Respiratory System Part III Immune System ... hirta Historical & Traditional Prescribing •...

Herbal Medicine Materia Medica 1

WHMF112 Session 6:

Respiratory System Part III

Immune System (Immunomodulators)

Part I

© Endeavour College of Natural Health endeavour.edu.au

Session 6

Respiratory System Part II: Lower Respiratory Tract

• Inula helenium

• Euphorbia hirta

• Grindelia camporum

• Thymus vulgaris

Immune System (Immunomodulators) Part I

• Echinacea spp

• Andrographis paniculata

• Scutellaria baicalensis

• Handroanthus inpetiginosus

© Endeavour College of Natural Health endeavour.edu.au 2

Inula helenium

Plant family: Compositae

Parts used: Root

Description:

• Expectorant and vermifuge with

ability to stimulate appetite (bitters)

(Weiss, 1988)

• Warming, pungent aromatic bitter

that contains a high dose f inulin

making this herb a nutritional agent

(Wood, 2008)


(Андрей Корзун. (2012). Inula helenium

Retrieved 20th April, /2014

from<http://upload.wikimedia.org/wikipedia/com

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Inula helenium

Historical & Traditional

Prescribing:

• Cough, of a teasing,

persistent character,

accompanied with

substernal pain, and

profuse secretion; atony of

abdominal viscera, with

engorgement and

relaxation; catarrhal

discharges.

(Felter & Lloyd, 1898)


(Luke1ace (2005). Inula helenium Retrieved 20th

April, /2014

fromhttp://en.wikipedia.org/wiki/File:Inula_heleniu

m.jpg)

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Inula helenium

Cautions / Contraindications / Warnings:

• Known allergy to members of Compositae family

(van Wyk & Wink, 2004)

Pregnancy and Lactation Data:

• According to the BHC Inula helenium is

contraindicated in pregnancy and lactation, however

no substantial basis has been found to support this

(Bone 2003)


Inula helenium

Preparation Adult mL/g Dosage directions &

considerations

Oral

Tincture 1:2 (60%) 20-40mL / week Take up to three times per

day

Decoction of dried root 1.5 - 4g / day


(Bone, 2003; Fisher 2009)

Qualities: dry/ acrid, warm / pungent, bitter

(Wood, 2008; Thomsen & Gennat, 2009)

Euphorbia hirta

Plant family: Euphorbiaceae

Parts used: Herb

Description:

• Used for respiratory disorders

that involve smooth muscle

spasm. Indicated for intestinal

amoebiasis.

• Has been found to antispasmotic

properties due to the shikimic

acid & choline content

(Medicines Complete, 2014)


(Dulal, K. (2012). Euphorbia Retrieved 20th April, /2014

fromhttp://upload.wikimedia.org/wikipedia/commons/thu

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Euphorbia hirta

Historical & Traditional Prescribing

• Specific Indications and Uses.—

Spasmodic action of respiratory

muscles, with bronchial irritation.

• Used in spasmodic asthma,

dyspnoea of cardiac disease and

recommended for chronic bronchitis

in old people. It promoted

expectoration, allayed cough, and

has given good results in

emphysema

(Felter & Lloyd 1898)


(Bloem, M. (2009). Euphorbia hirta Retrieved 20th April,

/2014

from<http://upload.wikimedia.org/wikipedia/commons/th

umb/8/82/Euphorbia_hirta1.JPG/640px-

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Euphorbia hirta

Cautions / Contraindications

• Do not use in children, haemophiliacs, those with

von Willebrand’s disease

Drug/ Herb Interactions:

• Additional effects: ACE inhibitors, Anticoagulants,

barbiturates, cholinesterase inhibitors

• Reduced effects: Anticholinergics

Pregnancy & Lactation

• Contracts & relaxes smooth muscle so is avoided

(Mosby, 2010, Medicines Complete, 2014)


Euphorbia hirta


considerations

Oral

Powder 120-300mg/ dose

Tincture1:2 (60%) 15-30mL / week Take up to three times

per day

Infusion 120-300mg / dose


(Mosby, 2010)

Grindelia camporum

Plant family: Compositae

Parts used: Aerial parts

Description:

• Potent antimicrobial, that reduces

smooth muscle spasm, thins thick

mucus and aids expectoration

(resins & saponins)

• Reduces inflammation and is a

cardiac depressant

(Bone 2003; Fisher, 2009)


(Miwasatoshi. (2008). Grindelia camporum


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Grindelia camporum


Prescribing

• Grindelia is a useful remedy in

spasmodic asthma, whooping

cough, bronchitis, and hay fever.

• It is used in heart disease to

slow and regulate the pulse, and

has been strongly

recommended in cystitis and

catarrh of the urinary passages.

(The British Pharmaceutical

Codex, 1911)


(Zell, H. (2009). Grindelia camporum Retrieved 20th April,

/2014

fromhttp://upload.wikimedia.org/wikipedia/commons/thumb/f/f9

/Grindelia_camporum_003.JPG/360px-

Grindelia_camporum_003.JPG)

http://upload.wikimedia.org/wikipedia/commons/thumb/f/f9/Grindelia_camporum_003.JPG/360px-Grindelia_camporum_003.JPG

Grindelia camporum

Pregnancy and Lactation:

• No adverse effects are expected (Bone 2003)

Quality: odour balsamic, taste aromatic and bitter

(Fisher 2009)



considerations

Oral Large doses may cause renal

irritation (saponins)

Tincture1:2 (60%) 10-20ml / week Take up to three times per day

Infusion: 2 – 3g infusion /

dose

(BHP 1983; Bone 2003; Fisher 2009,)

Thymus vulgaris

Plant family: Lamiaceae

Parts used: Flowering top, leaf

Description:

• Smooth muscle relaxation of bronchioles

and GIT and sedative effect via GABA

modulation (thymol volatile oil)

• Inhibits platelet aggregation, effective

against microbes, fungus and worms

• Topically is a rubefacient

(Leung, 2010)


(Vicente Selvas, V.M. (2007). Thymus vulgaris


fromhttp://upload.wikimedia.org/wikipedia/com

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Thymus vulgaris


• Cold infusion for dyspepsia with weak

& irritable stomach & as a stimulating

tonic in convalescence.

• The warm infusion aids hysteria,

dysmenorrhoea, flatulence, colic,

headache & to promote perspiration.

• A strong infusion slightly sweetened,

and mixed with gum Arabic, is a

valuable remedy for whooping-cough,

convulsive and catarrhal coughs, and

sore throat. (Felter & Lloyd 1898)


(Brisse A.H. (2007). Thymus vulgaris


fromhttp://commons.wikimedia.org/wiki

/File:Thymus_vulgaris3.jpg)

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Thymus vulgaris

Cautions / Contraindications:

• Thyme oil is a skin & mucous membrane irritant

• Thymol: toxic symptoms include nausea, vomiting,

gastric pain, headache dizziness.

Pregnancy & Lactation

• None expected if in the amount used in food

(Barnes, Anderson & Phillipson, 2007)


Thymus vulgaris


considerations

Oral

Tincture 1:2 (60%) 15-40mL / week Take up to three times

per day


(Barnes, Anderson & Phillipson, 2007)

Herbal Medicine Materia Medica 1

Immune System (Immunomodulators)

Part I

© Endeavour College of Natural Health endeavour.edu.au

Immune System


(Nucleus medical media,. (2013). Components of the immune system, Retrieved 20th April, /2014

from <http://ebsco.smartimagebase.com.ezproxy.endeavour.edu.au:2048/components-of-the-

immune-system/download-one?id=28961418&mt=tmp&decIDs=4506#content>)

Immune System


(Nucleus medical media. (2013). Antibody immune system response, medical animationRetrieved

20th April, /2014 fromhttp://ebsco.smartimagebase.com.ezproxy.endeavour.edu.au:2048/antibody-

immune-system-response/view-item?ItemID=15529)

http://ebsco.smartimagebase.com.ezproxy.endeavour.edu.au:2048/antibody-immune-system-response/view-item?ItemID=15529

Immune System


(DO11.10, (2006). Immunity, Retrieved 20th April, /2014 from,

http://upload.wikimedia.org/wikipedia/commons/thumb/d/d1/Immunity.png/799px-

Immunity.png>)

Immune

System


(DO11.10, (2003). B cell activation, Retrieved 20th April, /2014

fromhttp://upload.wikimedia.org/wikipedia/commons/thumb/f/f7/B_cell_activation

.png/640px-B_cell_activation.png)

http://commons.wikimedia.org/wiki/User:DO11.10

http://upload.wikimedia.org/wikipedia/commons/thumb/f/f7/B_cell_activation.png/640px-B_cell_activation.png

Immune System

General Herbal Actions to Consider

• Immune depressants

• Immune modulators

• Immune enhancing

Other systems / Organs involved include…?


Echinacea spp.

Echinacea species refers to several different plants

within the genus.

These include:

• Echinacea angustifolia

• Echinacea pallida

• Echinacea purpurea

(Fisher 2009)

There is much confusion about the botanical identify of

Echinacea in commercial preparations and research

(Blumenthal et al, 1998)


Echinacea spp.

Plant family: Asteraceae

Parts used: Root and aerial parts

Description:

• Action on infective agents (bacteria,

fungus, parasites, viruses) while

stimulating the non-specific immune

system (macrophages &

granulocytes) and T-lymphocyte

activity possibly via polyacetylenes,

alkylamides & essential oils

(Leung, 2010)


(Dy-e. (2007). Echinacea angustifolia Retrieved 20th

April, /2014

fromhttp://en.wikipedia.org/wiki/File:Echinacea_angustifo

lia.jpg)

http://en.wikipedia.org/wiki/File:Echinacea_angustifolia.jpg

Echinacea spp.

Description Continued:

• Found to reduce the collagen

damage generated by reactive

oxygen species (caffeoyl

derivaties, polysaccharides,

alkamides).

• Reduces the overproduction of pro-

inflammatory cytokines post viral

infection.

(Leung, 2010)


(Lavin, M . (2010). Echinacea purpurea Retrieved 20th

April, /2014

fromhttp://commons.wikimedia.org/wiki/File:Echinacea_

purpurea_(4990391475).jpg)

http://commons.wikimedia.org/wiki/File:Echinacea_purpurea_(4990391475).jpg

Echinacea spp.


Prescribing

• To correct sepsis and

malignancy in gangrene,

ulcerations, carbuncles,

boils, and various forms of

septicaemia; foul

discharges, discolouration

of skin or mucous

membranes, with a low

form of inflammation.

(Felter & Lloyd, 1898)


(Ernie. (2009). Echinacea angustifolia Retrieved 20th

April, /2014

fromhttp://commons.wikimedia.org/wiki/File:Echinacea

_angustifolia_-_01Aug2009_-_01.jpg)

http://commons.wikimedia.org/wiki/File:Echinacea_angustifolia_-_01Aug2009_-_01.jpg

Echinacea spp.

Cautions /

Contraindications:

• Allergy to the Asteraceae

family. Linked to acute

asthma, rash/ urticaria

and anaphylaxis

(Leung, 2010)

Pregnancy and Lactation

Data:

• No adverse effects are

expected


(Epibase. (2009). Echinacea purpurea Retrieved 20th April, /2014

fromhttp://commons.wikimedia.org/wiki/File:Echinacea_purpurea_Merlot1UME

.JPG)

http://commons.wikimedia.org/wiki/File:Echinacea_purpurea_Merlot1UME.JPG

Echinacea spp.

Drug/ Herb Interactions:

• May inhibit cytochrome P4503A4 enzymes

Immunomodulator drugs (decreased effects)he

drugs. Should not be used immediately before,

during, or after transplant surgery

(Mosby, 2010)

Taste: acrid, sweet and warm to the 2nd degree

(Thomsen, 2009)

Odour: mildly aromatic taste, sweet becoming bitter

and causing a tingling sensation on the tongue

(Fisher 2009)


Echinacea spp.

Preparation Adult mL/g Dosage directions & considerations

Oral

Succus: 6-9ml / day Fresh expressed juice

Tincture 1:2 (60%)

Echinacea

purpurea

Echinacea

angustifolia

20-40ml/week

Take 3 -6 times per day dependent

on dose size & acute / chronic

management

Dried herb 1 g/day


(BHP, 1983; Blumenthal et al., 1998; Bone, 2003; Fisher, 2009)

Andrographis paniculata

Plant family: Acanthaceae

Parts used: Aerial parts

Description:

• Prevention and treatment of

upper respiratory tract infections,

immunostimulant antigen-specific

& non-specific immunity),

antioxidant, anti-inflammatory.

• Bitter taste with liver protective

properties

(Bone, 2003; Davis, 2011)


(Garg, J.M. (2008). Andrographis paniculata


from<http://commons.wikimedia.org/wiki/File:Androgr

aphis_paniculata_(Kalpa)_in_Narshapur_forest,_AP_

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• Properties of the pure bitters, probably do

not differ from those of the other members

of the family of Gentianaceae. Overdoses

nauseate and oppresses the stomach.

Tonic properties: influences the liver,

promotes bile secretion; restoring healthy

evacuations in cases of habitual

costiveness. Used in dyspepsia, and in

the debility of convalescence

(Remington & Wood 1919)


(Zell, H . (2009). Andrographis

paniculata Retrieved 20th April, /2014

fromhttp://commons.wikimedia.org/wiki/

File:Andrographis_paniculata_002.JPG

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http://commons.wikimedia.org/wiki/File:Andrographis_paniculata_002.JPG


Cautions / Contraindications / Warnings:

• Hypersensitivity reaction (Davis, 2011)

• Suspend use 1 week before major surgery (Braun &

Cohen, 2010)


• Anti-fertility effect (animal trials at high dose) – do

not use in those trying to conceive or pregnancy

(especially first trimester)

(Bone 2003; Davis, 2011)



Drug / Herb Interactions:

• Additive effects: Anticoagulant, antiplatelet,

antihypertensive medication

• Reduced action: Immunosuppressant drugs in

combination with long-term use of herb

(Bone & Mills, 2013)




Oral High doses may cause gastric

discomfort, anorexia, emesis, but

generally, very few side effects

occur

Tincture

1:2 (45%)

20-40mL/week Take 3 -6 times per day

dependent on dose size & acute /

chronic management

Dried herb 5 g of herb in cup of hot

water, stand for 10

minutes

Take before meals to aid

dyspepsia


(Bone 2003; Braun & Cohen 2010)

Scutellaria baicalensis

Plant family: Lamiaceae

Parts used: Root

Description:

• Decreases IL-1 and prostaglandin

synthesis (Mosby, 2010)

• Supports DNA repair, inhibits viral

replication, lipid peroxidation & platelet

aggregation, blocks mast cell

histamine. Stimulates haematopoiesis,

appropriate apoptosis and glomerular

filtration (Mensies-Trull, 2013)


(Ghislain118,. (2005). Scutellaria

baicalensis Retrieved 20th April, /2014

fromhttp://commons.wikimedia.org/wiki/

File:Scutellaria_baicalensis_3.JPG)

http://commons.wikimedia.org/wiki/File:Scutellaria_baicalensis_3.JPG



Prescribing

• TCM herb used to clear ‘heat &

damp’. Heat-associated

symptoms include fever,

irritability, thirst, cough,

expectoration of thick , yellow

sputum. Damp-associated

symptoms include diarrhoea,

heavy sensation in chest,

painful urination.

(Bensky & Gamble 1986)


(Doronenko. (2007). Scutellaria baicalensis


fromhttp://commons.wikimedia.org/wiki/File:Scu

tellaria_baicalensis_flowers.jpg

http://commons.wikimedia.org/wiki/User:Doronenko

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Herb/Drug Interactions:

• May inhibit CYP450 enzymes (CYP1A2, CYP2E1).

Theoretical with no current adverse reactions

reported.

• Additive effect: increased bleeding times if combined

with warfarin/anticoagulants. Don’t use.

(Braun & Cohen 2014)




• No adverse reactions expected (Bone 2003)

• Traditional usage in pregnancy. May inhibit

maternal-foetal interface immunity reducing the

chance of spontaneous abortion in some instances.

Safety in pregnancy is still unknown.

(Braun & Cohen, 2014)

Side effects / Adverse Events:

• None expected if taken within the recommended

dosage range. Very low toxicity.

(Leung, 2010)




Oral Acute conditions effects should

be noted within a few days, while

for chronic diseases long-term

use is recommended.

Tincture 1:2

(60%)

30-60mL/ week Take up to three times per day

Dried herb 6-15 g/day


Taste: bitter and cold (Thomsen & Gennat, 2009)

(Braun & Cohen, 2014; Menzies-Trull, 2013)

Handroanthus inpetiginosus

Plant family: Bignoniaceae

Previously known as: Tabebuia

avellanedae

Parts used: Bark

Description:

• Maintains a healthy immune

system and is a broad

spectrum antimicrobial agent.

Anti-inflammatory, astringent,

decongestant.

(Menzies-Trull, 2013)


(Star, F. & Star, K. (2007). Tabebuia impetiginosa


fromhttp://commons.wikimedia.org/wiki/File:Starr_0702

21-4701_Tabebuia_impetiginosa.jpg)

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Prescribing

• Used by the Incas & Brazilian

Indians to treat eczema,

psoriasis, fungal infections &

skin cancers. The inner bark

was used for dysentery, fever,

sore throat, wounds &

carcinoma.

(Evans Shultz & Raffauf 1990)


(Halleypo. (2011). Handroanthus impetiginosus Retrieved

20th April, /2014

fromhttp://commons.wikimedia.org/wiki/File:Ipe_rosa_tabeb

uia_avellanedae_parque_flamengo.jpg)

http://commons.wikimedia.org/wiki/User:Halleypo

http://commons.wikimedia.org/wiki/File:Ipe_rosa_tabebuia_avellanedae_parque_flamengo.jpg


Cautions / Herb - Drug Interactions:

• Additive effect with anticoagulants due to

napthaquinones (lapachol)

Pregnancy and Lactation:

• Caution in pregnancy resulting from possible

abortive and teratogenic actions of napthaquinones

(lapachol)

(Bone, 2003; Brinker 2010)




Oral Adverse reactions have been

recorded during clinical trails using

lapachol but no evidence has been

found to suggest Pau d’arco would

cause similar effects.

Tincture 1:2 (45%) 20- 50mL/wk Take up to three times per day

Dried inner bark 1.5gm/ dose


Taste: Bitter and cold (Thomsen & Gennat, 2009)

(Bone 2003; Menzies-Trull, 2013)

References

(2010). Echinacea. In Leung's encyclopedia of common natural ingredients: Used in

food, drugs and cosmetics, Wiley, Hoboken, USA. Retrieved 11 July 2014, Credo

Reference

(2010). Echinacea. In Mosby's handbook of herbs & natural supplements, Philadelphia,

USA. Elsevier Health Sciences, Retrieved11 July 2014 from Credo Reference

(2010) Skullcap, baikal (huangqin). In Leung's encyclopedia of common natural

ingredients: Used in food, drugs and cosmetics, Wiley, Hoboken, USA. Retrieved

11 July 2014 from Credo Reference

(2010) Skullcap. In Mosby's handbook of herbs & natural supplements, Elsevier Health

Sciences

Bensky, D. & Gamble, A. (1986). A Chinese Herbal Materia Medica, Seattle

USA. Eastland press.

Blumenthal, M. (1998). Herbal medicine : The complete German commission E

monographs. Newton, Massachusetts USA: Integrative Medicine Communications.

Blumenthal, M. (1998). Herbal medicine : The complete German commission E

monographs. Newton, Massachusetts USA: Integrative Medicine Communications.


References

Bone, K., & Mills, S. (2013). Principles and practice of phytotherapy (2nd ed.). New

York, USA. Churchill Livingston Elsevier.

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for

the individual patient. St. Louis, Missouri. Churchill Livingston.

Braun, L., & Cohen, M. (2010). Herbs and natural supplements: An evidence based

approach, vol. 2 (4th ed.). Chatswood, NSW. Churchill Livingstone Elsevier.

Braun, L., & Cohen, M. (2010). Herbs and natural supplements: An evidence based

approach (3rd ed.). Chatswood, NSW. Churchill Livingstone Elsevier.

Brinker, F. (2010). Herbal contraindications and drug interactions plus herbal

adjuncts with medicines (2nd ed.). Sandy, Oregon. Eclectic Medical

Publications.

British Herbal Medicine Association

British Herbal Pharmacopoeia. (1983). Bournemouth UK. British Herbal Medicine

Association

(2010). Thyme. In Leung's encyclopedia of common natural ingredients: Used in food,

drugs and cosmetics, Hoboken, USA. Wiley. Retrieved 11 July 2014 from Credo

Reference


References

(2010). Pill-bearing spurge. In Mosby's handbook of herbs & natural supplements,

Philadelphia, USA. Elsevier Health Sciences. Retrieved 11 July 2014 from Credo

Reference

ESCOP Monographs. (2nd ed.). (2003). European Scientific Cooperative on

Phytotherapy: Exeter UK.

Evans Shultz, R. & Raffauf, R.F. (1990). The Healing Forest: Medicinal and Toxic plants

of The Northwest Amazonia, Portland. USA. Dioscorides Press.

Felter, H.W., & Lloyd, J.U. (1989). King's American Dispensatory, Retrieved 20th

February, 2015 fromhttp://www.henriettes-herb.com/eclectic/kings.html

Fisher, C. (2009). Materia medica of western herbs. Nelson, New Zealand. Vitex Medic.

Menzies-Trull, C. (2013). Herbal medicine: Keys to physiomedicalism including

pharmacopoeia, (2nd ed.). London, England. Faculty of Physiomedical Herbal

Medicine.

Mills, S., & Bone, K. (2000). Principles and practice of phytotherapy. London UK.

Churchill Livingston.

Thomsen, M., & Gennat, H. (2009). Phytotherapy desk reference. Global Natural

Medicine Pty Ltd l. Retrieved 20th February, 2015 from

www.globalnaturalmedicine.com


http://www.henriettes-herb.com/eclectic/kings.html

http://www.globalnaturalmedicine.com/

Tutorial

Session 6

Tutorial


(Realtime video, asthma triggers in childhood, Retrieved 17th July, 2015 from

<http://realtimehealth.com.au.ezproxy.endeavour.edu.au:2048/conditions/asthma/childhood>)

Tutorial

Layla: 42 years old, 178cm (height) 77kg (weight)

BP 140/90, HR 86 BPM

Presenting Complaint: chronic sinusitis for 10 years:

• Presents every three months, lasts for 4-6 weeks.

• Begins with cold-like symptoms (runny nose, clear

mucus) and watery eyes. Lasts for 1 week.

• In this time has trouble getting off to sleep, and

wakes very tired.

• Mucus turns yellow & sticky & is hard to blow out.

Sinuses & ears become sore & dull ache. Lasts

for about 4 weeks. Recurrence 4-5 x year.


Tutorial

Presenting complaint

• Sore & inflamed throat. This occurs 1-2 days prior

to the chronic sinus bout. If the throat symptoms

get better then Layla does not get a bout of

sinusitis.

Past Medical History

• Has a history of asthma as a child – began around

3 years old, still occurs Triggers: cold weather,

dust, pollen, exercise, sinus infection

• Tonsils removed when she was 8 years old


Tutorial

Immune System

• Has contact dermatitis, which is irritated by the

chemicals at her work (cleaner).

• Positive skin prick test to dust mite, grasses

Nervous System

• Her work life is highly stressed

• When sick feels uptight and irritated

• Headaches (face & forehead) with sinusitis,

better during a shower, hot compress. Worse

cold air.


Tutorial

Break into groups (three per group) or individually

Within your groups / individuals identify the important

areas of Layla’s health:

• considering the underlying causes

• when each of these started

• what the symptoms are now

• what makes these better or worse


Tutorial

Based on this information create short term & long term

treatment goals

• considering the system/ symptom that you are

working on

• what you are going to do – action / s

• what the body will do

• then the expected outcome (specific herbal action)

Example: work on the nervous system by using a

hypnotic herb to increase the body’s production of

GABA to improve the client’s ability to fall asleep.


Tutorial

• Once the treatment goals have been generated

create a list of herbs that fit the actions identified

within each goal

• From this list pick the herbs that best suit the case &

then generate a herbal prescription (type of herbal

delivery: tablets, decoctions, tinctures) including

amounts per dose, required doses per week and the

specific directions that suit your client

Class discuss their findings to the group


Recommended Readings


Fisher, C. (2009). Materia Medica of Western Herbs. Nelson. New

Zealand. Vitex Medica.

• Inula helenium p.45-46

• Euphorbia hirta p.98-99

• Grindelia camporum p.44-45

• Thymus vulgaris p.151-152

• Viola odorata p.258-259

• Echinacea spp p. 38-42

• Scutellaria baicalensis p. 149-150

• Handroanthus impetiginosus/ Tabebuia avallanedae p. 64-66


Braun, L., & Cohen, M. (2010). Herbs and natural supplements: An

evidence based approach, vol. 2 (4th ed.). Chatswood, NSW.

Churchill Livingstone Elsevier.

• Andrographis p. 33-40

• Baical skullcap p. 48-61

• Echinacea p. 285-297

• Thyme p. 982-985

Hechtman, L., Harris, K., & Bridgman, K. (2011). The Immune

system. In L. Hechtman, Clinical Naturopathic Medicine

Churchill Livingstone Elsevier pp. 280-5, 289-94, 337-343



American Botanical Society. (2013). Expanded Commission E

Online

• Thymus vulgaris

World Health Organisation. (1999). WHO monographs on selected

medicinal plants Volume 1. Vol. 2. Geneva Switzerland, World

Health Organisation.

• Monograph on Echinacea angustifolia

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