MEDICINAL HERBS

Denton County Master Gardener Association educates and engages county residents in the implementation of research-based horticultural and environmental practices that https://dcmga.com create sustainable gardens, landscapes, and communities. All photos in this presentation not individually credited are from public domain sources and may be used without attribution. Sources are documents in the references.

Joseph A. Carroll Building 401 W. Hickory Street, Suite 112 Denton, TX 76201-9026 1 [email protected] Phone: 940-349-2883 or Help Desk 940-349-2892 About DCMGA How to get copies of presentations

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4 DCMGA “Herbal Branch” Special Interest Meetings

Join the Master Gardeners one Monday each month, 10:00 – 11:00 A.M., at meetings of the Herbal Branch Special Interest Group. Everyone is welcome and admission is free. Each meeting will feature a presentation related to herbs.

The meetings are held at the Denton County offices of the Texas A&M AgriLife Extension at 401 W. Hickory Street, Suite 115, Denton TX 76201- 9026, unless otherwise specified.

Upcoming meetings: January 27: “Wisdom From the Garden” by Master Gardeners Carol Noble and Bernadette Gilbert February 24: “Celeriac” by Master Gardener Karen Stubbs

Questions? Contact the Denton County Master Gardener Help Desk at 940-349- 2892. MEDICINAL HERBS HOW DO MEDICINAL PLANTS DIFFER FROM MEDICINAL HERBS?

❖ Essentially any plant that is used for treating an illness is botanically defined as a medicinal plant whereas medicinal herb is the term applied to any herb used for medicine.

❖ In common usage, practitioners, researchers and consumers often refer to any plant used for medicine as herbal medicine.

❖ Medicinal herbs has become a generic term that may mean just herbal plants or may refer to any plant.

PLEASE NOTE: It should NOT be assumed that the information provided in this presentation on herbal medicine represents the views of the DCMGA or its sponsors. HERBAL PRODUCTS

Medicine in Ancient Times HISTORY OF PLANT MEDICINE ANCIENT TIMES

❖ PALEOLITHIC AGE. Based on archaeological evidence, the use of medicinal plants dates back approximately 60,000 years. It is thought that WOMEN during this period were primarily responsible for gathering and preparing plant foods, including those we term herbs today.

❖ ORIGIN OF PLANT USE. It is thought that ancient people observed animal behavior and their consumption of plants. Treatment of illness likely evolved from these observations. For example: ▪ Dogs eat grass to purge intestinal infections. ▪ Chimpanzees self-select medicinal plants for treatment of disease.

❖ EARLY MIND-BODY MEDICINE was likely included and practiced in the many rituals, magic rites, and beliefs in higher beings. Plants probably had a critical role.

[https://en.wikipedia.org/wiki/History_of_medicine] EARLY HISTORY OF PLANT MEDICINE

❖ 5000 B.C.E. (approximately) Sumerians compiled written lists of herbal plants.

❖ 2613-2494 B.C.E. (approximately). PESESHET is considered the earliest known woman physician. Her title was "Lady Overseer of the Lady Physicians,” and in addition to her supervisory role, Peseshet trained midwives at an ancient Egyptian medical school in Sais.

❖ 2400. B.C.E. (approximately). HESY-RA, earliest known male physician, served as "Chief of Dentists and Physicians” in Egypt. ❖ 1900 B.C.E. Egypt. Kahun Papyrus. Deals with the health of women, including birthing instructions. Includes many herbs that are commonly used today. ❖ 1550 B.C.E. EBERS PAPYRUS. Egypt. Contains over 700 medicines mainly of plant origin. [https://en.wikipedia.org/wiki/History_of_medicine] [Lewis, W.H. and Memory P.F. Elvin-Lewis. Medical Botany. 2003. Wiley.] [https://www.traditionalmedicinals.com/articles/inspiration/female-trailblazers-of-american-herbalism/ EARLY HISTORY OF PLANT MEDICINE

❖ 1600- 1046 B.C.E. Huangdi Neijing. Bronze Age China, Shang Dynasty medical text on 228 medicines (100 of which are plants).

❖ 460-370 B.C.E. The Medicine of Hippokrates. An ancient text by Hippokrates, a Greek physician. The 257 drugs mentioned are compared to modern Pharmacognosy texts, and only 27 of the medicines listed are not defined as medicinal plants today.

❖1098-1179 A.D. Hildegard von Bingen, a 12th century Benedictine abbess. Her teachings laid the groundwork for Traditional European Herbal Medicine, leading many historians to consider her one of the most significant scientists of Medieval Europe. Many of these herbal remedies can be found in her book, Liber Simplicis Medicine.

[https://en.wikipedia.org/wiki/History_of_medicine] [Lewis, W.H. and Memory P.F. Elvin-Lewis. Medical Botany. 2003. Wiley.] [https://www.traditionalmedicinals.com/articles/inspiration/female-trailblazers-of-american-herbalism/ Rise of Modern Herbalism Some Present Day HERBALIST ORGANIZATIONS

1933: The Herb Society of America, Inc. The group was founded by six Boston women who had studied botany and horticulture under Dr. Edgar Anderson of the Arnold Arboretum at Harvard University (plus one other woman who had not). “The Herb Society of America is dedicated to promoting the knowledge, use and delight of herbs through educational programs, research, and sharing the experience of its members with the community.” [www.herbsociety.org/about/hsa-history]

1989: American Herbalists Guild Twenty herbalists gathered at the Santa Cruz mountain home of Christopher Hobbs and Beth Baugh and formed the American Herbalists Guild. “The American Herbalists Guild promotes clinical herbalism as a viable profession rooted in ethics, competency, diversity, and freedom of practice. The American Herbalists Guild supports access to herbal medicine for all and advocates excellence in herbal education.” [www.americanherbalistsguild.com] HERBAL & TRADITIONAL MEDICINE ORGANIZATIONS

1987: Botanical Research Institute of Texas (BRIT) in Fort Worth, Texas. It is a repository for plants collected worldwide, and the organization focuses on providing research and educational support. [www.brit.org]

1988: American Botanical Council (ABC) in Austin, Texas. It is the leading nonprofit education and research organization using science- based and traditional information to promote the responsible use of herbal medicine. [www.abc.herbalgram.org]

1998: The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal (USA) Government's lead agency for scientific research on complementary and alternative medicine (CAM). [www.nih.gov] World Health Organization (WHO) Mandate A resolution on traditional medicine, adopted by the 56th session of the United Nations World Health Assembly in May 2003, urged Member States (countries), where appropriate, to ensure safety, efficacy and quality of herbal medicines. Recently updated for 2014-2023.

❖ (WHO) estimates that 80 percent of the population of some Asian and African countries presently use herbal medicine for some aspect of primary health care.

❖ Pharmaceuticals are prohibitively expensive for most of the world's population, half of whom lived on less than $2 U.S. per day in 2002.

❖ In comparison, herbal medicines can be grown from seed or gathered from nature for little or no cost. [https://www.who.int/] Chelsea Apothecary Garden, London, UK. Founded 1673. IS A DIETARY SUPPLEMENT AN HERBAL MEDICINE?

❖As defined by the Dietary Supplement Health and Education Act (DSHEA) of 1994, a Dietary Supplement includes: vitamins, minerals, enzymes, plant materials, animal organs, tissues, and metabolites. http://www.fda.gov/food/dietarysupplements/

❖ Although DSHEA defines herbs as dietary supplements, consumers tend to use them as “medicines.” Herbal Medicine What are its mechanisms of action?

As with an Allopathic (Western) medicine, improvement in a medical condition when using an “herbal medicine” may be due to:

❖ Autonomous Responses: normal body responses to illness or a wound.

❖ Specific Responses: responses to a specific medicine or treatment.

❖ Meaning-Placebo Responses: follow from the situation in which treatment occurs.

[Moerman, Daniel (2002) meaning, medicine and the ‘placebo effect’] Headaches and Advertising

Completely blinded Experiment: (Braithwaite and Cooper, 1981) •Group 0: “ Nothing” Received no pills (group was added by Daniel Moerman (2002) for illustrative perspective on placebo) •Group A: Placebo pills labeled as analgesic tablets •Group B: Placebo pills labeled as a highly advertised brand of aspirin •Group C: Generic aspirin tablets labeled as analgesic tablets (looked the same as Group A) •Group D: Generic aspirin tablets labeled as the highly advertised brand of aspirin.

(Moerman, Daniel (2002) meaning, medicine and the ‘placebo effect’) HOW ARE HERBAL MEDICINES MADE?

➢ Herbal teas or tisanes: The liquid obtained by extracting herbs in water. ❑ Infusions: Hot water extracts usually from leaves. Mint or chamomile tea.

❑ Decoctions: Long term boiled extracts from roots or bark. Willow bark.

❑ Maceration: Plants are chopped and added to cold water and let stand for 7-12 hours. Sage or thyme. ➢ Alcoholic extracts of herbs. ❑ Tinctures: Usually 100% ethanol, but wine or vodka may be used instead, and combined with water and the herb. Example: echinacea.

➢ Essential Oils: Plant components are soaked for days, weeks or even months in a food grade oil. Rosemary

➢ Inhalation Products: Aromotherapy. Essential oil plus flower essence that is then inhaled. Lavender

[https://en.wikipedia.org/wiki/Herbal_medicine] [Green, James, The Herbal Medicine-Makers Handbook. A Home Manual. 2000.] USE CAUTION! With Herbal Preparations

❖ Many of the plants and/or herbs used for medicinal purposes may have negative consequences if taken in the wrong dosage or for the wrong medical condition.

❖ Improper preparation of an herbal medicine may have a serious outcome.

❖ Incorrect identification of wild-collected plants, or even plants from your yard or garden that are subsequently used for medicinal purposes, may result in serious injury or even death.

❖ Have fun learning and experimenting, but please do consult reputable educational sources.

NOTE: It should NOT be assumed that the information provided in this presentation on herbal medicine represents the views of the DCMGA or its sponsors. HOW ARE MEDICINAL

HERBALHERBS MEDICINE USED? APPLICATIONS

Milk Thistle (Silybum marianum). By fir0002flagstaffotos. https://commons.wikimedia.org BOTANICALS, BIOFILMS, AND CHRONIC INFECTIONS Paul Bergner, ND Director, North American Institute of Medical Herbalism; Editor, Medical Herbalism Journal From a presentation at the Mountain West Herb Gathering in Breckenridge, CO, June 16-19, 2016.

▪ Bacteria live in a biofilm state Planktonic form. Biofilm Form. -Free moving -Non-mobile, linked in a matrix ▪ Basic Concepts: -Most bacteria in and on the human body exist in biofilm form. Most are beneficial commensal bacteria and provide barrier, immune, and metabolic functions. -Biofilms can be viewed as semi‐independent multicellular organisms with specialized metabolism and immune defenses. -A gradient of metabolism from aerobic at the surface to anaerobic at the core develops, allowing resistance to substances which might attack the metabolism. -In some species, an attached biofilm layer provides nutrients to a superficial layer, which may secrete antibiotics, reproduce, etc. -Once aggregated, bacteria in biofilms can dramatically change their functions and secretions. ▪ Whole herbs and whole plant formulas exhibit synergistic actions in which certain compounds potentiate the effects of others. These formulas appear to have a significant effect on drug resistance. [http://naimh.com ] Trifolium Compound, Eli Lilly 1898‐1942 PAUL BERGNER, ND An example of a group of herbs/plants used for their synergistic actions to treat a medical condition, probably an infection.

1. Trifolium pratense (clover, both red and white species); Family: Fabaceae *Anti- inflammatory and antidermatosis (skin) agent. Native Americans used it for its phytoestrogen effects on hot flashes in menopause.

2. Artcium lappa (burdock); Family: Asteraceae * Antibacterial actions.

3. Stillingia silvatica (queens’s delight); Family: Euphorbiaceae *Antibacterial.

4. Mahonia aquifolium (Oregon grape); Family: Berberidaceae *Antimicrobial. Note: This plant and several related species contain berberine, a compound currently being studied for its antimicrobial actions, especially in drug-resistant conditions.

Continued next slide Trifolium Compound, Eli Lilly 1898‐1942 PAUL BERGNER, ND 5. Phytolacca americana (poke salat; poke berry); Family: Phytolaccaceae *Antimicrobial??

6. Zanthoxylum simulans (Chinese prickly ash); Family: Rutaceae *This tree is native to China and Taiwan and is the source of sichuan pepper. Pepper is known to be antimicrobial.

7. Potassium iodide A chemical that is widely recognized for its hyperthyroid action to increase production of the thyroid hormone, thyroxine. It is sometimes used as an antifungal agent.

[Foster, Stephen and James A. Duke, Peterson Field Guide to Medicinal Plants of Eastern and North America. 3rd Ed. 2014]. [www.Wikipedia.org] [From a presentation by Paul Bergner at the Mountain West Herb Gathering in Breckenridge, CO, June 16-19, 2016.]

PLEASE NOTE: It should NOT be assumed that the information provided in this presentation on herbal medicine represents the views of the DCMGA or its sponsors. Mahonia aquifolium. (Oregon grape) https://commons.wikimedia.org/w/index.php?curid=1375500 CRANBERRY EXTRACTS URINARY TRACT INFECTIONS

❖ Cranberry (Vaccinium macrocarpon aiton. Family: Ericaceae) juice or cranberry extracts have been shown to be effective in treating urinary tract infections (UTI) and in reducing the number of recurrent UTI.

❖ In practice, cranberry juice is somewhat more effective than cranberry extract in treating UTI, but it entails drinking substantial quantities. The actual mechanism for the effectiveness of cranberry juice or extracts has yet to be determined.

❖ What has been shown clearly is that bacteria form biofilms in the urinary tract and that cranberry juice or extract is effective in preventing adherence of the biofilm to the wall of the urinary tract. Anti-adherence activity appears to peak about three hours after consumption.

[Bone, Kerry. A Brief Review of Recent Clinical Trials. 2016. HerbalGram. Issue: 112 Page: 29-33; www.abc.herbalgram.org] [Stapeleton, Ann E. Systematic review with meta-analysis: Cranberry-containing products are associated with a protective effect against urinary tract infections. 2013, www.ncbi.nim.nih.gov] [Foxman B1, Cronenwett AE2, Spino C3, Berger MB4, Morgan DM4. Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. Am J Obstet Gynecol. 2015 Aug;213(2):194.e1-8. doi: 10.1016/j.ajog. 2015.04.003. Epub 2015 Apr 13.] Cranberry (Vaccinium macrocarpon aiton. Photo by Keith Weller. https://commons.wikimedia.org/w/index.php?curid=146690 ALTERNATIVE & COMPLEMENTARY THERAPIES

A Review of Research on Integrative Medicine for Gastrointestinal Disease. Gastrointestinal conditions are prevalent in the population and account for significant morbidity and health care costs.

Patients with gastrointestinal conditions use integrative medicine. There is growing evidence that integrative medicine approaches can improve symptoms and affect physiology and disease course.

This article reviews data on some common and well-studied approaches, including mind-body therapies, acupuncture, diet, probiotics, and dietary supplements and herbs.

[Dossett ML, Cohen EM, Cohen J. A Review of Research on Integrative Medicine for Gastrointestinal Disease. Prim Care. 2017 Jun;44(2):265-280. doi: 10.1016/j.pop.2017.02.002.] [www.ncbi.nlm.nih.gov/pubmed/28501229] HERBAL MEDICINE IRRITABLE BOWEL SYNDROME (IBS) Symptoms of IBS: ❖ Abdominal pain or discomfort in association with frequent diarrhea and/or constipation.

❖ An urgency in pre-bowel movements, a feeling of incomplete evacuation, bloating, or abdominal distension (gas), and in some cases nausea. May be relieved by bowel movements.

❖ Often associated with IBS are other digestive system diseases or syndromes such as IBD (irritable bowel disease), GERD (gastroesophageal reflux disease) or gastroparesis (refers specifically to hypotonic or atonic smooth muscle in the stomach). IBEROGAST® (STW5) An herbal medicine used in the treatment of IBS Mechanism(s) of Action: ❖ Increases smooth muscle tone (contractility) in atonic or hypotonic segments of the intestines.

❖ Acts as a spasmolytic (muscle relaxant) on smooth muscle segments of the intestine that are in spasm.

❖ Demonstrates these actions in both functional dyspepsia and irritable bowel syndrome.

❖ “IBEROGAST (STW 5) is a role model for the concept of multi-targeting in therapy. Especially in complex syndromes such as FD and IBS, simultaneous multi-targeting of different functional causes seems to be a more promising approach than the classical paradigm of one disease – one receptor – one effect.” [Allescher H.-D.a · Abdel-Aziz H.b Dig Dis 2017;35(suppl 1):18–24. www.ncbi.nlm.nih.gov/] Peppermint (Mentha × piperita). By Sten https://commons.wikimedia.org/w/index.php?curid=73093. [By User:Sunnysingh22 https://commons.wikimedia.org/w/index.php?curid=33119890

Milk Thistle (Silybum marianum). By fir0002flagstaffotos. https://commons.wikimedia.org IBEROGAST® (STW5) Herbal Contents

Contains 9 plant extracts: 1. Bitter candytuft (Iberis amara totalis) In pharmacological studies both in vitro (e.g., in guinea pig ileum) and in vivo (e.g., in Wistar rats) the fresh plant extract of Iberis amara (IT) exhibited a tonicising effect on the smooth muscles of the stomach and small intestine.

2. Angelica Root (Angelica archangelica) Root is approved in European Phytomedicine for treatment of loss of appetite, stomach discomfort, mild gastrointestinal tract spasms, flatulence, and a feeling of fullness in the abdomen.

3. Chamomile flower (Matricaria Chamomilla or Matricaria recutita) Approved for internal use to treat inflammation or spasms of the gastrointestinal tract. One component in the leaves of the plant has been shown to have antianxiety and sedative actions. Other actions include antifungal, antibacterial, antispasmodic, anti- inflammatory, and anti-allergic. Continued next slide IBEROGAST® (STW5) Herbal Contents

4. Caraway fruit (Carum carvi) Use of seed approved in European Phytomedicine for mild spasms of the gastrointestinal tract accompanied by bloating, a sense of fullness after a meal, and flatulence.

5. Mary’s [milk] thistle fruit (Silybum marianum) Used in European phytomedicine to Improve appetite, allay indigestion, and restore liver function.

6. Lemon balm leaves (Melissa officinalis) Anti-anxiety actions, sleep aid and for disgestive tract spasms.

7. Peppermint leaves (Mentha piperita) The oil stops spasms of smooth muscles In the gastrointestinal tract, bile duct and gallbladder. Oil also has anti-inflammatory and anti-ulcer actions. Used widely in European Phytomedicine for treatment of irritable bowel syndrome (IBS). Recently USA gastroenterologists have begun prescribing it for IBS. Continued next slide IBEROGAST® (STW5) Herbal Contents Herbal Contents

8. [Greater] Celandine herb (Chelidonium majus) Approved in European phytomedicine for treatment of discomfort caused by spasms of bile duct and the gastrointestinal tract in controlled dosages. Experimentally, Celandine and its compounds have been shown to have anti-inflammatory, antimicrobial, analgesic, and liver-protectant activity.

9. Liquorice root (Glycyrrhiza glabra) Approved for use in European Phytomedicine for the supportive treatment of gastric and duodenal ulcers.

[Foster, Stephen, James A. Duke, Peterson Field Guide to Medicinal Plants of Eastern and North America. 3rd Ed. 2014]. [Forsch Komplementarmed Klass Naturheilkd. 2002 Dec;9 Suppl 1:21-33. https://www.ncbi.nlm.nih.gov/pubmed/12618547

PLEASE NOTE: It should NOT be assumed that the information provided in this presentation on herbal medicine represents the views of the DCMGA or its sponsors. Angelica Root, Angelica archangelica, By Franz Eugen Köhler, Köhler's Medizinal-Pflanzen - List of Koehler Images, Public Domain, https://commons.wikimedia.org/w/index.php?curid=255106 By Kat from St Albans, United Kingdom. https://commons.wikimedia.org/w/index.php?curid=7219001 WHAT CAUSES IBS?

❖ The actual cause of Irritable Bowel Syndrome (IBS) is unknown.

❖ The risk of developing IBS increases sixfold after acute gastrointestinal infection, and some researchers believe IBS patients suffer from an overgrowth of intestinal flora. Certain antibiotics (such as rifaximin) are effective in reducing this overgrowth, called "small intestinal bacterial overgrowth”.

❖ Drugs used to treat acid reflux disease (GERD) may lead to or worsen IBS.

❖ Another cause may be miscommunication between the brain and the gut. Since the gut is controlled by signals from the brain via the enteric nervous system, disruptions in these signals could cause changes in bowel habits as well as pain or discomfort.

[Posserud, I. et al. Gut. 2007 Jun;56(6):802-8. Epub 2006 Dec 5. www.ncbi.nlm.nih.gov/] PubMed] Photo taken in the Brazilian Amazon. l.-r. Unknown tribesman; Mark J. Plotkin, Ethanobotanist. PLANT MEDICINE TODAY

Mark Plotkin, Ethanobotantist. Co-Founder and CEO of the Amazon Conservation Team (a non-profit conservation organization). ❖ “Most primitive tribes possess an expert knowledge of medicinal plants, which often number in the hundreds.

❖ This knowledge is rapidly being lost as members of these tribes are exposed to modern traditions and as forests worldwide are being destroyed. Including in the USA.

❖ Ethanobotanists are striving to save the knowledge and the lives of countless people worldwide. No medical system has all the answers. No shaman that I’ve worked with has the equivalent of a polio vaccine and no dermatologist I’ve been to could cure a fungal infection as effectively (and inexpensively) as some of my Amazonian mentors.

❖ It shouldn't be the doctor versus the witch doctor. It should be the best aspects of all medical systems (ayurvedic, herbalism, homeopathic, and so on) combined in a way which makes health care more effective and more affordable for all.”

[Mark J. Plotkin, Ethnobotanist. Medicine Quest. 2000. Penquin-Putnam Inc.]. Web Resources

American Botanical Council (Austin, TX): Public access to web resources and HerbClips but ABC Membership may be required to access some databases. An excellent source for herbal information. Non-Profit. www.abc.herbalgram.org

PubMed: Free access to abstracts of scientific medical articles; most full articles require a fee to access) www.ncbi.nlm.nih.gov/pubmed

ReadCube: A service that provides read-only or print access to scientific journal articles for a reduced price. www.ReadCube.com

PLOS (Public Library of Science): Free and full access to journal articles on a variety of topics. www.plos.gov

Wikipedia: Free access. Provides good general information on a variety of topics. A non-profit website; donations welcomed. www.Wikipedia.org

Bing Images: Free images; Huge database. www.bing.com/images REFERENCES On the web: • [https://en.wikipedia.org/wiki/History_of_medicine] • [Posserud, I. et al. Gut. 2007 Jun;56(6):802-8. Epub 2006 Dec 5. www.ncbi.nlm.nih.gov/pubmed • [Forsch Komplementarmed Klass Naturheilkd. 2002 Dec;9 Suppl 1:21-33. https://www.ncbi.nlm.nih.gov/pubmed/12618547] • [Allescher H.-D.a · Abdel-Aziz H.b Dig Dis 2017;35(suppl 1):18–24. www.ncbi.nlm.nih.gov/] • [HerbalGram. 2016; American Botanical Council, Issue: 112 Page: 29-33] [www.abc.herbalgram.org] • [Dossett ML, Cohen EM, Cohen J. A Review of Research on Integrative Medicine for Gastrointestinal Disease Prim Care. 2017 Jun;44(2):265-280. doi: 10.1016/j.pop.2017.02.002.] [www.ncbi.nlm.nih.gov/pubmed/28501229] • Paul Bergner. http://naimh.com ] • Stapeleton, Ann E. Systematic review with meta-analysis: Cranberry-containing products are associated with a protective effect against urinary tract infections. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4091907/ • Foxman B1, Cronenwett AE2, Spino C3, Berger MB4, Morgan DM4. Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. Am J Obstet Gynecol. 2015 Aug;213(2):194.e1-8. doi: 10.1016/j.ajog.2015.04.003. Epub 2015 Apr 13. • By Ian Starr - Camera, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5091932 Mark J. Plotkin photo. REFERENCES

Books: • Belsinger, Susan and Wilcox, Tina Marie. The creative herbal home. 2007. Litho Printers. • Green, James. The Herbal Medicine-Maker’s Handbook. 2002. Crossing Press. • International Herb Association. Elder (Sambucus spp.) Herb of the Yeartm 2013. Compiled and edited by Karen O’Brien. • Lewis, W.H. and Memory P.F. Elvin-Lewis. Medical Botany. 2003. Wiley. • Moerman, Daniel E. Meaning, medicine, and the ‘placebo effect’. 2002. Cambridge Press. • Moore, Michael. Medicinal Plants of the Desert and Canyon West. 1989. Museum of New Mexico Press. • Plotkin, Mark J. Medicine Quest. 2000. Penquin-Putnam Inc. • Foster, Stephen and James A. Duke. Peterson Field Guide to Medicinal Plants and Herbs of Eastern and Central North American. 2014. Houghton Mifflin Harcourt Publishing Co.