California Poppy: A Clinical Perspective by Benjamin Zappin

California Poppy (Eschscholtzia californica) is a plant near and dear to the hearts of SIBM and to any herbalist who has taken time to establish a relationship with this predictably efficacious medicinal ally. Upon learning of, and experiencing it’s medicinal virtues, it is difficult to observe this plant in the wild or in a garden without feeling its calming effects on the spot.

The purpose of this writing is not to present a comprehensive monograph of California Poppy (this will be done is the second half of our Integrating Western Herbs into Chinese Medicine: Materia Medica series), but to highlight a few applications that are worth integrating into one’s personal herbal exploration and into one’s clinical practice. I also aim to give some contrasting perspectives on dosing as there are many ways of viewing one plant as an individual herb or part of a developed system of herbal application.

A favorite illustrative experience for me with this plant happened to me one day sitting in bumper to bumper traffic feeling urgent about getting to somewhere that seemed important to me at the time. My mind started racing with vitriolic rage at the drivers who were obstructing me from my destination and as a reflex (read oral fixation) I reached for the 1 oz tincture bottle by the gear shift and took a mere few drops of whatever it was. A few minutes later I caught myself aware that my frame of mind was profoundly serene, noticing the pleasant weather, and singing along to the radio without having to turn it up to drown my thoughts. This showed me that this herb can be very effective at lower drop doses, which I always welcome as it challenges my “more is better” perspective/complex.  I continue to recommend this herb in low doses to people with repeated success in addressing agitated, irascible states of mind and find it a profound tool for effecting shifts, often in just the right moment, thus coining it a favorite ‘road rage’ herb.

Another common application for me is to employ California Poppy either as a single herb or in formula for children. Extracted in glycerin, the bitterness becomes tolerable and this simple and safe herb predictably relaxes tension and quiets mental agitation while facilitating restful sleep. For irritability and difficulty focusing I combine it with Lemon Balm (Melissa officianalis) and Catnip (Nepeta cataria) and will increase the dosage in combination with the same herbs to help a child sleep, and it is to be considered in cases where nightmares or frightfulness ensue as well as scenarios where the nervous system is agitated due to too much stimuli. I usually start with a dropper of the glycerin tincture of these herbs to substantial effect. From an energetic perspective, this is utilizing the bitter, slightly acrid, and cooling nature to clear heat from the heart and quiet the spirit. This can also be employed in liver-gallbladder constraint scenarios where the heat ascends and creates heart vexation. The bitterness drains fire from the heart and liver and the acridity resolves liver-gallbladder constraint.

While my leaning is to spare my patients the intensely bitter flavor of this herb, it does make for a very useful decoction and is of great utility in remedying painful conditions such as menstrual pain, colic, toothache, stomach pain, and also pain from traumatic injury. California Poppy can provide substantial analgesia when applied to such conditions in doses of 4-12 g of the dried herb. I will also simmer a similar amount of the fresh root and/or seed pod for 10 minutes as I am more likely to recognize the fresh herb as what a condition needs and I rarely stock it dried. Consider such an application the next time someone you know takes a fall while you are waiting for the arnica to bring down the swelling. Also, consider giving California Poppy to your next patient who complains that the menstrual formula that they didn’t take very consistently wasn’t helping enough. The analgesic effects of the herb will meet their immediate needs and the bitterness will remind them to follow through with a consistent protocol around their cycle!

In a recent trip to Oaxaca, Mexico I was excited to see a near relative, Fouqueiria formosa, of a favorite domestic plant ‘Ocotillo’ or Fouqueria splendens, growing in the wild and in the exceptionally scenic El Jardin Ethnobotanico seen in these photos. Fouqueria splendens grows throughout the deserts of Southern California, Arizona, and various states in Northern Mexico while F. formosa grows throughout the southern high desert of Mexico along side scenic organ pipe and Saguaro cacti. I’ve now combed several books on medicinal plants of Mexico and had an opportunity to ask several practitioners and academic experts and received little clear explanation of methods of harvest or application of F. formosa in traditional medical practice. I did however taste some inner bark and found it to possess the same spectrum of bitterness and acridity as F. splendens suggesting to me that the applications I would consider would be the same.

F. splendens finds ample opportunity for expression as a useful herb in supporting a variety of therapeutic and physiologic processes in the lower jiao, as it is known in CM, which pertains to the L.I., S.I., and uro-genital systems of the body. Ocotillo functions to clear heat and transform dampness and also to quicken the blood and resolve stagnation of blood. It can thus be combined with appropriate herbs for treating such diverse conditions as vaginal discharge, hemorrhoids, itching and redness of the lower thighs, and uterine cysts.

When I returned from my trip with a visitor in my intestines of a protozoal or amoebic nature, I sought the help and advice of an excellent local herbalist Joshua Muscat who besides giving me a bottle of the anti-parasitic Quassia, suggested I include Ocotillo in my very simple prescription which has brought me rapid relief. Joshua explained that the role of Ocotillo was to activate the lymph in both the inguinals and small intestine to enable its immune activity and its scavenging of waste products of infection. In CM terms this roughly translates to clearing of heat and transforming dampness in the lower jiao!

Cow Parsnip (Heracleum lanatum) a well known plant from Western North America, being the only Heracleum native to the Americas. The seeds and root are known to be medicinal, but the root is very acrid and must be used with care and small doses. The seeds are more forgiving relating to their dosage and have been found by many herbalists to be excellent in the treatment of digestive pains due to spasm. This genus also has many Chinese species, the center of distribution of this genus in in China. Some are used as a substitute of Angelica Duhuo, and interestingly the genus name is Duhuo.

One species, Heracleum scabridum is called Dian Bai Zhi (滇白芷) as is considered acrid, sweet, and warm, enters the lung channel, treats yang ming headaches from cold evil, heat effusion, expels wandering wind from the skin. It is also used to stop cold pains in the stomach and other parts of the body, as well as wind-damp impediment. It is also used in gynecology in the treatment of prolapse uterus, white vaginal discharge, and painful menstruation due to cold.

Up-Date:

Heracleum candicans, known as Bai Du Huo (白独活) and is native to Southwestern China and Tibet at elevations from 2000-4200 meters is considered warm, acrid, and bitter. It dispels wind and dissipates cold, eliminates dampness and stops pain. It is used for common cold, headache, toothache, abdominal pain, wind-dampness impediment pain, and “numbing wind” (also translated as leprosy). It is decocted at 3-9g dosages, or it is made into a pill, powder, or tincture. (Source: Commonly Used Chinese Medicinals of Tibet).

Heracleum moellenderffii and Heracleum hemsleyanum are collectively known as Niu Wei Du Huo (牛尾独活). The former is native throughout much of China (excluding the far northern areas), while the latter is primarily found in Hunan and Sichuan provinces. The root is used and is considered acrid, bitter, and slightly warm.  The Commonly Used Chinese Medicinals of Sichuan says that it enters the liver and kidney channels. It expels wind and dissipates cold, overcomes dampness and stops pain. It is used for common cold, headache, toothache, abdominal pain, wind-dampness impediment pain, lower back and knee pain, and slow healing ulcers. It is administered in 3-9g dosages as a decoction, or produced as a pill or powder. It is also used externally as a liniment (tincture).  One formula for an internal tincture is given as this herb along with du zhong, sang zhi (15g each) and song jie (9g) ground and combined with 500g alcohol. 15g are to be taken daily for wind-cold impediment pain or sourness, cold, and pain in the lower back and knees.

Mahonia aquifolium

Mahonia species is found in herbal medical practice in several places around the world. The mahonia species from the Pacific Northwestern United States and Canada is home to what is probably the most popularly used of these species, Mahonia aquifolium. The yellow to orange root, especially the root back, contains berberine an alkaloid known to be antibacterial and antifungal. The root or its bark is can be prepared as a tea, decoction, or tincture and applied both internally and externally. Internally it is used to treat a variety of ailments including but not limited to skin conditions such as psoriasis, liver ailments, digestive ailments, and many other illnesses associated with what is considered “heat” in Chinese medicine. This “heat” may be in the form of an infection or simple inflammation.

In China there are several species used in essentially the same why as it is used in the West.

For more on how to use this plant from the Chinese perspective you can either look at Western Herbs According to Traditional Chinese Medicine: A Practitioners Guide by Thomas Avery Garran, or you can check out our up-coming series Western Herbs In Chinese Medicine for insights into this and many other excellent Western herbs that can and are being integrated into Chinese Medicine.

Mahonia genus is widely used in herbal medicine. This little up-date to the above blog is to try to give a little perspective on a few of the species within this genus by illustrating a number of different ways to employ the medicinal in clinical practice.

I’ll start with a Chinese species, then discuss some specific application of a group of Western species. The herb Gong Lao Mu (功劳木) or Shi Da Gong Lao (十大功劳) represents two species of Mahonia found in China. Both species are common throughout most of the southern half of China from Fujian west to Sichuan and Yunnan provinces. These herbs are both also somewhat common cultivars, both in China and abroad. Mahonia bealei (Fort.) Carr.  is known as Kuo Ye Shi Da Gong Lao (阔叶十大功劳). Mahonia fortune (Lindl.) Fedde  is known as Xi Ye Shi Da Gong Lao (细叶十大功劳). The difference in the names of the individual plants (notice only the first character is different in the names) represents the key to identification by simply looking at the plant. The second character “ye 叶” is the character for leaf, so right away we know there is a difference in the leaves of these plants. M. bealei is named with “kuo 阔,” which means “wide,” while M. fortune is named “xi 细,” which means “thin.” Not only are M. bealei’s wider, but it can grow to approximately twice the size (1-4m) of M. fortune, which stays between 1-2 meters in height. In both cases the stem or stem bark is what is used.

These herbs are not used far out of their growing regions. The flavor and nature of these herbs, like other species of Mahonia, is bit他er and cool to cold. They are said to enter the heart and liver channels and have the following actions:

Clear heat, dry dampness, resolve toxin

Clear the lung and stop consumption cough

Clear heart and stomach fire, resolve toxin

Clear heat, disinhibit dampness, resolve toxin

The conditions it treats is far ranging from in the lung with cough, liver heat disease, diarrhea, jaundice, red-swollen eyes, to externally for various skin diseases and burns.

I found an interesting formula in the Fu Jian Journal of Medicinal Plants for ear-ache. Although I have not tried this formula it appears to be a somewhat elegant combination of plants, a mineral, an essential oil, and a seed oil.

Kuo Ye Shi Da Gong Lao (M. bealei)

Ku Shen (Sophora flavescens)

Ku Fan (Calcined Alum)

Bing Shui (Borneol)

Ma You (Hemp oil)

The Mahonia, Sophora, and Calcined Alum are combined in equal parts by weight in the Hemp oil and allowed to soak over-night. This combination is then cooked until the Mahonia begins to show signs of turning color, toward burning. The dregs are strained from the oil and the Borneol is added. The amounts are not specified, but the finished product is used for ear-aches in children and other ear infections. It is put on a cotton ball and allowed to sit in the ear.

While I might question the solubility of some of the constituents from the first three components of this formula in oil, I think the formula itself has good potential for further study and it illustrates the use of Mahonia to treat heat, inflammation, infections, and the swelling associated with these conditions.

In the Pacific Northwest of the US and Western Canada there are several native species of Mahonia. These are the plants that I have the most experience with. There is little difference in the way Native Americans, Western herbalists, and others who use(d) these species from the ways that I have outlined above from the Chinese literature. However, I would suggest that this herb (here I am linking the entire group found in the area of Western North America mentioned above) has held a more prominent place in the Western herbal materia medica and so by this virtue has undergone a bit more scrutiny and research of clinical applications than their Chinese relatives. This, however, is somewhat tempered by the limited number of years of information we have about the use of this group of plants.

As many of us know, our knowledge of Native American people’s use of most plants is limited by a number of factors that are out of the scope of this article. And, do to the amount of time Europeans and others have had to use this plant our history may be somewhat limited. However, by the time we get to Ellingwood’s American Materia Medica, Therapeutics, and Pharmacognosy in 1919, of M. aquifolium we have the following statement: “When first introduced it was recommended in chronic malarial conditions, in intermittent fevers, and in the stomach , liver and intestinal and general glandular disorders of these fevers. It was claimed that its tonic influence was conspicuous in these conditions and that in certain cases it exercised marked antiperiodic properties. It certainly acts as a tonic and corrective to disorders of the liver, an influence that has been often remarked when given for skin diseases.”

I find it to be quite accurate, there is more to this plant and its relatives than this statement might lead one to believe. Be, to be fair, this statement is merely the final statement of a much longer monograph. We also know that this herb has berberine, a well known alkaloid that is likely one of the most researched individual alkaloids of plant origin. We also know that berberine, and the rest of the plant that gives it its heat clearing, anti-inflammatory, antibiotic, clear heat-toxin, etc. qualities also has a detrimental effect on the gut bacteria. While this is not nearly the kind of “carpet bombing” that a course of most any antibiotic drug that might be prescribed, it does nevertheless kill some of the good bacteria in the GI tract that we need.

Another consideration in a clinical setting is the concept of “yin vacuity heat/fire,” which comes from Chinese medicine. This is a very important clinical pattern, and one that seems to be being adopted by many Western herbalists who have very little training in Chinese medicine, but understand the clinical importance. Yin vacuity is a conglomerate of symptoms that may include such things as urinary tract infections, a sensation of heat at night or sweating while sleeping, dry throat and/or cough, menstrual problems, a floating and rapid pulse, and a dry red tongue (generally with little or no tongue fur). The primary causes of yin vacuity are exhaustion from “living life to the fullest,” long-standing disease (primarily associated with heat/inflammation), stress, and poor eating habits; essentially modern life as many of us know it.

Therefore, when we have the above picture in combination with any other type of disorder, what we have is a combination of various patterns that need to be addressed to relieve the suffering of our patient. Another issue that comes up for these types of patients is that their digestion is usually somewhat weakened, therefore the use of herbs like Mahonia need to be applied with care and with proper formulation. As I stated in my book, Western Herbs According to Traditional Chinese Medicine: A Practitioners Guide, I have found Mahonia to be valuable when used in these situations, but what I didn’t mention are two things: 1) I generally use the whole root, not just the root bark for this clinical pattern and 2) a special preparation of this herb that is borrowed from the Chinese system of paozhi* (炮制). The Chinese do not, to my knowledge, prepare Mahonia in this way, but I have taken a preparation technique used widely for other herbs, specifically Huang Bai (Phellodendron amurense 黄柏). The preparation takes a tree bark (Huang Bai), which has nearly the same clinical indications (and similar chemistry, berberine) as Mahonia, and soaks it with salted water then stir-fries the bark until it becomes dry. This process is said to have interesting and very useful changes to its medicinal application, 1) it does not damage the spleen and stomach (digestion) and 2) long-term use both nourishes the yin while downbearing fire (reduce chronic inflammatory symptoms).

The above processing technique changes the solubility of certain constituents and other changes, which are out of the scope of this article. However, I will say that I generally do not use this preparation as a tincture but in decoction. I have little experience with tincturing the processed plant. From a clinical aspect this is a very important and useful way of using Mahonia with myriad applications in the modern clinic.

*Paozhi (炮制) is a fascinating system of preparing medicinals from harvest to consumption. The most interesting parts, IMHO, are the pre-decoction preparations such as described above. There is more to come on this topic in the future….

I was recently asked about a plant used by the Hani People of Southern Yunnan, an area I have traveled a fair bit, thus these folks that I was a good person to ask. Here is some information I found about this plant for your reading enjoyment. For the record I am pretty sure I have seen this plant, though I was unable to find a photo in my collection.

There seems to be some nomenclature issues both with the botanical Latin and the Chinese, the latter of which is very common. The various different Chinese names are probably a little less critical for most of our readers, especially since this herb is not a commonly used herb in Chinese medicine. The 3 botanical Latin names I found were the initial name given to me in the question, Conoclinium coelestinum and in my research I also found the plant under 2 other names, Eupatorium adenophorum and Ageratina adenophora. However, in looking at the botany a little closer, it would seem that it is most likely Ageratina adenophora (Eupatorium adenophorum is no longer accepted) that is being referred to rather than Conoclinium coelestinum. It’s primary Chinese name is zi jing ze lan (紫茎泽兰), which means “purple stemmed ze lan” (ze lan is the Chinese name for a related or similar looking plant used in Chinese medicine known as Eupatorium japonicum). The English name given is “Crofton Weed.” I will revisit this information when I have more to say, but at the moment the information below should be understood to refer to Ageratina adenophora rather that Conoclinium coelestinum.

Here is some brief information about the Chinese uses of this plant. Flavor and nature: acrid, bitter, cool. Enters the urinary bladder, liver and kidney channels. Quickens blood and transforms stasis, quickens blood and regulates the menses. Courses wind and resolves the exterior [possibly diaphoretic], regulates the menses and quickens blood, transforms toxin and disperses swelling. Used to treat wind-heat “colds” [flu], damp diseases with fever, irregular menstruation, blocked [stopped] menstruation, flooding [menstruation], toxic swelling of unknown etiology, hot-toxic sores, rubella itching. Taken internally as decoction 6-15g daily, also used externally.

Recently a question was asked about the possible substitutes that could be used in place of the Chinese herb “xi xin” (細辛) Asarum sp. because the practitioner was concerned the this herb is “toxic.” This post is part of my response and a very short over-view of the literature on this herb in regards to its toxicity and dosage. This is not meant to be exhaustive in any way.

Asarum delavayi 川滇細辛 Yunnan, China

While I will agree that xi xin has some minor toxicity issues, I also think it is quite safe when use appropriately. I guess when I hear a practitioner say they don’t want to use an herb because it is toxic I feel the need to try to tease out where this is coming from in hopes to better understand how practitioners are thinking. Also, when one says they don’t want to use an herb because it is toxic, I start to wonder what “toxic” means to that person. If you take enough of anything it can be toxic.

I took three random books on materia medica in Chinese off my self and found this information. The first one is “Clinical Uses of Chinese Medicinals” which states xi xin “has small toxin” or it may be translated “slightly toxic.” Of course when a Chinese book says that there is no way to know if they are referring to toxicity as we might think of it, i.e. there is some chemical in the substance that may cause cancer, or it it is just really “hot” and when used in large doses can cause noticeable physical “side effects.” The other two are transcibed lectures from very well known materia medica scholars Lectures in Clinical Uses Chinese Medicinals by Zhang Ting-mo and Lectures in Chinese Medicinals by Yan Zheng-hua. Interestingly neither mention toxicity of xi xin and combined the two take up nearly 6 pages of writing. That’s a lot of talking about an herb without any mention that it is toxic, don’t you think?

The Grand Dictionary of Chinese Herbs lists 16 species (plus a couple sub-species).

Asarum debile (tong qian xi xin) no mention of toxicity, dosage 2-6g

Asarum caudigerum (wei hua xi xin) has small toxin, dosage 3-6g

Asarum caulescens (shuang ye xi xin), A. himalaicum (dan ye xi xin), A. chinense (chuan bei xi xin), A. fukienense (fu jian xi xin), A. delavayi (chuan dian xi xin) are all under the heading of “tu xi xin” there are several different sources cited for these herbs. One says there is no toxicity while another cites some research that suggests over-dose could cause difficulty breathing. I don’t have the research, so I don’t know any more than that. Dosage 1-3g

Asarum forbesii (du heng), A. ichangense (xiao ye ma ti xiang) have entries for both non-toxic and “has small toxin” dosage 1.5-6g

Asarum geophilum (da kui wa) listed as non-toxic, dosage 1-3g

Asarum heterotropoides (bei xi xin), A. sieboldii (hua xi xin), A. sieboldii var. seoulense (han cheng xi xin) all under the heading of “xi xin” and is said to “have small toxin” although a number of the older texts cited such as the Shen Nong Ben Cao and the Bie Lu either don’t mention toxicity or say it is non-toxic. Dosage 1.5-9g (1-3g when used as a powder)

Asarum splendens (hua lian xi xin) “has small toxin” dosage 2-3g

For fun, I also looked in the PMPH “jiao cai,” which is a pretty standard textbook and it says, 唯有小毒, 用当宜慎 “wei you xiao du, yong dang yi shen” which literally translates to “only has small toxin, use should appropriate caution” The second part of which I would render as “it should be used appropriately and with caution.” they give the dosage at 3-5g

I have harvested 3 different species of this plant in the US, and used both these species and an unknown number of Chinese species for 20 years and never been concerned with their toxicity. I use it appropriately, simple as that. This herb has a pretty narrow usage and is extremely effective when employed properly.

Asarum marmoratum with flower inset bottom right corner. Photo from Northern California.

So, I would say that anyone who has graduated from a reputable school, having studied Chinese herbs (or Western herbs for that matter) should be able to very comfortably employ any Asarum species without being concerned with toxicity. I am not saying one should not be aware of its restrictions, but being aware of, say dosage, should be pretty basic and, rightly or wrongly, I assume that a licensed practitioner should know this information about any herb they use.

Today I will touch on the wonderful herb known as Perilla frutescens in Latin but in Chinese it is called Zi Su (紫苏). The Chinese name is a dead give away for its appearance because the character zi (紫) means purple, and in fact the leaf and stem of this plant are purple (there is also a green variety).

There are three different parts of the plant used in Chinese medicine, the leaf (zi su ye 紫苏叶), the stem (zi su geng 紫苏梗), and the seed (zi su zi 紫苏子). I won’t bore you with all the details, but the leaf is commonly used for illnesses such as the common cold as well as a number of digestive illnesses, one of which is seafood poisoning. It should be noted here that the original coloring of pickled ginger served with sushi came from this leaf in the pickling process. It is very likely that most of the pickled ginger served these days in sushi restaurants is artificially colored. The stem is primarily used to regulate qi in the digestion. It is said to be able to both move the qi up and down, so is used in formulas with other herbs to facilitate this.

I recently harvested a bit of Perilla seed from the Autumn Reine Learning Garden, which is located just north of Beijing. Although I let most of the seeds be eaten by the birds that frequent the garden, I decided to harvest some last week. In all I ended up with about 30 grams of seeds, more than enough to have a large planting this next season. The plants in the garden were nearly 2 meters tall (6 feet) and probably would have yielded 10 times that many seeds if I had harvested at the right time. But I like the idea of feeding the birds; I hope they come back to eat the bugs next year in return for such a nice gift of seeds this Fall. Perilla seed’s main function is to direct qi downward for the treatment of cough. It also disperses phlegm, so it is a common herb for me to use in formulas for coughing. Although it is considered warm, I do not consider it overly so, and thus it is safe to use in many different types of cough, but it is particularly useful when there is deficiency of the lung and spleen leading to the cough and phlegm.