So when we come down this way: Salt River, Paul Manski

So when we come down this way were always walking across the salt river.

This is our great river the salt river. One of the things that i do when i come to the salt river

is offer salt river yerba santa, fragrant plants,

the Gobernadora, Larrea tridentata.

       I offer it to the river for safe passage, salt river, take these fragrant leaves, this yerba santa, for my brothers and sisters who use this water and who used this water.

      Everything you see everything you hear doesn't belong to me. It's part of what i need to use to survive. It doesn't belong to me but i use it and the way that i use it, is the way i define myself...the way i define myself as a person. I define myself as a person in this salt river, salt river valley...

i see over here la Gobernadora, Larrea tridentata, this is the plant, this is the plant that we use when we come this way. 

      When we come down to the salt river we see our plants that grow here, and some of the plants that grow here they are what they are. Here we have jojoba, here we have Larrea tridentata. These are the plants that we use.

 these are the plants that are our medicine here. The salt River is a great river for us. And it's important, when ever you cross the river, whenever you come into this country, whenever you plant your feet in a different way on this earth to walk to a new place...

acknowledge the river, acknowledge the truth of this river, the truth of this water that flows, like blood, like mud from way up above, from way up above, yes that's right, the salt river. The white river, the black river they come together, they mix, they mix right here.

    This is Larrea tridentata, the Gobernadora,

this is the plant that we use when we come to this place. Some people will say, "well, what plants do you use?", I say, "i use the plants that are here." Ha ha Ha ha ha, i use the plants that are here in the way that i use them. So that's what i do. So that's who i am.

Red Root, Ocotillo and an approach towards the spiritual heart by PaulManski

     

Red Root: Ceanothus spp. Rhamnaceae (Buckthorn family) Buckbrush, because deer may and do browse it. Growing in  a 6200ft low elevation coniferous forest. It grows in piñon juniper woodlands to open pine forests. Ceanothus fendleri Three parallel leaf veins, a central vein from the base to tip of leaf, a central longitudinal vein with two symmetric veins, together in a trio. In our southwest the leaf size varies greatly from species to species. fendleri presents as a small thorny shrub with narrowly oblong leaves about 3/4's of an inch in length. 

     Ceanothus greggii, or desert ceanothus is found at lower elevations. In flower it is fragrant and the plant is showy with white puffy flowers. It tends to not have the three parallel veins and the lacks the thorns of fendleri, in addition having  grey, more white tinged branches. It tends to grow at lower elevations inhabiting a zone called Arizona chaparral- which is not to be confused with the herb of commerce sometimes called chaparral, Larrea tridentata.

Associated with scrub oak Q. turbinella, manzanita, silk tassel, cliffrose and hollyleaf buckthorn.

      A third type of Ceanothus is C. integerrimus

which appears more montane, growing at higher elevations with higher precipitation, the leaves reflect this more abundant water supply and are larger, it has a mild 3 veined presentation, and it lacks the leathery waxy quality of our other Ceanothus. 

      Ceanothus has a history in western herbal medicine notably during the time of it's flowering from the 1830's to the early part of the 20th century. In the colonial period Red Root,  was called 'New Jersey tea' and was a substitute for the imported Chinese tea which was in short supply, as in the revolutionary act of dumping tea into the Boston harbor, the Boston Tea Party and was considered patriotic to part ways with the British, during the Revolutionary War time.

     "The Family Flora and Materia Medica", by Peter P. Good, A.M written in 1847 speaks of it being astringent and slightly bitter. Useful as an astringent in dysentery and as a febrifuge in Mexico. Good describes it as appropriate for sore throats, and the congested symptoms of impaired circulation in the throat area, here we are building a case for its use in the lymph transport of waste material from the throat into the surrounding tissue. In addition red root was described as an expectorant in relation to lung congestion. He also acknowledged its use in the portal system and uterine/menstrual pelvic stagnation.

     "Specific Symptomatology—It has a specific influence upon the portal circle, influencing the circulation. In lymphatic patients, with sluggish circulation and inactivity of the liver of a chronic nature, with doughy-sallow skin, puffy and expressionless face, pain in the liver or spleen with hypertrophy of either or both organs, and constipation, it has a direct and satisfactory influence, especially if the conditions are of malarial origin...or in general glandular disarrangements, the agent is indicated. Bronchitis, chronic pneumonitis and asthma are found present with the above general symptoms. Ovarian and uterine irregularities with such conditions will also be benefited by its use." -American Materia Medica:

Therapeutics and Pharmacognosy: Developing the ...
 By Finley Ellingwood, John Uri Lloyd 1915.

    While current south west herbalists, strongly influenced by Michael Moore, tend to view Red root as a lymphatic remedy, aiding the portal liver system, which was acknowledged by the eclectics of the time.

The herbalists of the period saw in red root a remedy for..." with my application of this shrub to diseases of the lungs. In 1833, while out botanizing one day, my attention was directed to this shrub, by its beauty while in full bloom, and the peculiar appearance of the root. I gave it the name of wild snowball, knowing no other name for it at that time. I tasted and chewed some of it, and I conceived the idea that it would be good for coughs. I gathered some of the shrub, dried it, and added some of it to my compound, used at that time for coughs. I was successful in treating coughs...In such cases I keep a syrup to suit. It is made as follows: Take ceanothus two parts, asclepias tuberosa one part, boil down till you have a very strong decoction; strain, and add refined sugar, and boil down to form a thick syrup; add the tincture of Tolu, to give a flavor, and bottle. Dose—one tablespoonful three times a day." -The New England Botanical and Surgical Journal, by Calvin Newton MD 1849.

     Besides the possibility of combining red root with pleurisy root for lung congestion, it is fascinating to see the renaissance scientist Dr Newton exploring the fields and forests, directly tasting the herbs and plants and developing an intuitive treatment from the forests of New England. 
     In my own studies of herbal medicine I was led both by intuition and direct suggestion from two teachers I had been studying with,

Michael Cottingham from Silver City and John Slattery

from Tucson, to combine two south west native plants. Specifically Red root, Ceanothus greggii and ocotillo, Fouquieria splendens. 
     First an attempt to grasp systems of the body in relation to the lymphatic system. John Slattery quote, "Putting ocotillo and red root putting them together, and I could give that happily to a vast portion of the population and in a subtle way enhance their immune response because of how it clears stagnation in the lymph, because how it mobilizes how waste products are removed and facilitates transport throughout the body." This is possibly what Dr Calvin Newton in 1849 had encountered and utilized in his formula to treat  tenacious coughs, and lung stagnation, expediting the transport of accumulated waste products in the lung. 
    Herbalist Paul Bergner writes, From The Healing Power of Echinacea and Goldenseal (Prima 1997), "The Eclectics used red root for stagnancy of the portal venous system.

The is the series of veins that carries nutrients from the digestive tract to the liver for processing before it can enter the general circulation. Like other venous blood, portal blood has no pulse or pressure. It also has to move upwards, against gravity, to get to the liver. A sedentary lifestyle, a heavy diet, intestinal disorders, and liver stagnancy can all cause this network to become stagnant. This also effect immunity because blood from the spleen, a lymphatic organ that filters the blood, must also drain through the portal system. Key Eclectic indications for the use of red root were a swollen spleen and a stagnant liver. It was used by soldiers during the Civil War for spleen inflammations that accompany malaria."
     

Darcy Blue an herbalist currency living near Flagstaff AZ writes, describing the energetics of ocotillo, writes that ,"Ocotillo is a warming and mildly drying lymphatic and blood/fluid mover. It has an affinity for the tissues and region of the pelvis and liver/portal vein system, and the respiratory system." It feels natural to combine red root and ocotillo, they both have affinity for the liver and lymph, ethnographical literature describe both as treating coughs, and Charles Kane, writes,

"traditional use of ocotillo among hispanic New Mexicans has been for sore throats, tonsillitis and to stimulate menses." Almost exactly as the eclectics described red root. 
     The idea and real quality of an organ system being stuck, like congestion in the lung, bronchitis, pneumonia, inflammation heat, swelling  has a psychological component. It produces a mental effect. Pelvic congestion, pain, stuck menses, painful cramps- these bodily states impinge on our thought processes. There is a way of being well and a way of being sick. A disease state within the body calls forth a subtle mental attitude. Of course we have to distinguish between chronic and acute. The length of time the disease state has effected consciousness. So that the treatment of disease is also the adjustment of mental states. 

      Herbs and plants like red root and ocotillo are both 'heart' medicines, medicines of the emotional spiritual heart. These medicines while not 'psychological' deal with our healing journey. They address the soul and our way of becoming in the place. Plants can be a way back to a place of balance. Our bodies may be out of balance with disease yet our hearts and minds are also stuck in the paradigm of disease states. Part of the process of healing is acknowledging the psyche and mind states through plant medicines.

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Currently I went back and found a quart of Ceanothus integerrimus I had fresh tinctured earlier this year. I had forgotten how astringent and sweet it was, with the strong taste of wintergreen. I decided I need to go back to my herbal medicines. I also pulled out the red root i harvested and mixed up a batch of 50% ocotillo bark and 50% red root, and will begin using it again.

I realized my heart is in need of healing and I felt I need to return to this herbal work for obvious reasons. 

Torote, Bursera microphyla, this is the way to return, by Paul Manski

Torote, Bursera microphyla,  this is a way to return, if you are lost, or have been lost. The plant taste is aromatic, hot dry and astringent, the gum like resin sap or copal comes out of the tree, pictured below and is a prized medicine. The aromatic scent is a combination of orange peel and piñon pine resin. 

I’m continuing to work with these plants and use them from a bioregional herbalist perspective. I first met them 25+ years ago in the Sonoran desert west of the Colorado river, in eastern San Diego and Imperial counties,  California, while working for the California Department of Parks and Recreation.      Torote is a powerful plant that can define the bioregion.

It’s scent is warm maybe pine sap maybe orange peels, kind of like both, you decide. It also has a hint of fresh cilantro seed/coriander. It’s a perennial, a tree. It keeps it’s small leaves year round except in drought and cold, in Arizona and California it’s at the north end of its range. It’s aromatic leaves are on cherry red stems coming from a swollen white papery trunk. In the south and heart of Mexico it is more evenly distributed, but in Arizona and California it grows in the warmest mico-climates often situating itself near dark desert varnished boulders or at it’s reported most Northern point in the Harquirvar Mountains 33.7N, 113.4W near Salome, AZ it will be in the wash. 

Thin papery bark admits light to photosynthetic layers beneath. Given rain it may leaf out at any season like an Ocotillo. Bursera Microphylla is considerd a sarcaulescent tree and stores water like a cactus in its lower trunk.

This sarcaulescent quality means it can survive dought alough it tends to like the summer rains coming from the Gulf of California. It has a an affinity to the grey vireo who eats and speads its seeds.

      I’m not sure I should mention any of this, I have no right to speak, probably no reason to speak, yet I’m speaking. I’ll tell you why, maybe one person will hear it and and it will help them come back to center. Robert Levi a Cahuilla elder and bird singer passed away August 29, 2007 he was 89. He talked to me one day about Mukat and Temayeit and bird songs. I listened to what he said, you couldn’t ask him if he remembers, he’s dead. I’m still alive so I”ll tell the story and no one can argue with it. That’s just the way it is.

     I found this tree maybe 30 years ago or at least 25. I was looking for something, I’m still still looking for something. I found a few things here and there, in the deserts. Probaby want to know where? Well this tree speaks for itself. It tells us where we are. It shows us which way to go, here, home. I can’t even tell you where it grows I found it at Bow Willow, Martinez Canyon and Ocotillo Wells when I was a young man.

My hair was brown and thick and I used to enjoy sleeping and cuddling with a beautiful woman , a youngish girl actually, my wife and friend, Eileen. She had my son and I named him after the tree that grew east of us in the Mohave, Joshua tree, with its arms out raised. I felt lost in the desert somehow I would see the promised land, but I wouldn’t enter like Moses, but Josh my son would, that’s another story. I just want you to know that now I think more of the past than the future, and if I think of anything it’s these plants growing here. They have an ability to pull us into the conversation of place.  I want you to remember them and seek them out, like I did and do. These plants and stories connect us to each other and the place we share. A place beyond fronteras, beyond jurisdictions and boundaries. Place is like that it is and will be, after our time is gone.

     Like Torote Colorado, the Bursera Microphylla, Robert Levi said the bird songs were songs of people looking for a place to live, looking for good things

Bird songs were in the Cahuilla way of making connections to this place of abundance and riches, beauty. They were sung in ceremonies and at a certain point Robert Levi recognized his work was to sing. His work was to preserve the songs. So he traveled and sang, he would shake the rattle and sing all over the Mohave, Banning and Morongo. He came to the Borrego valley a couple times and sang.

    He said, "So everyone are like these birds, looking for a place to live." Robert Levi was interviewed by LA Times, Jennifer Warren August 31, 1990 and he talked about the bird songs,

   “In one song, for example, the First People "feel this strong wind, coming up behind them, and they are looking for a place to stay," Levi said. "Then in the next song, it's getting cold as the wind is catching up to them."

The following piece tells of "clouds of rain gathering, and then of the rain falling on them," Levi said. "There is talk of the mournful cry of the bluebird, and the blackbird, and the cold rain.

http://pgmanski.blogspot.com/2009/10/climbing-san-ysidro-peak.html

  "It goes on like this and they finally come down on a high plateau or mountain, and see this lush valley below," Levi said. "This, the songs says, is the land where they will stay."” 

     I heard Robert Levi

sing them at Borrego Springs, Banning, 29 Palms, and up above at Los Coyotes. I had a cassette recorder, I would listen to them. I wrote a poem about Robert Levi, and the mountain in back of where we lived. The stories I knew, even though they weren’t mine, I asked Robert if I could record his songs and tell his stories, he told me yes, I needed to do that. He was a good man. I’m glad I met him only briefly.

   OK back to Torote. the Elephant Tree kelawat eneneka. This was an important tree in terms of medicine, song and story.  I went to the museum in Morongo and met Catherine Siva Saubel who was known in legendary terms, (by me mainly) as a Cahuilla woman who knew the stories of the plants. She was elegant and had a strong presence about her. I feel fortunate to have met people who loved the plants and their stories.

    My question is this, how can we describe our place? It’s important for me to use a bioregional perspective, the rivers and watersheds will do. It’s of the greatest importance that you know the first flower of spring, that the bushes are people just like you and I. When a drop of rain falls where does it go? That’s your life’s work, place. Where you are. Not so much where you’re from, or where you’re going but here and now, where does that drop of rain go? Follow it home. See it in your dreams, the clouds and the rain, four directions.

     Here where I live, it travels to the Colorado and the Gulf of California. I live just north of the Salt River, and the Agua Fria comes from the North, then the Gila River, we follow these rivers. This is how we describe our place. Now it’s work to say where you’re your from with the rivers and mountains. Then there are the plants. Saguaro, goes a long word towards describing this place. Yet here is Arizona, both torote and saguaro are at their northern limits. Torote much more so than saguaro. Torote is a guest here, saguaro is a local, and defines the bioregion. Saguaro i would say, makes known  us the place.

Another one, is ocotillo. In one place you'll find torote  ocotillo and saguaro together all three at the same time. Ocotillo crosses the Colorado into California. Saguaro does not cross the river. Saguaro and ocotillo coinhabit a large swath of Arizona. Then somewhere along the Gila near Safford, the saguaro peters out, too much cold but the ocotillo continues into New Mexico and Texas, places the saguaro doesn't go.

Then with the Madraen Sky Islands we have higher elevations, more rain and here we have pine, and Fir and Cedar. 

So within any watershed or drainage we have the Sky Islands that collect rain and these plants that go with the rain in these sky Islands are circumboreal. Often plants in these islands come from the north, Asia, Europe, Norway, they creep down these sky island roads like Juniper communis does, or Aralia spp, that is the north and a good thing. I met Juniperus communis plant with Aralia and Osha in the Sierra Blanca. These are for Bears, beaver and Elk and in the same way the south creeps up here. Bursera microphylla is like that. It creeps up following the sun, it’s part of us too. Just as much as deer and pine.  it’s not really belonging here. Yet it defines Sonora. These treaties of Hidalgo and Guadalupe, Tratado de Guadalupe Hidalgo, didn’t touch Torote, or any of the plants or animals, even the people, no one can live by lines, we breathe beyond lines and we move too. So I’m not good with borders, I do my best, but my thing is the plants, they are beyond the lines of Hidalgo.

     Bursera Microphylla defines Sonora, and yes I live in Sonora, I live with Torote. From Borrego Springs to Marana, Arizona it’s a place defined by Torote, the medicine. So I make medicine beyond the borders, I try to respect the borders but the medicine comes first.

     Michael Moore in his Materia Medica writes, “BURSERA MICROPHYLLA (Elephant Tree, Torote)
GUM. Tincture [1:5, 80% alcohol], 5-20 drops, and diluted for mouth wash. TWIGS/LEAVES. The torchwood family contains 550 species of shrubs and trees worldwide. Torote trees are nearly unknown to the general public, but nearly everyone has heard of their Old World relatives. The aromatic sap of the Boswellia sacra (Frankincense) and of Commiphora spp.( Myrrh) were once worth equal their own weight in gold. They were offered to Christ by the 3 Magi, the wise men who came from the east. Both myrrh and frankincense grow as small trees, on the Arabian peninsula or shrubs; they are of the botanical family Burseraceae. The Chineseview of these resins are,  “When combined, they provide these properties:

Fresh plant tincture [1:2], 10-30 drops.” And further in his book Los Remedios writes, that the resin or gum, is tinctured in alcohol and appled to sore gums, cold sores and tooth abscess, also the dried stems and leaves drunk in a tea for both painful urination and as an expectorant for lung, colds and chest congestion.

"One tends to rectify the blood; the other to rectify the qi;

When these two medicinals are combined together,

they complement each other.

Together, they effectively move the qi and quicken the blood,

dispel stasis, free the flow of the viscera, bowels, and channels,

quicken the network vessels, disperse swelling, stop pain,

constrain weeping sores and engender flesh."
     So now you have Torote. There was a place called Rabbit House, I would watch it way up there near Toro Peak in the Santa Rosas. There was an eagle flying, and called it Umna’ah, it was a good medicine with brittle bush and Elephant tree bark , for asthma and the resinfor dreaming  medicine, gambling medicine. An extract of the branches was effective against Staphylococcus aureus. {"Cahuilla Indians called the Elephant Tree kelawat eneneka and believed that the sap, ... red ..., had great power and was dangerous to be kept in the open. It was always hidden and used by tribal shamans"

    A teacher i studied with, John Slattery, of Tucson, AZ writes,

http://www.desertortoisebotanicals.com

“Bursera sp. – Elephant Tree/Torote bark

Bursera spp. only grow in diversity from there(Mexico)...  Closely relate to Myrrh which was traditionally used to stimulate vitality in response to an infection, oral infections being foremost.  In the past, I have thought of it as a local analog for Echinacea, but it doesn’t do everything that Echinacea does (nor vice versa, for that matter).  It has been used for scorpion bites, cough, and bronchitis throughout our region.  I see it as a lymphatic, antitussive, and expectorant great for thick, mucousy, intractable coughs.” Another teacher I have studied with Michaeal Cottingham, of Siver City NM, writes,

“ELEPHANT TREE (Bursera microphylla)

Some observations and notes

A remarkable plant medicine

 for depressed white blood cell count

and endogenous and deep tissue infections, and can be helpful in these conditions:

MRSA, Sepsis, Periodontitis, Herpes, Gangrene (bacteria - Clostridium perfringens), Streptococcus spp., Staphlococcus spp., Lyme and its many coinfections, Venomous Bites with Sepsis or Tissue Necrosis, Pediculicide (Lice treatment), Venereal (gonorrhea, chlamydia, syphilis) and other problematic and deep infections.

Elephant Tree (ET or Bursera) -

Is an antiviral, anti-fungal, antibacterial, astringent, anti-inflammatory, antiseptic, mucolytic, diuretic, diaphoretic, emmenagogue (lightly), vasodilator, and immune stimulant.”

https://www.facebook.com/michael.cottingham.Herbalist/posts/256028524607724

I wanted to end the blog post with quotes from these two teachers, because they bring the circle around. They both studied with South west herbalist, Michael Moore was passed away in 2009. They both teach and communicate the knowledge of plants in the Southwest and I am grateful for having met each of them and been able to hear their stories of the plants from this unique place. The Gila/Salt River Sky island province.

On Being a Bioregional Herbalist, revisited and Nuestra Señora de LosRemedios

    So here is herbal medicine and here is silence: firstly when I say 'medicine',  i am speaking of a principle which is in my self and in the world around me which tends towards healing and balance. So not pills or surgeries but healing, which in my path centers around herbs and plants growing in the southwest, which i consider to be the Gila/Salt rivers bioregion. The ocotillo-saguaro landscape filled in with various degrees of madrean sky islandness. Medicine is accessing the bounty and richness of this ecosystem.

     Secondly for me or maybe firstly for me, it depends, is Nuestra Señora de los Remedios. Nuestra Señora for me defines the spiritual portion of my herbal experience. She is the name for what i feel in these desert/mountains and sky islands.  She is all that came before. For me she is the oral and written tradition of this place, going back to the hidden message of Guadalupe. In a sense we know her through Juan Diego, we know her because he knew who she was immediately. She was waiting for him to walk by, they knew each other by sight. They could see into each other's needs and there was trust and compassion, She healed Juan's uncle, then she provided him with plants. I consider this the traditions of remedios, remedies for our sickness and problems. I am not alone in this, if you are Catholic, or Mexican, Latino, or a Mexican Catholic, it's not a difficult concept to grasp. 

     Juan Diego was like all of us sick, with problems, with family members with problems and he met Guadalupe on a mountain, she healed his uncle, and told him to collect and gather plants. If ever an herbalist was looking for a story it is this story. And in the land of ocotillos and cactus, deserts mountains and sky islands: this was and is the story. The great mother who heals with special plants that she gives and provides, the remedios, the remedies. 

      This is where i have to stand, live and breathe, because i was born Catholic and my grandparents, mothers we all said the rosary, even in the biggest darkest industrial city, we believed and knew of a mother, with many names who had good things in store for us. Even if the present day was rotten, that didn't matter, it was faith. Faith in the Cross, the saints, the Virgin to triumph.

     She is Our Lady and Mary who appeared to San Juan Diego. When she appeared it's said she spoke words and gave instructions to Juan Diego, saying, "Go up, my dearest son, to the top of the hill, to where you saw me and received my orders and you will find different kinds of flowers. Cut them, gather them, put them all together, then come down." It is sometimes said these were roses, but I like "different kinds of flowers". She said to him, "Allí verás que haya variadas flores: córtalas, reúnelas, pónlas todas júntalas. Luego baja aquí; tráelas aquí, delante de mí.”- She said, 'there you will see all the different flowers: Cut them, collect, gather them, put them all together and pack them up and bring them down here, place them before me."

To me this sounds like herbalism, as it was taught to me. When she said, 'place them before me', she meant connect your heart with mine, with the highest intentions for healing with those plants. That is service, because as herbalists who exist on the frontera, on the border of experience, undocumented healers, who have been called to do this work, we have this work and we have the laws, and often we are outside both, yet there is work to do. There are choices to be made, that's just how it is right now. And probably always was and will be. Often times i'm waiting for something, someone to happen not sure who or what it is.

    

One of the first steps to resolving an illness, towards remedying a disease state is to acknowledge that there is discomfort and pain.

And to know there is a remedio, a remedy.

    On some level you have to admit there is a problem before you can find a remedy for the problem. In many ways pain and discomfort, and acute inflammation  from a disease state are important because as they become more and more strong they demand attention. Uneasiness demands a remedy and requests a conversation. So when opening up a case first there is talking story and listening. A conversation is the first step.

    I often bring together the silence, occasionally only the silence and often not by choice, the silence is for me the place where I can acknowledge the disease state. It's where and for what I seek a gateway, insight or a remedy. No one should be silent all the time, that goes against who I probably need to be.  No one should be a partner in enforcedsilence , and silence should not be enforced upon another. Speaking listening and learning are part of the human experience. So as i said. begin with listening and at best a conversation, a dialogue with silence and listening as a conspicuous portion.

    Of course a long silence can be like a gestation  where something else is being born. A pause where something comes to be. So when conversing don't run towards silence or blah blah blah.

     So it's not so much listening or not listening, silence or speaking, but preparing for something new, preparing for something someone to come. "What would be the reason why silence would be imposed?"   Well that's a good question, and questions often have to remain just that, questions. It's important not to rush and run towards answers, when what is required, is time with the question.

     For me the silence has become intolerable so I give you the person, the place, and some of the plants that i know and love on the sky island in this Sonoran Desert home. I am lately calling it the Gila/Salt river, ocotillo saguaro, desert mountain, sky island province, yes bioregion but you can call it anything you wish. Outside of names it stands strong on its own.

     i bring myself , my place, my plants and my silence. Actually it is my silence that is the most important part of my herbal practice. It's important to realize that silence is not only not speaking, but speaking and not speaking within the silence.  Silence is also not listening, not hearing, not doing while being part of the flow. Much of the work of silence has to do with not listening making a conscious effort to not listen , or to hear the silence that surrounds 'not listening', paying attention to the non-attention, so that when someone speaks you make it a point to hear them, to notice them, to acknowledge their presence or their existence, that's part of silence and that's part of the herbal practice. That is called not blocking. This is where not listening is not opposed to listening, in the sense of the polar flux of let's say day/night, light/dark, like/dislike- just what is. So that one comes to terms with the is-ness of a thing.

     

     After all this is 2016, and counting and I live in America. 

    It is a work in progress and progressing. i am overcoming silence.  It is my work and I am claiming it and encouraging it as my work. It may,  in its present state be able to lead to connections that i can use and share. That is one reason why i share it. it may help someone in someway, as it has helped me. But mostly it helps me because when you speak so infrequently, it helps to write things down. It helps put pictures to them so that you can see your life and it's steps, at least the good ones. And as far as who is helping who, let's just say , we help one another. There is help being done but i'm not doing it. Help is there for those who need it, that's a degree of optimism. Pessimism is to imagine yourself, dream yourself into a helper. Why? Because they can't help themselves. Mostly everyone can help themselves to the degree that they need assistance. Trust Mary and the saints to do healing. Maybe it will happen, or maybe nothing will happen. 

    I write things down because If you don't put down the words on paper and if you don't take pictures you can forget that you've been places. you can forget that you've done things. It is one thing to be silent and another thing to be silenced so I choose to listen in that way I am at least part of a process of communication. i may be moving slowly but i am moving. In the same way Arizona Cypress may have difficulty even with their feet in the water in their head in the clouds yet they are still growing slowly. They were alive and still are alive. They were moving and still moving, they are becoming. And sometimes I realize I must embrace the gradualness of this process. Like the Arizona Cypress. The Arizona Cypress has a very warm medicine. It's antimicrobial and when you see the sap the drips it looks like blood, or like glass wet with water sparkling in the sun. The golden red sap is good medicine. Pick the last years growth of the branch ends. Make a tea, very nice. Or brew up a fresh plant tincture. It's very very warming in the Lungs. Takes to the kidneys, diuretic. Also for fungus, topical. All this valley fever, with Yerba mansa.

    i have found i  forget i'm alive and on a journey because when the silence is so profound that surrounds me and everything i do it's important that i  make some kind of a record of the plants I've seen, felt and encountered.

of what i've done and sometimes just making the record means that you've done something this is the state. This is America. This is me and what's left of me, This is 2016. 

     I go months on end sometimes years without speaking to anyone so it's important that I write things down because i could forget where i've been. maybe if I write things down, i'll see a pattern there and be able to change it or develop something out of it I guess that's why I do this blog.

However at this time I would have to say that the reason I share it is because it may help me and at this point that's the only person I'm thinking about.

    I think in America 2016 we often have a distinctly American herbalism. 

    Actually there are many herbalisms. There's the selling herbalism. People selling all kinds of things. Buying all kinds of things. A lot of it compulsive , repetitious and complicated. Putting it in a jar, putting it in a bottle, pills, powders and potions. Maybe best described as intranet herbalism. Commerce herbalism, herbs of commerce.  Silent herbalism, the herbalism of silence. So here I am exploring the  herbalism of silence. It may or may not be a bioregional herbalism. It is often is an herbalism of herbs without much sharing of the medicine. An herbalism of weak medicine. In many ways I hope to move beyond the silence into speaking. If you're reading this you're part of this journey of herbalism and moving beyond the silence.

    I am employed as an RN. I work 5 days a week. My work is divorced, estranged from my herbal practice. This separated fragmented divorced and strange quality pervades much of my life. Often out of fear and lack of confidence in my skill, and outright lack of skill in knowing how to do what need to do I have clung to the wastelands of the dominant culture. i've lived in America's 5th biggest city, capital of this bioregion, Phoenix, Arizona. Not in the suburbs of Phoenix, but right in the center, anonymously down town, literally and figuratively, down town.

  In fact don't mention herbs in the context of my job at work. Herbs are kind of medicine. My work is on one side and the herbs another, they don't often meet. As a nurse I am somewhat of a spokesman for the pharmaceutical industry and the medical establishment. My work as a pill pusher. I guess what I'm getting at is i compartmentalize my life so i can live my life, there's an uneasy truce with my little boxes and I'm working towards moving beyond that smallness into a more freestate. 

   This is healthcare 2016, i am in the photo, looking at a most amazing plant, the roots of Aralia racemosa, one of the plants i fantasized about since the 1980's. Spikenard was one of those mythical plants like ginseng, osha or Aristolochia that i dreamed about holding, touching and seeing growing wild. This is an example of how I am fragmented, separated from those things that are most meaningful to me are seldom shared. So in a sense I attempt to maintain traction so that I keep moving forward and don't lose momentum. So much of my energy is connected with my work. And it is draining so I'd like to focus on the herbalism and my Herbal studies, because it's easy to forget herbs plants and natural things when you're involved in a very mechanistic lifestyle. The clock is ticking too, how many more years?

     Just last week I was speaking with someone that I work with and he mentioned that he has severe allergies. He's always clearing his throat and coughing and making a loud sound sucking up the mucus that's clogging his sinuses. It's that stuck condition that lingers and then brings inflammation and the inflammation becomes further irritation. I kept hearing him cough and spit. It is the classic stuck conditions that my teachers and past teachers

John Slattery and Michael Cottingham 

have mentioned many times in their lectures and talks. It would definitely be an opportunity to utilize the herbal medicines that i have been working on. Yet i have a reluctance to share what I've learned mainly out of fear. I could be exposed as a fraud in terms of being an herbalist practicing without a license and could be exposed as a fraud in terms of being a registered nurse with a license.  In many ways I am seduced by my salary I don't want to let go of that security, that paycheck that comes in every two weeks.

    So now I am thinking of what it's like to be at work listening to my coworker with his mucus. He clears his throat loudly and then spits in the toilet in the bathroom. And he's telling me about all the allergy medicine  he's taking. all the anti-inflammatories and antibiotics and antihistamines all the over-the-counter meds and prescriptions that he's taking. how he's going online and he can see a doctor for free online and not even have to get in his car to see the doctor. he gets a free prescription that he can download on his computer and then take to the pharmacy and get more meds.

   Well just that weekend I had been out spending time with Torote, 

Bursera,  brittlebush, Encelia,  desert lavender, 

Hyptis and ,Triangle leaf burr sage, ambrosia and I was thinking this would make a perfect medicine for him and his allergic condition. I mentioned it to him. Then the usual fear came and I said to myself I can't give him this medicine. What if he has an allergic reaction to the medicine that I made? Then I thought to myself what if the medicine works? I should've just made the medicine and gave it to him let him try it and left it at that. Yet I couldn't and that's where I stood with that one.

     As a side note without drama, i  recently worked successfully to address bronchitis woman here in town with a local woman. So i am seeing progress. It was able to provide to her a custom made bioregional herbal formula i gathered and processed consisting of a tea i blended, two alcohol tinctures and one elixir.

     Here are the formulas and dosages: 1st dropper is Red root/Ceanothus fendleri and Ocotillo/Fouquieria combination 2:1 50%. 1 dropper PO Qid/by mouth 4 times daily- to enhance efficacy of the other herbs and red root used by eclectics for stubborn cough and facilitate waste removal.
Second 1oz dropper is a combination Spikenard/Aralia racemosa fresh root tincture , Osha/Ligusticum porteri fresh root tincture , yerba mansa/Anemopsis californica fresh root tincture ,
/warming start 5-10 drops PO Qid-4x daily
Third: is the cough syrup which is base of Aralia racemosa honey and tincture , with Prunus serrotina/wild cherry bark fresh bark tincture , osha glycerite and osha tincture , yerba santa/Eriodictyton angustifolium fresh plant tincture, native licorice/Glycyrrhiza lepidota root tincture  , Lobelia cardinalis fresh plant tincture -use by the tbs spoon for cough.
Fourth: the plastic baggy has a three ingredient tea; Yarrow/Achillia millifolium, Osha root, Yerba santa/leaf= in equal parts. Divide bag into 5 equal parts, add the osha root portion(osha is the thinly chopped dried root) 1st to boiling water, boil 10 minutes, turn off heat and equal amounts yarrow and yerba santa once the water stops boiling. You can inhale the steam it will help loosen secretions. Let water cool, add to quart jar. Keep in fridge. Drink tea during the day, if too strong add 50% water, may add tinctures to tea in amounts previous, or drink tea straight. Tea energetics will be aromatic and warming/

    

    There is a strangeness in America and Americans. In many ways we are thrown here by forces of biology and we're still trying to figure out where it is that we are, and what it is like to live on turtle Island. From my early childhood I would say that strangeness defines the America i know as it defines me and defines my herbalism.

Just as an example my grandfather was from Lebanon, my middle name is George, for my Syrian grandfather's first name, named for the patron saint of Lebanon.

My other grandfather was Italian his first name was Mario, he loved the mafia and ran numbers at a place downtown.  He also said that everything is a racket. My father was a policeman so it makes perfect sense that he had a friend  of the mafia living upstairs in his house and of course he sang opera, not Italian opera but  Russian opera. So I never knew about Elvis Presley but I do need to hear Boris Godunov  and Mussorgorsky at least once in while to feel rooted. 

    It was just last night at work

when I for the first time i explained to someone what I was doing. I explained the cultural milieu and wrapped and spun it as best i could in a warp of magical realism, linking the herbs, my spiritual tradition and my place along with devotion to Mary,  the mother of God that I inherited from my own mother who was devoted 

to Mary.

     Explaining how all of these elements are part of my herbal practice. It went well and i was able to explain my perspective and i felt there was mutual recognition and sharing. 

    I am working on freeing up the communication process and I am open to communication just speaking the words, sound, and experiencing others openess has been empowering. 

 It can be hard to link together things like herbs and plants, healing, folk medicine, botany, the eclectics of the late 19th century

and the angels, Saints,  Mary the mother of God, our Savior Jesus Christ. I work in a hospital as a registered nurse. As a registered nurse most of what I study I cannot mention- silence is somewhat comforting yet it is awkward.

and I have a limitation on what I can talk about in terms of something like bear root, osha, la Medicina de oso. Yet occasionally i am able to weave and spin it in it helps that many of the patients in the hospital are Latinos and they have in their heritage the use of these plants, like estafiate, osha,

yerba mansa, oregano del campo, and in general people have a hunger and desire to connect with place and herbs and plants of the bioregion tie in with this desire all of us have to belong. 

   Lately, over the last several years I have had some good experiences and reactions in mentioning some of the herbs and plants that have been used traditionally in our bioregion with the patients at the hospital that I work. I would say nearly in every instance there's been positive feedback and often times they mention a relative, a tia, an abuela, someone in their family who has used herbs. My intention is to empower someone with their own ethnicity. So that they can have some confidence, some point of reference where they can be themselves.

   I am glad that my mentioning of Latino herbalism goes to good effect. So for that I am very happy both among the people that I work and the patients that I treat. they have a positive regard for the herbs. It's good to see and experience that. Yet there is a clandestine, secret quality to this communication. Which i have come to see as necessary to the process.

    So I may speak but I cannot tell anyone that I've spoken. Yet I am speaking and getting good reaction, good reactions to my little talks here and there. We have a holistic health but not that holistic. Likewise in the community where I live similar blocks to communication occur. Based on race and ethnicity,  based on the transient quality of living in Phoenix Arizona. Phoenix Arizona is a city that is very young. It's vast and very fluid, it came out of nowhere and the disconnectedness is one thing that pervades life in this big southwestern American city.

    I am sure that there are curanderas, yerberas, abuelas, who i could make trips to the mountains with to gather herbs here. It would be amazing and wonderful yet it is a slow process.

 I live in the barrio Central, Primero Calle, for 10 years in the same place,

there is a 'tortilla curtain', yet as a neighbor told me, "Donde hay una cortina también es una ventana.", where there's a curtain there's also a window.

    Among herbalists there are   groupings among age, sex, and economics cohorts and ethnicity  although it's different it still has the feel of a club. It's part of the process and not an obstacle.

     

Whenever such a constellation  occurs it can often make it a challenge yet overcoming challenges and obstacles is essentially the path that I am on at this time. It helps to remember that herbs, healing and love belong only to those who use them. 

     i open to change growth and development. i continue my Studies as best I can within the understood parameters of silence and share  them with anyone willing to receive. I am moving on in the best way that I can using available tools.  I accept  the situation that I'm in I created because I created it and I can re-create it or perhaps uncreate it. I only seek to be someone who can better explain the herbs and plants. Someone who is open. Someone who can make available the plant teachings and speak for the plants. Yet I know I can't be anyone else so I work with what I have in the way that I can given the situation that I'm in. 

     i hope that someone else may one day say as I did to my teacher, "“Because of you John I saw the Anenome bloom, the tuberosa. I tasted it, I drank it every night from my tincture I made. The tincture you taught me to make. I saw the ocotillo, and heard her story, I looked I listened. I felt and tasted. This was what I needed to do.I listened to the desert willow, and I listened to you talk about the desert willow. And what you said was the same as what the desert willow said. As Gary Snyder said, we must be in a circle, able to be their representatives in the council of beings. We must be their voice, and we must hear their voice, what ever it’s saying. This takes courage to speak for those whose voices may be whispers. The world is a world of yelling and screaming. These things are soft… I think one thing you taught me John was to establish the importance of context; the person, the plant and the place…. I am proud to say you were my teacher. You are my teacher and you taught me how to have the plants be my teacher so I could listen again. I don’t know if anyone else had this experience in the class. I’m sure they did, it will come up for them in some way. They were beautiful gifted people who attended the program. I can’t look in any direction without seeing their eyes, and their faces and I am grateful for having met them.”   – Paul

     

     As I read over what I have written I realize that some of this has to do with the time of the year that we are in autumn/winter. Autumn is the time we reflect over the year and the things that we've done and the places we've been. 

    This time of the year is when we go to the roots. We go to the mountains and we harvest the roots. It is also the time when we nourish our own

In the spring and summer The energy of the plant is thinking of seeds and leaves the energy is moving from the

earth to the sky this is called the upward moving energy. You can see it in the osha, Ligusticum porteri,  how the leaves turn to yellow. You can feel the medicine going deep into the earth and taking with the night sky in the coolness of the evening. when you harvest the roots they are specially fragrant with licorice, carrot, celery and energetically it's a warm hot clearing medicine. I was washing the mud off the roots in the black river, several miles from where I had harvested them, and I could see just the oils rising to the top of the water and my hand stayed sticky with the oils of the osha  for several days.

    Now in Autumn we have the opposite, we have the downward moving energy, the energy now comes from sky, from the Milky Way, from the stars and from the moon and moves into the earth and the spiritual and chemical energy of the plant moves into the roots

For this reason the herbalist calls the Autumn,  The time to find the roots. And we call this time of the year the full moon for gathering roots or Root-moon.

    This time of year when the maple, Acer is red and osha, Ligusticum porteri  is brown,  aspen is yellow,

pedicularis is black.

The water of the Black River is not muddy, it's milky

    Now as a bioregional herbalist i have no problems praying on my knees to Mary the mother of God, some may know her as Queen of heaven and earth. I see her as the keeper of the plants. And in my understanding of the virgin of Guadalupe, it is she who's brought the medicine to the people. When I say a rosary I always enjoy the fifth glorious mystery, when I meditate on Mary as the woman crowned  in heaven with stars, the moon below her feet. Several times when I went alone up to the mountains to pray, at night when I was praying and searching for a vision  I could see the Virgin Mary in the Milky Way and around me at my feet was Artemesia estafiate. I realized that Mary and the healing plants are the remedy for the anger that I was facing. And also in the studies I was doing with John he talked of anger and the liver and how they are connected and in my vision of the Virgin Mary on the mountain when I was praying she confirmed that to me. She also communicated to me that she was just not the Mary in the church. She is not the Mary who is the statue made of wood or plaster. She is a living Mary who works with living things. She is Mary of medicinal plants. She wants to heal people with the plants and she wants to have people have gardens and grow plants. She said for us to say the rosary and I kept hoping that by now I could've found a woman who felt the same way and we could say the rosary together. And we could go to the mountains and gather plants. I had a kind of opening or vision about finding this woman who I could attend church  on Sunday and maybe open an herb store. It was like a dream that you get when you're praying all night long with the drum or with the rattle. One time Mary said to me I will show you the plants, I'll show you the plants with my rosary. So sometimes I will say the rosary for a while and then place my rosary on the plant and Mary the mother of God will usually show me something about the energetics of the plant and how it can be used as medicine.

. 

Nuestra Señora de Los Remedios, and others as Nuestra Señora de Guadalupe.   

For me Mary is the spiritual force that guides me in herbal medicine. I base this on my personal faith in the Virgin Mary to lead me to medicinal plants in the sky islands and deserts of Southwest Arizona.We are today still working with the person, the plant, and most importantly the place.

    One of the main tasks of the herbalist is to facilitate miracles, to make room for good things to happen. We are in no way different then our great San Juan Diego.

500 years ago our lady came and told him what he needed to know. She told him there was no need to worry. Besides speaking directly to him as she still does, she also communicated to him that she is in charge of the plants and medicine, and the removing of suffering. She said,

"Go to the top of the hill, to where you saw me and received my directions and you will find different kinds of flowers. Cut them, gather them, put them all together, then come down here and bring them before me." So I follow that advice of the Virgin of Guadalupe given to Saint Juan Diego and I go to the mountains and I gather the flowers and the roots. I find a way to place them before her and ask that people can use these plants as medicine to get well.

....and I put them altogether.., then I bring them down here....and I  make medicine with them that I can give to people suffering and help them get better. Living in America 2016 it's not so much the herbs alone that keep me going as the spiritual force of the mother invested and found in place. Lately I have been involving the angels, Saints, Mary and positive intention in my practice. I'm not sure exactly how this will go but I feel this is the way that I am being lead and I have confidence that the healing we need most today is a spiritual healing. A holistic healing with the herbs and plants of the bioregion and a spiritual cleansing or limpia. Without the three things, faith hope and charity, it's very easy for disease and illness to come back into the body. 

     So this is part of how i got through the plants. I bring the plants that i have used that we will use, i bring them before the Virgin Mary and the mother of God. I offer and communicate to the plants through the virgin. 

    Very often you may see an herbalist with a rosary and a magnifying glass. You may see an herbalist making the sign of the cross and dropping yerba santa into the salt River.

    I seek out the boundaries of places,

I look for saguaro  cactus,  Carnegiea gigantea, when it grows at the highest place. Or Torote, Bursera microphylla, at its northern most range.  

 look for the limits,  for how far things can go. go to the edge and then stand at the center in the middle balanced. acknowledge the natural world and the spiritual world. The sacredness of crossing the river. The absolute necessity of dancing, the therapeutic nature of sadnesses. I am not afraid to take refuge with the kings and queens of old Spain, of Europe, and say the stations of the cross. There is no escape in the present. in the same way i acknowledge the bear dance of the Ute. What ever i have come across is part of my arrival, part of the journey to health. For us it makes no difference that Our Lady of Guadalupe came and brought flowers. I gather flowers in summer and dig roots in Autumn. That is the herbal season.

After all we study flowers and group them by their ovaries.

i acknowledge the sexuality of flowers. i know  trees are male and female. i study in schools that have no rooms, or schools of mountains. i study flowers. And when i think of the mountains for us as poets of herbalism we have no problem with mountains constantly walking. 

     i am comfortable with science and i am comfortable with stories. i enjoy to sit and listen to stories, then later we will sit around the fire and tell stories stories that we have heard. And sometimes the storytellers become the story. When i see cactus explode with lightning or small medicine deer

dancing, sometimes the deer will dance with the skunk and i will see them as friends. We as bioregional herbalists listen to the skunks. i may sit with them and ask them questions. Really I have to sit more with the skunk and squirrels and listen to their stories more because that is the way to learn herbal medicine in this bioregion. Just like i may use a computer or a chainsaw, or a knife or a digging stick. The difference, and the distance between the distance of the difference is crucial.

For I seek to tell the story of the plant from the perspective of the walking Mountain.

i investigate the story of the medicine from the perspective of the skunk in fields of Yerba Santa.

   Yes ..pleasant dream.. Beautiful lady with auburn hair, in your eyes I see clouds down the back of your neck icy rain, in the folds of your armpits I smell medicine plants, I smell osha  and wild licorice,

the spiciness of yerba mansa runs down along the front of your body, your legs are strong because you support all the plants and animals of deer house, and from your ears i hear the songs of the canyon wren, red tailed hawk are your crown. 

     

     Nuestra Señora de los Remedios. I connect herbal medicine faith, hope and charity in the ability of God to cure illness.

It is very important that i view the plant medicines that we use as coming from Creator. 

You bring us, you bring to me the medicine of the mountains, the medicine of saguaro desert, with ocotillo,  mallow and brittlebush, so i am grateful

when  your voice is clear like the scent of piñon pine, in the desert pine with citrus peel, torote elephant tree,

all these prayers that i say are the plant medicine you give. When i as a bioregional  herbalist study with my teachers i bring your scapularios y medals for Milagros, miracles . Botany y rosaries, for me it's no different that your benediction is of skunks and toads, st john's wart and lobelia, poleo mint and skullcap.

Keep me going on this medicine road, you are Osha Chuchupate.

You are Mary the mother of God. You are our Savior's mother. You bring us so many good things. You show us the way to Sierra Ancha, 

you Open the door to the deer house, you bring us good ocotillo medicine for the heart,

you bring us the feathery Solomon seal, 

osha and aralia, Yerba Santa and Torote, Saguaro fruit. 

our holy Mary protected us...Nuestra Señora de Los Remedios

You have many names Mary. Whatever name we use you answer us because you love us. You are my lover because in my heart you have planted the seed for the flowers, the roots and seeds. In my heart you have placed the Lily. The feathery Solomon seal, to make me strong, when you call me to the mountains.

And do call me to the mountains, if you call me i will go, wherever medicine grows iwill go. i go in your name so remember me. I will not leave behind the rosary with the crucifix because you walk with me and you hold my hand and show me all the medicine plants I need to know. I remember one night alone on the mountain when I was praying you told me to bring the rosary and that through the rosary you would show me the plants i needed to know and even though I was alone someday there would be people and this too would probably come from you and I give thanks for that. 

You have brought us all the plants,

 all the animals, and you're blessed son Jesus, he is with us true true
Our Holy divine perfect Mother, with the moon shining..
.the stars a road 

from here to tomorrow..
.far beyond this way...with the wind blowing...Changing Woman Nahasdan Nadle', 

Sash nadle, 

Beautiful bear woman,

Turquoise Woman..
Leading us on the Corn pollen road...
Look at the stars the Milky way, Corn Pollen road...

past the red slick rock mountain singing...
 our house is the Changing Woman...
Cedar from up on the Bear's Ears mountain...

Sash Cedar moutain song..
.way up following the stars, the snow is falling. The snow is falling, the clouds are coming the rain is falling the clouds are moving quickly across the sky,
stay asleep a a little longer sash, 

Wait for the zigzag lightning to come back in the spring time, sleep sleep

,
when you wake you"ll tell us about the spring flowers and new grass...tell us about the bear medicine, osha 

When you wake up in the spring time dance, show us where the osha root grows,

La Medicina del oso.

Take me to the Black River

Yes ..pleasant dream..our holy Mary

Show me many things

Show me the ocotillo medicine,

Take me to where Yerba mansa grows

Bring me strong Yerba mansa medicine so i can help others love you more

And the Torote tree and copal resin

protected us...

with Yerba santa 

Our Holy divine perfect Mother, with the moon shining..
.the stars a road from here to tomorrow..
.far beyond this way...with the wind blowing...Changing Woman Nahasdan Nadle', Changing woman, Turquoise Woman..
Leading us on the Corn pollen road...
Look at the stars the Milky way, Corn Pollen road...
past the red slick rock mountain singing...
Our hogan is the Changing Woman...
Cedar from up on the Bear mountain...
Sash Cedar moutain song..
.way up following the stars, the snow is falling. 
stay asleep a a little longer sash, 
when you wake you"ll tell us about the spring flowers

and new grass...
Changing Woman, you are mother Mother...you belong to yourself...
You bless everyone always...
Black Obsidian woman moving from Natsin'an Navajo mountain to Dok'ad'slid-to Flagstaff, 
you're bringing us snow...
you're teaching songs, dropping like falling stars silent across the sky...

some day we will remember there is one mother blessings! always

Changing Woman, you are mother Mother...you belong to yourself...
You bless everyone always...
Black Obsidian woman moving from Natsin'an Navajo mountain to Dok'ad'slid-to Flagstaff, 

you're bringing us snow...
you're teaching songs, dropping like falling stars silent across the sky...

some day we will remember there is one mother blessings!always good medicine