Herbal Therapy in Acute Bacterial Infections

Most of my experience as a herbalist lies in helping people with chronic health complaints. It is rare that someone contacts me about an acute infection. However, I have recently witnessed several cases of infections of bacterial origin (UTI), or viral origin where bacterial infection takes hold at a later stage (e.g. acute bronchitis as an adjunct to a viral infection). I would like to share my thoughts and observations on the practical application of herbal medicine in acute conditions.

It is totally doable to successfully recover from an acute bacterial infection with herbal medicine alone, but it is a really hard job.

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The herbal protocol for acute infections is laboursome

I find that one needs to take various herbal preparations every 2 hours at the first onset of infection symptoms. These include tinctures, teas and topical applications if applicable. Once the symptoms lessen, the herbal treatment can be taken every 4 hours, and relaxed further. Herbal treatment should be continued for a week after all symptoms disappear. It is honestly much easier (and cheaper) to take an antibiotic. However, if you do stick to a herbal protocol and do get better, it is very empowering not to have been dependent on antibiotics during acute infection. You also get the extra bonus of a healthier gut flora and minimising risks of antibiotic resistance in the future.

Time is of the essence

If you do not start the herbal protocol immediately at the first symptoms of an infection, getting rid of an infection with plant medicines alone becomes even more laboursome with mixed results depending on the nature of the infections and your general health and immune status. One needs to take risks into account. For example, progression to kidney infection in UTIs that are allowed to linger for too long. You would not want this to happen as this would require much stronger antibiotics and longer recovery. Another example is acute bronchitis, where not using an effective treatment in the first place could cause damage to your lungs. Also mastitis could turn into breast abscesses requiring much stronger antibiotics and even surgical intervention.

You cannot stop the treatment protocol when your symptoms lessen or disappear

This is because it is likely that the infection is still in your body. You need to continue with the treatment for another week after all symptoms are clear. If you stop the treatment, the symptoms may return and you will need to start the protocol anew. Plus, there is a small chance that bacteria could develop some resistance to your herbal treatment by then (although it is much harder for bacteria to develop resistance to plants than to antibiotics due to several active compounds working together).

Accurate choice of herbs is of paramount importance

This is especially true for respiratory tract infections. Depending on the location and the stage of the infection different herbs may be used.

But will it work for me?

It can be scary to be treated with herbs alone in acute conditions (from personal experience). This is because in some cases you might not feel immediate relief and might get no significant improvement in the symptoms in the first couple of days. Antibiotics definitely provide more reassurance. Awareness of your own body and trust in your body’s ability to heal and get rid of infection are important. Allowing yourself to be ill, taking good care of yourself and recuperating is important too. People who force themselves through an acute illness trying to juggle usual workload with herbal treatment, do themselves a disservice and have lower recovery rates with herbal protocols.

And if not?

And last but not least, if your symptoms do not improve after a week of herbal protocol, or get worse at any stage, you must immediately seek conventional medical help. It does happen sometimes and this is what antibiotics are there for.

Plant Medicines for Stress

Stress was part of our modern lives before the pandemic struck. For most of us, stress levels have shot up massively during the pandemic. What is worse, there is no certainty of when our lives will get back to the old normal.

It is well known that prolonged exposure to an ongoing stress is harmful to our health. Let’s take the classic metaphor of the ancestral human meeting a tiger in a jungle. The “fight or flight” response initiated by this life-threatening event enables him to physically outrun the tiger and survive. The brain commands “danger”, and relevant neurotransmitters and hormones within the sympathetic nervous system tune in. Voila, and your heart rate is up, your blood pressure is up, your blood sugar is up and your digestion slows down. After the event, physiological markers return to normal as our ancestor is relaxed in a “rest and digest” phase governed by the parasymphathetic nervous system. Our bodies can cope well with exposure to short-term stressors.

But what if the “tiger” or the trigger, be it physical or emotional, is always there? Then await the undoubted negative impact on your nervous system, endocrine system, cardiovascular system, digestive system, respiratory system, immune system, musculoskeletal system and mental health. No wonder an old adage goes “All diseases are caused by stress”.  

Image by Pete Linforth from Pixabay

So, if the “tiger” is always there something must be done. Medicinal plants, or herbs, can really help to ease the effects of ongoing stress on the body (although good diet, adequate sleep and moderate exercise are also important).

Over many centuries and across different cultures such plants have been called rejuvenating herbs, qi tonics, rasayanas or restoratives. In 1968, Israel Brekhman from Russia coined the term “adaptogen” which is now used to describe this group of medicinal plants. These plants help the body’s physiology to adapt in the best possible way to living with the ”tiger”.

The majority of adaptogenic medicinal plants came to us from Ayurveda and Traditional Chinese Medicine. Many readers will have heard about Ashwagandha (Withania somnifera), Korean ginseng (Panax ginseng), Astragalus (Astragalus membranaceus), Schisandra (Schisandra chinensis), Shatavari (Asparagus racemosus), Gotu kola (Centella asiatica), Holy basil or tulsi (Ocimum sanctum) and Siberian ginseng (Eleutherococcus senticosus), to name but a few. However, there are also adaptogens that grow closer to home in Europe, such as Liquorice (Glycyrrhiza glabra) and Rhodiola (Rhodiola rosea).

There is a wide choice of adaptogenic herbs, but it is important to remember that not all adaptogens are the same. Some, like Korean ginseng are very stimulating and should not be used by those who have high blood pressure, or suffer from acute asthma.  Korean ginseng is best used short term to help with increased tiredness and stress. It can also be used where increased mental or physical performance is required. Korean ginseng also has other actions such as cardioprotective and anti-inflammatory. It also enhances male sexual performance and sperm production.  At the same time, it can be taken as a long term tonic in very small doses by the healthy elderly.  

Wild ginseng~Image by ebiz1966 from Pixabay

Some adaptogens like Ashwagandha are not overstimulating and gentle. Ashwagandha would be a good choice to support those recovering from acute illnesses or extreme stress. It also can be used as a general tonic even during pregnancy in small doses. Ashwaganda also has an anti-inflammatory action, a blood sugar-regulating action and a libido-enhancing action.

Some adaptogens have an immune-protective and enhancing action, which is interesting in light of the current pandemic. For example, Andrographis, known for its immunomodulating activity as well as benevolent action on the digestive system due to presence of bitter compounds.

Another adaptogen that has an immunomodulating action is Astragalus. It is well suited for the prevention of infection, strengthening impaired immunity, and chronic bacterial or viral infections. It also has cardioprotective actions and can help reduce blood pressure. However, it must not be used in acute illness and infections.

Astragalus flower~Image by Martin Hetto from Pixabay

Although adaptogens are extremely helpful in coping with stress and increasing energy levels, they should not be self-medicated by those suffering from extreme fatigue or adrenal insufficiency. 

Of course, it is always best to entrust the choice of adaptogens best suited for you to a professional. Medical herbalists are medically and pharmacologically trained to provide expert advice on the use of herbs for all health conditions. They can also formulate personalised prescriptions. So your “tiger” can be tamed.

Written by Julija Milovanova-Palmer

The Syriac Galen Palimpsest “On Simple Drugs” – a core reference medical text in the ancient world

Starting in 2015, the University of Manchester has been engaged on revolutionary research into the origins of herbal medicine.

Galen, born in 131 AD, is one of the forefathers of medicine and one of the most influential medical writers, physicians, scholars and philosophers. He left a vast legacy of written texts on medicine. Indeed, about half the texts known to us from the Hellenic period were written by Galen. Galen wrote in ancient Greek, but his texts were later translated into Syriac*, then Arabic and lastly Latin (through the Arabic invasions into Europe). His teachings profoundly influenced medical traditions around the world. Avicenna, a famous Islamic physician and philosopher, used Galen’s treatise “On Simple Drugs” as one of his core reference texts. Eventually, Avicenna wrote his own interpretation on Galen’s ideas that became a part of The Canon of Medicine, the most influential medical text both in Islamic world and medieval Europe.

What makes “The Syriac Galen Palimpsest On Simple Drugs” project unique is that University of Manchester scholars were able to work with the original 6th century Syriac manuscript that had been considered lost forever, before recent advances in technology.

Back in ancient days, parchment, or “pergament” was used as the writing medium. It was made from the skin of domesticated animals in an extremely time-consuming and costly process. A few centuries after the original translations, during Syriac church reforms, parchments that were no longer considered sufficiently useful were simply recycled. This was done by erasing the ink on the pages by steeping them in milk and covering them in chalk. The result was that the text underneath was not completely erased but was completely unreadable and unrecognisable.

But now new technologies, such as ultraviolet photography, allow the previously erased parchment texts hiding underneath other texts to be recovered. The principal University of Manchester study compared the recovered Syriac version of the manuscript to the Greek version. This identified gaps in the original printed Greek version that had been lost.

A large part of the manuscript “On Simple Drugs” is devoted to medicinal plants and their uses. The Galen’s manuscript focuses on the virtues of “simple” or “single” plants. Even today, we, herbalists, refer to “simples” when just one herb is prescribed, as opposed to when a cocktail of herbs is taken simultaneously in a “herbal mix”. Some of the medicinal plants Galen wrote about are still used in modern herbal medicine today, whilst others have fallen by the wayside. The former group includes Cinnamonum cassia (Chinese cinnamon), the bark of which modern research now suggests can improve blood glucose and cholesterol levels in people with type II diabetes (Diabetes Care, 2003). On the other hand, Galen was especially fond of apples. He considered apples to be a “cure for all”. Although apples have medicinal virtues (keeping teeth clean, preventing gallstones, lowering blood sugar and cholesterol levels) we do not really prescribe apples as a medicine these days.

*Syriac was a major literary and religious language of the Middle East from 1st century AD to 8th century AD.

An exhibition “Seeing the Invisible: Medieval Hidden Heritage Revealed” concluded the University of Manchester’s scientific discovery. The exhibition took place at John Rylands Library, University of Manchester between 30 October 2019 – 8 March 2020. Julija Milovanova-Palmer was an exhibition consultant on the use of medicinal plants described by Galen in the modern Western Medical Herbalism.

References: Cinnamon improves glucose and lipids of people with type 2 diabetes.Khan A, Khattak K, Sadfar M, Anderson R and Khan M, Diabetes Care 2003, 26: 3215-3218.

My Love is Like a Red, Red Rose…

The most popular plant in the Rosaceae (Rose Family) is the rose.

A Red Rose is a universal symbol of love. Rose oil and rose water were prized as aphrodisiacs for centuries and across many cultures (Greek, Roman, Arabic, Chinese). (Bartram, 1889; Wood, 2008).

Alexandrian author Achilles Tautus wrote about the rose in 2 BC “It is the ornament of the earth, the pride of the plant realm, the crown of flowers, the image of beauty. It is full-blown love in service to Aphrodite, resplendent with fragrant petals, swaying on its supple stem, rejoicing at the cheery zephyr”.

It was believed that the wild rose (Rosa canina) flowered where the tears of Aphrodite fell as she cried for Adonis.

In modern western herbalism we mainly use rose as a nervine, relaxant, mood uplifter and mild sedative. Rose water (distilled from petals) was first prepared by Avicenna in the 10th century and is still widely used to sooth and tone the skin. Rose oil contains geraniol, which has a strong antiseptic activity (Hoffman, 2003). It also contains tannins, which have astringent properties. This makes rose a good remedy of choice to treat sore eyes, mouth ulcers and diarrhoea, especially in children. (Barker, 2001). Rose also has an anti-inflammatory action and is a good choice of treatment in acute inflammatory conditions of the respiratory tract, especially for drying out mucus secretions (Wood, 2008). According to Mathew Wood (The Earthwise Herbal, 2008) Rosacea family plants are well indicated in autoimmune conditions. A randomised controlled clinical trial, where patients suffering from rheumatoid arthritis were given 5g of dried rose hip powder for 6 months were compared to a placebo group, showed slight improvement in the rose hip group (Willich et al., 2009)

Photo credits: Ivan Jevtic and Oziel Gomez on Unsplash

Orange Happiness or a Cup of a Sea Buckthorn Tea

With the advent of the colder season, orange coloured foods beckon. Pumpkin soup, roasted squash, red lentils (that actually look orange when cooked). Even oranges are at their best around January. Orange colour is destined to brighten the gloom cast by the shivering weather. Indeed, orange is associated with warmth and happiness. Give me more carrots!!!

Whilst pumpkin, lentils and oranges (and carrots!) undoubtedly have medicinal properties, we do not really think about them as medicines. In vain, my friends, in vain. Remember Hippocrates? “Let food be thy medicine and medicine be thy food”.

Out of interest, I scanned some herbal literature, and yes, Cucurbita pepo (pumpkin) and Daucus carota (wild carrot) are medicinal plants!!!

But I am not inspired by them today. I am going to tell you about a wonderful orange coloured berry – the fruit of Hippophae rhamnoides or Sea Buckthorn.

Sea Buckthorn grows in Britain in the wild. I encountered it on the Norfolk coast one November day. I remember its bushy appearance, with no remaining leaves at this time of the year. Just greyish stems covered with considerably long thorns and few vibrantly orange berries that burst with juice the moment your finger touched them, so overripe they were. I tasted it and the familiar tanginess and sourness hit my taste buds. (My husband made a face like he scoffed a whole lemon, but really it is not that bad!)

To be honest, I have been walking on the British coast for quite a few years, and this encounter in Norfolk was the only one. Not surprising that Sea Buckthorn is not popular medicinally or nutritionally in the UK. Core texts on classical Western Herbal Medicine do not mention it at all. 

In contrast, Sea Buckthorn is an officially listed medicinal plant in the Russian herbal pharmacopeia. It is also used as a medicine by the countries around the Baltic Sea and in Asia.

Sea Buckthorn berries are loaded with vitamins – A, C (content 15 times higher than in the orange fruit), B1, B2, B6, Folic acid, PP, K, P and E. The berries are also rich in carotenoids (both alpha and beta) and flavonoids (especially rutin amongst 36 types present). The berries are rich in zinc, iron, boron, selenium, copper, manganese. Berries are also a good source of organic acids (malic, tartaric and oxalic). Sea Buckthorn berries and bark have serotonin that is important for healthy functioning of the nervous system. A real superfood!

The most valued medicinal preparation of Sea Buckthorn is Sea Buckthorn Oil. It is obtained by the method of cold extraction from berries and seeds of the plant. It allows to access the bioactive compounds of the seed. These include vitamin D, saturated fatty acids, sterols, unsaturated fatty acids Omega-3, Omega-6, Omega-9 and rare Omega-7 (palmitooleic acid).

The oil is widely used in dermatology for wound healing due to its antioxidant, anti-bacterial, anti-inflammatory, analgesic properties and ability to stimulate regenerative processes in the skin (thanks to sterols and Omegas, especially Omega-7). The oil is also used internally for soothing and healing of the mucous membranes. For example, the oil is used in gastroenterology for treatment of peptic ulcer disease. Sea buckthorn oil is also used in treatment of sinusitis, chronic tonsillitis and periodontal disease.

Sea Buckthorn juice (taken as a tea diluted with boiling water) will relieve coughs and colds caused by viral respiratory tract infections. Sea Buckthorn juice and tea cannot be taken by gastritis and peptic ulcer sufferers as it is too sour (whereas the oil is not sour and will not impact the level of the stomach acid).

β-Sitosterol found in Sea Buckthorn berries significantly increases the level of beneficial high-density lipoprotein (HDL) cholesterol. It is therefore a great preventative for atherosclerotic disease. A human clinical trial looked at the effects of a combination formula (a Xinnaoixin capsule) of Rhodiola rosea, Lycium chinense berry and fresh Hippophae rhamnoides fruit juice on 30 patients with chronic cerebral circulatory insufficiency, and found significant improvement after 4 weeks of taking the formula.

Leaves of Sea Buckthorn are also used medicinally. Stephen Buhner in his book “Herbal Antivirals” refers to Sea Buckthorn leaf as a specific antiviral for Dengue Fever Virus (a debilitating viral disease of the tropics, transmitted by mosquitoes, that causes fever and sudden joint pain).

An animal study examining adaptogenic properties (alleviating negative effects of stress on the organism) of Sea Buckthorn leaf extract concluded that Sea Buckthorn is a potent adaptogen.

And of course, Sea Buckthorn can be enjoyed as a culinary delight – one can make liquors, jams and punches from the berry, steep them in honey and use them in baking. And then, how could I forget, on a trip to St.Petersburg, a few years ago, every single cafe and restaurant offered this exotic tea flavoured with honey. Orange happiness.


A.M. Zadorozhny, A.G. Koshkin & S.Y. Sokolov. Compendium of Medicinal Plants, Lesnaya promyshlennost, Moscow (1988)

S.H. Buhner. Herbal Antivirals, Storey Publishing, USA (2013)

Zielinska and Nowak, “Abundance of active ingredients in sea-buckthorn oil”, Lipids in Health and Disease. 2017; 16: 95. doi: 10.1186/s12944-017-0469-7

Sayegh et. al, “Potential cardiovascular implications of Sea Buckthorn berry consumption in humans”, International Journal of Food Sciences and Nutrition. 2014 Aug;65(5):521-8. doi: 10.3109/09637486.2014.880672.

Saggu et. al, “Adaptogenic and safety evaluation of seabuckthorn (Hippophae rhamnoides) leaf extract: A dose dependent study”, Food and Chemical Toxicology 45(4):609-617. doi: 10.1016/j.fct.2006.10.008

Photo credits

Pavlofox and Silviarita from Pixabay