Dalia Abdul MajideStudent ID # 2268180
Herbal 4
Assessment 2 case 3-4
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DALIA ABDUL MAJIDE   16/10/2017  
Learner’s signature   Date  
FEEDBACK SHEET – Assessment Task # 3 of # 4 – Case Studies 2
This document describes how you will be assessed and what evidence you need to submit to demonstrate Competency in respect of this Assessment Task. This is the list the assessor will use to mark your work. 
Name Dalia Abdul Majide 
Learner ID#  2268180  
Submission number 2 
Item Has the learner …
  Is result satisfactory?
Check appropriate box Comments by assessor to support result if MER or No
1. Case Analysis Successfully provided a correct interpretation of the disorder for each case study? ? Yes?? MER  ?No  
2. Treatment Objectives Were the priorities for treatment identified? ? Yes?? MER  ?No  
3. Herbal Prescription Were appropriate herbs selected for the case and a clear rationale provided? ? Yes?? MER  ?No  
4. Contra-indications; Herb-drug Interactions; Side Effects Possible contra-indications, herb-drug interactions and side effects identified? ? Yes?? MER  ?No  
5. Word Limits Word limit for each Case Study was appropriate and within 10% +/- 800 words? ? Yes?? MER  ?No  
6. Referencing Referenced information in accordance with APA style? ? Yes?? MER  ?No  
Has the learner submitted a completed and signed Authentication Statement? ? Yes?? No
Has reasonable adjustment been made by the assessor in assessing the learner’s competency in respect of this Assessment Task?   ? Yes?? No
If Yes, the assessor must specify the arrangements of the reasonable adjustment.

Name of assessor  
Signature of assessor  
Date of assessment Week 11
Overall Result for this Assessment Task  Satisfactory  ??
Not Satisfactory ?
More Evidence Required (MER) ?
If resubmission is required, provide date End of Week 12.

If resubmission is required, specify requirements 
  The complete Assessment Task is to be resubmitted.

 HM4_AT_3_of_4_V1.0  ? ?1 of 7 
Case 4
Acne is skin disease that occurs when hair follicles are clogged with oil or dead skin and it creates chronic inflammation of the sebaceous glands. Some of the causes could be genetics, disturbed hormones, diet, stress, environmental factors, or medications. However some of the factors involved in the development of acne could be elevated levels of androgen, excessive sebum production, abnormal follicular differentiation, or increased colonisation with antibiotic resistant bacteria. In our case here we have a 16 year old female which is the age of most likely disturbed hormones and her diet consists of lots of sugary food which could be the main reason affecting her acne.(Mayoclinic ,2015)
Herbal objective
Reduce inflammation
Reduce oestrogen level
Increase immunity
Fight bacterial infection
Eliminate toxins, detoxification
Burdock(Arctium lappa) has depurative , diuretic durative activity and can reduce excess sebum production that is one of the causes of cane. Burdock is a strong herb that needs to be used with caution it’s better to start in low dosage form. According to the website Health911.com, “The herb burdock is effective in treating acne and is the most important herb for treating all forms of chronic skin problems.” A 1967 German study reported in the book “Encyclopedia of Herbal Medicine” found that burdock root contains polyacetylenes, antifungal and antibiotic qualities that help fight acne-causing bacteria and fungi that infect cracked skin. Its diuretic action aids in eliminating impurities through the digestive system, rather than the skin where toxins can cause infections.(Defeo S, 2015).

Contraindication (Mediherb)
None known. (BHC, 46; TGHM, 318)
Interaction with drugs(Mediherb)
None known. (CGBLH, 118)
Calendula(Calendula officinalis) is another key consideration for acne as it also reduces the excess sebum production, it can be used internally or externally to help with bacterial infection. Calendula has vulnerary , antiinflammation,, anti microbial,antiviral (topically), anti fungal ( topically) properties. The Herb Research Foundation reports test-tube research indicates calendula contains antimicrobial compounds that may prevent the growth of certain strains of bacteria, fungus and protozoa. The antibacterial properties of calendula may kill the bacteria trapped inside skin pores leading to the condition known as acne. High iodine, carotene and manganese, which promote skin cell regeneration have also been found in the plant.(Mackenzie H.,2017).

Contraindication (Mediherb)
Inappropriate when there is already prescription of strong anti-in ammatory medication, (PPP, 148) and for those with known sensitivity to members of the Compositae family. (ESCOPM, 59; WHO2, 41; CGBLH, 120)

Side effects (Mediherb)
Weak skin sensitization and a case of anaphylactic shock has been reported from topical use (a gargle). (CGBLH, 120)
Interaction with drugs ( Mediherb)
None known. (HM, 45; ESCOPM, 59; TGHM, 100, 319; CGBLH, 120)
Yellow dock( Rumex crispus) is a good consideration for our case here since there is a constipation problem. Yellow dock has laxative effect that would help with constipation and has depurative effect as week which can assist in elimination and detoxification in the body. It works as well as a blood purifier and used for clearing out toxins which assist the liver and improve the flow of digestive juices and release the production of bile,it has cholagogue effect which can assist in digestion of fat. That could assist detoxing her diet that consists of lots of sugary food.

Contraindication (Mediherb)
Use with caution in pregnancy. (CGBLH, 474) Contraindicated or at least inappropriate in constipation associated with bowel irritability, bowel disease, diarrhea. (PPP, 173) Individuals with a history of kidney stones should use cautiously. (BSH, 100)
Interaction with drugs (Mediherb)
None known. (CGBLH, 474)
Chaste tree(Vitex angus-castus)lowers prolactin via dopaminergic effect which in turn may lower androgen and can assist acne. It is main actions prolactin inhibitors, dopaminergic agonist, indirectly progestogenic, galactagogue.

Contraindication (Mediherb)
Contraindicated in conjunction with progesterone drugs, the contraceptive pill, or HRT. (PPP, 332; BSH, 123; ESCOPM, 9)
Should be used cautiously during pregnancy and only in the early stages for treating insufficient corpus luteal function. (CGBLH, 142)
Side effects (Mediherb)
The herb may aggravate pure spasmodic dysmenorrhea not associated with PMS. (PPP, 332) Rare occurrences of itching, urticaria and headache have been reported. (PPP, 333; BSH, 123; HM, 63; TGHM, 108; ESCOPM, 9; CGBLH, 142)
Interaction with drugs (Mediherb)
May interact antagonistically with dopamine receptor antagonists, progesterone drugs, contraceptive pill or HRT. (PPP, 332; HM, 63; TGHM, 108; CGBLH, 142)
Echinacea is an immune enhancer that is useful in acne to keep the system healthy to fight any pathogens . It has anti inflammatory, lymphatic, depurative,vulnerary, sialogogue, and immune enhancing modulating properties. Some research has been done on the herb Echinacea and it’s effect on acne and found that; “Echinaforce could provide a safe two-fold benefit to acne individuals by inhibiting proliferation of the organism and reversing the bacterial-induced inflammation.” (Sharm M. et al.,2011). Therefore, Echinacea could be used as an alternative treatment for the disease to prevent more break outs as well.

Commission E cautioned that Echinacea pallidaroot and E. angustifolia herb and root should notbe used in systemic diseases such as tuberculosis, leukosis, collagenosis, multiple sclerosis, AIDS, HIV infections, and other autoimmune diseases (basedon theoretical considerations and not on any reportsof adverse ndings). Other authoritative sources donot support these restrictions. (HM, 94; TGHM, 121, 328; PPP, 359-360)
Side effects ( Mediherb)
Allergic reactions, mainly contact dermatitis, may occur rarely in susceptible patients from Echinacea aerial parts. The likelihood of Echinacea root preparations causing allergy is very low. (CGBLH, 185)
None known. (HM, 95; PPP, 360) Caution is advised for transplant patients taking immunosuppressive drugs, short-term therapy only is suggested. (PPP, 360; CGBLH, 185)
Herbs Liquid extraction Weekly dosage 7 day
Chaste tree 1:2 5-40ml 20ml
Calendula 1:2 10-30ml 20ml
Burdock 1:2 10-25ml 15ml
Echinacea 1:2 25-60ml 25ml
Yellow dock 1:2 15-30ml 15ml
Total. 105ml
Take 5 ml diluted in water three times a day.

Apply topically tea tree oil or calendula cream to help with bacterial infection.

Case 5
Otitis media is an inflammation in the middle ear that has several types of OM; there is AOM acute otitis media, OME otitis media with enfusion, COM chronic otitis media, and adhesive otitis media.

In this case we have 3 years old boy that is getting more frequently otitis media infection is regarded as immature immune system; it sounds more like the AOM which the main infection is most often bacterial (Mills and Bone, 2013, p. 247). AOM occurs more between the age of nine to 15 months it diminishes quickly between age 3 to 5 years old if untreated properly could lead to OME. As we have in this case there is frequent episode occurring. Research shows that children who experience frequent episodes of AOM have immature immune systems evidenced by inadequate cellular and antibody responses (Pichichero, 2013).
AOM implies rapid onset of disease associated with one or more of the following symptoms: (Waseem M.,2017)
Loss of appetite
And in this case he is experiencing some of these symptoms like fever, irritability, loss of appetite.

Herbal treatment objectives? Enhance immune function with immune enhancers and modulating herbs? Use anticatarrhal lymphatic herbs to reduce catarrhal and decrease lymphatic congestion? Eliminate infection by antibacterial anti microbial herb? Eliminate toxins with depurative lymphatic herbs
Pelargonium( pelargonium sidoises) is considered to be a good herb for children not bitter in taste and is great as an immune enhancer. Also, it has antibacterial, immune modulating, expectorant, and anti fungal properties to support the health of his body.

Eye bright (Euphrasia species)is an anticatarrhal herb that helps the upper respiratory tract to clear the infection. It has also an antiinflammatory, astringent, mucous membrane tonic effect.

Contraindication or side effects (Mediherb)
No contraindications noted. (PPP, 376; CGBLH, 203)
None known. (TGHM, 330; PPP, 376; CGBLH, 202)
Echinacea (Echinacea angustifolia) is also an immune enhancer to support his immune system and is needed to stop the frequency of episode of OM occurring again and to do that we need to build his immune system to fight the bacterial infection happening in the upper respiratory tract. Echinacea also has lymphatic and depurative action which enhance the elimination of any toxins outside the body (Bone and Mill, 2013). As we can see that this child eats a lot of dairy and is fond of biscuits and cakes therefore echinacea is needed to eliminate all the toxins that these bad food leave in the body so it can build a strong immunity system in the body.

Although it has not been studied for ear infections, some doctors may suggest echinacea to help prevent recurring ear infections. (University of Maryland)
Myrrh(Commiphora molmol) is an antibacterial herb which is primary as well here to fight bacterial infection that is the major cause of AOM as mentioned before. It also has anti microbial, anti inflammatory, astringent , lymphatic and vulnerary properties that also helps support his system.

Contraindication (Mediherb)
excessive uterine bleeding and known allergy.
Side effects(Mediherb)
Allergic contact dermatitis has been reported. Not to be ingested for prolonged periods(> few weeks). (CGBLH, 335)
Interaction (Mediherb)
None known. (CGBLH, 335)
Herbs Liquid extract ratio Weekly doses 7days
Pelargonium 1:5 20-40ml 30ml
Eyebright 1:2 15-30ml 20ml
Echinacea 1:2 25-60ml 30ml
Myrrh 1:5 10-30ml 20ml
Total. 100ml
Take 1 ml (young formula) three times a day with water
According to young formula; (age in year) divided by (age plus 12)
Case 6
Cystitis is an inflammation in the bladder that is caused by bacterial infection . It is also called urinary tract infection UTI. The infection in the bladder can cause pain and irritant feeling like our case here which is, feeling pain during her urination and generally unwell, the bacterial infection could be causing her mild fever and low energy as well because if the infection continues and spreads it could cause kidney infection which is a serious health condition. In Some of the causes could be; feminine hygiene, reaction to certain drugs, spermicidal jellies, or long term use of catheter where in this case it could be her reaction to antibiotics (drugs) where she has taken several courses before and it caused diarrhoea and thrush after taking them because antibiotics plays with her immune system and kill the good bacteria along with the bad and makes the body unprepared for any bacterial infection occurring again basically the body or urinary system became an easy target for any bacterial invasion.

Herbal treatment objective
Treat with anti inflammation herbs to reduce inflammation
Use urinary antiseptic herbs to eliminate bacteria
Enhance bladder tonic to stop recurrence
Use immune enhancer herb for better immune system to fight any bacterial infection
Use diuretic herb to help with elimination process
Buchu (Agathosma beguilina) works well for our case as it has antiseptic urinary tract properties to clear our bacterial infection and also has mild depurative to help with the elimination process. This herb benefits our case by minimising the reoccurrence of the infection and from taking further antibiotics again.
Crataeva (Crataeva nurvala) has antilithic, bladder tonic, and anti inflammatory property . Crataeva is a key herb for recurrent UTI and should be used with urinary tract antiseptic. The tonic effect on the bladder will decrease the residual volume of urine and assist the effective removal of microorganism from the bladder which will decrease the infection and re infection.(The Herbal Resource, 2017). Also, Mayo Clinic reports that this ayurvedic herb is one of the more commonly used natural remedies for urinary incontinence. According to “Total Health Magazine,” crataeva improves bladder muscle strength and tone, and decreases urinary urgency and frequency. It also improves the flow of urine, which helps in emptying the bladder more completely. When the bladder is emptied efficiently, there is less likelihood of urinary leakage at random times. (Byrne J.,2017)
Licorice (Glycyrrhiza glabra) is key consideration for our case due to its anti inflammatory and demulcent effect which help reduce the pain and irritability caused by the cystitis. It has a soothing effect on mucous membrane of the urinary tracts.(Hetchmen L.,2014)(Kerry B,2007). Study published in a 2009 edition of International immunopharmacology demonstrated the effectiveness of licorice root on Candiasis. The compounds within  HYPERLINK “http://www.naturalnews.com/licorice.html” licorice that have the most immunomodulatory effects are the flavonoid anti-oxidants liquiritigenin and liquiritin. This study demonstrated the powerful Th1 immune stimulation that these compounds provided in an effort to reduce the Candida growth.(Jockers D., 2013)
Contraindication (Mediherb)
It is recommended that patients with cardiovascularor renal disease use licorice only under care of health care professional. (TCPHP, 232; PPP, 474) Patients prone to potassium de ciency are also advised not to use licorice. (TCPHP, 232; TGHM, 161) Treatment not to exceed six weeks. (TCPHP, 232; BSH, 58; TGHM, 162) Contraindications: hypertension, cholestatic liver disorders, in ammatory liver disorders, liver cirrhosis, hypertonia, hypokalemia, severe obesity and severe kidney insuf ciency (HM, 236; BSH, 58; BHC, 146; TGHM, 161; WHO1, 190; AEHD3, 72; ESCOPM, 298) pregnancy and lactation (ESCOPM, 298). In the caseof pregnancy doses up to 3 g per day are likely to be safe. (PPP, 474) Also contraindicated if there is edema or congestive heart failure. (PPP, 474) Caution is advised with elderly patients. (CGBLH, 312)
Side effects(Mediherb)Ingestion of an excessive amount can lead to severe hypertension, cardiac arrhythmias, cardiomyopathy, cardiac arrest, pseudoaldosteronism, myopathy, pulmonary and generalized edema. (AEHD3, 73; BSH, 58; BHC, 146; AEHD3, 72; CGBLH, 313)
Interaction with drugs (Mediherb)
Should not be taken concurrently with corticosteroid treatment. (WHO1, 190; AEHD3, 77) Maydecrease plasma clearance and increase theAUC of prednisolone. Licorice may potentiate the activity of prednisolone and other corticosteroid drugs. (ESCOPM, 298; CGBLH, 313) Concurrentuse of furosemide may potentiate developmentof acute renal failure. (AEHD3, 77) Potassium loss due to other drugs, e.g. thiazide diuretics, can be increased. With potassium loss, sensitivity to digitalis glycosides increases. (HM, 237; TGHM, 161; WHO1, 190) Excessive use of licorice may interact with antiarrhythmic drugs or with drugs which induce reversion to sinus rhythm (e.g. quinidine). (ESCOPM, 298) Should not be administered in conjunction with spironolactone or amiloride. (WHO1, 190) Insulin may be synergistic with glycyrrhizin in causing electrolyte disturbances and suppressionof renin and aldosterone. (AEHD3, 77) There isa slight chance that licorice may counteract the contraceptive pill, on the basis of the constituent glycyrrhizin. (CGBLH, 312)
Echinacea is an immune enhancer which is needed to stop recurrent of urinary tract infection and has depurative and lymphatic action which assist in the elimination process of any bacteria. Echinacea can also assist in treating the thrush due to its immune enhancer where the body becomes an easy target for any bacterial, virus fungi invasion if the body is in a weak immune state.Echinacea stimulates the white blood cells in the blood that fights infection and boost the resistance to all types of invasions such as Candida. Various scientific studies back up the efficacy of Echinacea as an immune system booster. A clinical study in 1989 actually found a 50-150% increase in immune system functions after 5 days of Echinacea supplements.(Richards L.,n.d).

Thyme (Thymus vulgaris) has anti microbial, antibacterial and anti fungal effect (Kerry B.,2007),that could fight any bacterial, fungus, or virus invasion. This helps the uterine to fight the thrush that is reoccurring in this case, it also helps speeding up recovery from illness and protect against future ailments.Thyme prevent infections and keep healthy bacteria in balance because Thyme has some of the highest antioxidant levels among herbs. It is packed with bioflavonoids such as lutein, zeaxanthin, and naringenin which have powerful effects on eliminating free-radicals and other disease producing substances from the body. (William A.,2017). Thyme has also spasmolytic effect which helps in reducing the pain and increase the blood flow during menstrual cycle.

Contraindication (Meciherb)
Patients sensitive to birch pollen or celery may have cross-sensitivity or possible adverse reaction to this herb.
Side effects (Mediherb)
Contact dermatitis has been reported. (WHO1, 264) Classic cations and concerns for this herb are based upon therapeutic use and dosage and may not be relevant to its consumption as a spice. (BSH, 116)
Interaction (Mediherb)
None known. (HM, 377; TGHM, 219; WHO1, 264; CGBLH, 431
Herbs Liquid ratio Weekly dose 7 days
Buchu1:2 15-30ml 20ml
Licorice 1:1 10-40ml 15ml
Thyme 1:2 15-40ml 15ml
Crataeva1:2 40-100ml 30ml
Echinacea 1:2 25-60ml 25ml
Total. 105 ml
Take 5ml diluted in water four to six times a day for acute outbreaks and three times a day to prevent recurrent cystitis.

Sharm M. et al.,2011, NCBI, The Potential Use of Echinacea In Acne, retrieved from; https://www.ncbi.nlm.nih.gov/pubmed/20830697Mayoclinic,2015, Acne causes,retrieved from;
http://www.mayoclinic.org/diseases-conditions/acne/news/con-20020580Defeo S, 2015, Livestrong, Burdock Root for Acne, retrieved from;
http://www.livestrong.com/article/191294-burdock-root-for-acne/Mackenzie H., 2017, Livestrong, Calendula and Acne, retrieved from;
http://www.livestrong.com/article/151033-calendula-acne/Waseem M., 2017, Medscape, Otitis Media, retrieved from; http://emedicine.medscape.com/article/994656-overviewUniversity of Maryland, 2016, Otitis Media, retrieved from;
http://www.umm.edu/health/medical/altmed/condition/otitis-mediaByrne J, 2017, Livestrong, Natural Remedies of Bladder, retrieved from;
http://www.livestrong.com/article/232598-natural-remedies-for-bladderJockers D., 2013, Natural News,The health benefit of liquorice, retrieved from;
http://www.naturalnews.com/042885_licorice_health_benefits_glycrrhiza.htmlRichards L., n.d, The Candida Diet, retrieved from; https://www.thecandidadiet.com/echinacea/William A., 2017, Medical Medium Blog, Thyme tea, retrieved from; http://www.medicalmedium.com/blog/thyme-teaBone Kerry,2003, Mediherb, Retrieved 25 June 2017 from; https://www.standardprocess.com/MediHerb-Document-Library/Catalog-Files/contraindicationscautions0708.pdfHechtman L,2011, Clinical Naturopathic Medicine.

Bone and Mills, 2013, Principles and Practice of Phytotherapy.

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