1. Quiz Prescription Writing Answers Case 1: You are prescribing a tea for a patient who has a history of heartburn. Your tea prescription includes 1 ounce of Peppermint leaf, 1 ounce of Chamomile flowers and ½ ounce of Yarrow flowering tops. This should last the patient about 3 weeks. You tell your patient to take 1 Tbsp. of the mix in one cup of hot water and to let it steep for 15 minutes and then strain and drink 1 cup with each meal. You would like her to have 4 refills.

2. Quiz Prescription Writing Answers Rx and Qty:  Disp. 1 oz. Mentha x piperita, 1 oz. Matricaria recutita, ½ oz. Achillea millefolium Sig: 1 Tbsp. per cup hot aq, steep 15 min., strain and drink 1 cup cc Refills 1 2 3 4 prn x____months

3. Quiz Prescription Writing Answers Case 2: You see a female patient who is experiencing gas and bloating almost daily within an hour after every meal. Her vitals and physical exam are all within normal limits. You investigate her dietary intake and begin looking for possible dietary allergens. In the meantime, you prescribe a 1 oz. tincture with Matricaria recutita and Foeniculum vulgare equal parts. You would like her to take 15 drops of this tincture 15 minutes before each meal daily for the next 2 weeks with 3 refills.

4. Quiz Prescription Writing Answers Rx: Matricaria recutita tinc. And Foeniculum vulgare tinc. aa (or ss) Sig: 15 gtts 15 min ac qd x 2 weeks Qty: 1 oz. Refills 1 2 3 4 prn x ____months

5. Bitters Botanical Medicine 1 Brandy Webb, ND

6. Western Herbal Perspective The energy of bitter is cooling and drying Bitters move us out of a sympathetic- dominated state into parasympathetic- dominated state Bitter herbs stimulate the bitter taste buds causing secretion of gastric fluids, which aids digestion

7. Ayurvedic Perspective Ayurvedic medicine is a form of holistic medicine that started in India thousands of years ago and focuses on treating people constitutionally rather than based on their symptoms Bitter is the coldest, most drying, and most depleting of the 6 tastes (others are sweet, sour, salty, pungent, and astringent) Helpful for reducing fever, promoting digestion, relieving burning and itch Promote elimination of toxins, detoxification, and proper circulation

8. Ayurvedic Perspective Other uses for bitters:  Liver conditions (including jaundice and liver congestion)  As an antibacterial, antiviral, or antiparasitic  To promote proper sugar metabolism  To reduce body fat  For anti-tumor properties Bitter herbs can deplete overall vitality and depress sexual energy

9. Use of Bitters According to Western Herbalism Stimulate digestion Enhance absorption of nutrients Used as tonics/strengthen the body Tonify muscles, tissues and organs Promote elimination of toxins and metabolic waste products Purify the blood/eradicate infection

10. Additional Considerations for Use of Bitter Herbs Stimulate digestion when dosed in small amounts at appropriate time; however, in higher doses can actually suppress digestion Think of bitters with patients with heat conditions and high Pitta constitution  Pitta is the dosha characterized as hot and eruptive, having high metabolism and strong appetite

11. Additional Considerations for Use of Bitter Herbs Treatment of fever:  Best reserved for fevers in the core of the body or in the blood, or when the liver is hot  For more “surface” fevers, meaning those associated with colds and flus, use diaphoretics  Bitters can be helpful for lingering and recurrent fevers Commonly given with carminative herbs Best therapeutic effects achieved when used over an extended period of time

12. Achillea millefolium

13. Yarrow Asteraceae family Constituents  Volatile oils  Sesquiterpine lactones (bitter)  Tannins  Flavonoids  Alkaloids  Phenolic acids  Coumarins

14. Achillea millefolium Actions  Bitter  Astringent  Antispasmodic  Diaphoretic  Diuretic  Antimicrobial  Hypotensive  Anti-inflammatory  Hepatic

15. Gentian lutea

16. Gentian Gentianaceae family Constituents  Iridoids (bitter) Amarogentian Gentamarin  Xanthones  Alkaloids  Phenolic acids  Sugars  Volatile oils (trace)

17. Gentian lutea Actions  Bitter  Sialagogue  Cholagogue  Hepatic  Antimicrobial  Antihelminthic  Emmenagogue

18. Iris versicolor

19. Blue flag Iridaceae family Constituents  Volatile oils  Glycoside iridin  Acids  Triterpenoids  Gum  Resins  Sterols

20. Iris versicolor Actions  Cholagogue  Hepatic  Alterative  Laxative  Diuretic  Anti-inflammatory

21. Menyanthes trifoliata

22. Bog bean Menyanthaceae family Constituents  Iridoids (bitter)  Flavanoid glycosides  Anthraquinones  Coumarins  Alkaloids  Tannins

23. Menyanthes trifoliata Actions  Bitter  Cholagogue  Diuretic  Antirheumatic

24. Matricaria recutita

25. Chamomile Asteraceae family Constituents  Sesquiterpenes (bitter)  Sesquiterpene lactones (bitter)  Flavanoid glycosides

26. Matricaria recutita Actions  Bitter  Carminative  Antispasmodic  Anti-inflammatory  Antimicrobial  Nervine  Vulnerary