Herbs for Healthy Skin, Hair & Nails: Banish Eczema, Acne and Psoriasis With Healing Herbs That Cleanse and Tone to Body Inside and Out

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Echinacea Keats Good Herb Guide Upton, Roy. NTC Contemporary 9780879837723 9780071401333 English Echinacea (Plants)--Therapeutic use. 1997 RS165.E4U68 1997eb 615/.32355 Echinacea (Plants)--Therapeutic use.

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Nature's Immune Enhancer Echinacea, the beautiful purple coneflower that graces gardens and fields across America, is the most popular medicinal plant not only among herbalists, health professionals and American consumers today, but also among the Native Americans who discovered its many uses nearly 400 years ago. And with good reason. Not only is echinacea an invaluable tool for treating colds and flu, but it can reduce the inflammation of arthritis, assist in wound healing and enhance the body's immune defenses. Moreover, it possesses antibiotic properties and is effective in clearing a wide variety of skin conditions. Within these pages a prominent American herbalist tells you everything you need to know about this versatile herb and how to incorporate it into your wellness program.

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Echinacea Keats Good Herb Guide Upton, Roy. NTC Contemporary 9780879837723 9780071401333 English Echinacea (Plants)--Therapeutic use. 1997 RS165.E4U68 1997eb 615/.32355 Echinacea (Plants)--Therapeutic use.

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About the Author Roy Upton, a professional herbalist for the past 15 years, is trained in both Western and traditional Chinese herbal medicine. He is the founder and executive director of the American Herbal Pharmacopoeia, an educational organization dedicated to the development of authoritative monographs on botanical medicine; a founding member and vice president of the American Herbalists Guild; and a member of the American Herbal Products Association Standards Committee, a trade organization devoted to establishing quality control standards for herbal supplements. This is his long-awaited first book.

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A Keats Good Herb Guide

Echinacea

Roy Upton

"There is a lesson in each flower, a story in each stream and bower. In every herb on which you tread are written words, which rightly read will lead you from Earth's fragrant seed, to hope, holiness and God." Thomas Osborne Davis, 18141845

Keats Publishing, Inc. New Canaan, Connecticut

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Echinacea is intended solely for informational and educational purposes, and not as medical advice. Please consult a medical or health professional if you have questions about your health. Echinacea Copyright © 1997 by Roy Upton All Rights Reserved No part of this book may be reproduced in any form without the written consent of the publisher. Library of Congress Cataloging-in-Publication Data Upton, Roy. Echinacea / by Roy Upton. p. cm. Includes bibliographical references and index. ISBN 0-87983-772-1 1. Echinacea (Plants) Therapeutic use. I. Title RS165.E4U68 1996 615'.32355 dc20 96-36369 CIP Printed in the United States of America Keats Good Health Guides are published by Keats Publishing, Inc. 27 Pine Street (Box 876) New Canaan, Connecticut 06840-0876 98 97 96 6 5 4 3 2 1

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Contents Preamble Introduction Echinacea: 254 Years of Medical Use Modern Uses of Echinacea Commercial Considerations Choosing an Echinacea Preparation Making Your Own Medicines Dosages Echinacea in the Herbalist's Medicine Chest Toxicity, Contraindications and Other Guidelines Echinacea Cultivation for Future Generations Integrating Echinacea into a Total Wellness Program Preservation of Medicinal Plants Conclusion References Resources Index

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1 2 9 18 40 44 48 53 55 62 70 72 76 79 80 85 86

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Dedication

To Leah Lischner Conners, a wonderful healer, a great teacher and a good friend who introduced me to the wonderful herb echinacea.

My heartfelt thanks go to Christopher Hobbs who shared a significant amount of echinacea data with me and my wonderful wife Mary Moss Upton who provided awesome editorial support and made me tea, hot chocolate and toast with yeast at 3:00 A.M. while I was working on the manuscript.

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Preamble Echinacea: A Clarion Call to the Herbal Renaissance A tremendous increase in the popularity of herbal medicines is quickly bringing to light the vast healing potential of plants. Every day another newspaper or magazine article extols the virtues of a medicinal plant whose traditional use has been confirmed by modern scientific study. Perhaps no other herb has played a larger role in bringing about this change than echinacea, the most popular medicinal plant among herbalists, health professionals and American consumers. In researching and writing about echinacea, a story that brings together traditional Native American history, the development of American medicine and a renaissance of healing unfolds that clearly illustrates the incalculable value medicinal plants provide.

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Introduction Medicinal Plants: An Answer to America's Healthcare Crisis Much of the increased interest in medicinal plants began amidst the counterculture revolution of the 1960s as young people began seeking a more natural way to live, eating whole foods, more vegetables and fruits and shedding many of the more conventional practices of their parents. Along with tofu, yogurt, alfalfa sprouts and organic gardens came chamomile, peppermint and ginseng tea. These trends evolved into the burgeoning herbal community that we are seeing today. In the not-so-distant past, consumers of herbal medicines were primarily motivated by a philosophical belief that naturally derived plant medicines were better than synthesized laboratory chemicals. Now the motivation is more pragmatic. People are seeking herbal medicines primarily because they are disenchanted with modern medicine. People are weary of the side effects associated with the majority of prescribed drugs and want to avoid irreparable surgeries. They are also looking to nature for help that conventional medicines cannot give such as nontoxic alternatives for depression, reproductive health, migraine headaches and immune deficiency syndromes. While the herbal renaissance is relatively new to the United

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States, herbal medicines have been an integral part of the healthcare system of most every other country on the face of the earth for generations. The FDA oversees the development of therapeutic products. Besides trying to ensure the safety of our food supply, it has the responsibility to assure that the drugs and medical devices we use are safe and effective. This drug approval process has been estimated to cost approximately $300 to $500 million per drug. Because of the astronomical expense of obtaining drug approval, companies are reluctant to expend such exorbitant amounts of money on an herb, a natural product that they cannot patent. Without patent protection, anyone could go out and market chamomile or echinacea, for instance, and the company that researched its effectiveness would have little chance to recoup its investment. Therefore, little herb research is conducted in the U.S. and few if any data regarding herbs are submitted to the FDA. Of the numerous drugs used by physicians today, 65 percent were originally derived from plants, and these were derived from only a small sampling of plant species. We learned of these drugs primarily from traditional peoples who had mastered their uses, and their effectiveness was subsequently verified by scientific researchers in laboratories and clinics. Americans are just now beginning to recognize that there is a vast, unexplored world of botanical remedies waiting to be tapped into. Nature's pharmacy, with all of her roots, flowers, leaves, fruits, seeds and barks, has been evolving, ripening and maturing for a millennium, and is primed to fill therapeutic niches that researchers in laboratories have not yet even dreamed about. Echinaceathe beautiful purple conefloweris but one of these valuable medicines.

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Herbs vs. DrugsA Comparison The word ''drug'' originally was derived from an old Anglo-Saxon word, drogge, which meant "to dry," referring to the medicinal plants that once lined the rafters of old world apothecaries. In fact, a large percentage of modern day medicines are still derived from plants. Because of this, and because both herbs and drugs are used therapeutically, many people do not differentiate between herbs and drugs. However, there are important differences between traditional herbal medicines and laboratory-derived pharmaceuticals. Let us consider the safety and effectiveness of herbs vs. pharmaceutical drugs. For the majority of herbal medicines, there are hundreds, and in some cases, thousands of years worth of accumulated knowledge about how they can be used both safely and effectively. The literature abounds with knowledge of how herbs should be picked, dried and prepared. Herbal medicines have survived the test of time because of their relatively wide range of safety and effectiveness. In some cases the same combinations of herbs have been used for more than 1,000 years. Such a long history of use takes much of the guesswork out of healing and can give consumers and health professionals a large measure of confidence that the botanicals they are using have likely been used successfully by a significant portion of the world's population for a significant amount of time. When research studies compare the therapeutic activity of herbs with conventional drugs, herbs are found to be safer than the comparable pharmaceutical. While pharmaceuticals have been subjected to

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a certain amount of scrutiny via the drug approval process, this data pales in comparison to the breadth of knowledge achieved by cultures that have depended on herbs for a millennium. The evidence of this is clear when the relative toxicity of herbal medicines is compared with conventional pharmaceuticals. Nothing is without risk. Even the most benign substance, such as water, can be a deadly toxin if used inappropriately or if too much is taken. The relative benefit versus the risk of using a drug or an herb must be considered. The majority of the world's population relies on herbal medicines, yet there have been relatively few documented cases of toxicities due to herbal medicines. Most of the complaints associated with herbal use are mild, consisting of nausea, diarrhea or headaches. Occasionally there are more serious problems. In very rare situations, fatalities occur. Serious complications usually arise only when people take exceptionally high levels of a botanical or have a serious underlying condition prior to using the herb. However, when used within the appropriate dosage range, the majority of medicinal herbs available on today's market have a high degree of safety. One of the world's leading pharmacognosists (scientists who study the medicinal action of plants), Dr. Norman Farnsworth, research professor of the University of Illinois College of Pharmacy has stated that, "Herbal medicines do not present a major problem with regard to toxicity based on a review of the scientific literature. In fact, of all classes of substances reported to cause toxicity of significant magnitude to be reported in the United States, plants are the least problematic."1 In contrast, adverse effects associated with phar-

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maceutical medications are the primary reason for hospital admissions in the United States. Once in the hospital, 35 percent of patients can expect to suffer from some type of side effect and, according to a U.S. General Accounting Office study, more than 50 percent of approved drugs have been found to possess serious side effects that were not known at the time of approval. Along with the typical mild side effects of nausea, vomiting and diarrhea, these side effects included respiratory failure, liver disease, heart and kidney failure, birth defects, anaphylactic shock, blindness and death.2 In total, adverse effects due to approved pharmaceuticals result in approximately 100,000 deaths annually, the same number of deaths associated with alcoholism every year.3 Many of these problems occur even when the drug is used properly within its normal dosage range. Because of these startling statistics, Americans should make every attempt to find less invasive, safer therapeutic alternatives such as herbs. Another area where herbs have the advantage over comparable pharmaceuticals is their low cost. This is one of the primary reasons why herbal medicine is embraced by the World Health Organization. As we are finding out very quickly, high-tech medicine is too expensive. Our healthcare dollars should be focused on preventing disease through education about diet, exercise, stress reduction and the use of nutritional and herbal supplements as an integral part of a wellness plan. For example, with an herb less costly and at least as effective, if not more effective than conventional antibiotics, billions of dollars could be saved in medical expenses each year. Echinacea may be such an herb.

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Introducing Echinacea Echinacea is called "purple coneflower" because of the beautiful, purple elliptical petals radiating out from its flowering head. The basis of its name, echinos, comes from the Greek word-root for "hedgehog," referring to echinacea's spiny seed head. Echinacea is an erect perennial varying in height and breadth from the smallest variety, Echinacea angustifolia, a very spindly one-half to two feet tall (when growing in the wild) with sparse foliage, to Echinacea purpurea, a much denser plant, reaching a height of four to five feet. Echinacea's North American growing range reaches as far south as Texas and as far north as North Dakota and Canada. The cylindrical tap roots of commercially available E. angustifolia are long and slender, usually somewhat thicker than a pencil, occasionally larger, and of various lengths, usually five to eight inches in length. However, in the ground they are much longer, anywhere from 12 inches to almost two feet in length. Much of the thinner portion of the root is broken off in digging or handling. The roots are grayish to dark brown or blackish with long, wrinkled longitudinal furrows. They are very pithy, breaking easily, with the inside displaying characteristic medullary rays. The odor is very faint, but characteristic. The taste is an unmistakable sweetish and acrid flavor followed by a substantial tingling or numbing sensation. Ideally, the roots should not be picked before they are three to four years old in order to fully mature. Echinacea pallida roots are typically much larger than E. angustifolia but otherwise share many of the same

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characteristics. The roots of E. purpurea are very different, occurring in a mass of thin, beige-brown rootlets, rather than a single tap root, approximately 12 inches long. The taste lacks the characteristic numbing sensation associated with the other species.

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Echinacea: 254 Years of Medical Use Traditional Native American Uses Echinacea was one of the most widely used medicinal plants among Native American tribes of the upper Missouri River and the Plains. It has been reported to have been used for more illnesses than any other plant. Samples of echinacea have been excavated from Native American archaeological digs dating back 300 to 400 years.4 Many tribes, including the Cheyenne, Lakota and Dakota Sioux, Omaha, Ponca, Crow, Comanche and Kiowa, traditionally used echinacea for a variety of purposes including its numbing qualities to allay the pain of toothaches and muscular pains. In addition they utilized it for coughs, colds, swollen glands, tonsillitis, many types of skin diseases and as an eyewash. Some of its more common and somewhat universal uses were to treat stings, burns and bites, including the often fatal bite of rattlesnakes. In this case, the root would be used both internally, by having the victim chew the juice out of the fresh root, and externally, by making a fresh root poultice to help draw the poison out. Some medicine people took greater advantage of the numbing qualities by mashing the fresh root and rubbing the juice on their hands with tallow to enable them to handle fire painlessly

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and thus display a supernatural ability. Others chewed the root to numb the mouth in order to hold a hot coal in it, a very common traditional medical practice among many tribes. It was also used as an anesthetic when performing minor surgeries. The present-day Oglala Sioux of Pine Ridge, South Dakota continue to use echinacea for a variety of reasons, including toothache.5,6 With the influx of Europeans to the plains, many new diseases were introduced, including mumps, measles, a wide variety of other infectious diseases such as tuberculosis and smallpox, and a host of sexually transmitted diseases including syphilis and gonorrhea, all of which Native Americans had never before been exposed to. As civilization brought new diseases, therapeutic applications of echinacea expanded as a means to try to deal with them, apparently with some success. Early writers referred to echinacea as a premier remedy for the treatment of gonorrhea and syphilis. In addition to its medicinal uses, echinacea was also used by Pawnee children in a game in which the stems were twirled around each other. Many tribes used the spiny seed head as a hair comb and many chewed on the root to stimulate salivation as a means to allay thirst. Early Use by Europeans The earliest written record of non-Native American medicinal use of echinacea was reported in the second edition of Flora Virginica by Gronovius in 17627 where it was reported to "possess a sharp-tasting root," and was said to be very effective for the treat-

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ment of saddle sores on horses.8 At this time its botanical designation was Obelisocotheca barbulis pallide rubentibus, later named Echinacea purpurea. In 1830, noted naturalist and botanist Constantine Rafinesque cited Native American uses of echinacea in his highly acclaimed Medical Flora. Because of the herb's widespread use in treating rattlesnake bites and toothaches, among its common names were "Snake Root" and "Toothache Plant." Other names, referring to its physical characteristics, included such names as "Black Sampson," "Black Root,'' "Comb Flower,'' "Red Sun Rower" and the previously mentioned name, "Purple Coneflower." The Most Common Species of Echinacea There am nine species of echinacea and two varieties that are native to North America. The two species most widely used appear to have been E. angustifolia and E. pallida, although throughout its medicinal history up until the present time, proper identification of plants used in commercial products and pharmacological research has been problematic. Additionally, although there are few written records of its early use, large amounts of E. purpurea must have been used, since it has disappeared throughout most of its growing range. Most of the other species were used as well. Today, the most common species used are wild-harvested E. angustifolia and E. pallida and organically cultivated E. purpurea. The increased demand for the herb is putting a significant strain on wild populations, an important subject that will be elaborated on later.

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Echinacea's Eclectic History (18351935) From approximately 1835 to 1935, there was a group of physicians in the U.S. who relied exclusively on medicines derived from botanicals. These physicians were known as the Eclectics. The Eclectics left us a legacy of clinical herbal knowledge which is still relied upon by modern-day herbalists and naturopathic physicians. Another of their contributions was to bring high quality herbal extracts to the medical profession, thanks to the pioneering work of one of the most influential leaders of the Eclectic movement, John Uri Lloyd. Initially an apprenticeship-trained pharmacist, Lloyd went on to become one of the greatest figures in modern pharmacy. He authored more than 5,000 papers, several novels and numerous books and developed and patented numerous techniques and equipment used for the extraction of medicinal plants. In the fall of 1885, a German immigrant named H.C.F. Meyer wrote to Lloyd asking for his help in identifying the root of a plant that Meyer had used in an herbal preparation known as Meyer's Blood Purifier. Sixteen years earlier, "Dr." Meyer had learned about the use of this plant, presumably from Native Americans, and reported on its almost miraculous properties,9 including its use for the bites of venomous snakes and mad dogs. Simultaneously, Meyer sent a sample of the root to another influential member of the Eclectics, Dr. John "Pappy" King, extolling its virtues and asking for his help in bringing the benefits of his blood purifier to the medical profession. Dr. King replied that he could not recom-

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mend a medicine made up of a "secret mixture" and could do nothing with a plant that was not properly identified. In September of 1886, Dr. Meyer shipped samples of the whole plant to Dr. Lloyd. This was subsequently identified as Echinacea angustifolia by John Uri Lloyd's brother, Curtis Gates Lloyd, who was a trained botanist and mycologist. Due to the exaggerated claims put forth by Dr. Meyer, such as its use as an antidote in 613 cases of rattlesnake bite, John Uri did not display much interest in echinacea. In an attempt to convince Dr. Lloyd of its value, Dr. Meyer offered to come to Cincinnati and, before a committee of physicians, allow himself to be bitten by a rattlesnake of the committee's choosing and then use only echinacea as the antidote. This initial offer was graciously declined. Thinking it was because the Eclectics did not have a rattlesnake at their disposal, Dr. Meyer offered to bring with him "a full-sized rattlesnake possessed of its natural fangs" for the experiment, but again the offer was declined. Dr. King was not so quick to discount the validity of echinacea's use despite the exaggerated claims, and subsequently provided the medical profession with one of the first anecdotal reports of its positive effects. At the time, Dr. King's wife was suffering from ovarian cancer. Treatments he had tried for a number of years provided little comfort. However a tincture of echinacea, possibly the first pure echinacea tincture made, was one of the only remedies that provided her with any meaningful relief in that it reduced the pain associated with the disease, and "allayed a purulent discharge." Though Mrs. King died two years later of breast cancer, her daughter felt that

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though echinacea did not cure her mother, it eased her pain and prolonged her life. She was very grateful for having had the medicine available.10 Thus, Dr. King was convinced of echinacea's value, incorporated it into his practice, and corresponded with other physicians who used it. In 1887, King wrote an article for the Eclectic Medical Journal in which he stated, "Should echinacea be found to contain only one-half of the virtues attributed to it by Dr. Meyer, it will form an important addition to our materia medica." This was the official introduction of echinacea to the Eclectic medical profession. Within 11 years it became a standard entry in the writings of Eclectic physicians, and within 20 years it was among the most popular of all medicinal plants used by the Eclectics. In the 1905 edition of the now classic American Dispensatory by Dr. King, echinacea was reported to be useful for all conditions associated with septicemia (blood poisoning), including gangrene, weeping sores and ulcers, inflammation, cerebrospinal meningitis, and externally as an antiseptic.10 Another Eclectic physician, Dr. H.T. Webster, used it successfully to prevent convulsions associated with spinal meningitis, and on several occasions used it successfully to prevent the development of rabies and as a treatment against snake bites. In addition, Dr. Webster used it to treat fevers, measles and syphilis as well as to resolve skin conditions such as boils, abscesses and gangrene.11 John Uzi reported that Echinacea was the most widely used American drug since 1885. Many considered that E. angustifolia and E. pallida could be used interchangeably and used echinacea for a variety of conditions. At this time, an eight ounce bottle of echinacea extract cost $1.40.9 Its clinical

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application in most of the conditions reported as successfully treated with echinacea is consistent with its use in modern herbal practices, and many of these applications have since been substantiated through modern pharmacological investigations. Medical Use of Echinacea from 1852 Echinacea was included in the United States Dispensatory under the old botanical name, Rudbeckia purpurea, for its treatment of syphilis. Similarly, it was described as an aromatic and carminative in the Transactions of the American Medical Association (AMA) in the same year.7 In 1909, the AMA excluded echinacea from its list of new and nonofficial remedies based on "a lack of scientific scrutiny" regarding its use. The AMA had little respect for the Eclectics and considered most of Eclectic medicine as inferior to the bleeding techniques and mineral-mercury compounds used by the AMA allopathic physicians. Similarly, echinacea was deemed to be an ineffective medicine in 1921 by researchers at the U.S. Department of Agriculture.12 Although another researcher contested the author's conclusions,13 the Lloyd brothers decided to suspend all advertisements of echinacea for at least one year until they could survey physicians to determine echinacea's true worth. Hundreds of physicians, including Dr. S.M. Sherman, President of the Ohio State Board of Medical Examiners, responded in vigorous defense of echinacea. Universally, the physicians responded favorably to its effectiveness in all types of systemic infections, supporting the majority of the traditional uses ascribed to echinacea by the Eclectics.9

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EchinaceaDiscuse to Rebirth The widespread use of echinacea continued until the 1940s. The only official recognition given it by the predominant medical establishment was its inclusion in the National Formulary of the United States from 1916 to 1950. However, with the decline of Eclecticism and subsequent diminished interest in herbal medicine, interest in echinacea similarly declined. It was not until the 1970s that herbalism and echinacea made their return on the coattails of the "back to nature" movement of the 1960s and the work of a number of herbalists, in particular, Michael Tierra and Herbal Ed Smith, two of this country's most well-respected herbalists. My Introduction to Echinacea I was first introduced to echinacea in 1981 by an elderly nurse named Leah Lischner Conners. At the time, Leah was 82 years old and owned a health food store in Clearlake, California, the biggest community of senior citizens in the state. She had been a nurse most of her adult life, and was brought into the world in 1899 by a homeopathic physician named Dr. Imodene Wilcox. Her older brother was already a physician practicing homeopathic medicine in New York. Leah was never supposed to have been born as her mother had pernicious anemia and was told to not have any more children. Leah was extremely emaciated and frail as a child, but was nursed to health by Dr. Wilcox and her brother, Dr. Hyman Lischner, by using cod liver oil, alfalfa and echinacea. She was

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never vaccinated, and attributed her immune resistance predominantly to the use of echinacea. Leah provided natural healthcare to thousands of Clearlake residents over a period of 25 years. On any given day, her storefront, which was stocked with a basic array of nutritional supplements, fresh fruit and vegetable juices, a handful of herbal extracts, and a good selection of homeopathics, equaled any bustling medical clinic in volume of people seen and variety of conditions treated. She would spend hours, days and weeks educating people about the basic do's and don'ts about diet and lifestyle; she would outline a basic vitamin and herbal program to follow, and then send them on their way. Over a period of 10 years, I observed her successfully treat numerous cases of acute and chronic diseases including infections, asthma, heart disease, cancers and crippling rheumatoid arthritis. Echinacea was the staple of her herbal protocol. She recommended adding 10 drops of the fluid extract (1:1 concentration) to four ounces of water, three to four times daily. At age 89, Leah could be seen in front of the Santa Cruz County building and governmental offices holding a sign protesting the federal FDA attack against vitamins and herbs. The sign read: Born a homeopath Raised on vitamins Raised on herbs At 89, still going strong! At 97, Leah is still alive and feisty in a nursing home in Santa Cruz, California.

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Modern Uses of Echinacea Foundations of Natural Medicine The popular use of Echinacea has primarily been stimulated through the 10,000+ health food stores that have become an, integral part of America's communities. The first health food store was opened in the early 1900s by a gentleman named Dr. Benedict Lust. Dr. Lust was a German immigrant who was given up to die from pneumonia. His physicians recommended that he go back to Germany and die with his family. Lust did return to Germany. However, he was put into the care of a monk renowned for his knowledge of healing, Father Sebastian Kneipp. Not only did Lust not die, but he became one of Father Kneipp's most ardent followers. Kneipp instructed the young Lust to bring his "Nature Cure" system of medicine to America, which he faithfully did. These teachings subsequently became the foundation of today's naturopathic physiciansfully trained medical practitioners who specialize in using natural therapies for the treatment of disease. At the time, Americans were becoming overdependent on refined grains, consumed excessive amounts of animal fats and meat, and were quickly becoming reliant on the newly introduced, highly purified medicinal compounds that the chemical revolution was bringing. Lust had a difficult time finding the supplies he

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needed, and opened the first retail health food store as a means to supply his patients with the goods necessary for a natural health care regimen. Integral to Father Kneipp's philosophy was that healing comes from within and that it must be approached holistically from many different perspectives including diet, lifestyle, stress reduction, rest, exercise, fresh air, plenty of sunlight, hydrotherapy and simple herbal remedies. Health food stores have historically promoted preventive health care through these principles, in contrast to the overreliance on powerful synthetic drugs and highly invasive surgeries which are the foundation of modern medicine. With a renewed interest in phytochemicals, the so-called "active constituents" of plants, many of these principles are being lost, supplanted by a magic bullet, allopathic approach to using herbal medicines. Echinacea fits into Father Kneipp's philosophy quite nicely. For example, unlike numerous conventional antibiotics which tend to weaken the immune system, the primary action of echinacea is to stimulate the body's own immune response so as to mobilize one's internal defenses to fight off disease. While not a panacea for all of the ills of modern society, it does hold an extremely important place within the therapeutic armamentarium of today's modern herbalists, naturopathic physicians and health food stores. Echinacea was equally important with European homeopathic physicians, who primarily used a 1:10 concentration "mother tincture" made from the entire fresh plant. Originally it is believed that E. angustifolia was used. However, obtaining seeds was difficult so interest shifted to E. purpurea, which subsequently became the focus of much modern German

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chemical and pharmacological research. Today there are more than 280 echinacea products found in pharmacies throughout Germany, and hundreds more on the American market where it is sold singularly and is included as an ingredient in herbal formulas and multivitamins. Immunity Each cell of the body has a specific function. The primary work of the cells is carried out by chemical reactions which synthesize new substances for growth, energy and repair and break down used-up or damaged tissues. In order to protect itself, the body has various defense mechanisms. These include the skin and mucous membrane, the macrophage system and the inflammatory response. Each are components of the immune system, the actions of which are numerous and complex. They exist to maintain homeostasis or physiological balance in order to maintain health. Echinacea has a marked effect on many of these defense systems. It is an invaluable tool for minimizing bothersome symptoms of the cold and flu, reducing inflammation associated with arthritis or trauma, promoting the healing of tissue, helping to prevent opportunistic infections in cancer and AIDS patients and temporarily enhancing the body's immune defenses and detoxification mechanisms. Because of its widespread actions, it is clinically applicable for the treatment and management of many diseases, both as part of a self-healing program and when prescribed by a health professional.

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Wounds and Skin Conditions Early written reports of echinacea's role in helping to heal wounds led to a significant amount of research to determine the actions responsible for this effect. In the 1940s, researchers confirmed that echinacea, applied topically, stimulated the healing of suppurative wounds. Beginning in the 1950s, numerous researchers determined that echinacea inhibited the production or activity of an enzyme known as hyaluronidase, a finding that has since been well-established. Hyaluronidase stimulates the breakdown of hyaluronic acid which is the ''intercellular cement'' that keeps tissues together. Hyaluronic acid serves several functions with regard to wound healing. First, it regulates the flow and content of water in some tissues, which can help to alleviate swelling associated with inflammation; second, it provides the backbone by which molecules necessary for the formation of connective tissue form; third, it positively affects the activity of T-lynaphocytes and enhances phagocytosis, thereby helping to fight inflammation which can otherwise slow the healing of wounds. Since then, other wound-healing mechanisms of echinacea have been identified, including its ability to help in the implantation of fibroblasts, stabilize collagen and increase clotting time and phagocytosis. Fibroblasts are specialized cells that aid in the repairing of damaged tissue. In conjunction with the inhibition of hyaluronidase described above, echinacea is able to minimize the damage caused by acute inflammation while simultaneously aiding in the regeneration of connective tissue and epidermal (skin) cells.8 Collagen is the main protein building block of

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skin, bone, tendons, cartilage and connective tissue. Constituents of echinacea, most notably the caffeic acid derivatives, protect collagen from the oxidative damage caused by free radicals. Free radicals are the class of substances responsible for leaves turning different colors in the fall; they cause metal to rust and cause oxidative damage to the arterial walls and cells, which can lead to cardiovascular disease, premature aging and cancer. The most common form of oxidative damage associated with the skin is sunburn. The caffeic acid compounds in echinacea have been found to help in the prevention and treatment of damage associated with ultraviolet light, such as in sunburn and radiation therapy, by scavenging free radicals.14 Conversely, echinacea has also been shown to increase the internal production of reactive oxygen intermediates, a mechanism by which the body fights off opportunistic infections.15 In addition, echinacea has been shown to reduce the rate of necrosis in damaged skin tissue significantly, thereby facilitating a speedier heating of wounds.16 Phagocytosis is the process by which specialized immune cells known as macrophages wander through the blood and tissue engulfing microorganisms, foreign particles and bacteria. They are also present in the mucous membranes. Macrophages are like little "pac-men" which go about eating up pathogens, allergens and damaged cells such as those occurring in inflammation and infection. The ability of echinacea to stimulate phagocytosis has been well-established, and this is one of the mechanisms primarily responsible for its wound-healing and infection-fighting properties. There have been many studies conducted over the last 50 years regarding the effects of echinacea on

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various skin conditions. A database review of some of these studies outlines the following chronology. In 1953, it was observed that echinacea could cause infection from streptococcus to remain localized rather than spreading. This action was attributed to echinacea's ability to inhibit hyaluronidase and increase fibroblasts. In 1954, German researchers used injectable preparations of echinacea fractions in conjunction with conventional topical treatments for psoriasis. When used with echinacea, the incidence of psoriasis reoccurring was reduced as compared to conventional therapy alone. In 1976, other German researchers observed that echinacea produced a rapid and complete restoration of skin tissue in bacterial skin infections in humans. In 1978, a study involving 4,598 German patients with skin conditions was conducted. The ointment contained the juice extracted from the fresh flowering heads of E. purpurea. Over 500 physicians were responsible for reporting the findings. The author of the study concluded that the ointment was highly effective for several types of wounds, burns, eczema, inflammatory skin conditions, herpes simplex and varicose ulcers. In 1979, a study involving 109 patients with burns, minor skin injuries and leg ulcers reaffirmed the anti-inflammatory activity and wound-healing properties of a topical application of echinacea. The most impressive results were observed in the application of echinacea preparations to abrasions. Complete healing without complications was achieved in 87 percent of cases. First-degree burns and minor injuries were observed to heal quickly.17 In 1985, Italian researchers began looking at the anti-inflammatory effects of topical echinacea applications. One such preparation made up of a specific

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echinacea constituent (Echinacein B) was found to be more effective than a common nonsteroidal antinflammatory for reducing edema and inflammation.18 The same researchers, in 1987, demonstrated a significant anti-inflammatory activity in reducing edema and the infiltration into tissue of inflammatory cells using a polysaccharide fraction obtained from E. angustifolia.19 Again, in 1988, these researchers confirmed that several polysaccharide fractions obtained from E. angustifolia are at least partly responsible for the topical anti-inflammatory effects of echinacea preparations.20 Other German researchers have confirmed the wound healing effects of E. purpurea.21 Combination products which include echinacea have been used successfully to lessen the swelling and itching associated with mosquito bites.22 There is some direct evidence as to the potential efficacy of echinacea for the treatment of snakebite. Some of the caffeic acid derivatives contained in most species of echinacea have been shown to possess some anti-venom activity.23 Considering its documented pharmacological activities and widespread Native American use for snakebites, it is likely that echinacea would be an effective herb to include in a snakebite kit, although appropriate emergency care should be sought immediately. Because of these effects, echinacea is commonly used externally in antiseptic washes, cosmetics, salves and ointments, and can be used for all of the conditions mentioned above as well as in the treatment of vaginal candidiasis, trichomonas and herpes simplex.24,25 In addition to the positive effects on tissues using external echinacea applications, when used internally echinacea can help to increase tissue resis-

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tance against the invasion of pathogens such as streptococcus and listeria infection, and it has also been used internally and externally for ulcers caused by bed sores, diabetes and varicose veins.8 Effects of Echinacea Purpurea Ointment on Afflictions of the Skin Condition Inflammatory skin conditions Wounds Eczema Burns Herpes simplex Varicose ulcers

Nwnber of Patients 212 1,453 628 626 222 900

Success Rate 87.4% 91.5% 82.3% 96.3% 91.4% 71.1%

The most common way to use echinacea for the purpose of healing wounds is to apply it externally as a compress, wash, powder, ointment or salve. After washing with an echinacea solution, the sore or burn should be dusted with a freshly ground echinacea powder (or powder not more than a few months old), or covered with an echinacea ointment or salve and properly dressed. Initially, the dressing should be changed two to three times daily or as needed, depending on the severity of the wound, each time allowing a little exposure to air and sunlight, but taking care to prevent infection. However, some studies have shown that adding an internal administration of echinacea is more effective than using a topical application alone, emphasizing that it is ideal to treat wounds and most other conditions both internally and

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externally. Likewise, chronic problems such as gangrenous sores due to diabetes must be addressed systemically as well. Echinacea tea can be used to wash a cut to help prevent infection, but it is not very practical since it is difficult to get the necessary freshly harvested roots. Echinacea loses its potency very quickly, especially once powdered. I have kept echinacea powder in my first aid kit for many years and have applied it to wounds on numerous occasions, sprinkling the powder onto a sterile gauze pad or Band-Aid and applying it directly to the wound. Simultaneously, I would have the person begin taking an echinacea alcohol extract at approximately one to two droppersful (1/41/2 teaspoon) every few hours for the day. I have used it for cuts and puncture wounds and have never seen a wound treated with echinacea become infected. With puncture wounds I always try to squeeze a little bit of blood out as soon as possible and then wash and dress the wound. Monitoring the wound afterwards is very important, especially in puncture wounds. If black streaks are observed under the skin coming from the wound or if a mild fever occurs, medical attention should be sought immediately. Now I use a mixture of several herbs, including echinacea, as my primary first-aid powder. In absence of the echinacea powder or root, a compress can be made using the alcohol extract by adding one teaspoon of the extract to one-half cup of water and washing the wound; alternatively, put the extract directly on the gauze or Band-Aid and apply it to the wound. It will sting initially, but will subside momentarily as echinacea's local anesthetic activity kicks in. In vaginal yeast infections and trichomonas, both

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an ointment and/or a douche may be used. A douche can be prepared by adding one-half to one teaspoon of echinacea tincture to one pint of water or douching solution. I recommend adding one-half tablespoon of apple cider vinegar to the solution as well. Increasing Macrophage Activity As mentioned above, echinacea has the ability to enhance macrophage activity. Macrophages are relatively large cells that line the blood vessel walls and organ tissue and are present in the mucosa. They become highly active with inflammation. Their primary function, as previously discussed, is to destroy invading pathogens by eating them. They also stimulate the formation of antibodies, sensitize lymphocytes to invading pathogens and are actively involved in host defenses against bacterial or viral infection, seeking out and destroying invaders. If the skin is broken, macrophages are mobilized to the area to combat infection. In the lymph system, macrophages in the nodes filter out and eat up invading bacteria. In the lungs, macrophages along the alveoli either destroy or trap pathogens. The liver is an especially huge reservoir of tissue macrophages known as Kuppfer cells. One of the liver's primary blood supplies originates from the gastrointestinal tract. Because of this, huge amounts of pathogenic bacteria are carried from the bowels into the liver. Before the blood makes it into the primary circulation it has to pass through the sinuses of the liver, which are lined with Kuppfer cells. These sinuses represent such a sophisticated filtering system that almost no bacteria can make it into the blood via this route.

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The spleen and bone marrow are also reservoirs of macrophages which deal with pathogens that make it into the blood supply. A number of echinacea's polysaccharides strongly activate macrophages, resulting in pronounced extracellular cytotoxicity against tumor cells and certain microrganisms such as Leishmania enrietta, a parasitic protozoa responsible for often severe skin conditions. The polysaccharides have also been shown to enhance production of specific forms of interleukin and interferon, internally produced substances that increase resistance against pathogens.26 The majority of this research has been conducted using highly purified isolated polysaccharide fractions administered via injection. This has raised questions and concerns about relating such specialized research to the use of "crude" products administered orally. However, additional research using orally administered ethanol extracts of the three primary echinacea species were all found to significantly enhance phagocytosis. In E. angustifolia and E. pallida the fat-soluble constituents displayed greater activity than the water-soluble fractions, while in E. purpurea, the activity of the water-soluble constituents was more pronounced.27 This, in conjunction with the long-term, seemingly successful traditional use of echinacea provides significant evidence that many of the uses ascribed to echinacea by Native Americans and the Eclectics regarding its effectiveness in treating skin conditions are valid. Anti-Inflammatory Activity Inflammation is one of the body's responses to the adverse conditions which occur when tissue is damaged

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by an external trauma. It is a sequential reaction to cell injury designed to neutralize the inflammatory agent, remove dead' tissue and establish an environment suitable for healing and repair. However, inflammation can also be endogenously mediated, generated internally in response to negative chemical reactions that can occur as a result of poor diet, unhealthy lifestyle and other similar factors. There are various mechanisms at play in the inflammatory response. Echmacea has a mediating effect on many of them. Much of echinacea's anti-inflammatory activity is due to its ability to inhibit hyaluronidase, the enzyme that breaks down hyaluronic acid as previously described. Various authors have described echinacea as having "cortisone-like activity," presumably related to its anti-hyaluronidase effect.8 There are two other key enzymes involved with inflammatory responses, one is cyclooxygenase, the other is 5-lipoxygenase. Both enzymes utilize arachidonic acid to create powerful inflammatory mediators known as prostaglandins (PGE2). Inflammatory prostaglandins are associated with a wide variety of chronic inflammatory conditions including migraine headaches, certain forms of arthritis, irritable bowel syndrome and some nervous disorders. German researchers found that the alkymide fractions common to most echinacea species have an inhibitory effect on both 5-lipoxygenase and cyclooxygenase, while the isobutylamide fraction of E. angustifolia was slightly less potent.28 Some Italian researchers have focused on the anti-inflammatory activity of the watersoluble polysaccharides in external preparations,1820 while others have identified antihyaluronidase activity in several caffeic acid derivatives (chicoric acid, cynarin, caffaric acid and chlorogenic

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acid) obtained from E. angustifolia. The strongest effect was elicited by chicoric and caffaric acids.29 In addition, Dr. Rudolf Bauer, one of the world's leading researchers on the pharmacology and chemistry of echinacea, has identified a group of alkaloids from E. angustifolia which also have an inhibitory effect on cyclooxygenase and 5-lipoxygenase.30 Echinacea has been used clinically for a large number of inflammatory conditions, usually in combination with other herbs, but often alone. In investigations of echinacea's anti-inflammatory activity, a topical application of a crude polysaccharide mixture from E. angustifolia roots has been shown to reduce swelling and edema similar to that experienced by those with arthritis, while an alkylamide fraction from the roots of E. purpurea and E. angustifolia was also shown to possess a similar anti-inflammatory activity. The activity was reported to occur by inhibiting 5-lipoxygenase.28 Other pharmacological research has substantiated that echinacea is effective in the treatment of inflammatory conditions associated with the genito-urinary tract (specifically the prostate, urethra and epididymis) and inflammation of the ear, nose and throat. Each of these studies substantiate the use of echinacea by modern herbalists, many of whom rely on it as their primary botanical for inflammation associated with systemic infections. Echinacea has also proven effective in the treatment of pelvic inflammatory disease, a serious infection of the pelvic area that can result in sterility.7 Echinacea as Alternative The primary use of echinacea historically has been as an "alterative," a substance that helps in the res-

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toration of normal bodily functions, usually in the areas of digestion, assimilation and elimination. Detoxification and cleansing therapies have always been a cornerstone of many systems of natural health care. As the alterative herbs were widely used in these therapies, alteratives became commonly known as ''blood purifiers,'' although in actuality this is somewhat of a misnomer. Some of the primary indications for using echinacea as an alterative are for the treatment of a wide variety of skin conditions including weeping eczema, boils, herpes simplex, some forms of hives and certain types of acne. Singularly, or in combination with other alterative herbs, echinacea is very effective for these conditions, especially when used internally as well as externally as a wash, as previously described. The pharmacological mechanisms associated with some of these alterative actions have been discussed and include echinacea's ability to stimulate phagocytosis, specifically through the Kuppfer cells of the liver, its direct and indirect antibacterial, antifungal and antiviral activities, its ability to increase the resistance of connective tissue against the invasion of pathogenic microbes, and its ability to stimulate the regeneration of tissue. Antimicrobial Activity The antibacterial activity of echinacea was first identified in the 1950s. It was found that the caffeic acid derivative known as echinacoside, possessing mild antibiotic properties,47 was predominantly responsible for this action. Subsequent to this initial research, other compounds from E. purpurea and E. angusti-

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folia were found to possess bacteriostatic and fungistatic activity including inhibitory effects against Escherichia coliform and pseudomonas. Extracts of both E. purpurea and E. angustifolia also exhibited mild inhibitory activity against trichomonas.8 Echinacea and AIDS Considering that echinacea possesses a wide variety of constituents with immune-stimulating properties, it would appear likely that it would be a natural therapeutic agent to use in the treatment of immune deficiency syndromes such as Acquired Immune Deficiency Syndrome (AIDS). However, with few exceptions, many herbalists consider that echinacea is not appropriate as the primary botanical medicine for the long-term treatment and management of this disease. The German Commission E monographs concur with this opinion and state that the use of echinacea is contraindicated in AIDS. AIDS is a complex disease which is stimulating new research and understanding regarding immune activity. It is characterized by a dramatic decline in T-lymphocytes (CD4s) that significantly decreases immune resistance, thereby increasing one's susceptibility to opportunistic infections. New data suggests that the decline in absolute numbers of CD4s is only part of the picture associated with the progression of the disease, but that the level of activity of the CD4s is a more specific marker of disease progression. Normally, an immune-stimulating herb such as echinacea would be considered appropriate. However there is also a hypersensitive, autoimmune component of AIDS that brings into question the use of

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immune stimulants and immune tonics because of the concern that increasing the activity of various immune functions can actually increase the body's attack on itself. For this and other reasons, it presents a difficult scenario and the whole picture has yet to unfold. Many herbalists consider echinacea an important part of managing occasional opportunistic infections in people with AIDS on a short term basis, but otherwise consider it of limited value in an overall HIV/AIDS treatment protocol. There are at least three specific concerns regarding the use of echinacea in HIV and AIDS. One is regarding oxidative stress. As mentioned earlier, oxidative damage caused by free radicals is associated with a deterioration of cellular health. The AIDS virus actually uses free radicals as a means to activate itself. One of echinacea's mechanisms of action as previously mentioned is through the increased production of oxygen radicals via peritoneal macrophages as a means to combat pathogens such as Candida albicans. Oxidative stress is one of the primary factors associated with the progression from HIV+ to, AIDS. Oxidative stresses are prevalent in our everyday lives through poor dietary habits or through contact with environmental pollutants. These are likely to have a far greater negative impact on our health than that caused by echinacea. However, substances known to stimulate free radical production should generally be avoided whenever possible unless when medically indicated. Conversely, echinacea also exhibits significant protection against oxidative stress as observed in its ability to prevent tissue necrosis by inhibiting free radical-induced degradation of collagen, and in protecting against radiation poisoning.14 It provides this

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protection by mobilizing internal reserves of fat soluble nutrients, most notably vitamin A, carotenes and vitamin E and its antioxidant metabolites, at least partially through increased functioning of the vitamin E redox system. However in doing so, it can deplete these antioxidant reserves.14a This is especially important in HIV and AIDS because of the dangerous role oxidative stresses play in disease progression, and equally important because the majority of people with HIV/AIDS are considerably deficient in antioxidant nutrients already. Lastly, one of the primary activities of echinacea is in enhancing the activity of macrophages, specifically including increased production of tumor necrosis factor (TNF-a) that can help to combat cancer cells by destroying them.26 However, this toxic cytokine is also associated with the devastating wasting syndrome observed in patients with advanced stages of diseases associated with the deterioration of the immune system, including cancer and AIDS. To sum up, in relatively healthy people who are HIV+, echinacea can be used safely as a means to manage occasional opportunistic infections. In people at a more serious stage of the disease, such as in those with severe swollen lymph glands or acute infections, echinacea may similarly be used with positive results shortterm. However in all cases when taking echinacea, it is necessary to proportionately increase one's intake of antioxidant nutrients. A Personal Note Many of the findings of modern research on echinacea and other medicinal plants have been based on

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studies conducted with animals. Scientific researchers place a significant amount of importance on such data. Some feel that herbs should not be used until adequate numbers of animal studies have been conducted to determine both the safety and effectiveness of botanicals. While I have reported the findings of such data, in most cases I strongly disagree with the need for animal testing for many reasons. First and foremost, one of the inherent principles of herbalism is that all life is to be honored and respected. Second, more often than not, science only validates what traditional peoples have known for centuries. The time and expense expended and the pain inflicted upon the animals does not seem justified to find out something herbalists have known for hundreds of years. Third, animal physiology is very different from human physiology. One animal's medicine is another one's poison, so data based on animal research cannot always be applied to human use. Lastly, in this time of technological wizardry, it is likely that other more efficient, less costly and more humane models for studying medicine can be developed. If we lose our respect and love for animals, we lessen our respect and love for our own species. Echinacea as an Antibiotic Perhaps the greatest contribution echinacea can make to American healthcare is to lessen dependence on conventional antibiotics (anti = against/ biotic = life). Every year, literally tons of antibiotics are consumed by Americans, many by our children. For ear infections alone, there are 25 to 30 million visits to the doctor every year. Numerous reports cite that many

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of the diseases that we once thought were eradicated are coming back stronger than ever due to the ability of pathogens to develop resistance against antibiotics. Most of this resistance is a direct result of overuse of these drugs. Medical researchers acknowledge this problem and caution that the continued trend to over-prescribe will eventually lead to antibiotics becoming therapeutically useless in the treatment of infections such as pneumonia and meningitis. It has already been found that more than 50 percent of streptococcus strains are now resistant to conventional antibiotics. Antibiotics are routinely prescribed when practitioners do not know what else to give to satisfy consumers who expect a quick fix. One primary example of the overuse of antibiotics is in the treatment of chronic inner ear infections in children. The majority of American children have been subjected to multiple rounds of antibiotics before their first birthday. The penicillin-based antibiotic amoxicillin is often the drug of choice. While antibiotics can be lifesaving, they are prescribed far too often and for mild illnesses which can be dealt with using gentler remedies such as herbs. In 1991 the Journal of the American Medical Association reported that children who were administered amoxicillin were two to six times more likely to develop a recurrent infection than children who were not treated at all. The amoxicillin-treated children also experienced an increased incidence of hearing impairment due to scar tissue caused by the multiple infections.31 In a nutshell, one of the most widely prescribed antibiotics for chronic inner ear infections in children appears to be worse than no treatment at all. My wife Mary and I have a beautiful, healthy 13-

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year-old daughter, Heidi Rose, who has never had so much as an aspirin or antibiotic. This is not because she has never gotten sick or because we are adamantly opposed to conventional drugs: it is because we have used herbs, most notably echinacea, to stimulate her body's own defenses to manage illness. In our community there are many children, mostly of herbalists, who have likewise been able to manage the majority of childhood illnesses without the use of conventional drugs. Echinacea is by far one of the most relied-upon herbs in the botanical kingdom used as an alternative to conventional antibiotics in adults and children. In addition to those which are prescribed, large amounts of antibiotics are consumed when we eat commercial animal products. In fact, the majority of antibiotics produced in this country go to treating disease in commercially raised animals. In most of the commercial farms the animals are packed so tightly together that they are continually exposed to fecal contamination and develop a high incidence of disease. Large numbers of animals then share the same feed and water and so disease spreads, necessitating a continual ingestion of antibiotics. The antibiotics are consumed; pathogens begin to mutate in a manner that resists the effects of the antibiotics; we ingest the animal products; and a vicious cycle is generated that is leading to the reintroduction of many of the diseases that antibiotics once combated. We begin the process of compromising our children's immune systems early on in their lives 1) by not breastfeeding which provides the baby with antibodies, and the "seeds" necessary for generating the healthy intestinal flora needed for a healthy immune system; 2) by vaccinating too early before their im-

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mune systems have had a chance to develop; and 3) by introducing them to a multitude of antibiotic drugs within the first few years of their developing lives. It has been theorized that part of echinacea's ability to fight infection is due to the fact that the structure of its polysaccharides is similar to the surface coating of some pathogens. This mimics the pathogens, which makes the body think it is under a greater attack than it really is; thus the immune response elicited overpowers the relatively few pathogens. Because this is only a temporary jump-start of the immune system, it is unlikely to have any negative effects except perhaps if used in those with auto-immune disease. One herbalist I know recommends that echinacea be used in preparation for childhood or adult vaccinations by using it for one to two weeks prior to vaccination. Colds and Flus The most common use of echinacea is during the first signs of a cold, flu or fever and secondarily for other minor infections. It is the primary ingredient in the majority of herbal supplements designed for winter health and is one of the most popular of all medicinal herbs, equaled only by garlic and ginseng. At the first signs of a cold or flu, echinacea is a good choice in order to initiate a strong immune response as the pathogens are just beginning to try and take hold. It is most effective when taken in conjunction with a diaphoretic tea to induce sweating, such as the classic combination of peppermint leaves, elder flowers and yarrow flowers. In the majority of

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cases, this tea will work very well alone, so that echinacea can be reserved for more serious infections. However, it is good to always have a bottle of echinacea tincture on hand so that at the first sign of a cold or flu you can just squirt a few droppersful in your mouth. The dosage is important. In a double-blind study of 180 volunteers, it was found that two droppersful (approximately 1/2 teaspoonequivalent to 900 mg per day) of a liquid extract of E. purpurea root elicited no improvement in either the time or severity of the flu symptoms, whereas four droppersful (1 teaspoon) exhibited statistically significant improvements over administration of the placebo.32 Unfortunately, echinacea has also become somewhat of a marketing phenomenon in that it is an ingredient in a large number of multiple vitamin preparations whose manufacturers have found it fashionable to include the herb. Such indiscriminate use can have far-reaching consequences, not the least of which is the decimation of naturally occurring plant populations, and perhaps the body becoming so used to, echinacea that it may not work when really needed.

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Commercial Considerations Will the Best Echinacea Please Stand Up! Various manufacturers of echinacea products have stimulated controversy as to which species or part of the echinacea plant is the most potent. Sometimes it is difficult to separate the wheat from the marketing chaff, and so a discussion follows of some of the varying opinions, and a chart outlines the documented uses of each species. Echinacea angustifolia and Echinacea pallida: These were the two species first introduced into medical practice in the 1800s and thus were the species reported to be most widely used from the late 1800s to the 1950s and then again in the 1970s up to the present. Early physicians used these species seemingly successfully for treating many of the conditions which herbalists continue to use echinacea for today. Modern pharmacology has validated many of these uses. In most instances, E. angustifolia and E. pallida have been shown to have similar effects as well as similar chemistry. One study demonstrated that E. pallida had a greater phagocyte-stimulating activity than either E. angustifolia or E. purpurea.8 Another study reported that the isolated compounds from the three species "exhibited a high degree of

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similarity.''33 Other studies suggest that E. purpurea has a greater activity in some ways than either of the other two species.34 Echinacea purpurea: For commercial reasons, a large number of studies have been conducted on a specific injectable preparation of the leaf juice of E. purpurea, which is rich in immuno-stimulating polysaccharides. Early on in echinacea research, scientists believed the primary activity of echinacea was associated with the polysaccharides, so this became the primary focus of echinacea studies. Because the German research found that the leaf juice of E. purpurea possessed higher amounts of polysaccharides than the roots or parts of other species, numerous companies and even some writers have suggested that E. purpurea is superior to other species of echinacea. Many commercial interests created a marketing program around this research. There were several basic flaws with this marketing direction. First, the research was conducted on the juice of fresh leaves. Many products subsequently were made from the entire above-the-ground portion of the dried plant including the woody, largely fibrous stems which account for approximately 70 percent of the dried weight of the aboveground portion of the plant. As often happens, companies capitalized on the fresh juice research even though their products were not comparable to those used in the studies. The second flaw was that the majority of these studies were conducted with injectable preparations, not orally administered products. Although polysaccharides have a limited amount of activity when consumed orally, most polysaccharide researchers have found that the long chain sugars get broken down in

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the gastrointestinal tract and do not make it into the blood intact. Therefore, marketing a product based on its being rich in polysaccharides is of limited pharmacological value. Subsequent research has revealed that the medicinal activity of echinacea is not solely correlated to polysaccharides but rather is due to the broad spectrum of constituents contained within the plant. Moreover, it is now considered that the polysaccha-rides may contribute little to the overall immune-stimulating effects in oral preparations.8 Nevertheless, confusion in the marketplace persists. Other species of echinacea: A few additional species of echinacea have been used medicinally and studied pharmacologically. These include E. tennesseensis, E. atrorubens, E. simulata and E. paradoxa. Some pharmacological and chemical study has been conducted on these other species to determine their potential medicinal value. The chemical profile of E. simulata and E. paradoxa was found very similar to that of E. pallida and E. angustifolia, containing the alkamides, ketoalkenynes and echinacoside.35 From a taste test, E. atrorubens has an organoleptic alkamide profile similar to that of E. pallida and E. angustifolia. In my opinion, based solely on my own therapeutic experience, I consider the roots of E. angustifolia and E. pallida interchangeable for most of the uses attributed to echinacea, and favor these over the leaf juice and roots of E. purpurea. When other factors are considered, such as the fact that E. angustifolia and E. pallida are being overharvested in the wild, I have to strongly recommend that organically cultivated E. purpurea be used more frequently until ade-

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quate supplies of cultivated pallida and angustifolia are available. However, therapeutically, my favorite preparation is one that combines a high amount of freshly harvested angustifolia and/or pallida root, purpurea root, purpurea leaf juice and a smaller percentage of seed which is very rich in isobutylamides. I also believe that any properly manufactured echinacea supplement will deliver most of the medicinal activity desired as long as the material used is of high quality. With few exceptions, I believe differentiating between which species is best is more of an academic point than a therapeutic concern.

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Choosing an Echinacea Preparation Another common question that arises with herbs in general is, ''What is the best type of preparation to usepowder, capsules, teas, tablets or tinctures?" Traditionally, Native Americans used echinacea's fresh root juice internally and externally as well as its dried root. Fresh echinacea is likely to be more potent. Unfortunately, very few of us have access to the fresh roots growing on the plains and must look for other preparations. Each kind of preparation has advantages and disadvantages and each can be used with a relatively high degree of effectiveness as long as you start with fresh, undamaged plant material and prepare and store it properly. Teas: Infusions and Decoctions Teas are perhaps the oldest form of medicinal herb preparation in existence. While Americans drink tea predominantly for its flavor and for the ritual of it, peoples of many nations consciously drink various herbal mixtures as healthful beverages, varying the tea mixture depending upon how they feel at any given time. Teas are among the most beneficial preparations you can use, and certainly the most inexpensive. The water extractions have a high degree of bioavailability so it is easy for the body to absorb

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and assimilate their medicinal properties. They work very quickly. Bulk herbs are a fraction of the cost of ready-made products. With teas you have the flexibility of mixing whatever herbs you like together and they have the added benefit of involving you in your own healing process as you have to take the time to make the brew and then ideally sit down and relax while you drink it. This reaffirms in a very real way your commitment to your healing process in a manner not elicited with other preparations. The primary disadvantage of teas is that many medicinal herbs taste unpleasant, and while many can be enjoyed once a taste is acquired for them, others would gag a starving goat. There are many commercial medicinal tea bags on the market. Some of these are good. Others give so little herb per tea bag, and may even contain added caffeine, that they actually deliver little benefit other than the aesthetic pleasure and relaxation derived from sipping a cup of flavorful tea. Two teas that contain high quality echinacea are Echinacea Plus by Traditional Medicinals and Immuni-Tea by UniTea. Of course, you can always make your own creative blend. Powders, Capsules, Tablets Powder made into capsules or tablets is one of the most convenient forms of herbal products to take. The primary advantage is that capsules and tablets are easy to take simply by swallowing them with water, and you do not have to taste potentially not-so-nice-tasting herbal brews. Also, when purchasing the herb in bulk form from a health food store, you can make up your own combinations using pure echi-nacea root powder. The disadvantage of powders, es-

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pecially with echinacea, is that they lose their potency relatively quickly. Powdered echinacea can lose some of its effectiveness in as little as four months. Echinacoside content can degrade 10 percent in three years.36 Capsules lose their potency the quickest because a relatively high amount of surface area is exposed to light and air, which causes the active constituents to oxidize. Tablets can retain their potency for relatively long periods of time as they are tightly packed and therefore little surface area is exposed to oxidation. One potential disadvantage to both capsules and tablets is that the majority of these products also contain some amount of excipients and flow agents. The most commonly used excipients include di-calcium phosphate and magnesium stearate, both of which are considered basically inert. Depending on the manufacturer, excipients can account for less than 5 percent to higher than 35 percent of the total weight of the capsule or tablet. If improper tableting techniques are used, they can be too hard and therefore will not dissolve adequately. How well tablets dissolve can be tested by placing a few tablets in a cup of cold water. If they dissolve within 30 to 60 minutes in the passive medium of a plain cup of water, you can be assured they will quickly break down in the active medium of the digestive system. Liquid Extracts Alcohol: Alcohol extracts are by far the most commonly used echinacea preparations on the market. They have the advantage of coming in small one-fluid-ounce eyedropper bottles and so are very easy to carry. If extracted properly, they will capture a large percentage of the medicine contained within the

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root. They can be mixed with water, tea or juice to dilute the flavor, and they will maintain a relatively long shelf life of up to three years and beyond if properly stored in a dark cool area. When purchasing an alcohol extract I recommend one that contains a combination of the root, seed and leaf juice, ideally made from fresh or freshly dried plant material and extracted in an alcohol-water menstruum to a finished alcohol content of 60 to 70 percent. There are numerous preparations readily available that meet this profile. If only the leaf of E. purpurea is desired, buy a leaf juice extract, as products made from dried above-the-ground leaves and stems are much less potent. Glycerites: Glycerin extracts are finished herbal products which contain no ethyl alcohol and are therefore wellsuited for children or for those wishing to avoid ethyl alcohol. Glycerin is naturally sweet, and oftentimes flavorings are added to make glycerin extract preparations more palatable. Glycerin is a preservative and therefore will retain its potency for up to two years, after which glycerites should be replaced. They can be used both internally and externally.

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Making Your Own Medicines Medicinal Herb Teas There are two primary ways to prepare a tea. One is by steeping the herb(s) in hot water (called an infusion). The other is by boiling the herb(s) (called a decoction). Different herbs need different processes to maximize the extraction and preservation of their medicinal compounds. A general rule of thumb is that herbs that are rich in aromatic volatile oils (which have a perfume-like aroma) need to be infused; with decoctions the volatile compounds are boiled off. The best way to make an infusion is to boil the water, preferably in a glass or unchipped enamel pot or stainless steel pan. Place the herb(s) in the palm of your hand and rub with the thumb of your other hand. This bruises the cell membranes of the plant, thereby releasing the volatile components. Place the herb(s) (I teaspoon per cup of water) in a Mason jar. Pour the boiling water directly over the herbs. Cover the jar immediately in order to retain the volatile oils and let steep (infuse) for 10 minutes. Strain and drink. Echinacea root is best prepared as a decoction using approximately one gram of root (either chopped or powdered) to one cup of water. A decoction is prepared by placing the herb in cold water

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and bringing it to a boil or by bringing the water to a boil and adding the herb afterwards. When the water comes to a slow boil, turn the heat down low, cover and let simmer (decoct) for 10 to 15 minutes. Powder and Capsules Many communities have, health food stores which carry bulk herbs in either cut and sifted form or as powders. Ideally, it is better to buy herbs in their whole form and grind them yourself since whole herbs retain their potency the longest. After you decide which herb or mixture you want, purchase the appropriate amount of herbs along with size 0 or 00 gelatin capsules, depending on how well you do at swallowing capsules (00 is larger). Mix the powders together in the appropriate proportions (how to do this is outlined in many texts) and then fill the capsules either by hand or with one of the little capsule-pressing machines available at health food stores. Store the capsules in a cool, dark area. Properly stored capsules will retain much of their potency for more than a year. When taking them, make sure you drink plenty of water. It is common for them to get somewhat stuck in the throat because the gelatin becomes sticky when it is wet. If you are vegetarian, there are now vegetable-derived capsules on the market. Making Your Own Alcohol Extract To make your own simple alcohol extract, grind 4 to 8 oz. of whole, freshly dried echinacea root into a

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coarse powder with a coffee grinder. Place the powder in a Mason jar. Cover with 16 oz. of 80-proof vodka or with 3/4 cup Everclear and 1 1/4 cups water. Mark the jar with the name of the herb and the date prepared. Let stand for at least two weeks in a dark, cool place, shaking well every day. After two weeks, strain or pour through a coffee filter to eliminate sediment. Store the finished extract in amber bottles away from heat and sunlight. Label and date. Extracts should be good for up to three years. When using fresh plant material, mash it into a pulp with a mortar and pestle, add vodka as above to a blender along with the herb and blend on low speed to a slurry consistency. Pour into a Mason jar, let stand for two weeks covered, shaking it every day; strain and store in dark amber bottles. Making Your Own Glycerite Extract There are two primary ways to prepare a glycerin extract. The first is to soak an appropriate amount of the herb directly in glycerin. The second is to extract the appropriate amount of herb in the appropriate alcohol-water extracting menstruum and then evaporate the alcohol in a rotary evaporator and reconstitute the extract with glycerin to the desired concentration. The advantage to the first procedure, the simple glycerin macerate, is that anyone can do this at home very easily. In my experience, I feel fresh root material makes for a better glycerin extract when prepared via simple maceration. The disadvantage is that glycerin in and of itself is not an ideal extracting solvent, so much less medicine is obtained from the root with this extraction process as com-

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pared to alcohol extracts. Glycerin extracts prepared by placing the herb in alcohol first are going to yield higher concentrations of plant constituents. Another way to prepare a glycerin extract is to first make a tea by gently boiling the cut up or powdered roots for approximately 10 to 15 minutes; then add an equal or slightly greater amount of glycerin to the fluid and store in the refrigerator. Although the shelf life will not be as long as for an alcohol extract or a simple glycerin maceration, it will make a more potent medicine than the simple macerate. Flavors can be added by using herbal essential oils such as peppermint or lemon, or a concentrate of cherry or black cherry. Store in amber bottles away from heat and sunlight to maintain maximum shelf life. Label and date. Making Your Own Salve Add 3 to 6 oz. of dried herbs to I cup of vegetable oil (olive, coconut, etc.). Place in an uncovered cooking crock, stir well and bake in the oven at 100° to 150° for 3 to 5 hours (or you can use a crock pot). Check periodically to ensure the mixture does not burn and stir occasionally. When finished, squeeze the spent herbs through a strainer, allowing them to sit for awhile to drain off. This gives you an ''oil infusion." To harden the salve to the right consistency, add approximately I ounce of shaved beeswax to 1 cup of oil infusion. Warm over low heat until the wax is completely melted. When finished, pour warm oil into appropriate small jars and allow to cool. A few capsules of vitamin E oil should be added to help preserve the salve. After the beeswax has melted and the mixture has

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cooled some, scoop out a small portion with a spoon and place it in the refrigerator to harden quickly. Once it hardens, you can check its consistency. If it is too hard, additional oil can be added. If too soft, additional beeswax can be added. Alcohol extracts or essential oils of other herbs can be added to the warmed oil to increase the potency or modify its actions. When using essential oils, only add a few drops to the base oil. Essential oil of thyme can be added to increase the antiseptic quality. An alcohol extract of calendula blossoms can be added to increase wound healing. Essential oil of ginger root can be added for burns and bruises.

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Dosages Many people are cautious about self-prescribing or may have concerns that they may take too much, or in some cases, too little of an herb. As previously noted, there is a relatively large margin of safety with the, majority of herbs on the market. Whereas two to three times the normal dose of a pharmaceutical drug can be severely damaging, even fatal, it is not uncommon, especially with echinacea, to take four and even five times the normally recommended dose. Following are some guidelines to go by for echinacea. Powder 1 gram 3 times daily. Teas 1 gram boiled per cup of water. Drink 1 cup 3 times daily. Leaf Juice E. 6 to 9 milliliters daily. Purpurea) Tincture 1 dropperful 3 to 4 times daily, or as needed (a dropperful is (1:5) equal to approximately 35 drops or 1/4 teaspoon). Glycerite 2 droppersful 2 to 3 times daily.

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Rules for Determing Dosages for Children There are some specific rules for determining dosages for children. Age is one consideration, weight is another and physical constitution is another. Slight or frail children require less. Heavy or robust children can use more. The following are two general rules. Clark's Rule: To determine the approximate fraction of an adult dose, divide the weight of the child in pounds by 150. Example: 50 pound child ÷ 150 = 1/3. Therefore the child's dose is 1/3 of the adult dosage. Cowling's Rule: The age of the child at his or her next birthday is divided by 24. Example: a 3-year-old child ÷ 24 = 1/8. Therefore the dosage for a 3-year-old child is 1/8 of the adult dose.

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Echinacea in the Herbalist's Medicine Chest Echinacea is one of the most effective and safest herbs to stock in your family's home medicine cabinet. Either by itself or in combination with other herbs, it is invaluable to use for a wide variety of acute illnesses. Following are some favorite formulas of herbalists and some interesting uses. Brigitte Mars: ''I have a lot of wonderful experiences with echinacea, many with our own family, including using it successfully for both snake bite and the bites of brown recluse spiders. I use it by itself and in combination with usnea for infections of the throat, with osha for respiratory infections and sometimes use it with grapefruit seed extract for infections in general. I stopped using goldenseal many years ago because of its scarcity, but prior to that I used the combination a lot. My Inimuni-Tea blend is my favorite tea combination. It is a wonderful-tasting beverage that contains rosehips, lemon grass, peppermint, ginger, echinacea root, leaf and flower, elder flower, marshmallow root, licorice, astragalus and thyme. It offers a wonderful boost to the immune system. Even kids and skeptical spouses will drink it up.

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"I was bitten by a poisonous copperhead snake 20 years ago when living on a farm in the Ozarks in a tepee. I immediately ran into the tepee yelling, 'I got bit by a copperhead! I got bit by a copperhead!' and grabbed all my books to look for a snake bite remedy. The sensible thing to do would have been to go to the hospital, but it was an arduous trip in a four-wheel drive that would have taken an hour and we needed to do something right then. "My husband, Tom, bless his heart, almost immediately turned on a little shop vacuum we had and pressed it right up against the bite to try to suck the venom out. I riffled through the pages of several books and read in one of them that echinacea was used by Native Americans for snake bite. It was like magic since it was growing right outside the tepee! I don't know what species it was. Tom yelled to our friends up the hill and people came running down. Someone dug up some roots and I began chewing on the fresh root while the water boiled for tea. We mashed up some more fresh root and made a poultice and applied it right to the bite. I then drank several cups of the tea. I remember the most significant thing I experienced was a tremendous amount of anxiety but I tried to remain calm, thinking that I couldn't give in to the fear. I didn't get sick at allno symptoms other than the anxiety. That experience really changed my life. Living in the wilderness with two children, I realized that I didn't know enough to deal with emergencies, that I depended on my books too much. The very next day I began studying herbs in a whole different way, trying to internalize my knowledge of herbal medicine rather than depending on information in books, I began writing little easy-to-use index cards, something I have been doing ever

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since. It also showed me how profound herbal medicines could be. An old-timer told us later that he had used echinacea in the same way." David Winston: "Alternating echinacea with baptisia (wild indigo) is one of my favorite ways to use echinacea. One of my students had a client with a gangrenous foot that physicians were saying needed to be amputated. The discoloration and necrosis were severe. I had never seen a foot look so bad. I recommended the echinacea and baptisia be used internally and also recommended alternating hot and cold foot baths with echinacea and baptisia added to the water. The foot was almost entirely cleared up within three days and did not need to be cut off." Dosage: Echinacea, 2 droppersful every 2 to 3 hours. Baptisia, 20 drops 4 times daily. Uses: For all types of systemic infections and cervical dysplasia. Donald Yance: "Occasionally I use echinacea, singularly, but most often in combination with other herbs. Most people use it only in conditions associated with an excess or strong constitution. However, I use it in people who are both excess and deficient." Formula 1 Echinacea Thuja Baptisia

50% 25% 25%

Dosage: I dropperful of the combination 3 times daily. For external application, soak a gauze pad

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in the extract and dress the affected area or apply directly to cut, sore or infection and allow to dry. Uses: Bedsores. Use internally and apply externally. Formula 2 Echinacea Thuja Wild Indigo Poke root Greater Celandine Osha root

50% 10% 10% 10% 10% 10%

Dosage: 10 to 20 drops 3 to 4 times daily. Uses: Cervical dysplasia, viruses, respiratory infections. With mononucleosis, add red root. Ed Smith's Flu Drops Echinacea root Goldenseal root Osha root Spilanthes herb and root Yerba santa leaves Horseradish Elder flowers Yarrow flowers Watercress herb Wild indigo root

12.5% 12.5% 12.5% 12.5% 12.5% 6.25% 6.25% 6.25% 6.25% 6.25%

Dosage: 30 to 40 drops 3 to 5 times daily straight or in hot water. Uses: Colds and flu, fever, upper respiratory congestion, immune stimulation.

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Rosemary Gladstar's Immune Support Tea37 Pau d'arco bark 55% Echinacea root 35% Burdock root 10% Directions: Add 4 to 6 Tbs. of the herb mixture to I quart of cold water and gently simmer for 20 minutes in a tightly covered pot. Remove from heat and let infuse for another 20 minutes. Strain and drink. Optional flavoring herbs: cinnamon, orange peel, licorice root. Dosage: 3 to 4 cups daily as needed. Silena Heron, N.D.: "I use echinacea a lot, but mostly combined with other herbs according to the needs of my patients. I have had some remarkable success using the glycerite of echinacea for the treatment of hives. The following formula is typical of what I suggest for people with serious throat infections." Echinacea root Goldenseal root Osha root Thymus leaves Balm of Gilead buds Yerba mansa (glycerite) Licorice root Usnea

35% 10% 10% 10% 10% 10% 10% 5%

Dosage: Gargle the extract straight after drinking a glass of water. Or mix I Tbs. of extract in 1/2 cup hot water and gargle. Uses: As a gargle for sore throat associated with infections.

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Sunny Mavor: "These days my favorite echinacea. remedy is a glycerin extract of echinacea and Oregon grape root. I use the Oregon grape root instead of goldenseal because of how scarce goldenseal is becoming in the wild. This has worked really well for ear infections in my seven-month-old, 16-pound baby, one time literally working overnight. I recommend it for children over six months old, who have already begun eating solid food. I would not use it in infants or babies who have not eaten solid foods yet. Instead I would give it to the breastfeeding mother so that some of the immune-stimulating properties are carried to the baby in the milk." Echinacea root Oregon grape root

65% 35%

Add orange or blackberry flavoring to mask the taste. Dosage: 25 drops up to 4 times daily of glycerin extract. Uses: Ear infections. By far the most versatile herbal antiseptic wash I have ever used is the combination of echinacea, goldenseal, myrrh and calendula in a saline solution base. It was originally developed for the treatment of bed sores by Leah's brother. Subsequently new uses were found. People who have used it never want to be without it; it becomes an indispensable part of your home medicine chest.

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Herbal Antiseptic Combine equal parts of the extracts of echinacea, goldenseal, myrrh and calendula. Add approximately 1 Tbsp. of the combined extracts to 1/2 cup water and 1 rounded tsp. sea salt. Uses: External wash for cuts, scrapes, burns, bed sores, varicose ulcers, non-healing wounds, mastitis, bleeding hemorrhoids, poison ivy/oak, hives, bites, itching and stings. As a mouthwash and gargle for gingivitis, canker sores, thrush, tonsillitis, laryngitis, sore throat. As an eyewash for conjunctivitis, dilute 2 Tbsp. of the antiseptic wash in slightly less than 1 cup distilled water. Used dilute in an inhalator to soothe irritated mucous membranes in asthma, bronchitis and emphysema. Use a 20 percent solution (1/4 cup antiseptic solution plus I cup water) as a douche for various vaginal infections including trichomonas and yeast.

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Toxicity, Contraindications and Other Guidelines Because of echinacea's widespread popularity and its indiscriminate inclusion in many multivitamins, herbal products and fruit juice, it is important to know about its potential for toxicity. There are various issues of concern regarding toxicology. What long-term effects may the herb have? What are the side effects? Will it interfere with conventional medications or with other herbs? What about using it for children or in pregnancy and lactation? With few exceptions, there is a large measure of safety associated with the majority of commercially available herbs, including echinacea. This is due to the fact that many of the more powerful herbs, such as aconite, gelsemium or poke root, which possess a high potential for toxicity, are not commonly used except by experienced herbalists. The Eclectics, who used echinacea extensively for 50 years, considered it free of side effects when used within its normal dosage range. The experience of modern herbalists is similar. Symptoms associated with excessive consumption of echinacea reported by the respected Eclectic physician Harvey Wickes Felter include headache, joint pain, dry tongue, reduced temperature and gastrointestinal disturbances

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with diarrhea.38 Such symptoms could have as easily been associated with the mistaken use of Parthenium integrifolia (prairie dock or Kansas snake root), which is rich in sesquiterpenes that can cause some of these same symptoms. In toxicity studies conducted in the 1950s, injectable preparations of echinacea in amounts exceeding normal dosage limits showed no toxic side effects. In 1989, researchers again found the polysaccharide fractions to be virtually nontoxic.8 In fact, caffeine is many times more toxic than echinacea. Most toxicity studies of echinacea have been conducted on the polysaccharide fractions obtained from E. purpurea. In 1991 studies, high doses of oral and intravenous E. purpurea leaf juice were found to be virtually nontoxic in animals. Tests for mutagenicity and carcinogenicity all gave negative results.39 Additional studies to determine the toxicity of purified polysaccharides all suggest that they are nontoxic.40 Between 1994 and 1996, a team of herbalists worked on a document known as the Botanical Safety Index (BSI) under the auspices of the Standards Committee of the American Herbal Products Association. The BSI contains a review of the relative toxicity of approximately 650 herbs in commerce. The committee reviewed the primary texts associated with medicinal plant toxicity and assigned each herb to a category that reflects a significant amount of the accumulated traditional and scientific data. According to an initial review of the data, echinacea appears to be free of side effects. In the German Commission E monographs, considered by some to represent the most accurate information on herbal medicines available, there are few cautionary notes for echinacea. For E. purpurea the

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warnings include: not to be used for progressive systemic diseases such as tuberculosis, leukosis, collagenosis, multiple sclerosis. For E. pallida, the warnings also include AIDS, HIV infection and other autoimmune diseases. The warnings also state that injectable preparations of echinacea should not be used in people prone to allergies, especially allergies to members of the composite family (Asteraceae), or in pregnancy, and caution against the use of injectable preparations in diabetes. The Commission E monograph also states that echinacea preparations should not be used for longer than eight weeks. This recommendation is partly based on research which suggests that echinacea loses much of its effectiveness after eight weeks as the body becomes desensitized to it and partly due to the fact that if symptoms are still prevalent after eight weeks, then echinacea therapy is likely not working. In 15 years of using and recommending echinacea, I have seen only two negative reactions. One was a mild case of hives which I attributed to an individual allergic reaction; the hives went away as soon as the echinacea was discontinued. The other was in a woman who ingested an alcohol preparation made from the leaf, seed and root straight from the eyedropper. Immediately her throat closed almost completely; this lasted for only a few minutes, leaving her physically fine but scared. She had used echinacea often in the past but had always mixed it with water or juice or had taken it in capsule or tablet form. The reaction had never occurred when the extract was diluted in water, or when taking capsules or tablets. I experienced a similar reaction, but very mildly, when I squirted a dropperful of an extract into my mouth and inhaled at the same time. I got a very fleeting feeling

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of constriction and could see how someone with a particular sensitivity could react negatively. To avoid this potential problem, simply mix echinacea extract with water, nonacidic juice or herb tea. Mild fever has been associated with the use of injectable preparations. However, some physicians feel this is an indication of the therapy working, as fever is associated with the healing process. Constitutional Differentiation Most people believe that an herb like echinacea would be good for all of the people all of the time. This is not true. Certain herbs will work better for certain people, depending upon their own unique constitutional makeup. One important point to remember is that echinacea is an immune stimulant, not an immune tonic. Its primary activity is to mobilize defenses considered superficial in their action, such as enhancing phagocytosis or fighting inflammation. It does not strengthen deep immune defenses like other immune tonics such as the Chinese herbs astragalus and ganoderma (reishi mushroom) which have the specific effect of increasing the production of immune cells from the bone marrow and increasing energy production. Frequently, I have found echinacea will not work if used by people who are internally weak and run down because they lack the energy necessary to stimulate their immune system. In such cases of debilitation, the number of white blood cells (leukocytes, macrophages) is greatly reduced, so while the efficiency of the existing macrophages might be temporarily enhanced, the white blood cell deficiency will

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remain. In these cases, echinacea, may work to fight the acute infection, but it will not correct the underlying weakness. The use of echinacea in these situations would be similar to using conventional antibioticthe infection may subside temporarily, but it may quickly return. Many herbalists treat people who need frequent doses of echinacea throughout the winter because they keep getting sick. Clinically, this is often observed in those who consume a nutritionally inadequate diet, or who eat large quantities of raw or cold foods during the winter. Rather than using echinacea repeatedly, it would be better to utilize some of the deeper nourishing tonics such as astragalus or ganoderma during periods of relative health to maintain a strong immune defense. Using Echinacea Intermittently Many herbalists believe that the continual everyday use of echinacea should not be recommended. While somewhat controversial, this belief is based on two studies conducted using a homeopathic preparation and at least one other using a combination of mistletoe (Viscum album) and E. purpurea. In both studies utilizing the homeopathic preparation, it was observed that maximum increase in phagocytosis occurred at four to five days of treatment. After this, a rapid decrease in phagocytic activity was observed. Normal values returned on the 11th day.41 In the echinacea-viscum study, a normal therapeutic dose was administered, then followed by a week without any intervention. This resulted in an increase in cellular immunity via the production of lymphocytes and lymphokines. Daily administration of higher doses

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produced an immunodepressive action.42 The addition of viscum, an herb with significant biological activity, makes it difficult to interpret the results of this study. Other researchers have observed that maximum activity of echinacea occurs at day seven after echinacea has been given for five consecutive days.42 Oftentimes, when a substance is taken on a continual basis, the body becomes desensitized to its stimulus. In such cases, it may not work when it's really needed. Though herbalists differ on this point, this may be the case with echinacea. Today it is included in countless nutritional supplements that are designed for daily long-term use. It may be some time before we know if this practice compromises the effectiveness of echinacea preparations. At this point in time, I believe that the small dosages represented in most of these preparations is insignificant and will not lead to any therapeutic problems, although it is certainly contributing to the decimation of wild plant populations. I recommend that echinacea only be used acutely as needed for systemic infections or, if desired, at the first signs of a cold or flu to help knock it out. However, at the first stage of sickness, a hot cup of ginger root or peppermint leaf tea with appropriate rest and extra vitamin C will probably do the same or better. It is better to hold off using echinacea until necessary. Finding Quality Echinacea Products As early as 1893, it was reported that many different species of plants had been commonly sold as echinacea. Some of these adulterations were honest mistakes made by pickers who did not have the

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experience or knowledge to properly identify, echinacea. Others were so obviously different plants that one could only assume that the pickers were intentionally gathering other plants as a means to profit from the demand for the true herb. Such adulterations continue to be prevalent on the market today. Every health food store across the country carries a multitude of echinacea products from literally hundreds of different manufacturers. One of the duties and responsibilities of the retail staff is to assure the products they carry are manufactured in a way that ensures you will receive a high-quality product. Some retailers take this duty very seriously, while others do little research into the manufacturing practices of the various herb companies. Ask if your local store is a member of the National Nutritional Foods Association (NNFA). NNFA is the trade association for those manufacturing and selling dietary supplements. All NNFA members must adhere to a code of ethics and must participate in a ''True Label'' program by registering their products with the association. The products are then subject to be tested to verify that they are manufactured according to the appropriate Good Manufacturing Practices (GMPs). You can also find out it the manufacturer is a member of the American Herbal Products Association (AHPA). AHPA is the trade association specifically representing manufacturers of herbal products. AHPA members also adhere to a code of ethics and oftentimes manufacture their products according to GMPs which exceed those required by law. At the same time, you must use your own common sense and find a health food store whose personnel are demonstrably well-informed. Ask questions about the process used to ensure the store's products are

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quality products. Also, do not be afraid to pick up the phone and call a manufacturer's customer service department yourself. A key element to natural healthcare is for individuals to become active participants in their own healing process through educationeducation about the condition being treated, the appropriate nutritional and herbal supplements to take, the lifestyle modifications to make and the herbal products purchased.

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Echinacea Cultivation for Future Generations As the interest in medicinal plants continues to grow and as people realize the true therapeutic value of botanical medicines, plants such as echinacea will become more and more scarce in the wild. This is happening already. As little as four years ago, the roots that were being harvested were almost twice the size of those being harvested today. It takes approximately three to four years for the plant to mature before the root should be harvested. While echinacea is still plentiful in some areas, it is disappearing along roadsides where it was once prolific. Grow Your Own E. purpurea is a beautiful plant that is very easy to grow in your own garden whether as an ornamental or for the purpose of making your own medicines. Its beautiful purple flowering head is an elegant addition to a fresh or dried flower arrangement. The seeds are very easy to come by. Most every nursery carries them, sometimes under the herb's old Latin name, Rudbeckia purpurea. It is easy to germinate. Simply place the seeds in flats in the fall, cover or tamp into the soil 1/8" or 1/4" deep and keep the soil evenly

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moist until germination; then transplant. Seeds can also be planted directly into the ground in the fall and covered with straw to protect them. For a higher rate of germination, the seeds can be stratified by placing the seeds in moist peat moss or sand and putting them in the refrigerator for a few months. Once established, echinacea can be propagated by splitting the crowns as the plants come up in the spring.

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Integrating Echinacea into a Total Wellness Program It is very easy for us to be lulled into using herbs, especially an herb such as echinacea, as magic bullets to cure all of our ills. However, it is important to remember that herbalists have historically used herbs within the context of a broader therapeutic regimen which included dietary considerations and lifestyle modifications. If we reach for echinacea 10 times during the winter season in order to combat the sniffles, or if our psoriasis returns two weeks after we stop using echinacea, we have to look a little deeper to determine the underlying reasons for our imbalances. These most often will be rooted in poor diet, insufficient rest, lack of exercise and excessive stress. Each of these areas which are so vitally important to our overall health must be addressed in order for the herbs, or any medicines, to work in an optimal manner. Diet: The typical American diet is extremely unhealthy. Our overreliance on animal proteins, saturated fats, refined carbohydrates, salt and sugar have all contributed to a country whose health statistics are among the worst of any nation in the world.

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A healthy diet for those living in a temperate zone consists of a large variety of fresh vegetables, whole grains, legumes and fresh seasonal fruits along with moderate portions of fish and poultry. In the winter, many people's resistance goes down, leading to colds and flus. This is one of the primary times that people reach for echinacea. The increased susceptibility to winter illness can be minimized by maintaining a healthy diet with specific avoidance of cold, mucus-forming foods and drinks such as milk and cheeses as well as cold foods in general during the coldest months. This is especially important for children. Eating cold foods in a cold climate causes the body to work extra hard to maintain a constant 98.6° body temperature. The extra energy expended by the body would be better used to keep immune defenses up, but it is squandered in trying to counter the ice-cold fruit juices consumed straight out of the refrigerator. Many skin conditions are also associated with an overconsumption of animal fats, fried foods and refined carbohydrates. While echinacea can be effective for dealing with conditions such as psoriasis, eczema and boils, the skin will respond much more rapidly if the appropriate dietary changes are made. It is especially important in psoriasis and eczema to decrease the amount of saturated animal fats and alcohol consumed and increase the amount of essential unsaturated fatty acids either through the increased consumption of fresh vegetable oils or supplementation with oil of evening primrose, flaxseed oil or borage seed oil. Many natural health care practitioners believe that a high level of animal proteins and fat, especially from animals raised commercially with antibiotics

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and hormones, is a direct contributing factor in the development of cancer. While echinacea has been used historically for the treatment of cancer and modern research validates that it has specific antitumor properties, echinacea alone will do little to combat this disease. It has been used to help reduce infections while people undergo conventional cancer therapies, and it can be a valuable part of an overall cancer management program. However, preventing cancer is the key to treating cancer. Much better health can be expected if a healthy diet is maintained, with an emphasis on the consumption of cruciferous vegetables high in fiber and antioxidant nutrients such as vitamins A, C and E and the minerals zinc and selenium. These can also be taken in supplemental form for added antioxidant protection. Exercise: The human body has evolved with the physiological need for daily exercise. This pattern has been significantly interrupted over the past few hundred years with the industrial revolution. Pushbutton conveniences, central heating and plumbing and supermarkets have all contributed to a society which is quickly becoming physically sedentary, even though in some ways we are moving at a faster pace then ever before. Exercise increases our rate of metabolic efficiency and helps to keep organs functioning properly. Weightbearing activities preserve bone mass, combating arthritis and osteoporosis. Exercise also promotes lean muscle mass which increases energy production, thereby helping to maintain deep immune strength. It increases the elimination of toxins that

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can otherwise build up and cause chronic illness and is also a primary means of reducing stress. Proper exercise increases respiration, circulation and heart rate, yet does not leave you drained afterwards. One key principle of exercise as it relates to immune function is to elevate the core body temperature on a daily basis. Like echinacea, this can enhance phagocytosis and help to increase our resistance to external pathogens. Mental Attitude: The importance of a positive mental attitude cannot be overstated as a part of a wellness program as well as the management of cancer. Studies have shown that female cancer patients undergoing group therapy as a part of their healing program do significantly better both in the quality of life maintained and survivability than women who do not have an emotional support system. Most cancer patients and longterm AIDS survivors will tell you that a positive "never say die" attitude is the primary reason for their longevity.

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Preservation of Medicinal Plants Another integral principle of natural healing is that individual health is not separate from environmental health. The old adage that "we are what we eat" is a physical truth that we cannot avoid. Because of this, if a high level of human health is ever to be attained, we need to begin by preserving and restoring the health of our environment. This is accomplished by first respecting the plant life that shares this world with us, not just for what plants can give to us but because they have an inherent right to exist just as we do. Philosophically this is hard for legislators to swallow because clear-cutting rain forests and old-growth woodlands provides jobs and industry. In 1980, the sale of prescription drugs derived from medicinal plants was estimated to be $8 billion. In addition, the herbal market in this country has almost doubled since 1991. While other countries have been actively involved in the multi-billion dollar medicinal plant market for decades, the U.S. market has all but ignored it despite the fact that we have one of the most diverse ecosystems in the world. With recent legislation that allows for the continued trade of medicinal plants, exponential growth can be expected. However, continued loss of biodiversity through industrial development

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will continue to take its toll on this potential economic market. A fact that is little understood and even less recognized by the majority of people is that ultimately, a nation's wealth is only as great as its natural resources. Without natural resources, there is no economy. When the water, air and food become so contaminated with industrial waste that they are no longer fit for consumption, it will not matter whether we have a good auto industry or condominiums. When the natural resources necessary for sustenance run out, the quality of life as we know it will cease to exist. It does not have to be this way. Rather, we can invest in the future by developing sustainable economies such as the organic cultivation of medicinal plants can provide. There are an estimated 250,000 species of plants on earth. In comparison, there are relatively few prescription drugs in use today throughout the world. Of these, approximately 74 percent were derived from only 90 species of plants. Worldwide, only 5,000 plants have been studied scientifically, yet the overwhelming majority have been used in some useful way by humakind. Disgracefully, every hour we lose three species of plantsin a day, 75; and every year we lose 27,000 species of plants1,000 times the natural rate of species extinction. With this loss of species, human beings lose out on a vast therapeutic potential that could be used to treat life-threatening illness, prevent disease and improve our quality of life. Did one of those vanquished species include an effective therapeutic agent for Alzheimer's, diabetes, AIDS, arthritis or breast cancer? Unfortunately we will never know, as species after species disappear from the face of the earth forever.

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At the same time that echinacea is stimulating interest in medicinal plants, it is similarly playing a vital role in developing a sustainable economy for various communities around the country. In the past 10 years, echinacea has become one of the most popular herbs to grow commercially. Other medicinal plants such as ginseng, the famous longevity herb of China; saw palmetto, used for prostate enlargement; ginkgo leaves for improving mental acuity and possibly slowing the progression of Alzheimer's; and aloe vera, which is used in everything from drinks to toilet paper are also lucrative cash crops. So, while we can cultivate an herb like echinacea to support the internal functioning of the human immune system, we can also cultivate it to add to our precious natural resources.

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Conclusion Echinacea is an herb that holds within its roots, leaves, flowers and seeds a healing potential that present and future generations can rely upon if we use it appropriately, and preserve it as one of our natural resources. Other herbs can provide similar benefits for conditions and maladies which conventional medical wisdom does not have any idea how to address. We need only to take the time to educate ourselves about their marvelous and varied qualities. In doing so we not only benefit ourselves but also future generations, by respecting and preserving the largely untapped potential of nature's incredible pharmacy. Such education begins when we open our eyes and minds to the endless therapeutic potential that medicinal plants hold for usseed by seed, leaf by leaf, root by root.

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References 1. Farnsworth, N.R. Relative safety of herbal medicines. Herbal Gram, American Botanical Council, Austin, TX. Vol. 29, 1993. 2. GAO: Bulletin of the General Accounting Office. PEMD-90-15. FDA Drug Review. Post approval risks, 1990. 3. Classen, D.C., et al. Computerized surveillance of adverse drug events in hospital patients. Journal of the American Medical Association. Vol. 266, No. 20; Nov. 27, 1991. 4. Hobbs, C. EchinaceaThe Immune Herb. Botanica Press, Santa Cruz, CA. 1990. 5. Gilmore, M.R. Annual Report #33, Smithsonian Institution Bureau of American Ethnology, 1919. 6. Kindscher, K. Ethnobotany of Purple Coneflower (Echinacea angustifolia, Asteraceae) and Other Echinacea Species. Economic Botany, 43(4), 1989. 7. Foster, S. Echinacea: Nature's Immune Enhancer. Healing Arts Press, Rochester, Vermont, 1991. 8. Bauer, R.; Wagner, H. Economic and Medicinal Plant Research. Volume 5. Academic Press; 1991. 9. Lloyd, J.U. Echinacea, Lloyd Brothers, Cincinnati, Ohio 1923. 10. Lloyd. J.U. A Treatise on Echinacea, Lloyd Brothers, Cincinnati, Ohio 1917. 11. Stevens, J.V. Echinacea: Annual of Eclectic Medicine and Surgery, Vol. III, 1892.

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12. Couch, J.F.; Giltner, T. An experimental study of Echinacea therapy. Am. Jour. Pharm. March, 1921. 13. Beal, J.H. Comment to the paper by Couch and Giltner ''An experimental study of echinacea therapy.'' Am. Jour. Pharm. March, 1921. 14. Facino, R.M., et al. Echinacoside and caffeoyl conjugates protect collagen from free radical-induced degradation: a potential use of echinacea extracts in the prevention of skin photo-damage. Planta Medica, volume 61 no. 6: 510514, 1995. 14a. Paranich, A. V. et al. Effect of supposed radioprotectors on oxidation reduction of vitamin E in the tissues of irradiated rats. Radiata Biol. Radioecol. Sept.-Oct.; 33(5): 653657, 1993. 15. Steinmuller, C., et al. Polysaccharides isolated from plant cell cultures of Echinacea purpurea enhance the resistance of immuno-suppressed mice against systemic infections with Candida albicans and listeria monocytogenes. Int. Journal of Immuno-Pharmacology, 15 (5): 605614, July 1993. 16. Meissner, V.F.K. Experimental studies of the mode of action of a herba recens Echinaceae purpureae on skin flap. Arzneimittelforschung Drug Res. 37(1), Nr. 1, 1987. 17. Dweck, A. Literature review of echinacea species plants. Medicinal plant database: Internet, 1996. 18. Tragni, E. et al. Evidence from two classic irritation tests for an anti-inflammatory action of a natural extract, Echinacien B. Food Chemical Toxicology, 23(2): 317319, Feb. 1985. 19. Tubaro, A., et al. The anti-inflammatory activity of polysaccharide fraction (EPF) from Echinacea angustifolia roots. Journal of Pharmaceutical Pharmacology; 39(7), 1987. 20. Tragni, E., et al. Anti-inflammatory activity of Echinacea angustifolia fractions separated on the basis of molecular weight. Pharmacol. Res. Commun.; 20 Suppl. 5: 8790, 1988.

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21. Kinkel, H.J., et al. Objective demonstration of the effects of echinacein ointment on wound healing. Med. Klin., 79, No. 21: 580583, 1984. 22. Hill, N.; Stam C.V. The efficacy of prrrikweg gel in the treatment of insect bites: a double-blind placebocontrolled clinical trial. Pharm. World. Sci. 18, No. 1: 3541, 1996. 23. Selvanayagam, Z.E., et al. Plants with antisnake venom activitya review on pharmacological and clinical studies. Fitoterapia, 65, No. 2: 99111, 1994. 24. Wildfeuer, A.; Mayerhofer, D. The effects of plant preparations on cellular functions in body defenses. Arzneimittelforschung, 44(3): 361366, Mar. 1994. 25. Samochowiec, E., et al. Evaluation of the effect of Calendula officinalis and Echinacea angustifolia extracts on Trichomonas vaginalis in-vitro. Wiad. Parazytol. 25(1): 7781, 1979. 26. Leuttig, B. Macrophage activation by the polysaccharide arabinogalactan. Journal of National Cancer Institute, 3;81 (9): 669675, May 1989. 27. Bauer, R., et al. Immunologic in-vivo and in-vitro studies on echinacea extracts. Arzneimittelforschung, 38(2): 276281, Feb. 1988. 28. Jakic, B.M., et al. In-vitro inhibition of cyclooxygenase and 5-lipoxygenase by alkamides from echinacea and achillea species. Planta Medica, 60(1): 3740, 1994. 29. Facino, RM., et al. Direct characterization of caffeoyl esters with antihyaluronidase activity in crude extracts from Echinacea angustifolia roots by fast atom bombardment tandem mass spectrometry. Farmaco, 48(10): 14471461, Oct., 1993. 30. Bauer, R. Recent findings in the search for anti-inflammatory constituents from plants. Second international symposium on innovations in pharmaceutical science & technology. Ahmedabad, India, 1994. 31. Cantekin et al. Antimicrobial therapy for otitis media with effusion (secretory otitis media), Jour-

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nal of the American Medical Association, Vol. 266, No. 23, Dec. 18, 1991. 32. Braunig, B., et al. Echinacea purpurea radix for strengthening the immune response in flu-like infections. Zeitschriftfur Phytotherapie 13: 713, 1992. 33. Willigmann, D., et al. Chemical and immunological properties of the immuno-modulatory active compounds from the roots of different Echinacea species. Planta Medica, 59, (supplemental issue) 1993. 34. Bodinet, C., et al. Host-resistance increasing activity of root extracts from echinacea species. Planta Medica, 59 (supplemental issue), 1993. 35. Bauer, R.; Foster, S. Analysis of alkamides and caffeic acid derivatives from Echinacea simulata and E. paradoxa roots. Planta Medica Oct.; 57(5): 447449, 1991. 36. Bauer, R. Personal communications; Lindenmaier, 1995. 37. Gladstar, R. Herbal Healing for Women. Simon and Schuster, New York, 1993. 38. Felter, H.W. The Eclectic Materia Medica, Pharmacology and Therapeutics. Eclectic Medical Publications, Portland, OR. Reprint of 1922 edition, 1985. 39. Mengs, U., et al. Toxicity of Echinacea purpurea. Acute, sub-acute, and genotoxicity studies. Arzneimittelforschung, 41(10): 10761081, Oct. 1991. 40. Parnham, M.J. Benefit-risk assessment of the squeezed sap of the Purple Cone Flower (Echinacea purpurea) for long-term oral immuno-stimulation. Phytomedicine, 3(1): 95102, 1996. 41. Wagner, H., et al. Influence of homoeopathic drug preparations on phagocytic activity of human granulocytes/in-vitro tests and controlled single-blind studies. Arzneimittelforschung 36 (II), (9), 1986. 42. Coeugniet, E.G.; Elek, E. Immuno-modulation with Viscum album and Echinacea purpurea extracts. Beilage zur Zeitschrift ONKOLOGY: 2733, 1987. 43. Bukovsky, M., et al. Testing for immuno-modulat-

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ing effects of ethanol-water extracts of the above ground parts of the plants echinacea and rudbeckia. Cesk Farm 42(5): 228231, Oct., 1993. 44. Moser, J. Echinacea and a spurious root that appeared in the fall of 1909. Am. Jour. Pharm., May, 1910. 45. Kindscher, K. Medicinal Wild Plants of the Prairie. University Press of Kansas, Lawrence, Kansas, 1992. 46. Drew, M.B.; Clebsch, E.E.C. Studies on the endangered Echinacea tennesseensis (Asteraceae): plant community and demographic analysis. Castanea 60(1): 6069, 1995. 47. Stoll, A., et al. Antibacterial substances 11. Isolation and constitution of echinacoside, a glycoside from the roots of Echinacea angustifiblia. Helvetica Chem. Acta. 33, 1950.

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Resources Books for Further Reading Echinacea: Nature's Immune Enhancer by Steven Foster. Healing Arts Press, Rochester, Vermont, 1991. Echinacea: The Immune Herb by Christopher Hobbs. Botanica Press, Santa Cruz, CA, 1990. Medicinal Wild Plants of the Prairie by K. Kindscher. University Press of Kansas, Lawrence, Kansas, 1992. To Obtain Echinacea Seeds Abundant Life Seed Foundation, P.O. Box 772, Port Townsend, WA 98368. Associations American Association of Acupuncture and Oriental Medicine 4101 Lake Boone Trail, Raleigh, NC 27607. Tel: (919)787-5181. American Association of Naturopathic Physicians, 2366 East Lake Avenue. Seattle, WA 98102. Tel: (206)3237610. American Botanical Council (ABC), P.O. Box 201660, Austin, IX 78720. Tel: (512)331-4244. American Herbalists Guild, P.O. Box 746555, Arvada, CO 80006-6555. Tel: (303)423-8800. American Herbal Products Association, P.O. Box 30585, Bethesda, MD 20824. Tel: (301)951-3204. Herb Research Foundation, 1007 Pearl Street, Boulder, CO 80302. Tel: (303)449-2265.

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Index A abscesses, echinacea for, 14 acne, echinacea for, 31 acquired immune deficiency syndrome (AIDS), 3233, 34 echinacea for opportunistic infections, 20, 33, 34 alcohol extract (tincture), echinacea, 46-47, 49-50 alkaloids in echinacea, 30 alkymide fractions, 29 aloe vera, popularity of, 78 alterative herb, echinacea as, 30-31 Alzbeimer's disease, ginkgo for, 78 American Herbal Products Association, 63 American Dispensatory, 14 amoxicillin, ear infections and, 36 anaesthetic use of echincea, 9-10, 26 animal products, antibiotics in, 37 animal studies, validity of, 34-35 antibiotic, echinacea as natural antibiotic, 35-38 antibiotic drugs consumption of through meat, 37 drug-resistarit pathogens and, 36 overuse of, 35-36 side effects of, 36 antibodies, echinacea and, 27 antioxidant nutrients, HIV/AIDS and, 34 antiseptic washes, 24, 61 arthritis, prostaglandins and, 29 associations, recommended, 85-86 Asteraccae, composite family, 64 asthma, inhalator solution for, 61

astragalus, 65, 66 B baptisia (wild indigo), echinacea and, 57 Bauer, Rudolf, 30 bedsores, echinacea for, 24 formulas for, 57-58, 61 bites, echinacea for, 9, 61 black root, traditional name for echinacea, 11 black Sampson, traditional name for echinacea, 11 blood poisoning, echinacea for, 14 blood purifier, alterative herb, 30-31 boils, echinacea for, 14, 31 books, recommended, 85 Botanical Safety Index (BSI), 63 breastfeeding, importance of, 37 bronchitis, inhalator solution for, 61 brown recluse spider bites, echinacea for, 55 bruises, echinacea salve for, 52 burns, echinacea for, 9, 23, 51-52, 61 C caffaric acid, 29 caffeic acid derivatives, 22 caffeine more toxic than echinacea, 63 calendula blossoms, 60 echinacea salve ingredient, 52 cancer echinacea for opportunistic infections, 20 ovarian, echinacea tincture for, 13-14 preventing through diet, 74 Candida albicans, candidiasis, echinacea for, 24, 26-27, 33-34, 61 canker sores, formula, for mouthwash, 61 capsules, echinacea, 45-46, 49 size of, 49 vegetarian, 49

CD4s, T-lymphocytes, 32 cervical dyplasia, formula for, 58 Cheyenne Uibc, use of echinacea by, 9 chicoric acid, 29 children babies' use of echinacea, 60 immune systems of, 37-38 inner ear infections and, 36 recommended achinacco dosages, 53-54 chlorogenic acid, 29-30 Clark's rule (recommended dosages for children), 54 colds and flu alternative herbs for, 67 diet for, 73

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colds and flu (continued) echinacea for, 9, 20, 38-39, 58 increasing resistance to, 73 collagen, 21 Comanche tribe, use of echinacea by, 9 comb flower, traditional name for echinacea, 11 coneflower, traditional name for echinacea, 11 conjunctivitis, eyewash for, 61 Conners. Leah Lischner, 16-17 copperhead snake bite, echinacea for, 56-57 cortisone, echinacea similar to, 29 cosmetics, echinacea in, 24 coughs, echinacea for, 9 Cowling's rule (recommended dosages for children), 54 Crow tribe, use of echinacea by, 9 cuts, formula for antiseptic wash, 61 cyclooxygenase, 29, 30 cynarin, 29 D Dakota Sioux tribe, use of echinacea by, 9 decoction (simmered tea), 44-45, 48-49 Department of Agriculture (USDA), 15 detoxification, echinacea and, 20 di-calcium phosphate, excipient in capsules, tablets, 46 diabetes, echinacea for leg ulcers, 24 diaphoretic herb, 38 diet, 72-73 dosages, recommended, 39, 53 douche, echinacea, 26-27 drugs, pharmaceutical or prescription annual deaths caused by, 6 antibiotics, overuse of, 33-36

common side effects of, 6 50 percent have undocumented side effects, 6 herbs and, a comparison, 4-6 prescription, plant sources of, 3 safety of, 4-6 side effects of, 6 E ear infections antibiotics and, 35 formula for, 60 inflammation, echinacea for, 30 echinacea, all species actions of, 31 adulteration problem 67-68 alcohol extracts, 46-47, 49-50, 53 allergic reaction to, 64-65 anesthetic properties of, 9-10, 26 anti-inflammatory activity of, 28-30 antibiotic properties of, 35-38 antimicrobial action of, 31-32 Author's favorite preparations, 43 author's introduction to, 16-17 echinacea, all species (continued) babies' use of, 60 caffeine more toxic than, 63 capsules, 45-46, 49 cautions regarding use of, 64 children, recommended dosages for, 53-54 clinical trials involving, 23-24, 25, 39 commencial preparations of, 44-47 common names of, 11 cortisone-like activity of, 29 desensitization to, 67 early European uses of, 10-11

Eclectic medicine and, 12-15, 28, 62 external application of, 21, 24-26, 51-52 German use of, 19-20 glycerite, recommended dosage of, 53 history of name, 7, 11 immune system and, 19, 20 injectable preparations, 41, 63, 65 intermittent use of, 66-67 leaf juice, 41, 44, 53 limitations of effectiveness, 65-66 maximum activity dosage, 67 medicinal effects of, 19, 20 medicinal parts of, 41-43 medicinal uses of since 1852, 15-16 misidentification of, 63 most medicinal species controversy, 40-43 most popular plant used by Eclectic physicians, 14 numbing effects of, 9-10 ointment, success rates of (table), 25 overdose symptoms, 62-65 overuse of, 39 polysaccharides in, 28, 38, 41-42, 63 potency of, 26 powders, 26, 45-46, 49, 53 preparations, adding flavors to, 51 preparations, how to make, 48-52 preparation, recommended of, 39, 53 products, shelf life of, 45-47, 50 quality of, 67-69 roots most medicinal after 4 years, 7 safety of, 62-65 seed head used as hair comb, 10 seed source, 85 seeds chewed to relieve thirst, 10 seeds, germination of, 70-71

species of, 40-42 tablets, 45-46 taste of, 7-8 teas, 44-45, 53 tinctures (alcohol extracts), 39, 46-47, 53 traditional Native Amencari uses of, 9-10, 28 wash for wounds, 26 Echinacea angustifolia, 7, 11, 13, 19, 24, 28, 29, 30, 31, 40-42 Echinacea atrorobens, 42 Echinacea pallida, 7, 11, 28, 40-42, 64

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Echinacea paradoxa, 42 Echiwcea purpurea, 7, 8, 11, 19, 23, 24, 28, 31, 39, 40-42, 63, 66 how to grow, 70-71 ointment, 23, 25 Echinacea Plus tea, 45 Echinacea simulata, 42 Echinacea tennesseensis, 42 Fchinacein B, 24 echinacoside content of powders, 46 Eclectics American Medical Association and, 15 echinacea and, 12-15, 28, 62 Eclectic Medical Journal, 14 eczema, echinacea for, 23, 31 elder flower, diaphoretic tea, 38 emphysema, inhalator solution for, 61 epididymis inflammation, echinacea for, 30 Encherichia coliform (E. coli) bacteria, echinacea and, 32 Everclear alcohol, 50 excipients used in tablets, 46 exercise, importance of, 74-75 extracts, echinacea alcohol, 46-47, 49-50 leaf juice, 41, 47 eyewash, formula for, 61 F Farnsworth, Norman, 5 Felter, Harvey Wickes, 62 fever, echinaces for, 14, 38-39, 58 fibroblasts, echinacea and, 21 5-lipoxygenase, 29, 30 Flora Virginica, 10

flu, echinacea for, 9, 20, 38-39, 58 Food and Drug Administration (FDA), 3, 17 Formula I, 57 Formula II, 57-58 formulas, additional: see recipes G gangrene, gangrenous sores, treatment of, 14, 26 ganoderma (reishi mushroom), 65, 66 garglic, formula for, 61 garlic, popularity of, 38 General Accounting Office, 6 genito-urinary tract inflammation, echinacea for, 30 Germany Commission E, 32, 63, 64 echinacea products in, 19-20 ginger root, 52, 67 gingivitis, formula for mouthwash, 61 ginkgo, popularity of, 78 ginseng, popularity of, 38, 78 Gladstar, Rosemary, 59 glands, swollen, echinacea for, 9 glycerites (glycerine extracts), 47, 50-51 goldenseal, scarcity of, 55 gonorrhea echinacea used for, 10 Good Manufacturing Practices (GMPs), 68 Gronovius, 10 H hemorrhoids, formula for antiseptic wash, 61 herbs, medicinal common side effects of, 5 and drugs, a comparison, 4-6 history of, 1-2 organizations, 86 products, how to make, 48-53, 85

safety of, 4-6 toxicity of, 5 Heron, Silena, 59 herpes simplex, echinacea for, 23, 31 HIV/AIDS: see acquired immune deficiency syndrome (AIDS) hives, echinacea for, 31, 61 homeopathy, use of echinacea by, 19 horses, saddle sores on, echinacea used for, 10-11 hyaluronidase, hyaluronic acid, 21, 29 I immune system echinacea and, 19, 20 factors that compromise, 37 formula for, 58 immune-enhancing herbs, 65 Immune Support Tea, 59 Immuni-Tea, 45, 55 infections formula for, 57-58 opportunistic, echinacea and, 22 respiratory, formula for, 58 systemic, echinacea for, 30 inflammation, echinacea for, 14, 20, 29-31 inflammatory skin conditions, echinacea ointment for, 23 influenza: see flu infusion (steeped tea), 44-45, 48-49 interferon, echinacea and, 28 interleukin, echinacea and, 29 irritable bowel syndrome, prostaglandins and, 29 isobutylamide fractions, 29, 43 itching, formula for antiseptic wash, 61 J Journal of the American Medical Association, 36 K

Kansas snake root, 63 King, John, 12-14 Kiowa tribe, use of echinacea by, 9 Kneipp, Father Sebastian, 18-19 Kuppfer cells, 27-28, 31 L Lakota tribe, use of echinacea by, 9 laryngitis, formula for gargle, 61 Lischner, Hyman, 16

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Lishmania enrietia, 28 listeria infection, echinacea for, 24 Lloyd, Curtis Gates, 13 Lloyd, John Uri, 12 Lust, Benedict, 18-19 lymph glands, swollen, HIV/AIDS and, 34 lymphocytes, echinacea and, 27 M macrophage activity, echinacea and, 27, 65 magnesium stearate, excipient in capsules, tablets, 46 Marx. Brigitte, 55 mastitis, formula for antiseptic wash, 61 Mavor, Sunny, 60 measles, echinacea for, 10, 14 Medical Flora, 11 medicinal plants, preservation of, 76-78 meningitis, echinacea for, 14 mental acuity, ginkgo for, 78 mental attitude, importance of, 75 Meyer, H.C.F., 12-14 Meyer's Blood Purifier, 12 microbes, pathogenic, echinacea and, 31 migraine headache, prostaglandins and, 29 mistletoe, 66-67 mononucleosis, formula for, 58 mosquito bites, echinacea for, 24 mouthwash, formula for, 61 mumps, echinacea used for, 10 muscular pain, echinacea for, 9 myrrh, 60 N narrow leaved echinacea: see Echinacea angustifolia

National Formulary of the United States, 16 National Nutritional Foods Associaties (NNFA), 68 Native American uses of echinacea, 9-10, 28 Nature Cure, 18-19 nervous disorders, prostaglandins and, 29 nose inflammation, echinacea for, 30 O Obdisocothera barbulis pallide rubentibus, 11 Ogiala Sioux, use of echinacea by, 10 Ohio State Board of Medical Examiners, 15 oil infusion of echinacea, 51 ointment, echinacea, 23, 24, 25 Omaha tribe, use of echinacea by, 9 Oregon grape root, 60 organizations, recommended, 85 osha, echinacea and for sure throats, 55 oxidative stress, AIDS and, 33 P Parthenium integrifolia (prairie dock), 63 pathogens, drug-resistant, 36, 37 Pawnee tribe, echinacea used in children's game, 10 pelvic inflammatory disease, echinacea for, 30 penicillin, 36 peppermint diaphoretic tea, 38 tea for colds, flu, 67 PGE2 prostaglandins, 29 phagocytosis, echinacea and, 21, 22, 28, 65 phyto-chemicals, 19 plants, medicinal, preservation of, 76-78 poison ivy, forrimla, for antiseptic wash, 61 polysaccharides in echinacea, 28, 38, 41-42, 63 Ponca tribe, use of echinacea by, 9 poultice, fresh root, 9, 56

powders, echinacea, 45-46, 49 prairie dock, 63 prostaglandins, 29 prostate enlargement, inflammation saw palmetto berry for, 78 echinacea for, 30 pseudomonas, echinacea and, 32 puncture wounds, treatment of, 26 purple coneflower, traditional name for Echinacea purpurea, 11 R rabies, echinacea for, 14 radiation poisoning, echinacea for, 33-34 radiation therapy, echinacea and, 22 Rafineque, Constantine, 11 rattlesnake bite, echinacea for, 9, 13, 24 recipes antiseptic wash, 61 Ed Smith's Flu Drops, 59 eyewash, 61 Formula I, 57-58 Formula II, 58 glycerin extract for ear infections, 60 mouthwash/gargle, 61 Rosemary Gladstar's Immune Suppon Tea, 59 throat infection formula, 59 vaginal douche, 61 red sun Rower, traditional name for echinacea, 11 reishi mushroom, 65, 66 resources, 85-86 respiratory congestion, formula for, 58 Rudbeckia purpurea, 15, 70 S saddle sores on horses, echinacea used for, 10-11 salve, echinacea, how to make, 51; see also ointment

saw palmetto berry, popularity of, 78 scrapes, formula for antiseptic wash, 61 sesquiterpenes, 63 Sherman, S.M., 15

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skin conditions, diseases diet and, 73 echinacea for, 9, 21-27 Smith, Ed, 16 snake root, traditional name for echinacea, 11 snakebite, echinacea for, 14, 56-57 sore throat, formulas for, 58, 61 sores, weeping, echinacea for, 14 spider bites, echinacea for, 55 stings, echinacea for, 9, 61 streptococcus, echinacea and, 23, 25, 36 sunburn, echinacea and, 22 sweating, diaphoretic tea induces, 38 syphilis, echinacea for, 10, 14 T T-lymphocytes, echinacea and, 21, 32-33 table: effects of ointment on skin disorders, 25 tablets, echinacea, 45-46 excipients used in, 46 simple test for quality, 46 tea (infusion, decoction), echinacea, 44-45, 48-49, 55 throat inflammation, infection, echinacea for, 30, 58 thrush, formula for mouthwash/gargle, 61 thyme, essential oil of, echinacea salve ingredient, 52 Tierra, Michael, 16 tincture, alcohol extract, echinacea, 46-47, 49-50 best quality, 47 recommended dosage of, 39, 53 tonsillitis, echinacea for, 9, 61 toothache plant, traditional name for echinacea, 11 toothache, echinacea for, 9, 10 Traditional Modicinals, 45

Transactions of the American Medical Association, 15 trichomonas, echinacea for, 24, 26-27, 32, 61 tuberculosis, echinacea used for, 10 tumor necrosis factor (TNF-a), 34 U U.S. Department of Agriculture (USDA), 15 U.S. food and Drug Administration (FDA), 3, 17 U.S. General Accounting Office, 6 ulcers, varicose, echinacea ointment for, 23 ultraviolet light damage, skin, echinacea and, 22 Uni-Tea, 45 University of Illinois College of Pharmacy, 5 urinary tract infection, echinacea for, 30 V vaccination early, hazards of, 37-38 echinacea may prevent side effects of, 38 vaginal douche, 61 vaginal yeast infection (candidiasis), echinacea for, 24, 26-27 varicose ulcers echinacea ointment for, 23 antiseptic wash, 61 varicose veins, echinacea for, 24 viruses, formula for, 58 Viscum album (mistletoe), 66-67 vitamin E redox system, 34 W water extract: see tea Webster, H.T., 14 wellness program, 72-75 Wilcox, Imodene, 16 wild indigo (baptisia), 57 Winston, David, 57 World Health Organization, 6

wounds, echinacea for, 21-27, 52 Y Yance, Donald, 57 yarrow flower, diaphoretic tea, 38 yeast infection candidiasis, 24, 26-27, 33-34 vaginal, douche for, 61

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