A Herbal First Aid Kit 

BRUISING

Bruises are where trauma to tissues causes bleeding underneath the skin. They often take time to appear and can be more prevalent in the elderly or those on anti-coagulant (blood-thinning) medication. Usually, bruises will clear up themselves but you can aid healing with external herbal applications such as arnica (Arnica montana), St. John's wort (Hypericum perforatum), elder leaf (Sambucus nigra), or witch hazel (Hamamelis virginiana) oils and ointments.

It is important to note that large bruises can, in rare cases, cause clots which can be dangerous. If a bruise takes up a large area, e.g. an entire thigh, are extremely painful or are slow to disappear, seek medical help.

BURNS AND SCALDS

Burns can be caused by dry heat, e.g. catching skin on an oven or iron, whereas scalds are caused by wet heat, e.g. steam from a pot or by getting into an too-hot bath.  

Ensure you can identify different types of burns and what to do in each case, as minor burns can be easily treated at home but it is vital to understand when hospital treatment is needed. Deep burns can turn nasty quickly, leading to bad scarring at best, and serious infection at worst.

Steps to treat burns include removing the person away from the heat source and stabilising and cooling the affected area. Run cold or lukewarm water over the area for at least 20 minutes. Guides on how to treat burns can be found at:

●      https://www.nhs.uk/conditions/burns-and-scalds/

●      https://www.sja.org.uk/get-advice/first-aid-advice/effects-of-heat-and-cold/burns-and-scalds/

Types of burns:

Superficial burns e.g. sunburn. This can be treated simply by applying cucumber slices or Aloe vera gel, either a shop-bought one or the fresh plant juice from the centre of a fresh leaf.

An effective sunburn and burns ointment can be made using 50 ml Aloe Vera gel (shop bought), 10 ml of St. John's wort and/or calendula infused oil mix, and lavender (Lavandula officinalis) essential oil. To the 60ml mix of ointment, you can add up to 6ml of lavender essential oil. (In children only add 1ml of lavender essential oil). 

Medium thickness burns e.g. an oven burn, apply lavender essential oil directly to the burn (after you have gone through the cold water process). Cover the burn with a non-stick dressing to prevent infection. In very small burns there’s no need to do this. Apply the aloe ointment (recipe above) or a drop of lavender EO neat to the burn daily.  In very sensitive skins and young children, you may need to dilute the lavender with a drop of olive oil for every drop of lavender essential oil.

Third degree burns, where the deep tissue can be seen through the burn need immediate treatment at a doctor or hospital. Follow a first aid guide on treating these on the way to hospital. 

All chemical and electrical burns also require hospital treatment due to the potential for complicated side effects.  

CUTS AND WOUNDS

Follow first aid instructions to stop the bleeding.

In the case of small cuts where stitches are not needed, or you are going to apply butterfly stitches at home, you can apply strong antimicrobial tinctures to the wound to ensure it heals with no infection inside, e.g 3 parts 90% strength calendula (Calendula officinalis) to 1 part myrrh (Commiphora myrrha). Place these in a spray bottle for application to the area. Calendula is a useful wound healer as it helps tissue granulation, i.e. the ability the tissue can form a scab and heal (Or Givol et al., 2019)

Yarrow (Achillea millefolium), plantain (Plantago spp.), St. John's wort (Hypericum perforatum) and calendula are the most common go-to wound healers. They can be used as washes, poultices or compresses using fresh plant material, infusions, decoctions or tinctures.  For quick application, ready-made ointments and creams are ideal. 

There are many other herbs used for wound healing including self-heal (Prunella vulgaris), Gotu-Kola (Centella asiatica) but there is little room to discuss them all here. This knowledge will build up over the coming years. An overview review article can be found in the reference list (Maver et al., 2015).

Antimicrobials for preventing infection are also called for. Myrrh, a powerfully antimicrobial resin, sterilises wounds and leaves a sticky protective barrier to prevent further infection.  Essential oils such as lavender (Lavandula spp.), thyme (Thymus vulgaris), oregano (Origanum vulgare), eucalyptus (Eucalyptus spp.) etc. can also be added to balms and creams as effective anti-infectives.

If needed, dress the cut with a non-stick covering to prevent contamination and reopening until they are at least partially healed. Once safe, it is best to let wounds 'breathe' and heal where appropriate.

Although comfrey (Symphytum officinale) is a well known tissue healer, it can be too fast acting when used with deep wounds: causing the top to heal over before the base which can lead to infection and abscess. Comfrey is best used only on shallow grazes. Also see the section on sprains, strains, bruises and broken bones.

BOILS AND ABSCESSES

Deep boils and small abscesses are traditionally treated internally with tincture of burdock (Arctium lappa) due to its blood cleansing, alterative properties. Echinacea (Echinacea spp.) is also invaluable here. Treat externally using a drawing ointment to bring the problem to a 'head' (see recipe in splinters section).

RASHES

Itchy rashes with a known cause, such as eczema, dermatitis and chickenpox can have symptomatic relief using topical herbs (alongside other herbal treatments for the underlying cause). 

The fresh juice or fresh infused oil of Chickweed (Stellaria media) is a key herb for soothing itchy rashes. Porridge oats (Avena sativa) can be placed in a thin sock, the chopped off foot of a pair of tights or a muslin and tied into a parcel. Soak this package in hot water, allowing the mucilages (gloopy liquid) to come out. Smoothe the compress over itchy areas. It also makes a great wash/barrier cream for regular use for those with eczema or dry skin. Other mucilaginous herbs such as Marshmallow root (Althaea officinalis) or psyllium husk (Plantago ovata) could also be used but are not so straightforward.

Learn to recognise the signs of dangerous rashes such as those associated with measles and meningitis.

INFECTED WOUNDS

If a wound has become mildly infected, the herbal approach is to treat the infection both internally and externally. Topical anti-infectives alone are of little use if the infection goes deeper. Therefore, internal herbs are required to support the immune system and help prevent infections becoming systemic at which point antibiotics would be required. However, this is usually a rare occurrence.

Internally, herbs are used that fight infection through stimulating and/or supporting the body's own immune system.  A mixture of echinacea (Echinacea sp.), burdock (Arctium lappa), elderberry (Sambucus nigra), cleavers (Galium aperine) and thyme (Thymus vulgaris) tincture is helpful here.

Externally, a tincture of wound healers such as calendula (Calendula officinalis) combined with a strong antimicrobial such as myrrh (Commiphora myrrha) can be applied frequently. For an extra boost, add a few drops of thyme (Thymus vulgaris), lavender (Lavandula officinalis) and oregano (Origanum vulgare) essential oil to the tincture. The mixture should be well-shaken before each use.

If the infection does not clear in three or four days seek advice from a medical herbalist or visit a walk-in clinic. Research symptoms of serious infection such as ‘tracking’ to recognise when you should go to the hospital.

INSECT  BITES AND STINGS

Insect bites cause a wound with added irritation and itchiness. This calls for wound healers with anti-inflammatory as well as anti-allergic properties. Key herbs include plantain (Plantago spp.) or St. John's wort (Hypericum perforatum) used externally as a poultice, tincture, ointment or balm.

Bee stings need removing before treatment, but for both bee and wasp stings plantain  is especially useful used externally as a fresh poultice or ointment. 

For all the above, internal treatment is also advised. Herbs that can modulate the allergy responses such as plantain, nettle (Urtica dioica), elderflower (Sambucus nigra) can be taken in infusions or tinctures.

Ephedra sinensis, a schedule 20 herb, is a herb trained medical herbalists use to reduce strong allergic reactions. It is not recommended that you seek to use ephedra as a treatment at this stage, but it can be obtained from a medical herbalist after consultation if you have a problem with allergic response and would like to explore preventative herbs. 

In cases of anaphylaxis or known risk of anaphylaxis shock, urgent medical help should be sought.

SPRAINS, STRAINS AND BROKEN BONES

A sprain involves damage to the ligament that attaches two bones together, and a strain is damage to the tendon that attaches a muscle to a bone. Herbally, they are both treated in the same way. The conventional treatment for these is to remember the acronym RICE (rest, ice, compression and elevate) but you can also use heat instead of cold, whichever feels more comfortable for the patient.  Broken bones need medical attention first to ensure correct resetting, but can be treated with herbs post-trauma.

Comfrey (Symphytum officinale and other species) leaf and root  is the key indicated herb for these issues. Another common name for comfrey is knitbone because of its ability to help mend broken bones and tissues strongly and swiftly. This traditional use has been borne out by scientific research which shows that a compound, allantoin, increases the rate at which tissue cells proliferate during the healing phase (Barbakadze et al., 2009; Araujo et al., 2012). St. John's wort (Hypericum perforatum) horse chestnut leaf or seed (Aesculus hippocastanum), elder leaf (Sambucus nigra), arnica (Arnica montana), and daisy (Bellis perennis) are also useful herbs for topically reducing bruising, swelling and encouraging circulation to the area. All are usually applied as ointments.

One way of treating a sprain or strain is to apply comfrey ointment thickly to the affected area. Leave the ointment on and soak the body part (e.g an ankle) in a bowl of water that is as hot as can be borne without causing pain. Leave in the hot water for up to 30 minutes, changing or adding to the bowl with fresh hot water to maintain the temperature. Clean the ankle, reapply the comfrey, dress in a support bandage and elevate. Repeat the application of the ointment twice daily, and use the foot bath method every few days for a week.

A famous (in the herbal world) and great all round ointment for sprains, strains and broken bones was created by Dedj Leibbrandt called ‘Dedj’s Duck Poo’. It is made using 250 ml comfrey leaf or root infused oil, 25g beeswax, 100 ml arnica tincture and 100 ml of wintergreen (Gaultheria procumbens) essential oil. The comfrey oil and beeswax should be melted in a double boiler together, then taken from the heat and the essential oil and tincture whisked in briskly until a froth appears on the surface and it cools to 50 degrees celsius.

Instead of arnica, elder leaf or daisy tincture can be substituted in and instead of wintergreen, sweet birch (Betula lenta) essential oil can be substituted. These are both more local and cost effective. 

Wintergreen and sweet birch are both high in anti-inflammatory and pain-relieving methyl salicylate (avoid these essential oils in salicylate sensitivity). Though normally essential oils are only added to a ratio of 1-2% in a mixture, much more is able to be used in this recipe.

In the past, (and therefore you may come across this in older texts), herbalists would treat broken bones internally with decoctions or tinctures of comfrey root and leaf. However, this is no longer recommended due to concerns over its content of potentially hepato-toxic (liver-damaging) compounds called pyrrolizidine alkaloids (Evans et al., 2018; Frost et al., 2014) though this is hotly debated in the herbal world. However, external treatment with comfrey is very effective and so internal treatment is best supported using mineral-rich overnight infusions with horsetail (Equisetum arvense) and nettle (Urtica dioica) which contain bone building blocks such as silica and calcium. For the pain, infusions of oak bark or meadowsweet can also be used.

EARACHE

A drop of the herbal infused oil of Mullein (Verbascum thapsus) and/or St John’s wort (Hypericum perforatum) can be placed in the ear and some more massaged around the ear to help sooth pain.

ANXIETY/PANIC ATTACKS

This isn’t always covered in first aid but it’s an area where herbs can really help in what feels like a crisis. 

A small bottle of equal parts skullcap (Scutellaria lateriflora), passionflower (Passiflora incarnata) and lemon balm (Melissa officinalis) can be used for those suffering acute anxiety attacks. Give 5 to 10 drops at a time under the tongue or diluted in a little milk or water. Repeat every half hour until the patient feels better. This mix is not only highly effective but should not interact with other medications so is safe to give a stranger regardless of what they may be taking.  

Other helpful remedies include rose or orange flower water which the patient can use as a facial spray whilst they take deep calming breaths, and is especially useful if they recognise early signs of an approaching attack. This can be used as often as needed.  

The American herbalist 7song advocates the use of a drop of pulsatilla tincture under the tongue (Sevensong, 2005). However, this is a restricted herb (Schedule 20) and is not obtainable except by qualified herbalists or by prescription.

MOUTH ULCERS

Mouth ulcers can be a sign of a depressed immune system so if they are a frequent occurrence, especially if you have more than two at once we recommend seeing a medical herbalist.

Any astringent (drying, toning) herb that also has antibacterial properties can be used as a gargle to treat a mouth ulcer. E.g. Sage (Salvia officinalis), willow bark (Salix alba and other species), and blackberry leaf bud (Rubus fruticosus) either as a tea or tincture. Sip a small amount of the tea or tincture and allow it to sit in the affected area for as long as possible. Spit out the herbal mixture afterwards. Continue this several times a day.

Myrrh (Commiphora myrrha) and calendula (Calendula officinalis) tincture is also effective. Myrrh not only is powerfully antiseptic, but also protects the area by creating a resinous barrier, helping the tissue have a better chance to heal.  Equal parts of each tincture can be kept in a small bottle and a little dabbed on (it will sting so not for the faint hearted) or mix 1 teaspoon (5 ml) in 25-50 ml water and use as a mouth wash. 

A dab of clove (Syzygium aromaticum) essential oil or tincture can also help numb painful ulcers (see also the toothache section).

TOOTHACHE

A dab of clove (Syzygium aromaticum) or cardamom (Elettaria cardamomum) tincture or clove essential oil applied to the affected area can help reduce pain and infection.  Clove and cardamom contain eugenol, a powerful topical analgesic (pain-killer) which helps numb painful tooth and gums infections (Kamatou et al., 2012). If the pain and infection do not clear up, see an emergency dentist.

Using clove essential oil is only suitable for older children and adults. For teething babies, a cloth soaked in german chamomile (Matricaria chamomilla) infusion and then frozen makes an effective and soothing chew. Weak chamomile tea can also be given to drink. Diluted lavender essential oil rubbed on the outer cheek can also help to alleviate pain, redness and inflammation.  

SORE THROAT

Hot, inflamed throats are best treated with cooling, soothing anti-inflammatory herbs. As they are usually caused by viral or bacterial infections, immune modulating herbs such as Echinacea or elderberry (Sambucus nigra) are called for.

To soothe the symptomatic pain, a spray bottle with tinctures of Echinacea angustifolia root (because it contains the highest amount of alkylamides, a numbing, tingling chemical), sage (Salvia officinalis), a couple drops of clove essential oil and a little honey can work wonders. Shake well before use and pump a couple of sprays onto the back of the throat.

Herbal gargles of astringent (drying and toning) herbs are also called for including sage (Salvia officinalis), as well as many members of the rose family such as Rose (Rosa sp.), blackberry leaf (Rubus fruticosus), strawberry leaf (Fragaria vesca) and agrimony (Agrimonia eupatoria). Some practitioners like stronger approaches such as gargles with diluted fire cider but this depends on the willingness of the patient and should be avoided in children. 

Blackcurrant (Ribes nigrum) fruit cordial diluted in hot water was valued by the early 20th century herbalist, Maude Grieve and is more palatable for children.

INSOMNIA

We’ve included sleep within first aid as it’s often something we get asked when teaching the subject.

The treatment of poor sleep is complex as there are lots of reasons someone may not be able to sleep. A herbalist will investigate the cause such as anxiety, stress, poor digestion, medication etc. and seek to treat that alongside giving herbs to induce sleep.

For a lot of people the reason they can’t get to sleep is because they are unable to relax, and their ‘brain just won’t switch off’. This is very common with people leading very busy lives and constantly on the go.

Simple strategies are to first assess 'sleep hygiene' which includes switching off electronic screens a few hours before bedtime and avoiding working from the bedroom where possible (Sleep Foundation, 2020). Other herbal strategies could include taking a relaxing bath with soothing bath oils or using relaxing essential oils in burners.

Drinking a relaxing and mildly sedative herbal tea mix an hour before bed can also help. Useful infusion mixes could include some of the following: chamomile (Matricaria chamomilla), linden (Tilia sp., best used as a deep decoction), skullcap (Scutellaria lateriflora), lavender (Lavandula sp., just a pinch though, it can be bitter), rose (Rosa sp.), lemon balm (Melissa officinalis), passionflower (Passiflora incarnata) (singly or as a mixture). Valerian (Valeriana officinalis) and passiflora are effective sedatives, but in a rare few patients can act as stimulants, so it is worth testing them out first.

Some lavender essential oils can be stimulating so it is important to experiment with one you find relaxing. Some lavender producers say lavender oils with a higher ratio of lavandin and camphor can be stimulating. For relaxation, avoid lavandin oils and use a standard Lavandula officinalis instead as this has been shown to be effective at aiding sleep quality (Fismer & Pilkington, 2012).

If poor sleep continues visit a medical herbalist for more individualised prescriptions.

SPLINTERS

If a splinter or thorn has gone into the flesh and won’t come out, you can use a traditional herbal 'drawing' poultice to gently coax it out. 

Mix together a tsp of a herbal ointment e.g. a wound healing calendula (Calendula officinalis), plantain (Plantago  sp.), St. John's wort (Hypericum perforatum) or comfrey (Symphytum officinale), and 1/2 tsp of mucilaginous (gloopy) herbal powder, e.g. slippery elm (Ulmus rubra syn. fulva), marshmallow (Althaea officinalis), or a very astringent one such as oak bark (Quercus spp.). 

Apply the paste over the splinter and cover with a plaster so that no air can get to the mixture. Leave overnight, scrape off the paste in the morning and attempt to remove the splinter again. The process can be repeated several times if needed.

Caution: mix up the paste as needed, it cannot be kept mixed together in a jar as it will grow moulds and bacteria that could introduce infection into the wound.

DIARRHOEA

Diarrhoea is the body’s way of removing pathogens from the digestive system, e.g. parasites, bacteria, etc. The best thing to do is allow it to run its course rather than stopping the elimination with anti-diarrheal medication e.g. immodium (or the herbal equivalent).   However, it can be something that herbs can help control as recovery happens. If you have diarrhoea it is important that you stay home to prevent spreading it incase it is contagious.

In case of severe diarrhoea or in the case of babies, the very young, elderly or sick then seek advice from a doctor.  More information can be found at https://www.nhs.uk/conditions/diarrhoea-and-vomiting/

Remember to check for blood in the diarrhoea, as blood in stools mean a patient should seek medical advice to rule out anything more serious.

Drinking plenty of fluids is tehe key first step in diarrhoea, both water and in herbal infusions. Herbal astringents are indicated here to tone the digestive tract, prevent it from leaking fluids and dry up excess secretrions. Decoctions of oak bark (Quercus spp.) or infusions of agrimony (Agrimonia eupatoria), or bramble leaf/flower buds (Rubus fruticosus) are good herbs to have on hand. These should be mixed with soothing digestive tonics and antimicrobials such as Roman chamomile (Chamaemelum nobile), yarrow (Achillea millefolium), meadowsweet (Filipendula ulmaria), thyme (Thymus vulgaris) as well as soothing herbs such as marshmallow (Althaea officinalis) or slippery elm (Ulmus fulva), the latter would be taken seperately form the main infusion. 

In a tight situation where no herbs are available, 3-5 black tea bags can be used. Place them in a mug and cover with boiling water. Allow to steep for 5 minutes, then discard the water. This will remove the easily extracted caffeine. Cover the same teabags with boiling water again and infuse for another 5 minutes. This is helpful because tea (Camellia sinensis) is high in astringent tannins which help dry and tone the digestive tract. 

Preventing dehydration/ actively supporting rehydration is important in diarrhoea cases to replace lost electrolytes for proper cell function. A homemade rehydration drink can be bought from a chemist or made at home by adding 6 level teaspoons of sugar, 1/2 teaspoon of salt mixed well into 1 litre of water. This liquid should be sipped frequently. 

If a patient has frequently occuring loose bowel movements as part of their 'normal' pattern of digestion (i.e. chronic rather than acute) then this is possibly a sign of IBS or food intolerance and you should seek the advice of a medical herbalist or a GP.

In the case of babies and children, seek medical advice. 

CONSTIPATION AND BLOATING

Constipation can have many causes but most often may be down simply to dehydration and lack of dietary fibre. Certain medications and supplements can also cause slow digestion resulting in constipation, these include iron, diazepam and opioids. 

The first step to approaching constipation is to ensure adequate water and fibre intake. One of the most effective remedies is warmed prune juice (Prunus domestica).

Commonly available herbal laxatives may sound useful but check their Ingredients. Regular use of irritant laxatives like senna (Senna sp. syn. Cassia senna), except in urgent circumstances can be detrimental. These contain stimulating constituents that cause expulsion of gut contents. Whilst natural, over-reliance can further weaken bowel function and make constipation worse over time so should only be used in emergency situations, and never in babies. 

Bulk laxatives are the preferred method for easing constipation. These bulk out and moisten stools using water soluble, mucilaginous (gloopy) and fibrous materials. Herbs include Psyllium husk (Plantago ovata), slippery elm (Ulmus fulva),  marshmallow root (Althaea officinalis), flax or chia seeds, they are all mixed with water to create a gloopy, moistening mixture. They are best taken first thing in the morning, last thing at night and 30 minutes before eating.  Avoid taking within an hour of medication as they can coat the digestive tract and prevent drug absorption.

Herbs that can ease digestion are often high in essential oils e.g. fennel (Foeniculum vulgare), yarrow (Achillea millefolium), chamomile (Roman chamomile, Chamaemelum nobile, is more bitter and ideal for digestive upsets, whereas German chamomile, Matricaria chamomilla  is more mild and soothing as a general tonic), peppermint (Mentha spp.), aniseed (Pimpinella anisum), and angelica (Angelica archangelica) amongst others. These essential oils are mildly stimulating, carminative (reduce bloating) and antimicrobial where the cause may have been due to bad food. Garlic can also help ease constipation.

If you experience constipation and you have not had a bowel movement in 7 days, seek medical assistance. This is essential to check there is no bowel obstruction.  Regular constipation may indicate food intolerances.