About Our Health Care

Yarrow

Yarrow (Achillea millefolium) is an aromatic member of the Asteraceae (Compositae) family. This perennial European native with lovely, fern-like foliage is also named millefoil, or thousand leaves, because of its finely-divided leaves.

There are many species and subspecies of yarrow, including a similar native American variety known as A. Millefolium var. lanulosa. Yarrow is naturalized through-out North America and can be found growing wild in meadows, fields, and along roadsides.

Introduced to North America by early colonists, yarrow soon became a valued remedy used by many tribes of indigenous people. American Shakers gathered yarrow for use in numerous medicinal preparations. The plant was listed in the official U.S. Pharmacopoeia from the mid- to late nineteenth century.


Yarrow’s hardy rhizome, or underground stem, develops from underground runners as the extensive root system spreads. The lacy, finely-divided leaves are multi-pinnate, and grow alternately, clasping at the base along the simple, erect and angular stem. The feather-like leaves may reach 6 in (15.2 cm) in length.

They mound near the ground in early growth; then the slightly hairy stems reach upwards to 3 ft (0.91 m) in height during flowering. The tiny blossoms may be rose or lilac colored, or a creamy white; they flower from June until October. Yarrow blossoms grow in flat-topped composite clusters at the top of the stems.

Human relationships with this healing plant reach back to ancient times. The fossilized pollen of yarrow has been found in Neanderthal burial caves from as far back as 60,000 years.

Yarrow has long been associated with magic and divination, and is considered by some folk herbalists as a sacred plant with special spiritual powers to offer protection. Yarrow stalks are traditionally used to cast the I Ching, the Chinese book of prophecy. The herb was also believed to be useful in love charms and in conjuring.

One folk name for yarrow is devil’s nettle. Other names include bloodwort, carpenter’s weed, sanguinary, staunchweed, dog daisy, old man’s pepper, field hops, nosebleed, knight’s milfoil, soldier’s woundwort, and military herb. Yarrow accompanied soldiers into battle and was relied upon for its hemostatic action to treat wounds.

This use may have been the source of yarrow’s generic name, taken from the legend of Achilles. The Greek pahlawan is said to have used yarrow in the Trojan War to staunch the blood flowing from the wounds of fallen comrades. Yarrow was used in battle-field first aid as recently as World War I (1914–1918).

General use

Scientists have identified over one hundred active chemical compounds in yarrow, including the intensely blue-colored azulene derivatives found in the essential oil of yarrow and at least two species of chamomile (Chamaemelum nobile (L.) and Matricaria recutita).

Other chemical constituents in yarrow include lactones, flavonoids, tannins, coumarins, saponins, sterols, sugars, a bitter glyco-alkaloid, and amino acids. The aerial parts of yarrow, particularly the wild white-flowered variety, are most often used in medicinal remedies.

External uses

Yarrow is well known for its wound healing capabilities, particularly in staunching the flow of blood. The herb is considered a vulnerary and hemostatic with antiseptic and antibacterial properties. The astringent action of the leaf, when inserted into a nostril, may stop a nosebleed.

An infusion of the leaf, stems, and flowers will speed the healing of rashes, hemorrhoids, and skin ulcers. Dried and powdered yarrow sprinkled on cuts and abrasions may also facilitate healing. Native Americans used yarrow in poultice form to treat skin problems. Infusions of yarrow have been used as a hair rinse in attempts to prevent baldness.

Internal uses

In folk medicine, freshly gathered yarrow root mashed in whiskey was used as a primitive anesthetic. Yarrow has also been used to stop internal bleeding, and as a bitter digestive tonic. Its emmenagogic action promotes the flow of bile. Yarrow tea taken warm acts as a diaphoretic, or medication given to induce sweating.

It is particularly beneficial in the treatment of fever, colds, and influenza, as well as the early stages of measles and chickenpox. The essential oil, extracted by steam distillation of the flowers, is dark blue in color and has anti-inflammatory, anti-allergenic, and antispasmodic properties.

Fresh yarrow leaf chewed slowly is said to relieve toothache. The herb has also been used to induce nosebleed in an attempt to relieve migraine headache. Yarrow appears to be beneficial in reducing high blood pressure. Flavonoids in the herb act to dilate the peripheral arteries and help to clear blood clots.

Preparations

Yarrow diagram

Yarrow should be harvested while the herb is in flower, on a dry day after the morning dew has evaporated. The leaves, stems, and blossoms are all used medicinally. The leaves should be cut from the stems and spread out on a paper-lined tray to dry in a bright, airy room, out of direct sunlight.

Blossoms may be left on the stems and hung in small bunches upside-down in a very warm room. Dried flowers should be stored separately, and dry stems cut into small segments before storage in an airtight, dark glass container, clearly labeled to indicate the contents and the date and place of harvest.

Leaf infusion: Place 2 oz of fresh yarrow leaf, less if dried, in a warmed glass container. Bring 2.5 cups of fresh, nonchlorinated water to the boiling point and add it to the yarrow. Cover. Steep the tea for 10 to 15 minutes, then strain. Drink warm or cold throughout the day, up to three cups per day. The prepared tea can be stored for about two days in the refrigerator.

Tincture: Combine 4 oz of fresh yarrow leaf and stalks cut fine (or 2 oz dry powdered herb) with 1 pint of brandy, gin, or vodka in a glass container. The alcohol should be enough to cover the plant parts and have a 50/50 ratio of alcohol to water.

Cover and store the mixture away from the light for about two weeks, shaking several times each day. Strain and store in a tightly capped, clearly labeled dark glass bottle. A standard dose is 10 to 15 drops of the tincture in water, up to three times a day.

Precautions

Rose colored yarrow

Yarrow may have a cumulative medicinal effect on the system. Patients should avoid the frequent use of yarrow in large doses for long periods of time. Yarrow is a uterine stimulant; pregnant or lactating women should therefore not use the herb internally.

Side effects

People with allergies to ragweed, another member of the Asteraceae family of plants, may also want to avoid taking yarrow internally. In some cases yarrow may cause skin rashes or photosensitivity after ingestion.

Interactions

No interactions between yarrow and standard pharmaceutical preparations have been reported.

Wound

A wound occurs when the integrity of any tissue is compromised, for example, when skin breaks, muscle tears, burns, or bone fractures. A wound may be caused by an act, such as a gunshot, fall, or surgical procedure; by an infectious disease; or by an underlying condition.

Description

Types and causes of wounds are wide ranging, and health care professionals have several different ways of classifying them. They may be chronic, such as the skin ulcers caused by diabetes mellitus, or acute, such as a gunshot wound or animal bite.

Wounds may also be referred to as open, in which the skin has been compromised and underlying tissues are exposed, or closed, in which the skin has not been compromised, but syok to underlying structures has occurred, such as a bruised rib or cerebral contusion.

Emergency personnel and first-aid workers generally place acute wounds in one of eight categories:

• Abrasions. Also called scrapes, they occur when the skin is rubbed away by friction against another rough surface (e.g. rope burns and skinned knees).
• Avulsions. These occur when an entire structure or part of it is forcibly pulled away, such as the loss of a permanent tooth or an ear lobe. Explosions, gunshots, and animal bites may cause avulsions.
• Contusions. Also called bruises, these result from forceful syok that injures an internal structure without breaking the skin. Blows to the chest, abdomen, or head with a blunt instrument (e.g. a football or a fist) can cause contusions.
• Crush wounds occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures.
• Cuts are slicing wounds made with a sharp instrument, leaving even edges. They may be as minimal as a paper cut or as significant as a surgical incision.
• Lacerations. Also called tears, these are separating wounds that produce ragged edges. They are produced by a tremendous force against the body, either from an internal source as in childbirth, or from an external source like a punch.
• Missile wounds. Also called velocity wounds, they are caused by an object entering the body at a high speed, typically a bullet.
• Punctures are deep, narrow wounds produced by sharp objects such as nails, knives, and broken glass.

Causes and symptoms

Acute wounds have a wide range of causes. Often, they are the unintentional results of motor vehicle accidents, falls, mishandling of sharp objects, or sports-related injury. Wounds may also be the intentional result of violence involving assault with weapons, including fists, knives, or guns.

The general symptoms of a wound are localized pain and bleeding. Specific symptoms include:

• An abrasion usually appears as lines of scraped skin with tiny spots of bleeding.
• An avulsion has heavy, rapid bleeding and a noticeable absence of tissue.
• A contusion may appear as a bruise beneath the skin or may appear only on imaging tests; an internal wound may also generate symptoms such as weakness, perspiration, and pain.
• A crush wound may have irregular margins like a laceration; however, the wound will be deeper and syok to muscle and bone may be apparent.
• A cut may have little or profuse bleeding depending on its depth and length; its even edges readily line up.
• A laceration too may have little or profuse bleeding; the tissue damage is generally greater and the wound’s ragged edges do not readily line up.
• A missile entry wound may be accompanied by an exit wound, and bleeding may be profuse, depending on the nature of the injury.
• A puncture wound will be greater than its length, therefore there is usually little bleeding around the outside of the wound and more bleeding inside, causing discoloration.

Diagnosis

A diagnosis is made by visual examination and may be confirmed by a report of the causal events. Medical personnel will also assess the extent of the wound and what effect it has had on the patient’s well-being (e.g. profound blood loss, damage to the nervous system or skeletal system).

In cases of severe injury, or when a physician suspects possible internal injury, tests might be made to determine the extent of a wound. In late 2001, a new ultrasound (imaging inside the body via sound waves) technique was introduced that might help doctors diagnose internal bleeding, a serious complication of some injuries. The technique could help prevent invasive surgery for diagnosis.

Treatment

Treatment of wounds involves stopping any bleeding, then cleaning and dressing the wound to prevent infection. Additional medical attention may be required if the effects of the wound have compromised the body’s ability to function effectively.

Stopping the bleeding

Most bleeding may be stopped by direct pressure. Direct pressure is applied by placing a clean cloth or dressing over the wound and pressing the palm of the hand over the entire area. This limits local bleeding without disrupting a significant portion of the circulation. The cloth absorbs blood and allows clot formation; the clot should not be disturbed, so if blood soaks through the cloth, another cloth should be placed directly on top rather than replacing the original cloth.

If the wound is on an arm or leg that does not appear to have a broken bone, the wound should be elevated to a height above the person’s heart while direct pressure is applied. Elevating the wound allows gravity to slow down the flow of blood to that area.

If severe bleeding cannot be stopped by direct pressure or with elevation, the next step is to apply pressure to the major artery supplying blood to the area of the wound.

In the arm, pressure would be applied to the brachial artery by pressing the inside of the upper arm against the bone. In the leg, pressure would be applied to the femoral artery by pressing on the inner crease of the groin against the pelvic bone.

If the bleeding from an arm or leg is so extreme as to be life-threatening and if it cannot be stopped by any other means, a tourniquet—a device used to check or prevent bleeding or blood flow—may be required. However, in the process of limiting further blood loss, the tourniquet also drastically deprives the limb tissues of oxygen. As a result, the patient may live but the limb may die.

Dressing the wound

Once the bleeding has been stopped, cleaning and dressing the wound is important for preventing infection. Although the flowing blood flushes debris from the wound, running water should also be used to rinse away dirt. Embedded particles such as wood slivers and glass splinters, if not too deep, may be removed with a needle or pair of tweezers that has been sterilized in rubbing alcohol or in the heat of a flame.

Once the wound has been cleared of foreign material and washed, it should be gently blotted dry, with care not to disturb the blood clot. An antibiotic ointment may be applied. The wound should then be covered with a clean dressing and bandaged to hold the dressing in place.

Homeopathic remedies

In addition to the conventional treatments described above, there are alternative therapies that may help support the injured person. Homeopathy can be very effective in acute wound situations. Ledum (Ledum palustre) is recommended for puncture wounds (taken internally). Calendula (Calendula officinalis) is the primary homeopathic remedy for wounds.

Other effective treatments

A naturally occurring antiseptic is tea tree oil (Melaleuca spp.), which can be mixed with water for cleaning wounds. Aloe (Aloe barbadensis) can be applied topically to soothe skin during healing.

When wounds affect the nerves, especially in the arms and legs, St. John’s wort (Hypericum perforatum) can be helpful when taken internally or applied topically. Also, an important Chinese herb preparation called Yunnan Bai Yao, which includes the main herbal ingredient san chi, is used very effectively to stop bleeding, and promote healing for all sorts of wounds.

Other herbal remedies include Hypericum for nerve pain, and arnica for soft tissue damage. Acupuncture can help support the healing process by restoring the energy flow in the meridians that have been affected by the wound. In some cases, vitamin E taken orally or applied topically can speed healing and lessen scarring.

Allopathic treatment

A person who has become impaled on a fixed object, such as a fence post or a stake in the ground, should only be moved by emergency medical personnel. Foreign objects embedded in the eye should only be removed by a doctor. Larger penetrating objects, such as a fishhook or an arrow, should only be removed by a doctor to prevent further damage as they exit.

Additional medical attention is necessary in several instances. Wounds that penetrate the muscle beneath the skin should be cleaned and treated by a doctor. Such a wound may require stitches to keep it closed during healing.

Some deep wounds, which do not extend to the underlying muscle may only require butterfly bandages to keep them closed during healing. Wounds to the face and neck, even small ones, should always be examined and treated by a doctor to preserve sensory function and minimize scarring.

Deep wounds to the hands and wrists should be examined for nerve and tendon damage. Puncture wounds may require a tetanus shot to prevent serious infection. Animal bites should always be examined and the possibility of rabies infection determined.

Infection

Wounds that develop signs of infection should also be brought to a doctor’s attention. Signs of infection are swelling, redness, tenderness, throbbing pain, localized warmth, fever, swollen lymph glands, the presence of pus either in the wound or draining from it, and red streaks spreading away from the wound.

Emergency treatment

With even as little as one quart of blood lost, a person may lose consciousness and go into traumatic shock. Because this is life-threatening, emergency medical assistance should be called immediately.

If the person stops breathing, artificial respiration (also called mouth-to-mouth resuscitation or rescue breathing) should be administered. In the absence of a pulse, cardiopulmonary resuscitation (CPR) must be performed. Once the person is breathing unassisted, the bleeding may be attended to.

In cases of severe blood loss, medical treatment may include the intravenous replacement of body fluids. This may be infusion with saline or plasma, or a transfusion of whole blood.

Expected results

Without the complication of infection, most wounds heal well with time. Depending on the depth and size of the wound, it may or may not leave a visible scar.

Prevention

Most actions that result in wounds are preventable. Injuries from motor vehicle accidents may be reduced by wearing seat belts and placing children in size-appropriate car seats in the back seat.

Sharp, jagged, or pointed objects or machinery parts should be used according to the manufacturer’s instructions and only for their intended purpose, as well as educating children on the proper way to hold and handle them, or keeping them out from their reach.

Firearms and explosives should be used only by adults with explicit training; they should also be kept locked and away from children. Persons engaging in sports, games, and recreational activities should wear all proper protective equipment and follow safety rules.

Wormwood

Wormwood (Artemisia absinthium) is a perennial that is native to Europe and parts of Africa and Asia but now grows wild in the United States. It is extensively cultivated.

Also called shrub wormwood, Artemisia absinthium is a member of the daisy or Asteraceae family. The species name, absinthium, means “without sweetness.” Many species of the genus Artemisia have medicinal properties.

Wormwood grows alongside roads or paths. This shrubby plant is 1-3 ft (0.3-0.9 m) tall and has gray-green or white stems covered with fine hairs. The yellowish-green leaves are hairy and silky and have glands that contain resinous particles where the natural insecticide is stored. Wormwood releases an aromatic odor and has a spicy, bitter taste.


Constituents and bioactivities

Wormwood contains a wide variety of biologically active compounds that contribute to its medicinal value. The constituents of wormwood include:

• acetylenes (trans-dehydromatricaria ester, C13 and C14 trans-spiroketalenol ethers and others)
• ascorbic acid (vitamin C)
• azulenes (chamazulene, dihydrochamazulenes, bisabolene, camphene, cadinene, sabinene, trans-sabinylacetate, phellandrene, pinene, and others)
• carotenoids
• flavonoids (quercitin 3-glucoside, quercitin 3-rhamnoglucoside, spinacetin 3-glucoside, spinacetin 3-rhamnoglucoside, and others)
• lignins (diayangambin and epiyangambin)
• phenolic acids (p-hydroxyphenylacetic, p-coumaric, chlorogenic, protocatechuic, vanillic, syringic, and others)
• tannins
• thujone and isothujone
• sesquiterpene lactones (absinthin, artabsin, anabsinthin, artemetin, artemisinin, arabsin, artabin, artabsinolides, artemolin, matricin, isoabsinthin, and others)

Wormwood is a strong bitter that affects the bitter-sensing taste buds on the tongue that send signals to the brain to stimulate the entire digestive system (salivation, stomach acid production, intestinal tract movement, etc.).

This bitter taste also stimulates the production of bile by the liver and storage of bile in the gall bladder. The azulenes in wormwood have anti-inflammatory activity. The sesquiterpene lactones are insecticidal and have anti-tumor activity.

The toxin thujone is a brain stimulant. Wormwood also has anti-inflammatory, anti-depressant, carminative (relieves intestinal gas), tonic (restores tone to tissues), antibacterial, antifungal, antiamoebic, antifertility, hepatoprotective (prevents and cures liver damage), febrifugal (reduces fever), and vermifugal (expels intestinal worms) activities.

General use

Wormwood has been used in European traditional medicine as a restorative of impaired cognitive functions (thinking, remembering, and perception).

Wormwood is often used as a digestive stimulant. It is helpful in treating indigestion, heartburn, irritable bowel syndrome, stomach pain, gas, and bloating. By increasing the production of stomach acids and bile, wormwood can be useful to persons with poor digestion. It helps persons recover after a long illness and improves the uptake of nutrients.

As the name suggests, wormwood is used to eliminate intestinal worms, especially pinworms and roundworms. It is also used as an insect repellent and insecticide.

More recently, one of the sesquiterpene lactones, artemisinin, has shown promise as a treatment for breast cancer. Artemisinin was extracted from wormwood by the Chinese thousands of years ago to cure malaria, and is presently used in Asia and parts of Africa for that purpose.

Recent experiments have shown that artemisinin is effective against the malaria parasite because it reacts with the high levels of iron in the parasite to produce free radicals. The free radicals then destroy the cell walls of the malaria parasite. Cancer researchers then applied the same principle to target cancer cells, which have a higher concentration of iron than normal cells.

The researchers tested samples of breast cancer cells and normal breast cells that had first been treated to maximize their iron content and then treated with a water-soluble form of artemisinin. The normal cells showed little change, but within 16 hours, almost all of the cancer cells were dead.

Wormwood is also helpful in treating gall bladder inflammation, hepatitis, jaundice, fever, infections, and mild depression. Wormwood may also protect the liver from harmful chemicals and stimulate menstruation or miscarriage. It has been used to treat the pains associated with childbirth, cancers, muscle aches, arthritic joints, sprains, dislocated joints, and broken bones.

Wormwood has a historical dark side: absinthe. This clear green alcoholic beverage, which contains essential oil of wormwood and other plant extracts, is highly toxic and presently banned in many countries. A favorite liqueur in nineteenth-century France, absinthe was addictive and associated with a collection of serious side effects known as absinthism (irreversible damage to the central nervous system).

The toxic component of wormwood that causes absinthism is thujone. Wormwood may contain as much as 0.6% thujone. On the other hand, wormwood soaked in white wine is used to produce the liqueur called vermouth (derived from the German word for wormwood, Wermuth), which contains very little thujone.

Preparations

Wormwood preparation

Wormwood is harvested immediately prior to or during flowering in the late summer. All the aerial portions (stem, leaves, and flowers) have medicinal uses. Wormwood is used either fresh or dried.

Wormwood may be taken as an infusion (a tea), as a tincture (an alcohol solution), or in pill form. Wormwood should be taken only under the supervision of a professional. It should be taken in small doses as directed, and for no longer than four to five weeks at a time.

The infusion is prepared by steeping 0.5-2 tsp of wormwood in 1 cup of boiling-hot water for 10-15 minutes. The usual dosage is 3 cups daily, for a period not to exceed four weeks.

Wormwood tincture can be prepared by adding 1.5 cups of fresh, finely chopped wormwood or 8 tbsp of powdered wormwood to 2 cups of whiskey. The herb and alcohol mixture is shaken daily and allowed to steep for 11 days. The solids are strained out and the tincture is stored in a tightly capped bottle in a cool place.

This tincture may be used externally (to relieve pain) or internally. Ten to twenty drops of tincture are added to water, which is taken 10–15 minutes before each meal. As with the infusion, wormwood tincture should not be taken for longer than four weeks.

Wormwood preparations are usually sipped because the strong bitter taste is an important component of its therapeutic effect on stomach ailments. The bitter taste of wormwood infusion or tincture may be masked with honey or molasses when the bitter action is not necessary, as in the treatment of worms, fever, or liver ailments.

Powdered wormwood is available in a pill form that can be used in the treatment of intestinal worms. An essential oil of wormwood is available for use in aromatherapy; it is toxic if used excessively.

Insect repellent can be made from wormwood by mixing thoroughly crushed fresh wormwood leaves with apple cider vinegar. This mixture is put into a small piece of gauze or cheesecloth. The ends are folded up and tied to make a little bag, and the bag is rubbed over the skin of humans or pets to repel mosquitoes, gnats, and horseflies.

Precautions

Excessive use of wormwood leads to toxic levels of thujone in the body. The long-term use of wormwood oil containing thujone, or alcoholic drinks containing thujone oil (e.g., absinthe) can be addictive and cause seizures, brain damage, temporary kidney failure, and possibly death.

Using wormwood for longer than four weeks or at higher than recommended doses may lead to nausea, vomiting, restlessness, insomnia, vertigo, tremors, and seizures. Women who are pregnant or lactating (breast-feeding) should not use wormwood.

Side effects

Significant side effects are not encountered when wormwood is taken in small doses for only two to four weeks. One report stated, however, that using as much as 1 mL of wormwood tincture three times a day for up to nine months caused no side effects.

The U.S. Food and Drug Administration (FDA) states that wormwood may cause neurological symptoms, including delirium, paralysis, loss of intellect, and numbness of the legs and arms.

The side effects associated with absinthism include auditory (hearing) and visual (seeing) hallucinations; tremors and convulsions; sleeplessness; paralysis; stomach problems; brain damage; and an increased risk of psychological disorders and suicide.

Witch hazel

Witch hazel (Hamamelis virginiana) is a deciduous tree or shrub that is native to Atlantic North America, and it is now also cultivated in Europe and Asia. The shrub can reach a height of 15 ft (4.6 m).

It flowers in the fall, producing vivid yellow flowers. Witch hazel is also known as hazel nut, snapping hazel, spotted alder, tobacco wood, winterbloom, and hamamelis water.

Native Americans used witch hazel leaves and bark as a poultice to reduce swelling and inflammation. Those are among the uses of this herb that has long been among the best known and widely used home remedies.


The word “witch” in the name of the herb is actually a derivative from the Anglo-Saxon word wych meaning flexible. The word described the flexibility of the branches that Native Americans used to make bows.

General use

Witch hazel is a very versatile remedy, with generally accepted uses ranging from facial care to soothing aching feet. It is also used for the treatment of hemorrhoids, inflammation of the mouth and throat, and other conditions, such as varicose veins, wounds, and burns.

Witch hazel has so many applications that Andrew Weil, M.D., called the decoction or tincture of the bark the “all–around astringent.” Weil, who practices natural and preventive medicine, recommended using witch hazel to ease the pain of sunburn, windburn, insect bites, poison ivy blisters, and sore and sprained muscles.

The medicinal element of witch hazel is the hamamelis water that is distilled, decocted, or tinctured from fresh and dried leaves, and fresh and dried bark and twigs. Tannins and volatile oils are the primary active ingredients of witch hazel that contribute to its astringent benefits.

The tannin content of witch hazel leaves is 8%, and in witch hazel bark ranges from 1–3%, as the medicine derived from the bark will yield a higher tannin concentration than that from leaves. Recent research done in Asia indicates that it is the tannin content of witch hazel that is chiefly responsible for its strong antioxidant activity.

As with other herbal astringents, witch hazel reduces the irritation on the tissue surface through a form of numbing. Surface inflammation is reduced, and the astringent creates a partial barrier against infection. That barrier aids in the treatment of wounds and burns. The astringency helps to stop bleeding, so witch hazel is useful in treating bruises, cuts, and other skin abrasions.

In addition, a cold compress of witch hazel is said to ease a headache. Cosmetically, witch hazel is used as a facial skin freshener and astringent to reduce pore size, make-up remover, and to reduce bags under eyes. Products for men that contain witch hazel include herbal shaving cream and aftershave.

The above are among the mainstream applications of the herb that Native Americans regarded as a general tonic. They also brewed witch hazel as a tea for conditions including cuts, colds, heavy menstruation, tumors, and eye inflammation. Witch hazel was taken internally to stop bleeding from hemorrhage.

Some of those applications remain part of folk medicine. Other folk remedy applications of witch hazel include applications for backache, and internal use for diarrhea, nervousness, nosebleed, vaginitis, and venereal disease.

As of 2002, there has been relatively limited research on the uses of witch hazel in the United States. There is agreement among alternative health practitioners that external use of this herb is safe.

Research conducted in Europe provides more information about applications of witch hazel. There, witch hazel products were approved for skin injuries, inflammation of skin and mucous membranes, and varicose veins.

Witch hazel and leaves were approved for the topical treatment of skin injuries, burns, varicose veins, and hemorrhoids. Recent studies carried out in Germany and the United Kingdom have established that witch hazel extract offers some protection against UV radiation prior to sun exposure as well as relieving the inflammation of sunburn.

In the United States, there is another controversy about the remedial benefit of witch hazel. Hamamelis water, when distilled, contains no tannin. Distilled witch hazel consists of a mixture of 14% alcohol in water with a trace of volatile oil. The astringent effect of witch hazel is due to an alcohol content similar to that of red wine. But the unstudied volatile oils exert some effects similar to topical tannin, and are also antimicrobial.

Preparations

Witch hazel is available in various forms. Commercial preparations include witch hazel water and gels, although much commercial witch hazel is not true distilled witch hazel water. Witch hazel is also an ingredient in products, such as face and body pads and hemorrhoid pads, including Preparation H ointment.

As a topical astringent, witch hazel water is applied directly to burns, bruises, insect bites, and aching muscles. It can also be used to clean oily skin, remove makeup, or mixed with water for a relaxing footbath. Uses for the gel include treating cuts, diaper rash, and bedsores.

An infusion of fresh or dried leaves has been “cautiously used” in the treatment of internal hemorrhaging or to reduce excessive menstrual flow.

Infusion is a process that preserves the astringent tannin in witch hazel, using the leaves. A decoction may be prepared by simmering, not boiling, the herb’s bark.

This is done by steeping 1 teaspoon of witch hazel powder or twigs in a cup of boiling water. The mixture is boiled and covered for 10 minutes, then strained. After it cools, it can be applied directly or mixed into an ointment base such as petroleum jelly.

Uses of witch hazel leaf include remedies for diarrhea and menstrual conditions. The bark is used for skin injuries, inflammation of the skin, locally inflamed swelling, hemorrhoids, and varicose veins.

Witch hazel dosages

Recommended dosages when using witch hazel are as follows:

• Witch hazel water (distillate) can be used as is or diluted at a 1:3 ratio with water.
• A poultice can be made by using 20–30% of witch hazel in semi-solid preparations.
• For an extract preparation, use a semi-solid and liquid preparation that corresponds to 5–10% of the drug.
• Decoctions of 5–10 grams of witch hazel extract per cup of water can be used for compresses and rinses.
• Ointment or gel is prepared by mixing 5 grams of witch hazel extract in 100 grams of an ointment base.
• The recommended dosage of suppositories is 0.1–1 gram of the drug. Suppositories in the rectum or vagina can be used from one to three times daily.

Applications

Witch hazel is a multi-faceted remedy that is administered in several ways. Applications of witch hazel include:

• Gargle with a decoction of 1 teaspoon of witch hazel bark that has been steeped 10 minutes in boiling water and then strained.
• For skin conditions, ointment or cream can be used twice a day or as needed.
• Tincture can be placed directly on affected areas.
• A poultice can be applied to wounds and sores.
• Witch hazel extracts can be applied in combination with warm, moist compresses in the morning or at bedtime.
• For bruises, a washcloth can be used for a witch hazel compress. An ice cube placed inside the cloth keeps the compress cold and diminishes swelling.

HEMORRHOID RELIEF. Witch hazel’s applications include various methods for treating hemorrhoids:

• A hamamelis suppository can be inserted at bedtime to reduce inflammation of a swollen vein.
• For relief of hemorrhoids,Weil recommends moistening toilet paper with witch hazel. This compress is used to clean the anal area after bowel movements.

Combinations

Hemorrhoid treatment accounts for two remedies that combine witch hazel with another herb, such as pilewort. Pilewort is also known as celandine. Another hemorrhoid remedy combines witch hazel with horse chestnut.

Furthermore, witch hazel is combined with aloe vera in commercial products such as skin care treatments. Home recipes for facial cleanser and mask include witch hazel, essential oils, and other ingredients.

Precautions

Blooming witch hazel

When witch hazel is administered in designated therapeutic dosages, no health risks have been recorded. However, when witch hazel is taken internally, its tannin content can lead to digestive complaints. Furthermore, in rare cases, liver damage is conceivable following long term administration.

Witch hazel water is intended for external use and most sources cite recommended dosages are for adults. The amount should be adjusted for older people and the chronically ill. Individuals should check with their doctors about use of witch hazel.

External use of witch hazel may result in minor skin irritation for some people. When this occurs, the amount of witch hazel should be diluted.

While it is safe to use witch hazel for gargling, caution should be taken when using it internally. Witch hazel contains small amounts of safrole, a compound that the U. S. Food and Drug Administration (FDA) banned for use in food during the 1960s.

That ban came after laboratory animals that ingested large amounts of the compound developed cancer. Witch hazel has not yet come under fire for safrole content. However, as of March 2000, there was little research information available. Additional study was needed on the safe use of this home remedy that was a staple for Native Americans.

Side effects

Opinion varies about the side effects caused when witch hazel is taken internally. The tannin content can cause stomach irritation or cramping. A dose of 1 gram of witch hazel will cause nausea, vomiting, or constipation.

The FDA has approved witch hazel distillate as safe for external use. Sources had reported no known side effects as of March of 2000. However, future studies may provide more information about the safety or side effects of witch hazel.

Interactions

The 1998 Commission E monograph reported no contraindications or interactions related to the use of witch hazel. However, there are well-known interactions between many drugs and high tannin herbs that are too numerous to list.

Those on blood thinners for circulatory trouble should take internal witch hazel preparations with caution if at all. In addition, witch hazel should not be taken internally with medications containing alkaloids, as it interferes with their absorption. Alkaloid drugs include atropine and codeine.

Wheezing

Wheezing is a high-pitched whistling sound associated with labored breathing.

Wheezing occurs when a person tries to breathe deeply through air passages (bronchia) that are narrowed because of muscle contractions or filled with mucus as a result of: allergy, infection, illness, or irritation. Wheezing is experienced by 10-15% of the population.

Wheezing most commonly occurs when a person is exhaling. It is sometimes accompanied by a mild sensation of tightness in the chest. Anxiety about not being able to breathe easily can cause muscle tension that makes the wheezing worse.


Causes and symptoms

Wheezing is the symptom most associated with asthma. It can be aggravated by dry air and high altitude. A 2001 study also found a connection between nighttime wheezing/asthma and gastroesophageal reflux, or the flow of stomach acid backward into the lower part of the esophagus.

Wheezing can be caused by:

• exposure to allergens (food, pollen, and other substances that cause a person to have an allergic reaction)
• fumes
• ice-cold drinks, or very cold air
• medication
• strenuous exercise
• weather changes
• foreign objects trapped in the airway
• cystic fibrosis and other genetic disorders
• respiratory illnesses like pneumonia, bronchitis, congestive heart failure, and emphysema

The symptoms of wheezing are: labored breathing, whistling sound upon breathing, shortness of breath, and a tight or heavy feeling in the chest.

Medical emergencies

Breathing problems can be life-threatening. Immediate medical attention is required whenever a person:

• turns blue or gray and stops breathing
• becomes extremely short of breath, and is unable to speak
• coughs up bubbly pink or white phlegm
• seems to be suffocating
• develops a fever of 101°F (38.3°C) or higher
• wheezes most of the time, and coughs up gray or greenish phlegm

Diagnosis

A family physician, allergist, or pulmonary specialist takes a medical history that includes questions about allergies, or unexplained symptoms that may be the result of allergic reactions. If the pattern of the patient’s symptoms suggests the existence of allergy, skin and blood tests are performed to identify the precise nature of the problem.

A pulmonary function test may be ordered to measure the amount of air moving through the patient’s breathing passages. X rays are sometimes indicated for patients whose wheezing seems to be caused by chronic bronchitis or emphysema.

Treatment

Patients whose wheezing is related to asthma, chronic bronchitis, emphysema, or a severe allergic reaction may benefit from alternative medicine but they must continue to have their condition monitored by a conventional physician.

Mild wheezing may be relieved by drinking plenty of juice, water, weak tea, and broth. This helps to replace fluids lost because of rapid breathing and loosen mucus in the air passages. Ice-cold drinks should be avoided.

A vaporizer can help clear air passages. A steam tent, created by lowering the face toward a sink filled with hot water, placing a towel over the head and sink, and inhaling the steam, can do likewise.

Herbal remedies

Several herbal remedies exist for the treatment of wheezing and asthma.

• Baical skullcap (Scutellaria baicalensis) decoction relieves wheezing.
• Coltsfoot tea may relieve wheezing.
• Cramp bark (Viburnum opulus) tincture eases breathing.
• Elecampane (Inula helenium) can help to clear mucus.
• Garlic (Allium sativum) can ease asthma symptoms.
• German chamomile (Chamomilla recutita) infusion can relieve wheezing.
• Ginkgo (Ginkgo biloba) eases asthma symptoms.
• Marsh mallow (Althaea officinalis) root eases asthma symptoms.
• Mullein (Verbascum thapsus) tea in a vaporizer relieves wheezing.
• Nettle (Urtica dioca) infusion relieves wheezing.
• Passionflower (Passiflora incarnata) relaxes muscle spasms leading to a reduction in wheezing.
• Thyme (Thymus vulgaris) infusion relieves wheezing.

Ayurvedic treatment

Wheezing can be alleviated by drinking licorice tea. The tea is prepared by steeping one teaspoon of licorice (Yashti madbu) root in one cup of water, adding 5-10 drops of mahanarayan oil just before drinking.

The patient should take one sip every 5-10 minutes. A remedy for breathlessness is a mixture of onion juice (one quarter cup), black pepper (0.125 tsp), and honey (1 tsp).

Mustard seeds have bronchial system healing properties. Brown mustard oil may be massaged onto the chest. A mustard tea (one quarter teaspoon each ground mustard seed and pippali or black pepper) with honey may be drunk two or three times daily or sipped throughout the day. Another mustard remedy is taking brown mustard oil (1 tsp) with natural sugar (1 tsp) two or three times daily.

Homeopathy

Homeopathic remedies are chosen for each patient based on his or her pattern of symptoms. Arsenicum is indicated for patients who experience restlessness, fearfulness, wheezing, and shortness of breath between the hours of midnight and 3 A.M.

Spongia is recommended for those who have dry wheezing, which may occur as the patient is falling asleep, a feeling of suffocation, and a dry cough. Lobelia is for patients with chest tightness and wheezing that is worsened in cold air.

Sambucus is indicated for persons whose wheezing is worsened after midnight, but who don’t experience the fear or restlessness experienced by an arsenicum patient. Pulsatilla is recommended for those who are affectionate, and feel stifled in warm rooms.

Ipecac is for patients who have a lot of phlegm in the lungs (wheezing is accompanied by rattling sounds in the chest), coughing, and possibly vomiting. Bryonia is for patients with dry wheezing, who feel warm and thirsty, and whose symptoms are worsened by motion.


Other remedies

Other treatments for wheezing include:

• Aromatherapy. The essential oils of lavender, eucalyptus, and rosemary can relieve congestion. Adding German chamomile essential oil to a vaporizer can relieve wheezing.
• Diet. Eliminating red meat, and wheat and dairy products and following a macrobiotic diet of vegetarian foods may relieve asthma symptoms.
• Relaxation techniques. Because anxiety can worsen an asthma attack, and therefore wheezing, meditation, biofeedback, deep breathing, or other stress-reduction methods may help promote relaxation.
• Supplements. Magnesium may help to prevent bronchial spasms. The frequency of asthma attacks may be reduced by taking vitamin C and the B complex vitamins.
• Yoga. Certain yoga positions (Bridge, Cobra, Pigeon, and Sphinx) may relieve wheezing by improving breathing control and reducing stress.

Allopathic treatment

Bronchodilators (medications that help widen narrowed airways) may be prescribed for patients whose wheezing is the result of asthma. Antibiotics are generally used to cure acute bronchitis and other respiratory infections.

Expectorants (cough-producing medications) or bronchodilators are prescribed to remove excess mucus from the breathing passages. If wheezing is caused by an allergic reaction, antihistamines will probably be prescribed to neutralize body chemicals that react to the allergen.

A new type of drug was being tested in late 2001 that blocks immunoglobulin E (IgE), an antibody produced in excessive levels in patients with hay fever. The drug also appears to prevent asthma in patients with chronic hay fever. The drug, called omalizumab, is the first in a new line of drugs expected to appear in the next few years.

If wheezing and asthma symptoms worsen in the nighttime, diagnosis and treatment of possible acid reflux in the stomach might ease symptoms.

Expected results

Mild wheezing caused by infection or acute illness usually disappears when the underlying cause is eliminated.

Some doctors believe that childhood respiratory infections may activate parts of the immune system that prevent asthma from developing.

Prevention

Stopping smoking can eliminate wheezing; so can reducing or preventing exposure to allergens or conditions that cause wheezing.

A person prone to wheezing should wear a scarf or surgical mask over the nose and mouth during physical exertion outdoors during cold weather. Likewise, wearing a surgical mask outdoors during the allergy season is helpful for persons whose wheezing is triggered by allergies.

Licorice root tea may prevent asthma (wheezing) attacks. Ayurvedic herbal remedies to prevent asthma symptoms include:

• cinnamon (1 tsp) and trikatu (0.25 tsp) tea with honey twice daily
• licorice and ginger (0.25 tsp each) tea
• bay leaf (0.5 tsp) and pippali (0.25 tsp) mixed in honey taken two or three times daily
• sitopaladi (0.5 tsp), punarnova (0.5 tsp), pippali (pinch), and abrak bhasma (pinch) mixed with honey taken once daily
• spinach juice (0.125 cup) and pippali (pinch) taken twice daily