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      The dosage of herbs chosen for the prescription needs to be carefully determined.

      The dosage, the herbs chosen for the prescription, and the timing of administration all need to be determined. A largely built person with big bones and muscles, and a comparatively sluggish metabolism, will generally require herbs to be given in larger doses and over a longer period of time than a small framed, lightweight person with a more sensitive body and faster metabolism.

      Dosage for adult patients can also vary according to the practitioner and which kind of herbal medicines they practice. A standard dose of tincture can vary from a few drops to 5mls (one teaspoon). Teas are generally taken a cupful at a time, powders are taken in doses of ¼–1 tsp and syrups may require being taken a dessertspoon or tablespoon at a time.

       Chronic and Acute Conditions

      When treating chronic conditions, generally mild herbal remedies are taken three times daily, over months at a time if necessary. It may be that the first prescription and dietary advice is intended to improve digestion and absorption and to clear toxins from the system, which is necessary in so many cases. This will be followed up by more nourishing tonic medicines until the patient is better. Acute conditions may require stronger herbs given up to every two hours. To illustrate, ashwagandha is nourishing and strengthening and is taken often 2–3 times a day over a few weeks or months to improve energy, vitality, immunity and enhance resilience to stress. Echinacea and wild indigo are taken every 2 hours to enhance immunity and combat acute infections.

       Appropriate Administration

      Hot preparations are needed when treating fevers, colds, catarrh and problems associated with cold, such as poor circulation and menstrual cramps. Others problems such as urinary problems and conditions associated with heat, such as hot flushes and acne, are better suited to cool preparations. Skin problems may improve more rapidly using herbal teas as opposed to tinctures, while tinctures may be preferable when more concentrated medicines are needed, as when treating a virulent infection.

      The herbs chosen may also indicate their best method of administration. When giving teas, the aerial parts of a plant are prepared as infusions while roots, barks and seeds are better suited to decoctions. Nourishing tonics are best taken as powders stirred into warm milk or water, while warming spices to clear catarrhal congestion and coughs can be taken as powders mixed with honey and taken off a spoon.

      Generally, herbs are taken either side of or during a meal. When using herbs to enhance appetite, digestion and absorption, they can be taken before a meal; for problems associated with heat, acidity and inflammation they can be taken with a meal, otherwise they can be taken immediately after eating. Tinctures need to be diluted with water, otherwise they can be unpleasant tasting and can irritate a delicate stomach.

      CHILD'S DOSAGE GUIDELINES

      When it comes to dosage for children, there are two rules that are employed by some practitioners:

      Young's method: child's dosage = adult dose (generally 5mls) x age divided by the age +12.

      Cowling's method: child's dosage = adult dose x age divided by 24.

      Alternatively, dosage can be calculated according to weight: child's dosage = adult dose x child's weight divided by 68 kg (150 lbs).

      Safety Issues

      The question of possible side effects and toxicity has arisen more lately as herbs are increasingly under the scrutiny of the scientific eye. However, adverse reactions to herbal medicines seldom occur in practice, and those that do occur generally consist of mild rashes or bowel changes. A herbal practitioner would not normally expect a “healing crisis” with an exacerbation of symptoms before they start to recede.

      There are two main sources of information about the efficacy and the safety of herbal medicines – ancient folklore and modern science. The empirical evidence gathered by herbalists over thousands of years, which is now being increasingly justified by scientific research, means that patients may be assured that their herbal prescriptions are based on reliable foundations. Many herbs form the basis of modern orthodox medicines, and it may be surprising to learn that the pharmaceutical industry harvests huge plantations of herbs for use in the production of drugs each year. It also grows herbs for further research activities.

      The use of whole plant medicines, as opposed to isolated active ingredients, helps to prevent adverse side effects. The many types of substances in medicinal plants work synergistically together, and probably all have important roles to play in the healing process. The primary healing agents are the active constituents that were isolated by the early chemists and developed into modern drugs, but the importance of the other apparently secondary constituents should not be ignored, since they are vital for determining the efficacy of the primary healing agents. Some secondary synergistic substances make the active constituents more easily assimilated and available in the body, while others will buffer the action of other potent plant chemicals, preventing possible side effects. It is largely the combination of both types of substances occurring in the whole plant that determines the potency and safety of herbal medicine.

       Potential Adverse Reactions

      Having said this, with the huge range of biochemical constituents that occur in herbs it is possible that, though generally safe, some could potentially cause allergic reactions and idiosyncratic responses in the same way that foods do. Most of these can be avoided by herbalists who are generally familiar with the chemistry of herbs they are prescribing and only prescribe herbs which are formulated to suit the specific needs of the patient in appropriate doses only after taking a detailed case history. Certain people are more likely to have hypersensitive reactions to herbs than others, particularly those who already have a history of food allergy or intolerance or chemical sensitivity. This is more likely if they suffer from digestive problems, specifically imbalances in the intestinal

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