Herbal Antibiotics: Natural Alternatives for Treating Drug-Resistant Bacteria (14 page)

The authors of this study tested both aqueous (water) and ethanolic (alcohol) extracts of the plant—essentially infusions and tinctures—to see which were most effective. Most plants are used by indigenous cultures as water infusions (strong teas) or in whole form of one sort or another, either eaten or placed directly on the affected area of the body. Some cultures do use simple alcohol extractions. Of the active ingredients in plants, some are soluble in water, some in alcohol, and the researchers clearly wanted to find out which form of preparation was the most effective for this plant. It's
usable
information they were after. And they found it. They came to
Sida acuta
by looking at what traditional healers and herbalists in Nigeria were
using in their practice and they decided to test it for activity. If it was effective they wanted to find out how it was
most
effective. And they planned then on supporting the use of that plant widely throughout Nigeria to enhance their country's health care system. Nothing could be more alien to the medical establishment in the United States.

To be fair, there are some good studies occurring in the United States, but to be clear, virtually
none
of them support the use of herbal medicines by the general populace or even by educated herbal practitioners. Their focus, rather, is on the identification of an “active” constituent that can then be modified chemically, patented, and subsequently produced by a pharmaceutical company for profit. U.S. researchers, in spite of often being affiliated with universities, generally work for or in concert with pharmaceutical companies. They are not looking for something the general populace can use without a prescription; they are not working to empower self-care. In most instances they don't trust the general populace to be intelligent enough to provide their own health care, nor do they want to interrupt their own financial income stream.

We in the Western world, especially in the United States, are being left behind in an outmoded model that has no effective place in the real world. By the time we realize it, the rest of the world will be generations ahead. The rest of the world has abandoned our approach; they understand the problems they face and what lies ahead. In the meantime, we spend our time making better and better buggy whips, not realizing the automobile really is here to stay.

To find the top herbs that can be effectively used for treating antibiotic-resistant organisms, I have relied on decades of my own experience, the cumulative experience of a great many other practitioners, many thousands of journal papers of very good research by
committed researchers from many countries around the world, and the history of use of these plants by local peoples over centuries.

I have put the herbs in this book into three categories: systemic antibacterials, localized antibacterials, and facilitative or synergistic herbs.

Systemic antibacterials
are herbal medicines that are broadly systemic, that are spread by the bloodstream throughout the body, thus affecting every cell and organ within the body, and that are active against a range of bacteria. These herbs are good for treating infections such as MRSA that have spread throughout the body and are not responding to multiple antibiotic protocols.

Localized antibacterials
are those that do not spread easily throughout the body but are limited in their movement. Because they don't easily cross membranes, they are effective in the GI and urinary tracts and for external infections. These kinds of herbs are useful for infections such as
E. coli
O157:H7 or cholera or for infected skin wounds that refuse to heal.

Facilitative or synergistic herbs
are just that: plants that facilitate the action of other plants or pharmaceuticals. They either enhance the action of the antibacterial being used or affect the bacteria so that the antibacterial is more effective. Most plants contain both antibiotic substances
and
a potent synergist, quite often one or more efflux inhibitors. Goldenseal, which contains berberine, is an example.

Berberine, a strong antibacterial, is very active against a number of resistant organisms. It is considerably more active, however, in the presence of another constituent in goldenseal, 5′-methoxyhydnocarpin (5′-MHC), which is a multidrug efflux pump inhibitor. It reduces or eliminates MRSA's ability to eject antibiotic substances that might harm it from inside its cellular membrane. 5′-MHC has no known function other than to do exactly this, and it is one of the reasons goldenseal is so effective in the treatment of resistant infections of the GI tract.

Compounds such as 5′-MHC are why plants are often more effective than single constituents in treating disease conditions. Other
compounds in plants do still other things; some have no known function in the plant other than to reduce the side effects of the more pharmacologically active constituents. This is one of the reasons plants tend to be strange medicines in the minds of medical reductionists—they can't understand that kind of complexity or see the reason for its existence. Nevertheless, newer generations of researchers have grasped that the old paradigm is unworkable and they are looking toward plants with new eyes. They are understanding that plant medicines are much more sophisticated than pharmaceuticals (something those in older cultures innately understand).

As some specific examples: The anticonvulsant actions of yangonin and desmethoxyyangonin, kavalactones found in
Piper methysticum
, are much greater when the lactones are used in combination with other kava constituents. Concentrations of yangonin and another lactone, kavain, are much higher in the brain when the whole plant extract is used rather than the purified lactones themselves. In other words, some of the other constituents in kava help move the bioactive lactones across the blood-brain barrier into the brain. Blood plasma concentration of kavain is 50 percent less if the purified compound is used rather than an extract of the plant itself. Plant compounds in
Isatis tinctoria
, a potent antiviral and anti-inflammatory herb, are highly synergistic. Tryptanthrin, a strong anti-inflammatory in the plant, possesses very poor skin penetration capacity. However, when the whole plant extract is applied to the skin, penetration of tryptanthrin is very good. In other words, applying a salve of pure tryptanthrin to the skin, despite how anti-inflammatory that compound is, won't do you much good. But if you make the plant itself into a salve, the tryptanthrin moves rapidly into the skin and helps reduce skin inflammation.

Artemisinin is much more active against malarial parasites if administered with artemetin and casticin, flavonoids normally contained in the artemisia plant. Additional flavones in the plant, chrysophlenetin and chrysospenol-D, also act as potent synergists in this way. They are also permeability glycoprotein (P-gp) inhibitors (see
monograph on piperine,
page 236
), thus facilitating the movement of artemisinin and the plant's other constituents through the intestinal membrane and into the blood.

As a final example, side effects such as tinnitus and stomach ulcers that can occur from the use of acetylsalicylic acid don't occur if whole extracts of willow bark are given rather than that purified constituent; other compounds in the plant specifically ameliorate its side effects.

When it comes to plant combinations, things get even more complex. For example, constituents from licorice (glycyrrhizin and its related compounds) significantly enhance the solubility of other plant compounds, such as the saikosaponins from Asian ginseng, in water. Thus, combining plants
during the medicine-making process
—a field almost completely unexamined in Western herbal approaches—can produce much stronger tinctures than when they are produced singly.

Quercetin (an anti-inflammatory and moderate anticancer flavonol found in many plants and vegetables) is poorly soluble in water, but that solubility is strongly enhanced by complex mixtures of saponins if plants containing them are added to the mix when the medicine is being made.

So … while some plants such as goldenseal are synergistic within themselves from the presence of efflux inhibitors and potent antibacterial constituents, other plants, such as
Dalea spinosa
, are relatively mild as antibacterials but contain compounds that are multidrug resistance (MDR) inhibitors, making them synergists for other plants. Adding synergists to a systemic antibacterial when creating an herbal compound increases the potency of the primary herb being used, sometimes considerably. (This has long been recognized in the actions of such plants as licorice and western red cedar, though the reasons
why
were not known.)

Synergists, while known throughout herbal history, have been only mildly recognized for their actions, usually in the Chinese and Ayurvedic systems, but they have not been accepted as a legitimate
and unique category of herbal medicines that should be studied in their own right. Given the seriousness of emerging resistant pathogens, it is time to begin developing this category of herbal medicines in more depth, to begin to understand how to use them in practice, and to find the most potent ones that can be used for healing. The material in this book is, I hope, the beginning of that development.

I remember, growing up, how often the physicians in my family made fun of the old plant doctors and herbalists insisting that some plants must be harvested only at such and such a time or they would be too weak to work or their insistence that certain plants must be used together to work. Turns out there is a great deal to those old assertions. So … considerable attention is paid within this book to
how
and
when
the plants should be harvested, prepared, and made into medicine.

There are other complexities that come into play when it comes time to actually make your plants into medicine. There is a synergy between the plant and the medium in which it is extracted. Regrettably, there has been an unfortunate lack of attention paid to this in much of the world, especially among us American herbalists. For example: The word
alkaloid
means
alkaline-like
, a clue that has been overlooked in every herbal preparation manual I have read over the past 30 years. In practical terms: Plant alkaloids won't extract easily in alkaline waters; they need more acidic waters to do so. Extracts of plants with highly bioactive alkaloids increase in strength if the plants are extracted in liquid mixtures that are at least minimally acidic. The water being used to make extracts (tinctures and infusions) needs to be “soft,” or else an acid such as vinegar needs to be added in minimal amounts to make it so (see box,
page 92
).

Understanding these kinds of complexities in plants and the medicines they become comes from long exposure to them, from the same kind of intuitive sensing (holistic nonlinear perception) that all artisans use (in things from writing to house building to making music), and, most importantly, from a lack of intellectual hubris. If you
understand up front that plants are highly complex living beings that are a great deal older than the human species, it is much more difficult to place an intellectually reductionistic paradigm on them.
You can't see what you assume is not there.

Herbalism is an art; it is, and always will remain, much too complex to be approached from a reductionist and linear orientation with any expectation of success. “Phytorationalism” is an oxymoron. A practitioner with such an orientation will never grasp the essential nonlinearity of the world, of healing, of plant medicines.

The synergy within and among plant medicines, a prime example of the nonlinear complexity in this field,
means
that the combined effect of different substances will be greater than that which can be expected from the individual components alone. Combination produces outcomes beyond rational expectation. To face the challenges before us, we ourselves have no choice but to synergize within ourselves: to develop our abilities to feel and think
simultaneously
, neither in competition with the other, and blend those capacities together into a unique perceptual tool of tremendous elegance. I am talking about developing forebrain elegance here, not just tentative understandings of the hindbrain. As Erich Fromm once commented: “Reason flows from the blending of rational thought and feeling. If the two functions are torn apart, thinking deteriorates into schizoid intellectual activity and feeling deteriorates into neurotic life-damaging passions.”
³

Our epitaph [as a species] may well read: “They died of a peculiar strain of reductionism, complicated by a sudden attack of elitism, even though there were ready natural cures close at hand.”

—Gary Paul Nabhan,
Cultures of Habitat

Most herbalists,
irrespective of culture or country, do know of the antibacterial activity of plants and they do use them to heal bacterial disease on a regular basis, but, in general, our understanding of herbal antibiotics has been thin. By
thin
I mean we've been stuck in a paradigm of “take this for that” or “what's that plant good for” or even (among the reductionist herbal schools that have adopted the medical model; that is, the phytorationalists) “the active constituent of
Hypericum perfoliatum
should be standardized in order for the plant to be effective in the treatment of mild depression.” Given the seriousness of the emerging bacterial diseases, we need to have a more comprehensive paradigm in place, one that takes into account the potential sophistication of herbal medicine as a very ancient art form of healing, one that uses both perceptual and intellectual awareness, as well as a focus on outcomes, in its expression.