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F lower essences and homeopathiccell salts are natural remedies com-monly used for the treatment of

various disorders, yet less is writtenabout them than conventional homeo-pathic remedies. This article will exam-ine both types of remedies.

Flower Essences: BackgroundThe British doctor, bacteriologist andhomeopath Edward Bach discoveredflower essences back in 1930. Bach'sinterest in developing this system ofmedicine was grounded in his experi-ence of both conventional medicineand of homeopathy. He described 38remedies elaborated with flowers andshoots, each one corresponding to anemotional pattern or a typical personali-ty. He also developed remedies foremergency situations.1 Flower essenceremedies are designed to be a systemof emotional healing. Put succinctly,flower essences are selected by or for apatient with the intent of addressingissues associated with that person's psy-che. Outcomes are achieved through

changes in attitude and awareness,resulting resolution of the physical man-ifestation of illness. Flower essences aresafe, do not appear to interfere withany other medication, and are dis-pensed in homeopathic dosages.2 Assuch, they are popularly thought to behomeopathic remedies—but that is notstrictly correct.

Homeopathy and FlowerEssencesAccording to an article published in theBritish Homeopathy Journal3 in 1999,homeopathy and flower essence reme-dies have similarity and differences.Regarding similarities, they’re both con-troversial, treat the patient (not the dis-ease), prescribed on the basis of aseries of symptoms, and utilize the self-healing vital force. The differences arethat homeopathy tends to be a morecomplicated healing system whereasflower essences are simpler, and home-opathy is more deeply acting asopposed to a mild, gentle healingresponse from flower essences. The

author of the article also indicated thathomeopathy and flower essences couldcomplement one another.

It might also be stated that anothercommonality is that, like homeopathy,there are those who think that floweressences are nothing more than place-bos.

Is it Real, Or is it a Placebo?Some health care professionals believethat any benefit from the use of floweressences is due to the placebo effect.4

Others have expressed uncertainty as towhy exactly flower essences are effec-tive.5 Nevertheless, there are a surpris-ing number of health care professionalswho have integrated the use of floweressences into their therapeutic regi-mens. For example, in a survey sent outto complementary/alternative medicineorganizations, respondents indicatedthat flower essence remedies were rec-ommended as suitable treatments forstress/anxiety.6 In fact, nine hospitals inAustralia have used the flower essencesin their complementary therapy practice

By Gene Bruno, MS, MHS, RH(AHG)— Huntington College of Health Sciences

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where patients were treated for stressand pain management.7 Perhaps thebest evidence of efficacy are case stud-ies and clinical studies, which have beenconducted on flower essences.

Case StudiesA published case study8 reported theresults of using flower essences onsleep patterns (i.e. sleep perceptionand objective sleep) and onmenopausal symptoms. The participantwas a 53-year-old woman, at the post-menopausal stage, who had been diag-nosed with insomnia according to thecriteria of the American Academy ofSleep Medicine and complained of cli-macteric symptoms. The patient under-went treatment with a flower essenceblend for four months. Based uponsleep questionnaires and polysomnog-raphy measurements, results showedthat both sleep perception and objec-tive sleep were improved. The patient'sanxiety and menopausal symptomswere also reduced after the treatment.

Another published report9 describedthe case of a 78-year-old man who suf-fered from multiple disorders, includingherpes zoster. The patient was treatedwith flower essence therapy. The resultof the treatment was a short recoverytime for the different disorders, and areduction in anxiety for the patient.

A case-study10 analysis was conductedto explore the potential of floweressence remedies as a means of painrelief. The results were that, of 384 sub-jects, 41 suffered pain. Of these, 46percent felt treatment had relieved theirpain; in 49 percent the physical out-come was unknown. About 88 percentof all subjects reported an improvementin their emotional outlook. Researchersconcluded that flower essence remediesbrought about positive emotionalchanges in the majority of subjects inthis study.

Clinical StudiesThis section will examine the results of adozen clinical studies on flower essenceremedies. This includes studies on phys-ical and emotional disorders, depres-sion, anxiety, environmental light stress,carpal tunnel syndrome, overdue preg-nancy, tantrums in children, and ADHD(attention deficit hyperactivity disorder)in children.

Physical and emotional disordersA 14-month study11 was conducted on a

group of patients who received floweressence treatment for various physicaland emotional disorders, in a primaryhealth care center from a nurse trainedin this therapy. Patients (n=119, 78.15percent female) were enrolled in thistherapy based on a request by themedical/nursing consultants treatingpatients or by a patient's own requestto participate. The time period betweenthe first and the last visit varied accord-ing to each case and the individual'spersonality. Four hundred and five visitstook place—an average of 3.4 perpatient. Results were that 87.4 percentof those patients who received treat-ment reported good or very goodresults. Researchers concluded thatflower essence therapy appeared to bea good alternative to psycho-pharma-ceuticals, showed efficacious resultswith fewer secondary effects, and lessthan 2 percent of patients evidencedgastric intolerance.

Depression: five studiesFive independent clinical studies12 wereconducted in which flower essenceswere used in the treatment of depres-sion. The results of these studies weremeasured using the Beck DepressionInventory (BDI) and the HamiltonDepression Scale (HAM-D). Therapistsin Cuba under the Cuban Ministry ofPublic Health conducted four of thestudies. The first study tracked about 50patients who completed therapy over aperiod of five months. The results werea significant reduction in depressivesymptoms. Twenty patients participatedin the second and third studies over atwo-month and three-month period.Results were that significant drops in

depression scores were noted duringthe first month, with further decreasesduring the second and third months.Both studies show reductions of the BDItotal score of 76-77 percent. The fourthstudy utilized 24 cases over a three-month period. Results showed signifi-cant decreases in depressions in thefirst two months, with stabilization at a60 to 80 percent reduction during thethird month. The fifth study took placein the United States, and included 12depressed subjects included a one-month baseline followed by threemonths of treatment that entailed usualcare along with flower essence therapy.Results showed a 50 percent reductionin depression scores when floweressence therapy was introduced. Thisclinical change was maintained over aperiod of three months.

Anxiety and depressionIn an open study,13 91 patients sufferingeither anxiety (including stress) ordepression were treated with floweressences. They were followed up withregular assessments over severalmonths (up to 16 for a proportion ofpatients) by therapists and outcomeswere reported as either “nil,” “partial”or “complete” recovery. Although thenatural history of minor psychiatric dis-orders is that they are often transitory,the results were nonetheless interesting:89 percent of this group of patientsmade a partial to complete recovery.For the majority that made a partial tofull recovery, this took place within thefirst 18 weeks.

Environmental light stressA randomized, double-blind, placebo-controlled study14 examined the effectsof flower essence formulas on theintense environmental stimulation of flu-orescent lights and its accompanyingelectromagnetic fields (EMF). Twenty-four subjects were monitored usingEEG, along with the activity of six sur-face electromyographic (sEMG) sites,including thoracic (T6 Paraspinals). Thestudy assessed baseline activity, reac-tion to the flower essence or placebo,reaction to the high intensity light stim-ulation, and concluded with a recoveryperiod. The results of the study showEEG activation of the frontal lobes areato the light stimulation, but only forthose individuals who received theplacebo. Likewise, activation of the T6paraspinals was also noted, but only for

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Perhaps thebest evidenceof efficacy are

case studies andclinical studies,

which have beenconducted on

flower essences.

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only the placebo group as well. Thisdemonstrates that the stress responsewas seen only in the placebo group,whereas the two flower essence groupsshowed no similar stress response. Theconclusion is that flower essencesdemonstrated an antidote effect onenvironmental stressors.

Carpal tunnel syndromeA randomized, pilot, placebo-controlledclinical trial15 was conducted to evaluatethe effectiveness of a cream based onflower essence remedies on 43 patientswith mild to moderate carpal tunnelsyndrome. Patients were treated during21 days with topical placebo or a creambased on flower essences. Results werethat those patients using the floweressence cream experienced significant,self-reported improvements in symptomseverity and pain intensity. In addition,all signs observed during the clinicalexam showed significant improvementsamong the groups, as well as symptomsof pain, night pain and tingling. In con-clusion, the flower essence cream wasan effective intervention in the manage-ment of mild and moderate carpal tun-nel syndrome, reducing the severitysymptoms and providing pain relief.

Overdue pregnancyIn a randomized, controlled study16 of24 pregnant women who were at leastfive days overdue, subjects receivedflower essences, “attention,” or nointervention (control). Results were thatmedicines usage (i.e. orthodox medi-cines to control pain and nausea) wassignificantly less (p=0.032) for the groupreceiving flower essences when com-pared with the other two groups.Indeed, seven of the eight subjects inthe flower essence group used no med-ication. Furthermore, the investigatorreports that these mothers tended todeliver with less assistance, suggestingless anxiety.

Tantrums in childrenFifty-eight children aged 2-5 yearswhose parents reported frequenttantrums, participated in a study17 inwhich flower essences were tested forefficacy. Tantrum frequency, tantrumseverity, and parental mood were meas-ured on five occasions over eight daysbefore treatment and on a further fiveoccasions over 10 days after the start oftreatment. Compared to the periodbefore treatment, there was a continu-ing reduction in tantrum frequency (p =

0.002) and severity (p = 0.003) over theeight days of treatment. Not surprising-ly, there were significant day-to-day cor-relations between parents' mood andtantrum frequency and severity.

ADHD in childrenIn a randomized, placebo-controlledpilot study,18 flower essences or placebowere used in 10 children (5 to 12 years)with a diagnosis of ADHD. The resultswere that the flower essences wereeffective in reducing inattention andhyperactivity as measured by theChildhood Attention Profile (p=0.02). Inaddition, there was almost a doublingof improvement in global functioningcompared to control subjects as meas-ured by the Columbia ImpairmentScale. The flower essences used wereRescue Remedy or Calming Essence (acombination of impatiens, clematis, starof Bethlehem, cherry plum and rockrose), vervain, crab apple and walnut.

Cell Salt Therapy: BackgroundCell salt therapies use a set of specificminerals, also known as the 12 tissuesalts or cell salts, to correct symptomsarising from metabolic deficiencies. AGerman physician, W. H. Schussler,developed cell salt therapy in the1870s. He studied cremated humanbodies, and found that these 12 sub-stances made up the bulk of theremains. His research, eventually calledthe Schuessler’s Biochemic Theory, inte-grates the knowledge of the humanbody’s cellular structure and the use ofmineral salts, or cell salts as a system ofmedicine to fortify or energize the indi-vidual cells of the body. Schussler theo-

rized that these 12 cell salts are respon-sible for the harmonious functioning ofthe human organism, and that diseasefollows when a person becomes defi-cient in any of the 12 salts. The cell saltsare not dietary supplements, butinstead are prepared following the prin-ciples of homeopathy (using plant ormineral sources)—so the salts are pre-pared by a process of continued dilu-tion and shaking or pounding (succus-sion) to concentrate energetic or vitalprinciples.

As with flower essences, there areselect case studies and clinical studiesto substantiate efficacy.

Case StudiesPublished case studies on cell saltsinclude their use for back pain, throatcancer, allergies and headache.

Back painIn a case study,19 a lumbar conditioncausing pain and curvature of the verte-bral skeleton was treated with Calcareaphos in an adolescent boy who hadundergone treatment with orthodoxWestern medicines, but did not get anyrelief from the ailment. Results werethat the symptoms were effectivelytreated with Calcarea phos. X-ray andmagnetic resonance imaging (MRI) sup-ported recovery and a change in theskeletal curvature that was accompa-nied by removal of pain and other acutesymptoms of the ailment.

Throat cancerIn a case study,20 a 70-year-old malewith carcinoma of the larynx had beenreceiving homeopathic treatment afterthe diagnosis. He was advised to havesurgery, radiation and chemotherapy,which he underwent immediately. Thistreatment was followed by homeopathicconstitutional treatment. Ferrum-phoswas prescribed. There was a goodresponse. The patient was symptom-free at three-year follow-up. This sug-gests that tissue salts such as ferrum-phos prescribed on constitutionalgrounds may play a useful role in sup-portive and palliative for patients withmalignant disease.

AllergiesA physician reported21 clinical verifica-tion of homeopathic treatment ofpatients, especially in various allergicconditions with primary care practice.This included the use of cell salts. Forpreventive treatments in hay fever

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patients, silicea and Natrum muriaticumwas effective. For asthma patients, sil-icea was effective.

HeadacheThe use of complementary alternativemedicine (CAM) in pediatric populationsis considerably increased, especially forpain and chronic conditions, as demon-strated by epidemiological surveys bothin Europe and in the U.S. In this study,22

CAM was used in 76 percent patients ofa cohort of 124 children affected byheadache. CAM was used as preventivetreatment in 80 percent cases. One ofthe CAM therapies was homeopathy,which was utilized by 47 percent ofpatients. Among the homeopathicremedies include silicea and calcareaphos cell salts.

Clinical StudiesPublished clinical studies on cell saltsinclude their use for chronic sinusitisand ear infection.

Chronic sinusitisA multicenter observational study23 wasconducted with 550 patients to ascer-tain the therapeutic usefulness of home-opathic medicine as tissue salts in themanagement of chronic sinusitis (CS).Symptoms were assessed using thechronic sinusitis assessment score(CSAS). Regimes and adjustment ofregimes in the event of a change ofsymptoms were pre-defined. Resultswere that there was a statistically signifi-cant reduction in CSAS (P = 0.0001)after three and six months of treatment.Radiological appearances alsoimproved. The cell salts found to bemost useful in promoting markedimprovement included Sil. (55.2 percentof 210), Calc. (62.5 percent of 98), Phos.(66.7 percent of 45) and Kali iod. (65percent of 40). No complications wereobserved during treatment. In conclu-sion, treatment with cell salts may beeffective for CS patients.

Ear infectionIn a prospective observational study24

carried out by one homoeopathic andfour conventional ENT practitioners, thetwo methods of treating acute pediatricotitis media (ear infection) were com-pared. Group A received treatment withhomoeopathic single remedies (includ-ing silicea), whereas group B receivednasal drops, antibiotics, secretolyticsand/or antipyretics. The study involved133 children. Results were that, of the

children treated, 70.7 percent were freeof recurrence within a year in group Aand 29.3 percent were found to have amaximum of three recurrences. In groupB, 56.5 percent were free of recurrence,and 43.5 percent had a maximum of sixrecurrences. In group A, only five subse-quently received antibiotics, thoughhomoeopathic treatment was carriedthrough to the healing stage in theremaining children.

Mixing Flower Essences and CellSaltsFlower essences and cell salts are natu-ral medicines with a history of safe use.Furthermore, research suggests thatthese nature-based remedies have abroad range of effective applications forhuman health. Given that floweressences correspond to emotional pat-terns, while cell salts are more specificto metabolic deficiencies, there is noredundancy to their respective mecha-nisms of action. Furthermore, since theyboth have relationships with homeopa-thy, there may be value in their concur-rent use. In fact, a market trend seemsto be developing toward mixing floweressences and cell salts together, whichmay offer a safe and effective additionto the natural medicine repertoire. VR

References:1 Llonch M. [Floral essences, a fascinating world]. Rev

Enferm. 2005 May;28(5):47-8, 51-2.2 Mantle F. Bach flower remedies. Complement Ther

Nurs Midwifery. 1997 Oct;3(5):142-4.3 van Haselen RA. The relationship between homeopa-

thy and the Dr Bach system of flower remedies: a criticalappraisal. Br Homeopath J. 1999 Jul;88(3):121-7.

4 Hyland ME, Whalley B. Motivational concordance: animportant mechanism in self-help therapeutic ritualsinvolving inert (placebo) substances. J Psychosom Res.2008 Nov;65(5):405-13.

5 Whalley B, Hyland ME. Placebo by proxy: the effectof parents' beliefs on therapy for children's tempertantrums. J Behav Med. 2013 Aug;36(4):341-6.

6 Long L, Huntley A, Ernst E. Which complementaryand alternative therapies benefit which conditions? A sur-vey of the opinions of 223 professional organizations.Complement Ther Med. 2001 Sep;9(3):178-85.

7 Balinski AA. Use of Western Australian floweressences in the management of pain and stress in thehospital setting. Complement Ther Nurs Midwifery. 1998Aug;4(4):111-7.

8 Siegler M, Frange C, Andersen ML, Tufik S, Hachul H.Effects of Bach Flower Remedies on MenopausalSymptoms and Sleep Pattern: A Case Report. Altern TherHealth Med. 2017 Mar;23(2):44-48.

9 Martínez Luque R, Martínez Garrido R. [Herpeszóster treated with Bach flowers]. Rev Enferm. 2014Mar;37(3):45-8.

10 Howard J. Do Bach flower remedies have a role toplay in pain control? A critical analysis investigating thera-peutic value beyond the placebo effect, and the potentialof Bach flower remedies as a psychological method ofpain relief. Complement Ther Clin Pract. 2007Aug;13(3):174-83.

11 Oliva i Segura M. [Emotional support and BachFlower Therapy]. Rev Enferm. 2009 Oct;32(10):16-9.

12 Cram JR. A convergence of evidence: floweressence therapy in the treatment of major depression.Calix. 2004;1:90-106.

13 Campanini M. [Bach flower therapy: results of amonitored study of 115 patients]. La Medicina Biologica.1997;3:37-43.

14 Cram JR. Effects of two flower essences on highintensity environmental stimulation and EMF: a matter ofhead and chest. Subtle Energies Energy Med J. 2001;12.

15 Rivas-Suárez SR, Águila-Vázquez J, Suárez-Rodríguez B, Vázquez-León L, Casanova-Giral M, Morales-Morales R, Rodríguez-Martín BC. Exploring theEffectiveness of External Use of Bach Flower Remedies onCarpal Tunnel Syndrome: A Pilot Study. J Evid BasedComplementary Altern Med. 2017 Jan;22(1):18-24

16 Ruhle G. Pilot study on the use of Bach floweressences in primiparae with post-date pregnancy.Erfahrungsheilkunde. 1995;44:854-860.

17 Whalley B, Hyland ME. Placebo by proxy: the effectof parents' beliefs on therapy for children's tempertantrums. J Behav Med. 2013 Aug;36(4):341-6.

18 Mehta SK. Oral flower essences for ADHD. J AmAcad Child Adolesc Psychiatry. 2002 Aug;41(8):895.

19 Haque S, Das D, Bhattacharya S, Sarkar T, Khuda-Bukhsh AR. Homeopathy - A Safe, Much Less Expensive,Non-Invasive, Viable Alternative for the Treatment ofPatients Suffering from Loss of Lumbar Lordosis. JPharmacopuncture. 2016 Dec;19(4):358-361.

20 Rajendran ES. Homeopathy as a supportive therapyin cancer. Homeopathy. 2004 Apr;93(2):99-102.

21 Van Wassenhoven M. Clinical verification in home-opathy and allergic conditions. Homeopathy. 2013Jan;102(1):54-8.

22 Dalla Libera D, Colombo B, Pavan G, Comi G.Complementary and alternative medicine (CAM) use in anItalian cohort of pediatric headache patients: the tip of theiceberg. Neurol Sci. 2014 May;35 Suppl 1:145-8.

23 Nayak C, Singh V, Singh VP, Oberai P, Roja V,Shitanshu SS, Sinha MN, Deewan D, Lakhera BC, RamtekeS, Kaushik S, Sarkar S, Mandal NR, Mohanan PG, SinghJR, Biswas S, Mathew G. Homeopathy in chronic sinusitis:a prospective multi-centric observational study.Homeopathy. 2012 Apr;101(2):84-91.

24 Friese KH, Kruse S, Lüdtke R, Moeller H. Thehomoeopathic treatment of otitis media in children--com-parisons with conventional therapy. Int J Clin PharmacolTher. 1997 Jul;35(7):296-301.

Gene Bruno, MS,MHS, the dean ofacademics forHuntington Collegeof Health Sciences,is a nutritionist,herbalist, writer

and educator. For more than 30years he has educated and trainednatural product retailers andhealth care professionals, hasresearched and formulated naturalproducts for dozens of dietarysupplement companies, and haswritten articles on nutrition, herbalmedicine, nutraceuticals and inte-grative health issues for trade,consumer magazines and peer-reviewed publications.

He can be reached atgbruno@hchs.edu.

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