1. Vitalist Herbalism in the 21st Century
The Gathering 2011
Toronto, Ontario
Vitalist Herbalism in the 21st Century
Paul Bergner
Director, North American Institute of Medical Herbalism
Editor, Medical Herbalism

2. Supplementary notes, readings, texts
Powerpoint and supplemental materials at

3. Clinical Experience at NAIMH
January 1996 to present. More than 3000 cases from a sliding scale public clinic
Therapeutics include medical herbalism, clinical nutrition, flower essences, and lifestyle modification delivered in a Vitalist model.
Each patient visit becomes case-based learning
3 hour intake with 1 hr followup, averages.
Case writeup is studied in-depth collectively by clinical faculty and herbalists
“Community learning” among 250 students.

4. Conditions routinely cured or greatly improved
--Connective tissue autoimmunity. Multiple lupus cases
--Insulin resistance/NIDDM
--Chronic URI (sinus, sore throat, bronchitis).
--Chronic inhalant allergies/asthma
--Chronic upper GI (GERD)
--Chronic lower bowel (UC, Crohn's, IBS)
--Chronic UTI: (secondary to dysbiosis)
--Chronic musculoskeletal pain:
--Vague neurological complaints.
--Chronic anxiety/panic disorder
--Chronic fatigue/depression
(from a review of case files)

5. Vitalism: A recurring principle
The same principles of Vitalism emerge in Egyptian, Mesopotamian, Chinese, Ayurvedic, Unani, Physiomedicalist, Eclectic, and Naturopathic medicines without apparent linear transmission.
“If you reinvent the wheel, it will probably be round”
Medicine on the model of Agriculture

6. Vitalism
Modification of Regimen to maximize the healing expression of Nature
The primacy of food as medicine
The primacy of the digestive tract as a target for therapeutics
Use of herbs and foods to optimize the vital expression, remove obstacles to cure, and support Regimen
Reliance on the Power of Nature rather than the power of the drug
Avoidance of suppressive agents and strategies

7. The Classical Regimen Food Drink Rest Exercise Air Emotions
Water (hydrotherapy)
Physical Medicine

8. The Physician in History
Principles of Medicine
Humoral Diagnosis
Prognosis
Regimen
Dietetics
Medical Herbalism
Attending the critically ill
Attending the dying.

9. Polarity of Vital Force and Regimen
Any concept of Vital Force or Life Power separate from the patterns of Regimen necessary for its expression is a divergence from the principles of medicine

10. Baghdad Medical Qualification (800 AD)
“Any physician found to have given a strong herb when a mild herb would suffice, or a mild herb when a food would suffice, or a food when a lifestyle change would suffice will be disqualified from practicing in the marketplace”

11. Regimen in Homeopathy
“The physician must know the things that derange health and cause disease, and how to remove them he must know the obstacles to recovery in each case and is aware how to remove them he must know the most significant points in the whole history of a chronic disease he must take into consideration the physical constitution of the patients, the character, the occupation, mode of living, habits, social and domestic relations, age, sexual function., etc.  ”
Hahnemann, Organon

12. Regimen in Homeopathy and
Specific Medication
“Of all the schools of medicine in existence today, it is the Homeopaths who are strictest in insistence on the avoidance of those foods which irritate the stomach or oppress the system. ”
John Scudder, Eclectic herbal physician, 1898

13. Henry Lindlahr
In response to the challenge
"If your system is so effective, why don't more people engage in it?" 
Lindlahr’s reply
"Because it requires a degree of self-mastery?"  

14. Medicine as invitation to self-mastery
The task of the physician is to cooperatively assess the uniqueness of the relationship between the Life Force and the Regimen of the patient, to educate them, and to invite them to a higher level of self-mastery. 

15. What happened to medicine?
With the advent of chemical medicine in the 1800s, the medical profession dropped Regimen and humoral analysis in favor of strong suppressive drugs. Today Regimen is fragmented, treated superficially, ignored in conventional training, and relegated to a subsidiary legal status. Only NDs study the range of traditional regimen.
In the later twentieth century many Western herbal and naturopathic institutions, seeking social and scientific approval, followed the same pattern, with Regimen poorly defined.

16. How will you practice?
Will your practice, in a cooperative manner, invite the patient to a higher level of self mastery, or will it burn itself out in pursuit of the next shiny bauble or magic bullet which will let both patient and practitioner evade the task of their own self-mastery.

17. Vitalist Regimen in the 21st Century
Food: Provide basic nutrition for endemic deficiencies
Food: Review metabolic effects of macronutrients, evaluate for insulin resistance.
Food: Review immunologic effects of foods
Food: Review adverse effects of non-foods.
Food: Prepare food from scratch
Activity: minutes of activity per day; mixed low aerobic walking, short resistance, and high-lactate short burst, 6 days per week.
Rest: 8.5 hours average; 9.5 x 3 days = short therapeutic dose; weekend bed rest
Evaluate for Leaky Gut and impaired digestion
Optimize vitamin D status
Emotions: flower essences, talk therapy, affirmations, other
Non-suppressive and supportive medical herbalism as indicated
Time in Nature

18. Wade Boyle, ND “Medical Herbalism is using herbs as medicine.
Naturopathic Medical Herbalism is using herbs in support of Nature Cure.”

19. Herbs and Nutrition
Critical deficiencies in contemporary life: Minerals and trace elements
One ounce of most herbs contain nutritionally significant amounts of calcium, magnesium, and trace elements
Significant amounts of these nutrients are contained either dissolved or suspended in long decoctions/infusions of herbs
Model at NAIMH: Goal for each patient to take about a liter of herbal tea a day.

20. Mg per ounce; for Sel mcg per ounce
Calc Iron Mag Mang Pot Sel Sil
Alfalfa
Burdock
Catnip
Stellaria
Symp lf
Equiset
Kelp
Licorice
Althea
Urtica
Avena
Mentha
Trifol
Rubus
Skullcap
Mg per ounce; for Sel mcg per ounce

21. Herbal regimen for mineral nutrition
Increase nutrient density of the diet
Take 500 to 1000mL of a nutritional herbal decoction most days. 
Most nutritious herbs are Urtica and Avena (straw) 
Almost any herb offers mineral nutrition at a dose of 1-3 ounces in strong decoction. 
Use seaweeds for supplemental food most days.
Typical results: rapid increase in sense of well-being, within 4-7 days. Longer term improvement in tissue tone and hair quality.  

23. Evening-to-morning bloating pattern before dairy removal
Resolved chronic headaches, chronic yeast infections, constant nausea, and chronic fatigue

24. Abdominal lymphadenopathy after exposure to chicken-egg antigens
Bloating resolved within a week of return to avoidance of eggs.
Patient eventually was cured of long-standing MRSA infection

25. Abdominal swelling before and after elimination of dairy and gluten
Migraine headaches completely absent after withdrawal

26. Severe eczema due to covert buttermilk solids in gluten-free mix

29. Herbalism and the Leaky Gut
“What is good for the skin is good for the gut”
Vulneraries useful in restoring gut integrity
Plantago, Calendula, Aloe vera, Symphytum leaf in decoction (PA caution), Althea spp., Ulmus
Abdominal lymphatic engorgement
Plantago, Ceanothus, Galium, Scrophularia, etc.
Combine with bitters, carminatives, astringents, demulcents, etc as indicated
Herbal anodyne formulas as substitutes for NSAID

30. Herbal support for probiotic therapy
Many herbs in the composite family contain various quantities of the prebiotic inulin.
Arctium lappa rt (50% by weight)
Inula helenium rt (40%)
Taraxacum rt (25%)
May be administered as powder or as long decoction (inulin highly soluble in hot water)

31. Formulae for acute pain
Portions may be composed of simples or compounds of the herbs below.
Portions are added as parts of the formula along with 1-2 chief herbs.
Anodyne portion
Eschscholtzia, Corydalis, Piscidia, Lactuca, Pulsatilla
Antispasmodic portion
Viburnum opulus, Dioscorea, Paeonia, Peducularis
Sedative Portion
Scutellaria, passiflora, Valeriana, Humulus (as indicated)

32. Formulae for chronic pain
Build formula around the therapeutic pair of Curcuma and Glycyrrhiza
Deliver in larger quantities as powder.
Add modifying portions from acute formula if appropriate
A medium of lemon and honey (traditional corrigent for curcuma in Unani medicine)
Honey decoction. Heat a quantity of honey gently to just below its boiling point. For a brief period it will become as thin as water. Shortly therafter it will foam up. Before foaming, add 1/8 part lemon juice and then freshly ground powder of Curcuma (3), Glycyrrhiza (3), Rosa flos (1), and Pimpinella seed (1) until a thick consistency

33. Vitamin D and the junction proteins

34. The Pathophysiology of Sleep Debt
For some individuals, sleep debt occurs with less than 9 hours sleep. For the majority of individuals, it occurs with less than 8 hours sleep.
Sleep debt induces hypercortisolemia, disturbed cortisol rhythm, insulin resistance, immunodeficiency, and cognitive dysfuntion. Individual may meet diagnostic criteria for depression.
The neuro-endocrine effects are largely corrected with 3 successive night of sleep of 9.5 hours or more
Sleep coaching is necessary to re-establish sleep – effects of light, temperature, activity, daylight sun exposure, etc.
Herbs may help to induce or support sleep and restoration.

35. Herbs and Sleep Debt Non-hypnotic nervine tonics by day
May be given is context of sleep-coaching: effects of light, activity, etc on circadian rhythm
Non-hypnotic nervine tonics by day
Mild relaxants at transition to home, to support intentional efforts to relax.
Hypnotics, sedatives, anodynes by night
Pulsed dosing along with relaxation efforts
Doses at 90 and 30 min prior to bedtime, and at bedtime. Extra dose at bedside if waking up.

36. Wild Cards for Vitalism in the Future
Future shock/social and economic dislocation
Post Traumatic Stress Disorder (PTSD)
Mild Traumatic Brain injury
Jet lag, Climate lag, Season lag.
Electronic fields
Common forgotten remedy: Time in Nature

37. Supplementary notes, readings, texts
Powerpoint and supplemental materials at
See also:
Educational courses and CEU. Free copy of Scudder’s American Eclectic Materia Medica and Therapeutics.
Free searchable Medical Herbalism back issue article database (free). Free copy of Cook’s Physiomedical Dispensatory