Intestinal worm infestation.

Diagnosis of intestinal worms is made by discovery of eggs in microscopic stool analysis. Other indications may be iron deficiency anaemia and hypoproteinaemia if the infection is particularly heavy. (Kumar & Clark, 2002, p. 114)

Short-term aims are to prevent further contamination and re-infection.

Longer-term aims are to kill and eliminate the existing parasites whilst decreasing intestinal transit time in order to minimise the chances of dislodged parasites re-adhering to the intestinal wall. Also, decreased intestinal transit time will help minimise absorption of toxic products of either live or dead decaying parasites.

Phytotherapeutics, their Actions and Therapeutic Ranges:

• Andrographis - Anthelmintic, anti-inflammatory, antioxidant, antiplatelet, antipyretic, bitter tonic, choleretic, hepatoprotective, immune enhancing. (Bone, 2003, p. 65)

Range: 20-40 ml/wk of a 1:2 tincture in 45% ethanol. (Bone, 2003, p. 476)

• Wormwood - Anthelmintic, antiparasitic, bitter tonic. (Bone, 2003, p. 469)

Range: 5-20 ml/wk of a 1:5 tincture in 45% ethanol. (Bone, 2003, p. 480)

• Cascara sagrada - Laxative. (Bone, 2003, p. 127)

Range: 20-55 ml/wk of a 1:2 tincture in 25% ethanol. (Bone, 2003, p. 476)

• Gentian - Anti-inflammatory, bitter tonic, cholagogue, digestive stimulant, sialagogue. (Bone, 2003, p. 224) (Mills, 1994. p. 104)

Range: 5-15 ml/wk of a 1:2 tincture in 45% ethanol. (Bone, 2003, p. 476)

Synergistic compounding:

Both Andrographis and Wormwood have anthelmintic properties, so both will assist in eliminating worms from the body. Andrographis is also hepatoprotective, so will assist in protecting the liver from toxins released from the parasites decaying and releasing toxins in the intestines prior to their excretion from the body. It is also choleretic, so will stimulate the production of additional bile, working synergistically with Gentian, which has a cholagogue action. Additionally, Andrographis is antioxidant, which will help protect tissue against the toxic by-products of worms. Also, it is immune enhancing which will help the body defend itself against further infestation. (Bone, 2003, p. 65, 187 & 469)

Cascara sagrada decreases intestinal transit time by stimulating intestinal motility and fluid accumulation. (Bone, 2003, p. 129). Gentian works synergistically by stimulating the release of bile, thereby decreasing intestinal transit time via lubrication of the intestines. (Mills & Bone, 2000, p. 187) Gentian is also traditionally used in the treatment of intestinal worms. (Bone, 2003, p. 224). Both will work synergistically to minimise the time the decaying helminths have in the intestines.

Dosage: In this case the administration dosage will be 100 ml for one week, and will comprise the following:

• Andrographis - 40 ml
• Wormwood -  20 ml
• Cascara sagrada - 30 ml
• Gentian - 10 ml

Suggested daily dosage is 5 ml 3 times per day. Due to the warnings and precautions listed for wormwood, this dose will be for use in the short-term only, and the daily-recommended dose must not be exceeded.

I have chosen the maximum dosage of Andrographis as it is has many desired properties in addition to being anthelmintic, such as antioxidant, hepatoprotective, choleretic and immune enhancing. (Bone, 2003, p. 65)

I have also chosen the maximum dosage of Wormwood, as it has the important properties of being anthelmintic and antiparasitic. (Bone, 2003, p. 469)

I have chosen a mid-range dosage of Cascara sagrada as it is a powerful laxative, and too much stimulation may not be warranted. (Bone, 2003, p. 127)

I have chosen the maximum dosage of Gentian as, in addition to its above listed properties, it is a low dose herb, and its traditional use is in the treatment of worms. (Bone, 2003, p. 224)