Bitters are 'bitter' and this must not be disguised or the effect will be lost. Bitters are useful in sluggish digestion, constipation, diabetes, skin conditions, chronic inflammations. The importance of the liver to health in general is such that most simple medicines known as 'tonics' contain bitters to stimulate the liver.

STIMULANTS
The popular idea of a stimulant releasing untapped energy or causing improved mental alertness is different from the herbalist's use of the term. Stimulants increase normal functioning of particular organs. Thus there are stimulants of the circulation, of digestion, of liver function, of the adrenal gland's release of hormones, of the nervous system, etc.
Digestive stimulants include the bitters discussed above. Myrica, Zingiber, Zanthoxylum, and chilli or Capsicum are used for the circulation. Smilaxx stimulates release of the male hormone, testosterone, and Glycyrrhiza stimulates the production of the body's own steroids from the adrenal gland. Rosmarinus or Cola are good central nervous system stimulants.
Herbal stimulation is always done cautiously to encourage the body's systems back to more normal functioning. It should never be done excessively or exhaustion may follow.

SEDATIVES
Herbs that slow down the central nervous system are sedatives. They slow the flow of energy to and from the brain and are useful in controlling pain as well as excessive brain activity, especially when it is uncoordinated or damaging to health. Sedatives help in insomnia, anxiety or hysteria but are rarely used alone. They are an adjunct to other approaches. For example, a sedative may help the brain rest in insomnia, but not if there is underlying anxiety which should be tackled at the same time.

HYPO / HYPERTENSIVES
Blood pressure can be too low as well as too high. There are many factors that affect the circulatory system and careful diagnosis is necessary to know how to treat it. Control of water loss from the kidneys, the functioning of the heart muscle and the nervous system, and controls on the diameter of blood vessels all have a role. Although the physiology of circulation is now well understood, in around 80 per cent of all cases of raised blood pressure the cause cannot he identified: these cases are given the confusing name of 'essential hypertension'. Herbal treatment is available for all common causes of raised or lowered blood pressure. Excellent diuretics (Taraxacum leaf or Parietatia), herbs that dilate (Viscum, Tilia, Grateagus) or constrict (Sarothamnus) the blood vessels, and herbs that affect the heart muscle (Ephedra, Convallatia, lxonorus, Grateagus, Rauwolfia, Digitalis) are widely used.
Warning: do not attempt to treat blood pressure or heart disease without advice from a qualified herbalist or doctor.

DIURETICS
All diuretics increase the flow of urine but they can do this by different means. Diuretics are useful where malfunction of the kidneys changes the composition of the blood, or a weakened heart results in poor control of the amount of water in the body. Herbal diuretics are renowned for their efficiency and safety. Many common foods are also useful diuretics. The best diuretic is Taraxacum leaf, but Betula, Parietaria, Eupatorium purpureum, Collinsonia are also efficient. Common diuretic foods are celery, parsley, asparagus and the hot drinks, tea and coffee.

CARDIOACTIVES
Throughout history herbal medicines have had a reputation in treating heart and circulatory disease. Today they are important in treating heart failure, angina, irregular heart beat, and high or low blood pressure, blood clots or thrombosis. Digitalis or foxglove is perhaps the best known 'herb for the heart', but is not the most used. Others include Grateagus, Convallaria, Sarothamnus, Urginea, Ephedra, Melilotus, and Leonorus.

LAXATIVES
Bowel activity matters to herbalists. The elimination of waste is as important as the intake of water and nutrients. Wherever possible the diet should he carefully chosen to ensure a healthy bowel activity. This means high-fibre foods and not sprinklings of bran onto foods. Alas, this is not always possible or enough and the bowel often needs a helping hand.
When constipation strikes, careful attention must be given to the reasons before reaching for laxatives. There are three main types of laxative action. Choose the wrong one for a bout of constipation and matters could get rapidly worse. Simply eating too little food, however high in fibre, will lead to constipation. The most common reason for constipation is too little fibre in a diet of highly refined foods: it's like depriving a skilled craftworker of the tools for the job! However, there may also be spasm, or too little tone, in the muscles of the bowel wall, both of which also lead to constipation. Herbal laxatives are often incorporated into pharmaceutical laxative drugs.
Laxatives are of four main types.
   -The first simply increases the amount of fibre in the diet, usually by increasing the intake of high fibre foods: beans and pulses generally, root vegetables, whole cereals, dried apricots and prunes, fresh fruits, especially apples and plums.
   -Second are the osmotic laxatives that keep water within the bowel, stopping the stool being dried and hence hardened on its way to the outside world.
   -Next are the bulking laxatives that form soft gels within the bowel. These are large and indigestible and their bulk stimulates movement in the bowel wall to speed the stool on its way. Because it is soft, it is also easy to pass. Bulk laxatives include Psyllium husks and Linum or linseed.
   -The fourth are the better known stimulant laxatives that irritate the bowel wall and encourage rapid movement and hence expulsion of the stool. Senna (Cassia) and Cascara are the best known stimulant laxatives.
   A specifically herbal laxative action is obtained from the action of bitters (Rumex, Taraxacum, Berberis, Getitiana), which stimulate bile flow from the liver. Bile itself stimulates the natural peristaltic action of the muscles in the bowel wall and must be fairly described as the most natural of laxatives.

EMETICS
These drugs stimulate vomiting, which can he lifesaving, in certain cases of poisoning. The suitably named American herb, puke-weed (Lobelia), or ipec (Ipecacuanha) are reliable examples. These herbs are expectorant in very small doses.

ANTHELMINTICS
The curse of intestinal worms is not limited to farm animals and four-legged pets. They also inhabit humans. Pound worms and threadworms are the most common worm infections in industrial societies, especially among young children. Thymus, Artemesia, and Tanacetum vulgare are the most efficient herbs. Simple foods like pumpkin seeds, garlic and carrots have also been used.

ANTICATARRHAL
Often used in close association with the expectorants are interesting herbs that suppress excess catarrh production. All mucous membranes in the body produce catarrh when irritated or inflamed. The most obvious sources of catarrh are the nasal passages and throat during colds. However, catarrh can be produced in the stomach, intestines, and urinary tubules.
Anticatarrhal herbs work by toning and reducing inflammation of membranes. They are useful in conditions as varied as mucous colids, asthma and glue ear. The best herbs are Hydrastis, Clechoma, Plantago, Sambucus, Solidago.
Herbalists see catarrh production as a sign of general metabolic and nervous system disorder. The type of catarrhal condition has to be identified for effective treatment to be designed. Cold conditions produce a thinner, more voluminous catarrh and are associated with slow, stodgy people who usually eat a carbohydrate rich diet and have low energy. The hot types are usually more energetic, even nervy types, and produce thicker catarrh, as manifest in asthma.

DIAPHORETICS
These drugs have a suitably distracting name for societies embarrassed by sweating. They encourage sweating, a natural function that can be very useful in certain diseases. Many infections cause the body to raise its temperature in response. This is an attempt to kill off the invading infective organism. It is therefore a mistake to suppress the mild fevers encountered during colds and flu. Herbalists encourage these fevers and control them with herbs that promote the sweating. Useful diaphoreties are Sambucus, Tilia, Mentha, Yarrow, Zingiber.

ANTI-INFLAMMATORY
Inflammation is a healthy process. The redness around insect bites, scalds, or an infected graze or cut shows the body is doing its job through a protective reaction that also aids healing. Clearly out of control inflammation, as seen in Crohn's disease, rheumatoid arthritis and eczema, is not healthy. Excess or chronic inflammation is tackled first by seeing to the underlying cause where possible, but the symptoms may also need reheĢ Most of the bitter (see Bitters) herbs encourage the inflammatory process to speed its work of healing. Excellent anti-inflammatory herbs include Filipendula, Salix, Harpogophytum, Glycyrrhiza, Calendula, Matricaria, Hydrastis, and Phytolaca.

ALTERATIVES
This action has the literal meaning 'to alter'. It has the effect of altering the nutrition and waste elimination of tissues and organs so their metabolic functioning is enhanced to a more normal level. In traditional herbalism, the alteratives are associated with the depuratives, which are plants with the action of cleansing the blood. Both actions are often found in the same plants.
Alteratives are used most in conditions with tissue congestion or reduced immune function. Typical examples are rheumatism, eczema, psoriasis, swollen lymph glands, and tumours of any kind. Herbs are Arctium, Echinacea, Calium, Rumex, Phytolacca, and Viola tricolor.

HORMONAL
The body's fine tuning mechanism is a complex set of hormones that control the presence or rate of actions from the general metabolic rate (thyroid hormones), through water retention (antidiuretic hormone), to the release of an ovum from the ovary (Leutenising hormone). Without these hormones, we are dead. When they are not supplied in exactly the required amounts when needed, the body misbehaves. Many common illnesses are due to such hormone problems.
Many hormones are very similar, chemically, to steroidal saponins found in many plants. Herbal actions either stimulate glands to release hormones or provide look-alike chemicals so the body thinks there is more of the hormone available than the glands are releasing. Vitex, Smilax, Glycyrrhiza, Serenoa, Dioscorea, Elutherococcus, Panax.

WOUND HEALERS
The healing, or vulnerary, action must be among the first use of plants discovered by our ancestors. Even in the relative safety of modern housing, food gathering in supennarkets and safer transport, minor wounds are common. Imagine how much more common wounds were for hunter gatherers. Healing has many components or stages. Antisepsis may be necessary, stopping bleeding, keeping out infections, and encouraging the wound to heal.
Strong antiseptics and styptics are combined in the tannin-rich astringents (Quercus, Potentilla). Symphytum (comfrey) is a famous wound healer as one of its common names, knitbone, testifies. Here there is mucilage, which dries and binds the edges of wounds together like surgical stitches, as well as an ingredient, allantoin, that stimulates the regeneration of skin and even bone after damage. Many plants are useful wound healers because of their antiseptic oils, blood-dispersing property, anti-inflammatory benefits, or a combination of several useful actions: Hypericum, Arnica, Chamomilla, Calendula, Hamamelis, Baptisia.

RUBIFACIENTS
Deep heat rubs contain ingredients with this action. It is heating, which it does by slightly irritating the skin where it is applied. The local blood vessels dilate and more blood rushes into the area. The blood is heating, but it is also healing, which is why rubifacients are applied. They are useful on sprains, arthritic joints, tom muscles, etc. Many herbs rich in certain essential oils are used, hence their distinctively strong aromas: Cajapat, Camphora, Rosmarinus, Syzygium, Armoracia, Capsicum.

DEMULCENTS AND EMOLLIENTS
These are symptomatic treatments but are very efficient and are appreciated when applied. Demulcents protect tissues from irritation and soothe them, whereas emollients soften and protect. Both include mucilaginous herbs (Althaea, Symphytum, Ulmus, Getatia, Plantago, Linum, Tussilago), but also some astringent remedies. Emollients also include heavy ointments, which soften and protect the skin. These may include healing herbs as well as the oily base.

ANTIPRURITICS
After pain, the next most annoying symptom must surely be that itch that won't go away. Antipruritics reduce itching. There are many causes of itchy skin, from liver disease to allergies and stings. The underlying cause must always be sought and treated where relevant, but symptomatic relief is worthy of deep gratitude and is usually easily achieved with herbs. Stellaria is the best itch reliever.

ANODYNES
Pain is one of the commonest symptoms and relief is usually wanted immediately. The best approach is sometimes indirect. Headache pain can often be helped by relieving the nervous tension or dilated blood vessels in the brain. Intestinal cramps or colic need antispasmodics and carminatives that help dispel trapped wind. joint pain in rheumatism responds to anti-inflammatories. There are also herbal painkillers that either sedate or anaesthetize the local nerves. Aconite is so effective it can calm the pain of trigeminal neuralgia. Other herbal anodynes include Gelsemium, Eschscholzia, and Piscidia.

FORMS OF HERBAL MEDICINES
It is sometimes said that one distinguishing feature of herbal medicines is that the whole plant is used. In fact this is often not the case. It is true that parts of plants may be used whole. Whether eating dandelion leaves (Taraxacum), an apple (Malus spp.), or ginger root (Zingiber), only part of the plant is eaten, though the whole of the part is eaten.
Most herbal medicines use only a part of the plant( leaf, fruit, bark, etc.) but even then it is usually only an extract of the part that forms the medicine. The most common way of taking herbal medicine is as a tea or infusion. This is an extract of soluble ingredients in hot water. Cups of coffee and ordinary household tea are made by the same water extract, which is called an infusion. In each case the coffee grounds or tea leaves are not consumed but are thrown away.
Similar extracts are the basis of most herbal medicines used by professional herbalists, or the starting point for manufacturing a wide range of herbal preparations. Alcoholic extracts, like water extracts, are solutions of various ingredients in a solvent; solutions of alcohol and water in this case. Different strengths of alcoholic solution are used depending on the particular ingredients to be extracted. There are two main types of alcoholic extract. A fluid extract is one part by weight of dried herb to one part of alcohol. A tincture is more dilute, usually one part of herb to three or five parts of alcohol. Homoeopaths use herbal fluid extracts in making their very dilute remedies. They call their fluid extract a mother tincture.
There are as many forms of herbal medicine as there are of pharmaceutical drugs. Starting with either a finely powdered herb or an alcoholic extract, infusions, decoctions, creams, ointments, pills, tablets, lotions, liniments, powders, poultices, plasters, bougies, compresses, pessaries, suppositories, etc. can be made.