agk’s Library of Herbal First Aide
In order to cure wounds quickly and effectively we need to understand them. The main organ we are dealing with here is the skin. It protects the body from the entry of impurities. Numerous minute capillaries carry blood to the sub dermic layer – the third layer down from the surface. Here the plasma seeps out of the vessels, full of food and oxygen, which permiate into the second and first layers of the skin. Waste products are carried away by the veins and lymphatic vessels in the third layer. In the second layer we find the connective tissue that provides a supportive platform for the surface skin. Here the immune cells and particles congregate, providing an immune barrier. If the surface layer of the skin is broken an immune response will get to work on the impurities that enter. Finally, we reach the first or surface layer of the skin, the lower part of which is alive, generating new skin cells, the upper part of which consists of old, dead skin cells providing a protective barrier to the body. Nerve cells penetrate into the first layer, to provide the ability to sense by touch. Secretions of watery sweat and oily sebum lubricate, moisten, nourish, and keep the surface healthy.
A break in the skin can be a clean, knifelike cut, a mangled, jagged laceration, or a superficial abrasion (scrape). Blood and lymph are released from cut vessels. Nerves will be damaged, resulting in pain. The major needs of the moment are to stop the bleeding, reduce shock, and keep the wound clean. The blood contains coagulation factors that help form a scab. The lips of the wound probably release compounds that help the lips seek each other out and close the more quickly, in the same way broken bones release factors that search for the other broken bone and bring them together. Thus, there are herbs that ‘bring the lips of the wound together’ quickly. To remove unclean substances and bacteria, the process of inflammation (heat, redness, swelling, and pain) will set in. If the bacteria grow and proliferate this process will be unnecessarily extended and there will be a generation of pus from dead bacteria and immune cells. This may exit externally through the wound or internally through the lymph and veins draining the wound. As inflammation subsides the skin will concentrate on regrowing healthy tissue (granulation), forming minimum scar tissue, and minimizing damage to nerves.
Complications include excessive bleeding, dirt in the wound, prolonged inflammation, bacterial infection, pus production, ‘dirty blood’ or impurities that cause extended inflammation, poor granulation, excessive granulation (proud-flesh), poor formation of scar tissue, excessive scar tissue (keloids), poor lymphatic drainage, and chronic nerve injury and pain.
Although doctors generally only consider the activity of the coagulants in the blood when there is a need to stop bleeding the body actually has developed other functions that assist stopping or staunching blood flow. One of the most important of these is an increase in the blood flow to the capillaries in the rest of the body to keep excessive blood from flooding the area of the wound. The capillaries of the skin have the ability to take up to twenty times more blood than the skin needs in order to warm the surface to release heat from inflammation or to take blood away from a wound. This is why the old doctors gave ‘stimulants’ to stop bleeding. The Civil War doctors used whiskey as a stimulant.
Here is an example of incorrect and correct wound treatment that demonstrates how important it is to understand how healing works, rather than to simply throw herbs at a problem blindly. This is a medicine story told by herbalist 7Song. A man came to see him who had a deep cut on his finger that had been stitched up by a doctor. Someone told him to put comfrey on the wound. After a few days the wound got putrid, starting discharging pus and the finger turned blackish. 7Song removed the comfrey, put on yarrow and the next day the end of finger had “pinked up.” What happened here was that comfrey, which is well known for encouraging cellular proliferation or growth, caused the cells in the end of the finger to grow more quickly. Yet, they had no blood supply so they started to die off, shown by the blackish color. The yarrow, on the other hand, stimulated blood flow into the finger to nourish the tissues and out to remove waste products. It is an excellent wound healer, so it started the job of recovery correctly.
This is my favorite wound-remedy and is well known to many herbalists, though it is not advertised by the big companies and therefore is not as well known as it should be.
The Latin name Achillea comes from Achilles, the famous warrior. Homer gives an example of yarrow being used to treat an arrow wound. It was carried into battle by warriors for generations and is also known as “carpenter’s weed.”
Yarrow is specific for deep wounds that hemorrhage freely. It is less effective for a puncture wound or when the bleeding is not profuse. It almost seems like the more the blood, the more it sprays, the more it bleeds, the better yarrow works. It stops the bleeding quickly, brings the lips of the wound together, prevents infection and excessive inflammation and promotes healing with the minimum scar tissue. It doesn’t stop acute bleeding just by promoting coagulation and astringing the wound (laying down proteins that pucker the tissue) but also by stimulating peripheral circulation so that the blood is dispersed throughout the body and less of it is available to surge out of the wound.
Those who have used yarrow can attest that it helps the veins soak up blood with renewed vigor. It is not unusual to see a fresh bruise removed in a short time because the veins pull in the pooled blood. There are coagulating factors that help close the wound, yet the blood that needs to be removed from the wound is kept moving. Yarrow is a stimulant and like all stimulants, it increases circulation to the capillaries in general. This takes the burden off a local area of congestion and hemorrhage, decreasing bleeding. By decongesting the capillaries yarrow is also cooling and sedating.
Yarrow works on internal hemorrhages as well as external. My friend Margi Flint, a community herbalist in Marblehead, MA, was called by a patient in tears. Her teenage son fell off his skateboard onto the board. He seemed to be o.k. at first, but his kidney had been injured and the hospital could not stop the bleeding. Could anything be done? “Of course,” replied Margi. She administered yarrow and the bleeding was stopped in short order. The doctors were amazed.
The mother of one of my students was asked to help by her neighbors, who didn’t have health insurance. The husband had gouged out a chunk of flesh on the front side of the ankle on a barb wire fence. The tendons were freely visible in the wound. The couple went to the emergency room but when they heard they were going to have to have a skin graft from the other leg they asked their neighbor, who was a nurse, if she would help. She agreed to change the bandages every day and called her daughter to find out what herbal medicine could be given. She was advised to put on yarrow poultices. Feeling very much as if she was committing a crime, and afraid her license might even be endangered, she helped change the bandages and poultice the wound every day. In addition the man took yarrow and comfrey tea. Several weeks later the wound was completely healed with a barely visible scar. “I kept expecting the wound to get infected, but it never did,” the nurse commented to me. “That was almost more unbelievable than the fact that the flesh filled in with barely a scar.”
It was fortunate that the man did not put the comfrey on the wound externally since, as we have noted, this herb tends to cause a wound to grow back on the outside, rather than from the inside out. This would have caused the wound to heal on the outside but become rotten on the inside. However, comfrey is very good for regenerating tissue and is especially beneficial to the tendons, so the internal use was likely to be very helpful.
Several years ago another herbalist told me about a young girl in his neighborhood whose arm was badly mangled in an accident with a lawnmower. The parents were advised to have the arm amputated as the wound was so dirty and mangled. The father talked to the herbalist, who advised poultices of yarrow. The wound healed without serious infection.
This is an old central European folk remedy which was adopted by Samuel Hahnemann and introduced into the homeopathic pharmacopoeia. After having more or less died out as a folk remedy it was reintroduced into herbalism from homeopathy.
Calendula is suited to the treatment of cuts after the bleeding has stopped. It keeps the inflammatory stage, which follows the hemorrhagic stage, in check. It will keep a fresh cut clean or cleanse out an old, infected or purulent (pus- producing) wound. I always think of the archetypal calendula wound as resembling an infected cat scratch: red, swollen, tender, warm and possibly full of pus. Calendula does not generally open up a vent for pus so much as cleanse it out through the lymphatic ducts. In fact, this points to organ affinity: calendula is a great lymphatic cleanser. If there is need to open a vent for pus there is hardly a better remedy than the following.
This remedy is what we call a “drawing agent” in herbal medicine: it pulls material out of the body. Therefore it is particularly suited to cases where there is dirt, infection or poison in the cut.
One of my friends described a case she sat in on as an apprentice many years ago. A man fell off a motorcycle and skidded across the pavement. His ankle was cut up, full of dirt and infected. The doctors didn’t know how to clean out the wound but my friend’s teacher juiced plantain and poulticed the wound in the chopped leaves and juice. Shortly it looked clean and healed without trouble.
An Indian woman from Cass Lake described how her husband had a festering ulcer on his leg from an old wound that required him to go to the hospital in Minneapolis – six hours away – one a month and have a painful cleaning and bandaging done. Her mother-in-law suggested that she take a plantain leaf, bash it up slightly between two rocks and put it over the wound. The ulcer healed up completely. The doctor scolded the man and his wife for using a folk remedy!
A woman on one of my herb walks had a bad scrape on the knee that had gotten inflamed, red, swollen, and tender. “Just a second,” I said. I slightly chewed a plantain leaf and she placed it under the bandage. “It’ll look clean by tonight,” I promised. Sure enough, it was. She changed the bandage and put on some elecampane leaf I had given her. It healed without complication.
A common name for this plant is ‘scabwort.’ I used to think this meant it was for mangy diseases with scabby skin. Perhaps it is, but I was corrected by my friend Jennifer Tucker, of State College, Pennsylvania. Her teacher, Evelyn Snook used it as a remedy for ‘proud flesh.’ That is a condition that occurs when there is excessive granulation (flesh proliferation) and the next stage of wound healing (scab or scar formation) is retarded. So elecampne, according to Mrs. Snook, forms a good scab. Since that time I have seen this indication verified several times.
Elecampane has natural antibiotic and antiseptic properties so pronounced that it has actually been used as a surgical wound dressing to prevent infection after a wound (Maude Grieve). We will visit this plant again when we come to the respiratory tract; it is most famous in conditions with yellow-green mucus, indicating bacterial infection.
One of my students had a friend who got her bellybutton pierced. The cut got infected and continued to suppurate pus for weeks. She put elecampane on the wound and it quickly healed up. Later she sought out my friend for advice about a more serious problem. This is often how things work with herbalism: we establish trust with a little problem and are entrusted with more later on.
Long before the recent ruckus about St. John’s Wort as a treatment for minor anxiety and depression, it was used as an important medicine for wounds, especially those involving nerves. It is an old central European folk remedy, beloved in Russian herbalism, picked up by Samuel Hahnemann, the founder of homeopathy. The latter was able to determine specific indications calling for the use of Hypericum in wounds. It is for “injuries to areas rich in nerves.” This includes the spine, eyes, ears, genitals, and fingers. The area becomes hot, swollen, red and very painful. Hypericum keeps the nerves from being damaged and is the remedy for choice when a part has been lost and is sewed back on surgically or simply when it has been lost.
The two main herbal drawing agents that I am familiar with are plantain and pine. A careful observation of the natural history of each plant revealed why they are useful in this fashion. Plantain grows on ground that is hard-packed or compressed from the passage of foot traffic or wheels. It has extra power to draw nutrients and water out of the earth and what it can do for itself it can do for us. Pine shows us the same property in a different way. White pine is often the tallest tree in the forest, towering above all the rest. In order to feed the high limbs, where the needles grow, it has to have extra pulling power to pull nutrients all the way up the trunk from the ground. It does this despite the fact that it is full of sticky sap. The tree repairs its wounds with this sap, which led to its use to patch up wounds. It is also used to patch up birch bark canoes.
One herb student was visiting a class with her husband, who was a Navajo. We were discussing wound-remedies and he gifted us with a story the illustrated the use of this old Indian wound healer. Somebody shot his horse, but the wound wasn’t fatal. He stuck pine sap on the wound, it kept it from getting infected, pulled the bullet out, and healed it up. This would not have been the white pine, but most pines will work the same way.
I’m going to continue to tell bad stories about comfrey so that readers really understand how inappropriate it is to use an herb unless it is well indicated and specific.
One of my students in Pennsylvania reported that after birth she used comfrey on a vaginal tear. The remedy, rather than bringing the lips of the wound together, caused healing all over the surface of the tear, leaving the gaping wound intact but covered up by a membrane. In the end the doctors had to sew up the tear surgically. Another student in New York recounted how an acquaintance of hers used comfrey for diaper rash on her baby, only to have it cause the lips of the vagina to grow together. They had to be surgically separated. Another student in the class realized that exactly the same thing had happened when she used comfrey for diaper rash on her girl baby.
I am including a discussion of this remedy, not because it belongs among the top half dozen wound-medicines, but because it is has been used more often than it should be.
A common idea nowadays is to give goldenseal for cuts because it is a “natural antibiotic” and will kill the germs settling into the wound. Goldenseal was a fad herb for cuts when I was a young herbalist. That was before the days when people who read studies but had no direct experience butted in and interjected all sorts of nonsense. Goldenseal was recommended in those days because it has a powerful ability to “seal” external cuts.
Goldenseal might well be effective in a case where there is a clean hemorrhage that needs to be sealed up and where we want to prevent bacteria from entering the wound – the powder is sprinkled into the wound – but it is completely incorrect to give when there is a dirty, infected cut. We do not want to close this up. I have seen it seal up inflammation, pus, and dirt, resulting in systemic infection rather than cure. Therefore it is the wrong remedy to give unless we have a fresh, clean cut that we want to close up and keep from getting infected. Once inflammation has set in, with heat, swelling, redness, and pain, it is counterproductive. If there is pus in the wound, despite the fact that goldenseal is a natural antibiotic, it will make the situation worse by closing it up prematurely.
One time I was called to attend a mother of five out in the country west of me who was having trouble with a burn on her hand. It was small but had opened up – a third degree burn. She kept putting goldenseal on it and every few days it would close up. Then she would get a fever with exhaustion until the wound opened up again. She was closing up a vent that the body wanted to use and poisoning herself with the pus that was flowing into the bloodstream. I stopped her and used something else – I can’t remember what now. The burn quickly healed. I was rewarded with a few weeks supply of well appreciated goat milk for my efforts.
Here’s a case where goldenseal was appropriate. Years ago a friend of mine cut himself on the bottom of his foot while wadding in a city lake. He got the wound stitched up and used antibiotics but the wound would not close up since he still limped around on the foot. It was not infected but it would not close up. He put goldenseal on it and it closed up quickly.
------------------------------------------- from Matthew Wood: THE EARTHWISE HERBAL © 2008–2009 North Atlantic Books (two vols) -------------------------------------------