The nervous system is at the intersection between our inner and outer worlds, and maintaining it is of great importance. The nervine tonic herbs are a highly important class of medicines that have an affinity for the nervous system and are said to support, repair, and strengthen its function (Hoffman, 1988). I have a particular affinity for nervines and experience with using them and have found them profoundly helpful. 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 really need.
From the North American and European system of herbalism, key examples of nervine tonics include; St. John’s wort, skullcap, wood betony, 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, MS, nerve damage, and insomnia. The remainder of this article will discuss these aforementioned nervine tonic herbs as they are all of great importance in our materia medica.
St. John’s wort
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 perhaps the most important herb for nerve pain in European and North American herbalism. While it is also indicated in the treatment of anxiety, stress, depression, and other afflictions of the nervous system. It is an important component of many formulas designed to improve nervous system health as it is a very uplifting and deeply nourishing tonic herb. 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 potency.
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 gentle relaxant property. It pairs well with St. John’s wort as part of a treatment for nerve pain, anxiety, insomnia, and generally to help renew a depleted nervous system. Skullcap is also best in a fresh tincture and is a potent addition to our nervine tonic materia medica.
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 gentle nootropic quality to it and may be useful in treating various cognitive problems. It is another herb that works well alongside St. John’s wort, blue vervain, and skullcap in the treatment of several different nervous afflictions.
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 consider blue vervain, as a strong digestive bitter and nervine tonic, to have a particular affinity for both the digestive system and the nervous system. I have noticed only a small dose of this potent herb (10 drops) is enough to induce a profound state of relaxation. After a few days of use at least a few times a day, blue vervain appears to start energising the system, and I consider this a similar property to certain Asian tonic herbs like ashwagandha. It may have uses in the treatment of fatigue, but also insomnia, epilepsy, anxiety, stress, weak digestion, and nerve pain. I have noticed blue vervain has a mild nootropic property to it and tends to increase one’s sensitivity to the internal and external worlds, it may be added in relatively small amounts to improve the action of nervine restorative formula. It has a deep relaxing effect and is particuarly indicated in individuals prone to neck and shoulder tension. It is certainly one of the most valuable nervine tonic herbs we have in Western herbalism.
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). Gotu kola may be considered as a gentle nervine tonic herb and its effect may not be immediately noticeable, but is thought to act in the longer term to help restore an individual to health. It is applied in various afflictions of the nerves including, anxiety, stress, cognitive problems, nerve damage, ADD, ADHD, and also inflammatory conditions such as rheumatoid arthritis and psoriasis (Winston, 2007; Groves, 2016). It may be applied as a gentle supportive tonic for the body and nervous system alongside other remedies where indicated.
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 was likely used by the ancient Greek physician, Dioscorides, in treating inflammation of the eye (Motley, 1994). The Charaka Samhita, an ancient Ayurvedic text, speaks of it 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 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 effect on the nervous system. Alongside gotu kola and ashwagandha, it is indicated in Ayurveda for afflictions of the nervous system that include MS and various neuropathies (Frawley, 2000). 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.
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). Notably, 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). Ashwagandha has broad medicinal properties and may be useful in treating, anxiety, inflammatory arthritis, osteoarthritis, nerve pain, depression, autoimmune diseases, fatigue, and low limbido.
Ashwagandha is gently energising with time, after some weeks of application a brightness may be seen in the eyes. With its calming quality, ashwagandha may be useful in improving sleep, but can also over stimulate, so adjustment in dosing may be required or combination with relaxing nervines in a formula. A standardised extract called KSM66 has become widely available and popular, I have found it useful and strong, however, the disadvantage is that smaller doses than 1 capsule are not practical. Therefore, a good quality local tincture is a good option, especially if one capsule is proving too high a dose for a sensitive person. Another alternative is the Organic India company which sell high quality rasayana tonic herbs and instead use a less concentrated extract. Overall, ashwagandha is a very special herb in our materia medica.
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). Maria Groves in her text, ‘Body into Balance’, describes tulsi as ‘a greater protector’ (Groves, 2016). She mentions this herb improves health of the immune system to fight infections, but also strengthens digestion, decreases inflammation, while relieving anxiety and depression. A double-blind placebo controlled human study confirmed that tulsi is effective against anxiety (Saxena et al., 2011). Another world-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), thus 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). Tulsi combines well with reishi to treat allergies and other immunological disorders. It may also be combined with various nervines to increase its relaxing property on the nervous system. It may be beneficial in cases of depression when combined with uplifting nervines such as St. John’s wort and lemon balm.
Similar to ashwagandha, gotu kola, and calamus, tulsi is a versatile Asian tonic herb with broad applicability. It is also one of the gentler Asian tonic herbs so are more suited in people prone to insomnia, over sensitivity, and nervous system weakness. I have found the brand Organic India as a good supplier tulsi, it smells very nice and is effective. Although, it may be preferable to source a local supplier of a tincture, I still think the dried extract is fine to use in this case.
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 does wood betony, one of the most sacred European herbal remedies. We could call these tonic herbs adaptogens, but I am increasingly convinced that ‘adaptogen’ is not a particularly helpful and informative term. Adaptogenic or Asian tonic herbs do not intelligently balance the whole body; they are directional in their effects, have specific indications, and can over stimulate and cause problems in some cases. This is why I emphasise in this article the importance of the gentler Asian tonic herbs like tulsi and ashwagandha, the Western nervines, and also the importance of dose. Some individuals with a sensitive constitution may respond with over stimulation and insomnia to some of the Asian tonic herbs, therefore some caution is needed. Such problems do not seem to be readily encountered by using the Western nervine herbs such St. John’s wort and skullcap, which are still profoundly renewing. I am of course not arguing against the use of the adaptogenic tonic herbs per se, they are often very useful, versatile, and effective medicines. Their use, and indeed all herbal use, must be companied with sensible diet changes (e.g. a modified Paleolithic diet) and good lifestyle decisions. It may also be necessary to improve the health of other systems of the body to get them to work better, for example, the digestive and circulatory systems.
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). Personally, I agree with this statement and I think this is a good point.
There are also a variety of other very useful Western nervines I haven’t the time to discuss today, for example, lemon balm, valerian, and black cohosh. Valerian and lemon balm were once considered ‘cure alls’ in ancient Europe (Castleman, 2001). Finally, I have left out the Chinese reishi mushroom, a nervine tonic with many additional actions that include anti-cancer properties (Liao et al., 2013) and potential treatment of autoimmune disorders (Liu et al., 2015). To conclude, herbalism is a rapidly evolving system and it seems helpful to consider both traditional knowledge and scientific at the same time to have a balanced understanding of the depth and applicability of these important medicines.
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