The nervous system is at the intersection between the mind and the physical body so maintaining it is of great importance. The nervine tonic herbs, otherwise known as the nervine trophorestoratives, are an important class of medicines that have an affinity for the nervous system and are said to support, repair, and strengthen its function (Hoffman, 1988). David Hoffman in his book, ‘Holistic Herbal’, writes, ‘The nervine tonics strengthen and feed the tissues directly…. In many nerve problems, the aid of nervine tonics can be invaluable’. The nervine tonics work in the long term to nourish the nervous system, while in the short term often induce a feeling of relaxation and wellbeing. Too often in our society we are seeking the quick solution to our ailments, while in fact, it is the deeper acting long term solutions, which require patience, that we need.

From the North American and European system of herbalism, key examples of nervine tonics include; St. John’s wort, skullcap, wood betony, milky oats, and blue vervain. From the Ayurvedic system of medicine, the ‘medhya rasayana’ herbs possess similar properties and are said by Ayurvedic medicine to rejuvenate the brain and nervous system (Kulkarni et al., 2012). Medhya rasayana herbs are a sub division of the ‘rasayana’ herbs which are more general in their action to most of the entire body (Winston, 2007). However, many rasayana herbs also have an affinity for the nervous system. Examples of rasayana herbs which are also nervine tonics include; gotu kola, calamus, ashwagandha, and holy basil. These nervine tonic herbs from both systems are variably indicated by traditional medicine for diverse conditions such as depression, anxiety, stress, headaches, various cognitive problems, epilepsy, nerve damage, and insomnia. This article will discuss these nervine tonic herbs as they are all of great importance in our materia medica.

St. John’s wort

stjohnswortwikicommons

Hypericum perforatum or St. John’s wort is native to Europe and produces distinctive bright five-petaled yellow flowers (Benzie, 2011). The name comes from its flowering around St John’s Day on the 24th June. St. John’s wort’s use as a medicine can be traced back to the ancient Greeks (Castleman, 2001) and the Greek physician Dioscorides (40-90 AD) recommended St. John’s wort internally as a treatment for sciatica and topically for burns. The herb is also associated with many folk traditions and the Romans and Greeks believed that St. John’s wort protected them against evil spells. Later, the Eclectics, America’s 19th century physicians, stated St. John’s wort to have, ‘undoubted power over the nervous and spinal cord’. In humans, St. John’s wort is a confirmed anti-depressant across many high quality scientific studies (Ng et al., 2017).

Despite its scientific categorisation as an anti-depressant, St. John’s wort is known by herbalists as one of the most important herbs for nerve pain in European and North American herbalism. It is also indicated in the treatment of anxiety. It is an important component of many formulas designed to improve nervous system health as it is considered an uplifting and nourishing tonic herb. Folk lore states, it may heal nerve damage if taken long term (Groves, 2016). St. John’s wort works best as a tincture made from fresh flowers and should have a deep red colour to indicate its medicinal potency.

American skullcap

skullcap-scutellaria-lateriflor-672x372

Scutellaria lateriflora or American skullcap is a perennial member of the mint family, it may be found growing in the meadows and swamps of North America (Awad et al., 2003). American skullcap was used by the Native Americans as a sedative (Barceloux, 2008). In his book, ‘Holistic Herbal’, David Hoffman states skullcap ‘relaxes nervous tension in the central nervous system and also has a renewing effect’ (Hoffman, 1988). In human’s, skullcap has been found to have anti-anxiety and mild anti-depressant properties in double blind placebo controlled clinical trials (Brock et al., 2014; Wolfson et al., 2003). Skullcap is indicated for insomnia, anxiety, stress, epilepsy, seizures, and painful tight muscles. It is one of the best herbs to help restore a normal sleep pattern with its notable sedative effect that is stronger than St. John’s wort more gentle relaxant effect. American skullcap should be used as a fresh tincture, drying removes its medicinal powers and in the correct form it is a potent addition to our nervine tonic materia medica.

Wood betony

Secondary_stemflower_Betonica_officinalis_high_mountain_variety_Orjen_-_Montenegro_wiki

Betonica officinalis or wood betony is native to Europe and was highly valued by both the ancient Greeks and Romans (Wood, 1997). Antonius Musa, physician to the Emperor Augustus, wrote a book claiming wood betony cured 47 diseases. Steeped in folk lore at the time, the Anglo-Saxon Herbal dramatically mentions betony as a shield against ‘frightful goblins that go by night and terrible sights and dreams’ (Watts, 2007). Next to vervain, wood betony was the most highly esteemed remedy for early European herbalists, and similar to vervain, unfortunately it has fallen into neglect in more modern times. It has an affinity for the nervous and digestive systems. It may be applied against headaches, fatigue, cognitive problems, weak digestion, sciatica, musculoskeletal conditions, CFS, and insomnia (Bartram, 2013). It has a relaxant property to it comparable with St. John’s wort. Distinct to St. John’s wort and skullcap, but similar to blue vervain, it has a notable nootropic quality and may be useful in treating various cognitive problems.

Blue vervain

Verbena_hastata

Verbena hastata or blue vervain, is a direct descendent of ordinary European vervain. Vervain was used by the Greek physician, Hippocrates, he recommended it for plague and fevers (Castleman, 2001). It was also used by the Roman physician to Theodosius the Great for throat cancer. The Romans spread vervain around Europe and it became popular among the Druids of England in pagan times. Many years later, after introduction of European vervain into America, blue vervain was selected by Dr. O. Phelps Brown in New Jersey City as the most potent of several vervains he tested (Wood, 2004). In his book ‘The Complete Herbalist (1867)’, he writes, ‘the very great medicinal value of this plant was brought to my attention by an accidental knowledge of the good it had effected in a long-standing case of epilepsy’ (Wood, 1997). I have noticed only a small dose of this potent herb (2-10 drops) is enough to induce a profound state of relaxation, in addition blue vervain possesses a nootropic action, similar to wood betony. Blue vervain may have uses in the treatment of fatigue, but also insomnia, epilepsy, anxiety, stress, weak digestion, and nerve pain. It has a deep relaxing effect throughout the nervous system and is particuarly indicated in individuals prone to neck and shoulder tension.

Milky oats

Avena sativa or oats is an annual grass that has been cultivated for over 5000 years, while the mature seed is often eaten as a nutritious food, the immature fresh seed is used as a nervine (Singh et al., 2013). For just one week of the growing cycle of oats the developing oat seed is filled with fresh white milk, if the fresh seeds are harvested quickly then made into tincture, they make ‘the greatest nervous system trophorestorative’ (Winston, 2007). Fresh milky oats is a slow acting nervine tonic medicine that is subtle in its action, it may be used longer term to calm shattered nerves and stabilise emotions, and reduce symptoms of drug withdrawal. Energetically, milky oats is moistening and warming so it is quite unusual for a nervine, and so combines well with the cold drying bitter herbs. These properties make milky oats useful in constructing a herbal nervine tonic formula better suited for long term use even in a person prone to dryness.

Gotu kola

Gotu Kola (Centella Asiatica) Overview, Health Benefits, Side effects (3)

Centella asiatica or gotu kola is a creeping weedy herb that grows natively in tropical areas of India and Sri Lanka (Kuhn and Winston, 2000). The native Sinhalese of Ceylon observed in ancient times that elephants that appeared to be living unusually long periods of time enjoyed eating the leaves of gotu kola (Castleman, 2001). Ayurvedic practitioners consider gotu kola to be a medhya rasayana herb and nootropic (Kulkarni et al., 2012). Ex vivo and in vivo experiments have demonstrated the herb to possess anti-oxidant, neuroprotective, nerve regenerative, and anti-inflammatory properties (Kumar et al., 2003; George et al., 2009; Soumyanath et al., 2005). It is applied in various afflictions of the nerves including, anxiety, stress, cognitive problems, nerve damage, ADD, ADHD, but also in inflammatory conditions such as rheumatoid arthritis and psoriasis (Winston, 2007; Groves, 2016). Gotu kola is considered to be a powerful tonic herb for the nervous and immune systems, so is well suited for a variety of disorders.

Calamus

acorus_wiki

Acorus calamus otherwise known as calamus or sweet flag is native to central Asia and eastern Europe (Rajput et al., 2014). The word, acorus, is derived from the Greek work ‘acoron’, and acorus calamus has been hypothesised to have been used by the ancient Greek physician, Dioscorides, in treating inflammation of the eye (Motley, 1994). The Charaka Samhita, an ancient Ayurvedic text, speaks of calamus as a substance that restores consciousness and promotes longevity. Historically, it has also been a popular remedy in Europe and the 17th century English physician Nicholas Culpepper, considered calamus root a ‘strengthener of the stomach and the head’ (Breverton, 2013).

In Ayurveda, it is considered a medhya rasayana herb, similar to gotu kola, and has a supportive role to play for the nervous system. Alongside gotu kola and ashwagandha, calamus is indicated in Ayurveda for neuropathic pain (Frawley, 2000). David Frawley also considers it as one of the best Ayurvedic herbs for depression alongside holy basil. There is some preliminary scientific support using experimental models that supports its role in nerve regeneration, reducing pain (Muthuraman et al., 2011) and reducing inflammation (Mehrotra et al., 2003).

There have been some safety concerns because of the identification of a compound called β-asarone in calamus, this causes cancer in mice when taken at high enough concentrations long term. However, there is no evidence in humans alcoholic based extracts of calamus cause cancer, and in fact, some studies show anti-cancer activity due to other compounds present in the extract (Rajput et al., 2014). Overall, calamus is an important nervine tonic herb in our materia medica with an ancient worldwide history of medicinal use.

Ashwagandha

Withania_somnifera_04_wiki

Withania somnifera or ashwagandha is a small shrub native to India, but also regions of the Middle East and East Africa (Castleman, 2001). Ashwagandha has been used in Ayurveda for some 3000 years (Castleman, 2001). It was mentioned in the Charaka Samhita as a whole body tonic for emancipation, reproductive ability, and longevity. Ashwagandha is relatively well studied for a medicinal plant and well controlled human studies have found it effective in treating anxiety, osteoarthritis, and sub clinical hypothyroidism (Auddy et al., 2008; Ramakanth et al., 2016; Sharma et al., 2017). It also displays neuroprotective and neuro regenerative properties in various experimental models (Kurapati et al., 2013; Nakayama et al., 2007), which fits nicely with its nootropic action. Ashwagandha has affinities for the nervous, immune, and reproductive systems and may be useful in treating; anxiety, inflammatory arthritis, nerve pain, autoimmune diseases, fatigue, and sexual debility.

Tulsi

Ocimum sanctum otherwise known as holy basil or tulsi, is a small fragrant herb with purple-green leaves. It is found growing wild in India and is also cultivated for widespread medicinal use in folk and Ayurvedic herbalism (Kuhn and Winston, 2000). Similar to calamus, tulsi is highly versatile in its action on the nervous system as it possesses nootropic, antidepressant, and nervine relaxant actions.

Maria Groves mentions this herb improves health of the immune system to fight infections, but also strengthens digestion, decreases inflammation, while relieving anxiety (Groves, 2016). A double-blind placebo controlled human study confirmed that tulsi is effective against anxiety (Saxena et al., 2011). Another renowned herbalist, David Winston writes, ‘I use holy basil to enhance cerebral circulation and memory’ (Winston, 2007). A well-controlled human clinical study found that tulsi has nootropic or cognitive boosting effects (Sampath et al., 2015), supporting David Winston’s work. Additionally, he reports success in treating brain trauma with a combination of holy basil, St. John’s wort, ginkgo, and bacopa (Groves, 2016).

Similar to ashwagandha and gotu kola, tulsi is a versatile nervine tonic herb with broad applicability as it also acts on the immune system. It is also one of the gentler Asian tonic herbs so is more suited in people prone to insomnia, over sensitivity, and nervous system weakness.

Formulation Notes

It is often best to formulate the drying bitter tonics (e.g. blue vervain) with moistening herbs if taken long term, like licorice, milky oats, or shatavari. Long term intake of drying herbs may lead to dry skin, constipation, and other problems in those people who tend towards dryness. It is also widely accepted that long term intake of bitter cooling herbs should be accompanied by warming herbs like ginger or prickly ash. This will help maintain digestive power and increase absorption.

Nervine Tonic Formula

This formula may have applications in restoring sleep, reducing anxiety, and is thought to have a renewing effect on the nervous system.

Fresh milky oats (1 part) (warming, moistening)
Fresh American skullcap (1 part) (cooling, drying)
Fresh St. John’s wort (1 part) (warming, drying)

Dose: 15-45 drops, 3 times daily
Contraindications: People taking SSRIs, St. John’s wort may decrease the effectiveness of pharmaceutical drugs

Mood Formula

This is an example of a nervine formula for improving and stabilising mood.

Fresh milky oats (1 part) (warming, moistening)
Fresh lemon balm (1 part) (cooling, drying)
Fresh St. John’s wort (1 part) (warming, drying)

Dose: 15-45 drops, 3 times daily
Contraindications: People taking SSRIs, St. John’s wort may decrease the effectiveness of pharmaceutical drugs

Conclusions

It is interesting to note the parallels between the Western nervine tonics and the medhya rasayana herbs. The medhya rasayana herbs have nootropic properties and so do blue vervain and wood betony, two of the most sacred European nervine tonics. We could call some of these nervine tonic herbs adaptogens, such as ashwagandha and tulsi, but I am convinced that adaptogen is not always a helpful term. Adaptogens have specific indications, vary dramatically from one to the other, and can easily over stimulate. This is why defining specific indications and actions for the adaptogens are important, considering the gentler adaptogens, not over looking the Western nervine materia medica, and also considering low doses (e.g. 5-15 drops per herb). The original Chinese term for adaptogen is vital energy (Qi) tonic, this seems more appropiate because they are associated with increases in overall energy in the body.

In relation to the adaptogen discussion here, in a review article published in the year 2000, the authors stated that applying the term adaptogen to the adaptogenic herb, Eleutherococcus senticosus, ‘is vague and conveys no insights into the mechanism(s) of action. If a precise action can be attributed to it, then the exact term for said action should obviously be used; if not, we strongly urge that generalities be avoided.’ (Davydov, 2000).

There are also a variety of other very useful Western nervines that some herbalists consider nervine tonics I haven’t the time to discuss today, for example; lemon balm, valerian, lavender, and damiana. Finally, I have left out the Chinese reishi mushroom, a nervine and vital energy tonic with many additional actions that include anti-cancer properties (Liao et al., 2013) and potential for treatment of autoimmune disorders (Liu et al., 2015). These herbs will be included in a second part in the series.

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