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ABOUT CONSTITUTIONAL MEDICINE
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What is it?
In herbal medicine, we use the reddish brown and distinctively bitter bark that comes from the shrubby, deciduous Cascara tree. The bark must always be aged at least a year before use as during this time chemical changes occur in the bark that reduce a kind of griping that would otherwise be certain and entirely unpleasant!
Cascara was traditionally used by Native Americans and then the bark became known as the gentlest of the various stimulating laxatives that are available in herbal medicine. Many of the 16th century Spanish explorers who first visited Northern California suffered terribly from constipation and the local Indians had a solution which was such a profound relief to those who were suffering that the Spanish named it Cascara sagrada -- Sacred bark. The Spanish recognised Cascara as a relative of the powerful herb Buckthorn used in Europe since ancient times but when it was sent back to Europe it was seen that its effects were just as reliable but far gentler than that traditional remedy. Cascara may have great value when there has been a loss of tone in the rectum as can happen from certain types of diseases that affect the bowel or as a long-term consequence of an abdominal surgery. Cascara has also been widely used when a soft stool needs to be guaranteed, such as when there are anal fissures or haemorrhoids. H Felter writes 'Cascara is a simple and practically non-griping purgative, acting with but little or no prostration and never causing a watery stool. It has, moreover, a tonic action upon the stomach and bowels, and does not produce an after constipation. It is the most popular and most efficient agent for chronic constipation, and may be given for a considerable time without increase of dosage. In fact, the dose may be gradually decreased from day to day often with the result of completely curing the constipation. Cascara is adapted to cases of atony of the intestines. It is an efficient purgative in pregnancy, in hemorrhoids with loss of rectal tone, in atonic dyspepsia, and in sick headache due to atonic sluggishness of the bowels. Only preparations of old cascara bark are desirable; the fresh bark is emetic and otherwise disturbing. The taste of cascara is extremely bitter. This may be modified to a large degree by the addition of fluid extracts of licorice and aniseed' T J Lyle writes 'the bark is a very bitter tonic, a slow, mild, stimulating hepatic. It influence is chiefly expended upon the stomach, liver, gall ducts and bowels. It is of value in chronic constipation, torpor of the stomach and liver and chronic dyspepsia. It influences peristaltic action but is more tonic than cathartic' M Grieve writes 'Cascara Sagrada is a mild laxative, acting principally on the large intestine. It is considered suitable for delicate and elderly persons, and may with advantage be given in chronic constipation, being generally administered in the form of the fluid extract. It acts also as a stomachic tonic and bitter, in small doses, promoting gastric digestion and appetite... T Bartram describes Cascara's action as a 'non-habit forming stimulant laxative, pancreatic stimulant and bitter tonic' and says its uses are for 'habitual constipation, torpor of low bowel, congestion of liver and gall duct. To assist liver function in cirrhosis and for foul breath' He suggests doses of half to 1 tsp at night with honey to sweeten.
~ No synthetic substance has been found to equal the speed and effectiveness of Cascara at emptying the bowel and it is marketed by many pharmaceutical companies in pills, powders and extracts. The basis for Cascara's action is the presence of a mixture of anthraquinones either free (e.g. aloe-emodin) or as sugar compounds (glycosides). The free anthraquinones remain in the intestines and cause catharsis by irritating the intestinal wall; the anthraquinones that are bound together with a sugar molecule are absorbed into the bloodstream and eventually stimulate a nerve centre in the lower part of the intestine that causes a laxative effect. ~ The chemical components of cascara also stimulate the organs of the digestive tract including the gallbladder, pancreas and stomach, which results in increased digestive fluids (de Witte, P. and Lemli, L. The metabolism of anthranoid laxatives. Hepatogastroenterology 1990;37(6):601-605) ~ Aloe-emodin, a constituent in cascara and aloe, has been reported to have antiviral activity in vitro (Sydiskis, R. J., Owen, D. G., Lohr, J. L., Rosler, K. H., and Blomster, R. N. Inactivation of enveloped viruses by anthraquinones extracted from plants. Antimicrob Agents Chemother 1991;35(12):2463-2466) ~ The authors, titles and the 'where-and-when' published of over 60 further studies and articles on Cascara are listed in a PDF found here
The main worry with Cascara is that of developing a bowel dependency and many people who go on to use this herb on a regular basis do become dependent on it. The reason this in turn is a concern if if the bowel loses its own muscle tone and therefore becomes weakened. The time the alarm bells should start ringing in this case is when, over time, more frequent or higher doses are required to get the same effect. To balance this concern, it should be fairly stated that it would be far worse for a person to be exposed to the considerable toxicity (let alone the considerable discomfort!) of chronic constipation that it would be to have a dependency on a largely harmless herb.
For some years now, against this proven and safe way of herbalism, there has been a rising tide of excessive caution and scare-mongering in many parts of the world. The same authorities that, not so long ago, decried herbal medicines as ineffectual, have now taken up a different adversarial position; that they are dangerous substances that should only be prescribed by Doctors, who of course have zero training in them. Unfortunately, the same unnecessary fear and worry has crept into many natural health websites and popular publications on herbs. Herbs that we have safely used for thousands of years, that have no reports of adverse reactions in the medical literature despite widespread use by millions of people, are suddenly described as contraindicated because of something that should have been seen as completely unimportant, or at the utmost a merely theoretical concern, such as a laboratory study on one of the herb's constituents to use an all too common example. I wonder sometimes if the writers of such articles feel that the herb will be more deserving of respect if it is thought to be a little bit dangerous, in other words more like a drug than something that has simply come out of the earth and been used by ordinary people for generations beyond count. There is just so much misinformation about herbal medicine on the internet now. Ludicrous claims and cautions abound in equal measure; it seems like one group are trying to make money out of the public whilst the other are busily trying to scare them off. I have to believe that the kind of reader who takes the time to read pages on herbs that are as extensive as this one is much less likely to be swayed by marketers or misinformers. I hope that you will keep your wits about you if you get conflicting opinions from people who have never really got to know these herbs, who have never worked with them, or learned how to use them safely and effectively. I want to remind you that the reason that herbs can never be patented and owned by any individual or corporation is because they are, and always will be, the People's medicine. They belong to all of us and it is my great hope in sharing this work that you will learn how to use them wisely for yourself, and the people you care for. Be safe, but do not be afraid.
Few people are born with a faulty bowel but many go on to develop one. It is great to have this potent and effective herb on hand when it is needed and I have certainly had call to give Cascara many times over the years. For most people, the effects of Cascara will take about 8 hours to be felt but there are plenty of exceptions to this and it is very much a matter of personal experimentation to know when is the best time of day to take it. In any case, the herb should be completely eliminated from the system within 24 hours. Dosage, as always, is the key to success with herbal medicine, too little and there won't be a satisfactory evacuation of the bowel, too much and there will be griping (uncomfortable spasms) and an over-stimulation of the bowel that leads to repeated needs to go to the toilet. To make things more complicated there is no one fixed dose of any therapeutic substance that is right for everyone! What is too much for one person may be too low for another. From the tincture that we make in our own clinic, around 3-4 mls is usually ample to ensure a certain response without the danger of overdoing it however, some people need a substantially higher dose than this to get a certain effect and some people must take a much lower amount or they will suffer from some uncomfortable cramping in the bowel, one must be prepared to experiment. Plenty of Fennel seed and/or Licorice root extract is usually added to the Cascara extract to reduce the chance of griping. If a person is habitually constipated they need to 1) change their diet to reduce refined foods and eat more naturally, more about this here 2) move their bodies more and 3) use the important bowel herb Plantago, more here
"When I was treating a lot of kids in the Virgin Islands my primary treatment was for 3 days:
Much of the information here about the traditional uses of Cascara is consistent with the model of thinking whereby one may treat problem A with plant B. There is value in this approach, especially in how it helps us pass on useful knowledge to one another, but it falls short in one vital area; and that is that people are not all cut from the same cloth! Something that works brilliantly for one person may do less for another -- why is this? Part of the reason is that people vary in their constitutions as to whether they are either hotter or cooler and, at the same time, either dryer or damper. This useful and rather fascinating subject is introduced further here Another big part of using the right herb when it is most needed comes from understanding the need to treat what is going wrong for the person that had led up to their getting a health condition. In this light, Cascara can particularly offer its benefits when a cleansing action is needed in the 'cycle of healing', more about this here
Please understand that I cannot advise you, including on products or dosage, without seeing you in person in my clinic but for ideas
on how you might find a good herbalist in your area read here |
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© 2011 R.J.Whelan Ltd