SLIPPERY ELM
Common Names

Slippery Elm, Red Elm, Moose Elm, Indian Elm
Botanical Name
Ulmus fulva (also called Ulmus rubra)
Family
ULMACEAE ~ The Elm Family

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What is it?

Slippery Elm is the name of a tree from the great Elm family that is native to North America. The part used in medicine is the powdered inner bark. Note that it is important to only use Slippery Elm bark from trees that have been sustainably harvested as this is a herb that has become increasingly endangered.


LEAVES


SEEDS


POWDERED BARK

How has it been used?

Slippery Elm has been extensively used in herbal medicine for many centuries. It has pronounced nourishing and healing properties

TJ Lyle writes 'The inner bark of Slippery Elm forms one of the best demulcents for both internal and external use wherever there is an irritated condition. In constipation, dysentery, diarrhoea or cholera infantum, used both orally or by rectal injection it lubricates, soothes and relieves the intestinal irritation. It is a nutritious demulcent, soothing to the mucous membrane wherever needed and quieting to the nervous system.
Slippery Elm is one of the most valuable articles in the botanic practice and should be in every household. The finely powdered bark makes an excellent gruel or food and may be used as such in all cases of weakness, inflammation of the stomach, bronchitis, bleeding of the lungs, consumption etc.. It has a wonderfully soothing and healing action on all the parts it comes in contact with and in addition possesses as much nutrition as is contained in oatmeal. The food or gruel should be made as follows: Take a teaspoonful of the powder, mix well with the same quantity of powdered sugar and add 1 pint boiling water slowly, mixing as it is poured on. This may be flavoured with cinnamon or nutmeg to suit the taste and makes a very wholesome and sustaining food for infants.
The coarse powder forms the finest poultice to be obtained for all inflamed surfaces, ulcers, wounds, burns, boils, skin diseases, purulent ophthalmia, chilblains etc. It soothes the parts, disperses the inflammation, draws out impurities, and heals speedily. We cannot speak too highly of this remedy and are confident there is nothing to equal it in the world for its above-mentioned uses. Inflammation in the bowels of infants and adults has been cured when all other remedies have failed, by an injection into the bowels of an infusion of 1 ounce of powdered bark to a pint of boiling water, used while warm'

King's Dispensatory writes 'Slippery elm bark is a very valuable remedial agent in mucous inflammations of the lungs, bowels, stomach, bladder, or kidneys. It is also highly beneficial in diarrhoea, dysentery, coughs, pleurisy, strangury, and sore throat, in all of which it tends powerfully to allay the inflammation. A tablespoonful of the powder boiled in a pint of new milk, affords a nourishing diet for infants weaned from the breast, preventing the bowel complaints to which they are subject, and rendering them fat and healthy. Elm bark has likewise been successfully employed externally in cutaneous diseases, especially in obstinate cases of herpetic and syphilitic eruptions'

The British Herbal Pharmacopoeia (BHP) describes the actions of Slippery Elm as 'demulcent, emollient, nutritive, antitussive'. It says it is indicated for 'inflammation or ulceration of stomach or duodenum. Convalescence. Colitis. Diarrhoea. Locally for boils, abscesses and ulcers as a poultice' and specifically indicated for 'gastric or duodenal ulceration'. The BHP recommends a dose of 4 grams in 500mls boiling water or the powdered bark 1:8 as a decoction.

Thomas Bartram writes that the actions of Slippery Elm include 'soothing demulcent, nutrient, expectorant, antitussive. Topically as an emollient. The addition of a few grains of powder or drops of tincture of Myrrh enhances its antiseptic and healing action. Long lasting antacid barrier. Contains an abundance of mucilage'.
Bartram suggests uses for it including 'inflammation or ulceration anywhere along the digestive tract. Gastric or duodenal ulcer, acute or chronic dyspepsia and wind, diverticulosis, colitis, before a journey to allay travel sickness, summer diarrhoea in children (also as an enema) irritable bowel. Its blanketing action protects the gastric mucosa from the erosive effects of too much acid. Gastro-oesophageal reflux is one of the most common causes of dyspepsia; Slippery Elm powder protects the oesophageal mucosa and relieves pain of indigestion. Lasting protection against acid reflux. Suppresses acid production during the night when mucosal damage may occur. Together with carminatives such as Chamomile or Ginger it allays abdominal distension, reflux oesophagitis and hiatus hernia. Of value during convalescence, cachexia and wasting diseases.
Bartram recommends powdered Slippery Elm capsules (400mgs) taken freely (i.e. as many as required) or taken as a food (gruel) mixed into a paste before adding boiling water or milk; quarter to half a tsp to each cup, sprinkle powder on to porridge or muesli. The poultice made by mixing 1-2 tsps into a little water and spread over the dressing.

Andrew Chevallier writes 'this marvellous herb is a gentle and effective remedy for irritated states of the mucous membranes of the chest, urinary tubules, stomach and intestines. It was used in many different ways by Native Americans; as a poultice for wounds, boils, ulcers and inflamed eyes, and internally for fevers, colds, and bowel complaints. Slippery Elm has a strongly mucilaginous 'slippery' taste and texture'

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Science on Slippery Elm

As Andrew Chevallier writes 'there is limited research into Slippery Elm, but its action as a herb with large quantities of mucilage is well understood. When the herb comes into direct contact with inflamed surfaces such as the skin or the intestinal membranes, it soothes and coats the irritated tissue, protects it from injury, and draws out toxins or irritants.
When Slippery Elm is taken internally, it is thought likely that it causes a reflex stimulation of nerve endings in the stomach and intestines that leads to secretion of mucus by the membranes of urinary tract'
(Hence it may allay the symptoms of cystitis and urethritis)

Safety of Slippery Elm

Slippery Elm is super safe for people to use, young or old, and in pregnancy and breastfeeding. However, because of its remarkably high mucilage content, it should be noted that other herbs or drugs that are taken at the same time as any quantity of Slippery Elm may have a delayed absorption into the body.

The only real safety concerns are those to be had for the tree itself! As also mentioned at the top of the page; Note that it is important to only use Slippery Elm bark from trees that have been sustainably harvested as this is a herb that has become increasingly endangered.

General comment on herbal safety

All medicinal herbs that have the power to do good have the potential to do harm. The old maxim 'the poison is in the dose' precisely describes how too much of anything can be bad for us. The ancient rule to 'firstly, do no harm is, to this day, held as the core directive by all practitioners of traditional herbal medicine. Not only are we careful to do our best to use the right herbs, but equally we take care to not give too much of them or use them overlong.

For some years now, against this proven and safe way of herbalism, there has been a rising tide of excessive caution and scare-mongering in many parts of the world. The same authorities that, not so long ago, decried herbal medicines as ineffectual, have now taken up a different adversarial position; that they are dangerous substances that should only be prescribed by Doctors, who of course have zero training in them.

Lists of '10 popular herbs and why you should avoid them' include things like Garlic and Ginger that might 'thin your blood'. Such cautions are absurd to the point of the ridiculous, but fear is a universal driver that has long been proven to be effective at manipulating people.

Unfortunately, the same unnecessary fear and worry has crept into many natural health websites and popular publications on herbs. Herbs that we have safely used for thousands of years, that have no reports of adverse reactions in the medical literature despite widespread use by millions of people, are suddenly described as contraindicated because of something that should have been seen as completely unimportant, or at the utmost a merely theoretical concern, such as a laboratory study on one of the herb's constituents to use an all too common example.

I wonder sometimes if the writers of such articles feel that the herb will be more deserving of respect if it is thought to be a little bit dangerous, in other words more like a drug than something that has simply come out of the earth and been used by ordinary people for generations beyond count.

There is just so much misinformation about herbal medicine on the internet now. Ludicrous claims and cautions abound in equal measure; it seems like one group are trying to make money out of the public whilst the other are busily trying to scare them off.

I have to believe that the kind of reader who takes the time to read pages on herbs that are as extensive as this one is much less likely to be swayed by marketers or misinformers. I hope that you will keep your wits about you if you get conflicting opinions from people who have never really got to know these herbs, who have never worked with them, or learned how to use them safely and effectively.

I want to remind you that the reason that herbs can never be patented and owned by any individual or corporation is because they are, and always will be, the People's medicine. They belong to all of us and it is my great hope in sharing this work that you will learn how to use them wisely for yourself, and the people you care for. Be safe, but do not be afraid.

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Personal experiences

In modern herbal practice, Slippery Elm's two main uses are as a drawing agent when used as an external poultice and as an internal bandage for inflammation or ulceration anywhere along the digestive tract

Slippery Elm in a drawing poultice is a thing to behold. It is quite remarkable how it forms a gelatinous, gooey mass that soothingly sits there but then also hoovers up foreign material or damaged tissue.

Slippery Elm as an internal bandage is surely where it has provided its most dramatic healing affects and this is the method with which I have most of my own experience in using the herb.

If someone has actual physical damage to a part of their digestive tract then I will often use Slippery Elm as the first choice. As much as there may well be other agents that could be beneficial that do not have the same issues of scarcity that we have with Slippery Elm I just do not know anything that can help bandage an internal wound so quickly and effectively (in our own clinic we have found a supplier that certifies the herb is harvested sustainably).

You need to visualise what Slippery Elm does whilst it is in the gut to get a good feel for how to use it. Slippery Elm makes a wet, gooey, sticky mess if you dilute it and leave it to set and so, as it slowly slides down through the digestion on its way to being eliminated, it is able to make a gentle, soothing and effective bandage.

As soon as a person gets a significant inflammation in their gut lining, it physically changes the surface tissues to become rough, red and sore, rather like a graze. Slippery Elm is able to stick to those sore parts, at least for a while, and so give the tissues a much needed rest from further abrasion as material works its way through the digestive tract.

However, the bandage can’t stick there forever which is why we can need to use a frequent dose of Slippery Elm, at least in the beginning, because the longer the damaged gut surfaces stay bandaged, the faster they can heal, and gut tissue can heal quickly when it is given a chance.

The gut lining is just like the external skin, in that it is constantly shedding and replacing itself. It has to be like this because it is subjected to so many stresses. If you can keep that wound or graze well bandaged for long enough, which is often just a few days, then everything can quickly turn around for the good.

It is recommended to use enough Slippery Elm to form a bandage and to use it as frequently and for as long as needed. In practical terms this means I may be prescribing a heaped tsp in a slurry or a gruel or 4 capsules up to three times a day. More about dosages and methods of taking Slippery Elm below.

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Dosage methods

Capsules

Taking Slippery Elm as a powder has its challenges, more about this next, but it means that, for at least some people, capsules are the most convenient method to take Slippery Elm when it needs to be used on a frequent basis (i.e. more than once a day).
The standard dose for an adult is 4 capsules at a time and, especially as this may need to be repeated twice or even three times a day, it will help if the the person is reasonably adpet at swallowing a few capsules at a time. This is most easily done by simply focusing the attention on drinking a glass of room-temperature water with anything from 2 all the way up to 4 capsules in the mouth at the same time. A person who has always had to take just one pill or capsule at a time may think it impossible to swallow a few capsules at once but they really will just slip down if they don't overly focus on them and likewise resists the temptation to tilt their head back thus narrowing the neck. It is all a matter of where the attention is directed, we swallow larger amounts of food every time we eat.

Slurry

Capsules are tasteless and easy to swallow with a little practice. However, if the condition is quite bad and the area of damage in the gut is quite large, it may be best to use the Slippery Elm as a powder, either in a slurry or cooked in a gruel as described next.

One well-heaped tsp of Slippery Elm powder equates to about 5 grams of herb and this would be equivalent to about 10-12 capsules at a time. However, not everyone will be able to take such a large dose in a powdered form, or need to take so much and, given that the soothing action of Slippery Elm should be felt rapidly, the best way to know whether capsules or powder is necessary is simply to try and see. If it works, you were taking enough, if it doesn't take a higher dose.
The technique is to put a tsp, and how much you put on the tsp, less or more, may be according to how adapted you are to taking the herb in this method as well as how bad the condition is, then get water running at a a temperature that will be easy to drink and then add the water to the powder whilst rapidly stirring to mix it in.
Depending on the amount of powder and the success of your mixing technique, you may be able to dilute the whole lot in the first glass, but you must make sure you drink the slurry quickly, because the longer it takes the thicker it will get. There may be some residual powder left over at the bottom and, if so, it is recommended to remix it with some more water and drink it down! Slippery Elm has a distinctive taste and a markedly 'slippery' texture, but most people do not find it inherently unpleasant, just a little challenging to get used to. This process, like everything, gets easier with practice.

Gruel

The slurry is the fastest way to take a large dose, but it will not suit everyone or be palatable to all so, especially if the need is pressing, the traditional method of making Slippery Elm into a gruel, i.e. cooking and eating it, may be the best method to get the largest doses for the most rapid benefit. The gruel of Slippery Elm is certainly very effective and, if made correctly, is perfectly palatable.

Making Slippery Elm gruel is just like making a thin porridge, put one or two heaped teaspoons, or more if needed, of Slippery Elm Into a saucepan, add a liquid, either milk or water, to make a paste and then, whilst heating the mixture over a low flame or element, gradually add more milk, water or both until the desired consistency has been achieved.

Slippery Elm can absorb a lot of liquid and, as gruels are meant to be thin, you can add more liquid as you go if it is getting too thick. I think that it is essential to add some honey or sugar to the gruel, perhaps at least one tsp of at least one of them. Some further flavouring, such as with a little cinnamon or nutmeg, will likely make it all the more palatable. When finished, eat.

I have also had patients use the Slippery Elm gruel in combination with oats or rice porridge and this is also completely fine. However you get it into the body, so long as it is there in a sufficient amount, it will form a healing bandage for at least a while. Repeat as needed.


Ulmus fulva (Slippery Elm tree)

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Constitutional note

Much of the information here about the traditional uses of Slippery Elm is consistent with the model of thinking whereby one may treat problem A with plant B. There is value in this approach, especially in how it helps us pass on useful knowledge to one another, but it falls short in one vital area; and that is that people are not all cut from the same cloth! Something that works brilliantly for one person may do less for another- why is this?

Part of the reason is that people vary in their constitutions as to whether they are either hotter or cooler and, at the same time, either dryer or damper. This useful and rather fascinating subject is introduced further here

Another big part of using the right herb when it is most needed comes from understanding the need to treat what is going wrong for the person that had led up to their getting a health condition. In this light, Slippery Elm can particularly offer its benefits when a nourishing action is needed in the 'cycle of healing', more about this here

Please understand that I cannot advise you, including on products or dosage, without seeing you in person in my clinic but for ideas on how you might find a good herbalist in your area read here

This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd