J A H G Volume 12 | Number 3 Journal of the American Herbalists Guild 15 T herapeutics An Herbal Breakthrough in Rheumatology Bull Thistle (Cirsium vulgare) for Spondyloarthropathy Matthew Alfs, RH (AHG) Matthew Alfs, R.H. (A.H.G.) Abstract spondyloarthropathies (SpA), a constellation of is a practicing herbalist who Clinical work with a number of sufferers of diseases in which there is marked inflammation has maintained a successful spondyloarthropathy (including psoriatic at the point where tendons and ligaments insert clinical practice since 1997 arthritis, juvenile spondyloarthropathy, and the into bones—a condition known as enthesitis—as and currently practices in a arthritis accompanying inflammatory bowel well as an associated inflammation elsewhere multi-disciplinary clinic that he founded in 2004. disease) appears to confirm a little-known, folk- in the body and a family tendency for this A dedicated educator, he medicinal tradition that Cirsium vulgare (bull type of pathology. (Enthesitis, it should be has taught herbal medicine thistle) supports the health of joints, tendons, noted, is one marked feature differentiating at several area colleges and Frontier and ligaments in a most remarkable way. spondyloarthropathies from other progressive universities, has presented a joint diseases.) The spondyloarthropathies number of seminars to health- care professionals nationwide, include psoriatic arthritis (PA), reactive Your Trusted Source Definitions and is the founder and Bull thistle (Cirsium vulgare; formerly Cirsium arthritis (ReA; inclusive of Reiter’s syndrome), director of the Midwest School for Bulk Herbs lanceolatum), alternately known as “spear enteropathic arthritis (EA), (the arthritis of Herbal Studies (www. thistle,” is a biennial wild plant—often occurring in connection with inflammatory midwestherbalstudies.com). castigated as a “weed”—that grows in fields, bowel disease), ankylosing spondylitis (AS), and His third book on herbal meadows, pastures, and uncultivated land and undifferentiated spondyloarthropathy (uSpA). medicine, Diary of a Country Herbalist, is due to be released usually in moist soil or not far from a body Factors contributing to the onset and in 2015. of water. In its first year, it appears as a basal perpetuation of the spondyloarthropathies have rosette of easily-broken, bristly, irregularly- not been conclusively elucidated, although indented leaves, in which form it survives and current scientific research postulates that these even grows under the winter snows. By early afflictions may arise from ongoing immune summer of the second year, a branching stem activation against an infection, perhaps even appears, shooting the plant up to the height of one that has become dormant in some way. a man. In this manifestation, it bears spiny- (Berthelot et al 2013). In this scenario, the winged stems, spiny and alternate stem leaves, antigen(s), originally located in the gut, is and reddish-purple flower heads situated on (are) transported to the joints by monocytes/ spiny bracts at the tips of the stem branches. macrophages (Fantini et al 2009, Peluso et al Seronegative arthropathies are 2013), where autoreactive T cells (esp. CD8+) inflammatory joint diseases lacking the and TNF-alpha invoke the inflammation presence of rheumatoid factor in the blood, (Marker-Hermann & Schwab 2000, Costello A member-owned cooperative for over 35 years thus distinguishing them from rheumatoid et al 1999, Gonzalez et al 2012, Hermann frontiercoop.com • 1-800-786-1388 arthritis (RA). Most of these are classified as et al 1994). Some researchers have more 16 J A H G Volume 12 | Number 3 Journal of the American Herbalists Guild specifically proposed that secretory antibodies (“leaky gut”) (Martinez-Gonzalez 1994). produced against the invading bacteria in the As to evidence for the bacterial-induced herapeutics T gut transfer to the joint spaces where they autoimmune hypothesis, researchers have proceed to bind to tissues exhibiting cross- discovered antibodies against various reactive self-antigens, thereafter initiating pathogenic, and usually enteric, bacteria in PA damage to tissues by recruiting inflammatory sufferers (and even, in at least one case, the cells and/or by activating the complement discovery of the DNA of several of these genera Bull thistle (Cirsium vulgare). Photo by Franco Folini CC system (Rashid & Ebringer 2012). One in the synovial fluid of these sufferers), including BY-SA 2.0 via Wikimedia mechanism allowing any sort of migration Klebsiella, Yersinia, Salmonella, Campylobacter, Commons would seem to be intestinal permeability Chlamydia, and Mycoplasma (Lapadula et al 1992, Lapadula et al 1988, Gilroy et al 2001, Johnson et al 2000, Schaeverbeke et al 1996, Gerard et al 2001). The DNA of Klebsiella and of several other bacteria has been discovered in the joints of ReA sufferers (Gerard et al 2001, Johnson et al 2000), while antibodies to Yersinia spp. have also been found in these victims, as well as in those afflicted with AS (Wakefield et al 1989, Lapadula et al 1988). Also in AS victims, Mycoplasma has been found in their synovial fluid (Johnson et al 2000), whereas the bacteria Klebsiella pneumoniae—antibodies to which are marked in these sufferers (Rashid & Ebringer 2012, Ebringer & Wilson 1996)—has been shown to cross-react with the MHC-class 1 molecule HLA-B27 (Rashid & Ebringer 2012). This association was even tested clinically, when a hospital in London put AS sufferers on a low-starch diet designed to minimize Klebsiella in the bowel, which resulted in a reduction of total serum IgA and a marked decrease in both inflammation and symptoms (Ebringer & Wilson 1996). Conversely, studies such as those cited above have consistently not found bacteria in the synovial fluid of sufferers of osteoarthritis (OA) (Johnson et al 2000, Wilbrink et al 1998, Schaeverbeke et al 1996). Historical Data Relative to Bull Thistle (Cirsium vulgare) Native Americans have long treasured bull thistle as a food source. The Nlaka’pamux (Thompson) Indians, as one example, cooked and ate the fresh, peeled roots and also dried and stored them for later use. When needed, these were rehydrated, scraped, chopped, and cooked into stews (Turner et al 1990). Wilderness survival teacher Tom Brown, Jr., describes his Apache plant medicine mentor, Stalking Wolf, teaching J A H G Volume 12 | Number 3 Journal of the American Herbalists Guild 17 T herapeutics him how to peel and to eat the juicy leafstalks Chamberlin Muhr recounted her experience as as a rich source of water and how to peel and a 10-year-old girl in the early 1920s, burdened to eat the roots in late fall and early winter with what was then diagnosed as juvenile as a satisfying survival food (Brown 1985). rheumatoid arthritis. This was so pronounced From the mid-20th century onward, bull that she could not arise from a reclined position thistle also figures prominently in the edible- without the help of her father. One day, however, wild-plant literature usually associated with her mother was entertaining a “little woman” Euell Gibbons, where both its stem and its fleshy who lived in the mountains about 10 miles away. taproot are said to be edible and delicious once Upon seeing young Elaine lying down and crying peeled and cooked in two waters. (Warnings out in pain, the woman asked Elaine’s mother are given in this same literature about the need what caused her such misery, and was told that to exercise great caution when harvesting the the girl had rheumatoid arthritis. At that, the second-year plant, as when cutting or stripping woman—perhaps a folk herbalist—responded: material from it the springy stem can easily thrust “Mrs. Chamberlin, just go out and cut one of the spines into an eye, causing permanent corneal big bull thistles that grow so big along the creek, damage!) I have eaten both the boiled taproot cut it up and make a tea out of it and have your and the peeled leafstalk since the mid-1980s, daughter drink half a cup three times per day.” especially enjoying the latter’s celery-like taste. Elaine relates that her mother did just as she was Native Americans also used bull thistle to encouraged: She prepared a cup of the tea and heal a variety of afflictions. The Iroquois used it gave it to her that very evening, following this for bleeding piles and in an unspecified way for up with one-half cup the following morning. To cancer (Herrick 1995). The Cherokees treated her great delight, Elaine found that she was able neuralgia with an infusion of the leaves and to get up unaided at noon on that second day bruised the plant to poultice a sore jaw (Hamel & of treatment “and never had a bad spell since,” Chiltoskey 1975). The Delaware implemented the although she adds that her mother directed her to whole plant as a steam treatment for rheumatism. drink the tea “for several days” more (Muhr 1974). (Tantaquidgeon 1942, Tantaquidgeon 1972). Muhr’s account impressed me greatly when Native American healer Tis Mal Crow, who lived I first came across it a number of years ago. I tried for awhile in my own state of Minnesota and to contact her to get more details, but discovered who acquired quite a reputation here for being that she had died in 1997. Later in my herbal a talented and a colorful herbalist, devoted practice, however, when I came to a standstill an entry to bull thistle in his informative book in my healing efforts with several individuals Native Plants, Native Healing (2001), wherein he afflicted with severe, progressively deteriorating remarked that the plant is used in his (Muskogee) arthropathies, Elaine’s story would come back tradition as an alterative, as a febrifuge, topically to haunt me and I would try implementing as a vulnerary, and swished in the mouth as a this herb in the hopes that it would make the healing bath for stomatitis (Tis Mal Crow 2001).