Diabetic Ulcer Protocol by Paul Manski

Here is a protocol for dressing diabetic ulcers and in this case the amputation of the toe. I would like to thank my teachers John Slattery and Michael Cottingham for both guiding me to the plants and teaching me how to make these medicines. The purpose of this blog is to give some guidance on how to use the herbs which I recently sent to someone requesting them.

      One of the most important elements of dressing diabetic ulcers is to provide a moist wound bed, for debris enemy meant and development of healthy granulation tissue. It's also important to have a an anti-microbial dressing in place which does not antibiotic based and does not develop antibiotic resistance.

Commonly in place or silverdine based ointments and creams and silver impregnated dressings. I wanted to develop a protocol based on plants growing in my bio region which is the desert Montagne sky Island biotic province of Arizona and New Mexico.

     At first I was leaning towards a ointment with antimicrobial properties with a oil/beeswax base. However as I thought it over I began to realize that the beeswax could prevent the development of granulation tissue on the diabetic ulcer so instead I utilized in oil based anti-microbial infused oil containing the following orbs so that the possible infection would not be sealed in by the beeswax or prevent the formulation of granulation tissue in the wound bed.

       Infused Oil. was mixed in a blender with the following dried herbs: I used a base of organic cold pressed grape seed oil. I mixed as much of the herbs as I could put in 16 ounces of the oil without the blender bogging down, I wanted a very powerful anti-microbial oil.  I created a very thick slurry that I let sit for two days and then strained.

     2 parts:Yerba mansa root-Anemopsis californica; 2parts:Oregon grape root, Mahonia- Berberis haematocarpa; 2parts:Larrea tridentata -Creosote bush; 1/2 part:Arizona cypress- Cupressus arizonica; 1/2 part Juniperus communis creeping high mountain juniper;

1 part:Estafiate- Artemesia ludoviciana; 1 part:elephant tree, torote and copal resin-Bursera microphylla; 

    I mixed up the oil till it was fairly warm and then let it sit for two days before straining and filtering the oil.

   

For the dressing  I am using Usna, old man's beard that I gathered previously from an Arizona Cypress in the Sierra Blanca. Usnea, how's a long tradition in itself I was an antimicrobial topical dressing for wounds.

    Moist Dressing: My concept for the moist wet dressing with the Usnea, is to create an isotonic herbal solution, apply it to the Usnea and use the moistened Usnea with the infused oil. 

Take the following herbs 1 handful of Yerba mansa root-Anemopsis californica; 1 handful of Oregon grape root, Mahonia- Berberis haematocarpa; 1 handful of western yarrow-Achillea lanulosa and boil them together to make 8 ounces of liquid. Boil the mixture of herbs, bring to a rolling boil, then cover and simmer for 20 minutes. Let the mixture cool to room temperature and strain. Reserve the liquid in a clean sterile jar. To the 8 ounces of liquid add 1/4 teaspoon of salt making an isotonic saline solution.  An isotonic solution  is about 0.9 percent or 9g per 1000ml of fluid. It is about 1/4 tsp. of salt per 8 oz. of water. So by adding 1/4 teaspoon of salt to the 8 ounces of strange herbal mixture you will then have an isotonic solution.Pour the herbal mixture over the Usnea.  Keeping the Usnea moist, then apply the infused oil to the moistened Usnea dressing. Place the moistened Usnea dressing now impregnated with the infused oil directly on the wound bed. Cover the Usnea impregnated dressing with a 2 x 2 and gauze. The dressing should be changed twice per day. I am thinking that the reserved liquid could be saved for 2 to 3 days and if you have any questions you could re-boil it let it cool and use it in this way for several days. You can also apply the infused oil with a cotton ball directly to the wound bed. You could also use sterile cotton apply the liquid isotonic herbal solution in the infused oil in place of the Usnea. 

     Herbal Red Root Tea: (also called a decoction)

I also provided some dried red root, Ceanothus fendleri to make a tea or herbal decoction, which is a fancy way of saying a strong tea. 

Directions for making the redroot tea or decoction  are as follows. Take a handful of the dried red root chips, place them in 1 quart of water, bring the water to a rolling boil, cover, then turn down the heat and boil for 20 minutes at low heat. Strain out the Red Root chips. Save the chips, this is some strong fresh redroot and I am thinking that you can make at least two batches of the tea so use them again. Have the patient drink 1 quart of this red root tea a cup or so at a time throughout the day.

    To this red root tea you will add the alcohol tinctures that I provided. If you look at the small one ounce medicine dropper bottles you will see that they are labeled as follows. 

1oz Red Root tincture(Ceanothus fendleri)

1oz Ocotillo tincture (Fouquieria splendens)

1oz Yerba Mansa root tincture(Anemopsis californica)

Once you make the Red Root tea, or decoction add one squirt of each tincture, red root, ocotillo and Yerba mansa to the tea. A quart will make 4 cups of tea. So drink the tea four times a day, adding the tinctures to the tea each time the patient drinks a cup. 

     These herbal tinctures and the tea together are designed to stimulate the lymph  system, encourage the movement of fluid from the lower extremities, where you said that he had some edema going on. The Yerba Mansa is an herb that besides having strong antimicrobial properties also it has anti-inflammatory properties very useful in the condition of the diabetic foot ulcers and toe amputation. 

References:

Anemopsis californica, Medicinal Plants of the Southwest 

by Andrea Medina (ANTH457 Summer 1999 & Hort300 Fall 1999)

http://medplant.nmsu.edu/yerba.html

http://www.itmonline.org/arts/usnea.htm

Herbal Antibiotics: Natural Alternatives for Treating Drug-resistant Bacteria

By Stephen Harrod Buhner

Michael Cottingham, private conversations and online

https://m.facebook.com/michael.cottingham.Herbalist/posts/279318355612074

Usnea:The Herbal Antibiotic

by Christopher Hobbs

Botanica Press Capitola, CA

http://www.christopherhobbs.com/wp-website/wp-content/uploads/2015/01/Usnea-booklet-text.pdf

John Slattery: both personal conversations, written material, and online

http://www.desertortoisebotanicals.com/hello-world-2/

Ohlone Medicine

By Chuck Smith

http://www.cabrillo.edu/~crsmith/OhloneMed.html

Chuck Smith, Cabrillo College, 1999