Symptoms of appendicitis usually begin with pain around the umbilicus that intensifies over several hours and moves to the lower right quadrant of the abdomen. This area will be very tender to even light pressure, and you may notice your child holding or protecting it. A decreased appetite, vomiting, and fever are frequently present. Diarrhea may be present as well, and extending the right leg may make the pain worse.

An inflamed appendix can burst, causing a life-threatening infection of the abdominal wall. If this happens, your child will rapidly become very ill, with a fever, pale color, and
severe abdominal pain. Although a complaint of continuous abdominal pain is a key indicator of appendicitis, some children experience a milder onset of pain that comes and goes over
several days before settling in as constant and severe. If you suspect appendicitis, seek immediate medical care.

Conventional Treatment

In order to diagnose appendicitis, a doctor will want to know details of when the pain began and the location and quality of the pain. Your doctor will do an abdominal and rectal exam,
take a sample of blood to look for signs of an infection, and might order an x-ray or ultra-
sound scan to look for signs of blockage or inflammation.

If a diagnosis of appendicitis is confirmed, surgery to remove the inflamed appendix is the recommended course of treatment. Because of the danger that the appendix may rupture, surgery is usually done soon after the diagnosis is made.

To lower the risk of infection, your child may be given antibiotics before and immediately after surgery. If his appendix has ruptured, your child will definitely need intravenous antibiotics, and may need to be hospitalized for one to two weeks.

Because of the surgery and the manipulation of your child’s digestive tract, the intestines will slow down, and may even stop moving for a day or two. Your child may have a nasogastric tube, a tube placed in the nose and down into the stomach, that uses suction to pull the contents of the stomach out of the body. This prevents nausea and vomiting. Except for an occasional ice chip, your child will not be able to eat or drink anything until his
intestines begin working again. He will receive intravenous fluids to prevent dehydration and pain medication to help relieve discomfort.

Your child will have to get up out of bed and walk the day after surgery. Even though this
may seem like a daunting task, the importance of movement cannot be overemphasized. Among other things, walking helps the intestines to begin working again, and helps to prevent pneumonia from developing.

Dietary Guidelines

Even after your doctor gives full permission for him to eat, your child may have little or
no appetite. Begin slowly by offering clear liquids, such as broth, juices, and herbal teas.

To allow your child’s gastrointestinal tract to readjust to food, gradually work up to a full diet. Prepare whole, well-cooked foods that are full of the many vitamins and minerals your child’s body needs to heal and regain energy.

Homemade applesauce and soups are excellent “starter” foods for a child who has undergone surgery. Foods high in beta-carotene, such as squash and cooked greens, are also important.

Try to avoid giving your child any gas-producing foods, such as nuts and legumes, for the
first two weeks after surgery.

Nutritional Supplements

For age-appropriate dosages of some nutritional supplements, see page 81.

Beta-carotene, a precursor of vitamin A, helps to soothe injured mucous. membranes and heal tissue. Give your child one dose of beta-carotene each day for one month.

Lactobacillus acidophilus and bifidus are both very good for restoring bowel health after the trauma of surgery and potent antibiotics. Follow the dosage directions on the product label and
give your child one dose, twice a day, for one month. Then give your child one dose, once a day, for the second month.

The B vitamins help to restore strength. Give your child a liquid or capsule B-complex supplement, once a day, for one month.

Vitamin C and bioflavonoids aid in tissue repair and in decreasing inflammation. Give your child one dose of each, one to two times a day, for one month.

Vitamin E is an antioxidant nutrient and is a mild but effective natural anti-inflammatory. Give your child one dose, twice a day, for one month.

Zinc hastens wound and tissue healing and supports the immune system. Give your child a total of one dose of zinc each day for one month.

Note: Excessive amounts of zinc can result in nausea and vomiting. Be careful not to exceed the recommended dosage. Zinc is easiest on the stomach when taken at the beginning of a meal.

Herbal Treatment

Herbal treatment for appendicitis is directed at supporting recovery from surgery. It is not meant to be a substitute for surgical treatment. If you suspect appendicitis, seek medical treatment for your child immediately. For age-appropriate dosages of herbal remedies, see page 81.

Once the crisis is over, follow the regimen below to help your child recover.




Days 1-3: Give your child an echinacea and goldenseal combination formula to help detoxify the chemicals remaining in his blood after anesthesia. Echinacea and goldenseal also support the immune system and can help prevent a possible infection in a surgical wound. Give your child one dose, two to three times daily.
Days 4-7: Give your child one dose of astragalus (Astragalus membranaceous), three times daily. With its rich concentration of trace minerals and micronutrients, astragalus helps to strengthen the immune system. Do not give this herb to a child with a fever, however. If there is fever, continue giving your child echinacea and goldenseal until the fever is gone (but not for more than ten days in a row, or it will lose its effectiveness).

Days 8-14: Give your child one dose of American ginseng, three times daily. This is another excellent source of trace minerals and micronutrients, and will help strengthen your child’s internal defences.

Note: This herb should not be given if fever or any other signs of infection are present.

Days 15-21: Give your child two to three doses of nettle and/or gotu kola daily. These herbs contain many trace minerals, are very useful for healing wounds, and are good general tonics.

Note: Neither gotu kola nor nettle should be given to a child under four years of age. Also, some children experience stomach upset as a result of taking nettle. If this happens, discontinue use of the herb.

Days 21-35: Give your child one dose of minor bupleurum formula, twice daily. This is a Chinese herbal combination that is a good tonic and will help to restore strength.

Note: Minor bupleurum should not be given to a child with a fever or any other sign of an acute infection.

Once the wound has closed and healing has begun, and your surgeon gives you the okay, gently rub vitamin E oil, castor oil, or evening primrose oil into the wound to minimize scarring.

Homeopathy

Homeopathic treatment for appendicitis is directed at supporting recovery from surgery. It is not meant to be a substitute for surgical treatment. If you suspect appendicitis, seek professional medical treatment for your child immediately.

If your child seems to have had an adverse reaction to anesthesia, give him one dose of Nux vomica 30x or 200x to help lessen the side effects. Then follow this regimen to aid your child in his recovery from surgery.

Days 1-2: Give your child one dose of Arnica 30x or 9c, three or four times daily. Arnica helps to decrease inflammation following surgery and speeds the healing process.

Days 3-4: Give your child one dose of Staphysagria 30x or 15c, three times a day, to help the incision heal.

Day 4: To further hasten healing, give your child Ledum 12x or 6c, three times during the day.

Days 5-6: For nerve pain following surgery, give your child one dose of Hypericum 6x or 5c, three times a day.

Acupressure

For the locations of acupressure points on a child’s body, see Administering an Acupressure Treatment.

Massaging the stomach meridian, particularly Stomach 36, will help tone the digestive tract and speed recovery.

General Recommendations

To ensure a full and strong recovery after surgery, adequate rest is essential. Limit visitors and create a calm and familiar environment.

Once discharged from the hospital, your child will have periods of fatigue. Resuming a daily routine is probably fine, although he may need more rest than usual until his full strength is back. To help increase his energy level, you can give your child a liquid B-complex supplement for two weeks. One dose of American ginseng, given at approximately 11:00 A.M. daily, can also be helpful.

Contact sports, heavy lifting, and abdominal exercises must be avoided for as long as your doctor recommends, probably for six to eight weeks after surgery.

Prevention

There is no known way to prevent your child from developing appendicitis. Your best defense against the disease is to be aware of its characteristic symptoms, so that if your child develops appendicitis, he can be treated promptly and recover without complications.

Dosage Guidelines

Diet

Herbal Medicine

Homeopathy

Bach Flowers

Acupressure

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

Acupressure points are located along lines called meridians that run along the sides of the body. There are twelve of these meridians on each side of the body, each corresponding to and named for a specific organ. Pressure points are identified by numbers that indicate where they fall along a particular meridian. Spleen 6, for example, is the sixth point along the Spleen meridian.

In the sections on individual health conditions in Smart Medicine for a Healthier Child, specific pressure points are recommended for treatment of different disorders. Use the following diagrams to help you locate specific pressure points on the body. The front view shows points for the Four Gates combination and the Large Intestine, Liver, Spleen, and Stomach meridians. The back view shows points for Neck and Shoulder Release and the Bladder, Gallbladder, and Kidney meridians. The inset of the hand and arm shows points on the Lung and Pericardium meridians.

To give an acupressure treatment, choose a time when your child is relatively calm and relaxed. Make sure he is warm enough. You can apply pressure either directly to his body, or through a shirt or light sheet. Have your child breathe deeply for a few moments to aid relaxation. You may wish to start by giving a back rub, and then move into the acupressure treatment itself.

Expect the acupressure points relevant to your child’s condition to be somewhat tender to the touch. Use your judgment. Ask your child what feels good.

When administering acupressure, work the right- and left-side points at the same time whenever possible (if it’s not, work one side first and then the other). Using your fingers or thumbs, apply threshold pressure to the points. This is firm pressure that is just on the verge of being painful; the point is stimulated but the body doesn’t tighten up or retract from the pain. It is a “good hurt” feeling.

Apply from one to three minutes of continuous threshold pressure until the pain is relieved. Or apply pressure for ten seconds, release for ten seconds, apply pressure again for ten seconds, and release again; repeat this sequence ten times.

There are two special acupressure techniques suggested for several of the health problems discussed in the sections on individual health conditions:

• Four Gates Technique. Four Gates is a traditional Chinese point combination that has been used by acupuncturists for centuries. Working these points with acupressure will enhance relaxation and help relieve pain, nervousness, anxiety, and sleeplessness. Traditional Chinese doctors believe that working these points “opens the gates” of energy flow in the body. For this technique only, work first on one side of the body and then on the other. Apply pressure simultaneously to Liver 3 and Large Intestine 4.
• Neck and Shoulder Release. This is another traditional point combination, used to release the trapezius and other neck and shoulder muscles. Apply threshold pressure to Gallbladder 20 on the right and left sides, until you feel the muscle relax. Then do the same with Gallbladder 21.

   

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  From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

The History of Acupressure

Because acupressure evolved from acupuncture, an ancient Chinese healing practice, the history of this form of treatment begins with traditional Chinese philosophy as it applies to the healing arts. The fundamental principle of Chinese philosophy is the concept of yin and yang. The yin and yang are two opposite, yet complementary, forever-entwined forces that underlie all aspects of life. Yin-yang is depicted as the subtly curved light and dark halves of a circle. Both proceed from the t’ai chi (the Supreme Ultimate). According to this philosophical system, the human body, like all matter, is made up of five elements: wood, fire, earth, metal, and water. Each element corresponds to an aspect of the body, such as the organs, senses, tissues, and emotions, as well as to aspects of nature, such as direction, season, color, and climate. The five-element theory, combined with the principle of yin and yang, forms the basis of the Chinese concept of balance. The intention is to balance yin and yang and to balance the energies of the five elements.

Yin is earthy, female, dark, passive, receptive, and absorbing. It is represented by the moon, the tiger, the color orange, a broken line, and the shady side of a hill. Yin is cool, inward, still, and soft.

Yang is represented by the sun, the dragon, the color blue, an unbroken line, and the sunny side of a hill. Yang is hot, outward, moving, aggressive, and bright.

Because yin and yang are intertwined halves of the same whole, all things, and all people, contain elements of both, although at any one time, one or the other will be predominant. Thus, a baby or young child is more yin; an older child more yang. When your child asserts herself, it is her yang that is coming to the fore.

The sun is yang, the moon is yin. We awaken in the morning and greet the sun. It is natural to be active and moving throughout the daylight. As twilight descends into night, we become more passive and quiet. Nighttime expresses the qualities of yin.

Chinese medical theory teaches that the two branches of the body’s nervous system, the sympathetic and parasympa-thetic, correspond to the two halves of the yin-yang circle. The sympathetic branch is the part of the nervous system that mobilizes our bodies to respond to stress. It initiates the fight-or-flight re-sponse, a more yang part of the cycle. The parasympathetic branch replen-ishes and supports the body during rest, the yin part of the cycle. These two branches oppose and balance each other to create stability and health. When the yin and yang are balanced within the body, all the body’s functions are healthy. Illness is caused by an imbalance between yin and yang.

Conventional Western medicine typically pinpoints and directly treats only the affected part of the body. Chinese medical philosophy encompasses the entire universe. Everything that affects the patient is considered, including emotion, environment, and diet.

Chinese philosophy proposes a way of life based on living in accordance with the laws of nature. This profound connection with nature is reflected in the language used to describe illness. For example, a patient may be diagnosed with a “wind invasion” or “excess
heat.” Acupuncture (or acupressure) points may be chosen to “disperse wind,” “remove summer damp,” or “disperse rising fire.”

In traditional Chinese medicine, every aspect of health is described in terms of a balance between yin and yang. For example, yin illnesses are caused by excessive expansion (overweight as a result of eating too much sugar, for example), while yang illnesses are caused by excessive contraction (sunstroke or fever). An imbalance of yin and yang factors can be demonstrated by showing how red blood cells respond to different substances. When red blood cells are placed in water (yin), they absorb the water, expand, and finally burst. When red blood cells are placed in a concentrated saline (salt) solution (yang), they contract, shrink, and shrivel. In a solution of normal saline (0.9 percent salt), the yin and yang are perfectly balanced and the cells remain virtually unchanged. An example of how the ancient yin-yang theory can be used to describe concepts in conventional medicine can be found in the treatment of breast and prostate cancer: Female hormones (yin) help control prostate cancer (yang); male hormones (yang) help control breast cancer (yin). The interplay of the yin and yang-as one increases, the other decreases-describes the process of the universe and everything in it. In more familiar Western terms, as modern physical science teaches, “For every action, there is an equal and opposite reaction.”

The Five Elements and Their Correspondences
in Nature and the Human Body

In traditional Chinese Philosophy, all matter is considered to be composed of five elements (wood, fire, earth, metal, and water). The elements in turn have correspondences in various aspects of the natural world, including the human body. According to this philosophy, health is achieved when yin and yang, and the energies of the five elements, are all in proper balance. The elements and some of their corresponding characteristics and parts of the body are illustrated in the chart below.
THINGS IN NATURE	ELEMENT
	Wood	Fire	Earth	Metal	Water
Direction	East	South	Middle	West	North
Taste	Sour	Bitter	Sweet	Pungent	Salty
Color	Green	Red	Yellow	White	Black
Growth Cycle	Germination	Growth	Ripening	Harvest	Storing
Environmental Factor	Wind	Heat	Dampness	Dryness	Cold
Season	Spring	Summer	Late Summer	Autumn	Winter
HUMAN BODY
Organs	Liver, gallbladder	Heart, small intestine	Spleen, stomach	Lung, large intestine	Kidney, bladder
Sense/Organ	Eye	Tongue	Mouth	Nose	Ear
Tissue	Tendon	Vessel	Muscle	Skin and hair	Bone
Emotion	Anger	Joy	Meditation	Grief and Melancholy	Fright and fear

In Chinese philosophy, the energy that pulses through all things, animate and inanimate, is called chit Health exists when there is a harmonious balance under heaven of both internal and external forces. Each bodily organ must have the right amount of chi to function. Too much or too little chi causes an imbalance, resulting in illness or disease. Chi flows through all things, enters and passes through the body, creating harmony or disharmony.

Chinese medicine works directly with the natural, vital energy-or chi-of the body. The goal of acupuncture and acupressure is to normalize the body’s energies. Chi can tee tapped at specific points along channels known as meridians. Activating one key point sets up a predictable reaction in another area. By tonifying (increasing energy in) a specific area, the yin-yang balance is treated. Moving an excess of chi from one area and directing it to another, weaker area, corrects the yin-yang balance.

Acupuncture is an ancient protocol. As a component of Oriental medicine, it has been practiced for centuries. The Huangdi Neijing (Canon of Medicine), written about 500-300 B.C., is the oldest surviving medical text. Among other medical practices, it describes the use of acupuncture.

Acupressure Today

Acupressure is a form of body work in which pressure is applied to specific acupuncture points to balance internal function. Acupressure is practiced around the world.

The Chinese have a very descriptive term for taking advantage of a combination of two or more healing systems-a practice this book advocates. They say the’ patient is “walking on two legs.” A two-year study conducted jointly by the Northwestern University Medical School and Evanston Hospital in Evanston, Illinois employed a combination of acupuncture and acupressure. In this study, patients suffering from chronic head aches of all types, including migraine, cluster, whiplash, and tension, were first treated with acupuncture. The patients were then individually instructed in specific acupressure techniques to use when a headache seemed imminent. The researchers reported that the need for prescription painkillers and other drugs was eliminated entirely in most patients-thus verifying the effectiveness of “walking on two legs.”

Working with an Acupressurist

There are professionally trained and college-educated acupressurists, just as there are acupuncturists. If you wish to consult a trained acupressurist, check the yellow pages of your telephone book. You’ll find this category listed in most large cities.

For the most part, though, the gentle form of acupressure recommended in the Treatment and Care entries in Part Two of this book is something you can do yourself, at home, to ease a hurting or ailing child.

Treating Your Child with Acupressure

In The Chinese Art of Healing (Bantam, 1972), author Stephan Palos identifies the hand as “man’s original medical tool.” We instinctively use our hands to alleviate pain. When we suffer a bump or bruise, have a cramp, or hurt anywhere inside, we rub, knead, or massage the painful spot.

When your child is ill, gently working the acupressure points recommended in the appropriate entry in Part Two will probably be beneficial (the illustrations in Part Three provide guidelines for locating all of the acupressure points recommended). Your child will very likely love receiving an acupressure treatment.

Massaging a particular point will help relieve symptoms as well as strengthen and balance the yin-yang in your child’s body. For example, applying acupressure to the point identified as “Large Intestine 11” helps relax the intestine, thus relieving constipation. Another related

point is Stomach 36; massaging Stomach 36 helps tone an upset digestive tract. When your child is ill, the appropriate acupressure points, as well as other areas of your child’s body, will be tender. Use your intuitive sense. Ask what feels good.

Common Acupressure Points

In acupressure, there are twelve lines c ailed meridians that run along each side of the body. Each pair of meridians corresponds to a specific organ. For example, there is a pair of Lung meridians, Spleen meridians, Stomach meridians, and Liver meridians. Acupressure points are named for the meridian they lie on, and each is given a number according to where along the meridian it falls. Thus, Spleen 6 is the sixth point on the Spleen meridian. The table on page 38 lists some of the acupressure points most often recommended in the entries in Part Two of this book.

Administering Acupressure

When you give your child an acupressure treatment, your tools are your hands, notably your thumbs and fingers, and occasionally your palms. For the most part, you will be using the balls of your thumbs and fingers, never the nails. Before administering acupressure, make sure your fingernails are clipped short, so that you do not inadvertently scratch your child.

Choose a time of day when your child is most relaxed, perhaps after a warm bath and just before bedtime. Have her take a few deep breaths. This aids relaxation and will automatically focus your child’s attention inward on her body.

You might want to start an acupressure session with a loving and comforting back rub, a treat most children welcome, especially when ill. Remain calm and unhurried. Make sure to keep your child warm throughout the treatment. You can apply pressure to the points directly onto the skin, or through a shirt or light sheet.

Work right-side and left-side acupressure points at the same time. Use your fingers or thumbs to apply threshold pressure to the point. Threshold pressure is firm pressure, just on the verge of becoming painful The idea is to stimulate the point without causing the body to tighten up or retract a the pain. The pressure you exert should not hurt your child. Firm but gentle is the rule.

Apply from one to five minutes of continuous pressure. Or apply pressure for ten seconds, release for ten seconds, reapply pressure for ten seconds, release for ten seconds. Repeat this cycle five times.

To learn how to locate specific acupressure points, specific points
which are helpful for different childhood conditions are
included in
Administering an Acupressure Treatment.

When your child is ill, acupressure is a wonderful way to use your hands with a loving, nurturing touch, while also stimulating your child’s body to heal. By using the acupressure points described in this book, you will be working to relieve the underlying cause of illness. At the same time, your gentle healing touch will convey your love and concern to your child.

Common Acupressure Points

Point	Effect	Indications
Bladder 23	Increases circulation to the urinary tract and reproductive organs.	Vaginitis, urinary tract infection; lower back pain.
Bladder 28	Master point for the bladder.	Urinary tract infection.
Bladder 60	Increases circulation to the urinary tract and reproductive organs.	Urinary tract infection.
Four Gates	Motion sickness; chickenpox; croup; hay fever; herpes; hyperactivity; pain; fever; poison ivy; sleeplessness; weight problems.	Urinary tract infection.
Kidney 3	Strengthens the bladder and kidneys; increases circulation to the reproductive organs.	Bedwetting; urinary tract infection; vaginitis.
Kidney 7	Strengthens the bladder and kidneys.	Bedwetting.
Large Intestine 4	Beneficial to the head and face; relieves congestion and headaches; removes energy blocks in the large intestine; clears heat.	Acne; common cold; headache; menstrual cramps; teething; sore throat; fever; toothache.
Large Intestine 11	Relieves itching; reduces allergic reactions.	Chickenpox; hay fever; constipation.
Large Intestine 20	Decreases sinus congestion.	Hay fever; sinusitis.
Liver 3	Quiets the nervous system; relaxes muscle cramps and spasms.	Asthma; menstrual cramps; teething; headache; eye pain.
Liver 7	Clears the lungs; moistens the throat.	Asthma; common cold; sore throat.
Neck and Shoulder Release	Relaxes the muscles of the neck and shoulders; relaxes the body.	Headache; weight problems.
Pericardium 6	Relaxes the chest; relieves nausea; relaxes the ming.	Asthma; motion sickness; croup; sleeplessness; stomachache; vomiting.
Points Along Either Side of the Spine	Improves circulation; relaxes the nervous system; balances the respiratory system; relaxes the spine.	Anxiety; colic; common cold; menstrual cramps; nervousness; insomnia.
Spleen 6	Reduces uterine cramping.	Menstrual cramps.
Spleen 10	Detoxifies the blood.	Acne; herpes; impetigo; poison ivy, boils, vaginitis.
Stomach 36	Tones the digestive system; strengthens overall wellbeing.	Colic; diarrhea; chronic runny nose; vomiting, constipation, indigestion; stomachache.

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

The Bach Flower Remedies are dilute essences of plants. Unlike chemical mood-altering drugs, the flower remedies-while effective-are gentle and easy to use.

Although beneficial and benign, these natural flower essences have remarkable emotional and mental balancing effects. Because they act quite gently, they can be used whenever you think they may help your child to feel better. When choosing a Bach essence, match your child’s overall temperament, personality, and fears, as well as the particular emotional distress he is experiencing. If no single remedy seems to address all of these concerns, you may combine up to three remedies. (Although there is no danger in blending more than three remedies at any one time, their effectiveness can be diminished in a blend that is too complicated.)

Choosing a Remedy

Once you have identified the primary emotional distress your child is experiencing, use the table on pages 31-34 to find an appropriate remedy. Match the child’s personality, temperament, fears, and upset with the suitable Bach Flower Remedy. Bach Flower Remedies are available at many health food stores. If you cannot get them at a store near you, you can obtain them through Ellon Bach USA, Inc. (644 Merrick Road, Lynbrook, NY 11563; telephone 516-593-2206) or Homeopathic Educational Services (2124 Kittredge Street, Berkeley, CA 94704; telephone 510-649-0294).

Administering Bach Flower Remedies

Bach Flower Remedies are essences of flowers that come in tincture form. The bottled remedy you buy at your health food store is called the mother tincture, and is the most concentrated form available. There are two different ways you can administer a Bach remedy to your child.

• Place a drop of the mother tincture into a small glass of noncarbonated spring water and have your child sip this over a period of a few hours. For added benefit, teach him to swish the mixture around in his mouth before swallowing it.
• If you prefer, you can make a diluted mother tincture. Fill a two-ounce glass bottle with spring water. Add three drops of mother tincture and shake gently to blend. When using a diluted mother tincture, give your child two droppersful, three times daily.

After giving your child a flower remedy, observe his response. As his emotional response and behavior change, the need for a particular remedy may cease to exist. Give a remedy until the situation has been resolved. Once your child’s mood and emotions have been gently altered, you may need to select another remedy to complete and sustain the alteration. If your child’s destructive emotions have eased sufficiently and his emotional and mental state has come into balance, discontinue the remedy.

Of all the Bach Flower Remedies, the overwhelming favorite of many parents is Rescue Remedy. This is a premixed combination remedy made from the essences of cherry plum, clematis, impatiens, rock rose, and star of Bethlehem. It is useful in many crisis situations, such as after hearing bad news, before a test, before going to the dentist, after falling down and getting hurt, or after waking up from a night mare. It helps to restore balance and relieve apprehension. It will help calm a child who is crying, afraid, panicked, or tense.

Rescue Remedy is particularly good in acute situations in which the cause of your child’s distress is not clear-when a child begins crying and feeling intensely frustrated for no apparent reason and refuses to be consoled. Put two or three drops of this remedy in half a glass of water and give it to your child to sip as needed, or administer as you would any other Bach Flower Remedy.

Bach Flower Remedies are dilute essences of plants that treat emotional, mental, and physical distress. As with homeopathic remedies, choosing a flower remedy involves dose observation of your child’s emotional state, and then finding a remedy that matches your observations. Many parents report that these gentle preparations are excellent for alleviating stress and easing a sick, uncomfortable, or unhappy child.

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

Once a person is infected with the measles virus, it can incubate for nine to fourteen days before signs of illness develop. A child with the measles is considered contagious for at least seven days after the beginning of the illness. Usually, the disease is self-limiting and runs its course within ten days. The fever falls, making the sufferer feel more comfortable in general, and the rash fades to a brownish color that gradually disappears as the outer layer of skin is shed. Once this happens, the child is no longer contagious.

The seriousness of measles lies in the potential for complications following the illness itself. Ear infections are one common complication. Pneumonia and encephalitis (an inflammation of the lining of the brain) are also possible, and more serious, complications. If your child’s fever climbs to a very high level, if she has a seizure, or if you notice any changes in her level of consciousness or mental function, seek medical advice immediately. These may be symptoms of encephalitis, which can be fatal.

SYMPTOMS OF MEASLES The first signs that a child is coming down with the measles usually include some combination of the following: Fever. A stuffy and/or runny nose. A cough. Red and possibly itchy eyes that may be sensitive to light. Small red spots in her mouth. Three to five days after these initial symptoms, a child with measles will develop a rash with the following general characteristics: It is splotchy and brownish-pink in color. It begins around the ears and/or on the face and neck, then spreads over the rest of the body (although in mild cases, the arms and legs may not be affected). It is mildly itchy. It lasts for four to seven days before fading away.

Conventional Treatment

Treatment for measles is primarily aimed at alleviating symptoms while the virus runs its course. A child with the measles may run a fever as high as 104°F (in some cases higher), so fever control is a principal concern. You can give your child acetaminophen (in the form of Tylenol, Tempra, and other medications) or ibuprofen (Advil, Nuprin, and others) to bring down fever and ease overall achiness and malaise.


Note: In excessive amounts, acetaminophen can cause liver damage. Be careful not to exceed the proper dosage for your child’s age and size. ibuprofen is best given with food to prevent possible stomach upset.

Never give aspirin to a child who has–or
who you suspect may be coming down with-the measles. The combination of aspirin
and a viral infection has been linked to the development of Reye’s syndrome,
a serious disease of the liver and brain.

Because measles is a viral illness, antibiotic therapy is ineffective and therefore not appropriate. If your doctor confirms that your child has developed a secondary, bacterial infection, such as an ear infection, antibiotics may be prescribed to fight the secondary infection.

Make sure your child gets plenty of rest and drinks plenty of fluids. Also, because measles often causes a heightened sensitivity to light, your child will probably be more comfortable in a dimly lit room.

Dietary Guidelines

Lots of fluids are essential to prevent
dehydration. Keep a feverish child well hydrated. Offer fruit-juice popsicles,
spring water, herb teas, soups, and diluted juices. During the recovery period,
immune-boosting astragalus and vegetable soup is a good choice as well
(see THERAPEUTIC RECIPES).

Eliminate fats as much as possible. Fats
are difficult to digest under normal circumstances, and are even harder to
digest when the digestive system is weakened by infection. Undigested fats
contribute to a toxic internal environment.

Nutritional Supplements

For age-appropriate dosages of nutritional supplements, see Dosage Guidelines for Herbs and Nutritional Supplements.

Vitamin A aids in healing mucous membranes. Give your child one dose of vitamin A, once a day, for ten days.

Vitamin C and bioflavonoids help to stimulate the immune system. Three to four times a day, give your child one dose of vitamin C in mineral ascorbate form, and an equal amount of bioflavonoids, for one week. The following week, give the same dosage, but two to three times a day. During the third week, give the same dosage, two to three times, every other day. Then continue to give one-half dose, once a week, for three weeks.

Zinc stimulates the immune system and promotes healing. Give your child one dose, twice a day, for ten days.


Note: Excessive amounts of zinc can result in nausea and vomiting. Be careful not to exceed the recommended dosage.

Herbal Treatment

For age-appropriate dosages of nutritional supplements, see Dosage Guidelines for Herbs and Nutritional Supplements.

If your child is feeling very restless, give her one dose of chamomile tea, twice a day.

Echinacea and goldenseal combination formula helps clear an infection, supports the immune system, and soothes the skin and mucous membranes. Echinacea is a powerful antiviral. Give your child one dose, every two hours, until the fever breaks. Then give her one dose, three times a day, for one week.


Note: You should not give your child echinacea on a daily basis for more than ten days at a time, or it will lose its effectiveness.

An herbal fever-reducing tea will help to bring down your child’s temperature, decrease chills, and increase perspiration. Combine equal parts of some or all of the following: lemon balm leaf, chamomile flower, peppermint leaf, licorice root, and elder flower. For an older child, a little honey can be added to improve flavor. Give your child one dose, four times a day, for two or three days. A nursing mother may take one adult dose, four times a day, instead of giving the tea directly to her baby; its healing properties will be passed to her baby in her breast milk. The tea should be taken as hot as possible.


Caution: Do not put honey in the tea if you are giving it to a child less than one year old. Honey has been associated with infant botulism, which can be life threatening. Also, if you are using peppermint in the tea and also giving your child a homeopathic preparation, allow one hour to elapse between the two treatments. Otherwise, the strong smell of the mint will decrease the effectiveness of the homeopathic remedy.

Ginger tea can be effective against a fever. It is most helpful for the child who tends to feel cold, especially in the hands and feet. To decrease chills and increase perspiration, snuggle your child under light covers after giving her the tea. Give your child one dose, four times daily, for one day. If your child finds the taste too pungent, mix the tea with fruit juice.

Shiitake mushrooms have immure-stimulating properties. They may be eaten fresh, or taken in capsule form. Give a child twelve years old or older one capsule, three times a day, as long as signs of infection are present.

Give your child cool oatmeal baths to lessen the itching. Wrap a handful of oatmeal in a washcloth and let it soak in your child’s bath water. For extra relief, gently rub the oatmeal-filled washcloth over your child’s skin.

Homeopathy

Choose the most appropriate symptom-specific remedy from the suggestions that follow and give your child one dose, every two hours, up to a total of four doses a day, for up to two days.

Apis mellifica 30x or 9c is recommended for a child who has a swollen throat and difficulty breathing, and has a cough that causes pain in the chest. This child does not feel thirsty and is less comfortable in a warm room.

Choose Arsenicum album 30x or 9c if your child is restless but weak, feels worse after midnight, and wants frequent small drinks. This child’s skin may be itchy, and she may have diarrhea as well.

Belladonna 30x or 9c is the remedy for a child who has a high fever, red eyes, and a flushed face, and complains of a throbbing head and difficulty swallowing.

Gelsemium 30x or 9c is for the feverish child with droopy eyes and a croupy cough, who complains of feeling chilly and having a runny nose. This child’s rash is likely to be very red and itchy, and she may have a headache.

Pulsatilla 30x or 9c is helpful for a child who is tearful, with eyes that are sticky, discharging, and very sensitive to light. This child’s rash is dark red and spotty. She has thick yellow nasal mucus and a cough that is dry at night but looser during the day. She may have an upset stomach as well.

Acupressure

For the locations of acupressure points on a child’s body, see ADMINISTERING AN ACUPRESSURE TREATMENT.

Four Gates helps to relax a feverish child.

General Recommendations

To prevent dehydration, encourage a feverish child to drink plenty of fluids. The increased metabolic rate that results from a fever causes the body to lose fluids rapidly.

Make sure your child gets plenty of rest. Keep the lights in your child’s room dim.

Give your child an echinacea and goldenseal combination formula.

Select and administer a symptom-specific homeopathic remedy.

To promote perspiration and bring down a moderate to high temperature, give your child fever-reducing herbal tea.

If your child is uncomfortable and restless, give her soothing and calming chamomile tea.

Give your child vitamin C with bioflavonoids, zinc, and vitamin A.

If your child has the measles, be alert for signs that a secondary infection may be developing. If symptoms seem to get worse, or if new symptoms develop, seek medical advice.

Prevention

A vaccine that protects against measles is
available. It is usually given in the form of the MMR vaccine, which also
contains vaccines against mumps and rubella (German measles), when a child
is approximately fifteen months old. An additional dose is recommended either
before a child enters school or when she is between the ages of eleven and
thirteen. (See IMMUNIZATION-RELATED PROBLEMS>.)

A child who has recently been exposed to measles and may be incubating the disease should not be given the measles vaccine at that time. It may suppress the rash at the time, but it could leave her vulnerable to developing a more serious case of the illness in adolescence.

As much as possible, try to keep your child from contact with contagious children, particularly if she is not (or is not yet) immunized against the disease.

Dosage Guidelines

Diet

Herbal Medicine

Homeopathy

Bach Flowers

Acupressure

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

The theoretical and empirical basis of homeopathy is a concept called the Law of Similars, often summarized as “like cures like.” Perhaps more than anything else, what distinguishes the practice of homeopathy from other approaches to medicine is that instead of focusing on the specific causes of disease (such as viruses and bacteria), it focuses on the specifics of the symptoms of disease, as they are experienced by the individual patient.

The History of Homeopathy

Samuel Hahnemann (1755-1843) of Leipzig, Germany, created the practice of homeopathy. A medical doctor, Hahnemann did in-depth studies and wrote extensively on chemistry, pharmacology, and medicine. His study of arsenic, written in 1796, remains an authoritative text.

In 1790, Dr. Hahnemann began to question the accepted medical theories of the time. Cinchona officinalis, or Peruvian bark, had been the treatment of choice for malaria since 1700. Conventional medical thought attributed its beneficial action to its bitter and astringent properties. Hahnemann rejected this explanation. He observed that other plants and botanicals had even stronger astringency and greater bitterness, yet did nothing to relieve malaria. In an attempt to better understand how cinchona worked, he experimented by taking some himself. After taking the cinchona compound, Hahnemann promptly developed the symptoms of malaria.

This inspired him to further experimentation with many different plants, chemicals, and minerals. Hahnemann experimented first on himself, then on his family and friends. As his work continued, he noted the same remarkable effect again and again: Derivatives of certain extracts produced symptoms in the body similar to those produced by certain diseases. Pressing on with his experimentation, Hahnemann found that minute doses of extract actually produced the opposite effect.

Instead of causing the symptoms of a particular disease, the well-diluted extract reversed the course of the disease. This led Hahnemann to his observation that “like cures like”-that is, a substance that causes a certain set of symptoms in a healthy person will, in minute doses, cure a sick person of those same symptoms. He called this phenomenon the Law of Similars.

Many of Hahnemann’s colleagues argued against his practice of using himself as a guinea pig, prophesying dire consequences. But the doctor refused to heed their warnings, saying, “He knows with greatest certainty the things he has experienced in his own person.” Through his experiments, Hahnemann learned that a minute dose of a substance would cause illness in a healthy person, but paradoxically effect a cure in a sick individual. For example, a remedy that caused fever, chills, and leg cramps in a healthy person would cure a sick person of similar fever, chills, and leg cramps when given in microdoses.

Homeopathy Today

Homeopathy is accepted as an effective form of medicine in many parts of the world today, including Great Britain, France, Germany, Greece, India, and South America. The British royal family has been under the care of homeopathic physicians since the time of Queen Victoria.

Homeopathy is a systematic and precise form of natural medicine that addresses both physical and emotional symptoms. This protocol recognizes that each person is unique and will have an individual disease pattern. The experimentation, documentation, indepth testing, and recording of the effects of homeopathic remedies did not end with Dr. Hahnemann. Diagnosis of a specific disease is not the primary concern when treating your child with homeopathics. Rather, the correct remedy is chosen according to the specific symptoms and emotions your child is experiencing.

Homeopathic remedies stimulate the body’s vital force, enhancing its ability to heal itself. The “vital force” described by Hahnemann cannot be precisely identified. Even today’s most technologically advanced medical detectives do not really understand the ways in which body and mind work together. A complex interrelationship between immune factors and regenerative biological systems, the essential life force locked within body and mind remains a mystery.

Homeopathic remedies work by, in effect, “turning on a switch” that affects both body and mind. Homeopathic compounds somehow send a healing and normalizing message throughout the body. They spark unbalanced internal systems so that they are better able to perform their functions.

Working with a Homeopathic Physician

Remedies that may be appropriate for a variety of common childhood health problems are recommended in Part Two of this book. However, because the deeper concepts of homeopathy and the intricacies of the remedies can be difficult to master, you may find it helpful to consult a homeopathic physician. Often, a homeopathic physician can determine a constitutional remedy for your child that will help to balance her entire system.

Homeopathy is on the upswing in the United States. Many different types of health care practitioners use homeopathy. You’ll find medical doctors, naturopathic physicians, acupuncturists, herbalists, chiropractors, nurse practitioners, physician assistants, and laypeople who are knowledgeable in the field. Homeopathic pharmacies, even major health food stores, are other resources to explore. They may be able to tell you how to find a practicing homeopath in your area.

There are national organizations throughout the United States that can provide you with a list of homeopaths as welt If you can’t readily find a homeopathic physician in your area, you may wish to contact the International Foundation for Homeopathy (2366 Eastlake Avenue E, Suite 301, Seattle, WA 98102-3366; telephone 206-324-8230); the National Center of Homeopathy (1500 Massachusetts Avenue NW, #42, Washington, DC 20005; telephone 202-223-6182); or the Homeopathic Educational Service (2124 Kittredge Street, Berkeley, CA 94704; telephone 415-649-0294).

When choosing a homeopath to care for your child, it is important to select a physician with whom you feel very comfortable. This doctor will question you closely, asking you to reveal very intimate information about your child, and quite possibly about yourself as well. Much of homeopathic diagnosis and treatment depends on your ability to observe and relate specific details, some of which may even seem absurd or irrelevant to you at first.

Your homeopath will want to explore both your and your child’s emotional response to her condition, as well as symptomatic details. For example, if your child has a drippy nose or is coughing up phlegm, your homeopath will want to know the color, smell, and consistency of the discharge. You will probably be asked if it is heavier in the morning or evening, after eating, or before eating.

Your homeopath will also consider your child’s temperament and the way she responds emotionally to illness. Does your child want hugs and cuddles, or prefer to be left alone? Does your child become whiny and demanding when ill, or quiet and passive? Does she sleep a lot, or become restless and wakeful? Does she want the window open to admit cool, fresh air, or does your child feel chilly even snuggled under a cozy comforter?

How you respond to your sick child is something else your homeopath will ask you to reveal. When a child is ill, some parents become irritated and annoyed, some nervous and anxious. The very fortunate have a deep well of calm and certainty on which to draw. Be truthful when your doctor inquires about this. Emotional responses are not something you necessarily control consciously.

Faced with a hectic schedule, many parents have difficulty mustering up as much patience as they would like to comfort and nurture a sick child. All of the physical and emotional factors surrounding your child must be taken into account in determining the appropriate remedy. Because the emotional response of those around an ill child will unavoidably have an impact on her, your homeopathic physician may prescribe a helpful remedy for the primary caregiver as well.

Treating Your Child with Homeopathic Remedies

Of all the remedies commonly used in the various medical protocols, homeopathic remedies are unique in that they are symptom-specific. That is, the correct remedy is determined not by the disease, but by the specific complex of physical and emotional symptoms your child is experiencing. The choice of homeopathic remedies takes into consideration the temperament and emotional response of the patient, as well as the most minute details of her physical condition.

For example, the cold that infects your child and a neighbor’s child may be caused by the same virus, but each child will exhibit a unique set of symptoms and emotions. One child may have a headache and a runny nose, feel completely exhausted, and want to eat when not napping. The other may be clogged and congested, feel restless, be unable to sleep, and refuse food. Consequently, these two children, although infected by the same virus, will require entirely different remedies.

Homeopathy respects the complexity and uniqueness of each individual. To identify the correct homeopathic remedy, you must carefully observe your child’s unique-even quirky-behaviors and responses. Choosing the appropriate remedy requires a parent or homeopathic physician to match the child’s symptoms, both obvious and subtle, with the remedy.

Based on your child’s overall physical, emotional, and mental constitution, your homeopathic physician may prescribe a constitutional remedy. An appropriate constitutional remedy can help prevent illness, as well as maintain and support optimal health. For example, if your child is subject to recurrent ear and nose infections, colic, allergies, or digestive disorders, a constitutional homeopathic remedy may be extremely helpful.

The correct constitutional remedy will help strengthen and stimulate the vital life force. Your child’s response to the remedy will be at once subtle and profound, on the physical, emotional, and mental levels. Prescribing a constitutional remedy is a complicated art, however. To discover the most helpful constitutional remedy for your child, consult a homeopathic physician.

Common Homeopathic Remedies

Homeopathic remedies are prepared according to the standards of the United States Homeopathic Pharmacopoeia. All remedies are derived from naturally occurring plant, mineral, or chemical substances. Some of the most useful homeopathic remedies and their common indications are described in the table, “Common Homeopathic Remedies” below.

Homeopathic remedies come in different potencies. Of all of the issues in homeopathy, Dr. Hahnemann’s concept of potency is probably the one that has evoked the most questions, because it seems somewhat paradoxical at first. In his experiments, Hahnemann noted that symptoms continued to improve with ever-increasing dilution of a substance. In other words, as the concentration of the medicinal substance is reduced by dilution, the remedy becomes increasingly potent.

As yet, there is no satisfactory scientific explanation for this phenomenon. However, the astounding effectiveness of homeopathic treatment has been empirically documented around the world.

Commonly available homeopathic remedies come in several forms: the mother tincture, x potencies, and c potencies. Homeopathic tablets are made by mixing diluted remedies with lactose (milk sugar) to make solid pellets. There are also homeopathic creams, ointments, and salves, made by mixing diluted remedies with a cream or gel base.

Mother Tincture
The mother tincture is an alcohol-based extract of a specific substance, as it comes from the original plant, animal, or mineral. Mother tinctures are generally used topically or in a fashion similar to herbal tinctures.

X Potencies
In homeopathic remedies, the x (derived from the Roman numeral decimal system) represents 10. It indicates that the mother tincture has been diluted to one part in ten. The number preceding the x indicates how many times the remedy has been diluted. Thus, a 6x potency represents six such dilutions, beginning with the mother tincture. Remember that the more diluted a homeopathic remedy is, the more potent it is. So a 6x potency remedy, which has been diluted six times, is more potent than a 3x potency compound, which has been diluted only three times.

C Potencies
The c, also derived from the Roman numeral decimal system, represents 100. A c potency indicates that a mother tincture has undergone dilutions to one part in 100; the number preceding the c indicates how many dilutions it has undergone. Thus, a 3c potency indicates that the substance has been diluted to one part in 103 three times. As with x potencies, the higher the number, the stronger the remedy.

In home treatment, it is usually sufficient to use the lower potencies, such as 12x, 30x, 6c, and 9c. Many homeopaths agree that once you have identified the correct remedy, it will work regardless of potency.

If you are lucky, you may live in an area where you have access to a homeopathic pharmacy that specializes in homeopathic remedies. If not, check with your local health food store. Major health food stores across the United States usually carry a comprehensive selection of homeopathic remedies. If you don’t find what you’re looking for, many health food shops will special-order for you. A list of recommended suppliers of homeopathic remedies is also provided in the Appendix.

Proper storage and handling of homeopathic remedies is extremely important. They are sensitive and a certain amount of care must be taken in order not to diminish their potency or interfere with their action. Keep remedies out of sunlight and extreme heat, and away from strong smells. Avoid touching homeopathic remedies with your hands, and do not put any pellets that fall out of the bottle back in. Also, never touch the inner rim or the inside of a remedy bottle or lid.

Common Homeopathic Remedies

Administering Homeopathic Remedies

Many childhood health problems can be treated effectively and gently with homeopathy. Home administration of homeopathic remedies is ideally suited for acute situations-conditions that attack your child suddenly-rather than conditions medically termed chronic (illnesses that develop slowly and persist over a long period of time).

When you give the right remedy, it will work quickly. Experienced homeopathic physicians say that the “wrong” remedy will usually cause no harm. Once your child’s symptoms improve, discontinue the remedy. It is possible for a child to experience an aggravation or increase in the symptoms being treated, an effect caused by the Law of Similars. Should your child’s symptoms be increased by a remedy, stop administration of the remedy.

Homeopathic remedies come in pellet, tablet, and liquid form. Pellets and tablets are generally the best form of homeopathic remedies to use for children. You should avoid touching them with your hands, as this can decrease their effectiveness. Shake the pellets or tablets into a clean spoon or the top of the bottle, and then place them directly into your child’s mouth and tell her to let them dissolve rather than chewing them. Homeopathic pellets and tablets are mostly sweet milk sugar (lactose) that melts in the mouth, so it is generally easy to persuade a child to take them. If you are giving a remedy to an infant, you can dissolve the pellets in water and give the mixture to your child in an eyedropper.

The liquid remedies-homeopathic tinctures are not generally recommended for children because of their high alcohol content. However, as with herbal tinctures, if you put them in very hot water and let the mixture sit for five minutes, much of the taste of the alcohol will evaporate.

Homeopathic remedies work best when taken at least thirty minutes before or after eating. Clinical practice has shown that strong flavors (such as mint products), odors (paints, perfumes, etc.), foods and beverages that contain caffeine, and camphor or camphor-containing products (such as mothballs or deep-heating ointments-which should not be used on children anyway)-al1 decrease the effectiveness of the remedies, so all of these substances should be avoided when using homeopathic remedies.

Unless the treatment recommendations in Part Two specify otherwise, use the following guidelines when administering homeopathic remedies.

For a severely acute situation: For a problem such as a headache or fever, give your child one dose, every fifteen minutes, for one hour. If you see no change after four doses, you probably have the wrong remedy and should choose another.

For a less acute situation: For a problem such as a runny nose or a sore throat, give one dose, every two hours. Once symptoms start to improve, you can continue the remedy at less frequent intervals. During this stage, give your child one dose, three times daily.

A homeopathic remedy should be given for as long as it is needed. For example, if your child’s headache is gone fifteen minutes after she takes a headache remedy, she can stop taking the remedy. If the headache returns four hours later, try the same remedy again. Once your child feels better, she no longer needs to take the remedy.

Homeopathy is a highly individualized form of treatment that requires careful observation of your child’s physical symptoms as well as her emotional reaction to illness. It is a gentle and noninvasive form of natural medicine that can work particularly well for common, acute childhood health problems.

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.

A Natural Process

While every woman is different, the beginning of menopause commonly occurs between the ages of 42 and 55. In the five to ten years prior to menopause, the ovaries become less sensitive to hormonal signals which stimulate estrogen and progesterone. And although there are still about 10,000 immature follicles left in the ovaries, they fail to mature. Because the ovaries do not produce consistent amounts of hormones, the menstrual cycle becomes irregular. Eventually, the ovaries stop producing enough of the estrogen hormone, periods cease, and menopause arrives.

The Transition of a Lifetime

For a woman, menopause is perhaps the most crucial transition she will experience in her life. Approximately 1.3 million women reach menopause each year, and that number will double by the year 2010, when 60 million women will be close to, or complete with, the transition of menopause (1).

Although most women will experience some symptoms, they may be quite varied. Between 50% and 80% of women experience hot flashes, lasting two to three minutes, during the first several years of menopause. Women may also notice increasing fatigue, nervousness, insomnia, palpitation and emotional stress. Some sources include depression, although thankfully no studies objectively support that menopausal women suffer from it any more than the rest of society. Research indicates that women (as well as men) are more likely to experience depression in their twenties and thirties than in mid-life (2).

Estrogen Therapy–Is It For You?

About 95% of women in the Western nations spend approximately one-third of their lives in a state of estrogen deficiency. It is estimated that today as many as 30% of these women seek out some kind of estrogen replacement therapy (ERT). ERT has been used to alleviate hot flashes, night sweats, depression and anxiety. It is also recommended for prevention of cardiovascular disease and osteoporosis in menopausal and post-menopausal women.

In the United States, estrogen is commonly taken in doses ranging from .3 milligrams to 1.25 milligrams for the first 25 days of the month. Oftentimes, progestin is added for days 16-25 in doses of 2.5-10 milligrams. Some women have opted for the skin patch, which is applied once each week. Many women with symptoms who are also interested in taking the least amount of estrogen possible, have opted to take their estrogen every other day.

As most women know, choosing estrogen replacement therapy is not an easy decision, even if it does alleviate some menopausal symptoms. Results from several studies indicate that ERT provides some health benefits for women who have entered menopause. It reduces risk of death from coronary disease by 40% and risk of hip fracture by as much as 60%. However, the same studies show that this therapy also increases the risk of cancer in the uterus and the breast (3).

Herbal Combinations for Menopause?

On the bright side, natural medicine therapies have a long tradition of use in this country and abroad to support the changes during menopause. In the Orient, the hormonal decline experienced by women in their 40’s and 50’s is viewed as a “deficiency of the blood.” Therefore, menopause is a time to strengthen and build the blood with herbs such as Dong Quai (pronounced Dong Kwi). Dong Quai (Angelica sinensis root) has been used for centuries to help combat menopausal symptoms such as anxiety, depression, nervousness, insomnia, and hot flashes. It contains “phyto-estrogens,” or plant estrogens, which are easily absorbed and utilized. A Japanese study showed that Dong Quai increased both estrogen and progesterone levels in women with insufficient ovarian function (4).

Dong Quai is generally not taken by itself, but rather in combination with other nutritive and synergistic herbs. That’s because, in Chinese medicine, the herb is considered “warming”, and may therefore aggravate some of the menopausal symptoms such as hot flashes and nervousness. Typical Dong Quai-based formulas may include other female-oriented herbs that have “blood building” properties.

These herbs include:

• Vitex (Vitex agnus-castus root), traditionally used to stimulate the progesterone phase of the menstrual cycle.
• Red Raspberry (Rubus idaeus leaf), used for centuries as a “uterine tonic”.
• Nettle (Urtica dioica leaf), high in trace minerals.
• White Peony (Paeonia lactiflora root), from Chinese herbal medicine, a nervous system relaxant.

These herbs may be taken in the form of a liquid extract, capsule, tablet or strong tea. I usually recommend two to three doses per day, for one to two weeks out of the month.

Nutrition Can Help

Nutrients also support women through menopausal changes. The following are the most popular and beneficial:

• Vitamin E, in doses ranging from 50 iu to 400 iu per day, is often effective for hot flashes. In addition, that dosage range reduces cardio-vascular risk in women and provides antioxidant protection for the body (5).
• Pantothenic acid (Vitamin B5) has been used clinically for the last several decades in the treatment and prevention of menopausal symptoms. As ovarian function declines, there is some estrogen support originating from the adrenal glands. Pantothenic acid has been shown to support adrenal function (6). This is probably the explanation for its noted clinical effectiveness in treating some acute symptoms of menopause, including hot flashes, anxiety and fatigue. A dose of 50 to 100 mg, three times daily, is usually sufficient.
• Calcium supplementation is recommended for prevention of osteoporosis (thinning of the bone structure), which occurs in many post-menopausal women. Recent research shows that women taking at least 1000 mg of Calcium daily are less likely to suffer from bone fractures due to osteoporosis (7). I usually recommend the Calcium as a citrate, aspartate, or amino acid chelate, accompanied by Magnesium. At least 1000 mg per day is needed by menopausal and post-menopausal women.

Try a Little Relaxation

Western medicine often relies on sedatives for various stress-related symptoms, and menopause is no exception. There are, however, many herbal alternatives for these synthetic relaxants. Valerian (Valeriana officinalis root), Passionflower (Passiflora incarnata blossom), and Chamomile (Matricaria recutita blossom) are botanical relaxants with centuries of clinical and traditional use. They may be taken in the form of a liquid extract, capsule, tablet or strong tea. These herbs should be taken daily, as needed, and are often effective for menopausal women who are unable to sleep due to recurring hot flashes and insomnia.

Homeopathy and Menopause

Homeopathy is a highly researched medical system, and is a useful tool for treating menopausal symptoms. Consider these remedies:

• Lachesis is excellent in reducing hot flashes, anxiety and headaches.
• Sepia is useful for the woman who is typically dark complected, enjoys exercise and is experiencing irritability.
• Pulsatilla, Natrum mur, Aurum mur, and Sanguinaria are other remedies to consider.

Lower potencies– 3X, 6X, or 12X– taken three to four times daily usually provide good results. Obviously, it is best to consult a homeopathic Materia Medica or your health care practitioner to find the appropriate remedy for your case or constitution.

It’s Not a Program Without Diet and Exercise!

Diet is also of the utmost importance during this transition. The excessive use of caffeine, alcohol and cigarettes are all important lifestyle choices that worsen the symptoms of menopause. And refined sugar, red meat and chocolate don’t really help either! Your foods should be prepared simply, increasing your intake of fruits and vegetables and reducing high fat foods. You should replace frying with steaming or baking.

Exercise is also essential. If you do nothing else before, during, or after menopause– EXERCISE! An increasing number of clinical studies have shown that weight-bearing exercise improves bone density and should be used as part of a program to prevent osteoporosis (8). This means running, brisk walking, or low impact aerobic workouts of at least 30 minutes, three times each week. And exercise will not only help your bone density, it will reduce your risk of cardio-vascular disease (9).

A Rotational Program for Menopause

So, you ask, what should I do today? Although all cases of menopause may need to be treated individually, the following is a simple rotational program for women who are in their menopausal years (ages 42 to 55):

The Basics:

1. Do aerobic, weight-bearing exercise
2. Eat a healthy diet
3. Use a Calcium/Magnesium supplement
4. If menopausal symptoms are occurring, select the appropriate homeopathic remedy.

In addition, simultaneously follow this rotational program:

• WEEK 1
  Herbal support:
  1. Use a Dong Quai-based formula
  Suggested use: One dose, three times daily
• WEEK 2
  Nutritional support:
  1. Use a Vitamin E supplement
  Suggested use: 25-100 iu, three times daily

  2. Use a Vitamin B5 (Pantothenic acid) supplement
  Suggested use: 50-100 mg, three times daily

• WEEK 3
  Herbal support:
  1. Use a Dong Quai-based formula
  Suggested use: One dose, three times daily
• WEEK 4
  Nutritional support:
  1. Use a Vitamin E supplement
  Suggested use: 25-100 iu, three times daily

  2. Use a Vitamin B5 (Pantothenic acid) supplement
  Suggested use: 50-100 mg, three times daily

Note: If menopausal symptoms are acute, use both herbal and nutritional support remedies at the same time. If you suffer from insomnia and nervousness, use the relaxing herbs Valerian, Passionflower, and Chamomile as directed above, as needed. A Vitamin B Complex may be used during week one and three for additional nutritional support.

The above is a sampling of the many options available to the menopausal woman. This era in medical care is very exciting for many women who now have the opportunity to make menopause a less harrowing experience and a more comfortable transition.

Footnotes

1. The Menopause Generation, The Los Angeles Times, December 5, 1993
2. Cited in article, The Harvard Health Letter, November, 1993
3. Cited in article, The Harvard Heart Letter, May, 1993
4. Koyama, et al, Study, American Journal of Chinese Medicine, 1988
5. Stampfer, et al, Vitamin E consumption…, New England Journal of Medicine, June, 1993
6. Kosaka, et al, Action of pantetheine on the adrenal cortex, Horumon To Rinsho, October, 1966
7. Krieger, et al, Dietary factors and fracture…, International Journal of Epidemiology, 1992
8. Study at Winthrop University, Annals of Internal Medicine, January, 1994
9. Article, Journal of the American Medical Association, November, 1989

Janet Zand, OMD, L. Ac., is a respected naturopathic physician who lives and practices in the Los Angeles area. She has developed a unique and effective method of combining herbal medicine with nutrition, homeopathy and acupuncture. Her credentials include a Doctor of Naturopathy, Doctor of Oriental Medicine, and Certified Acupuncturist. Dr. Zand has over fifteen years of clinical experience treating with natural medicine, as well as having formulated her own line of herbal supplements.

Exercise

Exercise is the single most important thing one can do to preserve and increase one’s bone mass. It is clear from research that the best kind of exercise for strong bones is weight bearing in nature. Activities such as running and brisk walking are ideal. But don’t forget “fun” exercise like dancing, rope jumping, hiking, tennis and volleyball. Each of these activities is useful in strengthening the bones. I usually recommend 45 minutes of weight bearing exercise, three times each week. In addition, walk 20 to 30 minutes, three times a week. And remember, you are never too young or too old to begin an exercise routine. If you have any questions about how much exercise you should start with, consult your physician.

Diet

As far as your bones are concerned, what you shouldn’t eat is as important as what you should eat. Sugar is a big culprit, and as recommended in any healthy diet, it should be reduced. In addition, using too much table salt in the diet can actually cause calcium to be excreted through the urine. One study revealed that adding a teaspoon of salt to the diet of young women increased the amount of calcium lost in the urine — enough to diminish bone mass by 1.5% per year. It is important to include moderate amounts of animal protein and make certain that one includes two vegetable servings with any protein meal. And, of course, you should also include calcium-rich foods such as green, leafy vegetables and moderate amounts of dairy products in your diet.

Caffeine, Nicotine and Alcohol

Caffeine will also cause calcium to be excreted in the urine. One study has demonstrated that three cups of coffee will secrete 45 milligrams of calcium into the urine. Cigarette smoke has been shown to curtail estrogen activity, and anything that interferes with estrogen is very likely to increase one’s chances of osteoporosis. Women who smoke are clearly at high risk for osteoporosis. And alcohol should be reduced or eliminated. Chronic alcoholics are notorious candidates for poor bone density since research indicates that most osteoporosis in middle age men is associated with alcoholism.

Nutritional Supplements

Both calcium and magnesium are clinically used in the prevention and management of osteoporosis. These nutrients can be so effective that the Harvard Health Letter considers recent research (showing that calcium with vitamin D prevents hip fractures in the elderly) to be one of the top ten medical advances of 1993. In a recent clinical study, it was found that calcium supplementation alone significantly retarded the degree of bone loss and improved calcium balance in recently post-menopausal women.

In a study comparing the incidence of several types of fractures in women ages 50 to 84, it was found that those with a calcium intake of 1000 mg a day or greater were less likely to suffer from bone fractures. And some additional data indicates that magnesium is also valuable in the treatment and prevention of osteoporosis. In one study, supplementation using 500 mg of calcium and 600 mg of magnesium had a significant effect on reversing post-menopausal bone loss.

I usually recommend at least 1000 mg of calcium and 500 mg of magnesium daily. It is wise to use supplements that include multiple forms of each mineral (i.e., citrate, chelate, aspartate, carbonate, etc.). If you prefer taking a single form, such as calcium citrate, it may be wise to occasionally rotate to another type to ensure that your body is assimilating the nutrient efficiently.

Herbal Medicine

Dong Quai (Angelica sinensis root) has seen decades of clinical use in the Orient and the West for the treatment of menopause and the management of osteoporosis. Because declining estrogen levels are associated with increased risk of osteoporosis, botanicals that are estrogenic in function are commonly used in the clinic to support healthy bones. In a Japanese study, menopausal women showed a 5-7% increase in bone mineral content after being treated with an herbal formula containing Dong Quai and vitamin D3. I often recommend using a Dong Quai formula two to three times daily, for one or two weeks out of the month.

There are other herbs that may act “synergistically” to support calcium metabolism. These include Horsetail, Oatstraw and Nettle. These botanicals are rich in calcium and other trace minerals, and should also be considered in a program.

Summary

So, it is important to begin with looking at your lifestyle — proper exercise and diet are essential. Take a calcium/magnesium supplement and consider herbal support to help you on your way to stronger, healthier bones.

Janet Zand OMD, L.Ac., is a respected practitioner who lives and practices in the Los Angeles area. She has a unique and effective method of combining herbal medicine with nutrition, homeopathy, and acupuncture. Her credentials include Doctor of Naturopathy, Doctor of Oriental Medicine, and Certified Acupuncturist. Dr. Zand has over fifteen years of clinical experience in treating with natural medicine, as well as formulating her own line of herbal supplements.

Although all natural medicine prescriptions should be individualized for optimal results, there are many effective general programs to try. A good herbal program rotates botanical remedies and combines them with synergistic nutritional supplements in an organized and rational manner. I have found that this type of system greatly enhances effectiveness and works in conjunction with natural body rhythms. By using natural remedies in specific cycles, the body remains more responsive and clinical results improve dramatically. This is especially true for women who tend to have sensitive metabolisms due to the complexity of the menstrual cycle and fluctuating hormone cycles.

Herbal programs for women are based upon the 4 weeks of the menstrual cycle. The first phase (weeks 1 & 2) involves the transition from menstruation to ovulation. The second phase (weeks 3 & 4) deals with the ovulation to menstruation process. Using herbal and nutritional supplements that support metabolic functions during these two distinct phases is the key to obtaining optimal results.

In the first phase, we find that toning the body by “nourishing” the blood and balancing the hormones is most beneficial. During this time, the hormones are building as the estrogen prepares the body for ovulation and potential fertilization of the egg. The two most important herbs during this first phase are Dong Quai and Red Raspberry leaf.

Dong Quai (Angelica sinensis root) is the noted Chinese herb that is used as a blood tonic. It contains micronutrients known for their blood building properties (iron, vitamin B12, and vitamin E). Dong Quai balances estrogen in the body, and is traditionally used in China to regulate the menstrual cycle. Red Raspberry (Rubus idaeus leaf) is a rough equivalent to Dong Quai in Western herbology. It is a blood tonic and blood builder with hormone-regulating and uterine-toning properties.

Because Dong Quai is “warming” in nature, and Red Raspberry leaf is “cooling”, I prefer to use a blend of these two herbs. As a combination they are neutral, and may be used on a long term basis to treat a variety of menstrual complaints.

During the second phase, there is a metabolic shift in the body. The hormone Progesterone predominates, as it prepares the uterus for possible implantation of the fertilized egg. It is also during this time that the liver comes under the most stress. It is responsible for the balance of “favorable” estrogen with “unfavorable” estrogen, as well as the balance of estrogen with progesterone. The liver often becomes congested during these last two weeks of the cycle, causing the hormonal balance to fluctuate. Premenstrual symptoms are the result.

It is interesting to note that recent advances in Western physiology point to this dysfunction in liver metabolism. However, for over 2,000 years Chinese medicine has diagnosed the symptoms of premenstrual syndrome as a problem with liver function.

So, we find that “clearing” the liver is the preferred treatment plan for the second two weeks of the menstrual cycle. The Western herb Dandelion and the Chinese herb Bupleurum are effective in taking congestion out of the liver. Liver cleansing formulas with these herbs as the principal ingredients are beneficial. The nutrients Choline, Inositol, and Methionine (known collectively as “lipotrophic factors”) are also excellent for stabilizing liver function.

With these two phases in mind, let’s look at several herbal programs that benefit optimal health for women:

Optimal Health for Women: General

This is a general program for women to both regulate and balance the hormonal system as well as to enhance body resistance. It can be used for several months, however it is not designed for women with severe premenstrual syndrome.

Week 1

Dong Quai and Red Raspberry leaf combination
For hormone balancing and blood building
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

Week 2

Dong Quai and Red Raspberry leaf combination
For hormone balancing and blood building
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

Week 3

Adaptogenic herbs (Astragalus, American Ginseng, or Chinese Ginseng)
To tonify the body’s deep immune system
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

Week 4

Echinacea & Goldenseal combination
For their anti-bacterial, anti-viral, and anti-inflammatory properties
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

Premenstrual Syndrome: General

This is a general program based upon hormone balancing and blood building during the first two weeks, and liver clearing during the second two weeks.

Week 1

Dong Quai and Red Raspberry leaf combination
For hormone balancing and blood building
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

Week 2

Repeat Week 1, or until onset of ovulation (then skip to Week 3)

Week 3

Vitamin B6 and Magnesium
Nutritional support to reduce PMS symptoms and cramps
Dosage: 2-3 times daily

Lipotrophic Factors (Choline, Inositol, Methionine)
To stabilize liver function
Dosage: 2-3 times daily

Herbal liver cleansing formula (Dandelion, Bupleurum, et al)
Dosage: As a liquid extract, tablet, capsule or tea, 2-3 times daily

Week 4

Repeat Week 3, until the beginning of menstrual flow

Premenstrual Syndrome with Flu Like Symptoms

For women whose immune systems become compromised during the week prior the menstruation. They frequently complain of cold and flu symptoms, with aching and general inflammation. Follow weeks 1 and 2 of the above PMS program. For Weeks 3 and 4, try the following:

Weeks 3 & 4

Echinacea and Goldenseal combination
For their anti-bacterial, anti-viral, and anti-inflammatory properties
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

Vitamin B6 and Magnesium
Nutritional support to reduce PMS symptoms and cramps
Dosage: 2-3 times daily

Lipotrophic Factors (Choline, Inositol, Methionine)
To stabilize liver function
Dosage: 2-3 times daily

Herbal liver cleansing formula (Dandelion, Bupleurum, et al)
Dosage: As a liquid extract, tablet, capsule or tea, 2-3 times daily

Premenstrual Syndrome with Severe Cramps

For women with PMS accompanied by severe uterine cramps. Following the general program for premenstrual syndrome over a period of time will alleviate severe cramps if they are not due to a more serious condition (such as fibroids). For symptomatic relief of cramps, add the following at the onset of symptoms:

Week 4

Homeopathic Mag Phos 6X
To relieve the symptoms of uterine cramps
Dosage: Every 1 to 2 hours until relief, then three times daily for 3 days

Anemias

Women with anemia and borderline anemia need to build the blood. The following program should be used in conjunction with Iron and Iron synergistic nutrients prescribed by your health care practitioner. It features the blood-building herbs Dong Quai and Red Raspberry leaf every week of the month.

For all Four Weeks

Dong Quai and Red Raspberry leaf combination
For hormone balancing and blood-building
Dosage: As a liquid extract, tablet, capsule or tea, 3 times daily

In addition, add the follow individual herbs:

Week 1

Yellow Dock (Rumex crispus leaf)
Chlorophyll nutritional support
Dosage: As a liquid extract or tea, 3 times daily

Week 2

American Ginseng (Panax quinquefolius root)
For its blood-building properties
Dosage: As a liquid extract or tea, 3 times daily

Week 3

Nettle (Urtica dioica leaf)
Chlorophyll nutritional support
Dosage: As a liquid extract or tea, 3 times daily

Week 4

Alfalfa (Medicago sativa leaf)
Chlorophyll nutritional support
Dosage: As a liquid extract or tea, 3 times daily

Optimal health for women requires some thought in relation to the specific phase of the menstrual cycle. Keeping this in mind, your results with herbal and nutritional supplements can be greatly enhanced. These programs are not intended as a substitute for individualized care. In the event of illness, consult your health care practitioner.

Janet Zand, OMD, L.Ac., is a respected naturopathic physician who lives and practices in the Los Angeles area. She has developed a unique and effective method of combining herbal medicine with nutrition, homeopathy, and acupuncture. Her credentials include a Doctor of Naturopathy, Doctor of Oriental Medicine, and is a Certified Acupuncturist. Dr. Zand has over fifteen years of clinical experience treating women and children, as well as formulating her own line of herbal supplements.

Whether it is the nervous system or the immune system that becomes compromised, natural medicine has a number of effective remedies to support those under stress. And the first place to start is with the “nervines”. This category of botanicals includes Valerian, Passion Flower, Oatstraw, and Chamomile.

Valerian (Valeriana officinalis) is perhaps the most popular and certainly the most clinically effective of all the nervines. It has been widely used for centuries in North America and Europe for its calmative and sedative properties. Recent research has shown Valerian root to relieve insomnia and actually improve sleep quality. In addition, it has spasmolytic properties, and is useful in relieving cramps in the intestines as well as in the uterus. It is also effective for muscle spasms. The active components of Valerian include valerenic acid and its valepotriates.

Passion Flower (Passiflora incarnata), Oatstraw (Avena sativa), and Chamomile (Chamaemelum nobile) are also effective, especially when combined with Valerian. What makes these nervines beneficial is that they are strong relaxants and calmatives but do not cause the “hang-over” side-effects. They also have nervous system “toning” properties that are, in effect, “restorative”.

The adaptogenic herbs Siberian Ginseng (Eleutherococcus senticosus) and American Ginseng (Panax quinquefolius) are also useful. This category of herbs assists the body in adapting to stress, whether the stress is metabolic, physical, or psychological. In addition, both of these herbs also have immune-enhancing properties and support adrenal function. In my experience, the adaptogens should be used by all persons under stress to support energy as well as protect against further weakening of body metabolism.

Astragalus (Astragalus membranaceus) is closely related to the adaptogens, but should technically be in a category of its own. This noted herb from China is a strong tonic for energy and the immune system. In Oriental medicine, it is used to support resistance and protect the body from disease and sickness. In one recent study, Astragalus extract was found to be effective in preventing metabolic dysfunction in animals who had been subjected to severe noise stress. Like the adaptogens, Astragalus (most effectively used in a combination) should always be considered as an herbal supplement for those under stress.

The following is an Herbal Program that may be a useful tool in managing stress syndromes:

Take as needed, daily if necessary:

Valerian or Valerian combined with Passion Flower and other nervines
For its relaxant and nervine properties
Dosage: one dose, three times daily, as needed

Week 1

Siberian Ginseng or Siberian Ginseng combined with American Ginseng
For its adaptogenic properties and to support energy
Dosage: 1 dose, 3 times daily

B Complex
Supports metabolism during times of stress
Dosage: 1 dose (up to 50 mg of B1,B3,B6), 3 times daily

Week 2

Astragalus or Astragalus combination
For its deep toning support
Dosage: 1 dose, 3 times daily

Calcium/Magnesium
Further restores and relaxes the nervous system
Dosage: 1 dose (up to 250 mg of Calcium), 3 times daily

Week 3

Siberian Ginseng or Siberian Ginseng combined with American Ginseng
For its adaptogenic properties and to support energy
Dosage: 1 dose, 3 times daily

B Complex
Supports metabolism during times of stress
Dosage: 1 dose (up to 50 mg B1,B3,B6), 3 times daily

Week 4

NO SUPPLEMENTS THIS WEEK
Allow the body time to integrate the previous weeks supplements

Botanical medicines and other nutritional supplements are only a part of an anti-stress program. You may consider many other helpful tools on your road to relaxation: yoga, meditation, exercise, biofeedback, acupuncture, acupressure, and massage. And of course, a balanced diet will always be of benefit. Experimenting with these modalities as well as using the above Herbal Program will help lead you to a more relaxed, healthier life!

Janet Zand, OMD, L.Ac.. is a respected naturopathic physician who lives and practices in the Los Angeles area. She has developed a unique and effective method of combining herbal medicine with nutrition, homeopathy and acupuncture. Her credentials include a Doctor of Naturopathy, Doctor of Oriental Medicine, and Certified Acupuncturist. Dr. Zand has over fifteen years of clinical experience treating with natural medicine, as well as having formulated her own line of herbal supplements.