Tradition as a living system: A framework to bridge traditional knowledge with contemporary needs

The tension between traditional medicine systems and evidence-based medicine has been a source of challenge and debate in recent years. However traditional medicine is off to a good start in 2024 with a groundbreaking Australian study, published two months ago, providing important insights on how to better bridge the gap between traditional knowledge and contemporary health care to achieve appropriate and effective implementation of traditional evidence. The Contemporary Implementation of Traditional Knowledge and Evidence in Health (CITE) Framework was developed to support translation of traditional knowledge, from traditional medicine systems with written historical records, for use in modern-day research, education, policy and health care practice. 

The World Health Organisation (WHO) recommend the integration of traditional and complementary medicine into health care services as one important strategy to help improve health service delivery and health outcomes however its integration into a dominant health care system needs to be supported by quality evidence. The CITE Framework was designed with the intention of being accessible and useful to people both inside and outside of traditional medicine systems who wish to engage with traditional medicine knowledge in a meaningful way. It is comprised of three sections which each include guiding principles and criteria to approach traditional knowledge as a source of evidence, how to evaluate sources of traditional knowledge and how to integrate it into a contemporary setting. 

This project is the result of more than 10 years of research led by Associate Professor Amie Steel and Dr Hope Foley, working with stakeholders of traditional medicine systems from research, education, policy and practice to understand their experiences of using traditional knowledge, or using research, policies or interventions based on such traditional knowledge. Educational institutions, traditional, complementary and integrative medicine journals, and practitioner organisations from around the world have already expressed interest in adopting the framework in their activities. The authors believe that this framework will be critical to providing a rigorous, robust and respectful guide for selecting, evaluating and applying traditional knowledge in contemporary contexts.

The CITE Framework can be downloaded here.

References

Steel A, Foley H, Adams J, Bugarcic A, Leach M, Wardle J (2023). Contemporary Implementation of Traditional Knowledge and Evidence in Health (CITE) Framework. Ultimo, Australia: Australian Research Consortium in Complementary and Integrative Medicine, University of Technology Sydney.

Foley H, Bugarcic A, Adams J, Wardle J, Leach M, Steel A. Criteria for the selection, evaluation and application of traditional knowledge in contemporary health practice, education, research and policy: A systematic review. Health Info Libr J. 2023 Sep;40(3):233-261. doi: 10.1111/hir.12499. Pub 2023 Aug 2. PMID: 37531012.

A large plant belonging to the daisy family (Asteraceae), St. Mary’s thistle has a long-standing reputation as a bitter liver herb used as a preventative measure for liver damage caused by viruses, bacteria, fungi and chemical toxins. Perhaps of even more interest at this time of year, is the fact that the seeds of St. Mary’s thistle are often the first choice of herb to protect the liver from the ill effects of excessive alcohol consumption as they minimise hangovers and reduce toxic fatty degeneration of the liver.  

In practice, St. Mary’s thistle is commonly used for treating digestive disorders and any indication whereby improved liver function or liver protection may be a benefit. As well as being a general ‘liver cleansing’ agent, the seeds have been used traditionally to treat jaundice, hepatitis, haemorrhoids and psoriasis. The specific species name marianum preserves the legend that the white mottling surrounding the venation of the leaves was a result of a single drop of the Virgin Mary's milk as it gently fell onto the leaf surface. This medicinal plant is traditionally used as a galactogogue (stimulating milk production) and as a tonic for nursing mothers, perhaps contributing to the word origins of the other common name, milk thistle, along with the milky sap it exudes.  

There is often a connection between poor liver health and depression and St. Mary’s thistle is specific for depression that follows hepatitis. The British herbalist Gerard referred to it as ‘the best remedy that grows against all melancholy diseases.’ Melancholy, a term that is often equated with depression, derives its name from the Greek words ‘black bile’ and was treated historically with liver herbs, in addition to mood-enhancing plants. 

References

Jones L. A Working Herbal Dispensary. Aeon Books:Glasgow. 2023. p.237

Braun L, Cohen M. Essential Herbs and Natural Supplements. Chatswood:Elsevier. 2017. p. 866

HEC monograph

Known as a Christmas trimming associated with the ‘kissing under the mistletoe’ custom (the fictional young wizard Harry Potter had his first kiss this way), this romantic plant is more than just a holiday decoration. In ancient lore mistletoe signified life-force and fertility, hence the tradition of kissing under it, and it was considered a panacea with exceptional beneficial properties. Ethanolic liquid extracts of mistletoe have been widely used in folk medicine in Europe for blood pressure reduction. It has also been prescribed historically as a nervine for convulsions and epilepsy. In modern herbal medicine it is mostly chosen to help treat hypertension and insomnia. This semi-parasitic plant has also been used for more than 100 years in the complementary therapy of cancer and other immunological disorders. Several lines of evidence indicate that mistletoe improves patient survival, reduces the damage caused by conventional cancer therapies and increases patients’ quality of life. 

The relation between cancer and inflammation has been widely demonstrated. One researcher said, “inflammation and cancer dance together towards disaster”. Inflammation is considered a hallmark of cancer and related to the spread of the disease within the body and the resistance of cancer cells to the treatment. Chronic inflammation is closely related to oxidative stress and immunosuppression. A 2023 study researching the anti-inflammatory activity of mistletoe concluded that, although further data trials need to be performed, the examination of clinical and pharmacological evidence on the majority of oncological patients so far “allows us to consider European mistletoe extracts able to cause various anticancer achievements. This anticancer activity is matched with pro-apoptotic, antiproliferative and immunomodulatory effects, which are considered necessary to reduce the disease.” The researcher also said mistletoe can improve quality of life and treatment-related symptoms. 

In general, mistletoe does not kill its host tree as it needs the host alive for its own survival. It provides many habitat benefits for local native wildlife. The host plant chosen by mistletoe depends on the available flora. It can be found mostly in several deciduous and needle trees such as apple, linden, hawthorn, oak, elm, poplar, pines and firs. In Nigeria and Ghana it can be found on cocoa, kola and cashew trees. Mistletoe produces its own energy through photosynthesis, and can biosynthesise its own compounds, but it can also take some nutrients and water from the host trees. Pharmacologically active compounds pass from the host trees to the parasitic plants. Research from 2022 found that host trees play a key role in the phenolic profile and antioxidant capacity of mistletoe. 

References

Saha C, Das M, Stephen-Victor E, Friboulet A, Bayry J, Kaveri SV. Differential Effects of Viscum album Preparations on the Maturation and Activation of Human Dendritic Cells and CD4⁺ T Cell Responses. Molecules. 2016 Jul 14;21(7). pii: E912. doi: 10.3390/molecules21070912.

Melo MNO, Ochioni AC, Zancan P, Oliveira AP, Grazi M, Garrett R, Holandino C, Baumgartner S. Viscum album mother tinctures: Harvest conditions and host trees influence the plant metabolome and the glycolytic pathway of breast cancer cells. Front Pharmacol. 2022 Oct 31;13:1027931. doi: 10.3389/fphar.2022.1027931. PMID: 36386174; PMCID: PMC9662615.

Jones L. A Working Herbal Dispensary. Aeon Books:Glasgow. 2023. p239

Nicoletti M. The Anti-Inflammatory Activity of Viscum album. Plants (Basel). 2023 Mar 27;12(7):1460. doi: 10.3390/plants12071460. PMID: 37050086; PMCID: PMC10096603.

Nazaruk J, Orlikowski P. Phytochemical profile and therapeutic potential of Viscum album L. Nat Prod Res. 2016;30(4):373-85. doi: 10.1080/14786419.2015.1022776. Epub 2015 Mar 27. PMID: 25813519.

As we hurtle towards the silly season we are inspired by our beautiful rose-coloured branding to spread some LOVE because, as exciting as it is, it can all be a bit overwhelming and exhausting. We know the Christmas period is supposed to be joyous but, whether you celebrate it or not, it can be a source of stress, anxiety and depression for some. So as an antidote we have concocted a Christmas LOVE Potion containing heart-warming herbs so you can drink and be merry over the break. For extra nurturing we have added some rose (no not rosé) quartz which is known as the stone of love and emotional healing, working on the heart chakra.

While many people are making merry others find that the Christmas spirit can be undermined by the expense of gifts and food, the pressure of shopping, family tensions and the expectations of the festive season. The emphasis on family, friends and shared good times can exacerbate emotional triggers and feelings of isolation and bereavement. In times of stress and uncertainty plants can be turned to for nourishment and healing. Herbs are wonderful allies for vitality and relaxation and they have an innate ability to restore deficient and depleted energy. Some supportive and uplifting herbs to include in a mocktail to help you feel cheerful and jolly include Hawthorn (Crataegus monogyna), Arjuna (Terminalia arjuna), Lemon Balm (Melissa officinalis), Motherwort (Leonurus cardiaca) and Withania (Withania somnifera).

Christmas LOVE Potion Recipe

Recipe adapted from The Junior Herbalist Club rose lemonade recipe and Love Elixir in The Herball’s Guide to Botanical Drinks

Makes 1.5 litres

Ingredients:

• 20g dried organic rose petals

• 1 punnet (approx. 120g) of fresh or frozen organic raspberries, crushed with a pestle or fork

• 150g organic raw sugar (or sweetener of choice)

• 500mL boiling water

• 1L filtered water* (or sparkling water if preferred)

• 20mL of rose water

• 5 organic lemons

• 5mL Herbal Extract Company Hawthorn (or Arjuna)

• 5mL Herbal Extract Company Lemon Balm

• 5mL Herbal Extract Company Motherwort

• 5mL Herbal Extract Company Withania

Instructions:

1. Put the rose petals, raspberries and sugar into a large heat proof container, pour over the boiling water and leave for 10 minutes to steep.
2. Strain into a glass water jug, add the filtered (or sparkling) water and rose water.
3. Squeeze the lemons directly into the jug.
4. Add the liquid herbal extracts into the jug, add ice and stir.

This can be served over pieces of raw rose quartz crystals placed into glasses. Rose petals and fresh raspberries can be added for garnish. Sip quietly and savour.

*You may wish to infuse the 1L of filtered water with the rose quartz beforehand if you have time.

Rose Quartz-infused water

Gently clean the crystals under running water then carefully add them to a glass jug, pour over 1L of fresh filtered water, cover and leave to infuse for 2-3 hours, ideally in the sun.

References

Isted M. The Herball’s Guide to Botanical Drinks. Quarto Publishing Group:London. 2017. p.168
Hornby M. Official Leader Handbook. Junior Herbalist Club. c2023. https://www.juniorherbalistclub.com/

Though synonymous with tomato sauce (ketchup), the now gigantic condiment business started by Henry Heinz, has its roots in horseradish (pardon the pun). Born to German immigrants, the would-be condiment king grew up in Pennsylvania which in the mid-1800s was recognised as fertile ground for eye watering horseradish root, a classic German flavouring companion to fish and fatty meats such as roast beef. There were no refrigerators or freezers during this time and people ate fresh foods in the seasons when they were available. During the winter they ate what they had preserved in the late summer and autumn. Heinz’s first product was grated horseradish, from his mother Anna Heinz's recipe, preserved and bottled in clear glass to assure customers of its purity. This saved homemakers from a thankless, but necessary task. Horseradish sauce was not easy to make. It required long and tedious grating and the smell could be very strong. When it was being prepared it could cause the eyes to water and noses to burn. Heinz believed that women would gladly skip the process of grating their own horseradish if they could buy a trusted, packaged product. His hunch proved correct and the product sold well, becoming one of the earliest convenience foods. By 1898 Heinz’s factory had become the largest food processing facility in the world. In herbal medicine circles horseradish root is perhaps best known as lending a fiery kick, along with cayenne (Capsicum frutescens), to the oxymel known as Fire Cider, a favourite wintertime tonic remedy famed for its immune building and sinus clearing properties. 

Energetically horseradish is a pungent, very hot herb, meaning it also stimulates digestion and circulation, which can be warming on cold winter days. Internationally renowned medical herbalist David Hoffmann says it “stimulates the digestive process whilst easing wind and griping pains.” As well as being a circulatory stimulant, horseradish is an antimicrobial, expectorant and diuretic herb, that is particularly useful in supporting patients with either upper respiratory or urinary tract infections. It is widely used in combination with other ingredients, such as garlic (Allium sativum), in herbal decongestant formulations where it is reputed to eliminate excessive catarrh from the respiratory tract, as seen in hay fever and sinusitis.” 

UK clinical herbalist Lucy Jones, known for growing and processing most of her own herbs, says she often includes horseradish in prescriptions for patients with long standing sinus issues. “The Horseradish helps to resolve stagnancy in the circulation in the sinus area and shifts stubborn long-standing infections.” 

References

Quave, C.L. Quave Research Group Website. Version 11.0, April 2015. Armoracia rusticana G. Gaertn., B. Mey. & Scherb., Brassicaceae by Andrew Mongue [Internet]; 2015 [accessed 16 Oct 2023]. Available from https://etnobotanica.us/wp-content/uploads/2011/12/Plant-Monograph-Book-4.2013.pdf

Ruby E. Heinz: First Products and an Innovative Factory. c2023 Heinz History Center (updated 15 Oct 2019; accessed 16 Oct 2023). Available from https://www.heinzhistorycenter.org/blog/collection-spotlight-heinz-first-products-innovative-factory/

Ngozi A. How To Make Homemade Fire Cider (With Video!). The Herbal Academy. (updated 21 Dec 2016: accessed 16 Oct 2023).  Available from https://theherbalacademy.com/homemade-fire-cider/

Hoffmann D. The New Holistic Herbal. Element:Dorest. 1990. p. 207

Braun L, Cohen M. Herbs and natural supplements, 4th Ed. Sydney: Elsevier, 2015. p. 574

Jones L. A Working Herbal Dispensary. Aeon Books:Glasgow. 2023. p189-90

Commonly known as the “father of all foods”, alfalfa (also known as lucerne) is a tonic plant rich in proteins, vitamins and minerals, that is used to treat many diseases due to its pharmacological properties, such as anti-inflammatory and antioxidant activities. This perennial clover-type leguminous plant species is also commonly baled for hay as an animal fodder in Australia. The sprouts (germinated seeds) are a popular health food and the ground dried herb may be given during convalescence and debility because it is rich in vitamins and minerals.  

An energetically cooling herb, alfalfa has a long tradition of use as an Ayurvedic medicine, used in central nervous and digestive system disorders. It has been used in the treatment of perimenopausal symptoms in women. Hot flushes and night sweating completely disappeared with the treatment of alfalfa extract. It is also used to reduce haemorrhage, as a tonic after blood loss and during anaemia, and is considered useful in lowering cholesterol levels.  

The late Australian herbalist, Dorothy Hall said, “it’s hard to find anyone who doesn’t need alfalfa in a general food sense, but a description of the more specific ‘Alfalfa-type’ will show when it is needed medicinally.” And, Hall says, one part of this picture is “all the diseases caused initially by irritation; followed by inflammation, congestion and impaired function. This person is irritable, swollen here and there, with itchy or even painful areas of congestion and soreness which may change locality from day to day or time to time.” In her charming familiar tone Hall muses that alfalfa is for the “sins of the highly developed countries.” “Cultural sophistication always brings with it decadence from over-supply and over-indulgence in the good things of life at the table, far more than is needed for body maintenance and energy. Perhaps it’s not so coincidental that alfalfa has become popular at the time it is most needed. The remedy is always found close to the disease.” 

References

Raeeszadeh M, Beheshtipour J, Jamali R, Akbari A. The Antioxidant Properties of Alfalfa (Medicago sativa L.) and Its Biochemical, Antioxidant, Anti-Inflammatory, and Pathological Effects on Nicotine-Induced Oxidative Stress in the Rat Liver. Oxid Med Cell Longev. 2022 Mar 26;2022:2691577. doi: 10.1155/2022/2691577. PMID: 35378828; PMCID: PMC8976666.

van Wyk B, Wink M. Medicinal Plants of the World. Pretoria: Briza Publications; 2004. p. 201

Mills S. The Complete Guide to Modern Herbalism. Thorsons:London. 1989. p.144

Bora KS, Sharma A. Phytochemical and pharmacological potential of Medicago sativa: A review, Pharmaceutical Biology. 2011;49(2):211-220, DOI: 10.3109/13880209.2010.504732

Hall D. Dorothy Hall’s Herbal Medicine. Sydney:Lothian. 1988. p. 82-5

Australia now has its first nine certified Junior Herbalist Club Leaders after the UK founder Mel Hornby (pictured above right) personally delivered the training course at the end of last month at Torrens University, who kindly provided the space in Sydney. The Herbal Extract Company are proud Gold sponsors of this unique and enchanting program which helps children, aged between seven and twelve, learn about the healing plants around them in a safe and supervised environment. The program takes the children on a magical journey of discovery, engaging all their senses with playful practical skills, thus creating a whole new generation of budding herbalists.

During the five days of intensive training the passionate leaders, who are all qualified naturopaths and herbalists from throughout Australia, entertained their inner child and the most popular word throughout the week was FUN. The student leaders actively worked through each of the twenty sessions (covering the two-year syllabus) in ‘real time’. This included making, among many other goodies, marshmallows with real marshmallow root, lavender lemonade, lemon balm sun tea, cinnamon sugar lip scrub, bath bombs, daisy soda, magic liquorice throat coats (using Herbal Extract Company Liquorice 1:1), aniseed cough drops (made with Herbal Extract Company Aniseed 1:1), and antiseptic healing cream (made with the Herbal Extract Company Natural Base Cream and Calendula 1:1), a rose love potion (with the antidote), a dandelion clock lumiere to allay nightmares, learning about the importance of honey bees and how to help “windy bottoms”. The Naturopaths and Herbalists Association of Australia will maintain the register of qualified JHC leaders.

Sarah Hunter (pictured above left), from blackwoodapothecary, @blackwood_apothecary in the Hunter Region of New South Wales, was the lucky winner of our competition to win a ticket to the training course. She said: ”JHC training reaffirmed my love of herbal medicine and left me feeling so inspired. Mel has meticulously developed JHC to empower children with herbal wisdom and I felt so fortunate to spend an intensive week exploring the curriculum. I cannot wait to begin teaching my own classes in 2024. I am so grateful to HEC for giving me this opportunity.”

The Herbal Extract Company are committed to encouraging practitioners to create and run a JHC in their local area, giving children the opportunity to develop knowledge and skills that will benefit themselves and others for a lifetime. The leader training is expected to be offered again in 2024 so watch this space.