For several years I have been involved with a group of herbalists providing herbal first aid and acute medicine services at some of the summer festivals, including Glastonbury and The Big Green Gathering. The group was started by friend and experienced herbalist Dedj Leibbrandt and operates out of a converted caravan. A geodesic dome and a large tent combine to provide a consultation and treatment/observation area, a chill out and rest area where patients and the public can drink a selection of herb tea blends (we usually concoct various combinations on the spur of the moment!) and a catering area where we are all fed and watered after a hard day’s work. The caravan’s well stocked dispensary has a comprehensive selection of herbal tinctures (some of which are pre-formulated mixes), some dried herbs, essential oils, infused oils and creams. We also carry a selection of wound dressings, latex gloves, Mefix tape for securing dressings, bottles for dispensing the herbs into, and various other bits and pieces which come in handy.
Herbal first aid and acute medicine are an entirely different ball game to working in a clinic, where the vast majority of the patients have chronic, long standing illnesses. With herbal first aid, you get to deal with all those gory and gruesome things like wounds, burns and abscesses that you don’t tend to see in clinics! But once you get your head around the difference in therapeutic approach, herbal first aid is quite easy – what you see is what you treat. If someone has burnt themselves, for instance, you don’t need to know years of background to their complaint, minute details of their diet, or their family history. Once some basic information has been collected, all you do is treat the burn.
Another difference relates to dosage. In many acute conditions, herbs are used in ‘heroic’ doses. In other words, significantly higher doses are administered compared to those taken in chronic conditions. The dose is often administered more frequently too. It makes perfect sense if you think about the aim of the treatment: acute conditions affect the body so swiftly and significantly that high quantities of herbs are needed to counter the swift change in the body’s physiological processes and to move it back to a state of relative homoeostasis.
There is a myth that herbs take months to work. In long-standing illnesses herbs need to be used for extended periods of time because of the resultant deep-seated physiological changes in the body’s tissues, which are simply not going to respond to treatment overnight. Herbs are effective in first aid situations because chronic, degenerative changes do not (generally) need to be overcome and our bodies are perfectly able to respond quickly to the appropriate herbs and doses.
Down to the nitty-gritty: what sort of problems do we actually treat? At Glastonbury, a major problem (due to the time of year of this festival, the last weekend in June) is hayfever. Regularly, we get potential patients asking ‘does it work?’ and a reticence to buy a bottle of mix. The proof of the herbal pudding is in the eating, so we suggest they try to see how they respond. We offer single ‘stat’ doses (stat, in medical parlance indicates quickly, without delay, from the Latin ‘statum’ meaning immediately). We usually find that they visit us again after a short while to purchase a bottle of hayfever mix (this is one treatment where we keep the formulation pre-mixed). Typical herbs which are useful include Plantain, Eyebright, Ephedra (I consider these essential hay fever herbs which form the core of a prescription), Elderflower and Nettle.
We also get our fair share of coughs and colds. Again, a situation where we carry a pre-mixed respiratory formulation, but these basic formulae can be tweaked if required, by the addition of other herbs at the time of dispensing. Another absolutely essential herb for respiratory infections is Thyme. Echinacea and Baptisia are also of importance. Lymphatic herbs such as Cleavers, Marigold, Pokeroot are also valuable additions, along with decongestants and membrane tonics such as Elderflower and Ground Ivy.
Digestive problems of various sorts are also frequently encountered, which may affect one or both ends of the system! Many people suffer a temporary constipation during the first day or two of a festival, but that is usually easily treated with a combination of gentle laxative and gut relaxant herbs such as Dandelion root, Vervain, Yellow Dock and Chamomile. More serious is significant vomiting and diarrhoea (sanitary and hygiene conditions at festivals sometimes fall short of the ideal, and gut infections can also easily spread under the crowded conditions).As well as administering the appropriate herbs to reduce diarrhoea and vomiting, the administration of copious quantities of fluids and electrolytes is paramount to prevent dehydration. Herbs to treat these sort of infections are the more ‘heavyweight’, often Berberine-containing herbs such as Golden Seal, Rhubarb root, Berberis vulgaris, and the Artemisia’s.
Various skin problems are also frequently encountered, perhaps the most common being sunburn. Unless severe, this usually only requires the application of Aloe vera gel which is mixed with a little essential oil of Lavender. Wounds and burns are also a common occurrence, and need to be assessed for their degree of severity. The Aloe/Lavender essential oil preparation mentioned above is excellent for first degree burns (ones where the skin is unbroken). Where the skin is blistered and/or broken (second degree), sterility is paramount and a sterile non adherent dressing should be applied. Second degree burns should be regularly assessed, for as they heal they can easily become infected, and where the burn is either extensive (classed for adults as one which is greater than the size of your palm, or that goes all the way around a limb). Where a burn has destroyed the whole thickness of the epidermal/surface layer of the skin (third degree burn), the patient should be immediately taken to hospital.
Scalds should be treated in a broadly similar way. With all burns ands scalds immersion in cold water as soon as possible after they occur is also beneficial. I have used a combination of Nettle and St. John’s Wort (Hypericum) as a cold tea to great effect at this stage of treatment, which helps to reduce both pain and inflammation. At one festival we experienced the usual mixture of mud and sun, with people walking about in wellies. As the sun came out hot and strong and the mud dried up, many wellie-wearers couldn’t be bothered to return to their tents to change into something more suitable, and we saw a lot of people with angry scarlet urticarial type rashes on their calves and ankles. Again, I found the Nettle/St. John’s Wort soak, together with an anti-allergy type stat dose for the more severe cases, worked well.
Wounds are often frequently seen, usually relatively small cuts and grazes, but sometimes more severe. At one festival I saw someone who had cut his fingers severely on a lawnmower a few days before the festival, which we cleaned and dressed on a daily basis for him. We often clean wounds carefully before dressing, depending whether they are dirty or have a lot of dried exudate around them. Lavender water or Witch Hazel water can be used if the wound is showing no signs of infection, if infection is suspected then Myrrh or Marigold tincture is a better bet. As these are high alcohol strength tinctures, they may sting somewhat when applied, so if this is likely to be a problem (especially an issue with children), then they can be diluted in water before applying.
A real standby for dressing wounds is Myrrh powder, applied directly to the wound’s surface; not only will this get any infection under control, it also has a really cleansing effect on the damaged areas, and certainly seems to promote the formation of granulation tissue which promotes healing. Comfrey cream is also an excellent application to minor damage, but as it is such a speedily healing herb it is best avoided on deep wounds in case it heals the surface layer and traps infection underneath, leading to the risk of abscess formation. It is better to use something like Lavender or Marigold first to get a deep wound to heal from the base up.
For abscesses, regular applications of a drawing cream based on Marshmallow root, along with a fairly high and regular dose of an anti-infective mix (my favorite is Echinacea and Burdock root, although other herbs such as Marigold, Poke Root and Cleavers can be used as well) is indicated. It is important to monitor these sort of situations carefully and regularly, and we will often ask the patient to return later the same day, and during the following days, so we can keep a close eye on what is happening and that gives the opportunity to change the approach if necessary.
Damage to muscles and joints in the form of sprains (ligament damage), and strains (muscle damage) are also situations we regularly see. The medically accepted way of treatment can be remembered by the mnemonic RICE: rest, immobilisation, cold compress, elevation. But we have found that hot compresses can be really helpful in these circumstances. It is interesting that when looking around online for information on standard treatments, I found a site that stated there is no actual evidence available for the beneficial use of ice! So we tell the patient of the two choices, and then let them decide which one to take. Of course, hot compresses can include strong infusions of herbs. If bruising is likely to occur, Yarrow would be a good choice. Comfrey will certainly assist healing, and Lavender will have a good anti-inflammatory action.
I hope the above gives a broad outline of the sorts of things that can be effectively treated with herbal first aid at festivals. It is something that every herbalist should try at least once – just for the experience. There is always the possibility of unusual or unexpected situations, responses and reactions to problems and injuries. This is where your competency and proficiency as a herbalist is paramount, (along with training in standard first aid techniques). Once I got over the initial scariness of it all, I took to it like a duck to water! It will certainly give you a greater understanding of herb use, another string to your bow in terms of the skills you acquire, some good music, and maybe, just maybe, a little sunshine to offset the acres of mud!