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Synergy and Posology of Herbal Preparations.
By Ivor Hughes

Natural and Synthetic Drugs.

"All Professions are a conspiracy against the Laity."
George Bernard Shaw (1856 - 1950)

When a lay person examines a medical text book, with its arcane title and equally obscure contents. It is forgivable to assume, that as a specie, we know more than we actually do. A close examination, of a text book of Organic and Biochemistry, will reveal its cobweb like structure i.e. more holes than substance. Herbal Medicine is based upon thousands of years of Empirical knowledge. To date, Scientific knowledge, has only managed to confirm the validity of Empiric knowledge in relation to plant drugs.

Scientific Verification of Plant Synergy.
The following article was published in the conference section of BioMedNet.

http://news.bmn.com/conferences

Report:
Medicinal plants get much-needed boost
Investigator: Kim Lewis
Tuesday Jul 9th, 2002
by Rabiya S. Tuma   

Traditional societies have relied on the curative powers of medicinal plants for centuries, but recent efforts by pharmaceutical companies and others to convert these resources into effective drugs have been lackluster. Researchers have discovered why such efforts often fail and have identified the key that promises to unlock the mystery of such therapies.  

There are over 50,000 botanically-derived compounds with antimicrobial characteristics, but many of them are relatively weak and have narrow specificity, says Kim Lewis, a professor of biology at Northeastern University. "In short they're all junk," he said. 

But why would plants with millions of years of evolution combat microbes with such weak ammunition? Logically, this didn't make sense, Lewis said. He therefore began looking for factors that might improve the compounds' antimicrobial power.    

Plant compounds are very effective at invading bacteria but are rapidly excreted out by bacterial multi-drug resistant (MDR) pumps. These MDRs are the same proteins that confer resistance to antibiotics in human pathogens. 

Inhibiting a bacterium's MDR may be the key to an antimicrobial's potency, Lewis hypothesized. Indeed, when he removed the MDR from Staphylococcus aureus, and then exposed the cells to berberine - a "weak" antimicrobial found in goldenseal, Oregon grape, barberry and other plants - the compound became incredibly toxic to the bacteria.

The researchers then found a natural plant inhibitor of MDR, called 5'-methoxyhydnocarpin-D (5'-MHC). Although 5'-MHC has no antimicrobial activity on its own, berberine is much more effective when given in conjunction with the substance. 

"This is all snake oil and imagination or synergy," said Lewis. "Take one compound out and it doesn't work," but together they do. "This sets a precedent and now people are taking a second look at medicinal plants."   

To assess whether plants use this approach widely, Lewis and his colleagues tested a panel of randomly chosen botanical compounds, in combination with synthetic MDR inhibitors, in a variety of bacterial species.

Numerous compounds like rhein from rhubarb, and resveratrol, an antioxidant found in red wine, increase their antimicrobial efficacy several hundred-fold in combination with the inhibitors, the researchers found. The scientists have now also identified several more natural MDR inhibitors from geranium, artemisia, and other plants.     

Implications of the Article.
Firstly I would like to say that when the Life Sciences talk of a 'Plant Extract'. What they mean is, that a single compound, has been isolated from its parent body. This compound is usually considered to be the 'Active Principle' i.e. the compound that has been shown, to produce the required pharmacological response in an organism. Kim Lewis by his work, has revealed the fallacy of the Pharmaceutical Company approach. Synergy is the key. In other words a complete plant extract rather than a single compound. I predict, that it will come to be generally accepted, that all medicinal plants contain MDR inhibitors.    

All life, from single celled organism, to the incredible complexity of the human body, is part of a giant molecule that defies description. Ingested Bio-molecules are instantly recognised by the human body. Such evidence as there is would seem to suggest that it does so by the molecules spatial shape. The pharmaceutical industry is unable to patent natural compounds. Therefore their standard approach, is to isolate a compound that is considered to be the 'active principle'. Then a portion of the molecule will be snipped off or added to by chemical means. This 'unnatural' molecule can then be patented. Alternatively those natural compounds are produced synthetically by a totally different route to that of the natural process. The synthesized molecules have a different physiological effect to that of the natural molecules e.g. Alcohol which is produced from grains or fruits behaves in a different manner to that of alcohol produced by the synthetic route. This matter is soon settled by drinking some. No one questions that the different natural recreational alcohols are different in effect. That is why people tend to choose a particular type such as beer, wine, whisky and so on.   

Herbal Complexity
The therapeutic spectrum displayed by a single herb may be understood in terms of the functional groups that it contains, and its propensity to chemical reactions, in the number of carbon double and triple bonds that it contains. The following Table is an abbreviated version of an intricate chemical analysis of one herb, which was produced by Dr. James Duke, an international authority and Botanist for the USDA. 

Each of the compounds listed is a chemical entity with its own specific mode of action. Therefore if we damage or remove even a single compound the 'Synergy' is destroyed. The cascading physiological effect of the herb whereby the homeostasis of  human body is adjusted in a smooth and rational manner is totally disrupted by the ingestion of a single entity such as an alkaloid or glycoside and represents an assault on the human system as a whole. Normally the effects of this assault need to be ameliorated by the ingestion of a further entity to counteract the problems caused by such an approach. The crudity of which may be likened to attacking a computer with a hammer.

At the opposite end of the scale to this crudity we have polypharmacy which is the administration of two or more whole drugs or at the same time. At our current level of scientific knowledge we have no means of predicting with any certainty the outcome of such procedures. Still less so if we are to take account of racial idiosyncrasy and then of course the biological idiosyncrasy which go far beyond the approach of age and gender.  There are over 200 years of Homoeopathic proving that validate the words of Paracelsus (q.v.)

' In one herb there is more power than all of the papers read in high college '

Posology.
Here a word of warning, Under no circumstance should the Apothecary  prepare or dispense any herb that is included in the Restricted or Poisons List, except as a Homoeopathic preparation.  It is of utmost importance that one is thoroughly conversant with the Pharmaceutical calculations that are covered in Sections  8 - 43 through 8 - 60.   The dosage is the responsibility of the Prescriber and not that of the dispenser. However the dispenser should satisfy themselves that the dosage is in the recognised range. Therefore a brief discussion of the subject is in order.  Orthodoxy ignores synergy and proceeds from the standpoint of   ' Active Principle'.  In short the efficacy of a plant drug is measured by its content of a single constituent usually an Alkaloid or Glycoside. The bulk of the worlds supply of a particular plant drug are grown in specific regions around the globe. Consequently the level of the active ingredient within a particular specie of herb is a function of known variables, and from that a plus or minus percentage for those levels are also known. That variation is used by the Science of Toxicology to produce a chemically standardised medicine. LD 50 tests are then used to arrive at an approximation of a safe dose. The compound is then entered for human clinical trials. When an apparently safe, functional adult dose has been established, then there is the matter of dosage for children. There are various methods used to arrive at a proportional dose for a child e.g.  

(1) Clark's Rule:    
Used for children of 2 years down to 1 of age and is based upon body weight. 

(2) Young's Rule :  
For children over 2 years of age and is based on age in years.  

(3) The Eclectic Rule :   

Breast fed infants under 1 year would normally take the medicine through the mothers milk. The mother would take the adult dose and the child would receive a proportional dose across a 24 hour period.

(4) The Surface Area Rule :
The height and weight of the child is measured and then the figures are referred to a surface area chart. When the surface area is determined it is applied as follows   

Surface area divided by 1.7 x Adult dose = child's dose

Comments on Posology.
It is generally acknowledged that all the methods are flawed, with the surface area rule being the most accurate. However it is still flawed. The reason for this is that the adult dose is flawed. There is no such thing as an average adult. We live in an age of assembly line medicine. Standardised pills, to fit into standardised packets. to be swallowed by standardised people.  The motive is profit and the death toll from Iatrogenic disease and overdose is horrendous.  Never overlook the potential for disaster in compounding. Make yourself familiar with the pharmaceutical calculations in sections 8 - 43 through to 8 - 60 of the Pharmageddon Herbal. 

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