Foraging

The art of foraging is one which is mastered through time and experience. The main thing is to ensure you know what it is that you're picking. This can be achieved by foraging with others who have more experience or getting to grips with a good plant identification book. I would recommend:



The second most important thing is that you observe where the plant is growing in order to estimate the safety of the plant. Pick above wait height where possible so the liklihood of dog wee is less. Pick away from main roads as they coat plants in pollution. Do not pick near farm crops which may have been repeatedly sprayed with herbicides etc. Question the history of the land, are there any signs of toxic waste which may have leached into the soil? As with most things I'm sure one could get as complicated and detailed as one wishes with this but I like to keep it simple and minimal.

Companion Planting

Companion planting can be as simple or complicated as you like. The idea of companion planting is that when certain plants are put together it increases their productivity or protects them against disease.

It has been observed that the current practice of planting huge areas with a single plant (monoculture) leaves the plants vulnerable to disease and pests (not to mention the harm it does to soil). If however, plants are combined in a 'polyculture' pests and disease don't get as much a chance to evolve to utterly dessimate an area. At least if a disease does hit you you won't lose all your productive crop.

Some plants will attract insects to help pollinate your plants. Some will help deter other pests because they don't like the smell texture, taste or colour of the companion plants. IT is also possible to grow plants which have such different growing patterns they can use up a small amount of area and maximise productivity of that area. For example, the native american indians have a tradition of growing 'the three sisters' which is a combination of corn courgette/pumpkin and bean together. The beans provide nitrogen for the corn and climb up the corn which grows tall, while the courgettes cover the ground and supress weeds plus help maintain moisture in the soil.

More complex companion planting can sometimes consist of a combination of up to 9 different plants. However, in permaculture it would be expected that everything you choose for your space serves a purpose in making the ecosystem you design work more effectively.

General rules to follow when companion planting are:
- Nectar rich flowers attract pollinators and increase the amount of fruit harvested
- The pea family of plants are nitrogen fixers
- Roots and leafy crops can be grown side by side as they exploit different aspects of the soil
- If a plant if known for a specific pest put it near another plant which is known for deterring it, or introduce a competitor species to hunt that pest e.g. hedgehogs to eat your slugs

Below are some more examples of companion planting. However, one should be aware this isn't an area of knowledge which has been tried and tested much with science rigour. I have found there is some contradictive information out there. I provide some of the information but it is important that we rediscover the skill of observing so that you can figure out what works best for your land.

The Circulatory System

Anatomy and Physiology
The heart pumps blood from the body to the lungs to become oxygenated which goes round the body where the oxygen is used then brought back to the heart to repeat the process.
The left side of the heart has the largest muscle because it pumps blood to the extremities (as symbolised by the stick man on the diagram) through the aorta. It comes from the body through the superior vena cava and to the lungs via the pulmonary artery.

Arteries and veins have different anatomy for their different purposes. Arteries carry blood from the heart to the body which requires a thicker vessel wall to handle the high pressure of blood from the heart. Veins carry blood from the extremities back to the heart. They have valves to prevent blood from flowing backwards and thinner vessel walls than arteries do.

Physical assessment of the Cardiovascular System
Observations
Clubbing and splinter haemorrhaging may indicate infective endocarditis but there are other things associated with clubbing which are more common in other body system diseases. Cyanosis of the lips and tongue may indicate; shock, a cold environment or heart failure.

Jugular Venous Pressure
The JVP should be between 3 and 4 cm. This is a rough measure of the pressure of the jugular vein. If it is raised this can indicate constrictive pericarditis, cardiac tamponade, renal disease, excessive fluids or superior vena cava obstruction.

Inspection
Inspect the chest for kyphoscliosis, obvious scars which may indicate a pacemaker, a bulge indicating cardiac enlagment and abdominal pulsations (a lack of which may indicate an abdominal aortic aneurysm).

Palpation
Palpate for the 4 areas and the apex. Feel for heaves which may indicate right ventricular or left atrial enlargement. Also feel for thrills which indicate a palpable murmur. If the apex beat cannot be found this is usually due to obesity but can also indicate; emphysema, pericardial or pleural effusion.

Auscultation
Auscultate the 4 areas for murmurs caused by things like; a stenotic valve or regurgitation.

Cardiovascular pathologies
Ischemic heart disease
Atherosclerosis is the hardening of an artery’s inner wall caused by a plaque. Arteriosclerosis is a more general term used to describe any hardening of the artery inner wall including loss of elasticity by any cause. It is generally thought that atherosclerosis is made of an adipose plaque but in fact the plaque is made up of white blood cells which have gathered in the area of damage to the endothelial wall which has become saturated with red blood cells, fat and other cells. This collection of cells and fat create an inflammatory response whereby the body tries to protect itself from what seems to be a hostile cell by bringing in macrophages/ antibodies to fight. These are found in white blood cells and are what create the plaque, as mentioned above.

Smoking, obesity, diabetes, and hypertension can all contribute and sometimes cause atherosclerosis. Obesity, smoking and diabetes are associated with hypercholesterolemia which will influence the pathology above. Hypertension increases the pressure of the blood in the arteries and this in itself can sometimes cause damage to the endothelial wall.

It can occur from child hood and culminate in a trans ischaemic attach (stroke) or myocardial infarction (heart attack) later in life; usually around the middle ages. A change in diet and lifestyle is usually the best way to prevent this from happening as it is not symptomatic until another pathology occurs as a result. For example, the plaque can cause a blockage of the artery thereby cutting off the circulation to parts of the body and causing cell death through starvation of oxygen. This is how strokes and heart attacks occur, each area, either heart or brain, has been starved of oxygen.

Trans ischemic attack/ Stroke is otherwise known as a “brain attack” these can be deadly. They occur when either a part of a blood clot elsewhere in the body breaks off and blocks an artery in the brain (embolic stroke) or a blood clot occurs in the brain itself (thrombotic stroke). Sometimes the pressure in these blockages is too much and can haemorrhage bursting the artery walls and leaking into the brain (a simple hemorrhagic stroke) or the cerebrospinal fluid (subarachnoid haemorrhage). Other causes include arteritis (inflammation of the arteries), mass lesions (such as tumours). In children causes are usually different such as; congenital heart disease, drug abuse, clotting disorders, CNS (central nervous system) infection, neurofibromatosis, vasculitis, fibromuscular dysplasia, Marfan disease, tuberous sclerosis and tumours.

TIAs are acute and usually have happened before a health professional sees the patient. Symptoms are signs which occur after are speech difficulties, movement difficulties (usually affecting gait) and memory.

Myocardial Infarction/ Heart attack occurs when the blood supply is prevented from getting to the myocardium starving it of oxygen (hypoxia) resulting in cell death (necrosis). The symptoms usually present as a feeling of chest tightness and a sharp pain running down the left arm and up the neck up to the jaw. These can result in death. Usually a person at risk does not know they are until the myocardial infarction occurs. Blood thinners are the orthodox treatment to prevent this from happening however; these do leave the person at risk of severe bleeding.

Right/Left heart failure is brought about when the muscle of the heart can no longer fully pump as it once did. Left heart failure is the most common. This results in an accumulation of blood in the ventricle putting more pressure on the heart. Eventually it can spill over back into the lungs, as can be seen in the diagram above. Right heart failure gives a far wider ranging set of problems because blood backs up into the extremities. Oedema around the ankles is one of the most obvious symptoms of this. In both cases, if it is left untreated it can result in death. However, heart failure is not an acute problem the process usually happens over a long time period so it is possible to catch it before death occurs.

Angina is caused by ischemia (lack of blood supply resulting in hypoxia) to the heart muscle. This results in a severe pain as described for a myocardial infarction. Usually it is caused by either an embolism or spasm of the artery.

Arteritis is inflammation of an artery.

Vasculitis is inflammation of a blood vessel.

Peripheral vascular disease

Chronic and acute lower limb ischemia occur when the blood supply to the lower limbs are cut off by an embolism (break off of a blood clot) or a thrombus (break off from a plaque). Acute sufferers will complain of pain, paleness, paresthesia (a sensation of tingling, pricking and numbness) and paralysis. Chronic sufferers will complain of severe cramp on exercise and intermittent claudication (attacks of lameness and pain when walking).

Aneurysm is used to describe an artery which has thinning walls. This can sometimes rupture. Until they rupture the condition is asymptomatic (there are no symptoms). Abdominal aortic aneurysms can be deadly they cause severe pain, hypotension, tachycardia, profound anaemia and sudden death.

Raynaud’s disease is caused when constriction of the blood vessels prevents a full blood supply to the fingers (sometimes the toes). It is aggravated by cold weather and made better with warmth. When it is particularly chronic fingers can be lost to the disease.

Buerger’s disease occurs in young men who smoke. It seems to be caused by arteritis and sometimes vasculitis resulting in atherosclerosis leading to severe claudication and pain on rest leading to gangrene.

Peripheral Venous disease

Varicose veins occur when the vein becomes dilated these can usually be clearly seen on the leg and often cause pain to the patient.

Venous thrombosis is a general term used for thrombosis (blood clot) of any vein. Deep vein thrombosis is one such example. These usually occur after an injury to the vein or large periods of inactivity.

Valvular heart disease refers to diseases which affect the valves of the heart. Namely stenosis (hardening) of the valve or regurgitation which can occur after stenosis. These are called:
- Aortic stenosis
- Aortic regurgitation
- Mitral stenosis
- Mitral regurgitation
- Tricuspid stenosis
- Tricuspid regurgitation
- Pulmonary stenosis
- Pulmonary regurgitation

Cardiomyopathy, meaning a disease of the cardiac muscle, is a title used to classify a group of diseases. They are subdivided by their presentation into; dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy.
All the information in this paper was found in Kumar and Clarks (2002) section on cardiovascular disease.

Herbs for the Heart
These herbs are listed here for their affinity to the heart however, they do not just work on the circulatory system, and they are far more complex than this. Below is the use of each herb in relation to the circulatory system only.
Achillea millefolium this herb helps bring blood to the peripheries and promotes sweating
Cinammomum zeylanicum this herb opens the arteries allowing blood to flow more freely in cases of tension
Crataegus lavaegata this herb strengthens the heart muscle and can be used for hypertension and hypotension alike
Leonurus cardiac this is another herb which strengthens the heart but is traditionally used in high blood pressure, not low
Rosmarianus officianlis this herb increases circulation to the peripheries as well and has an affinity to the brain thus helping with headaches caused by poor circulation from stress (which causes constriction and prevents blood flow)
Zingiber officinalis is a hot herb, as is Rosmarianus, it helps bring blood to the peripheries and prevents sweating like Achillea does.

The Respiratory System

Anatomy and Physiology

Physical Examination
Inspection
Inspect the mental alertness of the patient. Is there blueness in the face (cyanosis) or breathlessness at rest? Is the patient using accessory muscles to breathe? Is there any clear deformities or scars and is there equal movement of the chest on each side?

Palpation and percussion
The chest can be palpated for broken ribs but this is rarely seen by a herbalist. The chest expension should be noted through palpation. Check the trachea position as it moves away from a pneumothorax and toward a collapsed lung. Also, palpate the lymph nodes; if enlarged lymph is found in the supraclavicular area it may indicate bronchial carcinoma. if dullness is discovered on percussion pneumonia, lung collapse, fibrosis or pleural effusion may be present. If hyperresonance is discovered a pneumothorax may be the cause.

Auscultation
The lungs must be listened to on normal breathe sounds as well as whispering and spoken voice if necessary. If a wheeze is heard this may indicate asthma or COPD. If crackles are heard there may be airflow limitation as in oedema, fibrosis and bronchiectasis. A pleural rub can be heard when there is inflammation and roughening of the pleural surface, this is also painful for the patient. When the lung is consolidated high pitches are extenuated and low pitches are very difficult to hear, whereas, when there is fluid on the lungs almost no low pitches can be heard.
A peak flow test is useful to assess the abilities for the lungs to take in oxygen it also gives an idea of consolidation, fluid in the lungs or constriction of the alveoli or bronchioles.

Respiratory Diseases
Rhinitis/ Hayfever is an inflammation due to irritation of the mucous membrane in the nasal passage.

Bronchitis is inflammation of the bronchioles. Usually this is caused by a virus. It results in an irritating dry cough followed by chest tightness, wheezing and shortness of breath (SOB). The cough eventually becomes productive with yellow or green sputum. Sometimes it is accompanied by a mild fever and usually it is resolved within 4-8 days.

COPD is a set of diseases which are characterised by obstruction to normal breathing. Usually they are caused by the inhalation of toxins which results in sputum and wheezing with breathlessness. It is aggravated by cold, foggy weather and atmospheric pollution. The lungs are hyperinflated which means the liver and heart can no longer be percussed for. It can lead to respiratory failure characterised by hypoxia and hypercapnea.

Bronchiectasis (a COPD) occurs when the alveoli and bronchi are abnormally dilated which gives them a more likely chance that they will collapse. Before this happens they produce large quantities of sputum which obstructs air flow. The sputum leads to a high chance of recurrent infections and gives a chronic productive cough. Halitosis, malaise, pneumonia and clubbing of the fingers can be observed.

Cystic fibrosis is hereditary and occurs in the lungs and the pancreas. It affects the pancreas by creating scarring and cysts which is what the name refers to. In the lungs it creates very thick (viscose) and sticky (tenacious) sputum. This increases the chances of infection. Sinusitis, breathlessness and haemoptysis are sometimes seen.

Pneumonia is usually caused by viruses or bacteria creating inflammation in the lungs. This leads to sputum production and a productive cough. Chest pain, fever, difficulty breathing are also seen.

Tuberculosis is an infectious disease which can infect other organs but is most commonly seen in the lungs. It presents with a chronic cough, blood tinged sputum, fever, night sweats, chest pain, and weight loss.

Bronchial carcinomas can cause chest pain, discomfort but more commonly they show no symptoms. However, it may be possible to feel raised lymph nodes in the supraclavicular area.

Pleurisy is pain arising from any disease of the pleura caused by inflammation.
Pleural effusion is fluid in the pleural cavity.

Pneumothorax occurs when air seeps into the pleural cavity. As the pleura expands with the air it pushes the lung over to the other side creating tracheal deviation away from the pneumothorax. It causes pressure which can be painful and fainting. It can also cause shortness of breathe and eventually cardiac arrest. In serious cases the lung may collapse under the growing pressure from the air. On auscultation a lack of breathe sound will be heard. Urgent intervention is needed.

Emphysema (a COPD) is caused by localised inflammation which leads to septal degradation. It is similar to bronchiectasis, another COPD.

Respiratory Herbs
Inula helenium is a strong expectorant which steadily dissolves thick green mucous to a much thinner and clearer consistency so it can be coughed up.
Thymus vulgaris is an anti-viral herb used when bacteria causes infections.
Glycyrrhiza glabra can be used to soothe the respiratory tract and helps dissolve sputum and is an expectorant. It is particularly useful in asthma.
Tussilago farfara is an expectorant which helps for those with congestive coughs.

The Musculoskeletal System

Anatomy and Physiology
The musculoskeletal system is a combination of the skeletal and muscular system as one could not function without the other. It gives us our movement and provides us with support. Although each joint appears the same the anatomy of each is very similar. There are 5 different types of joints as seen below; ball and socket, hinge, saddle, pivot and gliding. The knee joint, seen above, is a ball and socket joint.

Musculoskeletal Pathologies
Some of the most common musculoskeletal problems are those of arthritis. There are many types some of which are listed below.

Osteoarthritis is an inflammation of the joint which occurs after years of wear and tear. The activity wears down the synovial fluid and eventually the bones rub together. This causes inflammation and pain which gets worse as the day goes on. It usually occurs in an isolated joint.

Rheumatoid arthritis has similar symptoms but is symmetrical and usually presents with stiffness on rising which gets better during the day. It is an autoimmune response with an unknown cause however it does seem to run in families.

Reactive arthritis has similar symptoms to rheumatoid arthritis however; it is caused by a reaction to some kind of infection. It seems to affect the eyes causing conjunctivitis, urethritis (inflammation and irritation of the urethra).

Septic arthritis is cause by a purulent invasion of an infection and, again, has similar affects to the other arthritis. The only sure fire way to diagnose them precisely is usually further testing by the GP.

Gout (a form of crystal arthritis) is caused by uric acid crystals in the joints, tendons and surrounding tissue. It is characterised by acute flare ups of inflammation and pain.

Osteomyelitis is infection and inflammation of the bone marrow. It is usually caused by staphalaucoccus or salmonella. It presents with a fever, edema, tenderness to touch, and warmth.

Osteoporosis is a fragility of bones caused by a loss of bone density usually occurring after menopause.

Rhabdomyolysis usually occurs after injury and causes a breakdown of muscle fibres. This presents with weakness, pain, tenderness and edema as the muscles can not sufficiently move fluids around the body anymore.

Carpal tunnel syndrome is a pain, tingling and numbness in the hands. This happens because the carpal tunnel in the wrist pinches on the nerve.

Nerve entrapment causes pain, numbness, tingling and muscle weakness. Usually it is caused by a slipped disc in the spine (vertabrea).

Dupuytrens contracture is a contracture of the underlying palmar fascia in the hand. Sometimes it is a sign of lvier failure. It is not a painful condition but it is restrictive to the movement of the hand.

Ankylosing spondylitis is a bend in the spine which causes chronic pain and stiffness.

Fibromyalgia is generalised muscle pain. It can be associated with fatigue, sleep disturbance, joint stiffness, associated with depression and anxiety.

Systemic lupus erythamatous (SLE) is an autoimmune condition which affects the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. Flare ups bring fever, malaise, joint pain, myalgias (muscle pains) and fatigue.

Paget’s disease of the bone is characterised by enlarged and deformed bones. It causes bone pain, arthritis, deformities, fractures, headaches, hearing loss, paralysis, teeth may spread intraorally and chalk stick fractures may appear. It has genetic and viral causes.

M/S Herbs
Chamomilla recutita is an anti-inflammatory.
Sympthytum officinale root is used to knit bones together as is rarely used internally for any other reason as it contains pyrollizidine alkaloids which have been shown to cause liver damage in large quantities (in rats, intravenously).
Hypericum perforatum is a nervine and therefore helps with nerve pains.
Curcuma longa is a powerful anti-inflammatory, usually used to treat the gastro-intestinal tract inflammations but can be used for other locations of inflammation as well.

The Immune System

Anatomy and Physiology
The immune system is vital to our ability to fight off parasites, infections and viruses. It changes and develops new anti-bodies with each new substance we come into contact with; this is called ‘aquired immunity’. It is made up of the lymphatic system, white blood cells, thymus (which excretes t-lymphocytes), spleen and the tonsils which is not shown on the diagram above, it too produces t-lymphocytes. (Springhouse Publishing, 2002)
There are three different types of immune problems:
• Immunodeficiencies e.g. HIV
• Autoimmunities e.g. rheumatoid arthritis and SLE
• Hypersensitivity e.g. atopic conditions (eczema, rhinitis and asthma)

Immune System Pathologies
HIV (human immunodeficiency virus) is a virus which leads to the immune system failing. This happens in 4 stages:
- Incubation which is asymptomatic and lasts 2-4 weeks
- Acute infection which has similar sings to a cold; fever, lymphadenopathy, pharyngitis, rash, myalgia, fatigue, mouth, oesophagus sores, hepatosplenomegaly (liver and spleen enlargement) and nausea and vomiting. This lasts up to 28 days.
- Latency shows few or no symptoms and lasts from 2 – 20 weeks and over
- AIDS eventually occurs giving symptoms of opportunistic infections which the patient contracts

Atopic conditions include asthma, eczema and rhinitis (hayfever). These conditions are due to a hypersensitive reaction of the immune system to foreign substances. The body reacts as though the allergen is pathogenic in nature although it is not. Often all three of these occur during a persons life and they are often more likely to have food sensitivities as well such as celiac disease. Anaphylaxis is an extreme reaction to an allergen which can lead to death.

Systemic Lupus Erythematosus (SLE) is an autoimmune reaction. It may effect the joints, skin, kidneys, blood cells, heart or lugns. It may cause a butterfly rash on the face as in figure 2, fatigue, loss of appetite, low-grade fever, photosensitivity, mouth ulcers, pleurisy, pericarditis, arthritis, myalgia and poor peripheral circulation.

Rheumatoid arthritis is another autoimmune disease covered in the musculoskeletal system.

Myasthenia gravis is an autoimmune disease affecting the neuromuscular system resulting in progressive muscle weakness.

Herbs for the Immune System
Echinacea purpurea and angustifolia both help increase white blood cell count thereby increasing the resilience of the immune system. This helps when treating viruses and infections but can aggravate autoimmune diseases.
Thymus vulgaris is an excellent anti-viral which will help kill viruses without increasing the bodies resilience to deal with the pathogen itself. Most herbs high in volatile oils make good anti-virals.
Symphytum officinale fol. Is good as an anti-inflammatory for the bones.
Hypericum perforatum is another anti-inflammatory good for the nerves.
Chamomilla recutita and Calendula officinalis are both good anti-inflammatories as well.

Cherry syrup

How to make cherry syrup

This syrup is a good way to treat coughs especially when added with other herbs specific to the ailment at the time e.g. Echinacea to boost immunity, Elderflowers to break a fever or Thyme to kill a virus in it's tracks.

You will need:
Some cherries (washed and without stalks)
Sugar
Water
A saucepan
Empty bottles
A funnel
A jam strainer or muslin cloth

I used a recipe off my friend Karen at Sensory Solutions who uses Mrs.Grieves age old trick of a pound of sugar to a pint of water. The more water you use the more syrup you make but ideally you'd have at least a pound of cherries to your pint of water as well.

1. Wash your cherries in a collander.

2. Put your sugar in the water with the cherries a bring to the boil.
3. Keep it moving until the sugar has dissolved.
4. You may wish to start squishing the cherries against the side at this point.
5. Leave until the water has gone dark red/black or boil down to the amount you wish
6. Strain into a jug and allow to cool, composting the left over cherry skin and stone. Once cool transfer to bottles. I recommend you use glass bottles or plastic ones which havnt been used before. I tried reusing a bottle which had had thyme and liquorice syrup in and it contaminated the entire thing (not necessarilly a bad thing though!).