
QSPEVDFT
QFSTQJSBUJPO

equalizes the circulation, and purifies the blood of morbid t
BOUJJOnBNNBUPSZ flavonoids, dicaffeoylquinic acids8
waste material t
BOUJTQBTNPEJD flavonoids8
t
GPS
DPMET
JOnVFO[B
PCTUSVDUFE
QFSTQJSBUJPO
GFWFST
JO- t
DIPMFSFUJD dicaffeoylquinic acids8
cluding typhoid fever), eruptive diseases (including mea-
TMFT
BOE
DIJDLFO
QPY
t
IFNPTUBUJD




BDIJMMFJOF
BMLBMPJE
12

t
GPS
SFTQJSBUPSZ
DBUBSSI
DPOHFTUJWF
IFBEBDIF
NVDPJE
CMBE- t
BOUJUVNPS achimillic acids (sesquiterpenoids)13

der discharges
t
GPS
TVQQSFTTFE
VSJOBUJPO
TDBOUZ
VSJOF
JODPOUJOFODF
PG

urine, enuresis
t
GPS
BNFOPSSIFB
NFOPSSIBHJB
MFVLPSSIFB

BHP 19836
This text gave the specific indication of thrombotic condi-
tions with hypertension, including cerebral and coronary
thromboses.
Dose and dispensing
DRIED HERB 2-4 g of dried herb, as powder or as infusion, three times
Comparison with a similar herb per day (BHP)6.
TINCTURE 2-4 ml of 1:5 tincture in 45% alcohol, three to four times
ACHILLEA AND HYSSOPUS See Hyssopus. per day (BHP).
ACHILLEA AND TILIA See Tilia. INITIAL DOSE Can start at the standard dose (JR).
DURATION



$BO
CF
UBLFO
MPOHUFSN
CVU
MBSHF
RVBOUJUJFT
PG
TUSPOH

Achillea infusions are generally for acute conditions and for short-term
Constituents and pharmacology use only (JR).
TYPES OF CONSTITUENTS2
t
FTTFOUJBM
PJM
(0.2-1%) composition of essential oil varies Cautions
greatly with chromosome number, for example:
GENERAL CONTRAINDICATIONS Sensitivity to Asteraceae (M&B
- hexaploid plants have no chamazulene, but mainly Safety)14.
oxygenated monoterpenes, especially linalool (26%) and CHINESE CONTRAINDICATIONS Not widely used in Chinese
camphor (18%), with some borneol and 1,8-cineole medicine.
PREGNANCY AND LACTATION No adverse effects in humans repor-
- tetraploid plants contain mainly sesquiterpenes, es- ted, but see M&B Safety for animal research. No restrictions on breast-
pecially chamazulene (about 25%) and β-caryophyllene feeding listed by BSH15.
(11-22%) SIDE EFFECTS See General contraindications.
t
TFTRVJUFSQFOF
MBDUPOFT achillicin (= 8-acetoxyartab- OVERDOSE No adverse effects reported (M&B Safety).
sin) is the main prochamazulene DRUG INTERACTIONS No adverse effects reported (M&B Safety).

Jeremy Ross, Copyright © 2012

A Clinical Materia Medica Verlag Systemische Medizin AG
Achillea 3