Updated Bastyr Materia Medica

Bastyr Materia Medica
Achillea millefolium Aconitum napellus Adonis vernalis Aesculus hippocastanum Agropyron repens Alchemilla vulgaris Aletris farinosa Allium cepa Allium sativum Aloe barbadensis Althea officinalis Amni visnaga Ananassa sativa Anemone pulsatilla Angelica archangelica Angelica sinensis Apium graveolens Arctium lappa Arctostaphylos uva ursi Arnica montana Artemeisa spp. Asclepius tuberosa Aspidosperma quebracho blanco Astragalus mebranaceous Atropa belladonna Avena sativa Baptisia tinctoria Barosma betulina Berberis aquafolium Berberis vulgaris Betula pendula, B. alba. Borago officinalis Bos ellia spp. Brassica nigra Bryonia alba Bupleurum falcatum !alendula officinalis !amellia sinensis !apsella bursa pastoris !apsicum annum !aryophyllus aromaticus !assia spp. !aulophyllum thalictroides !eanothus americanus !entella asiatica !ephaelis ipecacuanha !hamelerium luteum !helidonium ma"us !henopodium ambrosioides !himaphila umbellata !hionanthus virginicus !imicifuga racemosa !inchona officinalis !ineraria maritima Updated Winter 2003 !innamomum verum -uglans spp !offea arabica -uniperus communis !ola nitida .arrea tridentata !oleus fors#ohlii .avendula officinalis !ollinsonia canadensis .entinus edodes !ommiphora molmol .eonurus cardiaca !ommiphora mu#ul .eptandra virginica !onvallaria ma"alis .igustrum lucidum !optis chinensis .igusticum porteri !orydalis dicentra .inum usitatissimum !rataegus o$ycantha .ithospermum spp. !ucurbita pepo .obelia ,nflata !urcuma longa .omatium dissectum !ynara scolymus .ycopus virginicus %atura stramonium /arrubium vulgare %igitalis purpurea /atricaria recutita %ioscorea villosa /edicago sativa %ryopteris feli$&mas /elaleuca alternifolia 'chinacea angustifolia /elilotus officinalis 'leutherococcus /elissa officinalis senticosus /entha spp. 'phedra sinica /enyanthes trifoliata 'quisetum spp. /itchella repens 'riodictyon californicum /omordica charantia 'schscholt(ia california /yrica cerifera 'ucalyptus globulus 0enothera biennis 'ugenia cardamomum 0plopana$ horridum 'upatorium perfoliatum 1ana$ spp. 'upatorium purpureum 1arietaria officinalis 'uphrasia officinalis 1assiflora incarnata )oeniculum vulgare 1aullinia cupana )ucus vesiculosis 1ausinystalia yohimbe )umaria officinalis 1etroselinum crispum *alega officinalis 1eumus boldo *alium aparine 1hyllanthus amarus *anoderma spp. 1hytolacca decandra *aultheria procumbens 1icorrhi(a #urroa *elsemium sempervirens 1impinella anisum *entiana lutea 1iper methysticum *eranium maculata 1iper nigrum *in#go biloba 1iscidia erythrina *lycyrrhi(a glabra 1lantago afra *rifola frondosa 1lantago lanceolata *rindelia caporum 1odophyllum peltatum *ymnema sylvestre 1opulus spp. Hamamelis virginiana 1ropolis +arpagophytum 1runus serotina procumbens 1ulmonaria officinalis +umulus lupulus 1ulsatilla vulgaris +ydrangea arborescens 1ygeum africanum +ydrastis canadensis 2uercus robur3 2. alba +yoscyamus niger 4au olfia serpentina +ypericum perforatum 4hamnus purshiana3 +yssopus officinalis 4. frangula ,nula helenium 4heum officinale ,ris versicolor 4heum palmatum Bastyr University Department of Botanical Medicine 4icinus communis 4osmarinus officinalis 4ubus idaeus 4ume$ crispus 4uscus aculeatus 5ali$ spp. 5alvia officinalis 5ambucus nigra 35. canadensis 5anguinaria canadensis 5arothamnus scoparius 5assafras lignum 5chisandra chinensis 5cilla maritima 5crophanthus 5cutellaria baicalensis 5cutellaria laterifolia 5elencerius grandiflorus 5erenoa repens 5ilybum marianum 5mila$ officinalis 5pilanthes oleracea 5tachys officinalis 5tevia rebaudiana 5tillingia sylvatica 5ymphytum officinalis 5y(ygium cumini 6abebuia avellanedae 6anacetum parthenium 6anacetum vulgare 6ara$acum officinalis 6hu"a occidentalis 6hymus vulgaris 6illia europa 6rifolium pratense 6rigonella foenum& graecum 6rillium pendulum 6urnera diffusa 6ussilago farfara Ulmus fulva Uncaria gambir Uncaria tomentosa Urtica dioica Usnea barbata, U. plicata 7accinium macrocarpon 7accinium myrtillus 7aleriana officinalis 7eratrum album 7erbascum thapsus 7erbena officinalis 7iburnum opulus3 7. prunifolium 7inca minor 7iscum album 7ite$ agnus&castus

Withania somnifera

8antho$ylum americanum

8ea mays

8ingiber officinalis

Bastyr University Department of Botanical Medicine

Acknowledgments:
6he department of Botanical /edicine at Bastyr University ould li#e to note its appreciation for the follo ing people for contribution to the development of these monographs9 /ary Bove :% .isa /eserole :% .ise Alschuler :% 5ilena +eron :% 4obin %ispasquale :% Bill /itchell :% 6ai .ahans .Ac 'ric ;arnell :% 5teve 1arcell :% 2002 5am 4usso :%, .Ac 2002 'lla :aydis :%, .Ac 200< 6eri -ohnson :%, .Ac 200< 6he follo ing references have been used to complete the monographs =not all references have been e$hausted for each herb ho ever>9 • )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB • !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE • /urray /, 1i((orno -. 6he 6e$tboo# of :atural /edicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC • Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. • /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. • 1%4, 2nd ed. =see 5teve 1arcell> • Weiss 4). +erbal /edicine, Fth ed. +ippocrates 7erlag *mb+ ACCF.

Bastyr University Department of Botanical Medicine

Definitions:
Biliousness9 A nonspecific term for a congestive disturbance ith anore$ia, coated tongue, constipation, headache, di((iness, pasty comple$ion, and, rarely, slight "aundice assumed to be from hepatic dysfunction.

Bastyr University Department of Botanical Medicine

Achillea millefolium
Common name: ;arro

Asteraceae (Compositae

Ha!itat:" • ;arro mainly gro s in the regions of eastern, southeast, and central 'urope, and on the southern edge of the Alps from 5 it(erland to the Bal#ans. Botanical description: 2 • )lo er and )ruit9 6he composite flo ers are hite, pin#, or purple in dense cymes ith small capitula. 6he bracts are imbricate, long, thorn&tipped, and taper to a point. 6here are E hite female florets. 6he disc florets are tubular yello ish& hite, and adrogenous. 6he fruit is A.E&2 mm long. • .eaves, 5tem, and 4oot9 0.A&0.E m high plant ith hardy, hori(ontal rhi(omes, hich gro from underground runners. 5tem is simple erect, and hairy. .eaves are lanceolate and multi&pinnate ith short&acute tips. #art used: +erba $nergetics: !onflicting opinions • 5ustaining and arming3 • Bitter, astringent, s eet, cool, dry< Constituents: % • 7olatile oil =0.2&A.0G> • 5esquiterpene lactones • 1olyynes • Al#amids • )lavonoids9 including rutin,apigenine&H&0&glucoside, luteolin&H&0&glucoside • Betaine #harmacology &' ( • 6he volatile oil, hich is rich in sesquiterpene lactones, gives ;arro its anti&inflammatory activity. • Al#amides = hich are also found in 'chinacea> may further reduce inflammation. Animal studies have sho n this herb can reduce smooth muscle spasms, hich might further e$plain its usefulness in gastrointestinal conditions. • 6he al#aloid obtained from ;arro , #no n as achilletin, reportedly stops bleeding in animals. ,t soothes the digestive system by relieving muscle spasms in the intestines, promotes the flo of digestive bile, fights bacterial invasion, and firms and tightens tissues. • 6hree ne antitumor sesquiterpenoids, achimillic acids A, B and !, ere isolated as methyl esters from Achillea millefolium and their structures ere determined spectroscopically. 6he compounds ere found to be active against mouse 1&3BB leu#emia cells in& vivo.B Medical actions: • 6onic bitter, anti&inflammatory, carminative, spasmolytic, antiphlogisitic =volatile oil> C, diaphoretic, anti&hemorrhagic, antispasmodic, alterative, diuretic, astringent. )raditional Medicinal Uses: • Used as a vulnerary, as an ointment made for ounds, and for dispelling melancholy. ,t as used in spell divination and in 'astern 'urope as used to bring about visions of a future spouse. ,t has been made into a snuff and as a salad ingredient in the AHth !entury. ,t has been used for bre ing beer in 5 eden and Africa. ,t has been #no n to be useful as an anti&inflammatory, for cramps, fever, piles, scabs, for baldness prevention, as a uterine tonic, rheumatism and toothache. A0 • 'clectics used yarro to relieve urinary problems =such as urinary irritation, strangury, nephritis =Bright@s d(>, urinary suppression, hematuria>, gynecological complaints =leu#orrhea ith rela$ed and irritated vaginal alls, atonic amenorrhea, menorrhagia>, and gastrointestinal conditions =gastric and intestinal atony, dysentery, flatulence>. AA • 'lling ood recommended yarro for all forms of passive hemorrhage, for urinary complaints, and for hot, dry burning s#in at the beginning of acute asthenic fevers, ith suppressed secretion. +e noted that Achillea is beneficial for the mucous membranes as it relieves irritation and profuse secretion, hich he too# advantage of to treat mild diarrhea. A2

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!oo# stated that the employment of Achillea Ishould be limited by the conditions of a depressed but not irritable pulse, cold s#in and rela$ation of the mucous membraneD =and> although of value, it should not be overrated,J A3 suggesting a role for this botanical as supportive in 1hysiomedical formulations. ,n turn, it as used for gastric and intestinal atony. ,n particular, !oo# used Achillea for feeble conditions of the digestive tract described by Iprecarious appetite, passive looseness of the bo els and consequent nervous prostration.J A< 5ummary9 *enitourinary !onditions9 Achillea as employed the 'clectic physicians for urinary irritation and in chronic urinary tract conditions to provides tone to the urinary system. AE 5cudder described the application for irritation of the #idneys, vesical and urethra ith the action being similar to Arctostaphylos and Buchu.AF 6he 1hysiomedical indication for Achillea as urinary incontinence. AH *ynecological !onditions9 ,n regard to female reproductive complaints, Achillea as employed in both leucorrhea ith atonic and irritated vaginal mucosa, gleet =mucous discharge from the urethra in chronic gonorrhea>, atonic amenorrhea and menorrhagia. AB, AC,
20, 2A

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,nflammatory !onditions9 !oo# noted that the arm infusion stimulates slo perspiration and elevates the temperature of the s#in, hich effect as put to use in a variety of fevers including those of an intermittent nature. 22 6he use of Achillea as a diaphoretic as also highly regarded by the 'clectics. 'lling ood specifically indicated Achillea for hot, dry burning s#in at the beginning of acute asthenic fevers, ith suppressed secretion.23 /ale !onditions9 'lling ood indicated that Achillea as used for fever in acute epididymitis. 2<

)CM #rospective:2E • 7itali(es the blood, removes congestion and moderates menstruationK promotes astriction, resolves mucous damp and stops bleeding and discharge. • ,ncreases reproductive qi and promotes menstruation as ell as resolves qi constraint to relieve pain and spasms . • 4esolves .iver35pleen disharmony9 stimulates digestion, promotes bile flo reducing liver congestion, fullness and appetite loss . • 1romotes s eating dispelling ind cold3heat. Current Medical Uses: • Achillea is a nervous and smooth muscle rela$ant having both stimulating and rela$ant properties. 6hus, Achillea appears to be homeostatic in these tissues. Achillea is both a rela$ant and tonifying agent for the smooth muscle of the pelvic viscera. Achillea influences the autonomic nervous system to relieve spasm and provide general tonification. ,t is astringent and used as a hemostatic in a variety of bleeding conditions associated ith mucous membranes. As a diaphoretic, it is utili(ed in any febrile condition, including acute, chronic and recovery phases. 2F • Weiss states that good results can be achieved only ith long&term regular use. Although /ill and Bone utili(e Achillea in a variety of conditions, their emphasis appears to be placed on its use as supportive rather than leading herb. Bill /itchell has observed that Achillea supports both the liver and #idney here he utili(es Achillea in bitter combinations for sluggish digestion ith !hionanthus and *entiana =aa>. • !ardiovascular !onditions9 7aricose veins, elevated diastolic blood pressure. 2H • *astrointestinal !onditions9 Being predominately bitter, Achillea is used for atonic states of the stomach. 2B 6he *erman !ommission ' lists indications as loss of appetite and dyspeptic ailments, such as mild, spastic discomforts of the gastrointestinal tract.2C /ills and Bone include the use of Achillea as a diaphoretic herb to control fever in gastrointestinal infections and viral hepatitis.30 • *ynecological !onditions9 Achillea is considered a universal regulator of female reproductive function. ,t achieves this effect through vitali(ing the venous circulation to remove uterine and pelvic congestion. 6he essential oil appears to be amphoteric. ,t is a uterine stimulant, and relieves delayed, painful menses and has a spasmolytic effect allaying dysmenorrhea. 6he herb is used as a hemostatic in dysfunctional uterine bleeding. 3A Weiss states that Achillea@s main area of indication is spastic parametrophathy =cramp&li#e pain in the pelvic area, often not clearly defined by location, bac# pain, vaginal discharge, pruritis, painful breasts and dysmenorrhea>.32 ,n regard to menorrhagia, Achillea ill chec# e$cessive bleeding if ta#en long&term and is used as a supportive herb for uterine myomas.33 As sit( bath Achillea can be used in the treatment of painful, cramp&li#e psychosomatic conditions in the lo er part of the female pelvis. 3< • 4espiratory 5ystem !onditions9 Achillea is indicated as a diaphoretic in acute and chronic bronchitis. 3E #harmacy: ,nternal9 • *eneral recommendations9 • <.Eg herb3day or 3g flo ers3day for teas or other galenic preparations. 3F • ,nfusion9 • A&2 g of herb in AE0 ml boiled ater $ A0&AE min. 5ig9 6,% ic 3H

• As diaphoretic9 < cups yarro tea at nigh, cover up and s eat out disease • 5uccus =pressed "uice from fresh herb>9 5ig9 Eml =Atsp> 6,% ic 3B • )luid e$tract9 • A9A=g3ml> 5ig9 A&2 ml 6,% ic3C • L&A drachm<0 • 6incture9 • A9E =g3ml>. 5ig9 Eml 6,% ic<A • As diaphoretic9 not as effective as tea. AE&<0 gtts <2 '$ternal • 5it( bath9 A00g herb320. =E gal> arm or hot ater. 5oa# A0&20 min, rinse. <3 Contraindications: • Allergy to ;arro or other composites.<< • 1regnancy. <E <F <H )o*icity: 6he volatile oil contains thu"one, hich is a neuroto$ic compound <B.

Aconitum napellus
Common name: Ha!itat: /on#shood, Wolfsbane

+anunculaceae

Botanical description: A robust, erect plant ith violet&blue flo ers occurring in racemes , follo ed by capsules of angular, rin#led seeds. 6he root is blac#, conical ith hite and starchy fracture. #arts used: root Constituents: • :or&diterpene al#aloids<C =A.2G>9 including aconitine, mesaconitine, hypaconitine, :&desethyl aconitine, o$oaconitine, aconine, neopelline, picraconitine, napelline, ben(oylaconine, traces of ephedrine and sparteineK • 0ther9 Acids =aconitic, itaconic>, 5ugars, 5tarch Medicinal actions: 5edative, anodyne, febrifuge #harmacology: 6he al#aloids in Aconite stimulate and then depress the myocardium, smooth muscles, s#eletal muscles, central nervous system and peripheral nerves.E0 Aconite as observed to increase the force of contraction of the heart via its stimulating effect on the nerves innervating the vasculature and the heart. Aconite inhibits ability to transmit nerve impulses by impairing the flu$ of ions across the nerve membrane. 6he nocieptive effect is due to adrenergic receptor interaction as opposed to opiod receptor interaction. 6he efficacy of the drug is based on the di&ester al#aloids aconitin, mesaconitin, and hypaconitin. Aconitin raises membrane permeability for sodium ions, and retards repolari(ation. Aconitin is initially stimulating, and then causes paralysis in the motor and sensitive nerve ends, and in the !:5. 6he other di&ester al#aloids function in a similar fashion. +ypaconitin or#s more intensely. Aconitin applied in small doses triggers bradycardia and hypotensionK in higher doses it has, at first, a positive inotropic effect, follo ed by tachycardia, cardiac arrhythmia, and cardiac arrest. %i&ester al#aloids ere sho n to be analgesic in animal e$periments. Applied topically in humans, the drug is initially stimulating, in the form of itchiness or burning, and then anaestheti(ing. ,n people ith fever, the drug causes outbrea#s of s eat and has an anti&febrile effect. 6herapeutic doses influence the heart minimallyK the heart rate may increase slightly. *iven orally, the drug is active after a fe minutes. EA )raditional Medicinal Use: 5pecific ,ndications and Uses9 6he small and frequent pulse, hether corded or compressible, is the direct indicationK asthenic febrile state, ith or ithout restlessnessK chilly sensationsK s#in hot and dryK irritation of mucous membranes, ith vascular e$citation and determination of bloodK hyperemiaK tonsillitis and laryngitis, early stageK simple colitisK E2 either elevated or depressed temperature and not due to sepsis, early stage of fevers ith or ithout restlessness.J E3 A remedy, such as aconite, hich stimulates the vascular system to normal activity in minute doses, reducing febrile states, described as a Mspecial sedativeM by the 'clectic physicians. As a special sedative, Aconite as deemed useful in all asthenic febrile and inflammatory diseases and in all affections in hich there is an increase of nervous, vascular, or muscular action ith determination of blood to the parts. !oo# did not describe the use of Aconite, therefore the follo ing indications are based on 'clectic observations. • !ardiovascular !onditions9 Aconite as observed to be a positive inotrope and increase the tone of the blood&vessels, particularly capillaries. 5cudder considered Aconite the remedy hen capillary circulation is poor due to dilatation and lac# of tone causing mar#ed enfeeblement of the circulation, hich is manifested by changes in the pulse =see the Aconite monograph in ?ings for more detail on pulse descriptions>. ,n cardiac diseases, it has been beneficially employed in palpitation secondary to irritation and for heart spasm, ith a feeling of suffocation and as if the heartNs action ould ceaseK it is a prompt remedy. • %ermatologic !onditions9 6he action of Aconite as ell regarded in many inflammatory s#in diseases as in erysipelas, hen high fever is present. 6he 'clectics believed that no remedies surpassed aconite and Belladonna in the e$anthematous diseases, and very frequently no other remedy than aconite ould be indicated in scarlatina and measles. +ere the hot, dry s#in, ith vascular e$citation, indicated Aconite. )ever as observed to fall as soon as the eruption appears, hich aconite aids in bringing out. • '':6 !onditions9 ,ts effect as understood to shorten the inflammatory stage and allay pain in acute catarrh of the middle ear, though suppuration as not al ays averted. ,nternal and e$ternal use of Aconite as applied in mastoid disease. • *astrointestinal !onditions9 Aconite as one of the first remedies for gastrointestinal diseases in the 'clectic practice, especially in bo el troubles of children. All disorders resulting from cold or ith inflammation, specified aconite as a part of the treatment. ,n aphthous conditions, ith fever, Aconite as combined ith 1hytolacca. %iarrhoea, cholera infantum, cholera morbus and acute gastrointestinal irritation, ere treated ith aconite and ,pecac. ,n dysentery, aconite, combined ith ipecac and magnesium sulphate, as used as a very prompt remedy. Aconite as often indicated in the diarrhoea of teething. !ombined ith *elsemium, Aconite as considered of value in cases of influen(a =Mla grippeM>. • *ynecological !onditions9 4ecent amenorrhea, due to cold, called for aconite if the circulation and temperature are

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increased. %isorders of the menopause, ith alternate chills and flushes of heat, M ith rush of blood to the bead,M cardiac palpitation, dyspnea, gastric fullness, and sense of distension in the bladder, ith frequent attempts to pass urine, are relieved by the usual dose of aconite every half hour ,n uterine hemorrhage, as menorrhagia, ith hot, dry face and e$cited circulation, aconite as used for relief. ,nflammatory !onditions9 ?ing noted that in asthenic or adynamic states Aconite reduces fever, generally in the proportion in hich it controlled the heart rate9 if the temperature as high, it reduced itK if it as abnormally lo , it raised it. ,n simple fevers, aconite as used to aid diagnosis9 if in t elve hoursN treatment ith aconite the patient is not ell, or mar#edly improved, he3she has more than a case of simple fever. ,n scarlatina, inflammatory fever, acute rheumatism, peritonitis, gastritis, and many other acute disorders, it has been used ith the most decided advantage. 4heumatic and intermittent fevers called for it, especially hen slight chilly sensations are repeatedly e$perienced. Aconite as use to increase the action of !imicifuga in acute rheumatism, and particularly here there is a tendency to muscular spasm, but infection must not be present. Aconite as also used to decrease peridental inflammation. /ental perturbation ith fever, a fear of impending disaster and melancholia, as said to be relieved by Aconite9 it as considered Mthe pulsatilla of the febrile state.M :eurological !onditions9 By its action on the sensory nerves, Aconite as considered a valuable remedy in various forms of neuralgia. ,ts action on neuralgias as not observed to be pronounced hen administered alone in most instances, but rather aids other indicated remedies, particularly here fever is a concomitant condition. )or e$ample, in facial neuralgia, Aconite as combined ith 1iper methysticum. Aconite as observed to act as a gentle stimulant to the sympathetic system. !onsequently, it as used to decrease irritation and inflammation in the parts supplied by the sympathetic nervous system. ,t also has a tendency to lessen pain and nervous irritation. 0phthalmological !onditions9 +yperemic, edematous con"unctiva, ith a feeling of burning and dryness, ere the indications for Aconite@s use locally and internally in inflammatory affections of the eye and its related structures. 1ulmonary !onditions9 By its control over the sympathetic nervous system, and its influence on the circulation and temperature, Aconite as regarded as one of the most important remedies in the treatment of respiratory lesions. Aconite as considered the remedy for irritation of the mucous surfaces =compare ith Bryonia>. Acute catarrh, nasal and faucial, acute pharyngitis, and ulcerated tonsils, ith elevated temperature ere used as indications for aconite. ,t as the first remedy thought of in tonsillitis, spasmodic and mucous croup. ,t as used internally and locally. ,n spasmodic croup, Aconite as observed to quic#ly allay spasm and dyspnoea. ,n tonsillitis it as used to materially lessen the duration of the disease. ,ts use in acute bronchitis and laryngitis provided good results. ,n pneumonia, catarrhal or fibrinous, it as used in the earlier stage to control the inflammatory process, though of less value in the latter stage hen Bryonia as preferred. ,t as considered one of the best agents to prevent acute catarrhal pneumonitis, as a complication of measles, and one of the best to control it in case it does supervene. ,n pleurisy it as associated ith Bryonia in the earlier stage, ith sharp pain, mar#ed chill and high temperature, and the use of the Bryonia as continued to remove the effusions after the acute pains had subsided. ,t as said to give relief in asthma, ith high temperature. 6opical Applications9 .ocally, aconite has been used in painful and neuralgic states.

Current Medicinal Use: Aconite is considered to be a po erful poison and is therefore not used often internally. ,n small doses it has some internal indications. :o human trials for Aconite have been performed to date. • *astrointestinal !onditions9 ,n gastrointestinal irritation manifesting as nausea and vomiting or diarrhea ith fever present, aconite ould be administered and e$pected to allay the irritation ithin hours. • ,mmune !onditions9 Aconite as also used to reduce fever and inflammation. Aconite as most specifically indicated in sudden onset fevers. ,ts administration ould restore normal body temperature, primarily through vasodilation in the e$tremities, and relieve associated pain and inflammation quic#ly. Aconite as also used for neuralgias to relieve the pain and any associated inflammation. • :eurological !onditions9 • 6opical Applications9 Aconite ill cause locali(ed anodyne and antiinflammatory effects. +o ever, the al#aloids are absorbed through the s#in and thus minute doses must be used topically to avoid to$icity. 0ne to t o drop added to a L o( ear drop formula is an e$ample of an e$ternal anodyne application. 0ther topical indications include trigeminal neuralgia, sciatica, and respiratory complaints. #harmacy: Aconite has a small therapeutic window A9A0 tincture9 A&A0 drops daily dose in < o(. ater, A tsp of the ater mi$ture q L&2 hr. to achieve a A330 th drop dose. for croup9 A drop in AF o(. ater, A teaspoon q AE&30 min. /a$ dose is one drop. =Alschuler> According to ?ing9E< 5pecific tincture9 A&E gtt tincture =strength not specified> in < o(. ater 5ig. A tsp q A32 to A hour.

39A 6incture H0G alcohol9 A to 3 drops '$tract9 A to 2 grains =made from evaporation of an appro$imately 3.E9 A percolate. )luid e$tract9 A3< to A drop =strength not specified> Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: :o information is currently available from the selected resources. )o*icity: 6o$ic effects may be seen ith greater than A0 drops of the tincture. )atal doses are9 A gm of plant, E ml of tincture, 2 mg of aconitine. 6o$icity symptoms are9 :ausea and vomiting, tingling or burning follo ed by numbness of the mouth, throat, and handsK di((iness, restlessness, loss of speech controlK intense headacheK pinpoint pupils, blurred visionK slo and ea# pulseK hypotensionK irregular heartbeat and breathingK chest painK ventricular fibrillation in about 2 hours =A&F hours>K s eating and hypothermiaK patient is cold and cannot standK face is pale, e$treme an$ietyK diarrhea, muscular ea#ness, convulsion and death due to respiratory failure. 6reatment9 Activated charcoal orally, gastric lavageK !14 and 02 prnK 6rendelenburg positionK stimulants =coffee or nu$ vomica>, digitali(ation for cardiac depressionK atropine to prevent slo ing of heart, phenytoin for heart.
49 50

,bid Brin#er ), The Toxicology of Botanical Medicines, 2nd ed., ACB392. 51 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 52 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 53 )elter, W, The Eclectic Materia Medica, Pharmacology and Therapeutics , 'clectic /ed. 1ubl, 5andy, 04, 3rd reprint ACC<, originally published AC22. 54 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

Adonis vernalis
#heasants eye dyspnea =30$>, cardiac incompetence

Aesculus hippocastanum

Hippocastanaceae Common name: horse chestnut • 5 eet chestnut is !astanea vesca hose leaves are used as an e$pectorant in bronchitis and hooping cough • A. glabra and A. flava, both #no n as the 0hio Buc#eye, are said to possess properties similar to A. hippocastanum Ha!itat: Botanical description: #art used: fruit =nut>, bar# =not commonly used in modern practice> $nergetics: Constituents EE )0.,U/ =leaf> • !ourmarin glucosides9 aesculin, flavonol glycosides. • 6riterpene saponins • +ydro$ycoumarins9 chief components aesculin, in addition fra$in and scopolin • )lavonoids9 including rutin, quercitrin, isoquercitrin • 6annins 5'/': =seed> • Triterpene saponins: =3&BG, saponin mi$ture #no n as aescin>9 chief components beta&aescin =diesterglycoside mi$ture of the protoaescigenins>, through migration of an acetyl group into the more ater&soluble, but hemolytically only some hat cryptoaescigenin, alpha&aescin is an equilibrium mi$ture made up of beta&aescin and cryptoaescin. • la!onoids: in particular biosides and triosides of the quercetins • "ligosaccharides: including A&#estose, 2&#estose, stachyose • Polysaccharides: starch =E0G> • "ligomeric proanthocyanidins, condensed tannins: =only in the seed&coat> • atty oil: =2&3G> #harmacology: Aesculus acts on the connective tissue barrier bet een blood vessels and tissue reducing vascular fragility and permeability. 6he inhibition of e$udation discourages edema. #$ As found in different animal tests, the principal ingredient in Aesculus seed e$tract, the triterpene glycoside mi$ture, aescin =escin>, has an antie$udative and vascular tightening effect. 6here are indications that Aesculus seed e$tract reduces the activity of lysosomal en(ymes hich is increased in chronic pathological conditions of the veins, so that the brea#do n of glycocaly$ =mucopolysaccharides> in the region of the capillary alls is inhibited. 6he filtration of lo &molecular proteins, electrolytes and ater into the interstitium is inhibited through a reduction of vascular permeability. EH Aesculus has demonstrated free radical scavenging activity and inhibition of lipid pero$idation in vitro. Aesculus e$tract demonstrated strong active o$ygen&scavenging activity and protective activity in vitro against cell damage induced by active o$ygen. 5tandardi(ed Aesculus e$tract =containing H0 escin> inhibited en(ymatic and non&en(ymatic lipid pero$idation in vitro and counteracted the deleterious effects of free radical o$idative stress in mice and rats =20=/00 mg3#g oral, 2E mg3#g ,7, respectively>. 'scin, in its natural form, is not absorbed in the gut. 4ather, modification is necessary for therapeutic use. EB +o ever, 'scin appears to accumulate in the s#in and muscles only ithin the area of topical application. 'scin reduces the locali(ed edema associated ith inflammation by reducing capillary permeability resulting in decreasing e$udation into the interstitial spaces. 6he inhibitory effects of plant constituents on the activity of the connective tissue en(ymes elastase and hyaluronidase as investigated in vitro. 5aponin constituents from Aesculus sho ed inhibitory effects on hyaluronidase. 6he activity as mainly lin#ed to escin and, to a lesser e$tent, its genin, escinol. 6riterpene oligoglycosides from Aesculus =escin la, ,b, ,,a and lib> e$hibited an inhibitory effect on ethanol absorption and hypoglycemic activity on oral glucose tolerance test in rats. EC Medical actions: venous trophorestorative, anti&spasmodic, anti&edemic, anti&inflammatory, tonic, astringent, febrifuge, narcotic antiseptic Historical use: :o information is currently available from the selected resources. )raditional Medicinal Uses:

5pecific ,ndications and Uses9 7isceral neuralgia, due to congestionK soreness of the hole body, ith vascular fullness, throbbing, and general malaiseK throbbing, fullness, and aching in the hepatic regionK rectal uneasiness ith burning or aching painK sense of constriction, ith itchingK large, purple pile&tumorsK uneasy sensations and refle$ disturbances depending upon hemorrhoids or rectal vascular engorgement.F0 ?ing noted that Aesculus influences the nervous and circulatory systems, having a selective affinity for the portal circulation. 6he 'clectics used Aesculus for visceral neuralgia and then only in cases of abdominal plethora, a generali(ed term for fullness or repleteness in an area =i.e. e$cess from a 6!/ perspective>. !oo# described the bar# as a narcotic astringent and not a curative agent. +e found the rind of the nuts is a stronger narcotic possessing about one&third the strength of opium, although ?ing stated that this claim is unsubstantiated. • !ardiovascular !onditions9 Use of the specific medication had taught the 'clectics that it is a remedy, for congestion and engorgement, but not active conditions. ,t as indicated in general by capillary engorgement, a condition of stasis, ith vascular fullness and sense of soreness, throbbing, and malaise all over the body. An uneasy, full, aching pain in the hepatic region is also an indication. 4ectal disorders, such as rectal irritation and hemorrhoids, ith mar#ed congestion and a sense of constriction, as if closing spasmodically upon some foreign body, ith itching, heat, pain, aching, or simple uneasiness, are indications here Aesculus as #no n to e$ert a specific influence9 such hemorrhoids are purple, large, do not bleed as a rule, but there is a sense of fullness, or spasm of the parts, and a free diarrhea may be present. • ,nflammatory !onditions9 6he 'clectics used Aesculus bar# in intermittent fever. • ,nfectious !onditions9 *angrenous and ill&conditioned ulcers have&been benefited by a strong infusion of the bar#. • 6opical Applications9 ,n 'urope, during the time of the 'clectics and 1hysiomedicalists, the oil of horse&chestnuts as considered a valuable local application in neuralgic and rheumatic affections. Current Medicinal Uses: • !ardiovascular !onditions9 Aesculus is a trophorestorative for venous tissue and is found to be much more effective than rutin. $% 6his effect is attributed to aesculin. 'scin, on the other hand, also e$erts an effect on the vascular alls enhancing the ability for tissue fluid to drain into capillaries by increasing intravascular oncotic pressure. 'scin has anti&edema and anti&inflammatory properties and decreases capillary permeability by reducing the number and si(e of the small pores of the capillary alls. 6he reduction in capillary permeability and edema appears to be due to inhibition of the lysosomal en(ymes =mentioned above> hich brea# do n the proteoglycans of the ground substance. ,nvestigators have also demonstrated that escin has venotonic activity. 6hus, Aesculus is indicated in acute thrombophlebitis, s elling ith bruises, fracture, brain trauma and stro#es. !linical trials have supported use for chronic venous insufficiency, varicose veins, and edema of the lo er limbs. $& 1rophylactic use decreases the incidence of deep vein thrombosis follo ing surgery. Aesculus is indicated in the early phase of inflammation. 6hus, Aesculus can be applied topically for hematoma, contusions and other non&penetrating ounds involving edema. )or varicose veins, Aesculus is combined ith bioflavonoids. As mentioned earlier, rela$ation of the venous all contributes greatly to the development of varicose veins. 'scin@s venotonic activity has been confirmed in clinical trials that demonstrate a positive effect in the treatment of varicose veins and thrombophlebitis. ,n fact, e$tracts of Aesculus seed standardi(ed for escin appear to be as effective as compression stoc#ings ithout the nuisance. ,n a placebo&controlled trial in patients undergoing surgery of the hand, intravenous administration of escin produced a fast reduction in postoperative inflammation and edema. 'scin is mainly used by in"ectionK for e$ample, to treat road accident victims ith severe head in"ury, here it reduced the dangerous rise in intracranial pressure, leading to a more favorable prognosis. 'scin has been effective in the treatment of cerebral edemas follo ing cranial fractures and cranial traumas ith or ithout retrograde amnesia, cerebral tumors, intracranial aneurysms, cerebral sclerosis, subdural hematomas, encephalitis, meningitis and cerebral abscesses. %epending on the seriousness of the condition, disappearance of cephalgia, vertigo and general discomfort ere observed ithin 3&AF days. !erebral edemas due to acute vasomotor insufficiency ere resolved quic#ly, hile in chronic diseases remission occurred slo ly over a long period of administration. F3 • /usculos#eletal !onditions9 Weiss prevented nocturnal leg cramps by ta#ing t enty drops or more at night as a long&term treatment. • :ervous !onditions9 Aesculus has also been used to remove fluid from the spinal ganglia and relieve the pressure on nerve strands in intervertebral disc abnormality. $' Aesculus may provide relief in other conditions here local tissue edema may be involved as in carpal tunnel syndrome, Bell@s palsy.FE • 6opical Applications9 '$ternal applications of Aesculus are used in the forms of ointments and gels for varicose veins =it is important not to massage the varicosity in order to avoid inflammation of the vein>. After application of the topical form, an elastic bandage or stoc#ing should be orn. A gel containing Aesculus e$tract and heparin as found to be effective in the treatment of acute and chronic traumas and venopathies in an uncontrolled study. ,n particular, the gel quic#ly bro#e do n hematomas. 6he tolerance and efficacy of a topical Aesculus preparation ere assessed in AE patients ith first and second&degree chronic venous insufficiency. 6he Aesculus

preparation contained A.< triterpene glycosides calculated as escin and as compared ith a preparation containing heparin. 'fficacy as assessed via the change in circumference of the lo er, middle, and upper leg and by changes in symptoms. Both treatments ere ell tolerated and the Aesculus preparation sho ed a higher tendency to improvement than the heparin. FF Current +esearch +eview • Cardiology: o -enous insufficiency: 5tudy A9FH  %esign9 0pen, controlled clinical trial  1atients9 )orty patients ith diagnosed chronic venous insufficiency  6herapy9 7enostasin =horse chestnut seed e$tract>, F00 mg qd or 1ycnogenol =)rench maritime pine bar# e$tract>, 3F0 mg qd $ < ee#s  4esults9 7enostasin only moderately but not significantly, reduced the circumference of the lo er limbs and marginally improved symptoms. 7enostasin had no influence on the determined +%. and .%. values. 6he authors concluded that 1ycnogenol is more efficacious than 7enostasin for the treatment of !7,. 5tudy 29FB  %esign9 4andomised partially blinded placebo&controlled parallel study design clinical trial  1atients9 6 o hundred forty patients ith chronic venous insufficiency.  6herapy9 !ompression stoc#ings class ,, or dried horse chestnut seed e$tract =+!5', E0 mg aescin, B,%> $ A2 ee#s.  4esults9 .o er leg volume of the more severely affected limb decreased on average by <3.B m. =n O CE> ith +!5' and <F.H m. =n O CC> ith compression therapy, hile it increased by C.B m. ith placebo =n O <F>. 5ignificant edema reductions ere achieved by +!5' and compression, compared to placebo, and the t o therapies ere sho n to be equivalent. Both +!5' and compression therapy ere ell tolerated. 5tudy 39FC  %esign9 Uncontrolled clinical trial  1atients9 6hirty five patients ith chronic venous insufficiency  6herapy9 5tandardi(ed horse chestnut e$tract  4esults9 +orse chestnut e$tract as effective against foot edema ithout inducing changes in hematocrit, body eight and serum potassium. 5tudy <9H0  %esign9 Uncontrolled clinical trial  1atients9 +ealthy volunteers and patients ith varicose veins  6herapy9 5tandardi(ed horse chestnut e$tract  4esults9 6here as an increase in venous tone ithout arterial constriction or change in blood pressure. 5tudy E9HA  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 1atients ith variocose veins  6herapy9 5tandardi(ed Aesculus e$tract, F00 mg =A00 mg escin> qd $ 3 #s  4esults9 4eduction of sub"ective symptoms. 5tudy F9H2  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 )orty patients ith leg edema caused by chronic deep venous incompetence  6herapy9 5tandardi(ed Aesculus e$tract H3B&B2< mg qd =containing AE0 mg escin> or placebo $ H ee#s  4esults9 5ignificant reduction in average leg volume as observed for the treated group compared to placebo, both before and after an edema provocation test. .eg pressure at rest as decreased =indicating better venous tone> and pronounced alleviation of symptoms occurred in the treated group. 5tudy H9H3  %esign9 4andomi(ed double&blind placebo&controlled clinical trial  1atients9 6 enty t o patients ith chronic venous insufficiency.  6herapy9 Aesculus e$tract, F00 mg =A00 mg escin>  4esults9 6hree hours after ta#ing Aesculus e$tract, a significant decrease in the capillary filtration coefficient =22G> as observed in the treated group. 5tudy B9H<  %esign9 4andomi(ed double&blind placebo&controlled clinical trial  1atients9 6 enty patients ith venous insufficiency  6herapy9 5tandardi(ed Aesculus e$tract, F00 mg qd =A00 mg escin> $ < ee#s.

4esults9 5ignificant improvement in volume changes of the foot and an#le, as ells as in symptoms such as edema, pain, fatigue, feeling of tension and itching. :o changes in venous capacity or calf muscle spasm ere observed. 5tudy C9HE  %esign9 4andomi(ed double&blind placebo&controlled clinical trial  1atients9 5eventy&four patients ith chronic venous insufficiency and lo er leg edema  6herapy9 5tandardi(ed Aesculus e$tract, F00 mg qd, =A00 mg escin> $ B ee#s  4esults9 .eg volume as reduced, progress of edema as slo ed, and sub"ective symptoms ere improved in the treatment group. 5tudy A09HF  %esign9 4andomi(ed double&blind placebo&controlled crossover clinical trial  1atients9 6 enty omen ith pregnancy&induced varicose veins or chronic venous insufficiency.  6herapy9 5tandardi(ed Aesculus e$tract $ < ee#s  4esults9 5ignificant reduction in leg volume 5tudy AA9HH  %esign9 4andomi(ed double&blind clinical trial  1atients9 6hirty patients ith peripheral venous incompetence  6herapy9 5tandardi(ed Aesculus e$tract, F00 mg qd, =A00 mg escin> $ < ee#s  4esults9 4eduction in leg circumference and improvement in sub"ective symptoms  #harmacy: Use should be limited for 2&< ee#s at hich point evaluation of patient status is considered =Alschuler> although /ills and Bone state that no restriction on long term use has been demonstrated. Although escin appears to or# ell alone, the hole plant seems to have greater benefit as escin combined ith bioflavonoids has a greater effect and escin bioavailability through the gut is poor.HB 1repared products9 4eparil =/adaus>9 modified aescinK 0ther prepared products9 Apoplectal, 7enastasin, !yclovenfc ,7 =β&escin> acute conditions, not to e$ceed 20 mg =infants9 0.A mg3#gK children 3&A0yrs9 0.2 mg3#g> %ried seed9 A&2 g qd =1reparations require soa#ing and discarding the ater prior to processing to remove a strychnine property.> 6inctures and '$tracts9 E9A standardi(ed e$tract9 200 mg, standardi(ed to contain <0 mg escin, 2&3 tablets qd A92 liquid e$tract9 2&F ml A9E tincture9 E&AE ml Drug ,nteractions: • Anticoagulant therapy9 bar# should not be used ith anticoagulants due to antiplatelet activity of esculetin =speculative>. HC Contraindications: *enerally, Aesculus is contraindicated in children under <, acute #idney inflammation, gastric ulcer, topical on bro#en s#in and pregnancy =/ills and Bone disagree indicating its use in pregnancy>. Brin#er also contraindicates its use in bleeding disorders due to inhibition of .0P and platelet aggregation. B0 )o*icity: Aescin has hemolytic properties, though such property is minimal ithin therapeutic doses. +o ever, past reports of acute renal failure from in"ection of β&aescin have revealed to be due to dosages much greater than manufacturer recommendations being used in children. (% ,n over&doses it affects the cerebro&spinal system some hat after the manner of nu$ vomica. %i((iness, fi$ation of the eyes, impairment of vision, vomiting, ry&nec#, opisthotonos, stupor, and tympanites are among its effects. ,n lethal doses these symptoms are increased, coma supervenes, and death finally ta#es place. 6he dried po der of the nut inhaled causes violent snee(ing.

Agropyron repens.$lymus repens
Common name: couchgrass

#oaceae

Ha!itat: ,ndigenous to the temperate regions of :orthern +emisphere. ,ntroduced to *reenland, 5. America, Australia, and :e 8ealand. Botanical Description: #arts Used: 4hi(ome $nergetics:/0 A bit s eet and bland, cold, moist Constituents: B3 • 5aponins • !arbohydrates =3&BG triticin polysaccharide, 2&3G inositol and mannitol, A0G mucilage> • 7olatile oil =agroyprene>, fi$ed oil • β carotene • /inerals =silica, iron, potassium> • 7anilloside • 5ilicic acid and silicates. #harmacology: • Agropyron is considered a saponin&based diuretic. B< • /annitol is used as a diuretic intravenously in acute oliguric renal failure. +o ever, it is unli#ely that mannitol by itself plays a significant role in diuretic action of Agropyron, since its absorption from the gut is poor, but similar sugar molecules may account for duiresis.BE Medicinal actions: • %iuretic, e$pectorant =Alschuler> • %iuretic, demulcent, anti&microbial BF, BH )raditional medicinal uses: BB • *enitourinary !onditions9 Agropyren e$erts a soothing, diuretic influence on the urinary system, greatly increasing the flo of urine ithout stimulating actual renal secretion. ,t is used henever urine has a high specific gravity and irritation of the mucosa of the bladder or #idneys. 5uch conditions include pyelitis, hematuria and catarrhal and purulent cystitis. Agropyron ill soothe the irritation caused by gravel. As for functional complaints, it is indicated in tenesmus and strangury =dysuria ith interrupted urination in drops produced by spasmodic musculature contraction of the urethra and bladder>. Although not urinary complaints, gout, chronic rheumatism and "aundice can be affected if any of the above conditions are concurrently present. Also, it has been applied to reduce a fever through diuresis. Current medicinal uses: • *enitorinary !onditions9 !ouchgrass is most indicated in irritation of the urinary system manifested by frequent urination and urgency ith the passage of mucus and even blood. ,t is specifically indicated for intense burning sensation and constant desire to urinate. Agropyron is also indicated in incontinence due to the follo ing conditions9 o Urinary infections such as cystitis, urethritis and prostatitis, particularly in combination ith Agathosma, Arctostaphylos or Achillea. BC o 'nlarged prostate due to its demulcent properties to soothe irritation and inflammation. C0 !an be combined ith +ydrangea.CA o *ravel and #idney stonesC2 • 1ulmonary!onditions9 ,t is a soothing e$pectorant and ill reduce the irritation of dry, non&productive coughs. ,t is best used as a tea or cold infusion and has a pleasant taste. • 0ther uses9 As a tonic diuretic, couchgrass has been used ith other herbs in the treatment of rheumatism. C3 Current +eseach +eview • 5earch of /edline revealed no human trials as of A3AE303

#harmacy: • %ecoction9 o 2 tsp3cup ater. Bring to boil, simmer $ A0 min. %rin# 6,%. C< o E&20 g3day QA tsp. OA.EgR • A9E tincture9 3&F ml tid Drug interactions: Contraindications: )o*icity: Agropyrens is ell tolerated and no side effects have been reported. CE

Alchemilla vulgaris
Common name: .ady@s mantle Ha!itat: 6his is a lo gro ing meado plant. ,t is very easily cultivated.

+osaceae

Botanical description: A perennial herb ith short rhi(omes, bearing erect stems and a rosette of basal leaves. 6he large leaves have demarcated lobes, and are circular in outline. ,n the morning, the leaved are folded up to form a funnel, containing a fe drops of de . 6he small, yello &green flo ers are in dense cymes, sepels are in 2 rings of < and there are no petals. 6he fruit is an acheme and the hole plant is covered ith soft hairs. 6he flo ers are not pollinated but develop seeds by the process of parthenogenesis. #art Used: +erba Active Constituents: 6annins, glycosides, saponins, bitter compounds, volatile oil, salicylic acid Medicinal actions: Astringent =locally and systemically>, anti&hemorrhagic, anti&inflammatory, uterine tonic. #harmacology: Medicinal use: Alchemilla is especially indicated in cases of e$cessive menstruation. 6he tannins are astringent on the uterus in cases of e$cess menstrual bleeding, postpartum bleeding, and conditions of abnormal tissue gro th such as fibroids. 6he anti&hemorrhagic effect can be seen ithin 3&E days of administration and can be given prophylactically A0&AE days before menses. 6he astringent properties of Alchemilla also ma#e it useful in the treatment of diarrhea and other inflammations of the gastrointestinal system. Alchemilla increases circulation to the reproductive organs and is anti&inflammatory and analgesic due to its salicylates. Alchemilla is most indicated in painful, heavy menses or uterine bleeding from fibroids. Both the pain and the e$cessive blood loss ill be attenuated. Alchemilla may have both phytoestrogenic and progesteronic properties. ,t is most indicated in cases of relatively high estrogen9progesterone ratio. As a hormone balancer, Alchemilla is especially ell&suited for peri&menopausal changes, easing the climacteric symptoms. Alchemilla is an emmenagogue, and as such, ill help to stimulate the menstrual flo if suppressed =this is apparently parado$ical to its astringent effects>. )ccording to Mills and Bone:*$ • *ynecologic !onditions9 A main aim of herbal assistance ith menopausal changes include assisting the body to adapt to the ne hormonal levels by reducing the effects of estrogen ithdra al. 5uch an effect can be achieved by utili(ing saponin& containing botanicals such as Alchemilla vulgaris. • *astrointestinal !onditions9 6annin rich herbs, such as Alchemilla are indicated for inflammatory conditions of the digestive tract such as diarrhea follo ing gastrointestinal inflammation. • 6opical Applications9 6annin rich botanicals can be utili(ed topically for open, discharging lesions, ounds, hemorrhoids and burns )ccording to +eiss9CH • *ynecologic !onditions9 6his herb has idespread use on one hand and lac# of real information on the other. 6he indication for its use should bye limited to constitutional leu#orrhea. #harmacy: According to /ills and Bone, tannin rich herbs should be ta#en after food in most cases. )or some upper *, lesions short&term use bet een or ith meals can be used. .ong&term used ith high doses is not advisable. CB ,nfusionK sig A&2 tsp.3 cup 6,% QA tsp. O 0.CgR 6incture A9E 2EG't0+K sig E ml 6,% )luid '$tract A9A 2EG 't0+K sig A&3 ml 6,% %ouche =for leu#orrhea> Contraindications: 6annin rich botanicals, in general, are contraindicated in constipation, iron deficiency anemia and malnutrition. CC )o*icity:

Aletris farinosa
Common name: Bla(ing 5tar, 5tar grass, 5tar 4oot, 6rue Unicorn 4oot Ha!itat: 6hroughout the U.5. gro ing in fields and at the edge of s ampy oods.

Haemodoraceae

Botanical description: .o &gro ing, spreading perennial herb. .eaves lanceolate, acute, ribbed, sessile, smooth, flat, pale colored. )lo er stem is A&3 feet high ith a spi#ed raceme of short&stal#ed, hite, bell&shaped flo ers. 6he root is hori(ontal, tuberous and cylindrical ith many fibers from its lo er surface. #arts used: 4oot Constituents: Bitter principle, resin, polysaccharides Medicinal actions: Uterine tonic, ovarian tonic, male reproductive tonic, stimulating e$pectorant Medicinal use: • *ynecologic !onditions9 Aletris is very bitter and is a good general tonic. 6he specific indications for Aletris are e$treme ea#ness of the uterus, often from frequent child&bearing. +yperactivity of the uterus and ovaries resulting in lac# of pelvic tone, deficient menstruation, infertility, pale, insufficient menstrual flo , and anemia are good indications for Aletris. When given as small doses, Aletris is helpful in any situation of pelvic ea#ness =i.e. prolapsus, menorrhagia, metrorrhagia, irregular menses, infertility>. Aletris is a good plant to use in dysmenorrhea. ,t eases the pain hile toning the uterus. Aletris and 7iburnum combine ell for dysmenorrhea and threatened abortion, easing the pain and rela$ing and toning the uterus. ,n menorrhagia, Aletris ill decrease the blood flo and tone the uterus. Aletris is useful in infertility and impotence in females and males and results may be seen ithin a fe ee#s to several months. Aletris is safe throughout pregnancy and is one of the best preventatives of miscarriage. Aletris is also an e$cellent partus preparator. Aletris is useful in dyspepsia and anore$ia of pregnancy through its bitter tonification of the stomach as it tonifies the stomach and relieves intestinal colic. )ccording to +eiss: • *ynecologic !onditions9 Aletris e$erts a tonic effect =as ith all bitters>. ,ts effect is directed to ard the pelvic organs ith indications of pelvic floor rela$ation and prolapse, particularly in older omen. !oncurrent lo bac# pain responds ell also. )ccording to ,cudder:%-• *astrointestinal !onditions9 6he Aletris is a gastric stimulant and improves digestion. • *ynecologic !onditions9 ,t has also proven a valuable tonic in uterine diseases. )ccording to .ing/s:%-% Aletris as commonly substituted for +elonias =6rue Unicorn 4oot> although the plants loo#, smell and taste nothing ali#e. ,t is placed among the simple bitter tonics and stomachics and as such it is employed to promote the appetite and aid digestion and in flatulence, colic, borborygmi, etc. 6his root and its preparations are almost entirely employed in dyspeptic conditionsK hile, in the abnormal conditions of the female reproductive organs, !hamelirium is used. #harmacy: decoction9 A32&A tsp. dried root3cup ater 6,% =Alschuler> tincture9 A9E, A&2 ml 6,% =Alschuler> 5pecific 6incture9 E&20 gtt =?ing@s> E0 mls per ee# according to :/,/+ 1repare a tincture from vii" of the root to Alcohol HFS 0" =pint>. 6he dose ould be from t o to ten drops. =5cudder> Aletris 0ligople$ =/addaus>

Contraindications: !aution is advised in use ith large amounts during pregnancy due to variable effects on animal uteri of either stimulation or depression =speculative>. A02 6he fresh root can be a mucosal irritant.A03 *iven the bitter aspect, it is also a stomach acid secretory stimulant and may be inappropriate in peptic ulcer conditions =empirical> A0< )o*icity: ,f given in large doses or if ta#en fresh, Aletris is narcotic, emetic and cathartic.

Allium sativum
Common name: garlic Ha!itat: Botanical description: #art used: bulb Historical use: $nergetics:

1iliaceae

Constituents: sulfur containing compounds9 sulfo$ides =alliin>,thiocyanates, volatile oil =0.A&0.3G, composed of about A< components>, protein, high concentration of trace min@s =5e>, vitamins, glucosinolated, en(ymes =alliinase, pero$idase, myrosinase> 0)ccording to +eiss, garlic also contains vitamin A, thiamine, nicotinaminde, vitamin !, choline, iodine, saponins and male3female gonad hormone&li#e constituents>A0E #harmacology: Weiss noted that isolation of a particular constituent that ould have at least the main action is not possible. +ence the full effect of garlic is based on the totality of the principles. Alliin is e$posed to alliinase ith crushing hich creates allicin. 7oliatile oil yields T F0G allicin after exposure to alliinase%-$1 Allicin is readily absorbed into the bloodstream and eliminated primarily via the lungs and s#in demonstrating the depth of penetration that garlic has in the body. /edline9 Ali =researcher>9 3 g qd for 2F ee#s inhibits A%1 induced platelet aggregation Medical actions: antimicrobial =antibacterial and antimycotic>, antispasmodic, antidyspeptic, counter irritant, diaphoretic, emmenagogue, e$pectorant, carminative, digestant, anti&hyperlipidemic, anti&platelet aggregant Medical uses: ,n !hinese medicine, garlic is considered a general tonic for the elderly. *arlic e$erts an immediate tonic effect that is thought to be based on stimulation of pituitary function hich relates to 5elye@s stress syndrome =Allium 5ymposium -uly AC&2A, ACB3>. )ccording to 2oo3:%-4 6he physiomedicalists described galic as stimulating, moderately rela$ing and very diffusable A0B. !oo# further stated that garlic e$cites the mucous secretions, facilitates digestion, improves chronic catarrh and promotes e$pectoration. 0ther indications include suppressed menstruation, atonic dropsies and hysteria due to its general e$citation of the nervous system. 6he poultice is used for bladder paralysis and as a counter irritant, often used as a fomentation on the feet to relieve the brain in Icerebral e$citementsJ. !oo# states that considerable quantities or e$ternal application ill e$cite the circulation and can flush the s#in and cause headache. 'ardrops are utili(ed for atonic deafness. Use is contraindicated during inflammation or acute irritation, internally or e$ternally. )ccording to Murray: • ,mmune 5ystem9 *arlic enemas have been used in the treatment of thread orm and 1in orm infections. 4esearch has demonstrated inhibition of 22 micro&organisms including !. albicans, Aspergillus parasiticus, A. flavus and A. ochraeus. Allcicin appears to be the antimicrobial component. %r. /urray describes it@s action against a variety of microbes9 &antibacterial9 5taph, 5trep, Bacillus, Brucella, 7ibrio. &antifungal9 !. albicans, !ryptococcus &antihelminthic9 Ascaris lumbricoides, hoo# orms &viruses9 +57, 1arainfluen(a, 7accinia, 7esicluar stomatitis, 4hinovirus =a"oene> *arlic also decreases nitrosamine formation. • !ardiovascular 5ystem9 ,ndications include arteriosclerosis in hich use and effects are long term. 5arlic inhibits the three processes of responsible for arteriosclerosis: hypercholesterolemia, reduced fibrinolysis and increased thrombocyte acti!ity . A. 6he aqueous e$tract has been sho n to reduce cholesterol levels, again ith allicin being identified as the active principle. *arlic also demonstrated preventative effects from raising cholesterol ith cholesterol consumption. 2. *arlic increases fibrinolytic activity by as much as A30G in one study =up to CE.E G in those patients ith infarction>. 4educed thrombocyte aggregation occurs as ell ith another sulphur compound being responsible =methyl allyl trisulphide& <&A0G of garlic> 6he use of garlic in hypertension has been debatable. 6he cru$ of the dispute tends to revolve around the preparation of garlic9 fresh garlic appears to have a hypotensive effect hile this effect is reduced ith storage. 0ther indiciations include intermittent claudication and arteriosclerotic retinopathy angina. 4esults are less significant ith cerebral arteriosclerosis. )or

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peripheral vascular conditions garlic must be used regularly for long periods, generally at least 3 months. Allium lo ers .%. and triglycerides, but the reduction in lipids is appro$imately A0G for .%. and A3G for triglycerides. *astrointestinal 5ystem9 *arlic is antiseptic in the intestine being idely indicated for gastrointestinal infections including amoebic dysentery and bacillary dysentery. 6hese t o forms of dysentery create a residual irritable bo el that combines functional disorder =spasm, pain, diarrhea, mucous in the stool> and dysbiosis. 6he antibacterial, antispasmodic, antidyspeptic effects come into play to prevent dysbiosis and relieve gas and diarrhea. *arlic has a dose dependent effect on the intestine in that lo er concentrations increased intestinal peristalsis and tone hile higher concentrations inhibited both. Apparently, the stimulation of peristalsis and tone is due to a parasympathomimetic mechanism =atropine bloc#>. ,n turn, the spasmolytic action affected smooth muscle directly. /etabolic )unctions9 *arlic can be utili(ed in the prevention of lead poisoning and in the deto$ification of lead. 'ndocrine 5ystem9 *arlic is utili(ed in diabetes mellitus and is believed to occupy insulin receptor sites freeing insulin to affect other cells.

#harmacy: fresh9 A&3 almond si(e pieces qd, A00&AE0 g used for inhibitiion thrombocyte aggregation =effect lasts for A&2 hrs> =<000 mg fresh O A0 mg alliin O <000 mcg allicin potential> 1o dered9 E g qd 1roducts9 ? ai has been ell studied and does sho some standaridi(ed9 FBµg allicin =antimicrobial study> =3000 mg> fluid e$tract A9E tincture9 20 gtt tid fresh "uice9 ?neipp brand, A 6 gid enema9 one clove is chopped boiled for A0 minutes in U . ater or mil# an retained. 6$ is once per ee#. poultice or compress enteric coated capsules =?losterfrau A#tiv&?apseln> syrup9 F o( garlic, sliced and bruisedK AF o( vinegarK 2 pounds sugar9 macerate garlic in vinegar for < days strain and add the sugar. !onsidering the high sugar content of this recipe, this author ould suggest combining the acetract ith a smaller amount of rice syrup until the desired consistency is attained. Drug ,nteractions: Anticoagulants: *arlic can destroy vitamin ? producing bacteria in the gut. 3g qd for 2F ee#s can reduce platelet aggregation. 6herefore, patients on anticoagulant therapy should have 16 and ,:4@s monitored to stabli(ed dosage of coumadin. Contraindications: Allium is not used ithin A0 days of surgery or ith medications that inhibit blood coagulation. !aution should be used in hypercoagulation conditions as ell due to embolic complications. )o*icity: *enarlly ell tolerated ith side effects being fe . *arlic can cause irritation to the gastric mucosa. *arlic breath is a common complaint although it passes quic#ly. ,n turn, as garlic e$its the lung and s#in the odor is noticeable so patients should be a are of this aspect of garlic therapy. Weiss states Iif the smell is reduced, so is the medicinal action.J

Aloe !ar!adensis. A2 vera
Common name: Aloe Ha!itat: Botanical description: #art used: Historical use: $nergetics: Constituents: A0C • Anthracene derivatives9 particularly anthrone&A0&!&gly#osyls, including aloin A, aloin B, H&hydro$yaloins and A,B& dihydro$yanthraquinones, including aloe&emodin • 2&al#ylchromones9 including aloe resins B, ! and % • 1olysaccharides9 /annose&F&phosphate =acemannan>. Acemannan is found under the s#in in Aloe vera leaves and is often not present in "uice or gel preparations. • )lavonoids #harmacology: 6he constituents that cause the cathartic la$ative effects of aloe late$ are anthraquinone glycosides. 6hese molecules are split by the normal bacteria in the large intestines to form other molecules =aglycones>, hich e$ert the la$ative action. AA0 6his la$ative effect is primarily caused by the influence on the motility of the colon, and stimulation of propulsive contractionsK this results in an accelerated intestinal passage and, because of the shortened contraction time, a reduction in liquid absorption. AAA ,n addition, stimulation of active chloride secretion increases the ater and electrolyte content, thereby strengthening the filling pressure of the bo els, and stimulating intestinal peristalsis. Aloe functions antibacterially and is effective against +erpes 5imple$ viruses. AA2 7arious constituents have also been sho n to have anti&inflammatory effects as ell as to stimulate ound healing.AA3 Medical actions: 6onic, la$ative, purgative, emmenagogue, and anthelmintic. )raditional Medicinal Uses: 5pecific ,ndications and Uses9 Atony of large intestine and rectum, mucoid discharges, prolapsus ani, pruritis ani, ascaris vermicularis, difficulty in evacuating the lo er bo el.AA< ?ing noted that Aloes e$ert a decided tonic influence if applied in small doses, but is seldom resorted to for this purpose. • *astrointestinal !onditions9 Both the 'clectics and 1hysiomedicalists observed that all varieties of aloes are stimulating to the large intestine, acting slo ly but effectively. 6hey observed that Aloes act on the smooth muscle of the large intestines increasing their peristaltic motion rather than effecting copious, thin or atery discharges Aloe as applied for semi&paralysis of the lo er bo el and for orms. ,t as mi$ed ith an al#aline carbonate, as soap, to be less irritating to the bo el. • +epatobiliary !onditions9 Aloe spp. also stimulates the gall&ducts and has been given in "aundiced conditions. • *ynecological !onditions9 !oo# noted that its action on the uterus is associated ith that upon the colonK therefore, he used it to promote menstruation po erfully in debilitated states of the uterus. +o ever, he did not consider it an advisable article for regular use in this purpose. Current Medical Uses: • *astrointestinal !onditions9 ,n ACBE, Bland reported the effect of orally consumed Aloe vera "uice on urinary indican, gastrointestinal p+, stool culture, and stool specific gravity in a semi&controlled study of A0 =five men and five omen> healthy human sub"ects. Urinary indican is used as an indicator of the degree to hich either dietary protein is malabsorbed or intestinal bacteria are engaged in putrefactive processes. After one full ee# of drin#ing F ounces of Aloe vera "uice three times daily, urinary indican levels decreased one full unit. 6his suggests that regular Aloe vera "uice consumption can lead to improved protein digestion and assimilation and3or reduced bacterial putrefaction. AAE 6he use of Aloe vera gel internally to treat peptic ulcers as studied in ACF3. 6 elve patients ith P&ray&confirmed duodenal ulcers ere given A tablespoon of an emulsion of Aloe vera gel in mineral oil once daily. At the end of A year, all patients demonstrated complete recovery and no recurrence. Based on e$perimental evidence, the follo ing factors ere thought to be responsible for the effectiveness9

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Aloe vera gel inactivates pepsin in a reversible fashion. When the stomach is devoid of food, pepsin is inhibited by Aloe vera gelK ho ever, in the presence of food, pepsin is released and allo ed to digest the food. 6he gel inhibits the release of hydrochloric acid via interference ith histamine binding to the parietal cells. Aloe vera gel is an e$tremely good demulcent hich heals and prevents aggravating irritants from reaching the sensitive ulcer. AAF .i#e ise, ith +eidelberg gastric analysis, Aloe vera "uice as sho n to increase gastric p+ by an average of A.BB units. 6his supports the findings of other researchers that Aloe vera gel can inhibit the secretion of hydrochloric acid. AAH ,mmune !onditions9 Aloe vera contains a number of compounds necessary for ound healing, including vitamin !, vitamin ' and (inc. Unli#e many other anti&inflammatory substances, Aloe vera has been sho n to stimulate fibroblast and connective tissue formation, thereby promoting ound repair. Aloe appears to stimulate the epidermal gro th and repair process, presumably due to its polysaccharides. /annose&F&phosphate, the ma"or sugar in the Aloe vera gel, may be its most active gro th promoting substance. Another interesting effect of aloe in ound healing is its ability to counteract the ound healing suppression effects of cortisone. ,n one study, Aloe vera at doses of A00 and 300mg3#g daily for < days bloc#ed the ound healing suppression of hydrocortisone acetate up to A00G using the ound tensile strength assay. 6he authors suggested this response as due to gro th factors present in A. vera mas#ing the ound healing inhibitors. While limited, the human research has been promising. )or e$ample, one study found Aloe vera gel quite successful in three patients ith chronic leg ulcers of E, H, and AE years@ duration. 6he gel as applied to the ulcers on gau(e bandages. 4apid reduction in ulcer si(e as noted in all three sub"ects and complete resolution occurred in t o. AAB 1ulmonary !onditions9 0ral administration of an e$tract of Aloe vera for F months as sho n to produce good results in the treatment of asthma in some individuals of various ages. 6he e$ception to this as the fact that the Aloe vera e$tract as not effective at all in patients dependent upon corticosteroids. 6he mechanism of action is thought to be via restoration of protective mechanisms follo ed by augmentation of the immune system.6he e$tract used in the study as produced from the supernatant of fresh leaves stored in the dar# for H days at <V!. 6he dosage as Eml of a 20G solution of the aloe e$tract in saline t ice daily for 2< ee#s. 'leven of 2H patients =<0G> ithout corticosteroid dependence reported significant improvement at the study@s conclusion.AAC %ermatologic !onditions9 ,n an open, uncontrolled clinical study, 2C A,%5 patients received Aloe vera hole leaf "uice, essential fatty acids and nutrients. 6he Aloe dose as equivalent to A200 mg acemannan. ?arnofs#y scores improved in A00G of these patients in AB0 days. A20 'ndocrine !onditions9 A more recent and larger study =<C men and 23 omen> no provides more support for the efficacy of Aloe in combination ith glibenclamide in diabetes. While there as no response to glibenclamide alone, the combination as very effective. 6he patients ere provided ith A tablespoon of Aloe gel and Emg of glibenclamide t ice a day, ith Emg t ice a day of glibenclamide serving as the control. After 2 ee#s, fasting blood sugar decreased significantly in the treated group, and by day <2 had decreased from an average of 2BCmgG to a remar#able A<B mgG. While the drop in serum cholesterol as not significant, serum triglycerides decreased from 223mgG to =again remar#able> A2B mgG by day <2. :o adverse effects ere noted using standard blood chemistries.A2A

Current +esearch +eview: • 3ncology o 4olid tumors:"00  %esign9 !ontrolled clinical trial  1atients9 )ifty patients ith lung cancer, *, tract tumors, breast cancer or brian glioblastoma  6herapy9 /.6 =pineal indole melatonin>,20 mg qd po in the dar# plus Aloe vera tincture, A ml B,% W e$perimental group. /.6, 20 mg qd po W control group  4esults9 1artial response as achieved in e$perimental group W 232< patientsK no response in control group. 5table disease as achieved in e$perimental group W A232< patientsK control group W H32F patients. 1ercentage of total non& progressing patients as higher in e$perimental group. 6he percent A&year survival as higher in e$perimental group as ell. 6he authors suggested that /.6 X A. vera e$tracts may produce some therapeutic benefits in terms of survival and stabili(ation of disease in patients ith advanced solid tumors, for hom no other standard effective therapy is available. o +adiation therapy: 5tudy A9A23  %esign9 6 o phase ,,, randomi(ed clinical trials9 =6rial A9 double&blind placebo&controlled and 6rial 29 controlled> clinical trials.  1atients9 Women receiving breast or chest all irradiation. 6rial A9 0ne hundred ninety four omen. 6rial 29 0ne hundred eight omen.  6herapy9 Aloe vera gel

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4esults9 5#in dermatitis scores ere almost identical on both treatment arms during both of the trials. 6he conclusion as that the dose and schedule of an aloe vera gel used in this trial does not protect against radiation therapy&induced dermatitis. 5tudy 29A2<  %esign9 1rospective, randomi(ed controlled blinded clinical trial  1atients9 1atients undergoing radiation therapy.  6herapy9 Aloe vera gel applied topically at various intervals throughout the day in addition to ashing ith mild non& scented soap.  4esults9 At lo cumulative dose no difference e$isted bet een control and e$perimental groups. At high cumulative dose =Y2,H00 c*y>, the median time as five ee#s prior to any s#in changes in the e$perimental group vs three ee#s in the control group. ,t as suggested that the protective effect of adding aloe to the soap regimen is seen hen the cumulative dose of radiation increases over time. Dentistry: o Aphthous stomatitis: 5tudy A9A2E  %esign9 0pen uncontrolled clinical trial  1atients9 6hirty one pediatric outpatients, aged F&A< years, affected by mouth ulcers.  6herapy9 Bioadhesive patch W Aloe vera hydrogel =IAlove$ patchJ> 3 or less patches qd $ < days.  4esults9 5eventy seven percent of patients have sho n a mar#ed resolution of spontaneous pain, hile in the other patients, pain as significantly decreased to mild or moderate level. 5ymptoms started to decrease ithin the second day of treatment in H<G of patients. Dermatology: o 1ichen planus:"0&  %esign9 !ase study  1atients9 1atient ith lichen planus  6herapy9 Aloe vera  4esults9 5uccessful treatment of lichen planus. o #ressure ulcers:"0(  %esign9 4andomi(ed controlled clinical trial  1atients9 6hirty patients ith pressure ulcers.  6herapy9 Amorphous hydrogel dressing derived from the aloe plant =!arrasyn *el Wound %ressing, !arrington .aboratories, ,nc., ,rving, 6P> W e$perimental. /oist saline gau(e dressing W control.  4esults9 !omplete healing of the ulcer occurred in AC out of 30 sub"ects ithin A0 ee#s. :o difference in complete healing as observed bet een e$perimental and control groups. 6he conclusion is that the acemannan hydrogel dressing is as effective as, but not superior to, a moist saline gau(e ound dressing for the treatment of pressure ulcers. o #soriasis:"0/  %esign9 %ouble&blind, placebo&controlled clinical trial.  1atients9 5i$ty patients, AB&E0 yo, ith slight to moderated chronic plaque&type psoriasis and 1A5, =psoriasis area and severity inde$> bet een <.B and AF.H. /ean duration of the disease as B.E years.  6herapy9 Aloe vera e$tract 0.EG topically 6,% $ E days3 ee# for ma$ of < ee#s.  4esults9 Aloe vera e$tract cream had cured 2E330 patients =B3.3G> vs 2330 =F.FG> in placebo group. 1atients ere considered healed hen they ere sho ing a progressive reduction of lesions, desquamation follo ed by decreased erythema, infiltration and lo ered 1A5, score. Aloe vera e$tract resulted in significant clearing of the psoriatic plaques =32B33CF W B2.BG> vs placebo =2B33FF W H.HG>. opically applied Aloe vera e$tract 0.EG in a hydrophilic cream is more effective than placebo, and has not sho n to$ic or any other ob"ective side&effects. o Burns:"05  %esign9 !ontrolled clinical trial  1atients9 6 enty&seven patients ith partial thic#ness burn ound  6herapy9 Aloe vera gel W e$perimental, 7aseline gau(e & control  4esults9 Average time of healing in aloe vera gel area as AA.BC days, and AB.AC days for the 7aseline gau(e treated ound, hich as found to be statistically significant. Aloe gel as concluded to be effective on partial thic#ness burn ound. o 6ound healing:"78  %esign9 !ontrolled clinical trial  1atients9 1atients ith full&face dermabrasion 

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6herapy9 1olyethylene o$ide gel dressing saturated ith stabili(ed aloe vera on one half of the face W e$perimental, polyethylene o$ide gel dressing on the other half of the face W control.  4esults9 By 2<&<B hours there as a vasoconstriction and decreased edema on the aloe&treated side. By 3 rd and <th days there as less e$udates and crusting at the aloe site, and by the E th to Fth day the re&epitheliali(ation at the aloe site as complete. 0verall, ound healing as TH2 hrs faster at the aloe site. 9astroenterology: o Hepatitis:"7"  %esign9 '$perimental and clinical trial.  1atients9 !lnical trial part9 6hirty&eight patients ith chronic hepatitis ith positive +BsAg.  6herapy9 ,n"ection of Aloe vera e$tract  4esults9 6otal effective s*16&lo ering rate as BF.BG. o Constipation:"70  %esign9 4andomi(ed double&blind, placebo&controlled clinical trial  1atients9 6hirty five patients ith chronic constipation  6herapy9 !apsules ith celandin&aloevera&psyllium $ 2B days.  4esults9 Bo el movements became fore frequent, the stools ere softer and la$ative dependence as reduced in e$perimental group compared to the placebo group. Abdominal pain as not reduced in either group. ,nfectious diseases: o )u!erculosis:"77  %esign9 !linical trial  1atients9 0ne hundred and forty three patients ith pulmonary tuberculosis.  6herapy9 !ombination of chemotherapy using desensiti(ing agents and tissue preparations according to 7. 1. )ilatov =a suspension of placenta tissue an aloe>.  4esults9 6herapy had immunomodulating effect. 6he efficacy amounted to BHG ith an account of the general immunity status. $ndocrinology: o Dia!etes:"7:  %esign9 '$perimental and clinical trial  1atients9 !linical trial part9 )ive patients ith :,%%/.  6herapy9 %ried sap of the aloe plant W aloes, L tsp qd $ <&A< ee#s  4esults9 6he fasting serum glucose level fell in every patient from a mean of 2H3X3& 2E to AEA X3& 23 mg3dl ith no change in body eight. 6he authors concluded that aloes contains a hypoglycemic agent hich lo ers the blood glucose by as yet un#no n mechanisms. Cardiology: o Atheromatous heart disease:"7%  %esign9 !linical trial  1atients9 )ive thousand patients ith atheromatous heart disease  6herapy9 Addition of the I+us# of ,sabgolJ and IAloe veraJ to the diet.  4esults9 /ar#ed reduction in total serum cholesterol, serum triglycerides, fasting and post&prandial blood sugar level in diabetic patients, total lipids and also increase in +%. ere noted. 5imultaneously the clinical profile of these patients sho ed reduction in the frequency of anginal attac#s and gradually, the drugs, li#e verapamil, nifedipine, beta&bloc#ers and nitrates, ere tapered. 6he patients, most benefited, ere diabetics = ithout adding any anti&diabetic drug>. 6he e$act mechanism of the action of the above t o substances is not #no n, but it appears, that probably they act by their high fiber contents. 

#harmacy: E0&A00 ml hole leaf concentrate provide a high concentration of acemannan =/ills and Bone did not state potency> -uice or gel Drug ,nteractions:"7& )loe 5el67uice • 9ly!uride =positive>9 see 'ndoncrine !onditions above • #olyethylene o*ide =positive>9 Aloe gel improved rate of healing of dermabrasion compared to the drug alone. • Hydrocortisone =positive>9 Aloe gel improves antiinflammatory activity hen combined for e$ternal use.

)loe 8eaf, dried: Aloe leaf can increase bo el transit time, reducing the absorption of oral drugs. 0veruse can lead to potassium loss, hich can increase the to$icity of these drugs9 • Antiarrhythmic drugs • Cardiac glycosides' Adonis' Convallaria' Urginea' Helle!orus' 4trophanthus' Digitalis • )hia;ide diuretics • Corticosteroids' 9lycyrrhi;a Contraindications: !oo# stated that Aloe spp. must not be used hen there are piles, tenesmus, or the least irritation of the colon. ?ing added that Aloes should never be given in inflammatory conditions, gastritis, enteritis, to females prone to menorrhagia nor during pregnancy. ,n regard to the dried leaf, Brin#er "ustifies all of !oo#s and ?ing@s contraindications as ell as renal disorders. Brin#er cites a trial here topical Aloe gel increased healing time in ounds closing by second intention. A3H )o*icity: !oo# observed that their continued use is very li#ely to bring on piles.

Althea officinalis
Common name: /arshmallo

Malvaceae

Ha!itat: ,ndigenous to Asia and spread est ard to southeast 'urope and east ard to !hina. ,n temperate latitudes Althea is established as a garden plant.A3B Botanical Description9 A3C • )lo er and )ruit9 6he reddish& hite flo ers are usually in a$illary or terminal clusters. 6he F&C sepals of the epicaly$ are fused at the base, pointed and B&A0 mm long. 6here are E sepals, E heart&shaped petals, and numerous stamens fused together ith the anthers to a column. 6he ovaries are in a ring. 6here are numerous styles. 6he mericarps are smooth and do ny. 6he E&B m fruit is disc&li#e and brea#s up into the mericarps, hich are do ny on the outside and often have fine, branched, and radiating ribs. 6he seeds are dar#&bro n, glabrous, #idney&shaped and some hat compressed. • .eaves, 5tem and 4oot9 #arts used9 .eaves, root =harvested in the )all> Constituents: 4oot9 mucilage =AB&3EG>, pectin, asparagine =2G>, tannins. .eaves9 mucilage, flavonoids, coumarin =scopoletin>, polyphenolic acids. #harmacology:":8 6he active constituents in /arshmallo are large carbohydrate molecules, hich ma#e up mucilage. 6his smooth, slippery substance can soothe and protect irritated mucous membranes. Medicinal actions: %emulcent, emollient, e$pectorant. )raditional Medicinal Use: )ccording to .ing:%'% 6he root of this plant is demulcent and diuretic =?ing also describes substitutes at the end of the Althea section>. 6hey ill be found valuable, in the form of decoction, in diseases of the mucous tissues. • *astrointestinal !onditions9 Althea is efficacious in gastro9intestinal irritation and inflammation including acute dysentery, and diarrhoea1 • *enitourinary !onditions9 ,n strangury, inflammation of the bladder, hematuria, retention of urine , some forms of gra!el, and indeed in nearly every affection of the #idney and bladder, their use ill be found advantageous. /uch use is made of them combined ith equal parts of spearmint, in urinary derangements including gonorrhea, !esical catarrh, renal irritation1 • 1ulmonary !onditions9 hoarseness, catarrh, pneumonia, • 6opical Applications9 '$ternally, marshmallo root is very useful in the form of poultice, to discuss painful, inflammatory tumors, and s:ellings of every #ind, hether the consequence of :ounds, bruises, burns, scalds, or poisonsK and has, hen thus applied, had a happy effect in preventing the occurrence of gangrene. Current Medicinal Use: Both the root and the leaves are demulcent due to their content of mucilage. Although no human studies have been done using althea for treatment of specific diseases the mucilage has ell #no n soothing effects on the mucus membrane. A<2, A<3 ,n fact, Althea is one of the most effective and safest herbal demulcents. 6he main areas affected by mucilages are the gastrointestinal system, the respiratory system and the urinary system. 6he roots tend to act most strongly on the *.,. system, hile the leaves e$ert more of their effects on the respiratory and urinary systems. /ucilages promote a soothing, emollient action on the gastrointestinal mucosa, hich, by refle$ action creates a demulcent action in the respiratory and urinary systems. • *astrointestinal !onditions9 ,n the *, system, Althea is used for conditions here there is irritation of the oral, gastric or pharyngeal mucosa . ,n dyspepsia and *'4%, mucilaginous herbs are used to assist on mucus production and protection from hyperacidity hen ta#en before meals and before bed. ,nflammatory diseased of the digestive tract in general call for these herbs. ,n regard to food allergy, Althea can be used to assist in reducing inflammation and promote gut healing. %'' Althea is most indicated in inflammatory bo el disease ith e$cessive mucous production. ,t is also part of 4obertNs formula. Althea ill also promote the healing of gastric ulcers. • *enitourinary !onditions9 /ucilaginous plants are associated ith a diuretic effect in !hinese medicine and Althea is one of the most soothing diuretics. ,n cystitis, Althea can be combined ith antiseptic herbs to benefit the bladder all 1A<E Althea can ease the passage of #idney stones. • *ynecologic !onditions9 Althea is a useful addition to douches in all types of vaginitis in order to soothe, promote healing, and

perhaps stimulate local immunity. • /etabolic !onditions9 6he mucilages are a class of soluble fiber hich is thought to reduce cholesterol biosynthesis9 Bacterial in the large intestine metaboli(e soluble fiber to produce short chain fatty acids. 5ome of these 5!)As are carried by the portal venous system to the liver here they influence hepatic metabolism to decrease cholesterol biosynthesis. A<F • 1ulmonary !onditions9 Acute and chronic bronchitis respond ell to Althea as mucilages are used to change an unproductive cough to a productive one. %'4 Althea is soothing to the tissues in tonsillitis and sore throat. Additionally, mucilages tend to be e$pectorating. 6hey ill allay a spasmodic, non&productive cough, thus promoting more productive e$pectoration. 6he *erman !ommission ' indicates Althea for irritation of the oral and pharyngeal mucosa and associated dry cough. A<B • 6opical Applications9 '$ternally, Althea ma#es an e$cellent poultice for the treatment of inflammations such as boils, ulcers, bruises and abscesses. ,n addition to the vulnerary, antiinflammatory and dra ing properties, the mucilages stimulate phagocytosis =in vitro>, and thus most li#ely e$ert vulnerary properties. #harmacy9 Althea and other mucilaginous plants can be ta#en before meals for digestive problems of the stomach and small intestine, during meals, or after meals in the cases of *'4 or hiatal hernia. As e$pectorants, they may be ta#en at any time and at any frequency. ,nfusion9 2&< gm3cup cold ater, infuse overnight as mucilages are best e$tracted in a cold infusion =place root in cold ater, let steep overnight>.K A cup 6,% QA tsp. O A.< gR =Alschuler> As the decoction3infusion soon decomposes, or becomes moldy or acid, it should al ays be made in small quantities, not more than A or 2 pints at a time, according to the temperature of the eather. =?ing> 6incture9 A9E 2EG 't0+K sig A&< ml 6,%K ee#ly ma$. dose is A00 ml =Alschuler> Contraindications: 6he use of mucilages may be inappropriate in congestive bronchial and catarrhal conditions. A<C Althea may delay the absorption of oral drugs if ta#en simultaneously =speculative>. AE0 )o*icity9 5afe herb

Amni visnaga
spasmolytic for angina A0&F0 gtt tincture bid =move to ards F0 gtt> /itchell

Anemone pulsatilla (#ulsatilla vulgaris
Ha!itat:

+anunculaceae Common name: indflo er, pasque flo er, pulstatilla, small pasque flo er =1. pratensis> 1. nigricans

Botanical description: A perennial plant ith a stem gro ing to about F&B in. hich elongates to about AE&AB in. hen fruiting. 6he basal leaves are pinnately divided into segments of H&C, hich are then divided again into 3&< segments. 6he shape is linear&lanceolate. 6he flo ers are solitary, E&H cm, compendulate, erect or suberect, and dar# purple in color. 6he fruits are in clusters and are feathered. #art Used: +erba, hole plant Constituents: • )resh plant& lactone glycoside protoanemonin hich can cause blistering and burning of the s#in. 6his dimeri(es to anemonin and anemonic acid upon drying, hich does not have this effect. • tannins, resins, triterpenoid saponins, flavone glycosides, pulsatin Medicinal actions: nervine, anti&spasmodic, alterative, sedative, analgesic, antiinflammatory Medicinal use: /itchell9 Icardiac consciousnessJ or a arness of heart function =3 gtt tid in ater>K prostate painful and enlarged ith 1etrosilinum and +ydrastis • 4eproductive !onditions9 1ulsatilla is used for nervous e$haustion and dysmenorrhea or amenorrhea in omen. ,t is specifically indicated in omen ho are intolerant to fatty foods, have cold e$tremities, a coated tongue and a feeble pulse. Anemone is especially useful for nervous tension and associated spasm in the reproductive tract =male and female>. Anemone is indicated hen emotional issues =esp. sadness and depression> are held in the pelvis, creating tension, eeping and pain. Anemone combines ell ith pelvic tonics as it reduces nervous irritation thus facilitating the actions of the tonics. Anemone may e$ert a progesteronic effect. • 0phthalmologic !onditions9 Anemone is useful e$ternally for con"unctivitis, eye fatigue, and sties. • :ervous !onditions9 Anemone is also useful in headaches secondary to nervous tension, emotional issues, and eye strain. )ccording to Mills and Bone:%#% • *ynecologic !onditions9 1ulsatilla is used in endometriosis for ovarian and ovulation pain. )ccording to +eiss:%#& • *ynecologic !onditions9 1ulsatilla is is said to have a beneficial effect on spasms of the genital region. ,t is not reported to have hormonal effects and use has been considered obsolete. :one the less, a number of proprietary preparations are based on the principle of hormonal action and used for functional disorders such as amenorrhea, oligomenorrhea, dysmenorrhea, particularly if there is mental lability and nervous over e$citability. • 0phthalmologic !onditions9 6he hole herb is used internally to treat inner eye conditions such as irititis, scleritis, diseases of the retina and, above all, grey or senile cataract and glaucoma )ccording to ,cudder9AE3 =5cudder appears to prefer the homeopathic preparation> I, value the remedy very highly, and am satisfied from an e$perience of ten years in its use that , do not overestimate it.J • :ervous !onditions9 6he principal use of 1ulsatilla is to relieve certain, difficult cerebral symptoms that are not relieved by other remedies. ,n some gynecological diseases, spermatorrhea, prostatorrhoea, heart disease, and some other chronic affections, certain head symptoms play an important part. 6he patient is nervous, restless, has an active imagination for disease, a fear of impending danger, etc. 6hese symptoms are very unpleasant, and not infrequently prevent the curative action of remedies. 1ulsatilla reaches them and gives prompt and certain relief. 6hough 1ulsatilla is the remedy for nervousness, it must not be given ith any e$pectation of benefit hen the e$citement depends upon irritation and determination of blood. ,n this case it ill either e$ert no influence or it ill be unfavorable. • /ale !onditions9 1ulsatilla e$erts a mar#ed influence upon the reproductive organs of both male and female 5ome cases of spermatorrhoea ill only respond to this remedy. As described above, the unnatural e$citement of the mind prevents a curative influence by other remedies. • !ardiovascular !onditions9 ,n some cases of heart disease, the head symptoms are the most prominent and unpleasant features. 4elieve the unpleasant mental sensations and dread of danger, and e have removed a permanent cause of e$citement. • *ynecologic !onditions9 1ulsatilla e$erts a mar#ed influence upon the reproductive organs of omen. I, regard it as decidedly the best emmenagogue, hen the suppression is not the result of or attended by irritation and determination of bloodK here there is simple suppression from atony or nervous shoc#, it may be used ith confidence.J

,n male or female it lessens se$ual e$citement. ,t does not diminish se$ual po er, but rather strengthens it by lessening morbid e$citement. ,n regard to Anemone nemorosa. =Wood anemone9 Wind flo er.>. ,t influences the functions of aste and repair, but acts directly upon the nervous system. Belonging to the same family as the 1ulsatilla, its action ill be some hat analogous. )ccording to .ing: 5pecific ,ndications and Uses.Z:ervousness and despondency, sadness, unnatural fear, tendency to eep, morbid mental e$citement, mar#ed depression of spiritsK pain, ith debility, nervousness, headache, not dependent on determination of blood to the headK insomnia, from nervous e$haustionK neuralgia in anemic, debilitated sub"ectsK pasty, hite, or creamy, thic# coating upon the tongue, ith greasy tasteK stomach disorders from indulgence in fats and pastriesK thic#, bland, inoffensive discharges from mucous surfacesK alternating diarrhoea and constipation, ith venous congestionK amenorrhoea and dysmenorrhoea, ith gloomy mentality and chillinessK severe pains in the ear, non&inflammatory and evidently neuralgicK pain from e$posure to indK "umping toothache, from abscess near the dental pulpK sties. 1ulsatilla forms an important remedy ith the 'clectic physicians as ell as ith the +omeopaths, ho ma#e e$tensive use of it. According to the late 1rof. -. /. 5cudder, /. %., ho used it largely in his practice, its most important use is to allay irritation of the nervous system in persons of feeble health, thus giving sleep and rest, preventing unnecessary e$penditure of nerve force, and, by this means, facilitating the action of tonics and restoratives. ,n feeble omen, and men ho have become nervous from sedentary habits or mental over&e$ertion, as ell as in the nervousness and restlessness of masturbators, or persons addicted to the e$cessive use of tobacco, he has found it very certain in its action. ,t is the remedy for nervous omen, hen there is debility and faulty nutrition of the nerve centers. ,n medicinal doses, pulsatilla increases the po er and regulates the action of the heart, and gives a better character to the pulse rate, particularly slo ing the irritable, rapid and feeble pulse due tonervous depression. ,t improves the sympathetic system and cerebral functions, and especially strengthens sympathetic innervation, this action being very mar#ed in troubles of the reproductive organs of male and female. 1ulsatilla is a remedy of ide applicability, but more particularly for those conditions in hich the mind is a prominent factor. A gloomy mentality, a state of nerve depression and unrest, a disposition to brood over real or imagined trouble, a tendency to loo# on the dar# side of life, sadness, mild restlessness, and a state of mental unrest generally denominated in broad terms Mnervousness,M are factors in the condition of the patient requiring pulsatilla. A pulsatilla patient eeps easily, and the mind is inclined to anderZto be unsettled. 6he pulse requiring pulsatilla is ea#, soft, and open, and the tissues have a tendency to dryness =e$cept hen the mucous tissues are discharging a thic#, bland material>, and, about the orbits the parts appear contracted, sun#en, and dar# in color. 6he hole countenance and movements of the body depict sadness, moroseness,despondency, and lac# of tone. +ysteria of the mild and eeping form may be a symptom. 6he hole condition is one of nervous depression, the nutrition of the nerve centers are at fault. With such symptoms, pulsatilla may be confidently prescribed in the conditions and disorders enumerated in this article. 1ulsatilla may be given to produce sleep, hen there is great e$haustion and opiates are inadmissible. ,f the insomnia depends upon determination of blood to the brain, pulsatilla ill not relieve, but hen due to nervous e$haustion it is a remedy to give rest, after hich sleep obtains. Where sleep is disturbed by unpleasant dreams, and the patient a a#ens sad and languid, pulsatilla should be given. 1ulsatilla has a large field in troubles incident to the reproductive organs, of both se$es. As an emmenagogue, it serves a useful purpose in amenorrhoea in nervous and anemic sub"ects, ith chilliness a prominent symptom. When menstruation is suppressed, tardy or scanty from ta#ing cold, or from emotional causes, pulsatilla is the remedy. ,n dysmenorrhoea, not due to mechanical causes, and ith the above&named nervous symptoms, no remedy is more effective. .eucorrhoea, ith a free, thic#, mil#y, or yello , bland discharge and pain in the loins, and particularly in scrofulous individuals, calls for pulsatilla. ,t is a remedy for mild forms of hysteria, here the patient is ea# and eeps easily, has fears of impending danger, and passes large quantities of clear, limpid urine, and menstruation is suppressed. 6he long&continued use of pulsatilla as an intercurrent remedy, is accredited ith curative effects in uterine colic, but it is of no value during an attac#. 1ulsatilla frequently proves a good remedy in ovaritis and ovaralgia ith tensive, tearing pain. 5luggish, ineffectual, and ea# labor&pains are sometimes remedied by this drug. ,t is frequently a remedy for pain, hen dependent on or associated ith debility, and sometimes hen due to acute inflammation. ,t is a leading remedy in epididymitis and orchitis, hether due to gonorrhoeal infection or to metastasis from mumps. 6he dar#&red, congested, enlarged, and sensitive testicle indicates it. ,t relieves the pains of orchialgia, and subdues mammary s elling from the metastasis of mumps. 1ulsatilla increases se$ual po er, but lessens morbid se$ual e$citement. ,t is especially valuable in relieving urethral irritation and consequent spermatorrhoea and prostatorrhoea. ,n these troubles it overcomes the nervous apprehensions so frequently a troublesome feature. ,t also alleviates the nervous irritability accompanying or produced by varicocele. ,n gonorrhoea, particularly of the chronic type, pulsatilla is of value, hen the urethral membrane is s ollen. 1ulsatilla has been used by some for the relief of hydrocele, but for this affection e possess better remedies. /any unpleasant conditions of the urinary apparatus are relieved by pulsatilla, as frequent but ineffectual attempts at urination, the bladder giving a sensation as if bloatedK dribbling of urine from movement, the dysuria of pregnancy, and in involuntary micturition from colds or from nervous debility. 1ulsatilla frequently proves a useful remedy in headache of various types. ,t relieves the frontal headache from nasal catarrh, nervous headache, particularly hen due to gastric disturbances, ith greasy taste, menstrual headache, ith chilliness and suppressed menses, bilious and gastric headaches, of a dull and heavy character, ith greasy taste and nausea, and headaches due to uterine irregularities

or to a rheumatic diathesis. 6hese headaches are all of anemic characterZthe opposite of those relieved by gelsemium. 6hough ordinarily not a remedy for acute inflammations =contraindicated in gastro&intestinal inflammation>, there are some conditions here small doses of pulsatilla are beneficial hen the usual symptoms calling for the drug are present. 6hese conditions are acute inflammation of the nose, fauces, laryn$, or bronchiae. ,t is especially effective in the secondary stage of acute nasal catarrh, hen the naso&pharyn$ is affected and there is a sense of ra ness and moisture, and an abundant discharge of thic#, yello , bland, inoffensive mucus or muco& pus. 1ulsatilla frequently serves a good purpose in asthma superinduced by pregnancy, or by suppressed menses, and it favorably influences hooping&cough in properly selected cases. 5o&called Mstomach coughM is frequently cured by pulsatilla. 1ulsatilla should be remembered as a remedy of much value to control the catarrhal symptoms of the e$anthemataK it also controls the irritability frequently accompanying these disorders. ,n measles, it has done good service in chec#ing the cory(a and profuse lachrymation, as ell as the dry, tight, painful cough, and hen retrocession of the eruption has ta#en place, it has reversed this unpleasant condition. ,t relieves the irritable condition in varicella. 1ulsatilla is very efficient in real and imaginary cardiac affections. ,t has proved useful in cardiac hypertrophy and in dilatation of the venous heart. ,t is especially effective in functional heart disorders ith giddiness, imperfect voluntary motion, impaired vision, and ith a symptom described as a sense of pressure over the laryn$ and trachea, ith imperfect respiratory movement, and sense of impending dangerK the symptoms "ust preceding are those not unfrequently associated ith functional heart disease, dyspepsia, uterine disease, or over&e$citation of the se$ual system, and are generally very unpleasant and annoying. ,t often relieves that form of venous congestion hich stops short of inflammation, as in threatened ovaritis, orchitis, varicocele, and crural phlebitis. 7aricocele and other varicoses are frequently improved by its administration ith other indicated remedies. ,ts chief advantage, outside of some control over the venous structure, is its relief of the nervous complications. ,t has been used to good advantage for the relief of hemorrhoids. !onstipation in the hysterical female yields to nu$ vomica and pulsatilla, and the latter has a pleasing action in some forms of indigestion and dyspepsia. 6hese cases are those in hich there is a thic#, creamy paste upon the tongue and a greasy taste. 5uch troubles are frequently brought about by indulgence in pastries and fatty food. 1ain is not mar#ed, but there is pyrosis and greasy eructations, gastric distension, uneasy gna ing sensations in the stomach, and chilliness may be a pronounced symptom. 6he patient is nervous, sad, and may have a soft, yello diarrhoea. )or such cases pulsatilla is an e$cellent remedy. ,t is also said to relieve alternating constipation and diarrhoea ith venous congestion. 1ulsatilla is a prompt and decisive agent in earache, brought on by cold, et, and e$posure to inds. 6here is an absence of fever, the pulse is open and soft, the child sobs, the face is pale, the tissues full and a$en, the pain is intense and frequently paro$ysmal and tearing in characterZevidently a neuralgic condition, for physical signs of local disturbance are seldom observed. ,n purulent otitis media, ith thic#, yello , bland discharge, and impaired hearing, and tinnitus aurium, pulsatilla is the indicated remedy. 0ne of the earliest uses of this plant as for the relief of Mamaurosis, cataract, and opacity of the cornea,M conditions in hich the reputed value of pulsatilla is very much overrated. 6here is a condition, sometimes #no n as Mnervous blindness,M hich has been benefited by pulsatilla, and this is probably the condition formerly referred to under the elastic term amaurosis. 1ulsatilla stands out prominently as a remedy for hordeolum or Mstye.M ,t is also a prompt remedy hen the con"unctiva is hyperemic and the vision ea#ened, especially after reading, or from se$ual abuse or se$ual e$cesses, and in profuse lachrymation from e$posure to inds or hen in the ind. ,t should be used locally =gtt. $ to aqua i"> and also given internally in small doses. ,n chronic con"unctivitis, ith bland, yello discharges, in scrofulous individuals, or due to the e$anthemata, and in ophthalmia neonatorum, ith li#e discharge, pulsatilla has been used ith signal success. ,t relieves deep&seated, heavy pain in the globe of the eye, and has been recommended in inflammation of the lachrymal sac. 5t[rc#, ho as one of the first to use pulsatilla, considered it useful in secondary syphilis, and in some forms of cutaneous diseases, as ell as in amaurosis and other ocular affections. 6his drug has been used ith much success in rheumatism, hen the pains ere shifting and relieved by cold and aggravated by armth. %epression of spirits is here a prominent feature. ,t has also aided in restoring the flo of mil# in agalactia in nervous and fear& depressed omen, hose breasts ere painful and s ollen. 1rof. W. '. Bloyer emphasi(es its value in M"er#ingM or M"umpingM toothache, usually due to the formation of a pus cavity near the nerve. +e applied the full strength specific pulsatilla, or diluted one&half ith ater, besides giving the drug internally. +e also recommends this treatment as Mespecially useful in inflammations caused by dead teeth, and the inflammatory, painful, and unpleasant conditions of the pulp cavity in those in hich the nerve has been destroyedM ='c. /ed. -our., ABCE, p. 2<B>. 6he dose of specific pulsatilla is from a fraction of a drop to A0 drops, administered in aterK of the fluid e$tract, from A to AE dropsK of the e$tract, from A3F to A grainK of anemonin, A320 to U grain. #harmacy: According to 5cudder, use of the *erman tincture prepared from the fresh herb according to the +omeopathic pharmacy is indicated. 1reparations made from the imported dried herb ill not give or# effectively. /ichael /oore agrees ith this and only recommends the tincture prepared from fresh herb. ,nfusion9 A32&A tsp. dried herb 3 cup aterK sig A cup B,% =%r. Alschuler> 6incture A9A0 <0G alcoholK sig .3&A ml 6,%, ma$imum ee#ly dose O 2A ml ".to i".K Water, iv. A teaspoonful every four hours. =5cudder> '$ternally as eye ash

1roprietary combinations9 )emisana =+ol(>9 7ite$, !helidonium, !imicfuga, 1ulsatilla )eminon =4edel>9 1ulsatilla, !imicifuga, 7ite$ )or eye conditions9 E0 g each po dered 1ulsatilla herb and e$tract. /a#e up HE pills, sig A&3 tid =Weiss> Contraindications: Anemone is contraindicated in cases of gastro&intestinal inflammation. Brin#er lists contraindications during pregnancy due to its uterine stimulating effect =in vitro and in animals=> and in nursing mothers because of gastrointestinal irritant effect.AE< )o*icity9 Anemonin is a mucous membrane irritant. Use may cause a burning sensation in mouth and throat, colic, abdominal pain, nausea and vomiting, bloody diarrhea, slo pulse and cardiac arrhythmia. '$ternal use can cause s#in irritation or contact dermatitis. AEE Adapted from ?ing9 6opically applied, the fresh plant of pulsatilla is irritant, and, if #ept long in contact ith the s#in, may produce vesication. When che ed, it produces a benumbing sensation and tingling formication, some hat li#e that produced by aconite or pric#ly ash. 6a#en internally in overdoses, it acts as a gastric irritant, producing a sense of ra ness, burning, pain in stomach, ith endeavors to vomit, all accompanied ith mar#ed prostration. A case of poisoning ith these symptoms is on record in the /edical *leaner, 7ol. ,7, p. AH3. A sense of constriction and tightness of the chest, ith chilliness, mar#ed ea#ness, and some congestion, has been produced by large doses. )ull doses depress the action of the heart, lo er arterial tension, and reduce temperature. 5ensory and motor paralyses have follo ed large doses of pulsatilla, hile to$ic doses may produce mydriasis, stupor, coma, and convulsions.
151 152

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 2<< Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. 3AC, 3<0 153 5cudder -. 5pecific /edications and 5pecific /edicines. 154 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AA< 155 Brin#er, p A<H

Angelica archangelica
Common name: 'uropean angelica =American angelica is A. atropurpurea> Ha!itat:

Um!elliferae

Botanical description9 6he roots are long and spindle&shaped, thic# and fleshy. ,t is a tall plant =2 m.> ith large, serrated leaves, ith smaller leaflets in groups of three, and globular umbels of small green flo ers. ,t gro s by the sea and at high mountainous altitudes. #arts used9 4oot, seeds, leaves Historical use: 6he historical and most ide&spread use of Angelica archangelica is as a flavouring agent. 6he seeds are used to flavor liqueurs such as gin and 7ermouth. 6he stems are candied. Constituents9 7olatile oil =root and seeds, 0.3&AG>, macrocyclic lactones, phthalates, coumarins, sugars, plant acids, flavonoids, sterols. Medicinal actions: '$pectorant, diaphoretic, carminative, diuretic, aromatic tonic, stimulant, emetic Medicinal use: • 1ulmonary !onditions9 /edicinally, the root and seeds are stimulating e$pectorants. Angelica archangelica is also a diaphoretic and thus is particularly useful in coughs accompanied by a fever. • *astrointestinal !onditions9 Angelica archangelica is also an effective carminative. 6he root contains bitter principles, hich ma#e this plant an aromatic tonic. A arm infusion is best. 6his plant is not ell&indicated in inflammatory conditions of the gastrointestinal tract. 6he seeds possess the same properties but are more diaphoretic than the root. • *enitourinary !onditions9 6he seed ill also promote diuresis, has demonstrated anti&inflammatory, bacteriostatic and fungistatic properties and thus may be useful in cystitis.AEF,AEH )ccording to Mills and Bone: %#( • ,nflammatory !onditions9 Angelica has been used topically as an anti&inflammatory. !ongestive chronic infections and inflammatory conditions respond ell to Angelica and other aromatics. ,t is a sustaining, arming herb that has also been utili(ed as a convalescent aid in recovering from febrile disease. ,n turn, Angelica can also be utili(ed to encourage a therapeutic fever. • *astrointestinal !onditions9 Angelica is considered an aromatic herb. ,n general, aromatics are indicated for gastrointestinal complaints such as colic, flatulence, irritable bo el disease, congestive dyspepsia and sluggish digestion and metabolism in general. Angelica increases gastric acidity. • 1ulmonary !onditions9 Angelica, as ell as other aromatics, can be utili(ed in catarrhal and bronchial congestion. 6hese herbs have a spasmolytic effect on bronchial smooth muscle. Angelica is a arming e$pectorant. )ccording to the Textboo3 of ;atural Medicine:%#* • ,mmune !onditions9 6he oil of Angelica has e$hibited significant antifungal and antihelminthic properties, but virtually no antibacterial activity. )ccording to +eiss:%$• *astrointestinal !onditions9 Angelica is frequently used in bitter formulas for its aromatic bitter qualities. 6he volatile oil is carminative and functions similarly to Artemesia absinthium. ;et, Weiss favors other carminative such as !arum, )oeniculum and Anisum for clinical use. • 6opical Applications9 Angelica oil is used e$ternally ith camphor for rheumatic conditions. )ccording to .ing:%$% Angelica has been applied as fomentation in tumefactions and s:ellings, and given internally in enteric fe!er and other typhoid states, chronic rheumatic complaints, gout and malarial intermittents . As a stimulant to the respiratory mucous surfaces, it has been serviceable in chronic bronchitis. )ccording to 2oo3:%$& • *astrointestinal !onditions9 6he roots may be che ed or used in arm infusion and prove diffusively stimulating and rela$ing to the stomach and s#in, ith a slight influence upon the #idneys. 6hy promptly relieve flatulence and colic. 6he seeds posses the same properties, but are rather more diaphoretic. 6he !ompounded 6incture of Angelica, !arminative drops =see belo > can be

• •

used for all forms of flatulence, colic and abdominal pains not connected ith inflammation. 'qual parts of these drops and the :eutrali(ing !ordial ma#e an admirable mi$ture in tormina ith sour stomach and a tendency to diarrhea, but not in dysentery. *ynecologic !onditions9 A arm decoction of them, used freely during an evening, is a popular remedy for retained placenta and suppression of the menses suddenly follo ing cold and is deserving of use if employed early. 1ulmonary !onditions9 A strong decoction has been asserted to cure chills, if suitable cathartics have first been usedK at the tincture for spasmodic coughs. ,t can be used profitably as an ad"unct to antispasmodic nervines. 1o dered root or seed9 E&30 grains =A g T AF grains> =?ing> %ecoction of the root and3or seed9 decoct A tsp. for E min.K sig A cup 6,% =Alschuler> 4oot can be decocted longer, AE&30 min, but seed should be shorter to avoid bitter taste =%ipasquale> A o(. per pint of ater, sig L to A ineglassful =?ing> A o(. root per A pint ater, infuse in a covered vesselK sig A&2 o(. as needed =!oo#> A9E tincture9 2&E ml 6,% =Alschuler> !ompounded 6incture of Angelica, !arminative drops9 Angelica root =< o(.>, %ioscorea root =2 o(.>, .eonurus, !oriander seed, Anisum seed, %ill seed =A o(. each>. !rush the hole and macerate in forty o(. of thirty percent alcohol for A0 days. Apply strong pressure and add half a pound of hite sugar to the clear liquid. 5ig L&A tsp. in ater q hr or more for adults. =?ing>

#harmacy9

Contraindications: Aromatics, in general, are not to be used in patients ith gastroesophageal reflu$ as the volatile oils rela$ the esophageal sphincter. Angelica is not proper in inflamed conditions.AF3 )or e$ample, it is to be avoided ith peptic ulcers due to its stimulation of gastric acid secretion =empirical>.AF< Brin#er states an empirical contraindication is pregnancy due to its emmenagogue effect. )o*icity: 1hototo$icity may occur given the content of furanocoumarins although this effect may be utili(ed in the treatment of psoriasis and vitiligo =empirical>. AFE

Angelica sinensis
Common name: %ong quai =-apanese angelica is A. acutiloba> Ha!itat: %ong quai is native to !hina, ?orea and -apan.

Um!elliferae

Botanical description: ,t gro s to about .E&A m high. 6he inferior leaves are tripinate and the superior leaves are pinnate on long, sheathed petioles. 6here are A0&A< umbels in irregular rays each ith A2&3F hite flo ers. 6he root is greyish bro n and rin#led loo#ing. #art used: root =different properties are ascribed to the head, body and tail of the root.> Historical use: $nergetics: 6aste9 s eet, acrid, bitter, arm /eridians entered9 +eart, 5pleen, .iver =/ills and Bone include the .ung>  6onifies the blood and regulates menses  ,nvigorates harmoni(es the blood  /oistens the intestines9 dry stool from $ue $u Constituents: 7olatile oil =0.<&0.H G>, phytosterols, ferulic acid, coumarins, flavonoids #harmacology: %ihydropyranocoumarins and dihydrofruanocoumarins form Umbelliferous plants have been sho n to possess significant coronary vasodilatory, spasmolytic and c&A/1 phosphodiesterase inhibiting activity. AFF Apparently, the mechanism of action is largely attributed to calcium channel antagonism. Angelica sinensis has been sho n to depress stimulation of β&2&adrenergic receptors thereby reducing e$perimental pulmonary hypertension.AFH ,t can prolong the refractory period, correct e$perimental atrial fibrillation and is a negative inotropic in the heart as ell. AFB )erulic acid is inhibits platelet aggregation and serotonin release. 3 Angelica sinensis has been sho n to depress stimulation of β&2&adrenergic receptors thereby reducing e$perimental pulmonary hypertension.AFC ,t can prolong the refractory period, correct e$perimental atrial fibrillation and is a negative inotropic in the heart as ell. AH0 )erulic acid is inhibits platelet aggregation and serotonin release. 3 )ccording to the Textboo3 of ;atural Medicine: ,n the smooth muscle of visceral organs, Angelic essential oil has demonstrated a rela$ing action hile the ater e$tract stimulates contraction initially follo ed by prolonged rela$ation. ,n regard to the immune system, !hinese and -apanese angelica, selectively inhibit the production of ,g'. !oumarin compounds are immune&enhancing in both healthy and cancer patients, stimulating macrophages and phagocytosis. 1ossibly, this activity may prevent tumor gro th and metastasis. 6he coumarins and polysaccharides of the ater e$tract have immune modulating activity9 they are B&lymphocyte mitogens, stimulate ,): production and activate both complement path ays. !hinese angelica also increases 6:) production. ,nterestingly, !hinese angelica appears to have antibacterial activity against both *ram positive and negative organisms hile -apanese angelica does not, yet this effect is considered less than desired for an antimicrobial agent. !hinese and -apanese angelica contain highly active phytoestrogens and demonstrated uterine tonic activity. +A and α&adrenergic receptors have been theori(ed to be the target sites for the uterine stimulant effects. AHA Medicinal actions: • uterine stimulant, emmenagogue, estrogenic, progesteronic, fetal rela$ant • hepatorestroative3protective, nervous sedative, cardiovascular rela$ant, antiplatelet aggregant, demulcent la$ative, antiarrhythmic immunostimulant, WB! stimulant, antitumoral, anti&inflammatory Medicinal uses: )ccording to Mills and Bone:%4& • *enitourinary !onditions9 %ong quai may be of benefit in the treatment of nephrotic syndrome. AH3 • *ynecologic !onditions9AH< %ong quai is a uterine spasmolytic and uterine stimulant. 5ome e$periments have sho n uterine stimulation hile others have demonstrated rela$ation or coordination of uterine contractions. ,t appears that the state of uterine tone determine the action.

%ong quai regulates menstruation. %ong quai relieves dysmenorrhea and chronic pelvic pain, including in endometriosis. )or menopause, there is not much clinical or traditional evidence supporting its use it does not have estrogenic activity. +o ever, its tonic effect may be beneficial. %ifficult conception mar#ed by e$cessive anovulatory cycles indicates %ong quai. A study of infertility due to tubal occlusion demonstrated beneficial results ith uterine irrigation of the e$tract. AHE • *astrointestinal !onditions9 %ong quai relieves constipation by lubricating the bo els • !ardiovascular !onditions9 Animal studies have demonstrated prevention of coronary atherosclerosis. 3 0ther effects include reduction of blood pressure, dilation of the coronary vessels and reduced serum cholesterol. ,t also has a hematopoietic effect on bone marro .AHF When combined ith Astragalus it has improved thrombocytopenic purpura in rabbits. )or cardiovascular conditions it is often combined ith %an shen =!odonopsis> • +epatobiliary !onditions9 %ong quai protects the liver and is indicated • ,mmune !onditions9 %ong quai appears to have a ea# stimulatory effect on phagocytosis and lymphocyte proliferation but inhibits antibody production. ,t can mildly counter the immunosuppressive effects of hydrocortisone but not as ell as Astragalus. )ccording to Tai 8ahans:%44 • !ardiovascular !onditions9 /acrocytic anemia responds to %ong quai as it is high in folic acid and BA2. ,t decreases atherosclerotic plaque formation and is utili(ed in aortitis coronary artery disease and stro#e. • 'ndocrine !onditions9 )or hyperthyroidism %ong quai has been in"ected into the thyroid. • *astrointestinal !onditions9 ,rritable bo el syndrome and dry constipation respond ell to %ong quai. #harmacy: %ong quai may be used long term. decoction9 3&AE mg dried radi$ qd A92 fluid e$tract9 <&B ml qd

Contraindications: !aution is advised ith use during diarrhea and damp obstruction in lo er "iao. %ong quai should not be used in yin deficiency ith heat signs. *iven its uterine stimulating effect, caution is advised during pregnancy ith abstinence during the early stages. AHB ,t should be avoided in hemorrhagic conditions and acute viral infections. )o*icity:

Apium graveolens
Common name: celery Ha!itat: Botanical Description: #arts Used: 5eeds $nergetics:"(5 A bit bitter and s eet, neutral, moist

Um!elliferaceae

Constituents9 • 7olatile oils =thought to be main active constituents>9 o 2&3G9 apiol, limonene, selinene.AB0 o 1erillyl alcohol =10+>. =Also found in small concentrations in the essential oils of lavendin, peppermint, spearmint, sage, cherries, cranberries, perilla =1erilla frutescens>, lemongrass, ild bergamot, gingergrass, savin, cara ay, and celery seeds.>ABA • )lavonoids =apigenin, isoquercetrin> • )urocoumarin glucosides • Al#aloids #harmacology =the follo ing are animal trials, unless noted other ise> : • !hemopreventative9 o 1erillyl alcohol9 chemotherapeutic agent for pancreatic, breast, and liver cancerK chemopreventive agent for s#in, lung, and intestinal cancer. ,t prevents inhibition of apoptosis, and may be protective against colon cancer and other cancers by enhancing the deto$ification of carcinogens by the liver. • .atest research9 1hase , trials have failed to sho a substantial therapeutic effect in humans, but phase ,, trials are presently being conducted for further evaluation. )uture phase ,, trials ill ta#e into account the short half&life of the perillyl alcohol metabolites and ill dose the drug more frequently at A.F g3m23dose. 6his ay, the dosing schedule ill be more similar to animal studies and hopefully better results ill be achieved. AB2 o .imonene, a monoterpene hich yields the same metabolites as perillyl alcohol, has been sho n to increase the urinary e$cretion of the carcinogen %/BA and its metabolites by 2.3&fold compared to control rats. When fed at a E&percent diet t o ee#s before %/BA administration, limonene prevents %/BA from interacting ith %:A by E0 percent hen compared to controls. A E&percent limonene diet can increase cytochrome 1<E0 family members !;12B and 2!, and increase epo$ide hydratase, hich are both members of the 1hase , liver deto$ification system, and can induce 1hase ,, deto$ification systems. AB3 • +epatoprotective effects9 o 6he different e$tracts of Apium graveolens ere tested for their hepatoprotective activity against induced hepatoto$icity in rats. 6he degree of protection as measured by using biochemical parameters li#e serum transaminases =5*06 and 5*16>, al#aline phosphatase, total protein and albumin. 6he methanolic e$tracts sho ed significant hepatoprotective activity comparable ith standard drug silymarin. AB< • .ipid lo ering effects9 o 6 o groups of rats ere fed a high fat diet for eight ee#s to induce hyperlipidemia. 0ne group as supplemented ith aqueous celery e$tract in the diet hile the other group served as control. At the end of the e$periment, a significant reduction as found in the serum total cholesterol =6!>, lo density lipoprotein cholesterol =.%.&!>, and triglyceride =6*> concentrations in the celery&treated rats. +o ever, the concentration of hepatic 6* as significantly higher in the celery&treated group than in the control group. +epatic triacylglycerol lipase =+.> activity as found to be significantly lo er in the celery&treated rats hile the reverse as observed for the hepatic microsomal 1<E0 content. ABE • 4ela$ant9 o Apigenin inhibited the contraction of aortic rings caused by cumulative concentrations of calcium =0.03&3 m/> in high potassium =F0 m/> medium, ith an ,!E0 of about <B micro/. Apigenin rela$es rat thoracic aorta mainly by suppressing the !a2X influ$ through both voltage& and receptor&operated calcium channels.ABF

Medicinal actions: %iuretic, 5edative nervine, !arminative, Anti&inflammatory Medicinal use: • :ervous !onditions9 6he al#aloids in Apium appear to have depressant, traqnquili(ing effects on the !:5. 6hese actions are useful in nervous restlessness and spasmodic tension. • /usculos#eletal !onditions9 Apium is a diuretic particularly suited to arthritic conditions, including those of an autoimmune nature. Apium is indicated in gout as ell as Urtica dioica and Betula pendula. ABH • *enitourinary !onditions9 6hrough stimulating acidic secretion, most notably uric acid, Apium is an al#alini(ing herb to the body in general.ABB Apium is most indicated as a diuretic for chronic deficient states ith sluggish #idney function. !elery seed stimulates circulation to and through the #idneys by mildly irritating them. Apium is also strengthening to bladder epithelium, especially hen used in con"unction ith E<uisteum spp.. • 4eproductive !onditions9 *iven the al#alini(ing effect of Apium, it can be utili(ed ad"unctively in an al#alini(ing regimen for over acidic cervical mucous hich may contribute to conception difficutly. ABC #harmacy: • 6he fresh seed "uice or tea is best. Up to C0 ml of "uice3day • ,nfusion9 A&< g3day QA tsp. O A gR Contraindications: • %ue to the irritating effect of the volatile oils, Apium is contraindicated in acute #idney conditions. 6he volatile oils have an empirical emmenogogue and possible abortifacient effect and should be avoided during pregnancy. 'mperical evidence also suggests increased photosensitivity due to the furanocoumarins. "58 • Apium has high sodiumK monitor those ith hypertension or fluid retention. )o*icity: • !elery pic#ers can develop photodermatitis after handling celery infected ith fungus, hich induces the celery to produce high levels of psoralens.ACA

Arctium lappa
Common name: Burdoc#, *obo

Asteraceae

Ha!itat9 Arctium is native to 'urope, gro s in temperate (ones on this continent and in Asia. ,t prefers moist soil. Arctium can be seen gro ing by roadsides and in abandoned lots. Botanical description9 6his is a thistle plant. A biennial root gives rise to the stem hich gro s 3&< feet tall. .arge, avy dull pale green leaves ith a grey do n on their undersurfaces are big at the base and small near the top. 6he tubular flo ers are purple, pale pin#, or hite and globular and are enclosed in a burr. Historical uses9 'uropeans have long used this plant as food. 6he roots ere dried and used in soups hile the green leaves ere coo#ed as ell. ,n -apan, *obo has been eaten for about A,000 years. ,t as brought into their country by Buddhist mon#s. 6he -apanese people traditionally used *obo root for constipation, syphilis, mercury poisoning, paralysis, to stimulate blood circulation, and as a diaphoretic. 6hey considered the leaves good for e$ternal elimination of pain over bro#en bones, for s#in burns, and for rash. 6he seeds ere used to eliminate to$ins, to control fever, and as a diuretic. 6oday, the average -apanese consumer still buys *obo leaves, believing this herb to be a source of strength and endurance. A. lappa has been cultivated in 'uropean gardens for centuries. %uring the t o World Wars, faced ith severe shortages of medicines, people throughout 'urope had to rely on herbs to treat casualties. A lappa as one of the herbs employed for the treatment of ounds. 1redating the World Wars, the 1ilgrims left records indicating that Burdoc# as one of the herbs they carefully safeguarded on their "ourney to the :e World. :ative Americans ere already using a native species. /edicine men of several :. American tribes dran# a bitter bre of A. lappa to concentrate better and to prolong the image of love in their minds. /edicine man, -.,. .ighthall, carried on the tradition of his people by using A. lappa as a defense against #idney ailments, to ease the passage of urine, and to reduce burning ith urination. About A00 years after the 1ilgrims set foot on the :. American continent, 1aracelsus as recommending A. lappa as a hair&gro ing agent. #arts used9 4oot, seeds, leaves 6he seeds are collected in the summer before the flo er heads are formed. 6he seeds need to be stored in a dry and cool place. 6he leaves are collected before the plant blossoms, and stored in a dry, cool place or eaten right a ay. 6he root should be dug in -uly from the first year plant =identifiable by its lac# of blossoms or burrs> and stored in a dar#, cool, dry place. According to !oo#, the seeds possess the same properties as the root but tend to act more quic#ly. Constituents (root unless otherwise stated 9 AC2 • ,mall amount of !olatile oil of !ery complex ma3e9up: including, among others, phenylacetaldehyde, ben(aldehyde, 2&al#yl&3& metho$y&pyra(ines,es<uiterpene lactones • Polyynes: chief components trideca&A,AA&dien&3,E,H,C&tetrain • 2affeic acid deri!ati!es: including chlorogenic acid, isochlorogenic acid • Polysaccharides: inulin, up to E0G =fructosan>, mucilages =$yloglucans, acidic $ylans> • 6he seeds contain AE&30G fi$ed oils, a bitter glycoside =arctiin> and chlorogenic acid. • 6he leaves contain arctiol, fu#inone, and tara$asterol. #harmacology: Burdoc# root contains high amounts of inulin and mucilage. 6his may e$plain its soothing effects on the gastrointestinal tract. Bitter constituents in the root may also e$plain the traditional use of burdoc# to improve digestion. Additionally, burdoc# has been sho n to reduce liver damage in animal studies.< 6his has not been confirmed in human studies, ho ever. Arctium is considered to be a desmutagen. Arctium stimulates hite blood cells, this action being due to the polyacetylenes. 6he stimulation of WB!s gives Arctium an anti&microbial effect hich ma#es it useful for treating acne and boils, and together ith its diuretic effect, for treating cystitis. Medicinal actions: gentle alterative, antimutagenic, diuretic, diaphoretic, aperient, immunostimulatory, anti&inflammatory, bitter =rela$ant and demulcent ith a limited amount of tonic property& !oo#> $nergetics9 5 eet, cool )raditional Medicinal Use: 5pecifically, Arctium is an alterative. Alteratives is an herb hich acts in a gentle and tonifying ay to Mimprove the quality of the blood, increase the appetite, promote digestion, and accelerate the processes of elimination.M Q)elter, p.B2R Alteratives brea# do n and remove to$ins from the body. 6he mechanism of action of alteratives is largely un#no n. ,t is presumed that they act through a combination of effects including9 choleretic, cholagogue, enhancing deto$ification path ays in the liver, increasing cellular metabolism, la$ative, nerve

tonic, and stimulation of glandular functioning. ,t acts slo ly and mildly upon several of the secreting organs, as the #idneys, s#in, and bo els.AC3 'lling ood states that Arctium has similar properties to 4ume$, being an alterative and affecting the s#in and mucous membranes. As a glandular alterative, Arctium is indicated in chronic glandular enlargements. 4pecific ,ndications and Uses2Z)eeble cutaneous circulationK scaly, dry eruptionsK impaired nutrition of s#inK urinary irritationK psoriasis.AC< • %ermatological !onditions9 5#in diseases, depending more so on a deficient state of the cutaneous tissues and less upon the state of the blood itself, are conditions in hich Arctium as indicated. ,n cases requiring burdoc# seeds the cutaneous circulation is feeble or there is an irritable condition of the system. ACE,ACF 6he seeds stimulate the sebaceous and s eat glands restoring the natural oiliness and diaphoretic characteristics to the s#in.ACH • *astrointestinal !onditions9 6o the 'clectics, Arctium as valuable in catarrhal and aphthous ulcerations of the digestive tract. 'lling ood stated that it promotes normal gastric secretion hile restoring ulcerative mucous membranes of the *, tract. !oo# claimed that the seed seemed to abate nausea caused by .obelia. ACB • *enitourinary !onditions9 ?ing recommended the seeds as very efficient diuretic alterative. +e described direct action of the seeds on the urinary tract, relieving irritation, increasing renal activity, assisting in eliminating morbid products and removal of orn& out tissues in chronic disorders.ACC 6hey increase the flo of urineK and are very effective in bladder irritation and urine ith mucous and grayish sediments.200 • ,nflammatory !onditions9 4heumatism, ithout structural alteration, as said to be benefited by the seeds. • 0phthalmologic !onditions9 Arctium has been used to remove boils and styes on the eyelids. 20A • 1ulmonary !onditions9 Arctium relieves bronchopulmonic irritation and cough, particularly hen a cachectic condition of the blood is present and here an alterative is indicated. 202 • 6opical Applications9 6he bruised leaves ere applied directly to boils, as a Idra ingJ and cleansing fomentation. 203 Current Medicinal Use: Burdoc# is considered a food. /ost medicinal foods tend to be tonifying in their effect as is Arctium. 1reparations of burdoc# root are used for ailments and complaints of the gastrointestinal tract, as a diaphoretic and diuretic, and for blood purifying. ,t may possibly be used in the treatment of cancer. 6he claimed efficacies have not been documented. 20<, 20E • %ermatological !onditions9 Arctium is an alterative that is especially indicated in conditions of dry, scaly cutaneous eruption ith mild inflammation and poor peripheral circulation. Arctium radi$ acts in a slo , gentle manner, the full effect being evident after several ee#s of use. Arctium is useful in conditions such as ec(ema, acne and psoriasis. 20F, 20H • 'ndocrine !onditions9 Burdoc# seeds can lo er blood sugar in rats, and in )rance the fresh root is used in diabetics to lo er blood sugar and to help remove adipose tissue. 6herefore, monitor insulin dosage in patients if used concurrently ith this medication. • *astrointestinal !onditions9 6he bitter taste of Arctium underlies its tonifying action to the digestive system via gustatory nerve stimulation from the taste receptors in the tongue to the vagal afferents on the organs of digestion. • ,nflammatory !onditions9 6he roots and leaves are useful in rheumatism and gout because they encourage the elimination of uric acid by the #idneys. Additionally, A. lappa has anti&inflammatory actions, ma#ing it a useful ad"unct in the treatment of rheumatoid arthritis. 0ne study demonstrated that Arctium minus spp. decreased inflammation in 4A sufferers by EHG versus <FG decrease in the control.20B • +epatobiliary !onditions9 6he leaves, in particular, stimulate secretion of bile =choleretic>. • 6opical Applications9 )inally, Arctium leaves are useful in e$ternal applications for bruises, s#in eruptions, and burns. #harmacy9 6ea9 A tsp. root3cupK A cup 6,% for several ee#s =!hildren one glass daily>. A tsp. seed3couple o(. ater 6,% ic for several ee#s =!hildren A32 tsp. seed3 2 o(. ater> 6hese decoctions can be used undiluted as a poultice. A9E tincture& 2&< ml 6,%

Contraindications: Brin#er speculates that e$cessive doses be avoided in pregnancy due to empirical o$ytocic effects and uterine stimulant effects.20C )o*icity9 :one has been reported, although a gentle approach ith this herb is advisable since it can be a po erful deto$ifier in some individuals.
192 193

+erbal 1%4, /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 194 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 195 )elter 196 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 2F3

197 198

!oo# !oo# 199 )elter 200 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 201 )elter 202 )elter 203 !oo# 204 +erbal 1%4, /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. 205 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 206 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000. 207 .ininger et al9 +ealthnotes, !linical 'ssentials, 1rima 1ublishing, 4oc#lin, !A. 200A. 208 1lanta /edica ACC0K EF9FEC 209 Brin#er, )rancis :%. +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB. p. <E

Arctostaphylos uva ursi
Common name: Bearberry, Uva ursi, upland cranberry, #inni#innic#

$ricaceae

Ha!itat:0"8 • Bearberry has spread from the ,berian 1eninsula across !entral 'urope to 5candinavia and 5iberia. • ,t is also found in the Altai /ountains, the +imalayas and :. America Botanical description:0"" • )lo er and )ruit9 6he flo ers are in 3&A2 short, terminal and hanging racemes. 6he pedicle has small, ovate, ciliate bracteoles at the base. 6he caly$ is A mm long, palmate and has E membranous tips. 6he corolla is ovoid to "ug&shaped, hite or reddish ith a red border, E&F mm long ith E short revolute tips. 6he A0 stamens are half as long as the corolla tube. 6he filaments are thic#ened in the base. 6he anthers have porous openings, are crimson and have a long hip&li#e, curling appendage. 6he ovaries are E&H valved and the style is longer than the stamens. 6he fruit is a globose, pea&si(ed, scarlet, floury drupe. 6he fruit has E&H stone seeds, < mm in length, hich are #idney shaped and compressed at the sides. • .eaves, 5tem, and 4oot9 6he plant is a decumbent, up to A.E m long, creeping espalier ith elastic, red&bro n branches. 6he leaves are alternate, coriaceous, short petioled, spatulate&obovate or edge&shaped, entire&margined and slightly revolute. 6hey are A2&30 mm long by <&AE mm ide, glabrous, glossy, and evergreen. 6he underside is reticulate and the midrib and the margins are often do ny. • 6he drooping clusters of flo ers at the ends of the branches bloom in /ay and -une. 6he berry ripens in autumn. 2A2 #arts used: .eaves =the summer and autumn leaves are more potent than the inter leaves> $nergetics:0"7 Astringent, cold, dry. Berry is also a bit s eet and astringent. Constituents: 2A<,2AE, 2AF • hydroquinone glycosides =<&AEG>9 arbutin, methylarbutin • polypheneols • tannin =increased in older leaves> • flavonoids =quercetin> • resin, acids =ursolic, gallic, ellagic> • allantoin • volatile oil =triterpene al#aloids> #harmacology: • 6he glycoside arbutin is the active ingredient present in fairly high amounts =up to A0G> in uva ursi. ,n the intestines, arbutin is split into a small sugar molecule and a hydroquinone. +ydroqiunone is then made ater&soluble in the liver and can be carried by blood to the #idneys. ,n the #idneys, if the urine is al#aline, the hydroquinone is released from its carrier. +ydroquinone is a po erful anti&microbial agent, hich is responsible for uva ursi@s ability to treat urinary tract infections. Arbutin has also been sho n to increase the anti&inflammatory action of synthetic cortisone. 2AH,2AB According to early animal research, activity of other commonly prescribed anti&inflammatory drugs can be potentiated by arbutin and possibly other constituents of uva ursi. 0ne study found that an aqueous e$tract increased the inhibitory activity of de$amthasone in allergic and inflammatory models ithout increasing any of the side&effects. 5imilar results have been demonstrated ith isolated arbutin hen combined ith indomethacin.2AC • )lavonoid components prevent the splitting of arbutin, thereby allo ing more arbutin to be hydroly(ed in the body, compared to amount of hydrolysis hen arbutin is administered as an isolated component. Arbutin alone has been reported to be an effective urinary antibiotic, but only if ta#en in large doses and if the urine is al#aline =once again documenting the value of hole plant medicines>. Arbutin is reported to be active against !andida albicans and 5. aureus, and especially active against '. coli. Uva ursi also has diuretic properties.220,22A Medicinal actions: antibacterial, astringent, anti&inflammatory, diuretic, tonic, o$ytocic )raditional medicinal uses: 222 • *enitourinary !onditions9 Arctostaphylos is generally used as a diuretic and a sedative for the genitourinary system, e$erting an astringent and tonifying effect. 6he specific indications for Arctostaphylos are rela$ed conditions of the bladder alls, to hich it imparts tone, induces normal contraction, and restrains e$cessive mucous discharges. Accordingly, conditions responsive to Arctostaphylos include ulceration of the bladder, cystitis, pyelonephritis and gonorrhea. As a general influence, its use has been

indicated in diabetes. )urthermore, it e$erts a soothing influence on the urinary tract, thereby finding a place in most formulas for conditions of these organs. Current medicinal uses: • *enitourinary !onditions9 • ,nflammatory !onditions9 ,nternal and e$ternal use may be indicated for contact dermatitis, inflammatory edema and arthritis as e$trapolated form pharmacological studies. 223 Arbutin may have synergistic activity ith conventional anti&inflammatory drugs =indomethaicn, prednisone, de$amethasone> on type < hypersensitivity reactions. &&' • %ermatological !onditions9 Arbutin appears to inhibit tyrosinase activity resulting in the decreased synthesis of melanin and may have a role in hyper pigmentary disorders. • !linical trials have supported use for cystitis, both acute and recurrent. According to the British +erbal 1harmacopoeia ACB3, the specific indication is acute catarrhal cystitis ith dysuria. 5tudies sho that the anti&microbial effect occurs ithin al#aline urine. !onsidering that a ma"ority of urinary tract infections produce acid urine, simultaneous administration of an al#alini(ing agent such as bicarbonate may be of benefit. Also, an al#aline forming diet, rich in fruits and vegetables should also be utili(ed. 22E )ccording to +eiss922F • *enitourinary !onditions9 ,n the case of urinary tract infections, it is very effective as an antimicrobial if the urine is sufficiently al#aline. Arctostaphylos has been successfully used to treat cystitis in paraplegics. Weiss indicates that the leaves have no diuretic action. ,n fact he cautions against flushing the urinary tract in acute cystitis as flushing increases tissue irritation. 4ather, he suggests that the bladder requires rest. Administering Arctostaphylos in a carrier of /atricaria tea ill also provide the antiphlogistic and spasmolytic properties of the latter herb. ,n turn, he ill flush the urinary tract in chronic catarrhal conditions in hich large quantities of Arctostaphylos tea are indicated although other diuretics may be less upseting due to the tannin content. • Alternative plants include 7accinium vitis&idea =co berry>, !alluna vulgaris =heather> and !himaphila umbellata. 'ach of these herbs contain arbutin to a lesser degree and little to no tannin. 6hus, here the tannin content of Arctostaphylos ould be undesireable, these other herbs may be of assistance. )ccording to the Textboo3 of ;atural Medicine &&4: • *enitourinary !onditions9 Arbutin has been reported to be active against !andida albicans, '. coli and 5. aureus. Arctostaphylos can be used in both the acute treatment and the prevention of recurrent cystitis. Arctostaphylos is used primarily in the treatment of cystitis, ulcerations of the #idney and bladder, and to soothe and tonify these organs. 6he hole plant contains al#alini(ing components, in addition the flavonoids in the plant envelop the arbutin, thus facilitating its absorption. )or this reason the hole plant is best. Additionally, further al#alini(ing the urine by adding bicarbonate ill strengthen the antimicrobial action of the plant. 6he urine may turn a dar# or bro nish&green color hen it contains sufficient amounts of o$idi(ed hydroquinone. Arctostaphylos is most effective against '. coli infections. Arctostaphylos is diuretic due to the flavonoids and ursolic acid. Arctostaphylos imparts tone to the urinary system and is, therefore, most indicated in ea#, atonic bladders =manifested by urinary frequency, incontinence, and a sensation of heaviness in the perineum>. 6he tannins in Arctostaphylos give this plant an astringent action, contributing to the antiseptic action hile tonifying and strengthening the urinary system. Arctostaphylos is a useful ad"unct in the treatment of renal calculi and gravel. )ccording to the Textboo3 of ;atural Medicine &&(: ,nflammatory !onditions9 Arbutin, and possibly other constituents, potentiate the activity of commonly prescribed anti <inflammatory drugs including de$amethasone and indomethacin. )ccording to Mills and Bone:&&* Any condition requiring astringent action calls for Arctostaphylos. • *astrointestinal !onditions9 diarrhea and intestinal irritaions. !urrent 4esearch 4evie • Urinary disorders9 ,n one double&blind study, the prophylactic effect of a standardi(ed uva ursi e$tract compared to a placebo on recurrent cystitis as evaluated in EH omen. At the end of one year, E32H omen in the placebo group had a recurrence hile 0330 omen receiving uva ursi e$tract had a recurrence. :o side&effects ere reported in either group. 230,23A. 6he !omission ' recommend its use for inflammatory disorders of the urinary tract. • 5earch of /edline revealed no human trials as of A3AE303 #harmacy: • %ried leaf9 =A tspO 2.Eg herb> 232 o up to A2 g qd =equivalent to <00&B<0 mg arbutin> as infusion or cold macerate. 233 • ,nfusion9 o A&2 tsp of dried leaves3cup boiling ater. ,nfuse A0&AE min. 5ig 6,%. 23< o 3 gm3AE0 ml ater up to 2,%23E & same dose for cold maceration.

• • • •

5tandardi(ed e$tract o H0 mg arbutin9 t o 0.H g tabs B,%&6,%. 23F o <00&B<0 hydroquinone derivatives calculated as ater&free arbutin. 23H 6incture9 o A9E tincture9 A0&AH ml qd23B o Unspecified strength9 2&< ml 6,%23C .iquid e$tract9 o A92 liquid e$tract9 <&B ml qd2<0 o Unspecified strength9 L tsp 6,%2<A %ecoction9 o A 6bsp32 cups, boil do n to A cup. :o sig given 2<2

Drug interactions: Contraindications: • !onsidering that arbutin converts to hydroquinone in al#aline urine, urinary acidifiers can theoretically inhibit this conversion. 2<3 Arctostaphylos should be avoided during pregnancy due to an o$ytocic effect. 2<<,2<E /ills and Bone also list lactation as a contraindication. Use in children under A2 may be contraindicated due speculation of possible liver impairment from metabolites and its inhibition of B cell maturation =in vitro>. 2<F,2<H !onsidering the high tannin content, Arctostaphylos is not recommended for long term use.2<B !onsidering the tannin content, use should be avoided in organic #idney disease. 2<C Use of .inum has been suggested as an ad"unct in preventing gastric irritation from the tannins, yet .inum prevent the absorption of arbutin.2E0 )o*icity: • 6he tannins can a cause gastric irritation if used for too long or in too high of a dose. 2EA 6he to$icology is proportional to the conversion of arbutin to hyrdroquinone as hydroquinone is a highly to$ic and mutagenic. AE g of the fresh leaves can provide A g of hydroquinone hich can be to$ic ith signs and symptoms of9 tinnitus, nausea, vomiting, sense of suffocation, shortness of breath, cyanosis, convulsions, delirium and collapse.2E2
210 211

1%4 for +erbal /edicine, Ast 'dition. /edical 'conomics !ompany, ACCB, p.FEB 1%4 for +erbal /edicine, Ast 'dition. /edical 'conomics !ompany, ACCB, pp FEH&FEB 212 5ource as not located 213 +olmes, 1. 6he 'nergetics of Western +erbs, 2nd 'dition. 5no .otus 1ress, Boulder, ACC<. p. F0C 214 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 215 Wren, 4.!., 1otter@s :e !yclopedia of Botanical %rugs and 1reperations, 1otter@s limited, 'ngland. ACBB. 216 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 217 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 218 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 219 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 220 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 221 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 222 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. <2C&30 223 /ills and Bone, p 2B0 224 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 2B0&< 225 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 2B0&< 226 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2<<&2<E 227 /urray p. CC0 228 /urray p. CC0 229 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 2B0&< 230 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 231 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 232 1%4, FEB 233 /ills and Bone, 2B0 234 +offman AH3 235 1%4, FEB 236 /ills and Bone, 2B0 237 1%4, FEB

238 239

/ills and Bone, 2B0 +offman AH3 240 /ills and Bone, 2B0 241 Weiss, 2<< 242 Weiss, 2<< 243 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB. p. 3E 244 Weiss, p. 2<E 245 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. 3<&E 246 Broo#s 5 =ed. >. Botanical 6o$icology. 1rotocol -ournal of Botanical /edicine, ACCE, A=A>9 A<H&EB 247 ?ing A*, .andreth ?5, Wierda %. Bone /arro 5tromal !ell 4egulation of B&.ymphopoiesis ,,. /echanisms of +ydroquinone ,nhibtion of B&!ell /aturation. - 1harm '$p 6her ACBC, 2E0 =2>9 EB2&C0 248 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 2B0 249 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB. 250 Weiss, p. 2<< 251 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. 3E 252 /urray p. CC0

Arnica montana
Common name: arnica, leopard@s bane, olf@s bane, mountain tobacco

Asteraceae

Botanical description: A 20&30 cm tall perennial herb ith opposite leaves. A&3 flo er&heads, one terminal and the others arising from the a$ils of the leaves. 4eceptacles E&B cm broad, ith AE&2E yello , ligulate florets. #arts used: )lo ers Constituents: • 1suedoguaianolide&type sesquiterpene lactones =0.2G&0.BG> • +elenalin and esters of helanalin • )atty acids, )lavonoids and flavonoid aglycones, 7olatile oil9 ith thymol, thymol esters, free fatty acids, sesquiterpenes, !inamic acid, !oumarins, 1olyacetylenes, !holine, Panthophylls, 1olyenes , +ydro$ycumarine #harmacology 0%7 Arnica e$hibits anti&inflammatory activity by affecting the neutrophils and liver cells through one or more of these mechanismsK uncoupling o$idative phosphorylation , elevating cA/1, inhibiting lysosomal en(ymatic activity, and inhibiting chemota$is. At high concentrations cycloo$ygenase may be inhibited Arnica e$hibits some antimicrobial activity. 6he essential oil has potent bactericidal effects on *ram positive and negative bacteria as ell as 2andida1 6he polyacetylenes from the root have demonstrated Antimicrobial effects against various pathogenic fungi and bacteria. Medicinal actions: Wound antiseptic, anti&rheumatic, antineuralgic, antiphlogistic =relieves inflammation> #harmacology: +elenalin and dihydrohelenaline esters are the main identified !onstituents. 6hese !onstituents have strong antimicrobial, antiphlogistic, antirheumatic, anti&arthritic, and antihyperlipidemic properties. 2E< )raditional Medicinal Use: 5pecific ,ndications and UsesZ/uscular soreness and pain from strains or over&e$ertionK advanced stage of disease, ith mar#ed enfeeblement, ea# circulation, and impaired spinal innervationK embarrassed respirationK lac# of control over urine and fecesK sleeplessness from impeded respiration, and dull precordial pain from Mheart&strainKM muscular pain and soreness hen the limbs are movedK tensive bac#ache, as if bruised or strainedK cystitis, ith bruised feeling in bladder, or from a fall or blo K headache, ith tensive, bruised feeling and pain on movementK hematuria, ith dull, aching lumbar pain, or from over&e$ertion. All cases of debility ith enfeebled circulation.2EE • 6opical Applications9 Arnica as considered a local irritant, the preparations of the flo ers being most po erful. Arnica as used in the form of an infusion, a fomentation, or diluted tincture of the flo ers, both to prevent and disperse local inflammations, to remove ecchymosis, and as a dressing for cuts, lacerations, contusions, etc. A fluid e$tract of Arnica has been found very useful as an application for the bites of mosquitoes and other insects. Current Medicinal Use: Arnica is reserved for topical use only. As an e$ternal agent is useful for sprains, bruises, hematoma, edema, fractures, over areas of phlebitis and thrombosis, arthralgia and rheumatic "oint pains, inflamed insect bites. Arnica is most specific for bruises and may also be used as a massage oil to help relieve muscle soreness and stiffness. • !ardiovascular !onditions9 !hronic venous insufficiency9 A ell&conducted trial sho ed Arnica to be superior to placebo in reducing edema and feelings of heaviness and improving venous tone 2EF =gel containing a 20G tincture given daily for three ee#s>. • 6opical Applications: Arnica gel as superior to placebo in A2 male volunteers ith muscle ache. 2EH #harmacy: '$ternal use over intact s#in only9 1oultice or application of infusion 2g3cup =A tsp. O 0.E g> or arnica oil. Contraindications: 5trong preparations should not be applied on bro#en s#in or full strength, as an erysipelatous inflammation has follo ed application to sensitive s#in.2EB 1rolonged e$ternal use can cause allergic dermatitis. Use should be avoided in pregnancy. 2EC ,nternal use should only occur under the supervision of #no ledgeable physician. )o*icity:

6he sesquiterpene lactones are to$ic causing gastroenteritis and ith higher doses cardiac arrest. 6he helenolides are also #no n to interfere ith myocardial recovery in bet een contractions. 6 o fluid ounces of the tincture has produced death. 2F0 1harmaco#inetic information about the sesquiterpene lactones is lac#ing and therefore oral dosing of Arnica is to be avoided. 2FA With prolonged e$ternal use, edematous dermatitis may result ith the formation of small vesicles. +elanalin and its esters are sensiti(ing agents and act as allergens.
253 254

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2H0 .ee ?+, et al, Phytochemistry, AF, ACHH9AAHH. 255 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 256 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p.2HA 257 ,bid 258 )elter 259 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 3A 260 )elter 261 Wichtl, /, Herbal Drugs and Phytopharmacetuticals, =Ann Arbor9 !4! 1ress>, ACC<9BE.

Artemisia a!sinthium . A2 spp2

Asteraceae Common name: orm ood =A. absinthum>, ormseed =A. santonica & !oo# states that A. contra and A. aborantum, a domestic plant, has a very similar in action to A. santonica. 'lling ood refers to this plant as A. pauciflora> Ha!itat9 :ative to 'urope, :. Africa, W. Asia and cultivated in the U.5. and else here. Botanical description9 A shrubby perennial reaching A mK leaves pinnately divided, up to A2 cm long, the lobes oval or lanceolate. Both surfaces covered ith fine, hitish, sil#y hairs. 6he flo ers are small, nearly globular, greenish&yello . #arts used9 +erba, collected at the end of the flo ering period bet een -uly and 5eptember. Wormseed is actually small flo er buds. Constituents9 • volatile oils =thu"one, absitol, a(ulenes> Q0.2&A.EGR • bitter sesquiterpenes and bitter sesquiterpene lactones Q0.AE&0.<GR • terpenoids , triterpenoid, flavone glycoside, hydro$ycoumarins, lignans #harmacology: :o information is currently available. Medicinal actions: bitter, carminative, anti&microbial, anthelmintic, choleretic, emmenagogue =thu"one> )raditional Medicinal use: • *astrointestinal !onditions9 Artemisia is another bitter plant. ,t is most indicated in conditions of poor appetite ith sluggish digestion. )ermentation in the gut causing halitosis can be relieved ith the use of Artemesia. %yspepsia, flatulence, malabsorption =including anemia>, and degeneration of the gastrointestinal system can all be relieved ith the use of Artemisia. Artemisia is ell indicated in the elderly population for decreased hydrochloric acid production and decreased pancreatic secretions. Artemisia decreases bile duct spasm and increases efficient bile duct contractions. ?ing recommended its used ,n small doses it is a stimulant tonic, improves the appetite, and is useful in atonic states of the gastro& intestinal tract, as a tonic dyspepsia, especially hen due to alcoholic e$cesses, in flatulent colic, and in obstinate diarrhoea. .arge doses are apt to irritate the stomach and increase the action of the heart and arteries. 2F2 6o the physiomedicalists the leaves and flo ers ere stimulating and rela$ing tonics, ith bitter and strong properties that act upon the stomach and gall&ducts. 0f these effects it as a favorite addition to tonic preparations for bilious conditions, intermittents, "aundice hypochondria, diarrhea and similar maladies.2F3 Artemisia is useful for s eet3sugar cravings especially hen combined ith /entha pip. =3&E gtts 5.>. Artemisia is a useful therapy for hypoglycemia if ta#en after meals =enhances absorption and helps to normali(e pancreatic and liver secretions>. 6he common name, Worm ood, signifies its use as an anthelmintic =especially against round orm, )scaris lumbricoides, and pin orm, )1 !ermicularis, and !oo# includes tape orm although no other authors do>. According to 'lling ood, there are a large symptoms associated ith the specific indication of lumbricoid orms, all of hich are seldom present at one time in a single present. 6hose symptoms orth noting are a deep red tongue ithout coating ith digestive symptoms of an e$cess nature due to intestinal irritation.2F< Artemisia absinthium is the strongest Artemisia species for this action although !oo# states that A. santonica is a prominent remedy for orms9 its actions seem to be much li#e A. absinthium, but more stimulating and diffusive and less locally tonic. A good combination is Artemisia absinthium.9 /entha puelgium9 6anacetum vulgare9Bentonite. 6his combination is best encapsulated and can be used for orms in pets as ell. • *enitourinary !onditions9 'lling ood noted that A. paucilfora could be used to increase the secretion of urine in children, restoring normal urinary function in post scarlatinal and post diphtheritic nephritis. 2FE • *ynecologic !onditions9 Artemisia can be used as a douche for infectious vaginitis. As a result of its influence on digestion, it e$erts a little stimulating influence upon the uterus indicating its use in ith good results in amenorrhea and leucorrhoea hen due to debility.2FF,&$4 • ,mmune !onditions9 Artemisia is a good general tonic useful in colds and flus. • :ervous !onditions9 Absinthium possesses decided medicinal qualities, acting ith considerable force upon the cerebrum and the sympathetic, nervous system. 'lling ood considered A. pauciflora a nerve sedative, particularly for irritation of a refle$ character hen the cause as faulty digestion and decomposition of food. +e also noted the successful use of this herb for refle$ive nervous irritation in the respiratory tract, mild heart pain, fever, pregnancy and epilepsy 2FB • 0phthalmologic !onditions9 Artemisia is an e$cellent addition to eye ash especially in an infusion ith 4ubus and 'uphrasia. • 5leep !onditions9 )inally, Artemisia is #no n to stimulate dreams, and Artemisia vulgaris is said to stimulate dreams of the future. 5ome individuals claim this effect by sleeping ith the herb under their pillo . • 6opical Applications9 Artemisia has indications outside of the digestive tract as ell. An oil of Artemisia is an e$cellent topical

application for bruises and infections. )or bruises, it combines ell ith .obelia, and ill decrease healing time and pain. ?ing has also described its use as an e$ternal application in chronic affections of the abdominal viscera, either in the form of tincture, infusion, or poultice. Current Use • 'ndocrine !onditions9 blood sugar disturbances, including the dietary management of diabetes • *astrointestinal !onditions9 6he specific indication for bitters is the patient ho is pale, lethargic and prone to infections. 5pecifically, Artemesia spp. are indicated for poor appetite and digestion, chronic gastritis and gastric ulceration, food intolerances and allergies. ,n regard to intestinal dysbiosis, focus on hepatic and biliary function as ell as the application of bitters supports a high fiber diet ith reduced simple sugar inta#e. 6hrough stimulation of hydrochloric acid and bile secretion, Artemesia can help prevent enteric infections, particularly in patients ith poor immunity. A. annua is an antiproto(oal agent as ell . 2FC • +epatobiliary !onditions9 liver and bile disturbances, "aundice, gall stone disease. 'vidence of hepatoprotective effects also arises from studies ith Artemesia species. • ,nflammatory !onditions9 fever, inflammatory conditions of the s#in, inflammation in general, allergic and hypersensitivity conditions • :eurological !onditions9 headaches and migraines. Current +esearch +eview • Breech presentation:0(8 o %esign9 randomi(ed, controlled, open clinical trial. o 1atients9 2F0 sub"ects, primigravidas in the 33rd ee# of gestation ith normal pregnancy and an U35 diagnosis of breech presentation. o 6herapy9 5timulation of the acupoint B. FH =located on the lateral nail bed of the little toe> by mo$a =-apanese term for Artemisia vulgaris> rolls $ H days, ith additional H days if breech persisted. o 4esults9 /o$ibustion $ A&2 ee#s increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery. • Dia!etes mellitus:0(" o %esign9 1reliminary study o 1atients9 AE patients ith diabetes mellitus o 6herapy9 Artemisia herba&alba Asso. '$tract =A+'> o 4esults9 A+' caused considerable lo ering of elevated blood sugarK A< out of AE patients had good remission of diabetes symptoms. #harmacy9 )or a bitter effect, Artemesia and other bitters do not need to be administered in high doses but only enough to stimulate a strong bitter taste. )or formulation, a tincture that is E&A0G bitters ill be adequate. Although long&term therapy is beneficial and may be necessary, or# to a place here bitters are ta#en only hen necessary. 2H2 A small portion serves ell in cases of decided languor and sluggishness of action. !onsiderable doses of long&term use leads to e$citement of the stomach, pulse and brain in a narcotic fashion although the effect is more li#ely due to a very slo and persistent stimulation and tonic action on both the heart and nervous system. !oo# rarely uses more than a half ounce of this herb in a total volume of one gallon of a tonic formula.2H3 1rolonged use of forms high in the essential oil such as alcoholic e$tracts should be approached ith caution due to to$ic effects thu"one accumulation =empirical>.2H< 1o der ,nfusion9 A&2 g3 B o(. ater, sig A32 cup ac QA tsp. O A.E gR =Alschuler> 6incture9 A9E 2EG 't0+, sig 0.E&A ml in ater acK ma$. dose 2E ml3 ee# =Alschuler> .otion or oil e$ternally over intact s#inK as a arm fomentation steeped in ater or vinegar and ater, and applied as hot as can be borne. Contraindications: Bitters are contraindicated in states of hyperacidity, especially duodenal ulcers. 2HE Although often avoided in gastric ulcers, bitters may be beneficial as this condition is often associated ith atrophic gastritis. !aution is advised in cases of gastroesophageal reflu$, although bitters may improve this condition by improving the tone of the lo er esophageal sphincter. )inally, caution is advised in patients ho are IsupertastersJ, people ho perceive the greatest sensitivity to tastes. 2HF 6raditional contraindications for bitters include conditions described as \cold&dry.@ )or e$ample, conditions involving shivering dry cough and notably including some #idney diseases.

6he use of Artemisia is contraindicated in pregnancy due to its emmenagogue and abortifacient effects =empirical> from the uterine stimulant action of its thu"one content =in vitro and animal studies>. 2HH 6he use of Artemisia is contraindicated in irritable nervous states, and sei(ure disorders =Alschuler>. )o*icity9 )dapted from .ing: 2HB 1hysiologically both oil of orm ood and e$tract of absinth act as nerve depressants. .ess than A3B ounce doses produced in tremors, spasmodic muscular action of a clonic character, into$ication, and loss of sensibility in animal studies. .arger doses produced violent epileptic sei(ures, in some instances resulting fatally. 5mall doses act as a gentle stimulant, larger doses produce headache, hile still larger doses induce cerebral disturbances and clonic convulsions. 7ictims of absinthism are sub"ect to disturbed rest, ith disagreeable dreams, a a#ening in the morning ith sic#ness and vomiting. A chronic into$ication ensues that is more fearful in its effects than that resulting from the abuse of alcoholics. A conspicuous feature is the tendency to epileptic attac#s. Both physical and mental po er is seriously impaired and the se$ual system ea#ened to such an e$tent that virile po er is lost in the male hile a premature menopause is a common result in the female. ,t is also said to produce a peculiar hyperaesthesia, most mar#ed in the integument of the hypogastria. 6hu"one is present in herbs such as Artemesia absinthium, Achillea, 5alvia and 6hu"a and is neuroto$ic as demonstrated by its presence in absinthe. 6he first sign of to$icity from thu"one is headache. +igh and prolonged doses of the above herbs should be avoided unless they are lo thu"one varieties.2HC As described above, Artemisia =primarily thu"one> is very to$ic to the !:5, causing paralysis, decreased coordination, and =euphoric> hallucinations. 6hese effects are said to be reversible. 6hu"one is not ell preserved in ater, thus ater e$tractions are safer than alcohol e$tractions.=Alschuler> Brin#er also discusses the potential for allergic responses =contact dermatitis or other effects> to herbs in the Asteraceae family due to the sesquiterpene lactones.2B0
262 263

)elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB39F !oo#, W/1 The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy1 'clectic /edical 1ublications, 5andy, 04 ACBE 92HA&3 264 'lling ood, ). )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago. ACAC p. E02 265 'lling ood p. E0< 266 )elter p F 267 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy= 'clectic /edical 1ublications, 5andy, 04 ACBE p. 2HA&3 268 'lling ood, ). )merican Materia Medica, Therapeutic and Pharmacognosy1 'lling ood@s 6herapeutist, !hicago. ACAC p. E03 269 /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 2000. p. AH3, AHB 270 !ardini ), Wei$in +. /o$ibustion for correction of breech presentation a randomi(ed controlled trial. 7)M) ACCBK2B0=AB>9AEB0&< 271 Al&Waili :5. 6reatment of diabetes mellitus by Artemisia herba&alba e$tract9 preliminary study. 2lin Exp Pharmacol Physiol ACBFKA3=H>9EFC&H3. 272 /ills and Bone 273 !oo# p. 2H0 274 Brin#er, ). Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A3H 275 /ills and Bone p. <A, Brin#er p. A3H 276 /ills and Bone p. <A 277 /ills and Bone p. CC, %r. Alschuler, Brin#er p. A3H 278 )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 279 /ills and Bone p 30 280 Brin#er p. A<F, A<C

Asclepias tu!erosa

Asclepiadaceae (Milkweed =amily Common name: 1leurisy 4oot, Butterfly Weed, 5 allo Wort, Wind 4oot, 6uber 4oot. Ha!itat: ,ndigenous to America ] !anada. Botanical description9 A perennial herb preferring dry, gravelly ] sandy soils. 6he large, irregular, yello ish&bro n tuberous roots can be nauseating ] bitter hen fresh, but this is less so as the root dries. 6he hairy stems can reach 2&3 feet in heightK bearing alternate, lanceolate, hairy leaves, hich are dar# green above ] pale beneath. 6he flo ers are erect ] are of a beautiful bright orange&yello in color. Asclepias tends to flo er in -une through late August to 5eptember, ] is follo ed by erect, long, narro , pubescent pods. #arts used9 4oot, although ra root is potentially poisionous. $nergetics: Bitter, 1ungent. !ooling. =&> 1itta ] ?apha. =X> 7ata. Constituents9 • !ardiac *lycosides9 !ardenolide steroidal glycoside called Ascepin. • )lavonoids9 4utin, ?aempferol, 2uercetin, ,sorhamnetin. • Amino Acids. • 5ugars. • 7olatile oil. #harmacology: !ardiac glycosides are considered the main active constituent group in 1leurisy root. 0f the t o types of cardiac glycosides, Asclepias contains cardenolide glycosidesK of hich ascepin is principle. !ardenolides are composed of 23 carbons & consisting of a lactone ring attached to a steroidal nucleus =similar to cholesterol> ] various sugars. A as rule, cardiac glycosides inhibit the sodium potassium pump, hich leads to a rise in intracellular calcium, follo ed by an increase in contractile force ] speed of the heart muscle. 6his increase in cardiac contractility ] heart rate leads to an increase in cardiac output & a phenomenon also #no n as positive inotropy. A refle$ive decrease in heart rate is cause by autonomic stimulation ] is called negative chronotropy. 6his is the basis behind the use of cardiac glycosides in the treatment of certain cardiovascular conditions. As ith most substances that are ta#en into the body, the more fat soluble a particular substance is, the more readily absorbed it is at the brush border. )at solubility of a particular substance is determined by its constituent groups. ,f a constituent, for e$ample attached to a cardenolide glycoside, is not particularly fat soluble, then once it reaches the large intestine, it ill be digested by gut flora into a more lipid soluble form called an aglycone. 6he ne ly formed aglycone is more lipid soluble than the original parent compound ] can thus be more readily absorbedK entering the portal venous system for further metabolism by the liver, before systemic action can be achieved. )lavonoids are a second important consitutent found in Asclepias. ,n general, flavonoids are the IBiological 4esponse /ediatorsJ of the body. 6his means that they help to stabili(e, protect ] potentiate most biological reactions ithin the body. /ore specifically, flavoinoids have the follo ing actions9 anti&o$idant, anti&anaphylactic, anti&allergic, anti&thrombotic, anti&inflammatory, cardiotonic, hypotensive, ] anti&arrhythmic. 6he flavonol glycosides rutin ] quercetin that are found in 1leurisy root are considered Ipermeability factorsJ, meaning that they have the ability to influence the stability of capillary cell alls to decrease their susceptibility to vascular fragility. 2uercetin has further #no n function ithin the body, namely in its use at decreasing the severity of allergic reactions by binding ,g* ] inhibiting *, ] respiratory mast cells from releaseing histamine ] other pro&inflammatory mediators. )lavonoids are thought to be absorbed ithin the gut ] concentrated in the s#in. -ust as flavonoids appear to have a protective role in animals, they seem to provide the same function for plants W providing protection for both plants ] animals from the effects of intense solar radiation by acting as anti&o$idants. As such ith other anti&o$idants, flavonoids act synergistically ith 7itamin !, aiding its ability to quench roaming free radicals throughout the body. Medicinal actions: Anti&spasmodic. %iaphoretic. %iuretic. .a$ative. 6onic. !arminative. '$pectorant. )ebrifuge. Current > )raditional Medicinal Use: Asclepias is particularly indicated in cases characteri(ed by9 a strong, vibratile pulseK here the s#in is moistK ] if there is pain, it is acute ] is often dependent upon motion.M ,t can also be used in cases here9 the s#in is either hot ] dry or inclined to moistureK here the urine is scantyK the face flushedK ] there are signs vascular e$citement in areas supplied by bronchial arteriolesK here there is inflammation of serous tissues, including the *,. Asclepias is also indicated in catarrhal conditions d3t a recent cold 20/" 1leurisy root is used in febrile ] inflammatory conditions, here perspiration needs to be promoted ] the heart calmed. ,n all cases, its use is follo ed by softening of the pulse ] improved action of the #idneys. 6he mucous membranes become firmed, ] the nervous system is soothed.

Asclepias is generally not chosen in chronic cases, depressed conditions, hen the surface becomes cold, or here the pulse is small ] feeble. Although, Asclepias should not be used here there is a tendency to too much perspiration. But, this does not mean that Asclepias is contraindicated hen the patient is freely perspiring, only hen perspiration is e$cessive ] tending to ards dehydration. 1leurisy root acts upon9 the pleura, peritoneum ] the mucous membranes of the lungs ] bo els. 1articularly indicated in catarrhal conditions of the respiratory or *, systems, esp. hen d3t recent colds. Asclepias as also traditionally used for9 intercostal neuralgia, rheumatism, ] in pericardial pains. ,n cases of e$anthematous fevers, pleurisy root supports the eruptive process ] helps to relieve painful inflammations through its diaphoretic action. • Cardiovascular Conditions: 6he principle action of 1leurisy root in relation to the !7 system is upon sympathetics, e$erting9 control over the s eat glands, rela$ation of the capillaries, to ultimately relieve pressure upon the heart ] vasculature. +ence, in general, Asclepias provides relief in acute arterial ] nervous conditions. • *astrointestinal !onditions9 5tomach troubles, particularly flatulent colic of children, benefit from small doses of 1leurisy root. Asclepias is often used as a remedy for nervous irritability in children, esp. hen nervous irritability is related to disturbances of the stomach. 5mall doses of pleurisy root can tone a ea# stomach d3t9 nervous impairment, catarrh, ] painful indigestion. %iarrhoea ] dysentery resulting from catarrh ] e$ternal cold has traditionally been resolved 3 Asclepias. +eadache d3t disordered digestion, also responds ell to Asclepias. • #ulmonary Conditions: ,n the lungs Asclepias stimulates secretions ] promotes e$pectoration. As its name indicates, pleurisy root is of much value in treating pleuritis. When combined 3 a sedative, Asclepias is one of the best #no n agents in the early stage of pneumonia ] later stages of pneumonia here the pleura has become irritated ] inflamed. Although, pleurisy root is thought to be the most effective in acute stages of pneumonia ] bronchitis. %uring the convalescent stage of respiratory lesions, here e$pectoration is depressed ] dyspnoea occurs, small, frequent doses of Asclepias are effective. ,t is effective as a remedy for dry ] constricted cough, ] is among one of the best drugs for acute nasal catarrh of infants. • ,nflammatory Conditions: /any consider Asclepias to be one of the most reliable of the diaphoretics, having a slo , but persistent effect. ,t can be combined 3 a more prompt stimulant, such as 8ingiberK acting more as an assisting herb, rather than as the leading remedy. ,t differs from most diaphoretics in producing a true secretion from the s#in, ] is thus called for here the s#in is dry ] harsh. Current +esearch +eview: 5earch of /edline yielded no human studies as of 5eptember 2002. #harmacy9 Contraindications.)o*icity: • !ontraindicated in pregnancy due to uterine stimulant action and estrogenic activity as demonstrated in animal studies. !ardiac glycoside content may enhance the activity of digitaloid glycosides. 2B2 ,n higher dosages, the herb has an emetic effect, and digitalis&li#e poisonings are possible d3t cardioactive steroid content. 2B3

Aspidosperma ?ue!racho<!lanco
Common name: White 2uebracho Ha!itat:

Apocynaceae

Botanical description9 :ative to Argentina. 6his is an evergreen tree hich may gro to A00 feet ith an erect stem and ide& spreading cro n. 6he bar# is thic#, greyish and deeply fissured e$ternally. 6he inner surface is yello ish&bro n ith a reddish tint. #arts used9 Bar# • • ,ndole al#aloids =0.E&A.EG>9 aspidospermine =30G>, yohimbine =quebrachine, A0G>, =&>&quebrachamine, a#uammidine rha(inilam, tannins, sugars, sterols

#harmacology: Aspidospermine and quebrachamine li#e yohimbine have been found to possess adrenergic bloc#ing activities for a variety of urogenital tissues. 2BE ;ohimbine functions as a monoamine o$idase =/A0> inhibitor to increase levels of the neurotransmitter, norepinephrine. ;ohimbine also acts as a central nervous system stimulator, here it bloc#s specific receptors =alpha&2 adrenergic receptors> and may increase energy levels and promote fat o$idation and promote lipolysis in the trun#al region. 2BF ,n addition to these effects, yohimbine can also dilate blood vessels W ma#ing it a potentially useful treatment for erectile dysfunction and some forms of impotence in men. 2BH ,n general, adrenergic bloc#ers prevent vasoconstriction hile still allo ing vasodilation. Medicinal actions: Antiasthmatic, tonic, febrifuge. )raditional Medicinal Use: 2uebracho is said to be valued as an antiperiodic by the !hileans. 5pecific ,ndications9 %yspnoea of functional originK dyspnoea ith emphysema, face pale, an$ious, and livid, lips • 1ulmonary !onditions92BC 6he chief value of Aspidosperma as considered its property of controlling dyspnoea, hen not due to organic changes. =5ome, ho ever, have contended that it is equally valuable hen structural changes are present.> Aspidosperma as used in both cardiac and asthmatic dyspnoea, as ell as in emphysematous states and as considered a remedy of mar#ed value here there is evidence of imperfect o$ygenation9 such cases sho a disturbed relation bet een the pulmonic circulation and the action of the heart. ,n cardiac asthma has been reputed one of the best remedies, and to relieve the distressing dyspnoea of capillary bronchitis, advanced bronchitis, asthmatic bronchitis, and simple asthma, ith insufficient cardiac po er, it has been highly praised. 1ure, uncomplicated asthma is not much benefited by it, but asthma associated ith emphysema is very promptly met by it. • 6opical Applications9 Wounds are sometimes dressed ith the fluid e$tract. Current Medicinal Use: 6he al#aloids are hypotensive overall. +o ever, they are arterially hypertensive, spasmolytic, diuretic, peripherally vasoconstrictive, and respiratory stimulating. • 1ulmonary !onditions9 2uebracho is most indicated hen dyspnea results from impaired pulmonary circulation secondary to a functional disturbance of the heart. 2uebracho increases the rate and depth of respiration and thus relieves dyspnea associated ith emphysema and asthma. ,t is best indicated long&term to reduce the frequency and severity of asthmatic events. 2uebracho ill not generally stop an asthmatic attac#. %r. /ary Bove calls 2uebracho the Msilybum of the lungsM. #harmacy9 6inctureZ0.E&A.E ml 6,%

Contraindications: :o information regarding contraindications currently e$ists. )o*icity: :o information regarding to$icity currently e$ists
284 285

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A %uetsch, ,solation and biological activity of aspidospermine and quebrachamine from an Aspidosperma tree source. - 1harm Biomed Anal. ACC< 0ctKA2=A0>9A2B3&H. 286 !lar#, -.4. et al., 5cience, 22E9B<H 287 Adimoel"a A. 1hytochemicals and the brea#through of traditional herbs in the management of se$ual dysfunctions. ,nt - Androl. 2000K23 5uppl 29B2&<. 288 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 p. 289 )elter

Astragalus mem!ranaceous
Common name: Astragalus, +uang 2i Ha!itat: Botanical description: #art used: radi$ Historical use: $nergetics: 5 eet, slightly arm. Astragalus enters the spleen and stomach meridians. Constituents: Astragalus contains numerous components, including2C09 • flavonoids • polysaccharides • triterpene glycosides =e.g., astragalosides ,W7,,>, • amino acids • trace minerals

1eguminaceae

#harmacology: ,mmune function: 05" ,n vitro9 • 'nhances the cytoto$icity and activity of :? cells • potentiates phagocytic function and supero$ide anion production by macrophages • 1rotects against immunosupression induced by chemotherapy +uman • ,ncreases serum ,g/, ,g', ,gA, cA/1, ,): levels • 6he polysaccharide fraction potentates :? cell activity induced by ,.&2 in A,%5 patients • 'nhances leu#ocyte synthesis • 'nhances 63, 6<, and 6<36B ratios in patients ith viral myocarditis. Antiviral activity9 2C2 ,n vitro • ,nhibits adenovirus • 1romotes production of interferon against parainfluen(a virus • +epatitis B surface antigen&inactivating activity /etabolic activity9 2C3 • Addition of Astragalus to cell cultures enhanced gro th, metabolism, and longevity • ,t lo ered o$ygen consumption in mitochondria, enhanced tolerance to stress and prolonged the life of human embryonic cells in culture • Administration of Astragalus to mice mar#edly increases plasma cA/1 • ,mproved learning performance in animal ma(e tests • ,mproved endurance in mice and increased eigh gain • .o ered collagen production in rat aorta and lung to levels found in young animals !ardiovascular activity9 2C< • 5aponins are inotropic possibly due to modulation of :a&?& A61ase • !ounters the ride in blood pressure and plasma rennin activity in a hypertensive model • !ardiac output increased in 20 patients ith angina pectoris after t o ee#s of treatment • Astragalus strengthened left ventricular function and had a antio$idant effect in acute myocardial infarction patients 0ther activity9 2CE Astragalus is also hepatoprotective, reduces blood cell deformability, decreases blood viscosity, and scavenges free radicals

Medical actions: metabolic restorative, hepatoprotectant, renal restorative, diuretic, astringent, hemostatic, vulnerary, immunostimulant, leu#ocytogenic, antitumoral, hypotensive )raditional Medicinal Uses: ,n !hinese herbal medicine, qi tonics are used to strengthen or supplement parenchymal tissue and bodily processes that are ea# in order help build defenses against disease. A qi tonic can be used along side other herbs to tonify qi, thus can be used in formulas that e$pel pathogens and formulas that treat deficiency patterns. 6onic herbs tend to strengthen and penetrate deeper into the body tissue and structures, thus are not to be used e$terior conditions hen no releasing herbs are present =pathogenic factor may linger or penetrate deeper into the body ith the tonic herb> 6onic herbs are often cloying and difficult to digest, thus precautions are ta#en if the patient e$periences yin deficiency=dry mouth, irritability, insomnia> or damage to the middle "iao =indigestion or abdominal discomfort>. 0ften, stages of tonification must be used to get to a level here common tonifying formulas can be administered as the patient may be to ea# to tonify in the ay that is being used. !ommon functions of Astragalus in !hinese herbal medicine include9 • tonifies 51, benefits qi9 asting3 thirsting syndrome • raises yang qi of stomach and spleen • stabili(es the e$terior or consolidates the e$terior to stop s eating • promotes urination, reduces edema • promotes healing, particularly in diabetic ulcerations • tonifies qi and blood9 postpartum, blood loss :o information is available from the selected 'clectic and 1hysiomedical resources on Astragalus. Current Medical Uses: • Hepato!iliary Conditions: 'arly clinical studies in !hina suggest Astragalus root might also benefit people ith chronic viral hepatitis, though it may ta#e one to t o months to see results 2CF. • ,mmune Conditions: Astragalus has been commonly used for 7iral ,nfections. /ore recently, Astragalus has been used to treat leu#openia due to chemotherapy or radiation therapy. 0ne !hinese study also found that Astragalus could decrease overactive immunity in people ith systemic lupus erythematosus 2CH. +o ever, much more research is needed to #no if Astragalus is safe in lupus or any other autoimmune disease. • +enal Conditions: A randomi(ed study found that ,7 Astragalus in people undergoing dialysis for #idney failure improved one facet of immune function compared to untreated controls 2CB. Current +esearch +eview: • Cardiology: o CH=:2CC  %esign9 !linical trial  1atients9 :ineteen patients ith congestive heart failure  6herapy9 Astragaloside ,7 =P*A> in"ection =constituents of Astragalus membranaceus> $ 2 ee#s  4esults9 %yspnea and chest distress ere alleviated in AE patientsK their capability of e$ercise reinforced. P*A as concluded to be an efficient positive inotropic drug, ith possibility to improve left ventricular modeling and e"ection function in patients ith !+). o -iral myocarditis:300  %esign9 4andomi(ed controlled clinical trial.  1atients9 1atients ith viral myocarditis.  6herapy9 Astragalus membranaceus =A/> oral liquor combined ith routine therapy W e$perimental, routine therapy alone & control  4esults9 !ellular immunity =6&lymphocyte subsets> as improved. o Myocardial infarction930A  %esign9 !ontrolled clinical trial.  1atients9 )orty&three patients first suffering from acute /, ithin 3F hours.  6herapy9 Astragalus membranaceus $ < ee#s.  4esults9 .eft ventricular function as strengthened and o$ygen free radicals =0)4> ere reduced. 4atio of pre&e"ection period3left ventricular e"ection time as decreased, 50% activity of 4B!s as increased, and the lipid pero$idation content of plasma as reduced. ,t is thought that the anti&0)4 effect of A/ is one of the mechanisms of its cardiotonic action. o ,schemic heart disease:302  %esign9 !ontrolled clinical trial.  1atients9 :inety&t o patients ith ischemic heart disease

 6herapy9 Astragalus membranaceus W e$perimental. !ontrol W :ifedipine and 6ab 5alviae miltiorrhi(ae.  4esults9 1atients had relief from angina pectoris. '?* improvement as B2.FG. o -entricular late potentials9303  %esign9 !linical trial  1atients9 6hirty&eight patients ith positive ventricular late potentials.  6herapy9 Astragalus membanaceus 2< g ,7 drip $ 2 ee#s =22 patients> or lidocaine A00 mg ,7 $ 2 ee#s =AF patients>.  4esults9 '?* normali(ed for 2 =A2.EG> in lidocaine group and for 3 =A3.FG> in A. membranaceus group. o Angina pectoris:78:  %esign9 !linical trial  1atients9 6 enty patients ith angina pectoris  6herapy9 Astragalus membranaceus $ 2 ee#s. ^  4esults9 ,ncrease in cardiac outputK no improvement on left ventricular diastolic function. A61 activity as not inhibited. • ,nfectious diseases: o Chronic cervicitis930E  %esign9 !linical trial.  1atients9 1atients ith chronic cervisitis.  6herapy9 ,nterferon alpha A =r,:)&alpha A> W one course and Astragalus membranaceus.  4esults9 C3.BG of cases sho ed clinical improvement and F0G mar#ed improvement. +17&AF and +57 detection rates dropped do n. Astragalus membranaceus as sho n to be synergic to interferon therapy. #harmacy: tincture =A9E>9 E ml tid dried radi$9 A&2 g 5tandardi(ed 5olid '$tract9 0.EG <&hydro$y&3&metho$y isoflavoneK A00&AE0 mg Drug ,nteractions: • ,n vitro studies have demonstrated enhancement of ,):&A and ,):&2 in spleen cells induced ith Astragalus and A0&fold potentiation of ,.&2. 30F • 1otentiation of acyclovir against +57&A ith 2E0 mg3?g3day for E days in mice. 30H • ,nduction of 6h cells and enhancement of antibody response to a 6&dependent antigen follo ing use of cyclophosphamide in mice.30B 6hus, speculation has arose around the theoretical counter effect of Astragalus on the immunosuppressive effect of cyclosporine and corticosteroids.30C • Use of the alcohol e$tract at 3gm3#g qd for H days reduced stillbenemidine induced liver damage in mice. 3A0 Contraindications: ,n !hinese herbal medicine, Astragalus is contraindicated in yin deficiency ith heat and e$terior e$cess heat conditions. Brin#er states that Astragalus be avoided in acute infections 3AA, similar to !hinese herbal medicine as e$terior e$cess heat is equivocal to an acute infection. )o*icity: :o information is currently available.

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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2H3&2HC 292 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2H3&2HC 293 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2H3&2HC 294 ,bid 295 ,bid 296 6ang W, 'isenbrand *. 2hinese Drugs of Plant "rigin. Berlin9 5pringer 7erlag, ACC2. 297 ?lepser 6, :isly :. Astragalus as an ad"unctive therapy in immunocompromised patients. )lt Med )lert ACCCK:ov9A2EWB Qrevie R. 298 2un ., .uo 2, 8hang 8;, et al. 'ffects of astragalus on ,.&23,.&24 system in patients ith maintained hemodialysis. 2lin ;ephrol ACCCKE29333W< QletterR. 299 .uo +/, %ai 4+, .i ;. :uclear cardiology study on effective ingredients of Astragalus membranaceus in treating heart failure. ?hongguo ?hong @i Ai 7ie He ?a ?hi ACCEKAE=A2>9H0H&C. 300 +uang 82, 2in :1, ;e W. 'ffect of Astragalus membranaceus on 6&lymphocyte subsets in patients ith viral myocarditis. ?hongguo ?hong @i Ai 7ie He ?a ?hi ACCEK AE=F>932B&30. 301 !hen .P, .iao -8, *uo W2. 'ffects of Astragalus membranaceus on left ventricular function and o$ygen free radical in acute myocardial infarction patients and mechanism of its cardiotonic action. ?hongguo ?hong @i Ai 7ie He ?a ?hi ACCEKAE=3>9A<A&3. 302 .i 52, ;uan 4P, *ao +. !linical observation on the treatment of ischemic heart disease ith Astragalus membranaceous. ?hongguo ?hong @i Ai 7ie He ?a ?hi ACCEKAE=2>9HH&B0

303

5hi +/, %ai 4+, )an W+. ,ntervention of lidocaine and Astragalus membranaceus on ventricular late potentials. ?hongguo ?hong @i Ai 7ie He ?a ?hi ACC<KA<=A0>9ECB&F00. 304 .ei 8;, 2in +, .iao -8. Action of Astragalus membranaceus on left ventricular function of angina pectoris. ?hongguo ?hong @i Ai 7ie He ?a ?hi ACC<KA<=<>9ACC&202, ACE. 305 2ian 8W, /ao 5-, !ai P!, et al. 7iral etiology of chronic cervicitis and its therapeutic response to a recombinant interferon. 2hin Med 7 0EnglB ACC0KA03=B>9F<H&EA. 306 Upton 4 =ed.> )stragalus Root. american +erbal 1harmacopoeia, 5anta !ru(, !A. ACCC 307 Upton 4 =ed.> )stragalus Root. american +erbal 1harmacopoeia, 5anta !ru(, !A. ACCC 308 8hao ?5, /ancini !, %oria *. 'nhancement of the immune response in imice by Astragalus membranaceus e$tracts. ,mmunophamacol, A09 22E&23E, ACC0 309 /iller .*. +erbal /edicnals& 5elected !linical !onsideratins )ocusing on ?no n or 1otential %rug&+erb ,nteractions. Arch ,ntern /ed. ACCB, AEB92200&22AA 310 8hang A., Wen 28, .iu !P. +epatoprotective effects of Astragalus 4oot. - 'thnopharmcol, ACB2, 309A<C&A<E 311 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A.

Atropa !elladonna
Common name: Ha!itat: %eadly nightshade, d ale

Solanaceae

Botanical description: 6he herb is a A m high perennial. 6he leaves are ovate, up to 2E cm long ith an entire margin. 6he flo ers are campanulate, green to purple in color and are follo ed by shiny, blac# berries. 6he root is 2 cm in diameter, pale bro n ith hite pith. #arts used: leaves, root Constituents: .eaf and 4oot9 • 6ropane al#aloids =up to 0.EG in leaves and roots>9 hyoscyamine, atropine, hyoscine, belladonnine +yoscyamine refers to the l&isomerK the most typical active constituent of Atropa, +yoscyamus and %atura. ,t converts to the d&isomer during the drying process creating atropine, racemic mi$ture of d,l hyoscyamine. +yoscine3 scopolamine9 is the l&isomer of hyoscine. • 0ther =leaf only>9 7olatile pyridine and pyrrolidine basesK )lavonoids, +ydro$ycoumarins9 scopoletin, scopolin, #aempferol and quercetin derivatives #harmacology: ,n the parasympathetic nervous system atropine and hyoscyamine bloc#s the muscarinic cholinergic receptors causing central nervous system stimulation follo ed by depression. 6he al#aloids also cause hallucinogenic and hypnotic effects =lo ered brain activity during hich time deep sleep does not occur, but dreams do>. +o ever, these effects do not appear to affect nicotinic acetylcholine receptors, thus targeting smooth muscle activity and sparing s#eletal muscle function. Atropa use may result in muscular tremor or rigidity due to effects on the central nervous system. Atropa as considered a sympathetic stimulant by the 'clectic physicians, and relatively spea#ing, sympathetic effects ere noted from its use. +o ever, these ere parasympatholytic effects that ere un#no n at their time. Atropine is a !:5 stimulant ith a tropism for the heart, lung and abdominal organs. ,n the peripheral nervous system, the anticholinergic actions include reduction of gastrointestinal secretions and motility as ell as rela$ation of bronchioles and s#eletal muscle. Atropa belladonna preparations have a positive dromotropic as ell as a positive chronotropic effect on the heart. 3A2 ,n contrast, +yoscine does not stimulate the central nervous system and is in fact a !:5 sedative, hich may be helpful in allaying motion sic#ness. ,t has a greater influence on the eye and secretory glands. Both atropine and hyoscine ill dilate the pupil of the eye hen prepared into ophthalmic eye drops. Medicinal actions: :arcotic, sedative, mydriatic, respiratory spasmolytic, anodyne )raditional Medicinal Use: 5pecific ,ndications and Uses9 %ull, e$pressionless face, dilated or immobile pupils, dullness of intellect, impaired capillary circulation of s#in or internal organsK dro siness, ith inability to sleep on account of painK cold e$tremities, dus#y, bluish face and e$tremitiesK s#in soft, doughy, or pastyK circulation sluggish, ith soft, full, oppressed, and compressible pulseK slo , labored, and imperfect breathingK sleeping ith eyes partially openK hebetudeK comaK urinal incontinenceK copious passages of limpid urineK deep aching in loins or bac#, ith sense of fullness. 6he remedy for congestion, ith dilated capillariesK a deep redness of the s#in, effaced by the finger, leaving a hite strea#, the blood slo ly returning to the partK spasm of the involuntary musclesK nervous e$citation, ith ild and furious deliriumK also in pallid countenance, ith frequent urination. 3A3 6he 'clectics classed Atropa ith the group of Ispecial sedatives.J 6hey observed that therapeutically employed Atropa =i.e. small doses> e$erted opposite effects from those of large doses =enough to dilate the pupils>, here large doses paraly(e and small doses stimulate the nervous system. Atropa as used by the 'clectic physicians for conditions ith impairment of the capillary circulation in any part of the body leading to congestion of internal organs, a soft, oppressed pulse, dilated pupils, pasty, soft s#in, coldness of the e$tremities, and involuntary micturition. ,n addition, Atropa is a remedy for pain and for spasm. !onditions accompanying spasmodic disorders, such as chorea and epilepsy, indicated it, as did febrile disorders, here hyperaesthesia caused delirium. ,t as observed to overcome spasm of the involuntary muscles, but as less effectual in spasm of the voluntary muscles. • !ardiovascular !onditions9 Atropa as considered superior to all agents in its immediate, and po erful positive inotropic and chronotropic action. 6herefore, it as useful in cases here there as a Idepression of the sympathetic nervous influenceJ, as in syncope from asthenia or shoc#, hypovolemic collapse or in failure of the heart@s action from cardiac drugs.

6he specific indication for Atropa as enfeebled circulation ith stasis of blood ith dullness and dro siness, dull eyes ith dilated pupils. /ar#ed contraction of the capillaries follo ing its use as the common e$pectation. • 'ndocrine !onditions9 Atropa as considered a specific in diabetes insipidus. • *astrointestinal !onditions9 Atropa as useful in spastic constipation, colic, and any spasmodic constriction of the digestive organs or gall bladder. • *enitourinary !onditions9 Belladonna as considered one of the most important remedies for genitourinary diseases by the 'clectics as it as observed to stimulate and at the same time relieve irritation of the urinary tract. ,t as the remedy in the congestive and early stages of #idney disease, ith a sense of fullness, eight, and dragging in the loins. ,t as also a specific remedy in urinary incontinence ere enfeeblement of the pelvic circulation as the principal cause. +o ever, it as not observed to give relief here the incontinence as secondary to vesical irritation. ,t as even used for dribbling urine in children as ell as increased frequency in children ith the mar#ed pallor of countenance and dullness of eye being present, and the condition evidently depending upon Ia cold.J %iabetes insipidus as treated by applying an Atropa plaster and administering the drug internally. ,n turn, Atropa as used as a diuretic in cases of urinary suppression secondary to spasm. Atropa as also used in acute nephritis to calm nervous irritation and contract dilated blood vessels. 6ubular nephritis =early stage>, scarlatinal nephritis, and all cases of renal capillary engorgement ere also indications for Atropa. ,t as also observed to decrease albumin in chronic albuminuria as ell as increased both the solid and atery urinary constituents in deficient secretion. • ,nfectious !onditions9 1erhaps in no class of diseases as the action of Atropa appreciated more than in the e$anthemata here it ould encourage the eruption and renal activity. Atropa as used as a childNs remedy frequently but cautiously. 5mall doses ere a ell&accepted prophylactic against scarlatina . ,n both scarlet fever and measles it as nearly al ays indicated, here the more congestive the form the more satisfactory the effects of treatment. ,t as used to a a#en children from a dro sy state or even unconsciousness in such illnesses. ,n turn, Atropa as also applied to quiet delirium. 'rysipelas ith burning and deep redness of the s#in, urticaria and erythema ere often relieved by it as ell. • /ale !onditions9 6he influence of Atropa as notable in spermatorrhea ith enfeebled pelvic circulation. • :eurological !onditions9 !ertain forms of neuralgia, particularly trigeminal neuralgia, ere treated ith Atropa, although other types of neuralgia ould sometimes respond to it. Aconite as combined ith Atropa if e$citation of the circulation and increase of temperature also presented. ,t as often serviceable in chorea and in epilepsy, ith congestion. • 1ulmonary !onditions9 Atropa as a remedy for spasmodic asthma, hooping&cough, and nervous cough from laryngeal irritation. ,n hooping&cough, it as usually indicated in the latter stage to lessen the severity and frequency of paro$ysms. ,n various forms of sore throat, Atropa as an important remedy. Where sore throat presented ith inflammation, s elling, soreness, difficult deglutition, dryness of the throat less fever, it as administered in alternation ith aconite every half hour. ,t as considered of great benefit in diphtheria, interfering ith the formation of the membrane if given early in the disease. • 6opical Applications9 :o remedy as considered of more value by the 'clectics to chec# secretion of the mammary gland hen prompt action is desired. ,t as a remedy for local or e$ternal inflammation, acute mastitis, inflammatory glandular s elling, buboes, gouty and rheumatic inflammations, etc. '$ternally the ointment, or e$tract, has been applied locally in spasmodic stricture of the urethra, bladder and rectum, strangulated hernia, spasmodic contraction of the uterus, hemorrhoids, etc. Belladonna plasters, or the e$tract ith vaseline, ere applied to relieve pain in the early stage of abscesses, recurrent boils, neuralgia, and lumbago. Current Medicinal Use: Atropa is used for the relief of pain and spasm. Belladonna may be applied topically or ta#en internally to relieve spasmodic pain and inflammation. Atropa is also used as crisis control herb primarily for symptomatic treatment. ,t reduces glandular secretions including +!l and is indicated in gastrointestinal spasm secondary to ulcer, biliary dys#inesia, mucous colitis, vaginal secretions, eye secretions, etc. 5pecific applications include dull, throbbing, congestive headacheK gastrointestinal nausea and vomiting perhaps ith diarrheaK deep&seated pain ith spasm and3or inflammation =i.e. dysmenorrhea, sciatica, facial neuritisK hooping cough ith spasmodic coughs and congestion and capillary impairmentK spasmodic constipationK pharyngitis ith redness, ra ness, s elling and soreness ith dysphagia and throat drynessK childhood e$anthems =i.e. chic#en po$, scarlet fever, etc.> in order to bring out the eruption, re&establish #idney function and eliminate congestion. • !ardiovascular !onditions9 6he primary indication for the internal use of Belladonna is impaired capillary circulation and resultant blood stasis. ,f this capillary stasis is accompanied by mental stupor, dilated pupils and e$pressionless countenance, Belladonna is the most specifically indicated herb. Atropa is also used in nervous heart complaints cardiac arrhythmia, cardiac insufficiency :;+A , and ,,. 3A< • 'ndocrine !onditions9 Belladonna is also an e$cellent remedy for diabetes insipidus. • *astrointestinal !onditions9 C%# Atropa is the gastrointestinal antispasmodic that outran#s all others. ,ts effect is rapid and long lasting. ,t suppresses secretions having a particular value in hyperacidity syndromes although the motor effect of Belladonna is more mar#ed than the antisecretory action. 6herefore, its use is equally effective in all spasmodic conditions of the stomach, intestine and bile

ducts. ,ntestinal spasm ith acute or chronic enterocoltits respond ell to Atropa. Atropa or#s for chronic intestinal disease and spastic constipation. • *enitourinary !onditions9 Belladonna stimulates and relieves irritation of the #idneys. ,t is especially indicated in acute congestion of the #idneys. • *ynecologic !onditions9 Atropa can be combined ith equal parts of +yoscyamus, 7aleriana and 0pium tinctures for a fast and • +epatobiliary !onditions9 Biliary dys#inesia responds better to Atropa than many other gallbladder remedies. At the least, Atropa should be added to the other gallbladder remedies to have a ma$imum effect. +o ever, the effect is not rapid and ill be inadequate in acute gallbladder colic. C%4 • ,nflammatory !onditions9 Atropa root has been utili(ed in the treatment of encephalitis. C%( • :ervous !onditions9 Atropine has been given in large quantities in the treatment of 1ar#insonism. 6he dose is usually above the ma$imum is surprisingly ell tolerated. A root preparation =6remoforat by ?lein> is recommended for all forms of 1ar#insonism and senile tremors and other forms of abnormally increased motor function. 1ost&influen(al 1ar#insonism particularly responds to treatment ith Atropa. • 1ulmonary !onditions9 ,ndications for respiratory spasmolytics include tight, breathless, non&productive coughing such as bronchitis as ell asthmatic symptoms such as hee(ing. • 6opical Applications9 ,n naturopathic medicine, Atropa is added to medicinal plasters for neuro&vegetative disorders, hyper#inesis, hyperhidrosis, and bronchial asthma. #harmacy: %r. Alschuler notes that small doses are essential, as these tend to be stimulating hile large doses paraly(e. /ills and Bone indicate short&term use only ith the solanaceous plants. +o ever, Weiss indicates that long&term medication ill be required, often for several ee#s or more for some conditions =i.e. 3&< ee#s for ulcers and gastritis>. ,n determining the therapeutic dose Weiss states that the dose should be such that there is "ust a slight dryness in the mouth and mild disturbance of vision, usually A0 gtt tid =he does not indicate strength although based on this amount it is li#ely a A9A0 tincture>. )rom here the dose is slightly reduced and maintained. +e also recommends ta#ing the drops in /atricaria tea, particularly if long&term treatment is indicated. A9A0 tincture of leaves =0.03G atropine>9 A&AE drops =U51 0.F&A.0 ml> total daily dose =%r. Alschuler> )or ulcer, chronic colitis9 B gtt tid for men, F gtt tid for omenK )or persistent constipation, mucous colitis, fermentative dyspepsia =Weiss>9 E gtt tid '$tract U51 =0.2 mg atropine>9 AE mg total daily dose ,/ in"ection9 5cudder utili(ed a A9A fresh plant e$tract using one fifth to one drop. +e ould also use a hypodermic form of one grain 5uppositories9 5uppositoria 5pasmolytica , %4) and ,,%4) =*ermany> Drug ,nteractions: 6he antagonism of belladonna and opium no seems ell established, both physiologically and clinically. Contraindications: 6he solanaceous plants may be inappropriate in glaucoma, urinary retention, paralytic ileus, intestinal atony and obstruction, tachycardia, arrhythmia, and B1+. )o*icity: A0 mg. Al#aloidsK %o not use in large or continuous doses. !hildren are especially sensitive to the to$icity of belladonna. *laucoma is a contraindication to the use of belladonna. 5igns of to$icity include dry mouth, flushing, s#in hot and dry, mydriasis =pupil dilation>, increased respiratory rate and volume, increased temperature in children, palpitations, increased pulse rate and blood pressure, incoordinate movements, incoherent speech, memory disturbed, disorientation, urinary urgency, difficult urination, eye pain, blurred vision, sensitivity to light, dysphagia, great thirst, nausea, vomiting, diarrhea, delirium, restlessness, confusionK .ater onset9 depressed cerebral and neural activity, stupor, circulatory collapse, coma and death from centric respiratory paralysis.
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 314 ,bid 315 Weiss 4). +erbal /edicine, Fth ed. hippodrates 7erlag *mb+ ACCF. p. E2, EB, 30<, 30B 316 Weiss 4). +erbal /edicine, Fth ed. hippodrates 7erlag *mb+ ACCF. p. E2, EB, 30<, 30B 317 Weiss 4). +erbal /edicine, Fth ed. hippodrates 7erlag *mb+ ACCF. p. E2, EB, 30<, 30B 318 Weiss 4). +erbal /edicine, Fth ed. hippodrates 7erlag *mb+ ACCF. p. E2, EB, 30<, 30B 319 5cudder

Avena sativa (A2 officinalis
Common name: Ha!itat: 0at, *routs

#oaceae

Botanical description: A 0.F to A.0 m tall erect plant ith narro , linear leaves. 6he flo ering top appears as spi#elets ith 2&3 florets in loose panicles. 6he preparations of oat are the dried and chopped pieces of the stem, leaf sheaths and leaf blades. 6he seed is also harvested and eaten as a cereal grain. #arts used: Aerial parts of the plant harvested "ust before it is in full flo er during the mil#y stage. =/il#y oat seed> When you pinch the top, a "uice should pop out. 6his indicates the time for harvesting. 6he hole oats as steel cut oats or oatmeal is used topically. Constituents 708 • 5oluble oligo& and polysaccharides9 including saccharose, #estose, neo#estose, beta& glucans, galactoarabino$ylans • /inerals9 ,ron =3C mg3#g dry eight>, /anganese =B.E mg3#g dry eight>, 8inc =AC.2 mg3#g dry eight> • ,ndole al#aloid9 gramine =seed>, avenine • 5ilicic acid esters, 1olyphenols, )lavonoids, )lavones =especially the flo er>, !arotenoids, !hlorophyll, 5teroid saponins =avenacoside A and B =leaves>>, Unusual amino acids =avenic acid A and B> • 5tarch =F0G> #harmacology: 6he al#aloids are believed to account for oats@ rela$ing action, but this continues to be debated in 'uropeK the *erman !ommission ' monographs do not endorse this herb as a sedative. +o ever, an alcohol&based tincture of the fresh plant has proven promising in cases of nicotine ithdra al. 32A 6he avenacoside triterpenoid saponins possess strong in&vitro fungicidal activity. 322 Medicinal actions: Antidepressant, nervous system trophorestorative, cardiac tonic )raditional Medicinal Use: 5pecific ,ndications and Uses9 :erve tonic, stimulant, and antispasmodic. 5pasmodic and nervous disorders, ith e$haustionK cardiac ea#nessK nervous debility of convalescenceK spermatorrhea from the nervous erethism of debilityK tensive articular s ellings. 323 ?ing described this plant is a nerve&tonic, stimulant, and antispasmodic and considered it among the most important restoratives for conditions depending upon nervous e$haustion. !oo# did not describe this plant. • !ardiovascular !onditions9 ,n enfeebled states of the heart, Avena as observed to act as a good tonic to improve the energy of the myocardium. • :ervous !onditions9 6he 'clectics used Avena for the nervous e$haustion secondary to a variety of lo fevers, and the secondary disorders arising from them such as decline in cardiac function, spermatorrhea, insomnia, etc. • /ale !onditions9 ,n spermatorrhea, Avena as applied to those cases of debility follo ing adynamic diseases, or in simple spermatorrhea hen not due to self&abuse. 5uch an atonic state is demonstrable though nocturnal emission of semen. +o ever, in cases related to prostatic irritation Avena as considered to be of less value, although as still used as a supportive herb. Current Medicinal Use: • Behavioral and 1sychological !onditions9 Avena is often used to aid people giving up tobacco or other addictive substances. ,n one study the use of Avena e$tract =A ml qid> helped habitual tobacco smo#ers significantly decrease the number of cigarettes smo#ed in those ho anted to quit,32< but as ineffectual in those ithout the desire to discontinue smo#ing. 32E,32F ,n regard to opium addiction, a small study demonstrated si$ addicts ho completely quit, t o ho reduced their use and t o ithout change in use after administration of Avena e$tract =2ml tid>. 32H Whether or not Avena decreases cravings for these substances is un#no n and many clinicians have failed to see this occur despite idespread claims and clinical reports to the contrary. ,t is possible that it is useful in drug addiction recovery simply because it helps to restore strength to the nervous system. • !ardiovascular !onditions9 Avena also feeds and activates the cardiac muscle and is most indicated in ea# and insufficient hearts. !ardiac disorders, hich are secondary to nervous irregularities, ill respond the most favorably to Avena. :ervous palpitations and ea# hearts =decreased contractility> may respond to administration of Avena. • %ermatological !onditions9 6he seeds or grains of Avena are high in mucilage and are #no n to soothe inflammation of the s#in. 0atmeal baths, compress and poultices are often recommended to relieve inflammation and pruritis of insect bites, ec(ema, 7aricella, topical fungal infections and contact dermatitis.

• *ynecologic !onditions9 Avena is a onderful herb to support the nervous system during menopause and is indicated in menopause associated depression. 32B • /usculos#eletal !onditions9 Avena is also thought to lo er uric acid levels. )or this reason, Avena is often included in arthritic formulas as a long&term tonic herb for gout. • :ervous !onditions9 Avena is 6+' nervous system trophorestorative. ,t feeds debilitated, ea#ened nervous tissue. ,t is used in states of nervous e$haustion, e$haustion from drug overuse and addictions, and ea#ness of the nerves from chronic an$iety or illness. :ervous trophorestoratives in general are used for nervous e$haustion, neuralgia, herpes infections, depression and insomnia after falling asleep, convalescence and neurasthenia. :eurasthenia encompassed a ider range of disorders than nervous e$haustion. ,n days before psychoanalysis and neurology, it included symptoms here the nervous tissues ere seen to be affected such as neuralgia and neuritis, depression and an$iety states and neurosis. 6he trophorestoratives ere thus often combined ith other tonics and convalescent foods such as molasses, yeast and malt e$tract =no #no n as rich sources of the B vitamins>, oatmeal and other cereals.32C Avena is both a trophorestorative and tonic. ,n regard to tonic herbs in general they are indicated in convalescence, debilitating conditions ith or ithout anore$ia and chronic fatigue syndrome. Avena may be a useful agent in paralysis and ea#ness associated ith aging. Avena is a nutritive rela$ant ith a slight stimulating edge on the motor system. 6a#en over time, Avena ill increase stamina and strength. 6he immediate effect of Avena is one of mild sedation and it is a good herb for hyperactive children.. 0ver time, Avena lifts the spirits and is a nourishing tonic that is often combined ith 5cuttelaria. Avena is theori(ed to stimulate the limbic system and motor ganglia thereby increasing energy level and one@s sense of ell being. 5usan eed describes Avena as Iupping the amperage of the nervous system so you can carry more voltage.J #harmacy: According to /ills and Bone, the digestive capacity is the main determinant of dosage of tonic herbs. ,f the stomach and digestive function is deficient, then tonics may be given ith or after meals. ,n severe cases, they may need to be ta#en ith liquid meals. %osage should be small and frequent. .ong&term therapy is the norm. 5imilar application is used for a trophorestorative effect. 330 ,nfusion9 A heaped 6B. = appro$. 3 g herba> to A 26. WaterK steep until at room temperature. %rin# throughout the day. A9E 6incture of fresh plant, 2EG 't0+9 sig A&E ml 6,% A9E tincture of dried plant9 sig E ml 6,%K ee#ly ma$. O A00 ml Drug ,nteractions: • 3pioid medications: Avena may antagoni(e the effect of morphine as demonstrated in mice. 33A Contraindications: 6onic herbs in general are to be used ith caution in severe debility, particularly hen associated ith immune or digestive collapseK renal or hepatic failureK rampant cancer or strong chemotherapy treatments. 332 )o*icity: :one #no n.
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 322 Wolters B, Dtsch1 )poth1 ?tg1, ACFF, A0F9AH2C. 323 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 324 Anand !., 'ffect of Avena sative on !igarette 5mo#ing. :ature, 2339 <CF, ACHA. 325 *abryno ic( -W. 6reatment of :icotine Addication ith Avena sativa. /ed - Australia, B32<3H<, p. 30F&H 326 Bye !, )o le A5W, .etley '. Wil#inson 5. .ac# of 'ffect of Avena sativa on !igarette 5mo#ing. :ature, 2E29EB0&A,g ACH< 327 Anand !.. 6reatment of 0pium and Addiction. Br /ed -, <9F<0, AC3H. 328 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AE<&E, 23E, 2<E 329 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AE<&E, 23E, 2<E 330 /ills and Bone p. AEE 331 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p AE< 332 /ills and Bone p. AEE

Baptisia tinctoria
Common name: ild indigo Ha!itat: Botanical description: #art used: root bar#, leaves Historical use: $nergetics:

1eguminacea

Constituents: 333 • Water&soluble polysaccharide9 in particular arabinogalactans • *lycoproteins • 2uinoli(idine al#aloids9 including cytisine, :&methyl cytisine, anagyrine, sparteine isoflavonoids, formononetin • +ydro$ycoumarins9 including scopoletine #harmacology: 6he polysaccharides and proteins in ild indigo are believed to stimulate the immune system, according to in !itro e$periments. 6he ethanol e$tract has had a significantly positive effect on the phagocytosis of human erythrocytes. ,t has also been found to raise the leu#ocyte count and to improve the endogenous defense reaction. Wild ,ndigo also has a mild estrogenic effect. 33< Wild indigo is rarely used alone and is a part of a popular product for colds and flu in 'urope that combines the herb ith 'chinacea and 6hu"a. 33E Medical actions: sialagogue, glandular stimulant, hepatic )raditional Medicinal Uses: 5pecific ,ndications and Uses9 feeble vitality ith tendency to disintegration of tissueK fullness of tissue, ith dus#y, leaden, purplish, or livid discolorationK tendency to ulceration and decayK sepsisK typhoid conditionsK enfeebled capillary circulationK color of s#in effaced by pressure and returns slo lyK patientNs face s ollen and bluish, appearing li#e one having been fro(en, or long e$posed to cold, fetid discharges, ith atony, and gangrene.33F !oo# noted that the bar# of the root as considered to act the same as the leaves, being antiseptic, ith decided stimulating and moderate rela$ing qualities, elevating the circulation and nervous action, yet ithout undue e$citement. ?ing described Baptisia as a gentle e$citant and local tonic to the vessels implicated in the ulcerative process. • ':6 !onditions9 Baptisia is of mar#ed value in many forms of malignant sore throat. 6he dus#y, leaden&colored, faucial ulcerations of scarlatina and tonsillitis indicated Baptisia. 1utrid ulcerations of the mucous membranes of the nasal passages ere considered and indication for Baptisia. ,n fetid discharges from the ears, the infusion as in"ected into the e$ternal auditory meatus. *astrointestinal !onditions9 ?ing stated that Baptisia increases the secretions of the glands of the gastro&intestinal tract, although he noted that this action can be so violent as to produce gastroenteritis. 5mall doses have been employed as a la$ative. All typhoid conditions, mar#ed by the dus#y appearance of s#ill and mucous tissues, ere promptly benefited by this agent. 6yphoid dysentery, ith stools li#e Mprune "uice or meat ashings,M or dar#, tar&li#e, fetid discharges, mi$ed ith decomposed blood, respond to the action of Baptisia. *ynecological !onditions9 ,n fetid leucorrhoea and ulceration of cervi$ uteri, especially ith muco&purulent discharges, a douche of Baptisia has been found beneficial. +epatobiliary !onditions9 Baptisia as considered an active and efficient hepatic, stimulating the liver and biliary secretion. ,nfectious !onditions9 ,t as said to be valuable in variola and cerebro&spinal meningitis. ,nflammatory !onditions9 ,t has been employed ith good results in atonic varieties of acute rheumatism. 1ulmonary !onditions9 %iphtheria, ith s ollen and enfeebled mucous membranes, ith free secretion, appearing either dus#y or blanched, and accompanied by sloughing as considered a call for Baptisia.

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6opical Applications9 Baptisia as first employed as a dressing for all #inds of ulcerations hen there is a degenerate condition and a tendency to gangrene. ,n particular, Baptisia as used to treat mouth ulcers hen accompanied by foul breath, loss of appetite, and general gastric disturbance. 5ore nipples, erysipelatous, scrofulous, and syphilitic ulcers ere treated ith a decoction of fresh Baptisia. ,t as used to control irritable and painful ulcers, lessens their foul discharges, and overcomes putrescency. 6he greater the tendency to mortification, the more highly the remedy as valued. 6he leaves applied in fomentations have decreased induration and s elling of the female breast.

Current +esearch +eview: • $@): o Common cold:33H  %esign9 4andomi(ed, double&blind, placebo&controlled, multi&center clinical trial  1atients9 6 o hundred si$ty three patients ith acute common cold  6herapy9 'sberito$_ & proprietary formulation of 4adi$ echinaceae, 4adi$ baptisiae, +erba thu"aeK sig 3 tabs 6,% $ H&C days.  4esults9 +erbal remedy as found to be superior over the placebo. ,n the subgroup of patients ho started therapy at an early phase of their cold, the efficacy of the herbal remedy as most prominent. #harmacy: ?ing noted that Baptisia loses much of its activity hen dried or boiled, hile !oo# noted that Baptisia should al ays be dried before using. Drug ,nteractions: :o information is currently available from the selected resources Contraindications: !oo# stated that Baptisia should never be given hen there is in ard irritation or inflammation. ,n con"unction, Brin#er states that Baptisia be avoided in cases of hyperemia due to empirical gastrointestinal irritation caused by baptio$ine =al#aloid> and baptin =phenolic glycoside>. Brin#er also notes its potential for to$icity in pregnancy and during prolonged use. 33B )o*icity: According to ?ing, .arge doses are dangerous, acting as an emeto&cathartic9 large doses have caused an e$cessive flo of viscid saliva, ulceration of the pharyn$, insomnia, restlessness, and ocular disturbances. ,t produces soft, mushy stools, accompanied by a sensation of soreness of the hole body. +e also asserted that baptito$ine increases the respiratory movements, and in to$ic doses #ills by asphy$iation through paralysis of the respiratory centers.
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 335 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 336 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 337 +enneic#e&von 8epelin +, +entschel !, 5chnit#er -, et al. 'fficacy and safety of a fi$ed combination phytomedicine in the treatment of the common cold =acute viral respiratory tract infection>9 results of a randomised, double blind, placebo controlled, multicentre study. 2urr Med Res "pin ACCCKAE92A<W2H. 338 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. ACC

Barosma !etulina (Agathosma !etulina
Common name: Buchu Ha!itat: 6his plant is native to 5. Africa, !ape region.33C

+utaceae

Botanical Description: 6he plant is a lo shrub gro ing up to t o meters. 6he leaves are rhomboid&ovate, A2&20 mm long and half as ide ith small and large oil glands. 6he flo ers have five hitish petals and bro n fruits. 6he leaves have a pungent and spicy taste. #arts Used: .eaves Constituents: 3<0 • 'ssential oil =2G>9 o /ain component9 monoterpene diosphenol o 0ther components9 limonene, =&>&isomenthone, =X>&menthone, =&>&pulegone, terpinen&<&ol, p&menthan&3&on&B&thiol. • )lavonoids9 diosmin, rutin )raditional Uses:7:" • Buchu has been commonly used for urinary tract infection, dysuria, cystitis, urethritis and prostatitis. 0ther traditional uses include as a la$ative, stomachic and carminative. 6he +ottentots use buchu as a perfume. $nergetics:7:0 )ccording to Holmes: Barosma is primarily pungent and bitter, mildly astringent, hot and dry. 5econdarily it is stimulating, restoring and stabli(es movement. ,t enters the ?idney, 5pleen and Urinary Bladder meridians. +e states its functions as9  4estores, strengthens and rela$es the urognential organs, leifies irritation and harmoni(es urination 9 ,ndicated in ?idney qi insecurity and bladder qi constraint and .in syndrome.  Warms and invigorates the urogenital organs and intestines 9 ,ndicated in ?idney yang $u, 5pleen yang $u.  4estrains infection and clears to$ins, dries mucous damp and arrests discharge 9 ,ndicated in Bladder and ?idney damp heat. !ompare ith Bu gi (hi =fructus 1soraleae> Medicinal actions: )ccording to 2oo3: %iuretic, Antimicrobial3Urinary Antiseptic, Anti&inflammatory, %iaphoretic )ccording to .ing/s: aromatic stimulant, tonic, diuretic, diaphoretic )raditional Medicinal Uses: )ccording to .ing/sC'C: • *astrointestinal !onditions9 Barosma promotes the appetite, relieves nausea and flatulence *enitourinary !onditions9 =,pecific indications are in italicsB ,n regard to urinary secretion, Barosma increasees both the solid and ater components. 0n the other hand, hen the #idneys are e$cessively active, their action is restrained by Barosma. ,t is principally used in chronic diseases of the urogenital organs including chronic inflammation of the mucosa of the bladder and urethra , in urinary discharge ith increased uric acid and incontinence associated ith a diseased prostate. Profuse muco6 mucopurulent discharge and altered secretions from the urethral glands point to its use. )cid urine, :ith continual desire to urinate but little relief occurs indicates Barosma. ,n turn, long&standing cystic irritation hith the patient having difficulty in restraining his urine also indicates Barosma 2 Barosma relieves catarrh of the bladder from gonorrhea, irritation or gleet =mucous discharge from the urethra in chronic gonorrhea>. )ccording to elter:C'' • *enitourinary !onditions9 )elter suggested that Buchu is to be used in chronic mucopurulent inflammation of the #idney and bladder. Buchu stimulates the #idneys and increases the atery and solid constituents, although in cases of ea#ness of the #idney, the amount of atery discharge ill be less. ,t relieves irritation of the bladder sphincter and increases the tone of muscles associated ith the urinary system. )elter cautions that Buchu should never be used in acute disorders. )ccording to 2oo3:C'# 02oo3 describes Barosma crenata :ith the common name BuchuB • *enitourinary !onditions9 Buchu is a mild and diffuse stimulant ith a rela$ing nervine action. 6he summary of its effects are tonification. 6he indication for Buchu is in chronic catarrh of the bladder. Buchu should not be used in acut or sub&acute irritation as it is too stimulating. ,n regard to male genitourinary conditions, Buchu is indicated in stagnant conditions of the prostate ith gummy discharges and aching through the penis and aspermatorrhea her the seminal dischare is thin ith a felling of impotence. )or chronic gonorrhea, it is combined ith !opaiba ,n all of these cases, Buchu decreases mucous secretion

*astrointestinal !onditions: Buch influences the mucous membranes of the stomach and uterus. ,t relieves sympathetic irritability and improves the tone of the stomach. )ccording to Elling:ood:C'$ • *enitourinary !onditions9 Barosma acts directly upon the #idneys increasing both the atery and solid constituents of the urine. ,t is valuable hen the ater portion of urine is e$cessive. ,t relieves irritation of the bladder and urethra and is valuable in catarrh or the bladder, pyelitis and honorrhea. ,t is particularly helpful hen bladder irritation is caused by e$cessive uric acid. By decreasing irritation of the urinary bladder sphincter, it increases tone of the muscular structure. Medicinal use: • *enitourinary !onditions9 Barosma is a stimulating diuretic. 6he volatile oils irritate the glomerulus thus increasing *)4 and creating a diuretic effect. Buchu is used to treat any inflammation or infection of the pelvic organs. 6o date no in&vitro effect against urinary pathogens has yet been observed. :onetheless, historical and clinical e$perience indicates an antibacterial effect. 6his effect is presumed to be due to diosphenol hich is e$creted as a glucuronic acid con"ugate. ,n this form, it may e$ert antibacterial effects. ,t is best indicated for cystitis ith abnormally acid urine, frequency, but ith little relief from voiding, and ith mucopurulent urinary discharge. 6he volatile oils can be irritating to #idneys, hich could e$plain its contraindication in acute disorders and limits its long&term use.3<H 6he clinical indications include renal lithiasis, renal inflammation, B1+, increased uric acid. )ccording to Mills and Bone:C'( • *enitourinary !onditions9 Although the alcoholic e$tract should some antimicrobial activity against typical microflora hich cause U6,@s, only the essential oil sho ed considerable activity against all the test organisms. Current +esearch +eview • 5earch of /edline revealed no human trials as of A3AE303 #harmacy: • %ried leaf9 o 3&F g qd or as infusion3<C o A&2 g qd3E0 • A92 liquid e$tract9 2&< ml qd3EA • 6incture9 o 6incture =strength unspecified> 2&< ml 6,%3E2 o A9E tincture9 E&A0 ml qd3E3 • ,nfusion9 A&2 tsp3cup ater infused for A0 min,6,%3E< Contraindications: • 1regnancy =speculative> due to the high content of pugelone, a volatile mucosal irritant and uterine stimulant. ,t is found in significantly higher amounts in Barosma crenulata =oval buchu, hich is often used as a substitute>. 3EE,3EF • Acute genito&urinary tract inflammation and especially #idney inflammation d3t the presence of diosmin, diosphenol and pulegone. 3EH • All e$cess heat or acute inflammatory conditions d3t being hot and irritant. Brea#s of several days are recommended every t o ee#s as continuous use may produce slight #idney inflammation. 3EB )o*icity: Buchu ill dar#en the urine so arn patients. Also, gastrointestinal irritation may occur if ta#en on an empty stomach. :o cases of to$ic reaction have been reported

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Betula pendula' B2 al!a' B2verrucosa
Common name: Birch Ha!itat: Botanical description: #arts Used9 Bar# and .eaves Constituents9 )lavonoids =up to 3G>, sugars, volatile oil, resins, saponins, ascorbic acid Medicinal actions: %iuretic, Anti&inflammatory, Alterative, Astringent

Betulaceae

Medicinal use: Birch bar# and leaves =leaves are best> contain flavonoids, sugars, vol. oil, resins, saponins and or#s by all four mechanisms as a diuretic. Birch =bar#> is often used e$ternally for its astringent properties. When added to an al#aline infusion Qadd bicarbonateR it becomes bitter and antiseptic. 6he flavonoids are thought to be responsible for the diuretic effects of this plant. ,t is most indicated in cystitis. ,t irrigates the urinary tract hile e$erting anti&inflammatory and antiseptic actions. ,t also causes sodium e$cretion. 6he high vitamin ! content contributes to the diuretic effect and discourages urinary and renal calculi. ,f drun# slo ly throughout the day, birch ill help to brea# do n stones and gravel. 6he volatile oils can be irritating to the urinary and respiratory tracts, but also lends an antiseptic action. 6he combined effect of the diuretic, anti&inflammatory and antiseptic actions is a gentle depurative useful in rheumatism, chronic s#in rashes and metabolic to$icity. #harmacy: )o*icity: A9E tincture9 A&2 ml3dayK for stones F&B ml3spread over entire day. %ecoction9 2&3 g3cup 2% & 6,% QA tsp. O AgK A6B O 2 gRR

Borago officinalis
Common name: Borage Ha!itat: Borage gro s in aste areas and is cultivated.

Boraginaceae

Botanical description: 4ound stems that gro to about A.E feet are branched, hollo and succulent. 6he oval leaves are alternate, large, rin#led, deep green and covered ith hite pric#ly hairs. ,n early summer the plant produces bright blue star&shaped flo ers that have anthers that form a cone in the middle. #arts used: .eaves, flo ers, seeds ,dentified Constituents: • 1yrroli(idine al#aloids =1A, 2&A0 ppm in commercial leaf samples> including lycopsamine, intermedine, amabiline, supinineK these al#aloids are not present in the seed. • 5aponins • choline, mucilage, potassium and calcium salts, tannins Medicinal actions: =leaf> diuretic, demulcent, emollient, refrigerant, adrenal restorative3adaptogen, galactagogue, e$pectorant, refrigerant #harmacology: Borage contains high amounts of calcium and potassium salts. 6hese constituents promote osmotic diuresis thus aiding the filtration of aste by the #idneys. 6he mucilage in the leaves of borage e$ert an refle$ antispasmodic and soothing action on the lungs thereby acting as an e$pectorant in a dry, non&productive cough. Medicinal use: • *ynecologic !onditions9 Borage is a galactagogue and ill stimulate the flo of mil# in nursing mothers. Borage or#s especially ell for this purpose if the mothers are e$hausted and even depressed =possible contributors to the deficient mil# production>. 1A free is best for this application =see 5hatavari, *alega, )oeniculum, 6rigonella also for other galactagogue options> • ,mmune !onditions9 Borage helps the body to e$pel heat, especially heat generated from dry infections. 7iral or bacterial infections, especially of the lungs, ithout perspiration ill respond favorably to borage. 6he lungs ill be soothed and spasm relieved. ,n addition perspiration ill ensue. Borage also acts as a diuretic. As described above, the osmotic diuresis promotes flushing of to$ins through the #idneys. 6his is another useful action of borage during infection and fever. • ,nflammatory !onditions9 Borage acts as a restorative to the adrenal corte$. 6his is most li#ely due to its ability to prolong the action of corticosterone via a undetermined mechanism. 6his adrenal restorative effect contributes to its anti&inflammatory action. 6he mucilage may also contribute to the anti&inflammatory action of borage. 6he anti&inflammatory actions of borage are pronounced and have been effective in conditions such as pleurisy, arthritis, and inflammation of the gastrointestinal tract. )resh borage leaves and flo ers have long been used as food. 6he plant has a cucumber&li#e fragrance and flavor and can be added to salad or steeped in ater or ine. 6he seeds of borage are high in gamma linoleic acid =*.A>. Borage seeds have become an important commercial source of this anti&inflammatory oil. Borage seed oil is useful in rheumatoid arthritis, ec(ema, cardiovascular disease, dysmenorrhea, etc. • 6opical Applications9 )resh borage leaves may be applied as a poultice e$ternally for its anti&inflammatory action. #harmacy: dried herb infusion9 2 tsp. 3cupK A cup B,% =Alschuler> cold infusion e$tracts more mucilage =%ipasquale> tincture9 A9E, A&A0 ml B,% =Alschuler> e$tract9 A9A, 2EG alcohol9 alcohol needs to be lo to e$tract mucilage -uice pulp from fresh leaves A0 ml B,% 5eed oil9 E00 mg capsule9 A&< capsules daily for maintenance, larger doses for therapeutic use

Drug ,nteractions: 3EC

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Hepatoto*ic drugs: =i.e. anabolic steroids, phenothia(ines, #etocona(ole, flucona(ole> due to additive effect of pyrroli(idine al#aloids =speculative>. Drugs that lower sei;ure threshold: =i.e. 6ricyclic antidepressants, phenothia(ines> due to *.A content of the seeds.

Contraindications: !aution ith ,nternal use or prolonged e$ternal use due to the presence of pyrroli(idine al#aloids. ,nternal use is contraindicated in children, pregnant or nursing mothers in patients ith liver disease. 3F0 )o*icity: +epato&occlusive disease due to pyrroli(idine al#aloid to$icity. 5ee 5ymphytum officinalis.
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Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. <H Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p <F

Boswellia spp2 (B2 carteri' B2 papyrifera' B2 serrata' B2thurifera
Dpdated all &--& Common name: )ran#incense or 0libanum. Ha!itat: =B. carterri> 5omalia, parts of 5audi Arabia. =B. papyrifera> 5udan, 'thiopia. =B. serrata> %ry (ones of ,ndia.

Burseraceae

Botanical description: B. carteri is a richly foliated tree 3 alternating leaves. ,t gro s 3 fe roots, hich are fused to the stony soil upon hich it gro s. 6he flo ers are solitary, hite or pale& hite in color ] later develop into a three part capsulated fruit, each 3 its o n seed. #art used: Bar# ] 6run#. *um resin that e$udes from incisions made in the trun# is collected after allo ing it to harden =T3 months>. $nergetics: 6aste W 1ungent, bitterK 5 eet, astringent. +eating in nature. =&> ?apha ] 7ata. =X> 1itta. B. carteri has similar action to /yrrh, but is slightly stronger in action upon the lungs ] !:5. 0dor W 4esinous, balsamic, oody. 3FA Constituents: 7&0 • 7olatile oil =E&CG>9 pinene, dipentene, phellanrene, others. • 4esins =F0G>9 alpha&bos ellic acid, 3&acetyl&`&bos ellic acid, others. • /ucilages 0%&EB #harmacology: • Anti<,nflammatory action: 6he gum oleoresin consists of essential oils, gum, ] terpenoids. 6he terpenoid portion contains the bos ellic acids. Bos ellic acids, the biologically active ingredients of the gum resin of Bos ellia serrata =5allai guggal>, have been sho n to be specific, noncompetitive inhibitors of E&lipo$ygenase, the #ey en(yme for leu#otriene biosynthesis. Bos ellia inhibits pro&inflammatory mediators in the body by inhibiting the synthesis of leu#otrienes. ,n contrast to :5A,%s, long&term use of Bos ellia does not lead to irritation or ulceration of the stomach. 3F3 Bos ellia bloc#s some parts of the complement path ay. Medicinal actions: '$ternally W causes mild s#in irritation. ,nternally W mild carminative 2 Anti&inflammatory. Anti&rheumatic. Alterative. Analgesic. 4e"uvenative. Current > )raditional Medicinal Use: • Historical use: 6he blac# #ohl po der =charred )ran#incense> as used by 'gyptian omen to paint their eyelids. Also used as ingredient in perfumes, incense ] in embalming preparations. • Anti<,nflammatory: Bos ellia as used for rheumatologic complaints, asthma, bronchitis, catarrh, cough, indigestion, laryngitis, s#in care, ounds, to build ea# immune systems, ] to reverse depression. ,t has also been sho n useful for inflammation of the *,, such as in chronic cholitis. 3F< Current +esearch +eview: • Chronic colitis: *um resin of Bos ellia serrata as found to be effective in the treatment of chronic colitis ith minimal side effects in the dose of C00 mg 2% in three divided doses $ F ee#s. 6hirty patients ere recruited. !ontrol group received 3 g sulfasala(ine 2% in three divided doses $ F ee#s. Bos ellic acids are thought to be responsible for decreasing the inflammation via inhibition of leu#otriene synthesis. =6he #ey en(yme for leu#otriene biosynthesis is E&lipo$ygenase. Bos ellic acids ere found to be non&redo$, non&competitive specific inhibitors of the en(yme E&lipo$ygenase>. 3FE • Ulcerative colitis: *um resin of Bos ellia serrata as also found to be effective in the treatment of ulcerative colitis, grades ,, and ,,,, in the dose of 3E0 mg B,% $ F ee#s. !ontrol group received 5ulfasala(ine, A g B,% $ F ee#s. Bos ellic acids are thought to be responsible for decreasing the inflammation via inhibition of leu#otriene synthesis. 3FF • CrohnAs disease: Bos ellia serrata e$tract +AE as not found to be inferior to mesala(ine in the treatment of active !rohn@s disease. 0ne hundred t o patients ere recruited. Authors concluded that considering both safety and efficacy of Bos ellia serrata e$tract +AE, it appears to be superior over mesala(ine in terms of a benefit&ris#&evaluation. 3FH • Bronchial asthma: 6he gum resin of Bos ellia serrata as found to be effective in the treatment of bronchial asthma in the dose of 300 mg B,% $ F ee#s. )orty patients ere recruited. 6his as a double&blind, placebo&controlled study. /echanism of action is thought to be through the inhibition of leu#otriene biosynthesis by bos ellic acids. 3FB • +heumatoid arthritis: o Bos ellia serrata e$tract +AE sho ed no measurable efficacy in the treatment of active rheumatoid arthritis in the dose of 3F00 mg =C tablets> 2%. 5eventy&eight patients ere recruited, 3H of hich ere available for detailed efficacy and safety analysis. 6he study as placebo&controlled. 1atients ere also receiving :5A,%s, doses of hich could be ad"usted on demand. 6here as no sub"ective, clinical or laboratory parameter sho ing a significant

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or clinically relevant change from baseline or difference bet een both groups at any time point of observation. 6he mean :5A,% dose reduction reached levels of E.BG =+AE> and 3.AG =placebo>. 0ne patient in each group sho ed a good response in all parameters but < patients in each group orsened. 6he others sho ed no alteration of their disease. 6he authors concluded that controlled studies including a greater patient population are necessary to confirm or re"ect their results.3FC o 1reliminary double&blind trials have found Bos ellia effective in relieving the symptoms of rheumatoid arthritis. 6 o placebo&controlled studies, involving total of BA individuals ith rheumatoid arthritis, reportedly found significant reductions in s elling ] pain over the course of 3 months. ,n addition, a comparative study of F0 people over F months found that Bos ellia e$tract produced effects comparable to oral gold therapy. 6oday, e$tracts are typically standardi(ed to contain 3H.EWFEG bos ellic acids. AE0 mg of bos ellic acids 6,% is the dose sho n to be effective in these studies.3H0 3steoarthritis: +erbomineral formulation containing roots of Withania somnifera, the stem of Bos ellia serrata, rhi(omes of !urcuma longa, and a (inc comple$ =Articulin&)> produced a significant drop in severy of pain and disability score in the patients ith osteoarthritis. )orty&t o patients ere studied over a period of B months. 6he study as placebo controlled. 4adiological assessment did not sho any significant changes. 3HA

#harmacy: • 5tandardi(ed e$tract =3H.E&FEG bos ellic acids>9 <E0&3F00 mg qd, as reported in the current literature above. Contraindications.)o*icity: '$ternally, B. carteri can cause mild irritation.3H2
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)ra ley, %avidK .ad, 7asant. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29202. PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. 363 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 364 'ffects of *um 4esin B. serrata in 1atients ith !hronic !holitis. Planta Med 200A -ulKFH=E>93CA&E.R 365 *upta ,, 1arihar A, /alhotra 1, et al. 'ffects of gum resin of Bos ellia serrata in patients ith chronic colitis. Planta Med 200AKFH=E>93CA&E>. 366 *upta ,, 1arihar A, /alhotra 1, et al. 'ffects of Bos ellia serrata gum resin in patients ith ulcerative colitis. Eur 7 Med Res ACCHK2=A>93H&<3 367 *erhardt +, 5eifert ), Buvari 1, et al. 6herapy of active !rohn disease ith Bos ellia serrata e$tract + AE. ? 5astroenterol 200AK3C=A>AA&H 368 *upta ,, *upta 7, 1arihar A, et al. 'ffects of Bos ellia serrata gum resin in patients ith bronchial asthma9 results of a double&blind, placebo&controlled, F& ee# clinical study. Eur 7 Med Res ACCBK3=AA>9EAA&<. 369 5ander 0, +erborn *, 4au 4. ,s +AE =resin e$tract of Bos ellia serrata, IincenseJ> a useful supplement to established drug therapy of chronic polyarthritisa 4esults of a double&blind pilot study. ? Rheumatol ACCBKEH=A>KAA&F. 370 't(el 4. 5pecial e$tract of Bos:ellia serrata =+ AE> in the treatment of rheumatoid arthritis. Phytomedicine. ACCFK39CAWC<. 371 ?ul#arni 44, 1at#i 15, -og 71, et al. 6reatment of osteoarthritis ith a herbomineral formulation9 a double&blind, placebo&controlled, cross&over study. 7 Ethnopharmacol ACCAK33=A&2>9CA&E 372 1%4, FCF.

Brassica nigra
Common name: Blac# mustard, mustard Ha!itat: Blac# mustard is native to the /editerranean region and is cultivated orld ide.

Cruciferae

Botanical description9 6he blac# mustard plant is a much branched herb that gro s to a height of 3 feet. ,t possesses petiolate leaves pinnately divided ith 2&< blunt lobes and a large terminal segment on the lo er segment and oblong and undivided on the upper part of the stem. 6he plant produces yello flo ers and erect follicles. 6he seeds of the plant are dar# reddish bro n and A&A.E mm in diameter. #arts used9 seed =medicinal and culinary>, leaves=culinary> Constituents9 3H3 • *lucosinates are considered to be the most active constituent group. When the seeds are crushed andcombined ith arm ater =not ith hot ater & en(ymes ould be destroyed>, or che ed, the glucosinates, particularly sinigrin, are hydroly(ed by en(ymes into active compounds such as allyisothiocyanate =from sinigrin>. Allyl isothiocyanate =A,6!> is a constituent of cruciferous vegetables. A,6! possesses numerous biochemical and physiological activities. ,t is cytoto$ic and tumorigenic at high doses and also is a modulator of en(ymes involved in metabolism of $enobiotics, including carcinogens. A ma"or urinary metabolite, is :&acetylcysteine =:A!>, a con"ugate of A,6 3H< • 1henyl propane derivatives9 including, among others, sinapine =choline ester of sinapic acid, AG> • )i$ed oil =30G> , 5inapine , 5inapic acid, )i$ed oil, 1rotein, /ucilage #harmacology: As a s#in irritant, it@s mode of action is through the principle of counter&irritation or the ability to influence deeper regions of the body by refle$ effects mediated by the nervous system. /ustard oil is highly corrosive and ill cause blistering if applied for too long. 3HE *lucosinolates and their various transformation products alter phase , and , deto$ification processes acting to reduce the production of carcinogenic compounds. ,t is best to ingest levels not in great e$cess because at these levels the effects are not fully #no n. +o ever, these compounds may have a role in the prevention of cancer. 3HF Medicinal actions: 4ubefacient, counter&irritant, stimulant, diuretic, emetic )raditional Medicinal Use: no information currently available Current Medicinal use: • *astrointestinal !onditions9 6he internal use of Brassica nigra is limited because of the gastric stimulation produced by the oils in the plant. 6he oils produce a counter&irritant effect on the mucosa of the stomach hich causes a stimulation of the gastric smooth muscles. As a result emesis occurs. ,n smaller doses, the internal use of mustard seed po der ill stimulate appetite and digestion. ,n addition, the oils of the seeds are bacteriocidal. :onetheless, the emetic properties of this plant and the damaging effects on epithelial tissue contraindicate its internal medicinal use. Brassica niger =Blac# mustard> is stronger than Brassica alba =White mustard>. )or this reason, most mustard used for culinary purposes is hite mustard. • 6opical Applications9 6he most common usage of mustard seed is as a po der. /ustard seed po der has been used historically as a topical application to create a counter&irritant effect. When Brassica nigra is applied topically in the form of plasters and poultices it creates an irritant, hyperemic effect. 6his causes locali(ed vasodilation and even inflammation. 6he enhanced circulation through the area stimulates the tissues underlying the area of application. /ustard seed plasters are most often applied over the lungs in order to loosen congestion and to stimulate e$pectoration. )ol# remedies throughout 'urope and the United 5tates have used mustard seed plasters and poultices to brea# up lung congestion and to prevent a common cold from developing. 6his same counter&irritant effect is utili(ed over rheumatic "oints. 6he counter&irritant effect increases blood flo through the "oint and consequently decreases "oint edema. /ustard compresses ill also help to relieve myalgia from hypertonic and inflamed muscles. /ustard foot baths =mustard seed po der in arm ater> is an old remedy for headaches, colds and flus. #harmacy9 '$ternal use only9 1laster9 A6B dry mustard seed9 2&3 6B flour 9 small amount of arm ater or mil# =hot ater inactivates the en(yme that converts glucosinolate into the active al#yl isothiocyanate> 1lasters need to be left on for at least E minutes, but the s#in must be monitored closely for any signs of blisters. 6he plaster should never be left on any longer than AE&30 minutes. At the first sensation of burning felt by the patient, the plaster should be removed. 6he local counter&irritant effect may persist for 2<&<B hours.

!ompress and ater baths9 A tsp. dry mustard seed 9 A cup or greater of ater Contraindications: /ustard seed applications are contraindicated hen there is severe circulatory damage and ith varicose veins. /ustard seed is not to be used internally in amounts greater than those for culinary purposes.=Alschuler> :o applications for children under the age of si$. 5ince mustard oils are absorbed by the s#in, these preparations should not be used hen #idney disorders e$ist.3HH According to Brin#er, Brassica is contraindicated in irritative or corrosive poisoning, gastrointestinal inflammation, pregnancy, e$ternally over unprotected s#in or for an e$cessive amount of time or in children under F years of age. 3HB )o*icity9 6he use of mustard seed e$ternally, hile effective, is dangerous. 6he oils found in mustard seeds causes dermal inflammation and erythema. /ustard seed applications if left on too long or over sensitive s#in ill cause vesication that can cause s#in ulceration, necrosis and permanent scaring. 6his is particularly true ith patients ith sensitive s#in and or vascular insufficiency. =Alschuler>
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A -iao %. ,dentification and quantification of the :&acetylcysteine con"ugate of allyl isothiocyanate in human urine after ingestion of mustard. !ancer 'pidemiol Biomar#ers 1rev. ACC< 5epK3=F>9<BH&C2. 375 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 30 376 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. 377 Blumenthal,/. 6he !omplete *erman !ommission ' /onographs9 6herapeutic *uide to +erbal /edicines, )irst 'dition, American Botanical !ouncil . ACCB 378 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A0E

Bryonia al!a
Common name: hite bryony Ha!itat:

Curcur!itaceae

Botanical description9 1erennial vine that climbs ith tendrils. .arge, palmate, E&lobed leaves occur along the vine. 5mall clusters of pale green flo ers are follo ed by blac# berries. A large, F cm diameter root supports the plant. Constituents 7(5 • !ucurbitacins9 including cucurbitacins B, %, ', ,, -, ?, ., 23,2<&dihydro&cucurbitacins, A,2,23,2<&tetrahydrocucurbitacins, 22& deo$ycucurbitacins • !ucurbitacin glycosides • 6riterpenes ith unusual structure • 5terols ith unusual structure • 1olyhydro$y fatty acids9 including C,A2,A3&6rihydro$y&octadeca&A0='>&AE=8>&dienic acid. • .ectins #harmacology: 7arious aqueous e$tracts of the drug display an antitumoral effect. 6he resin is a drastic purgative. 6he methanol e$tracts have a strong hypoglycemic affect. 3B0 Medicinal actions: hypotensive, platelet aggregation, cathartic, counter&irritant, diaphoretic, cathartic, anti&rheumatic, hydragogue )raditional Medicinal Use: 5pecific ,ndications and Uses9 5harp, cutting, lancinating, tensive or tearing pain, ith a sore feeling in any part of the body, particularly from serous inflammation or rheumatic pain, as if bruised, and al ays aggravated by motion and ith muscular tension and tenderness on pressureK dry, sensitive s#inK hard, moderately full, or hard, iry, frequent vibratile pulseK headache on right side or head so sore that one cannot bear to be touched, ith flushed right chee# above right malar bone =a prominent indication>K frontal pain e$tending alongside of head to basilar regionK hyperaesthesia of face or scalpK neuralgic pain ith hyperaesthesiaK irritative, hac#ing, rasping, or e$plosive cough, ith soreness or bruised feeling of parts, and ith laryngeal and suprasternal soreness and tendernessK abdominal pain ith tendernessK ocular tenderness, increased by movementK tensive earacheK articular and synovial pain, s elling, and tendernessK bo els Nconstipated and urine scantyK burning in eyes and nose, ith acrid nasal flo K apathy or lethargy short of dullnessK tired, eary feeling, too tired to thin#K disposition to perspire on the slightest movement. 3BA According to ?ing, the influence of Bryonia on the nervous system is mar#ed and it as used to free the circulation, overcome capillary obstruction, lo er fever and control pain. ,t is the remedy for inflammation of serous tissues, and is equally valuable in peritonitis and in synovial inflammations. ?ing also elucidated upon the quality of Maggravated by motion,M hich has long been a phrase applied to Bryonia cases. +e found in these cases a lethargy induced more by a desire to remain quiet than one of dullness, as is noticeable hen Belladonna is required. 6he patient is languid, torpid, tired, and has little inclination to go about. A general deficiency of nervous balance is observable, and every effort tends to induce perspiration. • !ardiovascular !onditions9 6o the 'clectics, Bryonia as deemed to be a valuable heart tonic in ea# and delicate individuals, ho, by over or# and nervous e$citation, bring on a depressed and irregular heart&action =heart&strain>K and in organic heart pathology hen e$posure and rheumatic pain triggers a cardiac paro$ysm. Bryonia, ith rest in bed, as asserted to po erfully and rapidly influence a condition for the better. ,n #eeping ith the general tropism for serous membranes, Bryonia as also valuable in pericarditis tending to hydropericardium. • ':6 !onditions9 Bryonia as indicated for treatment of partial deafness from cold and tensive pains in the ear in children. • *astrointestinal !onditions9 )or indigestion here the food is slo to digest leaving a sense of heaviness as if a stone ere in the stomach, Bryonia as the indicated remedy. 5cudder called especial attention to its use in the abdominal tenderness and pain in typho&malarial fever, and (ymotic diseases, and associated ith ,pecac or 'uphorbia in cholera infantum ith abdominal tension and tenderness, or articular pain and s elling =%iseases of !hildren, p. 3A>. ,n peritonitis the pain hich indicated Bryonia as of the character of colic, but is mar#ed by unusual tenderness and tension. • *ynecological !onditions9 Bryonia as considered a remedy for ovarian and menstrual dysfunction, ith soreness on pressure. Acute mastitis hen very painful and ith elevated temperature, and the mammary glands are s ollen, tender, and #notted, as treated ith 1hytolacca supported by Bryonia and Aconite. • +epatobiliary !onditions9 ,n hepatic disorders ith "aundice, highly colored urine, and developing pain upon pressure, ?ing considered Bryonia an e$cellent remedy. 1ains about the liver, as if the serous capsule ere involved, have also been considered indications Bryonia.

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/usculos#eletal !onditions9 6he 'clectics utili(ed Bryonia in cases of acute or chronic rheumatism, especially here the "oints ere s ollen and stiff, including rheumatism of the spine in children. 5ome 'clectics considered Bryonia to be an absolute specific in rheumatic s elling of the finger "oints. • :eurological !onditions9 Apparently, Bryonia as considered for cases of facial neuralgia and peripheral neuropathy. • 0phthalmological !onditions9 Bryonia as used for rheumatic iritis, ith aching soreness upon movement of the eyeball and in non&edematous puffiness of the upper eyelid. • 1ulmonary !onditions9 1erhaps no remedy in the hole range of respiratory therapeutics as considered more valuable than this one to the 'clectic physicians, particularly as specific Bryonia. ,t as considered the remedy for the types of pain described in the specific indications and hen there is a large quantity of mucus ithin the bronchioles, as evidenced by the loud mucous rales. ?ing describes a variety of pulmonary conditions indicating Bryonia in combination ith other botanicals and at specific diseases stages. 6hus, the monograph in his dispensatory is orth consulting for further information on the pulmonary applications of this herb. Current Medicinal Use: B1 alba is a specific for the fever of rheumatic fever and for the cardiac complications of rheumatic fever. ,t is also useful in hypertension, pulmonary edema and pleurisy ith associated cardiac insufficiency. B1 alba is used for rheumatic conditions of the "oints. ,t helps to relieve pain and stiffness by reducing fluid in the "oint space. Bryonia alba is considered to possess to$ic effects in relatively small doses, and is therefore infrequently used. 6he efficacy of Bryonia preparations for the claimed applications in humans has not been scientifically documented. • !ardiovascular !onditions9 Bryonia may be a useful addition to anti&hypertensive formulas. 6he cucurbitacins appear to rela$ smooth muscle. Additionally, hite Bryonia increases the elimination of ater through diaphoresis, diuresis and la$ation. 6he result of all of these actions is a reduction of blood pressure. White Bryony may help to relieve edema around the heart, especially hen this edema is the result of an infectious process. #harmacy9 A9A0 tinctureK 0.E ml 6,%K A0 ml ee#ly ma$imum Contraindications: !ontraindicated in pregnancy, lactation or in someone ith anal hemorrhoids. )o*icity9 6he fresh root of Bryonia is e$tremely irritating, occasioning blisters hen bruised and #ept in contact ith the s#in, and causing serious gastro&intestinal inflammation hen ta#en internally. 5ymptoms of to$icity of the fresh or large doses of the dried root include9 colic, vomiting, a profuse and uncontrollable diarrhoea, gastro&enteritis, cardiac depression ith ea#, thready pulse, fall of temperature, mydriasis, congestive headaches, di((iness, delirium, cold perspiration and collapse, death.3B2

Bupleurum falcatum

Apiaceae (Um!elliferae

Qmuch of this monograph is adapted from9 Bone, ? 2linical )pplications of )yur!edic and 2hinese Herbs, =2ueensland, Australia9 1hytotherapy 1ress>K ACCF92A&2<.R Common name: !hinese thorough a$, +are@s 'ar 4oot, !hai hu #arts used: 4oot Historical Use: Bupleurum has been of the !hinese herbal formulary for many centuries. ,dentified Constituents:3B3 • 6riterpenoid saponins #no n as sai#osaponins =up to 2.BG sai#osaponins a, bA&<, c, d, f> • 1olysaccharides =bupleurans> • 0ther constituents9 !oumarin, )lavonoids, 1olyacetylenes, 5ai#ogenins, 1olyhydro$y sterols, 6rihydro$y fatty acid, .ignan, 5ai#ochromone #harmacology3B< • .ipid lo ering effects in hyperlipidemic animals • 5ai#osaponin =a> has been sho n to inhibit platelet aggregation and thrombo$ane formation • 0ral doses are absorbed only A3A0th as much as in"ected doses • ,ncreases phagocytosis3BE #harmacology: Bupleurum has a variety of anti&inflammatory effects. 6he sai#osaponins enhances the activity of corticosterone by inducing liver en(ymes involved in the activation of corticosterone =A and B > and by stimulating adrenocortical function =stimulating A!6+& ! and '>. 3BF, 3BH Both of these effects lead to an overall anti&inflammatory action. 5ai#osaponins also suppress granulation tissue 3BB and inhibits prostaglandin '2 production =in&vitro> 3BC both of hich further help to e$plain the anti&inflammatory effect of Bupleurum falcatum1 6he sai#osaponins are also hepatoprotective. 1re&treatment ith these sai#osaponins inhibits acute and chronic to$ic effects of liver to$ins such as carbon tetrachloride.3C0 When in"ected, the sai#osaponins e$ert anti&tussive effects as strong as those of codeine via their action on the !:5. 3CA 0ral doses of Bupleurum falcatum transiently increase blood glucose, bile output and bile salt content =and thus lo er cholesterol>.3C2 ,t has been suggested that sai#osaponnins and sai#ogenins lo er cholesterol by increasing cholesterol e$cretion in the bile and may increase hepatic protein synthesis.3C3 Administration of Bupleurum to hyperlipidemic animals reduced cholesterol levels. 3C< 5ai#osaponin a and d =considered to be the most active sai#osaponins> demonstrate anti&tumor effects in&vitro. 3CE 5ai#osaponins undergo enterohepatic circulation and fecal e$cretion. Blood levels of sai#osaponins from oral doses are A3A0 th that of in"ected doses.3CF Medicinal actions: hepatoprotective, anti&inflammatory, anti&tussive, diaphoretic, carminative, alterative, choleretic, antipyretic, mild sedative, hyperglycemic $nergetics: bitter, slightly acrid, cool enters the liver, gall bladder meridians &resolves lesser yang patterns &smoothes liver qi &raises yang qi )raditional Medicinal Use: :either !oo# nor ?ing described this herb. Current Medicinal Use: Bupleurum falcatum has been one of the most important drugs in traditional -apanese and !hinese medicine. ,t has been used for the treatment of chronic hepatitis, nephrosis and auto&immune diseases. B1 falcatum is also used in chronic inflammatory diseases especially involving the liver and #idneys. !hronic autoimmune disease such as systemic lupus erythematosus and multiple sclerosis are particularly responsive to this plant. • *astrointestinal !onditions9 6he saponins may act by inhibiting gastric acid secretion and have been found to improve the integrity of gastric mucosa in rats. 3CH • *enitourinary !onditions9 Bupleurum given to patients ith poor fluid e$cretion produced a diuretic effect. 3CB • +epatobiliary !onditions9 Acute and chronic liver disease, to$ic damage to the liver and hepatic insufficiency are all indications for B1 falcatum. A clinical trial in chronic active hepatitis used oral doses of sai#osaponins at F mg3day =equivalent to 0.3 g of root3day>.

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5erum liver en(ymes ere reduced significantly hen measured at 3, F and A2 months. 3CC 6he saponins stimulate immune functions and in"ections of Bupleurum given to +epatitis B patients resulted in clinical improvement. <00 ,nfectious !onditions9 Uncontrolled trials demonstrated strong antipyretic effects hile numerous cell studies sho immunomodulating effects.<0A, <02, <03. 6his combined ith its macrophage enhancing activity<0< ma#e it useful in the treatment of colds and flus. !hronic infections and inflammatory diseases are indications for B1 falcatum because of its anti&inflammatory, adrenocortical&sparing, hepatoprotective and immunostimulatory actions. :aturopathically spea#ing, persons ith chronic disease ho have some stage of adrenal e$haustion and hepatic insufficiency are li#ely to benefit from Bupleurum falcatum1

Current +esearch +eview: • Hematology: o )hrom!ocytopenic purpura::8%  Abstract is unavailable on /edline. #harmacy: 6raditionally used in formulation. %r. %ipasquale prefers to use this herb in the second phase of female biphasic formulas to lift the spirits and improve hepatic function. %ried root9 A.E&F gm3day in divided doses as a decoction or in capsules A9E tincture9 E&20 ml3 day A92 fluid e$tract93&A2 ml3day in divided doses 3 &A20 mg sai#osaponins3day in divided doses Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: :o information is currently available from the selected resources. ,n 6!/, Bupleurum is contraindicated in conditions of the deficient yin of liver fire rising. )o*icity: Bupleurum falcatum is slightly sedating in some individuals and may causes increased bo el movements and flatulence.
383 384

Bone, ? 2linical )pplications of )yur!edic and 2hinese Herbs 1hytotherapy 1ress, 2000 p 2A&2< Bone, ? 2linical )pplications of )yur!edic and 2hinese Herbs 1hytotherapy 1ress, 2000 p 2A&2<. 385 *uinea /! et al: Biologically active triterpene saponins from Bupleurum fruticosum. Planta Med. ACC< AprKF0=2>9AF3&H. 386 +ashimoto, et al Planta Med, EA, ACBE9<0A. 387 !hang +/ and But, 11 Pharmacology and )pplications of 2hinese Materia Medica, 7ol.2, =5ingapore9 World 5cientific>, ACBH. 388 ibid. 389 0huchi ?, et al Planta Medica, ACBE920B. 390 6ang W and 'isenbrand * 2hinese Drugs of Plant "rigin, =Berlin9 5pringer 7erlag>, ACC2. 391 !hang +/ and But 11, ibid. 392 !hang +/ and But 11, ibid. 393 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 394 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 395 /otoo ; and 5a abu : 2ancer 8ett, BF, ACC<9 CA. 396 !hang +/ and But 11, ibid. 397 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 398 Bone, ? 2linical )pplications of )yur!edic and 2hinese Herbs 1hytotherapy 1ress, 2000 p 2A&2< 399 +i#ino + and ?iso ; ;atural Products for 8i!er Diseases, in Economic and Medicinal Plant Research, 7ol 2, eds. Wagner + et al, Academic 1ress, ACBB. 400 ?a#umu, 5. 'ffects of 6-&C 5ho&sai#o&to =#ampo medicine> on interferon gamma and antibody production specific for hepatitis B virus antigen in patients ith type B chronic hepatitis1 >nt 7 >mmunopharmacol. ACCAKA3=2&3>9A<A&F. 401 !hang +/ and But 11, ibid. 402 Bone, ? 2linical )pplications of )yur!edic and 2hinese Herbs 1hytotherapy 1ress, 2000 p 2A&2< 403 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 404 ?uma(a a ;, et al >nt 7 >mmunopharmacol, AA,ACBC92A. 405 %uan ;, 8hao P, Pu P. 6reatment of primary thrombocytopenic purpurea by modified minor decoction of bupleurum. 7 Tradit 2hin Med ACCEKAE=2>9CF&B

Calendula officinalis
Common name: /arigold, 1ot marigold, calendula Ha!itat9 :ative to 'uropeK common throughout the orld, mostly cultivated.

Asteraceae

Botanical Description: An annual plant ith branched stems. .eaves are pale green, and spatulate. 6he flo er heads are bright yello or orange ith ray and tubular florets surrounding a cro n shaped receptacle. #arts Used: 4ay florets =but hole flo er is usually used> Historical uses9 !alendula has been used in 'urope for a long time as culinary plant. 6he bright orange flo ers are a colorful addition to salads and ste s. !alendula as also thought to comfort the heart and soothe agitation. !alendula has a long history of use for headaches, "aundice, red eyes, and toothaches. 6he marigold as thought to dra evil spirits out of the head and strengthen the eyesight. Constituents: • flavonoids, found in high amounts in calendula, account for much of its anti&inflammatory activity • triterpene saponins • carotenoids, $anthophyls • calendulin =a bitter resin> • volatile oil, mucilage, salicylic acid, polysaccharide, Medicinal actions: Anti&inflammatory, anti&spasmodic, vulnerary, sytptic, antiseptic, antiviral, antiproto(oal, anti&fungal, anti&bacterial, cholagogue, depurative, diaphoretic, lymphatic, phytoestrogenic )raditional Medicinal Use: 5pecific ,ndications and Uses9 .ocally, to ounds and in"uries to prevent suppuration and promote rapid healing. ,nternally, to aid local action, and in chronic suppuration., capillary engorgement, varicose veins, old ulcers, splenic and hepatic ongestion.<0F !oo# described the flo ers of !alendula is a mild =no e$plosive action> diffuse =stimulates circulation>, stimulating =stimulates tissue functioning> yet rela$ing =anti&spasmodic> plant, e$pending their po er chiefly upon the nerves, and moderately upon the capillary circulation. +e noted that it is a vaso&motor stimulant, and relieves capillary engorgement of the mucous tissues and s#in. • :ervous !onditions9 .i#e all other articles of such qualities, they are nervine and antispasmodicK and have been used in hysteria and general nervousness, and to promote moisture at the surface. • *ynecological !onditions9 ?ing asserted that !alendula as reputed to act beneficially in dysmenorrhea, slightly promoting menstruation. !oo# praised the use of !alendula in vaginitis, endometritis, all uterine and vaginal abrasions, and non&malignant ulcerations, leucorrhoea, and as an intra&uterine ash. • 6opical Applications9 As a local application, !alendula as used to promote granulation and to advance the healing of contused ounds. !alendula as also used successfully after surgical operations to induce healing by first intention, to ash abscess cavities, to prevent cicatri(ation from burns and scalds, in ec(ematous and ulcerative s#in diseases, vaginitis = ash or tampon>, endocervicitis, gonorrhea, non&specific urethritis, and mercurial stomatitis. Current Medicinal Use: • *astrointestinal !onditions9 !alendula is antiinflammatory for the *.,. tract • ,nfectious !onditions9 6he anti&fungal properties are only found in a tincture =not in the succus or oil> because it is the resins that are anti&fungal and these need C0G 't0+ for e$traction. 6he antiseptic =demonstrated anti&bacterial, anti&viral and anti&parasitic activity has been demonstrated in several in&vitro studies> and immunostimulating properties are derived from the polysaccharides and volatile oil. !alendula is mildly anti&viral and seems to have a tropism for the lo er half of the body, versus Baptisia hich or#s best on the head and nec#. Both of these herbs combine synergistically ith 'chinacea. • +epatobiliary !onditions9 6he calendulin resin gives !alendula its cholagogue activity hich, in turn, contributes to the depurative action. • ,nflammatory !onditions9 6he saponins and resins decrease tissue s elling, increase capillary perfusion of tissue and therefore decrease inflammation. 6he diaphoretic action of !alendula is mild and is secondary to the increase in peripheral circulation. • .ymphatic !onditions9 As a lymphatic stimulant, !alendula is most specific for the lymphatics in the breast and pelvic tissues. 6his may follo the fact that the saponins in !alendula have mild phytoestrogenic activity, thus directing the herb to these areas.

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!alendula stimulates the drainage of enlarged, inflamed lymph nodes. )or this reason, calendula is good for pre& and post&op support. ,t combines ell ith 1hytolacca as poultice to drain cysts such as fibrocystic breasts. 6he main lymphatic herbs can be classified as follo s9 1hytolacca9 :ec#, Breast, Arms, *lands *allium9 /ost systemic, e$cellent in the throat, pelvic area, urinary tract !alendula9 1elvis and Breast 6opical Applications9 !alendula is antiinflammatory e$ternally especially hen used in a poultice. 6he styptic and vulnerary actions are due to the $anthophyls = hich stimulate granulation tissue>, the mucilage and volatile oil. 6he $anthophyls are ater soluble. 6hus, calendula succus and tea can be used topically for ound healing and internally for hemorrhage, inflammation of the throat, nasal passages, con"unctivitis =as an eye ash>, otitis, proctitis and colitis =esp. as suppositories> gastritis and vaginitis. !alendula is most indicated in chronic and acute inflammatory s#in lesions, the symptoms of hich may include itching, burning, and s elling. '$periments on animals suggest that calendula cream e$erts a ound&healing and anti&inflammatory effect, <0H but double&blind studies have not yet been conducted. <0B !alendula cream is also used to soothe hemorrhoids and varicose veins, and the tea reportedly reduces the discomfort of mouth sores.

Current +esearch +eview: • Dentistry: o Chronic catarrhal gingivitis::85  %esign9 !linical trial  1atients9 1atients ith chronic catarrhal gingivitis  6herapy9 !alendula immobili(ed on polysorb in the nearest period after treatment and later  4esults9 +ighly effective #harmacy: ,t is especially effective for s#in conditions =e$cluding fungal conditions> as a fresh plant succus. 5uccus in 2EG 't0+9 3&E ml 6,% A9E C0G 't0+ tincture9 A&2 ml 6,% )luid e$tract A9A <0G 't0+9 0.E&A ml 6,% ,nfusion A&< g 6,% QAtsp O 0.BgR 5pecific tincture A93 CFG 't0+, macerate 2 ee#sK sig A&3 ml3dayK !reams, ointments, oils, poultices, suppositories

Contraindications: Brin#er speculates that !alendula be avoided during pregnancy due to the uterine stimulant effect of cyrptopine. <A0 )o*icity: !alendula is an e$tremely safe herb ithout documented side&effects.
406 407

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. A33 408 5chul( 7, +ansel 4, 6yler 7'. Rational Phytotherapy: ) PhysiciansF 5uide to Herbal Medicine. 3rd ed. Berlin, *ermany9 5pringer&7erlagK ACCB92EC. 409 ?ra(han ,A, *ara(ha ::. 6reatment of chronic catarrhal gingivitis ith polysorb&immobili(ed calendula. ,tomatologiia 0Mos3B 200AKB0=E>9AA&3 410 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p E2

Camellia sinensis
Common name: 6ea, *reen tea, Blac# tea

)heaceae

Ha!itat: 2amellia sinensis is cultivated in ,ndonesia and !hina, ,ndia, -apan, and 5ri .an#a. Botanical description: A AE m high shrub . 6he plant bears oblong&ovate, dar# green, shiny leaves ith distinctly serrate margins. 5cented flo ers up to 3 cm in diameter ith E or F petals and numerous yello stamens appear singly. ,n commerce, the young shoots are pic#ed. 6o ma#e green tea, the young leaves are allo ed to ilt and are then rolled. 6his rolling e$udes some of the cell sap and the leaf structure is partly bro#en do n. 6o ma#e blac# tea, the leaves are then fermented in order to convert the polyphenols to phlobaphenes and for aromatic substances to be formed. 6he fermentation occurs as the result of the leaf en(ymes, particularly polyphenol o$idase, on tannins and catechins. 6o ma#e green tea, fermentation is omitted and instead the leaves are steamed =IroastingJ in the !hinese method and Is eatingJ in the -apanese method> hich inactivates the en(ymes and thus preserves the polyphenols. 4ed tea =oolong> and yello tea are partially fermented tea. 6he leaves are then dried by hot air. #arts used: ;oung leaves =poor quality tea, i.e. instant tea is made from the older leaves> Historical use: *reen tea has been drun# throughout Asia since at least 3000 B! to promote longevity, to improve mental functions, and to prevent disease. Constituents: )lavonols=polyphenols> EG&A0G, 6heogallin 2G&3G, 2uinic acids 2G, /ethyl$anthines =caffeine 3G&EG, theophylline 0.02G, theobromine 0.AG>, 6heanine <G&FG, !arotenoids, 6rigalloylglucose, /inerals FG&BG9 depending on soil content Al and /n are particularly prominentK volatile oils, vitamins, and caffeine *reen tea9 1olyphenols9 catechins =30G&<2G of the e$tracable solids>, gallocatechins =including epigallocatechin ='*!> and epigallocatechin gallate ='*!*> <AA, <A2> Blac# tea9 6he unique constituents in blac# tea are the result of o$idation and condensation of catechins. 6heaflavin, 6heaflavic acids, 6hearubigens9 including proathocyanidins, 7olatile components #harmacology: 6ea polyphenols are absorbed after oral ingestion and are easily detected in blood, urine and feces. 6he actions of polyphenols are thus local rather than the result of indirect gastrointestinal effects. <A3 6he tea polyphenols, especially epigallocatechin gallate ='*!*> directly scavenge free radical o$ygen. *reen tea polyphenols have been sho n to stimulate the production of several immune system cells, and have antibacterial propertiesZeven against the bacteria that cause dental plaque. <A< '*!* stimulates B cell proliferation in&vitro.<AE '!*! and epicatechin directly damage bacterial membranes and are thereby bacteriocidal compounds.<AF 6ea catechins are also proto(oacidal<AH and virucidal =including influen(a<AB and +,7<AC>. 6ea and coffee e$tracts demonstrate antibacterial activity against Gibrio cholerae, ,almonella typhimurium, and ,almonella typhi'&- all of hich are associated ith bacterial induced diarrhea. 1olyphenols increase antio$idant and phase ,, deto$ification en(yme activities in a variety of mouse organs. <2A U%1&glucuronosyl transferase, a phase ,, en(yme is elevated in rat livers after treatment ith green tea. <22 1olyphenols bind to cytochrome&1<E0 in rat livers and indirectly bloc# the activity of cytochrome&1<E0&dependent en(ymes. 6his may result in decreased to$ic and carcinogenic intermediates that are formed in livers ith up&regulated phase , of deto$ification. <23 6he in&vivo antio$idant activity in humans of green tea is si$ times greater than that of blac# tea.<2< 6ea polyphenols, especially the catechin gallates, may protect tissues from tumor development by enhancing gap "unction communication hich is other ise inhibited in tumor development. <2E 6ea polyphenols also inhibit tumor promoter binding to mouse s#in presumably by sealing receptors for these promoters.<2F '*!* directly binds to certain carcinogens.<2H When '*!* is given to mice, lung metastasis of e$perimental and spontaneous tumors is prevented. <2B *reen tea polyphenols are antimutagenic<2C and reduce the occurrence of chromosome alterations from e$posure to mutagens. <30 6here is some evidence that green tea constituents might help protect the s#in from sun damage and sunburn. <3A Unli#e normal sunscreen preparations, green tea does not physically bloc# ultraviolet light. 4ather, it seems to protect cells from damage. *reen tea e$tract is radioprotective especially against U7B&induced carcinogenesis. <32 !atechin gallates selectively inhibit E& dihydrotestosterone in&vitro.<33 E& dihydrotestosterone is associated ith benign prostatic hyperplasia, prostate cancer and male pattern baldness. !affeine inta#e causes a#efulness and sleep latency. !affeine antagoni(es adenosine@s sympathetic nervous stimulation of the vascular system, hear, #idney, and adipose tissue. Adenosine inhibits neuronal activity and behavior by inhibiting pre&synaptic neurotransmitter release and by inhibitory binding to post&synaptic neurons. !affeine is structurally similar to adenosine and therefore counteracts the inhibitory effect of adenosine. +o ever, chronic caffeine inta#e may cause an increase in the number of adenosine receptors. !onsequently, larger amounts of caffeine are required to maintain the caffeine antagonism of adenosine hich may e$plain the habituation effect e$perienced by some users of caffeine&containing beverages. Additionally, if the caffeine inta#e is suddenly ithdra n or reduced, the adenosine effect is intensified resulting in symptoms of caffeine ithdra al. <3<

!affeine may cause transitory hypertension and arrhythmias in some individuals, ho ever evidence that long&term administration of caffeine causes these conditions is lac#ing.<3E 6ea polyphenols bloc# o$idation of .%. in&vitro.<3F *reen tea consumption by humans =especially more than A0 cups per day> is associated ith decreased total serum cholesterol, .%., 7.%., triglycerides and increased +%.. <3H 6here is theoretical, but no clinical evidence for tea to promote the formation of calcium o$alate #idney stones because caffeine induces calcium e$cretion and tea is contains o$alates.<3B 6he essential oil of tea e$erts a most po erfully stimulating and into$icating effect. ,n !hina, tea is seldom used till it is a year old, on account of the ell&#no n into$icating effects of ne tea, due probably to the larger proportion of essential oil contained in the freshly& dried leaf =?ing>. Drug ,nteractions: %rug interactions e$ist ith arfarin, ephedrine, /A0 inhbitors, adenosine, clo(pine, barbiturates, ben(odia(epenes, β&bloc#ers, phenylpronaloamine, lithium, aspirin, fluo$amine, a variety of antibiotics, 0!1s, cimetidine, phenytoin, alcohol and adriamycin. 5ee Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. pABC&ACA for more detailed information. Medicinal actions: Antio$idant, Anti&tumor and anti&cancer, 5timulant, Anti&cholesterolemic, ,mmunostimulant and antimicrobial Anticariogenic =resists tooth decay> )raditional Medicinal Use: !amellia as considered a mild stimulant and astringent by the 'clectics. • ,nflammatory !onditions9 6he 'clectics used !amellia in fevers and inflammatory diseases, hen it as desired to chec# sleep. ,n colds, catarrhs, and slight attac#s of rheumatism, the arm tea as ta#en as a diluent, diuretic, and diaphoretic. <3C Current Medicinal Use: *reen tea is a good stimulant. ,t does possess caffeine and, in most people, ill cause stimulation of the central nervous system. ,n some individuals, a parado$ical sedation effect may occur upon consumption. 6his may the result of other compound in the plant hich cause !:5 sedation. ,n general, the stimulatory effect from tea is less pronounced than that from coffee mainly due to the lesser caffeine content =on average, there is E0 mg of caffeine per cup of blac# tea and even less per cup of green tea versus E0 to AE0 mg of caffeine per cup of coffee>. *reen tea has been a recent focus of attention in both research and use since the late ACB0@s. )rom both the research and the historical use of green and, to a lesser e$tent, blac# tea, several clinical indications for this plant have emerged. • !ardiovascular !onditions9 *reen tea mildly guards against cardiovascular disease in many ays, especially hen consumed in large quantities =A0 cups per day>. *reen tea lo ers total cholesterol levels and improves the cholesterol profile, <<0 reduces platelet aggregation, and lo ers blood pressure. <<A +o ever, not all studies have found that green tea inta#e lo ers lipid levels. <<2 While some studies sho that green tea is an antio$idant in humans, others have not been able to confirm that it protects .%. cholesterol from damage.<<3 0$idation of .%. cholesterol is thought to be important in causing or accelerating atherosclerosis. • +epatobiliary !onditions9 *reen tea might prevent liver disease. <<< 4esearchers found that on average individuals ith high inta#e of green tea =A0 cups or more of green tea per day > had lo er levels of liver en(ymes. 'levated liver en(ymes occur ith various liver diseases, so this data suggests that green tea might helpful in treating hepatitis and alcoholic liver disease. • *astrointestinal !onditions9 *reen tea given by capsule reduced fecal odor and favorably altered the gut bacteria in elderly -apanese living in nursing homes.<<E 6he study as repeated in bedridden elderly and green tea again as sho n to improve their gut bacteria.<<F • ,nfectious !onditions9 )inally, green and blac# tea possess significant anti&microbial effects against bacteria, proto(oa, and viruses. 6hese effects ma#e green tea useful for people ith immunodeficiency syndromes =both to help prevent infection and to combat fatigue> and in persons ith e$posure to infectious organisms. ,n addition, green tea is an effective ay to prevent tooth decay. • /etabolic !onditions9 *reen tea is an e$cellent source of anti&o$idant compounds. 4egular consumption of green tea ill reduce free radical damage and ill promote active deto$ification. 5imilarly, people ith high environmental e$posure to to$ic compounds ould be ell served to consume green tea regularly for its anti&o$idant and selective phase , do n&regulating effects. • :eoplastic !onditions9 6he anti&cancer effects of green tea complement the antio$idant effects. *reen tea is an e$cellent beverage for people ith cancer, ith a personal history of cancer, and3or ith ris# factors for the development of cancer. 6he polyphenols in green tea have also been associated ith reduced ris# of several types of cancer in humans. <<H ,n a double&blind study, people ith leu#opla#ia too# 3 grams of mi$ed oral and topical green tea or placebo for F months. 6hose in the green tea group had significant decreases in the pre&cancerous condition compared to placebo. <<B • 1ulmonary !onditions9 6here is theoretical grounds for using green tea in the treatment of asthma. *reen tea contains theophylline hich is a smooth muscle rela$ant. +o ever, green tea contains 0.02G theophylline. A typical dose of 3 gm of green tea therefore contains 0.0F gm of theophylline. 6he allopathic theophylline is administered at A0 mg3#g3day. )or a AE0 pound

person =FB #g>, a daily dose of theophylline ould be FB0 mg theophylline. 6o achieve this dosage ould require consuming appro$imately 33 gm of green tea per day. 6his is certainly possible in some individuals if they love green teab Current +esearch +eview (0888<0880 • $ndocrinology o 3!esity:::5  %esign9 0pen multi&center clinical trial  1atients9 /oderately obese patients  6herapy9 6he green tea e$tract A42E =B0G ethanolic dry e$tract standardi(ed at 2EG catechins e$pressed as epigallocatechin gallate> $ 3 months  4esults9 Body eight as decreased by <.FG and aist circumference by <.<BG. A42E is thought to e$ert its activity by inhibition of lipases and stimulation of thermogenesis. • Cardiology: o -asodilation::%8  %esign9 4andomi(ed controlled clinical trial  1atients9 2A patients ith mild elevations in serum cholesterol or triacylglycerol =triglyceride> concentrations.  6herapy9 E cups of blac# tea qd $ < ee#s.  4esults9 Brachial artery vasodilator function as measured. 6he results sho ed significant and consistent increase in endothelium&dependent and independent dilation. 0ne of the mechanism by hich blac# tea may reduce cardiovascular ris# is via improved vasodilator function of conduit arteries. o Hemostasis and cell adhesion::%"  %esign9 4andomi(ed controlled cross&over clinical trial  1atients9 6 enty t o sub"ects  6herapy9 E cups blac# tea qd $ < ee#s.  4esults9 Blac# tea resulted in lo er soluble p&selectin, hich provides a potential mechanism for cardiovascular benefits of regular tea ingestion. o CAD: 5tudy A9<E2  %esign9 4andomi(ed controlled crossover clinical trial.  1atients9 5i$ty si$ patients ith proven coronary artery disease.  6herapy9 Blac# tea & <E0 ml once to measure short&term benefits. Blac# tea W C00 ml $ < ee#s to measure long&term benefits.  4esults9 Both short& and long&term tea consumption improved endothelium&dependent flo &mediated dilation of the brachial artery. 1lasma flavonoids increased after short& and long&term tea consumption. ,t as concluded that blac# tea reverses endothelial vasomotor dysfunction, partly e$plaining the association bet een tea inta#e and decreased cardiovascular disease events. 5tudy 29<E3  %esign9 4andomi(ed, controlled, cross&over clinical trial  1atients9 )orty nine patients ith !A%  6herapy9 <E0 m. of blac# tea or ater, follo ed by C00 m. of tea or ater qd $ < ee#s  4esults9 Acute and chronic blac# tea consumption does not affect e$ vivo platelet aggregation in patients ith !A%. 6hese findings suggest that an effect of tea flavonoids on platelet aggregation is unli#ely to be the e$planation for the reduction in ris# of cardiovascular events noted in epidemiological studies. o Anti<o*idant potential: 5tudy A9:%:  %esign9 4andomi(ed controlled clinical trial  1atients9 :ine healthy patients, 2F&EC yo, A male, B females.  6herapy9 %ay A W no tea, days 2&3 W blac# tea ith mil# or blac# tea alone at hourly intervals bet een Cam and A< pm.  4esults9 5ub"ects ho consumed blac# tea ithout mil# had ferric reducing anti&o$idant po er =)4A1> increased by HFG measured at AEpm. +eavy consumption of blac# tea appears to elevate circulating anti&o$idant potentials in vivo, the effect hich appears to be negated by the drin#ing of tea ith mil#. 5tudy 29<EE  %esign9 !linical trial  1atients9 :ot stated in the abstract  6herapy9 6ea ith mil#, tea ithout mil#, and lemon tea

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4esults9 5ignificant decrease in serum lipid pero$idation level as observed half hour after ingestion of lemon and tea ithout mil#. 6he decrease is much significant in case of lemon tea than tea ithout mil# after half hour or one hour. ,nterpretation9 tea ithout mil# is a good anti&o$idant, and addition of lemon to tea increases its anti&o$idant potential. 5tudy 39<EF  %esign9 !ross&over clinical trial  1atients9 6 enty&one healthy volunteers = A0 male, AA female>  6herapy9 Blac# tea, green tea =2 g tea solids in 300 ml ater> or ater ith or ithout mil# W single dose.  4esults9 !onsumption of blac# tea resulted in a significant increase in plasma antio$idant activity reaching ma$imal levels at about F0 min. A larger increase as observed after consumption of green tea. As anticipated from the higher catechin concentration in green tea, the rise in plasma total catechins as significantly higher after consumption of green tea hen compared to blac# tea. Addition of mil# to blac# or green tea did not affect the observed increases in plasma antio$idant activity. 5tudy <9<EH  %esign9 4andomi(ed controlled clinical trial.  1atients9 6 enty healthy men  6herapy9 < hot drin#s W green tea and blac# tea =each at a dose equivalent to < standard cups>.  4esults9 Blac# tea has a mild acute effect on e$ vivo lipoprotein o$idation in human serum. o ,nflammation' hemostasis' and endothelial markers::%/  %esign9 4andomi(ed controlled clinical trial  1atients9 5i$ty&four healthy smo#ing volunteers  6herapy9 Blac# tea, green tea, green tea polyphenol isolate and mineral ater $ < ee#s =A3&AF per group>.  4esults9 6ea drin#ing had no effect on the levels of inflammation, haemostasis and endothelial cardiovascular ris# factors that ere measured in the study. Dermatology: o ,mpetigo contagiosa::%5  %esign9 4andomi(ed controlled clinical trial  1atients9 0ne hundred and four patients ith impetigo contagiosa, A months W <0 years, median W < years old, <H females and EH males. '$perimental W F< patients, control W <0 patients. 6hirty&five patients ere s abbed9 5. aureus or 5.aureus and 5trep. pyogenes ere isolated.  6herapy9 6ea liquor =lotion> and ointment W e$perimental. !ontrols W framycetin and gramicidin, or oral cephale$in.  4esults9 6ea ointment as very effective ith a cure rate of BA.3G. )ramycetin and gramicidin group W cure rate H2.2G, cephale$in group W cure rate HB.FG. Dentistry: o Dental pla?ue::&8  %esign9 4andomi(ed placebo&controlled clinical trial.  1atients9 AE0 healthy volunteers  6herapy9 !hinese green tea@s polyphenol tablet 6,% $ 3 ee#s or $ F ee#s.  4esults9 1olyphenol tablet had evident anti&plaque effect. After 2 ee#s of treatment the plaque inde$ of e$periment groups as lo er than in placebo group, and as #ept lo er for 3 ee#s after stopping the use of the tablet. o 9ingival inflammation::&"  %esign9 4andomi(ed double&blind placebo&controlled clinical trial.  1atients9 )orty&seven patients ith inflammation of gingival, mean age 2E.HF years.  6herapy9 !he B candies containing green tea e$tracts qd.  4esults9 6here as a distinct improvement in both appro$imal plaque inde$ and sulcus bleeding inde$ values in the e$periment groupK slight orsening of the values ere determined for the placebo group. 6he results indicate that the oral application of green tea catechins and polyphenols might have a positive influence on the inflammatory reaction of periodontal structures. #sychology: o Cognitive' psychomotor performance' sleep2:&0  %esign9 4andomi(ed five& ay crossover controlled clinical trial.  1atients9 6hirty healthy volunteers  6herapy9 A&2 cups of tea =3H.E mg or HE mg caffeine>, or coffee =HE mg or AE0 mg caffeine> or ater 2,%. =Cam, Apm, E pm, AA pm> 

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4esults9 ,ngestion of caffeinated beverages may maintain aspects of cognitive and psychomotor performance throughout the day and evening hen they are administered repeatedly. %ay&long tea consumption produces similar alerting effects to coffee, despite lo er caffeine levels, but is less li#ely to disrupt sleep. 3ncology: o 4olid tumors::&7  %esign9 1hase , clinical trial.  1atients9 cohorts of three or more adult cancer patients. A total of <C patients ere studied. 1atient characteristics9 median age, EH yearsK 23 patients ere omenK CBG had a 8ubrod 15 of AGK CBG had 15 of AK and 2A had non&small& cell lung, AC had head ]nec# cancer, three had mesothelioma, and si$ had other.  6herapy9 0ral green tea e$tract =*6'> qd or 6,% $ < ee#s. %ose levels of 0.E to E.0E g3m=2> qd and A.0 to 2.2 g3m=2> tid ere e$plored.  4esults9 6he ma$imum&tolerated dose as <.2 g3m=2> 2% or A.0 g3m=2> 6,%. :o ma"or responses occurredK A0 patients ith stable disease completed F months of *6'. A dose of A.0 g3m=2> tid =equivalent to H to B -apanese cups QA20 m.R of green tea three times daily> is recommended for future studies. o 3ral leukoplakia::&:  %esign9 4andomi(ed, double&blind, placebo&controlled trial.  1atients9 6hirty si$ patients ith oral leu#opla#ia induced by smo#ing.  6herapy9 /i$ed tea, 3 g qd po and 0.AG concentration smeared on mucosa lesion 6,% $ 3 mo amd $ F months.  4esults9 /icronuclei formation in e$foliated oral buccal mucosa cells decreased, hich indicates that mi$ed tea may reduce the oral cancer ris# by preventing %:A damage damage in oral leu#opia#ias induced by cigarette smo#ing. o U- radiation inBury::&%  %esign9 !linical trial  1atients9 :ormal volunteers e$posed to 2 minimal erythema dose solar simulated radiation 30 min post therapy  6herapy9 '$tract of green tea or one of its constituents topically  4esults9 Application of green tea e$tracts resulted in a dose&dependent inhibition of the erythema response evo#ed by U7 radiation. 6he =&>&epigallocatechin&3&gallate ='*!*> and =&>&epicatechin&3&gallate ='!*> polyphenolic fractions ere most efficient at inhibiting erythema, hereas =&>&epigallocatechin ='*!> and =&>&epicatechin ='!> had little effect. 0n histologic e$amination, s#in treated ith green tea e$tracts reduced the number of sunburn cells and protected epidermal .angerhans cells from U7 damage. *reen tea e$tracts also reduced the %:A damage that formed after U7 radiation. 

#harmacy: ,nfusion9 A heaping tsp. =A tsp. O 2.E g>3cupK steep 2 W A0 min.K A cup 2% W 6,%. Alternatively, if green tea is steeped for more than 2 minutes, there is an increase in tannins hich precipitate the caffeine and thus the stimulatory effects from the tea is decreased. 5timulation from green tea is more li#ely to occur ith an infusion time of under 2 minutes since caffeine is very ater&soluble and ill be e$tracted before the ma"ority of the tannins. *reen tea standardi(ed e$tract9 300&<00 mg polyphenols3dayK standardi(ed to B0G polyphenol and EEG epigallocatechin gallate. Contraindications: Brin#er contraindicates the use of !amellia in<FF • speculative9 #idney disorders, duodenal disorders, heart disorders, psychological disorders, prolonged use =blac# tea>, pregnancy, nursing • clinical studies9 young children due to increased incidence of microcytic anemia, possibly due to precipitation of iron by tannins. )o*icity: 6here is no reported to$icity associated ith 2amellia sinensis. +o ever, e$cessive use of caffeine may cause arrhythmias, insomnia, tremors, an$iety, dyspepsia, constipation, headache, restlessness neuralgia, difficult breathing, ringing in the ears, physical and mental e$haustion, and other deleterious effects and thus individuals sensitive to the effects of caffeine may not tolerate 2amellia sinensis.
411 412

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. H0 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 413 +e ;+, ?ies !, Plant oods Hum ;utr, ACC<K <F9 22A. 414 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 415 +u 82, 6oda /, 0#ubo 5, +ara ;, 5himamura 6, >nt 7 >mmunopharmacol, ACC2KA<9A3CC. 416 ,#igai +, :a#ae 6, +ara ;, 5himamura 6, Biochem Biophys )cta, ACC3KAA<H9A32. 417 4yu ', >nt 7 ?oonoses, ACB2KC9A2F. 418 :a#ayama /, et al, )nti!iral Res, ACC3K2A92BC. 419 :a#ane +, 0no ?, Biochemistry, ACC0K2C92B<A.

420 421

5hetty /, 5ubbannayya ?, 5hivananda 1*, 7 2ommun Dis, ACC<K2F=3>9A<H. ?han 5*, ?atiyar 5?, Agar al 4, /u#htar +, 2ancer Res, ACC2KE29<0E0. 422 Bu Abbas A, !lifford /:, ,oannides !, Wal#er 4, ood 2hem Toxicol, ACCEK3392H. 423 /u#tar +, Wang 8;, ?atiyar 5?, Agar al 4, Pre! Med, ACC2K2A93EA. 424 5erafini / *hiselli A, )erro&.u((i, Eur 7 2lin ;utr, ACCFKE092B. 425 5igler ?, 4uch 4-, 2ancer 8ett, ACC3KFC9AE. 426 ?omori A, ;atsunami -, 0#abe 5, Abe 5, +ara ?, 5uganuma /, ?im 5-, )u"i#i +, 7pn 7 2lin "ncol, ACC3K239ABF. 427 +ayatsu +, ,nada :, et al, Pre! Med, ACC2K2A93H0. 428 6aniguchi 5, et al., 2ancer 8ett1,ACC2KFE9EA. 429 BuAbbas A, !lifford /:, Wal#er 4, ,oannides !, Mutagenesis, ACC<KC932E. 430 5asa#i ;), et al, Mutat Res, ACC3K 2BF922A. 431 'lmets !A, 5ingh %, 6ubesing ?, et al. !utaneous photoprotection from ultraviolet in"ury by green tea polyphenols. 7 )m )cad Dermatol1 200AK<<9<2EW<32. 432 Agar al 4, ?atiyar 5?, ?han 5#, /u#htar +, Photochem Photobiol,ACC3KEB9FCE. 433 5hutsung ., +iipa##a 4A, Biochem Biophys Res12omm, ACCEK2A<9B33. 434 *roff -., *ropper 55, +unt 5/, )d!anced ;utrition and Human Metabolism, 2nd ed., ACCE, 5t. 1aul, /:9 West 1ubl. !o., <CF. 435 4obertson %, Wade %, Wor#man 4, et al, 7 2lin >n!est, ACBAKFH9AAAA. 436 /iura 5, et al, Biol Pharm Bull, ACCEKAB9A. 437 ,mai ?, :a#achi ?, Brit Med 7, ACCEK3A09A32. 438 /ar#s 7, Tea: 2ulti!ation to 2onsumption, ACC2, =eds. ?! Willson and /: !lifford>, :;9 !hapman and +all 1ubl., H0H. 439 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 440 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 20< 441 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 442 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 443 van het +of ?+, de Boer +5/, 7iseman 5A, et al. !onsumption of green or blac# tea does not increase resistance of lo &density lipoprotein to o$idation in humans. )m 7 2lin ;utr ACCHKFF9AA2EW32. 444 ,mai ?, :a#achi ?. !ross sectional study of effects of drin#ing green tea on cardiovascular and liver diseases. BM71 ACCEK3A09FC3WFCF. 445 *oto ?, ?anaya 5, :ishi#a a 6, et al. 6he influence of tea catechins on fecal flora of elderly residents in long&term care facilities. )nn 8ong9Term 2are ACCBKF9<3WB. 446 *oto ?, ?anaya 5, ,shigami 6, +ara ;. 6he effects of tea catechins on fecal conditions of elderly residents in a long&term care facility. 7 ;utr ,ci Gitaminol ACCCK<E9A3EW<A. 447 /u#htar +, Ahmad :. *reen tea in chemoprevention of cancer. Toxicol ,ci ACCCKE2=2 5uppl>9AAAWH. 448 .i :, 5un 8, +an !, !hen -. 6he chemopreventive effects of tea on human oral precancerous mucosa lesions. Proc ,oc Exp Biol Med ACCCK22092ABW2<. 449 !hantre 1, .airon %. 4ecent findings of green tea e$tract A42E ='$olise> and its activity for the treatment of obesity. Phytomedicine 2002KC=A>93&B 450 +odgson -/, 1uddey ,B, Bur#e 7, et al. 4egular ingestion of blac# tea improves brachial artery vasodilator function. 2lin ,ci 08ondB 2002KA02=2>9ACE&20A. 451 +odgson -/, 1uddey ,B, /ori 6A, et al. 'ffects of regular ingestion of blac# tea on haemostasis and cell adhesion molecules in humans. Eur 7 2lin ;utr 200AKEE=A0>9BBA&F 452 %uffy 5-, ?eaney -) -r, +olbroo# /, et al. 5hort& and long&term blac# tea consumption reverses endothelial dysfunction in patients ith coronary artery disease. 2irculation 200AKA0<=2>9AEA&F. 453 %uffy 5-, 7ita -A, +olbroo# /, et al. 'ffect of acute and chronic tea consumption on platelet aggregation in patients ith coronary artery disease. )rterioscler Thromb Gasc Biol 200AK2A=F>9A0B<&C. 454 .angley&'vans 5!. !onsumption of blac# tea elicits an increase in plasma antio$idant potential in humans. >nt 7 ood ,ci ;utr 2000KEA=E>930C&AE 455 6e ari 5, *upta 7, Bhattacharya 5. !omparative study of antio$idant potential of tea ith and ithout additives. >ndian 7 Physiol Pharmacol 2000K<<=2>92AE&C. 456 .eenen 4, 4oodenburg A-, 6i"burg .B, et al. A single dose of tea ith or ithout mil# increases plasma antio$idant activity in humans. Eur 7 2lin ;utr 2000KE<=A>9BH& C2 457 +odgson -/, 1uddey ,B, !roft ?%, et al. Acute effects of ingestion of blac# and green tea on lipoprotein o$idation. )m 7 2lin ;utr 2000KHA=E>9AA03&H 458 de Maat MP, Pijl H, Kluft C, et al. Con u!"tion of #lac$ and %&een tea 'ad no effect on infla!!ation, 'ae!o ta i , and endot'elial !a&$e& in !o$in% 'ealt'( indi)idual . Eur J Clin Nutr 2000*54+10,-757.63. 459 5harquie ?', al&6urfi ,A, al&5alloum 5/. 6he antibacterial activity of tea in vitro and in vivo =in patients ith impetigo contagiosa>. 7 Dermatol 2000K2H=AA>9H0F&A0. 460 .iu 6, !hi ;. '$perimental study on polyphenol anti&plaque effect in human. ?honghua .ou Hiang Ai @ue ?a ?hi 2000K3E=E>93B3&<. 461 ?rah in#el 6, Willershausen B. 6he effect of sugar&free green tea che candies on the degree of inflammation of the gingiva. Eur 7 Med Res 2000KE=AA>9<F3&H. 462 +indmarch ,, 4igney U, 5tanley :, et al. A naturalistic investigation of the effects of day&log consumption of tea, coffee and ater on alertness, sleep onset and sleep quality. Psychopharmacology0BerlB 2000KA<C=3>9203&AF. 463 1isters ?/, :e man 4A, !oldman B, et al. 1hase , trial of oral green tea e$tract in adult patients ith solid tumors. 7 2lin "ncol 200AKAC=F>9AB30&B 464 .i :, 5un 8, .iu 8, et al. 5tudy on the preventive effect of tea on %:A damage of the buccal mucosa cells in oral leu#opla#ias induce by cigarrete smo#ing. +ei ,heng Aan 7iu ACCBK2H=3>9AH3&<. 465 'lmets !A, 5ingh %, 6ubesing ?, et al. !utaneous photoprotection from ultraviolet in"ury by green tea polyphenols. 7 )m )cad Dermatol 200AK<<=3>9<2E&32. 466 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.ABH

Capsella !ursa<pastoris
Common name: 5hepherdNs 1urse Ha!itat: common plant gro ing all over the orld e$cept the tropics

Cruciferae

Botanical description: 6he plant is green, but some hat rough ith hairs. 6he leaves are 2&F inches long, variable in form from lanceolate to pinnately lobed, sometimes toothed, sometimes hairy. When not in flo er, its radiating leaves close to the earth distinguish the plant. A slender stem bears numerous hite, 2&3 mm, inconspicuous flo ers. 6he pod is an inverted, notched triangle containing the small seed. 6he odor is peculiar and some hat unpleasant. #arts Used: aerial parts ith the fresh herb being more active than dried <FH Constituents: )lavonoids, polypeptides, fumaric and bursic acids, choline, acetylcholine, histamine, tyramine bases, o$alates, vitamin ?, vitamin !, β&carotene, potassium, calcium #harmacology: 5tudies of the constituents of !apsella are inconclusive as to hich constituents are responsible for the actions of the plant. 6he polypeptides are thought to be responsible for the uterine contractile actions =similar to the contractions produced by o$ytocin>. 6he flavonoids are thought to contribute to the anti&inflammatory and anti&ulcer actions of the plant. Administration of !apsella produces a transient decrease in blood pressure, hich could be due to the acetylcholine. 6he hemostatic action is believed to be due to the high content of o$alic and dicarbo$ylic acids.<FB Medicinal actions: Anti&hemorrhagic, urinary antiseptic, antipyretic, uterine stimulant3 emmenagogue, diuretic Medicinal use: %ue to the antihemorrhagic effect, !apsella can allay internal bleeding in any site, but has most efficacy in staunching bleeding from ulcerated tissues =lung, stomach, #idneys, etc.>. ,ts styptic actions are noted on e$ternal application in the treatment of ounds, hemorrhoids, and epista$is. • *ynecologic !onditions9 !apsella is used for the most part as a styptic in the reproductive tract. !apsella is most indicated in cases of uterine hemorrhage. !apsella is also used to reduce menorrhagia =specifically ith colorless flo >, perhaps by stimulating uterine contractions and therefore uterine tone hile e$erting a styptic effect. 1ale colored blood is an sign of anemia, hich is a minor indication for !apsella due to the nourishment that it provides. • *enitourinary !onditions9 !apsella is also a soothing, mildly stimulating diuretic, most indicated in cases of hematuria and urinary sediment. )ccording to Mills and Bone:'$* • *ynecologic !onditions9 !apsella is a uterine antihemorrhagic and is utili(ed in the treatment of uterine myomas, one of the most common causes of menorrhagia. !apsella has also been indicated for bleeding from threatened miscarriage. )ccording to the Textboo3 of ;atural Medicine :'4• *ynecologic !onditions9 ,ntravenous and intramuscular in"ections have been found effective in menorrhagia due to function abnormalities and fibroids. )ccording to +eiss:'4% • *ynecologic !onditions9 Although !apsella has hemostatic properties, the actions are inconsistent. 6here is li#elihood that the active principles are soon destroyed in the gastrointestinal tract although this action is not fully investigated. Apparently the hemostatic principles are formed after storage through the conversion of other principles and are lost again as further conversion occurs ith e$tended storage. !apsella is far from satisfactory in obstetrics and is most indicated for chronic uterine bleeding such as essential uterine hemorrhage and hemorrhage due to myoma. )ccording to .ing/s:'4& • *enitourinary !onditions9 ,n urinary derangements of renal or cystic origin and in hematuria , an infusion, an especially a tincture of the herb ill be found very efficient. • *ynecologic !onditions9 ,t has li#e ise been used ith some success for the promotion of the catamenial flo in cases of simple amenorrhea. ,t is a remedy for chronic menorrhagia, ith too frequent and too long&continued or constant, but almost colorless flo . Associated ith this condition are a frequent urging to urinate, and a deposit of phosphates. • *astrointestinal !onditions9 )tonic dyspepsia and chronic diarrhea have been successfully treated ith it. ,n bleeding piles, diarrhea and dysentery it is stated to have been found beneficial. • 1ulmonary !onditions9 ,t has been used ith some success as an e$pectorant. #harmacy: ,nfusion9 3&E gm3dayK =for heavy bleeding9 Eg3cup 6,%> QA tsp. O A.EgR =%r. Alschuler>

A&2 tsp.3 glass, boiled briefly, sig 2&< cups qd =Weiss> 5pecific 6incture9 A&2 drams =A3B to U o(.> or A&30 drops q 2&3 hours =?ing@s> '$tract9 A93 2EG '60+K sig 2&A0 ml 6,% =A0 ml 6,% for heavy bleeding> =%r. Alschuler> L tsp. every L hour for <&F doses for heavy bleeding =%ipasquale> A9A, sig E ml bid to tid =Weiss> 20&F0 minims 1oultice, !ompress for e$ternal bleeding =Alschuler> or ecchymosis and rheumatic pains =?ing@s> Uterine myoma formula9<H3 A92 fluid e$tracts sig E ml tid !apsella bursa&pastoris =20>, Achillea millefolium =2E>, 6hu"a occidentalis =20>, 'chinacea angustifolia =20> 1ana$ notoginseng =AE> Contraindications: Brin#er suggests contraindication ith pregnancy due to its emmenagogue and abortifacient effects =empirical> and its uterine stimulant action as demonstrated in vitro and in animal studies. <H< !onsidering that !apsella contains o$alate salts, its use should be ta#en into consideration if the patient has a history of o$alate #idney stones.<HE 6he vitamin ? content should be considered if large quantities are used for a ee# or more in patients concurrently ta#ing anticoagulant medications.<HF )o*icity: Weiss considers !apsella perfectly safe.
467 468

)elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. <32 /urray /, 1i((orno '. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p. A<00 469 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 2<2 470 /urray p. A<00 471 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. 3AA 472 )elter, p. <32 473 /ills and Bone, p2<3 474 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A23 475 Brin#er p. AEA 476 Brin#er p. AFH

Capsicum annuum 12 var2 frutescens
Common name: cayenne, red pepper Ha!itat9 0riginated in tropical Americas then introduced into ,ndia and Africa.

4olanaceae

Botanical Description: A shrubby perennial plant 2&F feet high ith angular purplish branches. !aly$ five&cleft, erectK corolla hite. 6he leaves are long stal#ed, ovate or oblong, nearly entire, occasionally in pairs. 6he fruit is typically red and can reach up to A0 cm. in length. 6he fruit is oblong&conical in shape. 6he pericarp is glabrous, shriveled and orange&red. 'ach fruit contains A0&20 seeds hich are flattened and 3&< mm long. #arts used9 )ruit Constituents9 <HH • !apsaicin =0.A&A.EG> compounds hich is a mi$ture of9 capsaicin, dihydrocapsaicin, nordihydrocapsaicin, homodihydrocapsaicin. • !arotenoids9 capsanthin, capsorubin, carotene • Ascorbic acid =0.A&0.EG>, • 6ocopherols • 5teroidal saponins =capsicidins> in seeds and root. #harmacology: !apsaicin relieves pain and itching by temporarily stimulating release of various neurotransmitters from !&fiber afferent neurons, leading to their depletion. Without the neurotransmitters, pain signals can no longer be sent. %epletion ta#es appro$imatley three to ten days to occur after administration < times per day for H days. 0nce analgesia occurs, application should continue for three times per day. 0ther substances that deplete substance 1 are found in 8ingeber and !urcuma. Medicinal actions: !irculatory stimulant, tonic, carminative, spasmolytic, diaphoretic, antiseptic, rubefacient, counter&irritant. )raditional Medicinal Use: 5pecific ,ndications and Uses: /ar#ed depression and debilityK atonic dyspepsia of drun#ardsK delirium tremensK colic, ith abdominal distensionK congestive chillsK cold e$tremities, ith blanched lips and small, ea# pulseK congestion, ith capillary atonyK tongue dry and harsh, and buccal and salivary secretions scanty, in feversK chronic hemorrhoids, from rela$ation. <HB Both ?ing and !oo# described the fruit of !apsicum as one of the purest of all #no n stimulants, having a long lasting action that spreads through the system rather slo ly, but ultimately reaching every organ of the body. When used in a considerable dose, it e$cites the stomach strongly, yet is diffused so slo ly that for a time it disturbs the equilibrium of circulation and nervous action bet een the stomach and the ad"acent partsK and hence large quantities may be follo ed, for a short time, by hiccough, and even by a cramping pain in the stomach. 6his botanical as considered indicated for all forms of depression and atony, especially here these are dependent upon feebleness of either generalor local circulation, or loss of nerve po er not connected ith local irritability and acts also upon the nervous structures. 6he secernents all feel the beneficial effects of the article. !apsium as also used for the purpose of arousing tissues so that they ill respond to the impressions of other remedies. ,t relieves the e$treme restlessness hich usually accompanies depressed, atonic conditions on hich account it as combined associated ith .obelia and !ypripedium to secure an antispasmodic action. !apsicum is also appropriate in the the young and old, but is particularly useful in old people hen the body&heat is lo , vitality depressed, and reaction sluggish. • Behavioral31sychological !onditions9 According to ?ing, in the atonic dyspepsia of dipsomania 0alcoholismB it ta#es the place of alcoholic stimulants, removing the craving for alcoholics and sense of sin#ing at the pit of the stomach, prevents the morning sic#ness and vomiting, restores gastric tone and promotes the digestion of holesome food. ,t should be administered henever the desire for drin# comes on. • !ardiovascular !onditions9 !apsicum as believed to act mainly upon the circulation, first effecting the heart and the large and central blood vesselsK and subsequently traverses from the center to the capillaries. 6his action as thought to slo ly increase circulatory tone, though not so materially as to increase the frequency of the pulse, but giving po er to the pulse. ,n cases here the pulse is enfeebled or a creeping, iry, unsteady and very small pulseK and very much hurried from putrescent tendencies =conditions of morbid accumulations such as suppuration>, !apsicum as used resulting in diminished frequency but greater firmness of the arterial action. According to !oo#, this agent as also one of the most po erful arrestors of gangrene by virtue of its antiseptic qualities and its great influence in sustaining the circulatory function. • *astrointestinal !onditions9 !apsicum as used to directly arouse the stomach, being indicated in cases of indigestion

connected ith torpor, sluggishness, and loss of sensibility here it as generally combined ith rela$ing tonics. ,n atonic dyspepsia and catarrhal gastritis it stimulates the nerves of the stomach, promotes the secretion of the digestive "uices, and assists peristaltic motion. !ombined in small quantities ith cathartics, !apsicum as used to increase their intensity and prevent griping. ,ts o n steady stimulation of the bo els as relied on ithout cathartics as an aperient, particularly in persons suffering from a semi&paraly(ed condition of the gastrointestinal tract. !apsicum is said to reduce irritation and increase capillary activity in the rectum and may be a remedy for diarrhea, constipation, piles, and in dysentery, here the stools are bloody, the mucus tenacious, ith tenesmus and burning. 6hese cases are those in hich there is a la$ habit of body ith feeble digestion. • *enitourinary !onditions9 !apsicum is said to reduce irritation and increase capillary activity in chronic renal congestion as the 'clectics used it to affect the tenesmic action of the bladder in the presence of a la$ habit of body ith feeble digestion. • *ynecologic !onditions9 !apsicum has been used in passive hemorrhages, especially uterine, and, hen combined ith the compound po der of ,pecacuanha = an 'clectic preparation W see ?ing@s> ill, in many instances, promptly arrest hemorrhage after parturition. • ,nflammatory !onditions9 6he 'clectics utili(ed !apsicum in congestive intermittent fevers, reducing the needed dose of quinine. to quinine. ,t as also used in lo fevers, here there is dryness and constriction of the tissues, and the tongue is dry and harsh and there is but little buccal or salivary secretion. • /etabolic !onditions9 Alterative preparations of !apsicum ere designed for secondary syphilis, mercurial poisoning, etc., here the tone of the system as considered impaired. • :eurological !onditions9 ,n delirium tremens, it as considered the best of all stimulants by both the 'clectics and 1hysiomedicalists, in combination ith nervines. • 1ulmonary !onditions9 !apsicum as applied n degenerate coughs, ith a too abundant and tenacious e$pectoration. • 6opical Applications9 As an out ard application, !apsicum as considered one of the best bases of all stimulating liniments arousing circulation. ,t also made a e$ternal remedy for all internal inflammations and congestions, having been used freely as deep congestions require enormous quantities of it before it is felt. !oo# called it one of the best agents, both internally and e$ternally, in paralysis as a ash or used as a plaster in deep paralysis and over helming spinal congestion, to the entire length of the spine. +e also included its use in conditions here there is an Iover helming determination of blood to the brainJ =inflammatory processes involving the !:5 such as meningitis>, and the e$tremities become almost icy cold. )or such cases he applied !apsicum to the feet in the base of a paste. ,n suppurating difficulties about the throat, its liberal out ard application as the 1hysiomedical treatment. .ocally, !apsicum as an indispensable agent in malignant and indolent ulcers and carbunclesK in all sloughing sores and on all forms of gangrene. Current Medicinal Use: 6he fruit of 2apsicum frutescens is one of the purest of all #no n stimulants. ,t acts ith force and has a long& lasting, spreading effect. ,t acts mainly on the circulation and nerves to give increased tone to circulation manifested as increased force of the pulse. 4ed pepper relieves flatulence, increases appetite, and promotes urination. ,t is a stimulant in phlegmatic disorders, paralysis, and stomach atony. 2apsicum frutescens ill stimulate the function of most internal organs, especially hen they are in a congested, ea#ened state such as congested lungs, renal insufficiency, uterine atony, and feeble pulse. ,n summary, 2apsicum frutescens should be reserved for use hen significant stimulation is required. !apsicum frutescens has been evaluated for the relief of pain associated ith a great number of diseases. 6hese include9 post& mastectomy syndrome, urticaria, psoriasis, diabetic neuropathy, arthritis, osteoarthritis, pruritis, post&surgical neuromas, and others. • !ardiovascular !onditions9 6he vasodilating property of 2apsicum frutescens lends it systemic application. !ayenne acts upon the temperature regulatory center to increase body temperature. ,t also causes rubifaceant and diaphoretic effects. !ayenne, used by itself, can effectively restore proper circulation in the e$tremities. 2apsicum frutescens and 5in3go biloba combine ell together in the treatment of 4aynaud@s syndrome. ,t also sustains portal circulation. !apsicum ingestion appears to induce an increase in fibrinolytic activity and hypocoaguability of the blood. 6his has been demonstrated in 6hai people ho eat hot peppers daily. • %ermatologic !onditions9 6he hot principal in cayenne peppers, #no n as capsaicin, is used for many painful conditions, including shingles and postherpetic neuralgia. ,n a double&blind trial, a cream containing 0.0HEG capsaicin, applied three to four times per day to the painful area, greatly reduced pain. ,n another study, a lo er concentration of capsaicin =0.02EG> as also effective. 6 o or more ee#s of treatment may be required to get the full benefit of the cream. <HC, <B0 ,n psoriasis and pruritic conditions !apsaicin desensiti(es !&fibers hich reduced pain and itching. <BA, <B2 • *astrointestinal !onditions9 2apsicum frutescens is used to relieve flatulence and intestinal colic. ,t ill stimulate a ea#ened

stomach, increases gastric acid secretion <B3, and increases the intensity of cathartics hile preventing the gripping that is often associated ith their use. Additionally, it is a circulatory stimulant thus increasing blood supply to the digestive organs hence enhancing their activities =secretions and regular contractions>. !ayenne also has a counter&irritant effect hich causes vasodilation =and heat> in the tissues ith hich it comes into contact. 6his means that hile it enhances local blood flo in the gastrointestinal mucosa, it is also irritating, especially to ulcerated tissue. 2apsicum frutescens is therefore indicated in gastric and digestive atony and insufficiency, but relatively contraindicated in ulcerations and inflammations of the digestive tract. 6 o studies ere conducted to investigate the effects of red pepper =capsaicin> on feeding behaviour and energy inta#e. ,n the first study, the effects of dietary red pepper added to high&fat and high&carbohydrate meals on subsequent energy and macronutrient inta#es ere e$amined in thirteen -apanese female sub"ects. 6he results indicate that the ingestion of red pepper decreases appetite and subsequent protein and fat inta#es in -apanese females and energy inta#e in !aucasian males. /oreover, this effect might be related to an increase in sympathetic nervous system activity in !aucasian males. <B< • *enitourinary !onditions9 !urrent pharmacologic treatment of the overactive bladder relies on anticholinergic drugs. +o ever, these drugs often have troublesome side effects and frequently are given in doses insufficient to restore continence in patients ith detrusor instability. 0ne study presented the bac#ground and clinical research dealing ith intravesical instillation of capsaicin and resinfferato$in as treatments for the overactive bladder as capsaicin desensiti(es !&fiber afferent neurons, hich may be responsible for the signals that trigger detrusor over activity. 5tudies ith capsaicin over the past B years have demonstrated clinical efficacy ith minimal long&term complications. /ost of these studies have also sho n that the acute pain and irritation associated ith capsaicin are a ma"or deterrent to idespread use. <BE • /etabolic !onditions9 6he effects of dietary hot red pepper on energy metabolism at rest and during e$ercise ere e$amined in long distance male runners AB&23 yr of age. A standardi(ed meal as given on the evening prior to the e$periment. 6he sub"ects had a meal =2H20 #-> ith or ithout A0 g of hot red pepper for brea#fast. %uring rest =2.E h after meal> and e$ercise =pedaling for A h at AE0 W, about F0G 702 ma$, using cycling ergometry>, e$pired gasses and venous blood ere collected. 6he meal ith hot red pepper significantly elevated respiratory quotient and blood lactate levels at rest and during e$ercise. 0$ygen consumption at rest as slightly but not significantly higher in the hot red pepper meal at 30 min after the meal. 1lasma epinephrine and norepinephrine levels ere significantly higher in those ho had only hot red pepper at 30 min after the meal. 6hese results suggest that hot red pepper ingestion stimulates carbohydrate o$idation at rest and during e$ercise. <BF • 1ain !onditions9 !apsaicin administered via the nose can also be a useful therapy for cluster headaches. 6his is supported by double&blind studies. Wea#er scientific support e$ists for the use of capsaicin for migraines. <BH • 6opical Applications9 6opically, !apsicum frutescens increases circulation and ill cause hyperemia and blistering. 6opical applications of !apsicum frutescens ill relieve inflammation of the organs underneath hereas its internal use is contraindicated in inflammatory disorders. Applied topically it ill soften hardened s#in, dissolve discolorations, heal bites and stings, and gargled ill relieve toothache. !apsicum frutescens e$erts an analgesic effect systemically if ta#en internally or in the area of topical application. 6he depletion of substance 1 from sensory afferent nerves creates a temporary analgesic effect. 6hus, !apsicum frutescens is used to relieve pain associated ith +erpes (oster, arthralgias, and even headaches. 5everal double&blind trials have sho n that topical use of cayenne e$tract creams containing 0.02EW0.0HEG capsaicin reduces pain and tenderness caused by osteoarthritis. 6hese creams are typically applied 2,% for t o to four ee#s, after hich B,% application may be sufficient. 1roducts containing capsicum oleoresin rather than purified capsaicin may not be as effective. <BB, <BC, <C0 #harmacy9 All internal forms of capsicum are best tolerated if ta#en ith food. !apsicum may be used herever a pure stimulant is indicated, in all cases of diminished vital action, and may be combined beneficially ith other remedies, in order to promote their action, as emetics, cathartics, diaphoretics, tonics, etc. %ue to its stimulating nature it tends to enhance the tonifying and stimulatory effects of the other herbs in the formula. 1o der !apsules9 30&A20 mg three times daily =Alschuler> ,nfusion9 L to A tsp. po der per cup of ater, steepA0 minutesK mi$ A 6 this infusion ith hot ater and drin# prn=Alschuler> 6incture9 A93 6incture9 sig 0.2 ml three times dailyK ma$imum ee#ly dose is 3 ml =Alschuler> A920 tincture9 sig A ml three times dailyK ma$imum ee#ly dosage tincture is 20 ml =Alschuler> 0intment and creamZapply topically qid, pain ill be initially increased then subsides. At this point, usally 3&< days, application can be decreased to B,%. Analgesics can be used during the acute period of e$acerbation. Contraindications: !ontraindications to internal use include persons ith acute gastrointestinal inflammation or ulceration. According to !oo#, its use as also contraindicated in the presence of a full and hard pulse or in hot and burning s#in ith a large pulse. Brin#er suggests caution ith the use of !apsicum in acute asthma or inhalation due to bronchoconstriction ith initial systemic e$posure. +e contraindicates its application over damaged or hypersensitive s#in. <CA

1otential drug interactions include enhancement of theophylline absorption, increased sleeping time and plasma concentration of he$obarbital ith acute use = hich decreased ith chronic use>, reduced gastric mucosal damage hen ta#en an hour before aspirin, potentiation of coughing due to A!' inhibitors ith topical application, potentiation of platelet aggregation inhibitors. ,n general, acrid herbs increase intestinal absorption of medicines and other botanicals. <C2 )o*icity: Adverse reactions to topical application include9 burning, stinging, erythema, heat, pain, and ith prolonged use may cause permanent loss of sensory nerve function in the area of application. 5ymptoms of internal to$icity include9 heartburn, anal burning, gastric erosions. '$ternal adverse effects may occur if !apsicum e$tracts highly concentrated in capsaicin are applied for a prolonged period of time. =Alschuler> ,nternal to$icity may occur if !apsicum is ingested in quantities greater than the therapeutic doses a ay from food. ?ing notes that a drachm of red pepper may be s allo ed ith evident pleasure and ithout ill results. +o ever, larger doses may produce vomiting, purging, pains in the stomach and bo els, heat and inflammation of the stomach, giddiness, a species of into$ication, and an enfeebled condition of the nervous po er.<C3
477 478

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 479 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 480 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. F30&F3A. 481 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. F30&F3A. 482 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <A. 483 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <A 484 ;oshio#a /. 'ffects of red pepper on appetite and energy inta#e. Br - :utr. ACCC AugKB2=2>9AAE&23. 485 ?im %;. ,ntravesical neuromodulatory drugs9 capsaicin and resiniferato$in to treat the overactive bladder.- 'ndourol. 2000 )ebKA<=A>9CH&A03. 4evie . 486 .im ?2 %ietary red pepper ingestion increases carbohydrate o$idation at rest and during e$ercise in runners. /ed 5ci 5ports '$erc. ACCH /arK2C=3>93EE&FA. 487 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 488 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 489 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. F3A. 490 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2<B. 491 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. E0&A 492 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. E0&A 493 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3

Caryophyllus aromaticus ($ugenia carophyllus
Common name: !love Ha!itat9 'ast ,ndies

Myrtaceae

Botanical description9 'vergreen tree that gro s from A2 to 2E feet. )lo ers occur in corymbsK caly$ is green and becomes dull purple. 6he une$panded flo er&bud is the medicinal part and appears commerically as a dar#&red, cylindrical body, A&2 cm long ith < short thic# teeth at the summit enclosing the small globular bud. #arts used9 bud Constituents9 volatile oil =up to 20G consisting of eugenol, eugenin, caryphyllin> #harmacology: Medicinal actions: 5timulant, carminative, aromatic )raditional Medicinal Uses: )ccording to .ing: !arryophyllus is an aromatic, stimulant, and irritant. • *astrointestinal !onditions9 Used to allay !omiting and sic3ness at stomach, to stimulate the digestive functions, and to improve the flavor or operation of other remedies, and prevent a tendency to their producing sic#ness or griping. Current Medicinal Uses: • *astrointestinal !onditions9 !aryophyllus buds are a spicy, arming carminative. 6heir ingestion ill arm the gastrointestinal tract, stimulate digestive secretions and peristalsis via an irritant effect. !aryophyllus is most useful as a carminative that is associated ith nausea and vomiting and abdominal distention. • 6opical Applications9 6opical application of clove oil causes irritation to the s#in follo ed by partial anaesthesia. 6his application is particularly useful for the pain associated ith toothaches. • ,nsect repellant9 6he repellency of different concentrations =E, A0, 2E, E0, HE, and A00G> and combinations of E essential oils =Bourbon geranium, cedar ood, clove, peppermint, and thyme> to mosquitoes hen applied to human s#in as determined. 6hyme and clove oils ere the most effective mosquito repellents and provided A A32 to 3 A32 h of protection, depending on oil concentration. !love oil =E0G> combined ith geranium oil =E0G> or ith thyme oil =E0G> prevented biting for A A3< to 2 A32 h. 6he potential for using essential oils as topical mosquito repellents may be limited by user acceptabilityK clove, thyme, and peppermint oils can be irritating to the s#in, hereas both human sub"ects in this study "udged the odor of clove and thyme oils unacceptable at concentrations Y or O 2EG <C< • Blood thinner9 6 o anti&platelet components, eugenol and acetyl eugenol. 6hey inhibited arachidonate&, adrenaline& and collagen&induced platelet aggregationK they ere more potent in inhibiting aggregation by the first t o agonists. 6heir inhibitory effect as reversible. 6hese components ere antiaggregatory by a combination of at least t o effects9 =i> inhibition of platelet thrombo$ane formation, and =ii> increased formation of A2&lipo$ygenase products =A2&+1'6'>.<CE • 0ral antimicrobial9 6he antimicrobial action of natural substances as investigated in vitro against oral bacteria including 5treptococcus sp., Actinomyces sp., Actinobacillus sp., Bacteroides sp., !apnocytophaga sp., 'i#enella sp., )usobacterium sp. and 1ropionibacterium sp. Among the natural substances tested, hino#itiol as the most inhibitory to oral bacteria. !innamon bar# oil, papua&mace e$tracts, and clove bud oil in spice e$tracts ere also inhibitory against many oral bacteria. <CF #harmacy9 • ,nfusion9 L&Atsp3cupK A cup 6,%.<CH • 6incture9 A9E tinctureK 2.E ml 6,%. <CB • 0il9 c 0.A ml3day. <CC • 6opical9 for toothache put clove or oil on cotton ool near the tooth and #eep in the mouth. E00 )o*icity.4ide $ffects: • 6he potential of eugenol and of clove leaf oil, hich contains a high concentration of eugenol, to induce delayed s#in hypersensitivity or to elicit reactions due to pre&e$isting s#in sensiti(ation in man as evaluated by analysing patch&test data. 6he survey indicates that, at the concentrations present in consumer products, eugenol alone or as part of clove leaf oil has a very lo potential either to elicit pre&e$isting sensiti(ation =NelicitedN reactions> or to induce hypersensitivity =NinducedN reactions>.E0A

494 495

%.4. Barnard, I4epellency of 'ssential 0ils to /osquitoes =%iptera9 !ulicidae>,J. 7 Med Entomol, 5ep ACCC 7ol. 3F, :um. E, pp. F2E&C. ?.5. 5rivastava, IAntiplatelet 1rinciples )rom a )ood 5pice !love =5y(ygium aromaticum .>J QcorrectedR, Prostaglandins 8eu3ot Essent atty )cids, /ay ACC3, 7ol. <B, :um E, pp. 3F3&H2. 496 ;. 5ae#i, IAntimicrobial Action of :atural 5ubstances on 0ral Bacteria, Bull To3yo Dent 2oll, Aug ACBC, 7ol. 30, :um. 3, pp. A2C&3E. 497 Alschuler 498 Alschuler 499 Alschuler 500 %avid +offman, The ;e: Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesbury, %orset, ACC0, p. AC2. 501 A. 5. 4othenstein, I'ugenol and !love .eaf 0il9 a 5urvey of !onsumer 1atch&6est 5ensiti(ation,J ood 2hem Toxicol, %ecember ACB3K 7ol. 2A, :um. F, pp. H2H&33.

Cassia spp2
!. acutifolia, !. obovata, !. angustifolia, !. lanceolata Common name: 5enna Ha!itat9 Africa, 'gypt, ,ndia

1eguminosae

Botanical description9 5enna is a 2 foot high shrub ith greyish to yello ish green leaves that are lanceolate about A&E cm long and 0.E cm ide. 6he pods are #idney shaped, flat ith the imprint of the seed sho ing through the pod. #arts used9 .eaves, pod Constituents9 Anthraquinone glycosides =sennosides and their aglycones>, naphthalene glycosides, misc. mucilage, flavonoids, volatile oil, sugars, resins #harmacology: 6he anthraquinones are absorbed into the blood, re&secreted into the colon as active anthraquinones here they stimulate smooth muscle contraction. ,nterestingly, as the anthraquinones circulate in the blood, the heart rate decreases. +o ever, once they are secreted into the bo el evacuation occurs, the pulse rate increases. Medicinal actions: 5timulant la$ative, cathartic )raditional Medicinal Use: • *astrointestinal !onditions9 ?ing stated the specific indications as ind or bilious colic and as a la$ative for non&inflammatory conditions of the intestinal tract. ,t is very useful hen a la$ative is indicated in febrile diseases, particularly in the early stage bilious fevers1 E02 !assia is especially effective in children and ill affect nursing children by being given to the mother. ,t is to be used here a severe impression on the bo els is not desired. 'lling ood described its use only for temporary constipation such as that after surgery, in convalescence and in infants in children.E03 ,ts influence is chiefly on the small intestines, augmenting secretions and peristalsis and producing loose, yello ish&bro n evacuations according to !oo#. ;et, 'lling ood stated that it produces normal evacuations of the bo els ith little griping if used carefully. ,t does not act as a sedative or refrigerant, as does some other cathartics. !oo# described !assia as a rela$ing and stimulating cathartic, indicated hen fast action is needed and hen the abdominal and pelvic viscera are sluggish. E0< ,t first creates nausea and rela$ation of the pulseK subsequently there are griping, flatulence, moderate e$citement of the pulse, and e$citement of the abdominal and pelvic vessels. ,t leaves no tonic impression. ,t is very efficient, but not drastic nor unsafe. Current Medicinal use: • *astrointestinal !onditions9 5enna is useful in atonic constipation, or until the cause of constipation is discovered. Current +esearch +eview: • 9astroenterology: o 9astrointestinal tract dysfunction:%8%  %esign9 4andomi(ed controlled clinical trial  1atients9 A30 patients ith gastrointestinal tract dysfunction after abdominal operation  6herapy9 'nema administration =!lyster method> of !assia angustifolia e$tract =!A'>.  4esutls9 !A' as very effective in reducing the rate of gastrointestinal decompression, accelerating the restitution of borborygmi and the time e$haustion. o Constipation:%8&  %esign9 /ulticenter randomi(ed controlled clinical trial  1atients9 B0 adult patients admitted to E community hospitals and one provincial hospital ith at least H2 hours of constipation.  6herapy9 A20 ml !assia alata .inn. infusion hs. A20 ml mist. alba infusion hs for another group, and A20 ml infusion hs for placebo group.  4esults9 'ighty three percent of patients in !assia alata .inn. group passed stool ithin 2< hours, compared to ABG of patients in placebo group =and BFG of patients in mist.alba group>. /inimal side effects =nausea, dyspepsia, abdominal pain and diarrhea> ere noted in AF&2EG of the patients. #harmacy9

6he purgative effect of 5enna is increased by the addition of bitters. E0H, E0B 6o avoid griping, !assia should be combined ith carminatives. 6he resin =highest in the leaves> can be irritating to the upper *.,. causing nausea. ,f the pods are soa#ed in cold ater, these resins are not e$tracted. 6his cold infusion does have less of a la$ative action as ell. A hot 5enna tea is, therefore, a stronger la$ative. ,nfusion9 <&A2 dried pods steeped in cold or hot ater for F&A2 hoursK 5ig&A cup hs. 6incture A9E <EG 't0+K sig& 2&< ml hs Contraindications: 5enna is contraindicated in irritation, congestive or inflammatory conditions of the abdominal viscera, general debility, hemorrhoids, prolapsed anus, and in irritation of the omb and menorrhagia. )o*icity9 !atharsis and gripping
502 503

)elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 'lling ood, ). )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago. ACAC p. 30H 504 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy . 'clectic /edical 1ublications, 5andy, 04 ACBE 505 Wang /, ;an 5, Wang -. 2linical and experimental study on using 2assia angustifolia extract as enema after abdominal operation . ?hongguo ?hong @i Ai 7ie He ?a ?hi ACCBKAB=C>9E<0&3. 506 6hamli#it#ul 7, Bunyapraphatsara :, %echati ongse 6, et al. RandomiIed controlled trial of 2assia alata 8inn1 for constipation. 71 Med )ssoc Thai ACC0KH3=<>92AH&22. 507 )elter 508 !oo#

Caulophyllum thalictroides
Common name: Blue !ohosh Ha!itat: :ative to moist rich oods of eastern :. America.

Ber!eridaceae

Botanical description: A perennial plant ith a smooth, round, purplish stems gro ing to a height of A&3 ft. 6he leaves are biternate or tirternate, leaflets are oval, petiolate, ith a pale underside, about 2&3 in. long. 6he small flo ers are in racemes, yello &green to green& purple in spring. ,n late summer there are round bluish&blac# fruits. #art Used: 4oot Constituents: al#aloid =methycytistine, anagyrine, bapitfoline, magnoflorine>, saponin glycosides =caulosaponin, caulophyllosaponin> Medicinal actions: Anti&inflammatory, antispasmodic, diuretic, vermifuge, uterine tonic, emmenagogue. Medicinal use: *ynecologic !onditions9 !aulophyllum is primarily anti&spasmodic and tonic to the uterus. ,t increases blood supply to the uterus via vasodilatation. !aulophyllum is most indicated in conditions of uterine ea#ness and loss of tone due to chronic inflammation =i.e.. cervicitis, chronic 1,%, endometriosis, dysmenorrhea, amenorrhea, ovarian pain and3or inflammation, dysmenorrhea, and irregular menses>. !aulophyllum e$erts an anti&spasmodic action in cases of dysmenorrhea. ,t is specifically indicated hen the uterine spasms are orse the first day of the menstrual flo . !aulophyllum is most indicated hen there is pelvic organ ea#ness, sluggishness, and a sense of fullness. 5ome instances of amenorrhea can be due to atonicity and congestion in the pelvis. !aulophyllum is very appropriate in these cases to provide tone and bring on menses, often ithout producing menstrual cramping =d3t the anti&spasmodic action and the increased nutrition of the tissues>. !aulophyllum is most indicated as a pelvic tonic in cases here there is pelvic pain, a sense of pelvic fullness, ea# pelvic tissues =indicated by scanty menses, poor vaginal tone, ea# orgasmic contractions>, and uterine irritability =irregular menses, dysmenorrhea>. !aulophyllum is useful in the treatment of ea# #idneys, prostate ea#ness =B1+>, and uterine ea#ness. !aulophyllum combines ell ith /itchella repens. !aulophyllum has similar actions to !imicifuga racemosa =blac# cohosh> and used together, they facilitate labor by normali(ing uterine contractions and rela$ing the cervical os. 'ach of these herbs is useful in false labor. /uscle contractions are strengthened =positive inotropic effect> and slo ed do n =negative chronotropic effect>. !aulophyllum is used as a partus preparator because of its ability to tonify the uterus, especially in cases of delayed labor secondary to uterine debility and atonicity. ,t is often used during the last four ee#s of pregnancy as a partus preparator in the form of /otherNs !ordial9 Q!aulophyllum=A> 9/itchella=<>9 !hamaelirium luteum=A>9 7iburnum spp.=A>R. 5imilarly, the anti&spasmodic action of !aulophyllum ma#es this plant useful in cases of threatened miscarriage. )or threatened miscarriage, it is safe to use !aulophyllum at any time in pregnancy. )ccording to Mills and Bone:#-* • /usculos#eletal !onditions9 !aulophyllum is among the class of herbs hich contain stimasterol as ell as other potentially anti& inflammatory phytosterols and have a reputation for application in inflammatory diseases. • *ynecologic !onditions9 !aulophyllum can be utili(ed to support hormonal balance by correcting hypothalamic function9 in functional secondary amenorrhea, difficulty ith conception and endometriosis it can be combined ith 7ite$. )ccording to ,cudder:#%• *ynecologic !onditions9 !aulophyllum e$erts a very decided influence upon the parturient uterus, stimulating normal contraction, both before and after delivery. ,n this case, its first use is to relieve false labor painsK its second, to effect co&ordination of the muscular contractions. and third, to increase the po er of contractions. 6he first and second effects are the most mar#ed, yet the third is quite apparent as ell. 5cudder believes !aulophyllum e$erts its influence through the hypogastric ple$us K though to some e$tent it influences every process controlled by the sympathetic nervous system. Acting in this ay it influences the circulation, nutrition, and functions of the reproductive organs. ,t has been employed in chronic uterine diseases ith some success as ell. • :ervous !onditions9 ,t may be used ith good effect in some cases of nervous diseaseK especially in that condition #no n as asthenic plethora. • /usculos#eletal !onditions9 As a remedy for rheumatism it is inferior to /acrotys, but in some cases it e$erts a better influence. )ccording to 2oo3: !aulophyllum is moderately diffusive, stimulating and rela$ing in about equal degrees spending its main po ers upon the nervous system. 6hese qualities ma#e it one of the very best of antispasmodics the relieve nervous feebleness ith irritability as in cramping of the bo els t itching of the muscles in typhoid and parturient states, hysteria, painful menstruation, colic, etc. • *enitourinary !onditions9 ,t promotes diuresis by sustaining the pelvic nerves. ,t is useful in ea# #idneys, albuminous urine and chronic difficulties of the prostate.

• *ynecologic !onditions9 ,t is of special service in strengthening and relieving painful functional difficulties of the female generative organsK it can not be properly classed as an emmenagogue. ,t has a reputation in neuralgic forms of rheumatism, especially that form hich passes ith some as chronic inflammation of the omb. By sustaining the pelvic nerves it strengthens the uterus in leu#orrhea and insufficient menstruation. ,t is useful in nervous restlessness during pregnancy and before parturition to give tone and comfort to the uterus. ,t is one of the most valuable of all parturients hen the uterine action is becoming eary in hich case it may be combined ith the !omposition 1o der =a 6hompsonian formula> and a very little !apsicum or Bayberry added hen depression is considerable. • :ervous !onditions9 ,t sustains the nervous system, but at the same time soothes it. • 1ulmonary !onditions9 ,ts antispasmodic virtues may be used to much advantage in asthma, especially in combination ith diaphoretic rela$ants. )ccording to .ing: 5pecific ,ndications and Uses.Z6he specific indications for !aulophyllum are uterine pain, ith fullness, eight, and pain in the legsK fullness of tissues as if congestedK debility =irritability> of the nervous system, ith impaired muscular po erK spasmodic muscular painsK articular painK rheumatic pains of asthenic plethoraK epigastric and umbilical colic#y painsK dull frontal headacheK great thirstK as an o$ytocicK to relieve false pains and uterine irritabilityK se$ual debility, ith e$citabilityK spasmodic uterine contractionsK dysmenorrhoeaK irregular menstruationK crampy pains in stomach and bo els after eatingK pain in toes and fingers not due to tissue changes. 0f !aulophyllum, 4afinesque states that Mas a po erful emmenagogue it promotes delivery, menstruation, and dropsical discharges,M and that Mit as employed by the ,ndians and their imitators for rheumatism, dropsy, colic, sore throat, cramp, hiccough, epilepsy, hysterics, inflammation of the uterus, etc.M Blue cohosh is reputed antispasmodic, emmenagogue, and parturifacient, besides being diuretic, diaphoretic, and e$pectorant. As an antispasmodic it has been employed in chorea and epilepsy due to diseased states of the se$ual organs, but ith varying results. ,t is better suited for spasmodic intestinal affections, as flatulent and spasmodic colic, and cramps. ,t is not ithout value in obstinate singultus. ,ts antispasmodic effects are permanent. • *astrointestinal !onditions9 1rof. ?ing first employed blue cohosh for its beneficial influence on abnormalities of the mucous tissues, using it for aphthous stomatitis in decoction, alone or combined ith +ydrastis. ,t is also a remedy for gastric nausea and vomiting. • *ynecologic !onditions9 1rof. 5cudder believed that this agent e$erted its influence through the hypogastric ple$us, thus affecting the circulation, nutrition, and functions of the reproductive apparatus. As a gynecian remedy it has been employed to relieve irritation of the reproductive organs as if dependent on congestion. ,t controls chronic inflammatory states of these organs and gives tone in cases of debility. ,n the se$ual disorders of the female it is indicated by tenderness and pain in the uterus, in debilitated patients. ,t has been very successfully used in cases of hysteria to overcome the attac#, and to relieve ovarian, or mammary pain, or irritation hen accompanying that disorder. !hronic corporeal, or cervical endometritis, metritis, ovaritis, ovaralgia, uterine leucorrhoea, amenorrhoea, and dysmenorrhoea, are conditions in hich it has been most successfully employed. ,t has an established reputation as a remedy for rheumatism of the uterus, ith nervous e$citement, for uterine cramps attending menstruation, and for menorrhagia, depending on uterine subinvolution. ,ts use as a parturient originated in the custom of the ,ndian omen of employing a decoction of the root for 2 or 3 ee#s previous to labor to facilitate child&birth. 6here is no doubt but that !aulophyllum has a decided action upon the gravid uterus. %uring labor it relieves false pains and coordinates muscular contractions, at the same time increasing their po er. .i#e /acrotys, it is a better o$ytocic than ergot. Unli#e the latter agent it stimulates normal contraction instead of inducing spasmodic uterine action. ,t is most valuable in those cases here delay is due to debility, fatigue, or lac# of uterine nervous energy, and for deficient contractions here the tissues feel full, as if congested. As a partus praeparator, blue cohosh has en"oyed a ell&merited reputation. When used by delicate omen, or those ho e$perience prolonged and painful labors, for several ee#s previous to confinement, it gives tone and vigor to all the parts engaged in the accouchement, facilitating its progress, and relieving much suffering. 1rof. +ale testifies that omen ho have ta#en !aulophyllum previous to confinement, have overrun their time from A0 to A2 days, but all had very easy labors and made good recoveries. ,t is a good remedy for after&pains, especially hen spasmodic in character. !aulophyllin has also been used for this purpose. ,t is a remedy for hour&glass contraction and for spurious labor&pains. Blue cohosh acts as an antiabortive by relieving the irritation upon hich the trouble depends. ?ing states that for this purpose it is fully equal to 7iburnum. • *enitourinary !onditions9 By lessening irritation it has been serviceable in cystitis, urethritis, chronic nephritis, and albuminuria. 5pasmodic retention of urine is relieved by it. • 4heumatic !onditions9 ,t is a good remedy for some cases of rheumatism, though not so valuable as /acrotys. ,t effectually overcomes rheumatoid conditions of the uterus and of the stomachZin the latter instance hen crampy pains follo the ingestion of food. While valuable in all chronic cases of muscular rheumatism, it is especially adapted to articular rheumatism, particularly hen confined to the smaller "oints, as of the toes and fingers. ,t is a remedy for asthenic plethora, and for rheumatic pains accompanying that condition. • /ale !onditions9 Associated ith testicular support, it favorably influences orchialgia. • 1ulmonary !onditions9 ,t has been suggested as a remedy for bronchitis and catarrhal pneumonia. • 5leep !onditions9 By its sedative action it is valuable in some cases of insomnia.

#harmacy: %ecoction9 A tsp.3cupK sig A cup 6,% =%r. Alschuler> root " =A o(.> to aqua 0" =A pint>, from A to 3 ounces, every 3 or < hours =?ing> 6incture A9E, <EG't0+K sig A&3 ml 6,% =%r. Alschuler> tincture of the recently dried root, vii". to Alcohol HFS 0". 6he alcoholic fluid e$tract, representing ounce for ounce, is also a good preparation. =5cudder> 5pecific !aulophyllum, from 3 to A0 dropsK of caulophyllin, from 2 to < grains =?ing> )luid '$tract A9A H0G 't0+K sig 0.E&A ml 6,% =%r. Alschuler> .loydNs .eontin =theA per cent solution of the emmenagogue principle of blue cohosh> has been very successfully employed in amenorrhoea, dysmenorrhoea, and chlorosis. 6he dose ranges from E to AE drops in syrup or s eetened ater. =?ing> Contraindications: !aulophyllum should be avoided in pregnancy prior to the ninth month due to its emmenagogue and abortifacient effects =empirical> and the uterine stimulant activity of its saponin =in vitro and animal studies>. EAA )o*icity9 :ausea, headache, increased blood pressure at doses 3&< $ greater than those listed above.
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/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. A<B, 2<2&<. 5cudder -. 5pecific /edications and 5pecific /edicines. 511 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. <0

Ceanothus americanus
Common name: 4ed root, :e -ersey tea Haitat:

+hamnaceae

Botanical description9 4oot tough, oody, dar# bro n, striated or finely rin#led longitudinally. Bar# thin, brittle, deep bro nK ood reddish, ith obscure concentric rings. #arts used9 4adi$ Constituents9 • !yclic peptide al#aloids9 cyclic peptines • 6riterpenes including ceanothusic acid, ceanothenic acid • 0ther constituents include tannin =A0G>, resin, bitter component and gum #harmacology: ,n blood ta#en from young rats, an aqueous&ethanol e$tract of the drug reduced blood&clotting time by 2EG. +o ever, the results are difficult to assess.EA2 Medicinal actions: Astringent, antispasmodic, e$pectorant, hepatic stimulant, mild antiseptic. ,n addition, !oo# described it as mildly stimulating ith slight tonic qualities and nervine. )raditional Medicinal Use: 5pecific ,ndications and Uses9 'nlarged spleenK sallo , doughy s#in e$pressionless countenanceK non&inflammatory, catarrhal states, ith profuse secretion. !oo# considered !eanothus to be medicinal, but not very po erful or reliable, hereas ?ing described its use as effective for a variety of conditions. • *astrointestinal !onditions9 !eanothus as indicated in irritations of the mucous membranes including chronic diarrhea and dysentery, particularly if subse<uent to fe!er1 >t :as also considered a gastric stimulant 0although this seems associated :ith the shared !ascular origins of the li!er and spleen9 see belo:B1 ,t as useful as a ash in sore mouth and ea# ulcers • *ynecologic !onditions9 As an douche, !eanothus as used for leucorrhea. • +epatobiliary !onditions9 !eanothus as used as a gastric, hepatic, and splenic stimulant9 it is in splenic troubles that it as most indicated. %eep&seated splenic pain, ith or ithout splenomegaly, as ell as for sympathetic imbalance secondary to a splenic condition call for !eanothus. ,ts action as compared to ,ilybum marianum, influencing the hepatic, and more so the splenic vessels, overcoming congestion. ,t as also used for splenomegaly and splenitis of malarial origin9 the cases of splenitis calling for !eanothus are sub&acute hen pressure does not mar#edly aggravate the pain. EA3 ,t is also useful in portal hypertension ith constipation. EA< )or hepatic and splenic disorders the tincture of the leaves as preferred. • ,nfectious !onditions9 ,n syphilis and gonorrhea !eanothus as considered a good alterative for milder cases. • 1ulmonary !onditions9 ,n asthma and bronchitis, !oo# considered !eanothus a good alterative for milder cases hile on the contrary ?ing employed it for more severe, chronic pulmonary conditions including chronic bronchitis and :hooping9cough1 Current Medicinal use: • %ental !onditions9 A methanol e$tract of !eanothus americanus demonstrated antimicrobial activity against selected oral pathogens. 6hree triterpenes =ceanothic acid, 2H&hydro$y ceanothic acid and ceanothetric acid> and t o flavonoids =maesopsin and maesopsin&F&0&glucoside> ere identified. !eanothic acid and ceanothetric acid demonstrated gro th inhibitory effect against 5treptococcus mutans, Actinomyces viscosus, 1orphyromonas gingivalis, and 1revotella intermedia. EAE • +epatobiliary !onditions9 !eanothus is a liver stimulant useful in congestive and inflamed conditions such as hepatitis, and headaches 2S hepatic congestion. • 1ulmonary !onditions9 !eanothus is a stimulating tonic to mucous membranes, especially of the respiratory tract causing e$pectoration, sedation of paro$ysmal cough, and reduction of bronchial spasms . 6hus, !eanothus is useful in bronchitis, hooping&cough, and asthma. • 6opical Applications9 ,t is also antiseptic and is useful as an oral mouth ash, gargle, and s#in ash, ma#ing it useful in apthous ulcers, and s#in ulcerations. Current +esearch +eview

•

5earch of /edline revealed no human studies as of :ovember 2002. %ecoction A tsp.3cupK sig A32&A cup 6,% 6incture A9E <EG 't0+K sig 2&3 ml 6,% ac

#harmacy9

Contraindications: 6he use of tannins is contraindicated or inappropriate in cases of constipation, iron deficiency and malnutrition. EAF 6annin rich herbs may reduce the absorption of al#aloids and other basic drugs through precipitation. EAH )o*icity: none reported
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Herbal PDR, /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 514 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. 32F 515 .i, P.!., Antimicrobial compounds from !eanothus americanus against oral pathogens. Phytochemistry. ACCH 5epK<F=A>9CH&A02. 516 /ills and Bone, p AH0 517 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AEC

Centella asiatica

(Hydrocotyle asiatica

Um!elliferae (#arsley family

Common name: *otu ?ola, Brahmi =5ans#rit>, /an t@ien hsing =!hinese>. Ha!itat: ,ndigenous to 5' Asia, ,ndia, 5ri .an#a, parts of !hina, Western 5outh 5ea ,sl]s, /adagascar, 5outh Africa, 5' U.5., /e$ico, 7ene(uela, !olumbia, ] 'astern 5outh America. Botanical description: lo:ers J fruit: 1edicles are A.2 to A.< cm long. 5epals of the epicaly$ are oval to circular, 3 a membranous border ] are about 2.E to 3.0 mm long ] A.E to 2.E mm ide. Umbels have 2 or 3 sessile or short pedicled florets. 1etals are hite, to purple or pin#. 6he caly$ is not generally dentate. 6he fruit is oval to globose ] has a diameter of 2 to E mm. /ericarps are flattened at the sides ] usually have H to C ribs ] are raised rugose. 8ea!es J ,tem: A tender umbelliferous plant 3 numerous creeping stems, hich have roots at the nodes ] are glabrous. !ircular&reniform leaves are 2 to F cm long ] A.E to E cm ide, 3 a crenate margin ] E to C ribs. 6he petioles are 3 to 30 cm long. *otu ?ola is considered almost tasteless ] odorless. #art used: %ried aerial parts, fresh ] dried leaf ] stem. $nergetics: Bitter. !ooling. 5 eet. 'quali(es W 7ata, ?apha, 1itta. Affinity for all tissues, e$cept reproductive. /ainly blood, marro ] nerve tissues. 5ystems W :ervous, !irculating, ] *,2%"/ Constituents:EAC • 6riterpene acids9 including madasiatic acid. • 1seudosaponins =or 6riterpene acid esters from oligosaccharide digestion>9 including asiaticoside, asiaticoside A ] B. • 7olatile 0il. #harmacology: /ain constituents are thought to be the mi$ture of pseudosaponins, although an e$act mechanism of action could not be found at this time of revision.E20 Although the e$act mechanism of action is sill un#no n, *otu ?ola appears to mprove vessel integrity ] help to reduce the symptoms of !6 disease.E2A +ence, the follo ing is a list of physiologic effects that !entella asiatica has sho n through the use of animal models9E22 A. 5timulates hair ] nail gro th. 2. ,ncreases vasculari(ation of connective tissue. 3. ,ncreases the formation of structural glycosaminoglycans =chondroitin sulfate, hyaluronic acid>. <. ,ncreases tensile strength of the dermis. E. ,ncreases #eratini(ation of the dermis. F. 1ossesses a balancing effect on connective tissue. Medicinal actions: :ervine. 4e"uvenative. Alterative. )ebrifuge. %iuretic. Current > )raditional Use: Ayurvedic ,ndications9 :ervous disorders, epilepsy, senility, premature aging, hair loss, chronic ] obstinate s#in conditions, venereal diseases. *otu ?ola is considered to be one of the most important re"uvenative herbs in Ayurvedic medicine. ,t is particularly revitali(ing for the nerves ] brain cells. *otu ?ola is used to increase intelligence, longevity, ] memory ] to decrease senility ] aging. ,t cleanses ] feeds the immune system, as ell as strengthens the adrenals. *otu ?ola is also a po erful blood purifier, being specific for chronic s#in diseases, including leprosy, syphilis, ec(ema ] psoriasis. ,t is also helpful in intermittent fevers, li#e those of malaria. !entella is a tonic ] re"uvanative for 1itta, calms the nerves of 7atta, ] helps to reduce e$cessive ?aphaK hence it is considered an equali(er to the constitutional types. *otu ?ola is considered to be one of the most spiritual ] sattvic of all herbsK being used by the ;ogis of the +imalayas as food for meditation. ,t a a#ens the cro n char#a ] helps to balance the t o hemispheres of the brain. A cup of !entella tea can be ta#en 3 honey before meditation. As a mil# decoction, *otu ?ola ma#es a good nerve tonic. 6he po der is often used e$ternally as a paste for chronic s#in conditions. !entella is added to basil ] blac# pepper for fevers. As a re"uvanative, it is best prepared 3 ghee =clarified butter>. E23 Current +esearch +eview: • Cardiovascular Conditions: o Atherosclerosis: 66)!A =total treterpenic fraction of !entella asica>, in the dose of F0 mg 6,% po $ A2 months, as found to be effective to increase the echogenicity and homogenicity of echolucent plaques at the femoral bifurcation in prospective randomi(ed, placebo&controlled trial involving F0 patients. 6he composition of hypoechoic plaques is mainly due to lipid

•

• •

accumulation or thrombosis, and such plaques are associated ith an increased incidence of cerebrovascular events. 66)!A stabili(ed these plaques, lo ering the ris# of all thrombosis, rupture, and emboli(ation. E2< o -enous insufficiency: 1. A study of C< individuals ith venous insufficiency of the lo er limb compared the benefits of *otu #ola e$tract =A20 mg ] F0 mg 2%> against a placebo.H 6he results also sho ed a significant dose&related improvement in the treated groups in symptoms such as sub"ective heaviness, discomfort, ] edema. E2E 2. A revie of all the *otu #ola studies performed concluded that *otu #ola e$tract demonstrates a dose&related improvement in venous insufficiency ] related symptoms such as, foot s elling, an#le edema, ] capillary permeability.E2F 3. 6'!A =titrated e$tract of !entella asiatica> as found to be effective for the treatment of venous insufficiency in the dose of A20 mg or F0 mg qd $ 2 months, in a multi&center, double&blind, placebo&controlled trial involving C< patients. 5ymptoms of heaviness in the lo er limbs and edema, as ell as venous distensibility ere improved. E2H o -enous hypertension: 1. ,n one study of people ith e$perimentally induced venous insufficiency, 2 ee#s of treatment ith *otu #ola =total triterpenic fraction, F0 mg 6,%> as sho n to reduce the time necessary for the s elling to disappear. E2B 2. A placebo&controlled study = hether it as double&blind as not stated> of E2 patients ith venous insufficiency compared the effects of *otu #ola e$tract =AB0 mg 2% ] C0 mg 2%> against placebo. After < ee#s of treatment, researchers observed improvement in various measurements of vein function in all treated patients, but not in the placebo group. 6hey also found that the higher dose as more effective than the lo er dose. E2C 3. 66)!A as found to be effective, in the doses of F0 mg and A20 mg qd, in the treatment of venous hypertensive microangiopathy on both ob"ective and sub"ective scales in a single&blind, placebo&controlled, randomi(ed study. +igher dose as level as more efficient. 6he authors concluded that 66)!A can be safely used in venous hypertension in doses as high as A20 mg qd.E30 <. 66)!A as found to be effective in reducing both ob"ective and sub"ective symptoms of venous hypertension in randomi(ed controlled prospective clinical trial involving F2 sub"ects. 6 enty patients ere given F0 mg 6,%, 20 more patients ere given 30 mg 6,%, A2 patients ere treated ith placebo, and A0 healthy sub"ects ere treated ith F0 mg 6,% $ < ee#s. After the treatment, ob"ective symptoms = hich included capillary filtration rate, an#le circumference, and an#le edema> and sub"ective symptoms = hich included s elling sensation, restless lo er e$tremity, pain and cramps, and tiredness> decreased in patients ith venous hypertension in e$perimental groups. 6here as no change in the placebo group and in normal sub"ects. %ose of AB0 mg3day as more effective in the improving the signs and symptoms of venous hypertension. E3A o -aricose veins: 1. Another study follo ed BH people ith varicose veins ] compared the benefits of *otu #ola =F0 mg ] 30 mg 2%> against placebo. Again, the results sho ed improvements in both treated groups, but greater improvement at the higher dose.E32 2. 5ub"ects ith varicose veins have increased mucopolysaccharide turnover, indicated by increased serum levels of the uronic acids and lysosomal en(ymes involved in the mucopolysaccharide metabolism. 66)!A in the dose of F0 mg qd $ 3 mo, decreased mucopolysacchired levels in the sub"ects ith varicose veins during the treatment, and decreased levels of serum uronic acid and lysosomal en(ymes =beta&glucoronidase, beta&:&acetylglucosaminidase, and arysulfatase> at the end of the treatment. 6he authors concluded that results of this trial provide an indirect confirmation of regulatory effects of the e$tract of !entella asiatica on metabolism in the connective tissue of the vascular all.E33 o Dia!etic microangiopathy: 66)!A as found to be useful in diabetic microangiopathy in a clinical prospective randomi(ed trial involving fifty patients. 6hirty patients received 66)!A F0 mg 6,% $ F months, A0 patients received placebo, and A0 patients received no treatment. After F months there as a significant improvement in the e$perimental group, and no significant changes in t o control groups. Authors concluded that 66)!A is effective for treatment of diabetic microangiopathy by improving and protecting the microcirculation against deterioration and by decreasing capillary permeability. E3< An*iety9 A recent double&blind placebo&controlled trial of <0 normal individuals attempted to investigate *otu #olaNs possible effects on an$iety in an indirect ay.A 6he best ay to ould have been to use it on people ho actually have an$iety. 4esearchers studied hatNs called the acoustic startle responseK =the tendency to blin# in response to a sudden loud noise>. 'vidence suggests that easy startling ] chronic an$iety are related. +alf the participants in this study ere given A2g3day of *otu #ola, hile the other half received a placebo. All ere then sub"ected to occasionally produced bursts of noise. /easurements of eye blin#ing sho ed that treatment ith *otu #ola significantly reduced the startle response to these noise bursts. 6he most dramatic effects ere seen at A hour post ingestion.E3E Mental a!ility: 0ne study demonstrated a significant increase in the mental abilities of developmentally delayed children. After A2 ee#s the children ee more attentive ] better able to concentrate. Connective )issue Conditions:

• •

Burns9 6he standardi(ed e$tract of !entella =topically and3or intramuscularly> as used effectively in patients ith second ] third degree burns. 6he e$tract reduced scar formation, increased healing, ] decreased fibrosis. E3F o Cellulite: 6he standardi(ed e$tract has been used ith success in a number of clinical studies on patients refractive to other therapies.E3H o Celoids: 6he standardi(ed e$tract has demonstrated efficacy for #eloids in a number of clinical trials. 6he mechanism could be via reducing the inflammatory phase of scar formation hile enhancing the maturation phase. E3B o 4cleroderma: 6he standardi(ed e$tract has been tested in several trials ith success. !entella decreased s#in induration, improved finger mobility, ] decreased pain. o 6ound healing: At least AH studies have demonstrated !entella@s effectiveness in greatly aiding ound repair. '$amples of ounds healed include9E3C 'pistiostomies ] ':6 surgeries, s#in ulcers, traumatic in"uries, gangrene, s#in grafts. Dermatological Conditions: =the ma"ority of clinical studies utili(ed standardi(ed e$tracts containing <0G asiaticoside, 30G Asiatic acid, 30G madecassic acid, ] A&2G madecassoside F0&A20 mg3day> Hepato!iliary Conditions9 6hree 'uropean studies conducted in the ACH0s report on !entella in the treatment of fibrotic conditions of the liver.E<0 o

#harmacy: Contraindications.)o*icity: Brin#er states that empirical evidence suggests that !entella has an emmenagogue effectK therefore, internal should be avoided in early pregnancy.E<A !aution9 /ay aggravate itching, in large doses may cause +A or temporary loss of consciousness. E<2 .arge amounts can induce headache, di((iness, stupor, pruritis, as ell as bloody passages from the bo els. E<3
518 519

)ra ley %, .ad 71 The Aoga of Herbs: an ayur!edic guide to herbal medicine1 .otus 1ress, 6 in .a#es, Wisconsin, ACC29AH0&2. PDR for Herbal Medicines1 /edical 'conomics !ompany, /ontvale, :-, ACCC9H30. 520 PDR for Herbal Medicines, H30. 521 .ininger et al. Healthnotes: 2linical Essentials, Herb Monographs . 1rima 1ublishing, 4oc#lin, !A, 200A. 522 1i((orno -' -r, /urray /. The Textboo3 of ;atural Medicine, &nd ed1 !hurchill .ivingstone, :;, :;, ACCC9FE3. 523 )ra ley, AH0&2. 524 ,ncandela ., Belcaro *, :icolaides A:, et al. /odification of the echogenicity of femoral plaques after treatment ith total triterpenic fraction of !entella asiatica9 a prospective, randomi(ed, placebo&controlled trial. )ngiology 200AK E2 5uppl 295FC&H3. 525 1ointel -1, Boccalon +, !loarec /, et al. 6itrated e$tract of 2entella asiatica =6'!A> in the treatment of venous insufficiency of the lo er limbs. )ngiology. ACBHK3B9<FW E0. 526 !esarone /4, .aurora *, %e 5anctis /6, et al. Activity of !entella asiatica in venous insufficiency. Miner!a 2ardioangiol. ACC2K<09A3HW<3. 527 1ointel -1, Boccalon +, !loarec /, et al. 6itrated e$tract of !entella asiatica =6'!A> in the treatment of venous insufficiency of the lo er limbs. )ngiology ACBHK3B=A 1t A>9<F&E0. 528 Belcaro *7, *rimaldi 4, *uidi *. ,mprovement of capillary permeability in patients ith venous hypertension after treatment ith 66)!A. )ngiology1 ACC0K<A9E33W<0. 529 Belcaro *7, 4ulo A, *rimaldi 4. !apillary filtration ] an#le edema in patients ith venous hypertension treated ith 66)!A. )ngiology1 ACC0K<A9A2WB. 530 ,ncandela ., Belcaro *, %e 5anctis /6, et al. 6otal triterpenic fraction of !entella asiatica in the treatment of venous hypertension9 a clinical prospective, randomi(ed trial using a combined microciruculatory model. )ngiology 200AK 5uppl 295FA&H. 531 %e 5anctis /6, Belcaro *, ,ncandela ., et al. 6reatment of edema and increased capillary filtration in venous hypertension ith total triterpenic fraction of !entella asiatica9 a clinical, prospective, placebo&controlled, randomi(ed, dose&ranging trial. )ngiology 200AKE2 5uppl 295EE&C. 532 !esarone /4, .aurora *, %e 5actis /6, et al. 6he microcirculatory activity of 2entella asiatica in venous insufficiency. A double&blind study. Miner!a 2ardioangiol. ACC<K<292CCW30<. 533 Arpaia /4, )errone 4, Amitrano /, et al. 'ffects of !entella asiatica e$tract on mucopolysaccharide metabolism in sub"ects ith varicose veins. >nt 7 2lin Pharmacol Res ACC0KA0=<>922C&33. 534 Ce a&one M/, 0ncandela 1, 2e Sancti M3, et al. 4)aluation of t&eat!ent of dia#etic !ic&oan%io"at'( 5it' total t&ite&"enic f&action of Centella a iatica- a clinical "&o "ecti)e &ando!i6ed t&ial 5it' !ic&oci&culato&( !odel. Angiology 2001*52 Su""l 2-S49.54. 535 Brad e"n -, 8hou ;, ?os(yc#i %, et al. A double&blind, placebo&controlled study on the effects of *otu ?ola =!entella asiatica> on acoustic startle response in healthy sub"ects. 7 2lin Psychopharmacol. 2000K209FB0WFB<. 536 1i((orno, FE3 537 1i((orno, FE3 538 1i((orno, FE3 539 1i((orno, FE< 540 1i((orno, FE3 541 Brin#er ). Herb 2ontraindications J Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ACCB9HB 542 )ra ley, AH0&2. 543 )elter

Cephaelis ipecacuanha
Common name: ipecac Ha!itat: 6he plant prefers the undergro th of the tropical rain and cloud forests of 5outh America.

+u!iaceae

Botanical description9 A lo shrub up to <0 cm in height. 6he stem becomes oody near the ground. .eaves up to H cm long, oblong, ith an entire margin. Bise$ual flo ers in hemispherical clusters. 6he root is slender, tortuous, reddish&bro n and up to < mm in diameter. #arts used9 4oot, rhi(ome Constituents9 ,soquinoline al#aloids =2G&<G>Zemetine, cephaeline, psychotrine, and othersK ,ridoids W s eroside, H&dehydrologaninK 5apponins, *lycosides, 5tarch, 4esins, !holine #harmacology: 6he al#aloids in ,pecac =primarily emetine and cephaeline> promote increased mucocilliary activity by refle$ stimulation of the upper digestive all. E<< ,ts irritation of the stomach creates a refle$ stimulation of the ascending branch of parasympathetic nerves. ,n turn, this causes a refle$ive hydration of the mucous in the lungs thus facilitating e$pectoration. Medicinal actions: '$pectorant, emetic, stimulant, diaphoretic, amoebicide Medicinal use: • *astrointestinal !onditions9 An application of the gastric irritation caused by ipecac is its use as an emetic. ,n higher doses =see pharmacy section belo >, ipecac ill act as an emetic. 6he main application of this is in the emergency treatment of ingestion of non& caustic poisonous substances. U.5.1. ipecac syrup is the most common preparation. ,pecac syrup induces vomiting by gastric irritation. 6he onset of vomiting usually occurs 20&30 minutes after oral administration. 6he effects persist for 20 to 2E minutes. ,pecac syrup is used after accidental ingestion of poison ith the e$ceptions of volatile oils =vomiting may cause aspiration and lead to bronchospasm, pulmonary edema, or aspiration pneumonitis>, caustic substances =vomiting may induce additional in"ury to esophagus>. Be a are that some bulemics use ipecac syrup to purge. 6he 'clectic physicians used ipecac as a method of stimulating the entire gastrointestinal system. • ,nfectious !onditions9 A second area of medicinal application is as an amoebicidal agent. 6he emetine al#aloid has been demonstrated to be amoebicidal against 'ntamoeba histolytica. 1ractitioners in ,ndia the early part of this century used ipecac to treat amebic hepatitis. 6his use is also common in 5outh America here the plant gro s and here amoebic dysentery is endemic. • 1ulmonary !onditions9 ,pecac is an e$cellent e$pectorant. ,pecac is included in many cough preparations for its e$pectorating properties. ,t is most indicated in chronic bronchitis and ,^n acute bronchitis ith a relatively dry cough ith moderate amounts of thic# mucous that is difficult to e$pectorate. /ild coughs ith non&viscid mucous do not respond ell to ipecac. )ccording to Mills and Bone:#'# 6he traditional indications for emetics is poison ingestion. +o ever, emesis has been demonstrated as an inefficient ay to remove poison material, as appreciable amounts can be pushed into the small intestine. 0ther traditional uses include any acute to$ic or infective condition and bronchitis. 'metics ere used as a first line of treatment for enteric and bronchitic infections and for any evidence of biliary to$icity. ,t as al ays understood that their use as essentially debilitating so a rubust constitution as an essential prerequisite. !ephaelis also contains sapponins, hich are also engaged in the treatment of bronchial congestion and digestive difficulties. ,f used in small doses, then the sapponins act as tonics for debilitating conditions. ,n !hinese medicine, sapponin rich herbs are used as tonics and harmoni(ing components of formulas. )ccording to .ing:#'$ ,pecac, in material amounts, is irritant to the cutaneous and mucous surfaces. ,pecac produces a rela$ation of the s#in and consequent diaphoresis. 6herapeutically, ipecac is a very important remedy. ,t has three chief fields of operation9 =A> ,n large doses it provo#es emesis, and for this purpose it may be employed as suggested belo K =2> it chec#s active hemorrhagesK =3> it relieves gastro& intestinal and broncho&pulmonic irritation and inflammations. ,pecific >ndications and Dses: ,n small doses it is used to relieve irritation, no matter hat the disease may be. 6he specific action of ipecac is best observed in acute affections, hen there is hyperemia, capillary engorgements, and hypersecretion. 5pecific indications include9 as an emetic for overloaded or foul conditions of the stomach and other conditions indicating emesisK active hemorrhagesK irritative diarrhoeaK acute bo el disorders ith irritationK long, pointed tongue, ith reddened tip and edges, accompanied ith nausea and vomiting, and ith or ithout feverK dyspnoeaK irritative coughK hoarseness from coldK hypersecretion, ith mucous rales =small doses>K diminished e$pectoration =nauseant doses>. • !ardiovascular !onditions9 1hysiologically spea#ing, ipecacuanha is said to scarcely affect the circulation, but there is no doubt

that in minute doses in disease, it stimulates the circulatory apparatus, acting thereby as a special sedati!e, as that term is employed in 'clectic therapy. ,ts therapeutic action upon the circulation is ell sho n in its effects upon hemorrhageK and in acute disorders of the stomach, bo els, and breathing organs. • *astrointestinal !onditions9 ,pecac, in doses of less than A grain, acts as a gastric tonic and hepatic stimulant, but large doses prove emetic. When it fails to produce emesis, catharsis usually results, though both effects may ta#e place from its employment. 6he stools produced by this agent are of the so&called bilious type, and have been denominated Mipecacuanha stools.M ,pecac is a specific emetic, and the mildest of its class being safe even in large doses, seldom producing painful spasms of the stomach or bo els, and causing less prostration of the vital forces than synthetic emetics. As such, in 20&grain doses, it causes nausea and continued muscular straining, ith a free secretion of mucusK vomiting, ho ever, seldom ta#es place until AE or 20 minutes after its administration. ,t is best employed in combination ith other emetics, such as .obelia, and is preferred to any other emetic in the early stage of febrile diseases, and in other instances here a severe succussion of the system is indicated. ,pecac is the best emetic for unloading the stomach of undigested aliment, and acute indigestion, bilious attac3s, accompanied ith sic# headache, ,n nausea, ith a broad, flabby, and slimy tongue, give ipecac in full emetic doses. 4epeated doses of the po der in s eetened arm ater, until emesis ta#es place, are useful in the con!ulsions of children, cramps, colic, etc., arising from intestinal irritation, though it is less effectual than .obelia and *elsemium combined. While ipecac is an emetic, it has long been ell&#no n as a remedy to chec# nausea and !omiting. 6his is best accomplished by it hen the tongue is red and pointed, and sho s evidence of irritation. ,f the condition depends upon foul accumulations ithin the stomach, the emetic action ill be first required, after hich the small doses may be continued to control irritation, if present. 6he chief indications pointing to the sole or associate use of ipecac, in stomach and bo el disorders, are the elongated and pointed tongue, ith reddened tip and edges, ith large papillae, or effacement of the papillaeK tenderness on pressureK contraction of tissuesK pinched countenance, hite line around the mouthK tendency to nausea and vomiting, ith or ithout eructationsK and mar#ed hyperaesthesia. 6here is evidence of hypersecretion, sympathetic irritation and capillary engorgement, and the cases are acute. With these indications ell in hand, it ill be found of great service in gastric irritability, nausea, and !omiting =if not from organic stomach lesions>, and acute mucous diarrhoea. ,n the diarrhoea of teething, ith tongue coated hite, and stools green, bloody, and offensive, an associated ith nausea, ipecac serves a useful purpose. )or the offensive element chlorate of potassium may be associated ith it, and for t he peevishness and fretfullness usually present, matricaria. ,n simple diarrhoea, due to undigested and irritating food, an emetic or cathartic is preferable to small doses of ipecac, though the latter should be given to control after&irritation. ,n simple irritati!e diarrhoea, nu$ should be given ith it hen the preceding symptoms are present. :o remedy, ith the e$ception of magnesium sulphate, gives better results in acute dysentery, combined ith proper diet and absolute rest upon the bac#. ,pecac is specially adapted to cases of spo radic dysentery, and is less effectual in (ymotic cases, unless associated ith anti(ymotic treatment. %ysentery has been treated ith large doses of the po dered drug, sufficient to produce catharsis, but this method is less efficient than that indicated above. )ormerly, A grain each of dried e$tract of leptandra and ipecacuanha, and A32 grain of resin of podophyllum, given every 3 hours until it operated freely, as considered an e$cellent remedy for dysentery. ,t is a valuable remedy in muco9enteritis1 ,t should be associated ith aconite or epilobium. ,n acute cholera infantum, ith small and frequent mucoid passages, it should be given early. ,t is of less value here the stools are profuse and atery. 6hough less valuable in chronic than in acute diseases, it is applicable in chronic cholera infantum, ith pallid tongue, nausea, vomiting, abdominal pain, and pallid or yello ish face. But in this case nu$ vomica should be given ith it =5cudder>. • *ynecologic !onditions9 ,n menorrhagia, 20 grains of the po der at bedtime, follo ed by a saline cathartic in the morning, has, in the hands of several practitioners, promptly chec#ed the discharge. • ,nflammatory !onditions9 6he specific use of ipecacis to relieve irritation, no matter hat organ is affected. With this may be vascular e$citation, hich is probably due to the irritated condition of the sympathetic nervous system =the patient may be irritable and the s#in is heightened in color>. ,ts beneficial effects are particularly noticeable in acute irritative and inflammatory disorders of the stomach and bo els. 5mall doses of ipecac may follo to relieve irritation. ,n intermittent fe!er, and particularly in chronic ague, here quinine is ineffectual, the system may be gradually brought under the emetic action of ipecac, after hich the quinine ill give better results, and may even not be needed. ,n fe!ers and inflammatory affections, small diaphoretic doses of ipecac have been highly beneficial. ,ts action in these cases is also beneficial upon the nervous system and mucous membranes. '$citability and suppressed secretions being symptoms, it acts favorably in the erupti!e fe!ers. )ormulations ith the po der are very efficient in the night9s:eats of consumption. ,t ill li#e ise act as a sedative in many local inflammatory diseases, and ill be found e$tremely valuable in peritonitis, even the orst form occurring in puerperal omen. ,t is also of value in acute rheumatism, gout, Kaundice from biliary catarrh, and to rela$ the parts in the passage of small biliary calculi. • +emostatic 1roperties9 0 ing to its evident action upon the capillaries, it is a valuable agent in acti!e hemorrhagesZpost9partum, hemoptysis, hematemesis, hematuria, epistaxis, and hemorrhages from the bo:els. 6he cases calling for it are usually those of nervous individuals, ith mar#ed irritability and vascular e$citation. Under similar conditions it is of value in menorrhagia and metrorrhagia. ,t is sometimes of value in hemorrhoids, especially hen of the bleeding variety. ,t may be associated ith hamamelis, aesculus, or collinsonia as indicated.

• 1ulmonary !onditions9 ,pecac is a remedy of first importance in many respiratory disorders and it increases the broncho&pulmonic secretions. 6hese conditions are similar to those indicating its employment in gastro&intestinal diseases= irritation, capillary engorgement, and hypersecretion>. 6hus, it is associated ith the special sedatives and Asclepius and bryonia. ,t is a very valuable agent, in hoarseness or congestion of the !ocal cords, broncho9pulmonary congestion from colds, irritable and spasmodic coughs, and in the early stage of acute catarrhal affections, dyspnoea of pregnancy, and pertussis1 ,n colds, capillary bronchitis, acute bronchitis, and pneumonia, particularly of children, it has an important place. ,t acts chiefly on the bronchioles and the parenchyma of the lungs, allaying irritation, relieving cough, and diminishing e$pectoration hen profuse =small, stimulant doses>, and aiding e$pectoration hen scanty =large, nauseant doses>. Bronchitis in children, ith dry, hoarse, croupal cough, is often cut short by the emetic action of ipecac.,t also ans ers ell in subacute cases. ,t has been found very useful in typhoid pneumonia in combination ith sulphate of quinine. ,n spasmodic asthma =less valuable than lobelia>, hysteria, pertussis, sore throat, common catarrh, and stricture of the chest common in phthisis 0:astingB, ipecacuanha, as an emetic, ill sometimes be found very beneficial. ,n dry forms of cough it may be given in nauseant dosesK in hypersecretion, in small or stimulant dosesK in spasmodic cough, ith bloody e$pectoration, frequently repeated doses short of nausea. ,n croup and membranous croup, hen the secretions are ell loosened, ipecac is a useful emetic. ,n mucous croupK small doses should be combined ith aconite. ,n membranous croup it has been recommended ith bryonia. • 0phthalmologic !onditions9 %oses of from A3A0 to A3E drop of specific ipecac give prompt relief in the ma"ority of cases of phlyctenular diseases of the eye =small red nodules of lymphoid cells ith an ulcerated ape$ in the con"unctiva> ith photophobia, the latter symptom being quic#ly subdued by it. #harmacy9 A state of tolerance may be established from the prolonged use of ipecac. ,pecac is often employed to assist the action of other agents, particularly agents to act upon the bo els, and ith other agents hich control irritation. ,n particular, the special sedatives9 aconite, veratrum, gelsemium, and rhus, and such other irritation&relieving remedies, as matricaria, amygdalus, epilobium, bismuth, magnesium sulphate =small doses>, collinsonia, hydrastis, and bryonia, may be indicated ith ipecac. ,n fact, here the indications for ipecac are present, it ill materially aid the action of these remedies, one or more of hich are usually necessary, as ipecac seldom covers the hole range of symptoms present in these cases. E<H 5aponin&rich plants may be ta#en before meals of if there is a sensitive stomach immediately after eating. .ong&tem therapy ith saponin&rich plants involves small dosages unlessbenefits are apparent and diminish after ithdra al of treatment. E<B 6ea is not recommended because of the problem of directly assessing content of constituents. 1o dered herb9 '$pectorant9 0.2E W 0.E g daily in divided doses =Alschuler> A3< to A grain, rubbed up ith sugar for pneumonia of children =?ing> 'metic9 .E&2 g daily in single dose =Alschuler> Acute dysentery9 5pecific aconite, gtt. vK specific ipecac, gtt. $ to $vK magnesium sulphate, iK aqua, fl iv. /i$. %ose, , teaspoonful every hour. 5mall doses of diaphoretic po der =containing ipecac> are also useful in dysentery. Po:dered herb doses according to .ing: ,t must be remembered that sometimes po dered ipecac ill do that hich no fluid preparation of ipecacuanha can accomplish. A3< to A32 grain it acts as a tonic, improving digestion, increasing the appetite, and is valuable in irritati!e dyspepsia. L grain e$pectorant, stimulant A32 to 2 grains administered every 3 or < hours, it produces perspiration, and is beneficial in febrile and inflammatory diseasesK combined ith opium its diaphoretic influence is greatly augmented. +emostatic 3 to A0 grains ill produce nausea, hich may be continued for any length of time, and hich is attended ith more or less depression of the pulse, languor, moisture of the s#in, and an increased mucous discharge from all the mucous tissues of the system, hich renders it very useful in pulmonary and hepatic diseases. E to AE grains moves the bo els 20 grains or more emetic A9E tincture may be used in small doses W 0.2E&Aml3 dose =Alschuler> 5yrup of ipecac9 in children A&A2 yrs old9 AE ml, follo ed by < to B o(. of ater =Alschuler> 5pecific 6incture9 5ig9 the fraction of a drop to 20 drops. 6he usual prescription for specific purposes is 4$ 5pecific ipecac, gtt. v to $$K aqua, fl iv. %ose, A teaspoonful every A or 2 hours =?ing> ,n"ection =retention enema>9 )or the emetic effect hen it can not be given by the mouth, it may be used in in"ection, adding 2 drachms of the po der to A pint of arm ater, for an adult =?ing> Contraindications: 6he use of emetics are contraindicated in the follo ing9 E<C • poisoning associated ith coma or convulsion

• poisoning ith petroleum products or corrosive substances • strychnine poisoning • any debilitated condition or constitutional ea#ness 5apponin rich herbs are contraindicated topically on open ounds, in celiac disease, fat malabsorption and fat soluble vitamin deficiencies.EE0 5pecifically, !ephaelis is contraindicated in pregnancy =emperical, animal studies>, organic heart disease =empirical> and in children less than one year of age =empirical>. EEA )o*icity9 %epression, dro siness, arrhythmias, bradycardia, hypotension, atrial fibrillation, fatal myocarditis. Activated charcoal is an antidote to ipecac to$icity =Alschuler>. ,f the po der of ipecac contacts the s#in, there may be erythema follo ed by pustules hich may form into ulcers here it repeatedly contacts the s#in =Alsculer>. ,t is e$ceedingly irritating to the 5chneiderian =nasal> membrane, causing heat and violent snee(ing. ,n some individuals, the inhalation of the po dered drug provo#es paro$ysms resembling a spasmodic asthmatic attac#9 the chief symptoms are dyspnoea, ith mar#ed an$iety and prostration, and hee(ing respiration and cough. 6his is often accompanied ith violent and prolonged snee(ing and spitting of blood. 5uch attac#s are usually follo ed by a free e$pectoration of mucus. EE2
544 545

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. /ills and Bone p. AFC&H0 546 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 547 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 548 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AH0 549 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AFCK Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. BF 550 /ills and Bone p. AH0 551 Brin#er, p BF 552 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3

Chamaelirium luteum
Common name: )alse Unicorn 4oot, helonias root Ha!itat:

1iliaceae

Botanical description: A perennial herbaceous plant ith a large bulbous rhi(ome. 6he stem is angular, smooth, and gro s to a height of A&3 ft. 6he basal leaves are broad <&B in. long and lanceolate. 6he stem leaves are alternate spatulate to lanceolate. 6he flo ers are arranged in dense terminal racemes and are greenish& hite. #arts Used: 4oot Constituents: 5teroidal sapponins9 chamaelirin and helonin =based on diosgenin> Medicinal actions: Uterine tonic, diuretic, emetic, vermifuge, sialagogue =fresh plant only>, bitter, =emmenagoguea& Brin#er> Medicinal use: ,n summary, !hamaelirium is a stimulating tonic to the body overall, ith an especially pronounced effect on the pelvic organs. !hamaelirium is one of the most profound pelvic organ tonics =for both men and omen>. ,t nourishes the pelvic organs and promotes their secretions. ,ts specific indication is a dragging sensation in the e$treme lo er abdomen =i.e. organ prolapse>. • *ynecologic !onditions9 6his plant is particularly useful in dysmenorrhea, amenorrhea, and threatened abortion. !hamaelirium is most helpful in cases of amenorrhea and oligomenorrhea due to uterine atony and ovarian insufficiency. !hamaelirium is used for dysmenorrhea hen there is a bloated sensation in the abdomen ith an aching feeling of the uterus being distended ith blood. ,n a similar sense, !hamaelirium ill aid in e$cessive menstruation associated ith an atonic uterus through its uterine strengthening effects. ,t is phytoestrogenic, and acts amphoterically in situations of hormonal imbalance. ,t combines ell ith !imicifuga racemosa or Aletris farinosa in atonic conditions of the uterus =and pelvis>. !hamaelirium can be used to prevent miscarriage, especially in omen ith a history of repeated miscarriages. ,t combines ell ith 7iburnum prunifolium for uterine irritation =i.e. threatened abortion>. • *enitourinary !onditions9 ,t tonifies the genito&urinary system in both se$es. *enerally, !hamaelirium is indicated in persons tending to ard systemic ea#ness, enfeeblement, mental apathy, ith manifestations of this ea#ness in the pelvic organs. !hamaelirium is ell&indicated in conditions of pelvic ea#ness from e$cessive se$ual activity, in that it imparts tone and vigor to the se$ual organs =male and female>. • *astrointestinal !onditions9 !hamaelirium is a digestive tonic. ,t seems to help ith dyspepsia, anore$ia, and intestinal maldigestion, especially hen these conditions are associated ith reproductive disorders =organ atony, hormonal imbalance>. ,t is also helpful hen there is digestive, liver, or #idney insufficiency. • *ynecologic !onditions9 !hamelirium supports estrogen function in the body being indicated in dysmenorrhea, menorrhagia, and perimenopause. ,n functional secondary amenorrhea, !hamelirium can be used to correct hypothalamic dysfunction to achieve hormone balance, as in combination ith 7ite$ or !aulophyllum. 5uch effect can be utili(ed in e$cessive anovulatory cycles as ell. As a general pelvic tonic !hamelirium is indicated in pelvic inflammatory disease in combination ith %ioscorea. ,t is utili(ed in threatened miscarriage in combination ith 7ite$. ,n fibroadenoma of the breast, estrogen promoting herbs li#e !hamelirium may be beneficial as fibroadenoma is a defect of normal lobule development, hich is influenced by estrogen. 5pecific indications for !hamelirium are mental irritability and despondencyK se$ual lassitudeK atony of the female reproductive organsK gastric debility, ith anore$ia, nausea, indigestion, and malabsorption, particularly hen due to refle$es of uterine originK stic#y, slimy leu#orrheaK atonic urinary tractK dysmenorrhea ith pelvic fullness and heaviness, as if congested, ith a bearing&do n sensation, as if the parts ere about to fall out. %r. ?ing found this plant to possess a decidedly beneficial influence in cases of se$ual lassitude in both se$es and of nocturnal emissions, the result of e$cesses, especially in those instances here there are symptoms of gastric derangement ith impaired memory, mental apathy or indifference and an enfeebled condition of the general system ith ea#ness or dull pain in the renal or lumbosacral region. ,n comparison to Aletris, !hamelirium is chiefly a uterine tonic hile Aletris is more adapted to digestive disorders. • *astrointestinal !onditions9 !hamelirium has been beneficially used in dyspepsia, loss of appetite and remo!al of :orms . ,t is especially indicated for indigestion, dyspepsia and malabsorption here the root of the cause in a refle$ from or associated ith disorder of the female reproductive system such as uterine or ovarian irritation or lac# of uterine activity. • *enitourinary !onditions9 ,t is a decided tonic to the urinary tract and has e$erted some benefit in diabetes insipidus. ,t is said to render the urine al#aline.

•

*ynecologic !onditions9 ,t is reputed to be valuable in atony of the generati!e organs, gradually removing abnormal conditions hile imparting tone and vigor. +ence it is much used in leu3orrhea, amenorrhea, dysmenorrhea and to remove the tendency to repeated and successive miscarriages. ,t removes the irritability and despondency that often attends uterine troubles. ,n painful menstruation it has been found especially adapted to those cases in hich there is pelvic fullness, a sensation as if the omb and rectum ere distended ith blood and the aching, bearing&do n organs feel as if they ould fall out of the body. ,ts action here is very decided hen the smaller doses are employed. ,t is considered useful by some for the relief of vomiting of pregnancy. )ccording to 2oo3:### 6he root of +elonias is a strong bitter and one of the most distinctly stimulating of all tonics. ,t acts very generally upon the system, including in its range the salivary glands, respiratory organs, stomach, gall&ducts, uterus and ovaries. • *astrointestinal !onditions9 ,t stimulates the salivary flo . ,n atonic dyspepsia, it promotes appetite and stimulates the gastric secretionsK and at the same time arouses the biliary e"ections and stimulates the bo els to cast out foul mucous and other accumulations. ,t thus facilitates catharsis in cases of alvine alangour and sometimes e$pels ormsK but it is not to be classed as a distinct cathartic. • 1ulmonary !onditions9 ,t e$cites the fauces and respiratory passages and promotes e$pectoration, for hich purposes it is useful in greatly depressed and atonic conditions of the lung. • *ynecologic !onditions9 ,ts most prominent and valuable action is upon the uterine organsK here it scarcely has an equal in atonic forms of prolapsus, leu#orrhea, passive hemorrhage and menorrhagia and similar enfeebled conditions. While its use in sensitive patients and irritable uterine conditions is to be avoided, it can be employed to the greatest advantage in flaccid and prostrated states for the maladies named above. 6hough in no sense and astringent, its tonic influence is peculiarly efficacious in arresting too e$cessive menstruation and lochia, hen associated ith la$ity and depressionK and it rarely fails to arrest a threatened abortion arising form the same conditions. ,t has been reported that a full dose =a> ill arrest natural menstruation for <B hours if ta#en hen the discharge first sho ed itselfK and this ithout the least disadvantage to the oman. 6hat these influences over the uterine function are due to the pure tonic action of the agent is at once seen in the fact that it is a valuable article to restore the menstrual flo hen this is absent from sheer in ability of the generative organs. • *enitourinary !onditions9 +elonias has been used in atony of the #idneys, Bright@s disease and diabetes here it distinctly diminishes the amount of saccharine flo in the latter malady. #harmacy: +elonias is seldom administered aloneK but is most frequently employed in combination to give intensity to more rela$ing and less positive agents. =!oo#> )or e$pectorant effects, combine ith Aralia and 'upatorium perfoliatum. =!oo#> )or tonic effects, combine ith )rasera, 1opulus, +ydrastis and other agents. =!oo#> 1o dered root9 A&2 g =Alschuler> A0&AE grains, tid&qid =AE grains T Ag> for digestive complaints =?ing> 20&<0 grains =?ing> %ecoction9 A tsp.3cup aterK sig A cup 6,% =Alschuler> 6incture9 A9E <EG 't0+K sig 3&E ml 6,% =Alschuler> A lb. crushed root is macerated for t o days ith si$ty percent alcohol then percolated, sig 3&E gtt in simple syrup 5pecific 6incture9 A&20 gtt =?ing> )luid e$tract A9A <EG 't0+K sig A&2 ml 6,% =Alschuler> Contraindication: *iven the estrogenic effect of !hamelirium, it should be avoided in conditions of estrogen sensitivity or e$cess such as uterine myoma and endometriosis. !hamelirium should never be used in sensitive conditions of any organ system. EEF ,n particular, it is a mucosal irritant that should be avoided in inflammation of the alimentary tract.EEH )o*icity9 ,n large doses, it is a cardiac poison. !+A/A'.,4,U/ .U6'U/ ,5 0:' 0) 0U4 /056 ':%A:*'% 51'!,'5, !.05' 60 'P6,:!6,0: A!!04%,:* 60 U:,6'% 1.A:6 5A7'45.
553 554

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 23C&<F )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. <BC&C0 555 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. p <FH&B 556 !oo#, p <FH

557

Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AE2

Chelidonium maBus
Common name: *reater !elandine Ha!itat: Botanical description: #art used: root, herb Historical use: $nergetics: :o information is currently available Constituents: *reater celandine, li#e other members of the 1apaveraceae =poppy> family, contains al#aloids as its main active compounds. • ,soquinoline al#aloids including coptisine =main al#aloid>, !helido$anthine, chelidonine, chelidonine, berberine EEB #harmacology: Animal and in vitro studies have sho n that the al#aloids and hole plant e$tract can relieve gallbladder spasms and stimulate an under&active gallbladder.EEC ,n vitro and animal studies have also sho n celandine e$tracts and its al#aloids to have anti& inflammatory, anti&cancer and anti&microbial properties. 6hey have also consistently sho n !helidonium@s ability to protect animal livers from to$ic substances. EF0 Medicinal actions: 5timulant, acrid, alterative, diuretic, diaphoretic, purgative, and vulnerary. )raditional Medicinal Uses: 5pecific ,ndications and Uses9 ?ing listed9 large, pale, sallo tongue and mucous membranes, sometimes greenish yello K s#in pale and sallo , sometimes greenishK hepatic congestionK "aundice, due to s ollen bile ductsK sluggish hepatic actionK cough, ith hepatic painK fullness, ith tensive or throbbing pain in the right hypochondrium, and pain e$tending to right shoulderK melancholia, headaches, and gastric disorders, dependent upon faulty action of the liver. EFA 'lling ood added9 deficient glandular function ithin the abdomen, sluggish circulation ithin the abdomen. 6he specific e$ternal use is in the application of the "uice to arts and corns. +e further described the patient picture of !helidonium as a patient suffering from a headache hich began in the occiput before rising in the morningK poor appetiteK cold hands and feetK tongue large, thic#, pasty, ith a grayish colorK cool s#in of a dus#y color. EF2 • • • %ermatological !onditions9 !helidonium as used for scrofula, cutaneous diseases, and piles. *astrointestinal !onditions9 Bilious dyspepsia, ith headache, and other gastric and intestinal disturbances, due to faulty action of the liver, ere ell treated ith it. +epatobiliary !onditions9 Used in hepatic affections, it as supposed to e$ert a special influence on the spleen. ,t as said to influence tissues innervated by the branches of the solar ple$us =celiac ple$usa>, and ith blood from the hepatic artery, and to some e$tent by the splenic artery.EF3 !ongestion or irritation3inflammation of the liver, spleen or pancreas all respond to !helidonium as it stimulates the circulation of these organs. EF< Both acute and subacute forms of hepatic inflammation, hen suppuration as not present, indicated !helidonium as ere migraines, bilious headaches and supraorbital neuralgia =considered a hepatic associated headache>. +epatobiliary conditions due to capillary engorgement of the viscera indicated !helidonium. ,t is one of the best of remedies for biliary catarrh resulting from hepatic congestion, biliary calculi and for "aundice due to obstruction of the bile ducts. 6hus, any condition ith decreased bile secretion called for it. ,n particular, it is utili(ed in the prevention of biliary calculi. )ull, tensive, or throbbing pain in the right hypochondrium, and pain e$tending to beneath the right scapula, are the guides to its use in these hepatic disorders. EFE ,n addition, 5cudder stated that the mucous membranes enfeebled and full, right hypochondrium full, abdomen tumid, feces light in color, and urine of high specific gravity, and pale, but cloudy. As a rule there is no general abdominal pain. 'dema of the e$tremities is sometimes an added indication.EFF 6opical Applications9 6he "uice, hen applied to the s#in, produces inflammation and vesication. 6his use as #no n as a caustic for the removal of arts, indolent ulcers, fungous gro ths, etc as ell as in removing spec#s and opacities of the cornea. !elandine as considered superior to Arnica as a vulnerary for traumatic inflammations and as used internally in decoction or tincture, and e$ternally in poultice or ointment.

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Current Medicinal uses:

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+epatobiliary !onditions9 A number of uncontrolled clinical trials have demonstrated the spasmolytic and cholagogue effects of !helidonium hich may be beneficial in gall bladder colic. EFH :umerous herbs #no n variously as cholagogues and choleretics have a reputation for helping prevent gallstones in traditional herbalism. !holagogues are herbs that stimulate the gall bladder to contract, hile choleretics stimulate the liver to secrete more bile. Both of these actions could potentially help reduce the ris# of developing gallstones. :o modern studies have been done to test these hypotheses. Articho#e, turmeric, fumitory, fringe tree, greater celandine, dandelion root, barberry, and 0regon grape are cholagogues and choleretics. EFB

Current +esearch +eview: • 9astroenterology: o Cholangitis' cholelithiasis and cholecystitis: EFC  %esign9 Uncontrolled clinical trial  1atients9 )orty patients ith cholangitis, cholelithiasis and cholecystitis ithout stones  6herapy9 !helidonium fresh plant tincture standardi(ed to 20 mg al#aloids per A00 mlK sig 3 ml qd $ <3&E0 d.  4esults9 !helidonium e$tract e$erted good to very good results in 233 of patients. o A!dominal pain:%(8  %esign9 Uncontrolled clinical trial  1atients9 5i$ hundred and eight patients ith cramp&li#e pains in the gastrointestinal tract =<3G> or gall ducts =<B.2G>.  6herapy9 5tandardi(ed preparation of dried !helidonium. E tablets qd =2.BEmg of total al#aloids including 0.HC mg chelidonine3 tablet> initially, then 3 tablets qd in patients ho responded to treatment. Average duration9 22 days, longest W 2.E months.  4esults9 *ood or very good therapeutic effect on symptoms ith a quic# response in BH.<G of cases. 5ymptom relief occurred ithin 30 min of ta#ing the medication in F2.3G cases. ,n <F.AG of patients, the average duration of efficacy of each tablet as better than 3 hours. !helidonium as found to be efficient for treatment of cramp&li#e abdominal pains associated ith ,B5 and other causes. o Colonic polyposis: 4tudy "9EHA  %esign9 Uncontrolled clinical trial  1atients9 1atients ith colonic polyposis  6herapy9 'nemas ith infusion of dried !helidonium  4esults9 Administration of A0 or more enemas resulted in complete disappearance of colonic polyps in several cases. 4tudy 09EH2  %esign9 Uncontrolled clinical trial  1atients9 0ne hundred and forty nine patients ith colonic polyposis treated over a t o&year period.  6herapy9 'nemas ith infusion of dried !helidonium follo ed by fresh plant paste 2&3 hrs after an evacuant enema. 6 o&three courses consisting of A0&20 enemas each.  4esults9 6his therapy as inefficient for treating malignant regenerated or degenerated polyps. 0ut of A<C patients ith various forms of polyposis, BHG of patients sho ed improvement ith 2HG ma#ing a complete recovery. o Biliary dyskinesia:EH3  %esign9 4andomi(ed placebo&controlled double&blind multicenter clinical trial  1atients9 1atients ith dumpy or colic#y 4U2 abd pain d3t biliary dys#inesia. 3C patients W e$perimental, 3H patients W placebo.  6herapy9 !holagogum ) :attermann =dried e$tracts from 5choll#raut and !urcuma> $ 3 ee#s  4esults9 4eduction of pain as more rapid during the A st t$ ee# in the e$perimental group. 4eduction of other complaints =feeling of being filled up, food intolerance, n3v, meteorism> as similar in both groups during the hole t$ period. :o 5' ere observed. • Dermatology: o 6arts: EH<  %esign9 Uncontrolled clinical trial  1atients9 :ursing mothers ith arts, papillomas, condylomas and nodules.  6herapy9 Alcohol e$tract of !helidonium topically to the affected area T 200 $3day $ 2&3 ee#s or until improvement as noted.  4esults9 !omplete resolution of arts after AE&20 days in A3E omen. • #ulmonology:

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Chronic !ronchitis:EHE  %esign9 Uncontrolled clinical trial.  1atients9 !hronic bronchitis patients  6herapy9 5yrup or e$tract of !helidonium =equivalent of AE mg of herb qd>  4esults9 6he effective rate as TB0G. ,t as more effective in the simple type than the asthmatic type. o 6hooping cough: %(&  %esign9 Uncontrolled clinical trial  1atients9 E00 children ith hooping cough.  6herapy9 !helidonium syrup or a decoction of the fresh herb. ,nfants c F months9 E&B mlK F&A2 mo9 B&A0 mlK A&3 yo9 A0&AE mlK 3&F yo9 E&20 mlK and above F yo9 20&30 ml $ B&A0 days.  4esults9 3EE cases cured, AAF cases improved. 3ncology: o #ancreatic cancer:%((  %esign9 /onocentric controlled randomi(ed clinical trial, phase ,,  1atients9 C0 patients ith histologically proven unresectable pancreatic cancer.  6herapy9 3 groups. A9 A000 mg gemcitabine3m2, B9 20 mg U#rain =a semi&synthetic thiophosphoric acid compound of al#aloids isolated from !helidonium ma"us .>K !9 A000 mg gemcitabine3m2 follo ed by 20 mg U#rain.  4esults9 5urvival rates after F months ere 2FG in group A, FEG in group B, H<G in group !. o Caposi sarcoma:%(/  %esign9 6 o case reports  1atients9 A,%5 patients ith ?aposi@s sarcoma  6herapy9 U#rain E mg iv qod $ A0 in"ections.  4esults9 ?aposi@s sarcoma lesions diminished in si(e, sho ed decolouration during t$. :o lesion appeared in 30& day interval after the beginning of treatment. ,mmunological status improved9 total leu#ocytes, 6&lymphocytes, and 6&suppressor numbers increased. 0ne case sho ed increase in 6 helper lymphocytes. o Carcinomas9EHC  %esign9 6 o independent clinical trials  1atients9 2H patients ith various malignancies.  6herapy9 U#rain A0 mg iv q3d  4esults9 ,ncrease in both total 6&cells and 6&helper lymphocytes, a decrease in 6&suppressor cells, and normali(ation of the helper3suppressor ratio. 'rythrocyte&rosette&forming 6&cells and :? cells also increased. 5erum immunoglobulin levels, complement components =!3 and !<>, and acute phase proteins ere not significantly enhanced. 4estoration of cellular immunity as accompanied by an improvement in the patients@ performance status and in the clinical course of the disease. o 1ung cancer:%/8  %esign9  1atients9 :ine men, <2&FB yo, ith histologically proven lung cancer, previously untreated.  6herapy9 U#rain A0 mg iv q3d $ A0 in"ections.  4esults9 ,ncrease in the proportion of total 6&cells, and a significant decrease in the percentage of 6&suppressor cells. 6here as also a normali(ation of the +35 ratio. 4estoration of cellular immunity as accompanied by an improvement in the clinical course of the disease. 6he effect as particularly noted in patients ho responded to further chemotherapy. 0b"ective tumor regression as seen in <<.<G of treated patients. )our out of nine patients =<<.<G> died of progressive disease during the course of this study. ,t is concluded that U#rain can be immunologically effective in lung cancer patients and can improve human cellular response. $@): o Chronic tonsillitis:EBA  %esign9 !linical trial  1atients9 !hildren ith chronic tonsillitis  6herapy9 !helidonium ma"us .. tincture  4esults9 6incture improved tonsillar function, cellular and humoral immunity, nonspecific resistance, promoted a reduction in the number of recurrences. o

#harmacy: Contraindications: Brin#er speculates that !helidonium be avoided in pregnancy due to uterine stimulant activity in animal studies. EB2

)o*icity: Brin#er speculates avoiding use of !helidonium in children due to potential to$icity. EB3
558 559

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 560 ,bid 561 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 562 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. 3AE 563 )elter 564 'lling ood p 3AE 565 )elter 566 5cudder -. 5pecific /edications and 5pecific /edicines. 567 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000. p. 33B. 568 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 569 :eumman&/angoldt 1. Med +elt ACHHK2B=<>ABA&E. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 570 ?nieel 4, Urlacher W. ?eit )llg Med ACC3KFC=2E>9FB0&<. . !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 571 Aminev A/, 5toliaren#o A,. Gop "n3ol ACF0KF=B>BA&2. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 572 Aminev A/. )m 7 Proctol ACF3KA<=A>2E&H. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 573 :iederau !, !opfert '. 6he effect of cheldonium& and turmeric root e$tract on upper abdominal pain due to functional disorders of the biliary system. 4esults for a placebo&controlled double&blind study. Med .lin ACCCKC<=B>9<2E&30. 574 %emchen#o 1). Grachebn Delo ACEHKA29A33E&B. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 575 !hung +/, But 11. Pharmacology and applications of 2hinese material medica, vol A. World 5chietific, 5ingapore, ACBH93C0&<. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 576 !hung +/, But 11. Pharmacology and applications of 2hinese material medica, vol A. World 5chietific, 5ingapore, ACBH93C0&<. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 'dinburgh, 2000933B. 577 *ansauge ), 4amadani /, 1ressmar -, et al. :5!&F3AEH0 =U#rain> in the palliative treatment of pancreatic cancer. 4esults of a phase ,, trial. 8angenbec3s )rch ,urg 2002K3BF=B>9EH0&<. 578 7oltche# ,7, .iepins A, :o ic#y -W. 1otential therapeutic efficacy of U#rain =:5! F3AEH0> in A,%5 patients ith ?aposi@s sarcoma. Drugs Exp 2lin Res ACCFK22=3& E>92B3&F. 579 :o ic#y -W, 5tanis(e s#i A, 8bro"a&5ontag W, et al. 'valuation of thiophosphoric acid al#aloid derivatives from !helidonium ma"us .. =IU#rainJ> as an immunostimulatn in patients ith various carcinomas. Drugs Exp 2lin Res ACCAKAH=2>9A3C&<3. 580 5tanis(e s#i A, 5lesa# B, ?olod(ie" -, et al. .ymphocyte subsets in patients ith lung cancer treated ith thiophosphoric acid al#aloid derivatives from !helidonium ma"us .. =U#rain>. Drugs Exp 2lin Res ACC29AB 5uppl9F3&H. 581 ?hmel@nits#aia :/, 7orob@ev ?7, ?liach#o .., et al. A comparative study of conservative treatment schemes in chronic tonsillitis in children. Gestn "torinolarinol ACCBK=<>93C&<2. 582 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. E2 583 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. E2

Chenopodium am!rosioides' C2 antelminticum
Common name: Wormseed Ha!itat9 6ropical climates in Americas, esp. 'astern United 5tates

Chenopodiaceae =*oosefoot )amily>

Botanical description9 6he leaves are toothed ] oblong to lanceolate in shape. 6he small, numerous flo ers are yello ish&green in color, gro in small clusters at the a$ils of the leafy branches. 6he fruit is subglobular, 2 mm in diameter ] is greenish&yello to bro n in color. Upon rubbing the fruit, the pericarp is removed ] a single, small, glossy blac# seed is e$posed. 6he fruit has a strong odor, resembling that of 'ucalyptus. 6he taste is pungent ] bitter. )lo ering occurs from -uly W 5ept., 3 fruits ripening in the fall ] harvested in 0ct. #arts used9 5eeds. Constituents9 0il Qascaridol =an unsaturated terpene pero$ide, present up to H0G>, geraniol, cymene, terpinene, methyl salicylate, butyric acidR, triterpenes, triacontyl alcohol, alpha&spinasterol, nitrates Medicinal actions: Anthelmintic, Antispasmodic, 7ermifuge )raditional Medicinal Use: *, !onditions9 !henopodium e$pels round orms=Ascaris lumbricoides>, esp. in children. !henopodium is benificially antispasmodic, reducing the occurance of gripping that may occur 3 antihelminthic treatment. !henopodium seed oil has been used to treat hoo# orm =An#ylostoma uncinaria>, tape orm and hip orm as ell as round orms =Ascaris lumbricoides>. EB< *yne !onditions9 !henopodium seed oil is beneficial in amenorrhea. EBE !henopodium is thought to refle$ively stimulate the :5 and the uterus, ] is best used in cases of a depressed pulse ] asocc. surface cold. /enstruation can be promoted, esp. after e$posure to cold that has resulted in sudden suppression of menses. !henopodium is often combined 3 t ice the amount of A. archangelica to restore menses after e$posure to cold.EBF Current Medicinal use: *astrointestinal !onditions9 !henopodium is effective against round orms =Ascaris lumbricoides W esp. in #ids>, hoo# orms =An#ylostoma uncinaria>, ] small tape orms. .i#e other vermifuges, it is most effective hen given 3 a purgative to aid e$pulsion. !henopodium is less to$ic than other vermifuges, ] has been used in children, adults ] animals. Current +esearch +eview • 9astroenterology o #arasites:EBH  %esign9 'thnopharmacological evaluation and clinical field trials.  1atients9 Adults ith ascariasis  6herapy9 %ecoction of F000 mg of dried po dered !henopodium ambrodioides3 #g body eight  4esults9 :o significant anthelmintic effect as found on the adults of :ecator, 6richuris of Ascaris. #harmacy9 .i#e other vermifuges, it is most effective hen given 3 a purgative Before administering !henopodium, the patient has a liquid dinner and has no brea#fast the follo ing morning. )or children, treatment usually consists of one dose =administered ith sugar> of !henopodium follo ed in 2 hours ith a purgative and carminative. ,t is ise to administer a carminative =1impinella, )oeniculum, etc.> ith the purgative in order to ease intestinal colic. After purgation, the patient may eat food. 6his treatment may be repeated at A0 day intervals for at least 3 cycles. )or adults, the !henopodium is administered in three smaller doses =i.e. A&2 ml of tincture> spaced by 2 hours bet een each dose. 6 o to three hours after the last dose, a purgative =!astor oil, /g sulfate, 4hamnus purshiana, -uglans nigra, etc.> is given. 4epetition of the procedure at A0 day intervals is important in order to compensate for the lifecycle of the parasite. Brin#er states that repeated use of A&3 cc of the seed oil in a one& ee# period is contraindicated. EBB 1o dered seed9 A&< g 7olatile oil9 E&AF drops =A ml> A9E 6incture9 2&< m )luid e$tract9 A3<&2 tsp. Contraindications:

According to Brin#er, the seed oil may act as an irritant to the alimentary tract suggesting avoidance in stomach or intestinal disease. +e also states that the seed oil acts a cardiac depressant, thus it is contraindicated in heart diseaseK is hepatoto$ic being avoided in hepatic diseaseK in #idney disease as the seed oil has renal to$ic effects. ,n general, the seed oil should not be used alone in the undernourished or debilitated sub"ects or in very young children due to its potential to$icity. EBC=6here appears to be some contradiction here ith the findings of other authors. Brin#er states that large doses or use in children under four years of age is contraindicated.> 6he oil ill provo#e uterine pain in pregnancy and is contraindicated due to its emmenagogue and abortifacient effects =empirical>.EC0 )o*icity9 6he to$icity of !henopodium is lo er than other vermifuges hich ma#e this plant preferential in the treatment of orms. Burning sensation in throat and mouth, :37, h3a, tinnitus, dro siness, sleep, decreased respiration, variable heart rate, gastric ulcer, constipation, prostration, nephritis, decreased blood pressure, spinal cord depression, death by respiratory paralysis. Administer stimulants =i.e. coffee> to induce a#efulness. =Alschuler> 6he fresh plant can cause contact dermatitis. =Brin#er>
584

'lling ood, )1 )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago. ACAC p. E0E 585 )elter +W, .loyd -U1 .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 586 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy . 'clectic /edical 1ublications, 5andy, 04 ACBE 587 ?li#s //. 5tudies on the traditional herbal anthelmintic !henopodium ambrosioides ..9ethnopharmacological evaluation and clinical field trials. ,oc ,ci Med ACBEK2A=B>9BHC&BF. 588 Brin#er, ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A3H 589 Brin#er, ). Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A3H 590 !oo#, p. 33HK Brin#er p. A3H

Chimaphila um!ellata
Common name: 1ipsisse a Ha!itat:%5" 'urope, Asia, 5iberia, :. and 5. America. 1rotected species in *ermany.

$ricaceae

Botanical description: EC2 • )lo er and )ruit9 1ipsisse a has terminal inflorescences A0 cm long ith umbels of 2&H flo ers. )lo ers, hich are initially bright pin# and then hite, are nodding and mildly campanulate. 6he E sepals are obovate, dentate, and about a third as long as the E petals. 6he petals are broadly ovate, domed, pin#, and E&F mm long. 6he A0 stamens are thic#ened at the base, edges are inged, and ciliate. 6he anthers are short, thic#, and red. 6he style is very short and the stigma is broad and shorter then the antehrs. 6he fruit is a E&grooved capsule ith erect stems. • .eaves, 5tem, and 4oot9 1erennial semi&shrub up to 2E cm high ith upright, angular stem and a creeping hite rhi(ome. 6he evergreen, alternate leaves are short&petioled, coriaceous, ovate&spatulate to linear and edge&shaped. 6he leaf margin is sharply serrate. #arts used: • +erba, esp. leaves • 4oot EC3 Constituents and #harmacology2EC< =Ubiquitous or non&active constituents not included> • Arbutin =.eaf>9 Allelochemic >2#%L%1% mMK Antibacterial M>2L',---9(,--- ppmK Antiseptic $-9&-- mg6manK Antistreptococcic M>2L',---9(,--- ppmK AntitussiveK ArtemicideK !andidicideK %iuretic $-9&-- mg6manK ,nsulin&5paringK /ycoplasmistatK 1esticideK Urinary&Antiseptic • !affeic acid =.eaf>9 Aldose&4eductase&,nhibitor ' ug6ml 0:ea3 acti!ityBK AllergenicK AnalgesicK AntiadenoviralK AntiaggregantK AntibacterialK AnticancerK AnticarcinogenicK AntiedemicK Antielastase >2#-L*C um6lK AntifluK AntigonadotropicK Antihemolytic &# uMK Antihepatoadenomic &-- ppm diet orl musK Antihepatoto$icK Antiherpetic #- ug6ml E2#-LM#- ug6mlK AntihistaminicK Anti+,7 E2#-L&-- ug6mlK AntihypercholesterolemicK AntiinflammatoryK Antileu#otrieneK AntimutagenicK AntinitrosaminicK AntiophidicK Antio$idant %1C x Git1 E %6C <uercetin C- mM #- um >2#4LC- ppmK Antipero$idant >2#-L'' uMK AntiprostaglandinK Antiradicular %6C <uercetin %- uM C- mMK AntisepticK Antispasmodic E2#-LC1'9%# uMK AntistomatiticK AntisunburnK AntithiaminK AntithyroidK Antitumor &-- ppm diet orl musK Antitumor&1romoter >2'&L%- uMK AntiulcerogenicK AntivacciniaK Antiviral >2#-L$&1# ug6mlK !alcium&Antagonist >2#-L%1& uM rbtK !ancer&1reventiveK !arcinogenic &E 0dietBK !holagogueK !holereticK !lastogenicK !:5&ActiveK !o&carcinogenicK !ollagen&5paringK !ytoprotectiveK !ytoto$ic T2#-L&-- ug6mlK %iureticK %:A& ActiveK )ungicide M>2L-1' mg6mlK +epatocarcinogenic '-- ppm diet orl mus 0in the absence of alcoholB K +epatoprotectiveK +epatotropicK ,mmunostimulantK ,nsectifugeK .ipo$ygenase&,nhibitor >2&4L# mM >2#-L$&9%'( uMK .yase&,nhibitor >2#-L*'9 %$' uMK /etal&!helatorK 0rnithine&%ecarbo$ylase&,nhibitorK 1esticideK 1roo$idantK 1rostaglandigenicK 5edative #-- mgK 5unscreen >2#-L&1# mg6l >2*%L# mg6l >2*(L&# mg6lK 6umorigenicK 7ulneraryK Panthine&0$idase&,nhibitor >2#-LC*1&% um • 'ricolin =leaf>9 AntisepticK %iuretic • )erulic acid =leaf>9 AllelopathicK AnalgesicK AntiaggregantK AntiallergicK AntiarrhythmicK AntibacterialK Anticancer =!olon>K Anticancer =)orestomach>K Anticancer =.iver>K Anticancer =5#in>K AnticarcinogenicK AntidysmenorrheicK AntiestrogenicK Antihepatoto$icK AntiherpeticK AntiinflammatoryK AntimitoticK AntimutagenicK Antineoplastic 0,tomachBK AntinitrosaminicK Antio$idant C,--- uM >2#%L&-- ppmK AntiserotoninK AntispasmodicK AntithrombicK AntitumorK Antitumor =!olon>K Antitumor =)orestomach>K Antitumor =.iver>K Antitumor =5#in>K Antitumor&1romoter >2'$L%- uMK AntiviralK ArteriodilatorK !ancer& 1reventiveK !andidicideK !ardiacK !holagogueK !holereticK )ungicideK +epatoprotectiveK +epatotropicK +erbicideK +ydrocholerecticK +ypolipidemicK ,mmunostimulantK ,nsectifugeK /etal&!helatorK 0rnithine&%ecarbo$ylase&,nhibitorK 1esticideK 1hagocytoticK 1reservativeK 1rostaglandigenicK 1rostaglandin&5ynthesis&,nhibitor -1#(9C1& mMK 5unscreenK Uterosedative C-9 %-- mg63g i!n rat • *allic acid =plant>9 A!'&,nhibitor >2#-L414 mM6lK AnalgesicK AntiadenovirusK AntiallergenicK AntianaphylacticK AntiasthmaticK Antibacterial M>2L%,--- ug6mlK AntibronchiticK AnticancerK Anticarcinomic ED#-LCK AntifibrinolyticK AntifluK Antihepatoto$icK Antiherpetic E2#-LM%- ug6mlK Anti+,7K AntiinflammatoryK Antileishmanic E2#-L'1' ug6mlK AntimutagenicK AntinitrosaminicK Antio$idant 4 x <uercetin >2''LCC ppmK Antipero$idant >2#-L$* uMK AntipolioK Antiradicular 4 x <uercetinK AntisepticK Antistaphylococcic M>2L%,--- ug6mlK AntitumorK Antitumor&1romoterK AntiviralK ApoptoticK AstringentK BacteristatK BronchodilatorK !ancer&1reventiveK !arcinogenicK !holereticK !ycloo$ygenase&,nhibitorK )loral&,nhibitorK *ram=X>icideK *ram=&>icideK +emostatK ,mmunomodulatorK ,mmunostimulantK ,mmunosuppressantK ,nsulin&5paringK /yorela$antK :ephroto$icK 5typticK 6opoisomerase&,&,nhibitorK Panthine&0$idase&,nhibitor • *aultherin =leaf>9 AntiinflammatoryK %iuretic

• •

• •

•

/ethyl salicylate =leaf>9 #,''# 9 4,*&- ppm AllergenicK AnalgesicK AntiinflammatoryK AntipyreticK AntiradicularK AntirheumatalgicK AntisepticK !ancer&1reventiveK !arminativeK !ounterirritant 1&coumaric acid =leaf>9 Aldose&4eductase&,nhibitor ' ug6ml 0:ea3 acti!ityBK AllelopathicK AntibacterialK AntifertilityK Antihepatoto$icK AntinitrosaminicK Antio$idant >2&'LC- ppmK Antipero$idant >2#-LM%-- uMK AntispasmodicK AntitumorK !ancer& 1reventiveK !holereticK !ytoto$icK %iaphoreticaK )ungicideK .ipo$ygenase&,nhibitor >2%%L# mMK 1esticideK 1rostaglandigenicK 1rostaglandin&5ynthesis&,nhibitor 1&hydro$y&ben(oic acid =.eaf>9 AntibacterialK AntimutagenicK Antio$idantK AntiradicularK Antisic#ling %-1# ug6mlK !ancer& 1reventiveK )ungistat E2#-L$-4 ug6mlK ,mmunosuppressantK 1esticideK 1hytoale$inK 1rostaglandigenicK 5ecretogogueK Ubiquiot 6annic acid =leaf>9 Aldose&4eductase&,nhibitor >2#-L%1( ug6mlK AllergenicK Antianacarditic 0RhusBK AntibacterialK AnticariogenicK AnticoliticK AntidecubiticK AntidermatoticK AntidiarrheicK Antidote or Hea!y MetalsK AntidysentericK AntiencephaliticK AntienteriticK Antifeedant &9'E dietK AntigargantiticK AntigingiviticK AntihemorrhoidalK AntiherpeticK Anti+,7 >2*-L&-- ug6mlK AntimutagenicK AntinitrosaminicK Antiobesity 0)ntinutrientBK AntiophidicK Antio$idant >2#$LC- ppmK AntipharyngiticK AntipolioK AntirhiniticK AntisepticK AntistomatiticK AntitonsiliticK AntiulcerK AntiviralK AstringentK !ytoto$ic %# ugK %eto$icantK 'meticK ).avor EM) %9%,---K +emostatK +epatoto$icK ,mmunostimulant 7anillic acid =leaf>9 Aldose&4eductase&,nhibitor %-- uM6lK AnthelminthicK Antibacterial %1#9%# mg6mlK AnticancerK AntifatigueK AntiinflammatoryK Antio$idant >2&%LC- ppmK Antiradicular 4 x <uercetinK Antisic#lingK AntitumorK Antitumor&1romoterK AscaricideK !ancer&1reventiveK !holereticK ,mmunosuppressantK

Medicinal actions: astringent, alterative, tonic, diuretic, antiseptic )raditional Medicinal uses: *enitourinary !onditions9 1ipsisse a as used as tonic diuretic and alterative, influencing the urinary apparatus in a similar manner to the Buchu and Uva&Ursi. ,t as thought to relieve irritation of the entire urinary tract and to improve the circulation and nutrition of these organs. 6reatment of scrofula and secondary syphilis ere other indications. ECE 5pecifically, it as recommended to use !himaphila in cases of thic#, ropy urine ith bloody sediment, itching and pain in the urethra and bladder, in urethritis ith profuse and purulent discharge, strangury =painful, interupted urine produced in drops due to a spasmodic contraction of the urethra and bladder>, chronic nephritis, and chronic gonorrhea.ECF Current Medicinal uses: • *enitourinary !onditions9 Urinary tract antiseptic, diuretic, tonic. /ost useful in early pyelitis nephritis. 1rostitis and inflammation of the cervical lymph glands, urethritis. +as been used for gonorrhea. ECH !himphila is especially indicated for pelvic congestion manifested in the urinary system as scanty urine or thic#, mucopurulent and3or bloody urine, ith burning on urination and general ea#ness. 6he arbutin in !himiphila lends antimicrobial activity to the plant. Arbutin is most active hen the p+ of the urine is al#aline =5ee Arctostaphylos for more on arbutin. !ompared to Arctostaphylos, a #ey arbutin containing botanical, !himaphila does not have tannins, hich may differentiate the use bet een these t o herbs>. !himaphila can be used for any infection in the urinary system9 cystitis, pyelonephritis, and prostatitis. ,t is best combined ith other antimicrobial and demulcent herbs for infections of the urinary system. !himaphila can also be used for long&term support of #idney and bladder function hen there is ea#ness manifested as scanty urine, urinary incontinence, albuminuria, glucosuria, or lo &grade pelvic pain. 0ne physician has claimed that it ill reduce the mammary glands or testicles if ta#en too long. ECB • /usculos#eletal !onditions9 4oot can be used as anti&rheumatic via improvement of #idney function. ECC • Q *astrointestinal !onditions9 %igestive and hepatic tonic. !himaphila is indicated in the latter stages of typhoid fever ith deficient e$cretion. • .ymphatic !onditions9 !himaphila is also classified as a lymphatic and tends to promote decongestion of lymphatic tissues. ,ts use has been employed hen the lymph nodes of the abdomen are filled as in diarrhea or cholera. !ervical lymphadenopathy may also respond ell to !himaphila as in buboes or scrofula here the fresh plant tincture can be applied topically and internally. 'dema from any cause is an indication for its use. !himaphila has been used for enlarged parotid glands. • %ermatological !onditions9 !himaphila also removes lesions of the s#in, particularly the glands, caused by the presence of aste products resulting from defective catabolism. 6he fresh plant tincture can be applied topically and internally. • *ynecological !onditions9 !himaphila may be utili(ed in leucorrhea ith copious mucous secretion and mastitis and as an ad"unct in the treatment of breast cancer. RF00 Current +esearch +eview: • 5earch of /edline revealed no human trials as of A3AE303 #harmacy: • 6incture9F0A

• • •

Unspecified strength, from root, anti&rheumatic effect9 A0&20 qtts 2,% Unspecified strength, from root, genito&urinary agent9 E&30 qtts 2,% in large glass of ater. Unspecified strength, from hole plant, glandular effect9 3&20 qtts

Drug interactions: none #no n.F02 Contraindications: none #no n.F03 )o*icity.side effects: • 6he fresh leaves can cause contact dermatitis. F0< • 0rally, chronic use may lead to hydroquinone to$icity. 5ymptoms of to$icity include tinnitus, vomiting, delirium, convulsions, and collapse. F0E
591 592

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p.ECE ,bid. 593 W. /itchell, ;aturopathic )pplications of the Botanical Remedies, 2nd ed., ACB3, p.A3. 594 -ames A. %u#e, I!hemicals and 6heir Biological Activities in9 !himaphila umbellata,J Dr1 Du3eFs Phytochemical and Ethnobotanical Databases , chttp933 .ars& grin.gov3du#e3inde$.htmlY. 595 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed, 'clectic /edical 1ublications, 5andy, 04, AC03, p. A0C. 596 )inley 'lling ood, )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago, ACAC, pp. 3HH&B. 597 W. /itchell, ;aturopathic )pplications of the Botanical Remedies, 2nd ed., ACB3, p.A3. 598 4eference not found 599 /itchell, pp. 3F, <A. 600 4eference not found 601 /itchell, pp. A3, 3F, <A 602 I/onograph9 1ipsisse a,J :atural /edicine %atabase, April AC, 2002, chttp933 .naturaldatabase.com3monograph.aspamonodidOA02]hiliteOAY, April 2A, 2002. 603 ,bid 604 )rancis Brin#er, Herb 2ontraindications and Drug >nteractions, 2nd ed., 'clectic /edical 1ublications, 5andy, 0regon, ACCB, p. A<C. 605 A. ;. .eung, 5. )oster, Encyclopedia of 2ommon ;atural >ngredients Dsed in ood, Drugs and 2osmetics, 2nd ed., -ohn Wiley ] 5ons, :e ;or#, ACCF, cited in I/onograph9 1ipsisse a,J :atural /edicine %atabase, April AC, 2002, chttp933 .naturaldatabase.com3monograph.aspamonodidOA02]hiliteOAY, April 2A, 2002.

Chionanthus virginicus
Common name: )ringe tree Ha!itat: 6his is a small tree that gro s in the 5.'. part of the U.5.

3leaceae

Botanical description9 6he tree bears hite flo ers and has large leaves. 6he root bar# is found in irregular, quilled dull&bro n pieces. Historical uses9 ,t as used by turn of the century medical practitioners in the treatment of typhoid fever and malaria. #arts used9 4oot bar# Constituents9 .argely un#no nK chionanthin =hemolytic saponin glycoside>, phyllyrin =lignin glycoside> #harmacology: :ot specifically #no n. ,n general, cholagogues stimulate the flo of bile into the small intestine hereas choleretics increase the production of bile by the liver. Medicinal actions9 Alterative, choleretic, cholagogue, diuretic, tonic, antiemetic, la$ative. )raditional Medicinal Use: 5pecific ,ndications and Uses.Z%irty, sallo s#in, ith e$pressionless eyes and hepatic tendernessK an icteric hue, ith or ithout painK hepatic colicK intense pain from liver to umbilicus, attended ith nausea and vomiting and great prostrationK pain in epigastrium and right hypochondrium, simulating colic, sometimes e$tending to the abdomenK "aundice, ith itching s#in and thin, light&colored, atery stoolsK tympanitesK colic, ith green alvine dischargesK urine stains the clothing yello . F0F 0ther specific indications ere hepatic congestion, "aundice, 4U2 pain or soreness, pain in the epigastriumK pain radiating from the navel over the abdomenK nausea, vomiting, constipation ith dry feces, slight fever. • *astrointestinal !onditions9 !hionanthus as regarded to improve the appetite, aid digestion, promote assimilation, and e$ert a tonic effect on the hole system. ,n dyspepsia, ith hepatic complications, irritative states of the stomach from rich foods and in general chronic inflammatory conditions of the duodenum and common bile duct, !hionanthus served a useful purpose. ,t is also a good remedy in infantile dyspepsia and also in pancreatic disease, inflammatory or other ise. F0H • +epatobiliary !onditions9 !hionanthus as considered to principally act upon the abdominal glandular organs, and to some e$tent upon the venous system, relieving congestion. ,t as considered to promote all glandular secretions slo ly, but especially those of the liver, gall&ducts, and #idneys.F0B A strong indication is in acute congestion of the liver ith deficient bile secretion, particularly if "aundice is present. +ypertrophy of the liver, chronic hepatic inflammation, and portal congestion are speedily relieved by !hionanthus. 6he remedy acts quic#ly, often removing in from A to 2 ee#s, an icteric hue that has e$isted for months, and even years. According to ?ing, I,f there is any one thing true in specific medicine, it is that !hionanthus has a decidedly specific action in "aundice.JF0C ,t as considered the best remedy for all cases of "aundice, although debate occurred as to hether or not it as indicated hen gall stones ere present9 5cudder said it as, ?ing said it as not and !oo# did not comment. !hronic splenitis and nephritis are conditions in hich fringe&tree often proved a good remedy. !hionanthus as used historically to treat malaria because it stimulates the activity of both the liver and the spleen. • *ynecologic !onditions9 !hionanthus as utili(ed in uterine and ovarian congestion, hen the usual hepatic symptoms calling for it ere present. 0ccasionally, !hionanthus as used for uterine leucorrhoea. • 6opical Applications9 As a poultice it ill be found an e$cellent local application in e$ternal inflammations, ulcers, and ounds. Current Medicinal use: • 'ndocrine !onditions9 !hionanthus stimulates all glandular tissue to some e$tent. )or this reason, !hionanthus is helpful in the treatment of type ,, diabetes and hyperglycemia through its hepatic and pancreatic stimulation. ,n this regard, !hionanthus may be used long&term as preventative for diabetes and diabetic complications. • +epatobiliary !onditions9 !hionanthus is a very useful herb for all types of liver and gall&bladder complaints. ,t is especially indicated in inflammation of the gall&bladder and gall stone gravel as it stimulates the release of bile. 6hrough its cholagogue action, it prevents the formation of calculi, and e$pulsion of formed stones. 6his action also lends it an aperient effect. !hionanthus is also ell&indicated in congestive states of the liver, especially in overt "aundice. !hionanthus can be used to effectively treat neonatal "aundice and other "aundices in children. !hionanthus is most indicated in states of hepatic congestion ith partial obstruction =due to hepatic inflammation and3or gall stones>, e$cess mucous, and impaired hepatic functioning =i.e. impaired metabolism of urea ith resultant increase in uric acid e$cretion and consequent "oint disease, impaired production of bile>.

Current +esearch +eview: • 5earch of /edline revealed no human trials as of :ovember 2002. #harmacy9 ,nfusion9 A&2 tsp bar#3cup aterK sig A cup 6,% 6incture A9E 2EG 't0+K sig A&2 ml 6,%

Contraindications: !hionanthus should not be used in cases of impacted stones, malignant gro ths or other obstructions of the bile duct. FA0,FAA )o*icity: 1tyalism =e$cessive salivation> has resulted from its use.
606 607

)elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. )elter 608 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 609 )elter 610 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. 3A< 611 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. H<

Cimicifuga racemosa (Macrotys racemosa' Actaea racemosa

+anunculaceae Common name: Blac# cohosh, blac# sna#eroot, rattle sna#e root, bugbane, /acrotys, estern bug bane, tall bugbane, rattleroot, rattle eed, squa root, , rich eed Ha!itat: !imicifuga gro s on hillsides and in oods at higher elevations from /aine through 0ntario to Wisconsin at the north and to *eorgia through /issouri in the 5outh. Botanical description9 A perennial herbaceous plant, ith a smooth stem gro ing to a height of 2&< ft. 6he leaves are tripartate ith oblong leaflet that are incisely serrated. )lo ers are hite in long slender racemes, ith many stamens, and a disagreeable odor. 6he fruits are ovate capsules containing many flat seeds. #art Used9 4oot and rhi(ome =dried> Historical Use: :ative Americans used !imicifuga for relief of pain during menses and childbirth and against sna#e bites. Constituents9 • 6riterpene glycosides3 saponins9 actein, cimifugoside, 2H&deo$yacetin, cimigenol, cimicifugin O macrotin, racemoside • isoflavones =formononetin>e • other9 isoferulic acid, caffeic acid, ranunculin =yielding anemonin>, volatile oile, tannin, estrogenic principle, al#aloids, salicylatese, resin =cimicifugin>, flavonoids #harmacology: )dapted from Mills and Bone: ,n animal studies, in"ections have increased the eight of the uterus, established menstrual cycles in "uvenile and climacteric animals.FA2 ,t has demonstrated selective reduction of serum .+ in ovariectomi(ed rats. FA3 At least t o groups of compounds appear to be responsible for this endocrine activity.FA< 0ne of hich the isoflavone formononetin, hich has been suggested to be an estradiol competitive antagonist by binding to estrogen receptors but not activating themK therefore, formononetin does not appear to affect .+ secretion.FAE 6he .+ suppressive effect appears to be caused by synergistically acting compounds that are not ater soluble. FAF Unli#e estradiol, !imicifuga e$tract did not stimulate in vitro gro th of mammary tumor cells and strongly inhibited proliferation at a 2.E µg3ml, particularly ith tamo$ifen9 the effect as greater than either substance used alone. FAH,FAB !imicifugoside inhibits lymphocyte blastogenesis, has an immunosuppressive activity on B cells function, and may inhibit 6 cell function at higher doses.FAC ,n turn, an in vivo study demonstrated that hen combined ith tamo$ifen, the antiproliferative effect of tamo$ifen as enhanced. )ccording to the Textboo3 of ;atural Medicine:$&6he action of !imicifuga appears to mimic estriol more closely than estradiol. ,n clinical studies of menopausal omen, the action of !imicifuga e$tract as primarily on the vaginal lining, similar to estriol, rather than the uterine lining li#e estradiol. 'striol also occupies receptors for shorter times than estradiol, hich may e$plain the receptor activity of !imicifuga. 6he main effect of !imicifuga is li#ely attributable to the synergism of the triterpenes and flavone derivatives and another unidentified constituent. 6hese compounds are believed to affect the hypothalamus and vasomotor centers resulting in decreased .+ secretion and relief of associated menopausal symptoms. ,n addition, not all of the suspected active constituents bind to estrogen receptor sites. !imicifuga does not affect of the release of )5+ or prolactin. )ccording to Dr1 Po:ell: 6here is an e$tensive literature derived from both e$perimental and clinical studies demonstrating estrogen effects for 2imicifuga1$&% 1harmacological studies have sho n that alcoholic e$tracts of 2imicifuga bind to estrogen sites in !itro1 %ocumented estrogenic effects of 2imicifuga have been found associated ith at least three synergistically acting constituents and 2imicifuga has been found to suppress hot flashes and lo er .+, but not )5+ levels. F22 A reduction in .+ may cause a resulting reduction in progesterone. 5tudies have found that post&hysterectomy patients sho an estrogen&li#e stimulation of the vaginal mucosa and symptomatically respond as ell to treatment ith 2imicifuga as to treatment ith various estrogens.F23,F2<,F2E 2imicifuga has hypotensive effects and has been found to cause peripheral vasodilatation in humans. F2F,F2H )ccording to Dr1 8o: Dog: !imicfuga is not estrogenic and is li#ely not a 5'4/. 6he !hinese varieties have the effect of a 554,. 5ome research suggests that 554,s may help ith menopausal 5$. !imicifuga is antiinflammatory Medicinal Actions9 anti&spasmodice, estrogenic, sedative, diuretic, emmenagogue, anti&rheumatic, uterine tonic, anti&inflammatory, antitussive, e$pectorant, hypotensive, .+ antagonist, peripheral vasodilator, synergist Medicinal use: !imicifuga is used in three systems9 musculo&s#eletal, respiratory, and female reproductive. 6he isoferulic acid lo ers body temperature, thus this herb is cooling.

• *ynecologic !onditions9 6he anti&spasmodic and analgesic actions on the female reproductive system ma#e it useful for treating spasmodic dysmenorrhea or any spasm or tension of the female organs. !imicifuga =phytoestrogen> combines ell ith 7ite$ agnus castus =pituitary balancer hich increases progesterone> as a balancing formula for the female reproductive system. ,t combines ell ith !hamaelirium luteum in cases of amenorrhea and dysmenorrhea ith a dragging sensation in the pelvis. !imicifuga increases blood supply to the pelvis and hile it is anti&spasmodic, primarily e$erts a tonifying influence. !imicifuga is especially indicated in atony of the reproductive tract, i.e. infertility secondary to disordered action and lac# of tone in the reproductive organs. !imicifuga is a good partus preparator if given for several ee#s before labor. ,t is useful in labor hen the uterus is contracting ea#ly and irregularly yet there is e$cessive irritability of the uterine mm. !imicifuga ill help to sedate the uterus, ill soften the birth canal and ill aid in creating efficient uterine contractions. !imicifuga has been researched and utili(ed e$tensively in the management of menopausal symptoms. A standardi(ed e$tract called 4emifeminf manufactured in *ermany is used as a replacement or ad"unct for hormone replacement therapy. ,n a placebo controlled trial of AA0 menopausal omen ith climacteric hot flushes, 4emifeminf demonstrated effectiveness at relieving hot flashes.F2B 6he incidence of hot flushes is correlated ith increasing .+ levels, hich increase ith the ovarian insufficiency that occurs in menopause. 0ther clinical studies comparing 4emifeminf to estrogen and placebo sho that 4emifeminf has a superior ability to reduce menopausal symptoms and is ithout clinical side effects. +o ever, recent investigation has failed to find phytoestrogenic activity in 4emifeminf.F2C ,t has been postulated that the standardi(ation process may remove the phytoestrogenic compounds. • 1ulmonary !onditions9 ,t is anti&spasmodic, thus in the respiratory system it is useful in rela$ing spasms of bronchial smooth mm. as in the treatment of asthma =acute and chronic> or any paro$ysmal condition of the respiratory tract. !imicifuga ill allay a spasmodic, refle$ive cough by increasing bronchial secretions and sedating the nervous influence on the bronchial smooth muscle. • /usculos#eletal !onditions9 6he anti&spasmodic actions along ith the analgesic action =salicylatesa> ma#e it anti&rheumatic. !imicifuga is ideal for overstrained muscles ith dull aching pain=and rising temp. i.e. the beginning stages of a flu>. • !ardiovascular !onditions9 !imicifuga has been approved by the 4ussians an MofficialM treatment for high blood pressure due to its vasodilating action. !imicifuga is also a specific for auditory tinnitus =most li#ely secondary to +6:>. • /ale !onditions9 !imicifuga is indicated in inflammatory conditions of male reproductive organs soothing the nervous irritability and pain =i.e. orchitis, prostatitis> and assisting in the discharge of inflammatory products. )ccording to Dr1 Po:ell: 2imicifuga as commonly used by native Americans to relieve pain during childbirth and for treating dysmenorrhea and symptoms of menopausal syndrome. 'clectic physicians used 2imicifuga as Man ideal regulator of uterine contractions during labor.M 'arly Americans learned to use 2imicifuga for menopausal vasomotor instability. 2imicifuga as an ingredient in the famous .ydia '. 1in#hamNs 7egetable !ompound. A ACCE trial of 2imicifuga racemosa and Hypericum perforatum as found to be HBG effective in treating menopausal syndrome including hot flashes, headache, heart palpitations, irritability, and perimenopausal depression. 2imicifuga is commonly used in some 'uropean countries as an alternative to hormone replacement therapy =+46>. 6he efficacy of 2imicifuga in preventing osteoporosis has not been adequately studied. 2imicifuga racemosa has estrogenic effects that are relatively slo in appearing and it is observed that it is about one month before the full effects of 2imicifuga is established. ,t has been used to treat infertility ith decreased estrogen. 2imicifuga is also found particularly useful for omen ith nonspecific pelvic pain and endometriosis. ,t has been found useful in treating spastic dysmenorrhea, secondary amenorrhea, and hypomenorrhea associated ith lo estrogen and high progesterone levels, particularly in young omen. ,t has been used to treat epilepsy, particularly hen frequency of sei(ures increases premenstrually. 2imicifuga has an anti&inflammatory action that is useful in the treatment of fibromyalgia. ,t acts to reduce muscle soreness, heaviness, and stiffness. ,t as frequently used for Mlumbago and rheumatismM by eclectic physicians. ,t is a particularly effective in the treatment of fibromyalgia that accompanies the peri menopause and hypoovarianism. 2imicifuga has been used to treat degenerative and inflammatory arthritis, neuralgia, sciatica, and headaches that occur perimenopausally. 2imicifuga has been found useful in treating hypertension. 2imicifuga is a peripheral vasodilator, opposing the constricting effect of epinephrine on the circulatory system. ,t is found to be helpful in treating high blood pressure that is aggravated by, or associated ith stress. 6he anti&stress effects of 2imicifuga are also e$tend to its sedative and antispasmodic effects. ,t has been used to treat the detrimental effects caused by the chronic activation of the alarm stage of the /aladaptive 5tress 5yndrome =/55&A>. !imicifuga is 3no:n as a synergist, a botanical medicine that combines :ell :ith other botanicals1 The synergy is found to produce a beneficial therapeutic effect that is greater than the therapeutic effect of the isolated botanicals1 >t is 3no:n to combine particularly :ell :ith 7a3eriana spp )ccording to ,cudder the specific indications for !imicifuga are heavy, tensive, dull, aching pain as if d3t a contracted state of the muscular fibersK soreness of muscular tissues. )ccording to Mills and Bone:$C• *ynecologic !onditions9 !imicifuga is used in the treatment of climacteric symptoms and conditions arising from ovarian insufficiency. As an ad"unct, it may be used in the treatment of conditions requiring reduction in .+ levels such as miscarriage, cyst formation, infertility, ovarian tumorigenesis or polycystic ovary syndrome. ,n regard to menopause, omen appear to respond ell if premenopausal, perimenopausal or ith post&operative climacteric symptoms ith or ithout intact ovaries. Women ith symptoms of depression, short&term memory loss and tinnitus respond ell.

Another study demonstrated improvement after four ee#s of the standardi(ed e$tract ith similar improvement in nervousness, sleeplessness and depression. ,n omen ho had undergone hysterectomy ith at least one intact ovary and climacteric symptoms !imicifuga appears to be as effective as estriol and con"ugated estrogens. 5imilarly, it has been sho n at least as effective as con"ugated estrogens in stimulation of the vaginal mucosa, improvement in the vaginal cytological indices and associated s#in and hair problems. ,t as also more effective than dia(epam for vegetative and psychological alterations. )or dysmenorrhea, !imicifuga is an anti&inflammatory and hormonal herb that is indicated and can by combined ith !orydalis. • ,nflammatory !onditions9 1lants rich in phytosterols have been traditionally used for treatment of inflammatory conditions. !imicifuga has been used in the treatment of various types of arthritis although the research in this use is inconclusive. )ccording to the Textboo3 of ;atural Medicine:$C% • *ynecologic !onditions9 According to clinical trials, !imicifuga standardi(ed e$tract not only relieves hot flashes, but depression and vaginal atrophy associated ith menopause. :umerous clinical trials have demonstrated these effects. ,n regard to bone resorption, e$perimental and epidemiological evidence suggests that phytoestrogens reduce bone resorption and prevent osteoporosis. .ong&term evaluation of this effect is indicated. )or postmenopausal patients, bone minerali(ation can be monitored used the 0steomar#&:6P or %'PA scan. !imicifuga may also be beneficial in the treatment of menstrual disorders such as premenstrual syndrome, primary and secondary amenorrhea, dysmenorrhea, polymenorrhea, uterine fibroids. !imicifuga is a natural alternative to +46 hen the latter is contraindicated as in 9 omen ith a history of cancer, une$plained uterine bleeding, liver and gall bladder disease, pancreatitis, endometriosis, uterine fibroids or fibrocystic breast disease. !imicifuga may even demonstrate inhibitory effects as demonstrated in breast tumor cell lines. !ombination ith 6amo$ifen demonstrated the poteniation of the drug. )ccording to +eiss:$C& • *ynecologic !onditions9 !imicifuga is indicated specifically for conditions due to underlying estrogen deficiency including climacteric complaints and problems arising during pregnancy and in puberty. !imicifuga has a specific indication for spastic parametropathy. 6he ay in hich the menopausal syndrome responds to !imicifuga demonstrates the similarity of application for spastic parametropathy in young omen, particularly here the psychovegetative component is concerned. ,n regard to menopause this plant e$erts a positive effect particularly on the vegetative dysregulation and mental symptoms. ,t is particularly effective in treatment of climacteric depression. )ccording to .ing9F33 5pecific ,ndications and Uses.Z%r. 5cudder gives as the specific indications for this drug9 M/uscular painsK uterine pains, ith tendernessK false painsK irregular painsK rheumatism of the uterusK dysmenorrhea. As an antirheumatic, hen the pulse is open, the pain paro$ysmal, the s#in not dry and constricted.M 6o these may be added a sense of soreness, ith dragging pains in the hips and loinsK rheumatoid muscular painK rheumatoid dyspepsiaK chorea, associated ith Mabsentio mensium.M • /usculos#eletal !onditions9 )e of our remedies have acquired as great a reputation in the treatment of rheumatism and neuralgia. As early as AB<<, in the :e ;or# 1hilosophical -ournal, %r. ?ing recommended the use of a saturated tincture of !imicifuga in acute rheumatism, stating that the remedy ould permanently cure the disease. 1rof. ?ingNs o n statement of his use of it is as follo s9 M6he saturated tincture of this article as recommended by me in acute rheumatism, in the :e ;or# 1hilosophical -ournal, as early as in the year AB<<K to be given in doses of A0 drops every 2 hours, gradually increasing to F0 drops, or until its action on the brain is observed, hich action must be #ept up for several daysK it almost al ays removes the disease permanently, especially if it is a first attac#.M 6he e$periences of other physicians since that day give abundant evidence of the truth of his statement. ,ndeed, fe cases of rheumatism, or conditions depending upon a rheumatic basis, ill present, hich ill not be influenced for the better by /acrotys. 4heumatism of the heart, diaphragm, psoas muscles, Mlumbago,M Mstiff nec#,M in fact all cases characteri(ed by that #ind of pain #no n as Mrheumatic,M dull, tensive, intermittent, as if dependent upon a contracted state of muscular fibre, soreness in muscular tissue, especially over the abdomen and in the e$tensor and fle$or muscles of the e$tremities, all yield readily to it. ,f there be febrile and inflammatory conditions it should be associated ith specific aconite, or specific 7eratrumK or possibly specific Asclepius ill be indicated. ,f the pain be greatly aggravated by motion, and especially if the serous tissues be involved, specific Bryonia should be added to it. 5hould there be burning pain, aggravated by armth of the bed, specific 4hus. ,f effusion of serum into cellular structures be present, combine the /acrotys ith specific Apocynum. /uscular pain of a rheumatoid character, hen not amounting to a true rheumatic attac#, and other rheumatoid pains, hen acute and not of spinal origin, such as gastralgia, enteralgia, tenesmic vesical pain, pleurodynia, pain in the mediastina, orbits or ears, are relieved by !imicifuga. • :ervous !onditions9 /acrotys e$erts a po erful influence over the nervous system, and has long been favorably #no n as a remedy for chorea. ,t may be used alone or ith specific 7alerian, equal parts. ,t is particularly useful here hen associated ith amenorrhea, or hen the menstrual function fails to act for the first time. ,ts action is slo , but its effects are permanent. ,t has been used successfully as an antispasmodic in hysteria, epilepsy hen due to menstrual failures, asthma and #indred affections, periodical convulsions, nervous e$citability, pertussis, delirium tremens, and many other spasmodic affections. )or headache, hether congestive or from cold, neuralgia, dysmenorrhea, or from la grippe, it is promptly curative. • *astrointestinal !onditions9 ,n small doses the appetite and digestion are improved, and larger amounts augment the secretions of

the gastro&intestinal tract. !imicifuga is a remedy for dyspeptic manifestations hen due to rheumatoid states of the gastro&intestinal tube, or hen associated ith rheumatism of other parts of the body. ,t should be remembered in those cases here there is a dull or aching pain and tendency to metastasis, made orse by ta#ing food or drin#, and hen the alls of the stomach seem to be contracting upon a hard lump, the patient having a rheumatic tendency or history =Webster>. • *enitourinary !onditions9 '$cretions from the s#in and #idneys are increased by it, the peculiar earthy odor of the drug being imparted to the urineK • 1ulmonary !onditions9 6he secretions of the bronchial mucous surfaces are also augmented under its administration. A5 a palliative agent in phthisis = asting> pulmonalis, good results are obtained, in that it lessens cough, soothes the pain, especially the MachingM under the scapulae, lessens secretions and allays nervous irritability. • !ardiovascular !onditions9 Upon the heart and circulatory system its effects have been compared to those of digitalis, though being much less pronounced. 6he heart&beat is slo ed and given increased po er by it, hile arterial tension is elevated. ,n cardiac rheumatism it should be given early and in quite full doses, ithdra ing the remedy hen the full and dull headache is produced by the drug. ,n this ay confirmed rheumatism of that organ may often be averted. ,t is most useful in acute cases, being of value only to relieve the acute complications that may arise in chronic cardiac rheumatism. • *ynecologic !onditions9 Upon the reproductive organs it e$erts a specific influence, promoting the menstrual discharge, and by its po er of increasing contractility of the unstriped fibres of the uterus, it acts as an efficient parturient. /acrotys plays a very important part in the therapeutics of gynecology. ,t is a remedy for atony of the reproductive tract. ,n the painful conditions incident to imperfect menstruation. its remedial action is fully displayed. By its special affinity for the female reproductive organs, it is an efficient agent for the restoration of suppressed menses. ,t is even a better remedy in that variety of amenorrhea termed Mabsentio mensium.M ,n dysmenorrhea it is surpassed by no other drug, being of greatest utility in irritative and congestive conditions of the uterus and appendages, characteri(ed by tensive, dragging pains, resembling the pains of rheumatism. ,f the patient be despondent and chilly, combine /acrotys ith specific pulsatilla, especially in anemic sub"ects. ,n the opposite condition associate it ith gelsemium. ,t is a good remedy for the refle$ Mside&achesM of the unmarried omanK also for mastitis and mastodynia. ,t should be remembered in rheumatism of the uterus, and in uterine leucorrhoea, ith a flabby condition of the viscus, its effects are decided. When there is a disordered action or lac# of functional po er in the uterus, giving rise to sterility, !imicifuga often corrects the impaired condition and cures. 4efle$ mammary pains during gestation are met by it, and in rheumatic sub"ects it promptly relieves such ovarian troubles as ovarialgia and neuralgia, the pain being of an aching character. /acrotys has proved a better agent in obstetrical practice than ergot. ,t produces natural intermittent uterine contractions, hereas ergot produces constant contractions, thereby endangering the life of the child, or rupture of the uterus. Where the pains are inefficient, feeble, or irregular, /acrotys ill stimulate to normal action. ,t is an e$cellent Mpartus preparatorM if given for several ee#s before confinement. ,t is a diagnostic agent to differentiate bet een spurious and true labor plains, the latter being increased, hile the formers are dissipated under its use. ,t is the best and safest agent #no n for the relief of after&pains, and is effectual in allaying the general e$citement of the nervous system after labor. As a partus accelerator, it may be substituted for, and should be preferred to, ergotK A32 drachm of the po dered root may be given in arm ater every AE or 20 minutes, until the e$pulsive action of the uterus is induced, and hich it seldom fails to bring on speedily and po erfully. 6he po der, ho ever, is seldom no used, the specific /acrotys in from AE drops to A32 fluid drachm being given in the same manner. ,n acute troubles, as acute muscular rheumatism, and in false pains, and as an o$ytocic, Webster prefers the strong decoction of the recent root in tablespoonful doses. • /ale !onditions9 6he venereal propensity in man is said to be stimulated by !imicifuga. 0rchialgia and aching sensations of the prostate are conditions calling for /acrotys, and as a tonic it is not ithout good effects in spermatorrhea. • ,nflammatory !onditions9 )evers, intermittent and remittent have been benefited by it, ell&mar#ed antiperiodic and tonic virtues having been observed in the drug. )or rheumatic fever e have no better agent, hen combined ith aconite or veratrum. ,n the cerebral complications of the simple and eruptive fevers, especially in children, its action is prompt and decisive. ,t uniformly lessens the force and frequency of the pulse, soothes pain, allays irritability, and lessens the disposition to cerebral irritation and congestion. ,n febrile diseases especially, it frequently produces diaphoresis and diuresis. ,n the e$anthemata, it is a valuable agent, controlling pain, especially the terrible Mbone achesM of smallpo$, rendering the disease much milder. ,n scarlatina and measles, it relieves the headache and the bac#ache preceding the eruptions. ,t is stated that it has been used in the 5outh ith some success as a prophylactic against variola. !imicifuga e$erts a tonic influence over both the serous and mucous tissues of the system, and ill be found a superior remedy in the ma"ority of chronic diseases of these parts. ,n all cases here a acidity of the stomach is present, this should first be removed, or some mild al#aline preparation be administered in con"unction ith the remedy, before any beneficial change ill ensue. As a remedy for pain, /acrotys is a very prompt agent, often relieving in a fe hours, painful conditions that have e$isted for a long time. )ccording to 2oo3:$C' ,t is moderately prompt and diffusive, but requires hours to manifest its full action through the system. ,t is almost purely rela$ant, leaving behind only a trifling astringent impression on mucous membranes. ,t leaves behind a gently toned impression, rather than a rela$ed one. ,t soothes and strengthens. ,ts po er is e$pended chiefly upon the nervous structures beginning at the peripheries and e$tending to the brain, including the ganglionic systemK through the sensory nerves influencing the heart and pulse and through the sympathetic nerves ma#ing a decided

impression upon the uterus. ,t quiets mental e$citement and calms both body and mind, disposing to a placid sleep ith a sense of relief about the head. At the same time it softens and slo s the pulse and causes fullness of the capillary circulation and a gentle increase of perspiration. ,t manifests a distinct action upon the hole class of serous tissues and a milder action on the #idneys, lung and s#in. Upon this range of organs its impression is al ays rela$antK and that rela$ation is not the same in #ind as from .obelia, Boneset, !hamomile or any other agent, but is peculiar to this article alone. 0n serous tissues it allays irritation, soothes e$citement and relieves sub&acute and chronic inflammation. • :ervous !onditions9 0n the nerves it acts gradually but effectively, relieving pain dependent on local irritation and proving a good antispasmodic. ,ts soothing effect proves of service in general nervous e$citement and agitation as in periodic convulsions, hether of hysteria, epilepsy, puerperal convulsions or mania, neuralgia and irritation of the meninges such as cerebral and cerebro&spinal meningitis. )or meningitis it is used in treatment and convalescence as a primary remedy. '$tending its importance to the very brain it is of importance in delirium tremens and chorea as is not compared by any other remedy. 0ther indications for it have been claimed to include as a diaphoretic and antiperiodic in gastric intermittents as ell as to increase the flo of urine a little and relieves the #idneys some hat. Although much reliance should not be placed on it in these connections, the action on the nervous system may render it a good ad"uvant in certain forms of all of these maladies. • 1ulmonary !onditions9 ,t is soothing to the nervous e$citement associated ith hooping&cough and spasmodic asthma. ,t has been used in the treatment of tuberculosis =consumption> as a valuable agent to soothe the cough and impart tone to the lungs • /usculos#eletal !onditions9 ,t is used for great relief in all forms of articular and neuralgic rheumatism for hich it is one of the most useful agents. • *ynecologic !onditions9 ,ts action on the uterus is ell mar#ed, relieving neuralgia and rheumatism of this organ, proving efficient in painful menstruation accompanied by tardiness. ,t ill distinctly increase the menstrual flo . ,t decidedly and po erfully e$pedites delivery hen the uterine action becomes eary and irritable. ,t is rela$ing to a rigid os and an irritable vagina becomes moist and less sensitive. .abor pains become more regular and effective. A small portion combined ith 6rillium and !ypripedium is useful for after pains and to maintain the lochia. ,t is also suitable for ovarian irritation. #harmacy9 !imicifuga may be ta#en long term although the *erman !ommission ' recommends use to be limited to si$ months. 6his is the same recommendation for conventional +46 and as ma#e prior to the most current to$icology information. 5tudies have demonstrated benefits ith treatment lasting from <&A2 ee#s. !oo# states that !imicifuga should usually be in less quantity than the associated agents in a formula. +e further describes the ease ith hich it may be given in too large a quantity and at too short an interval. ?ing states that the saturated tincture of the root is recommended as a valuable embrocation in all cases here a stimulant, tonic, anodyne, and alterative combined are required. 6he specific /acrotys ill be preferable to the saturated tincture. 6he local use of the drug, ho ever, is not e$tensive. ,n phthisis = asting> pulmonalis, cough, acute rheumatism, neuralgia, scrofula, phlegmasia dolens, amenorrhea, dysmenorrhea, leucorrhoea, and other uterine affections, the alcoholic preparations, as the saturated tincture or the specific /acrotys, are the best modes of e$hibition, and e$ert a therapeutic influence not to be obtained from the impure resin, termed cimicifugin. 1reparations of !imicifuga, to be of any medicinal value, must be prepared from recently dried roots. =!oo# and ?ing> 1o dered root9 0.E&A g 3&< $ day =British 1harmaceutical !ode$>K E&A0 grains q <&F hours =!oo#> ,nfusion9 < drams po dered herb in B o( tepid ater, steep 30 min. in a covered container. 5ig 2&< drams q 2&3 hours. %uring parturition or a rheumatic attac# sig2 drams q hour. =!oo#> %ecoction9 2&3 gm.3pint aterK sig A cup 6,% =Alschuler> !oo# claims that the use of boiling ater damages it greatly, therefore nothing hotter than lu#e arm ater should be used to decoct this herb. 6incture9 A9E, sig 3.E&H ml qd =/ills and Bone> A9A0 F0G alcohol, sig 2&< ml 6,% =British +erbal !ompendium, vol. A> A9A0, sig F&A2 ml qd =British 1harmaceutical !ode$> < o(. bruised root, AF o( alcohol. /acerate for A0 days, e$press and filter. 6his form is best suited for impression on the brain and the throat as ell as hooping cough, asthma and other spasmodic bronchial affections, chronic rheumatism and dropsy. 5ig AE gtt to L dram q 2&3 hrK 20 gtt is an e$cellent parturient. 5pecific 6incture9 a teaspoonful of a mi$ture of from A0 drops to A drachm of specific /acrotys in < ounces of ater, the larger or smaller dose being determined by the condition of the patient. )luid '$tract A9A C0G alcohol, sig A ml 6,% =%r. Alschuler>K 3&< ml qd =%r. /urray> A92 , sig 2 ml 6,% =%r. Alschuler, /ills and Bone> A32 fluid drachm to 2 fluid drachms =?ing> 5olid '$tract9 <9A, 2E0&E00 mg qd =%r. /urray> 5tandardi(ed e$tract9 =4emifeminf ><0 drops B,% or 2 tablets B,% =2<.B&<2.H mg dried herb standardi(ed to triterpene

glycosides9 2H&deo$yactein, Amg per tablet>. 0ther proprietary preparations are !imicifuga&0ligople$ =/adaus> and !imicifuga 1enta#ran =%+U>. 5yrup9 B o(. tincture added to A2 o(. simple syrup, evaporate to a pint. Use for coughs and other pectoral affections. Add Ao( of .obelia tincture ma#es a superior e$pectorant and antispasmodic preparation for dry coughs, difficult breathing, irritable contractions of the diaphragm, etc. =!oo#> )or spastic parametropathy, Weiss indicates that administration should be consistent over an e$tended period in accord ith the chronic and intermittent nature of this condition. ,n diseases of the ear the drug is indicated hen the condition is aggravated by rheumatic association, or in neuralgia of the parts ith stiffness in the faucial and pharyngeal muscles. 6he dose should be about A3< to A32 drop of specific /acrotys every 2 hours. ,n eye strain, giving rise to headache, and associated ith a sensation of stiffness in the ocular muscles, or a bruised feeling in the muscles of the frontal region, the same si(ed doses ill give mar#ed benefit. ,n doses of A fluid drachm of the tincture, repeated every hour, it has effected thorough cures of acute con"unctivitis, ithout the aid of any local application. =?ing> 1o ell9 : 6incture of 2imicifuga rhi(omes =fresh T 92, dry A 9E>9 AE&2E minims up to < times3day. ,t may be used e$clusively during the follicular phase of the menstrual cycle =day A&AE>. %ecoction of 2imicifuga is generally not used because the active substances are apparently not ell e$tracted by ater. 1o der of dried 2imicifuga rhi(omes9 g00 capsules9 A&2 capsules up to 3 times3day 2imicifuga is appropriate for long&term use. ,t is often reported that the beneficial effects of 2imicifuga racemosa are slo in appearing and may ta#e one month before the full effects of treatment ith this botanical is established. Contraindications: !oo# states that it is not an agent suitable for any malady here the pulse is depressed, the s#in cold, the tissues rela$ed and the general sensibilities of the frame reduced. +e also affirms that acidity of the stomach ill almost holly prevent its action as does ?ing. !imicifuga is generally contraindicated in pregnancy and lactation ith the e$ception of assistance in birth. =/ills and Bone> hile %r. Alschuler and the 'clectics use it as a partus preparatory. !oo# reports that it may induce premonitions of abortion although these cases are the e$ception. Brin#er contraindicates its use during the first trimester of pregnancy due to its emmenagogue effect. +e also cautions against use in nursing mothers due to its potential to$icity in large doses =empirical> and the potential irritation to the infant digestive tract.F3E +erbs ith estrogenic activity should be avoided in cases of estrogen sensitive cancers. =Alschuler> 1o ell9 '$cessive doses of 2imicifuga are found to cause frontal headache, hich ceases after discontinuance. 2imicifuga is reported to sometimes aggravate hypotension. 2imicifuga is contra&indicated in pregnancy. )o*icity: ,n large doses, !imicifuga ill produce general rela$ation, dimness of vision, di((iness, bradycardia, hypotension, vomiting, diaphoresis, and frontal headache. 6hese effects are due to the resins, isoferulic acid, cimicifugin, and tannins, according to %r. Alschuler. /ills and Bone describe the frontal headache to be characteristic and may occur even at therapeutic doses although !oo# states that this effect is more li#ely to occur ith use of the tincture, but rarely ith the po dered herb or infusion. A fe studies have reported that some omen complained of continuing stomach problems after use of the standardi(ed e$tract. ,n large doses its action on the nervous system is very decided, producing vertigo, impaired vision, dilatation of the pupils, nausea, vomiting, and a reduction of the circulation, but no alarming narcotic effects. 6hree drops of the saturated tincture given every hour, for 20 hours, have been #no n to produce symptoms in every ay simulating those of delirium tremens. *reen tea is said to counteract its narcotic influences.F3F !imicifuga is not genoto$ic or mutagenic although three cases of use ithin the first trimester of pregnancy also reported fetal malformations.F3H
612 613

*i(yc#i +. 8 '$ptl /ed AC<<K AA39F3E&E<< -arry +, +arnischfeger *. 1lanta /ed ACBEK EA =A>9 <F&<C 3 -arry +, +arnischfeger *. 1lanta /ed ACBEK EA =A>9 3AF&3AC 614< -arry +, et al. 6reatment of /enopausal 5ymptoms ith e$tracts of !imicifuga racemosa9 in 7ivo and in 7itro 'vidence for 'strogenic Acitivity. 1hytopharma#a in )orschung un #linischer An endung. 5tein#opff, %armstadt, ACCE, pA0B
FAE

616 617

%u#er '/, et al. 1lanta /ed ACCAK EH=E>9 <20&<2< :esselhut 6, et al. Arch *yencol 0bstet ACC3K 2E< =A&<>9 BAH&B 618 :esselhut 6. '$pert )orum on 4emifemin_9 4eport and 4esults from 'ndocrinologya '$perf forum in .undeburg. /ay ACC3. 619 +emmi +, ,shida +. - 1harmocobiodyn ACB0K 3=A2>9 F<3&F<B 620 /urray /, 1i((orno -. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p. FEB 621 +ansel 49 Phytopharma3a1 2nd ed. Berlin9 5pringer 7erlagK ACCA 9223&30. 622 %u#er ', et al.9 'ffects of e$tracts from !imicifuga racemosa on gonadotropin release in menopausal omen and overiectomi(ed rats. PlantaMed ACCAKEH9<20&<2<. 623 .ehmann& Willenbroc# ', 4iedelllli9 ?entralblatt fiir 5yna3ologie ACBBK AA 09FAA&ABK 624 Warnec#e *. Med +elt ACBEKF09BH0&BH<.

625 626

5toll W9 Therapeuti3on ACBHKA923&3A. *ena((ani ', 5orrentino .. ;ature ACF2KAC<9E<<. 627 )arns orth :4. 5egelman AB. Tile Ti66%*4%N#4:#& 628 5tol(e +. Byne ACB2K 3=A>9 A<&AF 629 'iner&-ensen :, et al. /aturitas ACCFK 2E=2>9 A<C&AE3 630 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 303&B 631 /urray /, 1i((orno -. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p. FEB 632 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. 3AF&C 633 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. E30&3 634 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. 3<A&F 635 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 3H, ABA 636 ?ing@s p. E3A 637 /ills and Bone, p 30H

Cinchona officinalis
Common name: 1eruvian Bar#, -esuitNs Bar#, 4ed !inchona, ;ello !inchona Ha!itat: :ative to 5outh America.

+u!iaceae

Botanical description9 !inchona trees gro up to F0 feet tall. 6he elliptical leaves are up to 30 cm in length. 6he flo ers are up to 2 cm long and are light pin# in color. 6he bar# is 2 to 3 mm. thic# ith a gray outer surface and a reddish bro n inner surface ith fine longitudinal striations. #arts used9 Bar# Historical Use: 6he original use of !inchona is not #no n. ,ts first recorded use as in AF3C hen a prominent oman of 1eru as cured from a fever. At this point, the importation of !inchona into 'urope as almost e$clusively by the -esuits. 5everal decades later 'uropeans began to use !inchona. !inchona became one of the most important herbs medicines in 'urope and later in :. America as ell. Constituents9 • Huinoline al3aloids: =EG&AEG>9 quinine, quinidine, cinchonine, cinchonidine and <0X others, cinchonidine bitter triterpene acid monoglycosides, in particular chinovic acid&3&chinovoside, chinovic acid&3&glucoside F3B • !atechol tannins =BG>K #harmacology: !inchona is the original source of quinine, hich in its purified form is used as a cure for malaria, the mosquito&borne plague of the tropics. ,n addition, quinine&based drugs such as 2uinaglute and 2uinide$ are prescribed to control dangerous heartbeat irregularities. ,t as found that the t o potassium channel bloc#ers, quinine and quinidine, mar#edly enhanced phosphatidylserine synthesis and strongly decreased both phosphatidylcholine and phosphatidylethanolamine synthesis. 6he inhibition of phosphatidylcholine and phosphatidylethanolamine synthesis as due to the inhibition of the upta#e of choline or ethanolamine, respectively, by the cells. 6his effect as also observed hen using either cinchonine, cinchonidine and chloroquine. ,n contrast, these three drugs ere unable to modify phosphatidylserine synthesis, indicating that the ?X channel bloc#ers, quinine and quinidine, specifically affect the synthesis of this phospholipid. F3C Medicinal actions: Bitter, antimicrobial, topically antiseptic, astringent, cholagogue )raditional Medicinal Use: !inchona as frequently used by both 1hysiomedicalists and 'clectics ith fe other herbs observed so completely in regard to the scope of action on the body. !oo# described the bar# as a slo and very permanent stimulant and astringent to nervous tissue. 6his effect, he observed, begins in the stomach, slo ly and steadily e$tending first, the sympathetic nervesK second, the sensory nerves in generalK and third, the spinal cord and brain =only ith large doses or continued use>. 6he astringency causes a protracted state of tension in the nervous tissue. 6hrough the nerves, !inchona reaches nearly all the organs of the body, thereby leading to increased sensibility and e$citement, and inducing a peculiar and mar#ed state of tension throughout. By indirectly affecting the system at large, !oo# observed that it causes e$citement of the stomach and throat, ith drynessK constipation, and armth throughout the bo elsK increased frequency and hardness of the pulse after a time, and dry armth upon the surfaceK a general diminution of the secretionsK finally a throbbing headache, and perhaps giddiness, ith a general feeling of increased firmness of the muscular and other structures, as if the patient ere I strung up.J 6hese results advance slo ly, generally requiring from four to si$ hoursK and may not entirely pass a ay under ten or t elve hours. ,t as considered valuable in conditions of atony and la$ity of the tissuesK and here there are e$cesses of secretion consequent to atony. ,t is sometimes beneficial in chronic congestions = here !oo# differentiates this from inflammation> as a secondary agent hen the system is enfeebled. ,n other atonic difficulties, it is useful, as in gangrene, passive hemorrhages, chronic leucorrhea and diarrhea ith la$ity of fiber, etc. • !ardiovascular !onditions9 6he cardiac side effects of !inchona bar# ere discovered very soon after its introduction to the materia medica of academic medicine to ards the end of the AHth century. 6herapeutically these effects ere utili(ed sporadically as early as in the first half of the ABth century. 1urified quinine became a standard component of cardiac therapy in the 2nd half of the ACth century. ,n ACAB quinidine as introduced as the common al#aloid of !inchona bar# and is still used in rhythmology today. F<0 • ,nflammatory !onditions9 ,n any periodical recurrence of suffering, here the nerve tissues become rela$ed and there is no tendency to e$citement or engorgement of the brain, it is often of much service, as in such forms of periodical neuralgia,

1

• •

rheumatism, diarrhea, headache, etc. !oo# considered calling it a febrifuge an entire misnomer as it can increase present febrile e$citement and increase the possibility of in"ury by causing a retention of secretions. :one the less, he noted that the chief use of this article as as an antiperiodic, averting the IchillJ of intermittent fevers. ,n regard to periodicity of chills and fever, !oo# elucidated the method of appropriate of administration. +e observed that IchillsJ are dependent upon recession of blood from the surface to the portal organs, constituting nature@s first step in the effort to restore the circulation to balance. Accordingly, he noted that successful medication for a treatment of this condition must fulfill three indications9 A. remove the hepatic obstructions and accumulations hich are the prime disturbers of the circulation 2. sustain the firmness of the nervous tissues, to avert that rela$ation of these structures hich really forms the chill 3. secure a full out ard circulation, so that the heart and arteries shall be sustained simultaneously ith the nerves. !oo# stated that !inchona achieves only the second of these requirements and is holly insufficient ithout the other t o being met. +ence, !inchona may Ibrea# the chill,J but never permanently cure an intermittent. 6herefore, the only proper use of bar# in the management of intermittents is to attenuate the nervous rela$ation. ,t is not a suitable agent to use during the intervals bet een the paro$ysms, hen hepatic tonics and arterial stimulants are needed. *astrointestinal !onditions9 !oo# stated that the idea of sustaining appetite and digestion by use of !inchona may fasten the disease, hich is the cause of the failing appetite and digestion, more firmly upon the system. 6opical Applications9 !oo# noted that !inchona is e$cellent hen employed topically for an astringent and moderately antiseptic article for ea# and degenerating ulcers, aphthous sores, etc.

Current Medicinal Use: • !ardiovascular !onditions9 2uinine is a cardiac depressant and may be useful in tachycardic hearts. • *astrointestinal !onditions9 %igestive insufficiency manifesting as decreased appetite, abdominal distention, and flatulence indicate the use of !inchona. !inchona bar# is used to correct loss of appetite, dyspepsia and flatulence ith a sense fullness because it stimulates the secretion of saliva and gastric "uices. F<A When ingested, !inchona imparts a arming influence on the digestive organs. • ,nflammatory !onditions9 !inchona imparts strength and tone to a ea#ened system. 6his is especially true hen the patient has a febrile, eruptive and inflammatory disease in hich the symptoms appear ith periodicity. %uring the phases of lesser symptoms, !inchona is most effective. !inchona may maintain nervous tension, hich is one component of averting periodic chill. 1eriodic fevers, diarrhea, dyspepsia, and neuralgia ill respond favorably to !inchona bar# in most cases. !inchona may also be used as a tonic after an e$hausting illness or episode of hemorrhage. !inchona is not to be used in acute inflammatory states, states of deficient secretions or during fever. ,nternally, the analgesic effects are most notable in terms of reducing the achiness that may accompany a cold or flu. • ,nfectious !onditions9 !inchona has antimicrobial effects as ell. !inchona can be used to prevent the progression of a common cold. 6he al#aloids in !inchona, particularly quinine, are antimalarial. Although, this is primarily a historical usage, quinine may again be helpful in treating malaria, hich is resistant to ne er drugs. • 6opical Applications9 !inchona has mild analgesic effects. 6hese effects are evident ith e$ternal use and may help to relieve muscle spasm and pain. Current +esearch +eview: • 3ncology: o Malignant lymphoid diseases:&:0  %esign9 0pen phase , multicenter dose escalation clinical trial  1atients9 1atients ith refractory or relapsed malignant lymphoid diseases.  6herapy9 !inchonine dihydrochloride, ,7 $ <B hours, escalated over five dose levels from AE&3E mg3#d3d. !inchonine infusion started 2< hrs before ,7. do$orubicin =2E mg3m2>, vinblastine =F mg3m2>, cyclophosphamide =F00 mg3m2> and methylprednisolone =A mg3#g3d> =!+71 regimen> and lasted for 2< hrs after chemotherapy infusion  4esults9 2uinineNs isomer cinchonine as identified in earlier studies as a potent multidrug resistance =/%4> reversing agent, both in vitro and in animal models. ,n this study an /%4 reversing activity as identified in the serum from every patient and correlated ith cinchonine serum level. 6he conclusion as that i.v. infusion of cinchonine might be started A2 h before /%4&related chemotherapy infusion and requires continuous cardiac monitoring but no reduction of cytoto$ic drug doses. • ,nfectious diseases: o Malaria: 5tudy A9F<3  %esign9 4andomi(ed controlled clinical trial.  1atients9 5i$ty&four children, B mo&AE yo, ith uncomplicated flaciparum malaria.

6herapy9 2inima$ =association of cinchona al#aloids>, ,/, F0 mg base3ml, A2.E mg3#g qA2h $ H2 hrs, or 2uinima$, ,4 =intrarectrally>, 30 mg base3ml, AE mg3#g qA2h $ H2 hrs.  4esults9 :o significant difference as demonstrated bet een the clinical effectiveness of quinima$ administered by the ,/ vs ,4 route. 5imilar effect ere also observed on parasitemia hich disappeared completely in all patients by the end of the H2&hour treatment. Administration of diluted in"ectable quinine by ,4 route as concluded to be an effective, ell& tolerated alternative for treatment of childhood falciparum malaria. 5tudy 29F<<  %esign9 0pen randomi(ed controlled clinical trial.  1atients9 5eventy&si$ children ith cerbral falciparum malaria  6herapy9 2uinima$ =!inchona al#aloids association>, intrarectral =,4>, 20 mg3#g, then AE mg3#g qBh> or 2uinima$, ,7, B mg3#g infused over < hrs qBh $ 2 days. )ollo ed by chloroquine, po A0 mg3#d3d $ 3 d.  4esults9 ,4 group9 3E children cured =C0G> and < diedK mean coma recovery time W 3<.F hrs. ,7 group9 2B children cured =HFG>, C diedK mean coma recovery time W 33 hrs. 2uinima$, ,4, can be an alternative to ,7 administration for rapid onsed childhood cerbral malaria in the rural tropics, here the safety of parenteral administation cannot be guaranteed. 5tudy 39F<E  %esign9  1atients9 6 enty&one children, 2&A< years, ith acute uncomplicated 1lasmodium falciparum malaria  6herapy9 =A> 2uinine gluconate, A2.B mg3#g intrarectally, =2> 2uinima$. B mg3#g, ,/, or =3> 2uinima$, B mg3#g, ,7, < hrs infusion qBh $ 3 days.  4esults9 At 3F h, body temperature of all children of the three groups as returned to normal and remained so until day H. 6he decrease in parasitaemia did not differ bet een the three groups and the time required for a E0G fall in parasitaemia relative to baseline as A2.3 X3& E.<, AB.2 X3& F.A and A<.E X3& <.2 h in the intrarectal, intramuscular and intravenous treatment groups, respectively. 1arasitaemia e$pressed as a percentage of initial values as not significantly different in the three groups after <B h of treatment. All the patients ere aparasitaemic by day H.<. 6he good tolerability and efficacy of intrarectal quinine formulation out eigh its lo appro$imate bioavailability. ,t as found to be a safe and effective alternative to intramuscular quinine in"ection for the treatment of children ith acute uncomplicated 1lasmodium falciparum malaria in the field. 5tudy <9F<F  %esign9 4andomi(ed controlled clinical trial.  1atients9 5eventy&t o children ith uncomplicated 1lasmodium falciparum malaria attac#s, under A0 yo  6herapy9 2uinima$ salt, po 2E mg3#g qd in 3 equal doses $ 3 days or $ H days.  4esults9 !linical status as improved in CC.FG of patients treated for 3 days and in all patients treated for H days. 'ven if the 3 d course did not systematically eliminate parasitaemia, reducing oral 2uinima$ treatment of uncomplicated malaria from H to 3 d did not increase the recurrence of attac#s, even among the youngest children. 0ral 2uinima$ for 3 d as concluded to be a possible alternative regimen to chloroquine and sulfado$ine&pyrimethamine for treating uncomplicated malaria in highly endemic areas of Africa here clinical resistance to these drugs e$ists. 5tudy E9F<H  %esign9 4andomi(ed controlled clinical trial  1atients9 !hildren ith uncomplicated falciparum malaria.  6herapy9 !ombination of quinine3quinidine3cinchonine =combined drug> or quinine alone  4esults9 6he cure rates obtained ith the high dose regimen of the combined drug =A00G> ere significantly higher than in the lo dose regimen group =3H.EG>, and the quinine regimen produced a E0G cure rate. 4ed cell drug concentrations ere more closely related to the outcome of treatment than to plasma concentrations. 6he conclusion as that the combined drug may be very useful for treatment of multi&drug&resistant 1. falciparum infections.  #harmacy9 ,n regard to treatment of intermittent fever and chills, !oo# advised the administration timed three to si$ hours prior to the onset of chills rather than during to avoid inducing nausea and aggravating the febrile stage. %ried bar#9 A32 to 33< tsp.3 cupK steep A0 minutesK A cup AE min. 6,% ac QAtsp.OA.H gR )luid e$tract9 0.F&3 gm3day of e$tract containing <G&EG total al#aloids Drug ,nteractions:&:/ • Chemotherapy (positive : !inchonine al#aloid has been demonstrated to decrease multi&drug resistance in cancer chemotherapy in animal studies. !inchonine inhibits efflu$ of cytoto$ic drugs thus reducing drug resistance. !inchona e$tract may thus prove to be efficacious in reducing multi&drug resistance and thus improving chemotherapy effectiveness. )urther research is needed in this area.

• • • • • • •

Anticoagulants (positive : !inchona potentiates coumarin derivatives =empirical>, anticoagulants or drugs that induce thrombocytopenia due to the rare action of platelet reduction. Brin#er only cites secondary sources for this information. +ifampicin (negative : 2uinine clearance is increased ith use possibly due to en(ymatic induction. )o!acco (negative : 2uinine clearance is increased ith smo#ing possibly due to en(ymatic induction. =lecainide (antiarrhythmicD positive : Brin#er speculates that the plasma concentration of )lecainide may be increased due to quinine. Astemi;ole' terfenadine(Antihistamines 9 !ombination ith !inchona may cause ventricular arrhythmia due to the quinine content =speculative>. Digo*in (positive : 6he plasma concentration of digo$in may be increased =speculative>. Cimetidine (positive : 6he plasma concentration of quinine may be increased to inhibition of its metabolic conversion by cimetidine =speculative>.

Contraindications: !oo# stated that it is an unsuitable article herever there is the least tendency to gastric or intestinal irritation. +e also noted that it is inappropriate hen the structures are tense, hen there is febrile or inflammatory processes, dryness of the tongue and fauces, nervous irritability, and a deficiency of secretionK and hen harm may ensue from diminishing secretions and e$cretions. ,n con"unction ith the above, Brin#er also contraindicates the use of !inchona during pregnancy and nursing =empirical and animal studies>.F<C )o*icity9 Apparently, up to 30G of patients demonstrate a reaction to !inchona. FE0 A hypersensitivity s#in rash and fever may result. 4arely, some people may e$perience bleeding because of an induced thrombocytopenia. !hronic overdose may result in cinchonism, hich is characteri(ed by9 headache, abdominal pain, rashes and visual disturbances. 1regnant omen, people ith quinine hypersensitivity and people ith peptic or gastric ulcers should not ta#e !inchona.
638 639

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1elassy, !. 'ffect of !inchona bar# al#aloids and chloroquine on phospholipid synthesis. ?X channel bloc#ers specifically enhance the activity of the serine base e$change en(yme system in -ur#at 6 cells. 1harmacology. ACC3 -ulK<H=A>92B&3E. 640 1rin(, A. Q%iscovery of the cardiac effectiveness of cinchona bar# and its al#aloidsR. Wien ?lin Wochenschr. ACC0 %ec 2AKA02=2<>9H2A&3. *erman. 641 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 642 5olary ', /annone ., /oreau %, et al. 1hase , study of cinchonine, a multidrug resistance reversing agent, combined ith the !+71 regimen in relapsed and refractory lymphoproliferative syndromes. 8eu3emia 2000KA<=A2>920BE&C<. 643 Assimadi -?, *badoe A%, Agdod"an&%"ossou 0, et al. %iluted in"ectable quinine in the intramuscular and intrarectal route9 comparative efficacity and tolerance in malaria treatment for children. Med Trop 0MarsB 2002KF2=2>9AEB&F2. 644 Barennes +, /un"a#a(i -, 7erdier ), et al. An open randomi(ed clinical study of intrarectal versus infused 2uinima$ for the treatment of childhood cerebral malaria in :iger. Trans R ,oc Trop Med Hyg ACCBKC2=<>9<3H&<0. 645 Barennes +, 1ussard ', /ahaman 5ani A, et al. 'fficacy and pharmaco#inetics of a ne intrarectal quinine formulation in children ith 1lasmodium falciparum malaria. Br 7 2lin Pharmacol ACCFK <A=E>93BC&CE. 646 4ogier !, Brau 4, 6all A, et al. 4educing the oral quinine&quinidine&cichonin =2uinima$> treatment of uncomplicated malaria to three days does not increase the recurrence of attac#s among children living in a highly endemic area of 5enegal. Trans R ,oc Trop Med Hyg ACCFKC0=2>9AHE&B. 647 5abchareon A, !hongsupha"aisiddhi 6, Attanath 1, et al. 4ed cell and plasma concentrations of combined quinine&quinidine and quinine in falciparum malaria. )nn Trop Paediatr ACCAKAA=<>93AE&2<. 648 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. 649 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.FE 650 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. pFE

Cinnamomum verum
Common name: !innamon Ha!itat9 :ative to 5ri .an#a and south est ,ndia, cultivated orld& ide • •

1auraceae

)lo er and )ruit9 6he flo ers are hitish green, inconspicuous, and have an unpleasant smell. 6hey are arranged in loose, a$illary or te<rminal paniclesK they are about 0.E cm long and are covered in sil#y hairs. 6he fruit is berry&li#e, ovoid&oblong, short&thorned, and half&enclosed by the epicaly$. .eaves, 5tem and 4oot9 6he plant is a heavily foliated evergreen tree F.E&A2 m tall ith a pale bro n bar# in thin quills, several rooled, inside one another. 6he branches are cylindrical ith a gray&bro n bar#. 6he leaves are opposite, splayed hori(ontally to leaning, initially red, later green, tough. 6hey are about A2 cm $ E cm, roundish&ovate or ovate&lanceolate to oblong, more or less acuminate and entire&margined. 6he leaves smell li#e cloves.

#arts used9 ,nner bar# and oil distilled from bar# and leaves Constituents9 • volatile oil =up to <G consisting of cinnamaldehyde, cinamyl acetate, cinnamyl alcohol, cuminaldehyde, eugenol, and methyleugenol> • tannins, cinn(elanin, cinn(elanol, coumarin #harmacology: • !innamic acid is an e$cellent hypoglycemic • 7olatile oils9 antifungal, antiviral, bactericidal and larvicidal actions. 'ugenol, eugenol acetate and methyl eugenol enhance trypsin activity in !itro. Bar# also sho n strong lipolytic action. FE2 Medicinal actions: Aromatic, astringent, stimulant, carminative )raditional Medicinal Uses: Current Medicinal Uses: • !innamomum is chiefly employed for its smooth muscles rela$ing effects. ,t acts systemically in this regard and is thus useful in the treatment of hypertension, bronchial spasm, dysmenorrhea, diarrhea and spastic constipation and as a carminative. As a carminative, cinnamon is a useful companion to purgatives and is arming to the intestinal tract. 6he volatile oils in cinnamon are antibacterial, antifungal, and antiviral. !innamomum is an e$cellent agent to use for the treatment of colds and flus for this reason. ,n addition, cinnamaldehyde inhibits cycloo$ygenase and lipo$ygenase en(ymes, thus decreasing inflammation. 6he tannins and the oils in cinnamon lend it astringent properties, and it is useful for the treatment of diarrhea and also can be effective for conditions of passive hemorrhage =i.e. idiopathic hematuria, epista$is, menorrhagia, post partum hemorrhage>. ,n the treatment of post&partum hemorrhage, cinnamon is ell&indicated in a flaccid uterus and alternates ell ith ergot. • 2&< g3day of cut or ground bar#. • ,nfusion or decoction9 0.H&A.3 g3AE0 ml ater 6,%. • )luid e$tract =A9A>9 0.H&A.3 ml 6,%. • 6incture =A9E>9 3.3&F.H ml 6,% • 'ssential oil9 0.0E&0.2 ml. )o*icity.4ide $ffects9 • 6he concentrated oil in amounts Y 0.E ml3#g body eight can cause :37, #idney damage, coma. 6reatment is emesis or gastric lavage, activated charcoal, cathartic, maintain hydration and electrolytes.
651 652

PDR for Herbal Medicines, /edical 'conomics !ompany, /ontvale, :e -ersey, ACCB, p. HE2 A. ;. .eung and 5. )oster, Encyclopedia of 2ommon ;atural >ngredients Dsed in ood, Drugs, and 2osmetics, 2nd ed., -ohn Wiley ] 5ons, ,nc, :.;., ACCF, cited in /ar# Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs, ,ntegrative /edicine !ommunications, :e ton, /A, 2000, p.FF. 653 Blumenthal, p.FF.

Coffea ara!ica
Common name: !offee Ha!itat: !offea spp. are tropical shrubs.

+u!iaceae

Botanical description: 6he #ernels are grey&green, oval&concave on one side and flat on the other ith a central longitundinal groove. ,n commerical trade, the beans are roasted and become dar#&bro n. #arts used: ?ernels of the dried ripe seed ,dentified Constituents: !affeine AG&2G =less hen roasted>, 6rigonelline, !hlorogenic acid, 1olyamines, 6annins, B vitamins, !arbohydrates, 0il, 6annin, 5ugars, 1entosans Medicinal actions: 5timulant, %iuretic, Antinarcotic, Antiemetic #harmacology: !affeine inta#e causes a#efulness and sleep latency. !affeine antagoni(es the effect of adenosine on sympathetic nervous innervation of the vascular system, heart, #idney, and adipose tissue. Adenosine inhibits neuronal activity and behavior by inhibiting pre&synaptic neurotransmitter release and by inhibitory binding to post&synaptic neurons. !affeine is structurally similar to adenosine and therefore counteracts the inhibitory effect of adenosine. +o ever, chronic caffeine inta#e may cause an increase in the number of adenosine receptors. !onsequently, larger amounts of caffeine are required to maintain the caffeine antagonism of adenosine. 6his may e$plain the habituation effect e$perienced by some users of caffeine&containing beverages. Additionally, if the caffeine inta#e is suddenly ithdra n or reduced, the adenosine effect is intensified resulting in symptoms of caffeine ithdra al. FE< !affeine may cause transitory hypertension and arrhythmias in some individuals, ho ever evidence that long&term administration of caffeine causes these conditions is lac#ing.FEE Medicinal use: : !offee is drun# as a flavorful stimulating beverage throughout the orld. 6he medicinal use of coffee is no longer common. +o ever, there are some medicinal indications for coffee. • 1ain !onditions9 !offee potentiates the analgesic effect of aspirin and other non&steroidal anti&inflammatory drugs. • *astrointestinal !onditions9 !offee is a bitter substance and is a po erful promoter of peristalsis. )or these reasons, coffee is indicated in people ith digestive insufficiency and constipation. ,n addition, coffee has antimicrobial effects and is therefore indicated in infectious gastroenteritis as a supportive herb to #ill the pathogen and promote its elimination. 6he stimulatory effect of coffee on digestion is utili(ed in deto$ification as ell. !offee enemas are ill stimulate peristalsis and aste removal from the colon. 0ral inta#e of coffee may promote deto$ification as ell. 6he bitter effects of coffee are most evident in promoting +!l production and the release of bile. • :ervous !onditions9 6he stimulating effect of coffee is most evident on cerebral functioning. !offee increases mental alertness and stays fatigue and dro siness. 6hese cerebral effects of coffee are the result of the adenosine antagonism and also of its vasodilatory effects on cerebral and peripheral vasculature. !offee is thus also an effective ay to treat headaches secondary to vasospasm and vasoconstriction. !offee may act as an anti&depressant. 4egular ingesters of coffee have a decreased incidence of suicide. +o ever, one study demonstrated that people ho eliminate both caffeine and sugar from their diet demonstrate significant reduction in their depression for at least 3 months follo ing the eliminations. FEF Additionally, coffee orsens an$iety type of depression. • 'rgogenic Aid9 !affeine is also used to enhance e$ercise performance. !affeine potentiates calcium release from s#eletal muscle sarcoplasmic reticulum. !affeine also increases fat brea#do n, facilitates central nervous system transmission, reduces plasma potassium during e$ercise, increases force of muscle contraction at lo er frequencies of stimulation and has a muscle glycogen sparing effect. 6hese changes result in ergogenic benefits from caffeine during endurance e$ercise. #harmacy: A 6B 3 cup infusionK A cup 2% W 6,% %oses of caffeine at F mg per #g body eight ill be of ergogenic benefit in endurance performance. FEH

Contraindications: )o*icity: %rin#ing less than E cups of coffee per day long term does not appear to increase the ris# of cancer, cardiovascular disease, peptic ulcer or arrhythmia. 5hort term consumption of coffee can cause diuresis, gastrointestinal distress, tremors, insomnia, and an$iety. ,n persons sensitive to the effects of caffeine, caffeinism may occur. 6his is manifested by tremors, diuresis, arrhythmia, agitation, insomnia, diaphoresis, gastrointestinal distress =usually loose stool> and an$iety.

Cola nitida
Common name: !ola, *uru nut, #ola nut, Ha!itat: An evergreen tree native to W. Africa, :igeria, Bra(il, 5ri .an#a, and ,ndonesia.

4terculiaceae

Botanical description: 6he tree gro s to a height of 20 m. 6he leaves are F to B inches long ith pointed ends. 6he flo ers are yello ith purple spots. 6he yello ish&bro n fruit has < to E oody pods hich contain singular to several seeds. 6he seeds are red& bro n, irregularly shaped, usually oblong, conve$ on one side and flattened on the other side. 'ach seed is up to E cm long and 2.E cm in diameter. #arts used: 5eed Constituents: !affeine up to 2.EGK 6heobromine up to 0.AGK 6annoids EG & A0G9 catechol and epicatechol K 5tarch up to 3EGK 7itamins =ascorbic acid, riboflavin, thiaminK ,ronK Beta&carotene> Medicinal actions: !entral nervous stimulant, %iuretic, !ardiotonic, Astringent, Anti&depressive #harmacology: 4efer to !offea spp. monograph for pharmacology of caffeine. Medicinal use: !ola nitida is used to combat physical and mental fatigue and ea#ness. !ola nut is che ed by natives of the countries here it is cultivated in order to increase stamina and physical and mental endurance. !ola nut used to be an ingredient in !oca&cola after cocaine became illegal. • :ervous !onditions9 !ola nitida is especially indicated in someone ho is ea# and deficient. !ola consumption ill increase this persons energy and stamina and, in addition, ill act as an anti&depressant. As an anti&depressant, !ola is most indicated in someone ho has become fatigued as a result of heightened an$iety. )inally, the 'clectic physicians ould use !ola to help people ithdra from alcohol. 6he !:5 stimulatory effects of cola ere thought to help people ith alcohol ithdra al. • *astrointestinal !onditions9 0ther indications for !ola include nervous diarrhea. !ola is a pronounced astringent as ell as a bitter. !ola ill tonify the digestive system both through its bitter effects and its astringent effect. • !ardiovascular !onditions9 !ola also stimulates cardiac function. ,t ill increase heart rate and raise blood pressure. #harmacy: !ola is best used short&term. A&2 tsp. po dered seed 3 cupK decoct A0 W AE minutesK drin# as needed A9E tincture W A to < ml 6,%

)o*icity: /onitor people for caffeinism =see !offea monograph>. !ontraindicated in people ith pre&e$isting arrhythmia and3or hypertension.

Coleus forskohlii
!onstituents9 fors#olin =labdane diterpene> 1harmacology activates adenylate cyclase → ↑ cA/1 resulting in • inhibtion of platelet activation and degradation9 antagoni(es the action of 1A) 1A) activates neturophils, increases vascular permeability, enhances smooth muscle contractility. • inhibition of histamine from mast cells • positive inotropic • smooth muscle rela$ant all over th body • increases insulin secretion • increases thyroid output • increases +!l secretion • increases lipolysis • topical application decreases ,01 in glaucoma !linical uses9 allergy =asthma, ecema0 smooth muscle hypertonicity intestinal colic menstrual cramps urniary bladder spasmosis angina hypertension cardiovascular disorders9 synergi(ed by !rataegus cervebrovascular insufficiency glaucoma cancer metastasis 1harmacy9 E0 mg e$tract standardi(ed to contain ABG =Cmg> fors#olin bid to tid. !ontraindication9 hyperchlorhydria. Use ith digitalis as !oleulus poteniates the effects of this drug. Avoid in hypotension and ulcers. %o not use ith antihypertensives.

Collinsonia canadensis
Common name: 5tone root

1a!iatae

Ha!itat:&%/ ,ndigenous to :. America from !anada to the !arolinas in the U.5. Also found in central 'urope. Botanical description:&%5 • )lo er and fruit9 )lo ers are yello ish, labiate, ith red venation on the inside in richly blossomed panicles. 6he upper lip has an obtuse tip. 6he side tips of the lo er lip are small and roundedK the middle tips are larger and fringed. 6he caly$ is acuminate and has 2 stamens. 6he fruit is a small globose nutlet. • .eaves, 5tem and 4oot9 6he plant is a perennial that gro s C0&A20 cm high. 6he rhi(ome is grayish&bro n, very hard, fibrous, up to B cm long. 6he shoots are glabrous, often tinged red, ith fe side shoots. Bar# is very thin. .eaves are light green above and pale green, glabrous, broad, cordate, or ovate belo , becoming narro er and shorter above. $nergetics: !ollinsonia is mildly bitter and s eet, cool and dry, decongesting, astringing, stabli(ing, restoring and rela$ing. &&8 #arts used: 4hi(ome, .eaves =topical> Constituents and #harmacology: FFA =Ubiquitous or non&active constituents not included> • Beta&elemine =plant>9 %$ ppmK Anticancer =!ervi$> • !aryophyllene =tuber>9 Aldose&4eductase&,nhibitorK AntiacneK AntiasthmaticK AntibacterialK Anticariogenic M>2LM%,$-- ug6mlK AntiedemicK Antifeedant #-- ppmK Antiinflammatory >2#-L%-- uMK AntispasmodicK AntistaphylococcicK AntistreptococcicK AntitumorK !andidicideK ).avor EM) &-9&--K )ungicideK ,nsectifugeK ,rritantK 1erfumeryK 1esticideK 5edativeK 6ermitifuge • %elta&cadinene =plant>9 %C ppmK Aldose&4eductase&,nhibitorK AntiacneK Antibacterial M>2(-- ug6mlK AnticariogenicK AntistreptococcicK !ytochrome&1<E0&,nducerK 1<E0&,nducerK 1esticideK 6estosterone&,nducer • 'lemicin =plant>9 %( ppmK Antiaggregant >2#-LC$- uMK Antidepressant ihlK AntifeedantK AntihistaminicK AntiserotonicK AntistressK %:A&BinderK )ungicide M>2L( ugK +allucinogenicK +ypotensive ihlK ,nsecticide %-- ppmK ,nsectifugeK .arvicideK :euroto$icK 1esticideK 5chistosomicide • *ermacrene&% =plant>9 &C- ppmK 1esticideK 1heromone )CM #rospective: • ,t enters the .iver, 5pleen, .ung, Bladder and %ai meridians. • 7itali(es the blood, removes congestion and moderates menstruationK benefits the rectum • 1romotes astriction and stops discharge and bleedingK raises central qi and relieves prolapseK stimulates digestion and relieves appetite loss9 ,ndicated in cold damp in the intestines35pleen qi $u • 1romotes e$pectoration, resolves phlegm and relieves coughingK opens the chest, relieves hee(ing and benefits the throat 9 ,ndicated for damp phlegm in the .ung, .ung qi constraint. • !irculates the qi, releases constraint and relieves painK promotes and harmoni(es urination, relieves irritationK clears internal ind and stops spasms9 ,ndicated in +eart qi constraint, intestine qi constraints3.iver&5pleen disharmony, Urinary Bladder qi constriant and internal ind. =5ee 'lling ood, :ervous !onditions.> • 1romotes tissue repair and reduces contusion • %amp cold urogenital and intestinal discharges are the most appropriate conditions it addresses. !ompare ith 6erminalia +e (i =/yrobalan fruit>. Medicinal actions: • %iuretic, tonic, astringent, hepatic tonic, lithotrophic, anti&lithic, carminative, anti&inflammatory. • Alterative, tonic, stimulant, diuretic.FF2 • /ildly stimulating, moderately astringent and diffuse in action. FF3 )raditional Medicinal Uses: • 'clectics used stone root for a variety of conditions. 5cudder considered !ollinsonia as Ione of the most direct and valuable agents,J and !oo# sa !ollinsonia as mildly stimulating, moderately astringent and diffuse in action. • *astrointestinal conditions9 5tone root as considered a gastrointestinal tonic. ,t as used in colic pains and persistent la$ity of the bo els,FF< to improve the appetite and facilitate digestion,FFE FFF to help in catarrhal gastritis ith decreased circulation = ith addition of +ydrastis>, and to decrease persistent and steady rectal pain. FFH ,t as also #no n to relieve irritation and to help in9 constipation, indigestion, irritative dyspepsia, chronic gastritis, chronic gastric catarrh, diarrhea, dysentery, colic, spasmodic conditions of the stomach and intestines, tenesmus =accompanying dysentery, as ell as pain and inflammation follo ing surgery>, anal fistula, subacute proctitis, rectal ulcers and poc#ets. FFB 'lling ood specifically recommended

•

•

•

• •

!ollinsonia in all rela$ed conditions of the mucous membranes of the large intestine and rectal conditions, here there is a sensation of constriction, heat and eight ith deficient secretion from imperfect capillary circulation in the mucous membranes and dry, hard and round feces. FFC *enitourinary !onditions9 +elpful in acute cystitis =combined ith Aconitum> and spasm of the urinary sphincter and vagina. FH0 5tone root as considered a mild diuretic in general, but strong diuretic in sub&acute gonorrhea =decreases leu#orrhea> and catarrh of the bladder,FHA and mild tonic of the urinary tractFH2 and renal organs. ,t as found useful in decreasing irritation secondary to urinary gravel, and as considered a good remedy for any catarrhal condition of the genitourinary system and spermatorrhea.FH3 !ardiovascular !onditions9 !ollinsonia as a tonic to an enfeebled myocardium =e.g., in heart debilitated by prolonged fever or rheumatic inflammation>K it as used to induce steady, permanent improvement in cardiac function and general circulation. ,t as considered to have a direct ability to strengthen rela$ed, atonic vasculature =e.g. hemorrhoids FH<, varicosities of the vaginal all and vulva during pregnancy, and varicocele in the early stages or as a preventative>. FHE )elter and .loyd =.ing/s DispensatoryB say that !ollinsonia acts principally on the venous system. 6hey support the usage of !ollinsonia for ea# heart conditions =e.g. mitral regurgitation>. FHF :ervous 5ystem !onditions9 :ervous headache, nervous dysmenorrhea and other gynecological conditions =in combination ith .iriodendron and .eonorus>,FHH chorea and epilepsy.FHB )elter and .loyd thought that stone root has a mar#ed action on the vagus, thereby relieving irritation in parts to hich that nerve is distributed. 6hey said it relieves irritation of the nervous system by increasing secretion from the #idneys and s#in. FHC 4espiratory 5ystem !onditions9 !hronic laryngitis, chronic bronchitis,FB0 FBA aphonia, resulting from vascular hyperemia or congestion, tracheitis. 5pecific indications included a sense of constriction ith irritation3tic#ling in the throat, ith cough arising from use of the voice.FB2 '$ternal uses9 6he fomentation3poultice of the leaves as utili(ed for painful s ellings, sprains, bruises, burns, ulcers, etc. FB3
FB<

Current Medicinal Uses: • *enitourinary conditions9 • 1roctological problems9 Anodyne, enhances healing, good astringent. FBE • *astrointestinal !onditions9 • 6onic astringent to the *, tract. 5tomachic, stimulates gastric secretions =used ith 6ara$acum in geriatric p$>. !an be used for gastritis.FBF • 4espiratory conditions9 • .aryngeal and pharyngeal viral disease.FBH • !ardiovascular conditions9 • 6onic to the venous alls.FBB • Q *eneral info9 5tone root e$erts astringent and tonifying effects upon the mucosa of the gastrointestinal tract. ,n addition, stone root ill help to reduce spasm of the smooth muscle of the intestine, thus relieving intestinal colic. ,t stimulates appetite, stimulates hydrochloric acid release, and gently stimulates peristalsis. • *enitourinary !onditons9 !ollinsonia is primarily used as an astringent and to help pass #idney and gall bladder stones. • !ollinsonia canadensis is mainly used to aid the passage of renal and urinary calculi. ,t is most indicated in lithiasis ith colic. ,t rela$es spastic smooth muscle and in this manner presumably aids the passage of urinary stones. ,t may also aid in stone dissolution. ,t relieves irritation and inflammation of the urinary tract and, therefore, is of great benefit hen gravel is present in the urinary tract. !ollinsonia is usually combined ith other herbs such as 'upatorium purpurea and +ydrangea arborescens for this purpose. 5tone root is a useful pelvic tonic. ,t can be used for conditions of the female and male reproductive organs especially hen pelvic atony and poor venous circulation are present. 1ersons ith amenorrhea, dysmenorrhea, menorrhagia, pruritis vulvae, spermatorrhea, or varicocele, may all benefit from stone root. +emorrhoids, secondary to poor venous tone, ill benefit from local and internal use of stone root. • :ervous !onditions9 5tone root acts upon the nervous system as ell. ,t has a soothing, an$iolytic effect, and is especially indicated hen nervous tension manifests in visceral spasm. • 4espiratory 5ystem !onditions9 6he astringent effects of !ollinsonia are also useful in relieving hoarseness and cough secondary to overuse of the voice. • 7ascular !onditions9 6he astringent actions are pronounced on areas of venous congestion such as hemorrhoids and varicose veins. 6opical application is usually the preferred method of administration. 6he hepatic tonification may be the result of stimulation of portal circulation. RFBC #harmacy: • 'nema & hole plant tincture of unspecified strength, for proctological complaints9 E0 gtts in L cup ater. FC0 • 5uppositories for proctological problems9 hs

• 6incture • Whole plant tincture of unspecified strength, for tonic and astringent action on *, tract9 5ig 30 gtts 6,% ac. FCA • Whole plant tincture of unspecified strength, tonic for *, tract9 L&A dr. FC2 • A9E tincture, =<0G 't0+>9 sig 2&B m. 6,%.FC3 • )or hemorrhoids9 !ollinsonia9+amamelis, equal parts, sig9 20&30 gtts q 2 hrs. in combination ith a compress of +amamelis. FC< • %ried root9 • 1o dered root9 20 grains 6,%.FCE • A&< grams 6,%FCF • ,nfusion9 • A o( po dered root3quart boiling ater, infuse $ A hr. 5ig9 A&2 o( q <&3 hrs. FCH • %ecoction9 • A&< g root or rhi(ome3 AE0 ml boiling ater, simmer E&A0 min, strain. 5ig9 6,% FCB • )or perspiration9 A tsp3cup, sig9 A3< to A cup 6,%. FCC • .iquid e$tract9 • A9A liquid e$tract =2EG 't0+>9 A&< m. 6,%H00 Contraindications: )o*icity: • 6he fresh roots are e$tremely nauseating. /inute doses of the green plant ill promptly promote emesis. H0A • 0rally, ingesting large amounts of stone root can cause intestinal tract irritation and colic&li#e pain, di((iness, nausea, and painful urination.H02

Commiphora molmol (C2 Myrrha
Common name: /yrrh, Bola =5ans#rit>, /u ;ao =!hinese>. Ha!itat9 :' Africa, 'astern /editeranean countries, including Arabia.

Burceraceae

Botanical description9 5turdy bushes gro ing up to C feet in height ith #notted branches ] branchlets hich end in a sharp spine. 6he trifoliate, small, oval leaves are scanty. 6his shrub gro s in dry areas. 6hrough natural fissures in the bar# or at sites of in"ury, a pale yello granular secretion is formed. Upon drying, this secretion hardens to the si(e of about 2&3 cm. diameter ] becomes a red& amber in color. /yrrh is aromatic ] has a bitter taste. #arts used9 0leo&gum resin & e$uded from the bar# ] dried in the open air. $nergetics: Bitter, 1ungent. 5 eet, +eating. =&> ?apha ] 7ata. =X> 1itta in e$cess. Affinity for all tissues. 1articular systems affected, include9 !ardiovascular, 4eproductive, :ervous, .ymphatic, ] 4espiratory. Constituents9H03 H0< • Golatile oil =2&A0G>9 ,ncluding9 %ipentene, !adinene, +eerabolene, .imonene, 1inene, 'ugenol, m&!reosol, !innamaldehyde, !uminaldehyde, !umic Alcohol. • 5um =EH&FAG>9 Arabinose, *alactose, Pylose, /ethylglucouronic acid. • Resin =2E&<0G>9 !ommiphoric acid, +eeraboresnene, +eerabol/yrrhol, !ommiferin. • ,teroids9 !oampesterol, !holesterol, beta&5itosterol. • Terpenoids =30&E0G>9 1articularly alpha&Amyrin. #harmacology: 6here are three types of resins. 0leoresin is composed of resin ] essential oil. *um resins are composed of gums ] essential oil. )inally, oleo&gum resin is composed of essential oil, gum ] resin. /yrrh@s many actions are thought to be due to its content of oleo&gum resin. ,n general, resins are stic#y, ater&insoluble, soften on heating, ] they can not be easily represented by one simple chemical structure, but are instead composed of a comple$ mi$ture of many chemical structures hich afford to a resins particular physical characteristics ] actions. 4esins are e$uded by plants as a possible form of protection =as are mucilages ] gums>K ] can also provide protection for animal tissues as ell, in that they astringe ] protect the tissues by local stimulation of the immune system. 6his mechanism is though to be due to /yrrh acting as a local contact allergen. ,n general, all resins are contact allergens, ] hence have the potential of causing oral ulercation ] contact dermatitis on local application. /ore specificly, the oleo&gum resin in /yrrh has the follo ing special effects. 5ince resinous compounds are poorly absorbed, they act as contact allergens ] tend to be astringent to the tissues in hich they come into contact. When a resin is combined ith an essential oil, this combination tends to be anti&microbial in action by stimulating local macrophages hich signal for a reciprocal immune

response. When oils, gums ] resins are combined, they also have the general effect of stimulating local leucocytosis. 4esinous constituents have been found helpful in relieving inflammation of the upper *, tract, due to their ability to astringe ] soothe inflamed tissues. 6he ability of /yrrh to act as a contact allergen hile at the same time as an anti&inflammatory agent may seem counterintuitive, but thin# about it this ay. When a mucous membrane is stimulated, not only is an immune response mediated = hich includes inflammation>, but the mucosa also responds to this challenge by increasing its production of mucous as an immediate response to local irritation. +ence, hile the immune response is being mediated, the local tissues are trying to protect themselves ith a nice soothing layer of mucous. 6his also affords to /yrrh@s ability to act as a mild anodyne. 5econdly, the gums ithin /yrrh act as demulcents. *ums are comple$ chains of uronic acid that are characteri(ed by their highly viscous, slippery, slimy consistency. *ums are susceptible to hydrolysis to yield9 $ylose, mannose, arabinose ] galactoseK hence the preferred menstrum is ater. When gums come into contact ith ater to produce the above sugars, they s ell to become gelatinous. 6his ma#es gums useful as tissue demulcents, hich can coat ] soothe inflamed mocosa. /yrrh is an effective arming e$pectorant due to its content of resins ] essential oils, ] hence is indicated in congestive respiratory conditions of a cold nature, such as certain forms of bronchitis ] asthma. H0E H0F

Medicinal actions: /ucosal 5timulant. '$pectorant. Antiseptic. Astringent. Anti&inflammatory. Anti&spasmodic. !arminative. %emulcent. 'mmenogogue. 4e"uvanative. Analgesic. Current > )raditional Medicinal Use: +istorically, communities of the /iddle 'ast have long used /yrrh as incense ] a mouth ash for sore gums ] mouth sores. /yrrh is specificly indicated for use in chronic bronchitis that is characteri(ed by profuse secretion of mucus or muco&pus 3 difficult e$pectorationK membranes that are la$ ] pallidK tonsils that are enlarged ] spongyK a pale throatK soreness ] sponginess of the gumsK reproductive disorders of omen, 3 associated sensation of heaviness ] dragging in the pelvis ] leucorrhoea. ,n general, resins are arming ] stimulating, ] hence are a good choice for some types of cold ailments ] to promote circulation. H0H !old conditions 3 pale, la$, ] flaccid tissues, are tonified ] tightened. 0verall, /yrrh tends have a normali(ing effect on mucosal secretions & thinning copious, thic# mucous ] astringing to reduce the overall amount of mucous secreted by goblet cells, to reduce inlammed tissues. /yrrh is a stimulant, esp. to mucous membranes. ,ts property of restraining the mucous discharges is observed to be most pronounced upon the renal ] bronchial tract. ,t also e$erts an antiseptic influence, ] is used to promote e$pectoration, as ell as menstruation. ,t has also been used as a vermifuge. ,t is generally used in enfeebled conditions of the body, ] has been found useful in cases of e$cessive mucous secretion from any mucosal surface. • Dental Conditions: As a mouth ash, combining tincture of /yrrh 39 sage oil, peppermint oil, menthol, chamomile tincture, e$pressed "uice from 'chinacea, clove oil, ] cara ay oil has been used successfully to treat gingivitis. ,n cases of acute gum inflammation, 0.E ml of the herbal mi$ture in half a glass of ater 6,% is recommended. 6his herbal preparation should be s ished slo ly in the mouth before spitting out. 6o prevent recurrences, slightly less of the mi$ture can be used less frequently. A toothpaste containing sage oil, peppermint oil, chamomile tincture, e$pressed "uice from 'chinacea purpurea, /yrrh tincture, ] rhatany tincture has been used to accompany this mouth ash in managing gingivitis. H0B • 9astrointestinal Conditions: /yrrh is of value in chronic gastritis ] atonic dyspepsia ith full, pallid tongue ] mucous tissues, frequent mucous discharges ] flatulence.H0C !ommiphora through its astringent, anti&inflammatory, ] demulcent actions are effective for chronic inflammation in an atonic *i system. 6his action is best accomplished if the /yrrh is ta#en bet een meals, combining ell 3 *entian for this purpose. • 9ynecologic Conditions: /yrrh has some reputation as an emmenagogue. ,t is used in female disorders characteri(ed by eighty, dragging sensation in the pelvis, ] associated leucorrhoea. ,t as reputed to be useful in stimulating suppressed menses, ] in some cases of anemia. +o ever, in these conditions it as used as a supportive herb. HA0 !ysts ] ulcers =e.g. Bartholin@s glands on the cervi$>, vaginitis including !andidiasis, 6richomonas, *ardernella, ] +17 all respond favorably to douching 3 !ommiphora. A combination of !alendula, +ydrastis, 'chinacea ] !ommiphora can be effective against 6richomonas ] *ardernella hen diluted to A part tincture9 B parts ater. • #ulmonary Conditions: !ommiphora is indicated in acute ] chronic conditions, such as9 laryngitis, bronchitis ] other pulmonary diseases, hich are accompanied by profuse, tenacious secretions. /yrrh can be used topically in chronic pharyngitis that presents 3 tumid, pallid membranes, an elongated uvula, ] spongy, enlarged tonsils. • )opical Applications: 6opically, it is a very useful application to indolent sores, gangrenous ulcers, an aphthous or sloughy sore throat, spongy or ulcerated conditions of the gums, caries of the teeth, etc. ,n general, /yrrh astringes ] tonifies sluggish mucous membranes. !ommiphora po der can also be sprin#led directly on arts, abrasions, ] infections. As a topical for arts, /yrrh can be mi$ed 3 5anguinaria, 6hu"a ] !alendula. 7iral rashes, in diseases such as !o$sac#ie viral disease =+and&foot&]&mouth disease>, can be soa#ed in a solution of /yrrh ] Achillea for resolution. ,f applied to a blister, /yrrh ill bring the blister out more quic#ly, to then be further treated 3 5ymphytum or +ydrastis.

Current +esearch +eview: • 4econdary hypothyroidisim: !ommiphora molmol, li#e its ,ndian relative !ommiphora mu#ul, has a stimulating effect on the thyroid. 6he volatile oils bind to the 65+ receptors on the thyroid e$erting a stimulating effect, indicating its use in secondary hypothyroidism.HAA • 4chistosomiasis: !ommiphora molmol as found to be effective for the treatment of schistosomiasis in a dose of A0 mg3#g of body eight qd $ 3 days in 20< patients ith a cure rate of CA.HG. 0f those ho did not respond, HF.EG ere cured ith re& treatments, using a dose of A0 mg3#g body eight qd $ F days. 6 enty patients had biopsy si$ months after the treatment, and none of them sho ed living ova. 6he side effects ere mild and transient, and drug as ell tolerated. HA2 #harmacy9HA3 • A9E tincture9 B,%&6,% • 4inse or gargle9 E&A0 gtts in glass ater • %ental po ders9 A0G po dered resins 5ince resins are poorly absorbed, the best applications for /yrrh include using it as a gargle, steam inhalation, ] douche. Contraindications.)o*icity: !ommiphora is contraindicated in acute inflammation because it ill stimulate more mucous secretion ] therefore aggravate the inflammation. !ontraindicates in fever, arterial agitation, e$cessive uterine bleeding ] pregnancy based on empirical evidence. HA< !3, in conditions of high pitta. ,n large doses, /yrrh causes increased pulse, increased temperature, gastric burning, diaphoresis, vomiting, ] purgation. !ommiphora molmol is an emmenagogue.
703 704

PDR for Herbal Medicines1 /edical 'conomics !ompany, ,nc, /ontvale, :-, ACCC9HH0. )etro !, Avila -. Professional/s Handboo3 of 2omplementary J )lternati!e Medicines . 5pringhouse !orp, 5pringhouse, 1ennsylvania, ACCC9<<B. 705 5tansbury, -ill, :%. .ecture :otes9 Pharmacognosy for the Herbal Practitioner1 Battleground, WA, =3F0> FBH&2HCC, p.<A. 706 /ills 5, Bones ?. Principles J Practice of Phytotherapy1 !hurchill .ivingstone, +arcourt 1ublishers .imited, 200093H&B. 707 5tansbury, <A. 708 .ininger, et al. Healthnotes: 2linical Essentials, Herb Monographs1 1rima 1ublishing, 4oc#lin, !A, 200A. 709 )elter +W, .loyd -U. .ing/s )merican Dispensary, ABth ed. 'clectic /edical 1ublications, 5andy, 04, ACB3. 710 )elter. 711 6ripathi 5:, et al. >nd 7 Exp Biol ACHEKA3=A>9AE. 712 5heir 8, :asr AA, /assoud A, et al. A safe, effective, herbal anti&schistosomal therapy derived from myrrh. )m 7 Trop Med Hyg 200AKFE=F>9H00&<. 713 PDR for Herbal Medicines, HH0. 714 Brin#er

Commiphora mukul
Common name: guggul lipid Ha!itat: Botanical description: #art used: resin

Berseraceae

Historical use: 6raditionally an Ayurvedic herb, *uggul has been used for rheumatoid arthritis, lipid disorders, obesity and other disorders of lipids including a description of atherosclerosis. $nergetics: Constituents: guggul sterones, non&aromatic acids, diterpenes, lignans, fatty acid alcohols, sterols, esters #harmacology: 6he e$tract isolates #etonic steroid compounds #no n as guggulsterones. 6hese compounds have been sho n to provide the lipid& lo ering actions noted for *uggul.HAE *uggul significantly lo ers serum triglycerides and cholesterol as ell as .%. and 7.%. cholesterol. At the same time, it raises levels of +%. cholesterol. 1ossible mechanisms for this effect on cholesterol includeK stimulation of the thyroid gland =thyroid stimulation reduces cholesterol>, and stimulation of the .%. receptor causing enhanced upta#e of .%. and decreased cholesterol synthesis. HAF As antio$idants, guggulsterones #eep .%. cholesterol from o$idi(ing. *uggul has also been sho n to reduce the stic#iness of platelets, increase the brea#do n of fibrin, decrease platelet aggregation, and delay coagulation time.HAH Medical actions: anti&inflammatory, anti&hyperlipidemic )raditional Medicinal Uses: ,n Ayurvedic medicine, *uggul is utili(ed in the treatment of a variety of conditions including abscesses and cysts, lymphadenitis, tuberculous adenitis, bronchitis, ulcers, diabetes, gout, s#in disorders, dysmenorrhea and amenorrhea obesity and rheumatoid arthritis. ,t as also used as a gargle or mouth ash for spongy gums, dental carries, mouth and throat sores3ulcers and tonsilitis. Current Medical Uses: • !ardiovascular !onditions9 1revention of free radical damage of the heart has been sho n to be affected by guggul as ell as improved heart metabolism. ,n addition, guggul may prevent the development of a stro#e or embolism. A double&blind placebo&controlled study of *uggul for reducing cholesterol enrolled FA individuals and follo ed them for 2< ee#s. HAB,HAC,H20 After A2 ee#s of follo ing a healthy diet, half the participants received placebo and the other half received *uggul at a dose providing A00 mg of guggulsterones daily. 6he results after 2< ee#s of treatment sho ed that the treated group e$perienced an AA.HG decrease in total cholesterol, along ith a A2.HG decrease in .%., a A2G decrease in triglycerides, and an AA.AG decrease in the total cholesterol3+%. ratio. 6hese improvements ere significantly greater than hat as seen in the placebo group. 5imilar results ere seen in a placebo&controlled trial of <0 individuals H2A and a double&blind study of 22B individuals given either *uggul or the standard drug clofibrate found appro$imately equal efficacy bet een the t o treatments. H22 • %ermatologic !onditions9 ,n a study of acne, A0 patients ere treated ith E0 mg3day of gugulosterones for 3 months. !ompared to tetracycline patients ith oily s#in sho ed more improvement ith !. mu#ul. H23 • 'ndocrinological !onditions9 *uggul is stimulating to the thyroid. • ,nflammatory !onditions9 Use of guggul is indicated in acute and chronic inflammation. ,ts effect is about A3E th that of hydrocortisone and equal to phenylbuta(one and ibuprofen. ,n chronic inflammation, it has been sho n to be more effective than these three medications in reducing the severity of secondary lesions. • /etabolic !onditions9 *uggul is indicated in hyperlipidemia, particularly 6ype ,,b =high .%., 7.%., 6*> and 6ype ,7 =high 7.%. and 6*>. ,n turn, guggul is indicated in the prevention and treatment of arteriosclerosis as formation and regression of atherosclerotic plaques has been demonstrated in animals. #harmacy: *uggul contains a mi$ture of diverse chemical constituents hich can be separated into soluble and insoluble fractions. 6he insoluble fraction is considered to$ic and has no other pharmacological activity, thus preparations containing only the soluble fraction are used. /ost products are standardi(ed to 2.EG or EG. 6herapeutic dose is 2E mg tid O E00 mg of EG e$tract tid. 5ome companies are beginning to concentrate to A0&20G guggulsterones, but have not been evaluated.

Drug ,nteractions: Contraindications: • *uggul is contraindicated in hyperthyroid conditions due to thyroid stimulating effects =6. .o %og /%> )o*icity: !rude gum guggul, alcoholic and ether e$tracts are associated 3 s#in rashes, diarrhea and other unpleasant effects due to the insoluble fraction. 0ther ise, purified guggul has not displayed any to$ic effects hen evaluated by testing liver function, blood sugar control, #idney function or hematological parameters. ,t does not possess embryoto$ic or fetoto$ic effects and is therefore considered safe to use in pregnancy
715 716

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000, p. A0C 717 Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000, p. A0B&AAA. 718 Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000 719 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. FB0 720 5ingh 4B, :ia( /A, *hosh 5. +ypolipidemic and antio$idant effects of 2ommiphora mu3ul as an ad"unct to dietary therapy in patients ith hypercholesterolemia. 2ardio!asc Drugs Ther1 ACC<KB9FECWFF<. 721 7erma 5?, Bordia A. 'ffect of !ommiphora mu#ul =gum guggulu> in patients of hyperlipidemia ith special reference to +%.&cholesterol. >ndian 7 Med Res1 ACBBKBH93EFW3F0. 722 :ityanand 5, 5rivastava -5, Asthana 01. !linical trials ith gugulipid. A ne hypolipidaemic agent. 7 )ssoc Physicians >ndia. ACBCK3H9323W32B. 723 Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000, p. AA0&AAA.

Convallaria maBalis
Common name: .ily of the 7alley

1iliaceae

Botanical description9 !onvallaria is a lily plant ith lanceolate leaves up to AE cm. long and E cm. ide. 6he flo er stem holds B to A2 small, stal#ed, bell&shaped hite flo ers hich bloom in /ay. 6he root is slender and runs "ust underneath the surface. #art Used: +erb and )lora. )resh leaves are the most po erful. =Berries are poisonous.> Constituents9 • !ardioactive glycosides9 primarily convallato$in and several cardenolides= convallato$ol, convallamarin, convallarin, and convallaric acid> • 0ther constituents9 saponins, flavonoids, asparagin #harmacology: 6his is one herb here it has been clearly established that the hole plant is most effective. 0verall, !onvallaria e$erts a positive inotropic and negative chronotropic action on the heart. %ifferent glycosides are necessary for solubility and others for their action on the heart, and their natural configuration provides the most effective action. Although the aglycones are stronger than those in %igitalis, the glycone portion of the glycosides in !onvallaria slo s absorption. !onvallato$in has an absorption rate of about A0G and is increased by the other components in the herb. Additionally, the glycosides have a shorter half&life than those found in %igitalis. Medicinal actions: !ardio&tonic, anti&arrhythmic, hypertensive, diuretic )raditional Medicinal use: 5pecific ,ndications and Uses9 +eart irregularities due to mechanical impedimentsK mitral insufficiencyK edema of cardiac originK palpitation and vehement heart action, ith arrhythmic movements, dyspnoea, and diminished arterial pressure. 2uic#ened pulse ith capillary obstruction.H2< • !ardiovascular !onditions9 6he chief use of !onvallaria by the 'clectic physicians as that of a heart remedy. ,n small doses !onvallaria is a tonic to the heart, strengthening its action. ,t as noted that !onvallaria has an t o effects on the heart9 cardiac e$citation is relieved by moderate doses, hile large doses increase the heart action. %ue to its action on the heart it acts secondarily as a diuretic and as first for this purpose by the 4ussians. .i#e %igitalis, it as considered useful in those cases of edema here there is diminished myocardial circulation and here there is evidence of obstruction. 1alpitation and irregular movements, dyspnea, diminished renal action ith increase of solids in the urine, hepatic fullness and engorgement are usually symptoms of this form of cardiac inefficiency. 6he cases of edema benefited, therefore, are those of cardiac origin ith feeble circulation and diminished blood pressure. /itral insufficiency, ith attendant dyspnea and palpitation, is considered a proper indication for !onvallaria. ,nsufficiency or stenotic conditions of the aorta are less benefited than mitral complications. !onvallaria should be thought of in the cardiac debility follo ing severe and e$haustive diseases. • *astrointestinal !onditions9 !onvallaria as also considered a tonic to the digestive system, increasing the appetite and digestive po er, and acting slightly as an aperient. • 6opical Applications9 6he po dered flo ers have been used in fomentations for the removal of ecchymoses. Current Medicinal Use: • !ardiovascular !onditions9 !onvallaria is a ea#er =and safer> cardioactive plant than %igitalis purpurea due to the pharmacologic properties of its cardiac glycosides described above. !onvallaria is most indicated in bradycardic and3or arrhythmic forms of heart failure, although tachycardic hearts also respond to this herb. %r. /itchell notes that !onvallaria slo s the pulse and corrects some arrhythmias by increasing coronary circulation. A heart that is ea#ened secondary to poor valvular function is most li#ely to respond favorably to !onvallaria. 6hus, mitral stenosis, mitral regurgitation and cor pumonale are especially good indications for the use of this plant. %r. Bastyr ould combine !onvallaria ith 'chinacea and 1hytolacca to retard valvular deterioration. !onvallaria is indicated in mild to moderate degrees of heart failure. 6he asparagin has a diuretic effect and helps to drain fluid retained in edematous tissues. 6he flavonoids stimulate vasodilation of coronary vessels, although the plant has a slightly hypertensive effect systemically. 6he vital character of !onvallaria can be characteri(ed as strengthening and calming to the heart and mind. #harmacy: 6incture A9E <0G sig 0.E&A.0 ml 6,% =B&AE drops>

,nfusion9 A tsp.3cup 6,% QAE0 mg 6,%R gently decocted. %aily dose9 2&3 mg p.o. or 0.2&0.3 mg intravenously of standardi(ed e$tract =standardi(ed to 0.2&0.3G cardioactive glycosides> E&20 gtt bid =start at E gtt and titrate up> /itchell Drug ,nteractions: (0% • %o not use in con"unction ith potassium depleting drugs such as diuretics, quinidine, anthraquinone glycoside containing botanicals and corticosteroids. • !aution hen combining ith other cardiac glycoside containing botanicals due to additive effects. Contraindications: :o information is currently available from the selected resources. )o*icity9 !ompared ith %igitalis, !onvallaria is generally as efficient, both as a heart tonic and as a diuretic, and is safer. /oreover, it is freer from cumulative effects. 5igns of to$icity include nausea, vomiting, violent purging, cardiac arrhythmias, increased blood pressure, restlessness, trembling, mental confusion, e$treme ea#ness, depression, collapse of circulation, death.
724 725

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 23<

Crataegus o*ycantha
Common name: +a thorne Ha!itat:

+osaceae

Botanical description9 +a thorne is a hairless, thorny, deciduous shrub found in oodlands. ,t has 3&E lobed leaves ith uneven indentations particularly near the tip. White, dense clusters of flo ers are follo ed by red A&2 seed bearing false fruits. 6he plant flo ers in early summer and the berries appear in 5eptember. !. o$ycantha has t o seeds in the berry, !. monogyna has one seed in the berry, !. douglasi =a> and other !. spp have multiple seeds in the berry. .eaves are distinctly lobed. )lo ers are hite =ornamentals are pin#>. Berries turn red or blac#. 6horns can be 3&<J long. 5tamen heads change from a dar# orange red to pale after bees have visited the flo er =common finding in the rosaceae family> #arts used9 )lora, leaves, and berries Historical use: 6he shrub has been used for ood, hedges and flavoring for liquor =berries>. $nergetics:. )ccording to Holmes: !rataegus is primarily mildly s eet, bitter, astringent, mildly cooling and dry. 5econdarily, it is nourishing, restoring, calming, astringing, softening and dissolving. !rataegus has a tropism for the heart, arteries, intestines, blood and nerves. ,n 6!/, the fruit of ! pinnatifida and !. cuneata have been used to improve digestion, stimulate circulation and remove blood stasis /eridians entered include the 1!, +6, 5,, and ?% and the biotypes indicated are ;ang /ing 'arth and 6ai ;ang.
   

5trengthens and restores the heart, balances and harmoni(es the circulation 9 ,ndicated in heart qi $u. 6onifies the yin and clears deficiency heatK supports and stabili(es the heart and calms the spirit 9 ,ndicated in yin $u, heart and #idney yin $u. 5timulates the heart, promotes urination and relieves congestionK softens deposits and causes eight loss 9 ,ndicated in heart $ue stagnation, phlegm and damp accumulation 4emoves stagnancy and relieves distensionK creates astriction and arrests discharge 9 ,ndicated in spleen qi $u ith damp accumulation, heart $ue and spleen qi $u, qi stagnation in the lo er "iao and food stagnation. +olmes describes its use a digestive dispersant in cases of stagnation in the intestines.

Because !rataegus has a function restoring and stimulating effect on the heart and circulation, a net balancing effect occurs because the heart@s basic energetic role is to balance metabolism and neurosensation functionally and structurally. ,n Ayurvedic medicine, !rataegus increases 7ata and decreases 1itta and ?apha. Constituents9 • )lavonoids9 =highest in flo ers, then berries ith the e$ception of 01!@s hich are highest in the leaves> ° quercetin or 0& glycosides9 quercetin&3&galactoside hyperoside, rutin, luteolin&0&glycoside ° flavone !&glycoside9 7ite$in, 7ite$in&rhamnoside ° oligomeric procyanidins301!@s9 procyanidin B&2, epicatechin, catechin • 0ther constituents9 amines=phenethylamine, o&metho$yphenethylamine, tyramine>, 1henolic acids =chlorogenic, 2&phenylchromone derivatives>, catechols, carbo$ylic and triterpene acids =crategolic acid, ursolic acid> , tannins, ascorbic acid #harmacology: Antio$idant activityK co&factor for vitamin ! inta#eK stabli(ation of connective tissue toneK reduction of cholesterol H2F 1harmaco#inetics: 5tudies have sho n rapid absorption of 01!@s ith locali(ation in tissues rich in glycosaminoglycans and a plasma half life of E hours. 4utin sho ed poor absorption suggesting that 01! fragments, resulting from bacterial activity, are more bioavailable than flavonoids. !rataegus has numerous beneficial actions on the heart and blood vessels. ,t may improve coronary artery blood flo and the contractions of the heart muscle and may mildly inhibit angiotensin&converting en(yme =A!'> thereby reducing production of the potent blood vessel&constricting substance angiotensin ,,. 6his reduces resistance in arteries and improves e$tremity circulation. !rataegus e$tracts may mildly lo er blood pressure in some individuals ith high blood pressure. H2H 6he bioflavonoids in !rataegus are potent antio$idants. 6he oligomeric procyanidins are effective in strengthening and stabili(ing collagen in vitro by forming cross&lin#s bet een the polypeptide chains of collagen. H2B 6he amines have been sho n to e$ert a positive inotropic influence on the heart. +o ever, the amines are present in significant amounts only in the flo ers and are largely bro#en do n follo ing intestinal absorption. Antio$idant activity on hepatic microsomal preparations has been demonstrated =in&vitro> and has beenattributed to the total phenolic content, particularly epicatechin and procyanidin B&2. ,n !hina, research has sho n !. pinnatifida to induce 50% in mice. 4&*

!rataegus flo er e$tract inhibits thrombo$ane A2 in vitro. Medical actions: positive inotropic, cardioprotective, cardiac trophorestorative, astringent, diuretic ,ncreases coronary blood flo , reduces myocardial o$ygen demand, protects against myocardial damage. H30 Medical ,ndications: moderate +6:, arrhythmia, angina, tachycardia, 50B, cardiac insufficiency, anemia, valvular insufficiency, menopause )raditional Medicinal Uses: 6he specific indications for !rataegus are9 M!ardiac ea#ness, ith valvular murmurs, sighing respiration, or other difficult breathing, especially hen associated ith nerve depression or neurastheniaK mitral regurgitation, ith valvular insufficiencyK cardiac painK precordial oppression, dyspneaK rapid and feeble heart actionK mar#ed anemia, associated ith heart irregularityK cardiac hypertrophyK and heart strain, due to over&e$ertion or accompanying nervous e$plosions.J 4C% Current Medicinal Uses: ,n addition to the uses described belo , the flo ers and berries of !rataegus have been used for sore throats as an astringent and as a diuretic in #idney problems. • !ardiovascular !onditions9 !rataegus is often referred to as Mfood for the heartM and is an e$cellent cardio&tonic. 6he plant is gentle yet effective. !ardiac indications supported by clinical trials include congestive heart disease due to ischemia, hypertension and cardiac insufficiency. 6he flavonoids and procyanidins are the main constituents. 6heir main effects are improvement in coronary circulation, increased nutrition and energy stores of the myocardial cells, increased intracellular !a 2X stores, and inhibition of phosphodiesterase causing increased cA/1 levels. By increasing myocardial cA/1 through inhibition of 1%', !rataegus prolongs the effective refractory period compared to inotropic drugs, hich tend to shorten it. Also, current research suggests that he mechanism is through modulation of :a3? channel function. 6he heart tends to slo . +o ever, current research that the effect of 6hus, !rataegus has antiarrhythmic potential, especially as long&term therapy for e$tra systolic arrhythmias. *iven the actions stated previously, !rataegus is beneficial in the treatment of senile heart =degeneration of cardiac mm.>, coronary artery disease., angina pectoris, cardiac arrhythmia prevention, and ea#ness of the myocardium after infectious diseases. !rataegus has also been demonstrated to have a cardioprotective effect on the ischemic&reperfused heart. ,n regard to hypertension, hypertensive hearts !rataegus lo ers blood pressure by dilating larger vessels, inhibiting angiotensin converting en(yme, increases the functional capacity of the heart, and acting as a mild diuretic. !rataegus has a partial β&antagonistic effect as ell. ,n an uncontrolled trial mean systolic pressure fell from 20E mm +g to A<B mm +g and mean diastolic pressure fell from AA2 mm +g to B3 mm +g in hypertensive patients receiving !rataegus berry tincture. H32 A clinical study of B0 cardiac patients in -apan demonstrated statistically significant improvement in cardiac function, edema, and dyspnea ith an e$tract of !rataegus flo ers and leaves. H33 !rataegus has a long history of use in the treatment of congestive heart failure, particularly in combination ith herbs containing cardiac glycosides =e.g. %igitalis purpurea, 5lencereus grandifloris, !onvallaria ma"alis>. ,t potentiates the action of the cardiac glycosides, presumably via its ability to inhibit cA/1&1%' and to interact ith calcium channels. Because of this enhancing effect, lo er doses of cardiac glycosides can be used. )or mild to moderate cases of !+), crataegus e$tract used alone may be sufficient, but for moderate to severe !+), it should be used in combination ith other cardiac glycosides. 6here has been a significant amount of solid research regarding the use of !rataegus as a treatment for congestive heart failure. Bet een ACBA and ACC<, A< controlled clinical studies of !rataegus ere performed, most of them double&blind. H3<,H3E ,n all, H<A people participated in these trials. 6he cumulative results strongly suggest that !rataegus is an effective treatment for congestive heart failure. !omparative studies suggest that !rataegus is about as effective as a lo dose of the conventional drug captopril. H3F • !onnective 6issue !onditions9 01!@s have been demonstrated to be highly effective in stabili(ing collagen in vitro by strengthening cross&lin#s bet een collagen chains. =other 01! containing botanicals are grape seed and pine> • %ermatologic !onditions9 ,n an uncontrolled trial ith E0 patients demonstrated that application of a liposome containing e$tract reduced inflammation and improved s#in health. H3H • /etabolic 'ffects9 !rataegus has demonstrated protective action against diet&induced hypercholesterolemia by increasing bile acid e$cretion and depressed hepatic alcohol synthesis =in&vivo>. H3B !rataegus appears to bloc# .%. receptors in the liver. !rataegus stimulates digestive en(ymes hile decreasing o$ygen and energy demands resulting in decreased free fatty acids and lactic acid. 6hus, !rataegus is anabolic in regard to metabolism. H3C • 6opical Applications9 6opical applications have sho n inhibition of ornithine decarbo$ylase in e$perimental models of s#in tumor promotion. #harmacy: !rataegus is safe for long&term use requiring a minimum of 2 ee#s to become apparent. /ost of the medicinal effects of !rataegus are apparent only after long&term use. !rataegus is often used as ad"unct therapy in many conditions for long term use.

dried3fresh leaf, flo er or fruit = or a combination of all three>9 A.E&3.E g dry =3$ if fresh> infusion or decoction, depending on part used =internal or e$ternal use> A92 fluid e$tract =berry, leaf>9 3&F ml qd =internal or e$ternal use> A9E tincture =berry, leaf>9 H&AE ml qd =A tsp tid> e+igher doses than these may be necessary for effective control of +6: <9A 5olid e$tract9 U tsp qd to tid. L tsp bid for valvular insufficiency, coronary insufficiency =maintenance for life& /itchell> 5tandardi(ed e$tract9 F2E mg standard ,7 administration9 decreases blood pressure, e$perimental arrhythmia and increased peripheral blood flo to s#eletal muscle. H<0 Drug ,nteractions: • !rataegus may act synergistically ith cardiac glycosides and β&bloc#ers hich may require modification of medication dosage although adverse to$ic effects usually do not occur. !rataegus enhances the activity of cardiotonics such as !onvallaria, %igitalis, Adonis, digito$in, digo$in and g&strophanthin in animal studies due to its procyanidins. +o ever, it reduces the to$icity of these glycosides by its coronary vasodilatory and anti&arrhythmic effects. H<A Contraindications: *iven that !rataegus is hypotensive and bradycardic, use in these conditions is contraindicated. )o*icity: *enerally ell tolerated. 6he flavonoids may demonstrate a ea# mutagenicity in the Ames test.
726 727

/ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC. p <3C .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 728 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <<3. 729 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. 730 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC. p <3C 731 )elter, W, The Eclectic Materia Medica, Pharmacology and Therapeutics , 'clectic /ed. 1ubl, 5andy, 04, 3rd reprint ACC<, originally published AC22. p. 32F 732 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <<E. 733 , amoto, /. et al., 1lanta /ed., <2=A>, ACBA9A 734 .euchtgens 7+. !rataegus 5pecial '$tract W5 A<<2 in :;+A ,, heart failure. A placebo controlled randomi(ed double&blind study Qin *ermanK 'nglish abstractR. ortschr Med1 ACC3KAAA93FW3B. 735 6auchert /, 5iegel *, 5chul( 7. +a thorn e$tract as plant medication for the heartK a ne evaluation of its therapeutic effectiveness Qtranslated from *ermanR. MM+ Munch Med +ochenschr1 ACC<KA3F=suppl A>953W5E. 736 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 737 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <<E 738 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. 739 +olmes, 1eter. 'nergetics of Western +erbs, 7ol. A. Artemis 1ress. ACBC p. 2EC&2F0 740 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p <<2 741 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. B3

Cucur!ita pepo
Common name: pump#in

Cucur!itaceae

Ha!itat: H<2 • ,ndigenous to America and is ildly cultivated especially in temperate climates. Botanical description: H<3 • )lo er9 yello , monoecious, very large and solitary in the leaf a$ils. /ale flo er has a longer pedicle. !aly$ is fused to the corolla, e$c. for E&a l&shaped tips. !orolla is E&tipped and funnel&shaped. ,nterior is pubescent. 6hree stames are fused to the anther. 0vary is inferior and 3&locular. • )ruit9 large ith many seeds. )lesh is fibrous, yello &orange to hite and has a viscous placenta. 5eeds are H&AEmm long, narro , broad, or narro &ovate ith shallo grove and flat ridge around the margin. • .eaves, 5tem and 4oot9 annual plant 3&B m long ith decumbent or climbing, sharply&angular ith longitudinal grooves and ith hairy spines. .eaves are alternate, very large and bristly, periolate E&H lobes from a cordate base. #art used: seeds $nergetics: Constituents: H<< • 0il =linoleic> • Amino acids o !urcibitacins o 6yrosine o 6ryptophan o *ABA • ?aempferol • Beta sitosterol • !horophyll pigments • 5elenium, 8inc • 0ther vitamins, minerals #harmacology: • 6hree ma"or groups of active compounds9 essential fatty acids, amino acids, and vitamins. ,t is li#ely that the effects of !urcuma are based on a synergism bet een constituents. 4esearch on fatty acids derived from other sources has suggested they are anti&inflammatory and help lo er levels of fats in the blood. +o ever, research specifically sho ing these effects in humans is scarce. H<E • 1harmacodynamic activity has been ascribed to beta&sitosterol, cucurbitacins =not present in other species>, and tocopherols. 6hey increase tonicity or the bladder muscles, combined ith rela$ation of the sphincter mechanism. H<F • 1ump#in seed oil e$tracted by !02 in supercritical conditions has been sho n to inhibit E&alpha reductase in the conversion of testosterone to dihydrotestosterone as ell as the binding of androgens to cellular receptors. 6he prostatic prostaglandin content as also significantly decreased in pharmacological studies. H<H • Anthelmintic effect W mechanical. H<B 1ump#in seeds paraly(e the tape orm and do not #ill it. H<C Medical actions: AnthehelminticHE0 )raditional Medicinal Uses: • )ol# medicine9 #idney inflammation, intestinal parasites =particularly, tape orm> and vulnary. HEA • 'mulsion of seeds in ater acts transiently on #idneys, bladder, and urethra, and may be used in scalding urine and gonorrhea. ,t is also an effective remedy for tape orms as reported by some physicians. HE2 Current Medical Uses: • *enitourinary system9 o B1+9 ,rritable bladder and micturition associated ith B1+ stages A and 2. HE3 1ump#in seed oil has been used in combination ith sa palmetto in t o double&blind studies to effectively reduce symptoms of B1+. 4esearchers

have suggested the (inc, free fatty acid, or plant sterol content of pump#in seeds might account for their benefit in men ith B1+, but this has not been confirmed. Animal studies have sho n that pump#in seed e$tracts can improve the function of the bladder and urethraK this might partially account for B1+ symptom relief. 1ump#in seed oil e$tracts standardi(ed for fatty acid content have been used in B1+ studies in the amount of AF0 mg 6,% ith meals.HE<,HEE,HEF #harmacy: • 5eed9 o 20g3day of hole and coarsely ground seed and other galenical preparations for internal uses (&0 o A0g coarsely ground or ell che ed seed ta#en ith fluid =!ommission '> (&7 o A&2 heaping 6bsp =AE&30g> coarsely ground or ell che ed seed ta#en ith fluids B,% =*erman 5tandard .icense> (&: • )or anthelmintic effect9 o F0g seeds beaten ith equal amounts of sugar and mil#, or ater, added to ma#e a pint. 5ig9 3 doses q2hrs fasting, follo ed by castor oil fe hours after the last dose. HFE o 30 g seeds in emulsion ith sugar, gum Arabic and ater. 5ig9 am on empty stomac. ,f no result is seen, follo by cathartic on 2nd and subsequent days.HFF o 20&F0 gtt oil. +as been combined ith oil of male fern. HFH o 200&<00g of unpeeled ground seed mi$ed ith mil# or honey to a porridge&li#e consistency. 5ig9 am on empty stomach, follo ed by castor oil 2&3 hrs later. HFB

)o*icity: • 5afe in pregnancy, liver d(, #ids and decreased health HHA
742 743

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p. FAB. ,bid. 744 -ames A. %u#e, I!hemicals and their biological activities in9 !ucurbita pepo,J Dr1 Du3eFs Phytochemical and Ethnobotanical Databases , -une F, 2000, chttp933 .ars&grin.gov3du#e3inde$.htmlY, =April AC, 2002>. 745 .ininger et al9 Healthnotes9 2linical Essentials, Herb Monographs1 1rima 1ublishing, 4oc#lin, !A, 200A. 746 4udolf )rit( Weiss, Herbal Medicine, 6hieme, 5tuttgart, 200A, p. 2E<. 747 '. Bombarderlli, 1. /ora((oni, I!ucurpida pepo ..,J itotherapia, ACCH, 7ol FB, pp. 2CA&302, cited by /elvyn 4. Werbach and /ichael 6. /urray, 2nd ed., Botanical >nfluence on >llness: ) ,ourceboo3 of 2linical Research, 6hird .ine 1ress ,nc., 6ar(ana, !alifornia, 2000, p. AAB. 748 %avid +offman, The Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesburry, %orset, ACC0, p. 22E. 749 Weiss, p. A20. 750 +offman, p. 22E. 751 PDR, p. FAC. 752 W. /. !oo#, Physio9Medical Dispensatory: ) Treatise on Therapeutics, Materia Medica, and Pharmacy, 'clectic /edical 1ublications, ACBE. p. 3BH. 753 /ar# Blumenthal et al =eds.>, The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , American Botanical !ouncil, Austin, 6e$as, ACCB, p.AC3. 754 B.'. !arbin, 4. 'liasson, I6reatment by !urbicin in Benign 1rostatic +yperplasia =B1+>,J ,:ed 7 Biol Med, 7ol 2, ACBC, pp. H&C Qin 5 edishR. 755 B.'. !arbin et al, I6reatment of Benign 1rostatic +yperplasia ith 1hytosterols,J Br 7 Drol, 7ol. FF, ACC0, pp. F3CW<A Qin 5 edishR. 756 P. 8hang et al, I'ffect of the '$tracts of 1ump#in 5eeds on the Urodynamics of 4abbits9 an '$perimental 5tudy,J 7 TongKi Med Dni!, Gol1 %', ACC<, pp. 23EWB. 757 7.5. 5upha#arn et al, I6he 'ffect of 1ump#in 5eeds on 0$alcrystalluria and Urinary !ompositions of !hildren in +yperendemic area,J )m 7 2lin ;utr, 7ol. <E, ACBH, pp. AAEW2A. 758 7. 5uphiphat et al, I6he 'ffect of 1ump#in 5eeds 5nac# on ,nhibitors and 1romoters of Urolithiasis in 6hai Adolescents,J 7 Med )ssoc Thai, 7ol. HF, ACC3, pp. <BHWC3. 759 5upha#arn et al, pp. AAEW2A. 760 +offman, p. 22E. 761 Weiss, p. A20. 762 /ar# Blumenthal et al =eds.>, Herbal Medicine: Expanded 2ommission E Monographs, American Botanical !ouncil, Austin, 6P, 2000, p.32<. 763 ,bid. 764 ,bid. 765 +offman, p. 22E. 766 W. /. !oo#, Physio9Medical Dispensatory: ) Treatise on Therapeutics, Materia Medica, and Pharmacy, 'clectic /edical 1ublications, ACBE. p. 3BH. 767 ,bid, pp. 3BH&B. 768 Weiss, p. A20. 769 /ar# Blumenthal et al =eds.>, Herbal Medicine: Expanded 2ommission E Monographs, p. 32<. 770 ,bid. 771 Weiss, p. AAC.

Curcuma longa

Eingi!eraceae (9inger family

6his monograph is largely adapted from9 5no -/, I!urcuma longaJ, The Protocol 7ournal of Botanical Medicine, A=2>,Autumn ACCE, <3&<F J /urray, /, I!urcumin9 A potent anti&inflammatory agentJ, The )merican 7ournal of ;atural Medicine, A=<>, %ec. ACC<9A0&A3.

Common name: 6urmeric, ?hamin, Acafrao, U#on, +aldi, +aridra =5ans#rit>, -iang +uang =!hinese>. =:ote9 %o not confuse 3 !. $anthorrhi(a, hich is !urcuma W not 6urmeric.> Ha!itat: 6urmeric is native to ,ndia, !hina, ,ndonesia ] other parts of the tropics. Botanical description: !. longa is a tall perennial 3o stems. 6he rhi(ome is fleshy, palmate, 3 an orange interior. 6he leaves are light green =30&<0cm long ] B&A0 cm ide> 3 long petioles. 6he leaf blades are lanceolate. 6he inflorescence is cylindrical, A0&AE by E& H cm, ] arises directly from the center of the leaves. !urcuma has multiple yello flo ers. #arts used: 4hi(ome. $nergetics: 6aste & Bitter, astringent, pungent. +eating in action. =&> ?apha. =X> 7ata ] 1itta in e$cess. Affinity for all tissues of the body, esp. focus upon the *,, circulatory ] respiratory systems. HH2 ,dentified Constituents: • !urcuminoids9 including !urcumin =diferuloylmethan>, monodesmetho$ycurcumin, bisdesmetho$ycurcumin, cyclocurcumin, demetho$ycurcumin. !urcumin is considered the most active constituent in !. longa. • 7olatile 0ils9 5esquiterpenes Qalpha& ] beta&turmerone, artumerone, alpha& ] gamma&atlantone, curlone, (ingiberene, curcumol.R • 0ther constituents9 5tartch Quconan A, u#onan B, u#onan !RK 1roteinK !affeic acid. HH3 #harmacology: • Anti<o*idant: 6he constituent curcumin can protect %:A against single strand brea#s induced by single o$ygen. HH< !urcumin is lipophilic =fat soluble>, ho ever ater&soluble e$tracts have also demonstrated significant anti&o$idant activityK comparable to vitamins ! =slightly ea#er than !>, ' =slightly stronger than '> ] B+A =butylated hydro$yanisole>. !urcumin is bright yello in color ] thus is used as an antio$idant in butter, margarine ] cheeses. Water&soluble turmerin & li#e its fat&soluble counter&part curcumin & has also been found to have9 anti&o$idant, %:A protectant ] anti&mutagenic properties. HHE • Anti<inflammatory: !urcumin appears to be primarily responsible for the anti&inflammatory action of 6urmeric. When administered orally, curcumin inhibits neutrophil function, inhibits platelet aggregation, inhibits lymphocyte activity, promotes fibrinolysis, ] stabili(es lysosomal membranes.HHF HHH 5odium curcuminate =a form of turmeric obtained form mi$ing turmeric ith sla#ed lime> is the most effective as an anti&inflammatory agent. HHB !urcumin is e$erts its antiinflammatory actions topically via the mechanisms mentioned above ith additional counter&irritant activity hich ill deplete nerve endings of substance 1 =neurotransmitter of pain>.HHC • 1ipid Modulation: 0rally dosed turmerin ] curcumin e$tracts decrease total cholesterol, .%. cholesterol ] increase +%. cholesterol in humans.HB0 !urcumin interferes ith intestinal cholesterol&upta#e by increasing the conversion of cholesterol into bile acids via9 stimulation of hepatic cholesterol&H&alpha&hydro$ylase =the rate limiting en(yme in bile acid synthesis> ] through increased bile acid secretion.HBA HB2 • Anti<platelet: 6urmerin ] curcumin inhibit platelet aggregation by inhibiting the formation of thrombo$anes =promotes aggregation> ] increasing prostacylin =inhibits aggregation>. HB3 Medicinal actions: Anti&inflammatory, Anti&o$idant, Anti&neoplastic, Anti&hepatoto$ic, !holeretic, Anti&cholesterolemic, Antagonist of 1latelet Aggregating )actor =1A)>, !arminative, 5timulant, Alterative, Anti&bacterial, 7ulnerary. Current > )raditional Medicinal Use: • 6urmeric has many clinical applications. ,t has been used internally for liver ] digestive complaints, dysmenorrhea, "aundice, ] as an antiinflammatory agent. • Historical use9 6urmeric has been used throughout ,ndia, !hina ] ,ndonesia as a spice ] medicinal agent. 6urmeric has been applied to ounds, bruises, sprains, leech bites ] inflammed "oints. • Ayurvedic usage: ,ndicated for9 indigestion, poor circulation, cough, antibacterial pharyngitis, s#in disorders, diabetes, arthritis, anemia, ounds, ] bruises. 6umeric is a natural antibiotic that strengthens digestion ] improves intestinal flora, esp. in those chronically ea# or ill. 6ends to purify the blood as ell as stimulate the formation of ne blood tissues. 6umeric is thought to help cleanse the cha#ras, purify the channels ] help to stretch ligaments, hence its use for those ho practice +atha ;oga. 6umeric supports proper metabolism in the body, balancing e$cesses ] deficiencies, as ell as aiding the

• •

•

assimilation of protien. '$ternal application, 3 the addition of honey, is used for sprains, strains, bruises or itch. As a mil# decoction, it is tonic to the s#in.HB< Cardiovascular Conditions: 6he effects of 6urmeric on the cardiovascular system include inhibition of platelet aggregation ] lo ering of cholesterol.HBE,HBF 6hese properties are important for preventing ] treating atherosclerosis ] its complications. 9, Conditions: Because of its ability to stimulate the gall bladder, turmeric has been used as a treatment for dyspepsia =indigestion>. HBH,HBB,HBC,HC0, HCA ,n 'urope, gallbladder dysfunction =or the lac# of bile> is thought to be the main cause of dyspepsia. 6umeric as considered similar to ginger as a stimulant, although 6umeric as thought to be generally more bitter ] tonic. At one time it as en"oyed as a cordial, as a stomachic in "aundice. +o ever, its action as considered too transient to be of much use as an ad"uvant to tonic remedies. ,t as rarely employed, e$cept to color tinctures, liniments, ] ointments. HC2 Cancer: !linical studies ith humans demonstrated the anti&cancer effects are fe ] the results suggest that turmeric is best used as an ad"unctive treatment. A decrease in urinary mutagens in smo#ers HC3 ] a reduction in the symptoms of ulcerating oral ] cutaneous squamous cell carcinomas in persons unresponsive to standard treatments HC< are the most promising clinical trials.

Current +esearch +eview • 9astroenterology9 o #eptic ulcer: HCE  %esign9 1hase ,, clinical trial  1atients9 )orty&five patients ith peptic ulcer disease.  6herapy9 6urmeric, 300 mg E$3day =30 min&A hr ac, < pm, and hs> $ <, B, and A2 ee#s.  4esults9 Ulcers ere absent in <BG or A2 cases =%U C and *U 3>. 'ighteen cases =%U A3 and *U E> had absence of ulcer after B ee#s of treatment. :ineteen cases =HFG> =%U A< and *U E> did not have ulcers after A2 ee#s of treatment. 6he rest, 20 cases ere not found to have ulcers and some ere not endoscoped. 6hey appeared to have erosions, gastritis and dyspepsia. 6hey received turmeric capsules for < ee#s of treatment. 6he abdominal pain and discomfort satisfactorily subsided in the first and second ee#. 6hey could ta#e normal foods instead of soft meals. Blood chemistry and hematology of all E< patients had no significant changes in hematological system, liver and renal functions both before and after treatment.. o Biliary dyskinesia: HCF  %esign9 1lacebo&controlled double&blind clinical trial  1atients9 5eventy&eight patients  6herapy9 !holagogum ) :attermann =containing dried e$tracts from 5chol#raut and !urcuma> $ 3 ee#s  4esults9 4eduction of dumpy and colic#y pain in the A st ee# of treatment as faster than in placebo group ith no side effects. • ,nfectious diseases: o 4ca!ies: HCH  %esign9 !linical trial  1atients9 'ight hundred fourteen patients ith scabies  6herapy9 A(adirashta indica A%4 and !urcuma longa topically as a paste $ 3&AE days  4esults9 CHG cure rate ithout any adverse reactions • +heumatology: o 3steoarthritis: HCB  %esign9 1lacebo&controlled clinical trial  1atients9 )orty&t o patients ith osteoarthritis  6herapy9 +erbomineral formulation containing roots of Withania somnifera, the stem of Bos ellia serrata, rhi(omes of !urcuma longa, and a (inc comple$ =Articulin&)> $ B months  4esults9 5ignificant drop in severy of pain and disability score in the patients ith osteoarthritis. 4adiological assessment did not sho any significant changes o +heumatoid arthritis: HCC  %esign9 %ouble&blind controlled clinical trial  1atients9 1atients ith rheumatoid arthritis  6herapy9 !urcumin, A20 mg qd or 1henylbuta(one.  4esults9 !urcumin significantly helped to relieved the symptoms of rheumatoid arthritis, ho ever, phenylbuta(one as found to be superior, probably because it also has analgesic activity. • ,mmunology: o #ost<operative inflammation:B00

•

 %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 1ost&operative patients  6herapy9 !urcumin, A,200 mg qd, phyenolbuta(one, or placebo  4esults9 !urcumin as found to be more effective than phenylbuta(one or placebo. Cardiology: o Hyperlipidemia and angina pectoris: 5tudy A9 B0A  %esign9 Uncontrolled clinical trial  1atients9 5i$teen patients ith hyperlipidemia and angina pectoris.  6herapy9 6urmeric e$tract in the dose equivalent E0g turmeric qd $ A2 ee#s  4esults9 6urmeric as effective in the lo ering of plasma cholesterol levels by <C mg3dl =A.3 mmol.l> and triglycerides by F2 mg3dl. 5ymptoms of angina pectoris ere ameliorated as ell. 5tudy 29 B02  %esign9 !linical trial  1atients9 :inety patients ith hyperlipidemia and angina pectoris  6herapy9 6urmeric  4esults9 6urmeric as effective in the lo ering of cholesterol and triglycerides, as ell as reducing the symptoms of angina pectoris.

#harmacy: • .iquid e$tract =A9A <EG 't0+ or higher>9 E&A< ml 2% in <&E equal doses. B03 • 1o dered herb9 < g =heaped teaspoon> mi$ed ith ater 2%&B,%, can add A tsp lethicin to improve absorption. 1o dered herb may be better for anti&inflammatory effects. B0< • :ote9 curcumin is not ell absorbed orally =<0G&BEG is absorbed> ] ta#ing equal amounts of bromelain ith it or ta#ing the curcumin in a lipid base ill possibly enhance its absorption. B0E Contraindications.)o*icity: • According to empirical evidence, !urcuma should be avoided in bile duct obstruction, stomach ulcers, hyperchlorhydria ] pregnancy ] caution is advised in gall stone treatmentK ho ever, in regard to stomach ulcer, !urcuma reduced ulcers induced by reserpine ] indomethicine. B0F • 1recaution in cases of acute "aundice ] hepatitis, high 1itta, ] 1*. B0H • 6here have been no reports of to$icity at standard dosage levels. 6he .%E0 has not been established because huge amounts fed to rats fail to produce mortality or chromosomal changes in teratology tests. At high doses =i.e. A00 mg3#g body eight> in rats, curcumin is ulcerogenic.B0B 5tomach complaints may result ith e$tended use or in cases of overdose. B0C About A0&AEG of patients may e$perience *, distress. BA0
772 773

)ra ley, %avidK .ad, 7asant. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29A<C PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. ACCB9HBH. 774 5ubramanian /, et al, Mutation Research, 3AA, ACC<92<C&EE. 775 5rinivas . ] 5halini 7?, )rchi!es of Biochem J Biophysics, 2C2, ACC29FAH&23. 776 5rivastava ?!, Bordia A, ] 7erma 5?, ProstaglJins 8eu3otrienes J Essential atty )cids , E2, ACCE9223&22H. 777 5rivastava 4, )gents J )ctions, 2B, ACBC92CB&303. 778 *hata# : ] Basu :, >nd 7 Exp Biol, A0, ACH2923E&F. 779 1atacchini 4, /aggi !A ] /eli A, )rch Pharmacol, 3<2, ACC09H2&H. 780 5oni ?B ] ?uttan 4, >ndian 7 of Physiol J Pharmacol, 3F, ACC292H3&HE. 781 4ao %5, 5ehara :!, 5atyanarayana /: ] 5rinivasan /, 7 ;utri, A00, ACH09A30H&AF. 782 5rinivasan ? ] 5amaiah ?, >nt 7 Gitam Res, FA, ACCA93F<&C. 783 5rivastava 4, %i#shit /, 5rimal 4! ] %ha an B:, Throm Res, <0, ACBE9<A3&H. 784 )ra ley, %avidK .ad, 7asant. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29A<C&AE0 785 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed.,!hurchill .ivingstone, :e ;or#, :;, ACCC9FCA 786 /ills 5, Bone ?. Principles J Practice of Phytotherapy. !hurchhill .ivingstone, :e ;or#, :;, 20009EHF 787 Blumenthal, /. The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil, ACCB 788 1i((orno -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;, ACCC9FCA 789 /ills, EHH 790 PDR for Herbal Medicines. 791 6hamli#it#ul 7, Bunyapraphatsara :, %echati ongse 6, et al. 4]omi(ed double blind study of 2urcuma domestica Gal. for dyspepsia. 7 Med )ssoc Thai. ACBCKH29FA3W F20.

792 793

!oo# W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica J Pharmacy1 'clectic /edical 1ublications, 5]y, 04 ACBE 1olasa ?, et al , d 2hem Toxic, 2C, ACCA9FCC&H0A. 794 ?uttan 4, 5udheeran 1! ] -osph !%, Tumori, H3, ACBH92C&3A. 795 1ruc#sunand !, ,ndrasu#hsri B, .eethocha alit /, et al. 1hase ,, clinical trial on effect on the long turmeric =!urcuma longa .inn> on healing of peptic ulcer. ,outheast )sian 7 Trop Med Public Health 200AK32=A>920B&AE. 796 :iederau !, *opfert '. 6he effect of chelidonium& and turmeric root e$tract on upper abdominal pain due to functional disorders of the biliary system. 4esults from a placebo&controlled double&blind study. Med .lin ACCCKC<=B>9<2E&30. 797 !harles 7, !harles 5P. 6he use and efficacy of A(adirashta indica A%4 =\:eem@> and !urcuma longa =\6urmeric@> in scabies. A pilot study. Trop 5eogr Med ACC2K<<=A&2>9AHB&BA 798 ?ul#arni 44, 1at#i 15, -og 71, et al. 6reatment of osteoarthritis ith a herbomineral formulation9 a double&blind, placebo&controlled, cross&over study. 7 Ethnopharmacol ACCAK33=A&2>9CA&E 799 %oedhar 5%, 5ethi 4, 5rimal 4!. 1reliminary study on antirheumatic activity of curcumin =diferuloyl methane>. >ndian 7 Med Res ACB0KHA9F32&3<. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 'dinburgh, 20009EHF. 800 5atos#ar 44, 5hah 5-, 5henoy 5*. 'valuation of anti&inflammatory property of curcumin =diferuloyl methane> in patients ith postoperative inflammation. >nt 7 2lin Pharmacol Ther Toxicol ACBFK2<=A2>9FEA&E<. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 'dinburgh, 20009EHF 801 !hang +/, But 11. Pharmacology and )pplications of 2hinese Materia Medica, 7ol 2. World 5cientific 5ingapore, ACBH9C3F&C. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 'dinburgh, 20009EHF. 802 ,bid 803 /ills, EFC 804 /ills, EFC. 805 Werbach /4 ] /urray /. Botanical >nfluences on >llness: ) ,ourceboo3 of 2linical Research, =6hird .ine 1ress9 !alifornia>, ACC<9 AB,EC&F0, A0H&0B, 2CE. 806 Brin#er, ). Herb 2ontraindications J Drug >nteractions1 'clectic /edical 1ublications, 5]y, 04 ACCB. p. A33 807 ra:ley,%#-1 808 Ammon +16 ] Wahl /A, Planta Medica, EH, ACCA9A&H. 809 PDR for Herbal Medicines, 4(41 810 0bservation ,6. .o %og, /%

Cynara scolymus
Common name: articho#e Ha!itat: Botanical description: #art used: leaf Historical use: $nergetics: :o information is currently available Constituents: • !affeic acid derivatives9 cynarin, A,3 dicaffeoylquinic acid, 3&caffeoylquinic acid, and scolymoside. • )lavonoids9 in particular rutin and .uteolin • 5esquiterpene lactones9 cynaropicrin, dehydrocynaropicrin, grossheimin, cynaratriol #harmacology: 6he choleretic =bile stimulating> action of the plant has been ell documented in a placebo&controlled trial involving 20 healthy volunteers. After the administration of A.C2 grams of standardi(ed articho#e e$tract directly into the duodenum, liver bile flo increased by A2H.3G and AEA.EG at the 30& and F0&minute mar#, respectively. BAA Articho#e leaf may or# by interfering ith cholesterol synthesis. Besides cynarin, a compound in articho#e called luteolin may play a role in reducing cholesterol. BA2 Medicinal actions: %iuretic, alterative, choleretic )raditional Medicinal Uses: 4eputed very beneficial in dropsies =edema>, and has been efficient in rheumatism, gout, "aundice, tic&douloureu$, etc. ,t as described in the .ancet, AB<3.BA3 Current Medicinal Uses9 • 9astrointestinal Conditions: o Constipation and indigestion9BA<, BAE,BAF,BAH ,n a study persons suffering from non&specific digestive disorders =including dyspepsia and indigestion>, 320WF<0 mg of a standardi(ed articho#e e$tract given three times a day as effective in reducing nausea, abdominal pain, constipation, and flatulence in over H0G of the study participants. BAB o =atty liver of Fsluggish liverG: !ynarin caused an increase in fecal bile acid e$cretion in a small study on healthy volunteers and four patients ith fatty liver. 0ther studies support its use as a choleretic. /"5 • Cardiovascular Conditions: o Hyperlipidemia: 6he results of studies using articho#e for high cholesterol have been mi$ed. A study using cynarin at a daily amount of either 2E0 mg or HE0 mg concluded that it did not alter cholesterol and triglyceride levels in patients ith familial high cholesterol after three months of therapy. A recent open&label suggests that articho#e can alter lipid levels. 1atients too# a standardi(ed articho#e e$tract =320 mg3capsule> one to t o capsules 6,% for si$ ee#s, total cholesterol and triglyceride values decreased significantly by an average of AA.EG and A2.EG, respectively. +%.&cholesterol levels did not rise significantly. 6he results of this study must be questioned because of the lac# of dietary control and the lac# of a placebo group. B20 According to a ell controlled study performed in 2000, in A<3 individuals ith high cholesterol, articho#e leaf e$tract significantly improved cholesterol readings. 6otal cholesterol fell by AB.EG as compared to B.FG in the placebo groupK .%. cholesterol by 23G vs. FK and .%. to +%. ratio decreased by 20G vs. HG. B2A Current +esearch +eview: (4ource: Medline • Cardiology: o Hyperlipidemia9 4tudy ": B22  %esign9 !linical trial.  1atients9 5eventeen ambulant outpatients ith familial 6ype ,,a or 6ype ,,b hyperlipoproteinaemia.  6herapy9 !ynarin, the A,E&dicaffeyl ester of guinic acid, the constituent of !ynara scolymus. 5ig 2E0 mg and HE0 mg qd.

•

4esults9 6he mean serum cholesterol and triglyceride concentrations ere not significantly changed ithin 3 months. ,t as concluded than !ynarin, administered per os, has no hypolipidaemic effect in familial 6ype ,, hyperlipoproteinaemia. 4tudy 09B23  %esign9 %ouble&blind, randomi(ed, placebo&controlled, multi&center clinical trial.  1atients9 0ne hundred and forty three patients ith hyperlipoproteinemia ith initial total cholesterol of YH.3mmol3l =Y2B0mg3dl>.  6herapy9 %ry e$tract of articho#e =%rug3e$tract ratio 2E&3E9A, aqueous e$tract, !;<E0> as coated tablets, <E0 mg e$tract3tablet =tradename9 7alverde Artischo#e bei 7erdauungsbesch erden>  4esults9 %ecrease in total cholesterol as AB.EG in the e$perimental group, compared to B.FG in placebo group. .%.&cholesterol decrease as 22.CG in the e$perimental group vs F.3G in placebo group. .%.3+%. ratio decrease by 20.2G in the e$perimental group vs H.2G in placebo group. :o adverse effects ere observed. o #latelet aggregation:/0:  %esign9 !linical trial  1atients9 5i$ty t o men producing artificial fibres and chronically e$posed to carbon disulfide.  6herapy9 !ynare$ =articho#e e$tract preparation produced by the +erbs 1lant, +erbapol@ in Wrocla > $ 2 years  4esults9 1latelets ability to aggregate, spontaneously or by induction, as found to be statistically significantly reduced. 6he spontaneous aggregation after t o years of administration as reduced by TEAG. 9astroenterology: o ,B49B2E  %esign9 1ost&mar#eting surveillance study  1atients9 ,B5 patients ith dyspeptic syndrome  6herapy9 Articho#e leaf e$tract =A.'> $ F ee#s.  4esults9 5ignificant reduction in the severity of symptoms and favorable evaluation of overall effectiveness by both physicians and patients. :inety&si$ percent of patients rated A.' as better or at least equal to previous therapies. 

#harmacy: Contraindications: According to empirical evidence, !ynara should be avoided in bile duct obstruction due to its cholagogue effect. B2F )o*icity: :o information is currently available.
811 812

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs 1rima 1ublishing, 4oc#lin, !A. 200A. ?raft ?. Articho#e leaf e$tractZrecent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts. Phytomedicine1 ACCHK<93FCW3HB. 813 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 814 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 815 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 816 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 817 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. 818 )intelmann 7. Antidyspeptic and lipid&lo ering effect of articho#e leaf e$tract. ?eitschrift fur )llgemeinmed ACCFKH2=5uppl 2>93WAC. 819 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <3E. 820 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs 1rima 1ublishing, 4oc#lin, !A. 200A. 821 'nglisch W, Bec#ers !, Un#auf /, et al. 'fficacy of Articho#e dry e$tract in patients ith hyperlipoproteinemia. )rIneimittelforschung. 2000KE092F0W2FE. 822 +ec#ers +, %ittmar ?, 5chmahl )W, et al. ,nefficiency of cynarin as therapeutic regimen in familial type ,, hyperlipoproteinaemia. )therosclerosis ACHHK 2F=2>92<C&E3. 823 'nglisch W, Bec#ers !, Un#auf /, et al. 'fficacy of Articho#e dry e$tract in patients ith hyperlipoproteinemia. )rIneimittelforschung 2000KE0=3>92F0&E. 824 Woy#e /, ! a"da +, Wo"cic#i -, et al. 1latelet aggregation in or#ers chronically e$posed to carbon disulfide and sub"ected to prophylactic treatment ith !ynare$. Med Pr ACBAK32=<>92FA&<. 825 Wal#er A), /iddleton 4W, 1etro it( 0. Articho#e leaf e$tract reduces symptoms of irritable bo el syndrome in a post&mar#eting surveillance study. Phytother Res 200AKAE=A>9EB&FA. 826 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 3A

Datura stramonium
Common name: -imson eed, devil@s apple, stin# eed, angel@s trumpet

4olanaceae

Ha!itat: %atura stramonium is native to the 5W region of the United 5tates, /e$ico, !entral America, ,ndia, and Asia. ,t gro s in sandy soil in flat, open lo lands. Botanical description: ,t is an annual herb that branches freely. ,t gro s up to 3 feet in height. 6he leaves are large, angular, ith coarsely toothed margin. 6he large flo ers are encased in a caly$. 6he flo ers are 3 in. long and tubular and s ollen bello ending in five very sharp teeth. 6he corolla is hite and half&opened in a funnel shape. 6he flo ers contain blac#, flat, #idney&shaped seeds. #arts used: .eaves, flo ering tops, seeds Historical Use: %atura is has historical use as a hallucinogenic herb. ,t is has been used to aid in out of body e$periences. Witches ould include %atura as part of their flying ointment hich as rubbed over their bodies =the ointment as blac# in color, hence the association of blac# body paint and clothing ith itches> and as also rubbed onto ooden handles, i.e. broomstic#s and inserted into the vagina for increased absorption =hence the popular romanticism of itches flying on broomstic#s>. %atura fatuosa as employed in ,ndia by a brotherhood of thieves and murderersZthe %aturiahs, ho aylaid and strangled their victims or placed the po dered seeds mi$ed ith flour into food. %atura continues to be used by certain indigenous healers in !entral American and south estern United 5tates to aid in shamanistic voyages. Constituents .eaf9 • 6ropane al#aloids =0.A&0.FEG>9 chief al#aloids =&>&hyoscyamine, under drying conditions changing over to some e$tent into atropine, and scopolamine =ratio <9A>, furthermore including, among others, apoatropine, belladonnine, tigloylmeteloidin • )lavonoids • +ydro$ycoumarins9 including, among others, umbelliferone, scopolin, scopoletin • Withanolide: including, among others, ithastramonolide 5eed9 • 6ropane al#aloids =0.<&0.FG>9 chief al#aloids =&>&hyoscyamine, under drying conditions changing over to some e$tent into atropine, and scopolamine =ratio <9A>. • ,ndole al#aloids =`&carboline type>9 including, among others, fluorodaturin =very fluorescent>. #harmacology: ,n the parasympathetic nervous system atropine and hyoscyamine bloc#s the muscarinic cholinergic receptors causing central nervous system stimulation follo ed by depression. 6he al#aloids also cause hallucinogenic and hypnotic effects =lo ered brain activity during hich time deep sleep does not occur, but dreams do>. Atropine is a !:5 stimulant ith a tropism for the heart, lung and abdominal organs. ,n the peripheral nervous system, the anticholinergic actions include reduction of gastrointestinal secretions and motility as ell as rela$ation of bronchioles and s#eletal muscle. ,n contrast, +yoscine does not stimulate the central nervous system and is in fact a !:5 sedative, hich may be helpful in allaying motion sic#ness. ,t has a greater influence on the eye and secretory glands. Both atropine and hyoscine ill dilate the pupil of the eye hen prepared into ophthalmic eye drops. Medicinal actions: 5pasmolytic, antiasthmatic, anticholinergic, hallucinogenic, anodyne )raditional Medicinal Use: 5pecific ,ndications and Uses9 %elirium, furious, enraged, and destructiveK continuous tal#ingK restless, can not rest in any position, seems to be fearfulK pain, especially hen superficial and locali(edK spasm, ith painK cerebral irritationK bloating and redness of faceK purely spasmodic asthmaK convulsive cough.B2H 6he physiological action of %atura as observed to be practically the same as that of Atropa, though it as thought to Iinfluence the sympathetic nervous systemJ more strongly ith higher doses resulting irregular heart&action and greater ability to induce greater delirium. )ull doses of it ere said to increase the se$ual appetite and po er. 6he al#aloids from %atura, though chemically similar to Atropa, ere seen to produce a more profound effect than Atropa, being more liable to produce depression, heart failure, and unconsciousness. ,n medicinal doses, %atura as used as an anodyne antispasmodic similar to +yoscyamine and Atropa. +o ever, it as observed to be different in some of its therapeutic effects, particularly in regard to pain. While less effective than Atropa for the relief of pain, it as

still used employed in similar neuralgic conditions ith nervous irritation as a component as ell as spastic conditions of the uterus and gastrointestinal tract. • Behavioral and 1sychological !onditions9 ,n turn, %atura as considered more effective in mental disorders than Atropa. ,t has long borne a reputation as a remedy for acute delirium and acute mania here the patient presented as violent, boisterous, angry, and possessed a destructive tendency. 5uch delirium as observed to occur as a consequence of inflammatory processes, particularly in (ymotic diseases. ,t as often a remedy of value in hysterical mania ith convulsions, alternate laughing and eeping, and here there headache, flushed face, and se$ual irritation ere also present. • ,nfectious !onditions9 )or retrocession of the eruptions in the e$anthemata, %atura as considerable value along ith Atropa, though is as considered less efficient than Atropa. • :eurological !onditions9 )or deep&seated pain, as in deep neuralgic pain, %atura as considered far less effective than Atropa, but for superficial neuralgia, hen locally applied, it as the more effective plant. %atura has been lauded for vertigo and headache, secondary to hyperacidity of the stomach. ,ts indication as considered specific hen gastric headache as accompanied ith mar#ed nervous erethism and unsteadiness. %atura as also used for muscular tremblings of the hands of functional or refle$ origin, and associated ith great restlessness. 5imilarly to Atropa, %atura as observed to not readily produce sleep, but to alleviate pain or nervous irritability resulting in sleep. • 1ulmonary !onditions9 %atura as indicated in cough, ith constriction, difficult deglutition and impaired innervation. ,t as used for temporary relief in purely spasmodic asthma, but as ineffective hen dyspnoea or asthmatic breathing occurred secondary to primary pulmonary or cardiac diseases. %atura as a useful remedy in the severe paro$ysms of hooping&cough and in hemoptysis brought on by fits of coughing or by spasm. • 6opical Applications9 '$ternally, a poultice of the fresh, bruised leaves or the dried leaves in hot ater as found to be an e$cellent application in severe forms of gastritis, enteritis, peritonitis, acute rheumatism, painful bladder affections, pleurisy, etc. ,n cases of urine retention from enlarged prostate here it as impossible to introduce a catheter, the topical application as left in place for 30 minutes at hich time a catheter as then able to pass. 6he topical application as found beneficial as a local medication to all painful ulcers, s elled breasts, orchitis, parotitis, and other glandular inflammation, inflammatory rheumatism, and irritable hemorrhoidal tumors. 6he ointment as found e$ceedingly effective in treating cutaneous hypertrophy around the anus ith pruritis or sero&purulent secretion. Current Medicinal Use: %atura has respiratory tropism. ,t is used in treatment for 1ar#inson@s disease. !ompared to Atropa, %atura lends to less cerebral e$citement. • 4espiratory !onditions9 ,f ingested %atura may reduce bronchial spasms of asthma, although it as more commonly smo#ed for this purpose. =note9 smo#ing anything is generally not indicated for asthma>. • *astrointestinal !onditions9 6he anticholinergic effects can be used medicinally to control diarrhea or to reduce salivation =as in e$cess salivation ith 1ar#inson@s disease>. • 1ain !onditions9 %atura can be used as an anodyne antispasmodic. %atura is not as effective as Belladonna for this purpose, ho ever, if applied topically over an area of neuralgia, it ill prove pain relief as ell as reduce s elling. • 1ulmonary !onditions9 ,ndications for respiratory spasmolytics include tight, breathless, non&productive coughing as ell asthmatic symptoms such as hee(ing.(&( #harmacy: %atura may require months for 1ar#inson@s disease. A conservative approach is to start ith a smaller amount and increase daily by a drop until the effective dose is reached. /ills and Bone indicate that the solanaceous plants should not be used long term. A9A0 tincture9 0.F ml per day 5mo#ed9 less than 2 gmK less than once per ee# Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: 6he solanaceous plants may be inappropriate in glaucoma, urinary retention, paralytic ileus, intestinal atony and obstruction, tachycardia, arrhythmia, and B1+. )o*icity: Acute9 nausea, thirst, dilated pupils, vomiting, impaired vision, dry s#in and mucous membranes, staggering, di((iness, incoherence, hallucinations, loss of consciousness, ea# rapid pulse, inability to urinate, convulsions, delirium ith laughter, loquacity and violence, circulatory collapse prior to death.B2C !hronic9 %atura can be detrimental to the heart because of the tropane al#aloids. A tolerance is built up to the tropanes in the parasympathetic system, thus requiring more %atura to achieve its effects. +o ever, the heart does not build up tolerance and therefore may be damaged.B30

,n large doses, stramonium is an energetic, narcotic poison, producing dryness of the throat, thirst, nausea, giddiness, nervous agitation, dilatation of the pupil, obscurity of vision, headache, disturbance of the cerebral functions, perspiration, occasional rela$ation of the bo els, and, in some cases diuresis =4>. When about to prove fatal, maniacal delirium, loss of voice, dryness of throat, etc., are usually present.

Digitalis purpurea
Common name: )o$glove Ha!itat9 %igitalis gro s along the 1acific !oast in the United 5tates and in !olumbia.

4crophulariaceae

Botanical description9 Biennial plant that gro s 2&E feet tall. 6he plant flo ers from -une to 5eptember. 6he flo ers are bell shaped, are rose to purple on the outside and hitish ith red spots on the inside. #art Used: .eaves Constituents9 • !ardiac glycosides9 digito$in, digo$in, and gito$in are the most important. %igo$in is refined commercially as the drug %igo$in =.ano$in>. Medicinal actions: !ardio&stimulant )raditional Medicinal use: 5pecific Uses and ,ndications9 Wea#, rapid, irregular heart action, ith lo arterial tensionK ea# heart soundsK dus#y countenance, "ugular pulsation, cough, and dyspnoeaK edemaK anasarca ith scanty, high&colored urineK renal congestion. An antidote to aconite, but slo in its action.B3A +istorically, generali(ed edema as believed to be only due to renal conditions. 6he discovery of the cardioactive glycosides of %igitalis enabled the discovery of the cardiac origin of such conditions. ?ing summari(ed the uses of %igitalis in the follo ing conditions9 ,n structural heart lesions, as dilated heart ith mitral incompetenceK in mitral stenosis and regurgitation, and in dilated right heart ith tricuspid incompetence, and in relative or positive debility of the cardiac muscle. 6he general symptoms leading to its selection are a ea#, rapid, and irregular pulse, lo arterial tension, cough, dyspnoea, pulsation of the "ugular veins, a cyanotic countenance, deficient urination, the secretion being high&colored, and edema. According to )elter, %igitalis is indicated in, M ea#, rapid, and irregular heart action . . . ea#, rapid and flaccid pulseK ith dyspnea, cough, "ugular fullness. . . edema. . . ascites ith scanty supply of dar# urine. . .irritable heart ith ea# action. . . M. Qp.333R 6his describes the symptoms of congestive heart failure =!+)>. )elter identified three stages of the action caused by a continuous increased dosage of %igitalis. ,n the first stage, the therapeutic stage, the rhythm is slo ed and the contractile force of the heart is increased. %iastole is prolonged and the force of systole increases. 6his action is due to the vagal inhibitory activity and to the direct action on the myocardium. 6he second stage, the to$ic stage, =sometimes absent> occurs hen the drug is given continuously ithout a rest or hen given in overdose. ,n the second stage, there is e$treme inhibition of the heart. ,n this stage, the ventricle dilates thus prolonging diastole and systole becomes erratic. 6he atria approach failure and there is variance in rhythm bet een the atria and the ventricles =A&7 heart bloc#>. 6his quic#ly leads to the third stage, the e$treme to$ic or lethal stage. ,n the third stage, there is rapid ventricular action and racing pulse. 6he !:5 inhibition of the heart is lost such that the arrhythmia causes insufficient circulation and the heart finally stops in e$treme dilation. Current Medicinal Use: %espite its indication in the treatment of !+), %igitalis is not commonly used because the therapeutic dose and the to$ic dose are so close that both usually occur together. 6he to$icity of %igitalis has led to the isolation of digo$in hich is least cumulative and most rapidly e$creted glycoside. 6he glycosides in %igitalis are the strongest cardiac glycosides #no nK all other cardiac glycoside containing plants are compared against %igitalis to assess their relative strength. %igo$in e$erts strong positive inotropic action on the myocardium =refer to previous discussion on positive inotropic action>. ,n lo doses, digo$in e$erts a negative chronotropic action, but in increasing dosages, it becomes a positive chronotropic agent. %igo$in =allopathic medication> is used in short&term therapy, hereas intermediate glycosides are indicated in long&term therapy =most herbal remedies>. #harmacy9 6he hole %igitalis plant or plant e$tracts are no longer used. %osage ranges of allopathic digo$in are variable according to the degree of heart failure and the age of the patient ith a typical dosage range of A2 & 3E mcg3#g body eight. 6he maintenance daily dosage for most patients is bet een 0.2E&0.E mg once daily. A&2 g qd of leaf qd as maintenance =/itchell> ,nteractions: • !ertain other substances predispose to %igitalis to$icity, namely9 potassium depleting drugs such as diuretics, quinidine, anthraquinone glycoside containing botanicals and corticosteroids. /70 • !ardiotonic botanicals have an additive effect. • !rataegus potentiates the action of the cardiac glycosides, presumably via its ability to inhibit cA/1&1%' and to interact ith calcium channels. Because of this enhancing effect, lo er doses of cardiac glycosides can be used.

•

/agnesium has also been sho n to augment digitalis action.

Contraindications: ?ing observed that %igitalis is contraindicated in simple compensatory hypertrophy, aortic stenosis, fatty or other degeneration of the heart muscle, and atheromatous or other structural changes in the arteries. As a rule it should not be employed in the heart affections of old age, or hen dilatation is e$cessive, and particularly hen the flabby state of the heart muscle is due to degenerative changes. B33 )o*icity9 6o$icity symptoms develop several hours after ingestion. At first the pulse slo s dramatically and upon standing ill become erratic and rapid. 6here is nausea, an$iety, salivation, constriction in the head, giddiness, disordered vision, mental disturbance, vomiting. 1ersons may remain in this state for several days and may or may not survive. A #no n antidote to digitalis poisoning is Aconite.
831 832

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 23< 833 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

Dioscorea villosa
Common name: Wild yam, yam, /e$ican ild yam, colic root, rheumatism root Ha!itat: Wild yam gro s in eastern and central United 5tates and in tropical areas.

Dioscoriaceae

Botanical description: I6he tubers are cylindrical, pale bro n, compressed, aboutA0&AE cm long and A&2 cm thic#, curved, branched at intervals, sho ing stem scars on the upper surface and rootlets on the other. 0ccurs in commerce as hard, pale yello ish&bro n chips of rhi(ome and narro , fibrous roots. )racture short, hard. 6aste, insipid at first, then acridK odorless.J B3< 6he root is harvested in the fall. #arts used: 4oot ,dentified Constituents: 5teroidal saponins based on diosgenin Qusually AG&2GR=dioscin, dioscorin, and others>, 5tarch, Al#aloids, 6annins Medicinal actions: Anti&spasmodic, anti&inflammatory, anti&rheumatic, cholagogue, diaphoretic #harmacology: %iosgenin has been commercially processed into progesterone. Until ACH0, the diosgenin e$tracted from /e$ican ild yam as the only source for progesterone synthesis. After ACH0, largely due to economic factors, progesterone synthesis used the steroidal al#aloids from ,olanum species or many of the Dioscorea spp1 plants =D1 opposita and D1 hypoglauca> from !hina. 6otal synthesis as also developed that requires no starting plant material. !urrently, diosgenin is still used as the starting material for pregnenolone, corticosterone, and progesterone. 6his process requires microbiological fermentation, organic solvent e$traction, and acid hydrolysis. Dioscorea !illosa is anti&inflammatory by acting as an autonomic nerve rela$ant Medicinal use: Dioscorea !illosa is most indicated in inflammatory conditions of the gastrointestinal tract, "oints, uterus and ovaries. Wild yam reduces the inflammation and pain associated ith intestinal cramping. 6his may occur as part of inflammatory bo el disease, flatulence, diverticulitis, and nausea and vomiting. Wild yam is particularly useful in relieving the nausea of pregnancy. %ioscorea may also be used to prevent miscarriage =along ith 7iburnum opulus and 8ingiber officinale>. Wild yam also e$erts anti&inflammatory actions in rheumatoid arthritis or other inflammatory disorders of the "oints. %ioscorea can be helpful in allaying the inflammation and spasm of dysmenorrhea, ovarian cysts and torsion. %ioscorea not only reduces the inflammation associated ith these conditions but also reduces the smooth muscle spasms that occur. Both of these actions may be the result of altered autonomic nervous stimulation. 6he anti&inflammatory and anti&spasmodic actions of Dioscorea !illosa are some hat specific to the gall bladder. %ioscorea can decidedly rela$ the gall duct thus aiding the passage of gall stones and gravel. ,f dosed high enough, this action is quic# and significant and may be used in acute painful cholelithiasis and cholecystitis. ,n smaller doses, the cholagogue effects of ild yam ill promote the flo of bile and thus aid in hepatic insufficiency, lipidemia, and hormonal imbalances. #harmacy: A9E tinctureZ!hronic9 E ml 6,%K Acute9 2.E ml q L hourK ee#ly ma$imum dosage A00 ml A&2 tsp. root3cup aterK decoct AE minK !hronic9 A cup 6,%K Acute9 L&A cup q L hour.

)o*icity: :one #no n.
834

Wren 4! Potter/s ;e: 2yclopedia of Botanical Drugs and Preparations , =5affron Walden, 'sse$, 'ngland9 6he !.W. %aniel !o. .td.>, ACBB92B3.

Dryopteris feli*<mas (Aspidium fili*<mas' Aspidium marginale' #olypodium =ili*<mas
Common name: /ale fern, /arginal 5hield&fern Ha!itat9 :ative to 'urope, Americas, ,ndia, Africa ] Asia

#olypodiaceae =)ern )amily>

Botanical description9 6he rhi(ome is reddish&bro n, slender ] creeping. 6he root cro n is a bro n, tangled mass of leaf bases. As these fronds unroll, they attain a length of 2&< feet. 'ach frond is ide ] spreading, stiff, ] lanceolate. 6he pinnae are alternate, oblong 3 notched edges ] a slightly furro ed surface. 6he sori are on the upper half of the frond, at the bac# of the pinnules, in round masses to ards the base of the segments. #art used9 4hi(ome Actions: Anthelmintic 3 7ermifuge Constituents: 1hloroglucinol oleoresin derivatives QF.EG&AEGR =filicin9 filicinic acid, filicylbutanone, aspidinol, albaspidin, flavaspidic acids, paraspidin, desaspidin>, triterpenes, volatile oil, resins, sugar, starch, a$, tannins. )raditional Medicinal Use: • *, !onditions9 /ale&fern is used for the e$pulsion of the tape orm. (C#,(C$ • 6opical Applications9 %ecoction can be used as foot bath for varicose veins. A fresh, grated root poultice as used for lymphangitis.e Current Medicinal use: • *, !onditions9 As a vermifuge, 5heild fern causes live e$pulsion of tape orms =esp. of9 Bothriocephalus latus ] 6aenia solium>. )lavaspidic acid ] desaspidin are the active consitiuents. Current +esearch +eview: • 5earch of /edline revealed no clinical trials as of 0ctober 2002. #harmacy9 ,t is customary to give %ryopteris as a single dose at night before bed after a day of fasting. 6he fluid e$tract is the most effective preparation, although capsules, hile slightly less effective, are more pleasant to ta#e. ,n the morning, a purgative is given, although castor oil and any fi$ed oils are avoided since they enhance the absorption Qparticularly of the filicins =considered muscle poisons>R and to$icity of the %ryopteris. 5aline solution, -uglans nigra, or magnesium sulfate are good purgatives to use. )ollo ith a full meal ithout fats. ) decoction of the root is gi!en to expel :orms, but must be follo:ed by a purgati!e, in order to pre!ent poisioning of the body1 ,hield fern should ne!er be mixed :6 alcohol1OO A single dose is often sufficient to #ill and e$pel the orm. 6he therapeutic dosage range is some hat narro , ith insufficient dosage being ineffective and large doses causing to$icity. ,t is best to start ith smaller doses and, over time, increase the dose to the effective one. 1o dered rhi(ome =in capsules>9 A&A0 gK E g is normally the highest dose given )luid e$tract9 2.E&E ml A9E tincture9 3&F ml Q:ote9 alcohol increases absorption and to$icity, therefore tincture is not recommended.R Contraindications: /ale fern is not to be used ith castor oil or fi$ed oil. According to Brin#er, use of /ale fern in the follo ing conditions are to be it is to be avoided based on empirical evidence. ,t is not to be used in pregnancy due to its abortifacient effects and is speculated to be potential to$ic to the breastfed infant. ,t is to be avoided in anemic patients or in the elderly or debilitated sub"ects due to the impairment in respiration and circulation it may cause. ,t is to be avoided ith stomach and intestinal ulcers due to the mucosal irritants filmaron and filicic acid in the oleoresin. ,t is to be avoided in heart disorders due to cardiac depressive effects. ,t is to be avoided in #idney insufficiency or liver disorders due tot he albuminuria and bilirubinuria it has been sho n to cause. B3H )o*icity9 6he oleoresin has been sho n to be poisonous, five fatal cases out of t enty being recorded =?atayama and 0#amoto, ABC2>.B3B :37, +3A, vertigo, diarrhea, dyspnea, delirium, tremors, cramps, cold perspiration, cyanosis, disordered intellect, profound stupor, and convulsions are among its effects. ,n some cases amblyopia and permanent amaurosis have occurred, though the vision is generally restored. !ardiac and respiratory failure can occur leading to death.

,n the event of to$icity treat ith emetics or gastric lavage and colonic irrigation, follo and use caffeine for stimulation if necessary. =Alschuler>
B3E

ith epsom salt cathartic, #eep patient arm,

)elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy D 'clectic /edical 1ublications, 5andy, 04 ACBE p. 2B0&3 837 Brin#er, ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ACCB. p. CB 838 )elter
836

$chinacea spp2 ($2 angustifolia' $2 purpurea' $2 pallida' $2 tenniseensis
Asteraceae Common name: 1urple cone&flo er, !one&flo er, Blac# sampson Ha!itat: Botanical description: #arts used: hole plant

Constituents: • Water&soluble immunostimulating polysaccharides ='chinosides>9 <&0&methylglucuronylarabino$ylans, acidic arabinorhamno& galactans • 7olatile oil =0.0B&0.32GK pallidaYpurpureaY angustifolia, highest in the spring 9 germacrene alcohol, borneol, bornylacetate, pentadeca&B&en&2&on, germacrene %, caryophyllene, caryophyllene epo$ide • )lavonoids =leaves>9 rutoside, quercetin • !affeic and ferulic acid derivatives=root, primarily>9 echinaside, cichoric acid, cichoric acid methyl ester, 2&0& caffeoyl&3&0& feruloyl&tartaric acid, 2,3&0&diferuloyl tartaric acid 2&0&caffeoyl tartaric acid, cynarin • Al#ylamides =root>, isobutylamides, Al#aloids, resins, glycoproteins, sterols, minerals #harmacology: 6he root of 'chinacea contains inulin, hich activates the alternative complement path ay leading to granulocyte chemota$is, viral neutrali(ation and bacteriolysis. 'chinacea also increases serum properdin, hich also stimulates the alternative complement path ay. 6he polysaccharides are non&specific 6 cell activators and stimulate 6&cell mitogenesis, phagocytosis by macrophages, increase in 6:) ,.&A, ,g binding, and increases neutrophils. 'chinoside is antibacterial 6he al#ylamides and cichoric acid, both of hich are preserved in e$tract form, are the most potent stimulators of macro phagocytosis and are highest in '. purpurea, then '. angustifolia follo ed by '. pallida. 'chinacea also supports the immune system by activating natural #iller cells. B3C, B<0 6hree ma"or groups of constituents or# together to increase the production and activity of hite blood cells =lymphocytes and macrophages>, including al#ylamides3polyacetylenes, caffeic acid derivatives, and polysaccharides. 'chinacea also increases production of interferon, an important part of the body@s response to viral infections. B<A 0ther effects include an increase of the number of spleen cells, activation of the capacity for phagocytosis by human granulocytes, elevations in body temperature, reproduction of 6&helper cells and the production of cyto#ines such as interleu#in&A, interleu#in&F and 6:)&alpha. B<2 'chinacea also inhibits hyaluronidase, stabili(ing mucosal connective tissue against invasion by pathogenic organisms. 'chinacea also has antio$idant activity. /ethanol e$tracts of free(e&dried 'chinacea ='. angustifolia, '. pallida, and '. purpurea> roots ere e$amined for free radical scavenging capacities and antio$idant activities. 4oot e$tracts of '. angustifolia, '. pallida, and '. purpurea ere capable of scavenging hydro$yl radical and suppressing the o$idation of human lo &density lipoprotein. 6he mechanisms of antio$idant activity of e$tracts derived from 'chinacea roots include free radical scavenging and transition metal chelating. B<3 'chinacea enhances fibroblast gro th and formation of glycosaminoglycans. 'chinacea may increase the secretion of adrenal corte$ hormones. Medicinal actions: antiseptic, alterative, sialagogue, immunostimulant, 6issue regeneration, Anti&,nflammatory )raditional Medicinal Use: 5pecific ,ndications and Uses9 6o correct fluid depravation, Mbad blood,M tendency to sepsis and malignancy, as in gangrene, sloughing and spreading ulcerationsK foul discharges, ith ea#ness and emaciationK deepened, bluish or purplish coloration of s#in or mucous membranes, ith a lo form of inflammationK dirty&bro nish or "et&blac# tongueK tendency to the formation of multiple cellular abscesses of semi&active character, ith mar#ed asthenia. 0f especial importance in typhoid, septicemia and other adynamic fevers, and in malignant carbuncle, pulmonary gangrene, cerebro&spinal meningitis and pyosalpin$. B<< ?ing described '. angustifolia as a corrector of the depravation of the body fluids although he felt that this did not sufficiently cover the ground. +e rote that its e$traordinary po ers are demonstrated in its effect over changes produced in the fluids of the body, hether from internal or e$ternal causes, septic or of devitali(ed morbid accumulations, or alterations in the fluids themselves such as e$hibited in abscesses, glandular inflammations, sna#e or insect venom, diphtheria, cerebro&spinal meningitis, or septicemia. A tendency to ard malignancy in acute and subacute disorders, as considered a special indication for the use of 'chinacea. • %ermatologic !onditions9 As a remedy for ec(ema, 'chinacea as considered for chronic cases ith stic#y or glutinous e$udations associated ith asthenia and general depravity.

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':6 !onditions9 'chinacea as indicated in tonsillitis, particularly in the necrotic form, ith dirty&loo#ing ulcerative surfaces. 'chinacea as highly valued for the cure of catarrhal affections of the nose, naso&pharyn$, and other portions of the respiratory tract. 'chinacea as considered efficient in allaying the pain and healing the ulcers, particularly of the mouth, throat, and tongue. ,t is specially indicated by ulcerated and fetid mucous surfaces, ith dus#y or dar# coloration, and a general debilitated tendency. *astrointestinal !onditions9 ?ing considered 'chinacea is a good appetite and digestive stimulant, having been used ith benefit in fermentative dyspepsia, ith halitosis and gastric pain aggravated by food as prominent symptoms. +e also considered it useful in the treatment of duodenal catarrh, and other forms of intestinal indigestion, ith pain and debility. ,t has been praised in mildly inflammatory conditions of diarrhea, cholera and dysentery, ith a tendency to malignancy. *ynecological !onditions9 'chinacea as considered to act admirably in purulent salpingitis, hastening cure and allaying distressing pain. ,t as frequently used in leucorrhoea ith offensive discharges and in erythematous or erysipelatous vulvitis. ,nflammatory !onditions9 'chinacea has been prominently mentioned as a remedy for fevers. ,n the eruptive fevers and e$anthems, it has received some praise for its control over the catarrhal phase, its influence in mas#ing the odor and controlling pain. 6he fevers, ho ever, in hich it has accomplished the best results ere in sympathetic fevers from septic infection and rheumatic attac#s. ,nfectious !onditions9 'chinacea as first populari(ed as a remedy for septicemia and has been successfully employed in in"uries complicated ith septic infection. ,n cerebro&spinal meningitis, 'chinacea as utili(ed because of its sedative virtues and influence on the vascular area responsible for circulation of the cerebro&spinal meninges, and for its effects upon the general circulation. 6he cases benefited ere those characteri(ed by a slo , feeble pulse, or at least a pulse not appreciably quic#ened, ith the temperature scarcely elevated, and cold e$tremities. 'chinacea as used to relieve the pain of erysipelas, and contributed largely to a resolution of the s elling hen e$tensive, tense, and of a purplish&red hue. ,t as reported to have relieved the pain of cancerous gro ths, particularly hen involving the mucous membranes. 'pidemic influen(a as only occasionally ameliorated by 'chinacea. 4ather it as used to assists in convalescence. Used as an in"ection, 'chinacea as applied to relieve the pain and inflammation in gonorrhea. 1ulmonary !onditions9 !hronic catarrhal bronchitis has been benefited by 'chinacea, particularly in cases for hich fe remedies have been beneficial such as pulmonary gangrene. 6opical Applications9 5urgeons have used it ith sterili(ed ater to cleanse and dress ounds after operations to discharge tubercular abscesses, gangrene, empyema ith gangrene of the lung, appendicitis, and carcinoma of the breast and testicle. 'chinacea as highly endorsed as a topical dressing for malignant carbuncle, mammitis

Current Medicinal Use: • ,nfectious !onditions9 )resh pressed "uice of the flo ers of 'chinacea 0E1 purpureaB preserved ith alcohol and tinctures of root of 'chinacea 0E1 pallidaB have been sho n to reduce symptoms of the common cold in double&blind trials. %ouble&blind trials have also sho n that various 'chinacea e$tracts shorten the duration of the common cold. 6here is only one as yet unpublished study that has not supported this conclusion. 6he minimum effective amount of 'chinacea tincture or "uice to ta#e, according to these trials, is 3 ml 6,%. /ore =3WE ml 22+> is generally better and is safe, even for children. 'ncapsulated products may also be effective, according to a double&blind trial involving E1 pallida1 *enerally, 300WF00 mg capsules 6,% are used. According to another trial, employees of a nursing home ho consumed 'chinacea tea at the onset of a cold or flu reduced the duration of their symptoms by about t o days hen compared ith people consuming a placebo tea. 6he participants dran# five to si$ cups of tea on the first day of their symptoms and decreased this by one cup each day over the ne$t five days. 6hose consuming the 'chinacea tea reported a shorter duration of symptoms and quic#er, more effective symptom relief compared ith those ta#ing the placebo tea. While not as rigorously B<Edesigned as other studies e$ploring the use of 'chinacea for colds and flu, this study continues to support other findings that suggest 'chinacea or 'chinacea&combination products may reduce the duration and severity of both conditions. B<F, B<H, B<B • 6opical Applications9 ,n an uncontrolled study, F0 patients ith topical !andidiasis ere given <.E ml of the e$pressed "uice of '. purpura over A0 ee#s in con"unction ith an antifungal cream. 6he treatment group had a AHG recurrence rate compare to F0G for the group getting the antifungal cream alone. B<C Current +esearch +eview: • ,mmunology: o ,mmune function: 5tudy A9 /%8  Design: Randomized placebo-controlled, prospective clinical trial.  Patients: Forty-eight healthy female volunteers ( -!" yo#.  $herapy: %i& groups: %tandardized e&tract of '. purpurea ('P#, ultrarefined '. purpurea('.angustifolia

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(ur'P)#, '. purpurea('. angustifolia ('P)#, '. purpurea('. angustifolia plus larch arabinogalactan ('P)*)#, larch arabinogalactan (*)#,or placebo & + ,ee-s.  Results: .omplement properdin increased by " percent in the'P) group and by "/ percent in the 'P)*) group, compared to the placebo group. %elf administered 0uestionnaire sho,ed improvements in overall physicalhealth, vitality, and emotional health in the same t,o groups ('P) and 'P)*)#.  5tudy 29BEA  Design: Five placebo-controlled randomized studies.  Patients: 1ne hundred thirty four healthy volunteers, "/-+2 yo  $herapy: %tudy " 3 45 homeopathic comple& preparation ,ith '. angustifolia D"6 study 3 oral alchoholic e&tract of roots of '. purpura6 study 7a 3 oral alcholic e&tract of roots of ' purpurea6 study 7b 3 e&tract of '. pallida roots6 study + 3 e&tract of '. purpurea herb6 study ! 3 45 homeopathic comple& prepartion ,ith '. angustifolia D+. )pplied & + or & ! consecutive days.  Results: %tudies " and 3 phagocytic activity P89 ,as significantly enhanced compared ,ith placebo. 3ncology: o Chemotherapy:/%0  %esign9 0pen prospective controlled clinical trial  1atients9 )ifteen patients ith advanced gastric cancer undergoing palliative chemotharpy ith etoposide, leucovorin and E&fluorouracil.  6herapy9 1olysaccharide fraction from '. purpura herb cell cultures & 2 mg iv qd $ A0 days, starting 3 days prior to chemotherapy.  4esults9 1atients ho received the therapy had higher median number of leu#ocytes A<&AF days after chemotherapy compared to controls. 6his therapy might be effective in reducing chemotherapy&induced leu#openia. $@): o Common cold: 5tudy A9 /%7  %esign9 A placebo&controlled, randomised, double&blind clinical trial, phase ,7.  1atients9 'ighty adult male and female patients ith first signs of cold.  6herapy9 'chinaceae purpureae herba ='chinacin, '!3A-0>  4esults9 ,n the e$perimental group the median time of illness as F.0 days compared to C.0 days in the placebo group. '!3A-0 as clinically effective in alleviating symptoms more rapidly than placebo. 5tudy 29BE<  %esign9 4andomi(ed placebo&controlled clinical trial  1atients9 1atients ith e$perimental rhinovirus colds.  6herapy9 'chinacea  4esults9 'chinacea preparation used in the study did not significantly affect the occurrence of infection or the severity of illness. 5tudy 39BEE  %esign9 4andomi(ed, double&blind, placebo&controlled clinical trial.  1atients9 6 o hundred forty si$ of EEC healthy adult volunteers caught a common cold and ere treated.  6herapy9 A> 'chinaforce ='.purpurea preparation from CEG herba and EG radi$>, 2 tablets 6,%K 2> 'chinacea purpurea concentrate =same preparation at H times higher concentration>, 2 tablets 6,%K 3>5pecial '. purpurea radi$ preparation =totally different from that of 'chinaforce>, 2 tablets 6,%K <> placebo until healthy, but no more than H days.  4esults9 'chinaforce and its concentrated preparation ere significantly more effective than the special 'chinacea e$tract or placebo. o Cold and flu:/%&  Design: Randomized placebo-controlled double-blind clinical trial  Patients: ninety five patients ,ith early symptoms of cold or flu (runny nose, scratchy throat, fever#  $herapy: 'chinacea Plus tea, !-: cup 0d titrating to ".

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 Results: $reatment ,ith 'chinacea Plus tea at early onset of cold or flu symptoms ,as effective for relieving these symptoms in a shorter period of time than a placebo. o Cold and respiratory infections: /%(  Design: Randomized placebo-controlled double-blind clinical trial.  Patients: 1ne hundred and nine patients ,ith a history of more than 7 colds or respiratory infection in the preceding year  $herapy: 'chinacea purpurea fluid e&tract, + m*  Results: $he conclusion of the study ,as that treatment ,ith fluid e&tract of '. purpurea did not significantly decrease the incidence, duration or severity of colds and respiratory infections compared to placebo. Details: had at least one cold or respiratory infection during / ,ee- t& period: 7! of !+ 3 e&perimental group, +2 of !+ 3 placebo group6 average number of colds and respiratory infections per patient: 2.;/ 3 e&periment group, 2.<7 3 placebo group6 median duration of colds and respiratory infections: +.! days 3 e&periment group, :.! days 3 placebo group. o Upper respiratory infections:/%/  %esign9 6hree&armed, randomi(ed double&blind, placebo&controlled clinical trial  1atients9 6hree hundred t o volunteers ithout acute illness at time of enrollement.  6herapy9 'thanolic e$tract from 'chinacea purpurea roots, 'chinacea angustifolia roots, or placebo, po $ A2 ee#s.  4esults9 ,n this study a prophylactic effect of the investigated echinacea e$tracts could not be sho n. %etails9 6ime until occurrence of Ast U4,9 FF days W '.angustifolia group, FC days W '.purpurea group, FE days W placebo group. 1ercentage of people ho had infection9 3F.HG & placebo group, 32.0G & '. angustifolia group, 2C.3G & '. purpurea group. Dermatology: o Wounds:/%5  %esign9 !linical trial  1atients9 6hirty&one patients ith purulent ound of soft tissues  6herapy9 Application of immunomodulator thymogen in combination ith siliceous sorbent sillard application and adaptogenic preparation W tincture of 'chinacea purpurea.  4esults9 /ore rapid healing of the ound and normali(ation of the immunity inde$es. Infectious diseases: o Genital herpes:/&8  %esign9 5ingle&center, prospective, double&blind, placebo&controlled, cross&over clinical trial  1atients9 )ifty patients ith recurrent genital herpes, receiving F months@ placebo and F months@ therapy.  6herapy9 'chinaforce W 'chinacea purpurea e$tract  4esults9 :o statistically significant benefit could be detected. 9ynecology: o #regnancy:/&"  Design: Prospective controlled clinical trial  Patients: 2: pregnant ,omen. (%ame number of ,omen ,ere in control group#  $herapy: 'chinacea products  Results: 9estational use of 'chinacea during organogenesis is not associated ,ith an increased ris- for ma=or malformations.

#harmacy: 1reserved "uice of aerial portion ='. purpurea>, 22G ethanol9 2&3 ml prn tincture9 =A9E> 2&< ml e$tract9 =A9A> 2&< ml standardi(ed e$tract9 =3.EG echinacoside> AE0&300mg Drug ,nteractions:/&0 • $cona;ole nitrate =positive>9 '. purpurea "uice =po, ,7 or 5!> lo ered the rate of recurrent !andidiasis in con"unction ith topical econa(ole nitrate.

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,mmunosuppressive drugs =negative>9 Brin#er speculates that 'chinacea spp. may counter the effects of cyclosporine, corticosteroids or other immuno&supressive medications based on animal studies. Hepatoto*ic drugs =negative>9 '. spp. do contain pyrroli(idine al#aloids. +o ever, they are in e$tremely lo concentrations and do not contain the A,2&unsaturated cecine ring associated ith hepatoto$icity. :one the less, Brin#er suggests avoiding the combination of '. spp ith anabolic steroids, amiodarone, methotre$ate and #etocona(ole. (<!en;ylo*yresorufin: Apparently, '. angustifolia roots inhibit the !;1 3A< metabolic conversion of H&ben(ylo$yresorufin.

Contraindications:/&7 Brin#er speculates that 'chinacea be avoided in systemic progressive conditions such as9 multiple sclerosis and collagenosis due to the possible in&vitro stimulation of fibroblasts by '. purpureaK leu#osis and autoimmune conditions possibly due to non&specific immune stimulation due to the arabinogalactan polymers in hydroalcoholic e$tracts of the roots. +e also hypothesi(es that the arabinogalactans may be similar to those in the cell all of /ycobacteria tuberculosis that suppresses cell&mediated immunity. 6herefore, he suggests the avoidance of 'chinacea spp. in tuberculosis. ,n regard to the use of 'chinacea pallida and '. angustifolia in +,7 and A,%5 patients, Brin#er suggests that the nonspecific immune stimulation of the arabinogalactans. 6he arabinogalactans have been demonstrated in vitro to induce macrophage secretion of α&,): and 6:)α, cyto#ines that are generally elevated in +,7 and A,%5 patients and that are believed to contribute tot the disease process by depressing !%< cells and increasing +,7 replication respectively. )inally, allergic hypersensitivity to plants in the Asteraceae family is common, therefore e$ercise caution ith administration in atopic patients. )o*icity: ,mmuno&suppression has been reported at doses A000 times a recommended dose.
839 840

1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 841 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 842 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 843 +u, !. 5tudies on the antio$idant activity of 'chinacea root e$tract. - Agric )ood !hem. 2000 /ayK<B=E>9A<FF&H2. 844 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 845 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3EC 846 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 847 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 848 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 849 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3EC
/!2

>im *%, ?aters RF, @ur-holder PA. 4mmunological activity of larch arabinogalactan and 'chinacea: a preliminary, randomized, double-blind, placebo-controlled trial. Altern Med Rev 22 6;( #:"7/-+<.
851

/elchart %, .inde ?, Wor#u ), et al. 4esults of five randomi(ed studies on the immunomodulatory activity of preparations of 'chinacea. 7 )ltern 2omplement Med ACCEKA=2>9A<E&F0. 852 /elchart %, !lemm !, Weber B, et al. 1olysaccharides isolated from 'chinacea purpurea herba cell cultures to counteract effects of chemotherapy W a pilot study. Phytother Res 2002KAF=2>9A3B&<2. 853 5chulten B, Bulitta /, Ballering&Bruhl B, et al. 'fficacy of 'chinacea purpurea in patients ith a common cold. A placebo&controlled, randomi(ed, double&blind clinical trial. )rIneimittelfor schung 200AKEA=H>9EF3&B. 854 6urner 4B, 4i#er %?, *angemi -%. ,neffectiveness of 'chinacea for prevention of e$perimental thinovirus colds. )ntimicrob )gents 2hemother 2000K<<=F>9AH0B&C 855 Brin#eborn 4/, 5hah %7, %egenring )+. 'chinaforce and other 'chinacea fresh plant preparations in the treatment of the common cold. A randomi(ed, placebo& controlled, double&blind clinical trial. Phytomedicine ACCCKF=A>9A&F. 856 .indenmuth *), .indenmuth 'B. 6he efficacy of 'chinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms9 a randomi(ed, double&blind placebo&controlled study. 7 )ltern 2omplement Med 2000KF=<>932H&3<. 857 *rimm W, /uller ++. A randomi(ed controlled trial of the effect of fluid e$tract of 'chinacea purpurea on the incidence and severity of colds and respiratory infections. )m 7 Med ACCCKA0F=2>9A3B&<3. 858 /elchart %, Walther ', .inde ?, et al. 'chinacea root e$tracts for the prevention of upper respiratory tract infections9 a double&blind, placebo&controlled randomi(ed trial. )rch am Med ACCBKH=F>9E<A&E. 859 1otii W. Application of immunomodulators in comple$ of treatment of the soft tissue purulent ounds. .len .hir 2000K=A0>9AE&F. 860 7onau B, !hard 5, /andalia 5, et al. %oes the e$tract of the plant 'chinacea purpurea influence the clinical course of recurrent genital herpesa >nt 7 ,TD )>D, 200AKA2=3>9AE<&B. 861 *allo /, 5ar#ar /, Au W, et al. 1regnancy outcome follo ing gestational e$posure to 'chinacea9 a prospective controlled study. )rch >ntern Med 2000KAF0=20>93A<A& 3. 862 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. BE&BF 863 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.B<&BE

$leutherococcus senticosus
Common name: 5iberian ginseng, !i u"ia Ha!itat: ,t is native to southeastern 4ussia, northern !hina, ?orea and -apan. Botanical description: A slender, thorny shrub that gro s to 3 to AE feet tall. #arts used: 4oot

Araliaceae

Constituents: • *lycosides9 'leutherosides including eleutherosides B and 'K 5yringinK 1henylpropanesK 1olysaccharide =eleutheran glycans>K !i u"ianoside • 1henolic compounds, 7itamins ', b&carotene, !affeic acid, !opper Medicinal actions: Adaptogen, antio$idant, chemoprotective, immunomodulator, hypertensive =in a hypotensive state>, cardiotonic, tonic. #harmacology: Animal studies have sho n 'leutherococcus to decrease adrenal hypertrophy, corticosteroid production and hyperglycemia. Also in animals, 'leutherococcus reduces the e$tent of the alarm reaction and prevents or delays the harmful e$haustive phase of the stress response.BF< Animal studies support the use of 'leutherococcus as an antio$idant =eleutherosides>, improving survival and resistance to pesticides, heavy metals, narcotics, industrial chemicals and chemotherapeutic drugs. 6he eleutherosides inactivate free radicals and accelerate lipid mobili(ation thus e$erting a cellular protective effect. BFE 'leutherococcus also protects cells against ioni(ing radiation =eleutherosides>.BFF 'leutherococcus is immunostimulatoryK specifically it increases !d< cells and to a lesser e$tent !dB cells. BFH )raditional Medicinal Use: 'leutherococcus has only recently been an addition to the estern formulary. 6hus, the 'clectic and 1hysiomedical physicians did not describe this herb. Current Medicinal Use: 'leutherococcus has been studied e$tensively =more than A,000 papers have been published over the last three decades on 'leutherococcus> and has a long and continued history of use in 5iberia and !hina to increase the length and quality of life, prevent infection, improve memory and improve appetite. ,t has a bitter& arming and s eet& arming quality. !ompared to 1ana$ ginseng, 'leutherococcus is less stimulating, tends to have a more rapid action and has a more generali(ed effect on immunity. 'leutherococcus is an adrenal adaptogen. 6he adaptogenic properties of 'leutherococcus have been sho n to be useful in chronic cardiovascular conditions, chronic infections, post&surgery, and chronic pneumonia, ith improvement in mood, function, attention, energy, and sense of ell&being.BFB ,n summary, the medicinal uses of 'leutherococcus are9 treatment of chronic viral infections, prevention of infections, cancer prevention, ad"uvant cancer therapy, treatment of chronic illness and fatigue, alleviation of chronic stress, and reduction of damage from heavy metal and pesticide to$icity. • 'ndocrine !onditions9 As described by %r. %ir# 1o ell, 'leutherococcus is used to treat individuals ho have adrenocortical hypofunction and /aladaptive 5tress 5yndrome stage 3 =/55&3>. ,t can be used to facilitate the recovery from steroid&induced adrenocortical suppression here the normal function of the hypothalamic&pituitary&adrenocortical =+1A> a$is remains disrupted after discontinuance of steroid medications. Eleutherococcus senticosus has a long history of traditional use for treating fatigue and stress& induced illness and is #no n as adaptogenic, a glucocorticoid agonist, and tonic. 5tudies carried out on small animals have sho n that Eleutherococcus e$tracts can prevent stress& induced adrenal gland changes, and stress&induced disease. BFC • ,mmune !onditions9 A ACBH W. *ermany study supported the historical use of 'leutherococcus for the prevention of viral illness. ,n a double&blind, placebo controlled study involving 3F healthy volunteers, half received 'leutherococcus and the other half received placebo. 6he 'leutherococcus group sho ed an enhanced activation of !%< 6&lymphocytes. BH0 ,n another study, enhanced 6& lymphocyte activity as demonstrated by using A.CF g tid of a A9A alcohol root e$tract. BHA !%< cells are typically lo in +,7 disease, chronic viral infections and in cancer. 'leutherococcus as given to A3,000 or#ers on a daily basis at the 7olga Automobile 1lant and the overall disease incidence and absence from or# as reduced by A33 compared to a control group. BH2 'leutherococcus is useful in the treatment of cancer for the additional reasons that it improves the general health of cancer patients, reduces the chance of metastasis if started early in the diagnosis. BH3 'leutherococcus also improves appetite, eight gain, shortens healing time, and increases lymphocyte activity in people ith cancer. BH< Additionally, 'leutherococcus also dramatically reduces the side effects of radiation and chemotherapy including nausea, di((iness, loss of appetite. BHE

#harmacy: ,t is best to dose 'leutherococcus in the morning and around noon to match the diurnal rhythms of the adrenal gland. 4egarding adaptogens, starting ith a high dose to achieve an initial therapeutic effect is necessary. At hich point the therapeutic effect is achieved a lo er maintenance dose is then indicated. ,n turn, application as a tonics usually do not indicate a large initial dose and a lo er maintenance dose can be used initially. %ecoction hole po der9 2&< gm daily in t o doses =Alschuler> A9E tincture9 E ml t o times daily =Alschuler> A92 )luid '$tract9 A&B ml qd =%ipasquale> 5olid e$tract9 <9A or F9A U teaspoon A&2 times daily =Alschuler> 5tandardi(ed e$tract9 A00 mg capsule standardi(ed to greater than AG eleutheroside '9 200 W <00 mg daily in 2 doses /a$$im . 2<9A e$tract, sig A0&20 gtt bid Drug ,nteractions: /(& • Monmycin' kanamycin9 increases efficacy in treating 5higella dysentery and 1roteus enterocolitis =human>. • He*o!ar!ital: inhibits metabolism =in vitro>, enhancing the effect =animal>. • ,nsulin: may have additive effects =speculative> based on hypoglycemic effects =animal> • Digo*in: may falsely elevate digo$in levels by affecting the digo$in assay, but does not cause to$icity and previous reports of cardiac glycoside activity is unfounded. Contraindication: Brin#er contraindicates the use of 'leuthero in hypertension =YAB03C0 mm +g, human studies. Acute infections have also been listed as a contraindicationK ho ever, this may be debatable as 'leuthero does posses 6&cell stimulating properties and has been evaluated in some acute gastrointestinal infections in con"unction ith antibiotics. BHH 'leuthero has also been traditionally contraindicated in depleted states. )o*icity: :o information is available in the selected resources.
864 865

Wagner +, :orr +, and Winterhoff + Phytomedicine, A, ACC<9F3&HF. )erguson, et al, Toxicologist, 3, ACB39EA. 866 Ben&+ur ', )ulder 5, )m 7 2lin Med, C=A>, ACBA9<B. 867 Bohn B, et al )rneimittelforschung, 3H=A0>, ACBH9AAC3. 868 +iai 5, ;o#oyama +, et al Endocrinol 7pn, 2F, ACHC9FFA. 869 Bre#hman ll, ?irillov 0A9 'ffect of'leuthrococcus on alan%&phase of stress. 8ife ,ci, ACFCKB=3>9 AA3&A2A 870 >bid1 871 Bohn *, :ebe !6, Birr !. )lo &cytometric 5tudies ith 'leutherococcus senticosus '$tract as an ,mmunomodulatory Agent. )rnIeim19 orschung1, 3H=A0>9 AAC3&F, ACBH 872 Barenboim Medexport, ACBA. 873 ;aramen#o The ar Eastern ,cientific 2enter, U554 Academy of 5ciences, 7ladivosto#, HE&HB, ACBA. 874 ?upin, et al ;e: Data on Eleutherococcus: Proceedings of the ,econd >nternational ,ymposium on Eleutherococcus , /osco , ACB<92C<&300. 875 ,nstitute of 0ncology, /inistry of +ealth, D,,R oreign Trade Publication, =*eorgia, U554>K ACH0. 876 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. 1 BF 877 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p BF

$phedra sinensis (sinica
Common name: /a huang Ha!itat: Botanical description: #art used: stems and branches, root Historical use: $nergetics:

$phedraceae

Constituents BHB • 5tem9 AW3G total al#aloids of the 2&aminophenylpropane type, ith ephedrine accounting for 30WC0G of this total, depending on the plant species9 main al#aloids .&=&>&ephedrine =A4,25&=&>& ephedrine> and %&pseudoephedrine =A5,25&=]plusK>& ephedrine>K lesser al#aloids .&norephedrine, %& norpseudoephedrine. • 4oot9 ephedradine A3B =hypotensive componds>, mao#ine =hypertensive compound> #harmacology: Both ephedrine and its synthetic counterparts stimulate the central nervous system, dilate the bronchial tubes, elevate blood pressure, and increase heart rate. 1seudoephedrine =the synthetic form> is a popular over&the&counter remedy for relief of nasal congestion. .ittle research has been done on using the hole plant =compared to its isolated al#aloids> for any condition. BHC 'phedrine and pseudoephedrine both have adrenergic effects. BB0'phedrine is a sympathomimetic acting similarly to epinephrine9 • stimulation of α and β adrenergic receptors and :' release • increase diastolic and systolic blood pressure, cardiac output, heart rate, coronary, cerebral and muscular blood flo • decrease renal and splanchnic blood flo • increase bronchial muscle rela$ation and other smooth muscle e$cept the uterus 1seudoephedrine has other effects on the body including bronchodilationK ea#er pressor, cardiac and !:5 effectsK and antiinflammatory effects through reduction of 1* '2 synthesis. Medicinal actions: diaphoretic, antipyretic, antiallergic, antiasthmatic, sympathomimetic3respiratory spasmolytic Medicinal uses: • /etabolic !onditions9 'phedrine increases the basal metabolic rate of adipose tissue, thus best for patient ith a lo B/4 and ho is over eight. %ouble&blind studies have sho n that ephedra, particularly hen combined ith caffeine, promotes eight loss. +o ever, many doctors discourage the use of ephedra as a eight&loss aid because of the many side effects that can occur ith its use, especially since many of the side effects are intensified hen ephedra is combined ith caffeine. BBA • 1ulmonary !onditions9 6he sympathomimetic effect can be utili(ed for respiratory conditions such as asthma. 6he antiallergic and decongestive properities can be utili(ed in otitis media, influen(a, pneumonia, hooping cough, bronchitis and acute or chronic sinutis. )or asthma and hay fever, 'phedra is used in mild to moderate cases ith the pea# effect occuring in A hr after adiministration and lasting appro$imately E hr. 6he medicinal effect decreases ith chronic use due to adrenal fatigue caused by ephedrine. #harmacy: .ong term use should be supported by *lycyrrhi(a glabra, 1ana$ ginseng, vitamins !, BF, BE and magnesium and (inc to support adrenal function. 'phedra can be combined ith e$pectorants such as *lycyrrhi(a glabra, *rindelia camporum, 'uphorbia hirta, %rosera rotundifola, 1olygala senega.BB2 ,n the United ?ingdom 'phedra has a ma$imum permitted dosage of F00 mg tid. ,n the United 5tates, the sale of 'phedra products containing greater than B mg ephedrine per dose is restricted. %ried +erb =Asthma, eight loss>9 E00&A000 mg =A2.E&2E mg ephedrine> 2&3$3day Drug ,nteractions: //7 • Anesthetics9 combination may cause arrhythmia. • Antidepressants, tricyclic9 +ypertension and arrhythmia may result from combination. +o ever, amitriptyline bloc#s the hypertensive effect of ephedrine. • Antihypertensives9 A!' inhibitors and beta&bloc#ers may be antagoni(ed resulting in severe hypertension. 'phedrine antagoni(es the effect of guanethidine although the latter ith enhance the sympathomimetic effect.

• • • • • • • • • • •

Bromocriptine9 combination may increase to$icity. Bronchodilators9 effects may be enhanced by combination ith ephedrine. !ardiac glycosides9 combination may cause arrhythmia. %e$amethasone9 decreased half life ith ephedrine administration by increasing metabolic and urniary clearance. /ethyl $anthines =theophylline, caffeine>9 combination increases thermogenesis and eight loss. /A0 inhibitors9 adverse effects reported in human cases. 'phedrines sources should be avoided for 2 ee#s after stopping /A0 inhibitors. 0$ytoicn9 combination may cause hypertension due to additive vasoconstrictive effects. 4eserpine9 prior use of reserpine may antagoni(e the effects of ephedrine. Urinary acidifiers =ammonium chloride>9 increase urinary clearance of ephedrine and pseudoephedrine Urinary al#ali(ers =sodium bicarbonate>9 decreases urinary clearance of ephedrine and pseudoephedrine

Contraindications://:'//% • Anore$ia and bulemia due to appetite suppressant properties =animal> • An$iety • Bronchitis,chronic and emphysema, • !erebral blood flo impairment due to vasoconstriction =empirical>. • !hildren under F • %epression ith suicidal tendencies due to the an$iety caused by the sympathomimetic activity =empirical> • %iabetes due to the hyperglycemic effect of ephedrine in acute and long term use =human>. • *astric ulcer de to the possible reduction of mucus. • *laucoma due to reduced fluid drainage from the eye =empirical> • +eart disease and hypertension due to cardiac stimulant, potential arrhythmic and vasoconstrictive effects =speculative and empirical> • ,nsomnia due to adrenergic effects. • 1heochromocytoma due to e$cessive sympathomimetic effects. • 4enal failure due to accumulation of al#aloids secondary to reduced secretion. • 6hyroid, hyperactive due to immediate increase in B/4 and increased 63 to 6< ratio after < ee#s use =human> • 1rostatic enlargment due to alpha adrenergic activity causing contraction of bladder nec# and prostate musculature. • 1regnancy and nursing due to uterine stimulant action of the al#aloids =in vitro, animal> and sympathomimetic effects on the infant =speculative>. )o*icity: 'phedrine mimics the effects of epinephrine and causes symptoms such as tachycardia, high blood pressure, agitation, insomnia, nausea, loss of appetite, and urinary retention.
878 879

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 880 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 22B 881 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 882 /urray /, 1i((orno -. The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 883 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. BC&C0 884 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p BH&BB 885 /urray /, 1i((orno -. The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC

$?uisteum spp2
Common names: +orsetail, scouring rush, shave grass

$?uisetaceae

Botanical description: ,n spring, the plant produces unbranched stems ith bro n terminal cones that produce spores. ,n summer, the plant gro s to E0 cm and produces green sterile stems ith horls of < inged lateral branches. 6his genus is composed of primitive plants, hich are the only members of this family. #arts used: 'ntire plant $nergetics: 'nergetically, 'quisteum is a strong and hearty plant ith tremendous vital force. ,t pushes its ay up through soil, firm ground, ice and sno . 6he plant is decisively strengthening to its ingester. Constituents //& • ,norganic constituents =A0G>9 silicic acid =FEG> of hich A0G is in the form of ater&soluble silicates. • )lavonoids9 in particular quercetin&, #aempferol&, luteolin&, gen# anin&3&0&glucosides, E&0&,H&0&glucosides and diglucosides, apigenin and luteolin E&glucosides and their malonyl esters • !affeic acid ester9 including chlorogenic acid, dicoffeoyl&meso&tartaric acid • 5tyrolpyrone glucoside9 equisetumpyron • potassium salts, 1olyenic acidsK %icarbo$ylic acidsK 5ugars • 1yridine al#aloids9 nicotine and spermidine types =traces> #harmacology +orsetail is rich in silicic acid and silicates, hich provide appro$imately 2W3G elemental silicon. 5ome e$perts have suggested the element silicon is a vital component for bone and cartilage formation. 1otassium, aluminum, and manganese, along ith fifteen different types of bioflavonoids, are also found in this herb. 6he presence of these bioflavonoids is believed to cause the diuretic action, hile the silicon content is said to e$ert a connective tissue&strengthening and anti&arthritic action. BBH Medicinal actions: %iuretic, !onnective tissue tonic #harmacology: 'quisteum causes increased flo of ater through the ureters ithout altering the electrolyte balance. 'quisteum contains silica9 2 gm of herb boiled in 200 ml of ater for 3 hours ill yield EE mg of silica dio$ide. BBB 5ilica is found in trace amounts in s#eletal structures =bones and teeth>.BBC )raditional Medicinal Use: 5pecific ,ndications and Uses.Z!ystic irritationK nocturnal urinal incontinenceK tenesmic urging to urinateK dropsyK renal calculi.BC0 • 9astrointestinal Conditions: 6he ashes of the plant ere very valuable to the 'clectics for use in dyspepsia connected ith obstinate acidity of the stomach. • 9enitourinary Conditions: 6he 'clectics used 'quisetum for edema, suppression of urine, hematuria, gravel, nephritic affections, and in gonorrhea. 6his plant as considered to have a specific action in irritation of the bladder, particularly leading to urinal incontinence, and in dysuria ith tenesmic urging, in the nocturnal urinal incontinence of children. • Male Conditions: 'quisteum as used by the 'clectic physicians for the treatment of prostatitis ith symptoms of scanty urination and pain in the prostate. 6he 'clectics ould combine 'quisteum ith 5ali$ nigra in the treatment of prostatic enlargement =astringent and tonic actions>. Current Medicinal Uses: • 9astrointestinal Conditions9 6he ash from 'quisteum may also be ta#en internally for dyspepsia as it is particularly high in potassium and sodium hydrate =al#alini(ing substances>. 0lder plants =mid to late summer, fall> contain too much silica and are not to be gathered for internal use. Also important is the locale of the plant. • 9enitourinary Conditions: *erman !ommission ' monograph of 'quisteum spp. indicate it for edema secondary to trauma or dependent edema. 'quisteum is generally considered to be a ea# diuretic, although it@s action may be pronounced in some individuals. 'quisteum is most indicated in someone ith scanty urine, irritable bladder ith tenesmus, and incontinence caused by cystic irritation. • Connective )issue Conditions: 'quisteum is also used as a connective tissue tonic. 6his is primarily due to it is content of silica, hich is incorporated into connective tissue. 5ilica helps to stabili(e collagen and is part of the bony matri$. 6he silica in 'quisteum ill deposit into soft tissue as ell and ith accumulation over time this ill create tissue irritation. )or this reason, long&

•

term use =greater than one month> of 'quisteum is discouraged. ,f 'quisteum is to be used long&term, periodic vacations from the herb must be ta#en. 6he connective tissue tonifying action of 'quisteum seems to be most pronounced in the pelvic area. 6his combined ith its diuretic action, give 'quisteum strong indication in the treatment of repeated urinary tract infections, and urinary prolapse. 6he age of the plant hen harvested alters its medicinal effects. 6he young shoots are gathered early in the spring as an edible green. %uring the spring, the plant may be harvested for drying or made into a fresh plant tincture. 6he young shoots contain a nutritious sap hich may be squee(ed out of the stem as a s eet, nutritious drin#. Additionally, this sap is anti&inflammatory and antiseptic and may be applied directly to inflamed con"unctiva or fatigued eyes =this use is derived from :ative American usage of the plant>. )opical Applications: 6he plant is burned and the ash is also made into pastes and compresses to speed the healing of s#in lacerations and to reduce inflammations.

Current +esearch +eview: • @,DDM: Water e$tract of the aerial parts of 'quisetum myriochaetum sho ed a hypoglycemic effect in type 2 diabetic patients starting C0 min after its administration. A single dose of the e$tract =0.33 g3#g> as used in AA recently diagnosed type 2 diabetic patientsK the same patients served as control group. Blood glucose as reduced by the e$tractK there ere no significant changes in the insulin level.BCA • Diuretic activity: BC2 :o abstract available from /edline. #harmacy: Contraindications.)o*icity: 6he use of 'quisteum in conditions involving impaired cardiac and #idney function is contraindicated. BC3,BC<.ong&term use is contraindicated. Brin#er also cautions against use in children. E 'quisteum heavily concentrates minerals from the soil in hich it gro s. 6hus, 'quisteum plants by roads and industrial areas ill concentrate heavy metals such as cadmium and lead. 'quisteum should not be used in people ith edema that is the result of impaired #idney function. .ong&term continuous use =over A month> may result in tissue irritation and consequent inflammation. %igitalis and other cardiac glycosides may be potentiated due to potassium loss secondary to diuresis caused by 'quisetum. 'quisetum contains thiaminase as ell.
886 887

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 888 1ie#os 4, 1alsla s#a 5, Planta Medica, ACHE, 2H9 A<H. 889 6homas, !., 'd., Taber/s 2yclopedic Medical Dictionary, AHth ed., ACC3, =1hiladelphia9 )A %avis !o>9 AHCC. 890 )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 891 4evilla /!, Andrade&!etto A, ,slas 5, et al. +ypoglycemic effect of 'quisetum myriochaetum aerial parts on type 2 diabetic patients. 7 Ethnopharmacol 2002K BA=A>9AAH&20. 892 .emus ,, *arcia 4, 'ra(o 5, et al. %iuretic activity of an 'quisetum bogotense tea =1latero herb>9 evaluation in healthy volunteers. Ethnopharmacol ACCFKE<=A>9EE&B. 893 *erman !ommission ' monograph, E<uisteum herba, Ban( no.AH3, C3AB3ACBF. 894 Brin#er, ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ACCB9BE

$riodictyon californicum ($2 angustifolium' $2 crassifolium' $2 glutinosum
Hydrophyllaceae (6aterleaf family
Common name: ;erba 5anta, ;erba Blanca, /ountain Balm, Bear@s Weed, !onsumptive@s Weed, 6ar eed, *um Bush. Current )rade @ame: 4espirtone W as liquid e$tract, liniment, po der, syrup or tea.BCE Ha!itat: '. californicum gro s on dry ridges ] slopes from the north coastal range of !alifornia as far south as /onterey !ounty, up into southern 0regon, ] do n the est side of the 5ierra :evada from near /ount .assen to almost as far as 6ehachapi. ,t is also found in the 5an Bernardino /ountains. ,t gro s at an altitude of from A000 W E000 feet. Q)or habitat descriptions of other 'riodictyon spp., see /icheal /oore@s boo# entitled9 Medicinal Plants of the Pacific +est.R Botanical Description: A lo , shrubby evergreen plant, 2&< feet in height. 6he stems are smooth ] e$ude a gummy substance. .eaves are 3&<J in length, distinctively oolly on the undersides, containing a net or# of prominent viens, ] the resinous surface is smooth 3 depressed veins. 6he flo ers are terminal, appearing in shades of dar# lavender through pale shades of lavender to hiteK forming funnel&shaped clusters at the top of the plant. 6he fruit capsule is oval, grayish&bro n ] containssmall bro n shriveled seeds. #arts used9 .eaves. $nergetics: 1ungent taste. +eating. =&> ?apha ] 7ata. =X> 1itta. BCF Constituents:/5( • )lavonoids9 'riodictyonin, 'riodictyol, !hrysoeriodictyol, Panthoeriodictyol. • 7olatile oil =very little>. • 4esinous substances9 composes of flavonone ] flavone aglycones =triacontane, pentatriacontane, cerotic acid, eriodonol> • 6annins. #harmacology: '$pectorant action of ;erba 5anta is thought to be due its contents of flavonoids ] resins. )lavonoid glycosides have numerous effects in the body9 anti&o$idant, anti&anaphylactic, anti&allergic, anti&thrombotic, anti&inflammatory, cardiotonic, hypotensive, ] anti& arrhythmic. ,n general, flavonoids help to stabili(e, protect, ] potentiate the body@s o n biological response to e$ternal influences. +ence, flavonoids have been referred to as IBiological 4esponse /odifiersJ, acting by bringing the body bac# into homeostasis. BCB ,n the case of e$pectoration, homeostasis is supported via the clearing of pectoral congestion. 4esins are arming ] stimulating, ma#ing them useful for cold ailments ] for promoting circulationK as they are e$pectorating ] antibiotic. By combining the arming ] circulatory enhancing actions 3 anti&o$idant ] influences of homeostatic regulation, the combination of flavonoids ] resins in ;erba 5anta does help to understand its physiologic response in the body through a pharmacological perspective. Medicinal actions: Aromatic. '$pectorant. .ung 6onic. 5timulant. Current > )raditional Medicinal uses: • 6he name ;erba 5anta, or +oly Weed, as given by the 5panish ho became a are of its medicinal qualities from the local native ,ndians. 6raditionally, the fresh or dried leaves here boiled for9 colds, coughs, sore throat, catarrh, stomach aches, vomiting ] diarrhea. ;erba 5anta is a leading r$ for all respiratory conditions, ] also has a reputation of healing hemorrhoids, hen other r$ have failed. 'ridictyon can also be used in #idney conditions ] rheumatic pains. BCC • +espiratory Conditions: ;erba 5anta has been regarded as one of the most effective natural treatments for chronic respiratory problems. 'riodictyon is most indicated in chronic, productive, hac#ing, persistent coughs, ] is best suited for chronic lung afflictions such as9 asthma, chronic bronchitis, or chronic laryngitis. ;erba 5anta has been traditionally used as a lung tonic ] to mas# the taste of quinine in syrups. • Urinary Conditions: 'riodictyon may also be used for chronic inflammation of the urinary system. • )opical Use: :ative ,ndians used ;erba 5anta as a poultice on bro#en ] unbro#en s#in for pain from rheumatism, fatigued limbs, s ellings, sores, etc.C00 Current +esearch +eview: • 5earch of /edline yielded no human studies as of 5eptember 2002. #harmacy9 C0A

• A9E tinctureZ2&E ml 6,% • A&3 gm dried herba ;erba 5anta tends to mas# the bitter taste of other herbs. 'riodictyon can either be used alone or in combination 3 other herbs, as it combines ell. 6o )or its stimulating e$pectoration, it combines ell ith *rindelia robusta, i.e. for asthma. )or its tonifying action, it combines ell ith ,nula helenium.. !ontraindications36o$icity9 :o information is currently available from the selected references 2

$schscholt;ia california
Common name: !alifornia poppy Ha!itat: !alifornia Botanical description: #art used: hole plant, herb, root

#apaveraceae

Historical use: $nergetics: Constituents: al#aloids =isoquinoline, chelerythrine, sanguinarine, chelidonine, cryptidine>, flavone glycosides #harmacology:580 !helerythrine, an al#aloid constituent, is a protein #inase ! inhibitor ith antitumor activity. ,n the dorsal horn of the spinal cord, protein #inase ! activation contributes to constant pain induced by heat or chemical stimulation. !helerythrine reduced the number of nociceptive responses and may attenuate the development of morphine dependence. !helerythrine and sanguinarine have affinity for vasopressin 7A recepotors competitively inhibiting binding to this site. Medicinal actions: an$iolytic =lo er doses>, sedative =higher doses>, analgesic, anti&inflammatory, emenogogue Medicinal uses: )ccording to +eiss: • :ervous !onditions9 !alifornia poppy is used for childhood neuropahties and enuresis. )ccording to Mills and Bone: • :ervous !onditions9 %isturbed sleeping patterns can be normali(ed by 'schscholt(ia, particularly in con"unction ith !orydalis cava. 6he t o hebs in combination may establish an appropriate catecholamine status for maintaining sedative and antidepressant effects.C03 'schscholt(ia has been sho n to inhibit en(ymatic degradation of catecholamines as ell as the synthesis of adrenaline, dopamine β&hydro$ylase and monoamine o$idase. • 1ain /anagement9 5tudies have identified interactions ith opiod receptors and other neurotransmitter activity ith the combination of 'schscholt(ia. very helpful for children as glycerin for an$ious, agitated people !ombines ell ith other nervine herbs #harmacy: infusion9 A tsp. per cup +20 A9A e$tract

Contraindications: 1regnancy due to cyrptidine al#aloids )o*icity:

$ucalyptus glo!ulus
Common name: 'ucalyptus, Blue *um 6ree. Ha!itat: .argely Australia, but TC0 spp. *ro n in !A ] a fe in )lorida.

Myrtaceae

Botanical description9 6he leaves are s ord&shaped, A0&AE cm long ] about 3 cm ide, bluish&green, shortly stal#ed ] rounded at the base 3 numerous transparent oil glands. 6he tree attains great heights =even above <00N>, has a light&bro n bar# ] long s aying branches. #arts used9 0il, .eaves ] Bar#. $nergetics: 1ungent. +eating. =&> ?apha ] 7atta. =X> 1itta. Constituents: • 7olatile 0il =up to 3.EG>9 ma"ority as eucalyptol =A,B&cineol>. • 1olyphenolic Acids. • )lavonoids. #harmacology: 4at studies have sho n that consumption of the leaves or inhalation of the oil induces hepatic mi$ed function. '$trapolation of this function suggests that 'ucalyptus may increase the rate of metabolism ] clearance of certain drugs, including9 1henobarbital, /inopyrin, ] Amphetamines, as ell as increase the to$icity of plants containing pyrroli(idine al#aloids. C0< 6he volatile oil has been found to inhibit prostaglandin biosynthesis, having a mild hyperemic, e$pectorant ] secretolytic motor effect hen used topically. 'ucalyptus has also been sho n to relieve coughs by increasing surfactant. ,n general, the oil is secretolytic, e$pectorant, mildly anti&spasmodic, ] is a mild local hyperemic.C0E 'ucalyptus oil is similar to menthol in that it acts on receptors of the nasal mucosa, causing a reduction of nasal congestion. 6he oil of eucalyptus is also anti&bacterial against such organisms as Bacillus subtilis, as ell as several strains of ,treptococcus2C0F Medicinal actions: Antiseptic. Anti&spasmodic. '$pectorant. 5timulant. )ebrifuge. %iaphoretic. %econgestant. Current > )raditional Medicinal uses: ,n aromatherapy, 'ucalyptus oil helps to relieve mental fatigue, improve mental clarity ] alertness, is refreshing, reviving, energi(ing ] stimulating. • #ulmonary Conditions: 'ucalyptus oil is used most often in the form of a steam inhalation, acting as an anti&spasmodic to the respiratory passages. 6his is greatly beneficial in cases of asmtha, sinusitius, ] other congestive respiratory disorders, through its ability to promote e$pectoration. 'ucalyptus is thus a rela$ing e$pectorant ] promotes drainage from congested respiratory passages. 6he volatile oil is also antiseptic hich ma#es it ell indicated in respiratory ] sinus infections. • )opical Applications: 0il of 'ucalyptus is used e$ternally as a rubefacient, decongestant ] antiseptic. 'ucalyptus oil is one of the most po erful antiseptic oils, esp. upon e$posure to the air, as o(one is formed in the oil. 6he safest application of 'ucalyptus oil is as an inhalant. Current +esearch +eview: • )ension headache9 ,n a trial on tension headache, 1eppermint =A0 g> ] 'ucalyptus =E g> oil in combination, applied topically to the forehead ] temples for three minutes ith a small sponge, have been sho n to be helpful as a muscle rela$ant =but not for analgesia> in individuals ith tension headaches.C0H • Athletic training: ,n a study to prevent sore muscles 'ucalyptus as used as a pre&event arm&up3topical application. 6en normal sub"ects ere involved in this placebo&controlled study. /uscle temperature as measured before and 30 min after the application of 'ucalyptamint. 6here ere statistically significant increases in cutaneous blood flo =up to < times base&line> and s#in temperatures =up to 0.B degrees ! higher than base&line> after the application of 'ucalyptamint ith the effects lasting up to <E min after the application. 6he muscle temperature as also increased =0.< degrees !> significantly =1 less than 0.0E> 30 min after application of the 'ucalyptamint. 6he results of this study suggested that the eucalyptus preparation produced significant physiologic responses that may be beneficial for pain relief and3or useful to athletes as a passive form of arm&up. C0B • ,nsect repellant: 'ucalyptus oil e$tract is effective in protecting human volunteers from various types of biting insects. 0n human forearms, it as determined that the eucalyptus e$tract as nearly as effective as a 20G solution of diethyltoluamine =used in many insect repellents> in repelling bites of the )nopheles mosquito =the insect that spreads malaria> for up to five hours. 6he eucalyptus e$tract as also effective at repelling flies =C<G> and midges =A00G> for up to si$ hours. C0C

•

$@): 'ucalymine, 'ucalyptus&based drug made in 4ussia, as found to have a good anti&inflammatory effect in children ith acute ma$illary sinusitis, e$acerbation of chronic purulent ma$illary sinusitis, and peritonsillar abscess. CA0

#harmacy9 ,n order to provide an effective e$pectorant and antiseptic action, the leaf oil should contain appro$imately H0WBEG eucalyptol. CAA Contraindications.)o*icity: • !3,9 lo blood pressure, renal inflammation, *, and biliary inflammation, hepatic disorders and use by children under the age of t o.CA2 'ucalyptus oil is to$ic if ta#en internally, potentially causing #idney irritation ] damage =the organ through hich the ma"ority of the oil is e$creted> ] eventually causing !:5 depression ] respiratory paralysis.
904 905

Brin#er, ). Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04, ACCB9H0. PDR for Herbal Medicines. /edical 'conomics !ompany, ,nc, /ontvale, :-, 200A. 906 .ininger et al. Healthnotes: 2linical Essentials, Herb Monographs1 1rima 1ublishing, 4oc#lin, !A, 200A. 907 *obel +, 5chmidt *, %o ars#i /, et al. 'ssential plant oils and headache mechanisms. Phytomed ACCEK29C3WA02 908 +ong !8, 5helloc# )*. 'ffects of a topically applied counter irritant ='ucalyptamint> on cutaneous blood flo and on s#in and muscle temperature9 A placebo controlled study. )m 7 Phys Med Rehab ACCAKH092CW33. 909 6rigg -?, +ill :. .aboratory evaluation of a eucalyptus&based insect repellent against four biting arthropods. Phytother Res ACCFKA093A3WF. 4evie ed by ;arnell '. 5elected herbal research summaries HR;M ACCHKAAF. 910 6arasova *%, ?ruti#ova :/, 1e#li )), et al. '$perience in the use of eucalymine in acute inflammatory ':6 diseases in children. Gestn "torinolaringol ACCBK=F>9<B& E0. 911 4obbers -', 6yler 7'. Tyler/s Herbs of 2hoice: The Therapeutic Dse of Phytomedicines . :e ;or#9 +a orth 1ress, ACCC, A23. 912 Brin#er, p. FC

$upatorium perfoliatum
Common name: Boneset, 'upatorium Ha!itat9 :. America

Compositae

Botanical description9 A perennial herb ith opposite leaves, A0&AE cm. long, lanceolate, tapering to a narro point and united at the base. 6he margin is crenate and shiny yello points due to the resin glands are visible on the under surface. 6he flo ers are small and inconspicuous and occur in cymose&paniculate inflorescences. #arts used9 +erba Constituents9 CA3, CA< • 5esquiterpene lactones9 euperfolin, euperfolitin, and eufoliatin • polysaccharides, flavonoids #harmacology: 6he polysaccharides and sesquiterpene lactones are immunostimulatory and enhance phagocytosis in vitro. ,n vitro studies have demonstrated that e$tracts of '. perfoliatum have been sho n to stimulate immune cell function. CAE 6he cytoto$ic and antibacterial activity of an ethanol e$tract of leaves of 'upatorium perfoliatum as investigated in a recent study. 6he e$tract sho ed potent cytoto$icity ith '!=E0> values =A2&A< µg3ml> comparable to a standard cytoto$ic agent, chlorambucil. 6he e$tract sho ed a ea# antibacterial activity against gram&positive test organisms =5taphylococcus aureus and Bacillus megaterium>. CAF Medicinal actions: )ebrifuge, diaphoretic, tonic, la$ative )raditional Medicinal Uses: !oo# considered the leaves and flo ers of this plant are among the truly valuable remedies of our native /ateria /edica. +e described Boneset as almost a pure rela$ant that acts rather slo ly and persistently ith its greatest po er e$pended upon smooth muscle of the stomach, gall&ducts, bo els, and uterus here if combined ith a diffusive stimulant such as Pantho$ylum, a good antispasmodic influence ill be obtained. *iven by cold infusion, or other cold preparation, it is a soothing and rela$ing tonic9 • %ermatologic !onditions9 !oo# used Boneset in s#in diseases of hepatic origin. • *astrointestinal !onditions9 !oo# found the cold infusion of '. perfoliatum to be suitable for irritable dyspepsia and to secure a mild la$ative action for habitual constipation, ith thirst and dryness of the feces. )or strengthening purposes, he combined it ith stimulating tonics such as *entiana, 5abbatia, +ydrastis, Artemisia, and a small portion of !apsicum. ,n"ections, administration of a medicinal substance into a canal of the body, as a more frequently used technique in the time of the 'clectic and 1hysiomedical physicians than in modern times. 6he arm infusion of Boneset as used as a rela$ant rectal in"ection for constipation and for its nervine influence = hich as observed to perform better than hen given orally>. When combined ith a small amount of 8ingiber and demulcents, the in"ection as observed to create a lasting diffusion of blood into the intestinal mucosa. • +epatobiliary !onditions9 !oo# described the cold infusion of Boneset as a gentle hepatic rela$ant, promoting both the secretion and e"ection of bile. 6he 1hysiomedicalists found this preparation to be particularly effective for bilious cases hen there as sensitivity and tension of the tissues or hen it is necessary to maintain steady la$ity of the bo els ithout actual catharsis. 6hough the effect of boneset on the hepatic and gastrointestinal secretions is slo and mild, it as considered persistent and very reliable. • ,nflammatory !onditions9 Boneset as noted for the effect of relieving aching of the limbs in recent colds and rheumatism, the li#ely source of its name. 6he arm infusion of Boneset as used to induce a slo , gentle, persistent diaphoresis. )or this purpose the 1hysiomedicalists found it is very useful in bilious conditions ith fever and fevers associated ith infectious conditions here bo el function is not la$. 6he cold infusion has been used in recovery from febrile conditions, especially intermittent and bilious fevers. • 1ulmonary !onditions9 Boneset as noted to have a soothing and toning influence upon the respiratory organs =and that hether given in cold or arm preparations>. !oo# too# advantage of this effect to influence the lungs and as used in ea#ness of the chest, dull aching through the lungs, and chronic coughs, especially in slightly irritable conditions or in languid conditions, if combined ith a stimulant. Current Medicinal Uses: E1 perfoliatum is a stimulating, tonic and antispasmodic diaphoretic. • *astrointestinal !onditions9 ,t possesses mild aperient activity =by stimulating the release of bile> and ill thus gently address constipation. )or this reason, E1 perfoliatum is indicated in post&influen(al gastric irritation ith biliousness and constipation.

• •

,nflammatory !onditions9 6he plant e$erts anti&inflammatory actions. 'upatorium is indicated in bone&brea#ing fevers as it ill help to release the heat through stimulation of diaphoresis. E1 perfoliatum is most indicated for influen(a ith fevers and night s eats and aching bones. 1ulmonary !onditions9 Eupatorium perfoliatum is helpful in conditions of catarrh such as bronchitis. As a tonic, E1 perfoliatum is useful in debilitated states ith recurrent fevers and dyspepsia.

Current +esearch +eview: • $@): o Common cold:5"(  %esign9 !ontolled clinical trial  1atients9 )ifty three patients ith common cold  6herapy9 Acetylsalicylic acid =A5A> or homeopathic 'upatorium perfoliatum %2.  4esults9 :either sub"ective complaints nor body temperature or laboratory findings sho ed any significant differences bet een groups hich as ta#en as evidence that both drugs ere equally effective. #harmacy: As far bac# as to the 1hysiomedical tradition =as far as the Western tradition of herbalism goes> it as noted that, as ith many botanicals, Boneset is applicable to a variety of conditions according to the form in hich it is prepared. +ot tea ill produce diaphoresis, and in some cases, vomiting and evacuation of the bo els. !ool tea ill act as a tonic. Warm tea ill induce slight perspiration. ,nfusion9 A&2 tsp. herb3cup aterK during fevers of the flu drin# A cup every half hour as hot as possible. 6incture A9E 2EG 't0+K sig 2&< ml 6,% Contraindications: !oo# stated that '. perfoliatum is not applicable to cold and sluggish states of the stomach liver and bo els hen accompanied ith flaccidity of the tissues nor as a tonic in any case here the bo els are inclined to free action. Contraindications: '. perfoliatum is contraindicated in pregnancy due to the ris# of an abortifacient effect =animal studies> or cathartic effect =empirical> associated ith ingestion of large amounts. CAB )o*icity: .arge quantities, especially if used quite arm and at short intervals, ere used to induce emesis. CAC !ontact dermatitis can result due to the sesquiterpene lactones found in the Asteraceae family, particularly in the 'upatorium genus. C20
913 914

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 915 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 916 +abtemariam 5, 2ytotoxicity and antibacterial acti!ity of ethanol extract from lea!es of a herbal drug, boneset 0Eupatorium perfoliatumB1 1hytother 4es. 2000 :ovKA<=H>9EHE&H. 917 *assinger !A, Wunstel *, :etter 1. A controlled clinical trial for testing the efficacy of the homeopathic drug eupatorium perfoliatum %2 in the treatment of common cold. )rIneimittelforschung ACBAK3A=<>9H32&F. 918 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p <F 919 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 920 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p <F

$upatorium purpureum
Common name: gravel root, 2ueen of the /eado , boneset ='. perfoliatum>, -oe&pye eed Ha!itat:C2A ,ndigenous to :. America from !anada to )lorida. *ro s in s ampy and rich lo grounds.

Asteraceae

Botanical description: C22 5tem is rigidly erect, T usually E&F ft =but can be up to A2 ft> high, stout, unbranched, either hollo or ith incomplete pith. ,t is purple above the "oints and often covered ith elongated spots and lines. .eaves are oblong and pointed, rough above, but do ny beneath. 6hey are placed in horls of <&E on the stem =mostly E> and are nearly destitute of resinous dots. 6he margins are coarsely and unequally toothed, the leaf&stal#s either short or merely represented by the contracted bases of the leaves. 6he flo ers are purple, in a dense terminal inflorescence, the heads very numerous, E&A0 flo ered, contained in an eight&leaved, fresh& colored involucre. '. purpurum blossoms in the summer months. #arts used9 4oot and rhi(ome Constituents: • Boneset contains sesquiterpene lactones, such as euperfolin, euperfolitin, and eufoliatin, as ell as polysaccharides, flavonoids, C23, C2< and pyrroli(idine al#aloids #harmacology: • Boneset contains sesquiterpene lactones, such as euperfolin, euperfolitin, and eufoliatin, as ell as polysaccharides and flavonoids. ,n test tube and other studies, e$tracts of boneset have been sho n to stimulate immune cell function. 6his may e$plain its ability to help fight off minor viral infections, such as colds and the flu. Boneset also triggers s eating by raising body temperature, also potentially of benefit for colds and flu. C2E • 6he cytoto$ic and antibacterial activity of an ethanol e$tract of leaves of boneset ='upatorium perfoliatum>, as investigated in a recent study. 6he e$tract sho ed potent cytoto$icity ith '!=E0> values =A2&A< microg3m.> comparable to a standard cytoto$ic agent, chlorambucil. 6he e$tract sho ed a ea# antibacterial activity against gram&positive test organisms =5taphylococcus aureus and Bacillus megaterium>. C2F Medicinal actions: %iuretic, anti&lithic, anti&rheumatic,C2H stimulating nervine, tonic, alterative 6raditional /edicinal Uses9 • *enitourinary !ondtions9 ,ts principal influence as considered to be upon the #idneys, and it as employed as a diuretic. C2B 6he specific indications for '. purpureum ere irritation of the bladder in omen from displacement and chronic inflammation of the uterusK suppression of urine, partial or complete, during or after pregnancy. '. purpureum as used in edema, gravel, hematuria, strangury =painful and interrupted urination in drops produced by spasmodic muscular contraction of the urethra and bladder>, pain in the #idneys and bladder, cutting pain ith urination, constant desire to urinate, burning distress and mucous in the urine. C2C • *ynecological !onditions9 !hronic endometritis and other chronic uterine disease, leucorrhea, ovarian and uterine atony, and dysmenorrhea. ,n the pregnant omen, it as utili(ed for threatened miscarriage and insufficient labor pains. C30 • ,nflammatory !onditiions9 ,ntermittent fever ith chills in the lumbar region, bone pain and violent sha#ing ith little perspiration, frontal headache, ea#ness and fatigue, intermittent paro$ysms and fever ith night s eating. ,ts use has also been indicated for scarlet fever.C3A • :ervous !onditions9 'upatorium purpureum as thought to act on the ganglionic system of nerves. =:ote9 this appears to mean as having an effect on the sympathetic nervous system hich is li#ely calming as he further states that it improves digestion>. C32 Current Medicinal Uses: • *enitourinary !onditions9C33 • E1 purpureum is used most often in the treatment of renal and urinary calculi. ,t stimulates renal function, presumably through a stimulation of the sympathetic nervous system. ,t is both stimulating and sedating to the renal apparatus. As a diuretic, it stimulates the flo of ater and solutes. ,t is particularly helpful in removing urinary gravel. ,t aids the passage of the gravel hile soothing the urinary tract and relieving pain associated ith lithiasis. ,t has not been observed to dissolve a calculus once formed, ho ever, it does stimulate its passage and provide relief from the pain of the stone passage. • 6he diuretic action of gravel root is follo ed by a gentle tonification. 6his tonifying effect is also evident in a ea#ened, congested uterus or prostate '. purpureum may also promote the e$cretion of uric acid. )inally, the diuretic action of this plant lends it application in "oint and dependent edema. *ravel root is indicated in difficult and painful urination ith frequency, a sensation of obstruction, a feeling of heaviness in the supra&pubic area, burning urination and blood in the urine. 'upatorium purpureum is used in cases of hematuria, either due to cystitis or due to renal calculi.

•

E1 purpureum is also indicated in urinary incontinence. 5tress incontinence, incontinence of pregnancy, incontinence in children and incontinence associated ith inflammation may all be improved ith administration of gravel root. ,n addition, impotence in men and uterine ea#ness =habitual abortion, prolapse, retroversion, and chronic inflammation> may resolve ith the use of gravel root.

#harmacy9 • %ecoction9 A tsp3cup aterK bring to boil, simmer $ A0 min, sig A cup 6,% C3< • 6incture =strength unspecified>9 A&2 ml 6,% C3E • )luid e$tract9 =strength unspecified>9 L&A drams.C3F Contraindications: • Because of the pyrroli(idine al#aloids, internal use, particularly long&term, may lead to hepatoto$icity and should be avoided in patients ith liver disease. ,ts use is also contraindicated in pregnancy due to its abortifacient effect and during breast feeding, again due to the pyrroli(idine al#aloids.C3H )o*icity:
921

/rs /. *reive, ) Modern Herbal: The Medicinal, 2ulinary, 2osmetic and Economic Properties, 2ulti!ation and ol3lore of Herbs, 5rasses, ungi, ,hrubs, J Trees :ith Their Modern ,cientific Dses, %over 1ublications, ,nc, :e ;or#, ACHA, 7ol. ,, p. 3H<. 922 ,bid, pp. 3H<&E. 923 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy, !hurchhill .ivingstone, :e ;or#, 2000 924 .ininger et al, Healthnotes9 2linical Essentials, Herb Monographs, 1rima 1ublishing, 4oc#lin, !A. 200A 925 ,bid. 926 5. +abtemariam, F!ytoto$icity and antibacterial activity of ethanol e$tract from leaves of a herbal drug, boneset ='upatorium perfoliatum> ,P Phytother Res., :ov A<, 2000, :um. H, pp. EHE&H. 927 %avid +offman, The Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesburry, %orset, ACC0, p. 20< 928 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed, 'clectic /edical 1ublications, 5andy, 04, AC03. 929 )inley 'lling ood, )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago, ACAC, pp. <3B&C 930 ,bid. 931 ,bid. 932 ,bid. 933 :o reference found. 934 +offman, p. 20< 935 ,bid. 936 *reive, 7ol. ,, p. 3HE. 937 )rancis Brin#er, Herb 2ontraindications and Drug >nteractions, 2nd ed., 'clectic /edical 1ublications, 5andy, 0regon, ACCB, p.BH

$uphrasia officinalis
Common name: 'yebright Ha!itat9 'urope and :. America in meado s and grassy places

4crophulariaceae

Botanical description9 5emiparasitic. +as a square leafy stem, simple or branched, leaves almost entirely opposite, ovate, do ny, strongly ribbed, and furro ed. 6he flo ers are a$illary, solitary, abundant and inodorous ith brilliant colors ranging from hite to purple to yello . #arts used9 Aerial parts =dried>, gather in late summer hile in bloom Constituents: • ,ridoid glycosides57/ =aucuboside, aucubin, catalpol, euphroside, i$oroside> • )lavonoids =rutin, quercetin, apigenin glycosides> • tannin, acrid bitter principle, volatile oil, caffeic acid, ferulic acid, sterols, choline, fi$ed oils, fatty acids, vit. !, b&carotene, resin #harmacology: 6he plant has astringent properties that probably account for its usefulness as a topical treatment for inflammatory states and its ability to reduce mucous drainage. Aucubin has activity against hepatitis B in !itro and animal studies have demonstrated hepatoprotective, anti&tumor, anti&spasmodic, and anti&inflammatory effects. C3C Medicinal actions: anti&inflammatory, anticatarrhal, astringent, vasoconstrictor of nasal and con"unctival membranes )raditional Medicinal Uses: 5pecific ,ndications and Uses9 Acute catarrhal diseases of the eyes, nose, and earsK fluent cory(a ith copious discharge of atery mucus.C<0 5ecretion of acrid mucus from eyes and nose ith heat and pain in frontal sinus. C<A !oo# described the leaves are mildly stimulating and astringing, and e$ert a some hat tonic influence. C<2 6hey act principally upon mucous membranesK and may be used to advantage in all e$cessive mucous discharges as in leucorrhea, gonorrhea, coughs, earache, and headache, catarrh of the bladder, and la$ity of the bo els. 6hey are best adapted to mild cases, but are reliable in their action. • *astrointestinal !onditions9 !atarrhal diseases of the intestinal tract may be treated ith 'uphrasia. • 0phthalmologic !onditions9 'uphrasia as used ith benefit as an infusion or poultice in catarrhal ophthalmia and • 1ulmonary !onditions9 'uphrasia as considered to specifically influence the nasal membranes and lachrymal apparatus. ,n acute cory(a ith a profuse atery flo , it e$erts its most specific action. 'uphrasia as used to control the inflammatory, catarrhal and convalescent phases of measles.C<3 Current Medicinal Uses: 'uphrasia should be thought of as a remedy for any and all problems of the mucous membranes of the head and chest. 'uphrasia combines astringent and anti&inflammatory actions to produce an anti&catarrhal action. 'yebright tea is ta#en internally to treat "aundice, respiratory infections, and memory loss. +o ever, there is no scientific evidence that it is effective for these conditions. • 0phthalmologic !onditions9 'uphrasia is used for all types of eye inflammations and superficial in"uries to the eye or surrounding tissue. !ongestive conditions of the eye ith profuse lacrimation respond ell to 'uphrasia internally and as an e$ternal poultice. 'ye infections, ea# eyes, dim vision, hay fever, colds, coughs, hoarseness, earache, headache ith sinus congestion, basically all catarrhal conditions of the respiratory tract respond to 'uphrasia. .i#e many herbs, 'yebright contains astringent substances and volatile oils that are antibacterial against /iccrococus aureus, '. coli, some fungi and other microbes. 6here is no scientific evidence that 'yebright is effective for treating eye diseasesK *ermanyNs !ommission ' recommends against using it hereas 5imon /ills and ?erry Bone recommend it • 1ulmonary !onditions9 'uphrasia vaso&constricts the vessels of the nasal and con"unctival mucous membranes hich further contributes to its anti&catarrhal effects. 6he po erful anticatarrhal actions of 'uphrasia ma#e it useful in congested states of the sinuses and nose. 'uphrasia is most helpful for acute thin atery discharge of the nose especially hen accompanied by headache, earache, and3or eye pain. Current +esearch +eview: • ConBunctivitis:5:: o %esign9 1rospective, open label, one&armed, multicentered, multinational cohort trial o 1atients9 FE patients ith inflammatory or catarrhal con"unctivitis.

o o

6herapy9 'uphrasia rost#oviana +ayne single&dose eye drops9 A qtt A&E $3day 4esults9 !omplete recovery in E3 patients =BA.EG> and a clear improvement in AA patients =AH.0G>. 5light orsening in one patient in the 2nd ee# of treatment. :o serious adverse events. Authors concluded that 'uphrasia single&dose eye drops can be safely and effectively used for various con"unctival conditions.

#harmacy9 'uphrasia combines ill ith 5olidago, +ydrastis, !ommiphora, and 5ambuccus for conditions of the mucous membranes. ,t combines ell ith 'phedra as an e$ternal application for allergic conditions manifesting in the eyes. ,nfusion9 A tsp. herb3cup aterK A cup 6,% 6incture A92 fresh F0G't0+K sig A&< ml 6,% !ompress9 A tsp. dried herb in A pint ater and boil A0 minutes, let cool. /oisten a compress =cotton ool, gau(e, or muslin> in the lu#e arm liquid, ring out slightly and place over the eyes. .eave compress in place for AE min. Contraindications: :o information regarding contraindications is currently available. )o*icity: :o information regarding to$icity is currently available.
938 939

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p.3HE. /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3HF. 940 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 941 5cudder -. 5pecific /edications and 5pecific /edicines. 942 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 943 )elter +W 944 5tross /, /ichels !, 1eter ', et al. 1rospective cohort trial of 'uphrasia single&dose eye drops in con"unctivitis. 7 )ltern 2omplement Med 2000KF=F>9<CC&E0B.

=oeniculum vulgare
Common name: )ennel • •

Um!elliferae

)lo er and )ruit9 the inflorescence is fairly large umbels almost AE cm across on very irregular rays. 6he flo ers are fairly small and usually androgynous. 6he petals are a rich yello , broadly ovate and have an involute lobe at the tip. 6he style is very short and almost art&li#e. 6he fruit is glabrous, bro nish or greenish&gray, F&A0 mm long, some hat cylindrical ith blunt ribs and is strongly domed. .eaves, 5tem, and 4oot9 6he plant is bieniial to perennial, B0&AE0 cm high, glabrous, sea&green to glaucus and has a strong spicy smell. 6he stem is erect, round, glabrous, smooth, and filled ith late$. 6he lo er leaves are petiolate and have long sheaths ith the upper of these sitting on the sheaths, 3 or more pinnate and ith a hair&li#e tip.

#arts used9 )ruit Constituents9 volatile oil =up to BG consisting of anethole, estrogole, fenchone>, flavonoids =rutin, quercetin, #aempferol glycosides>, coumarins, sterols, fi$ed oils, sugars #harmacology: • 6he volatile oil rela$es the smooth muscles. • 5terols and coumarins and has phytoestrogenic action Medicinal actions: 5tomachic, carminative, anti&inflammatory, phytoestrogenic, galactogogue Medicinal uses: • *astroenterology9 6he volatile oil is spasmolytic, carminative, anti&inflammatory. 6he volatile oil rela$es the smooth muscles of the intestines, thus relieving griping and flatulence. )ennel is more rela$ing and more easily tolerated than !umin or dill seeds, and more stimulating than anise seeds. )ennel is often used ith purgatives to allay the associated griping. )ennel is also anti&inflammatory in the intestines. )oeniculum is reported to enhance hepatic regeneration. • 4espiratory 5ystem !onditions9 )oeniculum, via its volatile oils, ill rela$ bronchial smooth muscle spasm and is thus a useful inclusion in bronchitis formulas. • *ynecology9 ,t is most indicated in amenorrhea and oligomenorrhea and is most efficacious as a hot infusion. 6he pleasant taste of fennel ma#es it a good inclusion in carminative and phytoestrogen formulas. )oeniculum stimulates mil# production and combines ell ith *alega officinalis and 5ilybum marianum for this purpose. 6he concentrated oil of )oeniculum is abortifacient. • 0phthalmology9 6he e$ternal application of fennel seed infusion may be used in cases of con"unctivitis and blepharitis. • • • • • • • E&H g3day crushed or ground seeds for teas, tea&li#e products, and other galenic preparations for internal use )ennel syrup or honey9 A0&20 g !ompound fennel tincture9 E&H.E g =O E&H.E ml> ,nfusion9 A&3 g3AE0 ml ater B,%, 6,%, ic )luid e$tract =A9A, g3ml>9 A&3 ml, B,%, %,%, ic 6incture =A9E, g3ml>9 E&AE ml, B,%, 6,% ic :ative dry e$tract =3.C&<.C9A, 3 >9 0.2&0.H g B,%,6,% ic

Contraindications: • )ennel preparations should not be used on a prolonged basis =several ee#s> ithout consulting a physician or pharmacist. C<B )o*icity.4ide $ffects9 5#in irritation, :37, sei(ures, pulmonary edema, liver lesions.
945 946

PDR for Herbal Medicines, /edical 'conomics !ompany, /ontvale, :e -ersey, ACCB, p. BE0. ,bid. 947 /ar# Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs, ,ntegrative /edicine !ommunications, :e ton, /A, 2000, pp. A2H&B. 948 ,bid, A2B

=ucus vesiculosis
Common names: bladder rac#, fucus Botanical description: )ucus is a sea algae. ,t is a bro n alga ith a regularly bifurcate thallus up to A m in length. 'ach branch has a midrib and paired air bladders. #arts used: 6halliK usually dried, but may be eaten fresh Constituents: ,odine in the form of organic salts and in iodo&amino acidsK /ucilaginous polysaccharides =alginic acid, fucoidin, laminarin>K 1olyphenolsK .ipids =inc. phosphatidylethanolamine and phosphatidylcholine> Medicinal actions: metabolic stimulant, mineral supplement #harmacology: 6he iodine in ucus !esiculosus is ta#en up by the thyroid gland and is utili(ed to ma#e 6< and 63 hormones. 6his results in enhanced thyroid activity. )raditional Medicinal Uses: 6he 'clectic physicians used )ucus for a small number of conditions that are no recogni(ed to be associated ith hypothyroidism such as obesity and fatty degeneration of the heart. Current Medicinal Uses: )ucus has eaten for hundreds of years as a nutritious and flavorful vegetable. 5ince the AH00@s, fucus has been used for its iodine content. 6he earliest treatment for goiter =enlarged thyroid due to iodine deficiency> as fucus. ,odine as isolated by distilling the fresh ucus thalli. 1 !esculosus is still used for this purpose although not commonly. 6he iodine content varies from plant to plant. Also the bound and unbound forms of the iodine in fucus ma#es for variable absorption and upta#e by the thyroid gland. 6hese factors have largely dissuaded practitioners from relying on ucus !esiculosis as a remedy for secondary hypothyroidism due to iodine deficiency. +o ever, the use of 1 !esiculosis in eight loss formulas is still quite popular today. By supplying iodine, thyroid function is stimulated and thus metabolism increases. 0ne consequence of this is increased utili(ation of stored fat. 6he inclusion of fucus in eight loss formulas is questionable ho ever since not everyone has iodine deficiency and subsequent hypofunction of their thyroid gland. An inta#e of greater than AE0 g of iodine per day presents a danger of inducing and aggravating hyperthyroidism. ,nta#es less than this present these dangers in someone is not deficient in iodine. Aside from its iodine content, fucus contains essential phospholipids and other minerals. ,t is a nutritious herb hich may be useful in someone ith mineral deficiencies. )ucus is also a useful ad"uvant therapy in hypothyroidism. #harmacy: • • • • • • • A9E tinctureZE ml 6,%K ee#ly ma$imum dosage is A00 ml.

1ithium car!onate: this drug potentiates the hypothyroid action of large amounts of iodine =empirical>. 9, !leeding: due to the antithrombin effects of the fucan polysaccharides =in vitro> Hyperthyroidism: may be aggravated due to the iodine content =empirical> ,odine induced goiter or thyroid deficiency: due to e$acerbation by iodine content #artial thyroid removal or HashimotoAs thyroiditis: may induce my$edema by increasing interthyroidal concentrations of iodine, bloc#ing thyro$ine formation =empirical>. #regnancy or nursing: due to possible overe$posure of iodine to infant =empirical>. #rolonged use: due to possible overe$posure of iodine =empirical>.

)o*icity: ,f used for a long period of time and3or in doses that are too high, hyperthyroidism or thyroto$icosis are possible. 5ymptoms include palpitations, restlessness, insomnia, agitation, etc.
949 950

Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. << Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. <3&<<

=umaria officinalis

=umariaceae Common name: )umitory Ha!itat: :ative to 'urope and the British ,sles, )umaria prefers fields, gardens, ban#s and ditches. Botanical description9 )umaria is a small annual plant ith pinnate leaves and clusters of slender tubular, t o&lipped pin# flo ers. 6he fruit is globular and contains one seed. 6his plant flo er throughout the summer. Historical uses9 6he smo#e from the burned plant has the po er to e$pel evil spirits according to ancient e$orcists of 'urope. 0ne legend claims that the plant as produced from vapors arising out of the earth, rather than from seed, hence one of its other common names, M'arthsmo#eM. #arts used9 +erba Constituents9 • ,soquinoline al#aloids • )lavonoids9 including rutin • 0rganic acids9 fumaric acid • +ydro$ycinnamic acid derivatives9 including caffeoylmalic acid #harmacology: :o current information is available. Medicinal actions:9 6onic, mild diuretic, la$ative, alterative, gall&bladder trophorestorative )raditional Medicinal Uses: ?ing considered )umaria to be ea#ly tonic, slightly diaphoretic and aperient. ,t as very much used in cutaneous diseases, "aundice, obstructions of the abdominal viscera, scurvy, and in cases of debility of the digestive organs. CEA Current Medicinal Uses9 )umaria is used in stomach, liver disorders, and s#in conditions. )umaria seems to specifically tonify the stomach, liver and gall&bladder. • %ermatological !onditions9 According to !ulpepper, the "uice of )umaria mi$ed ith the "uice of ;ello doc# ma#es a supreme healing ash for all manner of s#in eruptions including scabs, pimples, blotches, ec(ema and heals. 6his action may in part be e$plained by the antiseptic action of sanguinarine. 6a#en internally, )umaria ill help to heal the above s#in conditions. 6his is due to the tonic effects on the liver, gall&bladder, and #idney. • *astrointestinal !onditions9 )umaria tonifies the digestive system overall =it is a bitter tasting plant>. • +epatobiliary !onditions9 )umaria is a unique gall&bladder remedy in that it acts amphoterically on the gall&bladder and duct. ,f the duct is in spasm, )umaria ill rela$ the smooth muscles, alternatively, if the duct is too rela$ed, )umaria ill enhance the contractility of the gall&bladder. 5pecifically, )umaria is indicated in 5pastic discomfort in the area of the gallbladder and bile ducts, as ell as the gastrointestinal tract. CE2 Although no placebo&controlled studies have been done, a number of empirical reports, clinical case reports and animal e$perimental studies have been published. Accordingly, in *ermany, )umaria officinalis is approved for the indication Mcolic#y pain affecting the gallbladder and biliary system, together ith the gastrointestinal tractM. CE3 0ver time )umaria ill tonify the gall bladder, due to the enhanced stimulus responsiveness. )umaria is slightly diaphoretic and aperient. Current +esearch +eview: • 9astroenterology: o Hepato<!iliary pathology:CE< Abstract is unavailable on /edline =AA3AH302>. #harmacy9 ,nfusion9 A&2 tsp. herba3cup aterK sig 6,% 6incture9 A9E 2EG 't0+K sig A&2 ml 6,%

)o*icity9 :one #no n.
951 952

)elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. ,bid 953 +entschel, !. et al9 Q)umaria officinalis =fumitory>&&clinical applicationsR. ortschr Med. ACCE -ul A0KAA3=AC>92CA&2. 954 %ubarry --. !linical study on the use of fumitory nebuli(er in hepato&biliary pathology. 7 Med Bord ACFHKA<<=F>9CAB&20.

9alega officinalis
Common names: *oat@s rue, )rench lilac Ha!itat: 6he plant is native to central, southern and eastern 'urope and cultivated else here.

1eguminosae

Botanical description: An erect branched plant that gro s to a height of A.E m. 6he leaves are A3&AE oblong, marginate leaflets. White or light blue papilionaceous flo ers in dense racemes bloom bet een -uly and August. #arts used: aerial plant Constituents: • *alegine =isomyleneguanidine> Qup to EG in the seedsR • 1eganine al#aloid • *alegine =Oisoamyleneguanidine>, its <&hydro$yderivative and peganine • 6annins, )lavonoids =)lo ers>, 5aponins, !hromium salts Medicinal actions: +ypoglycemic, galactagogue, diuretic, vermifuge #harmacology: 6he hypoglycemic effect of *alega, specifically galagine, has been demonstrated in allo$an&diabetic and healthy rats ith either the aqueous or alcoholic e$tract. CEE *alagine bloc#s succinic dehydrogenase and cytochrome o$idase, thus increasing anaerobic glycolysis and decreasing gluconeogenesis.CEF 6he hypoglycemic effect occurs hile the glycogen level in the liver and myocardium rose. CEH +igh doses of *alega can cause into$ication due to the guanidine derivatives. 1eganine also has hypoglycemic actions. CEB Biguadines inhibit glucose absorption from the intestine.CEC 6he chromium salt content =3.H ppm> may also contribute to the anti&diabetic action of 5alega officinalis. *alega also promotes lactation, possibly through stimulaion prolactin from the adenohypophysis. CF0 A gel&fractionated herbal e$tract from *alega officinalis has demonstrated in vitro to have an inhibiting and disaggregating effect on platelet aggregation. CFA Antibacterial activity has also been described. )raditional Medicinal Uses: +istorically, dating bac# to !ulpepper, *alega has been used as a vermifuge and diaphoretic. *alega as considered to be effective in eliminating a variety of parasites. 6his use is not common today. ?ing observed that *alega has a disagreeably bitter taste imparts a dar#&yello ish color to the saliva. 7arious properties ere attributed to it in former times, in hich it as considerably employed as a vermifuge, as a stimulant to the nervous system, as a diuretic and tonic in typhoid conditions, and is also stated to have been of service in the plague, as ell as to stimulate the lactiferous vessels to an increased secretion during the period of lactation. ,t as, seldom, if ever, prescribed in practice. Current Medicinal Uses: • %ermatologic !onditions9 Alcoholic e$tracts of *alega ere tested on *ram X and *ram & bacteria as the plant as claimed to hasten s#in healing after surgery. 'thanolic =F0G> e$tract e$hibited significant inhibition on gro th of both *ram X and *ram & bacteria.
CF2

• 'ndocrine !onditions9 *alega is used in the treatment of diabetesZtype , and ,,. :o human studies on the hypoglycemic effect have been performed although the hypoglycemic effect of the seeds has been demonstrated in animals. 6he hypoglycemic effect, hile significant, should not initially replace insulin therapy. 6he to$ic effects of high doses of *alega limit the e$tent of its hypoglycemic action. :onetheless, it is an important part of an overall anti&diabetic therapeutic program. • *ynecological !onditions9 *alega is also a very effective galactogogue. ,t ill promote lactation hen absent and ill increase the amount of mil# produced significantly. *alega is used in 'urope by veterinarians for stimulating mil# secretion. #harmacy: ,nfusion9 A.E tsp. 3 cupK A cup 6,% =A tsp. O A.3 gm> A9E tincture W 2 ml 6,%K <0 ml O ee#ly ma$imum

Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: *alega may be contraindicated during pregnancy.CF3 )o*icity: :o information is currently available from selected resources.

955 956

'vans W! Trease and E!ans/ Pharmacognosy , A<th ed., =1hiladelphia9 WB 5aunders !o .td>, ACCF9<<0. 0liver&Bever B, 8ahnd *4, Huart1 71 2rude Drug Res, AH,ACHC9A3C&CF. 957 5hu#yurov %8, *useinov, %ya, and ;u(bashins#aya 1A Do3l )3ad ;au3 )Ier1 ,,R, 30, ACH<9EBK 2hem1 )bstr1, B2, ACHE9A0F3C2. 958 'vans W!, >bid, <<0. 959 0liver&Bever B, 8ahnd *4, >bid, A3C&CF. 960 ?enner, % and 4equena, ; Botanical Medicine: ) European Professional Perspecti!e, =Broo#line, /A9 1aradigm 1ubl.>, ACCF9ACC<. 961 Atanasov A6. ,nhibiting and disaggregating effect of gel&filtered *alega officinalis .. herbal e$tract on platelet aggregation. - 'thnopharmacol. 2000 /arKFC=3>923E&<0. 962 1undari#a#shudu ?. Anti&bacterial activity of *alega officinalis .. =*oatNs 4ue>. - 'thnopharmacol. 200A 5epKHH=A>9AAA&2. 963 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 22<

9allium aparine
Common names: !leavers, bed&stra , gallium Ha!itat9 !ommon in gardens and in moist, shady areas of forests, often near a body of ater.

+u!iaceae

Botanical description9 An annual plant ith a ea# stem, hich climbs and clings due to the hoo#ed trichomes on the leaves and stems. 6he stem is hairy at the "oints and gro to a height of A2&2< in. 6he leaves are linear to lanceolate, A&2 cm. long, and tapered at the base. 6hey have rough margins and midrib, and are arranged in horls of F&B leaves. )lo ers are hite, arranged in loose cymes found at the a$il of the leaves. 6he caly$ is open E lobes, corolla is tube&li#e ith < lobes. 6he fruit is <&F mm., olive green to purple and covered ith hoo#li#e bristles. )lo ers /ay to -une. #art used: +erba Historical usage9 6he seeds have been dried and roasted as a coffee substitute. 6he stems have been used as fiber for ma#ing nets =*reece and 5 eden>. Constituents9 5&: • glycoside9 asperuloside • gallotannic acid • citric acid • volatile oil =small amount9 coumarins, rubichloric acid and asperuloside glycosides, en(ymes, tannins, galiosin #harmacology: *aliosin, an anthraquinone glycoside, and other glycosides and tannins and flavonoids may constitute the ma"or active constituents of cleavers. .ittle research has been conducted on this plant, but preliminary lab e$periments suggest it may have antispasmodic activity.CFE Medicinal actions: %iuretic, 7ulnerary, Astringent =mild>, Anti&lithic, .ymphatic cleanser, refrigerant )raditional Medicinal Uses: 5pecific ,ndications and Uses.Z%ysuria, painful micturitionK renal and cystic irritation ith burningK diuretic for inflammatory states of the urinary tract, and for febrile conditionsK Mnodulated gro ths or deposits in s#in or mucous membranesM CFF !oo# considered this herb to be a peculiarly soothing rela$ant, acting upon the #idneys and bladder and is some hat soothing to the nervous system.CFH • %ermatologic !onditions9 ?ing noted that *allium had been found useful in many cutaneous diseases, such as psoriasis, ec(ema, lichen, cancer, and scrofula, and is more particularly useful in these diseases hen they are combined ith a strumous diathesis. • *enitourinary !onditions9 !oo# observed that *allium increased the atery portion of the urine hich decreased discomfort in an irritated system. +e noted that its action is light and diffusive being suited for acute cases. +o ever, he placed it among the valuable agents in all forms of scalding urine, as in o$alic acid gravel, irritation at the nec# of the bladder, and the first stages of gonorrhea. 6o these actions ?ing added that *allium as an effective treatment for suppression of urine, calculous affections, inflammation of the #idneys and bladder, and in the scalding of urine in gonorrhea. • ,nflammatory !onditions9 ?ing used *allium freely in fevers and all acute diseases. *ro th or deposits of a nodular character in the s#in or mucous membranes are regarded as indications for its use. • 6opical Applications9 ?ing use the cold infusion as a ash several times a day in removing frec#les, lepra, and several other cutaneous eruptions =continued for 2 or 3 months in case of frec#les>. Current Medicinal Uses9 *allium has a tropism for the pelvis and urinary tract. ,t is most commonly thought of a lymphagogue. ,t increases lymphatic drainage, brea#s up lymphatic congestion& especially in the pelvis&, and in general is a lymphatic tonic. 6he en(ymes contribute to this action. 6he en(ymes are only preserved in the glycerite or "uice. • %ermatologic !onditions9 *allium is depurative =a strong alterative> hich ma#es it useful in the treatment of dry s#in conditions such as ec(ema and psoriasis. )or s#in diseases, *allium combines ell ith Arctium, 4ume$ and 6ara$acum. • *enitourinary !onditions9 *allium is also demulcent for the urinary tract, giving it indication in cystitis, urethritis, prostatitis and pyelonephritis. Additionally, *allium can brea# up renal stones Qits relative, 4ubia tinctoria is best #no n for thisR. *allium is a soothing and rela$ing diuretic and therefore reduces edema caused by ater retention of #idney origin.

•

,nflammatory !onditions9 *allium is a mild diaphoretic. *allium reduces edema of the "oints as in rheumatoid arthritis. *allium has a pleasant taste =similar to blac# tea> and is a useful addition to childrenNs cold3flu remedies. Unli#e 1hytolacca, another lymphatic botanical, *allium has no to$ic effects on the !:5 or *, and therefore is a good ay to treat the lymphadenopathy and fever of infections. *allium popsicles are a medicinal treat for #ids.

Current +esearch +eview • 5earch of /edline revealed no human studies as of :ovember 2002. #harmacy9 :ote9 hot ater, aged plant, and dried plant all decrease the medicinal value of the plantK fresh is best. ,nfusion9 A&2 tsp.3cup aterK steep A0 minK sig A&2 cups 6,% QA tsp. O A.H gR )resh "uice9 preserve ith E0G glycerinK sig E&AE ml B,% )luid e$tract9 A9A 2EG 't0+K sig 2&< ml 6,% 5pecific tincture A93 2EG 't0+K sig E&H ml 6,% )resh pulp as a poultice

Contraindications: ,t is contraindicated in diseases of a passive character, on account of its refrigerant and sedative effects on the system.CFB )o*icity9 :one

9rifola frondosa' 1entinus edodes' 9anoderma spp2
Common names: /aita#e =*. frondosa>, 5hita#e =.. edodes>, 4eishi =*anoderma> Ha!itat: )ungi hich are largely log cultivated. Botanical description: 6hese fungi have the appearance of large mushrooms. #arts used: )ruiting bodies Constituents: 1olysaccharides9 beta A&F glucan, beta A&3 glucanK Ascorbic acid analogsK 1roteinK 1hosphorus *anoderma spp • triterpenoids =ganoderic acids> • sterols, coumarin, mannitol, polysaccharides, and #harmacology: 6hese mushrooms all contain very high amounts of polysaccharides. 6hese polysaccharides appear to be the constituents responsible for immune modulation. 5pecifically, the polysaccharides induce interferon production, thus disrupting viral replication and inhibiting bacterial infection, including 5taphylococci, 5treptococci, and Bacillus pneumonia. 6he polysaccharides also increase 4:A and %:A in bone marro , thus increasing lymphocyte production. 9anoderma lucidum: 6he acidic protein bound polysaccharide, *.h &02 e$hibited antiherpetic activity ith E0G effective concentrations ='!E0> in vitro CFC. '$tracts ith *anoderma spp have been demonstrated to augment immunoglobulin *, e$pand the memory of 6&cells and increase ,.&A and ,.&2. Antitumor activity9 6he effects of e$tracts from *anoderma lucidum spores on the gro th of human cervi$ uteri tumor cells as ell as on the cell cycle and intracellular calcium level ere investigated. 0ne form of the e$tract of crac#ed open spores as sho n to be capable of bloc#ing the cell cycle at the transition from *A to 5 phase and inducing a mar#ed decrease of intracellular calcium level. . 6hese results imply that =A> the brea#ing of *. lucidum spores improves the release of cytoto$ic activity and =2> the effective e$tract might influence the cell cycle and cellular signal transduction by altering the calcium transport system CH0. Antiplatelet activity9 *anodermic acid 5 =*A5>, isolated from the !hinese medicinal fungus *anoderma, e$hibits inhibitory effects on platelet responses to various aggregating agonists. *A5 also participated in potentiating the response of human platelets to prostaglandin 1*' A. CHA 6he crude e$tracts of the *anoderma lucidum is considered not to have unto ard antiplatelet effect in vivo despite the high contents of adenosine. CH2 +o ever, the inhibitory effect of *anoderma lucidum on platelet aggregation in AE healthy volunteers and 33 patients ith atherosclerotic diseases sho ed that the first and the second phase of aggregation of platelets of the healthy volunteers ere obviously inhibited =1 less than 0.0A> hen atery soluble e$tract of *anoderma of different concentrations as added to the platelets in vitro. 6he inhibitory effect as related to dosage. CH3, CH< 6he apparent opposite findings in these studies may be due to the preparation of the e$tract. *anoderic acids may lo er blood pressure as ell as decrease .%. cholesterol. 6hese specific triterpenoids also help reduce platelet stic#iness. CHE 1rolonging life9 ,n this study, a controlled protocol as conducted in hich :e 8ealand Blac#3White )A mice ere fed standard cho ith prednisolone =0.E mg3#g3day> or *anoderma tsugae e$tract, commencing at 2 months of age. ,t as found that the )A mice responded ell to .ing 8hi e$tract. .ing 8hi improved the survival rate of lupus mice, decreased the amount of proteinuria, decreased serum levels of anti&ds%:A autoantibody, and sho ed evidence of decreased perivascular and parenchyma mononuclear cell infiltration in vital organs. CHF 9rifola frondosa: *rifolan =a polysaccharide from 5rifola frondosa> stimulates macrophage production of tumor necrosis factor& α hich regulates immune and inflammatory responses such that the host is protected against infection and cancer. A polysaccharide fraction in /aita#e, beta A&F glucan =most other mushrooms only contain beta A&3 glucan> potentiates the activity of macrophages, :? cells, cytoto$ic 6 cells and increases the synthesis of interleu#in&A and lympho#ines. 1entinus edodes: 6he polysaccharides of .entinus have antitumor effects and increase phagocytic activity. .entinan activates :? cells involved in tumor suppression. ,n addition, lentinan has been sho n to inhibit immunosuppressive cyto#ines, increase antibody production, increase opsonin production, and activate macrophages. CHH Medicinal actions: ,mmune stimulation3modulation, anti&viral, anti&bacterial, anti&cancer, anti&hypertensive 5ummary of effects of *anoderma lucidum according to !hristopher +obbs9 CHB Analgesic, Anti&allergy, Anti&inflammatory, Antibacterial, Antio$idant, Antibacterial, Antio$idant, Antitumor, Antiviral, +ypotensive, !ardiotonic =lo ers cholesterol but has no effect triglycerides, improves coronary artery perfusion>, !:5 depressant, 'nhanced :? cell, '$pectorant and antitussive, Anti&+,7 activity, +epatoprotective

)raditional Medicinal Uses: :o information is available from the selected resources. Current Medicinal uses: 6he overall indications for these potent immunostimulatory mushrooms include many conditions ith altered immune and adrenal =endocrine> function. 6hese include9 chronic fatigue immunodeficiency syndrome, +,7 infection and A,%5, cancer, .yme disease, hypertension, high cholesterol, hyperglycemia and diabetes. • !ardiovascular !onditions9 /aita#e and *anoderma have anti&hypertensive action. .entinus does not lo er elevated blood pressure, but shares ith the other mushrooms the ability to lo er cholesterol, triglyceride, and phospholipid levels. • 'ndocrine !onditions9 6hese mushrooms are also adaptogens, and thus enhance physiological resistance to stress. All of the mushrooms can lo er high blood sugar. 4eishi has analgesic, nervine rela$ant, anti&allergic =inhibits histamine release and all types of hypersensitivity reactions, is an antio$idant, and regenerates liver tissue =i.e. in liver necrosis and hepatitis>. • +epatobiliary !onditions9 3EE patients ith hepatitis B sho ed improvements in liver en(ymes and improved symptoms. *. lucidum is more effective in cases here there is no severe liver impairment. CHC .entinus formulations that contain the po dered mycelium =called .'/> may help decrease serum liver en(yme levels. 6hese findings came from an open study of persons ith hepatitis B using 2 grams 6,% of .'/. 0ne mar#er of hepatitis B infection in the blood, +BeAg, disappeared in A<G of the patients in this study. *iven the preliminary nature of the research, more information is needed to determine if .'/ is effective for hepatitis. CB0 • ,mmune !onditions9 /aita#e mushroom, along ith 5hita#e =.entinus edodes> and 4eishi mushroom or .ing 8hi =*anoderma> are potent immunostimulators. 6hey are deep immune tonics, most indicated in the treatment of chronic immune disturbances rather than in acute states of immune dysfunction. -apanese physicians use these immune stimulating mushrooms in their treatment of cancer. ,n fact, in -apan, e$tracts from three different mushrooms9 .entinus e$tract, 5hi(ophyllum, and !oriolus are listed among the most recommended anti&cancer drugs and are used in con"unction ith chemotherapy.CBA, CB2 /aita#e, called the #ing of mushrooms because it is so large, is believed by some to be the most potent of the immune stimulating mushrooms. ,t is very effective in oral doses for the treatment of tumors. /aita#e is also being researched for its ability to prevent +,7 from #illing !%< cells. 6he beta A&F glucan inhibits the cellular modulation caused by +,7 infection and thus prevents subsequent cellular destruction =in&vitro>. /aita#e has been studied in&vivo in persons infected ith +,7 and the results indicate increased !%< counts and improvement of symptoms. *anoderma inhibits the release of histamine preventing and alleviating types ,, ,,, ,,,, and ,7 allergic hypersensitivity reactions. *anoderma has been observed clinically to stabili(e immunoglobulin levels, reducing the number of e$cess antibodies and boosting lo levels. CB3. *anoderma may help reduce food sensitivities for this reason. • ,nfectious !onditions9 !ase reports from -apan are also suggestive that lentinan from .entinus edodes is helpful in treating individuals ith +,7 infection. +o ever, large&scale clinical trials to confirm this action have not yet been performed. CB<, CBE • 1ulmonary !onditions9 !linical studies in !hina of *anoderma ith over 2000 patients demonstrated improvements in a variety of pulmonary symptomologies. 1atients ith bronchial asthma sho ed the most improvement. CBF !urrent 4esearch 4evie 9anoderma spp • Chinese medicine: o #ulses:5/(  %esign9 4andomi(ed controlled clinical trial  1atients9 +uman sub"ects  6herapy9 '$tract of three !hinese herbs9 1ana$ ginseng, 1ana$ quinquefolium roots, and *anoderma lucidum.  4esults9 'ach herb has a specific effect on the )ourier components of the pulse, and is in agreement ith traditional !hinese medical descriptions. • Infectious diseases: o Herpes zoster:5//  %esign9 !linical trial  1atients9 )our patients9 t o ith postherpetic neuralgia recalcitrant to standard therapy and t o ith severe pain d3t herpes (oster infection.  6herapy9 +ot ater soluble e$tracts of *anoderma lucidum =*l>, 3F&H2 g dry eight qd  4esults9 %ramatic decrease in pain. • Cardiology: o Platelet aggregation:  5tudy A9CBC  Design: .linical trial  1atients9 )ive volunteers ith hemophilia A, positive +,7 antibody, and reversed helper3suppressor 6&lymphocyte ratio.  6herapy9 '$tract of *anoderma lucidum =*.&1>, containing AE0 mg adenosine3A00 gm e$tract. 'stimated sig9 A.3E mg adenosine qd  4esults9 1latelet aggregation tests before and after the trial sho ed no significant change.

5tudy 29CC0  %esign9 !linical trial  1atients9 )ifteen healthy volunteers and 33 patients ith atherosclerotic disease.  6herapy9 *anoderma lucidum =*.> A g 6,% $ 2 ee#s  4esults9 1latelet aggregation induced by A%1 in final concentration of 2 mumol3. and 3 mumol3. as inhibited, ith ma$imum aggregation inhibition rates 3A.<CG and AH.HG, respectively. .ength and eights = et and dry> of the e$tracorporeal thrombi ere reduced after oral administration of *.. Authors concluded that *. may be an effective inhibitory agent of platelet aggregation. Lomatium spp. • ,nfectious diseases: o H,-: 5tudy A9 CCA  %esign9 1lacebo&controlled clinical trials, phase ,3,,  1atients9 :inety&eight +,7&positive patients ithout current opportunistic infections, !%< levels of 200&E00 cells, AB&F0 yo.  6herapy9 6rial A9 2,E, or A0 mg of lentinan =beta A B3 glucan isolated from .entinus edodes> or placebo iv A$3 # $ B #s. 6rial 29 A or E mg of lentinan or placebo iv 2$3 # $ A2 #s.  4esults9 Patients in the study have sho,n a trend to,ard increases in .D+ cells and in some patients neutrophil activity. @ecause of the small numbers, these values do not have statistical significance. )uthors recommended a long-term clinical trial of lentinan in combination ,ith didanosine (dd4# or zidovudine. 4n trial , ten patients ,ith elevated p + levels, eight on lentinan and t,o on placebo had decreased p + levels. 1f these decreases, those ,ith lentinan and one ,ith placebo ,ere mar-ed.  5tudy 29CC2  %esign9 4andomi(ed controlled multicenter clinical trial, phase ,,.  1atients9 0ne hundred and seven +,7 positive patients ith !%< levels of 200&E00 cells3mm3.  6herapy9 %idanosine, <00 mg qd =B,%> po $ F #s, then 2 mg lentinan iv as added3 # $ 2<&B0 #s. !ontol W dd, only.  4esults9 5ignificant increases in !%< levels up to 3B ee#s in e$periment group, hereas dd, alone as significant at the EG level at A< ee#s. • Oncology: o Gastric, colorectal, and breast cancers:557  %esign9 4andomi(ed controlled clinical trial ith envelope method  1atients9 1atients ith advanced or recurrent stomach, colo&rectal, and breast cancer.  6herapy9 .entinan =.:6> W a purified polysaccharide e$tracted from .entinus ededes. )or *, cancer9 .:6 iv Amg qd 2$3 # or 2 mg qd A$3 # in combination ith mitomycine ! XE&)U =/)> or tegafur =)6>.  4esults9 .ife span prolongation and lo er incidence of abnormal value on hematological survey as observed for *, cancers. )or breast cancer & study as under ayK life span prolongation as observed. as ell. o reast cancer:55:  %esign9 !ontrolled clinical trial  1atients9 1atients ith advanced or recurrent breast cancer ho received bilateral oophorectomy and adrenalectomy  6herapy9 .entinan  4esults9 ,mprovement of prognosis in e$perimental group, compared ith the control #harmacy: 7it. ! appears to enhance the absorption of these immunostimulatory polysaccharides. 7it. ! reduces the high molecular eight of mushroom polysaccharides, reducing their viscosity and hence increasing their bioavailability. E&A0 g po der daily in divided doses. 6en grams daily of the dried /aita#e po der =equivalent to 200g of fresh mushroom> is typical. Drug ,nteractions: 6he ater e$tract of *anoderma lucidum diminished the stimulant effect of caffeine due to !:5 depressant activity and reduced the sleeping time induced by he$obarbital, possibly be increasing hepatic metabolism =both studies in mice>. CCE 6he protein bound beta&glucan % fraction of *rifola increased the inhibitory effect of mitomycin ! on transplanted hepatic carcinoma in mice. CCF Contraindications: :o information is currently available from the selectred resources. )o*icity: %oses of /aita#e as high as 30g have been studied for side effects and only constipation as noted. 5ome people e$perience mild diarrhea hen beginning oral supplementation, and this soon resolves.
969

4o, 5?, )ntiherpetic acti!ities of !arious protein bound polysaccharides isolated from 5anoderma lucidum1 - 'thnopharmacol. ACCC %ec AEKFB=A&3>9AHE&BA.

970

8hu, +5 Effects of extracts from sporoderm9bro3en spores of 5anoderma lucidum on He8a cells1 2ell Biol Toxicol. 2000KAF=3>920A&F. 971 5u, ! Potentiation of ganodermic acid , on prostaglandin E0%B9induced cyclic )MP ele!ation in human platelets . 6hromb 4es. 2000 -ul AEKCC=2>9A3E&<E. 972 *ua, .1, The lac3 of antiplatelet effect of crude extracts from ganoderma lucidum on H>G9positi!e hemophiliacs1 Am - !hin /ed. ACC0KAB=3&<>9AHE&C. 973 6ao -, Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation . - 6ong"i /ed Univ. ACC0KA0=<>92<0&3. 974 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A0A 975 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 976 .ai, :5, Pre!ention of autoantibody formation and prolonged sur!i!al in ;e: ?ealand Blac36;e: ?ealand +hite % mice :ith an ancient 2hinese herb, 5anoderma tsugae . .upus. 200AKA0=H>9<FA&E. 977 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A2E 978 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A00&A0A. 979 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A0A 980 +arada 6, ?aneta#a 6, 5u(u#i +, 5u(u#i ?. 6herapeutic effect of .'/ =e$tract of cultured 8entinus edodes mycelia> against +BeAg&positive chronic hepatitis B. 5astroenterol >nt ACBBKA=suppl A>9abstract HAC. 981 6aguchi ,. !linical efficacy of lentinan on patients ith stomach cancer9 'nd point results of a four&year follo &up survey. 2ancer Detect Pre!ent ,uppl ACBHKA9333W<C. 982 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A3< 983 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A02 984 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 985 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. 986 +obbs, !. /edicinal /ushrooms9 An '$ploration of 6radition, +ealing and !ulture. Botanica 1ress ACCE. p. A0A 987 Wang W?, !hen +., +su 6., et al. Alteration of pulse in human sub"ects by three !hinese herbs. )m 7 2hin Med ACC<K22=2>9ACH&203 988 +i"i#ata ;, ;amada 5. 'ffect of *anoderma lucidum on postherpetic neuralgia. )m 7 2hin Med ACCBK2F=3&<>93HE&BA. 989 *au *1, .in !?, .ee 55. 6he lac# of antiplatelet effect of crude e$tracts from ganoderma lucidum on +,7&positive hemophiliacs. )m 7 2hin Med ACC0KAB=3&<>9AHE&C. 990 6ao -, )eng ?;. '$perimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. 7 Tongii Med Dni! ACC0KA0=<>92<0&3 991 *ordon /, Bihari B, *oosby ', et al. A placebo&controlled trial of the immune modulator, lentinan, in +,7 positive patients9 a phase ,3,, trial. 7 Med ACCBK2C=E&F>930E&30. 992 *ordon /, *uralni# /, ?ane#o ;, et al. A phase ,, controlled study of a combination of the immune modulator, letinan, ith didanosine =dd,> in +,7 patients ith !%< cells of 200&E003mm3. 7 Med ACCEK2F=E&F>9AC3&20H. 993 6aguchi 6. 'ffects of lentinan in advanced or recurrent cases of gastric, colorectal, and breast cancer. 5an To .aga3u Ryoho ACB3KA0=2 1t2>93BH&C3. 994 ?osa#a A, Wani 6, +attori ;, et al. 'ffect of lentinan administration of adrenalectomi(ed rats and patients ith breast cancer. 5an To .aga3u Ryoho ACB2KC=B>9A<H<&BA. 995 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p AFB 996 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p A<0

9aultheria procum!ens
Common name: Wintergreen Ha!itat: Botanical description: #art used: Historical use: $nergetics: Constituents 55( • 7olatile oil9 chief components & methyl salicylate =CF&CBG>, additionally, oenanthic alcohol =n&heptan&A&ol> and its ester = hich contributes to the odor of the volatile oil> #harmacology: 0il of Wintergreen is high in methyl salicylate. /ethyl salicylate can be converted into salicylic acid in the body and is an ingredient in 1eat baths and in many topical analgesics. 5#in absorption of methyl salicylate as investigated in A0 volunteers. CCB By use of bathing concentration of 0.03 g3l of methyl salicylate, plasma levels of 220&B20 ng3ml ere found A h after beginning, and <F&AC3 ng3ml after F h. 6he half&time of elimination in urine after methyl salicylate bathing is =as ith in"ected salicylic acid> bet een 2.< to < h. Medicinal actions: stimulant, aromatic, astringent, carminative, analgesic

)raditional Medicinal Uses: 5pecific ,ndications and Uses9 !ystic and prostatic irritation, undue se$ual e$citement, renal inflammation =early stage>. CCC 6he 'clectics used the infusion as an astringent in chronic mucous discharges, as a stimulant in cases of debility. !oo# described *aultheria as rela$ing and gently stimulating, very diffusive and transient. • %ental !onditions9 6he oil allays the pain of carious teeth. • *astrointestinal !onditions9 6he essence of intergreen as used as a carminative, particularly by the 1hysiomedicalists to relieve flatulence and ind colic. • *enitourinary !onditions9 6he 'clectics used *aultheria as a diuretic in dysuria. Both the infusion and the essence ere used to relieve irritation of the urethra and bladder, and to the incipient stages of renal inflammation. 6ubal nephritis is alleged to have been arrested by it even hen e$amination has revealed in the urine the presence of red blood cell casts. !oo# indicted its effects on the #idneys hen used as a cold preparation. • *ynecological !onditions9 ?ing stated that *aultheria has emmenagogue, although did not elucidate on this action. • /ale !onditions9 5cudder recommended *aultheria in spermatorrhea ith increased se$ual e$citement, and as a sedative in irritation and inflammation of the urethra, prostate gland and bladder. • /usculos#eletal !onditions9 *aultheria as recommended as a valuable remedy for articular and muscular rheumatism. Current Medicinal Uses: • /usculos#eletal !onditions9 6he oil is administered e$ternally as an analgesic and rubefacient for the treatment of rheumatoid arthritis and related conditions. A000 :o clinical trials have been performed. #harmacy: Contraindications: ,nternal use can cause gastrointestinal irritation and should be avoided by lactating mothers due to the passage of potentially to$ic compounds in breast mil#.A00A )o*icity: .arge doses of it administered internally have caused death by producing inflammation of the stomach. A002

9elsemium sempervirens
Common names: ;ello "asmine, ild "asmine, yello "essamine, ild "essamine, ild oodbine Ha!itat: :ative to southern U5A.

1oganiaceae

Botanical description: 6he root is tortuous, bro n and smooth ith a thin bar# and oody center sho ing broad medullary rays. 6he rhi(ome is less tortuous and has a noticeable pith and purplish longitudinal lines on the bar#. This plant is not to be confused :ith the ornamental yello: flo:ering Kasmine1 #art Used: root Constituents: ,ndole al#aloids9 gelsemine, gelsemoidine, sempervirine, gelsemicineK ,ridoidsK !oumarinsK 6annins #harmacology: 6he indole al#aloids act similarly to nicotine and coiine in that they first stimulate, then depress neural function, especially in the medulla oblongata and spinal ganglia. A003 6he al#aloids have an overall !:5 depressant action thus slo s and inhibits nervous innervation ith resultant decreased end&organ activity. Medicinal actions: 5edative, hypnotic, diaphoretic, antispasmodic, febrifuge, anodyne, hallucinogenic )raditional Medicinal Use: 5pecific ,ndications and Uses9 *elsemium is indicated by bright eyes, contracted pupils, flushed face, great beat, and restlessnessK mental irritabilityK insomnia, ith e$citationK pain over the hole headK dysuria, ith scanty secretion of urineK irritation of the urinary tractK pinched, contracted tissuesK thin, dry, unyielding os uteri, ith dry vaginal allsK arterial throbbing and e$alted sensibilityK chilly sensations upon motionK hyperemiaK and convulsionsKA00< the patient is restless and uneasyJA00E. 6he 'clectics observed *elsemium to po erfully impress the nervous system and minor increases in dosage ere noted to have significant effects9 5mall, medicinal doses rela$ the muscles, especially the levator palpebrae, and allay nervous irritation. .arger doses impart a sense of rela$ation usually e$perienced by a tendency of the "a to drop and difficulty in controlling the eyelids. 6he continued administration of *elsemium affects the spinal centers and medulla causing mar#ed feebleness of muscular movements, blurred vision, and vertigo. 4efle$ action is depressed ith the loss of muscular po er, and confusion. /uscular paralysis usually occurs prior to loss of sensation. !onsciousness may be lost, but it is usually retained even hen to$ic doses have been ta#en. When fatal, ho ever, dissolution is usually preceded by loss of consciousness. With administration the pulse slo s to 30 or <0 beats, and there is a mar#ed decrease in temperature. 4espiration is at first quic#ened, then slo ed, breathing becomes shallo , and the action upon the heart appears to depend upon the effect upon respiration. As a rule, the mental function is not directly affected by it. • %ental !onditions9 6oothache, from peridental inflammation, as treated ith *elsemium as ell toothache that occurs specifically ith pregnancy. • %ermatologic !onditions9 By blunting peripheral sensation, *elsemium as used to decrease the itching of ec(ema and locally in other forms of pruritis. • '':6 !onditions9 *elsemium as used for con"unctivitis, muscular asthenopia =eyestrain secondary to imbalance in e$trinsic ocular muscles>, iritis, and in tinnitus. • *astrointestinal !onditions9 !onditions from inflammatory states of the digestive tract, especially in the lo er bo el, indicated *elsemium. ,t as also used to relieve the tenesmus of dysentery and other spasmodic conditions of the bo els. *elsemium as particularly indicated in the presence of gastrointestinal irritation and irritative dyspepsia, ith a feeling of ra ness, heat, and pain, and a sensation of #notty contraction in the stomach. • *enitourinary !onditions9 ,nflammation of the #idneys, bladder or urethra, as commonly treated ith *elsemium as it as observed to quic#ly relieve the tenesmic pain, urinary retention, etc., of irritative catarrhal conditions of the bladder. ,n spasmodic conditions of the urinary tract ith scanty flo of urine and irritation, *elsemium as frequently indicated. *elsemium as also used to produce rela$ation during the passage of renal calculi. *elsemium as given previously to or ith an indicated diuretic, hen urinal suppression is due to renal or cystic irritation =not congestion>, unless specially contraindicated. 0ne of its early uses as for gonorrhea, for hich it as thought to be almost specific, particularly in the early inflammatory stages here it as given ith Aconite and !annabis indica for this purpose. • *ynecological !onditions9 ,n the pelvic disorders of omen it as a favorite 'clectic remedy. ,ts po erful antispasmodic action made it especially applicable to spasm of the female reproductive tract.. With the specific indications, it as used to treat ovaritis, metritis and salpingitis. 5evere dysmenorrhea ith colic#y pains and uterine colic ere reported to be promptly relieved by large doses. *elsemium as used to rela$ a rigid os uteri, ith thin, unyielding edges, and a dryness. ,n fact, it as observed to rela$ all sphincters and, by rectifying such complications, as used to facilitate labor. *elsemium, alone or combined ith 1ulsatilla, as

invaluable to overcome the mar#ed restlessness caused by some parturients, and *elsemium as applied to slo a labor that had begun before the cervi$ as ready, particularly hen the oman as e$cessively e$citable and nervous. • ,nfectious !onditions9 ,n the treatment of e$anthemata this remedy as often indicated by the great heart beat and restlessness. ,t as nearly al ays called for in cerebro&spinal meningitis. ,n the past epidemics of influen(a =la grippe> probably no one remedy as more e$tensively used by the 'clectic physicians. • ,nflammatory !onditions9 *elsemium as first employed in a variety of febrile diseases, such as bilious, remittent, typhoid and intermittent fevers. ,n these conditions, it as found to have such a mar#ed antipyretic action that it rapidly rose in favor among the earlier 'clectics. 6he 'clectic fathers regarded it as the only agent capable of subduing fever in 2 to 20 hours, ithout the least possible in"ury to the patient. ,n doing so it as observed to quiet all nervous irritability and e$citement, equali(e the circulation, promote perspiration, and rectify the secretions. 6hey also believed it adapted to any stage of inflammation, hile the later 'clectic practitioners believed it best adapted to the earlier stages of fevers. *elsemium as considered best suited to sthenic cases ith determination of blood to nerve centers and a remedy for elevation of temperature, hether from cold, pneumonia, pleurisy, or even puerperal fever. !hilly sensations upon moving the body, usually follo ed by the high temperature and the stage of e$citation called for it. ,n the fevers and inflammations of children *elsemium as applied to prevent convulsions. • /usculos#eletal !onditions9 gout and rheumatism, in the latter disease aiding some of the antirheumatic remedies. '$ternally, *elsemium ill be found of service in neuralgic and rheumatic pains. • :eurological !onditions9 6herapeutically, *elsemium as described as acting on the cerebrospinal nerve centers, diminishing the blood supply to them in inflammatory conditions of the head and spine, thereby preventing spasmodic action. ,t as considered an antispasmodic second to none. +o ever, it as never the remedy hen congestion as present. *elsemium as seen to possess control over the nervous system, removing nervous irritability more completely than an other #no n agent. 0ther nervines, such as 1assiflora, ere used to increase its effect on the nervous system. A particular pattern in the nervous patient as treated ith *elsemium9 grouchy, touchy, every impulse and feeling, hether painful or pleasant, is magnified or accelerated, and the contracted pupil is not al ays specially noticeable. *elsemium as used to treat virtually any type of neuralgia ith po erful nervous t itching, convulsions ith cramping rigidity of the muscles, tetanus, insomnia, pain ith nervous tension and hyperemia such as headache especially from eye strain as in migraine, delirium tremens, mania and vertigo. • 1ulmonary !onditions9 *elsemium has been used quite e$tensively in hooping&cough, spasmodic cough, spasm of the glottis, asthma, and the cough of hysteria. Bronchitis, laryngitis Current Medicinal Uses: *elsemium is a very strong botanical and must be used ith caution. +o ever, it is very effective for treating neuralgia, nervous e$citement and an$iety, insomnia, gastroenteritis and diarrhea. *eneral indications for its use include conditions of e$cess ith acute onset. • *astrointestinal !onditions9 1ain associated ith visceral spasm responds ell to *elsemium such as colic of the gall bladder, abdominal pain due to gastroenteritis, diarrhea, • *enitourinary !onditions9 1ain associated ith urinary tract spasm responds ell to *elsemium, hich can occur ith nephritis or cystitis. • *ynecologic !onditions9 6he antispasmodic action of *elsemium ma#es it an e$cellent remedy for dysmenorrhea. *elsemium is e$tremely useful in labor to rela$ a rigid os and to help laboring omen move through the fear and an$iety that can hamper effective contractions. ,n regard to the cervical os, difficult 1A1 procedures can be eased by drop doses of *elsemium. • ,nflammatory !onditions9 *elsemium is traditionally used as an analgesic. ,ndications include pain associated ith inflammation such as arthritis, chondritis, tendinitis and myalgia. *elsemium is most indicated in states of acute inflammation such as fever and can even be used for peridontal pain. • :eurological !onditions9 *elsemium acts as an anodyne hen the pain is associated ith nervous tension or irritability as ell as pain associated ith vascular spasm such as migraines such as a throbbing headache. *elsemium has also been used to convulsions and some cases of neuralgic pain, particularly trigeminal neuralgia =tic de la rou$> and dental pain. *iven in small drop doses, *elsemium helps to calm someone ho is fearful and an$ious. • 1ulmonary !onditions9 6he antispasmodic effect of *elsemium can also rela$ respiratory smooth muscle as in an asthmatic attac#. *elsemium has been described by some herbalists as having a tropism for the respiratory system #harmacy: ?ing noted that as soon as its physiological effects are observed, the remedy should be discontinued. A00F A9E tincture =fresh plant, F0G 't0+>9 sig 0.3WA ml 6,% or smaller doses more frequently =q 3 hr.> =Alschuler> A9A0 tincture9 start ith E gtt and titrate up to AE gtt if needed. =Alschuler> Wee#ly ma$imum doseOE ml Drug ,nteractions: /ay interact ith pain medications or depressants

Contraindications: *elsemium is contraindicated in persons ith poor circulation and ea# hearts. According to /ills and Bone, strong analgesic botanicals are not to be used ith9 concurrent prescription analgesics, in children, depression and psychosis, liver and #idney disease or a history of allergic or anaphylactic shoc#. !aution is advised in the treatment of neurologic disease. Brin#er contraindicates its use during pregnancy and in the presence of gastrointestinal irritation, the later of hich clearly does not agree ith traditional and current uses.A00H )o*icity: *reater individuality in response compared to other lo dose herbs. )or e$ample, according to ?ing, appro$imately A ml =t elve minims> of the fluid e$tract had been reported to have been fatally to$ic in a 3 year old. ;et, recoveries have ta#en place from much larger doses. =)or report of t o fatal cases, see 6aylorNs /ed. -urisp., ABC2, p. AF<.> A00B 5ign of to$icity include9 internal strabismus ith double vision and ptosis, mydriasis, muscular ea#ness, giddiness, convulsions, s eating, slo ed, initial tachypnea follo ed by shallo and labored respiration, di((iness, diminished pulse, lo ered temperature and blood pressure, dro siness but easily aroused, intense abdominal cramps, paralysis, death from respiratory and cardiac failure usually ta#es place in from A to B hours. A00C
1003 1004

Brin#er, ), The Toxicology of Botanical Medicines, 2nd ed., ACB39EF. )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1005 5cudder -, ,pecific Diagnosis: ) ,tudy of Disease, =!incinnati9 Wilstach, Bald in ] !o.>, ABH<9FA. 1006 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1007 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 220, 2HH 1008 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1009 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

9entiana lutea
Common name: *entian

9entianaceae

Ha!itat9 A0A0 ,ndigenous to the mountainous regions of central and southern 'urope, cultivated in many other regions. Botanical description:"8"" • )lo er and )ruit9 flo ers are yello , terminal, pedicled and a$illary in cyme&li#e false horls. 6he caly$ is deeply divided in 2. 6he corolla is rotate and divided almost to the base into E&F lanceolate tips. 6here are E stamens ith B mm long anthers and A superior ovary. 6he fruit is F cm long and capsule shaped. 6he numerous seeds are flat, oblong, or round, ith a membranous edge. • .eaves, 5tem, and 4oot9 !ompletely glabrous perennial plant that gro s to A<0 cm high. 6he rhi(ome has a number of heads, and the top of the rhi(ome can attain the thic#ness of an arm. 6he main root is a taproot, hich gro s up to A m long. 6he stem is round, unbranched, hollo , and grooved in the upper region to finger thic#ness. 6he leaves are elliptical, bluish&green, ith strongly curved ribs, and gro up to 30 cm long and AE cm ide. #art used: 4adi$, the root is harvested in the fall and dried slo ly $nergetics: cooling and drying.A0A2 Constituents: A0A3 • ,ridoid monoterpene glycosides =bitter principles>9 amarogentin =determines the value>, gentiopricroside, s ertiamarine, s eroside • 5ugars9 saccharose, gentianose =some hat bitter>, gentiobiose =bitter> • Panthone derivatives =colored yello >9 including gentisin, gentisein, isogentisin, A,3,H&trimetho$y$anthone • 1yridine al#aloids, 7olatile oil =traces>, )lavonoids, 1henolic acids #harmacology: • 6he sesquiterpene lactone dimer absinthin is among the most bitter substances #no n along ith the glycosides gentiopicrin and amarogentin found in *entian. 6he taste of these can be detected even hen diluted E0,000 times. Besides stimulating secretion of saliva in the mouth and hydrochloric acid in the stomach, gentiopicrin may protect the liver. A0A< • 6he theori(ed mode of action of bitters is that of a priming effect on the upper digestive system mediated by a nerve refle$ from the bitter taste buds. 6he result of bitter stimulation is an increase in vagal stimulation resulting a transient rise in gastrinK a slight increase in gall bladder motility and priming of the pancreas. *astrin, in turn, stimulates in an increase in gastric acid, pepsin and bile secretion. ,ncreased gastric and intestinal mobility, increased secretion of bile and pancreatic en(ymes results. Bitters also increase saliva release, but inhibit the release of amylase. A0AE • According to research, the benefits of bitters occur as follo s9 A0AF o Bitters increase appetite only if a cachectic, malnourished or debilitated state e$ists in the body. o 5imilarly, bitters increase digestive po er mainly hen it is belo optimum. o '$periments ith bitters should involve actual feeding, that is, the presence of food in the stomach is important for their activity. o At normal doses, the effect of bitters only can be elicited if tasted, as opposed to studies here bitters ere applied directly to the stomach in hich no effect occurred. +o ever, some in vitro studies support a direct effect ith some herbs such as *entiana. Medicinal actions: Bitter, gastric stimulant, cholagogue, sialagogue, anti&microbial, antihelminthic. )raditional Medicinal Use: • )ol# medicine9 tonic and in teas to stimulate bile secretion and alleviate loss of appetite, fullness, and flatulence. A0AH • 'clectics used *entian for gastrointestinal and inflammatory conditions. 1hysiomedicalists also applied it topically and in gynecological problems. o *astrointestinal problems9  *entian as recogni(ed an e$cellent stomachic bitter by the 'clectics and 1hysiomedicalists. *entian as observed to actively promote appetite and digestion, slo ly increase the circulation and tonify the stomach, intestines, gall and pancreatic ducts. !onditions for hich it as applied included dyspepsia, diarrhoea, :orms, chronic biliousness, constipation and other maladies incident to general feebleness of the tissue.  ?ing described *entiana as a po erful tonic that improves the appetite, strengthens digestion, gives more force to the circulation, and slightly elevates the heat of the body. +e discussed the use of *entian as valuable for relief of irritation and to increase the appetite for use after protracted fevers ith depressed vitality and here

o o o

recovery depends upon ability to assimilate food.A0AB 5cudder specifically recommended it for a sense of depression referred to epigastric region, and associated ith sense of physical and mental eariness. A0AC 5imilarly, !oo# described *entian root as one of the purest bitter tonics ith a predominate stimulating quality and distinct rela$ant properties. +e also noted that *entian is most appropriate for a lymphatic temperament. Both !oo# and ?ing noted the indication of *entiana in cases of debility and e$haustion, and in all cases here a tonic is required. *ynecologic !onditions9 !oo# described the use of *entian to give tone to the uterus for some cases of amenorrhea. ,nflammatory !onditions9 6he 1hysiomedicalists observed that *entian as of much service during the period of remission in malarial fever. ?ing also noted that *entian derivatives ere a valuable substitute for quinine, acting rapidly and efficaciously on the spleen.A020 6opical Applications9 !oo# noted its use as an e$ternal application on degenerate, scrofulous and phagadenic ulcers =an ulcer that spreads peripherally destroying tissue as it increases in si(e.>

Current Medicinal Use: • *astrointestinal !onditions9 o Using bitters are one of the best ays to treat atonic conditions of the digestive system. Bitters may have a place in the treatment of a number of diseases that have an association ith hypochlorhydria or impaired vagal stimulation such as asthma, diabetes and hypoglycemia, anemia and food allergies. o *entian is considered one of the classic bitters. *entian has its strongest bitter actions by stimulating +!l acid and bile secretion. *entian is very bitter and astringent so, in the mouth, saliva secretion is increased in an attempt to relieve the mouth dryness. 6he plant also or#s by stimulating the taste buds, hich in turn prompt an increase in production of saliva and digestive "uices. A02A, A022, A023, A02< o *entian is most indicated in conditions of poor, sluggish digestion =bloating, fullness after eating, pain>, impaired appetite, anemia =it ill increase )e absorption> and malabsorption. A02E *entian is very tonifying to the digestive tract and should be considered for all persons ho have ea# digestion. *entiana is considered to have very strong broad& spectrum antimicrobial activity that is utili(ed in the treatment of bacterial overgro th of the small intestine. A02F o *entian is a component of Angnostura bitters. A lemon edge saturated ith Angnostura bitters as found to cure hiccups in BBG of sub"ects in an open trial. A02H o Bitters may e$ert a direct effect on the stomach. When isolated stomach cells ere e$posed to *entian root, a concentration dependent rise in gastric acid production as observed. 1atients too# A20 mg of E9A dry e$tract of *entian root and achieved relief of symptoms of constipation, flatulence, abdominal pain, and nausea. A02B o *entian is also a valuable inclusion in antihelminthic formulas. /ost bitters have some antimicrobial effects via their ability to enhance +!l acid production =#ills entering pathogens> and to stimulate bile secretion =antimicrobial>. 5ome bitters, such as *entian, have additional to$ic activity directly to the pathogen. A02C o Bitter herbs are used to improve gall bladder function in cases of cholelithiasis and biliary pain. A030 • ,nflammatory !onditions9 o 6he cooling bitters, including *entiana, 6ara$acum, !ichorium and 'rythraea are beneficial for gentle but strong reduction in febrile temperature. 6hese herbs have the advantage of stimulating the other ise dormant digestive system. 6herefore, they help counter fermentation or infection arising from the gut. *entiana is beneficial in convalescence as ell. A03A #harmacy: • %osage9 o Average single dose9 A g.A032 o %aily dose9 2&< g.A033 o :ot given in high doses9 "ust enough to promote a strong taste of bitterness. A03< • ,nfusion9 o L tsp =A&2 g>3 boiling ater, steep $ E&A0 min. 5ig.9 Acup of cold or lu#e arm tea several times3day, incl. L hr ac. A03E o A&2 g3AE0 ml boiling ater, B,%&6,%, Ahr ac.A03F • %ecoction9 o Ag3Acup.A03H o U tsp3cup.A03B o L tsp shredded root3cup, boil E min. 5ig. %rin# arm AE&30 min ac or hen acute stomach pains result from a feeling of fullness.A03C o A&2 g3AE0 ml cold ater $ B&A0 hrs, then boil.A0<0 • 6incture9 o Unspecified strength9 A&< ml 6,%,A0<A 20&<0 gtts3A32 glass ater ac.A0<2

•

•

o A9E <EG alcohol, sig. A&3 ml in A32 cup ater acK ma$. ee#ly dose9<0 ml. A0<3 .iquid e$tract9 o 2&< g.A0<< o A9< dry liquid e$tract9 A&30 gtts in little ater 2%&2,% ac. A0<E o A9A fluid e$tract9 A&2 ml, B,%&6,%, Ahr ac.A0<F 5tandardi(ed e$tract9 o 0.E&2 g 3day in form of pills. A0<H o :ative dry e$tract 3.E&<.E9A = 3 >9 0.2&0.< g B,%&6,%, A hr ac. A0<B

Drug.@utrient ,nteractions: Contraindications: • %uodenal ulceration."8:5 • I!old&dryJ conditions =e.g., shivering ith dry cough, some #idney d(@s>. "8%8 • *astric and duodenal peptic ulcers.A0EA )o*icity.4ide $ffects9 • ?ing noted that hen ta#en in large doses *entian ill oppress the stomach, irritate the bo els, produce nausea and vomiting, increase fullness of pulse and cause headache.A0E2 • 0ver e$citation of the stomach and a feeling of oppression occur ith increased force of circulation and bo el irritation. A0E3 • .arge doses for long periods of time can harm digestion and induce frontal headaches. A0E<

1010 1011

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p. B3H ,bid, pp. B3F&H 1012 5harol 6ilgner, Herbal Medicine rom the Heart of the Earth, Wise Acres 1ress, ,nc., !res ell, 04, ACCC, p. FE. 1013 PDR, p. B3H 1014 .ininger et al, Healthnotes9 2linical Essentials, Herb Monographs, 1rima 1ublishing, 4oc#lin, !A, 200A. 1015 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy: Modern Herbal Medicine, !hurchill .ivingstone, 'dinburgh, 2000, p. 3C 1016 4eference not located 1017 PDR, p. B3H. 1018 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3. 1019 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed, 'clectic /edical 1ublications, 5andy, 04, AC03. 1020 )elter 1021 /ar# Blumenthal, The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines, American Botanical !ouncil, ACCB. 1022 /ills, p. 3C 1023 PDR1 1024 .ininger . 1025 /ills, p. A3B, 1026 -oseph '. 1i((orno -r., /ichael 6. /urray =eds.>, Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, 'dinburgh, ACCC, p. A00 1027 /ills, p. 3C 1028 ,bid, pp. 3C&<0 1029 4eference not located. 1030 /ills, p. A3B, 1031 ,bid 1032 PDR, p. B3H. 1033 ,bid. 1034 /ills, p. AH3 1035 PDR, p. B3H. 1036 /ar# Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs, ,ntegrative /edicine !ommunications, :e ton, /A, 2000, p.AEA. 1037 PDR, p. B3H. 1038 6ilgner, p. FE. 1039 %avid +offman, The ;e: Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesbury, %orset, ACC0, p.202. 1040 Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs , p.AEA. 1041 PDR, p. B3H. 1042 4udolf )rit( Weiss, +eiss/s Herbal Medicine, classic ed., 6hieme, 5tuttgart, 200A, p. <2. 1043 %r. Alshuler

1044 1045

PDR, p. B3H. 6ilgner,, p. FE. 1046 Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs , p.AEA. 1047 Weiss, p. <2. 1048 Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs , p.AEA. 1049 /ills, p. AH3 1050 ,bid. 1051 Blumenthal et al =eds>, p.AE0. 1052 )elter. 1053 W/., +., !oo#, Physiomedical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy , 'clectic /edical 1ublications, 1ortland, ACBE, p. <<2 1054 6ilgner, p. FE.

9ermanium maculata
Common name: American cranesbill Ha!itat9 United 5tates preferring rich, moist soils in the oods.

9eraniaceae

Botanical description9 5ingular and leafless. 6he flo ers, hich bloom from -uly to 0ctober, are greenish&bro n in color on a long spi#e. 6he root is 3&E cm long, 0.E&A cm thic#, dull bro n, hard, #notty ith small rootlets. #arts used9 4oot, herba Constituents9 6annins =up to 30G> inc. gallic acidK 4esinous compounds #harmacology: 6he actions of *eranium relate to its tannins. 6annins are poorly absorbed, therefore the action of *eranium is primarily on the tissue ith hich it comes into contact. 6hus the direct effects of ingested tannins are locali(ed to the gastrointestinal tract. 6annins precipitate proteins, including e$posed proteins on cell surfaces. 6his results in a protective coating over the cell membrane as ell as mechanical shrin#age of the cell reducing passive diffusion out of the cell. ,ts ability to pull tissues together lend it secretolytic activity and antiinflammatory actions. Medicinal actions9 5typtic, astringent, vulnerary, tonic Medicinal uses9 *eranium is a supreme astringent. 6he specific indications for *eranium are9 M4ela$ed mucous tissues ith profuse debilitating dischargesK chronic mucous diarrheasK chronic dysenteryK diarrhea ith constant desire to defecateK passive hemorrhagesK gastric ulcerM. Q)elterR 0verall, *eranium is most indicated in passive hemorrhage or chronic or sub&acute states of inflammation ith flaccid tissues. • *astrointestinal !onditions9 *eranium is also hemostatic. 6herefore in cases of intestinal bleeding, even more so if concurrent ith diarrhea, *eranium is an e$cellent therapy. +emorrhoids, especially friable hemorrhoids respond ell to *eranium, either ta#en orally or as a suppository. • 6opical Applications9 ,f it is applied topically, *eranium ill help to allay bleeding from ulcers and lacerations hile shortening the healing time. *eranium can be gargled for mouth ulcers and other inflammatory pharyngitis. • *ynecologic !onditions9 *eranium is also useful in a douche for vaginitis in order to reduce e$udate and bleeding if present. *eranium combines ell ith 6rillium and Achillea for hemorrhage and e$cessive menstrual bleeding. )ccording to Mills and Bone:%-## • *astrointestinal !onditions9 ,ndications for tannins include inflammation of the upper digestive tract and diarreha follo ing gastrointestinal inflammation. 6annin containing herbs ill gently control diarrhea ithout ris# of aggravating infection by reducing intestinal motility. 6hey also reduce mocosal damage. 5trongly astringent herbs such as *eranium ill aggravate a gastric ulcer but may be suitable for duodenal ulcer treatment. • 6opical Applications9 6annins are also indicated for open, discharging lesions, ounds, hemorrhoids and third degree burns )ccording to the Textboo3 of ;atural Medicine:%-#$ • *ynecologic !onditions9 *eranium is among a group of botanicals used as hemostatics in the treatment of menorrhagia. 6he use of these botanicals should be reserved for intractable cases, cases here immediate cessation of blood flo is required and3or as a short&term ad"unct to other therapies. #harmacy9 6annins should be ta#en after food in most cases. )or some lesions of the upper digestive tract, short&term use bet een meals or before food is "ustifiable. .ong&term therapy ith high doses of tannins is not advisable. A0EH ,nfusion9 ,t may be employed in infusion ith good results, especially hen a topical action on the stomach and bo els is anted, or in chronic cases hen e desire the action of *allic Acid. =5cudder> %ecoction9 A&2 tsp.3cupK simmer A0&AE min.K sig A cup 6,% =Alschuler> 6incture9 A9E 2EG 't0+ 2&< ml 6,%K ee#ly ma$imum is F0 ml =Alschuler> 4obertNs formula QAlthea9 *eranium9 +ydrastis9 'chinacea9 1hytolacca9 Ulmus9 Baptisia9 !abbage po derR is used successfully for ulcerative colitis flare&ups and other forms of inflammatory bo el disease. %r. Bastyr used a modified version of this formula that also includes 5ymphytum, pancreatin, niacinamide and duodenal substance9 A0EB B parts each9 Althea, 'chinacea, *eranium, +ydrastis, 1hytolacca, Ulmus, cabbage po der < parts9 Baptisia tinctoria 2 parts each9 pancreatin, duodenal substance A part9 niacinamide

Contraindications: 6he use of tannins is contraindicated or inappropriate in cases of constipation, iron deficiency and malnutrition. A0EC Adapted from Brin#er9 A0F0 When e$tracted in hot ater, tannins can precipitate al#aloids from plants, al#aloidal drugs, proteins, salicylates, iodine and iodides and metals thereby slo ing, reducing or bloc#ing their absorption. 6he drug&tannin reaction can interfere ith dosing if sources of the t o compounds are combined in solution prior to administration. %rug&tannin precipitates are maintained in an al#aline p+ and dissovle in an acid environmnet such as the stomach. Unless the solution is sha#en ell, precipitates ill settle in the bottom leading to lo or no amounts in intial doses and high or toi$c amounts hen the last doses from the bottle are ta#en. 6he precipitates are generally soluble in mi$tures containing over AE&<0G alcohol. 6annins ill not precipitate lo concentrations of al#aloidal salts in the presence of many of the gums. )o*icity9 5afe herb, ho ever use ith caution in people ith spastic, dry constipation or people ta#ing anicholinergic medication as it ill potentiate smooth muscle irritability.
1055 1056

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AH0&A, AHF /urray /, 1i((orno -. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p.A3CC 1057 /ills and Bone p. AHA 1058 /urray and 1i((orno, p. A3<E 1059 /ills and Bone, p AH0 1060 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AEH&B

9ingko !ilo!a
Common name: /aidenhair tree Ha!itat: Botanical description: #art used: leaf Historical use: $nergetics:

9ingkoaceae

Constituents: A0FA, A0F2 6he medical benefits of 5in3go biloba e$tract are attributed primarily to t o groups of active components9 the *in#go flavone glycosides and the terpene lactones. *B' =*in#go biloba e$tract> refers to the standardi(ed e$tract. • *in#go flavone glycosides typically ma#e up 2<G of the standardi(ed e$tract here as the ra herb is comprised of 0.E&AG flavone glycosides. 6he glycosides include quercetin, #aempferol, isorhamnetin =including coumaric acid esters of flavonoids>. 6hese components are primarily responsible for *B'@s antio$idant activity and may mildly inhibit platelet aggregation. • 6erpene lactones9 *in#golides and bilobalide A, B, !, -, typically ma#e up FG of the standardi(ed e$tract. 6hey are associated ith increased circulation to the brain and other parts of the body, and they e$ert a protective action on nerve cells. *B' regulates the tone and elasticity of blood vessels, ma#ing circulation more efficient. • )lavonoids9 including monosides, biosides and triosides of quercetin ° Bioflavonoids9 for e$ample amentoflavone, bilobetin, E&metho$ybilobetin, gin#getin, isogin#getin ° 1roanthocyanidins, gin#olic acidsK sterols, procyanidinsK polysaccharides • 6rilactonic diterpenes9 *in#golide A, B, ! • 6rilactonic sesquiterpene9 bilabolide #harmacology: *B' has antio$idant actions in the brain, retina of the eye, and the cardiovascular system. A0F3 *in#go has a number of pharmacological effects including9 inhibition of cerebral edema and acceleration of its regressionK memory enhancement, reduction of retinal edema and of cellular lesions in the retinaK inhibition in age&related reduction of neurotransmitters as ell as stimulation of choline upta#e in the hippocampus. A0F<, A0FE ,n animal e$periments, improvement of hypo$ic tolerance, improved glucose utili(ation, membrane stabili(ation, and a reduction of blood viscosity have been noted. A0FF 6issue 'ffects9 *in#golides demonstrate prevention of membrane damage caused by free radicals as in cerebral ischemia. 0ther effects of *B' include membrane antio$idant, increases 02 and glucose utili(ation, increases membrane polari(ation, increases blood flo , tissue o$ygenation and tissue nutrition. White blood cell and 1latelet 'ffects9 *ing#o decreases adhesion3degranulation of mast cells, increases 1* , 2 and inhibition of platelet activating factor. 6his effect has been observed in the use of *in#golides to prevent antigen&induced bronchoconstriction and induction of air ay hyperreactivity by 1A). A thrombolytic effect on 1A)&induced thrombus has also been demonstrated as ell as reduction in the infarct si(e in e$perimental myocardial occlusion. *in#golides inhibit the effect of 1A) on eosinophils. *ing#o has improved pea# flo rates in asthmatic children and caused significant clinical improvements in adults. :erve !ells9 decreased emboli(ation in hippcampus and striatum, increased transmission rate, improves synthesis3turnover of neurotransmitters, normali(es A!h receptors in hippocampus , enhances memory and cognitive function, especially in the elderlyK reduced cerebral edema, normali(ed brain glucose and A61 follo ing ischemia 7ascular 'ffects9 increased perfusion rate to many areas, increased release of endothelium derived rela$ing factor leading to vasodilation =through the :0 path ay> and increased venous tone. Arrhythmia has been sho n to be prevented by administration of *in#golides. ,7 administration of *ing#o e$tract as more effective than 2B conventional medications in improving cerebral blood flo in stro#e victims. 0ther 'ffects9 • inhibited rate of /A0 activity • inhibited 1neumocytstis carinii in vitro and reduced the number of organisms in the rat • rela$es male human and rabbit copus cavernosal tissue • reduced disturbances of lipid metabolism and the severity of plaque formation in rabbits fed a high fat diet compared to placebo and rutin. *ing#o can affect metabolic processes in the liver and may modify lipid deposition in ma"or arteries.

,ntragastric administration ith 8ingiber officinalis demonstrated an$iolytic effects comparable to dia(epam. 1romoted hair regro th in shaved mice. ,nhibited the development of stress&induced polydipsia in rat9 *ing#o inhibited corticosterone hypersecretion and !4+ secretion. • *in#go has demonstrated anti&inflammatory activity comparable to indomethacin ith topical application 1harmaco#inetics9 )lavonoid glycosides and aglycones appear to be cleared by 2< hours of ingestion hereas flavonoid metabolites ta#e longer to be cleared. *in#golides are highly bioavailable Medical actions: anti&1A), antio$idant, tissue perfusion enhancer, circulatory stimulant, nootropic, anti&inflammatory, anti&platelet aggregation, anti&thrombotic )raditional Medicinal Uses: :o information is available in !oo#@s or ?ing@s dispensatory. *ing#o has been used as a botanical in Ayurvedic medicine. !hinese medicine incorporates *in#go nuts hich have signficantly different properites from the leaves. Current Medical Uses: • Behavioral and 1sychological !onditions9 *in#go biloba is supportive in the alleviation of depression elderly people not responding to antidepressant drugs. A0FH, A0FB, A0FC • !ardiovascular !onditions9 ° ,ntermittent claudication9 '$tensive studies have been done ith *in#go e$tracts =*B'> for treatment of intermittent claudication. 6 o double blind, placebo&controlled studies that included a total of A3C people ith intermittent claudication found that A20 mg of *B' per day increased pain&free and total al#ing distance. A0H0, A0HA ° Atherosclerosis =e$trapolation>9 *in#go may reduce the ris# of atherosclerosis by interfering ith platelet activating factor =1A)>. *in#go also increases blood circulation to the brain, e$tremities. A0H2 ° 5e$ual dysfunction =vascular etiology>9 *in#go, by increasing arterial blood flo , may help some impotent men. A small, open study on 30 men has sho n that *in#go can reduce se$ual problems caused by antidepressants li#e fluo$etine, bupropion, venlafa$ine, and nefa(odone in men and omen. A0H3 Appro$imately 200 mg per day of *in#go had a positive effect on se$ual function in HFG of the men. • :eurological !onditions9 ° Age&related cognitive decline =A4!%>9 *in#go has also been sho n effective for healthy aging people ith A4!%. ,n one study, 320 mg or F00 mg of standardi(ed *in#go biloba e$tract =containing 2<G flavonoid glycosides and FG terpenes> as ta#en once, one hour before cognitive testing. At both levels of supplementation, *in#go significantly improved the speed of information processing. ,n another study, 3A elderly people ith mild to moderate memory impairment ere given <0 mg of a similar standardi(ed *in#go biloba e$tract 6,%. 5ignificant improvements in cognitive function ere observed after A2 and 2< ee#s of supplementation. A0H< An e$tract made from the leaves of the *in#go biloba tree is a leading treatment for early&stage Al(heimer@s disease in 'urope. *in#go biloba e$tract =*B'> may improve memory and quality of life and slo progression in the early stages of the disease. ,n addition, four double&blind studies have sho n that *B' is helpful for people in early stages of Al(heimer@s disease, as ell as another form of dementia #no n as multi&infarct dementia. 1atients ith other types of dementia, including problems due to poor blood flo to the brain, also respond to *B'. 4esearch studies have used A20 to 2<0 mg of *B', standardi(ed to contain FG terpene lactones and 2<G flavone glycosides per day, generally divided into t o or three portions. *B' may need to be ta#en for si$ to eight ee#s before desired actions are noticed. A0HE, A0HF, A0HH ° 6innitis9 6 o studies have found an e$tract of *in#go standardi(ed to contain 2<G flavone glycosides and FG terpene lactones in the amount of A20 mg per day useful for tinnitus sufferers, although other studies have failed to find *in#go beneficial. A0HB, A0HC • 0phthalmological !onditions9 *in#go may help treat early&stage macular degeneration, according to double&blind research. %oses commonly used are A20W2<0 mg of standardi(ed e$tract =2<G *in#go flavone glycosides and FG terpene lactones> per day. A0B0, A0BA • 1ulmonary !onditions9 *in#go bloc#s the action of platelet&activating factor =1A)>, a compound that in part causes asthma symptoms. A controlled study used a highly concentrated tincture of *in#go leaf and found this helped decrease asthma symptoms. )or asthma, A20W2<0 mg of standardi(ed e$tract or 3W< ml of regular tincture 6,% can be used. A0B2, A0B3 #harmacy: E09A standardi(ed e$tract, A20 mg =equivalent to 2H&30 mg *ing#o flavone glycosides and A0 mg terpenoids per day or <&B g leaf3day depending on quality>. *enerally <0 mg tablets and <0 mg3ml liquids are available. 5ome studies have used t ice this dose. /ost studies have used a standardi(ed e$tract containing 2<G flavone glycosides and FG terpenoids hich eliminates many of the #no n constituents including bioflavonoids, gin#olic acids and sterols. *ing#o should be given to patients for at least F ee#s before being reassessed. !ombination products include9 6ana#an, 4#an, *in#gobil, ?averi, 6ebonin. A9E 6incture 6ea =very bitter> <&B g O A20 mg of the standardi(ed e$tract

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Drug ,nteractions: *in#go has also been combined ith standard antidepressant medications. Contraindications: !aution hen using *in#go ith patients on anticoagulant or antiplatelet medication such as arfarin and aspirin. 6hree case reports of spontaneous bleeding ith *in#go use have been reported =both standardi(ed and non&standardi(ed preparations>. !ases of e$cessive bleeding may also be contraindicated. *in#go may be contraindicated in anovulatory amenorrhea. 0ther drug interactions include possible potentiation of /A0 inhibitors and potentiation of papaverine. A0B< )o*icity: *ing#o standardi(ed e$tract use has very lo ris#. Use of the ra herb, ho ever, can cause complaints. 6he seeds, stems and leaves contain <@&0&methylpyro$idine hich can cause vitamin B F deficiency symptoms including convulsions. 6he stems have been measured to contain <2 µg per gram fresh eight. 6he oral to$ic dose in guinea pigs as AA mg3#g. Bilobalide appears to decrease the to$ic affect. 5ide effects from the consumption of the leaf are very fe 9 *, discomfort, HA, di((inessK from the fruit3nut9 erythema, edema, vesicles, severe *, irritation.
1061 1062

/ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p <0E .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1063 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <0E 1064 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <0<&<0H. 1065 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1066 ,bid 1067 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <0<. 1068 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1069 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HEB 1070 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1071 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000. p. <0< 1072 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <0< 1073 !ohen A-, Bartli# B. 5in3go biloba for antidepressant&induced se$ual dysfunction. 7 ,ex Marital Therapy ACCBK2<9A3CW<E. 1074 ,bid 1075 ,bid 1076 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <0<. 1077 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HEE. 1078 Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000, p. <0<. 1079 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HEF. 1080 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HEF 1081 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <0<. 1082 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 1083 Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000 1084 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. HH&B

9lycyrrhi;a gla!ra

1eguminosae (#ea =amily Common name: .icorice, 5 eet 4oot, ;ahsi /adhu or honey&stic# =5ands#rit>, *an cao =!hinese>. Q0ther species 3in this genera9 *. uralensis ] *. inflateK hich differ from *. glabra in the amounts of phenols each contain.RA0BE Ha!itat: ,ndividual varieties are found in different regions. *. glanulifera is found in 5' 'urope ] W Asia. *. pallida ] *. violocea are found in ,raq. *. tyica is indigenous to 5 'urope ] 5W Asia. Botanical description: .icorice is an herbaceous perennial that stands A to 2 m high on a long sturdy primary taproot. 6he taproot is AE cm long ] subdivides into 3&E secondary rootlets, A.2E m in lengthK ] several hori(ontal oody stolons, hich may reach B m. in length. 5turdy ne stems are produced every yearK hich are erect ] branched either from the base or from further up, ] are generally rough at the top. .eaves are alternate, pinnate ] A0 to 20 cm long. 6he leaflets are in pairs of 3&B. 6he stipules are very small ] drooping. #art used: 4oot. $nergetics: 5 eet, Bitter. !ooling. =&>7ata ] 1itta. =X> ?apha 3 long term use. Wor#s on all tissues, 3 a particular affinity for the *,, respiratory, !:5, reproductive, ] e$cretory systems. A0BF Constituents: A0BH • 6riterpene saponins =3&AEG>9 including the s eet tasting *lycyrrhi(in =*.>, hich brea#s do n into an aglycone called AB&beta&glycyrrhetic acid =*A>. *lycyrrhi(in is present in the form of potassium ] calcium salts. • )lavonoids =A&A.EG>9 give a yello color to the root, include9 liquiritin, chalcones ] isoflavonoids. • ,soflavonoids9 =aglycones> formononetin, glabrene, glabridin, glabrol, 3&hydro$yglabrol, glycyrrhisoflavone. • !umestan derivatives9 glycyrol, isoglycyrol, liqcoumarin. • +ydro$ycoumarins9 including herniarin, umbelliferone, glycycoumarin, licopyranocumarin. • 5terols9 including, beta&sitosterol, stigmasterol. • 7olatile oil =0.0EG>9 anethole, estragole, eugenol, he$anoic acid. Q0ther species 3in this genera9 *. uralensis ] *. inflateK hich differ from *. glabra in the amounts of phenols each contain.RA0BB #harmacology: *lycyrrhi(in has an intense s eet taste, hich is b3 E0&AH0$ s eeter than sugar. *lycyrrhi(inic acid lac#s this s eet taste.A0BC 6he t o most important constituents of licorice are glycyrrhi(in =*.> ] the flavonoids. W3 oral ingestion, *. is bro#en do n to glycyrrhetinic acid =*A>. *lycyrrhi(in is anti&inflammatory ] inhibits the brea#do n of cortisol through inhibition of E&β&reductase ] AA&β&hydro$ysteroid dehydrogenase.A0C0 )lavonoids in licorice help enterocytes to heal, as ell as acting as potent antio$idants hich or# to protect hepatocytes. ,n test tubes, the flavonoids have been sho n to #ill Helicobacter pylori, hence its use in treatment of stomach ulcers ] stomach inflammation. A0CA .icorice also has antiviral properties. *lycyrrhetic acid =*A> inhibits viral gro th ] can inactivate viral particles in some cases. *A is considered esp. effective against9 herpes simple$ virus, varicella&(oster virus, human herpes virus, and +,7. *lycyrrhi(in =*.> has not been proven as an effective antiviral, since oral doses of *. are converted into *A 3in the gut ] hence *. can not have systemic effects. +o ever, both *A ] *. are effective topical antivirals, esp. for herpes ] shingles.A0C2 Medicinal actions: Anti&inflammatory, /ucoprotective, an Adrenal 6onic, '$pectorant, %emulcent, mild .a$ative, Anti&carcinogenic. Current > )raditional Medicinal Uses: .icorice root as observed to be emollient, demulcent, ] nutritiveK acting upon mucous membranes to decrease irritation. ,t as considered useful in coughs, catarrhs, irritation of the urinary organs ] pain of the intestines d3t diarrhea. 5pecifically, it can be used for gastritis, gastric ulcers, ulcer prophyla$is and some types of viral liver inflammation. A0C3

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Historical use: .icorice '$tract has been used throughout the ages by many cultures. ,t as #no n in the times of %ioscorides ] appears to have been in common use in *ermany during the /iddle Ages. A common r$ for bad colds as to ma#e a strongly flavored beer 3 elecampane, .icorice, aniseed, sassafras ] fennel.A0C< A riter in the first half of the si$teenth century notes that .icorice is abundant in many parts of ,taly ] describes preparation by ma#ing a succus or e$tract by crushing ] boiling the fresh root. Ayurvedic Medicine9 Used for treating9 coughs, colds, bronchitis, sore throat, laryngitist, ulcers, hyperacidity, painful urination, abdominal pain, general debility. .icorice is an effective e$pectorant, as it helps to liquefy mucus. ,n large doses, it is a good emetic to cleans the lungs and stomach in persons of constitutional ?apha. .icorice acts as a mild la$ative, to soothe ] tone mucus membranes, relieve muscle spasms ] decrease inflammation. ,t is often added to formulas to mas# the flavor of more distasteful herbs, helping to harmoni(e their qualities, countering heat ] dryness ] reducing to$icity. )or colds ] ailments of the respiratory tract, it combines ell ith fresh ginger. As a tonic for the teeth, it is added 3 ginger ] cardamom. As a food, .icorice is tonic ] re"uvenating. ,t tends to be sattvic in quality, calming the mind ] nurturing to the spirit. .icorice nourishes the brain ] increases cranial ] cerebrospinal fluid, promoting contentment ] harmony throughout the body. ,n general, it improves9 the voice, vision, hair, comple$ion ] instills overall strength to the body.A0CE #ulmonary Conditions: ,t is employed principally for irritation of the respiratory mucosa ] as a supportive herb in e$pectorating formulas. $ndocrine Conditions: *lycyrrhi(a is commonly used in naturopathic medicine to treat Iadrenal fatigue.J +o ever, this is a term encompassing a nebulous variety of symptom presentations that may or may not be due to adrenal hypofunction =/aladaptive 5tress 5yndrome 5tage 3>. ,n fact, adrenal fatigue may present ith adrenal corte$ hyperfunction =/55 5tage A or 2>. 6herefore, appropriate assessment of adrenal corte$ function should be done prior to administration of *lycyrrhi(a for Iadrenal fatigue.J 9enitourinary Conditions9 *lycyrrhi(a prevents bacterial adherence to the bladder all. 9ynecologic Conditions9 /ills ] Bone include *lycyrrhi(a in the treatment of polycystic ovarian syndromeA0CF ,nflammatory Conditions: *lycyrrhi(a has be found to e$tend the effects of corticosteroids. ,t has been utili(ed in the treatment of rheumatoid arthritis. Meta!olic Conditions9 *lycyrrhi(a may be used to treat hyper#alemia, due to the aldosterone&li#e effect of glycyrrhi(in. 9astrointestinal Conditions9 Anti&ulcer activityA0CH #sychological.Behavioral Conditions: /ills ] Bone include *lycyrrhi(a in the treatment of depression. +o ever, it is important to note that patients ith chronic depression often have elevated cortisol levels. )opical Applications: 6opically as an anti&viral ] anti&inflammatory agent

Current +esearch +eview • Cardiology: o Hypercholesterolemia:A0CB  %esign9 1lacebo&controlled clinical trial  1atients9 /oderately hypercholesterolemic patients  6herapy9 .icorice root e$tract in the dose of 0.A g qd $ A month  4esults9 as found to decrease patients@ plasma susceptibility to o$idation, increase resistance of plasma .%. against three ma"or atherogenic modifications =o$idation, aggregation, and retention>, reduce plasma cholesterol levels, and reduce plasma triglyceride levels. 5ystolic blood pressure as also reduced by A0G. 1atients then received placebo $ Amo, after hich all the parameters returned to the baseline, e$cept the blood pressure • ,nfectious diseases: o Hepatitis C:  5tudy A9A0CC  %esign9 1lacebo&controlled clinical trial  1atients9 'uropean patients ith chronic hepatitis ! =non&responders to interferon therapy or genotype ,3cirrhosis>  6herapy9 ,7 glycyrrhi(in 3&F times3 ee# $ < ee#s.

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4esults9 6hese patients had a significant drop in A.6, compared to the placebo group, ith F$3 ee# treatments being more effective than 3$3 # treatments. 6he A.6 lo ering effect disappeared after cessation of treatment. :o ma"or side effects ere noticed  5tudy 29 AA00  %esign9 1lacebo&controlled clinical trial.  1atients9 )ifty&seven patients ith chronic hepatitis ! =non&responders to interferon therapy or genotype ,3cirrhosis>  6herapy9 *lycyrrhi(in 2<0, AF0 or B0 mg or placebo =0 mg glycyrrhi(in> ,7 3$3 ee# $ < ee#s.  4esults9 *lycyrrhi(in lo ered serum A.6 during treatment, but had no effect on +!7&4:A levels. 6he effect on A.6 disappeared after cessation of therapy. o H,-.A,D4: AA0A  %esign9 Uncontrolled clinical trial  1atients9 0ne hundred and t elve +,7 patients =H2 ith A,%5>  6herapy9 oral doses of A20 mg of *ly#e for 3&F month  4esults9 6hirty percent of patients improved immunologically as measured by 6<96B ratio and 6< counts. 6hree patients sho ed seronegative conversion after treatment but tests confirmed the virus as still present Dentistry: o Dental #la?ue: AA02  %esign9 !linical trial  1atients9 6 enty one sub"ects  6herapy9 /outh rinse ith glycyrrhi(in  4esults9 .ess dental plaque after 3 days. o Aphthous ulcers: AA03  %esign9 !linical trial  1atients9 6 enty patients ith aphthous ulcers  6herapy9 %eglycyrrhi(inated licorice =%*.> mouth ash  4esults9 )ifteen patients e$perienced E0&HEG improvement ithin one day follo ed by complete healing of the ulcers by third day. Dermatology: o $c;ema: AA0<  %esign9 !ontrolled clinical trial  1atients9 1atients ith ec(ema  6herapy9 0intment ith pure glycyrrhetinic acid topically  4esults9 ,mprovement as as effective as ith hydrocordisone. 

#harmacy: • .icorice is commonly administered in decoction, sometimes alone or ith the addition of other agents. ,t is preferred hen used in combination.AA0E • 6he average daily dose is E to AE gm of the root, equivalent to 200 to F00 mg of glycyrrhi(in, A teaspoonful O 3 gm herb AA0F • .iquid e$tract =A9A> 2&F ml 2% • %eglycyrrhi(in(ed licorice e$tract B19 A.2&<.F g 2% Drug ,nteractions:1107 %ue to the effect on :aX3?X balance9 • cardiac glycoside poteniation • stimulant la$atives ] thia(ide diuretics, spironolactone =contraindicated>, amiloride=contraindicated> • insulin therapy %ue to the inhibition of cortisol catabolism9 • hydrocortisone therapy poteniation Contraindications.)o*icity.4ide $ffects:

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!3,9 chronic hepatitis, cholestatic diseases of the liver, cirrhosis of the liver, severe renal insufficiency, hypertonia, hypo#alemia, and 1*.AA0B Also !3, in9AA0C o 5evere renal insufficiency or +6: as overuse may increase blood pressure through sodium ], subsequently, fluid retention through that action of glycyrrhi(in. o .o serum potassium or cardiac disease as overuse can decrease serum potassium as ell as induction of mineral corticoid effect through the prevention of hydrocortisone brea#do n =in vitro>. o 1regnancy due to the emmenagogue effect =empirical>, interference ith steroid metabolism ] phytoestrogen components. o .iver cirrhosis or bile stasis disorders due to its choleretic effect ] chronic hepatitis although it has been used to treat chronic infective hepatitis. o 4ecovering alcoholics due to seemingly greater sensitivity to the adverse effects, particularly myopathy secondary to potassium loss. o 6ype A diabetics since they appear to be predisposed to hypo#alemia ] sodium retention. o 6he same argument can be used for over eight individuals due to the increased ris# for +6:, diabetes ] cardiovascular problems. :o health ha(ards or side effects are #no n in con"unction ith the proper administration of designated therapeutic dosages. 1otassium loss occurs due to other drugs, e.g., thia(ide diureticsK ith potassium loss, sensitivity to digitalis glycosides increases. 6he inta#e of higher dosages =above E0 gm per day> over an e$tended period of time ill lead to hypernatremia, edema, hypertension ] cardiac complaints. ,n rare cases, myoglobinemia, due to the aldosterone&li#e effect of the saponins has been seen. 1reparations from the drug should for that reason not be administered for longer than F ee#s. 6he complaints disappear after discontinuing the drug.AAA0 5ystolic blood pressure increased by 3.A&A<.< mm +g in healthy !aucasian volunteers, ho too# licorice in the doses of E0&200g3day $ 2&< ee#s, corresponding to the daily inta#e of HE&E<0 mg glycyrrhetinic acid. 6his study demonstrated linear dose&response, but not time&response relationship. AAAA +eavy glycyrrhi(in e$posure =greater or equal to E00 mg3 ee#> by AA0 pregnant omen, did not significantly affect birth eight or maternal blood pressure, but it as significantly associated ith lo er gestational age.AAA2

9rindelia caporum. 92 ro!usta

Compositae . Asteraceae (4unflower . Aster =amily

Common name: *um eed. Q:ote9 *. squarrosa is a similar herb 3 the same constituents, but is thought to have different medicinal actions. Be sure to chec# spp. before use.R Ha!itat: :ative to Unites 5tates ] to 5. America. Botanical description9 'arly gro th is covered ith a glutinous varnish. 6his is a perennial or biennial small shrub ith stems up to A.E feet long, round, yello , ] smooth. .eaves are alternate, light&green, coarsely&toothed. 5olitary terminal flo er&heads are large ] yello . #arts used9 +erba $nergetics: 1ungent. +eating. =&> ?apha ] 7atta. =X> 1itta. Constituents • %iterpene Al#aloids9 *rindeline • )lavonoids9 Acacetin, ?umata#enin, 2uercetin • 4esin =20G> • 7olatile oil =0.2G> • 5aponins9 *rindelin • 5elenium. • 6annins. #harmacology: :o information is currently available from the selected resources. Medicinal actions: Anti&spasmodic. '$pectorant. Anti&asthmatic. %iaphoretic. Current > )raditional Medicinal Uses: *rindelia is ,ndicated in cases of9 asthmatic breathing, 3 soreness ] a ra feeling in the chestK a dry, harsh coughK labored breathing, 3 a dus#y coloration of the face, as in plethoric individuals. Also, gum eed can be used locally in the treatment of old atonic ulcers, as ell as in cases of 4hus to$ poisoning.AAA3 • 9enitourinary Conditions: 0n account of the irritant effects upon the #idneys, *rindelia acts as a diuretic, ] can be useful in cases of renal insufficiency.^ • #ulmonary Conditions: *. robusta as used traditionally in the treatment of9 asthma, bronchial affections, ] pertussis.AAA< *rindelia is a rela$ing e$pectorant, ]t is most useful in spasmodic coughs characteri(ed by production of thic# sputum, or in dry, irritated, non&productive coughs. *rindelia rela$es smooth muscles of the bronchi ] rela$es heart muscles. 6hus, if bronchial ] asthmatic conditions are associated ith palpitations ] nervousness, *rindelia is an e$cellent remedy. *rindelia may be used chronically or acutely, although it is better suited for short&term use. *rindelia combines ell 3 .obelia in the treatment of asthma. • )opical Applications: *rindelia is used e$ternally for contact dermatitis, chronic ulcers, or any chronic s#in condition characteri(ed by a deficiency of circulation. 6opical application causes drying, relieves inflammation, ] stimulates circulation to the area. A lotion or fluid e$tract of *rindelia is a soothing, healing application to poison oa# ] poison ivy. ,t has been traditionally useful in the treatment of old, chronic, indolent ulcers .AAAE Current +esearch +eview: • 5earch of /edline yielded no human studies as of 5eptember 2002. #harmacy9AAAF • <&F g herb qd • 3&F g liquid e$tract qd • 6incture9 A.E&3 ml qd Contraindications.)o*icity.4ide effects: 5ide effects include gastric irritation and diarrhea. .arge doses are said to have poisonous effect.AAAH
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)elter +W, .oyd -U. .ings )merican Dispensatory, ABth ed. 'clectic /ecial 1ublications, 5andy, 04, ACB3. )elter.

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5cudder -. ,pecific Medication J ,pecific Medicines. PDR for Herbal Medicines1 /edical 'conomics !ompany, /ontvale, :e -ersey, ACCB9BB3 1117 PDR for Herbal Medicine, BB3

9ymnema sylvestre

Asclepiadaceae Q6his monograph is adapted from9 Bone ? 2linical )pplications of )yur!edic and 2hinese Herbs =War ic#, Australia9 1hytotherapy 1ress> ACCF9AAE&AH.R Common names: 5mall ,ndian ,pecac, *urmar in +indi Isugar destroyerJ Ha!itat: !entral and 5outhern ,ndia and tropical Australia Botanical description: A large oody climbing plant. #arts used: .eaves Constituents: *ymnemic acids =saponin mi$ture>, *urmarin =polypeptide> Medicinal actions: +ypoglycemic, antidiabetic, hypocholesterolemic #harmacology: *ymnema leaves are thought to increase insulin secretion. AAAB *ymnema reduces blood sugar in hyperglycemic rats, hile having no effect on rats ith normal levels of glucose. AAAC *ymnema regulates blood sugar levels in diabetic rabbits and increases en(ymes hich facilitate the insulin&independent utili(ation of glucose. )or instance, glucose metabolism into protein and glycogen in the liver, #idney and muscle is increased ith *ymnema.AA20 *ymnema e$tract depresses portal release of gastric inhibitory peptide =*,1> after glucose infusion. *,1 normally stimulates insulin secretion from the pancreas. AA2A 6hus, this herb reduces hyperinsulinemia follo ing a loading glucose infusion. An ,ndian study using diabetic rats sho ed that fasting blood glucose levels returned to normal after 20 days of administration. 6here as also a rise in insulin and some pancreatic islet cell regeneration. AA22 A -apanese study sho ed similar results e$cept that pancreas eight and content of insulin ere not changed. AA23 6he saponins in *ymnema inhibit the reabsorption of bile acids and thus lo er cholesterol and triglycerides. 6he gymnemic acids and gurmarin have anti&s eet activity in the taste receptors of the mouth. AA2<,AA2E *urmarin binds to taste receptor protein bloc#ing the s eet taste. 6his action decreases after about 2 ee#s of continuous e$posure due to endogenous production of gurmarin binding proteins. Apparently, once gurmarin binding proteins are developed, the s eet bloc#ing effect cannot be regained. 6he leaves are also noted for lo ering serum cholesterol and triglycerides. AA2F While studies have sho n that a ater&soluble acidic fraction of the leaves provides hypoglycemic actions, the specific constituent in the leaves responsible for the hypolipidemic action has not been clearly identified. 5ome researchers have suggested gymnemic acid as one possible candidate. )urther research is needed to clearly determine hich constituent is responsible for this effect. )raditional Medicinal Use: :either !oo# nor ?ing described this herb. Current Medicinal Use: • 'ndocrine !onditions9 *ymnema is primarily used to help regulate elevated and3or fluctuating blood sugar levels. *ymnema e$tract has sho n positive clinical results in both type , and type ,, diabetes. 6here have been t o long&term clinical studies done hich demonstrate this. Both of these studies ere ithout placebo. ,nsulin&dependent diabetics ta#ing *ymnema reduced their insulin requirements and fasting blood glucose, glycosylated hemoglobin, and glycosylated plasma protein levels after using <00 mg3day of a ater soluble acidic fraction of the ethanol e$tract. AA2H ,n type , diabetes, *ymnema appears to enhance the action of insulin.An e$tract of the leaves of *ymnema sylvestre given to 2H patients ith type , diabetes on insulin therapy as sho n to reduce insulin requirements and fasting blood sugar levels, and to improve blood sugar control. ,n a study of type ,, diabetics, 22 ere given *ymnema e$tract along ith their oral hypoglycemic drugs. All patients demonstrated improved blood sugar controlK 2A out of the 22 ere able to reduce their drug dosage considerablyK and five sub"ects ere able to discontinue their medication and maintain blood sugar control ith the *ymnema e$tract alone. AA2B )or *ymnema to lo er blood glucose in insulin&dependent diabetics, it needs to be ta#en continuously for F to A2 months. *ymnema is a long&acting herb hich necessitates this long treatment time, but has the advantage of avoiding hypoglycemic reactions. *ymnema may be combined ith *alega and3or 6rigonella, both of hich are quic#&acting, to achieve more rapid results although sustainable only hile ta#ing the other herbs. *ymnema is therefore very useful in someone ith hyperglycemia, a craving for s eets, e$cessive appetite and elevated cholesterol. When ta#en over a long period of time, *ymnema ill lead to increased insulin output thus facilitating athletes developing a higher ratio of muscle mass to body fat.

*ymnema anestheti(es the s eet taste buds lo ers hyperglycemia and hypercholesterolemia. A double&blind clinical study revealed that gymnemic acid dramatically and selectively diminished s eet taste =by selectively anestheti(ing s eet taste buds> for up to several hours. ,n addition to lo ering blood sugar, appetite as significantly decreased for up to C0 minutes after the s eet&numbing effect. #harmacy: %ried herb9 3 g qd *5<9 <00 µg A9A fluid e$tract W E&A0 ml per day in divided doses. Use less if combining ith other hypoglycemic herbs. A9A fluid e$tract W A&2 ml per day for s eet taste suppression. =Apply drops directly to the tongue, or mi$ ith small amount of ater and s ish in mouth for 30 sec. 4epeat every 2&3 hours. Drug interactions: • ,nsulin: may require modification of dosage due to hypoglycemic effects. • 9ly!uride' )ol!utamide: additive effects =human> • impaired iron absorption ith dried leaf use Contraindications: :o information is currently available from the selected resources. )o*icity: :o information is currently available from the selected resources.
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5hanmugasundaram '4, et al 7 Ethnopharmacol 30, ACC092BA and 2CE. 5rivastava ;, et al >nt 7 2rude Drug Res 2<, ACBF9AHA. 1120 5hanmugaundaram '4 et al 7 Ethnopharmacol, H, ACB3920E. 1121 )ushi#i 6, et al 7 ;utr, A22, ACC2923FH. 1122 0#abayashi ; et al Diabetes Res 2lin Pract, C, A<39ACC0. 1123 Bas#aran ?, et al 7 Ethnopharmacol, 30, ACC092FE. 1124 .iu +/, et al 2hem Pharm Bull 0To3yoB, <0, ACC2. 1125 ,moto 6, et al 2omp Biochem Physiol, A00, ACCA930C. 1126 Bishayee A, !hatter"ee /. +ypolipidemic and antiatherosclerotic effects of oral 5ymnema syl!estre 4.Br. leaf e$tract in albino rats fed on a high fat diet. Phytother Res ACC<KB9AABW20. 1127 5hanmugasundaram '4, et al 7 Ethnopharmacol 30, ACC092BA and 2CE. 1128 Bas#aran ?, ?i(ar Ahamath B, et al. Antidiabetic 'ffect of a .eaf '$tract from *ymnema sylvestre in :onon&,nsulin %ependent %iabetes /ellitus patients. 'thnopharm 3093CE&30E, ACC0

Hamamelis virginiana
Common name: Witch +a(el Ha!itat: 6he shrub is found in all parts of the U.5. and !anada in damp oods and meado s.

Hamameliadaceae

Botanical description9 A large shrub consisting of several croo#ed and branching stems arising from the same root, and forming a bushy clump from B&A0 feet high. .eaves alternate, 3&E inches long and 233 as broad. )lo ers sessile, 3&< in a cluster and yello . #arts used: .eaves, Bar# Constituents: .eaves9 • tannins9 hamamelitannin =2,E&di&0&galloyl&%&hamamelose>, monogalloylhamameloses gallotannins, condensed catechins and proanthocyanins • flavonoids9 quercetin, #aempferol, astragalin, myricitrin • volatile oil Bar#9 • tannins9 hamamelitannins, condensed tannins such as d&gallocatechin, l&epigallocatechin, l&epicatechin • saponins9 volatile oil, resin #harmacology AA2C 6he proanthocyanidins are potent inhibitors of E&lipo$ygenase and 1A) in vitro. +uman e$periments have demonstrated suppression of U7B mediated sunburn ith topical application of +amamelis lotion. +amamelitannin demonstrated in vitro antio$idant activity and protected murine s#in fibroblasts from damage induced by U7B irradiation. ,t protected murine fibroblasts against e$ternal active o$ygen radicals generated by U7B irradiation by associating ith the cell surface through its sugar moiety. )urther tests indicated that hamamelitannin has higher protective activity against cell damage induced by supero$ide anions than gallic acid =its functional moiety>. ,n earlier or#, hamamelitannin increased the survival rate of fibroblasts compared ith controls. +amamelitannin inhibited supero$ide anion radicals at a much lo er concentration than ascorbic acid. )urther test results supported the supero$ide scavenging activity of hamamelitannin. +amamelis e$tract demonstrated strong active o$ygen&scavenging activity and protected against cell damage induced by active o$ygen. 6he authors recommended +amamelis as a potential antiageing or anti rin#le material for the s#in. 7asoconstrictive activity has been demonstrated by intravenous administration of +amamelis leaf preparations in isolated rabbit arteries. 6he activity as not bloc#ed by alpha&or beta&sympatholytic agents. 6opical application of a Witch ha(el leaf e$tract produced a significant reduction in s#in temperature in 30 volunteers. 6he lo ered s#in temperature as interpreted as a vasoconstrictive activity. A +amamelis concentrate e$hibited significant antiviral activity against herpes simple$ virus type A in vitro. Medicinal actions: astringent, anti&inflammatory Historical Use: 6he American ,ndians used it as a topical application for inflammation and s elling. )raditional Medicinal Use: 5pecific ,ndications and Uses9 7enous debility, ith rela$ation and fullnessK pale mucous tissues =occasionally deep&red from venous engorgement, or deep&blue from venous stasis>K mucous profluvia, ith venous rela$ationK passive hemorrhagesK varicosesK capillary stasisK hemorrhoids, ith full feelingK rela$ed and painful sore throatK dull, aching pain in rectum, pelvis, or female organsK perineal rela$ation, ith fullnessK muscular rela$ationK muscular soreness and aching and bruised sensation, hether from cold, e$posure, bruises, strains, or from physical e$ertion.AA30 !oo# described the leaves as a mild but reliably astringent, ith gentle tonic qualities and a soothing influence. +e considered it one in a small list of plants that combine diffusive rela$ant properties ith astringency allo ing it to be one of the most bioavailable of all the astringents. While most other astringents e$cite the tissue that they are astringing, +amamelis is unique in that it soothes tissues as it astringes, ma#ing it very useful in inflamed tissues. +e did not discuss the bar#, ho ever ?ing found that the bar# had similar properties.

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!ardiovascular !onditions9 6he main indication for +amamelis as in disorders involving the venous structures, particularly for chronic vascular conditions of mucous tissues, and to old, flabby, fetid ulcers. +amamelis, both internally and topically, as observed to arrest oo(ing of blood from mucous surfaces. ,t as not considered the remedy for active hemorrhage, but for passive bleeding, as from the lungs, stomach, bo els, renal or genital organs its action is satisfactory. ?ing noted that the decoction of the bar# as very useful in hemoptysis, hematemesis, epista$is, hemorrhoids. +amamelis as also applied in cases of cellulitis, phlebitis, and varicose veins. ':6 !onditions9 ?ing considered fe agents more effective in various subacute forms of sore throat, also in sore throat ith deep redness and great pain. +e found it a very valuable aid, locally, in the treatment of tonsillitis, ulceration of the throat, diphtheria, and acute catarrh. *astrointestinal !onditions9 6he 'clectics used +amamelis in e$cessive mucous discharges, ith full, pale, and rela$ed tissues. ,t is specially adapted to diarrhea ith a tendency to or associated ith passive hemorrhage. !oo# noted that +amamelis soothes the bo els rather than e$cites them, as many astringents do. *enitourinary !onditions9 6he 'clectics found +amamelis serviceable in renal affections due to vascular rela$ation. 6hus, in diabetes insipidus it as considered of some value. ,t as particularly valued in prolific mucous of the urogenital tract such as vesical catarrh ith tenesmus and in irritation of the bladder due to enlarged and rela$ed scrotal veins. +amamelis as applied in hemorrhage or catarrh of the bladder and in gonorrhea. ,t as noted to act mildly on the #idneys ithout drying the mucous membranes resembling Arctostaphylos, though less tonic and more transient in action. 6his action as ell demonstrated in non&inflammatory hematuria. *ynecological !onditions9 ,n female disorders +amamelis as indicated by ovarian congestion secondary to venous fullness and rela$ation suggested by dull, aching, ovarian pain. %r. 5cudder noted that +amamelis as indicated in chronic uterine congestion, here the cervi$ is enlarged ithout abnormal hardness, the os uteri being soft, open, and patulous, and perhaps leucorrhoea or prolapsus present. ,n leucorrhoea, ith fullness of the pelvic veins and rela$ation of the uterine and vaginal alls, its internal and e$ternal e$hibition as deemed beneficial. !oo# considered +amamelis an admirable ash in leucorrhea and prolapsus uteri and ani. !ombined ith a small portion of !apsicum, it as observed to be effective in arresting uterine hemorrhage and passive menorrhagia. !ombined ith !ypripedium or !aulophyllum, +amamelis as used to e$pedite parturition in nervous patients, and applied hot it gave great relief to the soreness of abdominal muscles and pelvic parts follo ing childbirth. Also, +amamelis as used as a part of the treatment of inflamed breasts. /ale !onditions9 +amamelis as used for testicular congestion secondary to venous congestion. )or varicocele it as used both internally and locally on the scrotum. +o ever, hile it relieves varicocele, too much must not be e$pected of it in the ay of a cure. 0phthalmological !onditions9 +amamelis as combined ith +ydrastis for purulent ophthalmia and as of pronounced value in hemorrhages into the eye ball, and locally relieves ecchymosis of the lids and con"unctiva. 6opical Applications9 ?ing described its useful form as a poultice in painful s ellings as ell as in e$ternal inflammations such as sprains, contusions, ounds, s ellings, burns, as ell as in irritated and inflammatory conditions of the e$ternal auditory meatus, especially hen due to irritation from the presence of inspissated cerumen. ?ing used +amamelis compress for muscular soreness and aching sensations, as of having been bruised, hether from colds, e$posures, strains, bruises, or severe muscular action.

Current Medicinal Uses: +amamelis is useful internally and e$ternally for the treatment of hemorrhoids, varicose veins, bruises and inflamed s ellings. +amamelis is a tonic to the tissues as ell, although the tonifying action is not as deep or long&lasting as other tonic herbs. +amamelis is also effective in stopping uterine hemorrhage and menorrhagia, especially hen combined ith a small amount of capsicum. • !ardiovascular !onditions9 ,n an uncontrolled study, E0 patients ith painful s#in lesions in the anogenital area ere treated ith a salve containing Witch ha(el bar# distillate, (inc o$ide and vitamins A and %. After a ee# the healing process as completed in <0 patients. ,n an uncontrolled trial on HE patients ith itching, painful and bleeding hemorrhoids, application of a salve containing Witch ha(el bar# resulted in a ma"ority of patients becoming free from symptoms after 3 ee#s of treatment.

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A comparison of this +amamelis bar# salve ith t o other salves =one containing corticosteroids> as underta#en in a double&blind trial on C0 patients ith grade A hemorrhoids. 5everal patients receiving the itch ha(el salve had also received sclerotherapy. All three preparations demonstrated similar efficacy, e$cept that the itch ha(el as superior ith regard to relief of symptoms9 greater reduction in itching and soreness, less frequent bleeding. ,n a similar double&blind clinical trial, C0 patients ith first&degree hemorrhoids ere treated ith itch ha(el bar# ointment and t o ointments containing synthetic agents, one of hich additionally contained a corticosteroid. 6reatment as of 2A days duration, ith follo &up e$aminations on the third, A<th and 2Ast day of treatment. )our typical symptoms =pruritis, bleeding, burning sensation, sore sensation> ere evaluated by both physician and patient. All three ointments proved highly effective. :o ma"or differences ere found bet een the three treatment groups but in the case of pruritis, a positive tendency in favor of the itch ha(el ointment as observed. 6he therapeutic effect of itch ha(el on venous tone as studied in patients ith varicose veins in an open trial. )our groups ere each given different medications and studied by plethysmography for the ne$t E hours. ,n the untreated controls, venous tone decreased during rest. A reference drug had no effect and the increase in venous tone induced by the ingestion of a high dose of +amamelis&+ydrastis mi$ture as equivalent to that induced by AE0 mg of oligomeric procyanidins.AA3A %ermatologic !onditions9AA32 Application of Witch ha(el leaf cream t ice daily for 2 ee#s in an uncontrolled study resulted in complete healing or considerable improvement in 3H patients ith various forms of ec(ema or atopic neurodermatitis. 6hirty&si$ patients ith endogenous ec(ema and B0 patients ith to$ic degenerative ec(ema ere treated in a double&blind, placebo&controlled trial ith either +amamelis salve =2E ater distillate from leaf and t igs> or a control preparation. 6he +amamelis salve as superior to placebo in the treatment of atopic dermatitis but of no benefit in the treatment of primary irritant contact dermatitis. 6 enty&t o patients ith atopic dermatitis ere treated ith a standardi(ed +amamelis salve on one arm and a non&steroidal antiinflammatory cream =containing bufe$amac> on the other over a 3& ee# period. Both treatments sho ed a clear improvement in the symptoms investigated9 redness, scaling, lichenification, pruritis, infiltration. 6he salve contained 2E g of ater distillate =from < g of fresh leaf and t igs> per A00 g of salve, hich as also standardi(ed for +amamelis #etone =0.HE mg>. +amamelis distillate cream =E.3E g +amamelis distillate containing 0.F< mg #etone3A00 g> as compared to 0.EG hydrocortisone cream and an unmedicated cream base in a double&blind, randomi(ed trial on H2 patients ith moderately severe atopic ec(ema over a period of A< days. All treatment regimes significantly reduced itching, erythema and scaling after A ee#. 6he hydrocortisone cream proved superior to the +amamelis distillate, hich as no more effective than the unmedicated base. ,n a previous study by the same authors, creams containing various concentrations of +amamelis distillate =containing 0.F<&2.EF mg +amamelis #etone3A00 g> ere compared to a /atricaria cream and a A& hydrocortisone cream on human volunteers ho had erythema induced by U7 irradiation and cellophane tape stripping of the horny layer. A mild antiinflammatory effect as demonstrated for the +amamelis cream, especially if incorporated into a phospholipid base. Although less active than hydrocortisone cream, +amamelis cream as superior to the unmedicated cream base. 6he antiinflammatory activity described here could, at least in part, be due to a vasoconstrictor activity. A mild antiinflammatory effect for standardi(ed Witch ha(el salve =2E g distillate from < g fresh leaf and t igs, 0.HE mg of #etone, all per A00 g>, compared to its neutral ointment base, as demonstrated by instrumental testing and transcutaneous o$ygen measurement in 22 healthy sub"ects and five patients ith dermatosis. *ynecological !onditions9 ,f used in a vaginal douche, it ill address purulent mucus discharge from inflamed tissues as ell as blood loss. A randomi(ed open study of 300 mothers e$amined the effectiveness of +amamelis ater, ice or 'pifoam in achieving analgesia for episiotomy associated ith forceps delivery. All three agents ere equally effective at achieving analgesia on the first day. Appro$imately one&third of the mothers derived no benefit from any of the treatments.AA33 %istilled itch ha(el ater for topical application !ream, 1oultice, !ompress, 7aginal ,n"ection 6incture A9E 2EG 't0+K sig 2&< ml 6,% ,nfusion A tsp.3cupK sig A cup 6,% QA tsp. O 2.E gR

#harmacy9

Drug ,nteractions:""7: When e$tracted in hot ater, tannins can precipitate al#aloids from plants, al#aloidal drugs, proteins, salicylates, iodine and iodides, metals, minerals and B vitamins thereby slo ing, reducing or bloc#ing their absorption. 6he drug& tannin reaction can interfere ith dosing if sources of the t o compounds are combined in solution prior to administration. %rug&tannin precipitates are maintained in an al#aline p+ and dissolve in an acid environment such as the stomach. Unless the solution is sha#en ell, precipitates ill settle in the bottom leading to lo or no amounts in initial doses and high or to$ic amounts hen the last doses from the bottle are ta#en. 6he precipitates are generally soluble in mi$tures containing over AE&<0G alcohol. 6annins ill not precipitate lo concentrations of al#aloidal salts in the presence of many of the gums. Contraindications: 6he use of tannins is contraindicated or inappropriate in cases of constipation, iron deficiency and malnutrition.AA3E Brin#er speculates that prolonged internal use should be avoided due to the high tannin content. AA3F )o*icity: *enerally, +amamelis is considered a safe herb. :o other information is provided in the selected resources.

Harpagophytum procum!ens
Common name: %evils !la Ha!itat: 6his plant is native to 5W Africa@s arid regions.

#edaliaceae

Botanical description: 6he plant bears a large, hoo#ed cla &li#e fruit. 6he tuber is up to F cm in diameter, ith a yello ish&bro n longitudinally striated bar#. 6he roots are collected at the end of rainy season. #arts used: 6uber =root> Constituents AA3H • ,ridoid glycosides =.E W 3G>, primarily harpagoside =A.<G&2.0G>, harpagide, procumbide • 5ugars =over E0G>, the sugars lead to an unusually high ater solubility • 6riterpenes, phytosterols =beta&sitosterol, stigmasterol>, phenolic acids and glycosides, flavonoids, +arpagoquinone #harmacology: +arpagoside and other iridoid glycosides found in the plant may be responsible for the herb@s anti&inflammatory and analgesic actions. AA3B 6he e$act mechanism is not #no n. ,solated iridoid glycosides have been demonstrated to not be as effective in isolation as the hole plant. +arpagophytum is comparable ith phenylbuta(one and cortisone in its antiinflammatory action. AA3C AA<0 +o ever, no change in inflammatory mediators has been demonstrated in studies of these herbs. Medicinal actions: antiinflammatory, anti&rheumatic, analgesic, sedative, bitter, choleretic )raditional Medicinal Use: Harpagophytum procumbens has been traditionally used by natives of 5outhern Africa for rheumatic and gastrointestinal complaints. Current Medicinal Use: +arpagophytum possesses notable analgesic effects. +arpagophytum is also vasodilatory thus augmenting circulation through the "oints. +arpagophytum is a bitter and thus a digestive stimulant and strengthener. • *astrointestinal !onditions9 6he bitter principle of this plant enhance digestion overall. • +epatobiliary !onditions9 As a bitter, Harpagophytum procumbens is especially stimulating to the liver and gall bladder. ,t is therefore useful as a mild depurative. • ,nflammatory !onditions9 6he main indications for Harpagophytum procumbens are arthritis, an#ylosing spondylitis, rheumatoid arthritis, neuralgia, gout, myalgia and fibrositis. ,t is indicated for several reasons, one of hich is its significant antiinflammatory activity. 0ther actions of +arpagophytum that aid in its anti&arthritic application are its analgesic and vasodilatory effects. 6he combination of these actions results in decreases "oint s elling and pain. A double&blind study compared %evil@s cla =2,FA0 mg3day > to the drug diacerhein =A00 mg3day>. AA<A %iacerhein is a member of a drug category called the slo &acting drugs for osteoarthritis =5A%0As>. Unli#e anti&inflammatory drugs such as ibuprofen, 5A%0As don@t give immediate relief, but rather act over a period of ee#s to gradually reduce arthritis pain. A22 patients ith arthritis of the hip and3or #nee ere given either devil@s cla or diacerhein for a period of < months. After four months, considerable improvements in osteoarthritis symptoms ere seen in both groups. +o ever, use of analgesic =acetaminophen&caffeine> and nonsteroidal anti&inflammatory =diclofenac> medications as significantly reduced in the +arpagophytum group, hich also had a significantly lo er rate of adverse events. While impressive, the fact that diacerhein itself is not universally accepted as an effective treatment for osteoarthritis ma#es the results less than fully convincing. A number double&blind studies sho a positive outcomes ith +arpagophytum. 0ne follo ed BC individuals ith rheumatoid arthritis for a 2&month period =FH0 mg of e$tract, 3G glycoside 6,%>. 6he group given %evil@s cla sho ed a significant decrease in pain intensity and improved mobility.AA<2 Another, ith E0 people e$periencing various types of arthritis found that A0 days of treatment =B00 mg of e$tract, A.E G iridoid glycoside 6,%> ith devil@s cla provided significant pain relief. AA<3 Another double&blind study of AAB individuals ith bac# pain reported that %evil@s cla = B00 mg e$tract 6,%> as also helpful for reducing lo bac# pain. AA<< 0ne double&blind study of ACH individuals ith bac# pain found devilNs cla only marginally effective. AA<E ,n this study, t o daily doses of oral +arpagophytum e$tract =F00 and A200, containing E0 and A00 mg of the mar#er harpagoside> ere compared ith placebo over < ee#s. A total of AB3 patients completed the study. 6he numbers of pain&free patients ere three =placebo group>, si$ =F00 mg group> and A0 =A200 mg group> =1 O 0.02H>. +o ever, research has not entirely supported the use of %evil@s cla in alleviating arthritic pain symptoms AA<F, AA<H and many herbalist report mi$ed results ith it.

,n addition, Harpagophytum procumbens stimulates the flo of lymph. 6hese combined actions ma#e Harpagophytum procumbens even more useful in the treatment of arthritis by aiding in the digestion and absorption of nutrients that are incorporated into connective tissue =note9 +!l is often lo in people ith arthritis> and in the elimination of metabolic aste products from the "oints. #harmacy: 5ome debate e$ists as t o hether +arpagophytum be ta#en in an enteric coated form as the iridoid glycosides may be destroyed by lo p+. +o ever, some argue that the secondary metabolites are the active constituents and that hat happens in the stomach is superferlous. 1o dered tuber9 2.E g qd as a single agent A9E 6incture9 E ml 6,% Contraindications: +arpagophytum is contraindicated in stomach inflammation and peptic ulcer disease based on empirical evidence. AA<B 6he choleretic action may contraindicate its use in the presence of gallstones. )o*icity: :o information is currently available. %iarrhea and decreased appetite are the most common complaints reported in trials.
1137 1138

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3<F .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1139 ?ampf, 4, ,ch:eiI )pthe3 ?eitung, AA<, ACHF933H. 1140 The 8a:rence Re!ie: of ;atural Products, E=2>, ACB<. 1141 .eblan %, !hantre 1, )ournie B. Harpagophytum procumbens in the treatment of #nee and hip osteoarthritis. )our&month results of a prospective, multicenter, double& blind trial versus diacerhein. 7oint Bone ,pine. 2000KFH9<F2W<FH. 1142 .ecomte A, et al. +arpagophytum dans l@arthrose9 'tude en double insu contre placebo. 8e MagaIine. ACC2KAE92HW30. 1143 'uropean 5cientific !ooperative on 1hytotherapy. Harpagophyti radix =devil@s cla >. '$eter, U?9 '5!01K ACCF&ACCH. /onographs on the /edicinal Uses of 1lant %rugs. )ascicule 2. 1144 !hrubasi# 5, 8impfer !+, 5chutt U, et al. 'ffectiveness of Harpagophytum procumbens in treatment of acute lo bac# pain. Phytomedicine. ACCFK39AWA0. 1145 !hrubasi# 5, -unc# +, Breitsch erdt +, et al. 'ffectiveness of Harpagophytum e$tract W5 AE3A in the treatment of e$acerbation of lo bac# pain9 a randomi(ed, placebo&controlled, double&blind study. Eur 7 )naesthesiol1 ACCCKAF9AABWA2C. 1146 Whitehouse .W, 8namirous#a /, 1aul !-. %evil@s cla 0Harpagophytum procumbensB9 no evidence for anti&inflammatory activity in the treatment of arthritic disease. 2an Med )ssoc 7 ACB3KA2C92<CWEA. 1147 *rahame 4, 4obinson B7. %evil@s cla 0Harpagophytum procumbensB9 pharmacological and clinical studies. )nn Rheum Dis ACBAK<09F32. 1148 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. FF

Humulus lupulus
Common name: +ops Ha!itat: Alder s amps and damp hedges. .argely cultivated throughout the orld.

Canna!inaceae

Botanical description: A 3&F m tall plant that t ines to the right. 6he leaves are coarsely pubescent, long&petioled, 3&H lobed ith coarsely serrate margin. 6here are 2&< cm long, yello ish&green female flo ers =the hop>. 6he flo ers are cone&li#e ith a small seed& li#e fruit at the base of the flo er. #arts used: 5trobile Constituents: • Bitter substances =acylphloroglucides, A0G> present in the resin9 humulone and lupulone and others all of hich are labileK 6hese • • •

bitter principles are thought to be responsible for the appetite&stimulating properties of hops.
'ssential oil =0.3G&A.0G in hops>9 mono& and sesquiterpenes =more than AE0 have been identified> 6annins =2G&<G in hops> )lavonoids =#aempferol and quercetin mono& and diglycosides>

•

1henol&carbo$ylic acids =ferulic and chlorogenic acids>

#harmacology: 6he sedative principle in hops has not yet been conclusively identified. +o ever, during storage and after oral inta#e, humulone and lupulone split off a !E&alcohol =2&methyl&but&3&en&ol > hich has been sho n in animal studies to have a strong sedative effect.AA<C 5everal unique flavonoid compounds have recently been isolated from Humulus lupulus and their presence has been detected in beer. 6heir chemical structures are similar to other plant&derived compounds, many present in the human diet, that have been sho n to have cancer chemopreventive properties due, in part, to inhibition of cytochrome 1<E0 en(ymes that activate carcinogens. Additionally, preliminary studies have sho n these flavonoids =at A00 micro/> to be inhibitory of 1<E0&mediated activation reactions in a variety of in vitro systems. 6he in vitro effects of these phytochemicals on c%:A&e$pressed human 1<E0 en(ymes !;1AAA, !;1ABA, !;1AA2, !;13A< and !;12'A ere e$amined by the use of diagnostic substrates and the carcinogen A)BA =aflato$in BA>. 6hese results suggested that the +op flavonoids are potent and selective inhibitors of human cytochrome 1<E0. AAE0 Medicinal actions: nervine, sedative, hypnotic, tonic, diuretic, anodyne, aromatic bitter, anaphrodisiac, febrifuge )raditional Medicinal Use: ?ing described +umulus as tonic, hypnotic, febrifuge, antilithic, and anthelmintic and noted that their tonic and anthelmintic properties are small, depending upon their bitterness. +umulus as considered by some to correct lithic acid deposits. • *astrointestinal !onditions9 +umulus as observe to e$ert stomachic effects. ,t as considered e$tremely efficient in dyspepsia here restlessness and a brooding disposition are prominent features. )ermentative dyspepsia ith eructations, often responds ell to +umulus. • :ervous !onditions9 +umulus as principally used for its sedative or hypnotic action, producing sleep, removing restlessness, and abating pain, although ?ing did not consider it a consistent remedy. A pillo stuffed ith hops has long been a popular remedy for procuring sleep. +ops ere useful in delirium tremens to allay nervous irritation • 6opical Applications9 '$ternally, in the form of a fomentation alone, or combined ith '. perfoliatum or other bitter herbs, hops have proved beneficial in pneumonia, pleurisy, gastritis, enteritis and as an application to painful s ellings or tumors. An ointment made ith 2 parts of %atura leaves and A of hops has proved an effectual application in ec(ema, ulcers, and painful tumors. Current Medicinal Use: 6he main internal indications for +umulus are sleeplessness from orry and an$iety, nervous gastropathies, and to reduce se$ual over e$citement in men=i.e. premature e"aculation>. '$ternally, hops may be used as a compress over s#in in"uries to reduce inflammation and to speed healing. • :ervous !onditions9 +ops is very sedating to the central nervous system. ,ngestion of hops eases tension and an$iety and is especially useful hen this tension leads to restlessness, headache, and indigestion. :ervous e$haustion indicates its use, but +umulus is a strong sedative rather than a tonifier as are other nervines.

+umulus is ell indicated to decrease se$ual e$citement and se$ual nervousness. +umulus contains phytoestrogens =30,000& 300,000 per A00g>. Because the phytoestrogens have an anti&androgen effect, +umulus ill suppress se$ual e$citement in men. ,n turn, for an aphrodisiac effect, hops have been combined ith camphor. %%#% Although not as strong a sedative as 7alerian, hops are effective for sleep problems. )or general nervous disorders, hops are commonly combined ith 7alerian. 6he *erman !ommission ' monograph recommends E00 mg for an$iety or insomnia. AAE2 +umulus is the main ingredient of beer and many of the medicinal effects are evident ith the consumption of beer. =?eep in mind, ho ever, that beer is more ea#ly concentrated in constituents and is addictive>. • *astrointestinal !onditions9 +umulus is a bitter and has antimicrobial properties, is an astringent and a smooth muscle rela$ant. 6hese properties combine to ma#e +umulus an effective digestive aid. +umulus ill tonify and strengthen the digestive system hile restoring normal peristalsis. 6hus, +umulus is useful for the treatment of ,B5, !rohn@s and nervous gastropathies and combines ell ith carminative herbs. #harmacy: ,nfusion9 A tsp. =appro$. O 0.E g> 3 cup K sig A cup 6,% or hs 1o der9 sig 0.E W A.0 g3 day A9E tincture F0G 't0+9 sig 2&3 ml 6,%K ee#ly ma$. O <0ml +op pillo for insomnia =effective for some and for others ill produce nausea and headache>.

Drug ,nteractions: • Barbiturates and 5edatives9 +umulus may potentiate the activity of these drugs or have an additive effect. Contraindications: Brin#er contraindicates the use of +umulus in depression =empirical> and allergic hypersensitivity due to contact or inhalation.AAE3 )o*icity: :o information is available from the selected resources.
1149 1150

Wohlfart 4, +ansel 4 and 5chmidt +, Planta Medica, ACB3,<B9A20. +enderson /!. ,n vitro inhibition of human 1<E0 en(ymes by prenylated flavonoids from hops, +umulus lupulus.Penobiotica. 2000 /arK30=3>923E&EA. 1151 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2BE&F 1152 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 1153 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.AAC

Hydrangea ar!orescens
Common name: Wild +ydrangea Ha!itat: United 5tates

4a*ifragaceae

Botanical description: A marsh plant ith roots of variable length and thic#ness. 6he e$terior is pale grey and tough, the inside is hite and succulent. #arts used: 4oots and rhi(ome $nergetics: AAE<  +ydrangea is pungent, s eet, cool, neutral, dissolving, restoring and calming. ,t enters the ?idney, Urinary Bladder and .ung meridians. o 1romotes deto$ification, clears damp cold, removes deposits and relieves ec(emaK promotes urination and drains fluid congestion9 ,ndicated in damp cold obstruction, .in syndrome o 1romotes and armoni(es urination, removes stagnation and relieves irritation and pain 9 ,ndicated in genitourinary qi stagnation =stagnation in the lo er "iao>, .ung dryness o !lears heat and damp, and reduces infection and inflammation 9 ,ndicated in damp heat of the ?idney and Urinary Bladder. o !ompare ith %ianthus 2u mai. Constituents: )lavonoids, hyrangin =glycoside>, saponin, volatile oil, resin, furanocoumarins AAEE #harmacology: • 6he furanocoumarins promote smooth muscle rela$ation of the ureter allo ing a #idney stone to pass =other furanocoumarin containing herbs include Ammi visnaga, 1eucedanum, .eptotania and 4uta graveolens>. AAEF Medicinal actions: %iuretic, anti&lithic, soothing genito&urinary tonic Medicinal use: =:o human trials had found at this time> • *enitourinary !ondtions9 6he specific indications for +ydrangea include9 Mfrequent urination ith heat, burning, accompanied ith quic#, sharp, acute pains in the urethraK partial suppression of urine ith general irritation and aching or pain in the bac#, QandR pain from the passage of renal sand.MAAEH +ydrangea gives tone to the #idneys, improving their function, arresting the formation of urinary deposits and calculiK therefore its action is more prophylactic. ,t relieves irritation of the bladder and urethra %%#(: +ydrangea is useful in the acute and prophylactic treatment of renal calculi. ,t or#s best in an al#aline urine, eliminating phosphate and uric acid crystals. +ydrangea is reduces stone formation from these crystals and causes diuresis. +ydrangea is considered a sedative diuretic, i.e., it relieves the pain associated ith renal lithiasis. AAEC • 1ulmonary!onditions9 +ydrangea influences the respiratory mucosa, relieving bronchial irritation. #harmacy: 6incture A9E 2EGK sig 2&< ml 6,% %ecoction9 2 tsp. dried root3cup ater 6,% Drug interactions: Contraindications: )o*icity:
1154 1155

+olmes, 1eter. 'nergetics of Western +erbs, 7ol. 2, 2nd ed. Artemis 1ress. ACC<. p. FB2&< Wren, 4.!., 1otter@s :e !yclopedia of Botanical %rugs and 1reperations, 1otter@s limited, 'ngland. ACBB. 1156 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. A3FF 1157 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. <<< 1158 5cudder , -/. 5pecific /edication and 5pecific /edicines, AEth ed. 'clectic /edical 1ublications, 5andy, 04, AC03 pAEE 1159 5ource un#no n

Hydrastis canadensis
Common name: goldenseal Ha!itat: shaded oodlands of the American southeast. Botanical description: #art used: root, rhi(ome Historical use: 6he !hero#ee use of +ydrastis as as a cure for cancer. $nergetics: Constituents: AAF0 • isoquinolone al#aloids9 chief al#aloids hydrastine, berberine, =&>&canadine

+anunculaceae

#harmacology: Berberine is cytoto$ic. ,t is also a mild la$ative and anti&inflammatory as ell as a vasoconstrictor and hypertensive. AAFA .ittle research has been done ith +ydrastis itself. Berberine, hich ranges from 0.EWF.0G of the al#aloids present in +ydrastis root and rhi(ome, has been the most e$tensively researched. Berberine has sho n antimicrobial activity against bacteria, proto(oa, and fungi, including9 AAF2 5taphylococcus sp., 5treptococcus sp., !hlamydia sp., !orynebacterium diphtheria, '. coli, 5almonella typhi, 7ibrio cholerae, %iplococcus pneumonia, 1seudomonas sp., 5higella dysenteriae, 'ntamoeba histolytica, 6richomonas vaginalis, :eisseria gonorrhoeae, :. meningitidis, 6reponema pallidum, *iardia lamblia, .eishmania donovani, !andida albicans. ,ts action against some of these pathogens is actually stronger than that of prescription antibiotics commonly used for these pathogens =in vitro>. Berberine@s action in inhibiting !andida, as ell as pathogenic bacteria, prevents the overgro th of yeast that is a common side&effect of antibiotics.6he antimicrobial activity of berberine increases ith p+ in all organisms studied. At p+ of B.0, its antimicrobial activity in vitro is typically t o to four times greater than it is at p+ H.0, hich in turn is one to four times greater than at p+ F.0. 6his suggests that al#alini(ation ill improve its clinical efficacy, particularly in the treatment of urinary tract infections. AAF3 4esearchers investigated berberine@s ability to inhibit the adherence of group A streptococci to host cells based on the fact that the therapeutic effect of berberine appeared to be greater than its direct antibiotic effects. Berberine@s ability to inhibit the adhesion of 5treptococci to host cells has several modes of action. )irst, berberine causes streptococci to lose lipoteichoic acid =.6A>. .6A is the ma"or substance responsible for the adhesion of the bacteria to host tissues. Another important action of berberine is preventing the adhesion of fibronectin to the 5treptococci as ell as eluting already bound fibronectin.6he results of the study indicate that berberine interferes ith infections due to group A streptococci not only by inhibiting streptococcal gro th, but also by bloc#ing these organisms from attachment to host cells. 6he study implies berberine&containing plants may be ideal in the treatment of Istrep throatJ, a condition historically treated ith +ydrastis by American naturopathic physicians. AAF< Berberine produces an antipyretic effect three times as potent as aspirin in a pyretic model in rats. While aspirin suppresses fever through its action on prostaglandins, berberine appears to lo er fever by increasing the immune system@s handling of fever&producing compounds from microorganisms. AAFE Medical actions: tonic, antimicrobial, anti&infective, immunostimulant , anti&cancer, anti&pyretic )raditional Medicinal Uses: 5pecific ,ndications and Uses9 +ydrastis is specifically indicated in catarrhal states of the mucous membranes, hen unaccompanied ith acute inflammation. An apparent e$ception to this is in acute Npurulent otitis media, in hich it is said to act better than in chronic conditionsK gastric irritabilityK irritation of parts ith feeble circulationK muscular tenderness and soreness, orse under pressure or on motionK passive hemorrhages from uterus and other pelvic tissuesK s#in diseases depending on a gastric abnormality, indicating +ydrastis.AAFF !oo# considered this root as one of the purest tonics, the stimulating property predominating, but the rela$ing property ell mar#ed. +e noted that +ydrastis acts slo ly and steadily, holding its influence for several hours and that its influence upon the system is very general. +o ever, he also stated that there seems to be no organ or tissue but can be benefited by its appropriate use. ,t as deemed most advantageous for mucous membranes, the digestive system, and the uterine organs and as considered unli#e almost all other stimulating tonics in soothing the irritation connected ith feeble and congested conditions of mucous membranes. =!oo# goes on to demonstrate the rivalry ith the 'clectics over ho IdiscoveredJ this herb>.

,n describing its action on mucous membranes, !oo# observed that +ydrastis first secures the discharge of any viscid secretion, then diminishes secretions ithout suppressing them, improving the overall healthy character. 6hus, its toning influence ill arrest e$cessive mucous discharges though it is not astringent. At the same time +ydrastis relieves turgid achings and disposes healing of any ulcerations. ?ing observed that +ydrastis appeared to stimulate the respiratory and circulatory systems, imparting increased tone and po er ith increased arterial tension and blood pressure in the capillaries. )or these reasons he found it valuable in overcoming blood stasis as research of the time had sho n that it increased contraction of arterial smooth muscle, but not that of the gastrointestinal tract. +e also noted that it as a valuable agent in debility of smooth muscle. +e described it as bitter, inducing activity of the salivary glands, sharpening the appetite and aiding digestion. ,n general, +ydrastis as used by the 'clectics in convalescence from diseases having e$cessive mucoid discharges, or here hemorrhage has played an important part. • %ermatologic !onditions9 +ydrastis has been used to some e$tent in cutaneous diseases dependent upon gastric difficulties. !ases of ec(ema, including those around the outlets of the body and secondary to gastrointestinal disturbances, have been cured by its internal use alone. 6he local use at the same time hastens cure. • ':6 !onditions9 ,n nasal catarrh, +ydrastis as applied as a snuffK in aphthous sores as a ash ith /yricaK in diphtheria and scarlatina ith /yrica, !apsicum and !ommiphora as a gargle. +ydrastis as considered a valuable local agent by the 'clectics in afflictions of the nose and throat that are subacute and naso&pharyngeal catarrh here the mucous membranes are dry and the secretions being altered in quantity and character. ,n catarrhal hypertrophy ith profuse discharge and thic#ening of the mucous membrane, +ydrastis as regarded as ithout an equal. • *astrointestinal !onditions9 +ydrastis as #no n to e$ert its chief action upon the mucosa and glandular tissue of the gastrointestinal tract. +ydrastis as used to improve appetite and digestion and as considered one of the most acceptable of all general tonics in indigestion, feeble assimilation, biliousness, prolapsus, and all forms of debility. As a stimulant of the gastric and intestinal mucosa, its action as ell regarded, particularly in functional disorders and in disorders of a sub&acute character and in atonic states ith increased flo of mucus. ,n chronic dysentery and diarrhea, and in either chronic or typhoid ulceration of the bo els, +ydrastis as considered unsurpassed. +ydrastis as considered equally as beneficial in catarrhal states of the intestines. ?ing stated that +ydrastis should be considered in obstinate constipation due to hepatic obstruction, hepatic congestion or atonic conditions of the intestinal glands. 1rof. ?ing considered it a valuable tonic for enfeebled states of the alimentary tract in infants and children, and recommended it for the same purpose in convalescence from gastrointestinal diseases. .ocal application, ith the internal use, has been applied in hemorrhoids, fissured anus, ulcers and ec(ema of the anus, and prolapsed and ulcerated rectum. • *enitourinary !onditions9 ,n catarrh of the bladder, +ydrastis as used both orally and as an in"ection through the urethra. Wea# #idneys ere considered much improved by its internal use, although it may prove too e$citing in cases that e$hibit sub& acute inflammation of the bladder or bo els. %r. ?ing used it for incipient stricture, inflammation, and ulceration of the epithelium of the bladder. • *ynecological !onditions9 ,n leucorrhea, +ydrastis as applied as a douche. 5everal 'clectic physicians have employed +ydrastis in hemorrhagic conditions of a gynecologic nature. +o ever, it as said to be too slo a remedy for active post&partum hemorrhage, but may be employed for the control of passive hemorrhage. • +epatobiliary !onditions9 +ydrastis as observed to mildly facilitate the discharge of bile from the gallbladder and secretion from the hepatic tubuli, and as used as an aperient to treat some forms of constipation. • /ale !onditions9 +ydrastis as used for cystic congestion and chronic difficulties of the prostate gland and in some forms of spermatorrhea. • /usculos#eletal !onditions9 5pecific +ydrastis as used by the 'clectics in cases of myalgic tenderness and soreness due to various causes, indicated here the symptoms are better during rest but aggravated by pressure and by motion. • 0phthalmological !onditions9 +ydrastis as used by the 1hysiomedicalists in the treatment of purulent and granular ophthalmia, ith ulceration of the cornea in hich +ydrastis ith a limited portion of .obelia, !apsicum, or !ommiphora as an eye ash. • 1ulmonary !onditions9 Added to rela$ant cough syrups, +ydrastis as used to support the respiratory system. • 6opical Applications9 As an e$ternal application, it as considered valuable in ulcers, bruises and ounds here there is a tendency to congestion ithout incipient mortification. ,t as observed to enhance the healing process. 6he 1hysiomedicalists considered it as one of the best remedies for dressing irritable chancres and buboes. ,t as also used as a ash or added to glycerin and used as an ointment or for local dressing. Current Medical Uses: • ':6 !onditions9 +ydrastis is frequently used for chronic sinusitis. Adminstration through nasal lavage in a saline solution has been an effective treatment and prophylactic practice for many patients.

•

*astrointestinal !onditions9 +ydrastis is most effective by direct contact. ,t does not seem to be an effective oral antibiotic, probably because the blood levels of berberine that can be achieved by ta#ing +ydrastis orally are far too lo to matter. AAFH +o ever, +ydrastis may also be beneficial in treating sore throats and diseases of the digestive tract because it can contact the affected area directly. Because of its antimicrobial activity, +ydrastis has a long history of use for infectious diarrhea. ,ts ma"or al#aloid, berberine has been sho n beneficial for people ith infectious diarrhea in some double&blind studies. AAFB, AAFC :egative studies have generally focused on people ith cholera, hile positive studies have loo#ed at viral diarrhea or diarrhea due to strains of E1 coli1 Berberine has sho n significant success in the treatment of acute diarrhea in several clinical studies. ,t has been found effective against diarrheas caused by '. coli =traveler@s diarrhea>, ,higella dysenteriae =shigellosis>, ,almonella paratyphi =food poisoning>, .lebsiella sp., 5iardia lamblia =giardiasis>, and Gibrio cholerae =cholera>. 5tudies in hamsters and rats have sho n that berberine also has significant activity against Entamoeba histolytica, the causative organism of amebiasis. AAH0, AAHA ,n one study, FE children under the age of E years ith acute diarrhea due to '. !oli, 5higella, 5almonella, ?lebsiella or '. faecalis ere treated ith 2E mg of berberine every F hours or standard antibiotic therapy. 1atients treated ith berberine responded better than those given antibiotics.AAH2 ,n another study, <0 children aged A&A0 years infected ith the parasite giardia received either berberine =Emg3#g body eight each day>, the drug metronida(ole =A0 mg3#g body eight each day>, or a placebo of vitamin B syrup in three divided doses. After F days, <BG of patients treated ith berberine ere symptom&free and, on stool analysis, FBG ere 5iardia&free. ,n the metronida(ole =)lagyl> group, 33G of patients ere ithout symptoms and, on stool analysis, all ere 5iardia&free. ,n comparison, AEG of patients on placebo ere asymptomatic and, on stool analysis, 2EG ere 5iardia&free. 6hese results indicate that berberine as actually more effective than metronida(ole in relieving symptoms at half the dose, but as less effective than the drug in clearing the organism from the intestines. ,n one study, patients ith traveler@s diarrhea randomly received berberine sulfate <00mg in a single dose or served as controls. ,n treated patients, the mean stool volumes ere significantly less than those of controls during three consecutive B hour periods after treatment. At 2< hours after treatment, significantly more treated patients stopped having diarrhea as compared ith controls =<2G vs. 20G>.)or those patients planning to travel to an underdeveloped country or an area of poor ater quality or sanitation, the prophylactic use of berberine&containing herbs during, and A ee# prior to and after visiting may be useful. AAH3, AAH< • ,nfectious !onditions9 6he famous herbalist 1aul Bergner has pointed out, there are three things rong ith ta#ing +ydrastis for colds9 =A> there is no credible evidence that +ydrastis increases immunityK =2> the herb as never used historically as an early treatment for coldsK and =3> antibiotics are not effective against colds any ay. AAHE • *enitourinary !onditions: 5ince berberine is concentrated in the bladder, +ydrastis may be useful in resolving bladder infections. • +epatobiliary !onditions9 Berberine has been sho n in several clinical studies to stimulate the secretion of bile =cholerectic effect> and bilirubin. ,n one study of 22E patients ith chronic cholecystitis, oral berberine doses of E&20mg three times a day before meals caused, over a period of 2<&<B hours, disappearance of clinical symptoms, decrease in bilirubin level, and an increase in the bile volume of the gall bladder. Berberine has been sho n to correct the hypertyraminemia of patients ith liver cirrhosis. ,t prevents the elevation of serum tyramine follo ing oral tyrosine load by inhibiting the en(yme tyrosine decarbo$ylase found in bacteria in the large intestine. Berberine inhibits tyrosine decarbo$ylase and tryptophanase activities of ,treptococcus faecalis and E1 coli, but not those of animal en(ymes. 6yramine is believed to be responsible for some of the cardiovascular and neurological complications of liver disease, such as hepatic encephalopathy. 6he accumulation of tyramine and its derivatives may cause lo ering of peripheral resistance, ith resultant high cardiac output, reduction in renal function, and cerebral dysfunction. Berberine, by lo ering plasma tyramine levels, helps prevent the complications of cirrhosis. 6his tyramine&lo ering effect of berberine may have significance in other conditions as ell. AAHF, AAHH • 0phthalmological !onditions9 Berberine has sho n remar#able effect in the treatment of trachoma. 6rachoma, an infectious eye disease due to the organism 2hlamydia trachomatis, is a ma"or cause of blindness and impaired vision in underdeveloped countries. 6he drug sulphacetamide is currently the most idely used anti&trachoma drug. ,n clinical trials comparing berberine =0.2G> and sulphacetamide =20.0G solution>, sulphacetamide sho ed the best improvement =decrease in con"unctival discharge, edema, and papillary reactions>, but the con"unctival scrapings of all patients receiving sulphacetamide ere still positive for 2hlamydia trachomatis. 6hese patients had a high rate of recurrence of the symptoms. ,n contrast, patients treated ith the berberine solution sho ed very mild ocular symptoms, hich disappeared more gradually, but their con"unctival scrapings ere al ays negative for 2hlamydia trachomatis. 6hese patients did not suffer relapse even A year after treatment. AAHB, AAHC 6ropism of Berberine containing plants according to +erb -oyner Bey9 +ydrastis canadensis9 gastrointestinal, genitourniary, respiratory Berberis vulgaris 9 genitourinary Berberis aquifolium9 s#in = acne, psoriasis, ec(ema> !optis chinensis9 gastrointestinal, s#in =carbuncles, furuncles>

Current +esearch +eview: 5earch of /edline revealed no human trials as of AA320302 #harmacy: 5tudies on the use of +ydrastis in gastrointestinal conditions used <00WE00 mg berberine 6,%K 3WE ml of tincture 6,% can also be used. dried root or as infusion =tea>9 2W< g tincture =A9E>9 FWA2 ml =A.EW3 tsp> fluid e$tract =A9A>9 2W< ml =0.EWA tsp> solid =po dered dry> e$tract =<9A or BWA2G al#aloid content>9 2E0WE00 mg. Drug ,nteractions: ""/8 • 4ulphacetamide =positive>: see 0phthalmological !onditions above. • Anti!iotics =positive>: ,n vitro evidence suggests berberine may induce susceptibility to penicillin and chloromycetin of some enteric bacteria that ere previously resistant. • #ento!ar!ital =positive>9 Animal studies sho that berberine increased sleeping time. • ,sopernaline =positive>9 +ydrastis e$tract potentiated the smooth muscle rela$ing effect =in vitro& trachea>, possibly due to β& adrenergic agonistic effect. Contraindications: ?ing noted that may cause harm in acute inflammatory conditions. Brin#er contraindicates the use of +ydrastis in pregnancy due to the uterine stimulant activity of berberine =animal studies> , renal disease =empirical>, hypertension =speculative>, acute stomach inflammation =empirical and human study> and in "aundice of ne borns =animal study> AABA )o*icity: :o information is available from the selected resources.
1160 1161

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1162 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p.HHF&HHH 1163 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC. HHH 1164 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HHH 1165 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p.HHB 1166 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1167 Bens#y %, *amble A, ?aptchu# 6-. 2hinese Herbal Medicine: Materia Medica. 5eattle, Wash9 'astland 1ressK ACBF. 1168 ?hin&/aung&U, /yo&?hin, :yunt&:yunt&Wai, et al. !linical trial of berberine in acute atery diarrhoea. Br Med 7 ACBEK2CA9AF0AWE. 1169 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy. !hurchhill .ivingstone, :e ;or#, :;. 2000. p. 2BB&2C0 1170 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HHB 1171 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2C3 1172 ,nfect ,mmun 3E9 <HA&HE, ACB2. 1173 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p.HHB 1174 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 1175 Bergner 1. The Healing Po:er of Echinacea, 5oldenseal and "ther >mmune ,ystem Herbs . 4oc#lin, !alif9 1rima 1ublishingK ACCH 1176 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p.HHC 1177 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2C3&2C< 1178 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. HHC 1179 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p.2C3 1180 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. AA0&AAA 1181 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. AA0

Hyoscyamus niger
Common name: +enbane Ha!itat: +yoscyamus is native to 'urope. ,t gro s in astelands.

4olanaceae

Botanical description: 6he plant is a biennial or annual. 6he stems are less than E mm in diameter and are quite hairy and slightly stic#y. 6he leaves of the annual plant are smaller and sessile. 6he leaves of the biennial plant are larger, up to 30 cm long, ovate or lanceolate, dentate margin and hairy in their second year. 6he flo ers are five&lobed, tubular, yello ith purplish veins. 6he annual plants flo er in -uly or August and the biennial plants flo er in /ay or -une. Historical Use: +yoscyamus also has psychotropic actions and is another herb that as used by 'uropean itches in the creation of their hallucinogenic e$periences. #arts used: .eaves and flo ering tops Constituents: AAB2 5eed9 • 6ropane al#aloids =0.0E&0.3G seed, -1-#9 -1&(E leaf>9 chief al#aloid .&hyoscyamine, under storage conditions changing to some e$tent into atropineK scopolamine and hyoscine, mandragorine, and others. +yoscyamine refers to the .&isomer, the most typical active constituent of Atropa, +yoscyamus and %atura. ,t converts to the %&isomer during the drying process creating atropine, the racemic mi$ture of %,.&hyoscyamine. 5copolamine is the .&isomer of hyoscine. • )atty oil • )lavonoids9 including, among others, rutin Medicinal actions: Antispasmodic, anodyne, sedative, mydriatic, hypnotic #harmacology: ,n the parasympathetic nervous system atropine and hyoscyamine bloc#s the muscarinic cholinergic receptors causing central nervous system stimulation follo ed by depression. 6he al#aloids also cause hallucinogenic and hypnotic effects =lo ered brain activity during hich time deep sleep does not occur, but dreams do>. 6his inhibition does not affect the nicotinic receptor activity on ganglia and motor end&plates. Atropine is a !:5 stimulant ith a tropism for the heart, lung and abdominal organs. ,n the peripheral nervous system the anticholinergic actions include reduction of gastrointestinal secretions and motility as ell as rela$ation of bronchioles and s#eletal muscle. )urthermore, they relieve muscular tremors of central nervous origin. 6he spectrum of actions of +yoscyamus niger additionally includes a sedative effect. AAB3 ,n contrast, +yoscine does not stimulate the central nervous system and is in fact a !:5 sedative hich may be helpful in allaying motion sic#ness. ,t has a greater influence on the eye and secretory glands. Both atropine and hyoscine ill dilate the pupil of the eye hen prepared into ophthalmic eye drops. 6he al#aloids are eliminated by the #idneys.AAB< )raditional Medicinal Use: 5pecific ,ndications and Uses9 :ervous irritability, ith unrest and insomniaK face flushed and pupils dilatedK fright, terror, restlessness in sleepK loquaciousnessK busy delirium of a lo muttering character, or ith singing, tal#ativeness, amusing hallucinations and illusions, etc.K garrulousnessK destructivenessK sharp, dry, nervous cough, orse upon assuming a recumbent position muscular spasmsK cho#ing sensationsK rapid and palpitating cardiac action.AABE 6he 'clectic physicians considered +yoscyamus as part of the special sedatives and observed it to be a po erful narcotic and potentially poisonous, though fatalities from use of it or its al#aloids as rare. 6he physiological action of +yoscyamine as #no n to differs from that of %atura and Atropa only in by causing the same effects, but to a lesser degree. +yoscyamus is a remedy for spasm and painZparticularly for spasmodic pain. As a special sedative, +yoscyamus as applied in neuralgic and spasmodic conditions, allaying pain, soothing e$citability, inducing sleep, and arresting spasm. ,nflammatory cases presenting ith nervous e$citability, but only ith mild fever indicated +yoscyamus. ,t as also used to relieve gout, rheumatism. • Behavioral and 1sychological !onditions9 +yoscyamus as highly valued in the treatment of the various forms of IinsanityJ. ,t as especially commonly used in acute and chronic mania here cases most benefited ere those ith great e$citation, a tendency to destructiveness, delusions, epileptic fits, and quarrelsomeness. +yoscyamus as also used to quell nervous disturbances manifested by lo muttering delirium, or by singing and tal#ativeness during fevers,.

• *astrointestinal !onditions9 +yoscyamus as used to improve the action of bitter tonics in allaying irritation of the gastrointestinal tract although it as not applied hen constipation as present.. • *enitourinary !onditions9 +yoscyamus as considered an e$cellent agent in irritable, spastic conditions of the bladder and urethra. %ecreased nervous tone indicated its use in urgency, tenesmus, and incontinence. ,t as found to be a urethral sedative, and combined ith camphor =pill>, had long been employed to relieve urethral irritation after the passing of catheters. • :eurological !onditions9 6he 'clectics described +yoscyamus a cerebro&spinal sedative. :ervous irritation ithout congestion, or high fever, but ith disturbance of the circulation in the cerebrum and tendency to mental aberrations ere the #ey&notes to its use. All these cases hen sho ing anemia and nervous depression, ill yield to +yoscyamus or its al#aloids. +o ever, its sedative effect required larger doses, hich as more transient and less po erful than Atropa. +yoscyamus as used to relieve pain and promote sleep, having been particularly useful in any neuralgia, including herpes (oster, headache associated ith spasm any here in the body. +yoscyamus as not used to force sleep in insomnia, as narcotic doses ere required. 4ather, it as used to allay irritability, hich sleeplessness often follo s, or to relieve restlessness and e$cessive dreaming during sleep. )or this purpose, no herb as considered more efficient than +yoscyamus having even been used in childrenNs diseases for this purpose. )or similar purpose, +yoscyamus as especially valuable to control the nervous phenomena follo ing fevers and other e$hausting diseases. +yoscyamus as also used to calm nervous heart action, particularly ith valvular insufficiency. • 1ulmonary !onditions9 +yoscyamus as used in spasmodic asthma and chronic cough, bronchitis ith short, dry, e$plosive cough and as an important remedy in hooping&cough ,n pneumonia the 'clectics obtained prompt results from small doses. ,n particular, dry, irritative cough or nervous cough aggravated by lying do n, ere considered the indications for +yoscyamus. As such , it as frequently given ith 1runus in a syrup. • 6opical Applications9 6he fresh leaves ere used as an a fomentation for e$ternal application to allay the inflammation and pain of ulcers and tumors, headache, and the pain in gouty, neuralgic or rheumatic affections. Current Medicinal Use: +yoscyamus is often compared to Belladonna as both plants e$ert anticholinergics effects. +o ever, +yoscyamus is less li#ely than Belladonna to stimulate the central nervous system and more ea#ly e$erts anticholinergic effects. +yoscyamus is most often used for its antispasmodic effects on the digestive and urinary tracts. ,t is used in conditions involving spasm of these systems especially if there is associated pain, restlessness, and nervous agitation. • 1ulmonary !onditions9 +yoscyamus can also be smo#ed in order to reduce bronchial spasm. +yoscyamus is also indicated in dry, nervous, irritable coughs. • *astrointestinal !onditions9 Additionally, the sedative effects of hyoscine are useful in relieving motion sic#ness, ramps, spasm, diarrhea, and bloating. AABF • *enitourinary !onditions9 5ome herbalists describe +yoscyamus as having a tropism for the genitourinary tract. • :ervous !onditions9 ,n small doses, +yoscyamus may help to alleviate depression and in larger doses may help to relieve mania. +yoscyamus is helpful in restoring rest in persons e$periencing delirium from e$haustion, as in after a sic#ness. +yoscyamus is used to treat /enierre@s disease in 'urope. #harmacy: 1o der9 AE&F0 mg per day A9A0 tincture9 A ml 6,%K ee#ly ma$imum O AE ml

Drug ,nteractions: no information is currently available from the selected resources. Contraindications: 6he solanaceous plants may be inappropriate in pregnancy, glaucoma, urinary retention, paralytic ileus, intestinal atony and obstruction, tachycardia, arrhythmia, and B1+. )o*icity: Acute to$icity presents ith facial dryness, nausea, increased pulse rate, vertigo, dull headache, dilated pupils, muscular ea#ness, reduced peristalsis, tachycardia, paralysis, delirium and hallucinations, coma, spasms, cramps, convulsions, rapid pulse, salivation, death. ?ing added giddiness, general e$citation, fullness of pulse, flushing of the face, eight in the head, headache, somnolency, furious delirium, unconsciousness, coma, unresponsive pupils to light, cold s eat, small, frequent, and feeble pulse, and deep and labored respiration. 6etanic rigidity may be present a portion of the time and sometimes convulsions, as ell as nausea, vomiting, and intestinal pain and purging. 6he treatment of poisoning by +yoscyamus is that indicated under Belladonna. AABH !hronic to$icity symptoms include a macular rash hich is dry and pruritic. AABB

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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1184 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1185 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1186 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1187 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1188 Brin#er ), The Toxicology of Botanical Medicines, 2nd ed., ACB39FE.

Hypericum perforatum
Common name: 5t. -ohn@s ort Ha!itat: +ypericum is native to 'urope and naturali(ed to :. America.

Hypericaceae

Botanical description: A F0 cm tall herbaceous plant. A yello ish&green hollo stem ith t o longitundinal opposite ridges bears translucently dotted leaves. 6he flo ers are yello ith long stamens and lanceolate, sharply pointed sepals. 6he leaves have small perforations in the leaves compared to ornamental varieties hich do not. =+old it up to the light> #arts used: )lo ering tops ,dentified Constituents: • Anthracene derivatives =0.A&0.3G>9 favoring naphthadihydrodianthrones, in particular hypericin, pseudohypericin • )lavonoids =2&<G>9 in particular hyperoside, quercitin, rutin, isoquercitrin, also biflavonolids, including, among others, amentoflavone • Panthones9 A,3,F,H&tetrahydro$y&$anthone • Acylphloroglucinols9 hyperforin ith small quantities of adhhyperforin • 7olatile oil9 chief components aliphatic hydrocarbons, including, among others, 2& methyloctane, undecane, furthermore dodecanol, mono& and sesquiterpenes9 including, among others, alpha&pinene, caryophyllene, additionally also 2&methyl&3&but& 3&en&2&ol • 0ligomeric procyanidines • !atechin tannins =up to A0G> • !affeic acid derivatives9 including, among others, chlorogenic acid #harmacology: • Anti&depressant9 6he sedative action of the plant stems from hypericins, biflavones and hyperforin, although the mechanisms of action remain unclear. 6he hypericins have monoamine o$idase =/A0> inhibiting actions in&vitro. 6his as thought up until recently to be the mechanism of action of the anti&depressant, sedative effects of 5t. -ohn@s ort. +o ever, the hypericins are largely degraded in the digestive processes and plasma levels do not reach significant enough amounts to account for the anti&depressant effects. AABC :e research suggests that 5t. -ohn@s ort e$tracts may e$ert their antidepressant actions by inhibiting the reupta#e of the neurotransmitters serotonin, norepinephrine, and dopamineK this action is possibly due to the constituent hyperforin. AAC0 +o ever, the dose required for these effects to occur in humans is impossible to ingest. AACA +ypericum e$tract reduces cyto#ine e$pression =interleu#in&F>. 6here is a theoretical possibility that interleu#ins can induce depression in susceptible individuals.AAC2 Another proposed mechanism of action involves the binding of +ypericum e$tracts to *ABA&a and *ABA&b receptors. +ypericum e$tracts have high affinity for these receptors.AAC3 *ABA plasma levels are lo in bipolar and unipolar depression and ben(odia(epine, hich enhance *ABA&a activity, may be effective anti&depressants in addition to being an$iolytic. AAC< • Anti&viral9 +ypericin and pseudohypericin inhibit encapsulated viruses, including herpes simple$ types A and 2, +,7&A, cytomegalovirus, para&influen(a 3 virus, vesicular stomatitis virus and equine infectious anemia virus. AACE 6he mechanism of +ypericum@s anti&viral action is undetermined. • !ardiotonic9 6he procyanidin fraction of +ypericum enhances coronary blood flo and antagoni(es histamine and prostaglandin )& induced arterial contractions.AACF 6hese action lead to enhanced flo of blood and therefore nutrients to the myocardium. • +epatoprotection9 A ater3alcohol e$traction of +ypericum increased bile duct flo in rats and reduced carbon tetrachloride& induced necrosis in barbiturate treated mice.AACH +ypericum accelerates the metabolism of many drugs by inducing !;1<E0 en(ymes. • /elatonin increase9 C0 drops of a commercial preparation of +ypericum Q+yperforatR significantly increased nocturnal melatonin after three ee#s.AACB • 1rotein ?inase ! ,nhibition9 +ypericin inhibits glioma cell line gro th in&vitro due to inhibition of protein #inase !. 6he glioma inhibitory activity is equal to or greater than 6amo$ifen. AACC 6his action implies anti&viral and anti&neoplastic actions. ,n addition the inhibition of protein #inase ! leads to inhibition of arachidonic acid and leu#otriene B release hich results in an anti&inflammatory action.A200 • Wound +ealing9 6he volatile oil and flavonoids in +ypericum possess anti&microbial activity. /a"or anti&bacterial =especially *m.

1ositive> and minor anti&fungal actions have been observed in&vitro. A20A 6opical application of +ypericum e$tracts inhibit ,taphyloccus aureus infection and speed the healing time for ounds, including burns. A202 1harmaco#inetics9 4ecent pharmaco#inetic studies have been published using the 0.3G hypericin content standardi(ed e$tract. 6he ma"or dra bac#s of these studies is the focus on hypericin and pseudohypericin. :onetheless, these studies effectively demonstrated that hypericin and pseudohypericin are absorbed. ,n one of the studies, it as sho n that after < days of ta#ing the standard dosage of the e$tract =300mg t.i.d.>, a steady state is reached ith mean ma$imal plasma levels during the steady&state period of B.Eng3ml for hypericin and E.Bng3ml for pseudohypericin. A203 Medicinal actions: anti&inflammatory, astringent, vulnerary, sedative nervine, anti&depressant, antimicrobial, nervous trophorestorative, diuretic )raditional Medicinal Use: 5pecific ,ndications and Uses9 5pinal in"uries, shoc#s, or concussionsK throbbing of the hole body ithout feverK spinal irritation, eliciting tenderness and burning pain upon slight pressureK spinal in"uries, and lacerated and punctured ounds of the e$tremities, ith e$cruciating painK hysteriaK locally to ounds, contusions, etc. A20< 6he 'clectics used +ypericum in diarrhea, dysentery, orms, "aundice, hemoptysis and other hemorrhages including menorrhagia, oliguria and in chronic urinary affections. ,n particular, +ypericum as applied to most cases involving the nervous system. • :ervous !onditions9 ?ing noted that +ypericum has undoubted po er over the nervous system, particularly the spinal cord. +omeopathic physicians have regarded it as the Arnica of the nervous system. ,t as used in in"uries of the spine as ell as lacerate or puncture ounds of the limbs to prevent tetanus and relieve pains. +ypericum as highly valued in spinal irritation ith burning pain elicited from gentle pressure on the spinous processes. 6hrobbing of the hole body in nervous individuals, fever being absent, as also said to be a good indication for +ypericum. 6he 'clectic physicians also noted that +ypericum as an efficacious remedy for nervous affections ith depression. • 6opical Applications9 '$ternally, +ypericum as used in fomentation, ointment or oil for dispelling hard tumors, ca#ed breasts, bruises, ecchymosis, s ellings, ulcers, etc. +ypericum as also combined ith an equal amount of %atura in an ointment for such conditions. Current Medicinal use: +ypericum has been used throughout 'uropean history to treat sciatica, ounds and burns. +ypericum as thought to ard off evil spirits. 6hese uses continue to be applicable ith the refinement of current medical terminology. • Behavioral and 1sychological !onditions9 +ypericum is used for mild to moderate depression, particularly in individuals feeling feelings of isolation, lac# of community and separation from the rest of the orld. +ypericum has been tested in over 3,000 patients against placebo and various controls. A meta&analysis of 23 randomi(ed trials of +ypericum ith a total of A,HEH outpatients ith mild to moderate depression reveals that +ypericum is significantly superior to placebo and comparably effective to standard antidepressants hile producing fe er side effects. A20E 0f these studies comparing +ypericum ith placebo, appro$imately EEG of patients receiving +ypericum improved, vs. 22G receiving placebo. ,n those studies comparing +ypericum ith standard antidepressants, F<G of patients receiving +ypericum improved hile EBG of patients receiving standard anti& depressants improved. 6he effects of 5t. -ohn@s ort may ta#e any here from 2 to B ee#s to manifest. 6he effects of long&term therapy ith 5t. -ohn@s ort is un#no n. '$tracts of 5t -ohn@s ort standardi(ed for hypericin content =most studies used the 0.3G hypericin content e$tract> has significant support in the treatment of mild to moderate antidepression. 6he official *erman !ommission ' monograph for 5t -ohn@s ort lists psychovegetative disturbances, depressive states, fear, and nervous disturbances as clinical indications for 5t -ohn@s ort. 6he clinical evaluation of 5t -ohn@s ort e$tract began ith an initial clinical study of si$ depressed omen, aged EE&FE, hich measured the change in urinary metabolites of noradrenaline and dopamine follo ing administration of a standardi(ed e$tract of 5t -ohn@s ort e$tract =0.A<G hypericin content>. 4esearchers found a significant increase in the catecholamine metabolite 3&metho$y& hydro$yphenylglycol, a mar#er commonly used to evaluate the efficacy of antidepressant therapy. A follo &up study by the same researchers follo ed AE omen ith depression ta#ing the same standardi(ed e$tract. 6he results demonstrated a significant im& provement in symptoms of an$iety, apathy, hypersomnia and insomnia, anore$ia, psychomotor retardation, depression, and feelings of orthlessness. :o side&effects ere observed. 5ince this initial study, a total of A,EC2 patients have been studied in more than 2E double&blind controlled studies.,n these studies, 5t -ohn@s ort e$tract as sho n to produce improvements in many psychological symptoms. 5t -ohn@s ort e$tract as able to achieve these benefits ithout producing significant side&effects. 6he currently available information clearly supports the short&term use of 5t

-ohn@s ort e$tract as an alternative to standard antidepressant drugs in cases of mild to moderate depression. Whether it ill be sho n to be suitable in the treatment of serious depressions =i.e. depressions associated ith psychotic symptoms and3or depressions ith serious ris# of suicide> remains to ans ered. A20F, A20H, A20B 6he aim of a controlled, single&blind study as to evaluate if 5t -ohn@s ort could be beneficial in treating 5easonal efefctive disorder =5A%> patients and hether the combination ith light therapy ould be additionally advantageous. 1atients ho fulfilled %5/& ,,,&4 criteria for ma"or depression ith seasonal pattern ere randomi(ed in a < ee# treatment study ith C00mg of 5t -ohn@s ort e$tract3day =0.3G hypericin content> combined ith either bright =3000 lu$, n O A0> or dim light =c300 lu$ therapy>. 6he significant reduction in the +amilton %epression scale in both groups =H2 and F0G, respectively> indicates that 5t -ohn@s ort e$tract may offer support to patients ith 5A% as a sole therapeutic agent as ell as in combination ith light therapy. A20C,A2A0 • :ervous !onditions9 +ypericum may reduce a variety of other neurological conditions. +ypericum reduces an$iety, insomnia due to restlessness, irritability, neuralgia, neuroses, migraine headaches, fibrositis, dyspepsia and sciatica. A2AA +ypericum is useful for enuresis due to nervous an$iety or nerve irritation in the bladder, especially in children. A2A2 5t -ohn@s ort has been sho n to improve sleep quality and ell&being in healthy elderly sub"ects. With antidepressant drugs, particularly tricyclic antidepressants and /A0 inhibitors, 4'/ =rapid eye movement> sleep is reduced. 5t -ohn@s ort did not interfere ith 4'/ sleep li#e other antidepressants and as sho n to increase the intensity of deep sleep during the total sleeping period as demonstrated by brain ave studies. While 5t -ohn@s ort improved sleep quality it did not act as a sedative =i.e. it did not reduce sleep onset> nor did it change total sleep duration.A2A3 0ne of the most interesting comparative studies as a double&blind study here 5t -ohn@s ort e$tract =0.3G hypericin content> as compared ith maprotyline in 2< healthy volunteers by measuring resting brain ave =''*> tracings and mental activity =visual and acoustic evo#ed potentials>. ,nterpretation of the differences in reactions indicated that, unli#e maprotiline, hich interferes ith mental function, 5t -ohn@s ort actually improves memory and other mental activities. A2A< • /usculos#eletal !onditions9 +ypericum is also used as an analgesic for pain and inflammation. Acute inflammations associated ith in"ury, trauma to the nerves and pain all respond to internal and topical use of +ypericum. • ,mmune !onditions9 6he research suggests that 5t -ohn@s ort may be a useful ad"unctive treatment for herpes simple$, mononucleosis, and influen(a, although further human studies are needed to establish the optimal dosage of the standardi(ed e$tract. 6he greatest promise of 5t -ohn@s ort, ho ever, may be in the treatment of A,%5. ,n response to the in vitro and animal studies, many A,%5 patients began self&administering 5t -ohn@s ort. Although most patients reported feeling better ith a more positive outloo#, more energy, and less fatigue, it as not #no n to hat degree this as due to a placebo effect. 6o better determine the benefits, a number of trials evaluated the efficacy of standardi(ed e$tracts of 5t -ohn@s ort in the treatment of +,7&infected individuals.,n one study, 5t -ohn@s ort e$tracts providing appro$imately A mg of hypericin3day ere studied in 3A patients. !oncomitant use of A86 and other treatments as permitted. 6he results of the study ere encouraging. ,n the subgroup of A0 patients ho too# no A86 either before or during the study =IA86 virginsJK none had A,%5>, the mean helper 6&cell count increased A3G from baseline after A month on 5t -ohn@s ort and maintained this increase for < months. Although these increases ere not statistically significant, in contrast, helper 6&cell counts of the A0 patients using A86 throughout the study fell significantly after an initial mild rise. 5ide&effects ere limited to reversible liver en(yme elevations in five patients ith all levels returned to baseline after A month ithout 5t -ohn@s ort e$tract. ,n another open pilot study, AB +,7 patients =three ith the !%! ,,, eight ith !%! ,,,, four ith !%! ,7 B and three ith !%! ,7 !A classification> ere treated solely ith standardi(ed 5t -ohn@s ort e$tract = ee#ly intravenous in"ection and daily oral inta#e>, providing a daily inta#e of 2mg of hypericin. 6he AF3AB patients ith good compliance sho ed stable or even increasing counts of absolute helper 6&cells over the <0 months of observation. Also the helper to suppressor 6&cell ratio sho ed an improvement in the ma"ority of these patients. !linically, it as note orthy that only t o of these AF patients encountered an opportunistic infection during the <0 months of observation. 6he other A<3AF patients remained clinically stable and active in or# and life. 6his steady&state condition of +,7 infection also correlated ith stable values of hemoglobin, leu#ocytes and platelets. )urthermore, none of the other ise #no n viral complications due to !/7, herpes or 'B7 as encountered in these AF patients. %espite these good preliminary results, the trials proved disappointing as significant blood levels of hypericin could not be achieved using the e$tract either orally or intravenously. Use of the standardi(ed e$tract for the treatment of +,7 infection has since been replaced by the use of intravenously administered synthetic hypericin. 1reliminary studies are again producing some encouraging results ith good safety, although photosensitivity may occur and long&term controlled evaluation is needed. A2AE,A2AF • 6opical Applications9 +ypericum may be applied topically to an area of pain and inflammation such as over the area of topical burns =post radiation, sunburn>, bruises, diaper rash, +erpes (oster or a painful tooth. !oncomitant internal use ill augment the effectiveness of +ypericum. +ypericum repeatedly applied to an area of in"ury that involved severing of a nerve may result in complete recovery of function to that tissue. #harmacy: 5tandardi(ed e$tract9 300 to C00 mg daily of e$tract standardi(ed to 0.3G hypericin ,nfusion9 2&< g 3 cup 2% to 6,% =A tsp. O A.B gm>

A9E tincture9 A&< ml 6,% A9A fluid e$tract, fresh plant Drug interactions: =for more detailed information, please see %r. Brin#er@s boo#> "0"( • Anesthetics, general9 /ay cause a hypotensive episode that is poorly responsive to resuscitation. • Anticoagulant medications9 ,ncreases clearance of arfarin and phenprocoumon • !yclosporine9 !oncomitant use decreased plasma concentrations of cyclosporine in a heart transplant patient. • %igo$in9 +ypericum reduced pea# concentrations after A0 days concomitant use. • 'thinylestradiol, desogestrel, 0!1s9 !oncomitant use induced brea#through bleeding due to increased clearance of the synthetic hormones. • 4eserpine9 antagonistic effects. • 554,s, /A0,s9 !oncomitant use has resulted in serotonin syndrome. • 6heophylline9 +ypericum induces !;1AA2 hich metaboli(es theophylline resulting in increased clearance. • ,ndinavir9 +ypericum induces !;13A< in hepatocytes and has been sho n to correlate ith reduced levels of indinavir in a small, poorly controlled trial. +o ever, other medications metaboli(ed by !;13A<, such as alpra(olam, have not sho n an interaction. :one the less, +ypericum has been recommended not to be used ith protease inhibitors and nonnucleoside reverse transcriptase inhibitors. 0ther drugs that +ypericum should not be combined ith include9 diltia(em, nifedipine, beta bloc#ers, impipramine, amo$apine, amitriptyline, phenobarbital, phenytoin, cylcophosphsamide, tamo$ifen, ta$ol, etoposide, rapamycin, tacrolimus, citralopram, fluvo$amine, naratriptan, ri(atriptan, sumatriptan, (olmatriptan, opiods, meperidien, sympathomimetics, nalo$one, prio$icam, tetracycline. Contraindications: "0"/ • 1regnancy due to emmenagogue and abortifacient effects =empirical> and uterine stimulant activity =in vitro, animals>. • 1sychotic symptoms, suicidal ris# or endogenous depression =speculative> • 5urgery, elective, due to potential interactions ith anesthetic drugs. • Ultraviolet light e$posure =speculative> due to possible photosensitivity if very high doses of hypericin are consumed, such as 3F00 mg standardi(ed e$tract in a single dose or F00 mg tid for AE days. )o*icity: Appro$imately 2.<G of patients report side effects hich include9 gastrointestinal irritations, allergic reactions, tiredness and restlessness.
1189 1190

5taffeldt B, et al., 71 5eriatric Psychiatry ;eurology, ACC<KH95<H. .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1191 1erovic 5 and /uller W., )rIneim9 orsch, ACCEK<E9AA<E. 1192 6hiele, B and Brin# ,, 7 5eriatric Psychiatry ;eurology , ACC<KH =suppl. A>95F0. 1193 /uller, W., et al., &nd >nternational 2ongress on Phytomedicine, /unich, ACCF. 1194 1etty, ). et al., Biological Psychiatry, ACC2K3293E<. 1195 .ope(&Bassocchi ,, +udson -, 6o ers *, Photochem1 Photobiol, ACCAKE<9CE.1 1196 /el(er 4, )ric#e U, +ol(l -, )rneim9 orsch, ACCAK<A9<BA. 1197 0(tur# ;, et al., Phytother1 Res1, U.?. ACC2KF9<<. 1198 %emisch ., et al., Pharmacopsychiatry, ACCA. 1199 !ould ell W, et al., ;eurosurgery, ACC<K3E9H0E. 1200 1anossian A, et al., Phytomedicine, ACCFK39AC. 1201 *aind, ?., *an"oo, 6., >ndian 71 Pharm1, ACECK2A9AH2. 1202 5al"ic -., 5er1 "ffen1, ACHEK29<0F. 1203 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC. 1204 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1205 .inde, ?, et al, British Medical 7ournal, ACCFK3A392E3. 1206 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000. 1207 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 1208 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC. 1209 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 1210 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000.

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'5!01, /onograph 5t. -ohn@s Wort. 'uropean 5cientific !ooperative for 1hytomedicines. 6he :etherlands9/eppelKACCF. Weiss 4, Herbal Medicine, Arcanum9 Beaconsfield 1ubl., .td., ACBB. 1213 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 1214 ,bid 1215 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000. 1216 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 1217 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. pAHC&AB< 1218 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. pAHC&AB<

Hyssopus officinalis
Common name: +yssop Ha!itat: +yssop is native to 'urope and is no cultivated idely.

1a!iatae

Botanical description9 6his is a perennial plant ith the lo er part of the stem oody and the upper part slender and and&li#e branches. 6he plant gro s to about 2 feet. 6he leaves are opposite, sessile, lance&linear, punctate. )lo ers bloom in -uly and are blue&purple, in small clusters upon cro ded spi#es. #arts used9 +erba Constituents:A2AC • 7olatile oil9 pinocamphone, alpha& and beta&pinene, linalool, A,B&cineole, limonene • 6erpenoids9 marrubiin, olanolic acid, ursolic acid • )lavonoids9 glycosides of hesperidin and diosmetin in the volatile oil • hyssopin glycoside, tannins, resin #harmacology: An in&vitro study of the essential oil of hyssop demonstrated a spasmolytic action, hich as found to be due primarily to linalool. 6he spasmolytic action as sho n to be non&specific. .inolool =<EG of the essential oil of +yssopus officinalis> acts on both receptor&stimulated and on ion&stimulated contractions.A220 6he terpenoid, marrubiin, is also found in /arrubium, and is an e$pectorant. 6he ursolic acid is antiinflammatory. Although in !itro studies indicate the total alcohol e$tract of hyssop as ell as its carbohydrates inhibit human immunodeficiency virus =+,7>,A22A hyssop has not been used as a treatment for +,7 infection. ,t is unli#ely to be used as such because of its lo potency. Medicinal actions: 5timulant, carminative, pectoral, sedative, tonic )raditional Medicinal Use: +yssop as considered a diffusive aromatic, stimulating and rela$ing, ith mild tonic properties that sustains capillary circulation gently, and the nervous peripheries.A222 • 1ulmonary !onditions9 +yssopus as principally used in sore throats, as a gargle, combined ith sage and alum. ,t as also recommended in asthma, coughs, and other affections of the chest including soreness, as an e$pectorant. • 6opical Applications9 6he leaves ere applied to bruises to speedily relieve the pain, and disperse every spot or mar# from the parts affected. Current Medicinal Use: At present, no clinical trials have been reported supporting hyssop@s use in any condition. • *astrointestinal !onditions9 +yssopus is an effective carminative. • 1ulmonary !onditions9 +yssop is vasodilatory to capillaries, thus sustaining blood flo to organs, i.e. the lungs. %ue to the anti& spasmodic action of the volatile oil, +yssop promotes e$pectoration, relieves asthmatic cough, and is reduces the inflammation associated ith respiratory infections. +yssop is ell suited to infections ith significant mucous accumulation, as it is a stimulating e$pectorant. Additionally, +yssopus is diaphoretic. • 6opical Applications9 Additionally, the volatile oils =particularly linalool> of +yssop have strong anti&fungal activity. +yssop may be used e$ternally as an anti&fungal and to speed the healing of bruises. #harmacy9 ,ts pleasant taste ma#es a hot infusion ell tolerated and effective. ,t is often combined ith /arrubium in an infusion. ,nfusion9 A&2 tsp. herba3cup aterK A cup 6,% A9E tincture 2&< ml 6,%

Contraindications: +yssop is contraindicated in pregnancy.A223 )o*icity: :o information on to$icity is available in the selected resources.
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A /a((anti *, .u /, 5alvatore *, 5pasmolytic Action of the 'ssential 0il form +yssopus officinalis .. var. decumbens and ,ts /a"or !omponents. 1hytotherapy 4es. ACCBK A29 5C2&5C<.R

1221 1222

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 1223 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. BH

,nula helenium
Common )rade @ame: :one #no n.

Compositae . Asteraceae (Aster . 4unflower family

Common name: 'lecampagne, 5cab ort, 'lf %oc#, 7elvet %oc#, Aunee, 1ush#aramula =5ans#rit>, Puan )u =!hinese>.

Ha!itat: ,ndigenous to 'urope ] :orth Asia. !urrently, naturali(ed over much of 'astern :. America. Botanical description9 A stout perennial herb hich thrives in moist, sandy, mountainous areas. 6he stems are 3&E@ high, do ny above ] branched. 6he leaves are large, ovate, 3 toothed margins, ] velvety undersides. 6he upper leaves clasp the stem ] the lo er leaves are stal#ed. 6he flo er heads are golden yello , 3&<J in diameter, solitary ] 3 narro raysK blooming in -uly ] August. 6he root is slightly grey, hard, horny, ] cylindrical, ] should be dug in the autumn of the second year. 6he root is usu split into longitudinal, oblique pieces having one or more roots. 6he hole plant is similar in appearance to horseradish. #arts used9 4oot ] )lo ers. $nergetics: 1ungent. Bitter. +eating. =&> 7ata ] ?apha. =X> 1itta. Affinity for all tissues, e$cept reproductive. A22< 6ends to be slightly arming, drying ] stimulating.A22E Constituents: • 7olatile oil =A&<G>9 5esquiterpene .actones =alantolactone, isoalatolactone, alantic acid, ] a(ulene>. • !arbohydrate9 ,nulin =up to <EG>. • /ucilage =branches of uronic acid>. • 1hytosterols. • 4esin. #harmacology: ,nulin derives its name from ,nula helenium. ,nulin is not metaboli(ed by the body and is secreted unchanged. 6he main component of the root is the carbohydrate inulin, hich in autumn, can comprise as much as <EG of total root eight. ,nulin is bitter ] acrid in taste, 3 an odour that is reminiscent of camphor. A22F 7olatile oils are thought to be the main active constituent group in ,nula. 5esquiterpene lactones in 'lecampagne are anti& inflammatory ] antibiotic in action. Antifungal activity has also been demonstrated. ,solated alantolactone has been used to treat parasites =e.g., round orm, thread orm, hoo# orm, hip orm>. 7olatile oils are also spasmolytic. 4esearch has sho n them to be useful for inhibiting tracheal ] ileal smooth muscle spasm. 0ut of 22 plants tested, the most potent spasmolytics ere9 angelica root, clove, thyme, elecampagne, ] lemon balm. A22H ,nulin ] mucilage in elecampagne are thought responsible for this herb@s anti&tussive ] carminative actions. A22B Medicinal actions: %iaphoretic. %iuretic. '$pectorant. Alterative. 6onic. Antiseptic. Anti&spasmodic. !arminative. Analgesic. 4e"uvenative .ung 6onic. Current > )raditional Medicinal Use: !onstitutionally, 'lecampagne is indicated for general catarrhal conditions, such as chronic pulmonary affections that have s$ of9 cough, 50B, hee(ing, a specific for hooping cough in children, diseases of the breast ] malignant fevers, hepatic torpor, dyspepsia, ] a feeling of stitches in the side caused by the spleen. 'lecampagne is #no n for its abilities to strengthen, cleanse, ] tone up pulmonary ] gastric membranes, encouraging a more harmonious metabolism by assisting the pancrease 3 the large amount of natural inulin contained in the root. 'lecampagne as highly valued in cases of incipient 6B. A22C • 9astrointestinal Conditions: Bitter principles indicate its use in cases here digestive tonification is indicated, such as in atony of abdominal viscera, 3 engorgement ] rela$ation of the tissues. • 9ynecologic Conditions9 ,nula as considered to have a moderate influence in promoting menstruationK for hich purpose it as suggested to be combined ith Anthemis and !aulophyllum. A230 • #ulmonary Conditions: ,nula is one of the most important lung tonics. ,t is used in any chronic lung condition acting as an e$pectorantK being a valuable r$ in t$ of chronic catarrhal, bronchial, ] all pulmonary irritations, including 6B. 'lecampagne is indicated in cases characteri(ed by cough of a teasing, persistent character, that is accompanied by substernal pain ] profuse secretionsK such as in \la grippe@ ] other more severe forms of colds. ,nula@s arming ] strengthening properties promote the discharge of viscid mucous. 'lecampagne is anti&inflammatory, immuno&stimulatory ] some hat sedating overall. ,nula aids

• • •

e$pectoration, esp. in persons ho are ea# from over or#, from disease, or from age. ,t is particularly indicated in cases of irritating bronchial coughs, especially in children or the elderly. ,nula soothes inflamed tissue ] stimulates e$pectoration. Anti!acterial: 6he antiseptic properties of this plant are pronounced. 6he bitter principle, helenin, is strongly bacteriocidal, esp. to the 6ubercle bacillus. ,mmune =unction9 ,nulin is a strong activator of complement ] thus enhances cell&mediated immunity. @ight 4weats: As a diaphoretic, ,nula helps to relieve night s eats.

Current +esearch +eview • ,schemic Heart Disease: :ine patients ith ischemic heart disease ere treated ith 3 g root po der of ,nula racemosa or nitroglycerin C0 minutes prior to testing. All nine sub"ects had improvement in 56&segment depression on '!*, ith greater improvements seen after ,nula treatment.A23A #harmacy9 • ,nfusion9 q g =A tsp O < g>K sig A cup 6,%&2,% as an e$pectorant. A232 ,nula is slo in action, hence its long&term use is indicated for chronic conditions. ,nulin is most soluble in alcohol. As a diaphoretic ] e$pectorant, ta#e 3 ginger, pippali, cinnamon, ] cardamom. As a tonic ] re"uvenative, ta#e 3 herbs li#e ash agandha, comfrey root or marshmallo . ,t can be used e$ternally as a paste for muscular pain. As along tonic W 0.Eo( simmered in A pt. ater for 20 min. ] ta#en tid after meals, 3 honey. A233 Contraindications.)o*icity: ,t is not suitable for cases of any class here the lungs are irritated or dry as it increases the dryness, and gives a feeling of constriction.A23< /ay cause contact dermatitis.A23E
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)ra ley %, .ad 7. The Aoga of Herbs. .otus 1ress, 6 in .a#es, Wisconsin, ACC29AAF 6ilgner 5. Herbal Medicine rom the Heart of the Earth. Wise Acres 1ress, ,nc, !res ell, 0regon, ACCC9F0. 1226 +utchens A4. >ndian Herbalogy of ;orth )merica1 5hambhala, Boston, /assachusetts, ACCA9AAH. 1227 /ills 5, Bone ?. Principles J Practice of Phytotherapy1 !hurchhill .ivingstone, :;, :;, 200092C. 1228 .ininger et al. Healthnotes: 2linical Essentials, Herb Monographs . 1rima 1ublishing, 4oc#lin, !A, 200A. 1229 +utchens, AAH. 1230 !oo# 1231 6ripathi 5:, Upadhyaya B:, *up#a 7?. Beneficial effect of ,nula racemosa =1ush#armoola> in angina pectoris9 a preliminary report. >nd 7 Physiol Pharmac ACB<K2B9H3&E. 1232 PDR for Herbal Medicines1 /edical 'conomics !ompany, ,nc., /ontvale, :-, ACCC9CA3. 1233 )ra ley, %%4 1234 !oo# 1235 Brin#er ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04, ACCB9FC

,ris versicolor
Common name: Blue flag iris Ha!itat:"07& ,ndigenous to southern 'urope

,ridaceae

Botanical Description:"07( • )lo er and )ruit9 6he flo ers are long&pedicled and perfumed. 6he tepals are hite or slightly blue. 6he outer ones are dar#er ith a yello beard. 6he anthers are as big as the filaments. 6he upper lip of the stigma branch is inclined for ard. 6he fruit is a large capsule ith a number of sections in hich the bro n seeds are lined up li#e rolls or coins. • .eaves, 5tem, and 4oot9 6he plants are perennial 30&A00 cm high. 6he rhi(ome is thic# and short. 6he strong flo er&bearing stem is branched from the middle. 6he leaves are broad, s ord shaped, usually curved and gray&green. $nergetics: cooling and drying.A23B #arts used9 4hi(ome, collected in the fall Constituents9A23C • 7olatile oil9 furfural • ,ridin glycoside • Acids =salicylic and isophthalic> • /isc9 monocyclic!3A triterpenoid, gum, resin, sterols #harmacology: Medicinal actions: alterative, anti&inflammatory, cathartic, diuretic, stimulant, anti&obesity agent, A2<0 emetic, cholagogue, sialagogue, anthelimtic, diuretic,A2<A lymphagogue,A2<2 choleretic, pancreatic bitter. )raditional Medicinal Use: • 'ven at the time of the 'clectics and 1hysiomedicalists, ,ris as recogni(ed to act upon the gastrointestinal, glandular and nervous systems. ,n particular, ,ris as noted to e$ert a po erful catalytic action upon the lymphatic glandular system, the ductless glands, liver, pancreas, and #idneys. 6he 'clectics used ,ris as directly stimulant to aste and e$cretion, to influence the lymphatic system, in cachectic states, imperfect nutrition and particularly in the treatment of secondary syphilis. A2<3 5uch applications demonstrated its use as an alterative and cholagogue. • 6he specific indications for iris may be stated as impaired general health, ith mental depression, and hen the s#in presents abnormal pigmentationK fullness of thyroid glandK enlarged spleenK chronic hepatic complaints, ith sharp, cutting pain, aggravated by motionK nausea and vomiting of sour liquids, or regurgitation of food, especially after eating rich pastry or fatsK atery, burning bo el dischargesK enlarged lymphatics, soft and yieldingK rough, greasy conditions of the s#inK disorders of sebaceous folliclesK abnormal dermal pigmentationK menstrual rongs, ith thyroid fullnessK unilateral facial neuralgiaK muscular atrophy and other asting of the tissuesK bad blood. A2<< • %ermatological !onditions9 ?ing believed that ,ris seemed to have a better action in chronic conditions and as particularly adapted to diseases involving the sebaceous gland. 6he 'clectics indicated ,ris for rough, greasy, discolored conditions of the s#in, and in those cases here pustular eruption seems to be associated ith functional disturbances of the reproductive system such as hen associated ith thyroid fullness in the female. 6he 'clectics have used ,ris beneficially in ec(ema rubrum of children, and in cases of ec(ema of the scalp in adults. • 'ndocrine !onditions9 6he 1hysiomedicalists recogni(ed that ,ris has a bearing to ard the glandular system and the 'clectics specifically indicated ,ris in soft glandular enlargements. 5cudder noted that ,ris e$erted a specific influence in cases of enlargement of the thyroid gland, having effected cures in very severe cases. A2<E ?ing described ,ris as a reliable herb for the treatment of goiter, hether the enlargement is constant or simply fullness due to menstrual irregularities. Basedo Ns disease =e$ophthalmic goiter> in the early stage, has been cured by ,ris. AddisonNs disease has been greatly improved, though not cured by it. A2<F • *astrointestinal !onditions9 6he 'clectic and 1hysiomedicalists noted that ,ris aroused the secretion of saliva, bile and other =e$ocrine> glandular secretions. ,t as rarely used alone as a cathartic, being too active for ordinary purposes. ?ing noted that ,ris po erfully e$cites the biliary, salivary, and pancreatic secretions and it influences every part of the system in small doses, and repeated at short intervals. ,t seems to act more particularly on the glandular system, e$citing them to a

•

•

discharge of their respective offices. ?ing applied ,ris, in small doses, for gastric irritation ith associated vomiting and in gastralgia, being valuable in cholera infantum and cholera morbus. +e also recorded good results in burning aphthous states of the oral cavity. ?ing observed that muscular mucosa of the viscera, such as refle$ muscular pains dependent on gastrointestinal and pancreatic disorders, ere relieved by it. %uodenal catarrh, ith "aundice, and clay&colored stools, indicating a lac# of biliary secretion, as cured by ,ris. ,ris as li#e ise considered valuable in constipation, dependent upon biliary and intestinal torpor. ,n chronic affections of the pancreas, ith a sodden, leaden&colored tongue, and in chronic splenic disease, hen the s#in is blanched, as in leucocythemia, ,ris as indicated. An interesting use of ,ris as for distressing sensations beneath the scapula, symptoms that are no associated ith pancreatic or biliary conditions. )or biliousness, ?ing noted its effect as prompt and efficient as a remedy for bilious headache, accompanied by nausea and vomiting, or in sic# headache, dependent upon indigestion. ,n chronic hepatitis, and other hepatic disorders, ith constipation, and sharp, cutting pains, increased by motion, ,ris as given alone or combined ith other hepatics. ,t as also considered very efficient in malarial "aundice, intermittent and bilious remittent fevers. A2<H,A2<B *enitourinary !onditions9 !ombined ith diuretics or used alone, !oo# noted that ,ris had a distinct affect on the #idneys. %&'* ?ing indicated the use of ,ris in chronic renal diseases, edema, ascites, anasarca, hydrothora$, and hydropericardium. ?ing used ,ris successfully for gonorrhea, spermatorrhea, and prostatorrhoea. 5pecific iris as found very useful in those prostatic discharges and nocturnal emissions, the result of masturbation, and hich are accompanied ith considerable debility, mental uneasiness, and more or less irritation of the nervous centers. A2E0 *ynecologic !onditions9 ?ing noted that ,ris has a mar#edly positive influence on the ovarian and uterine disturbances giving rise to fullness. As a remedy for uterine hypertrophy, enlarged ovaries, ulcerated os and cervi$ uteri, uterine leucorrhoea, and dysmenorrhea the specific tincture as used.

Current Medicinal Use: • 5#in conditions9 Wor#s through the liver, helps in deto$ification. Used for ec(ema, spots and blemishes. )or more chronic ec(ema and psoriasis, used as part of a ider treatment. A2EA • *astrointestinal conditions9 ,ris is included in the digestive section because of its stimulating effects on the liver, gallbladder, pancreas, and colon. ,ris promotes the production and secretion of bile along ith other hepatic functions ma#ing it useful in to$ic conditions =i.e. ec(ema, psoriasis>. ,ris stimulates glandular functions in general, including the pancreas. ,ris is an e$cellent herb to use in pancreatic insufficiency associated ith to$icity Qi.e. e$cessive intestinal permeability ith resultant ec(emaR. *iven the dual function of pancreatic and liver stimulation, ,ris is especially indicated in fat maldigestion. %ue to its stimulating effect on bile secretion, ,ris acts as an aperient. A2E2 ,ris is also useful in constipation associated ith liver problems or biliousness.A2E3 • 'ndocrine !onditions9 ,ris is helpful in other glandular disorders including hypothyroidism = ith thyroid enlargement>, splenomegaly, lymphadenopathy, menstrual irregularities =including uterine fibroids>, sebaceous gland disorders =i.e. boils, acne>. ,n summary, ,ris can be thought of as a glandular alterative. A2E< #harmacy9 • %ose9 ,f a pronounced action upon the gastro&intestinal and glandularsecretions is desired, from E to 20 grains of the po der, or A0 to F0 minims of the strong tincture, or E to 20 drops of specific iris may be used. )or its specific uses, ho ever, the specific iris, in doses of from A320 to E drops, is preferred. A2EE • 1o dered root9 o A g.A2EF o 2&20 g W liver stimulantK 3&AE grains W for lymphatic and splenic congestion or fullness. A2EH o 20 grains W cathartic. A2EB o 2&E grains, sig. 6,% as a glandular stimulant.A2EC • .iquid e$tract9 o Unspecified strength9 2&< ml,A2F0 E gtts.A2FA o A92 fresh strength liquid e$tract9 A&E gtts 2%&6,% in little ater. A2F2 • 6incture9 o Unspecified strength9 <&A2 ml,A2F3 A0&2E gtts 6,% W liver stimulant, A&20 gtts W for lymphatic and splenic congestion or fullness,A2F< 2&< ml 6,%.A2FE o A9E 2EG 't0+ tinctureK sig A&E ml 6,%K ma$. dose A00 ml3 ee#. A2FF o )resh root, 3o(.K B0G alcohol, A pint. /acerate for 2 ee#s. 5ig A0&20 gtts 6,%. A2FH • %ecoction9 o A tsp3 cup aterK sig A cup 6,%.A2FB

•

o L&A tsp of dried herb3cup ater, bring to boil, simmer A0&AE min. 5ig9 A cup 6,%. A2FC '$ternal applications9 o 1oultice or ointment.A2H0 o %r. )o$@s s#in cancer liniment & tincture9 ,ris9 red clover9 sanguinaria O 2o( 9 Ao( 9 Ao(. 5ig9 apply e$ternally to the affected area and cover ith plastic to retain moisture. A2HA

Contraindications: • 1regnancy.A2H2 )o*icity.4ide $ffects9 • )resh root may cause dermatitis. 6o$ic doses cause burning sensation in the mouth and throat, :37, violent diarrhea, abdominal burning, gastroenteritis resulting in death. A2H3
1236 1237

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p. EF3. ,bid, p. EF3 1238 5harol 6ilgner, Herbal Medicine rom the Heart of the Earth, Wise Acres 1ress, ,nc., !res ell, 04, ACCC, p. HH 1239 4.!. Wren, Potter/s Encyclopaedia of Botanical Drugs and Preparations, !. W. %aniel !ompany .imited, 5affron Walden, 'ngland, ACBE, p. 3C 1240 Wren, p. 3C. 1241 W. /itchell, ;aturopathic )pplications of the Botanical Remedies, 2nd ed., ACB3, p. E2 1242 6ilgner, p. HH 1243 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed., 'clectic /edical 1ublications, 5andy, 04, AC03. 1244 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3. 1245 5cudder. 1246 )elter 1247 )elter 1248 W/., +., !oo#, Physiomedical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy , 'clectic /edical 1ublications, 1ortland, ACBE, pp. <BE&H 1249 ,bid 1250 )elter. 1251 %avid +offman, The ;e: Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesbury, %orset, ACC0, p. AB3. 1252 Bastyr University monograph used earlier 1253 +offman, p. AB3 1254 Bastyr University monograph used earlier 1255 )elter . 1256 Wren, p. 3C. 1257 /itchell, p. E2, H0 1258 /itchell, p. E2 1259 !oo#, pp. <BE&H 1260 Wren, p. 3C. 1261 /itchell, p. H0. 1262 6ilgner, p. HH 1263 Wren, p. 3C. 1264 /itchell, p. E2, H0 1265 +offman, p. AB3 1266 %r. Alschuler 1267 !oo#, pp. <BE&H. 1268 %r. Alschuler 1269 +offman, p. AB3 1270 Wren, p. 3C. 1271 /itchell, p. F0 1272 6ilgner, p. HH 1273 6ilgner, p. HH

Huglans nigra . H2 cinerea. H2 regia
Common name: Blac# Walnut =-. nigra>, Butternut =-. cinerea>, Walnut )ruit 5hell =-. regia> Ha!itat9 :ative to the /iddle 'ast, cultivated orld& ide

Huglandaceae =Walnut )amily>

Botanical description9 A large tree ith strong, spreading boughs. .eaves are composed of H&C green leaflets, hich are E&A0 cm in length ] 3&< cm ide. .eaves have a characteristic odor, hich is gradually lost as the leaves turn bro n. 6he bar# is dull, blac#ish& bro n, tough ] fibrous. 6he taste is bitter ] astringent. #arts used9 .eaves, ,nner Bar# of root ] trun#, Unripe :uts. Constituents9 .eaves9 naphthaquinones ="uglone>, volatile oil, fatty acids, tannins =<<.BG>, ellagic acid, gallic acids, flavonoids, inositol. -uglandin =-. cinerea> W main constituent, cathartic action. A2H< #harmacology: of :apthaquinones Medicinal actions: alterative, la$ative, antiseptic, Aperient, 5udorific 3 %iaphoretic )raditional Medicinal use: %ermatological !onditions9 -. nigra can be used for various s#in eruptions =ie. acne, ec(ema, herpes, ulcerations, urticaria>, esp. in the t$ of chronic s#in conditions hich are assoc. 3 problems of digestion ] assimilation. -. cinerea is used for pustular ] ec(ematous s#in conditions, including topical applications for ring orm =6inea corporis>. Both Blac# Walnut ] Butternut are indicated in s#in conditions assoc. 3 abnormal *, function.A2HE ,n general, alteratives are indicated in s#in diseases that are assoc. 3 to$emia or septicemia. 6raditionally, alteratives are indicated in the t$ of "oint d(, !6 d(, ] in deto$ification formulas. %&4$ *, !onditions9 -. cinerea is a cathartic that is moderately slo , but reliable in action. ,ts rela$ing ] stimulating qualities increase *, tone by influencing9 the gall bladder, assoc. ducts, ] the mucous membranes ] musculature of the bo els. %&44 When constipation is a result of deficient *B secretions, butternut can be used as an aperient. A2HB 5ymptoms of patients 3 *B congestion, include9 anore$ia 3 a coated tongue, constipation, +A, di((iness, pasty comple$ion, ] slight "aundice =rare>. A2HC -. cinerea is helpful in cases of chronic and sub&acute diarrhea that is secondary to hepatic congestion accompanied by dense hemorrhoids. %&(- .i#e ,ris versicolor, butternut can also evacuate the bo els ith little griping hile stimulating *, glandular secretions. A2BA 6he fi$ed oil is effective in e$pelling orms, including tape:orms. +epatobiliary !onditions9 -. cinerea clears hepatic congestion ] stimulates *B secretions. ,t is a tonifying purgative during all forms of "aundice, here biliousness ] chronic constipation are the result of the deficient release of bile. ,n some circles, -. cinerea is thought to purge the hepatic tubes of all viscid accumulations, instead of acting entirely through the stimulation of *B secretions. %&(& Current Medicinal Use: *, !onditions9 6he dried ] po dered bar# is used as a po erful purgative. 6he unripe nuts themselves are anthelmintic in actionK hile the hus#, shell ] peel from the unripe nuts induce perspiration. -. cinerea ] -. nigra have very similar medicinal effects. ,n small doses, -. cinerea acts as a mild intestinal stimulant ] aperientK at larger doses, it is emetic ] cathartic. 6hus, -. cinerea can be used daily as a mild la$ative in the t$ of constipation. Butternut ill not cause rebound constipation that can result from heaning off of some of the stronger anthraquinone glycoside containing botanicals, such as !assia or 4hamnus spp. 6his gentle la$ative effect is particularly indicated in constipation&predominant ,B5.B ,t is also indicated in cases of9 chronic constipation, *'4% assoc. s$, ] ec(ema. -uglans spp are thought to stimulate both *B ] intestinal secretions =esp. glandular secretions ] ater>. Current +esearch +eview: • 5earch of /edline revealed no clinical trials as of 0ctober 2002. #harmacy9 .ong&term therapy ith alteratives is often appropriate and is usually safe. .a$ative herbs, ho ever, are best reserved for conditions of necessity. +o ever, Brin#er cites caution ith prolonged use of -. nigra due to mutagenic properties of "uglone as sho n in animals. 1o dered leaf9 2&F g =Alschuler> )luid e$tract9 2& F ml =Alschuler> A9E tincture A&2 ml =Alschuler>

Contraindications: Alteratives can be provocative to a s#in condition. !are and "udicious use is necessary to reduce the li#elihood of a ma"or e$acerbation. =/ills and Bone> According to !oo#, -. cinerea can cause sharp griping in sensitive people and those ith a nervous temperament. 6his effect is more common ith use of bar# material that has not dried long enough. +e further states that it is not a suitable agent for any form of intestinal sensitiveness or irritation. ,t often colors the feces nearly blac# as ell. )inally, stimulant la$atives such as -. spp. can potentiate cardiotonic medications. A2B3 5ee *eranium monograph for further contraindications of tannin rich herbs. )o*icity9 :37 and atery catharsis. =Alschuler> '$ternal application of the fresh may cause contact dermatitis =treat by ashing area ith soap and ater>.A2B<
1274 1275

+utchens, Alma 4. >ndian Herbalogy of ;orth )merica1 5hambhala. Boston. ACCA. p.F<. 'lling ood p. 32C 1276 /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 2000. p. A<B, AHC, AB0, 2E< 1277 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy D 'clectic /edical 1ublications, 5andy, 04 ACBE p. <BB&CA 1278 'lling ood, ). )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago. ACAC p. 32B 1279 5tedman 1280 !oo# p. <BB&CA 1281 'lling ood, p. 32B 1282 !oo# p. <BB&CA 1283 Brin#er p. AFA 1284 %r. Alschuler, Brin#er p. A<C

Huniperus communis
Common name: "uniper

Cupressaceae

Ha!itat: Widely distributed throughout the :. hemisphere gro ing on moors, heaths and scrublands in the plains and mountains. Botanical description: A small shrub that gro s <&F feet high. 6he berry is 0.E&Acm diameter, purplish&blac# ith three furro s "oined at the ape$. #arts used: Berries =actually, they are fleshy cone scales, similar to ye > Active Constituents: 7olatile oil =TAG>, condensed tannins, diterpene acids, sugars, resin, vit. ! Medicinal actions: 5timulating diuretic, antiseptic, carminative, anti&inflammatory, bitter, antidyscratic diuretic Medicinal use: • *enitourinary !ondtions9 6he volatile oils in -uniper irritate the #idneys, thereby causing diuresis. -uniper is a good addition to a urinary tonic formula as it tonifies through stimulation. 0ther ise, -uniper is an antiseptic in cystitis. -uniper is most indicated in atonic, chronic congestive states of the urinary system. -uniper is ell&indicated in renal insufficiency as long as inflammation is not present. -uniper is also ell&indicated after nephritis to restore normal #idney functioning. %r. !hristopher =an herbalist of the early&mid AC00Ns> recommended a spring cleanse hich consisted of eating one "uniper berry the first day, adding an additional "uniper berry each day until a total of A0 berries is consumed and then decreasing bac# do n in the same manner to (ero. • /usculos#eletal !onditions9 -uniper is also used in arthritis and rheumatism because of its anti&inflammatory and diuretic properties. -uniper can be applied e$ternally as an analgesic for painful "oints, sprains and bruises. 6he spirit is rubbed in after arming the "oint ith a bath, heat lamp or even a hair dryer. • *astrointestinal !onditions9 6he volatile oils also create a carminative effect and antiseptic effect. 6he volatile oils along ith the tannins e$ert anti&inflammatory actions, especially in the *.,. system. 6he anti&inflammatory and carminative actions combine ith a bitter action, ma#ing -uniper a useful digestive aid. )ccording to +eiss:%&(# • *enitourinary !ondtions9 !hronic urinary conditions call for -uniper. • /usculos#eletal !onditions9 6he main indications for -uniper is chronic arthritis and chronic gout as ell as neuromuscular rheumatic diseases, in general, including tendopathies and myogeloses =abnormal hardening of a portion of muscle>. '$ternal application of -uniper spirit has been used for rheumatism and neuralgic pain having a mild hyperemic effect. • 1ulmonary!onditions9 !oncentrated -uniper "uice may be used as a tonic for children, particularly if they are prone to sore throats and colds. 6his effect is li#ely due to the bitter component. -uniper has an e$pectorant property hich has been ascribed to the volatile oil. • %ermatological !onditions9 -uniper tar can be used topically to treat dermatitis and ec(ema. 6he tar has a mild disinfectant activity and is generally a ell tolerated topical application. 6ars in general should be used cautiously starting ith a concentration of 0.2EG, gradually increasing to 0.EG, then to AG. !oncentrations up to E&A0G or pure tar may be used if tolerated. 6hey are painted on dry or in a (inc paste. )ccording to ,cudder:%&($ =5cudder refers to -uniperus sabina> • *ynecological !onditions9 -uniper is a stimulant. ,t may be employed in menorrhagia, and in atonic leucorrhoea, ith advantage. ,n some cases of amonorrhoea it may be. employed as a stimulant, but never in those cases presenting e$citement of the circulation. • *enitourinary !ondtions9 ,t may also be used as a stimulant in vesical catarrh, and in diseases of the urethra. )ccording to Elling:ood:%&(4 • *enitourinary !ondtions9 -uniper is a renal sedative and corrective reserved for use in chronic conditions. ,t is indicated in feeble or aged patients ith persistent dragging or eight across the #idneys. Although used after acute nephritis, it may be employed in the prevention of nephritis. After acute inflammation, it ill restore the secretory po er of the epithelium of the renal tubules and read"ust the secretory function to the blood pressure. • %ermatological !onditions9 6he oil is applicable to s#in diseases, especially et ec(ema. ,t may be applied directly but can be irritating. ,t is also useful in psoriasis and topical parasites.

#harmacy: Weiss arns against longterm use of -uniper limiting use to si$ ee#s in succession hile Brin#er suggests limiting use to four ee#s in succession. ,nfusion =boiling ill cause the volatile oils to be lost>9 A tsp. lightly crushed berries3cup aterK infuse 20 minK A cup B,% 6incture A9E <EG 't0+ 0.E & A ml 6,% 'ssential oil9 E parts to 30 parts fi$ed oil, sig 30 gtt tid -uniper concentrate =5uccus -uniperi ,nspissatus>9 Eml bid -uniper 5yrup9 for rheumatic conditions9 up to AE ml bid, ta#en in spring and autumn =6his may be availble through 7ogel products> -uniper tar Contraindications: !ontraindicated in acute #idney infections or #idney disease =nephritits and nephrosis> and pregnancy due to the stimulation of uterine contractions.A2BB Weiss indicates the ris# of inducing abortion is not great yet recommends avoiding any form during pregnancy.A2BC )o*icity: A #ey sign that long term use may be irritating the #idneys is albuminuria.
1285 1286

Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 23E&F, 2F0 5cudder , -/. 5pecific /edication and 5pecific /edicines, AEth ed. 'clectic /edical 1ublications, 5andy, 04, AC03 1287 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. <<A 1288 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. BH&B 1289 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 23E&F

1arrea tridentata
Common name: !haparral, !reosote bush, !resotum Ha!itat: 6his plant gro s throughout the south est deserts at altitudes belo <,000 feet.

Eygophyllacea

Botanical description9 6his is a bush that can gro up to A2 feet tall but is usually E to F feet tall. ,t has many branches that produce many leaves. 6he small and curled leaf is dar# yello &green and has a greasy te$ture in moist conditions. ,n drought the leaf turns olive colored and in e$treme drought become bro n in color. 6he stems are also yello &green in order to do photosynthesis. 6he larger branches and trun#s are reddish&bro n to blac#. 6he small flo ers are yello . 6he plant blooms after a rain any time of the year and mature into fu((y round capsules. #arts used9 .eaves, flo ers, seeds, small t igs Constituents9 )lavone& and flavonol aglycones =AB different ones>K %ihydroflavonolK .arreic acidK *uaiuretic acid lignans including nordihydroguaiaretic acid =:%*A> QAG&A.EG of dry plantRK 2uercetin bioflavonoids #harmacology: 6he ma"or lignan in chaparral, #no n as nordihydroguaiaretic acid =:%*A>. 6he anti&o$idant action of chaparral is attributed to :%*A. :%*A is ithin the resin of !haparral and has both anti&inflammatory and anti&o$idant effects. :%*A decreases prostaglandin and thrombo$ane synthesis by inhibiting cycloo$ygenase. A2C0 :%*A also inhibits lipo$ygenase thus reducing leu#otriene synthesis.A2CA :%*A also decreases histamine and slo &reacting substance of anaphyla$is =545A> from lung tissue in addition to inhibiting the contractile response ithin lung parenchyma.A2C2 ,n addition, .arrea e$tracts possess anti&lipid pero$idation properties. 6he anti&o$idant properties of .arrea ill prevent oil rancidity. ,n addition, .arrea ill protect hepatocytes against lipid pero$idation. !haparral also contains antio$idant flavonoids and has demonstrated anti&amebic activity in !itro. 6he potential of chaparral for cancer treatment has not been proven in human studies. A2C3 Medicinal actions: Antimicrobial, hepatic stimulant, hypolipidemic, anti&hepatoto$ic, anti&pero$idant, anti&rheumatic

)raditional Medicinal Use: :o information is available from the selected resources. Medicinal use: All of the pharmaceutical actions contribute to the overall anti&inflammatory, anti&hepatoto$ic and anti&allergic effects of .arrea. 6hese effects are useful in conditions such as arthritis, autoimmune disease, atherosclerosis, and hormonal dysregulation. • +epatobiliary !onditions9 !haparral is a hepatic stimulant. ,t ill enhance the absorption of dietary fats via its choleretic action. !haparral ill also lo er .%. and 7.%. levels. 6he hepatic stimulation combined ith the antio$idant actions of !haparral ma#e it useful in various arthralgias including osteo& and rheumatoid arthritis. • ,mmune !onditions9 !haparral is used by some practitioners as an anti&cancer therapy. 6he proposed mechanism of action is based upon the inhibition of anaerobic respiration =primary respiratory path ay of cancerous cells> by inhibiting mitochrondrial :A%+ o$idase and succino$idase and folic acid dehydrogenase. +o ever, in&vivo studies have not sho n significant cancer regression. 6his may be because lo concentrations of :%*A stimulate cellular respiration. :onetheless, the antio$idant properties of chaparral prevent carcinogenic o$idants from initiating cancerous cellular changes and :%*A bloc#s chromosome damage caused by tumor promoters. 6hus, chaparral may be most useful in the prevention of cancer, particularly melanoma cancer =high sensitivity to the anti&carcinogenic and anti&neoplastic effects of chaparral>. • ,nfectious !onditions9 6he actions of !haparral stem from its ability to inhibit aerobic glycolysis in the mitochondrial of its o n cells. 6he oils leeched out into the surrounding soils inhibit seeds from burning up their sugars thus the seeds cannot sprout until rains ash a ay the oils.A2C< 6his same action is responsible for the antimicrobial properties of this plant. !haparral is bacteriostatic and bacteriocidal most li#ely secondary to its inhibition of aerobic glycolysis. ,t is useful in the treatment of gastroenteritis, vaginitis, impetigo, folliculitis and various dermatophytic infections. ,t must be ta#en or applied frequently to produce results, but rarely fails to reduce or eliminate the infection. Current +esearch +eview • 4afety:"05%  %esign9 4etrospective clinical trial  1atients9 6hirty si$ patients9

 

6herapy9 6hirteen patients W .arrea tincture poK t enty three patients W .arrea e$tract in 4icinus communis oil topically. 4esults9 :o patient in the study, hether using .arrea for short term or long, internally or e$ternally, sho ed any sign of organ damage during the period of follo &up. 4elatively small inta#es of .arrea tincture, or topical application of e$tracts in 4icinus oil, are safe hen prescribed by a clinically trained botanical prescriber. .arrea should be used ith caution in persons ith a history of previous, or current, liver disease. ,t may be preferable to avoid the use of .arrea capsules because they have been associated ith potentially dangerous overdosing. A9E tincture HEG 't0+9 A3< & A32 tsp. B,% to 2,% !apsules =00>9 A&2 capsules B,% & 6,% :ote9 .arrea tridentata is very bitterb

#harmacy9

Drug ,nteractions: :o information is currently available. +o ever, based on the contraindications belo regarding !0/6, use of .arrea may potentiate the effects of !0/6 and /A0 inhibiting medications. Contraindications: Brin#er contraindicates the use of .arrea in patients ith a history of liver disease based on reports of possible hepatoto$ic effects. +e also contraindicates its use in renal disease =human reports, animal studies> and during nursing. :%*A may also inhibit !0/6 causing an increase in plasma catecholamines =in vitro>. )o*icity: Avoid long&term use due to the presence of al#aloids. A A&2 month vacation every 2&3 months is advisable to avoid any long&term to$icity.
1290 1291

Armour !!, et al, Eur 7 Pharm, EE, ACBH9<C. Armour !!, et al, Eur 7 Pharm, EE, ACBH9<C. 1292 :a#adate, 6, et al, 7ap 7 Pharm, 3B, ACBE9AFA. 1293 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1294 /oore, /ichael, /edicinal 1lants of the %esert and !anyon West, 5ante )e, :/9 /useum of :e /e$ico 1ress, ACBC92B. 1295 +eron 5, ;arnell '. 6he safety of lo &dose .arrea tridentate =%!> !oville =creosote bush or chaparral>9 a retrospective clinical study. 7 )ltern 2omplement Med 200AKH=2>9AHE&BE.

1avendula officinalis (12 angustifolia
Common name: lavender Ha!itat: Botanical description: #art used: Historical use: $nergetics:

1amiaceae

Constituents: volatile oil9 alcohols, esters ,n .avendula gro n in lo er altitude, the alcohols are pushed more and they ill be more anti&inflammatory and tonic. +igh altitude gro n .avendula has more esters hich are antispasmodic and calmative. #harmacology: Medical actions: calmative, antimicrobial =antifungal, antibacterial>, vulnerary ,n comparison ith sedatives, calmatives do not put you to sleep or induce dro siness hereas sedatives do. Medical uses: nervousness, an$iety, restlessness, depression, melancholy insect repellant !an be used topically for tineas, although e$ercise caution ith tinea cruris by ma#ing a ea#er formula.. ,mpetigo,+eadaches vulnerary9 burns and ounds myalgia, arthralgia neuralgia #harmacy: 6opical application9 E&A0 gtt in AE ml of fi$ed oil. A&2 gtt essential oil for mouth and throat conditions. 0titis e$terna9 gtts on cotton ball inserted in ear. !andida vaginitis9 2&3 gtt in 2 6 fi$ed oil soa#ed into a tampon

)o*icity:

1eonurus cardiaca

1a!iatae Common name: /other ort ,n east Asia, .eonurus sibiricus is idely used as a medicinal plant on the same indications as .. cardiaca. .. heterophyllus is used in !hinese herbal medicine = hole plant9 ;i mu caoK seed9 !hong ei (i>. Ha!itat: 6he plant is commonly found in aste places near human habitation, along streets and fences Botanical description: 6he plant has perennial roots ith annual herbaceous stems, hich are stiff and hairy. 6he leaves are irregularly palmate deeply toothed, ith E&H lobes. 6he floral leaves are narro 3&E lobed and often entire. )lo ers are small forming close horls and long spi#es. 6he caly$ is E&toothed, corolla is pin#, tubed ith a hairy upper lip and a 3&lobed lo er lip. 6he fruit is a nut ith a flat angular top. #art used: +erba =leaves are best> $nergetics: ;i mu cao =.. heterophyllus>9 ,t is bitter, acid and slightly cold. ,t enters the liver and pericardium meridians. An interesting observation is that these t o meridians are involved ith the menstrual function and the heart, respectively. &invigorates blood, regulates menses &reduces masses &promotes urination &reduces s elling &tonifies blood to move bloodA2CF Active Constituents: Bitter glycoside =leonurin>, tannins, al#aloids =leonurine and stachydrine>, glycosides, v. oil, vits. A and !, iridoids. #harmacology: Medicinal actions: !ardiac tonic, sedative, nervine, antispasmodic, mild uterine stimulant and tonic, emmenagogue. .. heterophyllus9 uterine rela$ant, spasmolytic, estrogenic, hemostatic, emmenogogue, thyroid inhibitor, coronary and renal restorativeA2CH Medicinal use: .eonurus is most indicated in nervous debility ith irritation and unrest. .eonurus is diffusive in its action. ,t generally e$erts a rela$ing effect ith a slight stimulating edge. • *ynecologic !onditions9 6he al#aloids increase uterine contractions, hile the glycosides are antiseptic, nervine, anti&spasmodic, and hypotensive. 6he hypotensive action is due to its vasodilatory effect, hich also serves to increase circulation to the reproductive organs. .eonurus is most indicated in omen ho feel an$ious, restless, have pelvic and lumbar discomfort, and e$perience general ea#ness. .eonurus relieves stagnation in the pelvis, esp. suppressed discharges. ,t is specific for omen ith headache, insomnia, vertigo, pelvic complaints, an$iety attac#s and high stress. )inally, .eonurus is a galactagogue • !ardiovascular !onditions9 .eonurus, as a gentle cardiotonic, is specific for cardiac disorders of nervous origin =i.e. tachycardia secondary to an$iety>. 6his remedy is especially good for pregnant omen ith fear, palpitations, or 50B. • 'ndocrine !onditions9 .eonurus is also useful in hyperthyroidism =especially in combination ith .ycopus and /elissa>. )ccording to Mills and Bone:%&*( • !ardiovascular !onditions9 .eonurus is indicated for the combination of benign arrhythmias or ectopic beats ith thoracic tension. • /usculos#eletal !onditions9 .eonurus can be used in formulas for tension headache and migraine. • :ervous !onditions9 .eonurus is an antispasmodic and rela$ant being traditionally utili(ed for an$iety, irritability and restlessness, particularly in children. • *astrointestinal !onditions9 *astrointestinal complaints ith a nervous component call for antispasmodic3rela$ants such as .eonurus. 5uch complaints include nervous dyspepsia, irritable bo el and intestinal colic. • *ynecologic !onditions9 .eonurus is used for spasmodic dysmenorrhea. 6o calm the intensity of hot flashes and s eating in menopause, .eonurus can be utili(ed, particularly in con"unction ith 5alvia. )ccording to +eiss:%&** • !ardiovascular !onditions9 6here is indeed a medicinal action of .eonurus and that is mainly for functional heart complaints due to autonomic imbalance. ,t appears to be predominately sedative, similar to 7alerian. • :ervous !onditions9 )urther research is needed ith reference to neuroses of holly autonomic origin.

• 'ndocrine !onditions9 )urther research is needed ith reference to treatment of hyperthyroidism. )ccording to 2oo3:%C-6his herb is a pleasant and moderately strong tonic, some hat diffusive in action and combining rela$ing properties ith a slight e$cess of stimulation. A5 a tonic for nervousness, pains and palpitations of the heart, sufferings unique to omen and habitual restlessness it is an agent deserving of the first consideration. • *astrointestinal !onditions9 6he stomach is braced by it. ,n cold preparations it promotes appetite and digestion, strengthens the uterus and is of superior value in hysteria, facilitates and increases the menses and relieves uterine pains dependent upon neuralgic or semi&rheumatic conditions. • *ynecologic !onditions9 ,t acts decidedly on the uterus. ,n arm preparations it maintains a gentle out ard circulation and promotes the menstrual and lochail flo . ,n this form it proves of value in recent suppression of painful menstruation and hysterical forms of nervousness and palpitation. 6he emmenagogue action is quite reliable hen the menses have failed from local feebleness and especially if combined ith more specific emmenagogues. • :ervous !onditions9 6he nerves receive the most benefit of its influence, hence it is classified as a nervine tonic and antispasmodic. )ccording to .ing: /other ort is emmenagogue, nervine, antispasmodic, and la$ative. ,t is usually given in arm infusion in amenorrhoea from coldsK and in suppressed lochia e have found it superior to any other remedy. Also useful in hysteria and chorea =?ing>. 6he e$tract is recommended in nervous complaints, pains peculiar to females, in irritable habits, delirium tremens, typhoid stages, ith morbid nervous e$citability, all chronic diseases attended ith restlessness, a#efulness, disturbed sleep, spinal irritation, and neuralgic pains in the stomach and head, and in liver affections. ,t is adapted to cases of nervous debility ith irritation, nervous unrest, tendency to choreic or spasmodic movements, pelvic and lumbar uneasiness or pain, bearing do n pains, and the irritability due to female disorders. !ombined ith ,ctodes and resin of blac# cohosh, it forms a superior antispasmodic, nervine, and emmenagogue. '$ternally, it maybe used as a fomentation to the bo els in suppressed and painful menstruation, etc. #harmacy: Weiss indicates that .eonurus needs to be ta#en for a long period, over months to achieve a medicinal effect. ,nfusion9 6he root in infusion is diuretic, and is stated to be efficient in obstinate intermittents. 6he seeds have been given in half&teaspoonful doses in ater and in bilious colic. =?ing>. A tsp.3cup aterK sig A&2 cups 6,% =%r. Alschuler> As a arm preparation, it relieves pelvic congestion and e$erts antispasmodic action on the uterus. ,n cold preparations, it acts more strongly as a digestive tonic =especially on the stomach>, promotes suppressed menses secondary to pelvic ea#ness and relieves pelvic pain. =%r. Alschuler> 2 tsp.3cup ater, sig A cup morning and night =Weiss> sedative9 equal parts !onvallaria and /elissa =same amounts and sig for infusion above> %ecoction9 from 2 to < fluid ounces, every A, 2, or 3 hours =?ing> 6incture A9E <EG 't0+K sig <&F ml 6,% )luid e$tract A9A 2EG 't0+K sig 2&3 ml 6,% !apsules& 2E0 mg3capK sig A&2 cap 6,% 1roprietary 1reparations9 !ardisettes =Brenner>9 .eonurus, !rataegus, ?hella and !actus grandiflorus Contraindications: ,n !hinese herbal medicine, ;i mu cao is contraindicated in pregnancy. !oo# states to avoid use hen the menses are too free or high febrile tendencies are present. Brin#er contraindicates its e$cessive use in early pregnancy due to its emmenagogue effect =empirical> and the uterine stimulant action of its constituents stachydrine and leonurine =in vitro and animal studies> A30A )o*icity: .eonurus is generally safe and ell tolerated.A302
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.ahans 6. ,ntroduction to !hinese +erbal /edicine, .ecture notes. Winter 2000 .ahans 6 1298 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 203, 233, 2<E 1299 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. ABF 1300 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. E0H 1301 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. pA0< 1302 /ills and Bone p. 233

1eptandra virginica
Common name: Blac# root, !ulver@s root Ha!itat: 6his plant is native throughout the United 5tates.

4crophulariaceae

Botanical description9 6all, herbaceous perennial plant gro s to 3&< feet. 6he stem is smooth and do ny, has horls of lanceolate, serrated leaves and terminates in a F&A0 inch spi#e of hite flo ers. 6he plant flo ers in -uly and August. 6he root is cylindrical, some hat branched and dar# bro n e$ternally. Historical uses9 .eptandra as used by ACth century physicians in the treatment of typhoid fever for its effect on the liver and subsequent reduction in fever. 5imilarly, it as used for the treatment of malarial fevers. #arts used9 4oot, dried Constituents9 "787 • 7olatile oil9 composition un#no n • !innamic acid derivatives9 including, among others, <&metho$ycinnamic acid, 3,<&dimetho$ycinnamic acid and their esters • 6annins • *um, • 4esin =leptandrin> #harmacology: :ot specifically #no n . 6he constituents of this plant have not been fully investigated. Medicinal actions9 Alterative, bitter tonic, choleretic, aperient )raditional Medicinal Use: 5pecific ,ndications and Uses9 %ro siness, di((inessK tenderness and heavy pain in the hepatic region ith a ide area of dullness upon percussion, enfeebled portal circulationK the tongue is coated mar#edly hite, the s#in is yello , there is a bitter taste, cold e$tremities, nausea, and dull frontal headacheK thirst, ith inability to drin#K restlessness, ith insomniaK lassitude and gloomy, depressed mental state to the point of disinclination to or# or even move. ?ing stated diarrhoea, ith half&digested passages, or clay& colored evacuations, hile 'lling ood claimed constipation as specific symptomology. A30<,A30E .eptandra stimulates the glandular system to activity, and is valuable in chronic diseases of the mucous membranes. ,t as used as a #ey remedy in the treatment of malaria. All of the traditional authors agree on its effects as a tonic to the digestive system, choleretic and a stimulant to hepatic and glandular function. • *astrointestinal !onditions9 .eptandra as used to strengthen the functional activity of the digestive system, favoring normal intestinal e$cretion and improving digestion. 5cudder indicated its use hen circulation to the gastrointestinal tract is ea#ened. !oo# described its effect on the small intestines in removing material accumulations, ith little direct effect on the large intestine. ,ts effect is slo , ta#ing from A0 to AB hours and as therefore not used as a cathartic. ?ing considered it the best la$ative for atonic conditions and also specified its use for constipation of the upper bo el and secondary to hepatic torpor. • +epatobiliary !onditions9 ,ts primary influence as considered to be on the liver, directly stimulating the secretion of bile into the gall bladder, but not the e"ection from the gallbladder. +o ever, according to ?ing, it as not considered a suitable remedy for "aundiced conditions hen used alone and as combined ith cholagogue remedies. 'lling ood agreed in its use as an au$iliary herb for "aundice, but stressed that it is absolutely indicated. !oo# called it a mild, persistent, and reliable Ihepatic rela$antJ. +e called for .eptandra in all febrile cases, so long as the liver as deficient in activity.A30F Current Medicinal Use: • +epatobiliary !onditions9 6he dried root is a mild choleretic ithout acting as a strong la$ative. 6he dried root is purely a choleretic =it does not act as a cholagogue> and is therefore most indicated in the treatment of "aundice. ,t e$erts mild, persistent, gentle hepatic stimulation of bile production ithout stimulating the contraction of the gall bladder. • *astrointestinal !onditions9 6he bitter root also acts to tonify the digestive system, primarily the stomach and small intestinal glandular functioning, although it may cause nausea in some persons =due to e$cessive smooth muscle rela$ation>. ,t is most indicated in persons ith atony of their stomach, duodenum and liver.

Current +esearch +eview: • 5earch of /edline revealed no human trials as of AA3AH302 #harmacy9 As an alterative it is most effective hen combined ith other tonic and stimulating alteratives. A9A fluid e$tract9 20&E0 drops 6,% A9E tincture E ml 6,%K ma$. ee#ly dosage of A00 ml

Contraindications: !oo# stated that .eptandra is contraindicated in "aundice, in the elderly, and in cases chronic debility such as hen a general la$ity of tissues e$ists unless it is combined ith tonics and stimulants. A30H Brin#er adds that .eptandra be avoided ith any bile duct obstruction, internal hemorrhoids, during menstruation or pregnancy. A30B )o*icity: .eptandra can cause nausea. 6he fresh root is a violent cathartic ith the potential of producing violent emesis and bloody purging as ell as abortion.A30C
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 1305 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. 3A2 1306 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 1307 !oo# 1308 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. C0 1309 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p.

1igustrum lucidum
Common name: Ha!itat: White a$ tree, !hinese glossy privet, 1rivet berry, :u (hen (i

3leaceae

Botanical description9 6his is a shrub that gro s to a height of E to F feet. ,t produces and&li#e branches. 6he leaves are dar# green, A&2 inches in length, A32 to A inches ide, opposite, smooth and lanceolate. 6he flo ers are small and numerous, hite and in terminal panicles. 6he berries are spherical, blac# and in conical bunches. 6he seeds are conve$ on one side, angular on the other. .igustrum gro s in the 'ast and /id& est in oods and thic#ets and flo ers in /ay and -une. #arts used9 .eaves, fruit Constituents9 0leanolic acid Medicinal actions: Astringent, vulnerary, cardiotonic, diuretic, immunomodulator, anti&tumor, anti&bacterial

Medicinal use: 6his plant is rarely used in Western&based herbalism. 6raditional !hinese herbalists al ays use .igustrum as part of a formulaK never by itself. ,t may be used for conditions such as acute viral pnuemonia, bronchitis, tonsilitis, gingivitis, laryngitis, dysentery, gastroenteritis and urinary tract infections. According to 6!/, .igustrum is contraindicated in cases of e$cess yin, relative yang $u, and #idney yang e$cess. Western understanding of this plant is limited. ,t has been used historically as an astringent vulnerary plant. ,t may be applied topically to ulcerated tissue in order to speed the ound healing. .igustrum is also useful internally for ulcerations of the gastrointestinal tract. Ulceration of the bladder hich may occur as part of bladder cancer, a U6,, or passage of a renal stone ill also respond to the internal use of .igustrum. )inally, a gargle of .igustrum is considered specific for sore throat and aphthous stomatitis. #harmacy9 30&F0 grains of po dered leaves 6,% A32 tsp. leaves3cup infusion9 A cup 6,%

Contraindications )o*city9 !ontraindicated in e$cess yin, relative yang $u, and #idney yang e$cess. 6!/ practitioners are best qualified to use this plant internally for conditions other than ulcerations.

1igusticum porteri
Common name: 0sha

Um!ellifereae

Ha!itat: ,t gro s in high altitudes =it never gro s belo <000N and usually gro s above B000N>. Botanical description9 6he root is a large fibrous tape root. ,t is bro n on the outside ith a yello ish core and a celery&li#e smell. 6he stem is hollo , gro ing to a height of 3&F feet. 6he leaves are large, finely cut and are mostly at the base of the plant ith fe on the flo ering stem. 6he flo ers are hite in a flat umbel, hich ripen into an umbel of seeds. #arts used9 4adi$ Constituents9 7olatile oil, lactone glycoside, al#aloids, phytosterols, saponins, ferulic acid Medicinal actions: anti&viral, diaphoretic, anti&bacterial )raditional Medicinal Use: :o information is provided by ?ing or !oo# on this botanical. 7arious :ative American tribes che ed on .igusticum root in order to increase stamina and vitality. Current Medicinal Use9 • *astrointestinal !onditions9 .igusticum ill soothe the gastrointestinal system, allaying the nausea hile creating diaphoresis and immunostimulation. • 1ulmonary !onditions9 .igusticum is a very effective anti&viral and diaphoretic plant. ,t ill decisively raise body temperature and then cause diaphoresis. )or this purpose, it combines ell ith Achillea, /entha pip., 5ambuccus, /elissa and3or 'upatorium. ,t is especially indicated in viral infections of the respiratory tract. .igusticum is most indicated in the beginning stages of a cold or flu or in someone ho has had a nagging cough that has persisted for ee#s. ,f used for beginning flu, it is specifically indicated in someone ho has the beginnings of a cough and some nausea. Although .igusticum tends to be used most often for viral infections, it also is helpful for bacterial infections. ,t is directly bacteriocidal. • 6opical Applications9 .igusticum may even be applied topically to ounds for its antibacterial and vulnerary properties. Although there have not been any double&blind studies to verify its use, !hinese research suggests that a related species, 8igusticum :allichii, can rela$ smooth muscle tissue =perhaps thereby moderating the cough refle$> and inhibit the gro th of various bacteria.A3A0 Current +esearch +eview: • 5earch of /edline reveled no human trials as of 0ctober 2002. #harmacy9 %ecoction9 A&2 tsp.3cup aterK A cup 6,% A9H tincture9 2&< ml 6,% '$ternal ash

Contraindications: Brin#er suggests that .igusticum may have emmenagogue properties. A3AA )o*icity: :o information is currently available.
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Bens#y %, *amble A, ?aptchu# 6-. 2hinese Herbal Medicine: Materia Medica. 5eattle, Wash9 'astland 1ressK ACBF93B3W3B<. Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AHC

1inum usitatissimum
Common name: .inseed, )la$

1inaceae

Botanical description9 6his plant gro s up to A m in height. ,t is a slender annual plant hich produces light blue, E&part corollas hich open in the sunshine. 6here are numerous narro , linear, 3&nerved, glabrous leaves. .ight bro n capsules contain several seeds. 6he seeds are mostly glossy bro n to reddish&bro n, flattened and ovoid about <&F mm long and 2&3 mm ide. #arts used9 5eed Constituents9 • /ucilage =3G&FG> • )i$ed oil =30G&<EG>9 alpha&linolenic, linoleic, and oleic acids • 1rotein =2EG> • 1hosphatides =0.HG>K 5terolsK !yanogenic glycosides =A.EG> #harmacology: )la$ seeds are ta#en internally to affect fatty acid ratios throughout the body. )la$ seeds contain significant amounts of omega&3 fatty acids. 6hese acids are precursors to anti&inflammatory prostaglandins and leu#otrienes. 0mega&3 fatty acids result in increased levels of eicosapentaenoic acid ='1A>. '1A is found in high amounts in fish. )la$ seed, hile not as as efficient as fish oil in increasing '1A concentration, ill significantly raise the '1A levels if the overall diet is lo in omega&F fatty acids =eicosanoids derived from arachidonic acid hich are proinflammatory>. ,n one human study, oral administration of fla$ seeds =E0g3d> raises serum and red blood cell levels of omega&3 Qthese parameters reflect a systemic increase in omega&3 levelsR, lo ers cholesterol levels, lo ers postprandial blood glucose levels by 2HG. Another important constituent of fla$ seed and unfiltered oil is plant lignans. .ignans are similar in structure to endogenous se$ steroid hormones. 5ecoisolariciresinol, matairesinol, and shonanin are lignan phytoestrogens found great quantities in fla$seed. :ormally they are glycosidically lin#ed to carbohydrates and in the large intestine are decon"ugated from the carbohydrate portion by bacteria to produce mammalian lignans such as enterolactone and enterodiol. 6he aglycone lignans can be further modified to form the mammalian phytoestrogens enterodiol, enterolactone, and enterofuran, hich are absorbed into the body and e$creted in urine. A3A2 6hese lignans are absorbed and appear to reduce the ris# of cancer. /any lignans have antitumor, antimitotic, antio$idant, and phytoestrogenic actions. 6he mucilage in the seeds absorbs ater into the stool. 6he increased volume of the stool stimulates peristalsis via the stretch refle$. 6he mucilage further lubricates the colonic mucosa hich aids in the passage of the stool. Medicinal actions: Anti&inflammatory, demulcent, fiber supplement )raditional Medicinal Use: • *astrointestinal !onditions9 6he 1hysiomedicalists too# advantage of the demulcent property of .inum and noted that it is very soothing to the mucous membranes of the bo els, relieving inflamed and irritated conditions. A3A3 According to ?ing, .inseed oil in doses of 2 fluid ounces t ice a day, as said to have cured severe cases of piles ithin 2 or 3 ee#s. While using .inum, ?ing had his patients avoid liquors and stimulating foods. +e also reported it as beneficial hen internally administered in dysentery, colic, and lumbrical orms. A3A< Used as an enema ?ing found .inum advantageous in dysentery, hemorrhoids, and ascaris orms. +e used one pint of linseed oil, combined ith L ounce each, of oils of 0riganum and *aultheria, forms a pleasant catharticK to be given in the same doses as castor oil.
A3AE

• 1ulmonary !onditions9 6he demulcent property as also utili(ed to soothe the mucous membrane so the lungs as ell as to promote e$pectoration. 6he chief employment of fla$ seeds by the 1hysiomedicalists as in irritable coughs and similar pectoral difficulties. A3AF • *enitourinary !onditions9 .i#e other demulcents, fla$ seed as used in acute inflammation or irritation of the bladder and urethra. A3AH • 6opical Applications9 6he ground ere used as an emollient and oily poultice, due to the observation that retains its soft character indefinitely upon inflamed surfaces. A3AB Current Medicinal use: )la$ seed is an e$tremely popular prescription by naturopathic physicians. )la$ seed has a ide variety of applications.

•

*astrointestinal !onditions9 6he seeds, hole or crushed, are used as a bul#&forming la$ative. 6he mucilage in the seeds absorbs ater into the stool. 6he increased volume of the stool stimulates peristalsis. 6he mucilage further lubricates the colonic mucosa hich aids in the passage of the stool. 6hese actions ma#e fla$ seeds an e$cellent therapy for functional constipation =i.e. from ,B5, la$ative abuse, diverticulitis, gastritis, enteritis>. ,t is important to drin# a lot of ater ith the ingestion of fla$ seeds in order to avoid flatulence. 6he seeds are high in anti&inflammatory fatty acids Qlinolenic or omega W3R and therefore are especially indicated in gastritis and enteritis ith e$cessive mucous production and constipation. ,n a double&blind study, EE people ith chronic constipation caused by irritable bo el syndrome received either ground )la$seed or 1syllium seed =a ell&#no n treatment for constipation> daily for 3 months. 6hose ta#ing )la$seed had significantly fe er problems ith constipation, abdominal pain, and bloating than those ta#ing 1syllium. 6he )la$seed group had even further improvements in constipation and bloating hile continuing their treatment in the 3 months after the double&blind study ended. 6he researchers concluded that fla$seed relieved constipation more effectively than 1syllium. A3AC • ,mmune !onditions9 )la$seed has renoprotective effects in animal and human lupus nephritis. ,n lupus mice given fla$ lignan renoprotection as evidenced, in a dose&dependent fashion, by a significant delay in the onset of proteinuria ith preservation in *)4 and renal si(e, suggesting that 5%* may have a therapeutic role in lupus nephritis. A320 )la$seed or its lignans has been investigated for its ability to help prevent or treat cancer, particularly cancer of the breast and colon.A32A 'pidemiological evidence suggests that people ho eat more lignan&containing foods have a lo er incidence of breast and perhaps colon cancer.A322 6he lignans in )la$seed are phytoestrogens, phytoestrogens bind the same receptors here estrogen binds. ,f there is little estrogen in the body, for e$ample after menopause, lignans may act li#e ea# estrogen. +o ever, hen natural estrogen is abundant, lignans may reduce the hormoneNs effects by displacing it from cellsK displacing estrogen in this manner may help prevent those cancers that depend on estrogen, such as breast cancer, from starting and developing. • /etabolic !onditions9 5everal human studies have demonstrated that )la$seed can lo er cholesterol. A323, A32< ,n one study, 3B older omen ith high cholesterol ate bread or muffins containing either )la$seed or 5unflo er seed for F ee#s, later s itching to the opposing treatment for another F ee#s.A32E 6otal cholesterol dropped ith both regimens, but only those on the )la$seed regimen had significantly lo er .%.. ,n another study, 2C men and omen ith high cholesterol ate muffins ith either partially defatted fla$seed or a heat bran placebo for 3 ee#s each.A32F 6hose eating fla$seed sho ed significant decreases in both total and .%. cholesterol, compared to little change ith placebo. ,n none of these studies did fla$seed lo er +%. =MgoodM> cholesterol. While )la$ seeds may be beneficial )la$seed oil does not appear to be as good as fish oil for people ith elevated triglycerides.A32H • 6opical Applications9 )la$ seeds may be po dered and mi$ed ith ater to ma#e a poultice for e$ternal application to areas of inflammation. 6he demulcent effects ma#e fla$ seed poultice a soothing anti&inflammatory dressing. #harmacy: ,nternally, the crac#ed or coarsely ground seed, in hich only the cuticle and mucilage epidermis are damaged is used. ,nternal & A tablespoon of hole or bruised =not ground> seed ith AE0 ml of liquid 2 to 3 times daily for gastritis and enteritis9 2 to < tablespoons of milled linseed for the preparation of linseed gruel. A32B ,nfusion9 A 6B of hole or crushed seeds ith <&B o( ater B,% to 6,% =Alschuler> 2&3 6B of ground seeds ith ater to ma#e a poultice or internal demulcent =Alschuler> ,n"ection9 =rectal implant or retention enema> Contraindications: )la$seed is contraindicated in the follo ing conditions9 ileus, stricture of the esophagus and in the gastrointestinal area, acute inflammatory illnesses of the intestine, of the esophagus and of the stomach entrance. A32C =6his is an interesting description of contraindications by the 1%4 as the same source lists used for gastritis and enteritis as do many other authors>. Use of fla$seed and other bul#ing agents may cause reduced absorption of oral drugs due to adsorption to the mucilage. A330 )o*icity9 :o health ha(ards or side effects are #no n in con"unction ith the proper administration of designated therapeutic dosages. 6he cyanogenic glycosides present no danger ith the inta#e of therapeutic dosages. 6he use of large quantities of the drug as a la$ative ith too little fluid inta#e can lead to ileus. A33A
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'$traction and quantification of lignan phytoestrogens in food and human samples. )nal Biochem. 2000 %ec AK2BH=A>9A02&C. 1313 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. EA<&E 1314 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 1315 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 1316 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. EA<&E

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!oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. EA<&E 1318 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. EA<&E 1319 6arpila 5, ?ivinen A. *round fla$seed is an effective hypolipidemic bul# la$ative QabstractR. 5astroenterology . ACCHKAA29AB3F. 1320 A novel treatment for lupus nephritis9 lignan precursor derived from fla$. .upus. 2000KC=F>9<2C&3F. 1321 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. AEH 1322 Adlercreut( +, /a(ur W. 1hyto&oestrogens and Western diseases. )nn Med. ACCHK2C9CEWA20. 1323 Ar"mandi B+, ?han %A, -uma 5, et al. Whole fla$seed consumption lo ers serum .%.&cholesterol and lipoprotein=a> concentrations in postmenopausal omen. ;utr Res1 ACCBKAB9A203WA2A<. 1324 -en#ins %-, ?endall !W, 7idgen ', et al. +ealth aspects of partially defatted fla$seed, including effects on serum lipids, o$idative measures, and e$ vivo androgen and progestin activity9 a controlled crossover trial. )m 7 2lin ;utr1 ACCCKFC93CEW<02. 1325 Ar"mandi B+, ?han %A, -uma 5, et al. Whole fla$seed consumption lo ers serum .%.&cholesterol and lipoprotein=a> concentrations in postmenopausal omen. ;utr Res1 ACCBKAB9A203WA2A<. 1326 -en#ins %-, ?endall !W, 7idgen ', et al. +ealth aspects of partially defatted fla$seed, including effects on serum lipids, o$idative measures, and e$ vivo androgen and progestin activity9 a controlled crossover trial. )m 7 2lin ;utr1 ACCCKFC93CEW<02 1327 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 1328 1%4 for +erbal /edicines, ACCB 1329 1%4 for +erbal /edicines, ACCB 1330 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. H2 1331 ,bid

1ithospermum spp2
Common name: !ommon grom ell, 5toneseed Ha!itat: 6he plant gro s in deciduous forests and on sunny slopes.

Boraginaceae

Botanical description: 6he common grom ell is a plant that gro s up to 3 feet in height. 6he flo ers are small and greenish& hite. 6he plant is covered ith stiff hairs, as is characteristic ith plants of the Borage family. #arts used: 5eeds, aerial plant especially leaves Constituents: 1igmented naphthaquinone derivatives of shi#onin are produced at specific times and in specific cells of 8ithospermum1 /any members of the Boraginaceae family produce naphthaquinones in their roots. naphthaquinones are colored substances derived from phenylpropanoid and isoprenoid precursors. 1lants of the borage family are distributed orld ide and the naphthaquinones from many of these plants have been used in diverse cultures as colorants for cosmetics, fabrics, and foods , and for medicinal applications, including antitumor, antiinflammatory, and antimicrobial agents . 6he chemicals involved in the antimicrobial activities studied to date are all derivatives of shi#onin and its enantiomer al#annin.A • .ithospermum acid =phenolcarbo$ylic acid>K • :aphthoquinone derivative =shi#onin>K • !yclitol =scyllitol>K • !yanoglucoside&lithospermocideK • !affeic, chlorogenic and ellagic acidsK • !atechin&type tanninsK • .ithospermum red pigment =root bar#>K • /ucilage • /ineral salts =especially calcium and silicon salts> #harmacology: .ithospermum acid has anti&gonadotropic properties. ,t bloc#s the anterior pituitary@s production of )5+ and .+, A332 and most li#ely 65+ as ell. 8ithospermum also bloc#s thyroid secretion. )ree(e&dried e$tracts =)%'> of the plants .ycopus virginicus, .ycopus europaeus, /elissa officinalis, and .ithospermum officinale, as ell as products of the o$idation of certain of their constituents, have been sho n to e$ert antithyrotropic activity by virtue of their ability to form adducts ith 65+ that bind ea#ly, if at all, to the 65+ receptor. 6he thyroid&stimulating immunoglobulin * =,g*> found in the blood of patients ith *ravesN disease =*ravesN&,g*> resemble 65+ in their ability to bind to the thyroid plasma membrane, probably at the 65+ receptor, and to activate the gland. 2 ,n vitro or# suggests .ithospermum forms high molecular eight adducts ith bovine 65+ =b65+>, preventing it from binding to and stimulating adenylate cyclase in human thyroid membranes. 'ight 3,<&dihydro$ylated compounds, all structurally related to cinnamic acid, inhibited the binding of QA2E,R b65+ to human thyroid membranes. 0f these, < =caffeic, rosmarinic, chlorogenic, and ellagic acids> are present in the plant, and < =3,<&dihydro$yphenylacetic acid, deo$yepinephrine, adenochrome, and nordihydroguaretic acid> are structurally related. 6hese compounds ere inactive hen tested directly but became active hen allo ed to undergo auto&o$idation. With all B compounds, half&ma$imum inhibition of QA2E,R b65+ binding required quantities of o$idi(ed product equivalent to 20&B0 micrograms3ml =F0&ACE micro/> of the original compound. 3 !rude aqueous e$tracts of the plant .ithospermum ruderale have been sho n to have antigonadotropic activity that resides in its polyphenolic fractions. A study e$amined the ability of one such polyphenol, lithospermic acid, and its o$idation product=s> =o$y.A> to inhibit luteini(ing hormone secretion in vitro. < 6he study indicated that o$y.A may contain the primary antigonadotropic agents in .. ruderale.

1

!ell&specific production and antimicrobial activity of naphthoquinones in roots of lithospermum erythrorhi(on 1lant 1hysiol. ACCC )ebKAAC=2>9<AH& 2B. 2 AufNm#ol# /. '$tracts and auto&o$idi(ed constituents of certain plants inhibit the receptor&binding and the biological activity of *ravesN immunoglobulins. 'ndocrinology. ACBE /ayKAAF=E>9AFBH&C3. 3 AufNm#ol# /. 6he active principles of plant e$tracts ith antithyrotropic activity9 o$idation products of derivatives of 3,<&dihydro$ycinnamic acid. 'ndocrinology. ACBE /ayKAAF=E>9AFHH&BF. 4 'ffect of purified lithospermic acid and its o$idation product on luteini(ing hormone release in vitro. Biol 4eprod. ACBE 5epK33=2>930C&AE.

Medicinal actions:

%iuretic, emmenagogue, inhibitor of pituitary gonadotropins =)5+ and .+>, 65+ antagonist

)raditional Medicinal Use: ?ing described this plant as diuretic, having been used in both acute and chronic cystitis, and li#e ise in certain calculous affections. Current Medicinal Use: • 'ndocrine !onditions9 .ithospermum historically has been used as a contraceptive. ,ts inhibition of the production and hence secretion of )5+ and .+ from the anterior pituitary lead to anovulation. 6his effect is reliably achieved only after continuous daily use for at least F months. Women of certain :ative American tribes and tribes throughout Africa have used and continue to use this plant for birth control. .ithospermic acid has been e$tracted and utili(ed for this purpose in animals. 8ithospermum is an effective birth control, but does not have the A00G efficiency of oral contraceptives. )or this reason, it is rarely recommended. +o ever, in omen ho e$perience significant side effects from oral contraceptives, 8ithospermum may be a viable alternative. ,t is especially indicated hen combined ith natural fertility a areness methods. ,n cases of estrogen or progesterone e$cess such as dysmenorrhea or 1/5, 8ithospermum is a valuable therapy. 8ithospermum is also indicated in hyperthyroidism, especially secondary hyperthyroidism. ,t ill reduce 65+ stimulation of the thyroid as ell as reduce thyro$ine production. • *enitourinary !onditions9 0ne of the common names, 5toneseed, suggests its usefulness in relieving urinary and biliary lithiasis. While the mechanism remains unclear, 8ithospermum may aid in the dissolution and passage of biliary and urinary stones. ,t also is a diuretic hich encourages the flushing action through the #idneys. • 6opical Applications9 ,n Asia, topical preparations of the root are used to treat burns, inflammations, ounds and ulcers. 6he naphthaquinones appear to e$ert anti&inflammatory actions. #harmacy: ,nfusion9 A tsp.3cup aterK A cup3day for contraceptionK A cup 6,% for hyperthyroidism and other estrogen and progesterone imbalances. A9E 6incture9 A&E ml 6,% Drug ,nteractions: :o information is currently available from the selected resources. Contraindications:"777 • @ursing: due to antiprolactin effects. )o*icity: :one reported, ho ever this plant is an emmenagogue and is therefore contraindicated in pregnant omen.
1332 1333

Weiss, 4), ibid, 320. Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 2HB

1o!elia inflata
Common name: ,ndian tobacco Ha!itat9 .obelia is native to the 'astern United 5tates.

Campanulaceae

Botanical description9 .obelia gro s up to 2 feet high. 6he pale green leaves are sessile, alternate, ovate&lanceolate, 3&B cm. long ith toothed margins. 6he plant produces pale violet&blue flo ers in August&5ept. #art used9 Aerial partsK collected at the end of flo ering time. According to !oo#, the herb and the seeds are of the same action, the seeds being t ice the strength of the herb. Constituents A33< • 1iperidine al#aloids =FG>9 chief al#aloids .&lobeline =alpha&lobeline>K companion al#aloids including among others lobelanine, lobelanidine, norlobelanine, isolobinine • !helidonic acid, 4esins, *ums, )ats #harmacology 6he lobeline al#aloid is responsible for most of lobelia@s actions. 6hree ne piperidine al#aloids ere recently isolated from stems, leaves and flo ers of .obelia. ,n one study, the antiinflammatory potential of .obelia as connected ith the complement system. 6he ability of the residues, nonal#aloid fractions, al#aloid fractions and the three al#aloids at a concentration from 0.A2E to A.0 mg ml&A to inhibit complement activation and thus to prevent inflammatory process as estimated in vitro in human serum via both path ays. All of them inhibited complement activity ith a predominant action on !1. A33E Medicinal actions: 4espiratory stimulant, e$pectorant, emetic, diaphoretic, anti&spasmodic, nervine, sialagogue =?ing also described it as secondarily cathartic, diuretic and astringent.A33F )raditional Medicinal Use: .obelia as one of the most highly regarded medicines of the 'clectic and 1hysiomedical physicians. !oo# described it as a pure rela$ant, possessing only the faintest, transient, stimulating property, e$pending itself upon the fauces, the glands and mucous membrane of the mouth and respiratory organs. +e further stated Ithe quality for hich it is so greatly valued, is its peculiar influence in rela$ing the entire circuit of the organs and tissuesWma#ing prominent and diffusive impressions upon and through the nervous structures, but proving itself capable of reaching every portion of the body under the directing influence of the vital force.J A33H 6he 1hysiomedical %ispensatory has an e$tensive monograph on .obelia that is orth reading. 5pecific ,ndications and Use9 .obelia is specifically indicated by the full, labored, doughy pulseK the blood moves ith difficultyK pain in chest of a heavy, sore, or oppressive characterK angina pectorisK cardiac neuralgiaK pulmonary apople$yK mucus accumulation in bronchiK convulsive movementsK rigidity of muscular tissuesK rigid os uteri, ith thic# doughy edgesK rigid perineum, or vaginal allsK nauseaK oppressive sic# headache, ith nausea. As an emetic hen tongue is heavily coated at base. A33B • !ardiovascular !onditions9 .obelia as considered the drug for angina pectoris, neuralgia of the heart, cardiac congestion and pulmonary apople$y. 6o the 'clectics, .obelia as a cardiac stimulant9 although e class it ith the sedatives, for all sedatives in medicinal =small> doses are heart stimulants. 6he most prominent indication for the drug is the full, oppressed, sluggish, doughy pulse. oppression, thoracic pain, difficult breathing, soreness or bruised feeling ithin the chest, nausea ith tongue heavily coated at base, fullness of tissue. A33C • %ermatological !onditions9 .obelia as used in eruptive diseases hen retrocession occurred, to promote determination of blood to the s#in, promptly bringing the eruption to the surface. )or similar purpose, ,t as also indicated in scarlatina and measles hen the eruption as tardy in ma#ing its appearance. • *astrointestinal !onditions9 .obelia as used for intestinal obstructions and fecal impaction, particularly hen cathartics ould be contraindicated. ,ts antispasmodic action as put to use in any condition of spasm such as stranguary and spasm of the gall duct. ,t as frequently used for indigestion and dyspepsia, infantile colic, and sic# headache due to gastric derangement specified by the feeling of MqualmishnessM and nausea present. )or intestinal atony, lobelia as considered one of the best drugs for the relief of habitual constipation. !oo# described the appropriate dosing for the treatment of nausea and gastric irritation. 5ee his 1hysiomedical %ispensatory for more information. • *ynecologic !onditions9 .obelia as considered of value in obstetrical practice as it po erfully subdues muscular rigidity. 6he 'clectics considered .obelia the remedy to overcome a thic#, doughy, yet unyielding and rigid os uteri during parturition. 6he 1hysiomedicalists also indicated its use for a rigid uterine os during labor as ell as hourglass contractions of the uterus and ineffectual

forms of labor in hich a portion of the uterine fibers are rigid. At the same time, hen dosed properly =see !oo#D> .obelia rela$es the perineal tissues ithout interfering ith the action of those that are contracting properly. ;et, .obelia as not used as a distinct parturient. ,t as observed that .obelia did not give vigor to uterine contractions. 0n the contrary, its persistent use ill gradually rela$ the entire uterus, and finally all contractile efforts ill cease till the action of the lobelia has passed byK and this may readily ensue in cases here the uterine and vaginal structures are already flaccid. • ,nflammatory !onditions9 ,t may be used in forming stages of febrile affections, and is especially indicated by a general sluggishness of the hole system ith an oppressive feeling, and the tongue is heavily coated at the base. 6o the 1hysiomedicalists, its use in fever as considered valuable beyond any other remedy. By rela$ing the circulatory apparatus, it favors a full out ard flo of blood, ith diaphoresis. 6he relief obtained from the use of .obelia in meningitis, pleurisy, peritoneal inflammation, and acute rheumatism, is probably due as much to its rela$ing po er over serous tissues as to its soothing impression upon the nerves. 6o achieve positive results, large repeated doses ere used creating great rela$ation of the body ith increased perspiration. Again, see the 1hysiomedical %ispensatory by !oo# for more information on this use. A3<0 • :eurological !onditions9 !oo# considered .obelia unsurpassed for securing relief from the nervous restlessness of many conditions, such as acute hysteria, typhoid fever, delirium tremens, etc. • 1ulmonary !onditions9 1erhaps the most important use for this drug as in the treatment of respiratory affections, particularly in congestive conditions. 6he rationale for its use as to rela$ the tissues, improve innervation and circulation, and increase e$pectoration hen a large quantity of mucus is secreted and there is lac# of po er to remove it. Because of its antispasmodic effects, it as given in asthmatic paro$ysms, spasmodic croup, pneumonia =acute and chronic>, pleurisy and hooping cough. All chronic forms of sore throat, especially hen ulcerated, pneumonia, bronchitis, and laryngitis, asthenic laryngitis of children K chronic catarrhK dry, hard, or bar#ing coughs, colds, and all forms of irritation of the respiratory tract, ith oppression ere considered indications for .obelia by the 'clectics. 6he indications for this drug are the full, oppressed, or small, feeble pulse, precordial oppression, ith difficult respiration, oppression any here in the chest, ith accumulation of the bronchial secretions, cough ith loud mucous rates ithin the chest. A3<A • 6opical Applications9 According to ?ing, there as one condition in hich its use should not be overloo#ed, and that is in poisoning by 4hus to$icodendron. '$ternally, the infusion has been found useful in ophthalmic affectionsK and the tincture is a valuable local application to sprains, bruises, rheumatic pains, erysipelas, bites, stings of poisonous insects, spasmodic affections of the limbs, pains, and to produce muscular rela$ation. 6incture of lobelia, painted upon the parts before suppuration has begun, is said to abort felons. A3<2 Current Medicinal Use: .obelia as, and is, considered to be one of the best systemic rela$ants that e #no and is considered by many to be the supreme anti&spasmodic herb. ,t depresses the !:5, A:5, and neuromuscular functions. .obelia is used primarily for its rela$ant effects in the bronchioles. ,ts ability to rela$ the smooth muscle of the bronchioles ma#e it an invaluable part of an acute or chronic asthma formula. 5ystemically, .obelia e$erts po erful effects. .obelia reduces smooth muscle spasm and thus lo ers arterial pressure and vascular tension. ,t is also stimulates vegetative processes, i.e. that of digestion and glands. 4esults of human trials ith lobeline have been mi$ed and generally negative. 1reliminary uncontrolled studies suggest lobeline may improve lung function. A3<3 • Behavioral31sychological !onditions9 .obeline shares a structural similarity ith nicotine, and thus binds to nicotinic acid receptors and e$erts many of the same effects to a lesser degree =lobeline is A320&A3E as potent as nicotine>. )or this reason, .obelia is a useful aid in smo#ing ithdra al.A3<< 0verall, .obelia is useful in the follo ing respiratory conditions9 pertussis, croup, bronchial asthma, bronchitis, pleurisy. • *astrointestinal !onditions9 'ven though .obelia can cause emesis, it is also used to treat emesis if it is due to spasm of the stomach. ,t rela$es the tissue that is in spasm hile e$erting an overall rela$ation effect on the !:5 and A:5 = ithout causing a narcotic action>. • 1ulmonary !onditions9 6he al#aloids in .obelia e$ert parado$ical effects. .obeline is a po erful respiratory stimulant by stimulating the respiratory centers and e$erts this effect even in relatively small doses. ,solobeline is an emetic and respiratory rela$ant =rela$es smooth muscle> that most po erfully e$erts its action at higher doses. 6he combined action of both of these al#aloids ma#es .obelia a stimulating rela$ant. 6he net effect in the lungs ill be a promotion of mucous secretion, e$pectoration and a reduction in bronchial spasm. • 1ain !onditions9 .obelia is a potent anodyne hen the pain is secondary to spasm. • 6opical Applications9 '$ternally, .obelia is used as a poultice in the treatment of boils and ulcers. .obelia acts as a counter&irritant hen applied e$ternally. A !hinese species, .. radicans is also used e$ternally and internally to treat sna#e bite =if respiratory depression occurs>.A3<E,A3<F #harmacy9 !apsicum is often combined ith .obelia in order to reduce the systemic rela$ant effect =due to the stimulating and tonic properties of !apsicum>. ,n small, frequent doses, .obelia causes perspiration. ,nfusion9 A3<&A32 tsp dried leaves3 cup aterK sig A cup 6,%

6incture A9E F0G 't0+ fresh or A9B F0G 't0+ driedK 0.E ml 6,% Contraindications: .obelia is contraindicated in general rela$ation and dyspnea especially hen due to a ea#ened heart or valvular incompetence. !oo# stated to avoid .obelia in the treatment of IhumidJ asthma and difficult breathing accompanying heart disease. A3<H Brin#er notes the use of .obelia being contraindicated in nervous prostration, shoc# or paralysisK heart disease =including cardiomegaly, fatty heart, pericarditis ith effusion, valvular incompetence, cardiac decompensation, sinus arrhythmia or bundle branch bloc#>K pneumonia or pleural effusionK hypertensionK lo vitalityK pregnancy or tobacco sensitivity. A3<B )o*icity9 5$9 burning esophagus, salivation, :37, ea#ness, stupor, tremors, paralysis, tachypnea, hypothermia, rapid pulse, pinpoint pupils, unconsciousness, convulsions, coma, e$haustion, s eating, prostration, miosis, death. 6he to$ic dose is variable and some individuals are sensitive to the therapeutic dose.
1334 1335

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1hilipov 5, 1hytochemical study and antiinflammatory properties of .obelia la$iflora .. 8 :aturforsch Q!R. ACCB /ay&-unKE3=E&F>93AA&H. 1336 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 1337 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 1338 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 1339 )elter 1340 !oo# 1341 )elterc 1342 )elter 1343 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1344 Willard, 6., 6e$tboo# of Advanced +erbology, =Wild 4ose !ollege of :atural +ealing9 !algary>, ACC2 1345 1harmocology and Applications of !hinese /ateria /edica 7ol AM, 'd. +. !han 1346 1. But, 1ub. World 5cientific =ACBF> 5ingapore 1347 !oo# 1348 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. C3&<

1omatium dissectum
Common name: .eptotaenia, 6o(a root, lomatium

Apiaceae

Ha!itat9 .omatium gro s from 7ancouver ,sland and 5outhern B! south to 5. !alifornia, :evada, :e /e$ico and !olorado. ,t gro s from sea level to 2E00 meters. Botanical description9 .omatium dissectum is a spring flo ering perennial. ,t has a large taproot and gro s 20&F0 inches high. 5everal hollo , ribbed stems rise form the top of the root and culminate in finely divided leaves and large umbels of yello to bro nish&purple flo ers. #art used9 4adi$ Historical uses9 .omatium as #no n to many Western plateau region :ative Americans as 6o(a. ,t as used as nutritive food and as an internal remedy for all types of infection, especially those of the eyes, respiratory tract and urinary tract. .omatium as one of the most idely used medicines of the :ative Americans of the estern U.5. A decoction of the root as used internally and the above ground portion as smo#ed or burned and inhaled to treat coughs, colds, hayfever, bronchitis, asthma, influen(a, pneumonia, and tuberculosis. 6he decoction as applied e$ternally for cuts, sores, rashes and the oily sap as used on s#in lesions and in the eyes for trachoma and gonorrheal infections. 6he ra root as che ed for sore throat and used as a poultice for s ellings, sprains, and rheumatism. Constituents9 4oot& essential oil, gums, resins, glycosides =coumarins and saponins>, carbohydrates, protein, fatty acids, ascorbic acid =22G>. #harmacology: 6etranoic acids and a glucoside of luteolin appear to be the main anti&microbial agents in .omatium root. 6he oil e$tract of .omatium partially or completely inhibits gro th of9 !orynebacterium diptherium, %iplococcus pneumonia, 5treptococcus pyogenes and 5. viridans, 'scherichia coli =< strains>, 1seudomonas aeruginosa, 1roteus vulgaris and /ycobacterium tuberculosis, three strains of 5higella, t o strains of 1roteus, 5taph. aureus., +emophilus influen(a, :eisseria gonorrhea, and !andida albicans. 6he degree of inhibition is comparable to that of penicillin in comparable concentration. ,n general, coumarins have estrogenic, spasmolytic, sedative, anthelmintic actions. !oumarins activate adrenaline and A!6+&induced lipolysis and insulin&induced lipogenesis. !oumarins are vasodilatory and are non&to$ic. 6he coumarins in .omatium have significant antimicrobial activity. 6he furanocoumarins have antiviral activities against both %:A and 4:A viruses. 6he coumarins easily penetrate the virus coat as ell as bacteria, yeast and animal cell. 6his antimicrobial activity has been demonstrated in&vitro and in&vivo. 5aponins are tonic, tranquili(ing, e$pectorant, antitussive, anti&tumor, antimicrobial, and anti&inflammatory. 5aponins stimulate the production of serum proteins and ater soluble triterpenoidal saponins enhance antibody production. 6he saponins in .omatium presumably act similarly to saponins in general. 6he high ascorbic acid content of .omatium root contributes to its immunostimulatory actions. 6he carbohydrate content of .omatium probably represents some polysaccharides hich are immunostimulatory. )inally, the volatile oils are antiseptic, spasmolytic, and sedative. Medicinal actions: antimicrobial inc. antiviral, antifungal, and antibacterial, e$pectorant, antitussive, antiseptic )raditional Medicinal Use: :o information is currently available from the selected resources. Current Medicinal use: .omatium as used successfully by the American medical establishment =than#s to the :ative Americans> in the early AC00Ns during an influen(a outbrea#. +o ever, after the outbrea# as over, interests in .omatium died out. ,n the latter decades of the t entieth century, the interest in .omatium has gro n, perhaps coincident ith the prevalence of viral diseases. • ,nfectious !onditions9 0verall, .omatium is useful in acute and chronic viral, bacterial, fungal infections and other inflammatory disorders of the respiratory system. ,t is most effective in treating infections hen it is given as early as possible and in small frequent doses. .omatium is particularly ell suited for respiratory infections, not only for its antimicrobial actions, but also because it is an e$cellent e$pectorant. 6he saponins irritate pharyngeal and gastrointestinal mucosa hich causes a refle$ive hydration of mucus produced in the respiratory tract. 6his allo s for easier e$pectoration and reduction of spasmodic coughing. .omatium is also very beneficial in the treatment of chronic fatigue immunodeficiency syndrome. )or some people, a chronic viral infection is at the root of this disorder. .omatium is an e$tremely effective antiviral agent in these people. Current +esearch +eview: • 5earch of medline revealed no human studies as of :ovember 2002. #harmacy9 6incture A9E EEG 't0+K sig A&2 ml 6,%

.omatium isolate9 !hronic viral illness9 sig A2 drops 6,% $ 2 ee#s, maintenance dose B drops B,% Acute viral illness9 sig A2 drops 6,% Contraindications: )uranocoumarin containing plants can cause photosensiti(ation to U7 light. Use of .omatium should be avoided during e$cessive periods in sunlight or hile undergoing cosmetic or therapeutic U7 light e$posure. A3<C )o*icity9 6he resin fraction occasionally causes a hole&body rash in some people. 6here is not enough information at this time to determine if the resins are necessary for the medicinal action of .omatium. Another set of constituents, #no n as coumarins, may also contribute to the onset of rash.A3E0 6he rash is pruritic, generali(ed and maculopapular that mimics measles. 6he rash resolves several days after .omatium is discontinued. 6he .omatium isolate is prepared by separating out the resin. 6his form of the medicine can be used ithout the rash side effect.
1349 1350

Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 2AA .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A

1ycopus virginicus and 12 europeus
Common name: Ha!itat: Bugle eed, s eet bugle, gypsy ort, ater bugle

1a!iatae

Botanical description: !haracteristic mint family square stem gives rise to opposite, glabrous leaves, elliptical&lanceolate, toothed above. 6he small hite flo ers occur in a$illary clusters ith a purplish four&lobed corolla. 6he plant prefers damp ground in grassland, along streams and ditches. #arts used: aerial parts, collected "ust before the buds open Constituents: • 1henolic acid derivatives =caffeic, rosmarinic, chlorogenic, ellagic> • 1imaric acid methyl ester =in 81 europeus> • .ithospermic acid Medicinal actions: 5edative, astringent, anti&tussive, diuretic, peripheral vasoconstrictor, anti&hyperthyroid actions

#harmacology: .ithospermic acid and other organic acids =especially caffeic acid> are believed to be responsible for the activity of .ycopus. 6hese acids decrease levels of several hormones in the body, particularly thyroid&stimulating hormones and the conversion to thyro$ine =6<>. Administration of .ycopus e$tracts results in decreased 65+, 63 and 6< levels in animal models A3EA and .ycopus has been sho n in !itro to prevent 65+ from binding to and activating adenylate cyclase in human thyroid membranes. A3E2 .ycopus inhibits the binding of antibodies to the thyroid gland. 6hese antibodies can cause *raves@ disease, the most common form of hyperthyroidism. All these actions help e$plain .ycopus@ benefit in people ith overactive thyroids. .ycopus also decreases production of the pituitary gland hormone prolactin, an elevated level of hich is associated ith female reproductive difficulties and enlarged breasts in men =gynecomastia>. A3E3, A3E< )raditional Medicinal Use: 5pecific ,ndications and Uses9 7ascular e$citementK hemorrhage, in small amounts, resulting from determination of blood to the lungs, #idneys, or gastro&intestinal organsK albuminuria, ith frequent pulseK cough, ith copious e$pectoration of mucus or muco&pus, especially debilitating chronic coughK a#efulness and morbid vigilance, ith inordinately active circulationK frequent pulse, ith high temperature, and in tubercular deposits. .ycopus filled an important place in 'clectic therapeutics. ?ing described it as a sedative, mild narcotic, mild astringent, and tonic here it action is chiefly e$hibited on the vascular and sympathetic nervous systems. By its action as a nervine it as use to give rest and quiet pain. By its control over the circulatory apparatus it slo s the pulse and brings do n the temperature. 6umultuous action of the heart and consequent increase of the circulation through the lungs are controlled by it. ,t as employed in acute cases to control fever and inflammation. !oo# noted that .ycopus is distinctly soothing, acting on the peripheral, rather than the central nervous system. .ycopus as used in conditions mar#ed by heightened sensitivity and irritability. +e describe its action as rela$ant and moderately stimulant, of the very mild tonic character, and apparently leaving behind a slightly astringed impression on mucous membranes. !oo# noted its action on nervous forms of spermatorrhea, and its soothing tonic influence on the uterus, rendering it of service in neuralgia, and painful and e$cessive menstruation. • !ardiovascular !onditions9 ?ing noted that its sedative action is most pronounced and most frequently indicated here the vascular action is tumultuous, rapid pulse, and lac# of cardiac po er, particularly in advanced stages of acute disease ith great debility, and in chronic disease ith frequent pulse. As a sedative, 5cudder classed it ith Aconite and 7eratrum. !oo# observed .ycopus to rela$ the capillaries at the same time that it soothes arterial e$citementK and thus slo ly diverts the circulation out ardly, lessening the labored efforts of the heart. 5uch an effect as noted by relief of to relieves a rapid and hard pulse. +o ever, its influence on the cardiovascular system as considered not to be suited for febrile condition, but rather conditions associated ith cardiac and nervous irritability, rheumatic and gouty taints, etc. !ardiac disease, both organic and functional, have been mar#edly impressed by .ycopus. Administered to patients suffering from endocarditis and pericarditis it quic#ly subdues the inflammation. ,t is a good remedy for cardiac palpitation, dependent on irritation of the cardiac nerve centers, or hen arising from organic lesions. ,t is best adapted to those forms of heart disease characteri(ed by irritability and irregularity, ith dyspnea and precordial oppression. .ycopus po erfully increases the contraction of smooth muscle, particularly

those of the heart and arteries, hence its value in cardiac dilatation and hypertrophy hich have been #no n to undergo mar#ed improvement under its administration. ,t quic#ly relieves the suffering and an$iety nearly al ays e$perienced in heart diseases. .ycopus has given good results in hemorrhages, being particularly adapted to those cases in hich the bleeding is frequent but small in amount. Under such conditions specific .ycopus as considered valuable in hemoptysis, epista$is, hematemesis, hematuria, and uterine and intestinal hemorrhage. • 'ndocrine !onditions9 5everal cases of diabetes mellitus have been reported, through the 'clectic /edical -ournal, as benefited by lycopus. .ycopus as also favorably influenced e$ophthalmic goiter. • *astrointestinal !onditions9 .ycopus improves the appetite and acts as a mild gastric tonic. ,t as observed to normali(e gastric secretion, enhancing proper digestion of necessary nutrients. As a remedy for painful and distressing forms of indigestion, specific .ycopus as found advantageous as ell as a mild tonic in general debility. !oo# observed that it relieves pain, diminishes discharges slo ly, and gradually gives tone to the alvine canal. .ycopus as used by both the 1hysiomedicalists and 'clectics in dysentery and diarrhea and is equally valuable to allay irritation and inflammation in gastritis and enteritis, especially acute gastric disturbances and inflammatory diseases secondary to e$cessive alcohol consumption. .ycopus has been used both for its sedative effects and for its influence on the gastrointestinal troubles accompanying intermittent fevers. • *enitourinary !onditions9 !oo# noted that it relieves pain, diminishes discharges slo ly, and gradually gives tone to the #idneys, lessening e$cessive irritation, abating enuresis, and relieving achings in the #idneys and bladder. • 1ulmonary !onditions9 .ycopus as considered of great value in acute pulmonary complaints and of greater utility in chronic lung conditions. ,n the pulmonary system .ycopus as observed to act as a gentle sedative and tonic. ?ing noted that .ycopus reduces the frequency and force of the heartNs action =in contrast to above> indicated it in pulmonary lesions ith irritation, cough and tendency to hemorrhage. ,t as particularly valuable in chronic cases ith copious secretion of mucus or mucopurulent discharge. ,t lessens irritation, allays the distressing cough so frequently encountered in chronic bronchitis, pneumonia, and tuberculosis. +ere it gives rest, alleviates the pain and quiets the vascular e$citement. ,t as one the best 'clectic remedies for hemoptysis. !oo# also observed, that by equali(ing the circulation and soothing the nerves, .ycopus could relieve harsh coughs and arrest bleeding of the lungs. ,n tuberculosis, it as a remedy to relieve the distressing symptoms, administered in drop doses every hour. )or this condition, !oo# noted that its soothing and tonic influence is much more favorable than the rela$ing e$pectorants hich ere commonly employed. .ycopus as also considered valuable in acute as ell as chronic pneumonia. ,n ordinary acute catarrh it as administered ith Aconite, 'upatorium, and other indicated agents. )or pectoral purposes, the 1hysiomedicalists combined .ycopus ith Aralia racemosa, 5ymphytum, 1runus, and similar agents. • 6opical Applications9 Bugle eed, simmered ith fresh butter or petrolatum, may be employed as a topical dressing for burns and irritable ulcers. 6he 1hysiomedicalists relied on .ycopus to soothe and heal fistula through frequent ingestion and as a ash to the affected part. !oo# also used only a strong ointment, prepared of the solid e$tract triturated ith a carrier such as lard. 5uch a preparation had been used in a varieties of fistulas from lachrymal fistula to large abscesses in the lumbar region to chronic scrofulous ulceration. Current Medicinal Use: 6he specific indications for 8ycopus spp1 include9 I7ascular e$citement, ith rapid, tumultuous action of the heart, but lac#ing po erK hemorrhage, passive and in small quantities. . . chronic debilitating cough, ith ea# and rapid heart action and e$pectoration of mucousK morbid vigilance and a#efulness, ith inordinately active but ea# circulation. . . polyuria. . .J A3EE 8ycopus as highly valued by the 'clectic physicians for its use in people ith rapid, ea# heart rates and generali(ed debility. ,t as thought that 8ycopus acted upon the sympathetic nervous system and vascular system. 8ycopus as observed to lessen an$iety and to slo and strengthen the heart. 0ne consequence of these actions as to reduce cor pulmonale and the passive lung hemorrhage associated ith this condition. 8ycopus as often the remedy of choice in chronic coughs ith blood in the sputum, especially if these symptoms ere associated ith a rapid heart rate and3or palpitations. )inally, the 'clectic physicians used 8ycopus for insomnia ith concomitant agitation and an$iety. !urrent understanding of 8ycopus encompasses these indications, but pinpoints the pathology to the thyroid gland. ,n cases of mild to moderate hyperthyroidism, 8ycopus may be helpful in bloc#ing 65+ from binding to the thyroid. 8ycopus also inhibits iodine metabolism and thyro$ine release from the thyroid gland. A3EF )inally, as mentioned above, 8ycopus inhibits peripheral 6< conversion. 6hese actions ill cumulatively reduce the symptoms of hyperthyroidism including agitation, insomnia, palpitations, and eight loss. Although 8ycopus is not as strong as synthetic thiouracils and mercaptoimida(oles, 8ycopus is much safer. 8ycopus is often used in combination ith other anti&thyroid herbs such as Melissa officinalis, 8ithospermum spp1, and 8eonurus cardiaca1 #harmacy: 6he alcohol e$tract of 8ycopus appears to be the most efficacious preparation. 6he alcoholic e$tract ma$imi(es the amount of uno$idi(ed phenolic compoundsZthe constituents associated ith the anti&thyroid activity. !oo# noted that e$cessive heat dissipates its soothing properties. A9E tinctureZE ml 6,%K ma$imum ee#ly dose is A00 ml

%ried herbZA tsp.3 cup aterK infuse 20 minutesK A cup 6,% Drug ,nteractions:"7%( • )hyroid hormone: =speculative> as it may interfere due to bloc#age of conversion of 6< to 63 in the liver and inhibition of 65+ =in vitro, animal> • +adioactive ,odine: =speculative> may interfere by altering the regulatory metabolism of the thyroid hormones =in vitro>. Contraindications:"7%/ • 1ow thyroid activity or nonto*ic goiter =speculative> due to it antithyrotropic activity =in vitro, animals> and inhibiting conversion to 6< to 63 in the liver =in vitro>. • #regnancy or nursing: due to antigonadotropic, antithyrotropic and antiprolactin activity =speculative>. )o*icity: :one reported. Additional reading: Wagner +, +orhammer ., )ran# U. .ithospermic acid, the antihormonally active principle of 8ycopus europaeus .. and ,ymphytum officinale .. )rIneim orsch ACH0K209H0EWA2. ?ohrle -, Auf@m#ol# /, et al. ,odothyronine deiodinases9 ,nhibition by plant e$tracts. )cta Endocrin ,uppl ACBAKAF9ABBWC2. Auf@m#ol# /, ,ngbar -!, et al. '$tracts and auto&o$idi(ed constituents of certain plants inhibit the receptor&binding and biological activity of *raves@ disease immunoglobulins. Endocrin ACBEKAAF9AFBHWC3. 5ourgens +, Winteroff +, *umbinger +*, ?emper )+. Antihormonal effects of plant e$tracts9 65+ and prolactin&suppressing properties of 8ithospermum officinale and other plants. Planta Med ACB2K<E9HBWBF. Brin#er ). ,nhibition of endocrine function by botanical agents. ,. Boraginaceae and .abiatae. 7 ;aturopathic Med ACC0KA9A0WB.
1351 1352

Winterhoff +, *umbinger +*, et al, I'ndocrine effects of 8ycopus europeus follo ing oral applicationJ )rIneim9 orsch Drug Res, <<, ACC<9<A&E. Auf@m#ol# /, ,ngbar -!, et al. '$tracts and auto&o$idi(ed constituents of certain plants inhibit the receptor&binding and biological activity of *raves@ disease immunoglobulins. Endocrin ACBEKAAF9AFBHWC3. 1353 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1354 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 1355 )elter +W The Eclectic Materia Medica, Pharmacology and Therapeutics , Ast published AC22, 3rd printing, =5andy, 049 'clectic /edical 1ublications>, ACC<9<F<. 1356 Weiss 4) Herbal Medicine, =Beaconsfield, 'ngland9 Beaconsfield 1ubl.>, ACBB92HC. 1357 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. E0 1358 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. E0

Marru!ium vulgare
Common name: +orehound' White horehound.

1a!iatae . 1amiaceae (Mint =amily

Common )rade @ame: +orehound +erb, +ore +ound 6ea W as capsule of fluid e$tract =300mg>, lo(enges, syrup, tea, po der, ] confectionaries.A3EC Ha!itat9 :ative to 'urope, 6emperate (ones of :. America, esp. from /aine, south ard of 6e$as ] est ard to !alifornia ] 0regon. ,t gro s on dry, sandy fields, aste areas ] roadsides 3 poor soil. Botanical description9 6he entire plant is covered in hite, do ny hairsK giving it a \hoary@ appearance. +orehound is a perennial fibrous root 3 numerous annual bushy stems, hich generally gro to a height of A&2 feet. 6he stems are hite, ooly ] square. 6he leaves are rin#led, opposite, oval, rough, crenately&toothed, 3 veins ] hairs on the surface. .o er leaves rest on a long petioleK upper leaves are nearly sessile. 6he flo ers are small, hite, strongly t o&lipped ] densely cro ded at the uppermost a$ils of the stems. #arts used9 %ried leaves ] flo ering tops harvested hile in flo er, before the opening of the flo ers b3 -une ] 5eptember. $nergetics: Bitter, 1ungent. !ooling. =&> ?apha ] 1itta. =X> 7ata. A3F0 Affinity for the chest ] lungs. Constituents:"7&" • Bitter 1rinciples & +ydro$y %iterpenoid .actones9 chief components are /arrubiin =0.A&A.0G> ] 1remarrubiin =0.AG>. • !affeic acid derivatives9 including !hlorogenic acid ] !ryptochlorogenic acid. • )lavonoids9 including !hrysoeriol, 7icenin ,,, .actoyl flavones =i.e. luteolin&H&lactate ] apigenin&H&lactate>. • 7olatile oil =traces>9 including !amphene, p&!ymene ] )enchene. • 0ther9 %iterpene Alcohols, Al#aloids, !holine, Al#anes, 1hytosterols, ] 7itamin !. #harmacology: Although the e$act mechanism is still yet un#no n, the e$tectorant action of /arrubium is believed to be d3t its content of volatile oils, resins ] to marrubine. ,ts bitter principles stimulate the production of gastric "uices, 3 marrubinic acid acting as a choleretic.A3F2 6he volatile oils are also antimicrobial ] hypotensive. A3F3 6he flavonoids are anti&inflammatory in action.A3F< 6 6annins help to astringe ] tonify mucous membranes. Medicinal actions: '$pectorant. Bitter6onic. %iuretic. 5tomachic. 7ermifuge. %iaphoretic. Anti&spasmodic. Astringent. !holagogue. 7ulnerary. Current > )raditional Medicinal Use: /arrubium is considered a stimulant tonic, e$pectorant, ] as a diuretic 3 a diffusive action. 6he s#in and mucous membranes are chiefly affected by it. Along 3 the conditions listed belo , /arrubium has also been indicated in "aundice, amenorrhea, ] hysteria as a arm infusion. As a arm infusion, +orehound ill promote perspiration ] the flo of urine. • 9astrointestinal Conditions: 6he cold infusion is an e$cellent tonic for some forms of dyspepsia. ,n large doses, /arrubium as used as a purgative to e$pel orms. +orehound as also useful in cases of mercurial salivation. A3FE • #ulmonary Conditions: 6raditionally, /arrubium as used as a stimulant to laryngeal ] bronchial mucous membranes. +orehound as often used as syrup to treat9 coughs, colds, chronic catarrh, asthma, ] all other pulmonary affections. !urrently, /arrubium is most indicated in the treatment of bronchial conditions 3 ea# appetite ] sluggish digestionK or as a digestive r$ hen there is associated respiratory ea#ness. As an e$pectorant, +orehound is a diffuse ] gentle tonic. ,t tends to be amphoteric to the lungs, in that it supports the removal of e$cess mucous, but also helps to decrease e$cessive discharge. /arrubium is currently indicated in the t$ of9 colds, bronchitis, asthma, catarrhal dyspepsia, coughs of any #ind, as a gargle for pharyngitis, ] in liver ] stomach disorders. 6he anti&inflammatory properties of the flavonoids give /arrubium usefulness in the treatment of sinusitis. +orehound is most indicated as an acute therapy rather than a chronic one, especially for respiratory conditions. • Hepato!iliary Conditions9 A arm infusion is best for "aundice ] in the promotion of diaphoresis ] diuresis. /arrubine also increases bile flo ] hence its use as a cholagogue. A3FF • )opical Applications: /arrubium can also be used e$ternally as a vulnerary. +orehound is thought to only aid tissue healing, but ill not promote complete healingK hence it is best combined ith other herbs of vulnerary action. Current +esearch +eview:

•

5earch of /edline yielded no human studies as of 5eptember 2002.

#harmacy9 6he arm infusion ill produce diaphoresis, and sometimes diuresis hile the cold infusion as used for digestive and pulmonary complaints.A3FH, A3FB Although no human trails support its use, the *erman !ommission ' monograph recommends <.E grams of horehound per day or 2WF tablespoons of the pressed "uice for use in respiratory complaints. A3FC 5yrup or tinctures are the best forms for respiratory conditions. A cold infusion is best hen this herb is used as a simple. When combined 3 other herbs, a hot infusion of tincture is most effective. '$ample of combined tincture9 2&AE gtt 5cutellaria lateriflora, 20&<E gtt Asclepias tuberose, E&<0 gtt /arrubium vulgare. A3H0 • %ried herb9 <.E qd.A3HA • -uice9 2&E 6bsp qdA3H2 Contraindications: Was not considered a suitable agent to use in dry and irritable coughs, and in patients ith a tendency to spasmodic asthma.A3H3 !ontraindicated during pregnancy.A3H< )o*icity9 +ypertension may occur ith chronic use
1359 1360

Professional/s Handboo3 of 2omplementary J )lternati!e Medicines . 5pringhouse, 5pringhouse, 1ennsylvania, ACCC933<. )ra ley %, .ad, 7. The Aoga of Herbs. .otus 1ress, 6 in .a#es, Wisconsin, ACC2920<. 1361 Blumenthal /, Busse W4, *oldberg A, et al. =eds>. The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines . Austin9 American Botanical !ouncil and Boston9 ,ntegrative /edicine !ommunications, ACCB9A2HWB. 1362 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1363 %arryev, /0, et al. >I! )3ad ;au3 Tur3m ,er Biol ACHFK39BF. 1364 /ascolo :. et al, Phytother Res ACBHKA=A>92B. 1365 +utchens A4. >ndian Herbalogy of ;orth )merica. 5hambhala, Boston, /assachusetts, ACCA9AEE. 1366 .eung A;. Encyclopedia of 2ommon ;atural >ngredients used in ood Drugs J 2osmetics. -ohn Wiley ] 5ons ,nc., :;, ACB0. 1367 )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04, ACB3 1368 !oo# 1369 Blumenthal, A2HWB. 1370 +utchens, AEE. 1371 Blumenthal, A<B. 1372 ,bid 1373 !oo# 1374 Brin#er ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 , ACCB9B<

Matricaria recutita. M2 chamomilla
Common name: !hamomile, *erman chamomile Ha!itat:"7(% =/. recutita> ,ndigenous to 'urope and north est Asia, naturali(ed in :orth America and else here.

Asteraceae

Botanical description: =/. recutita>A3HF • )lo er and )ruit9 )lo er heads are terminal and long&pedicled. 6he flo er is hite ith a yello center. 6he margin flo ers are obtuse ith a tunicate margin. 6he ray florets are hite, linguiform, female, and 3&totthed. 6he dis# florets are tubular, androgynous, E&toothed, ith a hollo receptacle. • .eaves, 5tem and 4oot9 20&<0 cm high herb ith erect glabrous stem, hich is branched above. 6he eaves are 2&3 pinnatisect and have a narro thorny tip. #arts used9 )lo ers Constituents9 • volatile oil =0.3&A.EG> containing9 alpha bisabolol, alpha bisabolol o$ides, sesquiterpenes =anti&inflammatory, anti&spasmodic> such as chama(ulene, tricyclic alcohols, bicyclic alcohols, dicyclic ethers and matricin =usually converted to chama(ulene>.A3HH • coumarins9 umbelliferone, herniarin • flavonoids9 metho$ylated flavones and flavonols, apigenin, luteolin, quercetin • glycosidesK salicylic acidK cholineK fatty acidsK mucopolysaccharides #harmacology: • 6he volatile oils in this plant are primarily responsible for its anti&inflammatory, anti&spasmodic, and anti&microbial effects. 6he chama(ulene volatile oil gives the distilled oil a blue color. !hama(ulene is converted to a(ulene during distillation or hen steeped =heat and steam>. A(ulene is a strong anti&inflammatory constituent. 6he mechanism for the anti&inflammatory effects of a(ulenes are unclear. 6hey appear to be due in part to activation of the pituitary&adrenal a$is, hich causes release of cortisone, hich in turn prevents the release of histamine from cells. Another proposed mechanism is that the chama(ulenes inhibits E&lipo$ygenase mediated synthesis of leu#otrienes. A(ulene is a gentle sedative, restoring the nervous system to a calmer state.A3HB • 6he alpha&bisabolol is anti&inflammatory and anti&spasmodic in that it enhances prostaglandin production thus strengthens mucosal protective barrier =therefore protective against ulcers>. 6he alpha&bisabolol is useful in the treatment of ulcers for the reason that it decreases pepsin release ithout changing the p+. 6he dicyclic ether is a strong smooth muscle rela$ant by decreasing sympathetic sensitivity. 5ympathetic innervation decreases peristalsis. A3HC • 6he flavonoids are antiinflammatory and anti&spasmodic, stabili(ing capillaries and rela$ing smooth muscles, particularly in the gastrointestinal tract.A3B0 6he flavonoid apigenin =E,H,<N&trihydro$yflavone> has been reported to have antian$iety activity. 6he chemical modification of the flavone nucleus dramatically increases the an$iolytic potency. A3BA Medicinal actions9 5edative, carminative, antispasmodic, analgesic, anti&inflammatory, and anti&septic, A3B2 antiphlogistic, musculotropic, anti&peptic, anti&spasmodic, vulnerary, deodorant, s#in metabolism stimulant, A3B3 anti&ulcer, diaphoretic,A3B< anti&diarrheal, anti&emetic, carminative, anti&anaphylactic )raditional Medicinal Use: • )ol# medicine9 Used internally for diarrhea and flatulence. Used e$ternally for furuncles, hemorrhoids, abscesses, and acne.A3BE • ?ing described the effect of /atricaria as having t o particular specific fields of action9 on the nervous system, subduing nervous irritability, and on the gastrointestinal tract, relieving irritation. +e described a /atricaria patient as restless, irritable, discontented, and impatient. ,n children, there is mar#ed irritability and the child is only appeased hen continually carried. 6he child is peevish and fretful, the stools e$tremely fetid, and may e$coriate around the anus more or less. ,n appearance they varyZmay be atery and green, or slimy, perhaps in yello and hite lumps, or it may be of undigested curds of mil#, imbedded in a green mucusZan appearance aptly compared by 1rof. Bloyer to Mchopped eggs and greens.J A3BF • 5pecific ,ndications and Uses9 :ervous irritability, ith peevishness, fretfulness, discontent, and impatienceK sudden fits of temper during the catamenial periodK muscular t itchingK morbid sensitiveness to painK head s eats easilyK alvine discharges, fetid, greenish and atery, and of green mucus ith curds of mil#, or of yello and hite flocculi, associated ith flatulence,

•

colic, and e$coriation of the anal outletK a remedy particularly fitted for the disorders of dentition, and to correct the condition threatening to end in dentition convulsions.A3BH %ermatology9 /atricaria as used for s#in eruptions and rashes. • *astroenterology9 ?ing observed that nervous manifestations calling for /atricaria are nearly al ays present in the disorders of the *, tract such as flatulent colic ith distension and irritative =vs. atonic> diarrhea. ,n subacute inflammation and in congestion of the liver, small doses of /atricaria ere considered very efficient ith costive bo els, difficult urination, irritability, and 4U2 tenderness. • *ynecology9 ?ing noted that /atricaria =specific or infusion> is valuable in the treatment of amenorrhea, ith sense of eight and heaviness in the uterus, bloating of the abdomen and accompanied ith sudden nervousness. 6he infusion, given to the e$tent of producing free diaphoresis, as used to relieve dysmenorrhea and to prevent the formation of clots. ,n pregnancy, /atricaria as employed to relieve nervous t itching, cough, false pains, etc., accompanied by great unrest. Alone, or associated ith 1hytolacca, /atricaria as applied to relieve soreness and s elling of the breasts in lactation, and is useful in suppression of the lacteal secretion. • ,nflammatory !onditions9 ,f fever is present, the 'clectics combined /atricaria ith Aconite. • :eurology3psychiatry9 6he 'clectics noted that the action of /atricaria is most pronounced on the nervous system its, affecting both the sensory and motor nerves. /atricaria as considered to be peculiarly adapted to the nervous manifestations of dentition, and in other affections here there seems to be a morbid susceptibility to pain. 'arache, rheumatic and neuralgic pains, abdominal neuroses, etc., are relieved by it hen the nervous apprehension is out of proportion to the actual amount of pain e$perienced. %C(( • 1ain !onditions9 /atricaria as applied in various painful conditions ith Aconite including earache, rheumatism and catarrhal affections of the bo els, ears, nose, and eyes. • 6opical Applications9 .ocally, it has been used as a ash for leucorrhoea, mammary abscess, ulcerating bubo, and catarrhal con"unctivitis.

Current Medicinal use: • *astroenterology9 *astrointestinal spasms, inflammatory diseases of the gastrointestinal tract, peptic ulcer. A3BC /atricaria, strengthens the mucosal protective barrier, regulates pepsin release, improves motor function and rela$es smooth muscle. ,f cytoto$ins or mucosal invasion is part of the pathogenic process, the anti&inflammatory constituents of /atricaria are indicated. 6he smooth muscle rela$ing effect is most pronounced on gastric smooth muscle. ,n fact, e$cessive use of /atricaria teas can result in stomach muscle flaccidity. *astric indications include nausea, dyspepsia, food intolerances, peptic ulcer and gastro esophageal reflu$ disease =*'4%>9 as an anti&inflammatory and spasmolytic /atricaria reduces symptoms, reduces inflammation and promotes healing. /atricaria acts as a gastrointestinal spasmolytic for other areas of the *, tract as ell. )or e$ample, /atricaria decreases cramping associated ith diarrhea and irritable bo el syndrome. 6he spasmolytic effect decreases intracolonic pressure, hich along ith other treatments prevents stagnation and further degeneration of the bo el all. A3C0 ,n a ell&conducted randomi(ed controlled trial, children =F months to E.E years of age> ith acute, non&complicated diarrhea received either a preparation containing apple pectin and chamomile e$tract or placebo. At the end of three days of treatment, the diarrhea had ended significantly =p c 0.0E> more frequently in the pectin3chamomile than in the placebo group. A3CA A liquid e$tract of the flo ers helpQs prevent ulcer formation induced by ethyl alcohol, hile the bisabolol inhibits ulcer formation caused by indomethacin in rats.A3C2 As ith /entha, /atricaria can decrease gallbladder &associated spasm. %C*C • 4espiratory 5ystem9 ,nflammations and irritation of the respiratory tract. A3C< 6he volatile components may be inhaled most effectively from steam allo ing for deep and accurate penetration of medicinal agents to the hole respiratory system including the middle ear. 5team inhalation of /atricaria ill clear congestion, soothe membranes, and reduce hypersensitivity reactions.A3CE • %ermatological !onditions9 s#in and mucous membrane inflammations, ec(ema.A3CF ,n a partially double&blind, randomi(ed study testing chamomile cream vs. 0.EG hydrocortisone cream in patients suffering from medium&degree atopic ec(ema, the chamomile cream sho ed a mild superiority over 0.EG hydrocortisone and placebo. A3CH • *ynecologic !onditions9 0utside of the *.,. tract, another application of the sedative effect is in the treatment of dysmenorrhea. ,n combination ith *elsemium, /atricaria rela$es the uterus, fallopian tubes, and ovaries and promotes the flo of menses. • ,nflammatory !onditions9 Additionally, a(ulene decreases anaphyla$is =decreases ,g' mediators>, is anti&pyretic =inhibits hypothalamic regulatory center>, and is anti&septic =particularly against 5taph. and 5trept, viruses, and fungi>. 6he volatile oils bind, and thereby decrease, to$ins, especially those caused by 5taph. and 5trept. /atricaria is therefore useful in the treatment of ,B5 and colitis =for its anti&spasmodic, anti&ulcer, and nervine effects>. • 6opical Applications9 /atricaria increases granulation tissue =helps in ound healing>. '$ternally, /atricaria is useful in poultices for e$ternal ulcers =to increase granulation tissue>, for mastitis =anti&inflammatory>, and for hemorrhoids =anti&

inflammatory>. Because the a(ulenes are released ith distillation, a steam inhalation of /atricaria is an e$cellent treatment for asthma and U.4.,.s. .i#e ise, using /atricaria in the bath is an ideal ay to treat asthma, colds, ec(ema, hayfever, and generali(ed stress. /atricaria preparations are idely used in 'urope for the treatment of a variety of common s#in complaints including psoriasis, ec(ema and dry, fla#y, irritated s#in in general. #harmacy: • %osage9 o /atricaria is best dosed on the lo end of its dosage range over a long period of time. A3CB o 3 g flo ers 6,%&2,% ic.A3CC • !apsules9 o 3E0&H00 mg =A&2 00 caps> 6,%. A<00 • 5olid e$tract9 o sig A3< tsp 6,%.A<0A • 6incture9 o A9E tincture9 AE ml 6,%&2,%,A<02 o A9E E0G 't0+9 H&A< ml 2%.A<03 o A9E <EG 't0+K sig. A&< ml 6,%K ma$. ee#ly dose A00 ml. A<0< • ,nfusion9 o 6o obtain the a(ulene, steep the flo ers covered for 3&E minutes A&2 tsp.3cup aterK sig A cup 6,% QA tsp. & A gK A 6B & 2.E gR.A<0E o .ight tea& s eet =good for ulcers>. 5trong tea =steeped longer> and cool tea& bitter =good for *.,. conditions>. +ot tea ill be dispersed throughout the body. A<0F o )or e$ternal use9 2 dessert spoons3AL cup boiling ater. ,nfuse AE min, strain. A<0H o )or internal use9 3 g3AE0 ml boiling ater, cover $ AE min, strain. =AtspOAg>. 5ingle daily dose is 3 g. A cup 6,%& 2,%. A<0B o 3 g 3AE0 ml ater, 6,% or 2,% W for gastrointestinal complaints. A<0C o 2&< g flo ers 6,%.A<A0 • .iquid e$tract9 o A9< liquid e$tract9 A&< ml 6,%&2,%A<AA o A9Afluid e$tract9 3 ml 6,%&2,%. A<A2 o A9A <EG 't0+K sig. A&3 ml 6,%.A<A3 o A92 liquid e$tract9 3&E ml 2%. A<A< • '$ternal9 o Bath9 E0g3A . ater or Fg3steam bath,A<AE E0g3A0 . =T2L gallons> hot ater. A<AF o Washes and gargles9 several times a day.A<AH o ,nhalation of steam vapor of hot aqueous infusion for inflammation of the upper respiratory tract. A<AB o 1oultice9 semi&solid paste or plaster ith 3&A0G of flo er head. A<AC o 4inse9 hot aqueous rinse ith 3&A0G infusion. A<20 Contraindications: • 1regnancy9 /atricaria is a smooth muscle rela$ant and therefore may cause miscarriage in pregnant omen, especially before A2 ee#s.A<2A 'mpirical contraindications for large doses in early pregnancy due to the emmenagogue effect of the hole plant use in the eyes and allergic hypersensitivity. A<22 )o*icity: none.A<23
1375 1376

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p. 332 ,bid, pp. 33A&2 1377 .ininger et al, Healthnotes9 2linical Essentials, Herb Monographs, 1rima 1ublishing, 4oc#lin, !A, 200A. 1378 'arlier Bastyr University monograph 1379 'arlier Bastyr University monograph 1380 .ininger. 1381 I)lavonoids and the central nervous system9 from forgotten factors to potent an$iolytic compounds,J 7 Pharm Pharmacol., ACCC /ayK 7ol.EA, :um E, pp. EAC&2F. 1382 4. !. Wren, Potter/s Encyclopedia of Botanical Drugs and Preparations, 6he !. W. %aniel !ompany .imited, 5affron Walden, 'ngland, ACBE, p. HA.

1383 1384

/ar# Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs, ,ntegrative /edicine !ommunications, :e ton, /A, 2000, p.EC. 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy: Modern Herbal Medicine, !hurchill .ivingstone, 'dinburgh, 2000, p. 3AC. 1385 PDR, p. 333 1386 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3. 1387 )elter. 1388 )elter. 1389 Blumenthal, p. EC. 1390 /ills, pp. 3AC&32H 1391 I%ouble&blind comparison of an apple pectin&chamomile e$tract preparation ith placebo in children ith diarrhea,J )rIneimittelforschung, ACCH :ov. 7ol. <H, :um.AA, pp. A2<H&C. 1392 )rancis Brin#er, Herb 2ontraindications and Drug >nteractions, 'clectic /edical 1ublications, 5andy, 04, ACCB, p. E3 1393 /ills 1394 Blumenthal, p. EC 1395 /ills. 1396 Blumenthal, p. EC 1397 I1roof of 'fficacy of ?amillosan=4> !ream in Atopic 'c(ema,J Eur 7 Med Res, 2000 Apr AC, 7ol. E, :um. <, pp. AHA&E. 1398 Alschuler 1399 Blumenthal, p.F0 1400 Alschuler 1401 ,bid 1402 Blumenthal, p.F0 1403 /ills, p. 320 1404 Alschuler 1405 'arlier Bastyr University monograph. 1406 ,bid 1407 PDR, p. 333 1408 ,bid 1409 Blumenthal, p. F0. 1410 /ills, p. 320 1411 PDR, p. 333 1412 Blumenthal, p. F0. 1413 Alschuler 1414 /ills, p. 320 1415 PDR, p. 333 1416 Blumenthal, p. F0. 1417 PDR, p. 333 1418 Blumenthal, p. F0. 1419 ,bid. 1420 ,bid. 1421 'arlier Bastyr University monograph. 1422 Brin#er, p. E3 1423 /ills, p. 32<

Medicago sativa
Common name: alfalfa Ha!itat: :ative to the /editerranean, cultivated idely

1eguminosae

Botanical description: A perennial root ith t o stems. .eaves are alternate in three leaflets hich are oblong and toothed. )lo ers are purple ith a E toothed caly$, the traditional .eguminosease flo er. 6he pod is spirally coiled ithout spines. #arts used: +erba Constituents: al#aloids =aspragine, trigonelline>K phytoestrogenic compounds =formometin, coumestrol>K vitamins ?, A, ! and minerals !a, ?, )e, /gK saponinsK coumarins, porphyrins, flavonoids, trace minerals, proteins #harmacology: Medicinal actions: nutritive tonic, phytoestrogen, anti&tumor Medicinal use: /edicago is a nutritious herb containing many minerals and vitamins and is often included in formulas for its nutritional value along ith its tonifying influence. /edicago is most indicated hen there is insufficient nutrition, a tendency to ard emaciation, and accompanying organ ea#ness. • *ynecologic !onditions9 6he isoflavones =flavonoids> are estrogenic and antibacterial =*m.& bacteria>., and in addition, stimulates appetite and enhances overall nutrition. 6he action of /edicago on the reproductive system can be summari(ed as a restorative tonic. /edicago is phytoestrogenic and its action is to restore the strength and tone of the digestive, #idney, mammary, ovarian and uterine tissue. • *astrointestinal !onditions9 /edicago promotes digestion, assimilation and appetite. • +epatobiliary !onditions9 6he porphyrins stimulate bile production and secretion. 6he saponins are anti&cholesterolemic by binding to cholesterol and bile salts. /edicago is often included in deto$ification teas for its nutritional, al#alini(ing and cleansing actions. /edicago tea can be drun# as a coffee substitute =combine ith 6ara$acum radi$ and /entha piperita. /edicago is a good inclusion in formulas for the treatment of anemia and arthritis due to its high nutrient content, digestive, choleretic and cholagogue actions. • /ale !onditions9 ,n men, /edicago ill help ease prostatic hypertrophy by imparting nutrition and tone to the prostate. )ccording to the Textboo3 of ;atural Medicine : • /usculos#eletal !onditions9 Botanicals containing phytoestrogens are commonly used in the treatment of osteoarthritis although increasing the phytoestrogen content of the diet may be a more effective means of increasing phytoestrogen inta#e. #harmacy: ,nfusion9 A tsp.3cup aterK A&2 cups 6,% ,nclude as part of a mineral building formula, infusing overnight to be sure to e$tract the mineral content =%ipasquale> A9E tincture <&E ml 6,% 5olid e$tract =F9A>9 A3<&A32 tsp. 6,% for osteoarthritis9 the equivalent of E&A0 g qdA<2<

Contraindications: 6onic herbs, in general, are contraindicated in very severe debility, especially if associated ith immune or digestive collapse, renal or hepatic failure and in progressive cancer or strong regimens of chemotherapy. A<2E /edicago sativa var. itlaica has demonstrated uterine stimulant action in animals due to the stachydrine content and its e$cessive use internally should be avoided in pregnancy.A<2F /edicago increases the rate of metabolism of $enobiotics in the liver by increasing the activity of hepatic microsomal mi$ed&function o$idases.E Anticoagulant activity of arfarin could be reduced due to the high vitamin ? content. F )o*icity: !aution should be e$ercised in consumption of /edicago, particularly the sprouts, by patients ith systemic lupus erythematosus due to potential e$acerbation by .&canavanine as reported in a small number of cases. A<2H

1424 1425

/urray /, 1i((orno '. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p. A<<C /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AEE 1426 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 2H 1427 E F , , Brin#er p. 2B

Melaleuca alternifolia
Common name: 6ea tree Ha!itat: Botanical description: #art used: essential oil Historical use: $nergetics: Constituents: 6he oil contains numerous chemicals #no n as terpenoids. Australian standards ere established for the amount of one particular compound, terpinen&<&ol, hich must ma#e up at least 30G and preferably <0WE0G of the oil for it to be medically useful. Another compound, cineole, should ma#e up less than AEG and preferably 2.EG of the oil A<2B. #harmacology: 6he oil #ills fungus and bacteria, including those resistant to some antibiotics. 6ea tree oil has demonstrated a number of antimicrobial effects even against antibiotic resistant 5taph aureus A<2C. Medical actions: antimicrobial )raditional Medicinal Uses: :o information is available from the selected resources. Current Medical Uses: • %ermatologic !onditions9 A double&blind study found A00G tea tree oil applied topically as as effective as the anti&fungal medicine clotrima(ole for people ith onychomycosis. Another double&blind study found that A0G tea tree oil cream as as effective as anti& fungal medicine at improving symptoms associated ith foot fungus, though it as not more effective than placebo for eliminating foot fungusA<30. • ,nfectious !onditions9 A single blind study found that rinsing the mouth ith AE ml =A tablespoon> tea tree oil solution 2,% effectively treated thrush in A,%5 patientsA<3A. 1reliminary studies suggest it could be useful for treating vaginal infections caused by candida or other organisms A<32. Current +esearch +eview: • ,nfectious diseases: o 4taphylococcus aureus:":77  %esign9 4andomi(ed controlled clinical trial  1atients9 1atients ith methicillin&resistant 5taphylococcus aureus  6herapy9 <G tea tree oil nasal ointment and EG tea tree oil body ash.  4esults9 6he tea tree oil combination appeared to perform better than the standard combination, although the difference as not statistically significant due to the small number of patients. • Dentistry: o 4upragingival pla?ue:":7:  %esign9 !linical trial  1atients9 'ight sub"ects after professional teeth cleaning  6herapy9 4inse9 ater W ee# A, chlohe$idine W ee# 2, tea tree oil W ee# 3.  4esults9 6ea tree oil reduced neither the clinical parameters =plaque inde$ and area> nor the vitality of the plaque flora significant. ,t as determined that a solution ith tea tree oil, utili(ed as ordinary mouth ash, has no positive effect on the quantity or quality of supragingival plaque. • Dermatology: o Acne:":7%  %esign9 5ingle&blind, randomi(ed controlled clinical trial

o

o

 1atients9 0ne hundred t enty four patients ith mild to moderate acne  6herapy9 EG ben(oyl pero$ide or EG tea&tree oil  4esults9 Both therapies had a significant effect in ameliorating the patients@ acne by reducing the number of inflamed and non&inflamed lesions =open and closed comedones>, although the onset of action in the case of tea&tree oil as slo er. )e er side effects ere e$perienced by patients treated ith tea&tree oil. 3nychomicosis: 5tudy A9A<3F  %esign9 4andomi(ed double&blind placebo&controlled multicenter clinical trial  1atients9 5i$ty patients, AB&B0 yo, ith F&3F months duration of toenail onychomycosis.  6herapy9 2G butenafine hydrochloride and EG /alaleuca altenifolia oil in cream $ AF ee#s  4esults9 B0G of patients using medicated cream ere cured, as opposed to none in the placebo group. 5tudy 29A<3H  %esign9 %ouble&blind multicenter randomi(ed controlled clinical trial  1atients9 0ne hundred seventeen patients ith distal subungual onychomycosis proven by culture.  6herapy9 AG clotrima(ole =!.> solution or A00G tea tree =66> oil B,% $ F months. %ebridement at 0, A, 3, and F months.  4esults9 6he t o treatment groups ere comparable based on culture cure =!. O AAG, 66 O ABG> and clinical assessment ith partial or full resolution =!. O FAG, 66 O F0G>. 6hree months after finishing the therapy, TA32 of each group reported continued improvement or resolution. )inea pedis: 5tudy A9A<3B  %esign9 4andomi(ed placebo&controlled double&blind clinical trial  1atients9 0ne hundred fifty eight patients ith interdigital tinea pedis.  6herapy9 2EG or E0G tea tree oil solution B,% topically $ < #s.  4esults9 6here as a mar#ed clinical response seen in FBG of the E0G tea tree oil group and H2G of the 2EG tea tree oil group, compared to 3CG in the placebo group. 6he mycological cure rate as F<G in the E0G tea tree oil group, compared to 3AG in the placebo group. )our =3.BG> patients applying tea tree oil developed moderate to severe dermatitis that improved quic#ly on stopping the study medication. 5tudy 29A<3C  %esign9 4andomi(ed double&blind controlled clinical trial.  1atients9 0ne hundred four patients ith tinea pedis  6herapy9 A0G 3 tea tree oil cream or AG tolnaftate.  4esults9 5ignificantly more tolnaftate&treated patients =BEG> than tea tree oil =30G> and placebo&treated patients =2AG> sho ed conversion to negative culture at the end of therapyK there as no statistically significant difference bet een tea tree oil and placebo groups. All three groups demonstrated improvement in clinical condition based on the four clinical parameters of scaling, inflammation, itching and burning. 6he tea tree oil group =2<33H> and the tolnaftate group =AC333> sho ed significant improvement in clinical condition hen compared to the placebo group =A<33<>. 6ea tree oil cream =A0G 3 > appears to reduce the symptomatology of tinea pedis as effectively as tolnaftate AG but is no more effective than placebo in achieving a mycological cure.

#harmacy: topical application only Contraindications and to*icity: :o information is currently available from the selected resources .

1428 1429

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A Bone, ?. !linical Applications of Ayurvedic and !hinese +erbs, 3rd 'd. 1hytotherapy 1ress, War ic#, AU5. 2000 1430 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1431 -andoure# A, 7aishampayan -?, 7a(que( -A. 'fficacy of melaleuca oral solution for the treatment of flucona(ole refractory oral candidiasis in A,%5 patients. )>D, ACCBKA29A033WH. 1432 1eha '). Melaleuca alternifolia oil. ,ts use for trichomonal vaginitis and other vaginal infections. "bstet 5ynecol1 ACF2KAC9HC3WHCE. 1433 !aelli /, 1orteous -, !arson !), et al. 6ea tree oil as an alternative topical decoloni(ation agent for methicillin&resistant 5taphylococcus aureus. 7 Hosp >nfect 2000K <F=3>923F&H. 1434 Ar eller :B, %onos :, :etuschil ., et al. !linical and antibacterial effect of tea tree oil W a pilot study. 2lin "ral >n!estig 2000K<=2>9H0&3.

1435 1436

Bassett ,B, 1anno it( %., Barnetson 45. A comparative study of tea&tree oil versus ben(oylpero$ide in the treatment of acne. Med 7 )ust ACC0KAE3=B>9<EE&B. 5yed 6A, 2ureshi 8A, Ali 5/, et al. 6reatment of toenail onychomycosis ith 2G butenafine and EG /alaleuca alternifolia =tea tree> oil in cream. Trop Med >nt Health ACCCK<=<>92B<&H. 1437 Buc# %5, :idorf %/, Addino -*. !omparison of t o topical preparations for the treatment of onychomycosis9 /alaleuca alternifolia =tea tree> oil and clotrima(ole. 7 am Pract ACC<K3B=F>9F0A&E. 1438 5atchell A!, 5aura"en A, Bell !, et al. 6reatment of interdigital tinea pedis ith 2EG and E0G tea tree oil solution9 a randomi(ed, placebo&controlled, blinded study. )ustralas 7 Dermatol 2002K<3=3>9AHE&B. 1439 6ong //, Altman 1/, Barnetson 45. 6ea tree oil in the treatment of tinea pedis. )ustralas 7 Dermatol ACC2K33=3>9A<E&C.

Melilotus officinalis
Common name: s eet clover Ha!itat: Botanical description: #art used: herba

=a!aceae

Historical use: /elilotus placed bet een oolen clothing, as used in 'urope to guard against the ravages of the moth. Constituents: • coumarin =0.2&0.<E G> and its precursor melilotiside, substituted coumarins =umbelliferone, scopoletin> • flavones, caffeic acid derivatives.A<<0 #harmacology:"::" 5poiled /elilotus contains dicoumarol hich is the first anticoagulant discovered from co s ith \s eet clover disease@. 1roperly dried /elilotus does not have anticoagulant activity under normal circumstances as coumarin is A000 times less functional that dicoumarol. With use of properly prepared /elilotus the onset of blood coagulation is slo ed but bleeding and prothrombin times are not altered. !oumarin is antiedematous and anti&inflammatory by enhancing the brea#do n of protein accumulation in the e$tracellular spaces by macrophages. +ence indication includes postoperative edema. *radual removal of fibrotic tissue occurs as ell. 6horacic duct and lymph flo are increased as ell increasing lymphatic drainage. ,n the vascular system coumarin causes constriction of the precapillary sphincters and dilation of arteriovenous "unctions resulting in improved blood flo to in"ured tissue. !oumarin increases venous return and improves e$perimental thrombophlebitis. !oumarin inhibits prostaglandin formation in a similar fashion to aspirin, decreases endothelemia and favorable affects myocardial ischemia. !oumarin has been studied in prevention of early recurrence of malignant melanoma 6:/ stage AB and 2 demonstrating reduced recurrence. !oumarin has been combined ith cimetidine in e$perimental treatment of advanced melanoma and metastatic renal cell carcinoma ith some success and no to$icity. Medical actions: lymphatic, antiedematous, antiinflammatory, possibly antitumor and immune enhancing )raditional Medicinal Uses: 5pecific ,ndications and Uses9 ,diopathic headachesK long&standing neuralgiasK coldness, tenderness, lameness or mar#ed soreness of partsK painful menstruation ith lameness or sensation of coldK menstrual colicK ovarian neuralgiaK colic ith diarrhea and much flatus. 'ven as early as the turn of the century, the medicinal properties of /elilotus ere observed to chiefly be due to coumarin. /elilotus as considered for painful states, ith coldness, and mar#ed soreness or tenderness to the touchK rheumatic cases, sho ing mar#ed lamenessK and painful dysuria as ell as the conditions described belo . • :eurological !onditions9 /any observers have found it peculiarly effective in certain painful disorders, particularly long standing neuralgias associated ith debility. ,t as thought to be adapted to idiopathic neuralgic headaches, and to neuralgic affections not depending upon refle$ causes, although it has given good results in headaches arising from painful disorders of the stomach. 4ecurring neuralgia, especially from cold or fatigue, have been promptly relieved by small doses of the drug. • *ynecological !onditions9 /elilotus as considered Imagically effectiveJ in the treatment of ovarian neuralgia and in dysmenorrhea its beneficial effect is observed hen lameness and soreness are prominent symptoms, particularly hen the pain seems to follo the sciatic nerve. • *astrointestinal !onditions9 *astralgia, neuralgia of the stomach, and other abdominal viscera, have been promptly relieved by /elilotus, particularly hen associated ith coldness of the e$tremities. Current Medical Uses: • !ardiovascular !onditions9 ,ndicated conditions hich are supported by clinical trials include9 lymphedema, venous insufficiency, hemorrhoids, varicose veins, episiotomy, post traumatic inflammation, filaritic lymphedema and elephantiasis, cancer =malignant melanoma, renal cell carcinoma, prostatic carcinoma> particularly to prevent metastasis. A<<2 6hrough enhancement of lymphatic function /elilotus increases venous return and is beneficial in post&operative edema.

,n an open clinical study, 2A patients ith chronic upper arm lymphedema due to post&lymphadenectomy of the a$illa for breast cancer received <00 mg of /elilotus containing B mg of coumarin daily for F months. 6he circumference of the upper arm at 3 and F months from treatment as measured and the symptoms and tolerability as evaluated through a questionnaire given to the patients at every clinical control. 5ome patients also received manual lymphatic drainage, a possible confounding factor. 6his study concluded that the cumarinic e$tract of /elilotus officinalis as effective in reducing lymphedema in HCG of the patients treated for a period of si$ months. A<<3 An open&label study as performed on HF patients for si$&eight months ith a combination of !oumarin =6on#a beans> F0 mg3daily X *ing#o Biloba <0 mg3daily X /elilotus <0 mg3daily for the treatment of lymphedema of the lo er limbs. 6he study concluded that this formula provided a very significant improvement in lymphedema =centimeter&aspect> both in functional symptoms =pain heaviness in affected limbs> and physical signs =edema, episodes of infection>. 6olerance of long term treatment as good and the improvement as observed from the third month of treatment. A<<< /elilotus reduces inflammatory and congestive edema by brea#ing do n accumulated protein. ,t also increases venous return and improves lymph flo . /ills and Bone also e$trapolate use for high protein edema =including burns>, thrombophlebitis, reduction of vascular damage =i.e. endothelemia>, prevention of ischemic heart disease and conditions requiring enhance peripheral mononuclear lymphocytic activity. /any trials combining /elilotus and rutin have been conducted for venous insufficiency resulting in significant improvement ith reducing in edema as ell. ,/ in"ections have been utili(ed for this condition. /elilotus has been studied for venous insufficiency in pregnant omen ith success as ell. #harmacy: dried or fresh herb infusion liquid e$tract ,/ in"ection

6he therapeutic dose of coumarin has been established at around Amg3#g3day corresponding to about A0 ml qd of A92 fluid e$tract. Best results occur ith E&F divided doses. +igher doses have been used. /elilotus may be used long term in this dosage range. Best results from coumarin therapy are obtained by using frequent lo doses. Com!ination: +erbs ith vitamin 1&li#e activity9 Aesculus, !rataegus, .inden, 6ilia and other herbs containing flavone glycosides. Contraindication: Use precaution hen prescribing ith arfarin, salicylates and bromelain due to potential potentiation of hemorrhagic diathesis =theoretical>.A<<E )o*icity: :o adverse effects ithin the recommended dosage. !oumarin has been associated ith hepatoto$icity in rats and lung adenomas and carcinomas in mice. 6hus, use is avoided in patients ith impaired liver function or elevated liver en(ymes.
1440 1441

Wagner +, Bladt 5. 1lant %rug Analysis9 A 6hin .ayer !hromatography Atlas, 2 nd 'd. 5pringer&7erlag, Berlin, ACCF, p A2H. /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p <BE&H 1442 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p <B3 1443 1astura *, Q.ymphedema of the upper e$tremity in patients operated for carcinoma of the breast9 clinical e$perience ith coumarinic e$tract from /elilotus officinalisR. !lin 6er. ACCC :ov&%ecKAE0=F>9<03&B. ,talian. 1444 7ettorello, *, Q!ontribution of a combination of alpha and beta ben(opyrones, flavonoids and natural terpenes in the treatment of lymphedema of the lo er limbs at the 2d stage of the surgical classificationR. /inerva !ardioangiol. ACCF 5epK<<=C>9<<H&EE. ,talian. 1445 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A2F

Melissa officinalis
Common name: .emon balm, Balm, 5 eet balm, honey plant, balm mint, blue balm, common balm Ha!itat: /elissa officinalis is native to 'urope.

1amiaceae (1a!iatae

Botanical description: A square stem bears opposite leaves that are coarsely mar#ed, ovate, rin#led, coarsely serrate margin ith a rounded base. 5mall hite flo ers appear in mid&summer. 6he plant produces a lemon&li#e odor. #arts used: +erba Constituents: • 7olatile oil =0.02G&0.3G>9 monoterpenes, primarily citral =YF0G> sesquiterpenes =Y3EG> ith over H0 components identified • )lavonoidsK 1olyphenolic compoundsK 6riterpenic acidsK 4osmarinic acidK !hlorogenic and caffeic acids, tannins =higher in leaves> Medicinal actions: !arminative, 5edative, %iaphoretic, febrifuge, Anti&viral, Anti&thyroid, !holeretic, mild analgesic, antispasmodic #harmacology: 6he polyphenolic compounds possess choleretic actions. !itral induces the the activity or U%1 glucuronosyltransferases, a component of phase 2 con"ugation in the liver. A<<F While still incompletely understood, it is presumed that the polyphenolic compounds react ith viral and cell&membrane proteins. 6he result of this interaction is phenolic compounds occupying viral receptors thus preventing adsorption of the virus onto the cell membrane.A<<H 6his is particularly evident ith the +erpes virus.A<<B 0$idation products of caffeic acid inhibit protein biosynthesis in vitro, hich may account for the antiviral activity of topical application. A<<C Animal studies demonstrate a decrease in thyrotropin levels ith e$tract of /elissa officinalis. A<E0 ,n mice, aqueous e$tracts of /elissa have sedative and peripheral analgesic activities. A<EA 6he volatile oil inhibits the phasic contractions of the ileal muscle in vitro. A<E2 )raditional Medicinal Use: ?ing described /elissa as moderately stimulant, diaphoretic, and antispasmodic. • *ynecological !onditions9 /elissa as sometimes used to promote the menstruation as a arm infusion, • ,nflammatory !onditions9 /elissa as used as a diaphoretic in febrile diseases. ,t as observed to favor the flo of s eat and urine and soothe the nerves. ,t as commonly applied in acute colds and an ad"unct to less pleasant diaphoretics. Current Medicinal Use: /elissa has been in use throughout 'uropean history. ,t as used as a herb for longevity, memory, fertility, rheumatism, as a sedative and spasmolytic, and to create happiness. • 'ndocrine !onditions9 !urrently, /elissa has diverse actions in the body. 6he hormonal effects of /elissa are similar to those of .ycopus virginicus. /elissa interferes ith the binding of 65+ to thyroid cell membrane receptors. /elissa also inhibits iodothyronine deiodinase and thus prevents the incorporation of iodine into thyro$ine synthesis. 6hese actions ma#e /elissa useful in primary and secondary hyperthyroidism. Additionally, /elissa bloc#s the autoantibodies produced in *rave@s disease and +ashimoto@s from binding to the thyroid. /elissa is often the leading herb in formulas for *rave@s disease. 6he sedative effects of /elissa may be due in part to the anti&thyroid effects. ,n addition, /elissa contains sedative volatile oils. 6hese volatile oils and the polyphenolics are also anti&viral and carminative. • *astrointestinal !onditions9 7olatile antispasmodics such as /elissa can be used for nervous dyspepsia, colic, flatulence, irritable bo el disease and gastritis. +ence, these herbs tend to overlap ith the effect of aromatics. %'#C • :ervous !onditions9 As a sedative, /elissa is most indicated in a someone ith symptoms typical of hyperthyroidism9 an$iety, restlessness, palpitations, headache, and e$citability. ,n addition, /elissa is a mild anti&depressant. 6he volatile oils act on the limbic system in such a ay as to cause a lifting of depression and an$iety. /elissa brings "oy to the heart. /elissa is ell&indicated in stress&induced migraine headaches, palpitations, and insomnia. 6he volatile oils in /elissa also mildly rela$ smooth muscle, thus giving /elissa indication in hypertension, intestinal colic, dysmenorrhea, etc. 6he carminative effects of /elissa combined ith its sedative and anti&depressant actions ma#e /elissa particularly useful in intestinal colic secondary to or associated ith an$iety, stress or depression. 0ver all, /elissa is trophorestorative to the nervous system. /elissa and .avendula officinalis are an e$cellent combination in the treatment of stress associated tension. • ,mmune !onditions9 6he anti&viral and anti&cancer actions of /elissa are another important effects for immune application. 6he anti&viral

properties of /elissa are mainly due to the o$idation products of caffeic acid and its derivatives. 4osmarinic acid and other volatile oils in /elissa possess significant anti&viral actions as ell, hich may e$plain hy hot ater e$tracts are the strongest anti&viral non& processed preparation. Because of the herb@s pleasant taste, /elissa is often added to teas used in the treatment of viral infections. A topical application of /elissa is effective against +erpes simple$ type A and type 2 viruses. A pharmaceutical product of dried /elissa for e$ternal use against +erpes viruses is available as an ointment concentrated to H09A. 6his ointment has been tested clinically in randomi(ed, placebo&controlled, double blind studies. 6hese studies demonstrate that the /elissa ointment applied t o to four times daily to the affected areas of the s#in results in shortened healing time and less scabbing. A<E< 6here is some evidence from studies done on rats that /elissa inhibits tumor cell division and may be a useful ad"unctive treatment in some cancers. • ,nflammatory !onditions9 7olatile antispasmodics can be used as a component of fever management strategies. ,n this regard this class is distinct from the aromatics as they are more appropriate in hot a febrile conditions although the latter group should not be discarded in such cases. 4ather, a number of remedies may need to be used to find hich is best suited. %'## #harmacy: Antispasmodics are best ta#en immediately before meals as their effect on the digestion is ma$imi(ed form hot infusions. ,n general, long&term therapy is ell tolerated. %'#$ dried herb9 2&< g daily =po dered capsules> infusion9 2&3 tsp. dried herba or <&F fresh leaves covered ith "ust boiled aterK drin# A cup of this tea B,% W prn A9E tincture9 2&F ml 6,% of =ma$imum of A00 ml per ee#> 6opically9 poultice, compress, H09A e$tract =+erpelieve>9 apply 2W< times daily Drug ,nteractions: • Barbiturates9 increases the hypnotic effect of pentobarbital and the narcotic effect he$obarbital =animal studies>. A<EH Contraindications:":%/ • Benign prostatic hyperplasia9 !itral increases the vental epithelial and stromal gro th and stimulates estrogen receptors =animals> • Breast feeding9 due to the antiprolactin and hormonal influences. • *astric and enteric poisoning9 caution is advised in the application of volatile antispasmodics. A<EC • *laucoma9 2&E mcg of citral =3E&EEG of the volatile component> can raise intraocular pressure =animal studies> • +ypothyroidism9 due to antithyrotropic effects =in vitro> • 1regnancy9 empirical emmenagoue effect =empirical> as ell as antithyrotropic and antigonadotropic activity =in vitro, animals> )o*icity: :one #no n.
1446 1447

1ar#e %7, 4ahman +. 6he 'ffects of 5ome 6erpenoids and other %ietary :utrients on +epatic %rug&/etaboli(ing 'n(ymes. Biochem -. AA39 A21, ACFC. .itvinen#o, .,, et al., Planta Medica, ACHEK2H93H2. 1448 Aschoff 5, Ange 8, Phytotherap1, ACBAK292AC. 1449 !halbic( -, *alasins#i W. 6he !omponents of /elissa officinalis that ,nfluence 1rotein Biosynthesis ,n 7itro. - of 1harm and 1harmac ACBFK 3B=AA>9 HCA&<. 1450 5ourgens +, et al., Planta Medica, ACB2K<E9HB. 1451 5oulimani 4, et al., Planta Medica, ACCAKEH9A0E 1452 4eiter /, Brandt W. 4ela$ant 'ffects on 6racheal and ,leal 5mooth /uscles of the *uinea 1ig. Ar(neimittel&)orschung ACBEK 3E =AA>9 <0B&A<. 1453, C, A0 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AH2 1454 Woelbling 4+ and .eonhardt ?, Phytomedicine, ACC<KA92E. 1455, C, A0 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine.!hurchill .ivingstone,2000p.AH2
A<EF

1457 1458
A<EC

Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p A30, 2HB Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.A30

Mentha piperita. M2 spicata or M2 viridis
Common name: peppermint =/. piperita>, spearmint =/. spicata, /. viridis> Ha!itat:":&8 =/. piperita> • !ommon in 'urope and the U.5., usually cultivated.

1amiaceae

Botanical description:":&" =/. piperita> • )lo er and )ruit9 6he flo ers are false spi#es ith nuberous inconspicuous bracts. 6he caly$ is tubular ith a ring of hair. 6he corolla is violet, glabrous inside and has an almost even margin divided into < parts. • .eaves, 5tem, and 4oot9 1erennial plant, E0&C0 cm high. 6he usually branched stems are normally glabrous, but sometimes, they are gray&tomentose and are often tinged violet. 6he leaves are short&petioloed, oblong&ovate, and serrate. 6he plant has over& and underground runners. #art used: leaves $nergetics: Constituents: A<F2 • 7olatile oil9 chief components9 menthol =3E&<EG>, menthone =AE&20G>, menthyl acetate =3&EG>, neomenthol =2.E&3.EG>, ,somenthone =2&3G>, menthofurane =2&HG>, additionally including, among others, limonene, pulegone, alpha& and beta&pinene, trans&sabinene hydrate • !affeic acid9 including, among others, rosmaric acid • )lavonoids9 apigenine&, diosmetin& and luteolin glycosides, free lipophile metho$yli(ed flavone including, among others, $anthomicrol, gardenine %. #harmacology: /enthol causes muscle rela$ation by a bloc#age of calcium influ$ into the myocyte. Medicinal actions: 5pasmolytic, carminative, cholagogue, cholaretic, antiemetic, antitussive, antimicrobial, sedative, diaphoretic. 6opically9 antiseptic, analgesic, antipruritic.A<F3 )raditional Medicinal Uses: • %igestive disorders, respiratory disorders, headaches, and nervous disorders A<F<. *ree#s and 4omans cro ned themselves ith 1eppermint at their feasts and adorned their tables ith its sprays, and their coo#s flavored both their sauces and their ines ith its essence. ,t is mentioned in the ,celandic 1harmacopoeias of the thirteenth century, but only came into general use in the medicine of Western 'urope about the middle of the eighteenth century, and then as first used in 'ngland A<FE. • )ol# use9 n3v, morning sic#ness, respiratory infections, dysmenorrhea, and colds. A<FF • /entha piperita9 o /entha piperita is a diffusive stimulant and rela$ant. A<FH o *astrointestinal !onditions9 ,t is mostly used for flatlence and colicK but may be employed for other sudden pains and crampings through the abdomen. /ost stomachs receive it greatly and it often allays vomiting. ;et, some people do not tolerate it, ma#ing the stimulating properties unobtainable in those ith a sensitive stomach. A<FB • /entha viridis =spearmint>9 o 5pearmint is largely rela$ant and antispasmodic. ,ts soothing quality is reserved for a large variety acute and light cases. A<FC According to ?ing, the carminative, antispasmodic, and stimulant properties of spearmint are some hat inferior to those of peppermintK its principal employment is for its diuretic and febrifuge virtues. 6he oil is diuretic, stimulant, antispasmodic, and rubefacient, and is used e$ternally in rheumatic and other pains. 5pecific indications and uses include 5canty secretion of urine ith frequent desire to urinateK simple nausea. %ose, same as peppermint. A<H0 o *astroenterology9 5pearmint is more soothing and acceptable to the stomach than peppermint. ,t is useful in allaying nausea and vomiting and relieving children@s colic. But, it is not as strongly carminative as peppermint and thus is not as helpful in spasmodic conditions.A<HA 5cudder considered /entha 7iridis not only as a stimulant, but as one of the most #indly of the aromatics, rarely re"ected by the stomach. As a stimulant, it ill furnish a cheap and pleasant vehicle for many medicines.A<H2

:ervous 5ystem9 ,ts action is quic#ly diffused throughout the nervous system, particularly influencing the peripheries. A<H3 o *enitourinary !onditions9 ,t promotes a free discharge of the atery portions of the urine ma#ing it useful in recent suppressions of the urine. A<H< 5cudder regarded it as one of the most certain of the vegetable diuretics, and employed it frequently for this purpose. I,n suppression of urine in children, a teaspoonful of the tincture is added to t o ounces of ater, s eetened, and given freely. 5o certain is its action in childhood, that , rarely thin# of giving anything else, e$cept in cases here there is great irritation of the nervous system, and then *elseminum is added to it in the usual doses.J A<HE According to ?ing, the cold infusion is beneficial in high color, or scalding of urine, difficult micturition, etc.K it may be used alone or in combination ith marshmallo root. ,n fact, it is one of the best of simple diuretics, and acts nicely ith potassium acetate. A saturated tincture of the fresh herb ith gin has been found serviceable in gonorrhoea, strangury, suppressed urine, gravel, and as a local application to painful hemorrhoids. A<HF o 6opical Applications9 A liniment of spearmint as used for pain and neuralgia, particularly over the spine and large nerves. A<HH o ,nflammatory !onditions9 As a febrifuge, it is superior to peppermint, and may be used freely in arm infusion. A<HB • /entha spicata9 o 1eppermint is a po erful diffusive stimulant, antispasmodic, carminative, stomachic, and ea# anodyne. ,t undoubtedly possesses mar#ed antiseptic properties. 5pecific indications and uses include gastrodynia, flatulent colic, and difficult digestion. A<HC o *astrointestinal !onditions9 Used in the treatment of hysteria, spasms or cramps of the stomach, to allay the griping of cathartics, to chec# nausea and vomiting, and to disguise the unpleasant taste of other medicines. A<B0 o Current Medicinal uses: • *astroenterology9 .eaf is used for spastic complaints of the gastrointestinal tract, the gallbladder and the bile duct, dyspepsia, flatulence, intestinal colic, biliary disorders, dyspepsia, gastritis, enteritis. A<BA 0il is used for spastic discomfort of the upper gastrointestinal tract and bile ducts, irritable colon =in enteric coated capsules>, flatulence, ,B5, indigestion, nausea, diarrhea.A<B2 o ,B59 'nteric&coated peppermint oil has sho n benefit for people ith irritable bo el syndrome =,B5> according to double&blind studies.A<B3, A<B< 0ne study found that combining peppermint and cara ay oils in an enteric&coated tablet as superior to placebo for people ith irritable bo el syndrome. A<BE o !olic9 A tea of peppermint is a traditional therapy for colic in infants, and a double&blind study has confirmed its effectiveness.A<BF 6he tea used in this study contained mint and also licorice, 7erbena, fennel, and lemon balm. 1eppermint should be used ith caution in infants. o %yspepsia9 4andomi(ed controlled trials =4!6s> sho ed effectiveness for accelerating gastric emptying time, reducing symptoms of pain, nausea, belching, heartburn, flatulence, and bloating. A<BH o .iver and gallbladder complaints9 %ouble blind studies support the use of peppermint for reducing the si(e of gallstones, lo ering the cholesterol inde$ of bile. A<BB • '$ternal application9 0il is used in myalgia, neuralgiaA<BC o 1ain9 When applied topically, it acts as a counterirritant and analgesic ith the ability to reduce pain and improve blood flo to the affected area. A<C0 o +eadache9 A study of topical peppermint oil applied to the temples of healthy volunteers = ith or ithout eucalyptus oil> found that peppermint oil had a muscle&rela$ing action and decreased tension. 6his may e$plain its usefulness in treating tension headaches.A<CA 1eppermint oil alone reduced pain as ell. • 4espiratory 5ystem9 !atarrh of the respiratory tract, coughs, colds, sore throat. A<C2 • %ermatology9 oil is used e$ternally for pruritis, urticaria, and pain in irritable s#in conditions. A<C3 #harmacy: 1eppermint leaves9 • %osage9 o 3&F g 2% for infusion and e$tracts. A<C< • 6incture9 o A9A0 tincture9 E&AF g qd.A<CE o A9E tincture9 A0 ml B,%&6,%.A<CF • ,nfusion9 o A dessertspoonful3 AE0ml hot ater, strain after A0 min. 2&< g 2%, drin# arm, slo ly in sips. A<CH

o 6ea9 A cup 6,%&2,% ic.A<CB o 2 g3AE0 ml ater, B,%&6,%. A<CC o A dram per pint ater9 sig A 6 or less q A0&AE min for nausea =5pearmint>. AE00 o 2 drams herb per pint ater9 sig drin# freely or combine ith a small amount of 8ingiber =5pearmint>. AE0A • )luid e$tract9 o A9A fluid e$tract9 A ml B,%&6,%AE02 • 5tandardi(ed e$tract9 o %ry normali(ed e$tract 3.E&<.E9A = 3 >9 0.<<&0.EH g B,%&6,%. AE03 • '$ternal application9 o 6he fresh herb, bruised and applied over the bo els, ill often allay sic# stomach, and is efficient in cholera infantum. 6he same #ind of application sometimes relieves headache. AE0< o .iniment combined ith tincture of .obelia and oil of 4osmarinus =5pearmint> AE0E 1eppermint oil9 • ,nternal dose9 o F&A2 gtts3day.AE0F o )or irritable colon9 0.F ml3dayK 0.2 ml as single dose in enteric&coated form. AE0H o %issolveA fluid drachm of the oil in A fluid ounce of alcohol. %ose, from A0 to F0 drops, in s eetened ater. AE0B • ,nhalation9 o 3&< gtts3hot ater.AE0C o 'qual parts of the essence and alcohol, used by atomi(ation, relieve the cough of bronchitis and pneumonia. AEA0 • '$ternal application9 o )e gtts rubbed onto affected s#in area B,%&2,%. AEAA o )or young children9 E&AE gtts rubbed on the chest and bac#. AEA2 Contraindications: • *eneral9 :o health ha(ards are #no n in con"unction ith the proper administration of designated therapeutic dosages. 6he inta#e can lead to gastric complaints in susceptible persons. 6he volatile oil possesses a ea# potential for sensiti(ation due to its menthol content. 0ne is advised against administration of the drug in the presence of a tendency to gastroesophageal reflu$.AEA3 • 1ediatric Use9 1reparations containing the oil should not be applied to the faces of infants or small children, particularly not in the nasal area =glottal spasm or bronchial spasm up to asthma&li#e attac#s or even possible respiratory failure>. AEA< )o*icity: !ases of poisoning are not recorded. 6he minimal lethal dosage of menthol is estimated to be 2 gm, although individuals have survived higher dosages =B to C gm>. AEAE
1460 1461 1462 1463

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p. EB0 ,bid.

1%4 ,bid 1464 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy: Modern Herbal Medicine, !hurchill .ivingstone, 'dinburgh, 2000, pp. E0H&EA3. 1465 /rs /. *reive, ) Modern Herbal: The Medicinal, 2ulinary, 2osmetic and Economic Properties, 2ulti!ation and ol3lore of Herbs, 5rasses, ungi, ,hrubs, J Trees :ith Their Modern ,cientific Dses, %over 1ublications, ,nc, :e ;or#, ACHA, pp. E3H&E<3
1466 1467

1%4, p. EB0

W/., +., !oo#, Physiomedical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy , 'clectic /edical 1ublications, 1ortland, ACBE, pp. EF2&3 1468 ,bid 1469 ,bid 1470 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3 1471 !oo#, pp. EF2&3 1472 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed., 'clectic /edical 1ublications, 5andy, 04, AC03. 1473 !oo#, pp. EF2&3 1474 ,bid 1475 5cudder. 1476 )elter. 1477 !oo#, pp. EF2&3

1478 1479

)elter ,bid 1480 ,bid

/ar# Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs, ,ntegrative /edicine !ommunications, :e ton, /A, 2000, p.300 1482 Blumenthal, p. 30A
1481 1483 1484

W. 4ees et al., I6reating ,rritable Bo el 5yndrome ith 1eppermint 0il,J BM7, ACHCK ii, pp. B3EW3F. /. +. 1ittler, '. 'rnst, I1eppermint 0il )or ,rritable Bo el 5yndrome9 A !ritical 4evie and /etaanalysis,J )m 7 5astroenterol, ACCB :um. C3, pp.AA3AW3E. 1485 B. /ay et al., I'fficacy of a )i$ed 1eppermint3!ara ay 0il !ombination in :on&Ulcer %yspepsia,J )rIneim orsch Drug Res, ACCF, 7ol. <F, pp. AA<CWE3. 1486 8. Wei(man et al., I'fficacy of +erbal 6ea 1reparation in ,nfantile !olic,J 7 Pediatr, ACC3, 7ol. A22, pp. FE0WE2. 1487 /ills, pp. E0H&EA3 1488 ,bid
1489 1490

Blumenthal, p. 30A

+. *[bel, et al., I 'ssential 1lant 0ils and +eadache /echanisms,J Phytomed, ACCE, 7ol 2, pp. C3WA02. 1491 +. *[bel et al., I'ffect of 1eppermint and 'ucalyptus 0il 1reparations on :europhysiological and '$perimental Algesimetric +eadache 1arameters,J 2ephalalgia, ACC<, 7ol, A<, pp. 22BW3<.

Blumenthal, p. 30A Blumenthal, p. 30A 1494 ,bid, p. 300 1495 1%4, p. EBA 1496 Blumenthal, p. 300 1497 1%4, p. EBA 1498 ,bid 1499 Blumenthal, p. 300 1500 !oo#. 1501 ,bid 1502 Blumenthal, p. 300 1503 ,bid 1504 )elter 1505 !oo#. 1506 1%4, p. EBA 1507 ,bid 1508 )elter 1509 1%4, p. EBA 1510 )elter 1511 1%4, p. EBA 1512 ,bid
1492 1493 1513 1514

1%4 ,bid 1515 ,bid

Menyanthes trifoliata
Common name: Bogbean, buc# bean Ha!itat: ,ndigenous to 'urope, Asia, and America."%"& ,t is found in marshes, fens or bogs.AEAH Botanical description: AEAB • )lo er and )ruit9 White or reddish& hite, medium si(ed flo ers have many blossomed racemes on long leafless peduncle. 6here are E sepals. 6he corolla is fused ith E tips and is pubescent inside. 6here are E reddish stamens and A superior ovary. 6he fruit is an ovate capsule. • .eaves, 5tem and 4oot9 1erennial green, glabrous aquatic plant up to AE&30 cm high. ,t has small, finger&thic# creeping rhi(ome. 6he decumbent stem varies in length according to conditions. .eaf sheaths surround the stem. 6he eaves are on long, fleshy, grooved petioles. 6hey are trifoliate, E cm long, and 2.E cm ide, and have obovate leaflets. #art used: • .eaves =best if collected bet een /ay and -uly>.AEAC • +erb.AE20 $nergetics: 7ery bitter, cold, dry, stimulating, sin#ing."%0" Constituents:"%00 • ,ridoid glycosides9 foliamentin, dihydrogoliamenthin, mentiafolin, and loganin • 1yridine al#aloids9 gentianine • !oumarins9 scopoletin • 1henolic acids9 caffeic, protocatechuic, ferulic, sinapic, vanillic, others • /isc9 vit !, tannins, flavonoids =rutin>, sterols, volatile oil. #harmacology: see the monograph of *entiana for a description of the action of bitters. Medicinal actions: Bitter, diuretic, cholagogue, anti&rheumatic,AE23 la$ative in large doses,"%0: anti&hypertensive.AE2E )raditional Medicinal Uses: • )ol# medicine, esp. in 'urope9 diseases of the digestive system and fevers. AE2F • 6he 'clectics have given /enyanthes for intermittent and remittent fevers, chronic rheumatism, dyspepsia, hepatalgia, dropsy, orms, and some cutaneous diseases, and as a tonic in scrofula, and various cachectic affections. AE2H ?ing considered /enyanthes as a valuable tonic here digestion and blood ma#ing are impaired, particularly hen there is an associated uterine disease or irregularity, or hen follo ing the use of quinine in malarial disorders =5cudder>. • 1hysiomedicalist !oo# described the root of buc#&bean as rela$ing and stimulating ith the stimulating property predominating and of the tonifying character. +e noted that its main influence is e$pended on the glandular structures, promoting the flo of bile and urine, acting fairly on the bo els and s#in. 6he principle use is as a tonic in company ith alterants for such maladies as dropsy, scrofula, "aundice and general biliousness. !oo# used considerable doses to effectively purge the liver, gall bladder and bo els at the same time to sustain the strength and out ard circulation. ,n regard to ague =malarial fever>9 Although not an antiperiodic as is !inchona, !oo# noted that /enyanthes sustains the liver, spleen and portal circulation to decided advantage in those cases here !inchona causes too great cerebral e$citement. AE2B Chinese Medicine #rospective:"%05 • !lears heat, damp and to$ins, reduces fever and inflammation, removes lymph congestion, and stops vomiting. • 5timulates digestion, promotes bile flo , removes accumulations, and relieves appetite loss, fatigue and constipationK clears parasites. • 1romotes urination, resolves to$icosis, relieves edema and benefits the s#inK promotes menstruation and relieves amenorrhea • !irculates lung 2i, promotes e$pectoration, resolves phlegm and relives hee(ing. Current Medicinal Uses:

• •

,nflammatory !onditions9 4heumatism =e$c. here there is any colitis or diarrhea>, arthritis, and rheumatoid arthritis. AE30 Bogbean has general antiinflammatory properties being useful as an ad"unct in a formula, good in rheumatic conditions. AE3A *astrointestinal !onditions9 5luggish digestion, indigestion, and problems of the liver and gall bladder. AE32

#harmacy: • %osage9 o o • ,nfusion9 o 0.E&A g finely cut herb3boiling ater =or put this amount in cold ater and bring rapidly to a boil>. A tsp O 0.C g. 5teep E0&A0 min, strain. 5ig L cup ac.AE3E A&2 tsp dried herb3cup ater, infuse A0&AE minK sig. A cup 6,%. F&A0 g.AE3F 6ea9 A cup qd in mouthful doses W for hypertension. AE3H A.E&3 g3day.AE33 .arger doses W draining, smaller doses W stimulating to the digestion. AE3<

• •

o o o 6incture9 o 5trength unspecified9 A&< ml 6,%. AE3B o 5trength unspecified9 A&3 ml.AE3C 1o der9 o 300&F00 mg tid for tonic and gentle hepatic la$ative properties. AE<0

Drug.@utrient ,nteractions: :one found in the references used. Contraindications: ,ntestines =spleen> 2i deficiency presenting diarrhea.AE<A )o*icity.4ide $ffects: ,n large quantities, it is emetic,AE<2 particularly if fresh.%#'C /ay have irritant effect on the stomach.AE<<
1516 1517

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p. AA0 4udolf )rit( Weiss, +eiss/s Herbal Medicine, classic ed., 6hieme, 5tuttgart, 200A, p. <2 1518 ,bid. 1519 %avid +offman, The ;e: Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesbury, %orset, ACC0, p. AB<. 1520 4. !. Wren, Potter/s Encyclopedia of Botanical Drugs and Preparations, 6he !. W. %aniel !ompany .imited, 5affron Walden, 'ngland, ACBE, p. <F. 1521 1eter +olmes, The Energetics of +estern Herbs: ) Materia Medica >ntegrating +estern and "riental Herbal Medicine Traditions, rev. 2nd ed., 5no .otus 1ress, Boulder, ACC<, 7ol. ,,, p.F2A. 1522 Wren, p. <F 1523 +offman, p. AB<. 1524 Wren, p. <F 1525 W. /itchell, ;aturopahic )pplications of the Botanical Remedies, 2nd ed., ACB3, p. A2 1526 PDR, p. AA0. 1527 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3. 1528 W/., +., !oo#, Physiomedical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy, 'clectic /edical 1ublications, 1ortland, ACBE, pp. EF<&E 1529 +olmes, 7ol. ,,, p. F22 1530 +offman, p. AB<. 1531 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy: Modern Herbal Medicine, !hurchill .ivingstone, 'dinburgh, 2000, p. A<C 1532 +offman, p. AB<. 1533 PDR, p. AAA 1534 +olmes, 7ol. ,,, p. F22 1535 PDR, p. AAA 1536 +olmes, 7ol. ,,, p. F22 1537 /itchell, p.A2 1538 +offman, p. AB<. 1539 +olmes, 7ol. ,,, p. F22 1540 !oo#, p. EFE 1541 +olmes, 7ol. ,,, p. F22 1542 !oo#, p.EFE 1543 )elter.

1544

Weiss, p. <3

Mitchella repens
Ha!itat:

+u!iaceae Common name: 1artridge Berry =5qua 7ine as a previously used name for this plant and is no longer used due to its offensive nature>

Botanical Description: An evergreen plant ith a small, smooth, creeping stem. 6he leaves are A32 in long ith hite stripe, round& ovate on a short petiole, they are dar# green and very tough. 6he flo ers are 2 in number at the e$tremity of the stem, the corolla is hite tinged ith rose, and very fragrant. 6he fruits are berries, bright red and double in structure, ith a stoney seed and a pleasant flavor. #art Used: +erba Historical Use: /itchella as first used by the :ative Americans, and its use has not yet been thoroughly scientifically investigated. Constituents: tannins, saponins, bitter principle, al#aloids, mucilage Medicinal actions: 1arturient, Uterine tonic, %iuretic, emmenagogue Medicinal use: • *ynecologic !onditions9 /itchella tonifies the uterus gently over a long period =greater than 3 cycles>. Unli#e 4ubus idaeus, hich tonifies the muscle layer of the uterus, /itchella tonifies the mucous membrane layer. ,t is not technically astringent, but rather tonifies the mucous membranes, leading to decreased discharge hen e$cessive. /itchella is mildly anti&spasmodic. ,t is part of /otherNs cordial, hich is an 'clectic mi$ture drun# by pregnant omen during the last four ee#s of pregnancy to prepare for labor. /itchella e$erts its tonifying and anti&spasmodic influences through the nervous system. /itchella is the supreme partus preparator by both tonifying and conditioning the uterus and by allaying nervous3emotional anticipation of the mother. /itchella may also prevent spontaneous abortions in omen ith a prior history. ,n non&pregnant omen, it is helpful in dysmenorrhea, 1/5=especially ith ater retention>, prolapsus, leu#orrhea, and in regulating the menstrual cycle. ,t regulates uterine and ovarian dysfunction, increases circulation, allays congestion and irritation of the organs, and rela$es the nervous system. /itchella can be thought of as soothing and strengthening to the uterus and ovaries. • :ervous !onditions9 /itchella is useful systemically for chronic nervous ea#ness and irritability. • /ale !onditions9 ,t is a useful agent for the treatment of spermatorrhea in men. )ccording to Mills and Bone:%#'# • *ynecologic !onditions9 /itchella is traditionally considered an emmenagogue although the term has been popularly used to refer to herbs that regulate the menses in general and may not reliably indicate an emmenagogue effect. )or birth preparation, /itchella can be ta#en continuously after the first trimester, particularly in combination ith 4ubus idaeus. )ccording to ,cudder:%#'$ • *ynecologic !onditions9 /itchella e$erts a direct influence upon the reproductive apparatus of the female , giving tone and improving functional activity. ,t has been e$tensively used as a uterine tonic, to promote menstruation, to remove false pains and unpleasant sensations in the latter months of pregnancy, and has been thought to be a good preparative to labor, rendering the birth of the child easier, and less liable to accidents. )ccording to 2oo3: 6his article is mildly stimulating and slightly rela$ing, e$erting its influence rather slo ly but persistently and leaving a gentle but desirable tonic impression upon the frame. ,t influences the uterus, #idneys, testes and the entire nervous system as connected ith the generative organs. 0n the mucous membranes it e$erts a mild tonic influence, hich slo ly abates e$cessive mucous discharges. • *enitourinary !onditions9 ,t has been recommended in dropsy and gravel, but is only of secondary value. ,t maintains a fair secretion of urine and relieves aching in the bac#. • *ynecologic !onditions9 6he greater portion of its po er is e$pended upon the uterus here its action is tonic and moderately antispasmodic. 6he chief value set upon it is for its soothing and strengthening influence upon the uterus in hysteria, leu#orrhea, prolapsus and rheumatic or nerualgic pains and chronic painful menstruation. Used for several ee#s before parturition it allays the uterine cramping incident to the latter period of gestation and so strengthens this organ as to ma#e an easy labor much more probable. • /ale !onditions9 ,t e$erts a highly favorable influence over spermatorrhea, particularly in combination ith the flo ers of Althea, !elastus and Arctostaphylos.

•

:ervous !onditions9 0ften overloo#ed indications include all forms of nervous feebleness and irritability of a chronic character.

)ccording to .ing: 1artridgeberry is parturient, diuretic, and astringent. Used in dropsy, suppression of urine and diarrhoea, in decoction. ,t seems to have an especial affinity for the uterus, e$erting a po erful tonic and alterative influence upon this organ, and has hence been found highly beneficial in many uterine derangements, as in amenorrhoea, some forms of dysmenorrhoea, menorrhagia, chronic congestion of the uterus, enfeebled uterine nervous system, etc. ,t is said that the ,ndian omen drin# a decoction of this plant for several ee#s previous to their confinement, for the purpose of rendering parturition safe and easy. 5imilar virtues have been ascribed to it by competent physicians of our time. 6he remedy is peculiarly American, not being noticed or used by foreign practitioners. 6he berries are a popular remedy for diarrhoea and dysuria. #harmacy: 5cudder cautions against using plant material that may be too aged, instead suggesting preparations made from the green plant material. ,nfusion& A32 tsp.3cup aterK sig 3&< cups 6,% =Alschuler> %ose of a strong decoction, from 2 to < fluid ounces, 2 or 3 times a day. =?ing> 6incture A9E 2EG 't0+K sig E&A0 ml 6,% =Alschuler> )luid '$tract A9A 2EG 't0+K sig 2&< ml 6,% =Alschuler> 1repare a tincture from the fresh plant, vii" =B o(.> to Alcohol HFS 0" =AF o(.> %ose from gtts. v. to ss. =5cudder> As a douche in an infusion form =Alschuler> /other@s !ordial9 /itchellaQ<R, !hamaeliriumQAR, !aulophyllumQAR, 7iburnumQAR Used as follo s, partridgeberry is highly recommended as a cure for sore nipples9 6a#e 2 ounces of the herb, fresh if possible, and ma#e a strong decoction ith a pint of ater, then strain, and add as much good cream as there is liquid of the decoction. Boil the hole do n to the consistence of a soft salve, and hen cool, anoint the nipple ith it every time the child is removed from the breast. Contraindications: 'mmenagogues may be contraindicated in pregnancy or here pregnancy is being attempted, although /itchella appears safe for use after the first trimester .AE<H )o*icity:
1545 1546

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 2<0 5cudder -. 5pecific /edications and 5pecific /edicines. 1547 /ills and bone p 2<0, 2<F

Momordica charantia
Common name: Ha!itat: Botanical description: A green melon. #arts used: )ruit :ith seeds, leaf and stem Constituents: • 1olypeptide&p and other polypeptidesK • *lycosides ° !harantin =mi$ture of t o steroid glycosides> ° !ucurbitane&type triterpene glycosides called goyaglycosides&a, &b, &c, &d, &e, &f, &g, and Wh. ° )ive cucurbitane&type triterpene glycosides momordicosides A, !, )A, ,, and ?. AE<B • 0leanane&type triterpene saponins termed goyasaponins ,, ,,, and ,,, Bitter melon, bitter gourd, balsam pear, #arela

Cucur!itaceae

#harmacology: 6he hypoglycemic activity is in the seed and fruit. At least three different groups of constituents in bitter melon have been reported to have hypoglycemic =blood&sugar lo ering> actions of potential benefit in diabetes mellitus. 6hese include a mi$ture of steroidal saponins #no n as charantin, insulin&li#e peptides =including polypeptide&p> and al#aloids. ,t is still unclear hich of these is most effective, or if all three or# together. /ultiple controlled clinical studies have confirmed the benefit of bitter melon for people ith diabetes. AE<C ,n&vitro studies demonstrate enhanced glucose upta#e in muscle tissue, glycogen accumulation in muscle and hepatic tissue, but no effect on glucose upta#e or triglyceride synthesis in adipose tissue.AEE0 ,n&vitro e$perimentation ith the fruit e$tract revealed that it inhibits glucose upta#e by intestinal fragments.AEEA 6he antidiabetic activity of /omordica charantia as investigated in mice ith type 2 diabetes ith hyperinsulinemia. 6he ater e$tract of the fruit of /omordica charantia .. =/!> reduced the blood glucose these mice 3 ee#s after oral administration =pc0.0A> and also significantly lo ered the serum insulin of these mice under similar conditions =pc0.0A>. +o ever, /! did not affect the blood glucose in normal mice. /!&treated mice blood glucose significantly decreased in an insulin tolerance test. /oreover, the muscle content of facilitative glucose transporter isoform < =*.U6<> protein content in the plasma membrane fraction from muscle significantly increased in the orally /!&treated mice hen compared ith that of the controls =pc0.0A>. 6hese results suggest that the antidiabetic effect of /! is derived, at least in part, from a decrease in insulin resistance because of the increase of *.U6< protein content in the plasma membrane of the muscle. AEE2 1olypeptide&p is insulinomimetic hen administered subcutaneously to rodents and primates. ,n& vitro studies support this finding. /omordica seeds stimulate lipogenesis and inhibit corticotropin&induced lipolysis. 6he mechanism is thought to involve an interaction of these peptides ith α&adrenergic or corticotropin receptors.AEE3 !harantin is another active constituent in the melon. +ypoglycemic activity as observed in animals after p.o. , i.p. and i.v. dosing, although the hypoglycemic effect is not so evident in hyperglycemic animals. AEE< !harantin is better e$tracted in alcohol. 6 o proteins, #no n as alpha& and beta&momorcharin, inhibits +,7K ho ever, this research has only been conducted in !itro and not in humans. AEEE ,n traditional herbal medicine, bitter melonZand essentially all non&to$ic, bitter&tasting herbsZis thought to stimulate digestive function and improve appetite. 6his has yet to be tested in human studies. Un#no n compounds in bitter melon have sho n antio$idant effects in !itro. AEEF 0ther actions investigated in animal models include9 lipid lo ering, prevention of s#in cancer, anti&ulcer, antio$idant and antiviral effects. Medicinal actions: anti&diabetic =hypoglycemic> )raditional Medicinal Use: /omordica entered the estern materia medica only recently as as not described or used by the 'clectic or 1hysiomedical physicians. 6he !hinese and ,ndians have used /omordica for many centuries in order to treat symptoms of diabetes. Current Medicinal Use: • 'ndocrine !onditions9 /omordica has therapeutic potential for diabetic patients. 'ven though the glucose&lo ering effects of /omordica in a diabetic person may not be pronounced it is still a orth hile therapy. /omordica appears to enhance tissue upta#e and metabolism of glucose. Additionally, it may prevent the absorption of glucose from the intestines. ,t insulinomimetic effects may allo for reduced dosages of insulin in insulin&dependent diabetics.

4esearch summaries according to Brin#er9 !onsumption of 230g of the fried fruit daily for B&AA ee#s or E0ml of the fresh "uice daily increased glucose tolerance in C diabetic patients. ,n another study, A3 of AB ne ly diagnosed maturity onset diabetes had significant improvement in glucose tolerance in a 3 hour test after consuming a A00 ml "uice. ,n another study, daily consumption of A00 ml aqueous e$tract of A00 gm boiled fruit or the equivalent amount reduced to po der for three ee#s reduced serum glucose by E<G in the seven diabetics using the liquid e$tract compared to 2EG reduction in the five patients using the po der. AEEH #harmacy: -uice the melon =including seeds> mi$ this ith a favorite beverage and dilute ith ater. 1o der 6incture =A9E>9 E&A0 ml tid

Drug ,nteractions:"%%/ • ,nsulin: dosage may need to be ad"usted due to hypoglycemic effect =human> • Chlorpropamide: consumption of the melon may have additive effects in reducing glucosuria =case report>. Contraindications: /omordica may be contraindicated for use during pregnancy due to potential emmenogogue and abortifacient effects =empirical>.AEEC )o*icity: A mildly to$ic lectin occurs in the seeds and outer rind of fruits hich is capable of interfering ith protein synthesis in the intestinal all.AEF0
1548

/ura#ami. /edicinal foodstuffs. PP,. 5tructures of ne cucurbitane&type triterpene glycosides, goyaglycosides&a, &b, &c, &d, &e, &f, &g, and &h, and ne oleanane&type triterpene saponins, goyasaponins ,, ,,, and ,,,, from the fresh fruit of -apanese /omordica charantia .. !hem 1harm Bull =6o#yo>. 200A -anK<C=A>9E<&F3. 1549 4aman A, .au !. Anti&diabetic properties and phytochemistry of Momordica charantia . =!urcurbitaceae>. Phytomed ACCFK293<CWF2. 1550 /eir 1, ;aniv 8, Planta Medica, EA, ACBE9A2. 1551 /eir 1, ;aniv 8, >bid. 1552 /iura 6. +ypoglycemic activity of the fruit of the /omordica charantia in type 2 diabetic mice. - :utr 5ci 7itaminol =6o#yo>. 200A 0ctK<H=E>93<0&<. 1553 :g 6B, Wong !/, .i WW, ;eung +W 7 Ethnopharmacology , AE, ACBF9A0H&AAH. 1554 .otli#ar //, 4a"arama 4ao /4, >nd 7 Pharm, 2B, ACFF9A2C. 1555 8hang 2!. 1reliminary report on the use of Momordica charantia e$tract by +,7 patients. 7 ;aturopathic Med ACC2K39FEWC. 1556 5hi +, +iramatsu /, ?omatsu /, ?ayama 6. Antio$idant property of fructus momordicae e$tract. Biochem Molec Biol >nt ACCFK<09AAAW2A. 1557 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 3C 1558 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 3C 1559 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 3C 1560 .ampe ?), /c!ann /A, )M) Handboo3 of Poisonous and >nKurious Plants, American /edical Association, !hicago, ACBE.

Myrica cerifera
Common name: Ha!itat: Bayberry, a$&myrtle, candle berry, a$berry

Myricaceae

Botanical description9 6his plant is a branching shrub that gro s to a height of A to A2 feet. 6he stems are covered ith a grayish& bar#. 6he leaves are glabrous, cuneate&lanceolate, petiolate, pale in color, shiny and resinous and appro$imately 2 in. long and A32 in. ide. 6he flo ers appear in /ay. 6hey are hite and occur in clusters, each one enclosing a blac# #ernel. 6he root is curved and covered ith a thin, grayish, mottled epidermis ith slight transverse fissures. 6he inner bar# is reddish&bro n. #arts used9 Bar# of the root. Constituents:"%&" • 7olatile oil =traces> • 6riterpenes =tara$erol and myricadiol> • )lavonoids = myricitrin> • 6annins9 )rom the aerial parts of the /yrica epicatechin, gallocatechin, epigallocatechin, epigallocatechin&3&0&gallate, gallocatechin&=< alpha&B>&epicatechin, gallocatechin&=< alpha&B>&epigallocatechin, and gallocatechin&=< alpha&B>&gallocatechin& =< alpha&B>&gallocatechin =A>, ere isolated. AEF2 • 4esins, gums, phenols #harmacology: 6he aqueous ethanol e$tract of /yrica !orte$ =bar# of /yrica rubra 5ieb. et 8ucc., /yricaceae> sho ed in vitro testosterone Ealpha&reductase inhibitory activity and in vivo anti&androgenic activity using gro th of flan# organ in castrated 5yrian hamsters and3or hair regro th after shaving in testosterone&treated !EHBlac#3F!r5lc mice. 6hree constituents, myricanone, myricanol, and myricetin ere identified as the main active principles. AEF3 Antio$idant and radical scavenging effects ere studied of a diethyl ether e$tract of the fruit e$udate of /yrica gale .., and of !& methylated dihydrochalcones isolated from it. ,solated hepatocytes and liver mitochondria from the rat ere incubated ith tertbutyl hydropero$ide, and lipid pero$idation measured by the yield of thiobarbituric acid reactive substances. 6he main antio$idant of the e$tract, myrigalone B =/yB>, inhibited lipid pero$idation in hepatocytes ith an ,!E0 value of 23 X3& A micro/, hereas in mitochondria the value as E.2 X3& 0.A micro/. AEF< 6he inhibitory effect of a E0G ethanolic e$tract obtained from the dried leaves and the bar# of /yrica rubra, as investigated in vitro on melanin biosynthesis hich is closely related to hyperpigmentation. 6hese e$tracts inhibited tyrosinase activity, hich converts dopa to dopachrome in the biosynthetic process. )urthermore, the e$tracts inhibited the production of melanin from dopachrome by auto& o$idation and sho ed supero$ide dismutase =50%>&li#e activity. After bioassay&guided fractionation, quercetin, myricetin and myricetin 3& 0&rhamnoside ere isolated from the leaves. As they sho ed the inhibitory effect on tyrosinase activity, the activity is partially attributable to them in the e$tract of /. rubra. 6hese results suggested that the leaves or the bar# of /. rubra might be used as a hitening agent for the s#in.AEFE Bacteriostatic and fungistatic activity has also been reported. AEFF Medicinal actions: 5timulant, astringent, diaphoretic )raditional Medicinal Use: 5pecific ,ndications and Uses9 1rofuse mucous flo sK catarrhal states of the gastrointestinal tractK atonic diarrhea, typhoid dysentery, atony of the cutaneous circulationK full oppressed pulse. .ocally and internally9 sore mouthK spongy, flabby, bleeding gumsK sore throat of scarlet fever hen enfeebled and s ollen.AEFH ,t as largely employed by the follo ers of 5amuel 6homson, in catarrhal states of the alimentary tract. ?ing described /yrica as astringent and stimulant that as considered valuable in debilitated conditions of the mucous membranes. !oo# noted that /yrica combines stimulating and astringing effects in about equal proportions that are definite and persistent in action. +e observed that the entire circulation is slo ly but steadily influenced ith blood moving to ard the surface of the body. )inally, he noted that it leaves an astringing tonic impression on all the tissues of the body. ,ndeed, it promotes an increase of mucous secretion in cases here these tissues are la$, and increases the salivary flo some hat. 6he bar# has been successfully employed in scrofula, "aundice, diarrhoea, dysentery, aphthae, and other diseases here astringent stimulants ere indicated. • 'ndocrine !onditions9 5ome 1hysiomedicalists physicians used /yrica in cases of goiter.

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•

• • •

*astrointestinal !onditions9 6he 'clectics used small doses of specific /yrica as a gastric stimulant for chronic gastritis, chronic catarrhal diarrhea, muco&enteritis, and in dysentery having a typhoid character. +o ever, it as not considered adapted to acute disorders of the alimentary tract, as a rule. !oo# noted that a arm infusion might be used in cramping diarrhea =but not dysentery> and hemorrhage from the bo els. *ynecological !onditions9 A ea# infusion used as an in"ection in amenorrhea and atonic leucorrhoea, follo ed by use of the specific medicine or tincture internally. !oo# considered the arm infusion of /yrica valuable, either alone or in combination ith suitable stimulants, in uterine hemorrhage. +e also noted that /yrica unquestionably e$erts a direct stimulating influence on the uterus, leading to its firm contraction in cases of labor here the circulation is sluggish and the tissue flaccid. ,n turn, he applied the cold infusion in chronic menorrhagia, and leucorrhea ith prolapsus. ,nflammatory !onditions9 ,n arm infusion, !oo# noted that Bayberry favors perspiration, follo ed by an increase of arterial and capillary firmness and a general tension of the tissues. !ombined ith rela$ing diaphoretics, it may be used to advantage in recent colds and other cases of depression and la$ity of the tissues. 1ulmonary !onditions9 !oo# used the arm infusion in hemorrhage in the lungs. 6opical Applications9 6he po dered bar#, combined ith 5anguinaria, as used as an application to indolent ulcers, and has been employed as a snuff for some forms of nasal polyps. 6he decoction as applied as a gargle in apthous sores, sore throat, as a gum ash for tender, spongy, and bleeding gums and an in"ection for fistulas.

Current Medicinal Use: /yrica is most indicated in states of inflamed mucous membranes, hich are also ea#ened =manifested by susceptibility to repeated states of congestion and3or ulceration>. • ':6 !onditions9 /yrica is used most often in colds and flues and sinusitis. ,t is a po erful astringent. ,n addition to reducing the copious e$udate from inflamed mucous membranes, it also stimulates their overall function. /yrica is also a useful topical agent for pharyngitis and gingivitis. /yrica ill most beneficial in these conditions hen the tissue is s ollen and tender and even friable. 6he tannins in /yrica ill reduce the mucous accumulation and, in addition, ill help to heal the ulcerations. /yrica is often used for nasal congestion, especially sinusitis. ,n addition to reducing the mucous secretion from the nasal mucosa, /yrica can help to resolve nasal polyps. /yrica is specifically indicated in sinusitis hen the tissues are edematous. /yrica is effective in sinusitis as an internal and as a topical agent. • *astrointestinal !onditions9 /yrica can also be used for gastroenteritis ith e$cessive mucous secretion. 6he stimulating actions of /yrica ill also stimulate digestive functions, especially gastric secretions. When the plant is used in specific dosages =2&E drops> it ill stimulate digestion. Current +esearch +eview: 5earch of /edline revealed no human trials as of AA320302 #harmacy9 1o dered bar#9 A&< g 6,% A9E tincture9 3 ml 6,%K ee#ly ma$imum F0 ml 5pecific tincture9 2 & E drops daily

Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: !oo# noted that hile its astringency is sufficiently felt by all the mucous membranes, this same quality contraindicates its use in any case here there is a tendency to deficient mucous secretion, such as the early stages of pneumonia, acute dysentery, etc. Brin#er contraindicates its use during severe acute inflammation due to its local stimulant properties =empirical>. AEFB )o*icity9 6he tannins and phenols e$tracted from the bar# e$ert carcinogenic activity hen in"ected into rats, ho ever hether this effect is applicable to humans and in oral or topical administration is not #no n.
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PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 5antos, 5!. !ondensed tannins from /yrica gale. )itoterapia. 2000 5epKHA=E>9FA0&2. 1563 /atsuda, +. Anti&androgenic activity of /yricae !orte$&&isolation of active constituents from bar# of /yrica rubra. Biol 1harm Bull. 200A /arK2<=3>92EC&F3. 1564 /atheisen, .. Antio$idant activity of fruit e$udate and !&methylated dihydrochalcones from /yrica gale. 1lanta /ed. ACCE %ecKFA=F>9EAE&B.

1565

/atsuda, +. 5tudies of cuticle drugs from natural sources. ,,,. ,nhibitory effect of /yrica rubra on melanin biosynthesis. Biol 1harm Bull. ACCE AugKAB=B>9AA<B&E0. 1566 /alterud, ?'. Bacteriostatic and fungistatic activity of !&methylated dihydrochalcones from the fruits of /yrica gale .. Acta 1harm 5uec. ACB2KAC=A>9<3&F. 1567 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1568 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 3H

3enothera !iennis
Common name: Ha!itat: 'vening primrose, 6ree primrose, 5un drop

3nagraceae

Botanical description9 Biennial plant ith an erect, rough branching stem from 2 to E feet high. 6he leaves are ovate&lanceolate, alternate, 3&F in. long and A32 to A.E in ide, those on the stem sessile, the radicles tapering into a petiole. 6he flo ers are numerous, pale&yello , sessile, odorous, in a terminal. 6he flo ers are nocturnal and only bloom once and last for one day. 6he flo ers contain numerous seeds. #arts used9 .eaves, oil from seed Constituents9. )i$ed oil containing H0G cis&linolenic acid and CG cis& &linolenic acid =*.A> 6riacylglycerols #harmacology: *amma linoleic acid is involved in a variety of path ays through prostaglandin metabolism. Medicinal actions: 0il9 anti&inflammatory, nutritive, hypotensive, inhibitor of platelet aggregation .eaves9 %igestive restorative, anti&inflammatory )raditional Medicinal Use: According to 5cudder the specific indications for the leaves are9 M5allo , dirty s#in, tissues full and e$pressionless, tongue unnatural in si(e and color, being large and of the dirty color of the s#in, face dull and apatheticK dyspepsia, ith vomiting of food, and gastric distress, ith desire to urinate frequentlyK dysenteric dischargesK nocturnal restlessnessK innervation feebleK patient gloomy and despondentK atonic reproductive rongs of the female, ith pelvic fullness.M AEFC 6he 'clectic physicians ould prescribe evening primrose leaves for both gastrointestinal disorders and for pelvic ea#ness and stagnation in females. Current Medicinal use: 6he oil from evening primrose is provides a substantial amount of *.A. 6his oil =particularly the *.A> is utili(ed in a number of conditions. :ot all of the applications of *.A are arranted. :onetheless, there are several indications hich have been ell studied. • Behavioral and 1sychological !onditions9 Alcoholics may be deficient in prostaglandin 'A =1*'A> and in gamma&linolenic acid, a precursor to 1*'A. ,n a double&blind study, supplementation ith < grams of evening primrose oil per day = hich contains gamma& linolenic acid> appeared to facilitate ithdra al from alcohol. AEH0, AEHA A number of studies from 'ngland, ,reland, 5cotland, -apan and the U5A have demonstrated that these patients have lo levels of ')As. 4andomi(ed placebo&controlled trials have sho n mild or no improvements. AEH2 • !ardiovascular !onditions9 +igh dosages of evening primrose oil may be useful for 4aynaudNs phenomenon, a condition in hich a personNs hands and feet sho abnormal sensitivity to cold temperature. A small double&blind study found that *.A produced significantly better results than placebo. AEH3, AEH< 5imilar results have been obtained ith the omega&3 fatty acids found in fish oil. • %ermatologic !onditions9 'vening primrose oil is very effective for treating atopic ec(ema AEHE. ,t is ta#en internally for this condition. 6his is a safe and effective treatment for infants as ell as older children and adults. 4esearchers have reported that people ith ec(ema do not have the normal ability to process fatty acids, hich can result in a deficiency of gamma&linolenic acid. /ost double& blind research has sho n that '10 overcomes this bloc# and is useful in the treatment of ec(ema. An analysis of nine placebo& controlled trials reported that effects for reduced itching ere most stri#ing. /uch of the research uses A2 pills per dayK each pill contains E00 mg of '10, of hich <E mg is *.A. 5maller amounts have been sho n to lac# efficacy. 0ne study questioned the effectiveness of evening primrose oil for treating ec(emaK ho ever, this negative study has been critici(ed. AEHF, AEHH, AEHB • *astrointestinal !onditions9 0enethera leaves have been used for gastrointestinal disorders such as dyspepsia and3or hepatic insufficiency ith vomiting, gastrointestinal distress after eating, restlessness at night, diarrhea ith mucus in the stool. • *ynecological !onditions9 'vening primrose oil is also effective, hen ta#en internally, for mastalgia. AEHC 6his effect is often noted by omen ho ta#e evening primrose oil for their premenstrual syndrome symptoms. AEB0 6he alleviation of 1/5 symptoms including mood changes, breast tenderness, abdominal discomfort can be achieved by the administration of evening primrose oil. 'vidence suggests that *.A relieves cyclic mastalgia, perhaps by restoring the balance of essential fatty acids. 0ne revie of multiple cases published in ACBE compared the effectiveness of four different therapies in omen ith severe, painful mastalgia9 *.A from evening primrose oil and the pharmaceuticals dana(ol, bromocriptine, and progestins =often, but not quite accurately, called progesterone>. 6he results suggest that evening primrose oil as effective in "ust under E0G of participants.

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Another trial follo ed H3 omen suffering from cyclic mastalgia. 6he results ere consistent ith the previous results, finding that evening primrose oil reduced pain in almost E0G of the omen ta#ing it, hile only ACG of the omen improved in the placebo group. :egative results ere seen in a small placebo&controlled study of 23 omen ith established breast lumps. 1articipants ho too# evening primrose oil for F months sho ed no more improvement than individuals ho received no treatment. AEBA, AEB2, AEB3 0enethera leaves have also been used in omen ith pelvic conditions such as uterine prolapse, ovarian cysts, oligomenorrhea, and incontinence. /etabolic !onditions9 A A2& ee# double&blind study that enrolled A00 significantly over eight omen compared the effectiveness of evening primrose oil to placebo. AEB< :o difference as seen bet een the groups. +o ever, there as a high dropout rate in this trial =over 2EG>, hich some hat decreases the meaningfulness of the results. ,n addition, many participants ere #no n to have Mrefractory obesity,M meaning that they had already failed to respond to other forms of treatment. Another double&blind trial tested the unusual hypothesis that evening primrose might only or# in individuals ith a family history of obesity. AEBE A total of <H people ith a family history of obesity ere enrolled in this study. 6he results sho ed that use of evening primrose oil produced a small but significant loss of eight. /usculos#eletal !onditions9 0ils containing the omega&F fatty acid gamma linolenic acid =*.A>, such as borage oil, blac# currant seed oil and evening primrose oil ='10>, have also been reported to be effective in the treatment of 4A. 6he most pronounced effects ere seen ith borage oilK ho ever, that may have been due to the larger amounts of *.A used =such as A.< grams per day>. 6he results ith '10 ere conflicting and some hat confusing, possibly because the placebo used in these studies =olive oil> appeared to have an anti&inflammatory effect of its o n. ,n a double&blind study, positive results ere seen hen '10 as used in combination ith fish oil. *.A appears to be effective because it is converted in part to prostaglandin 'A, a compound #no n to have anti&inflammatory activity. ,n an unblinded trial for osteoporosis, omen received F grams of a combination of evening primrose oil and fish oil =containing F0G linoleic acid, BG gamma&linolenic acid Q*.AR, <G eicosapentaenoic acid Q'1AR and 3G docosahe$aenoic acid Q%+AR>, or a matching placebo, in addition to a F00&mg calcium supplement, daily for 3F months. ,n the evening primrose oil3fish oil group there as no loss of spinal bone mineral density in the first AB months, compared to a loss of 3.2G in the placebo group. %uring the second AB months, those ta#ing evening primrose oil3fish oil had a significant 3.AG increase in spinal bone mineral density. AEBF, AEBH :eurological !onditions9 6here is some evidence that *.A can be helpful for diabetic neuropathy, if you give it long enough to or#. ,n one double&blind placebo&controlled study, AAA people ith mild diabetic neuropathy received either <B0 mg daily of *.A or placebo. After A2 months, the group ta#ing *.A as doing significantly better than the placebo group. *ood results ere seen in a smaller study as ell. ,n addition, numerous studies in animals have found that evening primrose oil can protect nerves from diabetes&induced nerve in"ury. AEBB, AEBC, AEC0 According to ?1 ?halsa, *.A is beneficial in the management of 1ar#inson@s disease.

Current +esearch +eview ("558<0880 : • #ulmonology: o Cystic fi!rosis:"%5"  %esign9 !linical trial  1atients9 5i$teen cystic fibrosis patients  6herapy9 'vening primrose oil supplements =at least H2G linoleic and HG gamma&linolenic acids, e$pressed as G fatty acid methyl esters> $ A2 months.  4esults9 6here ere no significant changes in patientsN eights or respiratory function throughout. .evels of plasma prostaglandins =1*> and urinary 1* metabolites varied among individuals over a ide range, and urinary 1*)2 alpha metabolites fell during the supplementation. 6here as a significant fall in s eat sodium concentrations after F ee#s of supplementation, but s eat chloride as unchanged. ,t is not #no n hether the effect of essential fatty acids on s eat :aX reflects changes in cell membrane conformation or if there is a direct effect on :aX pump activity. • ,mmunology: o 4BorgrenAs syndrome:"%50  %esign9 %ouble&blind, placebo&controlled randomi(ed clinical trial.  1atients9 :inety patients ith primary 5"ogren@s syndrome ith or ithout signs of autoimmunity.  6herapy9 +igh dose *.A =from 'vening 1rimrose 0il> or corn oil $ F months.  4esults9 :o statistically significant improvement as found in fatigue or time needed for sleeping3resting during a 2<&hour period. :o difference for eye and mouth dryness or pain, muscle or "oint pain. According to this study, *.A treatment for fatigue in primary 5"ogren@s syndrome is ineffective. • Dermatology:

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Atopic dermatitis: 5tudy A9 "%57  %esign9 !linical trial  1atients9 )orteen atopic dermatitis patients ith itchy dry scaly s#in.  6herapy9 'vening primrose oil  4esults9 6he e$tent of the s#in lesions and the pruritis ere reduced in all patients. 5erum ,):&gamma levels ere increased after the treatment up to those of the normal control group, serum ,g' levels sho ed a significant decrease, failing to normali(e completely. ,t as concluded that '10 could be highly effective in the treatment of a grossly non&inflammatory type of atopic dermatitis. 6he effect of '10 may be through the modulation of the immunological mechanism involving ,):&gamma. 5tudy 29AEC<  %esign9 4andomi(ed controlled clinical trial.  1atients9 6 enty patients ith atopic dermatitis.  6herapy9 'vening primrose oil in an anphiphilic and a stable ater&in&oil emulsion $ < #s.  4esults9 '10 as found to have a stabili(ing effect on the stratum corneum barrier, but this as apparent only ith the ater&in&oil emulsion, not the emphiphilic emulsion. 5tudy 39AECE  %esign9 %ouble&blind, placebo&controlled parallel clinical trial  1atients9 5i$ty children ith atopic dermatitis and the need for regular treatment ith topical s#in steroids. 6 enty t o of these children had asthma.  6herapy9 'pogam evening primrose oil $ AF #s.  4esults9 6he plasma concentrations of essential fatty acids increased significantly in the group treated ith 'pogam capsules. 6he study demonstrated significant improvements of the ec(ema symptoms but no significant difference as found bet een the placebo and the 'pogam groups. :o therapeutic effect as sho n on asthma symptoms or fidget. 5tudy <9 AECF  %esign9 %ouble blind, placebo&controlled clinical trial.  1atients9 !hildren ith atopic dermatits  6herapy9 '10 ='pogam, 5earle, U?>  4esults9 A significant improvemtn in the overall severity of the clinical condition, independent of hether the children had manifestations of ,g'&mediated allergy. 6he percentage content of n&F fatty acids in erythrocyte cell membrane increased, especially in the children treated ith high doses of '10. ,n the high dose group, dihomogamma&linolenic acid =precursor of antiinflammatory prostanoids> increased. 4ed cell membrane microviscosity did not change in any group after treatment ith '10, even in high doses, despite a significant increase in the proportion of long chain polyunsaturated fatty acids. 5tudy E9 AECH  %esign9 %ouble&blind, placebo&controlled, parallel&group clinical trial  1atients9 0ne hundred t enty three patients ith atopic dermatitis  6herapy9 A> '10, 2> '10 X fish oil, or 3> placebo $ AF ee#s  4esults9 :o improvement ith active treatment as demonstrated. 6his study found no effect of essential fatty acid supplementation in atopic dermatitis. 5tudy F9AECB  %esign9 4andomi(ed controlled clinical trial  1atients9 )ifteen patients ith atopic dermatitis.  6herapy9 '10, containing H2G linoleic acid and A0G gamma&linolenic acidK sig <, B, or A2 capsules containing 0.E g oil.  4esults9 6he only n&F fatty acid sho ing a significant dose&related increase as dihomo&gamma&linolenic acid in neutrophil phospholipids. ,n both lesional and lesion&free epidermis, supplementation resulted in a rise in the ratio bet een n&F and monounsaturated fatty acids, reaching significance in lesional epidermis. 6his study sho s that moderate and favorable fatty acid changes can be obtained in the epidermis of A% patients, hen given F g per day of oil rich in n&F fatty acids. Chronic hand dermatitis:"%55  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 6hirty&nine patients ith chronic =Y Ayear>, stable hand dermatitis

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6herapy9 'pogam ='10>K sig F00 mg *.A qd $ AF ee#s 4esults9 ,mprovement in clinical parameters as present in the 'pogam and placebo groups, but no statistical difference could be confirmed bet een the groups. :o change in the lipid composition of plasma red cells or epidermis could be detected during the trail. Ultrastructurally s#in specimens sho ed no change during the study period. 6he study concluded that the therapeutic value of orally administered *.A for chronic hand dermatitis is not superior to that of placebo. 9ynecology: o #M4:"&88  %esign9 4andomi(ed double&blind placebo&controlled cross&over clinical trial  1atients9 6hirty&eight omen ith 1/5.  6herapy9 '10 ='famol, 7ita&*lo >  4esults9 Although the results sho ed an improvement in symptoms of 1/5 during the trial, no significant no significant differences in the scoring bet een the active and placebo groups ere found over si$ cycles. o Mastalgia: 5tudy A9 "&8"  %esign9 1rospective clinical trial.  1atients9 5i$ty si$ 0riental omen ith disturbing cyclical mastalgia  6herapy9 *amolenic acid in '10 ='famast, 5cotia 1harmaceuticals, .td, 5cotia +ouse, 5tirling, 5cotland>.  4esults9 an overall useful response rate of CHG as observed at F months. 5ide&effects ere found in A2G but all ere insignificant. 5tudy 29AF02  %esign9 !ontrolled clinical trial  1atients9 0ne hundred seventy patients ith mastalgia, mean age W <2, BHG nulliparous, ECG cyclical pain, 3BG unilateral pain.  6herapy9 7itamin BF, '10, or dan(ol  4esults9 4esponse rate to '10 as 2FG, little better than placebo. 5tudy 39AF03  %esign9 4andomi(ed controlled clinical trial  1atients9 Women ith mastalgia and breast cysts  6herapy9 '10  4esults9 )atty acid profiles improved to ards normal, but this as no necessarily associated ith a clinical response. o Breast cysts:"&8:  %esign9 4andomi(ed double&blind placebo&controlled clinical trial  1atients9 6 o hundred omen ith breast cysts proven by aspiration  6herapy9 'famol ='10>, F caps qd $ A yr.  4esults9 4ecurrent cyst formation in the first year as slightly but not significantly lo er in the 'famol group. ,nitial electrolyte composition of cysts did not predict for cyst recurrence. o Menopause:"&8%  %esign9 4andomi(ed double&blind placebo&controlled clinical trial  1atients9 )ifty&si$ menopausal omen suffering from hot flashes at least 6,%.  6herapy9 )our caps B,% of E00 mg '10 ith A0 mg natural vit ' or E00 mg liquid paraffin $ F months  4esults9 /ean improvement in the number of flushes in the last available treatment cycle compared ith the control cycle as A.C for daytime flushes and 0.H for night time flushes in omen ta#ing placebo. 6he corresponding values for omen ta#ing gamolenic acid ere 0.E and 0.E. ,n omen ta#ing *.A the only significant improvement as a reduction in the ma$imum number of night time flushes. 6he authors concluded that gamolenic acid offers no benefit over placebo in treating menopausal flushing. o #regnancy:"&8&  %esign9 4etrospective controlled clinical trial  1atients9 0ne hundred eight omen  6herapy9 'vening primrose oil  4esults9 0ral administration of '10 from 3H th gestational ee# until birth does no shorten gestation or decrease the overall length of labor. 6he use of orally administered '10 may actually be associated ith an increase in the incidence of prolonged rupture of membranes, o$ytocin augmentation, arrest of descent, and vacuum e$traction.  

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#ediatrics: o Breastfeeding:"&8(  %esign9 1lacebo&controlled clinical trial.  1atients9 6hirty&nine breastfeeding omen  6herapy9 'famol ='10> $ B months starting bet een the 2nd and Fth months of lactation.  4esults9 6otal fat and ')A contents of the mil# declined in the placebo group but rose in the primrose oil supplemented group. 6he mil# composition can be readily manipulated by changing the fatty acid composition of the maternal diet. Urology: o Hemodialysis:"&8/  %esign9 4andomi(ed controlled double&blind clinical trial  1atients9 5i$teen patients undergoing dialysis.  6herapy9 *.A&rich '10 or linoleic acidK sig 2 g qd $ F #s.  4esults9 6he patients given '10 e$hibited a significant increase in plasma dihomo&gamma&linolenic acid =a precursor of anti&inflammatory prostaglandin 'A> ith no concomitant change in plasma arachidonic acid =a precursor of pro&inflammatory prostaglandin '2 and leu#otriene B<>. ,n contrast, those given .A e$hibited a significant increase in .A but not in any other n&F ')As, hereas they e$hibited a significant decrease in plasma docosahe$aenoic acid. 6he patients given '10 sho ed a significant improvement in the s#in scores for the three different uremic s#in symptoms over the baseline values and a trend to ard a greater improvement in pruritus scores than those given .A. ,nfectious diseases: o Hepatitis B:"&85  %esign9 1lacebo&controlled clinical trial  1atients9 6en patients ith serological and histological evidence of chronic hepatitis B.  6herapy9 1olyunsaturated fatty acid&rich '10 capsulesK sig < g qd $ A2 month. .iquid paraffin capsules W placebo.  4esults9 !ompared to the placebo group, the patients receiving evening primrose oil sho ed no improvement in either biochemical or histological indices of liver damage, or in the rate of loss of circulating e antigen. ,t as concluded that dietary supplementation ith this dose of essential fatty acids is unli#ely to be of benefit in chronic hepatitis B. 9astroenterology: o Ulcerative colitis:"&"8  %esign9 4andomi(ed placebo&controlled clinical trial.  1atients9 )orty three patients ith stable ulcerative colitis  6herapy9 /a$'1A, super evening primrose oil, or olive oil =placebo> $ F months in addition to ongoing treatment  4esults9 6reatment ith super evening primrose oil increased red&cell membrane concentrations of dihomogamma& linolenic acid =%*.A> by <0G at F months, hile treatment ith placebo reduced levels of %*.A and %+A at F months. 5uper evening primrose oil significantly improved stool consistency compared to /a$'1A and placebo at F months, and this difference as maintained 3 months after treatment as discontinued. 6here as ho ever, no difference in stool frequency, rectal bleeding, disease relapse, sigmoidoscopic appearance or rectal histology in the three treatment groups. +heumatology: o +heumatoid arthritis:"&""  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 )orty patients ith 4A and upper *, lesions d3t :5A,%s.  6herapy9 '10, F g qd =*.A E<0 mg qd> or placebo W olive oil, F g qd  4esults9 :o patient stopped non&steroidal anti&inflammatory therapy but three patients in each group reduced their dose. 0ther results sho ed a significant reduction in morning stiffness ith gamma&linolenic acid at 3 months and reduction in pain and articular inde$ at F months ith olive oil. 6he authors concluded that hile gamma&linolenic acid may produce mild improvement in rheumatoid arthritis, olive oil may itself have unrecogni(ed benefits. $ndocrinology:"&"0 o ,DDM:  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 'leven children ith insulin&dependent diabetes mellitus.

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6herapy9 '10 capsules =<E mg *.A and 3F0 mg of linoleic acid>K sig 2 caps qd $ < months, then < caps qd $ < months more. 4esults9 After administration of < capsules daily the %*.A levels increased and 1*'2 levels decreased significantly in the '10 compared ith the placebo group. :either fatty acid nor 1*'2 and 1*)2 alpha levels ere altered by administration of 2 '10 capsules daily. 6he authors concluded that the altered essential fatty acid and 1* metabolism in diabetes may be reversed by direct *.A supplementation.

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3ncology: o 1iver cancer:"&"7  %esign9 4andomi(ed double&blind placebo&controlled clinical trial.  1atients9 1atients ith primary liver cancer  6herapy9 'vening 1rimrose 0il  4esults9 :o statistically significant effect as observed on survival time or liver si(e. 6here as a statistical significant beneficial effect on *amma *lutamyl transferase values as a measure of liver function. 6he large si(e of tumor and the lo doses of *.A used in this trial probably e$plain the lac# of significant effect on survival times.

#harmacy9 0il9 2E0&HE0 =X> mg daily .eaves9 6incture of fresh leaves9 A & AE drops daily =specific dosing> Drug ,nteractions: AFA< 0enethera oil may potentiate the epileptogneic property of phenothia(ines. Administration of gamma linoleic acid ith tamo$ifen resulted in a faster clinical response to tamo$ifen in 3B patients ith estrogen& dependent breast cancer. ?idney damage induced by cyclosporine as reduced by coadministration of A0mg3#d of '10 in rats. Brin#er speculates that anticoagulants may be potentiated due to decrease in plasma heparin&neutrali(ing activity and platelet aggregation inhibition associated ith 1*'A that is formed from metabolism of %*.A. '10 at doses of 3 g3day in A2 hyperlipidemic patients for < months decreased platelet aggregation by <EG and increased bleeding time by <0G. Contraindications: 0ne case report described sei(ures in a patient using evening primrose oil capsules along ith !imicifuga and 7ite$ for four months. Based on this information and the potentiation of phenothia(ines, Brin#er speculates that 0enethera be avoided in patients ith epilepsy. Brin#er also speculates that 0enethera be avoided in cases mania as it ill increase 1*' A, a prostaglandin already in e$cess in
this condition.AFAE

)o*icity9 :one reported.
1569 1570

)elter +W and .loyd -U, .ingFs )merican Dispensatory, ABth ed., 5andy, 049 'clectic /edical 1ubl., <th printing ACCH9A320. /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 1571 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1572 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3H0 1573 Belch --, 5ha B, 0N%o d A, et al. E!ening primrose oil 0EfamolB in the treatment of RaynaudFs phenomenon: a double9blind study . Thromb Haemost. ACBEKE<9<C0W <C<. 1574 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1575 Wright 5, Burton -., 8ancet ii,ACB29AA20. 1576 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p3FH 1577 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1578 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 1579 1ye -?, et al, 8ancet ii, ACBE93H3. 1580 +orrobin %), 7 Reprod Med, 2B=H>, ACB39<FE. 1581 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3FB 1582 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 1583 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1584 +aslett !, %ouglas -*, !halmers 54, et al. ) double9blind e!aluation of e!ening primrose oil as an antiobesity agent . >nt 7 "bes1 ACB3KH9E<CWEE3. 1585 *arcia !/, !arter -, !hou A. 5amma linolenic acid causes :eight loss and lo:er blood pressure in o!er:eight patients :ith family history of obesity1 ,:ed 7 Biol Med1 ACBFK<9BWAA. 1586 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A
1587 1588 1589

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3FB 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC

1590 1591

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A %odge -A, !ustance -/, *oodchild /!, et al. 1arado$ical effects of essential fatty acid supplementation on lipid profiles and s eat electrolytes in cystic fibrosis. Br 7 ;utr ACC0KF3=2>92EC&HA. 1592 6heander ', +orrobin %), -acobsson .6, et al. *ammalinolenic acid treatment of fatigue associated ith primary 5"ogren@s syndrome. ,cand 7 Rheumatol 2002K3A=2>9H2&C. 1593 ;oon 5, .ee -, .ee 5. 6he therapeutic effect of evening primrose oil in atopic dermatitis patients ith dry scaly s#in lesions is associated ith the normali(ation of serum gamma&interferon levels. ,3in Pharmacol )ppl ,3in Physiol 2002KAE=A>920&E. 1594 *ehring W, Bopp 4, 4ipp#e ), et al. 'ffect of topically applied evening primrose oil on epidermal barrier function in atopic dermatitis as a function of vehicle. )rIneimittelforschung ACCCK<C=H>9F3E&<2. 1595 +ederos !A, Berg A. 'pogam evening primrose oil treatment in atopic dermatitis and asthma. )rch Dis 2hild ACCF9HE=F>9<C<&H. 1596 Biagi 1., Bordoni A, +relia 5, et al. 6he effect of gamma&linolenic acid on clinical status, red cell fatty acid composition and membrane microviscosity in infants ith atopic dermatitis. Drugs Exp 2lin Res ACC<K20=2>9HH&B<. 1597 Berth&-ones -, *raham&Bro n 4A. 1lacebo&controlled trial of essential fatty acid supplementation in atopic dermatitis. 8ancet ACC3K3<A=BBF0>. 1598 5chafer ., ?ragballe ?. 5upplementation ith evening primrose oil in atopic dermatitis9 effect on fatty acids in neutrophils and epidermis. 8ipids ACCAK2F=H>9EEH&F0. 1599 Whita#er %?, !illiers -, de Beer !. 'vening primrose oil ='pogam> in the treatment of chronic hand dermatitis9 disappointing therapeutic results. Dermatology ACCFKAC3=2>9AAE&20. 1600 ?hoo 5?, /unro !, Battistutta %. 'vening primrose oil and treatment of premenstrual syndrome. Med 7 )ust ACC0KAE3=<>9ABC&C2. 1601 !heung ?.. /anagement of cyclical mastalgia in oriental omen9 pioneer e$perience of using gamolenic acid ='famast> in Asia. )ust ; ? 7 ,urg ACCCKFC=H>9<C2&<. 1602 Wet(ig :4. /astalgia9 a 3 year Australian study. )ust ; ? 7 ,urg ACC<KF<=E>932C&3A 1603 *ateley !A, /addo$ 14, 1ritchard *A, et al. 1lasma fatty acid profiles in benign breast disorders. Br 7 ,urg ACC2KHC=E>9<0H&C. 1604 /ansel 4', +arrison B-, /elhuish -, et al. A randomi(ed trial of dietary intervention ith essential fatty acids in patients ith categori(ed cysts. )nn ; A )cad ,ci ACC0KEBF92BB&C<. 1605 !henoy 4, +ussain 5, 6ayob ;, et al. 'ffect of oral gamolenic acid from evening primrose oil on menopausal flushing. BM7 ACC<K30B=FC2H>9E0A&3. 1606 %ove %, -ohnson 1. 0ral evening primrose oil9 its effect on length of pregnancy and selected intrapartum outcomes in lo &ris# nulliparous omen. 7 ;urse Med:ifery ACCCK<<=3>9320&<. 1607 !ant A, 5hay -, +orrobin %). 6he effect of maternal supplementation ith linoleic and gamma&linolenic acids on the fat composition and content of human mil#9 a placebo&controlled trial. 7 ;utr ,ci Bitaminol 0To3yoB ACCAK3H=F>9EH3&C 1608 ;oshimoto&)uruie ?, ;oshimoto ?, 6ana#a 6, et al. 'ffects of oral supplementation ith evening primrose oil for si$ ee#s on plasma essential fatty acids and uremic s#in symptoms in hemodialysis patients. ;ephron ACCCKBA=2>9AEA&C. 1609 -en#ins A1, *reen A6, 6hompson 41. 'ssential fatty acid supplementation in chronic hepatitis B. )liment Pharmacol Ther ACCFKA0=<>9FFE&B. 1610 *reenfield 5/, *reen A6, 6eare -1, et al. A randomi(ed controlled study of evening primrose oil and fish oil in ulcerative colitis. )ilment Pharmacol Ther ACC3KH=2>9AEC&FF. 1611 Br(es#i /, /adho# 4, !apell +A. 'vening primrose oil in patients ith rheumatoid arthritis and side&effects of non&steroidal anti&inflammatory drugs. Br 7 Rheumatol ACCAK30=E>93H0&2. 1612 Arisa#a /, Arisa#a 0, ;amashiro ;. )atty acid and prostaglandin metabolism in children ith diabetes mellitus, ,,. 6he effect of evening primrose oil supplementation on serum fatty acid and plasma prostaglandin levels. Prostaglandins 8eu3ot Essent atty )cids ACCAK<3=3>9ACH&20A. 1613 van der /er e !), Booyens -, -oubert +), et al. 6he effect of gamma&linolenic acid, and in vitro sytostatic substance contained in evening primrose oil, on primary liver cancer. A double&blind placebo&controlled trial. Prostaglandins 8eu3ot Essent atty )cids ACC0K<0=3>9ACC&202. 1614 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p C2 1615 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. C2

3plopana* horridum
Common name: Ha!itat: boggy, lo areas in forestsK gro s out ard in a circular pattern Botanical description: #art used: root bar# Historical use: :ative Americans used 0plopana$ for rheumatoid arthritis, tuberculosis and to ard off evil spirits.

Araliacea

$nergetics: ,nvigorates and strengthens on a physical mental and spiritual level. 5timulates self defense and standing up for oneself, can use ith rescue remedy =%ebra )rancis>. Constituents: • )alcarinol A9 oil • )alcarindiol 29 oil • 0plopandiol 39 oil • C,AH&0ctadecadiene&A2,A<&diyne&A,AA,AF&triol, A&ac&etate <9 oil '<, <CF2. • 0plopandiol acetate E9 oil • saponins, glycosides, tannins #harmacology: 6he glycosides are similar in function to those found in 1ana$. A methanol e$tract of the inner bar# of "plopanax horridus e$hibited antibacterial and antifungal activity. '$tracts ere also active against Mycobac9terium tuberculosis and Mycobacterium a!ium. A ,n addition, or# by /c!utcheon et al demonstrated that the inner bar# has activity against respiratory synchitial virus. 2 6he e$tract has potent hypoglycemic properties. ,n AC3B, a 1rince 4upert physician reported9
M0ur attention as brought to this material through the e$amination by one of us of a surgical patient ho on hospitali(ation, developed mar#ed symptoms of diabetes. 6his person, it as learned, had #ept in apparent good health for several years by oral doses of an infusion of this root bar#, and is in fact still leading a normal life ith the aid of this infusion.M 3

+e used the e$tract ith Belgium hares and noted that profound, hypoglycemic effect as repeatedly produced hen a dose of 0.A to 0.E cc per pound as used, either orally or intramuscularly. Blood glucose levels ere erratic ith higher doses and no effect from lo er levels. 6he hypoglycemic effect as more pronounced hen an acetone precipitate as given. 6he acetone filtrate produced a moderate hyperglycemia. :o to$ic effects ere proven, but test rabbits had more fatty degeneration of the liver than control animals. 6he use of this drug to enhance the ability of the shaman to enter his trance&li#e state may have been related to the hypoglycemic effect. 6he legend of the 5hamanNs increased strength after one ee# of only the e$tract for food, may be related to increasing tolerance to the hypoglycemic effects. < Medicinal actions: anti&stress, adaptogen, vulnerary, antihypoglycemic, purgative Adaptogens have three qualities9 • need to be nontoxic and relatively free of side effects↓ • nonspecific in action, increasing the resistance of the organism to physical, biological and chemical stressors • normaliIing action irrespective of the direction of pathology %ifferentiating adaptogen and tonic adaptogens9 Adaptogens increase the ability to adapt to stress. ,n this regard there is overlap ith tonification from the 6!/ perspective. 6onics increase reserves and promote health. 6rophorestoratives tend to indicate a specified system of influence.

1

?obaisy. Antimycobacterial 1olyynes of %evil@s !lub 0"plopanax horridus>, a :orth American :ative /edicinal 1lant, 71 ;at1 Prod1 ACCH, $-, A2A0&A2A3 2 /c!utcheon. Antiviral screening of British !olumbian medicinal plants. 7 Ethnopharmacol1 ACCE %ec AK<C=2>9A0A&A0. 3 -ustice -. Use of %evil@s club in 5outheast Alas#a. )las3a Med1 ACFF -unKB=2>93F&C. 4 ,bid

)raditional Medicinal Uses: 6he indigenous peoples of the north est and Alas#a have used %evil@s club traditionally for centuries. %evil@s !lub is the common name for )atsia horrida, =0piopana$ horrideum. 'chinopana$ horridium>. 6he 6lingit call it Msu$tM. 6he family is *inseng or Araliaceae. 0ther plants in the same family are 'nglish ,vy and 7irginia 5arsaparilla. ,t is a flo ering shrub that gro s abundantly in the rain forests of 5.'. Alas#a and British !olumbia. %r. Blasch#e, a physician in 5it#a in AB3F, reported 2E plants used by the 6lingits for medicine Apparently, %evil@s club is the only member of this pharmacopia to survive in common use today. E 'ver since the almost forgotten era of the un&recorded past hen a 6lingit of the ?a#e tribe observed t o bears attempting to soothe their battle ounds by che ing %evil@s club root, the use of this plant has been e$tensive from ;a#utat, Alas#a, to :eah Bay, Washington. Aside from medical purposes, the %evil@s club e$tract as used during the neophyte shamanNs purification rites as the only nourishment for ee#s. 6he hole stal#, complete ith thorns, as used for hipping suspected practitioners of itchcraft. Before a hale or a seal hunting e$pedition the hunters bathed their bodies in the e$tract. 6he dried bar# as mi$ed ith red paint as a love charm. 6he stal# as hittled and hung on a fish line as a lure. Ancient medicinal uses, hich are probably not practiced no , included9 body perfumeK baby talcK emeticK regulation of puerperal menstruationK as a lactation suppressant, and for menstrual cramps. 6lingit and +aida people ma#e an infusion of bar# or of the roots, after removing the hairy spines, and drin# it for general strength, colds, chest pain follo ing cold, arthritis, blac# eyes, gallstones, stomach ulcers, and constipation. Although tuberculosis as recently thought to respond to the e$tract, fe people refuse hospitali(ation today. Another ancient preparation in common use is made from the ra inner bar#. 6he stal# is che ed and spit directly upon open ounds as an emergency analgesic measure. 6he bar# may be laid in strips, inner side against the s#in, to reduce the pain and s elling from a fracture 6he dried, pulveri(ed inner bar# or roots are mi$ed ith pitch from red cedar or spruce am applied directly to small abrasions of the s#in 6oday many 6lingit fishing boats carry an ample supply. 6he pitch hardens and protects the ound from constant immersion. 6he pulveri(ed inner bar# can also be ta#en ith olive or corn oil by the teaspoon for pain relief. Current Medicinal Uses: • 'ndocrine !onditions9 9 0plopana$ can be used to stabli(e diabetics but is used more commonly ith hypoglycemia and may be used in the ongoing treatment of 5yndrome P. According to -ustice, F t o persons had glucose tolerance tests before and after ta#ing an e$tract of 0plopana$. 0ne hundred grams of glucose in 2E0 ml. of ater as given to a H2 year old ,ndian oman and a 32 year !aucasian man after A2 hours fast. 6he ne$t day after a A2 hour fast the same dose of glucose as given plus A.< cc per ,b and A.F cc3lb of %evil@s club e$tract, respectively. Blood glucose levels ere determined by the :elson&5omogyi method at the /t. 'dgecumbe hospital laboratory. 6he ,ndian oman as regularly drin#ing the e$tract prior to the tests. 6he !aucasian male had never ta#en the e$tract before. 6he !aucasian e$perienced diarrhea plus the effects of hypoglycemia. 6hese results sho variability of reactions, but do tend to confirm the animal e$periments in the !aucasian sub"ect. 6he results ere9 Qblood glucose /*/5 per A00 !!R ,ndian female9 )A56,:* A +4 2 +4 3 +4 Without e$tract9 C0 ABH A2B E0 With e$tract9 FC 202 A32 BB !aucasian male9 )A56,:* A +4 2 +4 3+4 Without e$tract9 BE AA2 =A.E hours> B2 With e$tract9 B0 B3 BE B3 1ulmonary !onditions9 /ild e$pectorant for coughs. 6opical Applications9 e$ternal application for ounds.

• •

#harmacy: When harvesting the herb, "ust cut a small part of the rhi(ome bet een t o above ground sections. 6he rhi(omes on either side ill continue to proliferate. Drug ,nteractions: :o information is currently available.
5 6

-ustice -. Use of %evil@s club in 5outheast Alas#a. )las3a Med1 ACFF -unKB=2>93F&C. -ustice -. Use of %evil@s club in 5outheast Alas#a. )las3a Med1 ACFF -unKB=2>93F&C.

Contraindications: :o information is currently available. )o*icity: 1eople ho regularly drin# the e$tract report that upon starting to ta#e the bre , one may have diarrhea and feel very ea#. *reater ea#ness is e$perienced if alcoholic beverages are ta#en concurrently. H

7

,bid

#ana* ginseng and #2 ?uin?uefolius

Araliaceae Qmuch of this monograph is adapted from9 Bone, ? 2linical )pplications of )yur!edic and 2hinese Herbs, =2ueensland, Australia9 1hytotherapy 1ress>K ACCF93<&<2.R Common name: !hinese or ?orean ginseng =1. ginseng>, American ginseng =1. quinquefolius> Ha!itat: 6here are appro$imately F species of ginseng native to Asia and t o species native to :. America. 1ana$ ginseng is native to :' !hina, ?orea and 4ussia. 1ana$ quinquefolius is native to the :. central and :' parts of :orth America. Botanical description: 1ana$ spp. gro as perennial plants up to 2 feet tall. 6he plant has a cro n of dar# green leaves and pale yello ish&green flo ers and small red berry&li#e fruit. 6he long tap roots intert ine ith one another and have a shape suggestive of a human form. #arts used: 4ootK harvested after at least F years of gro th. When the root is sun&dried, hite ginseng is produced. ,f the root is first steamed and then artificially dried and then sun&dried, red ginseng is produced. ,dentified Constituents: • /i$ture of steroidal and triterpenoid 5aponins9 • ginsenosides =genosides>K appro$imately 30 different ginsenosides have been identified =e.g. ginsenosides 4 0, 4a, 4b2, etc.> present at 2&3G in fresh rootK e$tracts usually contain E&AHG depending on the e$traction method used. The rootlets tend to ha!e ginsenosides that are more stimulating1 ° protopana$atriols =4e, 4f, 4gA, 4f2>9 The protopanaxatriols ma3e P1 ginseng are more stimulating and raise the le!els of all neurotransmitters in the body except serotonin1 ° protopana$adiols =4bA, 4b2, 4c, 4d>9 The protopanaxadiols are more sedating, :or3ing on the HP) axis sparing cortisol and affecting the ner!ous system through secondary mechanisms of countering neurotransmitter depletion1 • pana$osides =pana$oside A, B, !, etc.> • 1olysaccharides =glycans>9 in P1 ginseng, pana$ans =A&U> in P1 <uin<uefolium, quinquefolans =A, B, and !> • Acetylenic compounds including polyacetylenic alcohols =pana$ynol and pana$ydol> and polyacetylenes =ginsenoynes A&?> • 5esquiterpenes =B&elemene, panasinsanol A and B, ginsenol, etc.> • 5terolsK 7it. % group vitaminsK )lavonoidsK Amino acids Medicinal actions: adaptogenice, stimulant, tonic, hypoglycemic =glycans>, immunomodulating =glycans>, hepatoprotective, cancer preventative =inhibition of tumor gro th and proliferation>, circulation enhancer eAn adaptogen is a substance hich9 &is innocuous and causes minimal disorders in the physiology of the organism &has non&specific action &has a normali(ing action irrespective of the direction of the pathologic state *inseng increases the alarm reaction and prolongs the adaptation phase in 5eyle@s model. #harmacology: Both species of Panax ill be discussed as one plant. American ginseng =P1 <uin<uefoliusB contains a greater ratio of Wdiols than in Asian ginseng =P1 ginsengB and this causes the American ginseng to possess a slightly more sedating influence. /ost of the medicinal action of 1ana$ spp. has been attributed to the ginsenosides. 6he Wdiol genosides are most active on the hypothalamic&pituitary&adrenal a$is. 6hese genosides stimulate the anterior pituitary to release A!6+ in a non&stressed state thereby increasing overall alertness and ell&being. AFAF ,n many animal e$periments, *inseng administration increases resistance to physical, chemical and biological stressors =i.e. damage from radiation is reduced>. AFAH *inseng improves the efficiency of the feedbac# control from the adrenal corte$ to the hypothalamus and pituitary. 6his allo s for quic#er glucocorticoid output in times of stress and a faster drop after stress. *inseng normali(es blood sugar in both hyperglycemic and hypoglycemic states.AFAB *inseng is anti&diuretic either by acting on the posterior pituitary or by increasing mineral corticoid synthesis. AFAC *inseng and its ginsenosides stimulate %:A, 4:A, lipid and protein synthesis in hepatocytes, #idney cells and bone marro in& vitro.AF20 *inseng e$tract administered to rabbits increased red and hite blood cells and hemoglobin levels. AF2A *inseng administered to humans increases red blood cell count, blood o$ygen, hemoglobin, cardiac output, endurance, muscle strength and aerobic performance.AF22 %uring e$ercise, ginseng raises blood glucose levels hile lo ering lactic acid, pyruvic acid and free fatty acid

levels.AF23 6his is in part due to the fact that ginseng inhibits glycogen utili(ation in s#eletal muscle during e$ercise. 6he e$ercising muscles instead metaboli(e the free fatty acids. *inseng protect against carbon tetrachloride and galactosamine to$icity. *inseng enhances ethanol metabolism and blood alcohol clearance.AF2< *inseng enhances phagocytosis and non&specific immunity and increases :? cell and macrophage activity. AF2E *inseng enhances antibody formation and increased interferon production. AF2F ,n mice, ginseng appears to inhibit the incidence and proliferation of tumors hen the animals are e$posed to carcinogens.AF2H 4ed ginseng induces nitric o$ide to a significantly greater e$tent than uncoo#ed hite ginseng. 6hus, its supposed contraindication in hypertension is not founded. 6he mental effects of ginseng have been ell&studied. 0verall, ginseng is stimulating, given that the Wdiols are sedative hereas the Wtriols are stimulatory.AF2B 1ana$ raises the levels of all neurotransmitters e$cept for serotonin. AF2C 1ana$ has been sho n in several studies ith rats to enhance memory and to reduce an$iety. AF30 *inseng increases the production of gonadotropins in&vitro and in rats. When administered to male rats, their mating behavior increases. When given to ovarectomised rats, a strong estrogenic effect is seen. AF3A *inseng has significant effects on the heart. ,n a damaged heart, i.e. in heart failure, ginseng e$erts cardiotonic action. *inseng is anti&arrhythmic and protects the myocardium against ischemia&reperfusion damage. AF32 *insenosides from red ginseng inhibit !;1 AAA, 2BA, 3AA, 2'A. 1ana$ ginseng has been sho n to induce glutathione 5& transferase activity or its isotype levels in the liver as ell as :A%1+&quinone reductase activity or content in the liver. AF33 Historical Use: Panax ginseng and Panax <uin<uefolius have been used in Asia for over 2,000 years. ,t has been used to enhance overall health, alertness and longevity. *inseng is still used for these purposes and its mechanisms of action have been further clarified as outlined in the pharmacology section. )raditional Medicinal Use: 5pecific ,ndications and Uses9 :ervous dyspepsiaK mental and other forms of nervous e$haustion from over or#. Both ?ing and !oo# described 1. quinquefolium as a very mild tonic. !oo# noted that it is some hat aromatic and diffusive, principally rela$ant and felt its actions to be too light to use in depressed cases. ?ing classified it as a stimulant, but noted that continued use for some length of time is required for orth hile effect to occur. 6he 'clectics and 1hysiomedicalists observed that 1ana$ that made its chief impression on the nervous system. As a soothing and nervine tonic, its use as indicated its used in simple forms of dyspepsia, loss of appetite, nervousness, hysteria, and similar cases of nervous sensitiveness ith debility. 6he 'clectics specifically noted it is a very important remedy in nervous dyspepsia, and in mental e$haustion from over or#. Current Medicinal Use: *inseng is used to improve mental and physical stamina and performance. *inseng improves mental functioning, loss of memory, slo cognition ithin one ee# and the effect continues for months after administration. AF3< 6his indication has prompted natural foods merchandisers to add ginseng to a number of products and to promote ginseng tablets and liquid e$tracts. Panax spp1 can be used short&term to increase mental and physical performance or may be used long&term as a revitali(ing tonic. +o ever, it is important to #no that e$cess use of Panax spp1 can over stimulate the !:5 and cause an$iety, agitation, insomnia, palpitations, hypertension, tremor, headaches, euphoria, decreased se$ual function, diarrhea and s#in eruptions. ,n other ords, most of the therapeutic effects of ginseng are reversed hen ta#en in doses that are too high. • !ardiovascular !onditions9 *inseng should be considered for all heart failure patients. ,f cardiac surgery is to ta#e place, ginseng may significantly reduce myocardial ischemic and reperfusion in"uries during and after surgery. Also, ginseng may be helpful long term in these patients and in patients ho recently suffered a myocardial infarction to increase cardiac tone and protect against further ischemia. • *ynecological !onditions9 ,n omen, ginseng promotes an estrogenic effect. ,t has been studied as a therapy for menopausal symptoms. !ontrolled trials demonstrate that ginseng is effective in eliminating menopausal symptoms in a significant number of omen.AF3E :ot all omen respond favorably to ginseng and may be too stimulating for some omen. • ,mmune !onditions9 0ne of the other main indications for Panax spp1 is as an ad"uvant cancer therapy. *inseng appears to enhance the body@s resistance to chemotherapeutic drugs. *inseng increases the hite blood cell count and improves immune function in patients ith various cancers ho are receiving chemotherapy. AF3F *inseng may also prevent cancer and this may be one of the reasons it has been used historically to promote longevity. • /ale !onditions9 *inseng is useful in treating male infertility. ,f a male@s sperm count is lo , ginseng can raise the count. • 'ndocrine !onditions9 )or diabetes mellitus dosing is more time dependent than dose dependent =although one study demonstrated that at least 200 mg should be ingested>. %osage should be <0 minutes or more prior to eating in order to lo er postprandial glucose.

#harmacy:

Use acute dose for A&2 ee#s then lo er to a maintenance dose for a fe months then ta#e a month off and reevaluate. 0.E&3.0 gm3 day of dried root. Q1reparation of the main and lateral roots =vs. root hairs> is preferredK a ginsenoside ratio of 4gA to 4bA of greater than E0G indicates the main and lateral roots have been used.R standardi(ed e$tract9 =<&HG ginsenosides>9 A00&200 mg daily A9E tincture9 2&A0 ml qd A92 tincture9 6a#e a A ee# vacation after every 3 ee#s of use. Drug ,nteractions:"&7( • Alcohol: consumption of 3g3mg free(e dried hot ater e$tract decreased post consumption levels of alcohol by an average of 3E.2G in A< individuals. • Amitriptyline' 1ithium' #henyl;ine =/A0 inhibitor>9 combination produced manic symptoms in human case reports, although the true identification of 1ana$ as not established. • Amo*icillin and clavulanic acid9 combination 3 A00 mg 1ana$ e$tract bid increased bacterial clearance from the lungs during acute attac#s of chronic bronchitis more than the use of the medications alone. • ,nsulin: =speculative> 1ana$ may have a hypoglycemic effect requiring insulin dosage to be ad"usted in diabetic patients. • Methamphetamine: prior 1ana$ administration reduced striatal dopaminergic depletion =animal> and AE0mg3#g3day for E2 days increased adrenal dopamine levels ith no change to :'K in hypothalamus, :' as increased, dopamine decreased. =animal> • Morphine: 1ana$ inhibits hyperactivity and postsynaptic dopamine receptor super sensitivity induced by morphine =animal>. • 1ana$ has been sho n to promote the blood&brain transmission of dl&phenylalanine. • 6arfarin: combination may reduce anticoagulant activity of arfarin =speculative case report>. +o ever, in vitro evidence demonstrates antiplatelet activity =pana$ynol, ginsenosides>. 2g3#d bid for E days produced no significant changes on oral arfarin pharmaco#inetics hen arfarin as given as a single dose or at a steady state for si$ days =animal>. Contraindications:"&7/ • Asthma, acute =speculative> • ,nfections, acute =speculative>, though 1ana$ is often used to prevent infection. • +emorrhage =speculative>, such as menorrhagia or e$cessive epista$is, due to platelet aggregation inhibition. • +ypertension9 6his supposed contraindication is based on one human case report of questionable quality. ,n a subsequent study, of 1ana$ in +6: should a decline in 2<&mean systolic pressure in 2F sub"ects after B ee#s use. )o*icity: ginseng abuse syndrome9 heat signs, nose bleeds, tremors, +6:, insomnia, impaired se$ual functionK mastalgia, increased vaginal bleeding
1616 1617

!hang, +/ et al =eds> )d!ances in 2hinese Medical Material Research , =5inagpore9 World 5cientific>K ACBE. !hang, +/ and But 11 Pharmacology and )pplications of 2hinese Materia Medica =5ingapore9 World 5cientific>K vol. A9 ACBF. 1618 !hen, P )bst 2hin Med, 3, ACBC9 CA. 1619 !hen, +/ and But 11, ibid1, ACBF. 1620 ;amamoto, / et al )rIneim9 orsch, 2H, ACHH9 AA. 1621 ;one(a#a / et al 7 Radiat Res, 2F, ACBE9<3F. 1622 /c:augton, . et al >nt 2lin ;ut Re!, C, ACBC932. 1623 Ava#ian '7 et al Planta Medica, E0, ACB<9AEA. 1624 !hen, P )bst 2hin Med, 3, ACBC9 CA. 1625 !hen, P )bst 2hin Med, 3, ACBC9 CA. 1626 5ingh 7?, et al Planta Medica E0, ACB<9<F2. 1627 ;un 6?, et al 2ancer Detect Pre!ent, F, ACB39EAE. 1628 5hibata 5 et al9 !hemistry and 1harmacology of 1ana$ in )arns orth, :4 et al, Economic and Medicinal Plant Research , 7ol. A, =.ondon9 Academic 1ress>, ACBE. 1629 )isel - )rIneim9 orsch, AE,ACFE9A<AH. 1630 Bhattacharya 5? and /itra 5? 7 Ethnopharmacol, 3<, ACCA9BH. 1631 !hang +/ and But 11 Pharmacology and )pplications of 2hinese Materia, 7ol. A, =5ingapore9 World 5cientific>9ACBF. 1632 !hen P )bst 2hin Med,3, ACBC9CA. 1633 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.2EH 1634 1opov ,/, et al )m 7 2hin Med, A, ACH39 2F3. 1635 ;amaoto /, et al )m 7 2hin Med, AA, ACB39CF.

1636 1637

.iu !P and Piao 1* 7 Ethnopharmacol, 3F, ACC292H. Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. A0B&A0C 1638 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p A0H&A0B

#arietaria officinalis. #2 diffusa
Common name: 1ellitory&of&the& all Ha!itat:"&75 =1. officinalis> :ative to 'urope

1a!iatae

Botanical description:AF<0 =1. officinalis> • )lo er and )ruit9 5mall, green, sessile flo ers gro in a$illary racemes and bloom throughout the summer. 6he bracteoles are free and shorter than the caly$. 6he filaments of the stamens are "oind and so elastic that hen they are touched before the flo er has opened, they uncoil from rolle&up position and distribute the pollen. 6he achaenes are blac#. • .eaves, 5tem, and 4oot9 1erennial, heavily branched, bushy, and leafy plant up to H0 cm high. ,t has reddish hard stem and narro petiolate, ovate&lanceolate or elliptical, long&acuminate leaves 2.E&E cm long. 6he leaf stal# is shorter than the leaf blade. 6he stem and the undersurface of the leaf ribs are pubescent ith short, soft hairs. 6he upper surface of the leaves is almost glabrous and the ribs sun#en. #arts used: Aerial parts Constituents AF<A • )lavonoids =#aempferol, quercetin, isorhamnetin> • glucoproteins QallergensR, • bitter compound Medicinal actions: diuretic, demulcent, anti&lithic,AF<2 #idney trophorestorative Current Medicinal Uses: • *enitorurinary !onditions9 • 1arietaria is the Msilybum of the #idneysM. Any inflammatory condition of the urinary system ould benefit from 1arietaria. ,t is indicated in edema secondary to renal dysfunction.. • %iuretic, demulcent, and la$ative. Used for a variety of #idney disorders, including urinary tract infections =U6,s>, pyelonephritis, renal pain, and #idney stones.AF<3 • 4espiratory !onditions9 !hronic coughs. AF<< • 6opical9 burns and ounds. AF<E Current +esearch +eview: 5earch of /edline revealed no human trials as of A3AE303 #harmacy: • ,nfusion9 A&2 tsp dried herb3cup boiling ater, infuse $ A0&AE min. 5ig A cup 6,% AF<F • 6incture =strength unspecified>9 2&< ml 6,% AF<H Drug interactions: • :o interactions are #no n to occur, and there is no #no n reason to e$pect a clinically significant interaction ith pellitory&of&the& all. AF<B Contraindications.)o*icity.4ide $ffects:
1639 1640

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p.EHB ,bid. 1641 4.!. Wren, Potter/s ;e: 2yclopedia of Botanical Drugs and Preparations , 1otter@s limited, 'ngland. ACBB. 1642 %avid +offman, The Holistic Herbal: ) Herbal 2elebrating the +holeness of 8ife, 3rd ed., 'lement, 5haftesburry, %orset, ACC0, p. 20< 1643 I/onograph9 1ellitory&of&the Wall,J :atural /edicine %atabase, April AC, 2002, chttp933 .naturaldatabase.com3monograph.aspamonodidOA02]hiliteOAY, April 2A, 2002. 1644 ,bid. 1645 ,bid.

1646 1647

+offman, p. 22A +offman, p. 22A 1648 I/onograph9 1ellitory&of&the Wall.J

#assiflora incarnata
Common name: 1assionflo er, /aypop Ha!itat: 5outh America, 'ast ,ndies, 5outheast United 5tates

#assifloraceae

Botanical description: A herbaceous climbing plant, gro ing up to C m in length, bearing ovate or cordate, palmately 3&lobed leaves. 6here are coiled a$illary tendrils. 6he flo ers have 3 bracts, a caly$ ith E sepals and a corolla ith E hite petals ith hite and purple filamentous appendages and E large stamens. #arts used: flo ering tops, leaves Constituents: • )lavonoids =up to 2.EG>9 in particular !&glycosylflavones, including among others isovite$in&2ii&glucoside, schaftoside, isoschaftoside, isoorientin, isoorientin&2ii&glucoside, vicenin&2, lucenin&2 ° coumarins=roots>9 umbelliferone, scopoletin • !yanogenic glycosides9 gynocardine =less than 0.AG>K /altolK +arman and +armoline al#aloidsK 7olatile oil =trace> #harmacology: )or many years, plant researchers believed that a group of harman al#aloids as the active constituents in 1assionflo er. 4ecent studies, ho ever, have pointed to the flavonoids in passion flo er as the primary constituents responsible for its rela$ing and anti&an$iety effects.2 'uropean pharmacopoeias typically recommend passion flo er products containing no less than 0.BG total flavonoids. Animal studies have sho n that 1assiflora e$tracts have spasmolytic activity comparable to that of papaverine =a smooth muscle rela$ant drug>.AF<C 1assiflora e$tract binds to ben(odia(epine and *ABA A]B receptors.AFE0 Medicinal actions: Anti&spasmodic, sedative, hypnotic, hypotensive, anodyne, anti&depressant, nervine rela$ant )raditional Medicinal Use: 5pecific ,ndications and Uses9 ,rritation of brain and nervous system ith atonyK sleeplessness from over or#, orry, or from febrile e$citement, and in the young and agedK neuralgic pains ith debilityK e$haustion from cerebral fullness, or from e$citementK convulsive movementsK infantile nervous irritationK nervous headacheK tetanusK hysteriaK oppressed breathingK cardiac palpitation from e$citement or shoc#.AFEA • *astrointestinal !onditions9 1assiflora has been used to chec# diarrhoea and dysentery. • :ervous !onditions9 6he effect of 1assiflora as observed to effect on the nervous system chiefly, finding a ide application in spasmodic disorders and as a rest&producing agent. /oderate doses ere used as an antispasmodic and hypnotic. According to ?ing, an atonic condition appeared to be the #eynote to its selection. 5cudder believed 1assiflora improved sympathetic function, improving the circulation and nutrition, and suggested its use Min torpidity of the liver ith hemorrhoids, and in congestion of ovaries and uterus.M 6he 'clectics considered 1assiflora best adapted to debility, rather than does not act so ell in sthenic conditions, although not contraindicated in such. =5thenic conditions are those of heightened activity or force>. 1assiflora as especially useful to allay restlessness and overcome a#efulness secondary to e$haustion, or the nervous e$citement of debility. 1assiflora as considered especially useful in the insomnia of infants and old people. ,t gives sleep to those ho are laboring under the effects of mental orry or from mental over or#. :ervous symptoms due to refle$ se$ual or menstrual disturbances, and the nervous irritability resulting from prolonged illness ere also indications for 1assiflora. 6he 'clectics employed it to allay the restlessness of typhoid fever. Although its action as observed to be slo , it as considered reliable. 1assiflora as also deemed a remedy for convulsive movements and spasm such as epilepsy, chorea, post&partum puerperal eclampsia =,7> and even for a small number of cases of tetanus. ?ing applied it in full doses in epilepsy during the prodromal arning of an approaching attac#. 1assiflora as also praised for its control over spastic conditions in childhood, regardless of cause. 5pasms, dependent upon meningeal inflammation, have been controlled ith it. ,t appears not to be contraindicated in any form of spasm. • 1ain !onditions9 1assiflora as also used as a remedy for pain, particularly of the neuralgic type. ,t as used to relieve neuralgic and spasmodic dysmenorrhea, rectal pain, cardiac pain, facial and other forms of neuralgia, many refle$ painful conditions incident to pregnancy and menopause, and other forms of pain. +eadache due to acute illness, nervousness, debility, or from cerebral congestion also indicated 1assiflora. ?ing noted that all such cases sho mar#ed atony of some part or function. • 1ulmonary !onditions9 When hooping&cough is associated ith convulsions, 1assiflora has given relief, and in hysteria ith spasmodic movements it is reputed equally successful.

• 6opical Applications9 6he aqueous e$tract has been lauded as an application to burns, hemorrhoids, ulcerating carcinoma, painful ulcers, chancres, chancroid and dental carries. Current Medicinal use: 1assiflora is ell indicated in states of nervous tension and an$iety presenting as restless agitation and e$haustion ith spasm. ,t has anti&spasmodic effects on smooth muscles ma#ing is especially useful for an$iety induced intestinal spasm =diarrhea>, vascular constriction =hypertension>, and bronchial constriction =asthmatic hee(ing>. ,t is also utili(ed in cardiovascular conditions ith a nervous component such as hypertension and palpitation. Also, botanical sedatives, in general, may be applied in some cases of inflammatory conditions. %$#& • Behavioral and 1sychological !onditions9 ,n a study of opiate addiction, a total of FE opiates addicts ere assigned randomly to treatment ith 1assiflora e$tract plus clonidine tablet or clonidine tablet plus placebo drop during a A<&day double&blind clinical trial. 6he fi$ed daily dose as F0 drops of 1assiflora e$tract and a ma$imum daily dose of 0.B mg of clonidine administered in three divided doses. Both protocols ere equally effective in treating the physical symptoms of ithdra al syndromes. +o ever, the 1assiflora plus clonidine group sho ed a significant superiority over clonidine alone in the management of mental symptoms. 6hese results suggested that 1assiflora e$tract may be an effective ad"uvant agent in the management of opiate ithdra al. AFE3 • *astrointestinal !onditions9 1assiflora can be utili(ed in gastrointestinal conditions ith a nervous component such as dyspepsia and gastroesophageal reflu$ disease. • :ervous !onditions9 6he use of 1assiflora is indicated in irregular sleep patterns, including those associated ith fatigue. ,t is especially useful for insomnia accompanied ith or due to e$cessive muscular tension and spasm. 1assiflora, along ith other sedative botanicals, can be utili(ed in eaning off conventional sedative medications. 1assiflora or#s best to ease both restlessness and e$haustion from over or# and an$iety. 1assiflora is a good herb for children and the elderly because it is so gentle. +o ever, if used chronically, it can e$ert mild to$ic effects due to the accumulation of al#aloids in the nerve and muscle tissue causing irritability of that tissue. A study as performed on 3F outpatients diagnosed ith generali(ed an$iety disorder =*A%>. 1atients ere allocated in a random fashion9 AB to the 1assiflora e$tract <E drops3day plus placebo tablet group, and AB to o$a(epam 30 mg3day plus placebo drops for a <& ee# trial. :o significant difference as observed bet een the t o protocols at the end of trial. 0n the other hand, significantly more problems relating to impairment of "ob performance ere encountered ith sub"ects on o$a(epam. 6he results suggest that 1assiflora e$tract is an effective drug for the management of generali(ed an$iety disorder, and the lo incidence of impairment of "ob performance ith 1assiflora e$tract compared to o$a(epam is an advantage. AFE< Weiss suggests that 1assiflora is unli#ely to be effective on its o n. 4ather, it is a good supportive herb. 6his is because 1assiflora acts very gently and slo ly, and thus, if used singly, ill not produce a dramatic effect. %$## 6he 'uropean literature involving 1assiflora recommends it primarily for anti&an$iety treatmentK in this conte$t, it is often combined ith 7alerian, lemon balm, and other herbs ith sedative properties. AFEF #harmacy: ,f 1assiflora is used long&term, a A&2 day vacation for every 2 ee#s of use should avoid this to$icity. ,nfusion9 A tsp. =appro$. 2 g> per cup aterK sig A cup B,%&6,% A9E 6inctureK sig A&3 ml 6,%K ee#ly ma$9 <0 ml Drug ,nteractions:"&%( • Anticoagulant medications9 !oumarins have been speculated to have anticoagulant potential, possibly having an additive effect ith arfarin and other anticoagulant medications. +o ever the coumarins umbelliferone and scopoletin occur in the roots and both have failed to cause such an effect. • Barbiturates9 1assiflora potentiates sleeping time induced by pentobarbital and he$obarbital. • Ben(odia(epenes9 Use of 1assiflora helps ith ithdra al from these drugs. Contraindications:"&%/ • %epression =empirical> due to sedative effects. • 1regnancy =speculative> due to the uterine stimulant properties of harmoline and harmine =animal studies> and the cyanogenic glycoside gynocardine. )o*icity: /ild nerve and muscle irritation ith long&term use. ?ing observed that small doses may occasionally provo#e emesisK some individuals appear to be very susceptible to this effect. AFEC
1649 1650

?arnig 6., ?ummer&)ustinioni *., +eydel B, ,ci1 Pharm1, ACB3, EA92FC. Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.AEB

1651 1652

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. AE<, AHE, 202, 20<, 232&< 1653 A#hond(adeh 5, 1assionflo er in the treatment of opiates ithdra al9 a double&blind randomi(ed controlled trial. - !lin 1harm 6her. 200A 0ctK2F=E>93FC&H3. 1654 A#hond(adeh 5, 1assionflo er in the treatment of generali(ed an$iety9 a pilot double&blind randomi(ed controlled trial ith o$a(epam. - !lin 1harm 6her. 200A 0ctK2F=E>93F3&H. 1655 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2BH 1656 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1657 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p AEB 1658 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A.p. AEB 1659 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

#ausinystalia yohim!e (Corynanthe yohim!e
Common name: ;ohimbe

+u!iaceae

Botanical description: 6he bar# occurs comes from a tree that is native to the !ameroon 4epublic in Africa. 6he bar# occurs in flat or slightly quilled pieces up to HE cm long and 2 cm thic#. 6he outer surface is grey&bro n, crac#ed and fissured and often covered ith lichen. 6he inner surface is reddish&bro n and striated. #arts used: Bar# Constituents: ,ndole al#aloids =yohimbine, alpha& and beta&yohimbane, pseudoyohimbine, coryantheine> #haramacolgy: ;ohimbine is an alpha&adrenergic bloc#er Q!lar#, -.4. et al., 5cience, 22E9B<HR and thus may increase libido and cause lipolysis in the trun#al region. Alpha&adrenergic bloc#ing agents interfere ith the transmission of stimuli through path ays that normally allo sympathetic nervous e$citatory stimulation. =;ohimbe, Aspidosperma> Medicinal actions: Aphrodisiac, .ipolytic agent

#harmacology: ;ohimbine is the constituent that is considered to be the most active constituent. ,t is structurally similar to reserpine, and its medicinal effects are some hat similar. ;ohimbine is an alpha&2 adrenergic bloc#er and is therefore considered a se$ual stimulant. ,n the penis, the α2 adrenoceptors are involved in non adrenergic3non cholinergic nerves by bloc#ing release of nitric o$ide release. /ost studies confirm this mechanism and effect although a fe studies fail to demonstrate this action. AFF0 ;ohimbe is Medicinal use: Pausinystalia yohimbe is utili(ed for t o primary purposes. 6he first is as a se$ual stimulant. ;ohimbine is an alpha&adrenergic bloc#ing agent. Alpha&adrenergic bloc#ing agents interfere ith the transmission of stimuli through path ays that normally allo sympathetic nervous e$citatory stimulation. ,n order for se$ual arousal to occur, parasympathetic innervation needs to be predominant. ,n men ith functional impotence =i.e. inability to obtain an erection>. ,n men, Pausinystalia yohimbe results in increased libido and the ability to obtain a penile erection. ,n omen, Pausinystalia yohimbe results in increased libido and increased vaginal lubrication. ,t is important not to use too much Pausinystalia yohimbe as it ill lead to general depression. 6he second clinical application of Pausinystalia yohimbe is as an ad"uvant in eight loss. ;ohimbine binds to alpha&2&adrenergic receptors found on the cell membranes of lipocytes, especially in the trun#al region. 6he binding of yohimbine to these receptors causes lipolysis. 6he fat reducing effect of Pausinystalia yohimbe is clinically significant and may be a helpful ad"uvant to a eight loss program especially during the plateaus of eight loss. #harmacy: .iquid e$tract9 2&< ml E mg ;ohimbine&+!l =best dosed at the end of the day>K over time increase to E mg 6,%.

Contraindications: ;ohimbe may be contraindicated in both hypo and hypertension. )o*icity.Contraindications: Avoid large and prolonged doses as9 antidiuresis, increased blood pressure, tachycardia, irritability, tremor, s eating, nausea, vomiting and depression may result. !ontraindicated in persons ith renal disorders, children, and pregnant omen.
1660

!lar# -6, et al ,cience, 22E9B<H.

#etroselinum crispum. #2 sativum(Apium petroselinum
/ills and Bone refer to the seed 1. crispum and refer to the herb A. petroselinum. Common name: 1arsley #arts Used9 .eaf, stem, seeds, root. $nergetics:"&&" Bitter, pungent, neutral, dry

Um!elliferaceae

Constituents:"&&0 • 5eeds9 volatile oil 2G&HG =apiol, myristicin, terpenes>, fi$ed oil =20G> • Whole plant9 flavonoids =apiin, furanocoumarins>, vitamins =vitamin !, vitamin ?>, minerals =calcium, magnesium, potassium, iron> #harmacology: • 6he mechanism of action of parsley seems to be mediated through an inhibition of the :a=X>&?=X> pump that ould lead to a reduction in :a=X> and ?=X> reabsorption leading thus to an osmotic ater flo into the lumen, and diuresis. AFF3 • 6he methanolic e$tract from the aerial parts of 1etroselinum crispum sho ed potent estrogenic activity in estrogen&sensitive breast cancer cell line, hich as equal to that of isoflavone glycosides from soybean. 6he estrogenic activities of these flavones are nearly equal to those of the isoflavones, daid(ein =0.FA micro/> and genistein =0.F0 micro/>. 6he methanolic e$tract of parsley, apiin, and apigenin restored the uterus eight in ovariectomi(ed mice hen orally administered for consecutive H days. AFF< Medicinal actions: %iuretic, Anti&inflammatory, 5pasmolytic )raditional Medicianal Uses: Current Medical Uses: Medicinal use: • *enitourinary !ondtions9 1arsley acts similarly to, but more strongly, than celery seed. .i#e celery, parsley seed contains volatile oil. ,t is also high in )e and 7it. !. ,t is used for ea# bladder ith incontinence, and combines ell ith E<uisteum spp1 for this purpose. 1arsley is also anti&inflammatory, being especially indicated in cystitis secondary to allergies. 1etroselinum is a strong renal stimulant and diuretic. 6he volatile oils and flavonoids stimulate the renal parenchyma thus initiate diuresis. ,t is indicated in nephritis, cystitis, urethritis. • *ynecological !onditions9 6he seeds are so highly concentrated in apiol they can be to$ic. Apiol e$erts spasmolytic and o$ytocic actions and parsley seeds can be used for dysmenorrhea and as an emmenagogue. 1arsley seed e$tracts can induce abortions and omen using it in large quantities have been #no n to suffer long&lasting nerve damage and paralysis, although these cases of paralysis may actually be due to contamination ith tricresyl phosphate. • /usculos#eletal !onditions9 1arsley is useful for edema associated ith arthritis. )ccording to the Textboo3 of ;atural Medicine:%$$# 1arsely, as a food, can provide phytoestrogens to the diet. )ccording to Mills and Bone:%$$$ • *enitourinary !ondtions9 1arsely increases the e$cretion of urinary urates. • *astrointestinal !onditions9 1arsley root is considered to have antispasmodic acitivity being indicated in nervous dyspepsia, colic and flatulence, gastritis and irritable bo el disease. 6hese indications are more appropriate in hot and febrile conditions. =*iven that the seed contains the volatile oil ith this property, it seems safe to e$trapolate this use to the seed as ell> • :ervous !onditions9 *iven the antispasmodic property, 1arsley can be utili(ed in general nervou, irritable and an$ious conditions. )ccording to +eiss:%$$4 • *enitourinary !ondtions9 1arsley seed is an e$cellent diuretic being indicated in cases here a strong stinulaus is necessary to encourage micturation. 6his effect is so strong that a case report discussed that anuria due to mercury poisoning as overcome ith one cup of the infusion. 1arsely root has diuretic properties, although much less than the seed and may be used as a supportive herb, hen a milder effect is desired. =1arsley root may also improve the taste as it tends to be s eet.> )ccording to Elling:ood:%$$(

•

*enitourinary !ondtions9 An infusion of parsley is indicated hen the specific gravity of the urine is high and the urination painful and irritating to the mucous membranes. ,t is useful in gonorrhea, stangury and great irritation ith heat or a scalding sensation on urination. ,t can be given during the inflammtory stage including cystitis and nephritis =contrary to other riters>. it has also been given for edema ith success. • *ynecological !onditions9 6he volatile oils are beneficial for amenorrhea and dysmenorrhea. • ,nflammatory !onditions9 1etroselinum ill control e$cessive night s eats follo ing protracted malaria. Medicinal uses :o human studies ere found. 6he *erman !ommission ' approves the use of 1arsley root and herb preparations for flushing out the urinary tract and for preventing and treating #idney gravel. #harmacy: )or the antispasmodic effect on the *, system, 1arsely =and other spasmodics for that matter> should be ta#en "ust prior to meals. A9E tincture9 A&3 ml 6,% 'at A32 cup fresh parsley 3 day A cup fresh "uice drun# throughout the day ,nfusion9 A&3 g 3 day QA tsp. O A.EgR 7olatile oil9 for amenorrhea E&F minims in a capsule, 3&< times daily for F&B days before the menstrual period. Contraindications: Apium should not be used during inflammed conditions of the #idney as the volatile oil can be irritating to the renal epithelium.AFFC *iven its vitamin ? content, consumption of large quantities may affect prothrombin bloc#ing anticoagulants. )o*icity: 6he essential oil of A. petroselinum has been used as an abortifacient although 'lling ood states that it has no abortive influence.AFH0AFHA 6he essential has been found to actually inhibit uterine contractions. 6hus, the abortifacient action has been ascribed to general poisoning or gastrointestinal irritation, hich is an uncertain and dangerous application. AFH2 !onsumption of the hole plant in sufficient quantities may have a photosensiti(ing effect due to the furanocoumarins, particularly hen B&metho$ypsoralen is concurrently administered.AFH3
1661 1662

+olmes, 1. 6he 'nergetics of Western +erbs, 2nd 'dition. 5no .otus 1ress, Boulder, ACC<. p. E33 Wren, 4.!., 1otter@s :e !yclopedia of Botanical %rugs and 1reperations, 1otter@s limited, 'ngland. ACBB. 1663 %iuretic effect and mechanism of action of parsley. - 'thnopharmacol. 2002 /arKHC=3>93E3&H. 1664 /edicinal foodstuffs. P7,,,. 1hytoestrogens from the aerial part of 1etroselinum crispum /,ll. =1arsley> and structures of FM&acetylapiin and a ne monoterpene glycoside, petroside. !hem 1harm Bull =6o#yo>. 2000 -ulK<B=H>9A03C&<<. 1665 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. A3C2 1666 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. AH2, 22< 1667 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 23F&H 1668 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. <32&3 1669 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. A0C 1670 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. A0C 1671 'lling ood, 1 <33 1672 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 30 1673 Brin#er, p. A<H

#eumus !oldo
Common name: Boldo Current +esearch +eview: • 9astroenterology: o 3ro<cecal intestinal transit:"&(:  %esign9 1lacebo&controlled clinical trial  1atients9 6 elve healthy volunteers  6herapy9 2.E g dry boldo e$tract during 2 successive periods of < days.  4esults9 0ro&cecal transit time as larger after dry boldo e$tract administration compared to placebo =AA2.E X3& AE.< and BH X3& AA.B min respectively, paired t p c 0.0E>. ,t as concluded that dry boldo e$tract prolongs oro cecal transit time, being a possible e$planation for its medicinal use.

#hyllanthus amarus or #2 niruri
Common @ame: Botanical Description: Ha!itat: #arts used9 .eaves, +erba Historical Use: 1hyllanthus is part of the Ayurvedic materia medica. Constituents9 • lignans =phyllanthine and hypophyllanthine> • al#aloids • bioflavonoids =quercetin> • repandusinic acid

$uphor!iaceace

#harmacology: 6he active constituent, repandusinic acid, has been sho n to have anti&viral properties in&vitro, inhibiting +,7 and +6.7&, replication and +,7 reverse transciptase activity.AFHE 1hyllanthus bloc#s %:A polymerase, the en(yme needed for the hepatitis B virus to reproduce. 6he species P1 urinaria and P1 niruri may or# better than P1 amarus.AFHF 1hyllanthus has been sho n to have mild hepatoprotective effects in in&vitro tests. A study using rats demonstrated a normali(ing effect on fatty deposition in the liver after alcohol ingestion. 1hyllanthus has also been sho n to inhibit angiotensin&converting en(yme. AFHH Medicinal actions: +epatoprotective, antiviral, hypoglycemic Medicinal use: 6he main indications for 1hyllanthus are viral infections of the liver, diabetes, and "aundice 2S viral hepatitis. 1hyllanthus combines ell ith 5ilybum. • !ardiovascular !onditions9 1atients ith hypertension given 1hyllanthus sho ed significant increases in 2< hour urinary volume.
AFHB

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'ndocrine !onditions9 1hyllanthus has glucose&lo ering effects and is a useful ad"unct in the treatment of diabetes. +epatobiliary !onditions9 1hyllanthus is a 5o. ,ndian herb used in the treatment of "aundice. ,t has been studied by Western investigators since the mid B0Ns. 1hyllanthus is effective at improving "aundice due to viral hepatitis. 5everal in&vitro studies have demonstrated inactivation of +BsAg by inhibiting %:A polymerase, hich is required by the hepatitis B virus for its replication. An in&vivo study on oodchuc#s confirmed this activity. +uman studies have both supported and refuted this claim. A study published in the .ancet used F00 mg3day of the leaf on carriers of hepatitis B virus. AFHC AfterAE&20 days, ECG of the treated sub"ects had lost +BsAg compared to <G of the placebo sub"ects. 6he +BsAg had not returned up to C mo. later. +o ever, this effect is not as great in people ho carry +BsAg and +BeAg hich is actually a better indicator of replicating virus. 6 o subsequent studies did not demonstrate this effect on +BsAg, hile one further study did. 6he variability in study results may stem from slightly different species being used, varying qualities of the herb and its preparation, and3or study design.

Current +esearch +eview: • ,nfectious diseases: o Hepatitis B: 5tudy A9AFB0  %esign9 4andomi(ed controlled clinical trial  1atients9 )ifty&five patients ith chronic viral hepatitis B.  6herapy9 1hyllanthus amarus compound =1A !o> $ 3 months W e$perimental, domestic recombinant human interferon alpha&Ab =,):&alpha Ab> $ 3 month W control.  4esults9 6he total effective rate in the 1hylanthus group as B3.3G, sho ing no significant difference from the control. 6he normali(ation rates of A.6, A3*, and 5B in the e$periment group ere H3.3G, B0.0G, and HB.2G respectively, hich ere significantly higher than that in the control. 6he negative conversion rates of +BeAg and +B7&%:A in the e$periment group ere <2.3G and <H.BG , sho ing no significant difference from the control. 6he conclusion of the study as that 1A !o has remar#able effect for chronic viral hepatitis B in recovery of liver function and inhibition of the replication of +B7.

•

5tudy 29AFBA  %esign9 4andomi(ed placebo&controlled clinical trial  1atients9 )ifty&seven patients ith acute viral hepatitis B.  6herapy9 1hyllanthus amarus plant capsule, 300 mg3cap, 3 caps 6,%. 1lacebo& antiacid po der.  4esults9 1hyllanthus amarus po ders did not significantly reduce the duration of "aundice in persons ith virus B hepatitis. 5tudy 39AFB2  %esign9 !ontrolled clinical trial.  1atients9 0ne hundred t enty three patients ith chronic hepatitis B.  6herapy9 A> 1hyllanthus amarus =.> e$tract from 5.1. 6hyagara"an, /adras, ,ndiaK 2> 1hyllanthus niruri =.> e$tract from +ainan 1rovince in !hina, or 3> 1hyllanthus urinaria =.> e$tract from +enan 1rovince. !ontrol group received no herbal therapy.  4esults9 6he patients receiving 1hyllanthus urinaria =.> ere both more li#ely to lose detectable hepatitis B e&antigen from their serum and more li#ely to seroconvert hepatitis B e&antibody status from negative to positive than ere patients given either of the other t o preparations. :o patient changed status ith respect to hepatitis B s&antigen. 5tudy <9AFB3  %esign9 !linical trial  1atients9 6hirty asymptomatic carriers of hepatitis B surface antigen =+BsAg>  6herapy9 1hyllanthus amarus, 2E0&E00 mg 6,% $ <&B ee#s  4esults9 :one of the 30 sub"ects cleared +BsAg. !onclusion of the study9 1hyllanthus amarus is not effective in clearing +BsAg in asymptomatic carriers of the antigen. 5tudy E9AFB<  %esign9 4andomi(ed placebo&controlled clinical trial  1atients9 5i$ty&five adult asymptomatic chronic carriers of hepatitis B virus  6herapy9 5tage A9 1hyllanthus amarus, F00 mg qd $ 30 days W e$perimental. 5tage 29 1. amarus $ 30 days more and 1. amarus A,200 mg qd $ 30 days to placebo recipients in stage A.  4esults9 5tage A9 the conversion rate of +BsAg as FG in the study group at day 30. 5tage 29 the conversion as observed in A =EG> in the higher dose group. 6he results indicated that 1hyllanthus amarus, hole plant e$cept root, gro n in the central part of 6hailand, given at the studied dosage and duration, had a very minimal effect on eradication of +BsAg from 6hai adult asymptomatic chronic carriers. 5tudy FAFBE9  %esign9 !linical trial  1atients9 +epatitis B virus carriers  6herapy9 1. amarus $ A month  4esults9 F0G of the carriers lost +B7 during the observation period 5tudy H9AFBF  %esign9 1lacebo&controlled clinical trial  1atients9 5i$ty patients, carriers of hepatitis B.  6herapy9 1hyllanthus amarus $ 30 days  4esults9 6 enty&t o of 3H =ECG> treated patients had lost hepatitis B surface antigen hen tested AE&20 days after the end of the treatment compared ith only A323 =<G> of placebo&treated controls. 5ome sub"ects have been follo ed for up to C months. ,n no case has the surface antigen returned. Cardiology: o Hypertension:"&/(  %esign9  1atients9 :ine mild hypertensive patients =four of them also suffering from %/>  6herapy9 1. amarus $ A0 days.  4esults9 5ignificant increase in 2< hr urine volume, urine and serum :a levels as observed. A significant reduction in systolic blood pressure in non&diabetic hypertensives and female sub"ects as noted. Blood glucose as also significantly reduced in the treated group. 6incture A92K sig 0.3&2 ml 6,% =higher end of dosage scale for acute states>

#harmacy9

Contraindications: According to Brin#er, 1hyllanthus niruri has a hypoglycemic effect. AFBB )o*icity: :o information is currently available

#hytolacca decandra I#2 americanaJ
Common name: 1o#e, po#e eed, po#e root Ha!itat9 :orth America, prefers M aste landsM

#hytolaccaeae

Botanical description9 A perennial plant ith a large succulent hite root, hich gro s a stem to a height of E&B ft. 6he stem is A in. in diameter, smooth, green hen young and reddish&green hen mature. ,t is succulent and interrupted ith half&circular shelves of pith. .eaves are alternate, petiolate, oblong, <&F in., smooth, thic# and "uicy. 6he flo ers occur opposite the leaves in racemes, <&F in. long ith 20 or more on each raceme. 6he caly$ consists of E or more hite sepals. 6he fruit is a flattened berry ith ten furro s and ten seeds, dar# purple hen ripe in the fall. #arts used: 4oot =medicinal>, ;oung shoot =food>, )ruit =cathartic, irritating> Constituents: Al#aloids =phytolaccin, phytolaccanin>, 5apogenin =phytolaccagenin>, phytolaccic acid, resins, tannins ,n young shoot only9 beta&carotene, )e, 7it. !, !a Medicinal actions: rela$ant alterative, antirheumatic, mild anodyne, emetic, purgative, fungicide, parasiticide, lymphagogue )raditional Medicinal Use: 5pecific ,ndications and Uses9 1allid mucous membranes ith ulcerationK sore mouth ith small blisters on tongue and mucous membrane of chee#sK sore lips, blanched, ith separation of the epidermisK hard, painful, enlarged glandsK mastitisK orchitisK parotitisK aphthaeK soreness of mammary glands, ith impaired respirationK faucial, tonsillar, or pharyngeal ulcerationK pallid sore throat, ith cough or respiratory difficultyK secretions of mouth give a hite gla(e to surface of mouth, especially in childrenK hite pultaceous sloughs at corners of mouth or in the chee#K and diphtheritic deposits. AFBC ?ing observed that 1hytolacca acts upon the s#in and glandular structures, especially those of the buccal cavity, throat and reproductive system and very mar#edly upon the mammary glands. ,t further acts upon the fibrous and serous tissues, and mucous membranes of the digestive and urinary tracts. ,t is also one of our most useful remedies in asthenic hyperemia of the uterus, spleen, liver, and other organs. 6he drug is principally eliminated by the #idneys. !oo# described the berries of this plant as rela$ant ith a slo action. Although both the 'clectic and 1hysiomedical traditions used 1hytolacca, the 'clectic array of applications ere ider in scope and included the root, leaves and berries hereas the 1hysiomedicalists only applied the berry. • %ermatologic !onditions9 ?ing observed that indolent action of the s#in calls for it hen associated ith vitiated blood here the s#in maybe inflamed, but does not itch because there is not enough activity. ,t as often indicated in chronic ec(ema, syphilitic eruptions, psoriasis, tinea capitis, favus, and varicose and other ulcers of the leg. +e also noted that 1hytolacca is valuable in the treatment of scabies. • *astrointestinal !onditions9 ?ing used 1hytolacca for ulceration of the mucous crypts of the stomach and of 1eyerNs patches. +e also described a strong decoction of the leaves as being of much benefit in hemorrhoids if in"ected into the rectum 2 or 3 times a day, and a fomentation of the leaves applied to the hemorrhoids. • *enitourinary !onditions: 6he 'clectics have used 1hytolacca in gonorrhea, copious enuresis, albuminuria, particularly if accompanied by edema. • *ynecological !onditions9 According to ?ing, no other remedy equals 1hytolacca in acute mastitis. ,f employed early it prevents suppuration, yet acts #indly even hen the abscess has to be drained, here diluted specific 1hytolacca may be in"ected into the cavity. 6he remedy should be administered internally, alternated ith specific Aconite. .ocally, specific 1hytolacca and glycerin or the po dered root ith ater as applied hen suppuration had not yet begun. ?ing also observed that 1hytolacca that ovaritis, sore nipples and mammary tenderness, and sensitiveness of the breasts during the menstrual period call for 1hytolacca. ,nvolution of the uterus, uterine and vaginal leucorrhoea, and some cases of membranous dysmenorrhea are cured by this agent. • ,mmune !onditions9 ?ing considered 1hytolacca a po erful alternative for some forms of dyscrasia. • .ymphatic !onditions9 !oo# noted that the primary po er of the berries is e$pended on glandular structures, mildly and persistently securing an improved flo of saliva, urine and perspiration as ell as a freer action of the bo els. 6hey ma#e a valuable agent in glandular enlargements, especially those connected ith a chaffy s#in and costiveness. ,n diseases of the glandular structures, the 'clectics considered 1hytolacca and ,ris as their best components. Unli#e iris, though, 1hytolacca is best suited to hard, lymphatic enlargements and not for suppurative conditions of the glands. 1arotitis is usually cured ith 1hytolacca and aconite. /etastasis of mumps to the testes, as ell as orchitis, from other causes, indicate this drug. .ymphoma has been cured by it. • /usculos#eletal !onditions9 ,n chronic and sub&acute rheumatism, !oo# stated that fe agents e$ert so valuable and reliable a po er. in those forms of rheumatism hich affect the synovial and ligamentous membranes, the muscular sheaths, and other serous tissues.

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0phthalmological !onditions9 ?ing observed that 1hytolacca relieves con"unctival inflammation and gonorrhoeal and syphilitic sore eyes. ,n granular con"unctivitis, he used 1hytolacca personally by bathing his eyes daily ith a decoction of the root and applying it to the affected con"unctiva by means of a camelNs hair pencil, at the same time administering the tincture of the recent root internally. 1ulmonary !onditions9 According to ?ing, ,n diseases of the mouth and throat it as highly esteemed and as useful in acute and chronic mucous affections, as in tracheitis, laryngitis, influen(a, catarrh, and especially in those affections here there is a tendency to the formation of false membrane, as in diphtheria. 6he conditions for hich ?ing specifically indicated 1hytolacca had a pallid, some hat leaden&colored tongue, ith little coating that as slic# and glutinous, if covered at all. 6he mucous membranes presented ith hitish erosions, or vesicular patches. With these indications he employed 1hytolacca in tonsillitis, follicular pharyngitis, stomatitis, aphthae, nursing sore mouth, or ordinary sore mouth, and syphilitic faucial ulcerations, ta#en internally and used locally as a gargle. +e also found it beneficial in difficult respiration produced by bronchocele. !ombined ith Baptisia, he used it as a local ash all forms of nasal catarrh. 6opical Applications9 6he 'clectics roasted the root in hot ashes until soft, and then mashed and applied it as a poultice in abscesses and tumors of various #inds. 6hey also use the bruised leaves, applied locally, in indolent ulcers.

Current Medicinal Use: 1hytolacca is softening and dissolving in its actions. ,t has a specific action on the lymphatic system decreasing inflammation and increasing lymphatic drainage. ,t is most indicated in cases of hard lymph nodes ith pale mucous membranes. 1hytolacca acts most specifically on the head, nec# and breast lymphatics. 1hytolacca stimulates and clears =drains> the lymph system. )or this purpose, 1hytolacca combines ell ith !ommiphora, 'chinacea, *allium, and ,ris. • 'ndocrine !onditions9 1hytolacca is also helpful for goiterous thyroid glands and hypothyroid in general. 1hytolacca increases circulation through the thyroid and improves lymphatic flo through the thyroid. • *enitourinary !onditions9 1hytolacca is a great treatment for cystic #idneys. • *ynecological !onditions9 1hytolacca affects glandular tissue in general =ovaries, testes, mammary, thyroid, etc.> by increasing their secretions. 1hytolacca is much indicated in mastitis, sore nipples, and cystic breast tissue. ,t can be applied topically and3or ta#en internally. )or mastitis, A0 drops of 1hytolacca should be ta#en every t o hours for up to AB hours and applications of dried 1hytolacca root and potato =grated ra potato> and glycerin applied often. 6he fomentation helps to bring the inflammatory e$udate to the s#in. • ,nfectious !onditions9 1hytolacca is useful in inflammations of the upper respiratory tract =nasal, pharyn$, laryn$>. ,t is particularly good in acute inflammation, i.e. mumps =internally and e$ternally>. ,nternally, 1hytolacca mi$ed ith *alium =another lymphagogue> and anti& virals i.e. Baptisia is good in cases of mumps. )or the same condition, 1hytolacca =A32 o(> can be simmered ith 7erbascum =anti& inflammatory>=Ao(>, apple cider vinegar =A pint>, ater =A32 pint>, .obelia =A32 o(>, for E&A0 min. A32 tsp. capsicum is then added. 6his is applied as a hot fomentation. A similar fomentation, or "ust combining 1hytolacca ith Achillea and apple cider vinegar can be used for tonsillitis. • 6opical Applications9 1hytolacca is good added to poultices for scabies, tinnea infection, and acne. P1 decandra contains many ribosome&inhibiting proteins =4,1s>. 4,1s are anti&viral as they can enter virally&infected cells and inhibit viral replication. 1hytolacca increases catabolic aste removal, and for this reason, 1hytolacca is often added to alterative formulas. 1hytolacca, .obelia, and 7erbena are a good combination for acne as a result of poor s#in elimination. 1hytolacca can be used in formulas for ec(ema and psoriasis for the same reason. 1hytolacca can be used for chronic rheumatic diseases here there is s#eletal congestion. 1hytolacca combined ith !ommiphora and Baptisia ma#es a good mouth ash for s ollen tongue, can#er sores and sore gums. Current +esearch +eview: • $@): o Acute tonsillitis:"&58  %esign9 !linical trial  1atients9 )orty&eight patients ith symptoms of acute tonsillitis, F&H3 yo.  6herapy9 .iquid or tablet formulation of herbal compound of 1hytolacca, *ua"acum, and !apsicum.  4esults9 Aore than half of the patients reported mar-ed alleviation of the principal symptom, moderate or severe difficulty in s,allo,ing, ,ithin the first ! days of treatment. .omparable improvements occurred in other outcome measures, including earache, headache, and fatigue. #harmacy9 !oo# noted that the rela$ing quality of 1hytolacca berries is so great, that it is usually best to combine them ith a moderate quantity of such stimulants as /enispermum or 5tillingia %ecoction of fresh root9 A tsp.3cup aterK A cup 6,% 1o dered root9 0.3 g 6,% 6incture A9A0 <EG 't0+K sig 0.2&0.F ml 6,% QA0ml3 ee# O /APR 1oultice of fresh root or herba Q!aution9 application of fresh root or herba can cause erythema and blisteringR Contraindications: 1hytolacca is contraindicated during pregnancy and nursing.

)o*icity: 1hytolacca, particularly the al#aloid phytolaccin, can be to$ic. ,t affects the medulla in the brain causing paralysis, bradycardia, decreased respiration, and decreased s#eletal muscle coordination. 6he al#aloids can build up in the body and be at potentially to$ic levels for A&2 ee#s. 6herefore, if any to$ic effects are noticed, stop the use of this herb immediately. 6his al#aloid is eliminated through the #idneys, therefore someone ith #idney disease should not use 1hytolacca. 6his plant has mitogenic action and may cause blood cell abnormalities. 6he roots and seed are the most to$ic but it has been recorded that the young shoots and leaves have to$ic effects. 6o$ic effects include9 vomiting, diarrhea, nausea, stomach cramps, di((iness, hypotension, decreased respiration, and headaches. ?ing noted that hen applied to the s#in, either in the form of "uice, strong decoction, or poultice of the root, it produces an erythematous, sometimes pustular, eruption. 6he po dered root hen inhaled is very irritating to the respiratory passages, and often produces a severe cory(a, ith headache and prostration, pain in chest, bac#, and abdomen, con"unctival in"ection and ocular irritation, and occasionally causes violent emeto&catharsis.
1689 1690

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 4au '. 6reatment of acute tonsillitis ith a fi$ed&combination herbal preparation. )d! Ther 2000KAH=<>9ACH&203.

#icorrhi;a kurroa
Common name: Ha!itat: Botanical description small, perennial herb that gro s in the alpine +imalayas at 3000&E000 m #art used9 4oot

4crophulariaceae

Historical Use: 1icorrhi(a is a traditional Ayurvedic herb that is used as a la$ative, choleretic, galactagogue, bitter tonic, febrifuge, and for the treatment of asthma and poisonous bites and stings. /uch research has been done on the root, confirming its historical uses. Constituents9 • ,ridoid glycosides =picrosides and #ut#oside> • cucurbitacin glycosides #harmacology: 0f the constituents in 1icorrhi(a, the glycosides picroside ,, #ut#oside, androsin and apocynin have received most of the research attention. 6hey have been sho n in animal studies to be anti&allergic and to decrease arthritis. AFCA

•
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Antio$idant9 A tincture of 1icorrhi(a protected rats against o$idation in the liver, AFC2 suggesting 1icorrhi(a has antio$idant properties. 1icorrhi(a can protect animals from damage by several potent liver to$ins, offering protection as good as or better than silymarin.AFC3 Anti&inflammatory9 1icorrhi(a has general anti&inflammatory activity. 6his effect is mediated through increased sensitivity of B& adrenergic receptors and functional impairment of pro&inflammatory cells such as neutrophils, macrophages and mast cells. 6his latter effect is accomplished by influencing the membrane&lin#ed activation events in inflammatory cells. ,mmunomodulation9 1icorrhi(a , more specifically one of its constituents, apocynin, reduces neutrophil o$idative burst. AFC< 0ther neutrophil functions such as chemota$is, phagocytosis, and intracellular bacteriocidal activity are unaffected. Also unaffected are humoral and cellular immunity. 6his type of immune modulation is indicated in conditions such as rheumatoid arthritis, and indeed, a study utili(ing 0.02< mg3#g of apocynin demonstrates significant reduction in "oint s elling and to rebound flare&up of "oint s elling after treatment discontinuance.AFCE 6he immunostimulatory properties of 1icorrhi(a include enhanced 6&cell, B&cell, and phagocytic function. AFCF After oral administration, there is about a A0&fold increase in antibody production and about a HEG increase in activated lymphocytes. %elayed hypersensitivity is increased by 200G after an oral dose. AFCH /acrophage migration and phagocytic activity increase after oral ingestion. 1latelet inhibition9 Apocynin has been sho n to inhibit thrombo$ane synthetase and platelet&activating factor, thus inhibiting arachidonic acid&induced platelet aggregation. AFCB

Medicinal actions: +epatoprotection, choleretic, anti&asthmatic, anti&inflammatory, immunostimulatory Medicinal use: ,n summation, 1icorrhi(a is useful in the treatment of acute and chronic infections, ea#ened immunity, to$ic liver damage, liver infections, autoimmune disease, asthma =esp. vitiligo and rheumatoid arthritis>, and fevers of un#no n origin or 2S infection. 1icorrhi(a combines ell ith 5ilybum and 'chinacea. • %ermatological !onditions9 1reliminary research ith use of 1icorrhi(a for treatment vitiligo in combination ith metho$salen and sun e$posure found that it as helpful compared to using metho$salen and sun e$posure alone. AFCC • *astrointestinal !onditions9 1icorrhi(a is considered a good bitter herb good for improving digestion. • +epatobiliary !onditions9 ,t is hepatoprotective comparable to, and, in some cases, superior to, 5ilybum marianum in many animal studies.AH00, AH0A, AH02,AH03 1icorrhi(a e$erts its hepatoprotective activity by restoring en(yme activity after to$ic damage, scavenging free radicals =thus reducing lipid pero$idation>, and stimulating nucleic acid and protein synthesis. AH0<, AH0E 6hese actions are due to the iridoid glycosides and other as yet unidentified compounds. 1icorrhi(a also is effective against the complement&mediated liver damage 2S viral hepatitis =esp. +ep. B> leading to faster recovery. AH0F, AH0H 1icorrhi(a e$erts choleretic activity mar#ed by an increase in bile flo , and bile salt and bile acid output.AH0B 6his, in turn, causes a systemic lipid&lo ering effect. • ,mmune !onditions9 1icorrhi(a, given orally, has a mast cell stabili(ing effect throughout the body, and especially in the lungs. When compared ith aerosol doses of disodium cromoglycate, oral 1icorrhi(a resulted in greater mast cell stabili(ation and reduction in allergic reaction.AH0C 1icorrhi(a has been sho n to alter the mast cell membranes leading to their stabili(ation. ,n spite of its immune&stimulating activity, 1icorrhi(a has been sho n to be effective against a variety of autoimmune conditions such as vitiligo, psoriasis, rheumatoid arthritis, an#ylosing spondylitis. • 1ulmonary!onditions9 1icorrhi(a has been studied in the treatment of asthma AHA0, AHAA +o ever, these are

preliminary reports only and a follo &up double&blind study did not confirm these earlier studies. AHA2 1icorrhi(a also enhances the bronchodilating effects of sympathicomimetic amines. Current +esearch +eview: • Dermatology: o -itiligo: AHA3 Abstract is unavailable from /edline, AA3AC302. • ,nfectious diseases: o -iral hepatitis: AHA<  %esign9 '$perimental and randomi(ed double&blind placebo&controlled clinical trial  1atients9 !linical trial part9 6hirty three patients ith acute viral hepatitis, +BsAg negative  6herapy9 1icorrhi(a #urroa root po der, 3HE mg 6,% $ 2 ee#s  4esults9 %ifference in values of bilirubin, 5*06 and 5*16 as significant bet een placebo and 1# groups. 6he time in days required for total serum bilirubin to drop to average value of 2.E mgG as HE.C days in placebo as against 2H.<< days in 1# group. 6he present study has sho n a biological plausability of efficacy of 1# as supported by clinical trial in viral hepatitis, hepatoprotection in animal model and an approach for standardi(ing e$tracts based on picroside content. • #ulmonology: o Asthma9  5tudy A9AHAE Abstract is unavailable from /edline, AA3AC302  5tudy 29AHAF Abstract is unavailable from /edline, AA3AC302. #harmacy9 6he iridoid glycosides in 1icorrhi(a are best e$tracted in ethanol, but the root is so bitter, compliance may be lo . 6incture A92 K sig A&< ml3day !apsule of po dered root <00&AE00 mg3day, up to 3.Eg for the treatment of fevers AHAH

1691

6 +art BA, 5imons -/, ?naan&5han(er 5, et al. Antiarthritic activity of the ne ly developed neutrophil o$idative burst antagonist apocynin. ree Rad Biol Med ACC0KC9A2HW3A. 1692 Anandan 4, %eva#i 6. +epatoprotective effect of PicrorrhiIa QsicR 3urroa on tissue defense system in %&galactosamine&induced hepatitis in rats. itoterapia ACCCKH09E<WH. 1693 )loersheim *., Bieri A, ?oenig 4, 1letscher A. 1rotection against )mantia phalloides by the iridoid glycoside mi$ture of PicrorhiIa 3urroa =#ut#in>. )gents )ctions ACC0K2C93BFWH. 1694 5imons, -./. et al, )ree 4ad Biol and /ed, B, ACC092EA 1695 +art, BA et al, )ree 4adical Biol, /ed C, ACC09A2H 1696 Atal, !.?. et al, - 'thnopharmacol, AB, ACBF9 A33 1697 1uri, A. et al, 1lanta /ed, EB, ACC29E2B 1698 %orsch W, 5tuppner +, Wagner +, et al. Antiasthmatic effects of PicrorhiIa 3urroa9 Androsin prevents allergen& and 1A)&induced bronchial obstruction in guinea pigs. >nt )rch )llergy )ppl >mmunol ACCAKCE9A2BW33. 1699 Bedi ?., 8utshi U, !hopra !., Amla 7. PicrorhiIa 3urroa, an Ayurvedic herb, may potentiate photochemotherapy in vitiligo. 7 Ethnopharmacol ACBCK2H93<HWE2. 1700 1andey, 7.:. and !haturvedi, *.:., ,nd - /ed 4es, EH, ACFC9E03 1701 Ansari, 4.A. et al, ,nd - /ed 4es, BH, ACBB9<0A 1702 Ansari, 4.A. et al, - 'thnopharmacol, 3<, ACCA9FA 1703 5ingh, 7 et al, ind - '$p Biol, 30, ACC2, FB 1704 /ogre, ?. et al, ,nd - 1harmac, A3, ACBA 1705 !hander, 4. et al, Biochem 1harm, <<, ACC29AB0 1706 7aidya, A.*. et al, Ass 1hys ,nd !onf Abstracts, ACBA 1707 !haturvedi *:, 5ingh 4+. -aundice of infectious hepatitis and its treatment ith an indigenous drug, PicrorhiIa 3urrooa QsicR. 7 Res >nd Med ACFFKA9AWA3. 1708 5aras at, B et al, ,nd - Biochem Biophys, 2C, ACC293AF 1709 /aha"ani, 5.5. and ?ul#arni, 4.%.,nt Archs Allergy Appl ,mmun, E3, ACHH9A3H 1710 4a"aram %. A preliminary clinical trial of PicrorrhiIa 3urroa in bronchial asthma. >ndian 7 Pharmacol ACHEKH9CEWF. 1711 5han B?, ?amat 54, 5heth U?. 1reliminary report of use of PicrorrhiIa 3urroa root in bronchial asthma. 7 Postgrad Med ACHHK239AABW20. 1712 %oshi 7B, 5hetye 7/, /ahashur AA, ?amat 54. PicrorrhiIa 3urroa in bronchial asthma. 7 Postgrad Med ACB3K2C9BCWCE 1713 Bedi ?., 8utshi U, !hopra !., et al. 1icrorhi(a #urroa, an ayurvedic herb, may potentiated photochmotherapy in vitiligo. 7 Ethonopharmacol ACBCK2H=3>93<H&E2. 1714 7aidya AB, Antar#ar %5, %oshi -!, et al. 1icrorhi(a #urroa =?uta#i> 4oyle e$ Benth as a hepatoprotective agent W e$perimental and clinical studies. 7 Postgrad Med ACCFK<2=2>9A0E&B. 1715 %oshi 7B, 5hetye 7/, /ahashur AA, et al. 1icrorrhi(a #urroa in bronchial asthma. 7 Postgrad Med ACB3K2C=2>9BC&CE. 1716 5hah B?, ?amat 54, 5heth U?. 1reliminary report of use of 1icrorrhi(a ?urroa root in bronchial asthma. 7 Postgrad Med ACHHK23=3>9AAB&20. ";"; ?apoor, ..%., !4! +andboo# of Ayurvedic /edicinal 1lants, !4! 1ress, Boca 4aton, )., ACC0

#impinella anisum
Common name: Aniseed

Um!elliferae

Ha!itat: 0rigin of the plant is un#no n, but it probably came from the :ear 'ast. 6oday, it is cultivated mainly in 5outhern 'urope, 6ur#ey, central Asia, ,ndia, !hina, -apan, !entral and 5outh America. AHAB Botanical description9AHAC • )lo er and )ruit9 6he inflorescences are medium&si(ed umbels ith about H&AE scattered pubescent rays. 6here is usually no involucre, but sometimes there is a single bract. 6here are barely any sepals. 6he petals are hite, about AE mm long, and have a ciliate margin. 6hey have small bristles on the outside and have a long indented tip. 6he fruit is do ny, ovate to oblong and flattened at the sides. • .eaves, 5tem, and 4oot9 6he plant is an annual herb T0.E m high, hich is do ny all over. 6he root is thin and fusiform, and the stem is erect, round, frooved and branched above. 6he lo er leaves are petiolate, orbicular&reniform, entire and coarsely dentate to lobed. 6he middle leaves are orbicular and 3&lobed or 3&segmented ith ovate or obovate segments. 6he upper leaves are short&petioled to sessile ith narro sheaths, they are pinnatisect ith narro tips. #arts used9 %ried fruit Constituents: volatile oil =A&<G>, coumarins, flavonoid glycosides, phenylpropanoids, lipids, fatty acids, sterols, proteins, carbohydrates. #harmacology: • Aniseed is mildly estrogenic, probably due to dianethole and photoanethole. AH20 Medicinal actions: '$pectorant, anti&spasmodic, carminative, anti&microbial, aromatic, galactogogue )raditional Medicinal Uses: Current Medicinal Uses: • *astroenterology9 6he oil of aniseed one of the s eetest volatile oils. ,t is a true rela$ant and has carminative and calming effects in children and adults. ,t is a very reliable carminative and can be administered ith cathartics and other bitter tasting herbs to mas# the taste. 0ne or t o drops can be safely given internally to children to allay nausea and stomach pain. • 4espiratory 5ystem !onditions9 Aniseed is also an e$pectorant and anti&spasmodic. ,t is most indicated hen there is persistent, irritable coughing. 1impinella stimulates cilial function =in&vitro>, AH2A aiding its e$pectorating action. • *ynecology9 Aniseed is mildly estrogenic. • %ermatology9 '$ternally, aniseed can be used to control lice and scabies =especially if combined ith lavender oil>. #harmacy9 • ,nfusion9 A heaping tsp coarsely po dered herb3cup ater. AH22 • .iquid e$tract9 A93 dry plant liquid e$tract, sig A0&<0 gtts 2%&2,% in little ater. AH23 Contraindications: )o*icity.4ide $ffects:
1718 1719

PDR for Herbal Medicines, /edical 'conomics !ompany, /ontvale, :e -ersey, ACCB, p. A03F. ,bid. 1720 /. Albert 1uleo, 71 Ethnopharmacol1, ACB0, 7ol. 2, :. <, p. 33H. 1721 W. /ueller&.immroth and +. +. )roenlich, ortschr1 Med1, ACB0, 7ol. CB, :. 3, p.CE 1722 5harol 6ilgner, Herbal Medicine rom the Heart of the Earth, Wise Acres 1ress, ,nc., !res ell, 04, ACCC, p. 3< 1723 ,bid

#iper methysticum
Common name: ?ava&#ava

#iperaceae

Ha!itat: 1olynesia, 5and ich ,slands, 5outh 5ea ,slands. *ro s best up to A000 feet above sea level in cool, moist highlands or et forests. Botanical description: A perennial shrub coarsely branching, slightly succulent. 6he shrub gro s to several feet ith cordate leaves, acuminate and short a$illary spi#es of flo ers. 6he stem is dichotomous and spotted. 6he rhi(ome is hitish or grey&bro n roughly edge&shaped fragments. #arts used: 4hi(ome Historical uses: 6he natives of the 5outh 1acific ,slands here #ava&#ava gro s have long used #ava&#ava ceremoniously as a social lubricant. A fermented liquor is prepared from the rhi(ome. Alternatively, the root is che ed to mi$ ith saliva =the saliva brea#s do n the starch in the root and facilitates the suspension of the resin> and drun# ith ater or coconut "uice. 6he first effect is a numbing and astringent effect in the mouth. 6his is follo ed by a rela$ed, sociable state here fatigue and an$iety are lessened. ?ava&#ava has reported aphrodisiac qualities, and used ceremoniously in a group ill a a#en arm feelings to ards the participants. 'ventually a deep restful sleep ensues from hich the user a a#ens the ne$t morning refreshed and ithout a hangover. '$cessive continual use can cause inflammation of the body and eyes resulting in leprous ulcers ith a scaling dermatitis. Also, although non&addictive, e$cessive consumption can lead to di((ines and stupefaction. Constituents: root9 resinous #ava lactones, also called #ava alpha&pyrones =E.EG&B.3G>, mainly consisting of #avain, dihydro#avain, and methysticin. Medicinal actions: sedative3hypnotic, muscle rela$ant, anticonvulsant, anesthetic, analgesic, antifungal, spasmolytic, anti&depressant Medicinal use: • :ervous !onditions9 6he primary effect of #ava&#ava ingestion is stimulation follo ed by sedation of the !:5. 5mall doses produce euphoric ell&being, hile large doses or frequently repeated small doses produce e$treme rela$ation, lethargy and eventually induce sleep. 6he effects of #ava&#ava may not be noticed until after it has been used several times. 6hese sedative and hypnotic effects are best secured hen the total e$tract of the rhi(ome as used rather than any of the isolated #ava lactones.AH2< 5everal studies have demonstrated that the #ava lactones produce sedation and ''* changes similiar to sedative drugs. ,t appears that the limbic structures of the brain, especially the amygdalar comple$ and reticular formation, are the main areas affected by #avain and more e$tensively by #ava e$tract. Acting on these centers induces sleep ithout sedation =sleep hangover>. ?ava does not act similiarly to ben(odia(epines or tricyclic antidepressants since, unli#e the latter t o pharmaceuticals, #ava e$tract does not interact ith *ABA or ben(odia(epine binding sites in the brain. AH2E,AH2F ,n patients ith an$iety, administration of #ava e$tract can improve vigilance, memory and reaction time in addition to e$erting an an$iolytic effect similiar to o$a(epam.AH2H 6he combined an$iolytic and mild anti&depressive effects of #ava&#ava give it indication in all types of non&psychotic forms of an$iety and3or mild depression. ?ava does not dampen alertness or interact ith mild alcohol consumption, and unli#e ben(odia(epine drugs, #ava carries no ris# of tolerance or addiction. • *astrointestinal !onditions9 ?ava e$erts tonic activity on the gastrointestinal tract. ,t is most indicated in persons ho demonstrate sluggish digestion and are lethargic in their overall disposition. ?ava e$tract ill promote glandular secretions of the digestive tract and enhance assimilation of food. • /usculos#eletal !onditions9 ?ava e$tract e$erts muscle rela$ing and spasmolytic effects on both s#eletal and smooth muscles. 6he rela$ing effects on s#eletal muscle are noted ith small doses. +igher doses cause ata$ia and paralysis ithout loss of consciousness. ,f the respiratory center is unaffected, this is follo ed by complete recovery. 6he s#eletal muscle rela$ing effects of #ava&#ava can be utili(ed topically and3or internally. ?ava e$tract combines ell ith .obelia and 5tachys officinalis for the treatment of s#eletal muscle tension. 6he #ava lactones act synergistically to reduce convulsions, for e$ample those caused by strychnine or those of epilepsy =?ava is not strong enough to act as the sole therapeutic agent in epilepsy>. AH2B • 1ain /anagement9 ?ava e$tract e$erts local anesthetic and analgesic activities similiar to cocaine and procaine. .ocal in"ections of #ava lactone e$tracts may be of value in pain control. 6he strength of the analgesic activities of #ava e$tract fall bet een that of aspirin and morphine. ?ava lactones administered ith aspirin indicate an additive synergism bet een the t o. !affeine shortens the duration but not the intensity of the analgesic activities of #ava e$tract. ?ava e$erts its analgesic effects via non&opiate path ays as is indicated by the fact the nalo$one =a morphine antagonist> has no effect on the analgesic activity. AH2C • *enitourinary !ondtions9 ?ava #ava has historical use in the treatment of U6,s. ,t is an effective addition to U6, formulas

because of its analgesic effect. ,t as thought to be antibacterial as ell. +o ever, in vitro studies have failed to demonstrate significant antibacterial activity. :onetheless, some of the lactones are mar#edly fungicidal, although not against !andida spp. Additionally, it is possible that the lactones after being chemically altered in the blood do possess antibacterial activity in the urine.AH30,AH3A,AH32 Additionally, 1iper methysticum tonifies and soothes the mucosal membranes of the urinary system. )inally, ?ava possesses a diuretic action. ,nterstitial cystitis pain #harmacy: :one of the alpha&pyrones are soluable in ater. 6he are soluable in alcohol, saliva, oil, and other fat solvents. 6he #ava lactones are more bioavailable than the isolated #avains. AH33 6his is probably due to the content of saponins in the herb ma#ing the ater&insoluable compounds ater&soluable. +igh doses of ethanol potentiate the sedative and hypnotic activity of #ava but also increase the to$icity of #ava. !apsules, standardi(ed9 sig A00&200 mg #ava lactones3day in divided doses %ried rhi(ome9 sig A.E&3 g3day in divided doses =mi$ed ith saliva first> 6incture A92 <EG 't0+9 sig 3&F ml3day in divided doses =20&<0 ml3 ee#> :ote9 )or sleep inducing effects, the same daily dose should be ta#en 30&F0 minutes before bed. Contraindications: 0perating machinery )o*icology: .%E0 of #ava lactones given orally in mice as bet een C20 and A0E0 mg3#g of isolated lactones. 6he .%E0 of #ava lactones given by in"ection to various test animals ranged from 300&<00 mg3#g. %oses of E0mg3#g three times a ee# for 3 months produced no to$icity in rats.AH3<,AH3E +uman studies using #ava at therapeutic dosages have failed to demonstrate any to$ic effects. 1rolonged use of a dose equivalent to <00 mg or more of #ava lactones per day is li#ely to cause the characteristic s#in lesions of #ava&#ava to$icity =pigmented, dry, covered ith scales> hich heals upon discontinuance of the #ava e$tract. At doses greater than Cg per day, liver en(ymes can elevate.
1724 1725

?lohs, et al, - /ed 1harm !hem, A, CE9 ACEC +olm et al, Ar(neim&)orsch, <A, FH39ACCA 1726 %avies et al, 1harmacol 6o$icol, HA, A209 ACC2R 1727 .indenberg and 1itule&5chodel, )ortschr /ed, A0B, <C9 ACC0 1728 /eyer, and ?ret(chmar, ?lin Wschr, <<, C029 ACFF 1729 -amieson and %uffield, !lin '$p 1ath 1hysiol, AH, <CE9 ACC0 1730 +ansel, 1acific 5cience, 22, 2C39 ACFF 1731 +ansel et al, 1lanta /ed, A<, A9 ACFF 1732 %uffield et al, - !hromatogr, <HE, 2H39ACBC 1733 Biber, ,nternal 1ulbications of %r. Willmar 5ch abe, ?arlsruhe, ACBC 1734 /eyer, Arch ,nt 1harmacodyn, A3B, E0E9 ACF2 1735 /eyer, 1harmacology of ?ava %rugs, +abilitationsschrift, )reiburg, ACFF.

#iper nigrum
Common name: Blac# pepper, hite pepper Ha!itat: *ro s ild in southern ,ndia, and is cultivated in tropical Asia and the !aribbean. AH3F

#iperaceae

Botanical description9AH3H • )lo er and )ruit9 6he inflorescences are pendulous, a$illary spi#es E&AE cm long, containing over A00 inconspicuous hite florets. 6he florets have A large ovary ith 3 stigmas, 2 stamens and a reduced perianth. 4ed berry&li#e drupes form 30&E0 flo ers, hich are fertili(ed. • .eaves, 5tem, and 4oot9 6he plant is actually a liane, hich in cultivation is trained on posts and ire. ,t can gro to over F m. 6he stem is strong and oody and the leaves are E&A0 cm ide, B&AB cm long, and are on E cm long petioles. #arts used9 )ruit Constituents9 • 7olatile oil =2G&<G> QBlac# pepperR9 B&bisabolene, camphene, B&caryophyllene, etc. • Al#aloids9 piperine =AAG>, piperanin, piperettine,piperolein A and B, piperidineK • )i$ed oilK 1rotein Medicinal actions: !arminative, stimulant )raditional Medicinal Uses: • 6raditionally, pepper has been considered to be an aphrodisiac and a valuable treatment for impotence. Current Medicinal Uses: • 1epper is used throughout the orld as a condiment. /any chefs consider it to be the most important spice. • *astroenterology9 6he medicinal use of pepper is primarily as a digestive stimulant and carminative. 6he volatile oil and al#aloids create a spasmolytic effect in the gastrointestinal system. 6his allo s for normal peristalsis and hence optimal digestive functioning. 1epper is e$othermic and as such is arming to the digestive system. ,t is often used stimulate sluggish deficient digestion and to stimulate appetite. 1epper clears mucous from the digestive tract =as ell as the respiratory system> and is thus helpful in chronic inflammatory conditions. 1epper may also be added to deto$ification teas for its carminative, stimulating and arming effects. 1epper is more arming if it is heated. 1epper added to already coo#ed food has less stimulating and arming qualities. #harmacy9 • 0.3&0.F g as a single dose, or A.E g qd.AH3B Contraindications9 %o not use pepper internally in individuals ith active ulceration. )o*icity.4ide $ffects:
1736 1737

PDR for Herbal Medicines, /edical 'conomics !ompany, /ontvale, :e -ersey, ACCB, p. A0<E ,bid. 1738 ,bid.

#iscidia erythrina
Common name: -amaican %og ood Ha!itat:

1eguminosae

Botanical Description: A tree. 6he pods bear four pro"ecting longitudinal ings. 6he bar#Ns outer surface is yello or hite, and if damp a bluish color. ,nside it is fibrous and dar# bro n. #art Used: Bar# Constituents "(75 • ,soflavonoids9 including among others "amaicine, ichthynone, the rotenoids =rotenone, milleton, isomilletone>, sumatrol, lisetin, piscerythrone, piscidine, • resin al#aloid. • *lycosides9 piscidin, "amiacin, icthyone • 6annins Medicinal actions: 5edative, anodyne, sialogogue, diuretic, diaphoretic Historical Use: )isherman in the W. ,ndies use 1iscidia tree branches as fish spears, causing paralysis and death of the fish. )raditional Medicinal Use: Current Medicinal Use: *enerally, 1iscidia is indicated for pain, general distress, intestinal colic, gall&stone colic, renal colic, sleeplessness, migraine headaches and neuralgia delirium, hysteria, and spasm and associated pain of uterus and s#eletal mm. ,n some individuals ith a toothache =abscess, periodontal inflammation>, 1iscidia ill produce much relief and ill aid in sleep. +o ever, in other individuals, it ill cause nausea and not produce pain relief. • !ardiovascular !onditions9 1iscidia can be used in hypertension ith a ea#ened heart as it slo s the pulse, increases arterial tension follo ed by reduced arterial tension. • *ynecological !onditions9 1iscidia is used for spasm and associated pain of uterus, dysmenorrhea, ovarian neuralgia, labor pains dysmenorrhea ith assoc. nervous and3or musculos#eletal tension. • ,nflammatory !onditions9 1iscidia is indicated for inflammatory fever and rheumatism. • 1ulmonary !onditions9 1iscidia can be used in the treatment of spasmodic cough and bronchitis. • 5leep !onditions9 1iscidia is indicated in insomnia 2S nervous tension. As a treatment for insomnia, 1iscidia ill produce a restful and quiet sleep especially if the insomnia is due to an$iety and orry. #harmacy: %espite its to$ic tendencies, 1iscidia must be given in sufficient repeated doses in order to be effective. 6incture& A9A0K A&2 ml 6,% 6ea& A&2 gm 6,% Contraindications: 1iscidia is contraindicated in the treatment of children and elderly. AH<0 )o*icity: 1iscidia is narcotic and should not be used in e$cess of the prescribed dosage range. ,f given in high enough doses, 1iscidia ill cause bradycardia and if given in to$ic amounts ill cause convulsions, general paralysis, and death. 1iscidia may potentiate the effect of sedatives and tranquili(ers. AH<A
1739 1740

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. BH 1741 Brin#er

#lantago afra. #2 psyllium. #2 ovata. #2 ispaghula
Common name: psyllium Ha!itat: Botanical description: #art used: seed Historical use: $nergetics:

#lantaginaceae

Constituents: AH<2 • #lantago Afra =the dried ripe seed>9 /ucilages =A0&A2G, chiefly arabino$ylans> ,ridoide monoterpenes9 aucubin • #lantago ,sphagula =the ripe seed>9 /ucilages =20&30G, parent substances arabino$ylans>, )atty oil, ,ridoide monoterpenes9 aucubin #harmacology 4eeds • • • • • Atherosclerosis' hypercholesterolemia and hyperlipidemia 9 1robably due to its soluble&fiber content, psyllium lo ers .%.. Dia!etes9 1syllium slo s the gastric emptying and the subsequent postparndial rise in blood sugar. AH<3 Constipation9 6he la$ative properties of 1syllium are due to the s elling of the hus# hen it comes in contact ith ater. 6his forms a gelatinous mass that #eeps feces hydrated and soft. 6he resulting bul# stimulates a refle$ contraction of the alls of the bo el, follo ed by emptying.AH<< Diarrhea9 1syllium or#s for diarrhea by normali(ing the passage time of the bo el content by ater bonding. AH<E As a respiratory demulcent: 6he mucilage from the leaves has a soothing and anti&inflammatory effect on the lo er respiratory tract. 6he e$act mechanism is not clear.

Medicinal actions: demulcent, bul# la$ative )raditional Medicinal Uses: Current Medicinal Uses: • Cardiovascular o Atherosclerosis' hypercholesterolemia and hyperlipidemia: :umerous double&blind studies confirm 1syllium can lo er total cholesterol and lo &density lipoprotein =.%.> ho ever, levels of =+%.>cholesterol are not affected. AH<F • $ndocrinology o Dia!etes (at least three studies : A double&blind placebo&controlled ith A2E patients ere given E g 1syllium t.i.d. before meals over a F& ee# period. )asting plasma glucose, total plasma cholesterol, .%. cholesterol, +%. cholesterol and triglyceride levels ere measured every 2 ee#s. 6here as an e$cellent tolerance to 1syllium, ithout significant adverse effects. )asting plasma glucose, total cholesterol, .%. cholesterol, and triglycerides levels, sho ed a significant reduction =p c 0.0E>, hereas +%. cholesterol increased significantly =p c 0.0A> follo ing 1syllium treatment. 6hese results sho ed that E g t.i.d. of 1syllium is useful, as an ad"unct to dietary therapy, in patients ith type ,, diabetes, to reduce plasma lipid and glucose levels, resolving the compliance conflict associated ith the ingest of a great amount of fiber in customary diet. AH<H • 9astrointestinal o Constipation: 0ne hundred, forty&nine patients ith chronic constipation at t o gastroenterology departments in /unich, *ermany, ere treated ith 1lantago ovata seeds, AE&30 g3day, for a period of at least F #. 'ighty percent of patients ith slo transit and F3G of patients ith a disorder of defecation did not respond to dietary fiber treatment, hereas BEG of patients ithout a pathological finding improved or became symptom free. 6his study made an important conclusion for the naturopathic physician. 5lo *, transit and3or a disorder of defecation may e$plain a poor outcome of dietary fiber therapy in patients ith chronic constipation. A dietary fiber trial should be conducted before technical investigations, hich are indicated only if the dietary fiber trial fails. AH<B

#harmacy: Contraindications: )o*icity:
1742 1743

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 1744 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 1745 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. EAA 1746 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 1747 4odrigue(&/oran /, *uerrero&4omero ), .a(cano&Burciaga *. .ipid& and glucose&lo ering efficacy of plantago psyllium in type ,, diabetes. 7 Diabetes 2omplications ACCBKA292H3WB 1748 7oderhol(er WA, 5chat#e W, /jhldorfer B', et al. !linical response to dietary fiber treatment of chronic constipation. )m 7 5astroenterol ACCHKC29CEWB.

#lantago lanceolata.#2 maBor
Common name: lance shaped plantain =1. lanceolata>, broad leaf plantain =1. ma"or> Ha!itat: 1lantain species gro throughout the orld.

#lantaginaceae

Botanical description9 .eaves are strongly veined, in a basal rosette, narro and long tapering to a tip. 6he flo ers are tiny, yello ish& green ith purple then yello ish anthers in a long dense spi#e. 6he plant gro s to a height of up to < inches. #arts used9 .eaves Constituents9 AH<C • 1eaves9 1lantago .anceolata and ma"or o ,ridoid monoterpenes =2&3G>9 chief components are aucubin =rhinantin> and catalpol o /ucilages9 =2&FG, glucomannans, arabinogalactone, rhamnogalacturonane> o )lavonoids9 including among other chief components apigenine&F,B&diglucoside, luteolin&H&glucuronide o !affeic acid esters9 chlorogenic acid, neochlorogenic acid, acteoside =verbascoside> o +ydro$ycoumarins9 aesculetin o 5aponins =traces>, 6annins, 5ilicic acid , 0leanolic acid #harmacology: • 6he liquid e$tract and the pressed "uice of fresh plantain herb possess proven bacteriostatic and bactericidal effects due to the tannin content.AHE0 6he protective effect of mucilage isolated from 1lantago ma"or leaves against aspirin induced gastric ulcer has been demonstrated in rats.AHEA 6he polysaccharides from 1. ma"or protects against pneumococcal infection in mice hen administered systemically prechallenge. 6he protective effect is from stimulation of the innate and not the adaptive immune system.AHE2 • 6he mucilage from the leaves has a soothing and anti&inflammatory effect on the lo er respiratory tract. 6he e$act mechanism is not clear.AHE3 Medicinal actions: antiinflammatory, diuretic, antihemorrhagic, e$pectorant, astringent, antibacterial )raditional Medicinal Use: 5pecific ,ndications and Uses9 .ocally, toothache and earache. AHE< According to !oo#, the roots and leaves are diffusively rela$ant and stimulant, leaving behind a gentle tonic impression. 6he principle tissues of influence include the mucous membranes, glandular organs and #idneys. AHEE • ':6 !onditions9 1lantago as used as a remedy for toothache from dental caries9 the cavity as cleansed and specific 1lantago ma"or applied on cotton to the sensitive pulp and rene ed every half&hour. 6he same preparation, locally applied, as often used to treat earache. • *astrointestinal !onditions9 1lantago as utili(ed in the treatment of colic, cholera infantum, aphthae, diarrhoea, dysentery, and hemorrhoids, some hat for its toning influence on mucous membranes in subacute cases. • *enitourinary !onditions9 1lantago as indicated hen dysuria and hematuria ere present. 1lantain as of much use in subacute and chronic difficulties of the #idneys and bladder giving rise to an aching bac#, cystic catarrh and scanty, scalding urine. !oo# considered it toning rather than forcing to the #idneys. Bed etting in children, due to rela$ed vesical sphincter, ith profuse colorless discharge of urine, as said to be relieved by 1lantago. • *ynecological !onditions9 1lantago as indicated in the treatment of menorrhagia and leucorrhoea, as the toning influence on mucous membranes as thought of some service in subacute cases. • ,nfectious !onditions9 6he principal use of 1lantain as in scrofula and light cases of secondary syphilis. • /etabolic !onditions9 According to ?ing, 1lantago as used for asting =incipient phthisis>. • :eurological !onditions9 ,ts internal use as said to control toothache through its effects upon the trifacial, tic&douloureu$ =trigeminal neuralgia> being benefited in the same manner. • 1ulmonary !onditions9 1lantago as utili(ed in cases of pulmonary hemorrhage. • 6opical Applications9 A remedy in high repute as an antidote to the bites of venomous serpents, spiders, and insects, 1lantago as also e$ternally useful in ounds, ulcers, ophthalmia, ec(ema, erysipelas, and some other cutaneous affections. Current Medicinal use:

1. lanceolata shares its medicinal effects ith its close relative, 1lantago ma"or. +o ever, 1lantago lanceolata seems to e$ert more of its effects internally, hile 1. ma"or is a good plant for e$ternal use. 1lantago ma"or .. leaves have been used as a ound healing remedy for centuries in almost all parts of the orld and in the treatment of a number of diseases apart from ound healing. 6hese include diseases related to the s#in, respiratory organs, digestive organs, reproduction, the circulation, against cancer, for pain relief and against infections. 1. ma"or contains biologically active compounds such as polysaccharides, lipids, caffeic acid derivatives, flavonoids, iridoid glycosides and terpenoids. Al#aloids and some organic acids have also been detected. A range of biological activities has been found from plant e$tracts including ound healing activity, anti&inflammatory, analgesic, antio$idant, ea# antibiotic, immunomodulating and antiulcerogenic activity. AHEF • ':6 !onditions9 ,t is also indicated in 0titis media. • *enitourinary !onditions9 1lantago spp. are also useful in hematuria and dysuria, especially if long&standing, and hen accompanied by copious discharge. • 1ulmonary !onditions9 1. lanceolata is a gentle soothing e$pectorant most indicated in irritated coughs and mild bronchitis. ,t may be more beneficial long&term. ,t e$erts astringent and alterative properties internally, especially in chronic inflammatory conditions of the mucosa, glandular tissues, or septicemia. 6he !ommission ' indicates its use in !atarrhs of the respiratory tract, inflammatory alterations of the oral and pharyngeal mucosa. 1lantago is therefore most indicated in irritated lung conditions in hich blood is e$pectorated or hich are accompanied by glandular s elling, diarrhea, and3or s#in inflammation. ,n acute and chronic bronchitis 1lantago is indicated hen the sputum is particularly copious or if the productive cough lingers beyond the acute stage. 1lantain reduces mucus in the upper respiratory tract as ell. AHEH • 6opical Applications9 he e$ternal use of 1lantago is primarily restricted to 1. ma"or. '$ternally, 1lantago ma"or is antiinflammatory, antimicrobial, antipruritic, and vulnerary. 6he macerated leaves or fresh "uice of the plant are e$cellent, quic# healing agents for cuts, ounds, bruises and earache =infection>. #harmacy9 1lantain root and leaves are not strong, suggesting a concentrated decoction, tincture or e$tract for internal use. A9E tinctureZ2&3 ml 6,% =Alschuler> 2 tsp. dried herb3cup infusion 6,% =Alschuler> fresh "uiceZE&AE ml 6,% =Alschuler> Contraindications: :o information regarding contraindications is currently available. )o*icity: :o information regarding to$icity is currently available.
1749 1750

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1751 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p, 2F. 1752 +etalnd, 1rotective effect of 1lantago ma"or .. 1ectin polysaccharide against systemic 5treptococcus pneumoniae infection in mice.5cand - ,mmunol. 2000 0ctKE2=<>93<B&EE. 1753 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 20C 1754 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 1755 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. FAE&F 1756 5amuelsen AB2 6he traditional uses, chemical constituents and biological activities of 1lantago ma"or .. A revie .- 'thnopharmacol. 2000 -ulKHA=A&2>9A&2A. 4evie . 1757 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000.

#odophyllum peltatum
Common name: /ay apple, %evilNs apple, Wild .emon, American /andra#e Ha!itat: 6he plant is native to the middle and Western states of :. America.

Ber!eridaceae

Botanical description9 An erect perennial that gro s to 0.E meters in height. A single stal#, often for#ed, produces t o umbrella&li#e leaves at the top of the plant. A hite flo er, A.E inches in diameter, appears in the for# of the stem. 6he flo er is follo ed by a plum& li#e yello fruit. 6he reddish&bro n rhi(ome is composed of many thic# tubers held together by fleshy fibers, hich spread underground sending out many smaller fibers. 6he outer surface is smooth or rin#led. #arts used9 4hi(ome and resin e$tracted from it. ,dentified Constituents: AHEB • 8ignans: chief components podophylloto$in =20G>, additionally including among others alpha&peltatin =EG>, beta&peltatin =A0G>, <i& dimethyl podophylloto$in, dio$ypodo& phylloto$in • podophyllin resin • )lavonoids9 #aempferol, quercetin and their glycosides #harmacology: 1odophylloto$in and derivatives e$hibit pronounced biological activity mainly as strong antiviral agents and as antineoplastic drugs. 1odophylloto$ins are classical spindle poisons causing inhibition of mitosis by bloc#ing mitrotubular assembly. AHEC 6he podophylloto$in derivatives etoposide, etopophos =etoposide phosphate>, and teniposide are successfully utili(ed in the treatment of a variety of malignant conditions.AHF0 Medicinal actions: !athartic, 1urgative, Antineoplastic, Antiviral, !holagogue, Alterative, +epatic tonic, !ytoto$ic. )raditional Medicinal Use: 1odophyllum peltatum as for arded into the 'clectic medical practice largely by %r. -ohn ?ing, one of the foremost pharmacists and physicians in the mid&AB00Ns. %r. ?ing isolated the resin from the rhi(ome of 1odophyllum that he called podophyllin. +e identified this constituent as the active constituent responsible for the cathartic effects of 1odophyllum. +e advocated the use of podophyllin instead of the tradition mercury as a safer cathartic. After several decades podophyllin did become the cathartic of choice and is still used for this purpose today by conventional doctors. !oo# described the thoroughly dried root of 1hytolacca as a very concentrated stimulant, acting slo ly and persistently, influencing the salivary glands, mucous membranes, gall&ducts, liver, bo els and even the #idneys. ,t as used as a cathartic in the 1hysiomedical profession as ell. • *astrointestinal !onditions9 ,n moderate doses, 1odophyllum is strong cholagogue and a slo , but drastic purgative. Atonic constipation, especially ith portal insufficiency responds ell to 1odophyllum. 1odophyllum also stimulates the release of ater and other sero&sanguinous discharge from tissues and is thus helpful in relieving inflammation. ,n large doses, 1odophyllum can cause vomiting and even gastritis and enteritis, hich can potentially be fatal. 6he 'clectics ould administer 1odophyllum in small, repeated doses often ith other purgatives =i.e. Aloe and 4heum> and strong antispasmodic anodynes =i.e. +yoscyamus and Atropa belladonna>. 1odophyllum as never given arm or hot. .arge doses ere never used as they tended to cause violent emesis and catharsis. • *ynecological !onditions9 6he 'clectic physicians also used 1odophyllum to treat ovarian cancer. 1odophyllum has cytoto$ic properties and appeared to the 'clectics to be effective in treating ovarian cancer. Alopecia as a common side effect of this treatment. • +epatobiliary !onditions9 1odophyllum as considered by 'clectic physicians to be one of the most stimulating and po erful alteratives available. 1odophyllum acts strongly on the liver and intestines. ,t is a potent cholagogue and stimulates peristalsis significantly. 6he 'clectics used this herb to relieve hepatic congestion, dyspepsia and gall bladder dysfunction. • 6opical Applications9 1odophyllum po der an also be applied to condyloma acuminata and as reported by ?ing to be an e$cellent treatment. Current Medicinal Use: • 6opical Applications9 6he internal use of 1odophyllum is no longer advised because of its to$icity. ,n addition to being a drastic purgative, 1odophyllum e$erts cytoto$ic effects. 6opical application of 1odophyllum is still practiced. 1odophyllin is an ingredient in !ompound Ben(oin 6incture, hich is used for venereal arts and verrucae. !urrent forms of treatment for papillomavirus genital arts include cryotherapy, 1odophyllum resin, podophilo$, trichloroacetic acid, laser ablation, loop electrosurgical e$cision procedure =.''1>, fluorouracil and alpha interferon. 5uccess in treating

condyloma may be increased if the area is first soa#ed ith E percent acetic acid to more clearly sho the e$tent of the local infection. 4ecurrence is a problem no matter hat form of therapy is used. AHFA Current +esearch +eview: • 3ncology: o H,-<related hairy leukoplakia: AHF2  %esign9 4andomi(ed single&blind controlled clinical trial  1atients9 6en +,7&infected patients ith bilateral hairy leu#opla#ia of the tongue.  6herapy9 6opical podophyllum resin 2EG solution. =0ne side of the tongue treated, one side W control>  4esults9 5ignificant resolution of hairy leu#opla#ia as noted on the treatment side compared ith the control side at the 2&, H&, and 30&day levelsK the 2&day results ere the most significant. )urthermore, the patients reported minimal side effects, hich included burning sensation, bad or altered taste, and pain, that ere of mild intensity and short duration. 6he side effects ere reported to occur immediately after the topical application. o Cervical carcinoma:"(&7  %esign9 4andomi(ed controlled clinical trial.  1atients9 6 o hundred fifty si$ patients ith squamous cell carcinoma of uterine cervi$K AH3 patients ith stage ,, and B3 patients ith stage ,,,.  6herapy9 4adiation ith F000 mgeh 4a and <E00 4 F0!o W all patients. 0ne group W infusion of A g 1odophyllum qd after irradiation. Another group & A g acethyl&homocystein&thilactone =A+!6> prior to radiation and 1odophyllum after irradiation. 6he total dosage as bet een 30 and E0g 1od. and 30 and E0g A+!6.  4esults9 6he survival rate after three years as increased up to AEG. An earlier study revealed a five&year&survival rate of 23G. • ,nfectious diseases: o #enile condyloma acuminata:"(&:  %esign9  1atients9 6 o hundred t enty seven men ith penile condylomata acuminata.  6herapy9 Alcoholic solutions ith 20G podophyllin from 1odophyllum peltatum and 1odophyllum emodi, BG podophylloto$in, or BG colchicine, topically.  4esults9 'ffects in the treatment groups ere statistically ali#e. <3G permanent cure frequency after A&2 applications. .ocal side effects ere absent after only half the series of colchicine applications, hereas as much as about 33< of the treatment course ith podophyllin and pure podophylloto$in could be completed ithout provo#ing discomfort. Warts in the urinary meatus healed significantly less ell than arts on the other genital mucous membranes. 'ighty&nine per cent of patients ho had previously been cured of concylomata became art&free after A&2 treatments, as opposed to only <0G of those ho had never had this art type previously. 6he use of the commercially available colchicine offers an opportunity to establish a standardi(ed therapyK follo ing application of an BG solution, rinsing off should be performed after F&B hours. o #enile warts:"(&%  %esign9 1rospective double&blind randomi(ed clinical trial.  1atients9 6hree hundred fifteen patients ith penile arts.  6herapy9 5elf treatment ith podophylloto$in 0.EG =1%P 0.EG>, podophyllin 0.EG, or ith podophyllin 2.0G sourced from 1odophyllum emodii $ E ee#s.  4esults9 At E ee#s no significant differences ere found in the e$tent of healing of arts or in side effects for the three treatment groups. 1enile arts in selected cases can be safely treated ith 0.E&2.0G podophyllin self applied by the patient at a fraction of the cost of commercially available podophylloto$in. 6he shelf life of the podophyllin e$tracts is at least 3 months. • +heumatology: o +heumatoid arthritis:"(&&  %esign9 %ouble&blind placebo&controlled clinical trial.  1atients9 6hirty patients ith rheumatoid arthritis.  6herapy9 !1+ B2 =podophyllum derivatives W semisynthetic lignan glycosides> =!onpharm AB> $ A2 ee#s.  4esults9 1atients treated ith !1+ B2 sho ed a statistically significant improvement in most clinical and immunological variables. 5ome patients treated ith !1+ B2 reported gastrointestinal discomfort =diarrhea and abdominal pain>. #harmacy9 Age slo ly lessens the to$icity of 1odophyllum, sometimes ta#ing up to t o years to dry before becoming tolerable. 1odophyllum is listed by the )%A as an unsafe herb. A9A0 tincture9 A&A0 drops3day

)luid e$tract9 A&E drops3day 1o der9 E&20 grains3day Drug ,nteractions:"(&( • @aCl: !ommon table salt increases its purgative po er. • 1o!elia' ,pecac' 1eptandra' hen!ane and Belladonna render its cathartic effect milder. Contraindications: Brin#er contraindicates the use of 1odophyllum internally for gallstones, intestinal obstruction, in debilitated patients and pregnancy. +e contraindicates the topical use near the eyes, in diabetic patients or on moles, birthmar#s, inflamed3irritated verrucae, over large areas or for e$cessive periods of time. AHFB )o*icity: 1regnant omen should not ta#e 1odophyllum. 1odophyllin and podophylloto$in are embryocidal in animals and humans. !oo# described the effects of internal use of the fresh root as producing nausea, severe vomiting, burning at the precordia, and violent catharsis, ith tormina and atery =sometimes bloody> stools. 6hese symptoms are liable to continue for eight or t elve hoursK and to be follo ed by s elling, redness, dryness and tenderness of the lips and hole mouth, tenderness and heat throughout the bo els, e$treme prostration, ith perhaps bloating of the face and other parts of the body. 6hese feelings sometimes are not recovered from for several days, and the gastric tenderness may last a number of ee#s.
1758 1759

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 5in#ule -A. 'toposide9 a semisynthetic epipodophylloto$in. !hemistry, pharmacology, pharmaco#inetics, adverse effects and use as an antineoplastic agent. 1harmacotherapy. ACB< /ar&AprK<=2>9FA&H3. 4evie . 1760 !anel !, 1odophylloto$in. 1hytochemistry. 2000 /ayKE<=2>9AAE&20. 4evie . 1761 /ayeau$ '- -r. :oncervical human papillomavirus genital infections. Am )am 1hysician. ACCE 5ep AEKE2=<>9AA3H&<F, AA<C&E0. 4evie . 1762 *o dey *, .ee 4?, !arpenter W/. 6reatment of +,7&related hairy leu#opla#ia ith podophyllum resin 2EG solution. "ral ,urg "ral Med "ral Pathol "ral Radiol Endod ACCEKHC=A>9F<&H 1763 1aesch#e ?%. 4adio&chemotherapy of cervi$ carcinoma. , !linical part. ,traKlentherapie ACHFKAEA=<>93AA&H. 1764 von ?rogh *. 6opical treatment of penile condylomata acuminata ith podophyllin podophylloto$in and colchicines. A comparative study. )cta Derm Genereol ACHBKEB=2>9AF3&B. 1765 White %-, Billingham !, !hapman 5, et al. 1odophyllin 0.EG or 2.0G v podophylloto$in 0.EG for the self treatment of penile arts9 a double blind randomi(ed study. 5enitourin Med ACCHKH3=3>9AB<&H. 1766 .ansen A, 1etersson ,, 5vensson B. 1odophyllum derivatives =!1+ B2> compared ith placebo in the treatment of rheumatoid arthritis. Br 7 Rheumatol ACBCK2B=2>9A2<&H. 1767 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. A<B 1768 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. A<H&A<B

#opulus spp2
#opulus al!a.#2 tremuloides.#2nigra. #2 !alsamifera Common name: 1oplar, Aspen, Balm of *ilead =1. balsamifera only>

4alicaceae (6illow =amily

Ha!itat: 6he tree gro s in lo er !anada ] in the :orthern ] middle states of the Unites 5tates. Botanical description9 6his tree gro s to a height of 20 to E0 feet ith a diameter of B to A2 inches. 6he bar# is smooth ] greenish& hite. 6he leaves are orbicular&cordate, smooth on both sides, dar# green, 2&2.E in. long ] A.2E in ide on long slender petioles. 6he bar# is collected in early spring. #arts used9 Bar# Constituents9 • 1henolic glycosides9 5alicin ] 1opulin. • 6annins. • .ignans =in 1. nigra>. #harmacology: P'enolic %l(co ide a&e found in t'e 'i%'e t concent&ation 5it'in t'e (oun% tic$( #ud , 7 a&e t'e !ain acti)e con tituent 5it'in Po"ulu "". Po"ulu contain alicin, 5'ic' i con)e&ted in t'e %ut to alic(lic acid. Salic(lic acid i anti.infla!!ato&(, anti."(&etic, anal%e ic, 7 anti.&'eu!atic. 8 "i&in i !ade of alic(lic acid 5it' an additional acet(l %ou" to 'el" in %ettin% alic(lic acid ac&o t'e #lood #&ain #a&&ie&. 8lt'ou%' no clinical t&ial 'a)e #een conducted 59 Po"ulu , it can #e u ed in "lace of a "i&in in t'e !ana%e!ent of !ino& "ain condition . :o& a fu&t'e& unde& tandin% 7 a""&eciation of "'enolic %l(co ide 7 t'ei& !ec'ani ! of a# o&"tion, "lea e ee t'e !ono%&a"' on Sali; al#a. Medicinal actions: Anti&inflammatory. Anodyne. Astringent. %iuretic. 5timulant. Anti&pyretic. Anti&rheumatic. Current > )raditional Medicinal Use: 1opulus is specifically indicated in cases characteri(ed by9 e$treme debility ] impairment of digestionK tenesmic vesical irritationK or tenesmus after micturition. 6he inner bar# is thought to be an efficient ] pleasant astringent tonic, 3 an affinity for the mucosal membranes of the pelvis. 1opulus has also been used as a remedy in the treatment of reproductive disorders characteri(ed by9 nervous ] hysterical mental states, stubborn uterine congestion, prostatic hypertrophies, chronic ] purulent ophthalmia, or sub&acute gonorrhea. 1oplar d3t its tonic action, made it useful as an addition to stonger herbs in treating conditions of the stomach. 6he buds of 1. balsamifera ere observed to be stimulating to the mucous membranes ] #idneys, having an influence on the circulation, ] acting particularly on respiratory passages. • 9astrointestinal Conditions: 1opulus as often used to promote appetite ] digestion in all la$ conditions of the stomach. Balm of *ilead has been considered to be one of the best tonics in cases of sub&acute ] chronic diarrhea, scrofulous looseness of the bo els, ] in diarrhea that arises from la$ity of the stomach 3 associated indigestion. • 9enitourinary Conditions: 1opulin, the active phenolic glycoside of 1opulus, has an affinity for the *U tract, ] as thought to stimulate the recuperative po ers of the #idney hen undergoing granular degeneration. Because of its gentle action upon the #idneys, 1opulus as used in chronic oliguria ] lumbalgia. Balm of *ilead as highly commended in edematous dropsy, here it acts as a #idney tonic hen combined 3 stronger tonics. As a diuretic, it is of benefit in9 urinary affections, gonorrhea, gleet, etc. 1opulus also helps to reduce tenesmic spasm of the vesicles ] for tenesmus occurring after urination. When combined 3 Uva ursi or 'pigea repens, Balm of *ilead as used as a tonic for catarrh of the bladder ] similar renal difficulties. ,n addition, 1. balsamifera as thought to be only suited in cases characteri(ed by much torpor, ] then should be combined 3 rela$ant diuretics. 6his bar# is an e$cellent inclusion in formulas for urinary tract infections. 6he bar# ill lessen the inflammation ] associated pain of cystitis hile gently stimulating the flo of urine thereby promoting cleansing of the urinary tract. 1opulus ill also help to restore #idney function after infection, inflammation or degeneration. • 9ynecologic Conditions: 1opulus as used ith much advantage in leucorrhea, both in ardly and by in"ection, and in all female difficulties connected ith la$ity, as it soothes hile it tones, and is not liable to confine the bo els. AHFC • ,nflammatory Conditions: 1oplar bar# as considered a tonic ] febrifuge, having been used in intermittent fever ith advantage. An infusion of it as reputed a valuable remedy in emaciation ] debility, after protracted fevers. ,n purely chronic forms of rheumatism, 1. balsamifera ere added to form a fair stimulating addition to such articles as !imicifuga ] 1hytolacca. • #ulmonary Conditions: 6hese buds of 1. balsamifera ere used to promote e$pectoration ] give a tingling sensation in the bronchi ] the lungs. ,t as used to ma#e an e$cellent stimulating addition to e$pectorants that are more rela$ing ] tonics for old coughs ] dry asthma, ith pulmonic debility.

Current +esearch +eview: • 5earch of /edline yielded no human studies as of 5eptember 2002. #harmacy9AHH0 • E&A0 g herb qd Contraindications.)o*icity: 1. balsamifera should never be employed in recent or irritable coughs, or in any in flamed condition of the organs of respiration. AHHA !aution in the use of 1opulus nigra e$ternally due to occasional s#in reactions caused by the salicylates. AHH2
1769 1770

!oo# PDR for Herbal Medicines. /edical 'conomics !ompany, /ontvale, :-, ACCB9A0F0. 1771 !oo# 1772 Brin#er ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ,ACCB93B

#ropolis
Common name: propolis Ha!itat: Botanical description: #arts used: resin Constituents:"((7 • )lavonoids9 quercetin, apigenin, galangin, #aempherol, luteolin, etc. • 1henols9 caffeic acid ester • 6erpenes #harmacology !affeic acid phenethyl ester =!A1'> inhibits the lipo$ygenase path ay of arachidonic acid resulting in anti&inflammatory activity. !A1' also has anticarcinogenic, antimitogenic and immunomudulatory actions. !ompounds in 1ropolis also have Antimicrobial actions although the mechanism is not #no n. Medicinal actions: antimicrobial )raditional Medicinal Use: :o information is provided in the selected references. Current Medicinal Use: • Dental Conditions: A preliminary controlled study found that propolis mouth ash follo ing oral surgery significantly speeded healing time as compared to placebo. AHH< Current +esearch +eview: • Dermatology: o Minor !urns:"((%  %esign9 !ontrolled clinical trial  1atients9 1atients ith minor burns =less than 20G total body surface area> ithin <B hours post&in"ury.  6herapy9 +igh&grade Bra(ilian propolis s#in cream W e$perimental, silver sulfadia(ene =55%> W control. 1ropolis cream and 55% applied directly to the ound q3d.  4esults9 1reliminary results do not sho any significant difference in microbial coloni(ation bet een ounds treated ith 55% and propolis s#in cream, ho ever ounds treated ith propolis cream sho ed less inflammation and more rapid cicatri(ation. o #ost<surgically:"((&  %esign9 !linical trial  1atients9 1atients operated for goiter, patients ith ounds and ulcerations difficult to heal, patients ith non&specific rectal inflammation. 1atients ith +. pylori =propolis as used as supplemental treatment in this case>.  6herapy9 1ropolis  4esults9 1ropolis as found to be effective, ell&tolerated ith minimal side&effects. Authors concluded that preparations of propolis can be successfully used in surgery. • Dentistry: o Dentinal hypersensitivity9AHHH  %esign9 0pen clinical trial.  1atients9 2F female sub"ects, AF&<0 yo, ith dentinal hypersensitivity.  6herapy9 1ropolis  4esults9 'ighty five percent of the sub"ects ere highly satisfied at < ee#s follo &up. Authors found that propolis had significant effect on dentinal hypersensitivity during the study period. o #la?ue:"((/  %esign9 %ouble&blind, randomi(ed, controlled, parallel, clinical trial  1atients9 5ub"ects ere studies on de novo plaque formation.  6herapy9 1ropolis&containing mouth rinse. 1ositive =chlorhe$idine mouthrinse> control and negative control ere used.

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4esults9 1ropolis&containing rinse as marginally better than the negative control, but difference as not significant. !hlorhe$idine mouth rinse as significantly better than the others in plaque inhibition. o #eriodontitis:"((5  %esign9 !linical trial.  1atients9 1atients ith acute, e$acerbated, and chronic forms of periodotitis.  6herapy9 )our percent alcohol solution of bee glue added to the filler for root&canal fillings.  4esults9 6echnique as found to be highly effective. 6he filler has anestheti(ing effectK it resolves behind the root canal ape$ ithin 3&A2 months, is preserved in the root canals, does not stain the tooth cro n, promotes regeneration of the bone structures, and prolongs the effect of 0.<G ater&alcohol been glue emulsion. o 9ingivitis:"(/8  %esign9 !linical cases  1atients9 1atients ith chronic gingivitis and stomatitis of different etiology  6herapy9 1ropolan W propolis containing therapy.  4esults9 1ropolan is found to be effective ,nfectious diseases: o 9enital herpes (H4- :"(/"  %esign9 4andomi(ed, single&blind, mas#ed investigator, controlled multi0centre trial  1atients9 :inety men and omen ith recurrent genital +57 type 2.  6herapy9 !anadian propolis ointment containing natural flavonoids W e$perimental group, acyclovir ointrment group, and placebo group. =6hirty patients3group>. 0intments ere applied topically 2,% $ A0 days in men, and tampons ith ointments ere inserted vaginally 2,% $ A0 days in omen.  4esults9 1ropolis ointment as more effective than both acyclovir and placebo ointments in healing genital herpetic lesions, and in reducing local symptoms. 6he healing process appeared to be faster in the propolis group. o ,mmunostimulation:"(/0  %esign9 0pen prospective monocentric clinical trial.  1atients9 A0 healthy sub"ects, AB&<E yo, normal eight, either se$.  6herapy9 E00 mg 1ropolis P:1 =2 caps> po am $ A3 days.  4esults9 !yto#ine secretion capacity but not the cyto#ine plasma levels increased significantly during therapy. Authors concluded that prophylactic application of propolis led to a time dependent enhanced immune reactivity ithout undesired side effects. o -aginal infections.cervicitis:"(/7  %esign9 4andomi(ed double&blind controlled clinical trial.  1atients9 1atients ith acute cervicitis and ith vaginal smears ith positive cultures of some #ind of infection.  6herapy9 7aginal dressings using EG propolis W e$perimental group qd $ A0 days. .ugol dressings W control group.  4esults9 All patients in the e$perimental group had no other symptoms after treatment as completed since negative results ere attained in A00G of smears. :inety percent achieved a total epitheli(ation of the cervi$ ithin A0 days of treatment. o 9iardiasis:AHB<  %esign9 !ontrolled clinical trial  1atients9 0ne hundred and thirty eight patients9 <B children and C0 adults.  6herapy9 I1ropolisinaJ9 A0G, 20G, and 30G propolis e$tract W e$perimental group. 6inida(ole =imida(ole derivate> W control.  4esults9 !hildren treated ith A0G propolisina W E2G cure rate, adults treated ith 20G propolisina W results similar to tinida(ole, adults treated ith 30G propolisina W F0G cure rate vs <0G ith tinida(ole. +heumatology: o +heumatic diseases9AHBE  %esign9 5ingle&blind, placebo&controlled clinical trial  1atients9 AC0 patients ith pain and3or inflammation of the organs of movement.  6herapy9 1urified propolis and propolis saturated ith anti&inflammatory trace metal elements. 1ropolis saturated ith trace metal elements. 1oplar bud ointment saturated ith trace metal elements. /aterials ere applied topically and by iotophoresis.  4esults9 All therapy choices significantly improved symptoms. 6he preparations saturated ith metallic ions ere more effective. 5ide effects ere not observed. 3phthalmology: o 3phthalmic herpes se?uelae:"(/& 

    •

%esign9 !ontrolled clinical trial. 1atients9 6hirty five patients ith postherpetic trophic #eratitis and 20 patients ith postherpetic nebula 6herapy9 0cular medical propolis films =0/)> applied behind the lo er eyelid hs $ A0&AE days. 4esults9 0/) accelerated the cornea epitheli(ation. 'pitheliopathy and micropoint edema of cornea epithelium rapidly disappeared. 6ime of patients recovery reduced nearly t ice in comparison ith the control groupK visual acuity increased on the average in t o times. All patients endured the treatment ell.

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$@): o +hinopharyngitis:"(/(  %esign9 !ontrolled clinical trial  1atients9 1re&school and school children ith acute and chronic inflammatory diseases of upper air ays treated during the hole cold season ACC<&ACCE.  6herapy9 Aqueous propolis e$tract :,7!4,50. topically.  4esults9 6reatment as found to be effective. 6he number of cases ith acute or chronic symptoms as decreasedK there as also decrease and sometimes suppression of the viral&microbial flora carriage of the upper air ays. 6herapy as tolerated ell. #ulmonology: o 1ung diseases:"(//  %esign9 !linical trial  1atients9 0ne hundred four patients ith chronic non&specific pulmonary diseases =!h:1%>  6herapy9 Apitherapeutic cople$ =bee venom and bee #eeping apiculture produce>  4esults9 Apitherapy as found to be highly effective in a combined treatment of !h:1% patients. 5timulating and normali(ing influence on the function of adrenals as noted.

#harmacy: Contraindications9 1ropolis may cause contact dermatitis.AHBC )o*icity:
1773 1774

1%4 for :utritional 5upplements, /edical 'conomics, /ontvale, :-. )irst 'dition, 200A /agro )ilho 0, de !arvalho A!. 6opical effect of propolis in the repair of sulcoplasties by the modified ?a(an"ian technique. !ytological and clinical evaluation. 7 ;ihon Dni! ,ch Dent. ACC<K3F9A02WAAA. 1775 *regory 54, 1iccolo :, 1iccolo /6, et al. !omparison of propolis s#in cream to silver sulfadia(ine9 a naturopathic alternative to antibiotics in treatment of minor burns. 7 )ltern 2omplement Med 2002K B=A>9HH&B3. 1776 +art ich A, .egut#o -, Ws(ole# -. 1ropolis9 its properties and administration to patients treated for some surgical diseases. PrIegl 8e3 2000KEH=<>9ACA&<. 1777 /ahmoud A5, Almas ?, %ahlan AA. 6he effect of propolis on dentinal hypersensitivity and level of satisfaction among patients from a university hospital 4iyadh, 5audi Arabia. >ndian 7 Dent Res ACCCKA0=<>9A30&H. 1778 /urray /!, Worthington +7, Blin#horn A5. A study to investigate the effect of a propolis&containing mouthrinse on the inhibition of de novo plaque formation. 7 2lin Periodontol ACCHK 2<=AA>KHCF&B. 1779 ?osen#o 57, ?osovich 6iu. 6he treatment of periodontitis ith prolonged&action propolis preparations =clinical $&ray research>. ,tomatologiia 0Mos3B ACC0KFC=2>92H& C. 1780 /artine( 5ilveira *, *ou *odoy A, 0na 6orriente 4, et al. 1reliminary study of the effects of propolis in the treatment of chronic gingivitis and oral ulceration. Re! 2ubana Estomatol ACBBK 2E=3>93F&<<. 1781 7ynograd :, 7ynograd ,, 5osno s#i 8. A comparative multi&centre study of the efficacy of propolis, acyclovir and placebo in the treatment of genital herpes =+57>. Phytomedicine 2000K H=A>9A&F. 1782 Bratter !, 6regel /, .eibenthal !, 7ol# +%. 1rophylactic effectiveness of propolis for immunostimulation9 a clinical pilot study. orsch .omplementarmed ACCCK F=E>92EF&F0. 1783 5antana 1ere( ', .ugones Botell /, 1ere( 5tuart 0, et al. 7aginal parasites and acute cervicitis9 local treatment ith propolis. 1reliminary report. Re! 2uban Enferm ACCEKAA=A>9EA&F. 1784 /iyares !, +ollands ,, !astaneda !, et al. !linical trail ith a preparation based on propolis IpropolisinaJ in human giardiasis. )cta 5astroenterol 8atinoam ACBBKAB=3>9ACE&20A. 1785 5iro B, 5(ele#ovs(#y 5, .a#atos B, et al. .ocal treatment of rheumatic diseases ith propolis compounds. "r! Hetil ACCFK A3H=2E>9A3FE&H0. 1786 /aichu# ,u), 0rlovs#aia .', Andreev 71. 6he use of ocular drug films of propolis in the sequelae of ophthalmic herpes. Goen Med ?h ACCEK =A2>93F&C, B0. 1787 !risan ,, 8aharia !:, 1opovici ), et al. :atural propolis e$tract :,7!4,50. in the treatment of acute and chronic rhinopharyngitis in children. Rom 7 Girol ACCEK<F=3& <>9AAE&33. 1788 /asterov *%, /ersesian 0:. 6he role of apitherapy in the combined treatment of patients ith chronic non&specific lung diseases. 8i3 ,pra!a ACCEK=3&<>9AEE&B. 1789 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 3B

#runus serotina
Common name: Wild cherry37irginia prune bar# Ha!itat:

+osaceae

Botanical description9 .ofty blac# cherry tree. 6he ood is dar# red. Bar# is thic#, reddish, fragrant ith a rough dar# corticle separating in narro layers. .eaves are oblong, lanceolate, tapering, serrate ith short and incurved teeth, thic#, smooth, dar# green, shining, 3&< inches long. )lo ers are small, hite, rosaceous. )ruit is a small, round, blac# cherry, ith a round and smooth drupe. 6he tree blooms in /ay, ripens its fruit in August and 5eptember. :ote9 1runus virginiana is the smaller cho#e cherry. #arts used9 Bar# Constituents9 • 1runasin =cyanogenic glycoside hich is>, !yanogenic glycosides9 prunasin yielding 0.E&A.EG, E0&AE0 mg +!:3A00 gm =hydroly(ed by prunase to hydrocyanic acid> • ben(aldehyde, eudesmic acid, p&coumaric acid, scopoletin, tannins, sugars #harmacology: ,t is of interest that 1runus bar# contains cyanogenic glycoside, particularly prunasin, and that 1runus has a sedating yet tonifying influence on circulation. !yanide is required in very small amounts by en(ymes involved in the clotting cascade. /inute amounts of cyanide circulate in the blood stream for this purpose. 6hese glycosides, once bro#en apart in the body, act by quelling spasms in the smooth muscles lining bronchioles, thereby relieving coughs. AHC0 0f course, large amounts of cyanide are to$ic to the !:5 producing convulsions and death very quic#ly from respiratory paralysis. Medicinal actions: Antitussive, sedative, astringent )raditional Medicinal Use: 6he specific indications of 1runus are9 rapid, ea# circulation,K continual irritative cough ith profuse muco&purulent e$pectorationK cardiac palpitation, from debilityK dyspneaK pyre$iaK loss of appetiteK and cardiac pain. AHCA !oo# described 1runus bar# as a mild, soothing, slightly astringent tonic. AHC2 ?ing further differentiated these influences as a tonic and stimulating influence on the digestive apparatus, and a simultaneous sedative action on the nervous system and circulation. ,t as considered valuable cases here it is desirable to give tone and strength to the system, ithout, at the same time, causing too great an action of the heart and blood vessels, such as during convalescence from inflammatory and febrile diseases. ?ing considered its chief property is its po er of relieving irritation of the mucous surfaces, ma#ing it an admirable remedy in many gastro&intestinal, pulmonic, and urinary troubles and he felt that it is best adapted to chronic troubles. AHC3 • *astrointestinal !onditions9 )or chronic gastritis ith indigestion and during convalescence 1runus as considered an e$cellent tonic particularly hen most other tonics ere difficult to tolerate. • :ervous !onditions9 1runus as chiefly valued for the soothing influence hich accompanies its tonic actionK for hile it gently improves appetite, digestion, and the general strength, it quiets nervous irritability and arterial e$citement. )or e$ample, 1runus as used to settle palpitations secondary to nervous stimulus from fever or inflammation. • 1ulmonary !onditions9 1runus as considered a superior herb for irritable coughs, hether acute or chronic. • 6opical Applications9 0ut ardly, 1runus as used to ma#e a soothing and cleansing application to irritable and ea# sores, especially those of a scrofulous character in painful ulcers follo ing moderate burns, and in inflamed and painful chancres, especially in combination ith :ymphea.AHC< Current Medicinal Use: • 1ulmonary !onditions9 1runus strongly sedates the cough refle$. )or this reason, the primary use for 1runus is to allay irritated coughs. 6his action is most desired hen coughs disturb sleep or post&infection ith a lingering dry cough. ,t reduces nervous irritability and acts as a soothing mild astringent. Used acutely it may act as an tonic e$pectorant by reducing paro$ysms of coughs, acting as an astringent in mucous&laden lungs and bronchioles. ,n general, 1runus gently improves appetite, digestion, and general strength. 6hese latter actions give 1runus added indication in the post&convalescence stage of bronchitis. Current +esearch +eview: • 5earch of /edline revealed no human trials as of 0ctober 2002.

#harmacy9 6he astringent impression it e$erts is scarcely noticeable unless the bar# is decocted. %ecoction removes the soothing and volatile qualities, hich are preserved by infusion. ,nfusion9 Atsp dried bar#3cupK A cup 6,% A9E tincture9 2&< ml 6,% Contraindications: %epressed and sluggish conditions do not respond ell to 1runus because of its sedating influence on the nervous system and circulation. 1runus should be avoided during pregnancy or for prolonged periods of use due to the cyanogenic glycoside prunisin.AHCE )o*icity: :o information is currently available from the selected resources
1790 1791

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 1792 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 1793 )elter 1794 !oo# 1795 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A3E

#ulmonaria officinalis

Boraginaceae (Borage =amily Common name: .ung ort, 5potted .ung ort, /aple .ung ort, -erusalem !o slip, 5potted !omfrey. :ote9 %o not confuse 3 5ticta pulmonaria, hich is also called .ung ort. 6his herb is also used for respiratory complaints, but is instead in the .ichenes =.ichen> family. Common )rade @ame: .ung ort !ompound =formerly Bleeders Blend> W as tablets ] e$tracts. AHCF Ha!itat: 6hroughout 'urope, including Britian. Botanical description9 1. officinalis is a perennial standing about A foot high. 4hi(ome is thin ] branched, first producing flo ering shoots ] then the leaf rosettes. 6he shoots are fresh green ] covered in glandular hairs. 5tems are erect, slightly angular ] cordate to ovate, acute, ] are more long than ide 3 hitish spots. .eaves are alternate, tapering into a inged stem ] are sharply pointed ] lanceolate. 0nly the lo er leaves have some pinnatifid ribs. 6he blue, later blue&violet flo ers are in terminal curled cyme&li#e inflorescence on flo ering branches in /ay. 6he caly$ is fused ] has five tips. 6he corolla is fused into a tube ] the five tips are rotate. 6here are E stamens ] a <&valvular ovary 3 a single stylet, that can be either short or long. 6here are E tuffs of hair at the enterance to the corolla tube. 6he fruit consist of < nutlets, hich are 3.E &<.0 mm in length, glabrous, glossy bro n to blac#, mildly #eeled 3 a distinct ring.AHCH .ung ort prefers shady areas, ] is 3o any particular odour. #arts used9 .eaves. %ried ] fresh aerial parts. $nergetics: 1articular affinity for the chest ] lungs, esp. if there is associated bleeding. AHCB Constituents • /ucilages9 polygalacturonane, arabinogalactans, rhamno& galacturonane. • )lavonoids9 in particular 0&glycosides of the #aempferols ] quercetin. • 5ilicic acid9 more than 2.EG soluble silicic acid. • Allantoin. • !affeic acid derivatives9 chlorogenic acid, rosmarinic acid. • 6annins. • 5aponins. • 7itamins9 7it ! ] B2 "(55 • /inerals9 ,ron, !opper, 5ilver, /anganese, %erotin, 6itan, :ic#el, ] others.AB00 #harmacology: Anti&tussive action is thought to be d3t the presence of mucilages, hich hydrate ] soothe irritated tissues. 'mollient action can be attributed to the content of allantoin, hich is anti&inlammatory ] soothing. %uring topical application, astringent ] anti&inflammatory actions are attributed to the content of tannins ] flavonoids.K 3 the tannins causing precipitation of protein in the surrounding fluids to form a protective coating over a ound. AB0A

7itamin ] mineral content also essential in the healing of inflamed tissuesK either via stimulation of the immune system, acting as anti&o$idants, or both.
Medicinal actions: 'mollient. '$pectorant. Anti&hemorrhagic. Anti&tussive. Astringent. %emulcent. 1ectoral. 7ulnerary. Current > )raditional Medicinal Use: • 9astrointestinal Conditions: 1ulmonaria is astringent, ma#ing it useful in cases of diarrhea, esp. in #ids, ] in treating hemorrhoids. • 9enitourinary Conditons: 6o soothe ] astringe inflamed tissues of the #idneys ] associated urinary tract. • #ulmonary Conditions: Appling %octrine of 5ignatures, .ung ort can be used in chest conditions characteri(ed by congestionK here the hite spots on the leaves symboli(e locali(ed areas of lung congestion. As an e$pectorant, 1ulmonaria is most indicated in catarrhal lung conditionsK such as9 asthma, bronchitis, coughs, colds, ] influen(a. .ung ort is a gentle ] soothing tonic, ma#ing it most helpful hen the lungs ]3or throat are inflamed ] congested. 1ulmonaria seems to seal ea#ened tissues ] ta#e a ay inflammation. • )opical Applications: As a vulnerary, e$ternal application is useful for dressing ] ashing ounds, s ellings, ] in treating amenorrhea, as it is also antiseptic. .ung ort is thought to combine ell 3 /arrubium and .obelia.

Current +esearch +eview • 5earch of /edline yielded no human studies as of 5eptember 2002. #harmacy9 • ,nfusion9 A.E g qd =A tsp O 0.H g>AB02 5olvent9 Best in ater.AB03 )o*icity.Contraindications Unli#e other members of the Boraginaceae family, 1ulmonaria does not contain pyrroli(idine al#aloids.
1796 1797

Professional/s Handboo3 of 2omplementary J )lternati!e Medicines . 5pringhouse, 5pringhouse, 1ennsylvania, ACCC9<03. PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-, ACCB9A0H3. 1798 +utchens A4. >ndian Herbalogy of ;orth )merica. 5hambhala, Boston, /ass, ACCA9ABB. 1799 +utchens, ABB. 1800 +utchens, ABB. 1801 Professional/s Handboo3 of 2omplementary J )lternati!e Medicines , <02. 1802 1%4, A0H3 1803 +utchens, ABH&B.

#runus africanum.#ygeum africanum
Common name: 1ygeum, bitter almond, African plum tree Ha!itat: :ative to Africa.AB0<

+osaceae

Botanical description: 'vergreen tree that gro s to A20&AE0 ft in height. ,t has pendulous branches ith thic#, oblong&shaped, leather&li#e, mat&colored leaves and creamy hite flo ers. 6he ripe fruit =drupe> resembles a cherry. Bar# is dar#&bro n to gray. AB0E #art used: bar# $nergetics: Constituents: AB0F 6he ma"or active components of the bar# are9 • lipid&soluble pentacyclic triterpenes • sterolic triterpenes • fatty acids • esters of ferulic acid #harmacology: • 7irtually all of the pharmacological research has featured a pygeum e$tract standardi(ed to contain A<G triterpenes including beta&sitosterol and 0.EG n&docosanol. 6his e$tract has been e$tensively studied in both e$perimental animal studies and clinical trials ith humans. 6he primary target organ for pygeum@s effects in males is the prostate. AB0H • !hemical analysis and pharmacological studies indicate the lipophilic e$tract of pygeum bar# has three categories of active constituents9 phytosterols, pentacyclic terpenes, ferulic esters. AB0B o 6he phytosterols, including beta&sitosterol, have anti&inflammatory effects by interfering ith the formation of pro& inflammatory prostaglandins that tend to accumulate in the prostate of men ith B1+. o 6he pentacyclic terpenes have an anti&edema, or decongesting, effect. AB0C 6he pentacyclic triterpenes e$hibit anti& inflammatory effects ithin the prostatic epithelium and may be responsible for stimulation of the secretory cells of the prostate, seminal vesicles, and bulbourethral glands. ABA0 o )erulic esters reduce levels of prolactin and also bloc# cholesterol in the prostate. 6hese metabolites of cholesterol initiate degeneration of prostatic cells hich can promote prostatic enlargement. %rugs hich lo er cholesterol levels have been sho n to have a favorable influence on B1+, preventing the accumulation of cholesterol in the prostatic cells and limiting subsequent formation of damaging cholesterol metabolites. 1rolactin increases upta#e of testosterone in the prostate, and cholesterol increases binding sites for testosterone and its more active form dihydrotestosterone. • 6he fatty acid components are similar to those of 5erenoa repens and may e$ert similar effects as ell as improve the oral bioavailability of other components of the lipophilic e$tract. ABAA Medicinal actions: anti&inflammatory, decongestant )raditional medicinal uses: • 6he po dered bar# of pygeum is used by the natives of tropical Africa as a treatment for urinary disorders, often given ith a palm oil or mil#. ABA2 Current medicinal uses: • 1rostate disordersABA3 o B1+ & !0!+4A:' 4'7,'W ABA<9 A total of AB randomi(ed controlled trials involving AEF2 men met inclusion criteria and ere analy(ed. 0nly one of the studies reported a method of treatment allocation concealment, though AH ere double&blinded. 6here ere no studies comparing 1ygeum africanum to standard pharmacologic interventions such as alpha&adrenergic bloc#ers or E&alpha reductase inhibitors. 6he mean study duration as F< days =range, 30&A22 days>. 2ompared to men recei!ing placebo, Pygeum africanum pro!ided a moderately large impro!ement in the combined outcome of urologic symptoms and flo: measures1 /en using 1ygeum africanum ere more than t ice as li#ely to report an improvement in overall symptoms. :octuria as reduced by ACG, residual urine volume by 2<G and pea# urine flo as increased by 23G. Adverse effects due to 1ygeum Africanum ere mild and comparable to placebo. o 1rostatitis

• /ale infertility and impotenceABAE #harmacy: • 5tandardi(ed e$tract9 o .ipophilic e$tract =standardi(ed to A<G of triterpens, including β&sitosterol and 0.EG n&docosanol>9 A00&200mg3day in divided doses. !rude herb is not used.ABAF o B1+9 E0&A00 mg B,%.ABAH o 1rostatitis9 E0&A00 mg B,%. ABAB Drug interactions: :o interactions are #no n to occur, and there is no #no n reason to e$pect a clinically significant interaction ith pygeum.ABAC Contraindications: :o interactions are #no n to occur, and there is no #no n reason to e$pect a clinically significant interaction ith pygeum.AB20 )o*icity.4ide effects:"/0" • Acute or chronic to$icity tests in animal trials are negative. :o significant to$icity as demonstrated in human clinical trials. /ost common 5'9 gastrointestinal irritation =symptoms range from nausea to severe stomach pain>
1804 1805

-oseph '. 1i((orno -r, /ichael 6. /urray =eds.>, Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, 'dinburgh, ACCC, 7ol. ,, p. C03. ,bid. 1806 ,bid. 1807 ,bid., p. C0<. 1808 /ichal 6. /urray, The Healing Po:er of Herbs, rev 2nd ed., 1rima 1ublishing, 4oc#lin, !A, ACCE, pp. 2BFWC3. 1809 ,bid. 1810 1i((orno, p.C0< 1811 ,bid. 1812 /urray, p.2BH 1813 1i((orno, p. C0<. 1814 Wilt 6. J1ygeum africanum for Benign 1rostatic +yperplasiaJ =!ochrane 4evie >. !ochrane %atabase 5yst 4ev. 2002K=A>9!%00A0<<. 1815 1i((orno, p. C03. 1816 ,bid., p. C0H. 1817 /elvyn 4. Werbach and /ichael 6. /urray, 2nd ed., Botanical >nfluence on >llness: ) ,ourceboo3 of 2linical Research, 6hird .ine 1ress ,nc., 6ar(ana, !alifornia, 2000, p.AAB. 1818 ,bid, p.E<2. 1819 I/onograph9 1ygeum,J ;atural Medicine Database, April AC, 2002, chttp933 .naturaldatabase.com3monograph.aspamonodidO3BB]hiliteOAY =April AC, 2002>. 1820 ,bid. 1821 ,bid, p.AAB.

Kuercus ro!ur. K2 al!a
Common name: 2. robur=common oa#> 2. alba = hite oa#> Ha!itat9 6hroughout 'urope, cultivated else here

=agaceae

Botanical description9 0a# is a large tree that gro s very a ide trun#. 6he leaves are green ith largely toothed margins. 6he male flo er is a drooping cat#in, the female flo er is a cup&shaped cluster. 6he bar# is greyish on the outside ith a reddish&bro n inner surface ith longitudinal striations. 6he taste is astringent. #art used: Bar# Historical Use: 6he *ree#s held the 0a# sacred, the 4omans dedicated it to -upiter, and the %ruids venerated it. 'lders of the 5aanich and !o ichan !oast 5alish people of southern 7ancouver ,sland treat many ailments ith bar# preparations. ,ntervie s ith t o elder 5alishan omen revealed that9 respiratory ailments ere treated ith bar# of 2uercus garryana. AB22 Constituents9 tannins =up to AE&20G consisting of phlobatannin, ellagitannins, and gallic acid> Medicinal actions: Astringent, hemostatic, antiseptic Medicinal use: 2uercus robur is used almost e$clusively for the treatment of inflammation that has resulted in e$cessive discharges =mucus, ater, blood>. 2uercus is a strong astringent and antiseptic and a mild tonic to the tissues hich it contacts. 2uercus seems to be most efficacious in situations of congested, s ollen tissues. ,n small doses, 2uercus acts as a tonic for debilitated tissues and atonic organs ith discharge =i.e. passive hemorrhage from the bo el, uterus or lungs>. • 1ulmonary!ondtions9 2uercus is useful in the treatment of pharyngitis and diptheria as a gargle, in the treatment of diarrhea as tea or tincture. • *astrointestinal !onditions9 ,t is used in the treatment of hemorrhoids as an enema, suppository, or compress. ,n addition, 2uercus is effective treatment for aphthous stomatitis. ,n cases of intestinal hemorrhage or diarrhea, 2uercus combines ell ith a carminative such as cinnamon or fennel. )ccording to Mills and Bone:%(&C • *astrointestinal !onditions9 ,ndications for tannins include inflammation of the upper digestive tract and diarreha follo ing gastrointestinal inflammation. • 6opical Applications9 6annins are also indicated for open, discharging lesions, ounds, hemorrhoids and third degree burns. )ccording to .ing:%(&' 0a# bar# is slightly tonic, po erfully astringent, and antiseptic. ,n colli<uati!e s:eats, the decoction is usually combined ith lime& ater. 4pecific ,ndications and Uses: 4ela$ation of mucous membranes, ith unhealthy dischargeK ulcerations, ith spongy granulations. • *astrointestinal !onditions9 ,t is useful, internally in chronic diarrhoea, chronic mucous discharges, passi!e hemorrhages , and • herever an internal astringent is required. ,t is used as an astringent in"ection for prolapsus ani, hemorrhoids, etc. ,n sic#ly, debilitated children, and in severe diarrhoeas, especially hen the result of fe!ers, the decoction, given internally, and used as a bath to the body and limbs, 2 or 3 times a day, ill be found very efficient. When given for diarrhoea or dysentery, it should be combined ith aromatics, and sometimes ith castor oil. • *ynecologic !onditions9 ,t is used as an astringent in"ection for leucorrhoea = a douche rather than an enema in this case> • 1ulmonary!ondtions9 ,t is, ho ever, more generally used in decoction, as an e$ternal agent, hich forms an e$cellent gargle for relaxed u!ula and sore throat, a good stimulating astringent lotion for ulcers ith spongy granulations. A coffee made from roasted acorns, has been highly recommended in the treatment of scrofula 0cer!ical tuberculosis lymphadenitisB. • 6opical Applications9 6he ground bar#, made into a poultice, has proved useful in gangrenous or mortified conditions. A bath is often advantageous in some cutaneous diseases. 6he green bar# of elder and hite oa# bruised together, or in strong decoction, forms a very useful and valuable application to abrasions. )ccording to ,cudder:%(&# 6he 4ed 0a# is not only astringent from its tannic acid, but it possesses other properties that ill render it useful in some cases. Among them is its tonic influence, and its action upon s#in and #idneys. , have used it in chronic ec(ema associated ith 4ume$, both as a local and internal remedy, ith mar#ed advantage. A combination of 2uercus 4ubra, 4ume$ and Alnus is my favorite remedy in obstinate cases of scrofula here there are old ulcers, feeble tissues and cicatrices. ,n these cases , use it as a local application and as an internal remedy. #harmacy9 6annins should be ta#en after food in most cases. )or some lesions of the upper digestive tract, short&term use bet een meals or before food is "ustifiable. .ong&term therapy ith high doses of tannins is not advisable. AB2F

1o der9 A&2 g 6,% =Alschuler> %ecoction9 A tsp. cupK A cup 6,% =Alschuler> sig, A to 2 fluid ounces =?ing> 4;t&actfrom E to 20 grains =?ing> A9E tincture9 A&3 ml 6,% =Alschuler> vii". of the fresh inner bar# to Alcohol HFS 0". %ose from gtts. v. to ss =5cudder> Contraindications: 6he use of tannins is contraindicated or inappropriate in cases of constipation, iron deficiency and malnutrition. AB2H 6annin rich herbs may reduce the absorption of al#aloids and other basic drugs through precipitation. )ull baths for eeping ec(ema, fever, infections, stage 3 or < heart failre and stage < hypotonia are contraindications for 2uercus as ell. AB2B )o*icity:

+auwolfia serpentina
Common name: ,ndian 5na#eroot Ha!itat: *ro s in ,ndia and 5' Asia.

Apocynaceae

Botanical description9 6he leaves are lanceolate and ridged ith smooth margins. 0ccasional flo er heads appear on the stem and produce a cluster of bell&shaped flo ers. 6he root is fine and branches to form several roots ith rootlets. #arts used9 root Constituents AB2C • Al#aloids9 4eserpine is the most idely used and studied preparation. 1o dered 4au olfia serpentina contains several al#aloids.Although individual 4au olfia al#aloids differ slightly in chemical structure, they have similar actions, uses, and cautions. #harmacology: AB30 6he precise mechanism of the hypotensive action of 4au olfia al#aloids has not been established. 4au olfia al#aloids deplete catecholamine and serotonin stores in many organs, including the brain and adrenal medulla, and reduce upta#e of catecholamines by adrenergic neurons. An increased sensitivity of the effector cells to catecholamines reportedly may result. Although the hypotensive effects of the 4au olfia al#aloids appear to result largely from peripheral adrenergic bloc#ade, !:5 effects probably are also involved. With repeated doses of 4au olfia al#aloids, depletion of catecholamine stores occurs very slo ly, resulting in a very gradual decrease in peripheral vascular resistance and blood pressure hich is frequently associated ith bradycardia. With prolonged therapy, venous dilation and peripheral pooling of blood reduce venous return to the heart and cause decreased cardiac outputK a slight decrease in renal blood flo and glomerular filtration rate may result. With usual oral doses of the drugs, cardiovascular refle$es are only partially inhibited and postural hypotension usually does not occur. 4au olfia al#aloids also produce a tranquili(ing effect, apparently due to depletion of serotonin and catecholamines in the brain. !onvulsions and e$trapyramidal reactions have occurred follo ing large doses. Although small doses of the drugs may stimulate respiration, large doses produce respiratory depression. %ecreased body temperature also may occur follo ing large doses. 5ympathetic inhibition produced by 4au olfia al#aloids also may result in vasodilation and increased cutaneous blood flo ith resulting flushing, feeling of armth, or nasal congestion. ,n addition to bradycardia, increased parasympathomimetic activity resulting from adrenergic inhibition produces increased *, motility, increased gastric acid secretion, and miosis. %uring prolonged therapy, atrioventricular =A7> conduction time may increase, apparently due to an increase in the refractory period of the A7 conduction system follo ing depletion of myocardial catecholamine stores as ell as adrenergic bloc#ade. 5odium and ater retention may occur in patients receiving 4au olfia al#aloids, especially if a diuretic is not administered concurrently, and may result in tolerance to the hypotensive effect of the drugs. 4au olfia al#aloids may increase prolactin secretion =dopamine is 14. inhibiting factor>. 0nly limited information is available on the pharmaco#inetics of 4au olfia al#aloids in humans. ,n one study in a small number of healthy individuals, pea# blood concentrations of radioactivity occurred ithin 2 hours follo ing oral administration of a single 0.2E&mg dose of radiolabeled reserpine in an alcoholic solution. 6he onset and duration of the pharmacologic effects do not appear to be related to al#aloid concentrations in the blood or brain. 6he full effects of fi$ed oral doses of the drugs are usually delayed for at least 2Z3 ee#sK !:5 and cardiovascular effects may persist several days to several ee#s after chronic oral therapy is discontinued. Medicinal actions: +ypotensive )raditional Medicinal Use: :o information is available in ?ing@s or !oo#@s dispensatories. Current Medicinal use: • Behavioral and 1sychological !onditions9 4au olfia al#aloids have been used in the symptomatic treatment of agitated psychotic states such as schi(ophrenic disorders. Although other antipsychotic agents have generally replaced the al#aloids, 4au olfia al#aloids may be beneficial in some patients ho cannot tolerate other antipsychotic agents or ho also require antihypertensive therapy.AB3A • !ardiovascular !onditions9 6he main indication for 4au olfia is hypertension as the al#aloids create a gentle hypotensive effect. Blood pressure ill ta#e 2&3 ee#s to respond, but may return to pre&treatment levels several ee#s after discontinuation of the 4au olfia. 4au olfia is also best used in combination ith other anti&hypertensives in order to avoid large doses of it. By using moderate therapeutic doses, the ma$imum therapeutic effect of 4au olfia may not be evident for F&A2 months after beginning continuous treatment ith it. +o ever, larger doses may cause nasal congestion, diarrhea, and depression. 4au olfia al#aloids are used in the management of mild to moderate hypertension. ,n the stepped&care approach to antihypertensive drug therapy, adrenergic inhibitors including 4au olfia al#aloids generally are considered step 2 drugs and generally are reserved for patients ho fail to respond to nondrug therapies and ho fail to respond to therapy ith a step A drug

•

=e.g., diuretics, beta&adrenergic bloc#ing agents, angiotensin&converting en(yme QA!'R inhibitors, alpha A&adrenergic bloc#ing agents>. AB32, AB33 4au olfia al#aloids are generally most effective hen used ith a diuretic. 6he use of a diuretic may prevent sodium retention, edema, and resulting tolerance, hich may occur during 4au olfia al#aloid therapy. 4au olfia al#aloids also have been used ith other hypotensive agents, permitting a reduction in the dosage of each drug and, in some patients, minimi(ing adverse effects hile maintaining blood pressure control. AB3<, AB3E 'ndocrine !onditions9 4eserpine has been used as short&term ad"unctive therapy in the treatment of tachycardia, palpitation, and psychological disturbances in patients ith thyroto$icosisK ho ever, propranolol is the drug of choice. 4eserpine may be useful in the management of thyroto$icosis resistant to propranolol. 4au olfia al#aloids do not affect the underlying disease, hich must be treated ith an antithyroid agent or other measures. AB3F

#harmacy9 ,ndole al#aloids obtained from Rau:olfia serpentina or other Rau:olfia species are commercially available as a po dered dried hole root preparation of Rau:olfia serpentina, a partially purified al#aloidal fraction of Rau:olfia serpentina =Alsero$ylon>, and as pure al#aloids =deserpidine and reserpine>. .actose, starch, or 4au olfia serpentina containing a higher or lo er al#aloid content is added to the commercially available product so that it contains 0.AEZ0.20G of the reserpine&rescinnamine group al#aloids, calculated as reserpine. Alsero$ylon, an e$tract of Rau:olfia serpentina containing reserpine and other fat&soluble al#aloids, is standardi(ed so that it contains H.EZA0G of the reserpine&rescinnamine group al#aloids, calculated as reserpine. Begin ith small doses and increase gradually until there is a drop in blood pressure or side&effects develop =nasal congestion, diarrhea, depression>. A hole e$tract used in the po dered form is most desirable9 E0&300 mg daily. 6he pure al#aloid reserpine is initially dosed at 0.E mg daily for A&2 ee#s, hich is then lo ered to a maintenance dose of 0.A&0.2E mg daily. Contraindications: !ontraindicated in pregnancy =teratogen and abortifacaent>, depression, peptic ulcers, hyperprolactinemia. )o*icity9 5igns of to$icity include9 sedation, depression, nightmares, abdominal cramps, diarrhea, gastrointestinal ulceration and hemorrhage, ater retention, nasal congestion, flushing of the s#in, pinpoint pupils, hypotension, bradycardia, vertigo, stupor, tremors, coma.
1829

American +ospital )ormulary 5ervice %rug ,nformation, a %rug ,nformation 4eference from the =H2H2 Wisconsin Avenue Bethesda, /% 20BA< 30AWFEHW3000 >. . Accessed C.30.0A. 1830 American +ospital )ormulary 5ervice %rug ,nformation, a %rug ,nformation 4eference from the =H2H2 Wisconsin Avenue Bethesda, /% 20BA< 30AWFEHW3000 >. . Accessed C.30.0A. 1831 ,bid 1832 ,bid 1833 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 202 1834 American +ospital )ormulary 5ervice %rug ,nformation, a %rug ,nformation 4eference from the =H2H2 Wisconsin Avenue Bethesda, /% 20BA< 30AWFEHW3000 >. . Accessed C.30.0A. 1835 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 202 1836 American +ospital )ormulary 5ervice %rug ,nformation, a %rug ,nformation 4eference from the =H2H2 Wisconsin Avenue Bethesda, /% 20BA< 30AWFEHW3000 >. . Accessed C.30.0A.

+hamnus purshiana. +2 frangula
Common name: !ascara sagrada =4. purshiana>3 Buc#thorn =4. frangula>

+hamnaceae

Ha!itat9 :ative to the 1acific !oast of :. Amercia 4hamnus pushiana is a small tree that prefers the base and sides of canyons. Botanical description9 6he tree gro s to a height of AE&20 feet and has dar# green elliptical leaves that are from 2&F inches long. ,t bears small greenish flo ers hich are follo ed by blac# berries. 6he bar# is shaved off. ,t has a smooth e$terior that is covered ith a removable greyish& hite layer. Underneath, the inner bar# is reddish&bro n and the internal layer is pale yello ish&bro n. #arts used9 Bar#, collected in the spring and early summer hen it is easily peeled from the ood. 6he bar# is stored for at least one year =up to 3> in order to allo for the consitituents =most li#ely glycosides> that ould other ise cause griping to decompose. 6he collected bar# is dried in the shade. Historical uses9 6his plant as introduced to 'uropeans and 5paniards in the :e World from :ative Americans ho used this bar# e$tensively for constipation. 6hey ould ma#e a decoction of the bar#. ,n ABHH, %r. Bundy as introduced to cascara and ma#e a fluid e$tract hich quic#ly became a favorite la$ative throughout the orld. Constituents9 Anthroquinone glycosides =up to A0G>, emodin glycosides, dianthrones, free aglycones. #harmacology: 6he anthraquinone glycosides are absorbed into the blood and are then re&secreted into the intestinal lumen hich irritates the intestinal muscle and mucosa. 6he net result is intestinal contraction and increased intestinal secretions. 6he emodin glycosides tend to inhibit smooth muscle contraction hich may help to mitigate the cathartic action of the anthraquinone glycosides. 6hose agents that or# to stimulate bo el function are divided into four groups based on the amplitude of action9 A. Aperients are mild la$atives that help to promote the natural movement of the bo els rather than provo#ing movement other ise. e.g. psyllium seed, fla$ seed, fiber, 4ume$, )oeniculum, 6ara$acum, bile. 2. .a$atives are plants that actively promote bo el movement. /ost contain anthraquinones and are ell indicated for long term , chronic use. e.g. !ascara sagrada 3. !athartics are plants that stimulate bo el movement but are stronger and quic#er acting than la$atives. Usually ithin 3 hours of ta#ing the plant, there is an uncontrollable urge to defecate. /any plants can have either a la$ative or a cathartic action depending on the dose and timing of the doses used. e.g. -uglans nigra, Aloe vera, !assia angustifolia =5enna>. <. 1urgatives are plants cause drastic purgative action. 6hese remedies ere given as a ay to clear the system of to$ins and ere usually given ith emetics. 6hese are not used in modern medicine because they are considered too to$ic. Medicinal actions: .a$ative, bo el tonic, bitter )raditional Medicinal Use: • *astrointestinal !onditions9 'lling ood described the la$ative action of !ascara, small doses being mild enough for constipation in pregnancy. ?ing did not describe these plants. !oo# described the use of the berries of 4. catharticus =4. frangula> and those being more severe cathartics than the bar#.AB3H 'lling ood also indicated !ascara for catarrhal gastric or intestinal mucosa here it tonifies and astringes. 6hus, it as used for diarrhea ith these underlying characteristics. AB3B • +epatobiliary !onditions9 'lling ood described its use in chronic liver conditions ith deficient biliary secretion. AB3C Current Medicinal use: • *astrointestinal !onditions9 4. purshiana stimulates the bo el through irritation. 4. purshiana can be la$ative or cathartic depending on the dose and the sensitivity of the personNs bo el. 4hamnus is most indicated in chronic constipation. ,t is a gentle, tonifying la$ative and is therefore ell indicated in the elderly and pediatric populations. 0verall, 4. purshiana is stimulating and is thus most indicated in atonic constipation. )or cases of chronic constipation, the use of 4. purshiana can be curative if dosed appropriately. :ote that because of the emodin glycosides and the tonifying effect on the intestines, 4hamnus may be useful in cases of diarrhea, due to lac# of efficient contractions and over&secretion. Current +esearch +eview: • 5earch of /edline revealed no clinical trials as of 0ctober 2002. #harmacy9

A dosage regimen for chronic constipation ould start ith once daily dosages for a ee# and increase ee#ly to a ma$imum of a three times daily dosage =if this is not too cathartic> and then decrease the dose in the same fashion. 1o dered bar#9 A&2.Eg3dose !ascara liquid e$tract =B1>9 2&E ml3dose !ascara 'li$ir =B1>9 2&E3dose %ecoction of root9 A&2 tsp.3cup3dose A9E tincture 0.E&Aml3dose. Contraindications: Brin#er speculates that !ascara should be avoided hen nursing or during pregnancy. +e further states that empirical evidence supports it not to be used in intestinal inflammatory disease, during menstruation, in diarrhea, debilitation, intestinal obstruction or abdominal pain of un#no n cause, in children or for e$tended use. )inally, he indicates potential drug interaction ith cardiac glycosides and diuretics.AB<0 )o*icity9 )resh 4hamnus purshiana bar# is emetic and cathartic.
1837 1838

!oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy . 'clectic /edical 1ublications, 5andy, 04 ACBE p. 'lling ood, )1 )merican Materia Medica, Therapeutic and Pharmacognosy1 'lling ood@s 6herapeutist, !hicago. ACAC p. 303 1839 'lling ood, p. 303 1840 Brin#er, ). Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. <B&C

+heum palmatum. +2 officinale
Common name: 6ur#ey rhubarb Ha!itat9 :ative to !hina no cultivated orld& ide

#olygonaceae

Botanical description9 6he leaves of 4. palmatum are palmate and roughK the root is thic# and oval ith long branchesK the stem is erect, round, hollo , branched and gro s to a height of F&A0 feet. 6he taste is bitter and the odor aromatic. 6he root is gathered hen the plant is F years old in late summer. #arts used9 4hi(ome Constituents9 Anthraquinone glycosides including emodin, tannins, stilbene derivatives, volatile oil, rutin, fatty acids, calcium o$alate #harmacology: :o information is currently available Medicinal actions: Astringent, aperient, tonic, stomachic, sialogogue )raditional Medicinal Uses: • 9astrointestinal Conditions: According to !oo# and 'lling ood, 4heum has the combination of rela$ant, stimulant, and astringent qualities resulting in both tonification of deficiency and restraining e$cess. AB<A,AB<2 6he first t o perform a mild tonic action and the last diminishes mucous discharges. ;et, 4heum rarely relieves constipation although it has an astringent quality. ,ts action is mild leaving a soothing impression on the intestinal mucous membranes. +o ever, the action is dose dependent9 in small doses, it soothes cases of indigestion accompanied by acidity, gastric la$ity, loose bo el movements in the morning, and sallo comple$ion. 6hese effects are due to its cholagogue action. ,n larger doses it is gently la$ative, increasing peristaltic motion and dislodging impacted feces =scybala> or other accumulations. ,n sensitive persons, or hen the intestinal tract is sensitive, large doses may cause gripingK and in febrile conditions the pulse is accelerated. ,ts action is peculiarly beneficial in diarrhea and dysentery by dislodging crude material. Whether for diarrhea or as a la$ative the stimulated bo el movements are not atery, but consolidated. 6o tell that 4heum has been absorbed one ill note that the saliva becomes yello quic#ly and the feces also become yello in ten to t enty hours, or hen it has passed through the bo els. ,t may even color the urine and perspiration. Current Medicinal use: 4heum palmatum is most often used for its la$ative effects. 6he la$ative effects are the result of the anthraquinone glycosides stimulating peristalsis. %epending on the dose given, 4heum ill act as an aperient or a la$ative. 6he presence of tannins lend an astringent effect. 6his astringent action has a tonifying effect and thus 4heum is especially ell indicated in atonic constipation or diarrhea secondary to lac# of tone. 4heum has an antiseptic action as ell. 6he astringent, antiseptic and la$ative actions also ma#e 4. palmatum ell indicated in infectious diarrhea in order to both promote elimination hile allaying the ater, mucous, and blood loss from the intestines. 6he emodin and volatile oil lend an antispasmodic effect hich helps to mitigate the gripping associated ith la$ative use. 6he bitter taste of 4heum enhances appetite and digestion. 4heum appears to specifically enhance gastric secretions and the secretion of bile =cholagogue>. :ote that other species of 4hubarb ='nglish, American and ,ndian> possess the same actions as the 6ur#ish rhubarb, but are ea#er in their effects. Current +esearch +eview: • Urology: o Chronic renal failure: AB<3  %esign9 4andomi(ed controlled clinical trial.  1atients9 !hronic renal failure patients ith elevated levels of urinary ,.&F  6herapy9 4heum palmatum and captopril W e$perimental groupK captopril W control group.  4esults9 Urinary ,.&F and serum creatinine levels reduced significantly in the study group. Authors concluded that 4heum palmatum improves renal function by inhibiting the production of ,.&F and lo ering immune inflammation. • 9astroenterology: o 9astric and duodenal ulcer !leeding: AB<<  %esign9 !ontrolled clinical trial.  1atients9 3A2 patients ith duodenal and gastric ulcers ith positive occult blood.  6herapy9 Alcoholic e$tracts of 4heum officinale Baill, 4heum palmatum ., and 4heum tanguticum /a$im e$ Balf tablets.



4esults9 0ccult blood changed from positive to negative for9 C0.HG of patients over EH.A hours in 4heum officinale Baill group, C3.HG of patients over E3.< hours in 4heum palmatum . group, and C2.BG of patients over EF hours in 4heum tanguticum /a$im e$ Balf. /edical difference as found to be insignificant bet een the groups. 6he e$tracts ere concluded to be efficient in curing the upper digestive tract bleeding.

#harmacy9 4hubarb po der9 %ecoction9 A9E tincture9 0.E&Eg3day A tsp.3cupK A cup 6,% up to F ml3dayK <0 ml3 ee# ma$.

Contraindications: Brin#er speculates that 4heum should be contraindicated in pregnancy, hen nursing or ith #idney stones. +e further states that empirical evidence supports its contraindication ith children, fever, inflammation, intestinal obstruction, abdominal pain, hemorrhoids or prolonged use.AB<E )o*icity9 %iarrhea ith mild gripingK icterus and hepatic enlargementK renal insufficiency and proteinuria. 6reat by precipitating o$alates by giving calcium orally, ensure elimination, maintain hydration.
1841 1842

!oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy . 'clectic /edical 1ublications, 5andy, 04 ACBE p. 'lling ood, )1 )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago. ACAC p. 30< 1843 5ong +, Wang 8, 8hang ). ,nvestigation of urinary interleu#in&F level in chronic renal failure patients and the influence of 4heum palmatum in treating it. ?hongguo ?hong @i Ai 7ie He ?a ?hi 2000K20=2>9A0H&C 1844 8hou +, -iao %. 3A2 cases of gastric and duodenal ulcer bleeding treated ith 3 #inds of alcoholic e$tract of rhubarb tablets. ?hong @i Ai 7ie He ?a ?hi ACC0KA0=3>9AE0&A, A3A&2. 1845 Brin#er, ). Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AAE&F

+icinus communis
Common name: !astor bean Ha!itat9 :ative of ,ndia, cultivated orld& ide

$uphor!iaceae

Botanical description9 !astor oil plant can attain a height of 30&<0 feet in tropical climates or may be a shrub <&E feet high in temperate climates. Alternate leaves are F&B inches across, palmate, toothed edges, and blue&green in color. 6he stem is purplish in color. 6he flo ers are on a clustered, oblong, terminal spi#e. 6he fruit is blunt, green, smaller than A inch diameter and covered ith pric#les. ,nside the fruit are small oval seeds. #arts used9 5eeds, leaves, young seedlings Constituents9 ricinoleic acid, fi$ed oils, ricin =to$albumin>, ricinine Medicinal actions: .a$ative, anti&inflammatory Medicinal use: 4icinus has both internal and e$ternal application. ,nternally, 4icinus is used as a purgative agent. 6he seeds are highly to$ic hen ta#en internally and thus must be used ith e$treme caution. 6he to$ic constituent, ricin, is not absorbed from the gastrointestinal tract hich gives 4icinus a indo of therapeutic action. 6he oil of 4icinus does not e$tract the ricin and therefore is safer to ta#e internally. As a purgative, its effect dramatic and pronounced. 6he ricinoleic acid e$erts the purgative effect. )our to five hours after ingestion, purgation ill result. !astor oil produces sure purgation, but is not painful. !astor oil is indicated for sporadic use, but is not indicated in chronic cases of constipation because over time, its use ill be irritating to the intestines. !astor oil is ell indicated in the treatment of constipation, food poisoning or indigestion in children. ,f disguised in s eet "uice or oil, castor oil ill cause purgation and ill also contribute to somnolence after ards. !astor oil is often used as a purgative before and3or after vermifuges are given to aid in the e$pulsion of orms. 4icinus oil commonly produces nausea and this detrimental effect is mitigated by the use of /entha piperita lo(enges. 4icinus combines ell ith 4heum palmatum to produce sure purgation. '$ternally, 4icinus is applied over an area of inflammation or in"ury. ,ts topical application reduces inflammation of the tissues in the area and speed healing time of in"ured tissue. !astor oil applied topically over the intestines ill also promote purgation. 6opical application is also safe because the main to$ic ingredient, ricin in not e$tracted from the seeds into the commonly used oil. #harmacy9 ,nternally9 A 6B. castor oil 2% & B,% '$ternally9 Apply 4icinus oil as needed over intact s#in

)o*icity9 6o$ic dose is 2&< seeds for adults. )atal dose is 2&< dose in children, B seeds in adults. >t should not be used :ith Dryopteris felix9mas as it increases the toxicity of the male fern1 4icinine is considered one of the most to$ic materials #no n. 6o$icity symptoms9 ,mmediately9 burning of mouth and throat, thirst, vomiting, stomach pain, dull ea# rapid pulse, uremia, diarrhea, colic. 2&E days later9 h3a, di((iness, dullness of vision, depression, liver and #idney damage, retinal, scleral or !:5 hemorrhage, trembling, ea#ness, convulsions %eath up to A2 days after ingestion. 6reat ith emesis or gastric lavage, activated charcoal, vit. !, al#alini(e blood.

+osmarinus officinalis
Common name: 4osemary Ha!itat:

1amiaceae

Botanical description9 Woody stem, hich bears linear leaves about A.E&3.E cm long, green above and hitish beneath, ith strongly resolute margins. )lo ers are bluish and t o&lipped ith t o stamens only. #arts used9 herba Constituents "/:& • 7olatile oil =A.0&2.EG>9 chief components A,B&cineole =20&E0G>, alpha&pinene =AE&2EG>, camphor =A0&2EG>, further including among others camphene, borneol, isobutyl acetate, beta&caryophyllene, p&cymene, limonene, linalool, myrcene, alpha& terpineol, verbenol • %iterpenes =bitter>9 including, among others, carnosolic acid =picrosalvin>, isorosmanol, rosmadial, rosmaridiphenol, rosmariquinone • !affeic acid derivatives9 chief components rosmarinic acid • )lavonoids9 including, among others, cirsimarin, diosmin, hesperidin, homoplantiginin, phegopolin • 6riterpenes9 chief components are oleanolic acid =A0G>, ursolic acid =EG> #harmacology A number of constituents have sho n activity in !itro. 6he volatile oil, including eucalyptol =cineole>, is considered to have potent antibacterial effects and to rela$ smooth muscles in the lungs. AB<H Animal tests have demonstrated spasmolytic effects on the gallbladder ducts and on the upper intestine as ell as a positive inotropic effect and an increase in coronary blood flo . 0il of rosemary improves circulation hen applied e$ternally, due to a certain s#in irritant. AB<B 4osmarinic acid has antio$idant activity and another ingredient of rosemary, #no n as carnosol, inhibits cancer formation in animal studies. ,nhalation and oral doses of 4osemary oil can increase locomotor activity in mice. AB<C :o human studies confirm rosemary@s use for these conditions. Medicinal actions: Anti&inflammatory, tonic astringent, diaphoretic, stomachic, capillary stabili(er )raditional Medicinal Use: Both ?ing and !oo# described the leaves are diffusively stimulating and rela$ing in actionK and hen used as a arm infusion prove slightly diaphoretic and nervine, and some hat emmenagogue. 6he leaves considered useful in recent colds, recent suppression of the menses from e$posure, and as an antispasmodic in mild hysteria, painful menstruation, and other difficulties. • 6opical Applications9 6he oil is a good nervine stimulant for e$ternal uses, as in neuralgia and other acute painsK and enters into compounds named under camphor and spearmint. Current Medicinal Use: 4osmarinus rela$es smooth muscle spasm and the smooth muscles of capillaries and arteries, thus enhancing blood flo . 4osmarinus has a tonifying effect on the circulation and on the nervous system. • Behavioral and 1sychological !onditions9 ''* activity, alertness, and mood ere assessed in <0 adults given 3 minutes of aromatherapy using t o aromas, lavender =considered a rela$ing odor> or rosemary =considered a stimulating odor>. 1articipants ere also given simple math computations before and after the therapy. 6he lavender group sho ed increased beta po er, suggesting increased dro siness, they had less depressed mood and reported feeling more rela$ed and performed the math computations faster and more accurately follo ing aromatherapy. 6he rosemary group, on the other hand, sho ed decreased frontal alpha and beta po er, suggesting increased alertness. 6hey also had lo er state an$iety scores, reported feeling more rela$ed and alert and they ere only faster, not more accurate, at completing the math computations after the aromatherapy session. ABE0 • !ardiovascular !onditions9 4osmarinus may have a tropism to the cerebral vessels, and is used to increase circulation to the head and to improve mental clarity, improve memory, and improve vision. Also, diosmin decreases capillary fragility. Additionally, it increases coronary blood flo and e$erts a positive inotropic action in the myocardium. 4osmarinus oil may be applied topically for these purposes as ell as the tea or tincture ta#en internally. 6his ma#es 4osemary effective in chronic circulatory ea#ness including hypotension. • 'ndocrine !onditions9 Brin#er states that 4osmarinus has a hyperglycemic effect although no other information is provided. ABEA • *astrointestinal !onditions9 4osemary is an e$cellent tonic for the elderly as it ill stimulate the appetite and tonify the circulatory and nervous systems. 6he essential oils e$ert a carminative effect, and thus this herb may relieve flatulence, distention. 4osemary is spasmolytic on the bile duct and small intestine. At the same time, the bitterness of the plant lend it digestive strengthening and appetite stimulating effects.

• ,nflammatory !onditions9 4osemary is anti&inflammatory, most li#ely due to the rosmarinic acid, ursolic acid and apigenin. • 6opical Applications9 4osemary baths are a tonifying, stimulating option for persons ho are run&do n, hypotensive and pale. A rosmaricine derivative has stimulating and mild analgesic activity. 4osemary may be applied e$ternally over a painful area such as arthritic "oints and neuralgic areas in order to reduce the pain and inflammation. #harmacy9 Alcohol e$tractions are the ideal preparation of 4osmarinus since the alcohol ill e$tract the volatile oils ell. 4osemary ine has historically been used in place of tincture. A9E 6incture9 < ml 6,%K B0 ml ee#ly 6ea9 A tsp. dried herba3cupK A cup 6,% QA tsp. O 2 gR '$ternal applications9 baths, ointments Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: Brin#er contraindicates the use of 4osmarinus during pregnancy due to empirical emmenagogue and abortifacient effects and to$ic side effects of the essential oil. ABE2 )o*icity: :o information is currently available from the selected resources.
1846 1847

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1848 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1849 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 30. 1850 %iego, /A, Aromatherapy positively affects mood, ''* patterns of alertness and math computations. ,nt - :eurosci. ACCB %ecKCF=3&<>92AH&2<. 1851 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AFF 1852 Brin#er, p. AAH

+u!us ideas

+osaceae Common name: 4aspberryK other species include 4. villosus =blac#berry>, 4. canadensis =creeping blac#berry>, 4. trivialis =lo &bush blac#berry or 5outhern de berry>, 4. chamaemorus =cloudberry> and 4. odoratus =mullberry> Ha!itat: *ro s in dense clusters ith upright stems, hich are covered ith bristles and thorns. Botanical Description: 6he young stems are smooth and dotted. 6he leaves are compounds of 3&E oblong&ovate, pointed, and cut& serrated leaflets, hich are light green above and do ny hitish&gray beneath, A&2 in. long. 6he flo ers are hite ith E petals and ripening into a red, hemispherical fruit. #art Used: .eaves and fruit, root bar# of 4. villosus and 4. canadensis Constituents: .eaves9 6annins, v. oil, citric acid, malic acid, polypeptides, flavonoid glycosides, !a, /g, )e, niacin, 5e )ruit9 7its. A, !, ?, !a, /g Medicinal actions: Astringent, uterine tonic, facilitates parturition Medicinal use: • *ynecologic !onditions9 6he plant e$erts parado$ical actions of uterine rela$ation and tonification. 6he rela$ation may be due to the restoration of proper !a and /g concentrations and possibly due to the actions of the polypeptides =mechanism un#no nK perhaps incorporated into prostaglandin synthesis>. 6hrough its astringent effect, 4ubus tonifies the smooth muscle layer of the uterus such that there is increased contractility, regularity of contractions and decreased spasm. 6hus, 4ubus prepares the uterus for childbirth, but should not be used before AF ee#s of gestation because the rela$ing effect may too strong and threaten the pregnancy. )inally, 4ubus ideas can reduce post&partum hemorrhage, heavy menses, and after pains of labor. According to !ulpepper, raspberry is of a cooling nature. • *astrointestinal !onditions9 6he astringent effect is notable in the *, tract as ell. 4aspberry is useful in mouth and throat inflammation. 6he tannins bind to e$posed proteins on inflamed tissues, form insoluble comple$es hich, in turn, ma#e the proteins resistant to proteolytic en(ymes =thus reducing continued cell destruction ith resultant inflammation>. Additionally, the binding of tannins to tissue proteins reduces viscous mucous production, creating an astringent effect, and simultaneously e$erts a tonifying effect on these tissues. 4ubus =esp. 4. villosus Qblac#berryR> is anti&inflammatory and tonifying in cases of diarrhea. )ccording to Mills and Bone:%(#C • *ynecologic !onditions9 4ubus can be used in the short&term treatment of dysmenorrhea to relieve uterine spasm. 4ubus is also indicated in endometriosis demonstrating its use in chronic pelvic pain. ,n regard to partus preparation, 4ubus is indicated after the first trimester and li#ely builds up the strength of the myometrium. )ccording to .ing/s:%(#' 5pecific indications for 4. villosus include gastrointestinal atony ith copious, atery and pale alvine discharges. • *astrointestinal !onditions9 An infusion of the leaves of 4. idaeus or a decoction of the roots of 4. villosus or 4. canadensis is an e$cellent astringent remedy in diarrhea, chronic dysentery, cholera infantum, relaxed conditions of the intestines of children, passi!e hemorrhage from the stomach, bo:els and colli<uati!e diarrhea1 6he fruit, particularly of 4. villosus, ma#es an e$cellent syrup, hich is of much service in dysentery, relieving tenesmus and affecting cure. 6he "elly or "am may li#e ise be used in similar cases. 6he fruit of 4. idaeus, hen eaten freely, promotes the action of the bo els. 4ubus villosus is especially adapted to children/s diarrheas, the stools being copious, atery and clay&colored. 5uch children are pale, fretful, ithout appetite, there is deficient glandular activity and the gastrointestinal tract sho s evidence of enfeeblement and rela$ation. 6he decoction of the leaves of 4. idaeus ill allay nausea and vomiting. !ombined ith aromatic, the decoction is useful in diarrhea, cholera morbus and cholera infantum. • *ynecologic !onditions9 6he preparation as described above is beneficial for passi!e hemorrhage of the uterus. 6he decoction, used as an in"ection, is useful in gonorrhea, gleet 0mucous discharge from the urethra in chronic gonorrheaB, leu3orrhea and prolapse of the uterus or anus1 %uring labor, 4ubus idaeus ill increase the activity of the uterine contractions hen these are feeble, and is useful in after9 pains. • ,nflammatory !onditions9 4aspberry syrup, hen added to ater, forms a refreshing and beneficial beverage for fe!er patients and during convalescence. • *enitourinary !onditions9 4. odoratus is used freely in affections of the urinary organs and dropsy1 4. !hamaemorus is successfully employed in cystic debility and dropsy1 )ccording to 2oo3:%(## Rubus idaeus

•

• • • •

*astrointestinal !onditions9 6he leaves of the red raspberry are mildly astringent and of a peculiarly soothing nature, being very acceptable to the stomach, al ays leaving a slight tonic impression, often allaying nausea and vomiting. 6he infusion is a mil# astringent tonic in sub&acute dysentery and diarrhea, lessening the discharges ithout abruptly chec#ing them, and soothing instead of e$citing the bo els. ,t may be used as an in"ection for dysentery. :ervous !onditions9 ,t is soothing and sustaining to the nervous system. *enitourinary !onditions9 ,t e$erts a moderate impression the #idneys and may be used for mild catarrh of the bladder. *ynecologic !onditions9 ,t e$erts an influence on the uterus sustaining it in flagging labor. )or this purpose it has been made as an infusion ith !ypripedium and a minute portion of !apsicum. ,t also anticipates flooding and relieves after&pains. ,t may be used as an in"ection in leu#orrhea and mild gonorrhea. 0phthalmologic !onditions9 As a ash, it is e$cellent in recent opthalmia, especially in infants.

Rubus !illosus • 6he roots are strongly astringent, drying but not stimulating and e$ert some tonic action. 6hey are used in chronic dysentery and diarrhea and in sub&acute forms ith decided rela$ationK as an in"ection in prolapsus and leu#orrhea ith la$ity, prolapsus ani, bleeding pile and colliquative diarrheaK and as a ash to apthous sores, bleeding gums and other hemorrhages. !ombined ith 1imento or similar aromatics, they are good in passive uterine hemorrhage and e$cessive menstruation. • 6he fruit is #ind for ea# and irritable stomachs and may be used freely to the greatest advantage in diarrhea and bilious la$ity of the bo els in summer. ,t alone is often the only corrector of the bo els neededK though hen the stomach is quite sensitive, it should be crushed and strained to remove the seeds. ,t is frequently made into blac#berry cordial, for hich there are many formulas. #harmacy: 1o dered root bar#, 20&30 grains several times a day ,nfusion9 2 tsp. herb 3 A cup aterK sig A&2 cups 6,% QA tsp. O 0.F gR =Alschuler> A o( to a pint of boiling ater, strained ith pressure, sig A&2 o(. at suitable intervals =!oo#> %ecoction9 A&< o( of decoction ta#en several times a day ,n prolapsed uterus, it may be used either alone or combined ith the internal use of a decoction of equal parts of blac# cohosh and blac#berry roots, ta#en freely. =?ing@s> 4ubus villosus9 A o( root decocted for 2 hours in a pint of hot ater, sig A o( q 2&3 hours =!oo#> )luid e$tract A9A 2EG 't0+K sig E ml 6,% =Alschuler> during labor9 Eml doses, up to F $ qd =/ills and Bone> 'ye ash 7inegar or ine Blac#berry !ordial9 6a#e any desired quantity of berries and set them on a moderate fire until they begin to brea# then mash them ell and strain ith pressure. 6o each pint of "uice put t o drams each of 8ingiber, !innamomum and Allspice and one dram each of /ace, and cloves all ell crushed and tied in a thin piece of muslin and immersed in the "uice for an hour. ?eep at a moderate heat ith the vessel closely covered. 4emove the spices, press them ell, and to each pint of the "uice add a pound of hite sugar and dissolve. When cold add four ounces of brandy to each quart of the syrup and #eep in close bottles. 5ig A 6 <&F $ day. =!oo#> =:ote9 given the current insight as to the effects of sugar on the system a smaller amount or appropriate substitution may be recommended.>

Contraindications: 6he use of 4ubus in pregnancy has been proven in many cases and there is no evidence for any deleterious effect.ABEF Brin#er, on the other hand, suggests contraindication in pregnancy ith a history of precipitate labor due to its uterine stimulant activity as ell as it having antigonadotropic activity =empirical based on in vitro studies>. +e further states that it has uterine stimulant and hormonal effects as ell.ABEH Adapted from Brin#er9 ABEB Both 4. idaeus and 4. villosus have a tannin content of A0&AEG. When e$tracted in hot ater, tannins can precipitate al#aloids from plants, al#aloidal drugs, proteins, salicylates, iodine and iodides and metals thereby slo ing, reducing or bloc#ing their absorption. 6he drug&tannin reaction can interfere ith dosing if sources of the t o compounds are combined in solution prior to administration. %rug&tannin precipitates are maintained in an al#aline p+ and dissolve in an acid environment such as the stomach. Unless the solution is sha#en ell, precipitates ill settle in the bottom leading to lo or no amounts in initial doses and high or to$ic amounts hen the last doses from the bottle are ta#en. 6he precipitates are generally soluble in mi$tures containing over AE&<0G alcohol. 6annins ill not precipitate lo concentrations of al#aloidal salts in the presence of many of the gums. )o*icity: none found ith revie of the current literature

1853 1854

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 2<A, 2<<, 2<F )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. AFB2 1855 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. FFH&B 1856 /ills and Bone p2<F 1857 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AAE 1858 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AEH&B

+ume* crispus
Ha!itat: 4ume$ gro s in aste places, roadside ditches, and side al# crac#s=b>.

#olygonaceae

Common name: ;ello doc# =,n this monograph 4ume$ refers to 4. crispus. +o ever, 4 acetosa is another 4ume$ species having different medicinal qualities.>

Botanical description9 A perennial herb ith a yello tap root that gro s bet een B and A2 inches and an annual stem of 2&3 feet. 6he leaves are lanceolate, slender and have a crisp, avey margin. 1ale green drooping flo ers are interspersed ith the leaves. #arts used9 radi$ =harvest in late fall>. According to ?ing, the fresh root as much more active than the dried root. Historical uses9 4ume$ as popular among many :ative American tribes. ,t as used e$ternally as poultice to treat boils and other conditions in hich the pus needed to be dra n out. ,t as also used internally as la$ative and mild astringent tonic and for the treatment of many and diverse conditions in hich to$icity played a part. Constituents9 • Anthraquinone glycosides • 0$alates9 o$alic acid, calcium o$alate • 6annins =3&FG> =other 4ume$ species are generally more astringent> • )lavonoids9 including, among others, quercitrin • Anthracene derivatives =0.C&2.EG>9 aglycones physcion, chryosphanol, emodin, aloe&emodin, rhein, their glucosides • :aphthalene derivatives9 neopodin B&glucoside, lapodin • ,ron and other minerals #harmacology: 6he anthraquinone glycosides are absorbed in the "e"unum and are hydroly(ed during absorption. 6hey are then resecreted bac# into the bo el here they irritate, and hence, stimulate the intestines to undergo peristalsis. ;ello doc# contains relatively small amounts of anthraquinone glycosides, compared ith other botanicals ith these constituents. ABEC Medicinal actions9 Alterative3%epurative, Aperient, Astringent, !holagogue )raditional Medicinal Use: !oo# described 4ume$ as a slo ly rela$ing and stimulating alterative hich has a mild astringency that leaves behind a mild tonic impression. ,t or#s in the classic sense of an alterative by removing aste material, supporting tissue restoration. ABF0 6he alteratives are indicated hen there is ulceration of the mucous membranes or disease of the s#in results from impure blood. A chief use made of it as in scrofulous conditions, particularly of the s#in and *, tract. ABFA /ucous membranes that lac# tone responds ell to 4ume$, particularly hen combined ith an astringent. 4ume$ as reported by 'lling ood to be effective in prevention of metastasis and used hypodermically for the treatment of some mild, early cases of cancer. 4pecific ,ndications and Uses: Bad blood ith chronic s#in diseasesK bubonic s ellingsK lo deposits in glands and cellular tissues, and tendency to indolent ulcersK feeble recuperative po erK irritative, dry laryngo&tracheal coughK stubborn, dry, summer coughK chronic sore throat, ith glandular enlargements and hypersecretionK nervous dyspepsia, ith epigastric fullness and pain e$tending through left half of chestK cough ith dyspnoea and sense of precordial fullnessKABF2 e$haustive morning diarrhea bet een Fam and A2 am. ABF3 • %ermatological !onditions9 ?ing found 4ume$ useful in large variety cutaneous conditions, particularly those cases secondary to metabolic impurities in the blood. By acting on the glandular system 4ume$ as used to influence conditions here a tendency to indolent ulcerations and inflammatory deposits occur.ABF< ,n nearly all forms of dry, scaly, and pustular s#in diseases it as reputed both as an in ard and out ard remedy.ABFE • *astrointestinal !onditions9 4ume$ as used in nervous dyspepsia ith epigastric fullness and pain, and aching or darting pain in the left chest, ith flatulent distension of the stomach and gas. 6hough not a cathartic, it as used as a mild la$ative, hich e$erted a desirable tonic influence on the *, tract. !onversely, 4ume$ as also used to chec# painless atery diarrheal discharges as it seems to give solidity and tone to the assimilative function. • 1ulmonary!onditions9 4ume$ as employed for Mcough ith a sensation of fullness in the chest, ith sighing, ya ning, and efforts to ta#e a full inspiration.MABFF ,t is most valuable in respiratory affections due to devitali(ed blood, catarrh, and in chronic sore throat ith hypersecretion. %ry and stubborn coughs also responded ell to 4ume$.

•

6opical Applications9 6he fresh root as used in a diversity of forms for scrofulous conditions, itch, and a discutient for indolent glandular tumors. =According to 5tedman@s, a discutient is a dispersing agent for pathological, including cancerous, accumulations.>

Current Medicinal Use: 4ume$ is most indicated in chronic to$ic conditions ith debilitation, tendency to tissue stagnation =lymphadenopathy, ulcers, glandular enlargement>, feeble recuperative po er, chronic sore throat, irritated dry cough, digestive atony = ith bloating, gas, epigastric fullness>. 4ume$ is especially indicated in chronic s#in conditions ith *.,. complaints, debilitated to$ic conditions such as cancer, and rheumatic or inflammatory "oint disease. 4ume$ is high in minerals, especially iron. ,n addition, 4ume$ enhances the absorption of minerals =again, primarily iron>. • %ermatological !onditions9 5#in that is dry, scaly and crusty responds ell to 4ume$. 4ume$ increases the elimination of to$ins from the s#in. 4ume$ is often included in deto$ formulas and spring tonics as it helps to flush to$ins through the s#in, lymphatic system, liver3*B, and intestines. Q6ara$acum9 4ume$9 Arctium or as a spring tonic& Arctium9 4ume$9 5mila$9 'chinaceaR • *astrointestinal !onditions9 6he anthraquinone glycosides in 4ume$ lend the plant its mild la$ative =aperient> action. 4ume$ is therefore ell indicated in mild constipation and3or diarrhea due atonicity. 6he tannins in 4ume$ give it astringent action on the gastrointestinal tract and in that ay, 4ume$ is a gentle intestinal tonic. • +epatobiliary !onditions9 4ume$ is a cholagogue in that it flushes bile through the liver and gall bladder. 4ume$ rela$es the bile duct hile stimulating the release of bile from the gallbladder. 6his ma#es 4ume$ very useful in conditions of cholelithiasis that consists of gravel. 6his property also enhances fat absorption through better esterification. 4ume$ combines ell ith other choleretics and cholagogues for the treatment liver congestion. *iven the stimulating actions on both the liver and the intestinal tract, it naturally follo s that 4ume$ has great value as an alterative. • 6opical Applications9 4ume$ may be used e$ternally as a ash to enhance granulation tissue and thus ound healing. 4ume$ tonifies epithelial tissue and is a useful e$ternal application for hemorrhoids. Current +esearch +eview: • 5earch of /edline revealed no clinical trials as of 0ctober 2002. #harmacy9 %osage is important as large doses tend to aggravate the s#in condition and also deposit more o$alates in tissues. %oses less than 2E ml3 ee# are sufficient and effective. %ecoction9 2&F gm3 B o(. aterK sig A&2 cups 6,% 6incture9 A9E 2EG 't0+K sig 2E ml3 ee# 5yrup9 A32g gently boil crushed root in A pint syrup $ A hr.K sig A tsp. 6,% 0intments, creams Contraindications: !ontraindicated in irritable bo el, spastic colon, pregnancy. Brin#er cautions against use in patients ith renal disease due to the o$alate content.ABFH 6he use of tannins is contraindicated or inappropriate in cases of constipation, iron deficiency and malnutrition.ABFB 6annin rich herbs may reduce the absorption of al#aloids and other basic drugs through precipitation. ABFC )o*icity9 :o cases of to$icity have been reported.
1859 1860

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs 1rima 1ublishing, 4oc#lin, !A. 200A. 'lling ood p 3HB 1861 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy1 'clectic /edical 1ublications, 5andy, 04 ACBE p. 1862 )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 1863 'lling ood, ). )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago. ACAC p. 3HB 1864 )elter 1865 !oo# 1866 )elter 1867 Brin#er, )1 Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AE0 1868 /ills and Bone, p AH0 1869 Brin#er, ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AEC

+uscus aculeatus
Common name: butcher@s broom Ha!itat: Botanical description: #art used: root Historical use: $nergetics: Constituents: • 5teroid saponins =<&FG>9 ruscogenin, ruscine, ruscoside, aglycones neoruscogenin • Ben(ofuranes9 euparone, ruscodiben(ofurane

1iliaceae

#harmacology: 4uscogenins and neoruscogenins contain the basic steroid structure found in adrenocortical hormones and are responsible for the medicinal actions of 4uscus. 5imilar to diosgenins, found in %ioscorea, ruscogenins decrease vascular permeability.ABH0 Medicinal Actions: antiinflammatory, vasoconstrictor, antihemorrhagic )raditional Medicinal Uses: :o information is currently available from the selected resources. Current Medical Uses: • !ardiovascular !onditions9 Although ruscogenins do not have cortisone&type actions, they do decrease vascular permeability to inflammation and cause vasoconstriction, reducing hemorrhage. 6he effect is partially on the venous system, thus 4uscus is considered to be a specific tonic for the veinsABHA and 4uscus is indicated in 2° lymphedema.ABH2 4uscogenins have proved particularly effective in the treatment of anorectal syndrome, varicose veins and hemorrhoids. !linical studies have confirmed the benefit of a combination of vitamin !, flavonoids, and 4uscus for treatment of chronic venous insufficiency. ABH3,ABH< • 'ndocrine !onditions9 An e$tract of 4uscus combined ith flavonoid derivatives has been sho n to benefit patients ith diabetes, by lo ering cholesterol levels and improving glucose tolerance. ABHE #harmacy: !ommercial products9 4uscorectal ointment and suppositories ='ndopharm> ABHF AF.E&33 mg ruscogenins tid Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: :o information is currently available from the selected resources. )o*icity: :o information is currently available from the selected resources.
1870 1871

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. 1872 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC 1873 !apelli 4, :icora /, %i 1erri 6. Use of e$tract of Ruscus aculeatus in venous disease in the lo er limbs. Drugs Exp 2lin Res ACBBKA<92HHWB3. 1874 4udofs#i *, %iehm !, et al. !hronic venous insufficiency9 6reatment ith Ruscus e$tract and trimethylhesperidin chalcone. MM+ ACC0KA32920EWA0 1875 Archimo ic(&!yrylo s#a B et al. !linical effect of buc# heat herb, Ruscus e$tract and 6ro$erutin on retinopathy and lipids in diabetic patients. Phytother Res ACCFKA09FECWF2.
ABHF

4ali* spp2
Ha!itat: ,ndigenous to central ] southern 'urope, Asia, ] parts of :orth America.

4alicaceae (6illow =amily

Dpdated all &--& Common name: White Willo =5. alba>, Blac# Willo or American Willo =5. nigra>, 'uropean illo .

Botanical description: A dioecious tree bearing oblong to lanceolate leaves 3 finely serrated margins. 6he tree bears flo ers in erect cat#ins. /ale cat#ins have protruding yello stamens, ] the female cat#ins have green stamens. 6he bar# is A&2 mm thic# 3 a glossy, greenish yello or bro nish grey outer surface that has faint longitudinal striations. 6he inner bar# is pale yello to hite ] is either smooth or has fine longitudinal striations. #arts used: Bar#. Constituents:"/(( • *lycosides ] esters yielding salicylic acid =A.E&A2G>9 salicin =0.A&2G>, salicortin =0.0A&AAG> ] salicin derivatives hich are acylated to a glucose residue. • 6annins =B&20G>. • )lavonoids. 1harmacology9 *lycosides ] esters are converted into salicin upon entering the stomach or small intestine. When salicin reaches the distal ileum or colon, gut flora digest salicin into salicyl alcohol ] glucose. 5alicyl alcohol =5aligenin> is then absorbed into the bloodstream ] finally converted into its active form, salicylic acid, via o$idation 3in the blood ] liver. /ore than BFG of salicyl alcohol is absorbed from the gut, hich creates a constant plasma level of salicylic acid for several hours. ABHB /etabolites are secreted in the urine. 5ince salicylic acid is also secreted via the #idneys, it can be used as an analgesic to the urethra ] bladder. 5alicylic acid is an analgesic ] antiplatelet agent.ABHC 6he analgesic actions of illo are typically slo &acting but last longer than standard aspirin products. ABB0 5alicylic acid also has antipyretic, anti&inflammatory ] antiseptic qualities as ell, ] has been sho n to inhibit cycloo$ygenase.ABBA /odern day aspirin is derived from the bar#, ] is often used to reduce pain ] inflammation associated ith rheumatoid arthritis. ,n AB3B, salicylic acid as first prepared in pure form from illo bar#. ,n ABF0, salicylic acid as synthesi(ed. 6hen acetylsalicylic acid as synthesi(ed ] aspirin as born.ABB2 Aspirin ] related anti&inflammatory drugs are notorious for irritating or damaging the stomach. +o ever, hen ta#en in standard doses, illo does not appear to produce this same side effect. ABB3 6his may be partly d3t the fact that most of the salicylic acid in illo is present in chemical forms that are only converted into salicylic acid after absorption from the gut. ABB< 'vidence suggests that standard doses of Willo bar# are the equivalent of A baby aspirin per day, rather than a full dose. ABBE ,t appears that other ingredients may also play a role, such as tremulacin. ABBF Medicinal actions: Analgesic, Anti&inflammatory, )ebrifuge, 6onic, Astringent. Current > )raditional Medicinal Use: • Historical Use: Willo has been used to lessen hemorrhage ] chronic mucous discharge, d3t its tonic ] astringent principles. ,t has also been used to astringe the tissues ] calm the spirit of se$ual e$cess. • 9astrointestinal Conditions: 5. alba as used to treat chronic diarrhea, atonic forms of dyspepsia 3 characteri(ed by loose stools, ] scrofulous maladies 3 curdy diarrhea. 0ther conditions associated 3 debility of the digestive organs also called for 5ali$. • 9ynecological Conditions: 5ali$ as used to treat atonic menorrhagia ] for leucorrhea. • +eproductive Conditions: 5pecific indications for 5. alba includes9 I5e$ual irritability 3 lascivious dreams, D e$treme se$ual e$citability 3 uncontrollable desire, erotomania, nymphomania, D prostatitis, 3 cystic irritation, D ovaritis, orchitis DJABBH 1hysicians relied on 5ali$ to quell e$treme se$ual behavior, hen this behavior resulted from irritability of the pelvic organs =rather than from mental ] emotional causes>. 5ali$ as considered to be a potent ay to reduce se$ual functioning, ho ever, it as also considered to be tonic to reproductive organs. 6onification as most pronounced hen there as inflammation of pelvic organs follo ing overuse. • )opical Applications: '$ternally, 5ali$ as considered a good application for bleeding surfaces, indolent scrofulous ulcers, ] cold sores • ,nflammatory Conditions: 5ali$ spp. is used in a variety of conditions ith symptoms of fever ] pain. /ild flus ] colds ith fever, mild headaches ] other pain caused by inflammation are indications for this plant. 6he inhibition of cycloo$ygenase accounts for the anti&inflammatory, anti&pyretic, ] analgesic effects. 5ali$ spp. has been used for various forms of arthritis for

centuries. %ue to the analgesic actions of salicylic acid 5ali$ may be used as one ould use aspirin, but ith less concern about possible *, irritation. Current +esearch +eview: • 1ow Back #ain: o Willo bar# e$tract as found to be an effective treatment for lo bac# pain in the dose, delivering 2<0 mg of salicin =3CG of patients became pain&free> or A20 mg of salicin =2AG of patients became pain&free> $ < ee#s. 6his as a randomi(ed placebo&controlled, double&blind study, involving 2A0 patients. 6he response in 2<0 mg group as seen after only a ee# of treatment. 0ne patient suffered a severe allergic reaction, possibly due to e$tract. ABBB o A larger, open non&randomised, study, involved <EA patients. Assali$ =proprietary e$tract of illo bar#> as given in the dose delivering A20 mg of salicin =ACG of patients became pain&free> or 2<0 mg salicin =<0G of patients became pain&free> qd $ < ee#s. !ontrol group of 22< patients received orthopedic care =ABG of patients became pain&free, also e$acerbations had been shorter, but the pain as more intense>. 6he authors suggested that more regular full dosing ith :5A,%s by orthopedists may be more effective and less e$pensive treatment overall, but the possibility of more side effects.ABBC o Assali$, in the dose delivering 2<0 mg salicin qd $ < ee#s, as found as effective as !0P&2 inhibitor rofeco$ib in the dose of A2.E mg in relieving the symptoms of lo bac# pain. 6his as an open randomi(ed trial involving 22B patients. 6reatment ith Assali$ as found to be less e$pensiveK the incidence of adverse events as similar in the t o groups.ABC0 • 3steoarthritis: o Willo bar# e$tract sho ed a moderate analgesic effect in a dose corresponding to 2<0 mg salicin qd $ < ee#s. 6his as a double&blind, randomi(ed placebo&controlled trial, involving HB patients. ABCA o 0ne double&blind trial found that a product featuring Willo = ith Blac# cohosh, *uaiac , 5arsaparilla, ] Aspen bar#> effectively reduced the pain of osteoarthritis compared to placebo. Another trial found that A,3F0 mg of Willo bar# e$tract per day =delivering 2<0 mg of salicin> as some hat effective in treating pain associated ith #nee ]3or hip 0A.ABC2 #harmacy: • 5tandardi(ed e$tract, delivering A20&2<0 mg salicin qd, as reported in the current literature above • A teaspoon O A.E g herb. ABC3 Contraindications.)o*icitiy.4ide effects: 5ali$ spp have a tannin content of B&20G, hich can lead to precipitation of some substances =see Brin#er or -. nigra monograph for more specific information.> 5ide&effects are not e$pected hen using the hole plant. 1ersons ith #no n hypersensitivity to salicylates may e$perience a reaction =urticaria, rhinitis, asthma, bronchial spasms>. 6his reaction is rare, ho ever, given the form of the salicylate in the hole plant =sodium salicylate>.ABC<
1877 1878

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. ACCB9AAA2. Wichtl, /, Herbal Drugs J Phtyopharmaceuticals, :* Bisset, 'd, Ann Arbor9 !4! 1ress ACC<9 <3B. 1879 /ills 5, Bone ?. Principles J Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;, 20009FA 1880 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1881 /eier B ] / .iebi, ?1 Phytotherap, ACC0, AA9E0. 1882 Weiss, 4), Herbal Medicine, Beaconsfield, 'ngl]9 Beaconsfield 1ubl. .td.ACBB9303. 1883 !hrubasi# 5, 'isenberg ', Balan ', et al. 6reatment of lo bac# pain e$acerbations ith illo bar# e$tract9 a r]omi(ed double&blind study. )m 7 Med1 2000KA0C9CW A<. 1884 ,bid 1885 ,bid 1886 !hrubasi# 5, 'isenberg ', Balan ', et al. 6reatment of lo bac# pain e$acerbations ith illo bar# e$tract9 a r]omi(ed double&blind study. )m 7 Med1 2000KA0C9CW A<. 1887 'lling ood, ), )merica Materia Medica, Therapeutics J Pharmacognosy , Ast publ. ACAC, =5]y, 049 'clectic /edical 1ubl., ACC<>9<EH. 1888 !hrubasi# 5, 'isenberg ', Balan ', et al. 6reatment of lo bac# pain e$acerbations ith illo bar# e$tract9 a randomi(ed double&blind study. )m 7 Med 2000KA0C=A>9C&A<. 1889 !hrubasi# 5, ?un(el 0, Blac# A, et al. 1otential economic impact of using a proprietary illo bar# e$tract in outpatient treatment of lo bac# pain9 an open non& randomi(ed study. Phytomedicine 200AKB=<>92<A&EA. 1890 !hubasi# 5, ?un(el 0, /odel A, et al. 6reatment of lo bac# pain ith a erbal or synthetic anti&rheumatic9 a randomi(ed controlled study. Willo bar# e$tract for lo bac# pain. Rheumatology 200AK<0=A2>9A3BB&C3. 1891 5chmid B, .udt#e 4, 5elbmann +?, et al. 'fficacy and tolerability of a standardi(ed illo bar# e$tract in patients ith osteoarthritis9 randomi(ed placebo&controlled, double blind clinical trial. Phytother Res 200AKAE=<>93<<&E0. 1892 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A

1893 1894

PDR for Herbal Medicines. AAA2. Wichtl, /, >bid, <3B.

4am!uccus nigra.42 canadensis
Common name: Blac# elderberry =5. nigra>, American elderberry =5. canadensis>

Caprifoliaceae

Ha!itat: 6he small tree prefers sunny locations on the edge of other trees in a moist environment. Botanical description9 5hrubs or small trees, leaves compound ith a terminal leaflet, deciduous. )lo ers are small, hite, in a sho y terminal cluster. )ruit is fleshy, berry&li#e containing several bony nutlets. #arts used9 .eaves =to$ic>, root =to$ic>, bar#, ).0W'45, berries Constituents9 )ruit9 /inerals, vitamins, sambucin, anthocyanosides, pectin .eaves9 rutin, minerals, vitamins )lo ers9 minerals, vitamins, essential oil, rutin, quercetin, mucilage, tannin Bar#9 baldrianic acid. #harmacology 8ni!al tudie 'a)e 'o5n t'e flo5e& to 'a)e anti.infla!!ato&( "&o"e&tie . 1895 :la)onoid , includin% <ue&cetin, a&e #elie)ed to account fo& t'e t'e&a"eutic action of t'e elde&#e&&( flo5e& and #e&&ie . 1896 3'e lectin in Sa!#uccu a&e u ed in la#o&ato&ie to detect #.=alacto e Sialic acid. 3'e e;act !ec'ani ! fo& t'e anti)i&al effect 'a not #een elucidated. Medicinal actions: )lo ers9 mild diaphoretic, mild la$ative, diuretic, alterative, demulcent, antirheumatic, antispasmodic, anticatarrhal, carminative, emetic. Berries9 anti&rheumatic, emunctory stimulant =all e$cretory organs or ducts>, anti&neuralgic, antiscorbutic, alterative, carminative, emetic. .eaves, 4oot, Bar#9 anti&inflammatory, vulnerary, diuretic, diaphoretic, purgative, poisonous. )raditional Medicinal Use: 5pecific ,ndications and Uses.Z,n s#in affections, hen the tissues are full, flabby, and edematousK epidermis separates and discharge of serum is abundant, forming crustsK indolent ulcers, ith soft, edematous bordersK mucous patches, ith free secretionsK post&scarlatina dropsyK lo deposits in, or depravation of tissues. ABCH !oo# described the infusion of the flo ers as diffusely rela$ant and mildly diaphoretic, gently nervine, and as a soothing diuretic. ABCB • *astrointestinal !onditions9 6he e$pressed "uice of the berries, evaporated to the consistence of a syrup, as a valuable aperient and alterative in small doses. 6he flo ers and e$pressed "uice of the berries have been beneficially employed in scrofula, cutaneous diseases, syphilis, rheumatism, etc. According to ?ing, the fresh inner green bar# as observed to be cathartic ith large doses producing emesis and small doses used as an efficient deobstruent =removal of obstructions>, promoting all the fluid secretions, and as much used in dropsy =edema>, especially that febrile and e$anthematous diseases, as ell as in many chronic diseases. +o ever, !oo# suggested using only the dried inner bar# as a rela$ing and stimulating alterant although it as seldom employed. 6he berries are s eetish, and by many ere used as food and as a mild la$ative and secernent. • ,nfectious !onditions9 6he flo ers ere considered useful in measles, recent colds, and in erysipelas. • 6opical Applications9 '$ternally, 5ambuccus is a valuable agent, especially for eruptions hich appear as full, flabby, and edematous and particularly hen attended ith abundant discharge of serum. /ade into a cream, 5ambuccus as considered an e$cellent discutient ointment of much value in burns, scalds, and some cutaneous diseases, such as ec(ema, old ulcers, ith soft, edematous edges and free secretion of serum, and in mucous patches, ith free discharges. Current Medicinal use: 5ambuccus flo ers are e$cellent diaphoretics if ta#en as a hot tea. 6hey combine ell ith other herbs for this purpose. ,n this regard, 5ambuccus flo ers are e$cellent remedies for the treatment of colds, other acute infections ith fever and hot dry s#in, headache and nausea. 4hinitis, sun sic#ness, asthma, croup, hay fever, con"unctivitis, rheumatism, pharyngitis, tonsillitis, and stomatitis each respond ell to 5ambuccus, particularly in combination ith 6illia. 'lderberry, as ell as small amounts of 'chinacea and bee propolis, is idely used as a cold and flu remedy. 5ome evidence suggests that this mi$ture may stimulate the immune system and inhibit viral gro th. ABCC ,n a preliminary double&blind study, the combination therapy significantly reduced the recovery time from epidemic influen(a.AC00 'lderberry is also being studied for potential activity against other viruses, including and herpesAC0A and +,7AC02 ,f the flo ers are ta#en as a cool tea, it ill more li#ely act as a diuretic. 6he alterative actions of the flo ers are nourishing and slo &acting. 0ver time, the liver ill be gently tonified. 6he mucilage in the flo ers creates a demulcent action.

5ambuccus berries are anti&rheumatic, emunctory =e$cretory duct> stimulant, anti&neuralgic, antiscorbutic, alterative, carminative and emetic. %ried, coo#ed berries are not emetic. 6he anthocyanidins in the berries account for the anti&rheumatic by cross&lin#ing collagen fibers, acting as antio$idants, preventing en(ymatic cleavage of collagen during inflammation, preventing release and synthesis of compounds causing inflammation =i.e. histamine, prostaglandins, leu#otrienes>, and promoting mucopolysaccharide and collagen biosynthesis. 6hus, the berries are useful for "oint diseases, allergic conditions =i.e. sinusitis, asthma>, colds and coughs, diarrhea, and rheumatism. 6he high content of vit. ! in 5ambuccus berries potentiates these effects on collagen and mast cells. 5ambuccus leaves, root, and bar# are safer if coo#ed since coo#ing destroys the to$in, di&sambunigrin, but the internal use of these plant parts is still unsafe. 6hese parts of the plant are best indicated e$ternally for hemorrhoids and labial tears, bites, ounds, stings, sunburn, boils, abscesses, sore "oints, bruises, sprains, ulcerations =esp. ith ater discharge>, and as a dra ing salve for boils, splinters, and eeping ec(ema. 6hey are vulnerary and astringent. • *astrointestinal !onditions9 5ambuccus flo ers are also an e$cellent remedy for colic in babies. • 1ulmonary !onditions9 5ambuccus is useful in someone ho has a lot of phlegm that needs to be softened and e$pectorated. Also, 5ambuccus ill or# ell in someone ho has a dry, irritated cough ithout congestion. 5ambuccus flo ers are anti& spasmodic and are therefore useful in someone ho has asthma, or to decrease their cough in order that they may sleep. 5ambuccus flo ers have anti&catarrhal action, ith the locus of action especially pronounced in the sinuses. 5ambuccus contains tannin hich astringes the mucosa of the sinuses, thus relieving congestion. 5ambuccus ill also cause constriction of the blood vessels supplying the sinuses and therefore should be used ith caution long&term. Current +esearch +eview: • 5earch of /edline revealed no human trials related to specific conditions as of 0ctober 2002. #harmacy9 )lo ers9 +ot tea =diaphoretic, la$ative> 2&< 6B3cup aterK A cup 6,% !old tea =diuretic and alterative> 2&< 6B3cup aterK A cup 6,% Berries9 5yrup !ordial %ried berry decoction A&2 tsp3cup aterK L cup 6,% -uice9 !over fresh berries ith ater and boil for 3 minutes then e$press the "uice. Add A part honey to A0 parts "uice and boil in order to preserve the "uice. %rin# A glass ith hot ater B,% .eaves, Bar#, 4oot9 1oultice, 5alve, !ompress, )omentation, 2&3 6B3sit( bath

Toxicity: > e of t'e f&e ' "a&t of t'e "lant +lea)e , &oot , #a&$, &a5 un&i"e #e&&ie , can lead to e!e i , "u&%ation, 'eadac'e, di66ine , tac'(ca&dia and con)ul ion .
1895

8a#ay&4ones 8, 7arsano :, 8lotni# /, et al. ,nhibition of several strains of influen(a virus in vitro and reduction of symptoms by an elderberry e$tract = ,ambucus nigra ..> during an outbrea# of influen(a B 1anama. 7 )ltern 2omplement Med. ACCEKA93FAW3FC. 1896 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1897 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 1898 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 1899 Bara# 7, +alperin 6, ?alic#man ,. 6he effect of 5ambucol, a blac# elderberry&based, natural product, on the production of human cyto#ines9 ,. ,nflammatory cyto#ines. Eur 2yto3ine ;et:1 200AKA292C0W2CF. 1900 8a#ay&4ones 8, 7arsano :, 8lotni# /, et al. ,nhibition of several strains of influen(a virus in vitro and reduction of symptoms by an elderberry e$tract = ,ambucus nigra ..> during an outbrea# of influen(a B 1anama. 7 )ltern 2omplement Med. ACCEKA93FAW3FC. 1901 . /orag A, /umcuoglu /, Baybi#ov 6, et al. ,nhibition of sensitive and acyclovir&resistant +57&A strains by an elderberry e$tract in vitro QabstractR. Phylotherapie1 ACCHK2E9CHWCB. 1902 5hapira&:ahor B. 6he effect of 5ambucol on +,7 infection in vitro. Annual ,srael !ongress of /icrobiology, )ebruary FWH, ACCE.

4anguinaria canadensis
Common name: Bloodroot Ha!itat: 6he plant is native to :. America and !anada and gro s in cool, moist, deciduous oods.

#apaveraceae

Botanical description9 6he plant is an herbaceous perennial. 6he rhi(ome is A cm. in diameter, E cm. in length, reddish bro n and longitudinally rin#led. 6he fracture is short and sho s a hitish transverse section ith numerous red late$ vessels. #arts used9 4oot =harvested in early summer Q/ay&-uneR or in autumn hen leaves have dried. #art used: rhi(ome Historical Use: 5anguinaria has been used medicinally by :ative Americans since at least the AF00Ns. Constituents9 • Ben(ophenanthridine type isoquinolone al#aloids =<&HG>9 sanguinarine, chelerythrine, o$ysanguinaridine • protoberberine&type9 berberine, coptisine • protopine&type9 protopine, alpha& and beta&allocryptopine. AC03 • other al#aloids9 chelilutine, chelirubine, protopine, sanguidimerine, sanguirubine, allocryoptopine, sanguidaridine, sanguilutine #harmacology: Al#aloids, principally sanguinarine, constitute the primary active compounds 5anguinaria, having antimicrobial, antifungal, antiinflammatory, and mast cell histamine release inhibition effects. 5anguinarine and chelerythrine have been sho n to uncouple phosphorylation and intercalate ith %:A, hich may e$plain the antibacterial and antiviral properties of this plant. AC0< 6he al#aloids are sometimes used in toothpaste and other oral hygiene products because they inhibit oral bacteria. AC0E ,n vitro studies indicate that the anti&plaque action of 5anguinaria is due to its ability to inhibit bacterial adherence to ne ly formed pellicle, its retention in plaque being A0&A00 times its saliva concentration, and due to its antimicrobic properties. 6he /,! of sanguinarine ranges from A0 to 32 g3ml for most species of plaque bacteria. AC0F Medicinal actions: '$pectorant, antimicrobial, anesthetic. )raditional Medicinal Use: !oo# described the dried root as a slo rela$ant and stimulant, influencing the mucous membranes, gall&ducts, and secreting organs in general. • *astrointestinal !onditions9 5mall doses ere used arouse the stomach in atonic dyspepsia3 • +epatobiliary !onditions9 !hronic torpor of the liver in bilious temperaments, and chronic "aundice, are the conditions in hich its use as most indicated. )or chronic affections of the s#in, arising from hepatic torpor, 5anguinaria as used in quite small proportions to support rela$ing alterants. • 1ulmonary !onditions9 5mall quantities ere added to rela$ants for e$pectorant purposes. ,t as indicated only in sluggish conditions. !oo# combined it in limited quantities ith +ydrastis and .obelia for use in chronic catarrh and nasal polyps, as a snuff, if the mucosa as freely discharging and not too sensitive. • 6opical Applications9 !oo# found great benefit in applying the same combination above, in po der, upon indolent chancresK in a short time obtaining a discharge and the removal of the gray membrane, hen the 5anguinaria may be omitted. 6he po der as considered a good application to fungus ulcers. !oo# did not believe 5anguinaria acted as an escharotic, as is generally asserted. AC0H Current Medicinal Use: • %ental !onditions9 6he antimicrobial effects of 5anguinaria ma#e it a potentially useful plant in oral rinses in order to reduce plaque and gingivitis. A toothpaste and oral rinse each prepared ith 5anguinaria e$tract ere studied in clinical trials involving 2F0 patients. 6he cumulative data from these trials demonstrated reduced plaque, gingival inflammation and bleeding ithin A< days of use. 6hese effects lasted for the duration of 5anguinaria use =up to F months in one study>. AC0B • 1ulmonary !onditions9 ,n the early AB00Ns, 5anguinaria as incorporated into the United 5tates 1harmacopoeia in tinctures and cough syrups as an e$pectorant. 5anguinaria is most indicated in the treatment of bronchitis, emphysema, bronchiectasis, asthma, croup, and laryngitis. 6his plant e$erts smooth muscle rela$ing and antimicrobial properties hile also causing e$pectoration. 5anguinaria is most indicated in chronic, congestive lung conditions. 6he cough is irritated and may be dry, and respiration is difficult. 0verall, the person may describe itchy mucous membranes =ears, pharyn$, laryn$, trachea, rectum, vagina>. 5anguinaria is indicated in sore throat ith s ollen, beefy red mucosa. 5anguinaria combines ell ith resin&containing herbs such as ,nula and /arrubium.

• 6opical Applications9 5anguinaria is used as a component of Iblac# salveJ, a type of escharotic salve produced by a number of companies ith varying recipes that are considered proprietary. #harmacy9 A9E tinctureZ2&Eml 6,% A tsp. dried root3cup aterK A cup 6,%

Contraindications: ,t is not an agent to be used in sensitiveness or irritability of any mucous membrane or other part. AC0C 5anguinaria is contraindicated in pregnancy.ACA0 )o*icity: .arge quantities are nauseant, and even emetic.

4arothamnus scoparius
Common name: 5cotch broom Ha!itat:

(Cytisus 4coparius

=a!aceae

Botanical description9 6his is a large shrub hich gro s up to F feet tall. 6he dar# green branches contain many stiff green leaves and yello pea flo ers are produced. #arts used9 +erba and )lora Constituents9 • !ardioactive al#aloids9 sparteine, sarothamnin, genistein • o$ytyramine #harmacology: 5parteine, and to a lesser e$tent sarothamnin and genistein, appear to be an important al#aloids in slo ing ectopic atrial depolari(ation and in reducing irritability in the conduction of the myocardium. 5parteine acts as a potassium channel antagonist, resulting in delaying systolic depolari(ation. 5parteine is a negative inotrope and a negative chronotrope. ,t prolongs the refractory period and raises the depolari(ation threshold, reducing the ris# of fibrillation and e$trasy stoles. ACAA 5parteine as once used as an o$ytocic but such use as discontinued after the discovery that about EG of males and females studied ere unable to metaboli(e sparteine by :&o$idation, li#ely due to a genetic defect. 5uch inability ill result in uterine spasm in omen.ACA2 Medicinal actions: !ardiotonic, anti&arrhythmic, hypertensive, narcotic, diuretic and purgative )raditional Medicinal Use: !oo# described the flo ers of 5arothamnus as primarily stimulating, and moderately rela$ant, acting some hat slo ly but decidedly. ,n large doses, 5arothamnus as observed to be emetic and catharticK in small doses, diuretic. 5curvy and "aundice have been successfully treated ith it as ell. • !ardiovascular !onditions9 6he 'clectics used 5arothamnus in all chronic forms of edema of the thora$ as it as said to never fail in increasing the flo of the urine. • *enitourinary !onditions9 !oo# observed their chief influence on the #idneys, having used them in edema. +e noted that 5arothamnus can readily over or# the #idneys. Current Medicinal Use: • !ardiovascular !onditions9 6he al#aloids effect the conductivity of the heart, not the contractility as do cardiac glycosides. 5arothamnus is used specifically to treat arrhythmias follo ing myocardial infarction, sinus tachycardia, atrial and ventricular fibrillation, and ventricular e$tra systoles. A heart ith e$tra systoles may respond favorably to 5arothamnus. .ong&term therapy is often needed to effectively control these arrhythmias. 1aro$ysmal tachycardia ill not respond to 5arothamnus. 5arothamnus is also a peripheral vasoconstrictor, due primarily to the o$ytyramine, so it increases venous return to the heart =helping to relieve edema>. 6his increase in blood pressure along ith normali(ed cardiac rate stimulates #idney diuresis. ,t should be used as a diuretic hen there is lo blood pressure and a ea# heart. • *ynecological !onditions9 5arothamnus stimulates uterine contractions. 5arothamnus is thus useful in post&partum hemorrhage. #harmacy9 +igh doses of the herb are necessary to achieve therapeutic levels of sparteine and related al#aloids. • %ecoction9 A o(. flo ers to AF o(. ater for A0 minutes, sig < o(. q hr, until it produces some effect, using about A pint in 2< hours =?ing> 0.E o( dried flo ers to A0 o(. aterK sig A&2 o(. tid =!oo#> • 6incture =A9E <EG 't0+>9 0.E&2 ml 6,% =Alschuler>K A0 gtt bid =/itchell> Drug ,nteractions:"5"7 • Kuinidine' haloperidol' moclo!emide inhibit metabolism of sparteine, increasing the possibility of to$icity. • MA3 inhi!itors may lead to a hypertensive crisis due to tyramines in the flo ers. • 4ympathomimetics may result in hypertension due to additive effects • Antipyrine' rifampicin may increase metabolism of sparteine.

•

Antihypertensives ill antagoni(e effects.

Contraindicated: !aution should be e$ercised hen prescribing 5arothamnus to people ith high blood pressure because the increase in peripheral vasoconstriction ill increase blood pressure. 5arothamnus should not be used during pregnancy, in spleen, liver or acute #idney disorders or in A&7 bloc#.ACA< )o*icity9 5igns and symptoms of to$icity include a staggering gait, impaired vision, and profuse vomiting and s eating. ACAE
1911 1912

/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 p. EB /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 p. EB 1913 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A pAH<&E 1914 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p AH< 1915 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

4assafras lignum. 42 al!idum
Common name: 5assafras, !innamon ood Ha!itat: native to :orth America

1auraceae

Botanical description: A decidious tree, it stands 30 m tall ith multiple slender branches and smooth orange&bro n bar#. 6he leaves are alternate and vary from 2& to 3& lobed to ovate petiolate leaves. 5mall yello flo ers are arranged in cymes. 6he tree produces cinnamon&li#e berries. 6he roots are large and oody. 6he root bar# is soft and spongy, rough and a reddish bro n color. :ative to :orth America ='astern> #arts used: root bar#, collected in autumn Constituents "5"& • 7olatile oil =F&CG>9 chief components safrole =up to C0G>, E&metho$yeugenol =up to 30G>, asarone =up to ABG>, camphor =up to EG> • ,soquinoline al#aloids9 of the aporphine and reticuline type =less than 0.AG> • .ignans9 sesamin, desmetho$yaschantinK 6anninsK 5itosterol and other sterolsK Al#aloids9 aporphine, ben(ylisoquinoline derivativesK 4esin #harmacology: 5afrole is carcinogenic in animals =causing primarily liver cancer>. ACAH 5afrole, and its metabolite, A@&hydro$ysafrole, act as a nerve poison causing lo ered body temperature, e$haustion, tachycardia and collapse. 5afrole is absorbed slo ly from the alimentary canal, is e$pired from the lungs and e$creted through the #idneys here it is o$idi(ed into piperonalic acid. ACAB A case report describes diaphoresis caused by consuming sassafras tea. ACAC Medicinal actions: !arminative, diaphoretic, antiseptic, antirheumatic, alterative )raditional Medicinal Use: 5assafras has been used for hundreds of years as a medicinal agent for chronic diseases and 5assafras as considered to be an alterative ith efficacy in chronic inflammatory disorders of the s#in and "oints. . !oo# added that 5assafras is an aromatic rela$ant and stimulant ith the arm infusion being a fair stimulating diaphoretic and nervine. +e described the oil as among the best of the nervine stimulants and rela$ants. AC20 • /etabolic !onditions9 6he 'clectics generally used 5assafras in combination ith other alteratives, particularly 1odophyllum. • !ardiovascular !onditions9 !oo#ed called attention to its action as a stimulant to the capillary circulation and the absorbents =venules and lymphatics>. • %ermatological !onditions9 5assafras as utili(ed in the treatment of many cutaneous eruptions, particularly in combination ith vapor, spirit or sulphur baths. • *ynecological !onditions9 6he oil as used to afford relief in the distressing pain attending menstrual obstructions, and that follo ing parturition. • ,nfectious !onditions9 6he 'clectics employed this herb in the treatment of syphilitic affections, gonorrhea and scrofula. • ,nflammatory !onditions9 chronic rheumatism • 0phthalmologic !onditions9 6he mucilage of the pith as used as a local application in acute ophthalmia. • 6opical Applications9 '$ternally, 5assafras as used as a rubefacient, in painful s ellings, sprains, bruises, rheumatism, and under such circumstances, to promote the absorption of effused materials. 5assafras as also said to chec# the progress of gangrene. Used internally and applied e$ternally 5assafras as reputed an e$cellent treatment for 4hus poisoning. 5assafras oil as used by the 1hysiomedicalists in rubefacient liniments for rheumatism, deep&seated congestions and inflammations, edema, abdominal and pelvic sufferings, sprains, bruises, etc. Current Medicinal Use: 6he root has a spicy and s eet taste and as such as a popular tea and flavoring agent. 6he oils in sassafras are stimulating. %iaphoresis occurs ith internal use. 5assafras as most indicated in chronic mucous producing conditions =i.e. bronchitis, cystitis, vaginitis, etc.>. 5assafras also provides some analgesic effects and as thus used acutely in addition to its long&term. +o ever, the discoveries of the to$ic and carcinogenic potential of sassafras have limited it to e$ternal use only. • 6opical Applications9 5assafras is effective as a topical application for antiseptic and anti&inflammatory purposes. ,t is effective for inflamed arthritic "oints primarily through its rubefacient action. ,ts application ill relieve pain and s elling ith the additional benefits of acting as a local antiseptic. 6he antiseptic quality of sassafras ma#e it a useful topical treatment for chronic inflammatory disorders of the s#in ith secondary infections =i.e. ec(ema> and for tinea infections.

Current +esearch +eview: • 5earch of /edline revealed no human trials as of :ovember 2002. #harmacy: ,t is recommended to use this plant e$ternally only. ,nternal9 2.E g =33< tsp.> dried root bar#3cup3dayK hot infusion for A0 min.K strain and drin#. '$ternal9 1oultice, !ompress, oil

Contraindications: 5assafras should be avoided in early pregnancy due to emmenagogue properties and prolonged use =daily for a year> of forms containing the essential oil component should be avoided. AC2A )o*icity: ,n large doses and3or prolonged use, lo ered body temperature, e$haustion, tachycardia, and collapse may occur. 5afrole inhibits hepatic microsomal en(yme function, prolonging he$obarbital induced necrosis in animal studies. AC22
1916 1917

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A /iller '!, et al 2ancer Res , ACB3, <39 AA2<. 1918 *rieves /, ) Modern Herbal, ACHA, =:;9 %over 1ubl>9 HAE. 1919 5assafras tea and diaphoresis. 1ostgrad /ed. ACCA 5ep AEKC0=<>9HE&F. 1920 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 1921 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AAC 1922 Brin#er

4chisandra chinensis
Common name: Wu& ei&(i fruit Ha!itat: Botanical description9 5chisandra is a !hinese climbing shrub.

Magnoliaceae

Historical uses9 6his berry has been used in !hina as a tonic herb, #no n as Mfive&taste fruitM #arts used9 Berry Constituents9 • 5chi(andrin • Biphenyl octenoid lignans = u ei(isu !, u ei(ichun B, schisantherin A, B, ! and %>

hich acts on all organs.

Pharmacology 3'e !ajo& acti)e co!"ound in Sc'i and&a a&e li%nan + c'i6and&in, deo;( c'i6and&in, %o!i in , and "&e%o!i in, found in t'e eed of t'e f&uit. 8ni!al tudie u%%e t Sc'i and&a !a( "&otect t'e li)e& f&o! to;ic da!a%e, i!"&o)e li)e& function, and ti!ulate li)e& cell &e%&o5t'. Pa&t of 'o5 Sc'i and&a li%nan a""ea& to "&otect t'e li)e& i #( acti)atin% t'e en6(!e in li)e& cell t'at "&oduce %lutat'ione, an i!"o&tant antio;idant u# tance. 1923 1i%nan al o inte&fe&e 5it' "latelet acti)atin% facto&, a c'e!ical t'at "&o!ote infla!!ation in a nu!#e& of condition 1924. Medicinal actions9 Astringent, sedative, aphrodisiac, #idney and s#in tonic, an$iolytic, hepatoprotective, adaptogenic Medicinal use: 5chisandra is a tonic herb and therefore should not be used in acute conditions. 5chisandra strengthens the lungs, #idneys and adrenals. 5chisandra is #no n to calm the shen and is therefore useful for an$iety and insomnia, palpitations, and forgetfulness due to e$cessive stress. As a #idney strengthener, it is employed in diseases ith spontaneous perspiration or night s eats. 5chisandra fruit may also have an adaptogenic and action, much li#e the herb Asian ginseng, but ith ea#er effects. .aboratory or# suggests that 5chisandra may improve or# performance, build strength, and help to reduce fatigue. AC2E • +epatobiliary !onditions9 5chisandra protects against liver damage. /ills and Bone consider 5chisandra as a hepatic stimulant and hepatorestorative, increasing liver metabolism and improving deto$ification processes. AC2F ,n the presence of to$ins, 5chisandra reduces liver damage, improves protein synthesis and accelerates liver repair. 5chisandra elevates liver microsomes hich increase the ability of the liver to deto$ify foreign substances in the body. 5chisandrin lignans lo er 5*16 levels and 5chi(andra is a useful remedy in chronic hepatitis.AC2H • ,nfectious !onditions9 ,n a !hinese study of ABC people ith hepatitis B, those given 5chisandra reportedly improved more rapidly than those given vitamins and liver e$tracts AC2B. • :eurological !onditions9 6he lignans found in 5chisandra =lignans are also found in 'leutherococcus senticosus and 7iscum album> improve concentration, fine coordination and sensitivity. By affecting the !:5, 5chisandra can improve vision, enlarge the visual field, improve hearing and heighten s#in sensory discrimination. 6he !:5 effect of 5chisandra is stimulatory and also results in decreased fatigue and improved endurance. Current +esearch +eview: • 4ports medicine: o 4alivary nitric o*ide content:"505  %esign9 1lacebo&controlled double&blind study.  1atients9 Athletes  6herapy9 5tandardi(ed e$tracts of the adaptogen herbal drugs 5chi(andra chinensis and Bryonia alba roots.  4esults9 ,n the beginning of a test ith athletes, 5chi(andra chinensis and Bryonia alba e$tracts increased the concentration of :0 and cortisol in blood plasma and saliva similar to athletes ith heavy physical e$ercise. 6hese results correlate ith an increased physical performance in athletes ta#ing adaptogens versus athletes ta#ing placebo. ,n contrast, after treatment ith the adaptogen, heavy physical e$ercise does not increase salivary :0 and cortisol in athletes, hereas in athletes treated ith placebo, heavy physical e$ercise increased salivary :0. 6hese results sho that the salivary :0 test can be used both for evaluation of physical loading and stress protective effect of an adaptogen. #harmacy9 <00&<E0 mg po dered herb in capsules 6,% 6incture A93 30G 't0+K sig A&2 ml 6,% ,nfusion A&2 tsp. berries3cup aterK sig A cup 6,%

)o*icity: :o information is currently available.
1923 1924

.ininger et al9 +ealthnotes, !linical 'ssentials, 1rima 1ublishing, 4oc#lin, !A. 200A. -ung ?;, .ee ,5, 0h 54, et al. .ignans ith platelet activating factor antagonist activity from ,chisandra chinensis =6urc(> Baill. Phytomedicine ACCHK<922CW3A. 1925 .ininger et al9 +ealthnotes, !linical 'ssentials, 1rima 1ublishing, 4oc#lin, !A. 200A. 1926 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. AHH. 1927 'vans, W.!., 6rease and 'vansN 1harmacognosy, =WB 5aunders !o. .td9 .ondon>, A<th ed., ACCF9<3B 1928 .iu *&6. 1harmacological actions and clinical use of ructus schiIandrae. 2hin Med 71 ACBCKA029H<0WH<C. 1929 1anossian A*, 0ganessian A5, Ambartusmian /, et al. 'ffects of heavy physical e$ercise and adaptogens on nitric o$ide content in human saliva. Phytomedicine ACCCKF=A>9AH&2F.

4cilla maritima a2k2a2 Urginea maritima
Common name: 5quill Ha!itat:

1iliaceae

Botanical description9 6his plant has a perennial root ith a large coated bulb that is full of thic# "uice. 6he leaves of this plant are 3&< inches ide, bright green and some hat thic#, and filled ith late$. 6he stem gro s to 3 feet in height. 6he flo ers gro in spi#es and are small and hite. #arts used9 Bulb =inner scales> Constituents9 • !ardioactive glycosides Q0.AE&2G in dried po derR9 FFG proscillaridin and scillaren A, the remaining 33G composed of at least 2E other glycosides • mucilage, fructooligosaccharides Medicinal actions: !ardio&tonic, diuretic, e$pectorant, emetic Historical Use: :icolas !ulpeper refers to this plant as a hot and biting plant. 6he bulb is very bitter and ill blister the s#in if handled e$cessively. )raditional Medicinal use: 5pecific ,ndications and Uses9 !hronic cough, ith scanty, tenacious sputaK scanty, high&colored urine, ith sense of pressure in the bladderK over activity of the #idneys ith inability to retain the urineK dropsy, ith no fever or inflammation, and a general asthenic condition.AC30 ?ing described 5quill as an irritant, emetic, cathartic, diuretic, and e$pectorant. 6he "uice of fresh 5quill acts as a rubefacient, and it stimulates all of the secretory organs. • !ardiovascular !onditions9 Urginea as used e$tensively by the 'clectics in edema of cardiac origin, but not due to organic changes in the heart. Urginea as considered to act better in general, asthenic and passive cases rather than in locali(ed edema. ?ing noted that it may be made to restrain or to increase the amount of urine secreted, according to dose. 6o chec# the renal flo , the minute dose should be employed. While in the ma"ority of cases Urginea as employed ith %igitalis, in small doses =A to A0 drops> of a strong tincture it as observed to act favorably here there is a Mdry, harsh s#in, parched tongue, fevered lips, and contraction of featuresM =5cudder>. • 1ulmonary !onditions9 ?ing noted that small doses of Urginea relieve irritation of the mucous surfaces and chec# e$cessive secretions. As an e$pectorant it ill be found useful in chronic catarrh, asthma, pneumonia and other chronic bronchial affections. ,n chronic respiratory troubles, ith little febrile reaction and no inflammation and scanty tenacious sputa, A part 5quill may be added to 3 parts 1runus. Current Medicinal Use: • !ardiovascular !onditions9 6he cardiac glycosides create positive inotropic and negative chronotropic effects on the heart. 6hese glycosides are strong in their physiological action, due to absorption =AEG for scillaren and 20&30G for proscillaridin> and half& life =2< hours for proscillaridin>. 6herefore, Urginea is indicated in mild to moderate heart failure. +o ever, Urginea ill increase arterial tension more strongly than %igitalis. Urginea is also a potent diuretic =due to the mucilage> and is therefore especially ell indicated in a person ith congestive heart failure. A person ith both cardiac and #idney ea#ness should respond favorably to 5cilla. • 1ulmonary !onditions9 5cilla is also used as a soothing e$pectorant hen there is thic# sputum =again due to the mucilage>. ,t is a stimulating or refle$ e$pectorant that provo#es increased mucociliary activity by refle$ stimulation of the upper digestive all. AC3A ,n larger amounts, Urginea ill increase bronchial secretions, ho ever, in smaller doses it ill decrease e$cessive secretions in the lung and thus aid in e$pectoration. 6he combined actions of 5cilla ma#e this plant e$tremely ell&indicated in someone ith 4&sided heart failure =this condition can lead to pulmonary edema and dependent edema>. 0ther indications for its use as a stimulating e$pectorant include cough secondary to bronchial congestion, bronchitis and emphysema. • /usculos#eletal !onditions9 5timulating e$pectorants may also be usefully applied in some cases of rheumatic and connective tissue diseases.AC32 #harmacy9 ,nfusion 6incture

A9E <EG sig 0.E&2 ml 6,% =Alschuler> A9A0 A0 gtt bid =/itchell> 0.A&0.E g of standardi(ed e$tract po der Qstandardi(ed to 0.2G proscillaridinR Drug ,nteractions: "577 • !ertain other substances predispose to to$icity =similarly to %igitalis>, namely9 potassium depleting drugs such as diuretics, quinidine, anthraquinone glycoside containing botanicals and corticosteroids. • !aution hen combining ith other cardiac glycoside containing botanicals due to additive effects. Contraindications: ?ing noted that Urginea is contraindicated here there is inflammation or vascular e$citement. Brin#er contraindicates the use of Urginea in the presence of gastrointestinal irritation and pregnancy. As a refle$ e$pectorant Urginea can transiently irritate the gastric mucosa and should be used ith caution in dyspeptic conditions, dry and irritable conditions of the lungs, asthma, and in children.AC3< )o*icity9 ,n small doses it may cause nausea and depression of the pulse, ithout stimulating the circulation. .arger doses result in severe and painful vomiting and purging, *.,. inflammation, decreased bloody urine, dullness and stupor, intermittent paralysis and convulsions. %eath ta#es place ithin A0 to 2< hours, ith a dose as lo as 2< grains =A<<0 mg>. AC3E ?ing noted that continuous use of 5quill gives rise to gastric irritation and loss of appetite, and hen these effects are the result of its internal use the tincture may be rubbed into the s#in or applied to the abdomen by means of compresses saturated ith it.
1930 1931

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 20C 1932 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2A0 1933 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 23< 1934 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2A0 1935 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

4cutellaria !aicalensis
Common name: Ha!itat: Botanical description: #arts used: Constituents: • flavonoids9 bacalein #harmacology: 6he root of !hinese s#ullcap contains a flavonoid substance, baicalin that has been sho n to have protective actions on the liver. Anti&allergy actions and the inhibition of bacteria and viruses in in !itro studies has been documented ith !hinese s#ullcap. 5ome initial !hinese studies, generally of lo quality, suggest that !hinese s#ullcap may help people ith acute lung, intestinal, and liver infections, as ell as hay fever and hypertension. /ore e$tensive clinical or# is needed to clearly demonstrate !hinese s#ullcap@s effectiveness for these conditions. AC3F Medicinal actions: )raditional Medicinal Use: Current Medicinal Use: #harmacy: Baicalein bloc#s the action of phospholipase, possibly by inhibiting calcium influ$ into the cell, thereby inhibiting the release of calcium from the sarcoplasmic reticulum inside the cell. Contraindications: )o*icity:

1936

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A

4cutellaria laterifolia
Common name: Ha!itat: 5#ullcap, +ood ort, 2ua#er Bonnet, +elmet )lo er

1amiaceae (1a!iatae

Botanical description: 6he leaves are opposite, cordate&lanceolate, shortly stal#ed ith a tapering ape$. 6he flo ers are blue ith a helmet&shaped upper lip and occur in a$illary racemes. #arts used: +erba Constituents: )lavonoid glycoside9 scutellarin, scutellarien and othersK ,ridoids9 catalpolK 7olatile oilK Wa$esK 6annins, /inerals #harmacology: ,n contrast to its !hinese relative, 5cutellaria baicalensis, there is not yet e$perimental data to support the medicinal claims for this plant. ,cutellaria laterifolia 6he active agents in the leaves are scutellarin, essential oil as ell as fatty oil, tannin, and resin. 5#ullcap has sedative, antispasmodic =little research>, anti&inflammatory, and lipid pero$idation inhibitor effects. )e studies have been completed on the constituents of American 5#ullcap. 0ne of its constituents, scutellarin, has been sho n to have mild sedative and antispasmodic actions. +uman studies have not yet been conducted to confirm the use of s#ullcap for an$iety or insomnia. AC3H Medicinal actions: 5edative, nervine rela$ant, nervine trophorestorative, mild antispasmodic =compare 3 5tachys>, tonic )raditional Medicinal Use: 5pecific ,ndications and Uses.Z:ervousness, attending or follo ing acute or chronic diseases, or from mental or physical e$haustion, teething, etc.K nervousness manifesting itself in muscular actionK tremors, subsultus, etc.K hysteria, ith inability to control the voluntary musclesK functional cardiac disorders of a purely nervous type, ith intermittent pulse. AC3B !oo# described 5cutellaria as equally rela$ant and stimulant ith antispasmodic and tonic properties that acting on and through the nervous system. ?ing described 5cutellaria as a tonic, nervine, and antispasmodic. +e noted that the arm infusion has a tendency to be mildly diaphoretic and the cold had a tonic influence. 'ither preparation as #no n to leave a toning and soothing impression on the system, ithout being e$citable or irritable as is the case ith some other nervines. • !ardiovascular !onditions9 5cutellaria as observed to control functional cardiac disorders secondary to nervous causes. • %ental !onditions9 5cutellaria infusion as given to children during teething. • :ervous !onditions9 5cutellaria as considered one of those valuable agents for the nervous system by both the 'clectics and 1hysiomedicalists. 6hrough the nervous system, 5cuttelaria as though to reach locali(ed pain throughout the body hen due to nervous feebleness ith agitation, but not associated ith acute or sub&acute inflammatory e$citement. 5cuttelaria as applied freely in all cases of nervous e$citability, attending or follo ing acute or chronic diseases, regardless of cause. :ervous e$citability ith feebleness, fatigue or depression also called for 5cutellaria. 5ome specific conditions for hich it as applied include chorea, convulsions, tremors, intermittent fever, neuralgia, and delirium tremens. 6he 1hysiomedicalists also used 5cutellaria for the insomnia that follo s opium ithdra alK ho ever, ?ing did not agree ith its effectiveness for this application. 5cutellaria as used for spasmodic difficulties secondary to nervous irritation such as some cases of gastrointestinal pain or gynecological complaints. Current Medicinal Use: 5cutellaria is a sedative, antispasmodic, a rela$ant and nervous trophorestorative, a mi$ture of qualities not found in most other herbs. • !ardiovascular !onditions9 5cutellaria is used to ease emotional and mental tension and is combined ith herbs such as .eonurus or 5alvia militorrhi(a for palpitations. %*C* • *astrointestinal !onditions9 5tress may be the underlying cause of gastroesophageal reflu$, especially if irritable bo el disease is evident. 5edative herbs such as 5cutellaria are thus indicated. %*'• *ynecologic !onditions +erbal antispasmodics and rela$ants such as 5cutellaria can be useful for spastic dysmenorrhea. • ,nflammatory !onditions9 +erbal sedatives such as 5cutellaria may also be used in some cases of inflammatory disease. • :ervous !onditions9 *eneral indications for sedatives include moderate tension and an$iety syndromes, difficulty falling asleep and coming off conventional prescription sedatives. 5edatives can also be used to calm restlessness disturbing convalescence. Antispasmodic and rela$ant herbs can be used in cases of irritability and restlessness, tension headaches and migraines.

As a nervous trophorestorative, 5cutellaria can be used in cases of nervous e$haustion, neuralgia, herpes infections, depressive states and insomnia mar#ed by a#ing up in the early hours of the morning after falling asleep easily. 0ther applications include convalescence and neurasthenia =see Avena>. 5cutellaria or#s ell for states for heightened an$iety ith accompanying muscle and nervous tension manifested as restlessness, an$iety and insomnia. 5cutellaria can be used acutely for this purpose as the volatile oils and flavonoids presumably act to relieve spasm and inflammation. 5cutellaria tonifies the nervous system, hich ma#es it indicated in persons ith run&do n nervous systems. 5cutellaria combines ell ith 5tachys. 5cutellaria can also be used long&term for nervous tension ith an underlying condition of nervous e$haustion. 6he long&term action of 5cutellaria is most li#ely the result of the minerals and flavonoids. ,t is also indicated in persons ho have general irritability and culminate their stress into angry outbursts. 5cutellaria is also indicated for persons ith muscular t itching and tremors. 5cutellaria also allo s inner inspirations to become strengthened and cools the mind for meditation. !ompare it ith 7erbena. #harmacy: 5cutellaria is indicated for short& and long&term use depending on the action desired. )or treatment of moderate tension and an$iety, short&term or intermittent use is indicated. 5edatives may be ta#en as required, at bedtime or ith food. Administration should be for a fi$ed time as they can be used to suppress an underlying condition. 5econdly, the body may habituate resulting in diminishing returns.AC<A )or antispasmodic and rela$ant effects, hot infusions made ith generous quantities and large doses are indicated. 5cutellaria should not be decocted and should be covered hen infused. 6he trophorestorative effect is a#in to being nutritional in effect being ta#en as needed or before food. .ong&term therapy is the generally application. 1o dered herb9 sig A&2 gm3day ,nfusion9 A tsp W A 6B 3 cupK sig A cup 6,% or hs 6incture Qfresh or dried =A9E>RK sig 2&< ml 6,%K ee#ly ma$. O A00 ml Drug ,nteractions: • 4edative and )ran?uili;ing Medicines: )or some herbs hose mechanism of activity has not yet been determined, caution is advised due to possible adverse effects ith combination. AC<2 Contraindications:%*'C Although the sedative class of herbs has a beneficial effect on the nervous system, direct substitution for conventional sedatives is not advised. 4ather, careful planning and co&management is advised. 5edatives are generally contraindicated for depression and insomnia mar#ed by increasing restlessness during the early morning. 6rophorestoratives are to be used ith caution in e$tremely debilitated patients. =:ote9 A disparity appears here regarding the sedative effect and trophorestorative effect of 5cutellaria. ,n regard to the treatment of depressive states, sedatives are contraindicated hile nervous trophorestoratives are indicated. 5ubsequently, a second contradiction arises discussing insomnia in the early morning9 sedatives are contraindicated hile nervous trophorestoratives are indicated. .i#ely, utili(ing small, frequent doses allo s for a trophorestorative effect hile larger doses provide a sedative effect.>. )o*icity: 5cutellaria is a gentle herb, ithout concern about to$icity. 6eucrium species =germander> has been substituted for 5cuttelaria at the manufacturing level, compromising the safety of the product. AC<<
1937 1938

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1939 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AHE 1940 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AHE 1941 /ills and Bone p. 233 1942 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 23H 1943 /ills and Bone p. 233 1944 /ills and Bone p. A0C

4erenoa repens
Common name: 5a palmetto

Arecaceae

Ha!itat: :ative to the coastal regions of the southern states of the U.5., from 5. !arolina to )lorida and southern !alifornia. AC<E Botanical description: AC<F • )lo er9 !ream inconspicuous flo ers in short, densely pubescent, paniculately branched inflorescens. • )ruit9 %eep purple to almost blac#, ovate, 3 cm long, A&seeded berry ith hard but fragile pericarp that covers a pale bro n, spongy pulp. 6he endocarp is thin and papery. )ruit is slightly rin#led, A.2E&2.E cm long, A.2E cm diameter. 6he hard seed is pale bro n, oval, or globular, and has a hilum near the base. 6he hole panicle eighs up to < #g. • .eaves, 5tem, and 4oot9 Bushy palm up to F m in height. .arge, yello &green leaves ith up to 20 segments form a cro n. #art used: berry $nergetics: Constituents: AC<H,AC<B,AC<C

•
• • •

6he lipid&soluble compounds are thought to be the ma"or pharmacological components. 6he purified fat&soluble e$tract is used medicinally and contains bet een BE and CEG of fatty acids and sterols
A.EG of a fruity&smelling oil containing saturated and unsaturated fatty acids and sterols. About F3G of this oil is composed of free fatty acids including capric, caprylic, caproic, lauric, palmitic, and oleic acids Beta&sitosterol and its glucoside !arotenes, lipase, tannins, and sugars

#harmacology: • 6he primary therapeutic action of sa palmetto e$tract in the treatment of B1+ has been thought to be a result of inhibition =via bloc#ing E&alpha reductase> in the intraprostatic conversion of testosterone to dihydrotestosterone =%+6> and inhibition of its intracellular binding and transport. +o ever, more recent research has suggested additional mechanisms of action, including anti&estrogenic and receptor site&binding effects. ACE0 • Additional effects ,nclude spasmolytic activity ,n animals, antiestrogenic activity, and antiinflammatory activity. ACEA Medicinal actions: • Anti&androgenic, anti&e$udative.ACE2 • Anti&inflammatory, endocrine agent, spasmolytic, possibly anti&androgenic. ACE3 )raditional medicinal uses: • 6he dried berries, liquid e$tract, or pressed oil ere used in respiratory complaints, esp. if accompanied by chronic catarrh, and genitourinary complaints, esp. to reduce irritation =e.g., cystitis> and for prostatic hypertrophy. Was considered to be a tissue building plant.ACE< • 'clectics used sa palmetto for respiratory problems, atrophy of the breast, ovaries and testes, and B1+. Was also used to treat inflamed gonads in the male or female, uterine hypertrophy, and as an aphrodisiac. ACEE Current medicinal uses: • 1rostate disorders9 o B1+ & !0!+4A:' 4'7,'W9 2C3C men fromAB randomi(ed trials lasting < to <B ee#s ere assessed. AF trials ere double&blinded and treatment allocation concealment as adequate in C studies. !ompared ith placebo, 5erenoa repens improved urinary symptom scores, symptoms, and urinary flo measures. !ompared ith finasteride, 5erenoa repens produced similar improvements in urinary symptom scores and pea# urine flo . Adverse effects due to 5erenoa repens ere mild and infrequent. Withdra al rates in men assigned to placebo, 5erenoa repens or finasteride ere HG, CG, and AAG, respectively. 4evie ersN conclusions9 6he evidence suggests that 5erenoa repens improves urologic symptoms and flo measures compared ith placebo. 5erenoa repens produced similar improvement in urinary symptoms and flo compared to finasteride and is associated ith fe er adverse treatment events. 6he long term effectiveness, safety and ability to prevent B1+ complications are not #no n. o :on&infectious prostitis =e$trapolations from pharmacological data> ACEF #harmacy:

• •

• •

Berry9 o A&2 g 2%ACEH o 2&< g dried berry 2%ACEB 5tandardi(ed e$tract9 o %osages used in studies demonstrated efficacy at AF0 mg B,% or 320 mg 2%. ACEC o AF0 mg B,% of liposterolic e$tract =B9A&A09A concentrate compared to the original dried berries ACF0 o 320 mg of lipophilic ingredients e$tracted ith lipophilic solvents =he$ane or ethanol C0G v3v> 2%. ACFA o B1+9 .iposterolic e$tract =standardi(ed to BE&CEG fatty acids and sterols> AF0 mg B,%, corresponding to 3&< g dried berries 2%ACF2 )luid e$tract9 o L&A drachm.ACF3 o A92 e$tract =<E&C0G 't0+>9 2&< m. 2%ACF< 5olid e$tract9 E&AE grains.ACFE

Drug interactions: :one #no n"5&& Contraindications: :one #no n"5&( )o*icity.4ide effects: • 4are cases, stomach problems. ACFB
1945 1946

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p.FFE ,bid, pp. FF<&E 1947 -oseph '. 1i((orno -r, /ichael 6. /urray =eds.>, Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, 'dinburgh, ACCC, 7ol. ,, pp. C<3&< 1948 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy: Modern Herbal Medicine, !hurchill .ivingstone, 'dinburgh, 2000, p.E2< 1949 .ininger et al, Healthnotes9 2linical Essentials, Herb Monographs, 1rima 1ublishing, 4oc#lin, !A, 200A 1950 1i((orno, 7ol. ,, p. C<< 1951 /ills, pp.E2E&F 1952 /ar# Blumenthal et al =eds.>, The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , American Botanical !ouncil, Austin, 6e$as, ACCB, p.20A 1953 /ills, p. E23 1954 /rs. /. *rieve, ) Modern Herbal: The Medicinal, 2ulinary, 2osmetic and Economic Properties, 2ulti!ation, and ol3lore of Herbs, 5rasses, ungi ,hrubs JTrees :ith Their Modern ,cientific Dses, %over 1ublications, ,nc, :e ;or#, ACHA, 7ol. ,,, p.H20 1955 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3, 7ol. 2, pp.AHE0&2 1956 /ills, p.E23 1957 Blumenthal, p. 20A. 1958 /ills, p.E2< 1959 PDR, p.FF<&E 1960 /ills, p.E2< 1961 Blumenthal, p.20A 1962 /elvyn 4. Werbach and /ichael 6. /urray, 2nd ed., Botanical >nfluence on >llness: ) ,ourceboo3 of 2linical Research, 6hird .ine 1ress ,nc., 6ar(ana, !alifornia, 2000, p.A2A 1963 /rs. /. *rieve, ) Modern Herbal: The Medicinal, 2ulinary, 2osmetic and Economic Properties, 2ulti!ation, and ol3lore or Herbs, 5rasses, ungi ,hrubs JTrees :ith Their Modern ,cientific Dses, %over 1ublications, ,nc, :e ;or#, ACHA, 7ol. ,,, p.H20 1964 /ills, p.E2< 1965 *rieve, p.H20 1966 /ills, p.E3A 1967 /ills, p.E3A 1968 Blumenthal, p.20A

4elencereus grandiflorus (Cactus grandiflorus' Hylocereus undatus' #eniocereus (Cereus
Common name: :ight blooming !ereus3!actus Ha!itat:

greggii

Cactaceae

Botanical description9 %uring -une, this cactus blooms for t o or three nights ith 2&3 in. slender petalled hite flo ers. ,n the fall, the ovaries mature into red, pear&shaped, edible fruit. )or the rest of the year, the cactus is bro nish&green colored, ith tall s#inny stems 0.E&A inch around, 2 to F feet tall, and ea#ly spined. A large tuber =E&A0g> supports the plant. #arts used9 +erb and stems Constituents9 • !ardiac glycosides9 peniocerol, viperidone, deso$yviperidone, viperidinone, hordenine • B&sitosterol #harmacology: 6he al#aloid hordenine increases blood pressure by liberating :' and inhibiting :' upta#e. ACFC Medicinal actions: !ardio&tonic, anti&arrhythmic, sedative, diuretic )raditional Medicinal Use: 5pecific ,ndications and Uses9 ,mpaired heart&action, hether feeble, violent, or irregularK cardiac disorder ith mental depression or nervousness, precordial oppression, an$iety, apprehension of danger, or deathK hysteriaK tobacco heartK nervous disorders, ith heart complicationsK verte$ headacheK vaso&motor spasms.ACH0 !actus has been found useful in virtually any condition that is secondary to cardiac dysfunction including cerebral congestion, mental derangements, rheumatism, inflammations of mucous membranes, prostatic diseases, irritable bladder, renal congestion, general dropsy, edematous condition of the limbs, dysmenorrhea, chronic bronchitis, eye and ear conditions, etc. • !ardiovascular !onditions9 ?ing observed that !actus impresses the sympathetic nervous system, and is especially active in its po er over the cardiac ple$us through the superior cervical ganglion, e$pending its force in regulating the action of the heart and controlling the cerebral circulation, thus giving increased nutrition to the brain. 6he effects of !actus ere noted to permanent and not merely temporary. According to 1rof. 5cudder =5pec. /ed.>, it neither increases nor depresses innervationK that it is neither stimulant nor sedative. ?ing noted the state of the nervous system in cardiac diseases that indicated !actus9 there is a mar#ed mental depression, often leading to hypochondria and fear of impending death. 1recordial eight and oppression and difficult breathing also occur. !actus as considered one of the best of cardiac tonics, influencing functional disordersK organic conditions ere observed to only benefit in a small measure. +o ever, allopathic physicians considered !actus a valuable agent in mitral regurgitation due to valvular lesions. ?ing considered it the remedy for almost all functional cardiac irregularities such as palpitation, pain, cardiac dyspnoea, intermission in rhythm, etc. ,n cardiac pain of a constrictive character, as if the organ ere held ith a strong band, it as considered to have the most prompt effect of all cardiac remedies. %uring menstrual periods and at the menopause, nervous omen frequently e$perience unpleasant cardiac disturbances of a functional character hich responded ell to !actus. Current Medicinal use: • !ardiovascular !onditions9 5elencereus is a cardio&tonic plant neither stimulating or sedating, but impressing normali(ing effect on cardiac rhythm as a result of modulation of sympathetic output. !ardioactive glycosides give this plant a cardio&tonic effect and positive inotropic effect. +o ever, it does not possess a negative chronotropic effect. !actus acts upon the sympathetic nervous system, enhancing the output to the cardiac ple$us. ,n sufficiently large therapeutic doses, cactus ill quic#en a slo heart rate. ,t is specific for vague chest pain and shortness of breath associated ith tobacco and caffeine abuse and ith depression as a reaction to stress. As a cardio&tonic, cactus may also be used in endocarditis and pericarditis, cardiac ea#ness follo ing over& e$ertion, chest discomfort associated ith menstruation, or ea#ened heart ith renal congestion =it is a mild diuretic>. !ereus also reduces cardiac arrhythmias and paro$ysmal tachycardia secondary to altered nervous stimulation and ea#ness of the myocardium. 5elencereus is especially indicated in valvular disorders of the heart hen there is associated arrhythmia. %r. Bill /itchell uses !actus ith 200 mg each /g and ? aspartate to correct an irregular pulse. • 1ulmonary !onditions9 5elencereus may also be used to treat bronchitis ith rapid, shallo breathing and a dry, tight sensation across the chest.ACHA #harmacy

6incture A9E <EG sig 0.A&2 ml 6,% 20 gtt bid&tid =/itchell> A0 gtt in small amount of ater q min for 3&< doses for angina =/ithcell> Drug ,nteractions: • MA3 ,nhi!itors may potentiate cardiac effects as hordenine is metaboli(ed by /A0. Contraindications: Brin#er contraindicates the use of !actus in high blood pressure or heart over activity due to cardiostimulant, positive inotropic and hypertensive effects of hordenine =empirical, animal studies> )o*icity9 As a secondary effect of over&stimulation, it may induce heart&failure. 6he tincture, in large doses, produces gastric irritation, and also affects the brain, causing confusion of mind, hallucination, and slight delirium. ,n e$cessive doses, a quic#ened pulse, constrictive headache, or constrictive sensation in the chest, cardiac pain ith palpitation, vertigo, dimness of sight, over&sensitiveness to noises, and a disposition to be sad or to imagine evil, are among its many nervous manifestations. /elancholia often follo s such action. ,t is generally conceded, ho ever, that the mental, cerebral, gastric, and other effects are secondary to and dependent largely upon the primary effects of the drug upon the heart. ,n sufficiently large doses it acts as an intense irritant to the cardiac ganglia, producing thereby irritability, hyperaesthesia, arythmia, spasm and neuralgia of the heart, and even carditis and pericarditis. 6achycardia, arrhythmia, cardio&spasm, mental confusion, violent throbbing headaches, vertigo, hyperasthesea, amblyopia, gastrointestinal upset, quic#ened pulse, chest constriction, noise sensitivity, sadness and paranoia follo ed by depression, pericarditis. QBrin#er, 6he 6o$icology of Botanical /edicines, 2<R

4ily!um marianum (Carduus Marianus
Common name: mil# thistle, 5t. /ary@s thistle Ha!itat: Botanical description: /ary thistle is an annual, or biennial plant, glabrous, or but slightly ooly, gro ing to a height of 2 or 3 feet, and branching but little. ,ts leaves, hich are shining and smooth above, are mar#ed ith hite veinsK the lo er leaves are deeply pinnatifid, the lobes being broad and very pric#lyK the upper ones clasp the stem by pric#ly auricles, and are scarcely decurrent. 6he large, drooping flo er heads, ith purple florets, are solitary and terminal upon the branches. 6he involucral bracts are very broad at the base and have a stiff, spreading leaf&li#e appendage, terminating in a long spine, and bordered at its base ith pric#les. 6he fruit is an achenium. 6he pappus hairs are simple.ACH2 #art used: seed Historical use: $nergetics: :o information is currently available. Constituents: • Bioflavonoids9 5ilymarin is made up of three parts9 silibinin, silidianin, and silicristin. 5ilibinin is the most therapeutically active constituent. #harmacology /il# thistle e$tract may protect the cells of the liver by bloc#ing the entrance of to$ins and helping metaboli(e these to$ins. 5ilymarin has also been sho n to regenerate in"ured liver cells. ACH3 5ilymarin has the ability to bloc# fibrosis, a process that contributes to the eventual development of cirrhosis in persons ith inflammatory liver conditions secondary to alcohol abuse or hepatitis. ACH< 5ilymarin is also a po erful antio$idant.ACHE Medicinal actions: +epatotrophorestorative, galactagogue )raditional Medicinal Uses: 5pecific ,ndications and Uses9 5plenic, hepatic and renal congestion, face sallo , appetite capriciousK nervous irritabilityK despondencyK physical debilityK pain in either hypochondriaK pelvic tension and eightK congestion of the parts supplied by the celiac ple$us and nervesK non&malarial splenic hypertrophyK dull, aching, splenic pain passing up under the left scapula, and associated ith pronounced general debility and despondencyK general bilious conditions accompanied ith stitches in the right side, ith hard and tender spotsK gall stoneK "aundiceK hepatic pain ith s ellingK vomiting in pregnancy secondary to involvement of the liver or spleen. ACHF • !ardiovascular !onditions9 6o a lesser e$tent, the hole venous apparatus is influenced by this herb, strengthening the veins, and preventing !aricosities and other dilatations. But little effect, ho ever, is observed on the hemorrhoidal circulation. • *ynecologic !onditions9 Amenorrhea secondary to dysfunction of the portal circulation and uterine hemorrhage have been successfully treated by it. • +ematologic conditions9 +emorrhages associated ith splenic or hepatic disorders respond ell to 5ilybum. ,t influences the tissues supplied by the celiac artery, particularly the distribution of the hepatic and splenic arteries. !ongestive conditions of the splenic circulation are those most benefited by it. ,t controls splenic pain even here no enlargement can be detected, and it is the remedy for hypertrophy of the spleen hen non&malarial in character. • +epatobiliary !onditions9 !ongestion of the liver, spleen and #idneys is relieved by its use. Current Medicinal Uses: • *astrointestinal !onditions9 By improving liver function, 5ilybum may be useful in the treatment of constipation. ACHH • *enitourinary !onditions9 5ilibinin as demonstrated to prevent #idney damage from cisplatin ithout diminishing the anti&tumor activity in&vitro.ACHB • *ynecologic !onditions9 By promoting the brea#do n of estrogen, 5ilybum may be useful in the treatment of conditions such as endometriosis, fibroids, and 1/5.ACHC • +epatobiliary !onditions9 ,n patients ith chronic viral hepatitis, preliminary double&blind studies have found that mil# thistle can produce significant improvement in symptoms such as fatigue, reduced appetite, and abdominal discomfort, and lo er liver en(ymes.ACB0 A 2A&day double&blind placebo&controlled study of EH people ith acute viral hepatitis found significant improvements in the group receiving mil# thistle.ACBA 0ther studies have sho n equivalent results.ACB2,ACB3

1reliminary evidence suggests that mil# thistle might protect against liver to$icity caused by drugs such as acetaminophen, %ilantin =phenytoin>, butyrophenones, alcohol, and phenothia(ines. ACB<, ACBE /il# thistle alters bile ma#eup, thereby potentially reducing ris# of gallstones. ACBF Current +esearch +eview: • Drug interactions: o ,ndinavir:"5/(  %esign9 !linical trial  1atients9 6en healthy volunteers  6herapy9 /il# thistle AHE mg =AE3 g sylimarin> 6,% $ 3 ee#s, follo ed by < doses of indinavir, B00 mg qBh ic. !ontrol W < doses of indinavir, B00 mg qBh ic prior to and post e$periment.  4esults9 6he study concluded that mil# thistle in commonly administered dosages should not interfere ith indinavir therapy in patients infected ith the human immunodeficiency virus. • 9astroenterology: o Ulcers:"5//  %esign9 '$perimental and clinical trial  1atients9 1atients ith ulcer of stomach and duodenal intestine.  6herapy9 :atursilum from 5ylibum marianum  4esults9 :atursilum has gro th efficiency of conventional treatment of an ulcer of a stomach and duodenal intestine patients both on end results, and on terms of an adhesion increases. o Biliary lipid composition:"5/5  %esign9 '$perimental and placebo&controlled clinical trial  1atients9 !linical trial part9 )our patients ith gallstone and AE patients ith cholecystectomy  6herapy9 5ylimarin, <20 mg qd $ 30 days  4esults9 Biliary cholesterol concentrations ere reduced after 5ilymarin treatment and the bile saturation inde$ significantly decreased accordingly. Authors concluded that 5ilibinin&induced reduction of biliary cholesterol concentration both in humans and in rats might be, at least in part, due to a decreased synthesis of liver cholesterol o 1iver cirrhosis: 5tudy A9ACC0  %esign9 !linical trial.  1atients9 1atients ith active cirrhosis of different etiology.  6herapy9 Ursodeo$ycholic acid and silymarin  4esults9 Both therapies seemed safe and ameliorated the biochemical indices of cytolysisK ho ever, silymarin did not appear to be effective hen hepatic dysfunction as associated to hepatitis ! infection. 6he residual functional liver mass, as assessed by quantitative liver function tests, as not affected by either cytoprotective agent. 5tudy 29ACCA  %esign9 4andomi(ed double&blind placebo&controlled clinical trial  1atients9 5i$ty patients ith alcoholic liver cirrhosis.  6herapy9 5ilymarin /8&B0, AE0 mg 6,% $ F month  4esults9 5ilymarin is ell&tolerated and produces a small increase in glutathione and a decrease in lipid pero$idation in peripheral blood cells in patients ith alcoholic liver cirrhosis. %espite these effects, no changes in routine liver tests ere observed during the course of therapy. 5tudy 39ACC2  %esign9 !linical trial  1atients9 6 enty&seven patients ith primary biliary cirrhosis ho had sho n a suboptimal response to ursodeo$ycholic acid =U%!A> and a persistent elevation of al#aline phosphatase activity at least 2$ the upper limit of normal for more than F months.  6herapy9 5ylimarin, A<0 mg 6,% po $ A yr, as given in addition to U%!A  4esults9 :o significant changes in serum al#aline phosphatase activity, total bilirubin, aspartate transaminase =A56>, albumin, or /ayo ris# score ere noted after A year of treatment ith combination therapy. ,n conclusion, although silymarin as ell tolerated, this medication did not provide benefit to patients ith 1B! responding suboptimally to U%!A. 5tudy <9ACC3  %esign9 1rospective randomi(ed double&blind placebo&controlled clinical trial  1atients9 0ne hundred seventy patients ith cirrhosis, including alcoholic, non&alcoholic, males, females, and children.  6herapy9 A<0 mg sylimarin 6,% $ 2 yrs

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4esults9 ,n the placebo group, 3H =X2 drop outs> patients had died, and in 3A of these, death as related to liver disease. ,n the treatment group, 2< =X< drop outs> had died, and in AB of these, death as related to liver disease. 6he <&year survival rate as EB X3& CG =5.'.> in silymarin&treated patients and 3C X3& CG in the placebo group. Analysis of subgroups indicated that treatment as effective in patients ith alcoholic cirrhosis and in patients initially rated I!hild AJ 5tudy E9ACC<  %esign9 4andomi(ed double&blind placebo&controlled multicenter clinical trial  1atients9 6 o hundred alcoholic patients ith histologically or laparoscopically proven liver cirrhosis.  6herapy9 5ylimarin, <E0 mg qd =AE0 mg 6,%> in a 2&year study.  4esults9 5urvival as similar in patients receiving silymarin or placebo. 6he effect of silymarin on survival as not influenced by se$, persistence of alcohol inta#e, severity of liver dysfunction or by the presence of alcoholic hepatitis in the liver biopsy. 5ilymarin did not have any significant effect on the course of the disease. 5tudy F9ACCE  %esign9 4andomi(ed double&blind controlled clinical trial  1atients9 1atients ith alcoholic cirrhosis  6herapy9 5ilymarin  4esults9 5ignificantly higher surviving rate in e$perimental group. 5tudy H9 ACCF  %esign9 0pen controlled clinical trial  1atients9 5i$ty insulin&treated diabetic patients ith alcoholic cirrhosis.  6herapy9 5ilymarin, F00 mg qd X standard therapy $ A2 months, or standard therapy alone & control  4esults9 6here as a significant decrease in fasting blood glucose levels, mean daily blood glucose levels, daily glucosuria and +bAAc levels already after < months of treatment in the silymarin group. ,n addition, there as a significant decrease in fasting insulin levels and mean e$ogenous insulin requirements in the treated group, hile the untreated group sho ed a significant increase in fasting insulin levels and a stabili(ed insulin need. 6hese findings are consistent ith the significant decrease in basal and glucagon&stimulated !&peptide levels in the treated group and the significant increase in both parameters in the control group. 6here also as the significant decrease in malondialdehyde3levels observed in the treated group. 6he conclusion as that treatment ith silymarin may reduce the lipopero$idation of cell membranes and insulin resistance, significantly decreasing endogenous insulin overproduction and the need for e$ogenous insulin administration. Alcoholic liver disease: 5tudy A9ACCH  %esign9 4andomi(ed placebo&controlled clinical trial  1atients9 5eventy&t o patients ith alcoholic liver disease  6herapy9 5ilymarin, 2B0 mg qd  4esults9 .ife table analysis did not sho significant differences in mortality bet een e$perimental and placebo groups. )inal laboratory values and their changes in those ho survived did not differ bet een 5ilymarin and placebo. 6hose ho abstained from alcohol had a significant fall in gamma glutamyl transferase during follo up. ,t is concluded that in this trial that 5ilymarin did not change the evolution or mortality of alcoholic liver disease. 5tudy 29ACCB  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 1atients ith chronic alcoholic liver disease  6herapy9 5ilymarin, <20 mg qd $ F months  4esults9 6he originally lo 50% activity of erythrocytes and lymphocytes and 50% e$pression on lymphocytes as significantly enhanced. ,n addition, silymarin therapy mar#edly increased the serum level of ree&&5+ groups and the activity of glutathione pero$idase. 6hese data indirectly suggest that antio$idant, antipero$idative effects might be important factors in the mechanism of hepatoprotective action of silymarin. 5tudy 39ACCC  %esign9 4andomi(ed double&blind placebo&controlled clinical trial.  1atients9 0ne hundred si$teen patients ith histologically proven alcoholic hepatitis, EB of them ith cirrhosis.  6herapy9 5ylimarin, <20 mg qd $ 3 months.  4esults9 )our patients died of hepatic failure during the trial, 3 in the placebo group. 5ignificant improvement in the score of alcoholic hepatitis and serum amino transferase activity, as noted in both groups during the trial, irrespective of treatment ith silymarin or placebo. 6he conclusion as that silymarin <20 mg3d is not clinically relevant in the treatment of moderate alcoholic hepatitis. 1iver diseases:  5tudy A9 2000 

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%esign9 4andomi(ed placebo&controlled clinical trial. 1atients9 0ne hundred and si$ patients ith liver disease ith elevated serum transaminase levels. ,n general, the series represented a relatively slight acute and subacute liver disease, mostly induced by alcohol abuse.  6herapy9 5ilymarin $ < ee#s.  4esults9 6here as a statistically highly significantly greater decrease of 5&5*16 =5&A.A6> and 5&5*06 =5&A5A6> in the treated group than in controls. 5erum total and con"ugated bilirubin decreased more in the treated than in controls, but the differences ere not statistically significant. B51 retention returned to normal significantly more often in the treated group. 6he mean percentage decrease of B51 as also mar#edly higher in the treated. :ormali(ation of histological changes occurred significantly more often in the treated than in controls. 5tudy 29200A  %esign9  1atients9 0ne hundred eighty patients ith chronic persistent hepatitis =!1+>, chronic active hepatitis =!A+>, and hepatic cirrhosis =+!>.  6herapy9 4omanian product 5ilimarina =synonym .egalon> $ <0 days  4esults9 6he results sho ed favourable effects similar ith those obtained ith other preparations produced by foreign drug industries 5tudy 39 2002  %esign9 6 o double&blind placebo&controlled clinical trials  1atients9 5tudy A9 t enty&four patients ith chronic hepatitis. 5tudy 29 6 elve patients ith chronic hepatitis.  6herapy9 5ilymarin, $ 3mo&A yr  4esults9 ,n the laboratory tests investigated no remar#able difference bet een silymarine and placebo therapy as seen. 5ome histological changes, ho ever, ere improved under silymarine, one of them significantly. Dentistry: o Dental surgery:0887  %esign9  1atients9 1atients undergoing implantation of titanium implants  6herapy9 :atursilum in surgery and in post&operative period  4esults9 0ptimi(ation of an implant osteointegration and normali(ed physicochemical and metabolic parameters of the oral liquid. ,nfectious disease: o Chronic hepatitis:  5tudy A9 200<  %esign9 4andomi(ed placebo&controlled clinical trial  1atients9 6 enty patients ith chronic active hepatitis  6herapy9 5ylibin comple$ =,dBA0AF>K 2<0 mg of sylibin 6,%  4esults9 6here as a statistically significant reduction of mean serum concentrations of aspartate aminotransferase =A56> from BB.0 =X3& A3.3> to FE.C =X3& H.E> u3l, of alanine aminotransferase =A.6> from AAE.C =X3& A2.C> to B2.E =X3& A0.F> u3l, of gamma&glutamyltranspeptidase =gamma&*6> from EA.< =X3& C.3> to <A.3 =X3& <.2> u3l, and of total bilirubin =6B> from 0.HF =X3& 0.0B> to 0.E3 =X3& 0.0<> mg3dl. Al#aline phosphatase =A1> fell slightly from A<3.< =X3& F.<> to A3H.E =X3& H.B> u3l. 6here ere no significant changes in /%A, !u or 8n serum concentrations. 6hese results sho that ,dBA0AF may improve .)6s related to hepatocellular necrosis and3or increases membrane permeability in patients affected by !A+. o Hepatitis B:  5tudy A9 088%  %esign9 !linical trial  1atients9 )orty patients ith acute hepatitis B.  6herapy9 /isoprostol or sylimarin $ A2 months.  4esults9 At the end of treatment phase, improvement of liver function as faster in misoprostol&treated group. After A2 months of follo &up +BsAg as cleared in all misoprostol&treated patients and in BEG among sylimarin group. /isoprostol treatment resulted ith normali(ation of bilirubin concentration and en(ymes activity in all patients. 6 o among sylimarin treated patients =both +BsAg positive>, had transaminases activities elevated over A00 U3l, that resulted ith significantly higher values than in misoprostol treated group. 5tudy 29200F  %esign9 !ontrolled clinical trial  1atients9 0ne hundred fifty one patients ith acute viral hepatitis B.  6herapy9 5ilymarin =.egalon>  

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4esults9 6he frequency of nearly normali(ed values of transaminases and serum bilirubin after A0, 20 and 30 days as not higher in the group treated ith 5ilymarin as compared to the controls. ,t as concluded that 5ilymarin has no favourable effects on the cause of acute viral hepatitis. Cognitive disorders: o Al;heimerAs disease:088(  %esign9 4andomi(ed double&blind placebo&controlled multi&center clinical trial  1atients9 6 o hundred t enty t o patients ith mild to moderated dementia of Al(heimer type.  6herapy9 5ilymarin, <20 mg qd $ A ee# X tacrine, <0 mg qd $ F #s, then tacrine, B0 mg qd $ F ee#s or tacrine X placebo.  4esults9 5ilymarin does not prevent tacrine&induced A.6 elevation but does reduce the rate of gastrointestinal and cholinergic side effects ithout any impact on cognitive status. As a consequence, silymarin =<20 mg3day> could be co& administered ith tacrine to improve tolerability in the initial phases of A% treatment. Cardiology: o Hyperlipidemia:088/  %esign9 0pen clinical trial  1atients9 )ourteen patients ith type ,, hyperlipidemia  6herapy9 5ilymarin =.egalon>, <20 mg qd $ 3 months, then placebo $ 2 months, then .egalon, <20 mg qd $ A months.  4esults9 6here ere no remar#able changes e$cept that the total cholesterol and +%.&cholesterol levels slightly decreased. At the A2th ee#, in all cases, the apolipoprotein levels ere some hat decreased compared to the baseline values. By the significant decrease of both apo A&, and A&,, values, a decrease of the total structural protein amount of +%., and thus a relative increase in the proportion of cholesterol in +%. fraction as suggested. 6here ere minor changes in serum protein concentration and liver function tests, but all values remained ithin the normal range. All of the renal function parameters remained unchanged during both treatments and the placebo periods. )o*icology: o 3ccupational e*posure: 5tudy A9200C  %esign9 controlled clinical trial  1atients9 )orty nine or#ers e$posed to toluene and3or $ylene vapours for E&20 years ith abnormal liver function tests =elevated A56 and A.6> and3or abnormal hematological values =lo platelet count, leu#ocytosis, relative lymphocytosis>  6herapy9 .egalon, 6,% $ 30 days.  4esults9 Under the influence of .egalon the liver function tests and the platelet counts significantly improved. 6he leu#ocytosis and relative lymphocytosis sho ed a nonsignificant tendency of improvement. 5tudy 2920A0  %esign9 !ontrolled clinical trial  1atients9 )ifty&five patients ith occupational to$ic chronic or subacute hepatopathy caused by various to$ic substances, mostly solvents, paints, and glues.  6herapy9 5ylimarin, <20 mg qd  4esults9 6he treatment ith 5ilymarin has sho n slight variations in some parameters. 6he therapeutic effect is probably not dependent upon the #ind of pathogen no$aK it seems instead to be more evident hen the e$posure period is shorter. 6he group MplaceboM does not sho significant variations. #harmacokinetics: o Bioavaila!ility: 5tudy A9 08""  %esign9 0pen single dose t o& ay randomi(ed cross&over clinical trial  1atients9 6 elve healthy sub"ects  6herapy9 B0 mg of silybin in a A92 comple$ ith phosphatidylcholine, soft capsule or hard capsule  4esults9 5ilybin as more bioavailable from soft gelatin capsule than from hard capsule. 5tudy 2920A2  %esign9 4andomi(ed controlled clinical trial  1atients9 :ine healthy volunteers.  6herapy9 A> ,dB A0AF =comple$ of silybin and phosphatidylcholine>, 3E0 mg silybin $ A dose or pure silymarin =equivalent to 3F0 mg silybin>. 2> ,dB A0AF, A20 mg B,% $ B days  4esults9 6he bioavailability of ,dB A0AF as much greater than that of silymarin. 6he plasma silybin level profiles and #inetic parameters on day A ere similar to those determined on day B. /ost of the silybin present in the systemic circulation as in 

con"ugated form. ,t is concluded that comple$ation ith phosphatidylcholine in ,dB A0AF greatly increases the oral bioavailability of silybin, probably by facilitating its passage across the gastrointestinal mucosa. #harmacy: Contraindications: :o contraindications are present in the literature. )o*icity: :o to$icities are reported in the literature.
1972 1973

)elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 5onnenbichler -, 8etl ,. 5timulating influence of a flavonolignan derivative on proliferation, 4:A synthesis and protein synthesis in liver cells. ,n )ssessment and Management of Hepatobiliary Disease, ed. . 0#olicsanyi, * !somos, * !repaldi. Berlin9 5pringer&7erlag, ACBH, 2FEWH2. 1974 5chuppan %, 5tr[sser W, Bur#ard *, Walose# *. .egalon_ lessens fibrosing activity in patients ith chronic liver diseases. ?eits )llgemeinmed ACCBKH<9EHHWB<. 1975 )eher -, .ang ,, et al. )ree radicals in tissue damage in liver diseases and therapeutic approach. To3ai 7 Exp 2lin Med ACBFKAA9A2AW3<. 1976 )elter 1977 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. AHC. 1978 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A0< 1979 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 2<0. 1980 Berenguer -, !arrasco %. %ouble&blind trial of silymarin vs. placebo in the treatment of chronic hepatitis. Munch Med +ochenschr. ACHHKAAC92<0W2F0. 1981 /agliulo ', *agliardi B, )iori *1. 4esults of a double blind study on the effect of silymarin in the treatment of acute viral hepatitis, carried out at t o medical centres Qtranslated from *ermanR. Med .lin. ACHBKH39A0F0WA0FE. 1982 )eher -, %es# *, /u(es *, et al. .iver protective action of silymarin therapy in chronic alcoholic liver diseases Qin +ungarianR. "r! Hetil. ACBCKA3092H23W2H2H. 1983 )intelmann 7, Albert A. 1roof of the therapeutic efficacy of .egalon_ for to$ic liver illnesses in a double&blind trial Qtranslated from *ermanR. Therapie:oche1 ACB0K309EEBCWEEC<. 1984 Brin#er ). Herb 2ontraindications and Drug >nteractions: +ith )ppendices )ddressing ,pecific 2onditions and Medicines . 2nd ed. 5andy, 0re9 'clectic /edical 1ublicationsK ACCB9A03. 1985 1alasciano *, 1ortincasa 1, 1almieri 7, et al. 6he effect of silymarin on plasma levels of malon&dialdehyde in patients receiving long&term treatment ith psychotropic drugs. 2urr Ther Res1 ACC<KEE9E3HWE<E. 1986 .ininger et al9 +ealthnotes, !linical 'ssentials, 1rima 1ublishing, 4oc#lin, !A. 200A. 1987 1iscitelli 5!, )ormentini ', Burstein A+, et al. 'ffect of mil# thistle on the pharmaco#inetics of indinavir in healthy volunteers. Pharmacotherapy 2002K22=E>9EEA&F. 1988 *il@miiarova ):, 6utel@ian 7A, 4adoms#aia 7/, et al. 'ffect of biologically active components on natursil on the course of reparative processes in the gastrointestinal mucosa in e$periments and inpatients ith stomach and duodenal ulcers. Gopr Pitan 200AKH0=E>92C&3<. 1989 :assuato *, ,emmolo 4/, 5tra((abosco /, et al 'ffect of 5ilibinin on biliary lipid composition. '$perimental and clinical study. 7 Hepatol ACCAKA2=3>92C0&E. 1990 .irussi ), 0#olicsanyi .. !ytoprotection in the nineties9 e$perience ith ursodeo$ychollic acid and silymarin in chronic liver disease. )cata Physiol Hung ACC2KB0=A& <>93F3&H. 1991 .ucena /, Andrade 4-, de la !ru( -1, et al. 'ffects of silymarin /8&B0 on o$idative stress in patients ith alcoholic cirrhosis. 4esults of a randomi(ed, double&blind, placebo&controlled clinical study. >nt 7 Pharmacol Ther 2002K<0=A>92&B. 1992 Angulo 1, 1atel 6, -orgensen 4A, et al. 5ilymarin in the treatment of patients ith primary biliary cirrhosis ith a suboptimal response to ursodeo$ycholic acid. Hepatology 2000K32=E>9BCH&C00 1993 )erenci 1, %ragosics B, %ittrich +, et al. 4andomi(ed controlled trial of silymarin treatment in patients ith cirrhosis of the liver. 7 Hepatol ACBCKC=A>9A0E&A3. 1994 1ares A, 1lanas 4, 6orres /, et al. 'ffects of silymarin in alcoholic patients ith cirrhosis of the liver9 results of a controlled, double&blind, randomi(ed and multicenter trial. 7 Hepatol ACCBK2B=<>9FAE&2A. 1995 Benda ., %ittrich +, )eren(i 1, et al. 6he influence of therapy ith silymarin on the survival rate of patients ith liver cirrhosis. +en .lin +ochenschr ACB0KC2=AC>9FHB&B3. 1996 7elussi /, !ernigoi A/, %e /onte A, et al. .ong&term =A2 months> treatment ith an anti&o$idant drug =silymarin> is effective on hyperinsulinemia, e$ogenous insulin need, and malondialdehyde levels in cirrhotic diabetic patients. 7 Hepatol ACCHK2F=<>9BHA&C. 1997 Bunout %, +irsch 5, 1etermann /, et al. !ontrolled study of the effect of silymarin on alcoholic liver disease. Re! Med 2hil ACC2KA20=A2>9A3H0&E. 1998 /u(ec *, %ea# *, .ang ,, et al. 'ffect of silimarin =.egalon> therapy on the antio$idant defense mechanism and lipid pero$idation in alcoholic liver disease =double blind protocol>. "r! Hetil ACC0KA3A=AF>9BF3&F. 1999 6rinchet -!, !oste 6, .evy 7*, et al. 6reatment of alcoholic hepatitis ith silymarin. A double&blind comparative study in AAF patients. 5astroenterol 2lin Biol ACBCKA3=2>9A20&<. 2000 5almi +A, 5arna 5. 'ffect of silymarin on chemical, functional and morphological alterations of the liver. A double&blind controlled study. ,cand 7 5astroenterol. ACB2KAH=<>9EAHWE2A. 2001 6anasescu !, 1etrea 5, Baldescu 4, et al. Use of the 4omanina product 5ilimarina in the treatment of chronic liver diseases. Med >nterne ACBBK2F=<>93AA&22. 2002 ?iese etter ', .eodolter ,, 6haler +. 4esults of t o double&blind studies on the effect of silymarine in chronic hepatitis =author@s transl>. 8eber Magen Darm ACHHKH=E>93AB&23. 2003 *il@miiarov '/, %olgova *lu, 4adoms#aia 7/, et al. ,mplantation ith natursil as a method for repair of dental defects and normali(ation of oral homeostasis. ,tomatologiia 0Mos3B 200AKB0=E>92F&C 2004 Bu((elli *, /oscarella 5, *iusti A, et al. A pilot study on the liver protective effect of silybin&phosphatidylcholine comple$ =,dB A0AF> in chronic active hepatitis. >nt 7 2lin Pharmacol Ther Toxicol ACC3K3A9<EFW<F0. 2005 )lisia# 4, 1ro#opo ic( %. 0ne year follo &up of patients treated ith misoprostol in acute phase of viral hepatitis B. Prostaglandins "ther 8ipid Mediat 2000KF0=<& F>9AFA&E.

2006 2007

Bode -!, 5chmidt U, %urr +?. 5ilymarin for the treatment of acute viral hepatitisa 4eport of a controlled trial =author@s transl>. Med .lin ACHHKH2=A2>9EA3&B. Allain +, 5chuc# 5, .ebreton 5, et al. Aminotransferase levels and silymarin in de novo tacrine&treated patients ith Al(heimer@s disease. Dement 5eriatr 2ogn Disord ACCCKA0=3>9ABA&E. 2008 5omogyu A, 'csedi **, Bla(ovics A, et al. 5hort term treatment of type ,, hyperlipoproteinaemia ith silymain. )cta Med Hung ACBCK<F=<>92BC&CE. 2009 5(ilard 5, 5(entgyorigyi %, %emeter ,. 1rotective effect of .egalon in or#ers e$posed to organic solvents. )cta Med Hung ACBBK<E=2>92<C&EF. 2010 Boari !, /ontanari )/, *alletti *1, et al. 6o$ic occupational liver diseases. 6herapeutic effects of silymarin. Miner!a Med ACBA9 H2=<0>92FHC&BB. 2011 5avio %, +arrasser 1!, Basso *. 5oftgel capsule technology as an enhancer device for the absorption of natural principles in humans. A Bioavailability cross&over randomi(ed study on silybin. )rIneimittelfor schung ACCBK<B=AA>9AA0<&F. 2012 Bar(aghi :, !rema ), *atti *, et al. 1harmaco#inetic studies on ,dB A0AF, a silybin&phosphatidylcholine comple$, in healthy human sub"ects. Eur 7 Drug Metab Pharmaco3inet ACC0KAE=<>9333&B.

4mila* officinalis
Common name: 5arsaparilla

1iliaceae

Botanical description: 6he plant produces numerous roots, appro$imately 3 m long hich are attached to a short rhi(ome. 6he roots are narro , very long, and cylindrical. 6he root is harvested and dried in the sun. 6he dried root is then cut and tied into bundles. 6he root is grey to yello or reddish&bro n ith ridges, furro s and scars possibly present. 0ccasionally the thic#er rhi(ome is also harvested. 6he plant is native to tropical America and the West ,ndies. 6he roots may be harvested throughout the year. #arts used: 4oots, rhi(ome Constituents: 5teroidal saponins =smilagenin, sarsasapogenin, sarsaparilloside>K *lycoside saponins Qparillin =sarsaponin>, smilasaponin =smilacin>RK B&sitosterol, stigmasterol glycosidesK 0$alic acid, )atty acids, ,odine, /ineral salts, 5tarch Medicinal actions: Alterative, antiinflammatory, antipruritic, antiseptic #harmacology: 1arillin has antibiotic activity.20A3 6he steroid molecules in the root e$ert steroidal effects in the body. 6hese steroidal compounds are also used in the manufacture of cortisone and other steroids.20A< Medicinal use: ,milax spp1 have been used throughout the last three centuries. ,ts reputation has ranged from granting inner strength and virility to curing syphillis. ,t has also been used as a flavoring agent in beverages. !urrent popular use by body builders for its hormonal influence is some hat unfounded. 5mila$ does contain steroidal molecules, some of hich may be metaboli(ed into testosterone or act as phyto& testosterone, ho ever there is no evidence to suggest that the plant contains testosterone or progesterone. ,milax spp1 is a useful alterative. ,t has been used historically to heal chronic s#in conditions such as psoriasis and other scaling s#in diseases. ,t has also been used to relieve rheumatoid arthritis symptoms. !ertain saponins in 5mila$ binds gut endoto$ins thus relieving the to$ic load entering the blood. *ut endoto$ins have been sho n to stimulate c*/1, therefore their decrease ould decrease the stimulus for cell division that occurs in psoriasis. ,n a AC<2 clinical study, patients ith psoriasis ere treated over a t o year period ith sarsaponin tablets made from sarsaparilla. ,mprovement as noted in F2G of the cases, although the nature and e$tent of this improvement is not clear.20AE !onsider combining ,milax spp1 ith Rumex crispus, and )rctium lappa for the treatment of psoriasis. 5mila$ spp1 have been used ith reported success in secondary syphilis and leprosy. 6hese conditions are better addressed ith modern pharmaceuticals, ho ever 5mila$ may be a useful ad"uvant. #harmacy: )o*icity:
2013 2014

A&2 tsp. 3cut aterK decoctK A cup 6,% A9E tincture9 A&2 ml 6,% .ong&term use may cause ulceration of the gastrointestinal mucosa.

6schersche 4 in I1harmacognosy and 1hytochemistryJ, 'd. + Wagner and . +orhammer, =5pringer&7erlag>, ACHA. 'vans W!, >bid, 300. 2015 6hurmon )/ ;e: Engl 7 Med, 22H=<>, AC<29A2B.

4pilanthes oleracea . 42 acmella
Common name: 1ara cress

Compositae

Ha!itat: 6he 5pilanthes genus is a tropical plant. ,t is considered a eed. 5. oleracea is a native of 5outh America. Botanical description9 ,t has opposite leaves and terminal, stal#ed flo er&heads. ,t is a small erect herb, of rapid gro th ith cordate stal#ed leaves. 6he flo ers are small, yello and solitary on terminal peduncles. ,t is consumed as a salad =para cress>. 5. acmella is an '. ,ndian species ith properties similar to 5. oleracea. #art used: Constituents9 7olatile oil, Acrid resin, 6annin, Al#aloid=s> Medicinal actions: 5ialogogue, ,mmunostimulant, Antimicrobial, Bitter, Anti&inflammatory )raditional Medicinal Use: Although not used in this country at the time, ?ing described 5pilanthes and considered its use for flatulence, to improve the appetite and digestive functions, and to overcome nausea and vomiting. ,t may also be used in deficient salivary secretion and in inflammations of the mouth and throat by using very small doses of a strong e$tract. 6he natives of the countries to hich it is indigenous, are stated to have employed in gouty and rheumatic affections, in uric acid gravel, in edema, and as a vermifuge. Current Medicinal use: 5pilanthes is an under&investigated herb that is not commonly used. +o ever, for those practitioners ho do use 5pilanthes, their loyalty to this plant is great. • *astrointestinal !onditions9 5pilanthes is a sialagogue and also stimulates the release of digestive secretions from the stomach, pancreas and intestines. At the same time, 5pilanthes ill decrease inflammations of the mucosa of the digestive tract, especially in the mouth and throat. • ,nfectious !onditions9 5pilanthes is currently employed by some herbal practitioners as a antimicrobial and immunostimulant. 5pilanthes is a very effective addition to formulas containing 'chinacea, as these plants seem to share some of the same medicinal properties. 5pilanthes also appears to have anti&fungal and anti&parasitic properties and combines ell ith other anti& fungal plants such as Usnea barbata, +yssopus officinalis, and other plants ith a high content of anti&fungal volatile oils. Current +esearch +eview: • 5earch of /edline revealed no human trials as of AA320302. #harmacy9 A9E tincture9 up to E ml 6,%

Contraindications: :o information is available from the selected resources. )o*icity: :o information is available from the selected resources.

4tachys officinalis . 42 !etonica
Common name: Betony, Wood betony Ha!itat: 5tachys is native to 'urope and prefers open oods, hedgeban#s, and grass lands.

1a!iatae

Botanical description: Basal leaves up to H cm long, ovate or oblong, obtuse, cordate at the base, coarsely crenate. 5tems are upright and hairy, bearing smaller leaves, 2&3 pairs. )lo ers bright reddish&purple, in tight oblong spi#es, the tube longer than the caly$. #art used: Constituents 08"& • Al#aloids9 stachydrine, betonicine • ,ridoide monoterpenes • Betaines9 =&>& and =]plusK>&stachydrine flavonoids9 including, among others, palustrin • !holine, 6annins, 7olatile oil Medicinal actions: 5edative, s#eletal muscle rela$ant, bitter, aromatic, astringent )raditional Medicinal Use: 6he historical use of 5tachys as as a panacea of all afflictions of the head including hysteria, headaches, protection form fearful visions and nightmares. 5tachys gently tonifies and strengthens the nervous system hile e$erting its overall rela$ing effect. Current Medicinal Use: • Cardiovascular Conditions: 5tachys combines ell ith 5cutellaria for the treatment of nervous headaches and ith other hypotensives for the treatment of headache secondary to hypertension. • Hepato!iliary Conditions: ,n <C patients ith obstructive "aundice ho under ent surgery because they ere unresponsive to conventional deto$ification therapy, a 5tachydrene preparation as given. 5tachyrene as administered before and after the operation. Under the influence of the preparation, a more rapid normali(ation of the indices of homeostasis occurred. 6he most pronounced effect as noted in patients ith benign obstructive "aundice. 20AH • Musculoskeletal Conditions: 5tachys rela$es s#eletal muscle and has a tropism for the muscles of the upper bac#, shoulders, and nec#. ,t is useful in the treatment of headaches secondary to muscle tension and3or hypertension that is orsened by an$iety. A related set of indications is nervous debility associated ith an$iety and tension. 5tachys has astringent and alterative actions, giving it usefulness in treating rheumatism and to$ic conditions. Current +esearch +eview: • 5earch of /edline revealed no human studies as of 0ctober 2002. #harmacy: Contraindications)o*icity: )resh leaves are into$icating.

4tevia re!audiana
Common name: 5tevia Ha!itat: #arts used: leaves Constituents: 5tevioside =ent&#aurane glycoside>

Compositae

#harmacology: 7arious glycosides, particularly stevioside, give 5tevia its s eetness. 5tevoside is some here bet een A00 and 200 times s eeter than sugar. 'arly reports suggested that 5tevia might reduce blood sugar =and therefore potentially help ith diabetes>, 20AB although not all reports have confirmed this. 20AC 'ven if 5tevia did not have direct anti&diabetic effects, its use as a s eetener could reduce inta#e of sugars in such patients. 0ther studies have sho n 5tevia to dilate blood vessels in animals, hich might reduce high blood pressure. 2020 6he amounts used ere higher than those used for s eetening purposes, and this effect has not been proven in humans. Medicinal actions: 5 eetener, hypoglycemic )raditional Medicinal Use: 5tevia has only recently entered the estern material medica and as not described by the classical estern herbalists such as !oo# or ?ing. Current Medicinal Use: 6here is very little #no n from modern research about the medicinal properties of 5tevia. 6he plant is native to :' 1araguay. 6he stevioside and other related glycosides are s eet, in fact they are 300 times as s eet as sucrose. 202A 6he plant is no e$ported to Bra(il and -apan and other countries to be used as a s eetener in soft drin#s and foods. 6he 5outh American fol# uses of the plant include its use as a s eetener. ,n addition, 5tevia has historically been used to lo er blood sugar. 6here is some anecdotal evidence to suggest that it has the capacity to regenerate the B&cells of the pancreas and thus may be e$tremely therapeutic in type , diabetics. 5tevia is also used e$ternally as a poultice to decrease inflammations and to hasten the healing of cuts and ounds. #harmacy: Use po der as a sugar substitute. 5tevia e$tract mi$ed ith maltode$trin is available as a sugar substitute. A tsp. herba3cup aterK drin# A cup B,% to 6,%

Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: :o information is currently available from the selected resources. )o*icity: :o information is currently available from the selected resources.
2018 2019

!uri 4, Alvare( /, Ba(otte 4B, et al. 'ffect of ,te!ia rebaudiana on glucose tolerance in normal adult humans. BraI 7 Med Biol Res ACBFKAC=F>9HHAW< White -4 -r, ?ramer -, !ampbell 4?, Bernstein 4. 0ral use of a topical preparation containing an e$tract of ,te!ia rebaudiana and the chrysanthemum flo er in the management of hyperglycemia. Diabetes 2are ACC<KAH9C<0. 2020 /elis /5. A crude e$tract of ,te!ia rebaudiana increases the renal plasma flo of normal and hypertensive rats. BraI 7 Med Biol Res ACCFK2C=E>9FFCWHE. 2021 'vans W!, >bid, <F0.

4tillingia sylvatica
Common name: 2ueenNs %elight Ha!itat: 6his plant is native to the 5outhern United 5tates.

$uphor!iaceae

Botanical description9 A perennial plant that gro s to a height of < feet. 6he glabrous stem offers sessile, leathery leaves. ;ello flo ers in a terminal spi#e bloom April through -uly. A mil#y sap e$udes from any bro#en part of the plant. 6he root is tapering, tough, and fibrous. ,t is gray&bro n e$ternally and pin#ish internally. Historical uses9 6his herb has been in use by medical doctors in the United 5tates from the early AB00Ns. ,t as primarily employed as a remedy in the au$iliary treatment of primary and secondary syphilis. #arts used9 4oot. =?ing stressed the use of fresh plant material.> Constituents9 diterpene esters of daphnane and tigliane type, fi$ed oil, volatile oil, resins #harmacology: :o information is currently available Medicinal Actions9 Alterative, la$ative, diuretic, tonic )raditional Medicinal Use: 5pecific ,ndications and Uses9 ?ing indicated use in9 feeble tissues, ith tardy removal of bro#en&do n material, and slo rene al of the partsK mucous membranes, tumid, red, and glistening, ith scanty secretionK s#in affections, ith irritation and moist dischargeK laryngeal irritation, ith paro$ysmal, hoarse, croupous coughK irritation of the superior pharyn$ "ust behind the fauces, ith coughK inter& cough of irritationK periosteal pain and tendency to form nodesK an important remedy in struma and syphilitic affections. 2022 6o this 'lling ood added9 blood dyscrasia ith general enfeeblement. 2023 5tillingia as a very important remedy. By improving the lymphatic function, it as used to aid in Igood blood&ma#ing and nutritionJ. ,ts alterative action as employed to e$ert an influence over the secretory and lymphatic functions and circulation in general. ,t as considered unsurpassed by fe , if any other of the #no n alteratives. 5tillingia as e$tensively used in all the various forms of primary and secondary syphilitic affections, in scrofulous, hepatic and cutaneous affections, mercurial cache$y, strumous diseases, and chronic inflammations.202< 'lling ood stated its general use in cancerous diathesis as ell. !oo# described it as an acrid stimulant, ith a fair portion of rela$ant influence acting ith much persistency. • 1ulmonary!onditions9 5tillingia as found to be very beneficial in chronic laryngeal and bronchial affections. 5mall pieces ere che ed for laryngitis and bronchitis. ,n fact 5tillingia as considered one of the most important of laryngeal remedies, not only relieving irritation, but proving beneficial in irritative disorders of the oropharyn$, trachea, and bronchi. 6herefore, it as used as an important cough remedy, particularly for chronic cough here there is a sensation of tightness around the chest or here a cough is hoarse and corupal ithout secretion. • /usculos#eletal !onditions9 6his remedy e$erts some influence upon the periosteal structures and is applicable to the periosteal pains in old cases of syphilis ith tendency to periosteal destruction and the formation of nodes and e$ostoses, as of the tibia, head, and face. ,t is li#e ise said to favorably influence the persistent pains of chronic periosteal rheumatism. Current Medicinal Use: 5tillingia root is a stimulating alterative. 6he root is slo ly stimulating to glandular secretions, catharsis, and to general circulation. • %ermatological !onditions9 ,t is indicated in chronic s#in conditions ith hepatic insufficiency as a part of the etiology and ith glistening red mucosal membranes ith scanty secretions also evident. • *astrointestinal !onditions9 5tillingia tends to be irritating to some stomachs causing emesis and is therefore best indicated in persons ithout e$cessive stomach sensitivity. • 1ulmonary!onditions9 5tillingia root also speeds the healing time of bronchitis and laryngitis. ,t is useful in these chronic coughs ith tightness in the chest via its lubricating effect =resins> and hence reduction in the irritation of the bronchi and laryn$. • 6opical Applications9 '$ternally, 5tillingia liniment is used to cause stimulation follo ed by rela$ation. ,t can be applied over a sore throat, the chest in bronchitis and spasmodic asthma, and inflamed, rheumatic "oints. Current +esearch +eview: • 5earch of /edline revealed no human trials as of :ovember 2002. #harmacy9 6he fresh root, or at least less than one year old must be used. A9E tincture 2&< ml 6,%K B0 ml3 ee# ma$. dose

A9A fluid e$tract A0&30 drops 6,% Contraindications: ,n large doses, 5tillingia can cause vomiting and purgation, producing a peculiar, disagreeable burning sensation in the alimentary canal, accompanied ith prostration. Brin#er recommends avoiding 5tillingia hile nursing. 202E )o*icity9 6he "uice of the green root causes inflammation of the s#in and s elling. 202F *astroenteritis ith severe burning, heavy bile& filled, loose diarrhea, vomiting, tachycardia and muscular ea#ness, and prostration.
2022 2023

)elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. 3HF 2024 )elter 2025 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AB3 2026 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A.

4trophanthus
heart failure ith edema do not use in an aqueous medicine as it precipitates. 4ather, use tincture straignt or mi$ed in yogurt 5ig 3&B gtt up to qid, mother tincture =A9A0>

4ymphytum officinalis

Boraginaceae

Common name: !omfrey Ha!itat: Botanical description9 1erennial root that is large, fiberous, and fleshy. 6he roots are spindle shaped, about A&3 in. in diameter and up to a foot long. 6he leaves are broadly lanceolate, ranging from B&20 in. long and arising from a basal rosette. 6he hole plant is dar# green and covered ith pric#ly hairs. 6he flo ers are racemes, hich uncurl li#e a scorpionNs tail. 6he corolla is bell&shaped and blue to pin# in color. #art Used9 4adi$ , .eaves Historical Use: 5ymphytum has been used medicinally since <00 B.!. 5ymphytum is the *ree# ord for coming together. 6he early *ree#s used !omfrey to stop heavy bleeding and treat bronchial symptoms. ,n the first century, *ree# physician, %ioscorides used the leaves and roots of 5ymphytum to heal ounds and mend bro#en bones. Constituents9 /ucilage =esp. root>, gums, allantoin =esp. in root>, tannins, pyrroli(idine al#aloids =higher in root>, resins, starch and sugars, chlorophyll =higher in leaves, calcium, potassium, phosphorus, trace minerals, vitamins A and !. #harmacology: Allantoin stimulates cell proliferation and other constituents in 5ymphytum encourages proper connective tissue matri$ formation. Allantoin cataly(es the gro th of leu#ocytes hich adds to its ound healing properties by preventing s#in infection. 6he al#aloids are not absorbed through the s#in, thus reducing concern over its to$icity. A ater e$tract of comfrey has been sho n to stimulate production of prostaglandins in the stomachs of e$perimental animals. 6his may partially e$plain the historical use of comfrey to help heal ulcers. 202H Medicinal actions: Antihemorrhagic, anti&inflammatory, astringent, anti&rheumatic, cell&proliferant, vulnerary, demulcent )raditional Medicinal Use: ?ing asserted that all mucilaginous agents e$ert an influence on mucous tissues, hence the cure, by their internal use, of many pulmonary and other affections in hich these tissues have been chiefly implicated. +o ever, he cautioned that physicians must not e$pect a serious disease to yield to remedies hich act on mucous membranes onlyK and to determine the true value of a medicinal agent, they must first ascertain the true character of the affection, as ell is of the tissues involved. 202B !oo# supported this observation stating that 5ymphytum as rarely used alone, but made a good soothing addition to more tonic agents. 202C • 9astrointestinal Conditions: !omfrey root is very useful in diarrhoea and sub&acute dysentery. • 9ynecologic Conditions: !omfrey root is very useful in leucorrhoea, and female debility, these being principally raucous affections. • +ematological !onditions9 5ymphytum as considered of some value in passive hemorrhages from the bo els, #idneys, or omb. • #ulmonary Condtions9 !omfrey root is very useful in bronchial irritation, coughs, hemoptysis and other pulmonary affections. • )opical Applications9 '$ternally, the fresh root, bruised, forms an e$cellent application to bruises, ruptures, fresh ounds, sore breasts, ulcers, hite s ellings, etc. Current Medicinal Use: 6he mucilage content of 5ymphytum is almost as high as it is in Althea, ma#ing 5ymphytum a supreme demulcent. • Autoimmune Conditions: As an anti&inflammatory comfrey may be helpful in arthritic, s#in and other chronic inflammatory conditions.&-C• 9astrointestinal Conditions: ,nternal use of 5ymphytum is indicated in the treatment of diarrhea and dysentery, shallo *.,. ulcers. 6hese conditions respond to the demulcent, vulnerary, astringent, antihemorrhagic, and anti&inflammatory properties of the plant. 6he demulcent quality combined ith allantoin =cell&proliferant> ma#e 5ymphytum e$tremely ell indicated in all types of ulcers and inflammation. 5ymphytum has potent healing effects on the gut all =used short term> and the tannins also help astringe, thus it may be utili(ed in lea#y gut syndrome. 6he astringent action of 5ymphytum also reduces hemorrhage associated ith ulcers and colitis. 5ymphytum combines ell ith Althea, *eranium, Ulmus and )ilpendula for these conditions. • 9ynecologic Conditions: 7aginal leu#orrhea and cystitis are good indications for the use of 5ymphytum, again for the astringent, vulnerary, demulcent properties. • Musculoskeletal Conditions: )inally, the healing time and quality of bone fractures, bruises, in"uries of tendons and ligaments are much improved ith the internal use of 5ymphytum. =!onsider also using homeopathic 5ymphytum> Applying 5ymphytum over in"ured ligaments and bones ill also decrease healing time.

• •

#ulmonary Conditions: Bronchial irritation and irritated coughs ith hemoptysis respond ell to 5ymphytum. ,t is a soothing demulcent e$pectorant. )or respiratory conditions, 5ymphytum combines ell ith 6ussilago, /arrubium, ,nula, and 7erbascum. )opical Applications9 '$ternal use of 5ymphytum is ell indicated for a variety of conditions. 6opical ulcers, especially hard to heal diabetic leg ulcers, respond ama(ingly ell to a topical application of 5ymphytum po dered root mi$ed ith hot ater to ma#e a fomentation or ith oil. *round up fresh root can also be used as a poultice. Bruised fresh leaves can be applied to the s#in, covered ith cloth and left on for several hours. Bruises, ruptures, fresh ounds, sore breasts secondary to bruising, and crac#ed nipples all heal more efficiently ith the application of 5ymphytum. )or hemorrhoids 5ymphytum can be applied topically for the astringent and vulnerary properties.

Current +esearch +eview • 1ocomotor Distur!ances: 0ne hundred five patients ith locomotor system symptoms ere treatecd ith an ointment containing a 5ymphytum active substance comple$ B,% in an open, uncontrolled study. A clear therapeutic effect as noted on chronic and subacute symptoms that ere accompanied mainly by functional disturbances and pain in the musculature. 6he preparation as most effective against muscle pain, s elling and overstrain, arthralgia3distortions, enthesopathy, and vertebral syndrome. Activity as ea#er against degenerative conditions, for hich the ointment may have an ad"uvant role ith the aim of improving muscular dysfunction and alleviating pain.203A • ,nflammatory Disorders: ,n Western 'urope, comfrey has been applied for inflammatory disorders such as arthritis, thrombophlebitis and gout and as a treatment for diarrhoea. 0nly recently as the use of comfrey leaves recogni(ed as a substantial health ha(ard ith hepatic to$icity in humans and carcinogenic potential in rodents. 6hese effects are most li#ely due to various hepatoto$ic pyrroli(idine al#aloids such as lasiocarpine and symphytine, and their related :&o$ides. 6he mechanisms by hich to$icity and mutagenicity are conveyed are still not fully understood, but seem to be mediated through a to$ic mechanism related to the biotransformation of al#aloids by hepatic microsomal en(ymes. 6his produces highly reactive pyrroles hich act as po erful al#ylating agents. 6he main liver in"ury caused by comfrey =5ymphytum officinale> is veno&occlusive disease, a non& thrombotic obliteration of small hepatic veins leading to cirrhosis and eventually liver failure. 1atients may present ith either acute or chronic clinical signs ith portal hypertension, hepatomegaly and abdominal pain as the main features. 2032 #harmacy9 • 6incture9 A9E 2EG alcoholK sig 2&< ml 6,%2033 • )luid e$tract 9 A9A 2EG alcoholK sig A&3 ml 6,%203< • 6opical9 0intment, !ream, .otion, )omentation, !ompresses, 1oultices, Washes, Baths Contraindications.)o*icity: %o not use 5ymphytum on deep ounds, as it may cause healing of the superficial tissue ithout healing the underlying tissue leaving open the possibility of necrosis. 203E Brin#er contraindicates internal use and use on bro#en s#in due to the pyrroli(idine al#aloid content.203F 0bviously, 5ymphytum is contraindicated in pregnant and nursing mothers and any person ith a history of liver disease. 6he current debate about hether to use 5ymphytum internally is due to concern over the pyrroli(idine al#aloids, specifically the echimidine al#aloid. 6his al#aloid has been sho n to cause veno&occlusive disease of the liver =one documented human case and in rats>. 'chimidine al#aloid is not found in the root of 5ymphytum officinalis, but are in 5. asperum =1ric#ly !omfrey>. 5. officinalis and 5. asperum are frequently hybridi(ed to form 5. uplandicum hich is found globally. ,n the U.5. most of the 5ymphytum is officinalis species, therefore is remains questionable ho to$ic the al#aloids of this species are. 6o be most safe, avoid using the young leaves internally and boil the root, thro a ay the ater =the al#aloids are ater soluble> and then tincture it. 203H
2027 2028

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 2029 !oo#, W/. The Physio9Medical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy1 'clectic /edical 1ublications, 5andy, 04 ACBE 2030 /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 2000. 2031 ?ucera /, ?alal -, 1olesna 8. 'ffects of 5ymphytum ointment on muscular symptoms and functional locomotor disturbances. )d! Ther 2000KAH=<>920<&A0 2032 5tic#el )2 6he efficacy and safety of comfrey. Public Health ;utr1 2000 %ecK3=<A>9E0A&B. 2033 Alschuler ., :% 2034 Alschuler ., :% 2035 Alschuler ., :% 2036 Brin#er ). Herb 2ontraindications and Drug >nteractions1 'clectic /edical 1ublications, 5andy, 04 ACCB9F3 2037 Alschuler ., :%

4y;ygium cumini . $ugenia Bam!olana
Caryophyllus aromaticus' $ugenia carophyllus' 4y;ygium aromaticum
Common name: -ambul, -ava plum refer to 5. cumini hereas clove refers to 5. aromaticum Ha!itat: :ative to ,ndia, 5. America and W. Africa Botanical description: 0val seeds, appro$. 3 mm diameter, hard and polished, vermilion red ith upper third blac#. #arts used: 5eed and )ruit

Myrtaceae

Constituents: 1henols, 6annins, essential oil, -ambosine =al#aloid> and Antimellin =glycoside>, triterpenes, essential oil #harmacology: An e$tract of the fruit and seed of 5. cumini causes a significant hypoglycemic effect in animals and eliminates glycosuria in rats. 203B /ethanol e$tracts of clove inhibit rat intestinal maltase. 'ugeniin sho ed inhibitory activity ith an ,!E0 value of A0=&3> /. 'ugeniin also inhibited maltase activity to ard a human intestinal epithelial cell line. 203C 'ugenol, the active principle of clove, as sho n to offer protection against !!l< induced hepatoto$icity in rats. 20<0 6 o antiplatelet components, eugenol and acetyl eugenol inhibited arachidonate&, adrenaline& and collagen&induced platelet aggregation. 6heir inhibitory effect as reversible. 6hese components ere antiaggregatory by a combination of at least t o effects9 =i> inhibition of platelet thrombo$ane formation, and =ii> increased formation of A2&lipo$ygenase products =A2&+1'6'>. 20<A Medicinal actions: +ypoglycemic, astringent, diuretic, local anesthetic, smooth muscle rela$ant, antiseptic, antibacterial, antifungal, antiviral )raditional Medicinal Use: ?ing described 5. aromaticum as aromatic, stimulant, and irritant. ,t as used to allay vomiting and spasm of the stomach, to stimulate the digestive functions, and to improve the flavor or operation of other remedies, and prevent a tendency to their producing sic#ness or griping. Current Medicinal Use: • %ental !onditions9 6he antimicrobial action of natural substances from 5. aromaticum as investigated in vitro against oral bacteria including 5treptococcus sp., Actinomyces sp., Actinobacillus sp., Bacteroides sp., !apnocytophaga sp., 'i#enella sp., )usobacterium sp. and 1ropionibacterium sp. Among the natural substances tested, hino#itiol as the most inhibitory to oral bacteria. !innamon bar# oil, papua&mace e$tracts, and clove bud oil in spice e$tracts ere also inhibitory against many oral bacteria. 20<2 • 'ndocrine !onditions9 5y(ygium cumini is a useful herb in lo ering blood glucose, especially in diabetics. 6he herb e$erts a po erful effect in this regard and is often the leading herb in formulas intending to reduce blood sugar. When giving this plant to type , diabetics, as ith any other glucose&lo ering plant, be cautious about ta#ing the patient off of insulin too quic#ly. 'ven if the insulin dose can be lo ered substantially, it is imperative to monitor the patient for several months after this point to insure that the herb is e$erting a consistent and sustainable effect. ,n regard to research for the hypoglycemic effects, only negative results have been demonstrated. 6he postulated antihyperglycemic effect of the 5. cumini as tested in three e$periments. ,n the first, a randomi(ed, parallel, placebo controlled trial, tea prepared from leaves of 5. cumini did not present any antihyperglycernic effect in 30 non&diabetic young volunteers submitted to a glucose blood tolerance test. ,n the animal e$periments, the effect of the crude e$tract prepared from leaves of 5. cumini as tested for 2 ee#s on the post&prandial blood glucose level of normal rats and rats ith diabetes mellitus. 6he treatment did not produce any antihyperglycernic effect in both models. 6hese results do not rule out hypoglycemic effects in patients ith type ,, diabetes mellitus, but strongly suggest that, for a hile, the "ambolan cannot be recommended as an antihyperglycemic treatment. 20<3 +o ever, these studies ere performed using leaf rather than seed preparations. Another study as underta#en to investigate hether a tea prepared from 5y(ygium cumini, reported to be used by diabetics in 1orto Alegre, Bra(il, might have an antihyperglycemic effect in e$perimental models. :one of the tea concentrations had any detectable antihyperglycemic effect either in normal or in diabetic rats, suggesting that this plant, prepared in a manner similar to that employed by humans, is destitute of an antihyperglycemic effect. 20<< • 6opical Applications9 As an insect repellent, the effect of different concentrations and combinations of five essential oils =Bourbon geranium, cedar ood, clove, peppermint, and thyme> to mosquitoes hen applied to human s#in as determined. 6hyme and clove oils ere the most effective mosquito repellents and provided A A32 to 3 A32 h of protection, depending on oil concentration. !love oil =E0G> combined ith geranium oil =E0G> or ith thyme oil =E0G> prevented biting for A A3< to 2 A32 h. !love, thyme, and peppermint oils can be irritating to the s#in, both human sub"ects in this study "udged the odor of clove and thyme oils unacceptable at concentrations greater than or equal to 2EG20<E

6he essential oil has been utili(ed for topical anesthesia. 20<F #harmacy: 0.3&2 gm po dered seed. Drug ,nteractions: 5. aromaticum920<H • Anticoagulants: may be potentiated due to platelet aggregation inhibiting effects of eugenol and acetyl eugenol =speculated, in vitro> • Aminopyrine: metabolism by hepatic monoo$ygenase is inhibited =in vitro> Contraindications: ,n concentrated form, oil of cloves may be irritating to mucosal tissues. )o*icity: 6he potential of eugenol and of clove leaf oil, hich contains a high concentration of eugenol, to induce delayed s#in hypersensitivity or to elicit reactions due to pre&e$isting s#in sensiti(ation in man as evaluated by analy(ing patch&test data. 6he survey indicates that, at the concentrations present in consumer products, eugenol alone or as part of clove leaf oil has a very lo potential either to elicit pre&e$isting sensiti(ation =NelicitedN reactions> or to induce hypersensitivity =NinducedN reactions>. 20<B
2038 2039

-ain 54, 5harma 5: Planta Medica, AE=<>, ACFH9<3C. 6oda /., Alpha&glucosidase inhibitors from clove =5y(gium aromaticum>.Biosci Biotechnol Biochem. 2000 )ebKF<=2>92C<&B. 2040 ?rishnas amy ?, Bioactive phytochemicals ith emphasis on dietary practices. >ndian 7 Med Res. ACCB :ovKA0B9AFH&BA. 4evie . 2041 5rivastava ?!. Antiplatelet principles from a food spice clove =5y(ygium aromaticum .> QcorrectedR Prostaglandins 8eu3ot Essent atty )cids1 ACC3 /ayK<B=E>93F3&H2. 2042 5ae#i ;2 Antimicrobial action of natural substances on oral bacteria. Bull To3yo Dent 2oll1 ACBC AugK30=3>9A2C&3E. 2043 6ei$eira !!, Absence of antihyperglycemic effect of "ambolan in e$perimental and clinical models. 7 Ethnopharmacol1 2000 -ulKHA=A&2>93<3&H. 2044 6ei$eira !!, 6he effect of 5y(ygium cumini =..> s#eels on post&prandial blood glucose levels in non&diabetic rats and rats ith strepto(otocin&induced diabetes mellitus. 7 Ethnopharmacol1 ACCH /ayKEF=3>920C&A3. 2045 Barnard %4. 4epellency of essential oils to mosquitoes =%iptera9 !ulicidae>. 7 Med Entomol1 ACCC 5epK3F=E>9F2E&C. 2046 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p.30 2047 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. 1 FF&FH 2048 4othenstein A5. 'ugenol and clove leaf oil9 a survey of consumer patch&test sensiti(ation. ood 2hem Toxicol. ACB3 %ecK2A=F>9H2H&33.

)a!e!uia avellanedae
Common name: 1au d@arco Ha!itat: Botanical description: #arts used: bar#, heart ood Constituents: .apachol and beta&lapachone =#no n collectively as naphthaquinones> are t o primary active compounds in 1au d@arco. 0ther constituents include anthraquinones and flavonoids including quercetin. #harmacology: According to laboratory tests, 1au d@arco has anti&fungal properties as potent or more so than #etacona(ole, a common anti&fungal drug. Although these compounds also have anti&cancer properties, the effective amount for this effect is to$ic 20<C. 6abebuia interferes 3 electron transport and o$ygen upta#e of microorganisms. According to %r. /urray, 6abebuia is • Antibacterial against acid fast and Brucella species. • Antifungal against !. albicans, 6richophyton mentagrophytes • Antiviral9 β<lapachone and &interferes 3 electron transport and 02 upta#e of microorganisms, inhibits 4:A3%:A polymerase, reverse transcriptase • Antiparasitic against scistosomes, trypanosomes • Antineoplastic • Antiinflammatory9 quercetin inhibits mitochondrial electron transport, 1%', cA/1 dependent protein #inases, 6yr protein #inases, !a2X 1.&dependent 1? Drug ,nteractions:08%8 • .apachol has an anticoagulant effect in humans that produces vitamin ? antagonism similar to arfarin. • 6abebuia has been theori(ed to count the immunosuppressive effects of cyclosporine and corticosteroids, possibly due to the immunomodulating activity of its napthaquinones and possibly other components. Medicinal actions: antimicrobial, antineoplastic, antiinflammatory )raditional Medicinal Use: :o information is available from the selected resources. Current Medicinal Use: +uman studies are lac#ing to confirm the efficacy of 1au d@arco. 6abebuia has primarily been used as an antimicrobial, particularly for fungal infections. Current +esearch +eview: • 5earch of /edline revealed no human studies as of 0ctober 2002. #harmacy: %ried herb9 E g, 2&B3day 5tandardi(ed e$tractK 2&<G lapachol& AE&20 g 3&<3day Wash, soa# =can be used by soa#ing a tampon for vaginal application Contraindications: Brin#er speculates that 6abebuia be avoided during pregnancy due to potential abortifacient and teratogenic effects of lapachol in rats.20EA )o*icity: 0nly occurs ith isolated lapachol.
2049 2050

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.AEC 2051 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. pAEC

)anacetum parthenium
Common name: feverfe , chrysanthemum Ha!itat: Botanical description: #art used: Historical use: $nergetics: Constituents 08%0 • 7olatile oil9 chief constituents are .&camphor, trans&chrysanthylacetat, including, among others, camphene, p&cymene, linalool, borneol, terpenes&<&ol • 5esquiterpene lactones • )lavonoids • 1olyynes #harmacology: ,t is thought that a significant increase in serotonin from platelets may trigger the chain of events leading to a migraine attac#. )everfe contains a range of compounds #no n as sesquiterpene lactones. 0ver BEG is a compound called parthenolide. 1arthenolide is antiplatelet and inhibits the release of serotonin and some inflammatory mediators. 6his may occur via the ability of 6anacetum to interact ith the protein #inase ! path ay. 20E3 )everfe @s parthenolide content as originally thought to account for the anti&migraine action of this herb, but this has been a matter of recent debate. 20E< Medicinal actions: )raditional Medicinal Uses: !oo# described this herb as stimulating and moderately rela$ing, rather diffusive, leaving a biting tonic&stimulating impressionK the arm infusion inducing perspiration.20EE ?ing described its properties as tonic, carminative, emmenagogue, vermifuge, stimulant. 20EF Whereas ?ing described the cold infusion as a valuable tonic, !oo# considered such a preparation too harsh and unpleasant an article for internal use e$cept under necessity. • *astrointestinal !onditions: ?ing believed this agent to be one of the most pleasant of the tonics, influencing the hole intestinal tract, increasing the appetite, improving digestion, and promoting secretion. 6he arm infusion as ascribed to be an e$cellent remedy in flatulency, orms, atonic dyspepsia 6he seeds, and flo ers hen nearly ripe, ere reputed to be a good remedy for orms. • *enitourinary !onditions9 6anacetum as considered to have a decided action upon renal function according to the 'clectics, particularly in regard to suppression of urine. • *ynecological !onditions9 6he 1hysiomedicalists sometimes used 6anacetum to stimulate menstrual function in atonic amenorrhea. Although !oo# considered it a rather harsh remedy, he noted that it as a popular agent for all menstrual suppressions, often employed to medicate vapor for baths about the pelvis. 6he arm infusion as a notable remedy for irregular menstruation. • ,mmune !onditions9 6he arm infusion as used for the acute stage of colds. • 6opical Applications9 6anacetum as added local baths for the treatment of rheumatism, sprains, etc.K as a fomentation for uterine and intestinal rheumatism and in severe pain or s elling of the bo els. 0ther indications of the 1hysiomedicalists included enhancing cutaneous functions, nervous debility, hysteria and in some febrile diseases. Current Medicinal Uses: • 1ain !onditions9 /igraine headache 20EH, 20EB9 According to three double&blind studies ith migraine patients, feverfe reduces the severity, duration, and frequency of migraine headaches. 6hese successful studies employed dried, po dered leaves. 0ne negative study used an alcohol e$tract indicating the dried leaf preparation is probably superior. 20EC, 5tudies suggest that a standardi(ed )everfe e$tract providing at least 2E0 mcg of parthenolide per day is most effective. 20F0 #harmacy:

Contraindications: 6anacetum is contraindicated in early pregnancy due to its potential emmenagogue effect and may cause contact dermatitis. 20FA )o*icity:
2052 2053

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 3BF 2054 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 2055 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 2056 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 2057 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p.3BE 2058 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. CHF 2059 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 2060 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. CHH 2061 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. HA, A<F

)ara*acum officinalis
Common name: %andelion

Asteraceae

Ha!itat9 :orth temperate (one in pastures, meado s, la ns. =6. mongolicum is the variety utili(ed in 6!/ for distinctly different uses.> Botanical description9 6hic# tap root, dar# bro n on the outside, hite on the inside. .eaves in a rosette, close to the ground, shiny ithout hairs and the margin of each leaf ith great "agged teeth =Mdent&de&lionM in )rench, translated into 'nglish as dandelion>. A yello flo er arises straight up from the root bearing yello elongated florets. #arts used9 4oot, young leaves, =flo ers>. ?ing stressed use of fresh plant material. According to %r. Alschuler, the fresh root is best, leaves are beneficial fresh and dried. 6he root is best harvested in early )all. Historical uses9 %andelion has been in medicinal use for centuries, ith the first mention of it as medicine in the Arabian medical te$ts of the A0th and AAth centuries. ,t has been used for liver complaints and in many forms including as a ine =flo ers>, coffee&li#e beverage =roasted roots> and as food =leaves>. Constituents9 • %andelion is a rich source of vitamins and minerals. 6he leaves have a high content of beta carotene Qthe is higher than in carrotsK A<,000 iu3 A00 g ra leavesRas ell as moderate amounts of vitamin %, vitamin !, various B vitamins, iron, silicon, magnesium, (inc, and manganese.20F2 • 5esquiterpene lactones =bitter substances>9 including, tara$inacetyl&Ai&0&glucosides, AA,A3&dihydrotara$inacetyl&Ai&0& glucosides, tara$acolide&Ai&0&glucosides, <alpha,AE,AAbeta,A3&tetrahydroridentin B 20F3 • 6riterpenes and sterols9 beta&sitosterol, beta&sitosterol&glucosides, tara$asterol, psi&tara$asterol, tara$erol, tara$ol 20F<, triterpene steroids =sitosterin, stigmasterin, phytosterin> • 1olysaccharides9 ,nulin • )lavonoids, mucilage, phenolic acids, protein, sugars, pectin, choline #harmacology: 6he leaf contains sesquiterpene lactones hich are a form of flavonoid. 6his constituent creates an osmotic diuretic effect. 1reviously referred to as tara$acin, these constituents are of the eudesmanolide and germacranolide type and are unique to 6ara$acum.
20FE

6he inulin in the root activates complement, thus contributing to the anti&inflammatory, and immune&enhancing properties of 6ara$acum. 6he bitter compounds in the leaves and root help stimulate digestion and are mild la$atives. 6hese bitter principles also increase bile production and flo . 6he increase in bile flo may help improve fat =including cholesterol> metabolism in the body. 20FF Medicinal actions: .eaf9 diuretic, choleretic, anti&inflammatory 4oot9 choleretic, cholagogue, tonic, antirheumatic, bitter, alterative, depurative

)raditional Medicinal Use: 5pecific ,ndications and Uses9 .oss of appetite, ea# digestion, hepatic torpor, and constipation. 20FH 6ara$acum as reputed as beneficial in edema secondary to lac# of action of the abdominal organs, in uterine obstructions, chronic diseases of the s#in, and impairment of the digestive functions. 20FB !oo# described 6ara$acum root as a mild la$ative and alterant, having rela$ing&tonic grade qualities that slo ly and gently influence the liver, small intestines, and #idneys. 20FC 'lling ood affirmed that it encouraged hepatic metabolism as ell as the production and elimination of urea and the e$cretion of uric acid. 20H0 • %ermatological !onditions9 6ara$acum as considered by 'lling ood to be the alterative for chronic s#in eruptions and s#in conditions in general. • *astrointestinal !onditions9 6ara$acum as used a stomachic and tonic, ith slightly diuretic and aperient actions. Apparently, it as reported to relieve apthous ulcerations of the mouth. • +epatobiliary !onditions9 ,t has long been used to e$ert an influence upon the liver and gall bladder, removing torpor and engorgement of the liver as ell as of the spleen. According to 'lling ood, 6ara$acum as indicated in chronic "aundice attributable to auto&into$ication. Current Medicinal Use: 6he scientific basis for the use of 6ara$acum is scanty and most of the or# has been done on animals. 6ara$acum is one the best remedies for #idney and liver hypofunction. 6ara$acum root is a useful alterative for chronic to$ic conditions manifesting as ec(ema, acne, arthritis, chronic gastritis and enteritis. 0verall, 6ara$acum is most indicated in mild, chronic hepatic congestion as it e$erts a slo , but consistent, gentle action.

• •

*astrointestinal !onditions9 6he bitter in the root, lends it stimulating and tonifying properties for the digestive tract, especially the stomach. 6he bitter compounds in the leaves and root help stimulate digestion relieve dyspepsia and have a mild la$ative effect. 20HA,
20H2,20H3

•

•

*enitourinary !onditions9 6he leaves have decisive diuretic action, yet are not over stimulating to the #idneys. Animal studies sho , at a doses of 2 grams per #g of body eight>, the leaves possess diuretic effects comparable to the prescription diuretic furosemide =.asi$>. 20H<6he leaves are high in potassium, replacing potassium lost in diuresis, thus e$erting a potassium&sparing effect. 6ara$acum is best employed for peripheral edema or fluid accumulation associated ith "oint inflammation =%andelion is anti& inflammatory>. 6ara$acum leaf combines ell ith most other diuretics including 'quisteium, Agropyrens, Achillea, Betulina, etc. 6ea or fresh "uice are the most diuretic, ith tincture having a mild lesser effect. +epatobiliary !onditions9 9 6he root is stimulating to the digestive system, most notably the liver. 6he leaves are mildly stimulating to the liver. 6ara$acum is idely regarded as the supreme liver tonic. ,t e$erts cholagogue effects, and thus acts as a mild la$ative. ,t is indicated in any condition of liver and3or gall&bladder inflammation and stasis inc. cholelithiasis, metabolic to$icity, and "aundice.20HE Another study demonstrated that dandelion e$tract as able to treat "aundice, hepatitis =unspecified type>, and dyspepsia 20 to deficient bile secretion. 20HF6ara$acum root increases both the production and the flo of bile =the latter is accomplished by increasing gall&bladder contractility>. 6he triterpenes bear a close structural similarity to cholesterol hich may in part e$plain the ability of 6ara$acum root to increase the solubility of bile. 6he choline may be in large part responsible for the choleretic and cholagogue effects. 6hus, in treatment of sluggish liver function due to alcohol abuse or poor diet, the bitter principles increase bile production in the gallbladder and bile flo from the liver. 20HH, 20HB,20HC )or liver congestion, 6ara$acum combines ell ith !helidonium, Berberis vulgaris, and 4ume$ crispus. /etabolic !onditions9 0ne small study ith A2 patients sho ed a cholesterol lo ering effect. 20B0

Current +esearch +eview: • 5earch of /edline revealed no human trials as of 0ctober 2002. #harmacy9 6ara$acum combines ell ith most other herbs. 4oot decoction9 2&B gm3day .eaf decoction9 <&A0 gm3day 6incture A9E of root and3or leaf9 sig 3&E ml 6,% %ried herba9 <&A0 g 6,% QA tsp. O A.2 gR 4oasted root as a coffee substitute %andelion ine made from the flo ers and young leaves. )resh young leaves ma#e an e$cellent salad green. -uice of the pureed leavesK sig up to 20 ml3 day

Contraindications: ?ing and Brin#er recommended that ,t should not be used by those hose digestive organs are ea#, as it is apt to cause dyspepsia, flatulence, pain, and diarrhea. 20BA, 20B2 Also, the presence of irritable conditions of the stomach or bo els, or acute inflammation, contraindicate its use. Brin#er further states that 6ara$acum be avoided in biliary obstruction or inflammation and he speculates that 6ara$acum may enhance lithium to$icity.20B3 )o*icity9 5afe herb
2062 2063

,bid PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A. 2064 ,bid 2065 ,bid 2066 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs, 1rima 1ublishing, 4oc#lin, !A. 200A. 2067 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ublications, 5andy, 04 ACB3 p. 2068 )elter 2069 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 2070 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. 32F 2071 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 2072 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed.,!hurchill .ivingstone, :e ;or#, :;. ACCC, p. CBA. 2073 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 2074 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed.,!hurchill .ivingstone, :e ;or#, :;. ACCC, p. CBA. 2075 /ascolo, :. et al, 1hytother. 4es., A=A>, ACBH92B 2076 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed.,!hurchill .ivingstone, :e ;or#, :;. ACCC, p. CBA. 2077 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 2078 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed.,!hurchill .ivingstone, :e ;or#, :;. ACCC, p. CBA.

2079 2080

Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed.,!hurchill .ivingstone, :e ;or#, :;. ACCC, p. CBA. 2081 )elter 2082 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. FE 2083 Brin#er, p.FF

)huBa occidentalis
Common name: cedar Ha!itat: Botanical description: #art used: leaf Historical use: $nergetics: Constituents: 20B< • Water&soluble immunostimulating polysaccharides and glycoproteins • 7olatile oil =A.<&<G>9 chief components =&>&thu"one =alpha&thu"one, ECG>, =]plusK>&isothu"one =beta&thu"one, H&A0G>, fenchone =A0&AEG> • )lavonoids9 including, among others, quercitrin, mearusitrin, the bioflavonoids hino#i flavone, amentoflavone, bilobetin& procyanidins #harmacology: 5even diterpenoids from the stem bar# of 6hu"a sho ed strong inhibitory effects on 'pstein&Barr virus early antigen activation. Among these compounds, AE,AF&bisnor&A3&o$olabda&B=AH>, AA'&dien&AC&oic acid as revealed to have the strongest inhibitory effect on the 'B7&'A activation, being stronger than that of beta&carotene hich has been intensively studied in cancer prevention using animal models. AE,AF&bisnor&A3&0$olabda&B=AH>, AA'&dien&AC&oic acid as also found to e$hibit the e$cellent anti&tumor promoting activity in t o& stage mouse s#in cancer. 20BE 6hu"a polysaccharides ere sho n to be an inducer of the !%<X cells in human peripheral blood. ,t as also demonstrated that 6hu"a is a potent inhibitor of the e$pression of +,7&A&specific antigens and of the +,7&A&specific reverse transcriptase. 6hu"a induces ,.&A beta, ,.&2, ,.&3, ,.&F, gamma&,):, *&!5), */&!5), and 6:)&beta production in 1B. culturesK and ,.&A beta and ,.&F in monocyte3 macrophage cultures. 20BF 6he essential oil causes cramping. Medical actions: antiseptic, stimulant )raditional Medicinal Uses: 5pecific ,ndications and Uses9 'nlarged prostate, ith dribbling of urine in the agedK urine easily e$pelled upon coughing or slight muscular e$ertionK vesical, irritation and atonyK enuresis of childrenK verrucous vegetationsK trachomaK chancroid. 20BH 6hu"a is a remedy for blood changes and glandular disorders. 6issue degeneration in the epithelial structures appears to be influenced by it. ,t is first stimulant, after ard subastringent 1rof. ?ing stated that a decoction of the leaves had been used in fevers, coughs, rheumatic and scorbutic affections, and gave the usual notice respecting its po er to remove arts but ill not destroy s iftly gro ing venereal arts. • %ermatologic !onditions9 1erhaps one of the best #no n properties ascribed to 6hu"a is its po er to remove arts, hether of the hands, face, or genitals. 6he 'clectics preferred subcutaneous in"ection of 6hu"a around the base of arts. ,t as also considered of value in some chronic s#in affections, sho ing a tendency to vegetations. • ':6 !onditions9 6hu"a as also believed valuable as an application to post&nasal catarrh, and to shrin# nasal polyps and other gro ths in the nose and nasopharyn$. .ocally and internally, it as described to provide e$cellent results in chronic tonsillar affections and in milder cases of diphtheria. • *ynecological !onditions9 6hu"a has been employed in amenorrhea ith pelvic atony and in catarrhal diseases of the female organs. 6he 'clectics have used it as a topical application to thic#, spongy, or tender os uteri, ith leucorrheal discharge. • *astrointestinal !onditions9 4ectal troubles, such as fissured anus and hemorrhoids, have been frequently cured ith 6hu"a, including hypodermic in"ection into piles. ,n this case, 6hu"a as used to affect cure by inducing atrophy. ,n fissured anus, the drug as said to at first aggravates the trouble, but to soon effect a permanent cure. • *enitourinary !onditions9 6hu"a as employed for irritability in the bladder and a variety of forms of nocturnal enuresis in children and adults. • ,nfectious !onditions9 6he 'clectics used 6hu"a as a remedy of choice in the treatment of syphilis, gonorrhea and chancroid.

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/ale !onditions9 6hu"a as ell #no n a specific for the cure of hydrocele by hypodermic in"ection into the tunica vaginalis testis. 0ld men ith enlarged and greatly irritated prostates inducing a constant dribbling of urine ere treated ith E&drop doses of 6hu"a. 0phthalmological !onditions9 6hu"a preparations ere formulated to treat trachoma ith reportedly e$cellent results in chronic cases. 5ome 'clectic physicians stated that specific 6hu"a =A3E to A33&drop doses> acts upon the deep ocular tissues, and has been used in scleritis, episcleritis, sclerochoroiditis, and syphilitic iritis, ith gummata on the irisK also e$ternally and internally for the removal of tarsal tumors. 1ulmonary !onditions9 6he 'clectics have used an inhalation of 6hu"a in bronchial diseases, chronic catarrhal conditions and hemoptysis. ,nhalation as also indicated in the treatment of diphtheria and membranous croup. 6opical Applications9 6hu"a came highly recommended as a dressing for sloughing ounds, ulcers, bedsores, gangrene, and carcinomatous ulcerations. ,t as considered valuable to restrain hemorrhages caused by malignant gro ths.

Current Medical Uses: • 1ulmonary !onditions9 6hu"a is used for respiratory tract infections including 5trep throat and bronchitis. • %ermatologic !onditions9 ,n con"unction ith antibiotics, 6hu"a has been used in the treatment of bacterial s#in infections and Herpes ,implex. • 6opical Applications9 6he drug is used in e$ternal application as an ointment for treating pains in the "oints, arthritis and muscle rheumatism. 20BB Current +esearch +eview: 5earch of /edline revealed no human trials as of AA320302 #harmacy: Contraindications: Brin#er contraindicates the use of 6hu"a in pregnancy due to emmenagogue and abortifacient effects =empirical> and cautions against prolonged use in general due to cumulative to$icity of thu"one. 20BC )o*icity: Brin#er cautions against prolonged use in general due to cumulative to$icity of thu"one. 20C0
2084 2085

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 6ana#a, 4. !ancer chemopreventive agents, labdane diterpenoids from the stem bar# of 6hu"a standishii =*ord.> !arr. !ancer .ett. 2000 %ec 20KAFA=2>9AFE&H0. 2086 0ffergeld 42 /itogenic activity of high molecular polysaccharide fractions isolated from the cuppressaceae 6hu"a occidentalis .. enhanced cyto#ine&production by thyapolysaccharide, g&fraction =615g>. .eu#emia. ACC2KF 5uppl 39ABC5&ACA5. 2087 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 2088 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 2089 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. AC0 2090 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. AC0

)hymus vulgaris
Common name: 6hymus

1a!iatae

Ha!itat9 6hymus is ild and cultivated. ,t is native to the /editerranean region and the mountains of 5pain and 'urope. 6hymus is no cultivated throughout the orld preferring sandy, dry soil. Botanical description9 A perennial shrub ith many branched, square, oody stems gro ing to a height of A0&AF in. 6he leaves are opposite, small, linear, ith an enrolled margin and a hitish underside. 6he flo ers are t o lipped, small hite&pin# arranged in dense terminal spi#es. )lo ers /ay&0ct.. 6he fruit is a four nut&li#e acheme. #art used9 +erba Historical use9 6he ancient *ree#s used 6hymus to inspire courage and to as a mar# of grace, energy and bravery. 6he *ree#s also used 6hymus for its antiseptic properties. ,n later 'urope, 6hymus as employed medicinally for coughs and shortness of breath, for sciatic and "oint pains, for headaches and poor vision, and as a fragrance in soaps and perfumes. Constituents9 20CA, 20C2 • 7olatile oil =A.0&2.EG>9 inc. terpenes such as thymol =20&EEG>, carvacrol =A&A0G>, borneol =up to BG>, cineol, p&cymene =A<& <EG>, linalool =up to BG> • !affeic acid derivatives9 rosmarinic acid • )lavonoids9 including, among others, luteolin, apigenin, naringenin, cirsilineol, cirsimaritin, thymonin, partially present as glycosides • 6riterpenes: including, among others, ursolic acid =2G>, oleanolic acid =0.FG> • 6annins, Bitters, 4esin, *ums #harmacology /any constituents in 6hymus or# synergistically to provide its anti&tussive, antispasmodic, and e$pectorant actions. 'ssential oil of 6hymus has a rela$ing effect on tracheal smooth muscle. 5pasm caused by specific receptor agonists =acetylcholine, histamine, .& noradrenaline> is inhibited by 6hymus e$tract.20C3 Water e$tracts of 6hymus sho an ability to #ill Helicobacter pylori, a bacteria related to many stomach ulcers, in !itro. 6he antibacterial and the antifungal activity of thymol is ell recogni(ed against oral bacteria as ell as bacteria involved in upper respiratory infections.20C< 6he 4osmarinic acid in 6hymus inhibits lipid pero$idation and quenches free radicals and thymol has been sho n to inhibit o$idation of .%. and scavenge hydro$yl radicals.20CE Medicinal Actions9 Anti&septic, anti&helminthic, anti&viral, anti&bacterial, astringent, e$pectorant, secretolitic =decreases over& secretions>, spasmolytic. )raditional Medicinal Use: !oo# described 6hymus as a pleasant diffusive aromatic, stimulating and rela$ant, acting as a carminative and mild emmenagogue. ,t may be used in recent colds. A arm infusion may be used freely, and gently promotes perspirationK and the action of the plant is similar to that of pennyroyal.20CF • *astrointestinal !onditions9 6he cold infusion as considered useful in dyspepsia, ith ea# and irritable stomach, and as a stimulating tonic in convalescence from e$hausting diseases. A arm infusion as used for colic, and general flatulence. • *ynecological !onditions9 A arm infusion as used for menstruation obstructed and painful from e$posure. • 6opical Applications9 0ccasionally the leaves have been used e$ternally, in fomentation. 6he oil as regarded as a valuable local application to neuralgic and rheumatic pains. Current Medicinal Use: 6he uses for 6hymus fall into the main categories of pulmonary, urinary, *.,., and e$ternal uses. • *astrointestinal !onditions9 )or the gastrointestinal system, 6hymus is indicated in gastritis, flatulence, and for orms, especially thread& and pin orms. 6he volatile oils help to reduce *.,. spasm and the bitter compounds enhance digestive functioning. )or the treatment of pin orms, 6hymus is usually given in a base of castor oil in order to slo do n the absorption of thymus =A part 6hymus9 2 parts !astor oilK A tsp.3day for children>. ,f someone has bronchitis and decreased appetite and concomitant spastic constipation, 6hymus ould be an e$cellent remedy. • *enitourinary !onditions9 )or the urinary system, 6hymus is a diuretic, antiseptic, and spasmolytic. )or cystitis, urethritis and as a general urinary antiseptic, thymus as a tea can be quite effective. 6 o quarts of tea3day and3or a tsp. of tincture every 3 hours until

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•

symptoms improve. 6hen drin# A quart each day for E&H days after the disappearance of symptoms. Warm infusion of thymus can also relieve dysmenorrhea and abdominal colic. 1ulmonary !onditions9 6he pulmonary uses of 6hymus are based on its antiseptic and anti&bacterial actions combined ith the e$pectorant and spasmolytic actions.20CH 6hymus is most indicated in dry and3or spastic coughs, although because it is anti& bacterial, it is useful in catarrhal coughs as ell. 6hymus helps to rela$ the respiratory muscles hile giving a stimulating edge at the same time =v. oils>.20CB 6hymus has a rela$ing effect systemically. 6his ma#es 6hymus especially indicated for children ho are an$ious around their spasms of coughing. A double blind randomi(ed controlled trial ith F0 patients demonstrated that 6hymus syrup as as effective as bromhe$ine =a mucolytic drug>.20CC 6hymus combines ell ith 1rimula vera =co slip> and 1lantago lanceolata =plantain> or Althea officinalis =marshmallo >. )or an acute viral U4,, 6hymus, 5ambuccus, and 'uphrasia are a good combination. )or asthma, 6hymus combines ell ith 6ussilago, 'phedra, and .obelia. 6he taste is bitter so ith glycerol added, #ids tolerate the herb better. Alternatively, using 6hymus oil in ater as an inhalant, or applying the oil to a cotton ball and placing that in humidifiers or# ell for children. 6opical Applications9 '$ternally, 6hymus can be used as an infusion and mouth ash for sore throats, mouth ulcers, leu#opla#ia. ,n addition, thrush. 6he infusion can also be used as a s#in ash. 6hymus is anti&fungal and anti&viral topically, but application of the undiluted oil ill irritate the s#in. 6hymus infusion can also be used as a douche in the treatment of *ardnerella vaginitis.

#harmacy9 6he *erman !ommission ' monograph recommends a cup of tea made from AW2 grams of the herb ta#en several times daily 14: for a cough. A fluid e$tract can be used in the amount of AW< ml 6,%. Another alternative is to use a tincture of 6hymus in the amount of 2WF ml 6,%. ,nfusion9 A&2 tsp.3cup aterK sig 3&< cups3day 6incture9 A9E <EG 't0+K sig 2&E ml 6,% 5yrup 0il !reams, salves, lotions, douche Contraindications: 6hymus is contraindicated during pregnancy, acute renal or urinary tract inflammation and acute gastrointestinal inflammation.2A00 )o*icity9 =especially of the essential oil>& headache, vomiting, painful diarrhea, tinnitus, #idney failure .
2091 2092

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 2093 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. EF<. 2094 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. EFE. 2095 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. EFE. 2096 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 2097 8eylstra, +.+., M6hymus vulgarisM, :e +erbal 1ractitioner , A3=A>, ACBF9C&A0 2098 7an den Brou#e, !.0. et al, 1harm. Wee#bl. , E=A>, ACB39C 2099 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p, EFF. 2100 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB.p.A2C,AEA, AB0

)ilia europea' )2 cordata' )2 platyphyllos
Common name: .ime flo er, .inden tree Ha!itat:

)iliacea

Botanical description9 6he tree has a smooth bar# ith spreading branches. 6he leaves are broad and round ith a sharp point and serrated edges. 6he flo er stal# bears 3&F yello ish& hite, five petalled flo ers on stal#s half&"oined to an oblong bract. 6he leaves are heart&shaped, greyish beneath and do ny. #arts used9 )lo ers, leaves, buds Constituents9 • 6he ma"or active compounds in 6ilia are thought to be flavonoids =inc. hesperidin, quercetin, etc.>, glycosides, and possibly a volatile oil=farnesol>.2A0A • 0ther constituents include phenolic acids =inc. chlorogenic and caffeic>, mucilage =arabino&galactans>, and tannins. #harmacology 0ne study found that a comple$ mi$ture of compounds, primarily flavonoids, reduced an$iety in mice. All of 6ilia@s active compounds appear to be soluble in ater. ,t has been hypothesi(ed that 6ilia may rela$ muscles in arteries as ell, thereby giving it a hypotensive effect. 2A02 Medicinal actions: +ypotensive, sedative, diaphoretic, anti&spasmodic Historical Use: 6he 'uropean species =6ilia europea> is a common domestic remedy in 'urope for the relief of many nervous and catarrhal disorders. )raditional Medicinal Use: ?ing considered the properties of 6ilia to be stimulant, lentitive, tonic, and nervine, being used to allay irritation and restlessness, and to promote rest and sleep. 6he hot infusion as employed to chec# diarrhoea from cold, and in the various forms of colds and catarrhal conditions, hile, either hot or cold. ,t as also used in restlessness, nervous headaches, painful and difficult digestion, and mild hysteria. 6he effects upon the nervous system ere sometimes obtained by an enema, or bath, prepared from the flo ers. 2A03 Current Medicinal Use: 6he volatile oils and flavonoids give this product its sedative, antispasmodic, tonic and hypotensive effects. 6ilia flo ers are primarily indicated in nervous dyspepsia, hysterical states, headaches, and palpitations. ,t is rela$ing overall, and is best combined ith other remedies for its sedative actions. • !ardiovascular !onditions9 ,t is a reliable hypotensive, although it is rarely strong enough on its o n to reduce blood pressure. ,t is gentle and ell&tolerated and therefore is most efficacious as a part of a hypotensive formula. According to -ohnathan 6reasure, 6illia is used in formulas for atherosclerosis because it Ita#es fats from here they shouldn@t be and puts them here they should be.J • *astrointestinal !onditions9 !linical trials have sho n that 6ilia tea can help people ith mild gallbladder problems =but not gallstones>, dyspepsia, and e$cessive gas that causes the stomach to push up and put pressure on the heart =also #no n as the gastrocardiac syndrome.> 0"8:, 0"8% Antispasmodic action on the intestines has been confirmed in at least one human study. 0"8& • 1ulmonary !onditions9 6ilia is also a notable diaphoretic and is often used in colds and flu to address the an$iety and tension headaches hile stimulating diaphoresis =and thus immunity>. 6ilia alleviates pharyngeal irritation secondary to cough and post&nasal drip. 6ilia and ,ambuccus nigra are often combined together as an infusion for both prevention and treatment of influen(a. #harmacy9 6he young, fresh flo ers should be used in an infusion, as the aged flo ers can be narcotic. 6inctures e$tract more volatile oil. ,nfusion9 A heaping tsp. 3cupK A cup 3&E times daily. QA tsp. O A.B gR A9E tincture9 < ml 6,%K B0 ml3 ee# Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: :o information is currently available from the selected resources. )o*icity: :o information is currently available from the selected resources.
2101 2102

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A

2103 2104

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB )iegel 7*, +ohensee ). '$perimental and clinical screening of a dry, ater e$tract of tiliae libri. )rIneim orsch ACF3KA39222WE Qin *ermanR. 2105 5ade# +/. 6reatment of hypertonic dys#inesias of 0ddi@s sphincter using a ild 6ilia suspension. Hospital 0Rio 7B ACH0KHH9A<AWH Qin 1ortugueseR. 2106 .anger /. !linical observations on an antispastic factor e$tracted from Tiliae sil!estris alburnum. 2lin Ter ACF3K2E9<3BW<< Qin ,talianR.

)rifolium pratense. )2 al!a. )2 repens. )2 pendulum
other species: )2 arvense' )2 fi!rinum' )2 su!erraneum =6rifolium ill refer to 6. pratense in this monograph unless other ise indicated> Common name: red clover =6. pratense>, hite clover =6. alba>, haresfoot clover =6. arvense>

1eguminosae

Ha!itat: 6hroughout 'urope and :. America. *ro s in sunny, grassy areas. 6. arvense is commonly found on dry sandy soils and heathlands. Botanical description: 6he roots are perennial ith several clusters of stems. 6he stem is slightly hairy gro ing to a height of A2 to AB inches. 6he leaves are composed of three smooth, ovate leaflets ith a hitish underside. 6he flo ers are numerous, occasionally paired, sessile, pin#ish to reddish purple in a large globular head. 6. arvese has bro nish pin# flo erheads. #arts used: )lo erheads =gathered bet een /ay and 5eptember> Historical Use: 6. arvense has a long tradition as an antidiarrheic remedy. Constituents: 6. pratense9 • ,soflavones9 aglycones =formononetin hich is also present in !imicifuga racemosa, biochanin A> • flavonoids, phenolic glycosides, coumarins, cyanogenic glycosides, minerals :othing is #no n about the constituents of 6. arvense. #harmacology: )ormononetin can be converted to daid(ein, hich in turn can be metaboli(ed to equol by bo el flora. 'quol has significantly more estrogenic activity than its precursors, yet is produced to different levels in different people. +igh equol producers are more li#ely to have greater estrogenic effects from use of 4ubus =or *ylcine ma$. for that matter>. 2A0H Medicinal actions: alterative, antispasmodic, e$pectorant, sedative, phytoestrogenic, nutritive, lymphatic Medicinal use: 6rifolium is a very gentle herb, ell&suited to long&term use. ,t is a pronounced alterative that combines nutritive properties =due to the high content of lime, silica, calcium, and other mineral salts> ith sedative anti&inflammatory properties. ,t is ideally suited for children and the elderly. ,t is also indicated in persons ith debilitating, chronic disease =i.e. mononucleosis, hepatitis>. 6rifolium is useful for any chronic condition of to$icity. 6he alterative properties of 6rifolium derive from its gentle stimulation of metabolic activity. ,ts use helps to reduce the ear and tear of tissues that occurs in degenerative processes or the normal aging process. 6rifolium is thought to improve mental functioning especially in persons ho are over or#ed =stressed> ith resultant confusion of ideas, loss of ords or memories. 6rifolium seems to enhance the upta#e of o$ygen and nutrients by the brain =this is as of yet undocumented>. • Alterative 'ffect9 6rifolium =6. pratense and 6. repens>, by the doctrine of signatures, is a blood cleanser. 6rifolium alba, hite clover, is a lymphagogue. 6rifolium enhances the deto$ification functions of the liver, pancreas and spleen. As an alterative, 6rifolium combines ell ith Arctium lappa and 'chinacea spp. in the form of tea. • %ermatological !onditions9 6he alterative properties of 6rifolium give this herb great usefulness in the treatment of s#in conditions. ,t is of great value in recurrent boils or acne, ec(ema, and psoriasis. When ingested in sufficient quantities, 6rifolium can be used acutely for s#in conditions such as acute contact or allergic dermatitis. 6rifolium is also used for the healing of burns. ,t stimulates tissue repair. 4ed clover oil is often employed for this purpose. 4ed clover oil or ointment is useful to heal bed sores and other hard to heal ounds. • ,mmune !onditions9 ,t is included in many anti&cancer formulas for this reason and for the fact that it possesses anti&tumor actions. • 1ulmonary!onditions9 6rifolium seems to have a tropism for the throat and salivary glands. 6rifolium is a gentle e$pectorant. ,t allays spasmodic coughs =anti&tussive action>. ,t is also useful hen there is dry irritation of the pharyn$ or laryn$. 6rifolium is a good herb to use in debilitated children ith U.4.,.s, colds, flu, or atopic dermatitis. ,t can be sued successfully for hooping cough. ,t combines ell ith 6hymus, /atricaria and Urtica for these purposes. • *astrointestinal !onditions9 6rifolium is often added to digestive and mineral teas for its al#alini(ing property and mineral content =e$plains the al#alini(ing effect>. • *ynecologic !onditions9 )inally, 6rifolium possesses phytoestrogenic actions. 6rifolium spp. e$ert some of the strongest phytoestrogenic effects among medicinal plants. ,t is a onderful herb for menopausal omen because of its phytoestrogenic and mineral constituents. 4ed clover may be used in douches or vaginal suppositories for vaginitis, as it ill help to soothe the tissues, reduce inflammation and heal damaged tissue. )ccording to Mills and Bone:&%-(

6rifolium has eliminative properties as a lymphatic and e$pectorant being utili(ed in s#in and "oint disease, including those of an autoimmune nature. ,t is also included in cancer treatment. )ccording to +eiss:&%-* • *astrointestinal !onditions9 6rifolium arvense has good diaphoretic properties. Although not scientifically researched, it is reported to decrease the length of severe dysentery&li#e diarrheas, particularly summer diarrhea in children and adults. • /ale !onditions9 6. fibrinum has been used in sub&acute and chronic proctitis. )or this condition it is used as a tonic to stimulate secretory function in the mucosa and improve smooth muscle tone in the bo el. !alamus can also be used this ay. )ccording to ,cudder:&%%• 1ulmonary!onditions9 6he 4ed !lover e$erts a specific influence in some cases of hooping cough, and in the cough of measles. ,t is not curative in all, but hen it has an effect, the benefit is speedy and permanent. ,t may also be prescribed in other cases of spasmodic cough, in laryngitis, bronchitis and phthisis = asting>. )ccording to .ing: 5pecific ,ndications and Uses.Z5ome forms of hooping&coughK irritation of the laryngo&pulmonic passagesK provo#ing spasmodic coughK cough of measlesK cancerous diathesis. 4ed clover is an e$cellent alterative, and one of the fe remedies hich favorably influences pertussis. ,n earlier editions of this or# it as stated that Ma strong infusion of the plant is said to afford prompt relief in hooping&cough, suspending the spasmodic cough entirely in 2 or 3 daysK M 5ince then the remedy has come into e$tensive use, but the statement should be modified, as it does not reach all classes of cases. When the proper case is found it acts promptly, but as yet the specific indications in this complaint have not been discovered. ,t is also a remedy in other spasmodic coughs, as those of measles, bronchitis, laryngitis, phthisis = asting>, etc. ,t is an e$cellent internal agent for those individuals disposed to tibial and other forms of ulcers, and it unquestionably retards the gro th of carcinomata, and may be freely administered to those of a cancerous diathesis. 6he e$tract, spread on linen or soft leather, has long been said to be an e$cellent remedy for cancerous ulcers. 6his assertion, ho ever, has not been so ell verified as its action in retarding the gro ths hen administered internally for a prolonged period. ,t is also highly recommended in ill&conditioned ulcers of every #ind, and deep, ragged&edged, and other ise badly&conditioned burns. ,t possesses a peculiar soothing property, proves an efficient detergent, and promotes a healthful granulation. #harmacy: ,nfusion9 2&< g =A&3 tsp.> dried flora per B o(. ater =%r. Alschuler> 6he infusion =i to ater 0"> may be used freely =5cudder> 6incture9 A9E, sig 2&E ml 6,% =%r. Alschuler> 1repare a tincture from the recently dried blossoms of 4ed !lover, vii". to Alcohol E0S 0". %ose from gtt. ". to gtts. $. =5cudder> 1repare from the recently dried flo ers =viii> in E0 per cent alcohol =0"> sig from A to F0 drops =?ing> 5pecific 6rifolium, A to F0 drops. =?ing> A9A )luid e$tract A&2 ml 6,% =%r. Alschuler> 5tandardi(ed e$tract =1romensilf> 6rifolium )orte =decoction of flo ers simmered over lo heat for appro$imately one ee# results in a tarry substance that can be used topically over gro ths or burns>. '$ternally as oil, in steams, baths, and hair rinses 1harmaceutical 1reparation of !lover.Z'P64A!6 0) 64,)0.,U/ !0/10U:%. 6his preparation as a specialty of the Win.5. /errell !hemical !o., of !incinnati, 0hio. ,t is a combination of the alterative, tonic, and eliminative properties of the recently e$pressed "uices or e$tracts from fresh or green plants ith potassium iodide. 6he compound contains the e$tracts of 6rifolium pratense, 5tillingia sylvatica, .appa minor, 1hytolacca decandra, !ascara amarga, Berberis aquifolium, 1odophyllum peltatum, tincture of 8antho$ylum carolinianum and potassium iodide. ,t is designed for administration in syphilis, scrofula, chronic rheumatism, glandular and various s#in affections. )or hooping cough it is to be given in A32 fluid ounce, every A or 2 hours, throughout the day.

Contraindications: )o*icity:
2107 2108

/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. FH /ills and Bone p. A<B, 2E< 2109 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. A03, AAE 2110 5cudder -. 5pecific /edications and 5pecific /edicines.

)rigonella foenum<graecum
Common name: )enugree# Ha!itat: 6he plant is native to the /editerranean region, the U#raine, ,ndia and !hina.

1eguminosae

Botanical description: 6his plant gro s up to E0 cm tall. 6he leaves are petiolate and in threes. 1ale yello flo ers bloom in the a$ils of the leaves. 6he pods are up to 20 cm long and contain numerous seeds. #art used: 5eeds

Constituents: • !arbohydrates predominately mucilage =galactomannans> <EG&F0G, E0G of the seed is fiber. • 1rotease inhibitors =act on human chymotrypsin and trypsin> • 5teroidal saponins hich can be hydroly(ed into diosgenin and yamogenin • 1roteins =rich in tryptophan, poor in sulphur&containing amino acids 20G&30G>, )i$ed oil =unsaturated fatty acids> FG&A0G#, )urostanol glycosides =bitter principle>, 5terols =sitosterol>, Al#aloids including trigonelline, 'ssential oil =BG, EA components>, )lavonoids =7ite$in, saponaretin, homoorientin, rutin, quercetin, #aempferol glycosides, coumarins> Medicinal actions: +ypoglycemic, demulcent, nutritive, la$ative, digestive, antipyretic, e$pectorant. #harmacology: )enugree# seeds have demonstrated significant anti&diabetic effects in e$perimental and clinical studies. Administration of the defatted seed =in daily doses of A.E&2g3#g> to both normal and diabetic dogs reduces fasting and postprandial blood levels of glucose, glucagon, somatostatin, insulin, total cholesterol and triglycerides, hile increasing +%. cholesterol levels. 2AAA, 2AA2 )oenugracein may have a hypoglycemic action along ith virostatic and cardiotonic actions. 2AA3 ,t slo s the metabolism of nicotinic acid =present in 6rigonella>. :icotinic acid normally increases glucose upta#e from the blood and its subsequent o$idation. 6he seeds are rich in dietary fiber, hich may also contribute to the hypoglycemic effect in diabetes. 2AA< !oumarin and trigonelline may also contribute to the hypoglycemic effect. 6he mucilage in 6rigonella seeds is postulated to coat the mucosa of the gastrointestinal tract thereby inhibiting the absorption of nutrients, hich may e$plain the hypocholesterolemic effect of fenugree# as the addition of fenugree# seeds to a hypercholesterolemic diet prevented a rise in the cholesterol level.2AAE ,n turn, the steroidal saponins account for many of the beneficial effects of 6rigonella, particularly the inhibition of cholesterol absorption and synthesis. 2AAF Aqueous e$tracts of the seeds stimulate uterine contractions, intestinal peristalsis and have a positive chronotropic action on the heart.2AAH 0rally administered aqueous e$tract of fenugree# seeds to rats promotes the healing of gastric ulcers. 2AAB )raditional Medicinal Use: :either !oo# nor ?ing described this herb. Current Medicinal Use: 6rigonella has a variety of clinical applications. 6rigonella seeds are an alternative source of diosgenin for steroid hormone manufacture. )enugree# is also used a flavoring agent in coffee and vanilla. • 'ndocrine !onditions9 6rigonella is used in the treatment of diabetes. 6he hypoglycemic effects of 6rigonella have been observed for centuries and this plant is often part of formulas to lo er blood sugar. +o ever, the hypoglycemic action of fenugree# seeds appears to be ea# and transient hen it is given to diabetic patients. 6rigonella is best used along ith other herbs to lo er elevated blood sugar as it is not strong enough on its o n. 4andomi(ed and uncontrolled studies have confirmed 6rigonella helps stabili(e blood sugar control in patients ith insulin& dependent and non&insulin&dependent diabetes. 2AAC,2A20 6rigonella has been found to be effective for :,%%/ in doses of 2E g of the po dered seeds for AE days or 2.E g daily for three months. 2A2A %efatted fenugree# seed po der given t ice daily at a E0g dose to insulin&dependent diabetics resulted in significant reduction in fasting blood sugar and improved glucose tolerance test results. 6here as also a E<G reduction in 2< hour urinary glucose e$cretion and significant reductions in .%. and 7.%. cholesterol and triglyceride values. ,n non&insulin diabetics, the addition of AEg of po dered fenugree# seed soa#ed in ater significantly reduced postprandial glucose levels during the meal tolerance test. 2A22 0ne human study found that 6rigonella can help lo er cholesterol and blood sugar levels in persons ith moderate atherosclerosis and non&insulin&dependent diabetes at a dose of 2.E g daily for 3 months. 2A23 6he digestive stimulating properties may be indirectly helpful in type ,, diabetics. 1eople ith intestinal malabsorption are nutrient depleted and hence they may crave foods ith high glycemic inde$es to give themselves immediate energy, a process that can certainly aggravate hyperglycemia. • *astrointestinal !onditions9 6rigonella is a good bitter and carminative. 6hese actions combined ma#e it a useful digestive aid,

especially in someone ith digestive insufficiency and small intestinal symptomatology. )enugree# seeds ill help to restore optimal digestive function and thus reduce the impetus to eat sugary foods. • /etabolic !onditions9 6rigonella is a good aid to cholesterol&lo ering plans. 6rigonella is often part of a more comprehensive plan. E g daily for three months lo ered total cholesterol and triglycerides in 30 coronary artery :,%%/ patients and 2E g lo ered total cholesterol, .%., 7.%. and triglycerides in A0 hypercholesterolemic patients over a <&2< ee# period. 2A2< • 1ulmonary !onditions9 6rigonella is also high in mucilage and this ma#es it indicated in respiratory congestion. 6he mucilage in the seeds refle$ively hydrate the mucosa of the respiratory system thus facilitating easier e$pectoration. • 6opical Applications9 '$ternally, 6rigonella is a good emollient for boils, acne, ec(ema and other inflammations. ,t decreases the inflammation and helps to resolve the lesion. #harmacy: %osage is large due to high fiber content =E0G>. %efatted seed is available if lipid content is of concern. )or diabetics, begin ith half dosing to avoid gastrointestinal irritation. ,nfusion9 0.E g 3 A cup aterK cold infusion for at least 3 hoursK A cup =s eetened o.#.> 6,% QA tsp. O <.E gmR /i$ po dered seeds ith hot ater to create a paste for e$ternal application. Drug ,nteractions:0"0% • ,nsulin: due to potential additive effects =animal> • 3ral drug absorption may be decreased due to inhibition by the mucilage content =speculative>. • Cholesterol<lowering agents: possible additive effect =speculative> • 6arfarin: possible potentiation =speculative> although E g daily for 3 months did not affect fibrinogen, fibrinolytic activity or platelet aggregation =human>. Contraindications: 6rigonella may be contraindicated for use during pregnancy due to emmenagogue and abortifacient effects =empirical> as ell as potential uterine stimulant action =in vitro, animals>. 2A2F )o*icity: :o information is available from the selected resources.
2111 2112

4ibes, *, et al )nn ;utr Metabol, 2B, ACB<93H. 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC. 2113 *hosal 5, 5rivastava 5, !hatter"ee %! and %utta 5? Phytochemistry, A3, ACH<922<H. 2114 4ibes *, 5auvaire ;, %a !osta !, et al. Antidiabetic effects of subfractions from fenugree# seeds in diabetic dogs. Proc ,oc Exp Biol Med ACBFKAB29AECWFF. 2115 5harma 4% ;utr Rep >nt, 33, ACBF9FFC. 2116 5auvaire ;, 4ibes *, Baccou -!, .oubatieres&/ariani //. ,mplication of steroid saponins and sapogenins in the hypocholesterolemic effect of fenugree#. 8ipids ACCAK2F9ACAWH. 2117 Abdo /5, Al&?afa i AA Planta Medica, AH, ACFC9A<. 2118 Al /eshal, ,A, 1armar :5, 6ariq /, Ageel A/, itoterapia, EF, ACBE923F. 2119 /adar 8, Abel 4, 5amish 5, Arad -. *lucose&lo ering effect of fenugree# in non&insulin dependent diabetics. Eur 7 2lin ;utr ACBBK<29EAW<. 2120 4aghuram 6!, 5harma 4%, 5iva#umar B, 5ahay B?. 'ffect of fenugree# seeds on intravenous glucose disposition in non&insulin dependent diabetic patients. Phytother Res ACC<KB9B3WF1 2121 5harma 4%, 4aghuram 6!, 4ao :5. 'ffect of fenugree# seeds on blood glucose and serum lipids in type , diabetes. Eur 7 2lin ;utr ACC0K<<930AWF. 2122 /ada 8, Abel 4, 5amish 5, Arad -. *lucose&lo ering effect of fenugree# in non&insulin dependent diabetics. 'ur - !lin :utr ACBBK <29 EA&E< 2123 Bordia A, 7erma 5?, 5rivastava ?!. 'ffect of ginger 0?ingiber officinale 4osc> and fenugree# 0Trigonella foenumgraecum .> on blood lipids, blood sugar, and platelet aggregation in patients ith coronary artery disease. Prostagland 8eu3otrienes Essential atty )cids ACCHKEF93HCWB<. 2124 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. C< 2125 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. C< 2126 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. C3

)rillium pendulum' )2 erectum' )2 sessile
Common name: Bethroot, Birthroot Ha!itat: !entral and Western states in :. America

1iliaceae

Botanical description: A lo =<&A2 inches high> gro ing herb ith stout and unbranched stems. At the top of the stem there is a horl of three large and broad leaves. A single flo er ith three large hite petals gro s from the a$il of the leaf& horl. 6he root is perennial, round, an inch in diameter, one to t o inches long, fleshy and tuberous. #arts used: Bulb3 4hi(ome Historical Use: 6rillium as called birth root by the :ative Americans of the !entral and Western regions because of its use in aiding in parturition. $nergetics: !ooling and drying, an earth li#e smell and taste, can be initially s eet, then acrid. Constituents: 5aponin glycosides =trillin and trillarin>, steroidal glycosides, tannins, fi$ed oil %r. ?ing suggests that an aromatic portion is present, hich contains an astringent principle although no volatile oil present. #harmacology: 6he astringent varieties have been found useful in hemorrhageN the acrid species in chronic mucous discharges, bronchrrea, leu3orrhea, menorrhagia, etc1 Medicinal actions: Uterine tonic, astringent, e$pectorant, antiseptic, genito&urinary tract tonic, pelvic nervine Medicinal use: • *ynecologic !onditions9 6rillium affects the mucous membranes most prominently. ,t is most indicated in tenacious mucus discharge ith generali(ed pelvic debility. '$cessive menstruation, leu#orrhea, prolapsus uteri, poor vaginal tone, and threatened abortion are all indications for the use of 6rillium. 6he astringent action of 6rillium is pronounced, but ill not cause e$cessive drying of the mucosa. 6rillium is also a uterine tonic. ,t or#s hen the uterus is ea# and is not contracting fully and strongly. 6rillium is therefore useful in menorrhagia, prolapsed uterus and leu#orrhea. ,f ta#en before parturition, 6rillium ill facilitate uterine contractions and thus labor. 6rillium ill also reduce the occurrence and severity of post&partum hemorrhage and pain. 6rillium root is a rela$ing stimulant and hile itNs initial action is quic#, the mild tonification and astringency it imparts ill persist for several hours. • 6opical Applications9 6he topical application of 6rillium is also indicated for its astringent and mild antiseptic properties. Ulcers and inflammatory s ellings respond ell to the topical application of 6rillium. • 1ulmonary!onditions9 6rillium has also been used to treat pulmonary congestion, cough and bronchial congestion. ,n these conditions, the 6rillium acts to reduce mucous accumulation and soothes spasmodic coughing. 6rillium also reduces the tendency to hemorrhage =more li#ely ith forceful coughing>. • 0ther ,ndications9 6rillium may be used to relieve hemorrhage of the #idneys, bladder, bo els, stomach, lungs and nose. 6rillium is a mild antiseptic especially in topical form. 0ne #ey to the success of this plant is effective dosing =see belo >. )ccording to ,cudder:&%&4 6he common use of 6rillium in large doses obtained its astringent influence, possibly from the tannin it contains. 6he preparation from the fresh root is only slightly astringent. We ould employ it in disease of mucous membranes ith increased secretion, and e$pect decided benefit. ,n the earlier part of my practice , used 6rillium in chronic bronchitis, in chronic catarrh, in cough ith free e$pectoration, ith e$cellent results. )ccording to .ing/s:&%&( 5pecific indications for 6rillium include rela$ation of tissues ith mucous discharges or passive hemorrhage. • 1ulmonary!onditions9 6rillium is successfully employed in hemoptysis, dyspnea, cough, asthma1 *iven the acrid species are useful in chronic affections of the respiratory organs, phthisis 0:astingB, hectic fe!er , etc. All varieties are effective internally or e$ternally for chronic mucous discharges, including bronchorrea1 6he red 6rillium varieties ill chec# ordinary epistaxis by merely smelling the freshly&e$posed surface of the recent root. • *ynecologic !onditions9 All varieties are effective internally or e$ternally for chronic mucous discharges, in menorrhagia, uterine hemorrhage, metrorrhagia, leu3orrhea, etc. ,t has been traditionally used by :ative American omen to promote parturition. • *enitourinary !onditions9 6rillium is successfully employed in hematuria • *astrointestinal !onditions9 Boiled in mil#, 6rillium has been administered ith benefit in diarrhea and dysentery.

•

'ndocrine !onditions9 ,nfusion of equal parts of 6rillium and .ycopus virginicus ahs been highly recommended for the cure of diabetes1 ,t does not diminish the amount of sugar e$creted in the saccharine form, but restrains the secretion of the renal discharges in both forms. • '$ternal !onditions9 A poultice is very useful in tumors, indolent or offensi!e ulcers, anthrax, buboes, stings of insects and to restrain gangrene1 ,n some instances its efficacy has been increased by combination ith 5anguinaria. )ccording to 2oo3:&%&* 6he root is possessed of rela$ing and stimulating properties, hich act ith moderate promptness and leaves a mild tonic and astringent impression that is quite persistent. 6he mucous membranes receive most of its influence and it is used in tenacious mucous discharges ith debility as in chronic dysentery, leu#orrhea, catarrh, etc. ,ts astringency is not so great as to cause dryness yet is sufficiently mar#ed to diminish superfluous discharges prove of the greatest service in bleeding from the lungs, nose, stomach, bo els, #idneys and bladder • *ynecologic !onditions9 ,t is particularly useful in chec#ing e$cessive menstruation and lochia. ,ts po er over hemorrhages is peculiar and e$cellent and it is one of the very fe remedies that prove reliable in the hemorrhagic diathesis. 6here is a moderate antiseptic po er in it, hich ma#es it available in foul leu#orrhea as an in"ection. .i#e 4ubus and Arctostaphylos it e$erts a distinct, and proportionately stronger, influence over the uterus, promotes parturition in languid cases, anticipates flooding, relieves after& pains =especially in company ith !ypripedium> and is an e$cellent associate ith !onvallaria, 5ymphytum and Aralia racemosa, in all ordinary female ea#nesses, particularly hen the tissues are la$. 6he leaves are also used as an application to ulcers and s ellings. 6he common impression of the astringency of the root has led many practitioners to overloo# its e$cellent tonic propertiesK but it is a remedy deserving of the first attention in the cases above named. • 6opical Applications9 6here is a moderate antiseptic po er in it, hich ma#es it available as a local application in foul and some hat degenerative ulcers. #harmacy: 1o dered herb9 A dram to be given in hot ater =?ing> A0&20 grains 3&< $ day =!oo#> ,nfusion9 A tsp. dried radi$ or 2 tsp. fresh root per cup aterK drin# 3&< c3 day as a tonic, or A32 c every AE min to A32 hr. to slo bleeding =%r. 6ilgner and %r. %ipasquale> strong infusion, 2&< o(. qd =?ing> A o( to A pint ater, sig A o( doses =!oo#> 6incture9 A9E A&< ml 6,% W 2,% =%r. Alschuler> A9A fresh plant e$tract A0&F0 drops as necessary every AE min, not to e$ceed 3F0 drops =2 tsp.> per day. =6ilgner> fresh root, vii". to Alcohol HFS 0". %ose from A&20 gtt =5cudder, ?ing> 6opical application9 1o dered 6rillium and po dered Ulmus ith a small part of .obelia mi$ed into arm ater =i.e. 2 o(. of 6rillium, 2 o(. of Ulmus, A3< o(. .obelia seed> is an e$cellent topical ash for ulcers =including vaginal ulcers> =%r. Alschuler> )or uterus prolapsus, leu#orrhea9 6rillium combines ell ith *eranium maculatum =Alschuler> Contraindications: 6rillium can be irritating to the mucosa and may therefore be contraindicated in conditions of inflammation of the alimentary tract.2A30 Brin#er also lists it as an emmenagogue. !ontraindicated in pregnancy e$cept "ust prior to labor. )H,4 #1A@) ,4 B$C3M,@9 $@DA@9$+$D A@D ,4 #+3)$C)$D ,@ 43M$ 4)A)$42 U4$ ,) 4#A+,@91L2

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5cudder -. 5pecific /edications and 5pecific /edicines. )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. ACCH 2129 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. HAE&AF 2130 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AE2

)urnera diffusa ()2 aphrodisiaca
Common name: %amiana Ha!itat: 6ropical parts of the 5W U5A, /e$ico, and Africa

)urneraceae

Botanical description: A small shrub ith ovate leaves that broaden to ards the top end. 6he leaves are smooth and pale green. 6he flo ers are yello that arise singly from the a$illa of the leaves. 6he flo er has an aromatic smell and bitter taste. #arts Used: .eaves Historical Use: %amiana has a long history of use as an aphrodisiac and euphoric.

Constituents: 7olatile oil =0.2&AG>, resin =A<G>, tannin =3.EG>, starch =FG>, bitter compound =damianian>, flavonoids, hydroquinone, arbutin Medicinal actions: nerve tonic and trophorestorative, anti&depressant, urinary antiseptic, la$ative, aphrodisiac Medicinal use: • :ervous !onditions9 %amiana is an e$cellent nerve tonic especially hen the person is e$periencing an$iety and3or depression, sympathetic predominance, and lo ered se$ual drive. ,t has a long and ide&spread use as an aphrodisiac and seems to be most indicated therapeutically in cases of an$iety or depression that have impotence or lo se$ual desire as a main manifestation. • *ynecologic !onditions9 ,t is also a pelvic tonic and demulcent. ,n addition, as a pelvic tonic, damiana can be used for oligomenorrhea, suppressed menstruation, and amenorrhea. ,t is an emmenagogue and this is most li#ely here these effects are derived from. %amiana can also be effective treatment for premenstrual acne, dysmenorrhea, and headache. • *enitourinary !onditions9 ,t can be used for cases of cystitis and nephritis, especially ith e$cessive mucous discharge. • /ale !onditions9 ,n men, %amiana ill address impotence, especially hen associated ith a lac# of desire or inability to rela$. ,t can also be used as a male tonic, and combines ell ith 'quisteum spp., 1iper methysticum, Alchemilla vulgaris, and 5erenoa repens. )ccording to Mills and Bone:&%C% 6urnera is considered a traditional tonic herb. ,n general, tonics are indicated in convalescence, debilitating conditions ith or ithout anore$ia and chronic fatigue syndrome. • :ervous !onditions9 6urnera is a tonic and trophorestorative supporting the nervous system, particularly ith hormonal concurrent symptoms and combines ell ith Withania for such conditions. :ervous trophorestoratives in general are used for nervous e$haustion, neuralgia, herpes infections, depression and insomnia after falling asleep, convalescence and neurasthenia =see Avena for a discussion on neurasthenia>.. • /ale !onditions9 6urnera has been traditionally used to relieve some of the problems of older men including support for benign prostatic hypertrophy. )ccording to .ing: 5pecific ,ndications and Uses.Z6o relieve irritation of the genito&urinary mucous surfaces. =5e$ual ea#ness and debility, ith nervousness and depression QaR>. 6his drug has been almost eulogi(ed for its positive aphrodisiac effects, acting energetically upon the genito&urinary organs of both se$es, removing impotence in the one, and frigidity in the other, hether due to abuses or age. /any physicians ho have tried it, deny its possession of such virtues, but the friends of the drug attribute their failures to the use of the spurious articles. ,t ill very li#ely be found to possess la$ative, tonic, and diuretic properties onlyK and the aphrodisiac effects follo ing its use, no more prove that these belong to it, than the same effects, that not infrequently appear after the employment of many other agents prove that such agents possess similar e$citant virtues. Upon the system at large, it e$erts a tonic influence, and is useful in some cases of chronic cystic and renal catarrh. ,t relieves irritation of the urinary mucous membranes, improves digestion, and overcomes constipation in some instances. ,n respiratory disorders, it may be employed to relieve irritation and cough, and, by its tonic properties, to chee# hypersecretion from the broncho&pulmonic membranes.

#harmacy: According to /ills and Bone, trophorestoratives may be ta#en as required or before food. ,n regard to tonic herbs, the digestive capacity is the main determinant of dosage. ,f the stomach and digestive function is deficient, then tonics may be given ith or after meals. ,n severe cases, they may need to be ta#en ith liquid meals. %osage should be small and frequent. .ong&term therapy is the norm.2A32 ,nfusion9 A tsp. leaves3cup aterK sig A cup 6,% When drun# in sufficient amounts =2 heaping tsp.3cup> an aphrodisiac&li#e high can occur. An infusion may need to be drun# daily for several ee#s in order to create a lasting effect on se$ual desire. =%r. Alschuler> 6incture A9E F0G 't0+K sig A&2 ml 6,% )luid e$tract is from A32 fluid drachm to A32 fluid ounce=?ing> 5pecific %amiana, E to F0drops =?ing> 5mo#ed =combines ell ith 5cutellaria laterifolia, .obelia inflata, 1assiflora incarnata, /entha spicataK this blend being #no n as ;uba *old>9 induces a mari"uana&li#e euphoria along ith systemic rela$ation, particularly noted in the bronchioles in asthmatics. Contraindications: According to /ills and Bone, tonic herbs in general are to be used ith caution in severe debility, particularly hen associated ith immune or digestive collapseK renal or hepatic failureK rampant cancer or strong chemotherapy treatments. Brin#er describes the potential oral hypoglycemic effect ith 6urnera. 2A33 )o*icity:
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/ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AEE, 22E, 23< /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. p AEE 2133 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AF<&E

)ussilago farfara
Ha!itat:

Compositae

Common name: !oltsfoot =Apparently, Asarum canadense also shared the common name of coltsfoot>

Botanical description9 6he root is perennial, small, creeping, blac#ish&bro n, ith numerous fibers. 6he flo er stems rise directly from the root, appearing early in spring before the leaves, from F&B inches high, and each bearing a single flo er head. 6he flo er appears as a daisy in early spring, ith bright yello ray florets in several ro s. .eaves all radical, appearing later in the season than the flo ers. #arts used9 .eaves, flo ers Constituents9 )lavonoids =rutin, hyperoside, isoquercetin>, mucilage =BG>, pyrroli(idine al#aloids =0G&0.0AEG>, tannin, bitter glycosides #harmacology: :o information is currently available Medicinal actions: '$pectorant, demulcent, antitussive, anticatarrhal )raditional Medicinal Use: !oo# described the root as a stimulant and rela$ant ith a arming taste, and ith some demulcent property. ,ts arm infusion as considered to promote an out ard circulation, increase e$pectoration, and leave a arm and slightly tonic impression. 2A3< • • +epatobiliary !onditions9 6ussilago as used by some 1hysiomedical physicians as a depurative to the liver and as a good hepatic tonic of the moderately stimulating grade in scrofulous cases. 1ulmonary !onditions9 6he principal use made of 6ussilago as in debilitated coughs, hooping& cough, and humid forms of asthmaK for all of hich it as combined ith such articles as 1runus or 'upatorium perfoliatum, though !oo# considered that its virtues have probably been overrated. 6he po der as used as a snuff in chronic catarrh, hen the discharge has become viscid and offensive.

Current Medicinal Use: 6he mucilage and bitter combine to ma#e it a soothing tonic. 6he tannin in 6ussilago gives it astringent action and supports the tonic action from the bitter principles. • *enitourinary !onditions9 6ussilago is also a diuretic and may be used in the treatment of cystitis. • 1ulmonary !onditions9 6ussilago is a diffusive e$pectorant, sedative and demulcent, most useful in debilitated and chronic conditions. 6ussilago is most efficacious in chronic cases of cough such as emphysema and silicosis. Weiss recommends ta#ing a cup of 6ussilago tea first thing in the morning and at night in order to relieve the chronic cough associated ith these conditions. )or spasmodic coughs, such as that of asthma, chronic or acute bronchitis, and hooping cough, 6ussilago combines ell ith .obelia, Amni visnaga =#hellin>, and 7iburnum. ,n general, 6ussilago combines ell ith other lung tonics such as ,nula, 'riodictyon, and 7erbascum. +o ever, its chronic use is limited in some people due to the presence of pyrroli(idine al#aloids. 'ven though the amount of these al#aloids is so small, their presence suggests caution in certain individuals. !oltsfoot leaf as originally approved for the treatment of sore throats in the *erman !ommission ' monograph but has since been banned in *ermany for internal use. • 6opical Applications9 6he fresh bruised leaves may be applied topically to boils, abscesses and suppurating ulcers. #harmacy9 ,nfusion A&2 tsp.3cup aterK sig A cup B,%&6,% A9E tincture 2&E ml 6,%

Contraindications: 6ussilago is relatively contraindicated in children ho are more susceptible to the effects of pyrroli(idine al#aloids, but if prescribed in small medicinal doses, it should not be a problem. 0ther people ho should avoid pyrroli(idine al#aloids include pregnant or nursing mothers. 1rolonged use, longer than <&F ee#s per year is contraindicated due to accumulation of pyrroli(idine al#aloids. 1ersons ith elevated liver en(ymes or #no n liver disease should not be ta#ing 6ussilago. )o*icity: 0ne case has been reported of neo&natal fatality from veno&occlusive disease ith apparent daily consumption by the mother of tea made from the leaves.2A3E

Use of any pyrroli(idine al#aloid containing plant in con"unction ith 'ucalyptus is contraindicated due to microsomal en(yme induction.
2134 2135

!oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE Brin#er, ) +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. F2&3

Ulmus fulfva
Common name: 5lippery elm Ha!itat9 !entral and :orthern U.5. and !anada

Ulmaceae

Botanical description9 Ulmus is a small tree. ,t has rough branches, long toothed leaves ith hair on both sides. 6he inner bar# is the medicinal part. /any trees are stripped to their death. 6he inner bar# is sold in flat pieces 2&3 ft. long, several inches ide and A3B to A3AF inch in diameter. 6he bar# is tough and fle$ible. 6he outer bar# is longitudinally striated and of a reddish color. 6he inner bar# is paler and finely ridged. #arts used9 ,nner bar# =bar# from A0 year old trees is considered superior to bar# from younger trees> Constituents9 /ucilage Medicinal actions9 %emulcent, emollient, e$pectorant, diuretic, astringent, anti&inflammatory, nutritive. Medicinal use: Ulmus fulva is one of the most useful herbal remedies. ,ts high content of mucilage give it effects similiar to Althea. Ulmus combines ell ith almost all herbs and can be a useful addition to respiratory, urinary, and gastrointestinal formulas. • *astrointestinal !onditions9 ,t is a gastrointestinal emollient, demulcent, and anti&inflammatory. Ulmus both soothes and astringes the inflammed and hypersecreting intestinal mucosa. Ulmus seems especially ell&suited for inflammatory and nervous diarrhea and can allay diarrhea in other ise intractable cases. ,t is useful in gastritis, 1U%, enteritis, colitis, diarrhea. Ulmus is ell&tolerated even in situations of gastric upset and :37. Ulmus is very nutritious as ell. 'lderly persons and infants ith debilitation and3or inflammation of the digestive system ill benefit greatly from. Ulmus can be used as part of a vermifuge formula and is ell absorbed for this purpose as a suppository. • 1ulmonary!ondtions9 6hrough refle$ action, it is a respiratory soothing e$pectorant =especially in spasmodic coughs> • *enitourinary !onditions9 ,t is a soothing diuretic. • :ervous !onditions9 Ulmus seems to e$ert a pacifying influence on the nervous system, even to the e$ent of acting as a somnerific. • 6opical Applications9 Ulmus is a useful topical agent. When applied topically to inflammatory ounds such as abcesses, boils, ulcers, hemorrhoids, and burns, a soothing, healing, anodyne and antiinflammatory effect is observed. Ulmus may be applied to an infected gum or cavity to lessen the pain and delay the decay. Ulmus is typically avoided on open ounds. Mills and Bone:&%C$ • *astrointestinal !onditions ° %igestive inflammation9 /ucilaginous and healing properties of ulmus. ° !onstipation9 Ulmus increases stool bul#. ° %iarrhea9 6he mucilage helps to ease the effects of cytoto$ins and inflammation. ° %iverticular disease9 As a source of fiber that also helps maintain healthy flora. ° %yspepsia and *'4%9 As a mucoprotectant ta#en after meals or before bed. ° +emorrhoids9 6he mucilage #eeps the stool soft. ° ,ntestinal permeability9 By reducing inflammation. ° ,B59 6o reduce associated constipation. • /etabolic !onditions9 ° +yperlipidemia9 6he mucilage is a type of soluble fiber that is metaboli(ed by intestinal flora to produce short chain fatty acids =5!)A>. 6hese 5!)A can influence the liver to reduce cholesterol synthesis. • 1ulmonary!ondtions9 6he mucilage has a soothing and anti&inflammatory effect on the lo er respiratory tract. )ccording to 2oo3:&%C4 Ulmus acts soothingly upon all mucous membranes and the cold ater infusion may be used to best advantage in all mucous irritaitons and inflammations as of the bronchi, lungs, stomach, bo els, #idneys, bladder and uterus. ,t is used in forms of fever here the intestinal canal is liable to irritation. 6he mucilage hen made thic# si sometimes uesd as avehicle for other, po erful herbs. 6he mucilage or the po der ma#es the most soothing of all in"ections in acute dysentery, and a vehicle hen any remedy to to be give by in"ection ith reference to its being retained in the bo el for the sa#e of its slo action. =+ere !oo# describes in"ections for hich the modern description ould be an rectal implantation or a retention enema.> • *ynecologic !onditions9 ,t has been used previous to parturition, to secure moistness and early distension of the passages.

• 6opical Applications9 6he po der ma#es one of the most soothing and available of all demuclent poultices for inflamed surfaces, ora basis for poultices hen any class of po ders are to be mi$ed ith a demulcent. )ccording to .ing:&%C( 'lm bar# is nutritive, e$pectorant, diuretic, demulcent, and emollient, and is a very valuable remedial agent. ,n mucous inflammations of the lungs, bo els, stomach, bladder, or #idneys, used freely in the form of a mucilaginous drin#. ,t is highly beneficial, as ell as in diarrhoea, dysentery, coughs, pleurisy, strangury, and sore throat, in all of hich it tends po erfully to allay the inflammation. • *astrointestinal !onditions9 As an in"ection, the infusion ill prove useful in diarrhoea, dysentery, tenesmus, and hemorrhoids, also in gonorrhoea and gleet =mucous discharge from the urethra in chronic gonorrhea>. • *ynecologic !onditions9 5ome physicians consider the constant use of it, during and after the seventh month of gestation, as advantageous in facilitating and causing an easy delivery =A32 pint of the infusion to be dran# daily>. • 6opical Applications9 'lm bar# has li#e ise been successfully employed e$ternally in cutaneous diseases, especially in obstinate cases of herpetic and syphilitic eruptions. As an emollient poultice, the bar# has been applied to inflamed parts, suppurating tumors, fresh ounds, burns, scalds, bruises, and ulcers. ,n the e$cruciating pains of the testes, hich accompany the metastasis of mumps, hether of recent or long standing, the constant use of an elm poultice, regularly changed every < hours, ill be found a superior remedy. #harmacy9 Ulmus often or#s the best if dosed frequently. %o not combine mucilagenous herbs ith tannin rich herbs as the mucilages ill precipitate out. %ecoction9 /i$ A part po der to B parts ater =mi$ the po der ith small amount cold ater initially to insure the mi$ing>K bring to boil and simmer for A0&AE minutesK sig A32 cup 6,% /i$ A tsp. po der or cut ] sifted bar# into A cup cold ater. .et sit for <&A2 hours, strainK sig A32 cup B,%&2,% =Alschuler> A tablespoonful of the po der boiled in a pint of ne mil#, affords a nourishing diet for infants eaned from the breast, preventing the bo el complaints to hich they are sub"ect, and rendering them fat and healthy =?ing> *ruel9 /i$ A tsp. po der in "ust enough cold ater to ma#e a pasteK add A cup hot ater and cinnamon and3or sugar, stirK drin# A32 cup B,%&2,% =Alschuler> 1oultice9 /i$ the po der ith enough boiling ater to ma#e a paste =Alschuler> ,n"ection9 A tsp. po der in <&F o(. cold ater. .et stand until thic#ened =!oo#> Contraindications: :ot ithstanding its general value as an application to ulcers, it may be in"urious hen used as a cataplasm =poultice> to ulcers, hich might be cured by astringent or other ashes. ,t could render the ulcer more irritable and difficult to heal. 2A3C )o*icity9 5afe herb3food
2136 2137

/ills, 5. Bone, ?. 1rinciples and 1ractice of 1hytotherapy. !hurchhill .ivingstone, 2000. !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. HAC&20 2138 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 2139 ibid

Uncaria gam!ir
Common name: *ambir Ha!itat: Botanical description: #art used: leaf, root Historical use: :o information is currently available. $nergetics: :o information is currently available. Constituents: • 0$yindole al#aloids • *lycosides • 6annins9 30&3EG #harmacology: 0$yindole al#aloids may give cat@s cla much of its ability to stimulate the immune system. 6he al#aloids and other constituents, such as glycosides, may account for the anti&inflammatory and antio$idant actions of this herb. 2A<0, 2A<A Medicinal actions: Medicinal uses: • ,nfectious Conditions: 6he standardi(ed e$tract of cat@s cla has been tested in small, uncontrolled studies and sho ed promise in preventing !%< cell counts from dropping and reducing the incidence of opportunistic infections in +,7 and A,%5.2A<2,2A<3 )urther study is needed to determine efficacy. • Musculoskeletal Conditions: Although a traditional remedy for osteoarthritis and rheumatoid arthritis, no human studies have been performed. Current +esearch +eview: • 5earch of /edline revealed no human trials as of AA3AC302. #harmacy: Contraindications: 6he use of tannins is contraindicated or inappropriate in cases of constipation, iron deficiency and malnutrition. 2A<< 6annin rich herbs may reduce the absorption of al#aloids and other basic drugs through precipitation. 2A<E )o*icity:
2140 2141

Aquino 4, %e )eo 7, %e 5imone ), et al. 1lant metabolites, ne compounds and antiinflammatory activity of Dncaria tomentosa1 7 ;at Prod ACCAK E<9<E3WC. 4i((i 4, 4e ), Bianchi A, et al. /utagenic and antimutagenic activities of Dncaria tomentosa and its e$tracts. 7 Ethnopharmacol ACC3K 3B9F3WHH. 2142 ?eplinger U/. ,nfluence of ?rallendorn e$tract on retroviral infection. ?uPrcher )>D, .ongress 8urich, 5 it(erland, 0ct AFWH, ACC2 Qabstract in *ermanR. 2143 ?eplinger U/. 6herapy of +,7&infected individuals in the pathological categories !%! AA and !%! B2 ith a preparation containing ,//&20H. ,7. "Psterreichischer )>D,9.ongress, 7ienna, Austria, 5ept AHWB, ACC3, <E QabstractR. 2144 /ills and Bone, p AH0 2145 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AEC

Urtica dioica
Common name: :ettle, 5tinging nettle Ha!itat: *ro s throughout 'urope and :. America

Urticaceae

Botanical description9 A F0&A20 cm tall herb bearing ovate and acuminate leaves ith a coarsely serrate margin. 6he leaves are dar# green to pale green underneath. 6he leaves are covered ith erect stinging hairs and softer non&stinging hairs. 6he stems are square and more than 3 mm thic#. 6he hitish&green flo ers occur as panicles larger than the leaf petioles. =Urtica urens is differentiated by the flo ering panicles hich are shorter than the leaf petioles.> #arts used9 +erba, 4adi$, 5eeds Constituents9 6here has been a great deal of controversy regarding the identity of nettle@s active constituents. !urrently it is thought that polysaccharides =comple$ sugars> and lectins =large protein&sugar molecules> are probably the active constituents. 2A<F • )lavonoids =glycosides of quercetin, #aempferol, and rhamnetin> concentrated in flo ers • !arotenoids9 B&carotene and $anthophylls • 7itamins !, B, ?AK • 6riterpenes • 5terols =including =&sitosterol> • /ineral salts including silica, potassium salts, nitrates • )ormic, acetic, citric and other acids • Amines in stinging hairs including histamine, serotonin, choline #harmacology: 6he leaf has been sho n to be anti&inflammatory by preventing the body from ma#ing inflammatory prostaglandins. Urtica root has been demonstrated to inhibit aromatase conversion of testosterone to AH β estradiol in combination ith 1ygeum africanum.2A<H :ettle@s root affects hormones and proteins that carry se$ hormones in the bodyK this may e$plain hy it helps benign prostatic hyperplasia =B1+>.2A<B, 2A<C '$tracts of nettle also ea#ly inhibit E α reductase, inhibits the classic complement path ay, inhibit cycloo$ygenase and E& lipo$ygenase, may stimulate the antiinflammatory cyto#ine ,.&F =,.&F inhibits prostaglandin '2 synthesis>, and may decrease the release of 6:) α and ,.&A β. :ettle hairs contain acetylcholine and may be comparable to the concentrations in stores of cholinergic nerve endings in animals. Medicinal actions: tonic, anti&inflammatory, diuretic, astringent, e$pectorant, anti&allergic, reduces B1+, anti&rheumatic )raditional Medicinal Use: 5pecific indications and Uses9 !hronic diarrhoea and dysentery, ith large mucous evacuationsK profuse secretion of gastric "uice, ith eructations and emesisK choleraic dischargesK summer bo el diseases. of children, ith copious atery and mucous passagesK chronic ec(ematous eruptions.2AE0 !oo# described the root as a strong astringent, ith moderately stimulating and tonic qualities. Apparently the 1hysiomedicalists only used the root of Urtica, hile the 'clectics used all parts of the plant. • %ermatologic !onditions9 5ome 'clectic physicians praised the specific tincture of the seeds as a local application for severe forms of ec(ema. • 'ndocrine !onditions9 6he seeds, according to ?ing, ere highly recommended as a remedy for goiter. • *astrointestinal !onditions9 6he 'clectics used Urtica radi$ for diarrhea, being reserved for chronic cases ith profuse discharges. 6hey also used a strong syrup made of the root, ild&cherry bar# and blac#berry root as a remedy for all bo el affections of adults. )or cholera infantum and other disorders ith profuse atery or mucous discharges, specific Urtica as used. 6he seeds ere used by the 'clectics to reduce e$cessive obesity and as an anthelmintic. • *enitourinary !onditions9 ?ing recommended the use of Urtica radi$ a variety of nephritic complaints, here as !oo# as not impressed ith its effect on the #idneys. • +ematological !onditions9 As a hemostatic, Urtica radi$ as considered to have fe equals, according to the 1hysiomedicalists. 6he infusion or tincture as used internally po er for bleeding from the nose, lungs, stomach, bo els and passive menorrhagia. • 6opical Applications9 Urtica leaves have been used as a po erful rubefacient and as a styptic hen applied to bleeding. 6he "uice as used by the 'clectics as a treatment for arts as ell. • ,nflammatory !onditions9 A ine made from the seeds and flo ers as used in small doses by the 'clectics for forms of malarial& li#e fevers.

Current Medicinal Use: Urtica dioica has a ide variety of uses. 0nly a fe of these uses have been studied clinically. • 'ndocrine !onditions9 Brin#er reports that Urtica has a hypoglycemic effect. 2AEA • *enitourinary !onditions9 0ne of the most idespread and best studied effects of nettles is its mild diuretic action. 4ecent investigations have confirmed this action.2AE2 ,n fact, this is the only usage for nettles listed in the *erman !ommission ' monograph. Urtica appears to increase urine output and to increase the removal of uric acid and may be helpful in the treatment of gout.2AE3 6he diuretic action of Urtica ma#es it useful in the treatment of edema, arthritis ith s ollen "oints, and congestive heart disease. %avid Winston, a reno ned herbalist and !hero#ee medicine man, has recently started using the seed as a renal trophorestorative in patients ith chronic renal failure. • /ale !onditions9 6he e$tract of the root may increase urinary volume and the ma$imum flo rate of urine in men ith early&stage B1+. ,t has been successfully combined ith both sa palmetto and 1ygeum to treat B1+. 2AE<, 2AEE ,n a number of uncontrolled trials nettle root e$tract improved B1+ urinary symptomology such as frequency, nocturia, and urinary flo . 6he dosage ranged from F00&A200 mg per day of the E9A e$tract over 3 ee#s. 0ther studies have demonstrated the ability to lo er levels of se$ hormone binding globulin =5+B*>, a independent etiological factor in the development of B1+ and prostate cancer. 2AEF • /etabolic !onditions9 Urtica is often included in re&minerali(ation teas. Urtica contains many minerals. /inerals found in plants are generally quite bioavailable, especially after the cell alls in the plant material is bro#en do n. 6he minerals in plants occur as mineral salts hich are generally highly absorbable at gastric p+. When Urtica is steeped for a long period of time, for instance overnight, the minerals in the plant leach into the ater. 5imilarly, if Urtica is steamed and3or coo#ed and eaten, the cell alls are destroyed hich ma#es the minerals bioavailable. 6hus Urtica, along ith other mineral&rich herbs such as /edicago sativa, 6rifolium spp., 'quisteum arvense, 4ume$ crispus, etc. is an e$cellent ay to increase the mineral stores of the body. • /usculos#eletal !onditions9 0ne case report of arthritis describes the counterirritant effect of fresh nettle applied over several ee#s. Also a number of open and pilot studies demonstrated improvements in !&reactive protein and total "oint score and pain relief comparable to :5A,% therapy.2AEH • :eurological !onditions9 %r. Bill /itchell recommends A000 mg Urtica tid for treatment of migraine headache. • 1ulmonary !onditions9 Urtica has been employed in the treatment of allergies and colds and flus. ,t appears as though :ettle reduces histamine&mediated allergic reactions. 6his is some hat parado$ical since the stinging hairs of Urtica contain histaminic acid. :onetheless, clinical e$perience ith various e$tracts of nettles have repeatedly demonstrated this anti&allergic effect. Allergic reactions are both prevented and, if they occur, the severity of the reaction is reduced. Urtica can be used singly or in combination for the treatment of asthma, environmental allergies, hives, rhinitis, and sinusitis. • /ale !onditions9 A more recent use of Urtica is in the treatment of B1+. '$tracts of nettles, especially the root, appears to alter the binding of E&α&dihydrotestosterone to se$ hormone binding globulin =5+B*>. 2AEB .ignans found in nettle e$tracts have been sho n to bind to 5+B* hich is postulated to have t o results. 0ne is the displacement of steroid hormones such as testosterone from 5+B*. 6he other result is the inhibition of 5+B* binding to its cellular receptor. 6he net effect of both of these actions is to reduce testosterone&induced stimulation of prostatic cA/1 and consequent prostatic hyperplasia. 2AEC :ettle e$tracts also appear to inhibit :a& and ?&A61ase pumps in prostate cells. 2AF0 Administration of Urtica decreases residual urine volume and increases urine flo .2AFA 6he mineral content of Urtica might further e$plain the effectiveness of this plant in treating B1+. 6he minerals may help to strengthen the connective tissue of the pelvic area. Current +esearch +eview: • +heumatology: o 3steoarthritis:0"&0  %esign9 4andomi(ed double&blind placebo&controlled crossover clinical trial  1atients9 6 enty&seven patients ith osteoarthritic pain at the base of the thumb or inde$ finger.  6herapy9 5tinging nettle leaf =Urtica dioica> qd $ A ee# topically to the painful area. 1lacebo& hite deadnettle leaf =.amium album> $ A ee# after five& ee# ashout period.  4esults9 After one ee#@s treatment ith stinging nettle, score reductions on both visual analogue scale =pain> and health assessment questionnaire =disability ere significantly greater than ith placebo. o Hoint pain:0"&7  %esign9 !linical trial  1atients9 'ighteen self&selected patients ith "oint pain  6herapy9 :ettle sting of Urtica dioica.  4esults9 All, e$cept one respondent, ere sure that nettles had been very helpful and several considered themselves cured. • $@): o Allergic rhinitis:0"&:

    #harmacy9

%esign9 4andomi(ed double&blind placebo&controlled clinical trial. 1atients9 :inety&eight patients ith allergic rhinitis 6herapy9 )ree(e&dried preparation of Urtica dioica =stinging nettles> $ A ee# 4esults9 Urtica dioica as rated higher than placebo in the global assessments. !omparing daily symptom diaries information Urtica dioica as rated only slightly higher. ,nfusion9 2 tsp. herba3 cupK A cup 6,% to F times per day QA tsp. O 0.B gR =;ou may infuse overnight.> A92.E fresh tincture 30G alcohol9 E ml 6,%K ee#ly ma$. O A00 ml !oo# into soups Acetract9 simmer of infuse in E0G distilled vinegar and E0G ater. %ecoction of radi$9 <&F g 2% for B1+.

Drug ,nteractions: E0g ste ed leaf enhanced the antiinflammatory effect of E0 mg of diclofenac by < times hen given to AC patients, li#ely through inhibition of !0P and E&.0P en(ymes. 0"&% Contraindications: Brin#er contraindicates the use of Urtica in pregnancy due to possible emmenagogue and abortifacient effects =empirical> and uterine stimulant action of its serotonin constituent=in vitro, animal studies>. +e also states to avoid use in edema due to heart disorders or #idney insufficiency due to inadequate e$cretion of urinary salts. 2AFF )o*icity9 +ypersensitivity or allergy to Urtica may occur. 6he symptoms are pharyngeal constriction and aggravation of sinusitis and rhinitis. 5tart ith lo dosesb 6he fresh leaves cause heals due to the formic acid is the nettle hairs. 6his reaction is self&limited and may even be used therapeutically to produce a counter&irritant effect.
2146 2147

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A +artmann 4W, /ar# /, 5oldati ). ,nhibition of Eα&reductase and aromatase by 1+.&00B0A =1rostatonin ®>, a combination of 1; A02 =1ygeum africanum> and U4 A02 =Urtica dioica> e$tracts. 1hytomed, 3=2>9 A2A&A2B, ACCF. 2148 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 2149 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 2150 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 2151 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 2<0 2152 ?irchhoff +W, Phytotherap, <, ACB39F2A. 2153 .utoms#i - and + 5peichert, PharmaIie in unserer ?eit, A2, ACB39ABA. 2154 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. AAE0 2155 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <C< 2156 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <CE 2157 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. <CE 2158 5chmidt, ?, ortschr Med, A0A=AE>, ACB39HA3&F. 2159 5chottner /, Planta Medica, F3, ACCH9E2C&32. 2160 +irano 6, +omma / and 0#a ?, Planta Med, F0,ACC<930&3. 2161 4omics, ,, >nt Drol ;ephrol, AC=3>, ACBH92C3&H. 2162 4andall !, 4andall +, %obbs ), et al. 4andomi(ed controlled trial of nettle sting for treatment of base&of&thumb pain. 7 R ,oc Med 2000KC3=F>930E&C. 2163 4andall !, /eethan ?, 4andall +, et al. :ettle sting of Urtica dioica for "oint pain W an e$ploratory study of this complementary therapy. 2omplement Ther Med ACCCKH=3>9A2F&3A. 2164 /ittman 1. 4andomi(ed, double&blind study of free(e&dried Urtica dioica in the treatment of allergic rhinitis. Planta Med ACC0KEF=A>9<<&H. 2165 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.AB< 2166 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.AB<

Usnea !ar!ata . U2 plicata
Common name: 0ld /anNs Beard, 6ree lichen

Usneaceae

Ha!itat: Usnea is actually a lichen and gro s on tree branches in et forests throughout the :. hemisphere. Botanical description: ,t appears as grey&green thin filaments that hang off of tree branches =pines, oa#s, %ouglas fir, apple and other fruit trees> 6he outer portion of each filament =corte$> is grey&green. 6he entire filament is round. When a main stem is gently pulled apart, a slender, hite elastic cord is inside. QRamilina reticlata can be confused ith Dsnea barbata, but R1 reticlata has no inner core.R .ichens are technically not plants, but are fungus and chlorophyll&containing algae living together in inseparable symbiosis. 6ogether, these organisms produce chemicals that neither one can produce on its o n. #art used: Whole lichen

Constituents:2AFH • .ichen acids =poly#etides>9 including among others usnic acid, thamnolic acid, lobaric acid, stictinic acid, evernic acid, barbatic acid, diffractaic acid, protocetraric acid, the lichen acid spectrums of the different species vary from one another. • polysaccharides • mucilage • anthraquinones9 endocrocin • fatty acids, all essential amino acids, vitamins, carotene. #harmacology: Usnic acid gives Usnea its bitter taste and acts as an antibiotic. Usnic acid is primarily antibiotic, especially against *m. positive organisms such as9 5treptococcus, 5taphylococcus, /ycobacterium tuberculosis and other fast&gro ing species. Dsnea spares the gram&negative bacteria that coloni(e the intestinal tract and is not bacteriocidal to *m. negative pathogenic bacteria. ,n vitro, usnic acid is more effective than penicillin against /ycobacterium tuberculosis, 5treptococcus and 1neumococcus. Usnic acid is thought to disrupt the cellular metabolism of bacteria, by preventing the formation of A61 from A%1 or by uncoupling o$idative phosphorylation. +uman cells are much less permeable to usnic acid and are therefore unaffected by it. Because Dsnea and penicillin do not share the same mechanism of action, they may be used together to enhance the overall antibiotic effect. Usnic acid is also anti&fungal and effective against 6richomonas. 1reliminary test tube studies suggested an anti&cancer activity for usnic acidK ho ever, this action has not been sufficient to arrant further investigation. 2AFB %iffractaic acid and usnic acid ere identified as the analgesic and antipyretic components of a lichen, Usnea diffracta. 2AFC Besides the antibiotic properties noticed at lichens products there have been discovered the follo ing pharmacological actions9 antiinflammatory , antitumoural, immunostimulatory 2AH0. 6he polysaccharides have demonstrated anti&tumor activity in animal studies. Medicinal actions: antibiotic, anti&fungal, immunostimulating, demulcent Historical Use: Dsnea has a long history of medicinal use throughout this continent, in 'urope and in Asia. ,t as used by many :ative American tribes in the north estern region of the United 5tates. !hinese herbalists have used the D1 longissima species =5un&.o>. ,n 6raditional !hinese /edicine, Dsnea longissima =5un .o> is considered to be cooling and slightly bitter. 6he alcoholic preparation is surface&acting, hereas the ater e$traction is internally acting. Dsnea enters the lung, spleen and #idney meridians. )raditional Medicinal Use: :o information is available from the selected resources. Current Medicinal Use: 6here is very little in the herbal literature about Usnea. !hristopher +obbs has ritten the most thorough revie entitled9 Usnea9 6he +erbal Antibiotic =and other medicinal lichens>. • ,nfectious !onditions9 Dsnea also contains polysaccharides hich are immunostimulatory, hich enhance the antimicrobial effect of usnic acid. Usnea is a good addition to any formula directed against an infectious process QU6,, U4,, gastroenteritis, impetigo, 5trep. pharyngitis, s#in infections =including fungal>R. • 6opical Applications9 Usnea is quite useful topically and internally as an anti&fungal and anti&bacterial. 6he tincture is the most commonly used form of this herb, ho ever, a decoction of Dsnea is useful as a first aid remedy. Current +esearch +eview: • 5earch of /edline reveled no human trials as of :ovember 2002.

#harmacy: All species of Dsnea contain usnic acid, hich is one of the main identified constituents. ,t is apparently difficult to e$tract this constituent, the process requiring a hot distillation. ,t is of note, ho ever, that :ative Americans made infusions of this lichen and en"oyed its medicinal attributes, perhaps because of the slo er absorption but longer lasting effects of the ater e$traction. ,n any case, the tincture is considered the strongest preparation of Dsnea. Up to A0 gm3day po dered herb 6incture A9F C0G 't0+9 sig 2&E ml 6,% '$ternal application as tincture or compress Drug ,nteractions: :o information is available from the selected resources. Contraindications: :o information is available from the selected resources. )o*icity: 6here is the potential for to$icity, ho ever because of the poor human cellular absorption of usnic acid, Dsnea spp1 is considered non&to$ic.
2167 2168

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 2169 0#uyama '. Usnic acid and diffractaic acid as analgesic and antipyretic components of Usnea diffracta. 1lanta /ed. ACCE AprKFA=2>9AA3&E. 2170 %obrescu %. !ontributions to the comple$ study of some lichens&Usnea genus. 1harmacological studies on Usnea barbata and Usnea hirta species. 4om - 1hysiol. ACC3 -an&-unK30=A&2>9A0A&H.

-accinium macrocarpon
Common name: cranberry Ha!itat: Botanical description: #art used: Historical use: $nergetics: Constituents: hippuric acid #harmacology: =Berberine also appears to have bacterial antiadhesive properties in the gut hich may has been utili(ed in cystitis.> 2AHA Medicinal actions: Medicinal uses: )ccording to the Textboo3 of ;atural Medicine:&%4& • *enitourinary !ondtions9 !ranberries and cranberry "uice has been demostrated to be effective for treatment of urinary tract infections by numerous studies. Although many believe that the mechanism is through acidification of the urine, this is not li#ely the case. At least one liter of "uice ould need to be consumed at one siting in order to acidify the urine. 6he concentration of hippuric acid ith this amount is inadequate to be bacteriostatic. 4ather, cranberry "uice reduces the ability of '. coli to adhere to the epithelium of the bladder and urethra. Blueberry also possesses a similar effect. Current +esearch +eview: • Urology o Cidney 4tones:0"(7  %esign9 !ontrolled clinical trial  1atients9 6 elve healthy male sub"ects, AB&3B yo  6herapy9 Blac#currant, cranberry, or plum "uice, 330 ml  4esults9 !ranberry "uice decreased the urinary p+, and increased e$cretion of o$alic asic and relative supersaturation for uric acid. Authors concluded that cranberry "uice acidifies urine, and therefore can be useful in the treatment of brushite and struvite stones as ell as U6,. o U),0"(:  %esign9 0pen randomi(ed controlled clinical trial  1atients9 0ne hundred fifty omen ith U6, caused by '. coli.  6herapy9 !ranberry&lingonberry "uice concentrate, E0 ml qd $ F months or A00 ml of lactobacillus drin# E $3 ee#  4esults9 At si$ months, eight =AFG> omen in the cranberry group, AC =3CG> in the lactobacillus group, and AB =3FG> in the control group had had at least one recurrence. 6his is a 20G reduction in absolute ris# in the cranberry group compared ith the control group. ,t as concluded that regular drin#ing of cranberry "uice seems to reduce the recurrence of urinary tract infection o Bacterial !iofilm load in the !ladder:0"(%  %esign9 !linical trial  1atients9 )ifteen spinal cord in"ured patients  6herapy9 !ranberry "uice, A glass 6,%. Water as a control  4esults9 !ranberry "uice inta#e significantly reduced the biofilm load compared to baseline. 6his as due to a reduction in adhesion of *ram negative and *ram positive bacteria to cells. Water inta#e did not significantly reduce the bacterial adhesion or biofilm presence. o Bacteriuria.pyuria 5tudy A92AHF  %esign9 %ouble&blind placebo&controlled crossover clinical trial.  1atients9 )ifteen children ith neurogenic bladder receiving clean intermittent catheteri(ation

•

6herapy9 !ranberry concentrate or placebo concentrate for F months =3 months receiving one concentrate, follo ed by 3 months of the other>.  4esults9 %uring consumption of cranberry concentrate, the frequency of bacteriuria remained high. !ultures of HEG =AA< of AEA> of the AEA samples obtained during consumption of placebo ere positive for a pathogen compared ith HEG =A20 of AF0> of the AF0 samples obtained during consumption of cranberry concentrate. '. coli remained the most common pathogen during placebo and cranberry periods. 6hree symptomatic infections each occurred during the placebo and cranberry periods. :o significant difference as observed in the acidification of urine in the placebo group versus the cranberry group =median, E.E and F.0, respectively>. 6he frequency of bacteriuria in patients ith neurogenic bladder receiving intermittent catheteri(ation is H0GK cranberry concentrate had no effect on bacteriuria in this population. 5tudy 292AHH  %esign9 4andomi(ed controlled clinical trial  1atients9 'lderly omen  6herapy9 !ranberry "uice coc#tail, 300 ml qd $ F mo  4esults9 Bacteriuria and pyuria can be reduced by E0G. !onsumption of cranberry "uice is more effective in treating than preventing bacteriuria and pyuria. 5tudy 392AHB  %esign9 4andomi(ed double&blind placebo&controlled clinical trial.  1atients9 7olunteer sample of AE3 elderly omen =mean age, HB.E years>.  6herapy9 !ranberry beverage, 300 ml qd or a specially prepared synthetic placebo drin# that as indistinguishable in taste, appearance, and vitamin ! content but lac#ed cranberry content.  4esults9 6he odds of bacteriuria ith pyuria in e$perimental group ere only <2G of the odds in the control group. 6heir odds of remaining bacteriuric&pyuric, given that they ere bacteriuric&pyuric in the previous month, ere only 2HG of the odds in the control group. ,t as concluded that the use of a cranberry beverage reduces the frequency of bacteriuria ith pyuria in older omen. o Uropathogen adhesion:0"(5  %esign9 !linical trial  1atients9 7olunteers  6herapy9 Water, ascorbic acid, or cranberry supplements  4esults9 0nly ascorbic acid inta#e consistently produced acidic urine. !ranberry and ater produced urine ith higher surface tensions. Urine obtained after cranberry and ascorbic acid supplementation reduced the intial deposition rates and numbers of adherent '. coli and 'nterococcus faecalis, but not 1seudomonas aeruginosa, 5taphylococcus epidermidis, or !andida albicans. !onversely, urine obtained from sub"ects ith increased ater inta#e vastly increased the initial deposition rates and numbers of adherent '. coli and '. faecalis. o Urostomy:0"/8  %esign9 !linical trial  1atients9 6hirteen urostomy patients  6herapy9 !ranberry "uice, AF0&320 g qd $ F mo  4esults9 ,mprovement in s#in condition from F patients ith erythema, maceration or pseudoepithelial hyperplasia at the beginning of the study to 2 patients ith maceration or 1'+. 6he average p+ of the urine ta#en from the patientsN pouches decreased a statistically significant amount from B.0 to H.3, yet une$pectantly, the average p+ of the fresh urine increased a statistically significant amount from E.B to F.2. 6he authors conclude that hile drin#ing cranberry "uice did not appear to acidify the urine as e$pected, improvements ere still seen in the s#in conditions of the study participants, suggesting that drin#ing cranberry "uice does positively impact the incidence of s#in complications for these patients. o Urinary pH0"/"  %esign9 4andomi(ed controlled clinical trial  1atients9 6 enty&one female and AC male sub"ects ho had normal physical and laboratory e$aminations  6herapy9 !ranberry "uice, AE0, AB0, 2A0, or 2<0 m., cc $ A2 days  4esults9 6here ere significant differences in mean urinary p+ bet een each control group and its corresponding e$perimental group. Dentistry: o Bacterial adhesion:0"/0  %esign9 !linical trial  1atients9 :ot stated in the abstract  6herapy9 +igh molecular eight nondialysable material =:%/> isolated from cranberry "uice, concentration 0.F&2.E mg3ml  4esults9 ,n the clinical trial, :%/ reduced 5. mutans counts in saliva. ,t as concluded that anti&adhesion activity of cranberry "uice has a potential for altering the oral microbial flora resulting in improved oral hygiene. 

•

•

Biochemistry o Anti<o*idant capacity:0"/7  %esign9 !ontrolled clinical trial  1atients9 :ine female volunteers  6herapy9 E00 ml blueberry "uice, cranberry "uice or a sucrose solution post overnight fast.  4esults9 !onsumption of cranberry "uice resulted in a significant increase in the ability of plasma to reduce potassium nitrosodisulphonate and )e=,,,>&2,<, F&6ri=2&pyridyl>&s&tria(ine, these measures of antio$idant capacity attaining a ma$imum after F0&A20 min. 6his corresponded to a 30G increase in vitamin ! and a small but significant increase in total phenols in plasma. 6he authors concluded that increase in plasma antio$idant capacity follo ing consumption of cranberry "uice could mainly be accounted for by an increase in vitamin ! rather than phenolics 9astroenterology: o Hypochlorhydria:0"/:  %esign9 4andomi(ed controlled clinical trial  1atients9 :ineteen elderly patients9 ith hypochlorhydria d3t omepra(ole treatment, ith atrophic gastritis, or normal.  6herapy9 Water, cranberry "uice or 0.A: hydrochloric acid ta#en ith protein bound vitamin BA2.  4esults9 With cranberry "uice ingestion, the omepra(ole&treated group sho ed an increase in absorbed protein&bound vitamin BA2. With dilute hydrochloric acid ingestion, there as a further increase in vitamin BA2 absorption. 6he conclusion as that omepra(ole causes protein&bound vitamin BA2 malabsorption, and ingestion of an acidic drin# improves protein&bound vitamin BA2 absorption.

#harmacy: "uice9 0.E .3day =,t is important to note that this needs to be pure cranberry "uice that is sugar free. )resh cranberry =or blueberry "uice can be s eetened ith a small amount of apple or grape "uice.> standardi(ed e$tract. Contraindications: !ranberry is ell tolerated having no #no n contraindications or to$icities. )o*icity: none.
2171

4abbani *+, Butler 6, ?night - et al. 4andomi(ed !ontrolled 6rial of Berberine 5ulfate 6herapy for %iarrhea due to 'nteroto$igenci '. col and 7. cholerae. -ournal of ,nfectious %iseases, ACBHK AEE9 CHC&CB< 2172 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. AABF 2173 ?essler 6, -ansen B, +asse A. 'ffect of blac#currant&, cranberry&, and plum "uice consumption on ris# factors associated ith #idney stone formation. Eur 7 2lin ;utr 2002K EF=A0>9A020&3, 2174 ?ontio#ari 6, 5undqvist ?, :uutinen /, et al. 4andomised trial of cranberry&lingonberry "uice and .actobacillus ** drin# for the prevention of urinary tract infections in omen. BM7 200AK322=H302>9AEHA. 2175 4eid *, +siehl -, 1otter 1, et al. !ranberry "uice consumption may reduce biofilms on uroepithelial cells9 pilot study in spinal cord in"ured patients. ,pinal 2ord 200AK3C=A>92F&30. 2176 5chlager 6A, Anderson 5, 6rudell -, et al. 'ffect of cranberry "uice on bacteriuria in children ith neurogenic bladder receiving intermittent catheteri(ation. 7 Pediatr ACCCKA3E=F>9FCB&H02. 2177 )leet -!. :e support for a fol# remedy9 cranberry "uice reduces bacteriuria and pyuria in elderly omen. ;utr Re! ACC<9E2=E>9AFB&H0. 2178 Avom -, /onane /, *ur it( -+, et al. 4eduction of bacteriuria and pyuria after ingestion of cranberry "uice. 7)M) ACC<K2HA=A0>9HEA&<. 2179 +ebash /B, 7an der /ei +!, Busscher +-, et al. 6he effect of ater, ascorbic acid, and cranberry derived supplementation on human urine and uropathogen adhesion to silicone rubber. 2an 7 Microbiol ACCCK<E=B>9FCA&<. 2180 6su#ada ?, 6o#unaga ?, , ama 6, et al. !ranberry "uice and its impact on peri&stomal s#in conditions for urostomy patients. "stomy +ound Manage ACC<K<0=C>9F0& 2, F<, FF&B. 2181 ?inney AB, Blount /. 'ffect of cranberry "uice on urinary p+. ;urs Res ACHCK2B=E>92BH&C0. 2182 Weiss '., .ev&%or 4, 5haron :, et al. ,nhibitory effect of a high&molecular& eight constituent of cranberry on adhesion of oral bacteria. 2rit Re! ood ,chi ;utr 2002K<2=3 5uppl>92BE&C2 2183 1edersen !B, ?yle -, -en#inson A/, et al. 'ffects of blueberry and cranberry "uice consumption on the plasma anti&o$idant capacity of healthy female volunteers. Eur 7 2lin ;utr 2000KE<=E>9<0E&B. 2184 5alt(man -4, ?emp -A, *olner BB, et al. 'ffect of hypochlorhydria due to omepra(ole treatment or atrophic gastritis on protein&bound vitamin BA2 absorption. 7 )m 2oll ;utr ACC<KA3=F>9EB<&CA

-accinium myrtillus
Common name: bilberry, huc#leberry, 'uropean blueberry, hortleberry, blueberry Ha!itat: Botanical description: #art used: berry, leaf, flo ers Historical use: $nergetics:

$ricaceae (-acciniaceae

Constituents: • flavonoids9 anthocyanosides =0.A&0.2EG>2ABE , catechin, epicatechin, oligomeric proanthocyanidins =01!s are also found in !rataegus, grape seed and pine bar#> • tannin =HG to 20G>2ABF,2ABH • ,ridoid monoterpenes9 asperuloside, monotropein • !affeic acid derivatives9 chlorogenic acid • 1henolic acids9 including, among others, salicylic acid, gentisic acid • 2uinoli(idine al#aloids9 myrtine, epimyrtine #harmacology: According to /urray and 1i((orno, pharmaco#inetic studies demonstrate tropism for the s#in, #idneys and the eyes. Anthocyanidins are e$creted through the #idney. • 5tabli(ation of !ollagen by cross lin#ing fibers, preventing free radical damage, inhibiting en(ymatic cleavage from leu#ocytic en(ymes during inflammation, promoting mucopolysaccharide and collagen biosynthesis, stimulating reticulation of collagen fibrils. • Anti&inflammatory9 preventing release3synthesis of inflammatory compounds • :ormali(ation of !apillary 1ermeability9 by stabili(ing membrane phospholipids and increasing endothelium integrity, increasing the biosynthesis of mucopolysaccharides of !6 ground substance thus restoring altered /15 pericapillary sheath.9 ↓ perm of BBB. • Anti&Aggregation of 1latelets • 5mooth /uscle 4ela$ation9 preliminary study in dysmenorrhea has been Anthocyanosides have strong Ivitamin 1J activity. ,ncluded in their effects are an ability to increase intracellular vitamin ! levels and to decrease capillary permeability and fragility. 6heir effect in reducing capillary fragility and permeability is roughly t ice that of rutin, in both intensity and duration of action. Medical actions: astringent =leaf>, antiseptic, absorptive, antiemetic, antidiarrheic )raditional Medicinal Uses: ?ing described the dar# berry varieties of 7accinium together as diuretic and astringent having been used in scurvy, dysentery, and derangements of the urinary organs. 6he berries and roots, bruised and steeped in gin, form an e$cellent diuretic, hich has proved of much benefit in edema and gravel. A decoction of the leaves or bar# of the root is astringent, and may be used in diarrhea, or as a local application to ulcers, leucorrhoea, and ulcerations of the mouth and throat. !oo# described 7. resinosum =huc#leberry> ith similar properties as those ascribed by ?ing. Current Medical Uses: .eaves are used in indications requiring astringency and in vascular disorders, especially of lo er e$tremity. • Behavioral and 1sychological !onditions9 '$perimental studies indicate that 7accinium may be useful in the treatment of schi(ophrenia.

• !ardiovascular !onditions9 0"//, 0"/5 Uncontrolled trials dating bac# to ACF< demonstrated the efficacy of Bilberry in the treatment of peripheral vascular disorders. ,n later trials, Bilberry e$tract =equivalent to BF&AH3 mg anthocyanins per day> improved edema and sub"ective symptoms of lo er limb varicose syndrome, reduced protein e$udate of varicose ulcers and decreased the total drainage time after reactive hyperemia in chronic venous insufficiency. Bilberry e$tract =EH&AAE mg anthocyanins per day for 2&3 months> provided relief for venous disorders including hemorrhoids during pregnancy. A revie of uncontrolled trials from ACHC to ACBE on a total of EFB patients ith venous insufficiency of the lo er limbs concluded that Bilberry e$tract caused rapid disappearance of symptoms and improvements in venous microcirculation and lymph drainage. Bilberry e$tract =equivalent to AH3 mg anthocyanins per day> or placebo as administered for 30 days in a single& blind, placebo&controlled clinical trial on F0 patients ith venous insufficiency. 5ignificant reduction in the severity of symptoms =edema, sensation of pain, paraesthesia, cramping pain> as observed for the treated group after < ee#s treatment =pc0.0A>. ,n a double&blind, placebo&controlled trial, <H patients ith peripheral vascular disorders of various origins ere treated ith Bilberry e$tract =equivalent to AH3 mg anthocyanins per day> or placebo for 30 days. 6he treated group e$perienced a reduction in sub"ective symptoms including paraesthesia, pain, heaviness, and edema. ,n uncontrolled trials, Bilberry e$tract =equivalent to EH&2BB mg anthocyanins per day> improved symptoms caused by decreased capillary resistance =petechiae, bruising and fecal occult blood>, reduced the microcirculatory changes induced by cortisone therapy in patients ith asthma and chronic bronchitis and improved diabetic retinopathy ith a mar#ed reduction or even disappearance of retinic hemorrhages. 1ostoperative complications from surgery of the nose ere reduced in patients ho received Bilberry e$tract =equivalent to AAE mg anthocyanins per day> administered for H days before and A0 days after surgery. • 'ndocrine !onditions9 6he decoction of the leaves appears to have a hypoglycemic effect. 6he collagen strengthening effects and inhibition of sorbitol formation protects vasculature from diabetic complications. 2190 • *astrointestinal !onditions90"5" 6he anthocyanidins give action to the berries in the treatment of diarrhea as a frequently administered decoction. Bilberry tea or uns eetened "uice combined ith quar# =soft hite cheese> is effective in diarrhea and dysentery. 6he uns eetened "uice must be used to avoid the affects of sugar on the digestive tract. ,n infants, po dered berry suspended in ater or tea and simmered lightly is a useful remedy for dyspepsia and diarrhea. 0n the contrary, hen the ripe berries are eaten in large quantity the effect is la$ative in nature as the astringent nature is over helmed. 6he fiber from the s#in, irritant effect of the pips and fruit acid create a roughage effect that is beneficial in chronic constipation. 7accinium soothes inflammation hich may also accompany chronic constipation. Anthocyanidins may have a bacteriostatic effect as ell. 0ther indications include nausea and vomiting as ell as Ithe dystrophic and trophic states =of the intestine> hich are difficult to treat.J 6he astringent and disinfectant properties ma#e it useful for inflammatory conditions of the oral cavity. • *enitourinary !onditions9 9 7accinium also has a tropism for the s#in and #idneys, t o e$cretory organs hich are high in collagen and mucopolysaccarhides hich are nourished by 7accinium. • /etabolic !onditions9 7accinium reduces serum cholesterol and triglyceride levels in primary dyslipidemia. 7accinium may prevent arteriosclerotic plaque formation as ell. &%*& • 0phthalmological conditions9 ,nitial observations of the effect of 7accinium demonstrated improved night vision, quic#er ad"ustment to dar#ness and faster restoration of visual acuity after glare e$posure. 6he anthocyanosides have a tropism for the pigmented epithelium of the retina. 7accinium is indicated in visual disturbances3poor vision including pigmentary retinitis and hemeralopia. 2193 *iven the effects on the collagen structure of the eye, 7accinium is used in the prevention and treatment of glaucoma. 6he integrity collagen of the vasculature of the eye is improved as ell. 5orbitol production is inhibited in the eye decreasing cataracts, retinal degeneration, and diabetic retinopathy. ,n uncontrolled trials conducted as early as ACF<, Bilberry e$tract =including isolated anthocyanins>, alone or in combination ith beta&carotene and retinol, improved vision in healthy sub"ects and in patients ith visual disorders such as myopia. 'nlargement of visual range as observed for patients ith pigmentary retinitis and retinal sensitivity as improved in patients ith hemeralopia =defective vision in bright light>. 7isual perception improved in HF of myopic patients receiving Bilberry e$tract =equivalent to E< mg anthocyanins per day> and retinol for AE days. 5imilar results ere obtained for patients ith simple glaucoma. Bilberry e$tract =equivalent to AAE mg anthocyanins per day> for C0 days improved dar#ness adaptation in all myopic patients and improved day vision in those suffering from light to medium myopia.2AC<,2ACE ,n a placebo&controlled trial, Bilberry e$tract =equivalent to AAE mg anthocyanins per day for A2 months> improved early&phase diabetic retinopathy as indicated by a reduction of hard e$udate at the posterior pole. ,n a double&blind, placebo&controlled clinical trial, A< patients ith diabetic and3or hypertensive retinopathy received Bilberry e$tract =equivalent to AAE mg anthocyanins per day> or placebo for A month. 5ignificant improvements in the ophthalmoscopic and angiographic patterns ere observed in HH&C0 of treated patients.2ACF,2ACH

• 4heumatological !onditions9 6he antio$idant effects ma#e 7accinium useful in gout and rheumatoid arthritis as collagen synthesis is increased and collagen brea#do n is inhibited. ,n gout, uric acid levels and tissue destruction are reduced. /obili(ation of finger "oints as improved in patients ith 4aynaudNs syndrome. #harmacy: 5tandardi(ed e$tract =2EG anthocyanosides>9 B0&AF0 mg tid )resh berries 2&< o(. tid diarrhea preparations9 in infants simmer AE0&200 mg3#g sifted po dered berry as a EG suspension in older children ma#e a A0&20G suspension ith AEG rice flour as a stabili(er decoction, as a mouth ash or tea9 simmer 3 6 in L .iter of ater for A0 min., drin# throughout the day

Drug ,nteractions:0"5/ • /ay protect against ulcer formation induced by phenylbuta(one, indomethacin, reserpine, ethanol and acetic acid =animal studies>. • Antiplatelet medications9 activity may be enhanced by the platelet aggregation inhibiting effect of the anthocyanosides. Contraindications9 7. myrtillus is contraindicated in hemorrhagic disorders. )o*icity: :onto$ic. :o other information is provided by the selected resources.
2185 2186

/urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. 2187 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 2188 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 2189 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 2190 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. 2191 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2192 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. 2193 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. 2194 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 2195 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 2196 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 2197 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 2198 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.3B

-aleriana officinalis. -2 sitchensis
Common name: 7alerian

-alerianaceae

Ha!itat: 7alerian is native to 'urope and Asia and has been naturali(ed in :orth America. ,t gro s ild in oodlands, along river ban#s and in damp meado s. 7aleriana sitchensis gro s at a higher altitude Botanical description: A 30&AE0 cm tall herb. A single stem has pinnate leaves. 6he stem ends in a terminal cyme of hite or pin# flo ers hich bloom -une through 5eptember. 6he rhi(ome is ovoid&cylindrical and bears multiple roots. 6he roots are light to medium greyish bro n, A&3 mm thic#, and are covered ith coarse longitudinal furro s. #arts used: 4oot Constituents 2ACC • 7alepotriates =7aleriana&epo$y&triacylates, iridoid monoterpenes, 0.2&2.0G>9 chief components =E0&B0G> , isovaltrate =up to <FG>, isovalero$yhydro$y didrovaltrate =,7%+&valtrate, A0&20G>, including, among others, didrovaltrate, acevaltrate • 7olatile oil =0.2&A.0G>9 chief components =&>&bornyl isovalerenate and isovalerenic acid =both aroma&carriers>, including, among others, =&>&bornyl acetate, isoeugenyl valerenate, isoeugenyl isovalerenate, also ith some strains valerenal, valeranone, cryptofaurinol • 5esquiterpenes9 valerenic acid =0.A&0.CG>, 2&hydro$yvalerenic acid, 2&aceto$y&valerenic acid • 1yridine al#aloids =traces, cat pheromone>9 actinidine, 7alerianine, alpha&methylpyrryl#etone • !affeic acid derivatives9 chlorogenic acid. #harmacology: 4esearch done in the ACB0@s confirmed the use of 7alerian in the treatment of insomnia, but the mechanism as un#no n. ,n ACBC, *erman researchers discovered that the volatile oils, particularly valerenic acid, bind to *ABA&A receptors leading to the release of γ&aminobutyric acid =*ABA> hich in turn inhibits the release of other neurotransmitters. 6hese volatile oils also inhibit the degradation of *ABA.2200,220A 6he net effect is sedation of the central nervous system =!:5>. Ben(odia(apines =i.e. 7alium, +alcion, Pana$> also bind to *ABA&A, ho ever 7alerian binds more ea#ly to these receptors. Because of this ea# binding, 7alerian causes sedation ithout addiction and ithout the lethargy and grogginess associated ith ben(odia(epine. Upon processing, particularly through drying and o$idation, valepotriates are formed. 7alepotriates are not present in the crude plant or in tincture or decoction. 7alepotriates possess cytoto$ic and antitumor actions in vitro but have not been demonstrated to do so in humans. 7alepotriates are also both stimulating and sedating to the autonomic nervous system leading to an overall amphoteric effect.2202,2203 7alerenic acid is spasmolytic and has muscle rela$ing effects on smooth and s#eletal muscles. 220< A remar#able aspect of 7alerian is the no single uniform active constituent is responsible for the effects of 7alerian. 4ather, the therapeutic effect depends on the interaction of a number of principles as demonstrated in e$perimental studies9 the sedative effect is due mainly to the volatile oil and valeric acidK the depressant effect on the autonomic nervous system is due to the valepotriate content.220E Medicinal actions: hypnotic, nervine, hypotensive, antispasmodic, carminative, sedative =parado$ical stimulant> Historical Use: 7alerian has been used historically throughout 'urope to treat digestive problems, nausea, liver problems, an$iety and insomnia. ,n fact this cluster of symptoms as referred to as hysteria, and in omen, often led to the removal of their uterus =hence IhysterectomyJ>. )raditional Medicinal Use: 5pecific ,ndications and Uses9 A cerebral stimulant. +ysteria, chorea, hemicrania, all ith mental depression and despondencyK cerebral anemiaK mild spasmodic movements.220F !oo# described 7alerian root as largely rela$ant, moderately stimulant and some hat diffusive. +e noted that hen using 7alerian, the pulse becomes fuller and softer and its repeated administration ill impart the 7alerianic odor to the breath. 7alerian as considered to have enough stimulating po er to ma#e it suitable in moderately depressed conditions and as a good ad"unct to diffusive stimulants and light tonics. 220H ?ing stated that the cases indicating 7aleriana are those evidencing enfeebled cerebral circulation here there is despondency and mar#ed mental depression. +e further remar#ed that the failure of 7alerian to favorably impact a condition is li#ely due to administration ithout due regard to the indications and the condition of the nerve centers.

• *astrointestinal !onditions9 impregnating the "uices and eructations of the stomach for many hoursK • *ynecological !onditions9 !oo# combines 7aleriana ith .iriodendron, 8antho$ylum, 1impinella and !aulophyllum for uterine neuralgia, dysmenorrhea and any gynecological condition accompanied by feebleness and poor circulation. • :ervous !onditions9 7alerians principle influence in on the nervous system9 first, the periphery here its action is as a nervine and antispasmodic in cases of irritability, restlessness and acute nervousness. 5econdly, it affects the brain inducing quietude and sleep. 5leep induced by 7alerian is natural and accompanied by a gentle, arm perspiration leaving no morbid impression after it has orn off. 7alerian is adapted to the milder spasmodic affections here its effect is much more significant if applied in the prodromal hyperaesthetic state than hen spasm has ta#en place.7alerian as used in treatment of convulsion in infants, epilepsy, chorea =combined ith !imicifuga> and delirium tremens, headache of a neurologic origin. • ,nflammatory !onditions9 in the lo forms of fever, here a nervous stimulant is required. Current Medicinal Use: • Behavioral and 1sychological !onditions9 )orty&eight participants ere placed under situations of stress in a double& blind study of 7alerian. ,ndividuals in the 7alerian group reported less an$iety. 220B 0ne study also found evidence that 7alerian helps reduce reactions to stressful situationsK this study lac#ed a placebo group. 220C • *astrointestinal !onditions9 7alerian is a bitter, antispasmodic and carminative for the digestive organs. • /usculos#eletal !onditions9 6he muscle rela$ing effect of 7alerian ma#es it useful in individuals ith an$iety and that hold their tension in their muscles. 7alerian is also a good addition to e$ternal massage compounds. • :ervous !onditions9 7alerian is mainly indicated for nervous e$citement, nervous sleeplessness and nervous palpitations. )or nervous e$citement, 7alerian combines ell ith /elissa, ith +umulus for nervous sleeplessness and !onvallaria for nervous palpitation. !urrently, 7alerian is used as a sedative. ,t is most effective for nervous e$citement, nervous sleeplessness and nervous palpitations. 7alerian is useful for individuals ith restlessness and insomnia, hich is aggravated by an$iety. 7alerian ill improve the quality of sleep, reduce the time it ta#es to fall asleep, ill not cause somnolence in the morning, nor ill it affect dream recall. 22A0,22AA 7alerian is not physiologically addicting and is a good herb to use in the place of ben(odia(epine sleep medications. When used in amounts belo that hich ill cause somnolence, 7alerian may be used throughout the day to relieve an$iety. An impressive study of 7alerianNs effectiveness in treating insomnia involved A2A people over 2B days. +alf of the participants too# F00 mg of an alcohol&based 7alerian e$tract A hour before bedtime, the other half placebo. By the end of the study, the participants treated ith 7alerian ere definitely sleeping better. Another trial follo ed A2B sub"ects ho had no sleeping problems. 0n three consecutive nights they too# 7alerian, a 7alerian&hops combination, or placebo. 6he results sho ed that on the nights they too# 7alerian alone, participants fell asleep faster than hen they ere ta#ing placebo or the combination. Additional evidence for 7alerianNs effectiveness comes from a double&blind placebo&controlled study of HB elderly patients. ,n this case, sleep improved by the end of the study, at A< days. ,n addition, a 2B&day double&blind trial of HE individuals ith insomnia compared 7alerian =F00 mg at bedtime> ith the standard drug o$a(epam =A0 mg at bedtime>. 6he results sho ed no differences in effectiveness. A double&blind comparative study that enrolled <F patients compared the effects of the standard drug broma(epam to a mi$ture of 7alerian and hops ith either treatment ta#en one&half hour before bed. 6he results suggest that the t o treatments ere equally effective. )inally, the combination of 7alerian and lemon balm has been tried for insomnia. A 30&day double&blind placebo&controlled study of CB individuals ithout insomnia found that a 7alerianWlemon balm combination improved sleep quality as compared to placebo. 5imilarly, a double&blind crossover study of 20 people ith insomnia compared the benefits of the sleeping drug +alcion =0.A2E mg> against placebo and a combination of 7alerian and lemon balm, and found them equally effective. 22A2, 22A3, 22A< According to /oore =1lants of the 1acific West>, 7alerian is indicated in an over active mind& chec# off list in the head may cause bad dreams ith a groggy a a#eningK stimulant to digestion, lungs, cardiac output. ,f you are an adrenal driven person, it is a tonic sedative. ,f you are an adrenocortical stressed person, you ill be sedation and physical stimulation. #harmacy: Weiss remar#s that in order for 7alerian to be effective it requires a sufficiently high dosage. Also, preparations from dried root must be used to access the autonomic amphoteric effect of the valepotriates. !rude herb9 0.3&A.0 gm daily as po dered herbK 3&E gm QA tsp. O 2.E gmR daily in decoction, cold maceration =soa# for BWA0 hours so set it up in the morning>, or infusion3maceration =left to stand A2 hours>. %rin# cold. dried root capsules standardi(ed to 0.2G&0.BG valerenic acids9 300&E00 mg for sedation at bedtime, AE0&300 mg for mild an$iety daily E&A0 ml of A9E tincture for sedationK 2.E ml of A9E tincture B,% to 6,% for mild an$iety Drug ,nteractions:00"% • Ben(odia(epines9 7alerian products containing valepotriates appear helpful in ben(odia(epene ithdra al. • Barbiturates9 may potentiate the effects barbiturates and therefore, concomitant use should be avoided.

•

5edatives9 may potentiate the effects of alpha&bloc#ers, anesthetics, analgeiscs, tricyclic antidepressants, antiemetics, antiepileptics, beta&bloc#ers and hypnotics.

Contraindications: 5ome individuals ill parado$ically to 7alerian and ill actually be stimulated by it. 7alerian e$cites the cerebro& spinal system. .arge doses cause headache, mental e$citement, visual illusions, giddiness, restlessness, agitation, and even spasmodic movements, and frequently nausea.22AF 6his reaction may be due to the a heightened sensitivity on their part to the valepotriates. 7alerian is high in arginine and should be avoid in +erpes simple$ outbrea#s. )o*icity: 6here is no #no n or reported to$icity ith the use of 7alerian. 7alerian is safe during pregnancy and lactation. 7alerian carries no ris# of habituation or dependence and does not negatively affect concentration
2199 2200

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 4eidel ', et al., Planta Medica, ACB2K<F92AC. 2201 /ennini 6, Bernasconi 1, et al., itoterpia, ACC3KF<92CA&300. 2202 'ic#stedt, ?W von, )rIneim orsch, ACFCKAC9CCE. 2203 7eith -, et al., Planta Medica, ACBFK39AHC. 2204 +endri#s +, et al., Planta Medica, ACBAK<29F2. 2205 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2B3&< 2206 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 2207 !oo#, W/, /%. 1hysiomedical %ispensatory9 a 6reatise 0n 6herapeutics, /ateria /edica and 1harmacy. 'clectic 1ublications ACBE =originally published in ABFC> p. H23&F 2208 ?ohnen 4, 0s ald W%. 6he effects of 7alerian, propranolol, and their combination on activation, performance and mood of healthy volunteers under social stress conditions. Pharmacopsychiatry. ACBBK2A9<<HW<<B. 2209 !ropley /, !ave 8. 'ffect of #ava and 7alerian on physiological responses to psychological stress assessed under laboratory conditions QabstractR. )2T. 200AKF9HF. 2210 .eath ood 1.%., !hauffard ), 7 Psychiatr Res, ACB3KAH=2>9AAE. 2211 .eath ood 1.%., et al., Pharmacol Biochem Beha!, ACB2KAH9FE. 2212 6he :atural 1harmacist, =tpn.com>. 2213 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 2214 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC. 2215 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p ACF&ACH 2216 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

-eratrum spp2(-2 al!um' -2 viridie' -2 californicum
Common name: Ha!itat: Botanical description: #art used: Historical use: $nergetics: Constituents: #harmacology: Medical actions: Medical uses: #harmacy: )o*icity:

1iliaceae

-er!ascum thapsus
Common name: /ullein

4crophulariaceae

Ha!itat9 World ide in all temperate (ones. ,t gro s in astelands, by roadsides, in meado s&& herever the soil is gravelly or sandy. Botanical description9 A biannual root ith an erect, nonbranching, ooly stem gro ing 3&F ft. in height. 6he basal leaves are large, some up to a foot long, oval rounded at the ape$ and ooly. 6he stem leaves are alternate, decreasing in si(e as they gro up the stem. 6hese leaves are also ooly and are grey&green in color. Bright yello flo ers bloom bet een -uly and August and are sessile in a raceme along the upper part of the stem. 6he first year plant is a basal rosette of leaves. 6he second year plant elongates ith a tall stem ith flo ers. #arts used9 )olia and floris Historical use9 6he use of /ullein throughout history is varied and e$tensive. ,t has been used to start fires, to ard off evil spirits ='urope and Asia>, and for coughs in animals and humans. :ative Americans learned about the use of /ullein from the early settlers and employed as a remedy for coughs. 6hey ould smo#e the rolled leaves or boil it ith molasses to ma#e a syrup. Constituents9 • /ucilage =leaves9 3G>9 including, among others, arabino galactans, $yloglucans • 6riterpene saponins =leaves>9 chief components verbascosaponine • ,ridoid monoterpenes9 including, among others, aucubin, Fbeta&$ylosylaucubin, catalpol • !affeic acid derivatives9 verbascoside =acteoside> • )lavonoids =0.E&<.0G>9 acubin, apigenin&H&0&glucosides, #aempferol&H&0&glucosides, rutin digiprolactone • 7olatile oil =flo ers>, 6annins, 4esins =flo ers>, Bitters #harmacology 6he mucilaginous constituents are primarily responsible for the soothing actions on mucous membranes. 6he saponins may be responsible for the e$pectorant actions of mullein by their ability to loosen mucus. 22AH22AB Medicinal actions: %emulcent, emollient, e$pectorant, vulnerary, mildly antispasmodic and rela$ing. )raditional Medicinal Use: 5pecific ,ndications and Uses.Z6o quiet nervous irritation, bronchial irritation and cough, and urinary irritation ith painful micturition. ?ing described 7erbascum as mildly nervine, controlling irritation, and favoring sleep. 6he seeds are narcotic, and have been used in asthma, infantile convulsions, and to poison fish. 22AC • ':6 !onditions9 6he flo ers, placed in a ell&cor#ed bottle, and e$posed to the action of the sun, are said to yield an e$cellent rela$ing oil. 6his oil is also valuable in some cases of deafness, used locally for its effect upon the membrane tympani, and upon the secretion of cerumen. • *astrointestinal !onditions9 6he leaves have been used internally for bo el complaints and an infusion as a deservedly popular remedy in sub&acute dysentery and diarrhea, probably from their action on the lacteals. 6he seeds, it as said, ill rapidly pass through the intestines, having been used in intestinal obstructions. • *enitourinary !onditions9 6he oil as reputed to be an effective treatment for nocturnal enuresis and in vesical irritation caused by al#aline urineK painful micturition, in lithemia, chronic cystitis, and urinary calculus. • 1ulmonary !onditions9 Upon the upper portion of the respiratory tract its influence is pronounced, particularly here the laryn$ and trachea are involved. 6he infusion is useful in coughs, protracted colds, catarrh, hemoptysis, diarrhoea, dysentery, and piles. ,t is applicable to dry, hoarse coughs, hich occur chiefly at night, as ell as to cough associated ith an abundant catarrhal discharge. ,ts diuretic properties are rather ea#, yet it is very useful in allaying the acridity of urine, hich is present in many diseases. • 6opical Applications9 A fomentation of the leaves also forms an e$cellent local application for inflamed piles, ulcers, and tumors. 6he leaves and pith of the stal# form a valuable cataplasm in hite s ellings, and hen infused in hot vinegar or ater it ma#es an e$cellent poultice to be applied to the throat in tonsillitis, malignant sore throat, and mumps. !oo# particularly called attention the peculiar and reliable po er of the leaves over the Iabsorbent systemJ, for he considered their po er in promoting absorption in cellular dropsy, chronic abscesses, pleuritic effusions, and similar accumulations of fluid, truly remar#able. +e used them for similar purpose in synovial dropsy, and scrofulous and other s ellings. 2220

Current Medicinal Use: 7erbascum flo ers are used primarily for their sedative, antiseptic, anodyne and anti&spasmodic properties. +o ever, there has not been very much scientific investigation into this popular herb. • ':6 !onditions9 /ullein essence, or /ullein oil is used ith great success for earaches, ulcerations of the ear, deafness, and serous otitis and otitis media. /ullein essence ma$imi(es the vulnerary properties of the flo er. )or earaches, some or all of the follo ing herbs could be combined ith 7erbascum =vulnerary, antiinflammatory, antispasmodic>9 +ypericum =anti&viral, vulnerary, antiinflammatory>9 Allium sativa =antimicrobial>9 /atricaria =antiinflammatory, antimicrobial, antispasmodic>9 .obelia =antispasmodic>9 Aconite =analgesic>9 'phedra =dilates the '. tube>. • *enitourinary !onditions9 7erbascum root is useful in the treatment of cystitis, nocturnal enuresis, incontinence, and testicular inflammation, 7erbascum root tonifies the trigone area of the pelvis. 7erbascum also allays inflammation and irritation of the urinary system. Urinary incontinence may resolve ith one drop of the oil ta#en internally several times daily. • 1ulmonary !onditions9 6he first or early second year leaves are used for respiratory conditions. 7erbascum leaves are e$pectorant and some hat anti&spasmodic. 6hese actions are due primarily to the saponins hich, li#e detergent, dra fluid from the tissues, thereby creating a thinner mucous that is easier to e$pectorate. )or this reason, /ullein is indicated in dry, hoarse coughs or et, productive coughs ith thic# e$pectorate. 6he acubin flavonoid glycosides and mucilage, hich are both anti&inflammatory, reduce copious mucous production =i.e. in asthma>. 7erbascum combines the stimulating e$pectorant action of the saponins ith the soothing and rela$ing action of the mucilage and aucubin glycoside. When combined ith .obelia, 7erbascum is very anti&spasmodic. 7erbascum is very useful in the treatment of asthma and U4,s not only for its e$pectorant, antiseptic =volatile oils>, anti&spasmodic =volatile oils>, and anti&inflammatory effects, but 7erbascum also addresses the emotional component of these conditions. 7erbascum seems to allay the an$iety associated ith U4,s and asthma. 7erbascum can be used in combination ith other herbs as a tincture, or the leaves may be burned as incense or smo#ed. ,ncense of /ullein and 'riodictyon is a good prophylactic for asthma. • 6opical Applications9 6opically, /ullein leaves may be steamed and applied to areas of muscle spasms =i.e. hiplash> and painful "oints. 7erbascum oil is also useful hen applied topically for testicular inflammation. #harmacy9 ,nfusion A&2 tsp.3cup aterK sig A&2 cups 6,% 6incture A9E 2EG 't0+K sig <&F ml 6,% )luid e$tract A9A 2EG 't0+K sig 2&< ml 6,% 1oultice, e$ternal ash, incense, oil 6he essence can be made by cutting off the stal# ith the flo ers and hanging it upside do n in a ine bottle. )or 2&3 days, the bottle is placed in the sunlight during the day and stored in a cool place at night. 6he essence =vehicle O oil> drips to the bottom of the bottle. /ullein essence and fresh plantain "uice is an e$cellent remedy for all manner of earaches. ,f the 7erbascum oil is used, it is most effective if heated first.

Contraindications: !oo# considered topical application of 7erbascum to be improper on carbuncles, buboes, cancers, and other s ellings from hich it ould be in"urious to have a deposit absorbed. 222A )o*icity9 :o #no n to$icity
2217 2218

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 6yler 7. The Honest Herbal. 3rd ed. :e ;or#, :;9 1harmaceutical 1roducts 1ressK ACC39 2ACW220. 2219 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 2220 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 2221 !oo#

-er!ena officinalis.-2 hastota .-2 urticfollia
Common name: Ha!itat: 7ervain =blue 7erbena9 7. hastota>, stiff nec# remedy

-er!enaceae

Botanical description: A perennial herb up to H0 cm in height. 6he stem is oody at the base. 6he sesile to short&petioled leaves are opposite. 'ach leaf is coarsely incised ith crenate lobes. 6he flo ers have a <&E part caly$ and a pale lilac corolla and occur in A0&2E cm long spi#es. ,n 7. officinalis, the leaves are dryer and ider than 7. hastata #arts used: +erba =esp. flora>, radi$ ,dentified Constituents: • ,ridoid glycosides =0.2G&0.EG>9 verbenalin, hastatoside, verbanaline • !affeic acid derivatives9 verabscoside • volatile oilK mucilageK bitter substances =inc. verbenalol>K tanninsK al#aloid #harmacology: 6he iridoids have been tested in animals and have been sho n to e$ert antiphlogistic, analgesic, and ea# parasympathomimetic activities. 7erbenalin possesses anti&tussive activity. 2222 7erbena acts as a synergist to prostaglandin '2 and therefore research into its use as an agent to induce abortion has been suggested.2223 7ervain e$tracts are antithyrotropic. 6his action appears to derive from some interaction bet een certain constituents, hich attach themselves to the 65+ receptor or combine ith 65+. 222< Medicinal actions: 1arasympathomimetic, anti&spasmodic, mild analgesic, nervous system tonic, bitter, emmenagogue, reproductive organ tonic, bitter, hepatic stimulant, diuretic, galactagogue )raditional Medicinal Use: !oo# described the roots and leaves as rela$ant tonics, closely resembling the leaves of '. perfoliatum, but a little more stimulating. A arm infusion of 7erbena as observed to promote diaphoresis, la$ity of the bo els, and is emetic if used in e$cess. 7erbena as sometimes used in colds, bilious remitting fever, and delay of the menses. A cold infusion is a good tonic and mild la$ativeK and a free use of a concentrated decoction many times ill open and sustain the liver and gall&ducts so effectually as to cure intermittents. ,t has also been used for orms, here its action is similar to chelone. 6his article is nearly overloo#ed by the profession, but deserves decided attention. ?ing 7ervain is tonic, emetic, e$pectorant, and sudorific. ,n small doses, a tincture of verbena relieves gastric irritation. As an emetic and sudorific it has proved beneficial in intermittent fever, given in arm infusion or in po der. ,n all cases of colds and obstructed menstruation, it may be used as a sudorific. 6a#en cold, the infusion forms a good tonic in some cases of debility, anore$ia, and during convalescence from acute diseases. ,t has been reputed valuable in scrofula, visceral obstructions, gravel, and orms. 6he follo ing application has been recommended as effectual in promoting the absorption of the blood effused in bruises, and in allaying the attendant pain9 6a#e of 7erbena, 5enna, and hite pepper, of each, equal parts. /a#e a cataplasm by mi$ing ith the hite of eggs. Current Medicinal Use: 7erbena has diverse indications and should be thought of primarily as a tonic herb. 6onic herbs in general are indicated in convalescence, debilitating conditions ith or ithout anore$ia and chronic fatigue syndrome. &&&# 7erbena increases the insight. Bach indicated 7erbena for those ith an intense attitude to ard life, strong illed, enthusiastic, unable to rela$, mental3physical e$ertion, good ideas but not able to hold on to them, constipation, muscle spasmD. 7erbena is said to deepen one@s understanding of the orld and to aid in meditation. ,t is useful in irritated, depressed states and acts to lift one@s spirit and one@s energy. %r. /ary Bove ill have pregnant couples ho do not get along drin# the tea together. ,t is cool and nourishing and is specific for the nec# =compared to 5tachys>. • %ermatologic !onditions9 7erbena may be used e$ternally to speed the healing of ounds, sores and burns. • *astrointestinal !onditions9 6he bitter constituents in 7erbena ma#e it a digestive tonic. With continued use of 7erbena, there is increased secretion of saliva, +!l, pancreatic en(ymes, increased bile secretion and gall bladder contractility, and increased intestinal motility. • *enitourinary !onditions9 7erbena is also employed as a diuretic hen there is #idney and lo er urinary tract ea#ness, especially hen it is contributing to arthritis and3or edema. 7erbena has demonstrated moderate solvent action on uric stones hich as lin#ed to the al#alini(ing capacity of the infusion as ell as possible urinary antiseptic activity. &&&$ • *ynecologic !onditions9 ,t is a reproductive organ tonic. 6he verbenaline glycoside and al#aloids increase uterine muscle

tone and thus strengthen the uterus. Uterine contractions become more regular. 7erbena ill thus bring on menses delayed due to pelvic congestion and uterine ea#ness. 6his effect is also the result of the choleretic effects of 7erbena =see belo >. 7erbena is a good tonic to use in pregnancy =third trimester only>and in omen ith dysmenorrhea because of its ability to decrease muscle spasticity hile increasing muscle tone. 7erbena can also be used as a galactagogue in breast&feeding omen and the nervous tonic use is used for postnatal depression =see 7ite$> • +epatic !onditions9 7erbena is a mild choleretic and hepatic stimulant. • :ervous !onditions9 7erbena is both a trophorestorative and tonic. ,n regard to tonic herbs in general they are indicated in convalescence, debilitating conditions ith or ithout anore$ia and chronic fatigue syndrome. As a nervous trophorestorative, it can be used in cases of nervous e$haustion, neuralgia, herpes infections, depressive states and insomnia mar#ed by a#ing up in the early hours of the morning after falling asleep easily. 0ther applications include convalescence and neurasthenia =see Avena>. 7erbena or#s to calm an$iety and anger. ,t is especially indicated for omen =and men> ho hold their anger in their pelvis leading to hormonal imbalances and pelvic congestion. 7erbena ill promote the parasympathetic aspect of central nervous system functioning hile e$erting mild choleretic and cholagogue effects. • 1ulmonary !onditions9 7erbena is also used as an e$pectorant in chronic bronchitis and asthma 7erbena reduces mucous production in these conditions. #harmacy: ,n regard to tonic herbs, the digestive capacity is the main determinant of dosage. ,f the stomach and digestive function is deficient, then tonics may be given ith or after meals. ,n severe cases, they may need to be ta#en ith liquid meals. %osage should be small and frequent. .ong&term therapy is the norm. 5imilar application is used for a trophorestorative effect. 222H 7erbena is often added to formulas and tends to potenti(e and iden the range of formulations. ,n biphasic formulas, 7erbena can be used in both phases. ,nfusion9 A tsp. =appro$. A.E g> 3 cup aterK sig A cup 2% to 6,% =fresh 3$ dried> %ecoction of radi$9 A 6bl.3 cup aterK sig A cup 2% to 6,% A9E tincture 2EG 't0+K sig A&E ml 6,%K ee#ly ma$. O A00 ml A9A fluid e$tract 2EG 't0+K sig A&3 ml 6,% Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: 6onic herbs in general are to be used ith caution in severe debility, particularly hen associated ith immune or digestive collapseK renal or hepatic failureK rampant cancer or strong chemotherapy treatments. 222B 6rophorestoratives are used ith caution in e$tremely debilitated patients. 7erbena is also contraindicated in the first and second trimesters of pregnancy due to its emmenagogue effect. )o*icity: :o information is currently available from the selected resources.
2222 2223

?ui ! and 6ang 4, ?hongyao Tongbao, ACBE, A09<FH. 1e#ing /edical !ollege, 21)1, ACHE, B29A<CFE0. 2224 ?ol#, /A, Endocrinology , ACBE, AAF9AFBH. 2225 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AEE 2226 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AEE 2227 /ills and Bone p. AEE 2228 /ills and Bone p. AEE

-i!urnum opulus. -2 prunifolium
Ha!itat: (-2 prunifolium :0005 • ,ndigenous to the eastern and central U.5.

Caprifolicaceae

Common name: !rampbar#, +igh !ranberry =7. opulus>, Blac# ha =7. prunifolium> =7iburnum ill refer to 7. opulus in this monograph unless other ise indicated>

Botanical description: (-2 prunifolium 0078 • )lo er and )ruit9 6he flo ers are hite and richly blossomed ith flat apical cymes. 6he central florets are campanulate and fertileK the lateral ones are much larger, rotate and infertile. 6he caly$ margin is small and E&tipped. 6he corolla of the fertile florets is campanulate and E&petalled. 6here are E stamens, a semi&inferior ovary and 3 sessile stigmas. 6he fruit is shiny blac#, "uicy berry. )ruit of 7. opulus is red. • .eaves, 5tem, and 4oot9 %eciduous tree E m tall. ,t has gray&bro n bar# and green, grooved branches. 6he leaves are opposite, petiolate, 3&E lobed, roughly dentate, green on both surfaces and softly pubescent beneath. #art Used: %ried bar# corte$, particularly of the root for 7. prunifolium Constituents: bitter compound, viburnin =glycoside>, 7alerianic acid, coumarins =scopoletin, aesculetin>, salicosides, resin and 3G tannin, o$alates #harmacology: 6he spasmolytic effect of 7iburnum spp. may be due in part to the presence of the coumarin, scopoletin, hich has uterine sedative effects probably mediated through bloc#age of A:5. 223A,2232 5copoletin and aesculetin in 7. prunifolium have mar#ed spasmolytic activity on guinea pig small intestine.2233 Medicinal Actions: 5pasmolytic =d3t viburnin> restores sympathetic and parasympathetic balance in voluntary and involuntary muscle spasms =6ilgner>, sedative nervine= d3t 7alerianic acid>, astringent =d3t tannins>, anti&asthmatic, tonic, diuretic, alterative, hypotensive, carminative, antiinflammatory )raditional Medicinal Uses: According to ?ing@s9223< 7. opulus9 7. opulus resembles 7. prunifolium closely in its effects and may be used in the conditions named for hich Blac# +a is useful. 5pecific indications include crampsK uterine pain, ith spasmodic actionK pain in thighs and bac#K bearing do n, e$pulsive painsK neuralgic or spasmodic dysmenorrhea. As an antiabortive. • 9ynecologic Conditions9 7. opulus is a po erful antispasmodic being very effective in rela$ing cramps and spasms of all #inds such as hysteria, cramps of the limbs or other parts in females, especially during pregnancy, and it is said to be highly beneficial to those ho are sub"ect to convulsions during pregnancy, or at the time of parturition, preventing the attac#s entirely , if used daily for the last 2 months of gestation. .i#e 7. prunifolium, it is a remedy for the prevention of abortion and to prepare the ay for the process of parturition. ,t allays uterine irritation ith a tendency to terminate in hysteria, hile in the neuralgic and spasmodic forms of dysmenorrhea, it is a favorite remedy ith many physicians. !ramps of limbs attending pregnancy yield to both 7. prunifolium and 7. opulus. • 9enitourinary Conditions: ,t has been used in spasmodic contraction of the bladder and in spasmodic stricture. • #ulmonaryConditions: 7. opulus is useful to ally the spasm associated ith asthma. • )opical Applications: %r. ?ing has found a poultice to be very efficient in indolent and malignant ulcersK and, applied around the throat in the inflammation and s elling attending scarlatina maligna, and other diseases, it gives prompt and mar#ed relief. 7. prunifolium9 5pecific indications include uterine irritability, and hyperaesthesiaK threatened abortionK uterine colicK dysmenorrhea ith deficient mensesK severe lumbar and bearing&do n painsK cramp&li#e, e$pulsive menstrual painK intermittent, painful contractions of the pelvic tissuesK after&pains and false pains of pregnancyK obstinate hiccough. • )opical Applications9 %ecoctions have been used as a gargle for apthae, as a ash for indolent ulcers, and in various ophthalmic disorders. • 9astrointestinal Conditions9 6he astringent property lends its use for diarrhea and dysentery. 5pecific +a , in drop doses, is a valuable drug in obstinate singultus =hiccough>. • Cardiovascular Conditions: +eart palpitations have been reported to be relieved by it. 5uch cases are sympathetic disturbances, generally near the menstrual period.

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9ynecologic Conditions9 As a uterine tonic, it is unquestionably of great utility. ,t restores normal innervation, improves the circulation and corrects impaired nutrition of these organs. ,t is called for in ea#ened conditions of the body, ith feeble performance of the uterine functions. ,n amenorrhea in pale, bloodless sub"ects, the menses are restored by it. ,n the hyperaesthetic or irritable condition of the uterus incident to highly nervous omen, or as the result of over or#, it ill be found and admirable agent. ,n dysmenorrhea, ith deficient menses, uterine colic, and in those cases here there are severe lumbar and bearing&do n pains, it ill prove and efficient drug. +elonias is also an e$cellent agent in the latter condition. ,t is specifically indicated in cramp&li#e menstrual pains& pains decidedly e$pulsive and intermittent in character& and in the various painful contractions of the pelvic muscles, so common to disorders of omen. 7. prunifolium is of some value in nervous disorders and has been advised in chorea, hysteria, hystero&epilepsy, petit mal, and paralysis agitans. ,t is of service only hen these troubles are associated ith menstrual rongs. Blac# +a promptly allays ovarian irritation. ,t has been combined ith Wild !herry and aromatic herbs into a cordial to allay the pangs of dysmenorrheaK to arrest leu#orrhea and of the second climacteric. Uterine congestion and chronic uterine inflammation are often greatly relieved by specific 7. prunifolium. ,t acts promptly in spasmodic dysmenorrhea, especially ith e$cessive flo . /enorrhagia due to malaria is promptly met. ,t is a good remedy for uterine hemorrhage, attending the menopause. 6he condition for hich it is most valued is threatened abortion. ,t is the most prompt drug in the materia medica to chec# abortion, provided the membranes have not ruptured. ,n all cases of habitual abortion it should be given in small doses for a considerable length of time. By its quieting effects upon the irritable omb, omen ho have previously been unable to go to full term have been aided by this drug to pas through the pregnancy ithout mishaps hich ould other ise have proven disastrous to both child and mother. 5mall doses of the specific Blac# +a ould be administered throughout the dangerous period, and may be continued ith good results until parturition. ,t has been used to quell postpartum hemorrhage, but is less effective than ergot and !innamon. ,t assists in reducing the si(e of the omb in subinvolution of that organ. !ramps of limbs attending pregnancy yield to both 7. prunifolium and 7. opulus. )alse pains of pregnancy are readily controlled and for after&pains it is nearly as valuable as /acrotys or Actaea. Male Conditions9 Blac# +a is said to be of value in sterility. 5ome cases of spermatorrhea are benefited by it. Musculoskeletal Conditions: ,t is considered almost specific for cramp in the legs, not dependent on pregnancy, especially hen occurring at night.

According to !oo#9 7. opulus9 6he bar# is a slo ly&acting rela$ant ith gentle tonic properties, mild and chiefly influencing the nervous system. 6he character of its action is that of the antispasmodic class. • 9ynecologic Conditions9 ,t is chiefly employed in hysteria, painful menstruation, neuralgia and rheumatism of the omb and the uterine cramping incident to pregnancy. )or these purposes it is usually employed in combination, especially in the !ompound 5yrup of /itchella. • 9astrointestinal Conditions: ,t is sometimes used in colic and cramping of the bo els, here it may be associated ith %ioscorea. • #ulmonaryConditions: ,t is used in asthma and nervous restlessness ith !aulophyllum. 7. prunifolium9 ,t is a good tonic of the mildly astringent class, acting slo ly and rather soothingly and influencing the #idneys to a limited e$tent. • 9ynecologic Conditions: 6he best use to be made of it is as a tonic for uterine ea#nesses, as prolapsus ith flaccidness of the structures, chronic leu#orrhea and passive menorrhagia. Current Medicinal Uses: 7iburnum has a tonifying effect on the pelvic and digestive organs. 7iburnum rela$es smooth muscle including uterus, bronchi and blood vessels. 7iburnum e$erts a rela$ing effect on s#eletal muscle as ell and is helpful in relieving muscle cramps and spasms. 7iburnum can be applied e$ternally and massaged into tense muscles. ,t also helps to restore the coordination of the parasympathetic3sympathetic nervous system. • 9ynecologic Conditions: 6he astringent action of 7iburnum combined ith its tonifying effect and anti&spasmodic effect, ma#e it useful in treating dysmenorrhea ith e$cessive blood loss, or middleschmer( ith ovulatory pain. ,n treating dysmenorrhea, 7iburnum is a good herb to use in an acute formula to be ta#en beginning a fe days before menses and then all the ay through menses and for a fe days after ards. )or menstrual cramps, use as much as possible throughout the day. Also, thin# about prescribing a long&term separate formula to nourish, tonify and increase circulation to the pelvic area. 7iburnum restores normal ovarian function, and is useful in treating irregular menses and infertility. ,t is specific for cases of scanty menstrual flo or profuse menstrual flo ith crampy pains ith associated cardiac abnormalities, i.e. palpitations. 7iburnum is good for congested tissues ith associated debility and3or spasm. 7. prunifolium is more specific to the rela$ing the uterus. 7iburnum opulus, hile effective for uterine spasm, has a more diffusive anti&spasmodic action. 6his may be more indicated in a oman ith pelvic cramping ho has systemic tension. 7iburnum is good for threatened miscarriage due to

increased muscle contractility3spastic uterus. =6raditionally, 7. prunifolium is held in high regard for treating threatened miscarriage. A good ay to remember this is I1 for pregnancyJ>.7iburnum is also good to decrease the post&partum pains of uterine contraction. ,t can be ta#en ith the first 2< hours ithout danger of passing into the breast mil#. According to /ills and Bone9223E • Cardiovascular Conditions9 7iburnum can be utili(ed in Angina for its vasodilating and rela$ing effect and can be combined ith 6illia. 5imilarly, as a supportive herb, it can also be utili(ed in the treatment of hypertension. • 9ynecologic Conditions9 7iburnum ill relieve oviductal spasm ma#ing it useful for some conditions of conception difficulty. ,n regard to dysmenorrhea, 7iburnum is indicated in short&term treatment to reduce uterine spasm. ,t is also utili(ed as a long term treatment to relieve chronic pelvic pain as seen in endometriosis. )or threatened miscarriage, 7. prunifolium or 7. opulus is indicated for cramping or bearing do n sensations. ,n preparation for childbirth, 7iburnum can be utili(ed if there is a problem ith dilation of the cervi$. • 9astrointestinal Conditions9 )or spasmodic constipation, 7iburnum ill improve motor function and reduce spasm, hich can be enhanced in combination ith /atricaria or %ioscorea. ,n addition, the reduction of gastrointestinal spasm ill reduce intracolonic pressure, hich can be of benefit in diverticular disease. 6his effect can be carried over for the treatment of ,rritable Bo el 5yndrome, in con"unction ith /entha as ell as the other herbs listed above. ,n regard to peptic ulcer disease, 7iburnum can be utili(ed to improve gastrointestinal motility. ,n turn, it can also quell gastrointestinal spasm as in vomiting, particularly hen it is secondary to a respiratory condition that is causing severe coughing such as hooping cough. • Hepato!iliary Conditions9 *iven its spasmolytic effect on smooth musculature, 7iburnum can be used to relieve biliary spasm and pain in gall bladder conditions. According to Weiss9223F • 9ynecologic Conditions: 7. prunifolium has been considered almost a specific for dysmenorrhea. Although medicinal properties are contained in this herb, they have been greatly overrated. 6here has been no evidence so far that there is a particular action on the genital sphere and the effect is probably sedative and moderately antispasmodic. ,t ould be an interesting trial to compare 7. prunifolium ith Achillea. According to 5cudder9223H 7. opulus9 6he 7iburnum has been employed as an antispasmodic ith reported success, hence it@s name, cramp bar#. ,f e are to be guided by the descriptions of our earlier practitioners, e ould conclude that it e$erted a direct influence in controlling spinal irritation, and spasmodic action arising from this. 7iburnum 1runifolium. =Blac# +a .> ,t is claimed that 7iburnum is a specific against abortion. Current +esearch +eview: • 5earch of /edline revealed no human studies as of 0ctober 2002. #harmacy: • 1o der9 2&< gm 6,%223B • %ecoction9 A&3 tsp. per cup aterK sig A&2 cups 6,% QA tsp. O A.2 gR 223C • 6incture9 A9E, <EG alcoholK sig E&A0 ml 6,%, for acute& up to E ml q A32 hour, up to 30 ml total in 2< hours 22<0 7. prunifolium e$tracted at 30G alcohol as five times more spasmolytic than a F0G e$tract. 22<A • '$ternally as a rub or ointment ='qual parts ith .obelia 22<2> • 1ost&partum uterine contraction pain9 7iburnum=3>9.obelia=A>K 30&F0 drops every A.E hr. up to <&E times 22<3 Contraindications.)o*icity: 7. prunifolium contains o$alates that may be ta#en into consideration in cases of the propensity for o$alate stone formation.22<< !ramp bar# should not be ta#en during pregnancy unless under the guidance of a #no ledgeable herbal practitioner. 6he berries have been #no n to cause death. 22<E .arge doses sometimes produce nausea and vomiting. 22<F
2229 2230

PDR for Herbal Medicines, /edical 'conomics !ompany, /ontvale, :-, ACCB, p. A2A<. ,bid 2231 -arboe !+, et al. 5copoletin, an Antispasmodic !omponent of 7iburnum opulus and prunifolium 1 7 of Med 2hem ACFHK A09 <BB&C 2232 0"e ole -A0, Adesina 5?. /echanism of the +ypotensive 'ffect 0 5copoletin ,solated from )ruit of 6etrapleura tetraptera. Planta Medica ACB3K <C9<E&E0 2233 +orhammer ., Wagner +, 4einhardt +. 0n :e !onstituents from the Bar#s of 7iburnum prunifolium and 7. opulus. ?eitschrift fur ;aturforschung ACFHK 22b9HFB&HF 2234 )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3920EB&F0 2235 /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchill .ivingstone, 20009EA, AHB, AHC, AB0, AC<, 202, 203, 2AH, 233&< , 2<A, 2<3&<, 2<F 2236 Weiss 4). Herbal Medicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. 30H 2237 5cudder -. ,pecific Medications and ,pecific Medicines1

2238 2239

Alschuler ., :% %i1asquale 4, :%, Alschuler ., :% 2240 %ipasquale 4, :% 2241 Balansard *, et al. 5election criteria for a 7iburnum '$tract, 7iburnum 1runifolium .., as a )unction of ,ts 7enotonic and 5pasmolytic Action. Plante Medicinales et Phytotherapie ACB3K AH=3>9 A23&A32 2242 Alschuler ., :% 2243 Alschuler ., :% 2244 Brin#er, )1 Herb 2ontraindications and Drug >nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AE0 2245 6ilgner 2246 )elter +W, .loyd -U. .ing/s )merican Dispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. 20F0

-iscum al!um
Common name: /istletoe Ha!itat: Botanical description: #art used: .eaves Historical use: $nergetics: Constituents: !onstituent composition depends on the host plant. • lectins =also called viscoto$ins> • choline derivatives • al#aloids • polypeptides • polysaccharides • phenolic compounds9 flavonoids, caffeic acid, syringin, eleutherosides • sterols9 triterpenes • amines9 AA, histamine, tyramine

1oranthaceae

#harmacology: 5everal groups of compounds have been sho n to contribute to the medicinal action of mistletoe. /ost notable are mistletoe lectins =also called viscoto$insK particularly lectin A>, choline derivatives, al#aloids, polypeptides, and polysaccharides. 6he lectins, peptides, and polysaccharides have sho n immune&stimulating activity in human studies hen mistletoe e$tracts are given by in"ection 22<H. ,n regard to immune function, 7iscum has a variety of effects9 &↑macrophage phagocytic and cytoto$ic function &↑neutrophil production &↑thymic eight & ↑cortical thymocyte activity3proliferation &↑:? cell activity &↑,g dependent !/, &,.A, ,.F, 6:) induction 5ome studies suggest these compounds, as ell as mistletoe al#aloids, can also #ill cancer cells in animals or in !itro&&'( . 6he *erman government@s !ommission ' has stated that mistletoe in"ections around "oints can help alleviate problems due to rheumatoid or other inflammatory forms of arthritis22<C. /istletoe e$tracts can stimulate insulin secretion from pancreas cells. AE /istletoe has also been sho n to help reduce symptoms in diabetic mice22E0. Medical actions: immunostimulant, antineoplastic, antihypertensive Medical uses: • Cardiovascular Conditions: 0pen studies carried out using oral mistletoe have found it can reduce the symptoms of high blood pressure, particularly headaches and di((iness. *erman doctors generally agree ith these findingsK ho ever, mistletoe has a small =if any> effect on actually lo ering blood pressure 22EA, 22E2. +o ever, %r. /urray has described 7iscum as being cholinomimetic resulting in inhibition of the medullary vasomotor center • @eoplastic Conditions: :umerous clinical trials have found that subcutaneous in"ections of mistletoe e$tracts can help people ith cancer of various organs, though some have also failed to sho any benefit. 6here is no evidence that giving mistletoe orally ould benefit people ith cancer 22E3. Current +esearch +eview: • 3ncology: o Carcinoma:00%:

o

%esign9 1rospective non&randomi(ed and randomi(ed matched&pair studies nested ithin a cohort study. 1atients9 A0,22F patients ith carcinoma of the colon, rectum, or stomach, breast carcinoma ith or ithout a$iillary or remote metastases, or small cell or non&small&cell bronchogenic carcinoma. AFFB patients W e$periment group.  6herapy9 ,scador W total e$tract of 7iscum album  4esults9 ,scador treatment can achieve a clinically relevant prolongation of survival time of cancer patients and appears to stimulate self&regulation. Cancer:00%%  %esign9 !ontrolled clinical trial  1atients9 1atients ith cancer  6herapy9 7iscum album e$tract  4esults9 6reatment ith 7. album e$tract leads to an increase in 6hA cyto#ine levels, ,):&gamma, and ,.&2, suggesting positive effect on cell&mediated immunity.  

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Breast cancer:00%&  %esign9 !linical trial  1atients9 A< patients ith advanced breast cancer  6herapy9 ,scador, an e$tract of 7iscum album, parenterally.  4esults9 ,ncrease of %:A repair as observed in A2 patients, hich could be due to a stimulation of repair en(ymes by lympho#ines or cyto#ines secreted by activated leu#ocytes or an alteration in the susceptibility to e$ogenic agents resulting in less damage.

•

$@): o +ecurrent respiratory infections:00%(  %esign9 4andomi(ed controlled clinical trial  1atients9 :inety&t o children, E&A< yo, living in areas e$posed to radioactive fallout from !hernobyl ith recurrent respiratory infections =44,>  6herapy9 7iscum album praeparatum mali or pini =,scador / or 1>K 2 sub2 in"ections a ee# $ E ee#s ith doses of 0.0A& A.0 mg.  4esults9 Both 7iscum preparations ere effective in reducing clinical symptoms. After a year of a single treatment course, the frequency of 44, relapses decreased by HBG and H3G, respectively. 7iscum album resulted in normali(ation of initial immune indices either belo or above the normal ranges. +igh levels of antiviral activity before treatment ere significantly decreased by 7iscum album mali ,mmunology: o $ffect on lymphocytes:00%/  %esign9 !linical trial  1atients9 +ealthy volunteers  6herapy9 Aqueous e$tract of 7iscum album .. of the oa# tree =7a2u)r)> A mg sub2 in"ections.  4esults9 6here as a fall in the absolute numbers and percentage of !%33 2E& and !%B33B&positive lymphocytes 2< hours post in"ection. /onocytes in percent and absolute numbers sho ed a transient fall F&C hours, lymphocytes only in absolute and !%&< positive lymphocytes only in percentage 2 hours after in"ection. 6here is increased e$travasation of =activated> lymphocytes and monocytes after subcutaneous in"ection of 7a2u)r).

#harmacy: %ried herb9 2&F g tid tincture =A9E> <EG A&3 ml tid fluid e$tract =A9A> 2EG .E ml tid 1reparations9 ,scador9 fermented "uice, ↓ to$icity 'uri$or9 standardi(ed to lectin , .e#tinol Contraindications: Brin#er speculates that 7iscum be avoided during pregnancy due to uterine stimulant action of tyramine. 22EC )o*icity: 6he berries are considered much more to$ic than the leaves or stems.
2247 2248

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A

2249

Blumenthal /, Busse W4, *oldberg A, et al. =eds>. The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines . Austin9 American Botanical !ouncil and Boston9 ,ntegrative /edicine !ommunications, ACCB 2250 5 anson&)latt 5?, %ay !, Bailey !-, )latt 14. 'valuation of traditional plant treatments for diabetes9 5tudies in strepto(otocin&diabetic mice. )cta Diabetologica 8atina ACBCK2F9EAWE. 2251 Bo man ,A. 6he everlasting mistletoe and the cardiovascular system. Texas Heart >nst 7 ACC0KAH=<>93A0W< Qrevie R. 2252 0@+are -1, +oyt .+. /istletoe in the treatment of hypertension. ;e: Eng 7 Med AC2BKACC9A20HWA3. 2253 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 2254 *rossarth&/atice# 4, ?iene +, Baumgartner 5/, et al. Use of ,scador, an e$tract of 'uropean mistletoe =7iscum album>, in cancer treatment9 prospective non& randomi(ed and randomi(ed matched pair&studies nested ithin a cohort study. )ltern Ther Health Med 200AK H=3>9EA&FF, FB&H2, H<&F. 2255 ?ovacs '. 5erum levels of ,.&A2 and the production of ,):&gamma, ,.&2 and ,.&< peripheral blood mononuclear cells =1B/!> in cancer patients treated ith 7iscum album e$tract. Biomed Pharmacother 2000KE<=F>930E&A0. 2256 ?ovacs ', +a"to 6, +ostans#a ?. ,mprovement of %:A repair in lymphocytes of breast cancer patient treated ith 7iscum album e$tract =,scador>. Eur 7 2ancer ACCAK2H=A2>9AFH2&F. 2257 !hernyshov 71, +eusser 1, 0melchen#o .,, et al. ,mmunomodulatory and clinical effects of 7iscum album =,scador / and ,scador 1> in children ith recurrent respiratory infections as a result of the !hernobyl nuclear accident. )m 7 Ther 2000KH=3>9ACE&203 2258 5tross /, 1eter ', *orter 4W. %ecrease of activated lymphocytes four and nine hours after a subcutaneous in"ection of a 7iscum album .. e$tract in healthy volunteers. ;at >mmun ACCBKAF=E&F>9ABE&CH. 2259 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. AE0

-ite* agnus<castus
Common name: !haste berry, mon#@s pepper, 7ite$ Ha!itat: 7ite$ is native to the /editerranean and !entral Asia. ,t prefers cree# beds and river ban#s.

-er!enaceae

Botanical description: 7ite$ is a deciduous perennial shrub that gro s to heights bet een F and 2E feet. 6he leaves are divided into E&H narro , 2&F inch long leaflets that are dar# green above and gray underneath. 5lender spi#es of lavender blue flo ers bloom in summer and early fall. 6he fruit then appear. 6he fruit appear as tiny blac# peppercorns ith a pepper&li#e aroma and flavor. #arts used: )ruitK occasionally leaves, flo ering tops Historical Use: 7ite$ is a plant of medicinal antiquity being mention in the or#s of +ippocrates, %ioscorides and 6heophrast. ,n the /iddle Ages, the berries ere a symbol of chastity and ere used to suppress se$ual e$citability as mon#s ould use them to replace pepper and suppress their libido. Gitex agnus9 castus and other Gitex species have been used traditionally by many cultures in Africa, ,ndia, and 5outheast Asia for birth control purposes =at high dosage levels>. $nergetics: Aside from these physiological indications, Gitex agnus9castus may be prescribed based on its subtle qualities. 7ite$ has s eet and cool qualities. %r. Alschuler describes it as e$erting a centering influence. A person ith the follo ing characteristics ill benefit from 7ite$9 nervous energy, e$cess sympathetic states that are manifested by Ie$cessiveJ se$ual drive, nervousness, palpitations, or menstrual irregularities. 7ite$ e$erts a calming and strengthening effect. Constituents: :o single constituent has been identified as being the active one, in fact, ith the e$ception of agnoside, all constituents are found in other plants. 6he total sum of constituents appear to generate a synergistic effect. • la!onoids9 castican, orientin, isovite$in • >ridoid glycosides9 agnuside =the reference constituent for standardi(ation>, aucubin • !olatile oil =0.B&A.FG>9 terpenoids 0cineole, sabinene, limonene, camphene>, α& and β&pinene • C93etostaroids: Gitex has been found to contain 3&#etosteroids =probably progesterone and AH &a&hydro$yprogesterone> by thin&layer chromatography. 22F0 6he flo ers and leaves may also possibly contain progesterone, AH&hydro$yprogesterone, testosterone, and epitestosterone although further research is needed. 0ther constituents in the flo ering tops include flavonoids =particularly !&glycosides>, and iridoids =aucubin, agnuside, eurostoside>, 3&#etosteroids, essential oils=0.B&A.FG>9 0&cymol, f>&famescene, a9 and f>&pinene, cineol, sabinene, limonene. #harmacology: 7ite$ affects the pituitary gland in t o primary ays. )irst, Gitex has been sho n to inhibit prolactin ith both in !itro =pituitary cell cultures> and in !i!o studies by binding to dopamine receptors on the pituitary gland. 22FA, 22F2 6hus, the binding of 7ite$ causes a suppression of prolactin synthesis and release by binding to the %2 receptor. 6he decreased prolactin results in increased corpus luteum gro th and increased progesterone.22F3 6he second effect that 7ite$ has on the pituitary gland is by increasing the anterior pituitary@s production of luteini(ing hormone =.+> and inhibiting the production of follicle stimulating hormone =)5+>. 22F< 6his results in a relative increase in progesterone and a decrease in estrogen, and in men a decrease in testosterone. 7ite$ does not appear to affect *n4+. 22FE 6he flavonoid fraction of some Gitex spp. has been found to have anti& androgen effects. 22FF 6he constituent volatile oils have demonstrated antibiotic effects. Aucubin has demonstrated hepatoprotective activity against e$perimental hepatoto$icity induced by carbon tetrachloride and α& amanitin. Medicinal actions: 1ituitary ad"uvant, dopamine agonist, galactagogue, emmenagogue, )5+ antagonist, .+ agonist, prolactin antagonist, hepatoprotective, antiseptic, and anaphrodisiac Medicinal use: • *ynecologic !onditions9 7ite$ has found a special application in :aturopathic /edicine for the treatment of endocrine disorders involving corpus luteal insufficiency as evidenced by the absence of a midcycle thermal shift or a shortened luteal phase ith basal body testing, progesterone deficiency, and an abnormally lo progesterone3estrogen ratio. 7ite$ has been found to normali(e abnormally shortened luteal phases. ,t has been used to treat hormone imbalance due to ovarian suppression after discontinuing oral contraceptives. All of the follo ing conditions are manifestations of this relative progesterone deficiency and3or e$cess prolactin9 acne dysmenorrhea endometrial hyperplasia endometriosis infertility insufficient lactation menopausal syndrome menorrhagia metrorrhagia oligomenorrhea perimenopausal depression polycystic ovary syndrome =1!05>

polymenorrhea premenstrual syndrome secondary amenorrhea threatened miscarriage uterine myomas Along ith relative progesterone deficiency, prolactinemia is an indication for 7ite$.Although Gitex has sho n prolactin inhibiting effects, it has been found to be an effective galactogogue. 5tudies have demonstrated that Gitex in breast feeding mothers is effective for maintaining adequate breast mil# production.22FH Gitex has traditionally been used to decrease libido and can be used in androgen e$cess disorders. ,t is has been used to treat virili(ation, and e$cessive se$ual drive. /enstrual disorders9 /enstrual disorders, particularly secondary amenorrhea, ovarian cysts, cystic hyperplasia of the endometrium =often a premenopausal disorder that causes e$cessive uterine bleeding> respond favorably to 7ite$. 22FB,22FC,22H0 ,n both of these cases, there is often corpus luteum deficiency resulting in abnormal or absent follicle development and lac# of ovulation. 6here have been several clinical trials done that demonstrate the efficacy of 7ite$ in restoring the luteal phase of the menstrual cycle. =:ote9 these trials are open, uncontrolled studies.> 6hus, the menstrual cycle appro$imates a more optimal length, menstrual bleeding is reduced if e$cessive and cystic tissue resolves. )or menstrual function to stabili(e, many months of 7ite$ administration are required. ,nfertility9 7ite$ administration may restore fertility in omen if they have anovulatory cycles as a consequence of shortened luteal phase and decreased progesterone.22HA,22H2 6here are potentially many confounding variables, not to mention the placebo effects. :onetheless, the restoration of fertility is a common usage of 7ite$ and seems to prove its reputation in current clinical practice. 1remenstrual syndrome9 5ome cases of 1/5 may be helped ith 7ite$. 6he etiology of 1/5 in unclear, but at least in some omen, it appears to be the result of decreased progesterone to estrogen ratio. ,nterestingly, in these cases, progesterone administration is not al ays successful. 7ite$ may be a more subtle and effective ay to treat this type of 1/5. A controlled trial done in 'ngland found 7ite$ to be of benefit for all types of 1/5 e$cept those omen ith a definitive picture of 1/5&! =headache, craving for s eets, palpitations, di((iness>.22H3 7ite$ also has been noted in several studies to reduce atypical manifestations of 1/5 such as post&traumatic epilepsy22H<, mouth ulcers22HE, and orofacial herpes simple$22HF. ,n an unpublished study comparing the efficacy of 7ite$ ith placebo, omen suffering from 1/5 symptoms such as breast tenderness, abdominal bloating, migraine, and acne e$perienced a <0G reduction of symptoms compared to a A0G reduction of symptoms in the omen on placebo. ,nterestingly, the emotional symptoms of 1/5 ere reduced by H0G in the 7ite$ group, but the placebo group also e$perienced a F0G reduction of emotional symptomsb 22HH Acne9 7ite$ increases .+ and lo ers )5+, one consequence of hich is lo ered testosterone levels. 6his may e$plain the benefit of 7ite$ in improving acne. ,n one placebo controlled trial of males and females, after 3 months of treatment ith 7ite$, both males and females e$perienced a H0G improvement in their acne. 22HB 6his as significantly better than the placebo. ?eep in mind that if 7ite$ is given to someone ho does not have a relative progesterone deficiency, his or her acne ill orsen, and in fact may be initiated by the prescription of 7ite$. /ale !onditions9 ,t may be useful in the treatment of benign prostate hypertrophy in con"unction ith ,eronoa, Drtica, and Pygeum1 )ccording to Mills and Bone:&&4* • *ynecologic !onditions9 A common cause of cyclical disorders involves hyperprolactinemia. 6he latent condition is generally present throughout the cycle. At the end of the luteal phase the inhibitory effect of progesterone is removed. As a result, high quantities of prolactin are released at night as a response to stress. =note9 A relative insufficiency of the corpus luteum can also lead to a relative hyperprolactinemia>. 'fficacy appears to be about H0G. Breast !onditions9 Because of it ovarian regulating function 7ite$ is a primary herb in the treatment of breast cysts and fibroadenoma. 7ite$ ill also promote mil# production in the lactating mother. 22B0,22BA 1/59 7ite$ has been sho n to be beneficial for 1/5&A, 1/5&% and 1/5&+, particularly ith the symptoms of breast tenderness and fluid retention. 1/5 associated ith hyperprolactinemia may be a more specific indication for 7ite$. 22B2 /enstrual %isorders9 7ite$ is indicated for menorrhagia and secondary amenorrhea. =:ote9 Although these conditions appear to be the opposite ends of the spectrum for menstrual bleeding, the fact that 7ite$ can be used to treat both indicates its vast normali(ation ability in normali(ation of menstrual function>. Women ith cystic hyperplasia of the endometrium respond ell to 7ite$ as this condition is due to a relative progesterone deficiency. ,n particular, omen ith corpus luteum deficiency are assisted by 7ite$. ,nfertility9 7ite$ may be indicated for difficult in conception. After using 7ite$ omen tended to ard a longer luteal and an increase in .+4+ suggesting enhanced corpus luteum function. B,C Uterine )ibroids9 7ite$ is a primary component to treatment of uterine fibroids and may be given at high doses for severe cases. 'ndometriosis9 7ite$ is li#ely the most important herb for the treatment of endometriosis and usually is used in higher doses. 1ostnatal depression9 see formula belo . • %ermatological !onditions9 7ite$ has been used to treat acne in both men and omen. 22B3 )ccording to the Textboo3 of ;atural Medicine:&&(' • *ynecologic !onditions9 6he 6:/ mentions use for the above conditions including corpus luteum insufficiency, 1/5, abnormal menstrual cycles and hyperprolactinemia.

)ccording to +eiss:&&(# • *ynecologic !onditions9 6he primary indication for 7ite$ is menstrual disorders due to corpus luteum insufficiency9 hyper or polymenorrhea and premenstrual syndrome base on hyperfolliculinism. 0ther premenstrual complaints may respond to 7ite$ such as acne and oral herpes as ell as premenstrual #nee "oint effusions and ater retention. 7ite$ may be used as a galactagogue although some time is necessary for the effect to occur. At the same time, it can be give for ee#s to months to maintain a good level of mil# production ithout side effects. )ccording to .ing/s:&&($ 6his agent is a reported galactagogue and emmenagogue and is said to repress the se$ual passions for hich purpose the ancient Athenian omen employed it. ,t has been suggested in small doses in impotence and sexual melancholia. ,t is probably a remedy for sexual irritability ith nervousness or melancholia or mild dementia. #harmacy: 7ite$ is not a fast&acting botanical requiring A&2 menstrual cycles for effect to occur. 6reatment for more difficult conditions such as anovulatory cycles and infertility may ta#e many months before demonstrating benefit. )or secondary amenorrhea of greater than 2 years duration, administration should be for at least A.E years. 22BH ,t is best to dose 7ite$ first thing every morning in accordance ith the diurnal rhythm of the pituitary gland. ,t may be prescribed during the luteal phase of the menstrual cycle =day AE&2B> or throughout the cycle. 7ite$ is slo acting and its efficacy should be assessed only after 3 months of treatment, ith the full therapeutic effect typically manifesting after F months. ,t should be discontinued if the length of the menstrual cycle is e$cessively changed. ,nfusion9 steep A32 to one teaspoon =E&A0 g>of the berries or seeds in B o(. of hot ater for AE minutes9 B ounces of the infusion, 3 times3day, or once during the morning. A9E tincture9 3 to A0 ml per day in am A92 fluid e$tract9 A to < ml per day :/,/+ lists 20 ml per ee# as ma$imum dose =but this seems lo from my perspective> =%ipasquale drop doses for energetic effect 5tandardi(ed e$tract =Agnolyt, 7itale$ =*erman>>9 <0 drops or A capsule every morning =C g of fruit per A00 ml e$tract > 1ostnatal %epression22BB9 1ana$ ginseng =A0 ml>, +ypericum perforatum =2E ml>, *lycyrrhi(a glabra =AE ml>,Withania somnifera =30 ml>, 7erbena officinalis =20 ml> =all A92 e$cept *lycyrrhi(a hich is A9A> Contraindications: 7ite$ can aggravate spasmodic dysmenorrhea due to enhanced secretion of progesterone. ;et, spasmodic dysmenorrhea that is present ith congestive 1/5 ill respond to 7ite$. !aution is advised in pregnancy due to its emmenagogue effect =empirical> though it has been used to help prevent miscarriage in the first trimester hen due to progesterone insufficiency =empirical>. 22BC A report that 7ite$ may be inappropriate ith in&vitro fertili(ation treatment as a promoter of normal ovarian function is li#ely premature. 22C0 7ite$ is potentially inappropriate to administer in con"unction ith progesterone drugs, 0!1s or +46.22CA )o*icity: ,n high doses =20 times therapeutic>, 7ite$ inhibits all aspects of anterior pituitary function resulting in decreased pituitary, adrenal and uterine function in guinea pigs.22C2 4are occurrences of formication, abnormal menstrual cycle changes, itching, urticaria, gastrointestinal and lo er abdominal complaints and short term headaches have been reported in large scale trials.

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5aden&?rehula /, et al. %elta&3&#etosteroids in the )lo ers and .eaves of 7ite$ agnus&castus. 1lanta /edica ACC0K EF9 E<H /ile ic( A et al. )rmeim19 orsch1 ACC3K<39HE2 2262 5liut( *, et al. +orm /etab 4es ACC3K 2E=E>9 2E3&2EE 2263 /ile ic( A, *e"del ', 5 oren +, et al, Gitex agnus9castus e$tract in the treatment of luteal phase defects due to latent hyperprolactinemia9 4esults of a randomi(ed placebo&controlled double&blind study. )rIneim orsch Drug Res ACC3K <3=H>9HE2&F. 2264 +aller -, 5eb und 5yna3ol, ACFAK AEF92H<. 2265 -arry +. et al. '$p !lin 'ndocrinol ACC<9 A02 =F>9<<B&<E< 2266 Bhargava 5?. MAntiandrogen effects ora flavonoid&rich fraction of7ite$ negundo seeds9 a histological and biochemical study in dogs.M Ethnoph1 ACBC K2H=3>932H&3C. 2267 Amann W. ,mprovement of acne vulgaris ith 7ite$ agnus castus Ther1 D1 5egen:1 ACFHKA0F9=A>9A2<. 2268 .och ', Bohnert ?-, 1eeters /, et al. 6he treatment of menstrual disorders ith Gitex agnus9castus tincture. Der rauenarIt, ACCAK 32=B>9BFH&H0. 2269 1robst 7, 4oth, 0A, Dtsch Med +schr, ACE<, HC92AHA. 2270 1ropping %, ?at(or#e 6, Bel#ien .. %iagnosis and therapy of corpus luteum deficiency in general practice. Therapie:oche ACBBK 3B92CC2&300A. 2271 1ropping %, ?at(or#e 6+. ? )llgemeinmed, ACBH, F39C32. 2272 1ropping %, ?at(or#e, 6, Bel#ien ., Therapie:oche, ACBB92CC2&300A. 2273 *erard +ouse, D. promotional brochure, ACBB. 2274 'c#er *, 8andarIt, ACF<K <09BH2.

2275 2276

+illebrand, +, 8andarIt, ACF<K <09AEHH. Albus *A, ?1 Haut9und 5esch, ACF<K3F9220. 2277 !ommunication ith ?erry Bone, ACC<. 2278 *iss * and 4othenburg W Haut9und 5esch, ACFBK<39F<E. 2279 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 23C&<F, 32B&333 2280 :oac# /. %tsch /ed Wschr AC<3K C920<&20F 2281 /ohr W. +ippodrates ACEHK 2B9 EBF&ECA 2282 Bohnert, ?. 6he Use of 7ite$ agnus&castus for +yperprolactinemia. 2uarterly 4evie of :atural /edicine ACCH9 5pring, p. AC&2A. 2283 *iss *, rothenburg W. 8 +aut *eschlechst#r ACFBK <3 =AE>9F<E&F<H 2284 /urray /, 1i((orno '. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC 2285 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. p 3AH&C 2286 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. 20EF 2287 /urray and 1i((orno, p. A023 2288 /ills and Bone p 2<F 2289 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. EE 2290 !ahil %-,etal. +um 4eprod ACC<K C =B>9A<FC&H0 2291 /ills and Bone and 6:/ and Brin#er 2292 +aller -. 8 *eburtsh *yna#ol ACFAK AEF=3>92H<&302

6ithania somnifera
Dpdated all &--&

4olanaceae (@ightshade =amily

6his monograph is adapted from9 Bone ?, IWithania somniferaJ, 2linical )pplications of )yur!edic J 2hinese Herbs , =2ueensl], Australia9 1hytotherapy 1ress>, ACCF9A3H&<A.

Common name:

Ash aganda =5ans#rit>, Winter !herry, ,ndian ginseng.

Ha!itat: 6he drier parts of subtropical ,ndia ] /iddle 'astern countries. !ultivated in many parts of the orld. Botanical description: 'rect shrub up to 3.E feet in height. 5imple leaves up to A0 cm long. ,nconspicuous pale green flo ers in cymes. 6he fruit is a berry, hich is orangish&red hen mature. #arts used: 4oot. $nergetics: Ash aganda has the smell of a horse, as it gives the vitality ] se$ual energy of a horse. Bitter, 5 eet Astringent. +eating. =&>7ata ] ?apha. =X> 1itta ] Ama hen in e$cess. Affinity for muscle, fat, bone, marro , nervesK and the reproductive, respiratory ] nervous systems.22C3 Constituents:005: • 5teroidal compounds including lactones = ithaferin A, ithanolides> ] acylsteryl glucosides. o 5aponins ith an additional acyl group9 sitoindoside 7,,, 7,,,. o Withanolides ith glucose at carbon 2H9 sitoindoside ,P, P. • tropane al#aloids =tropine, pseudotropine, isopelietierine, anaferine>. • ,ron. #harmacology: Withanolides are believed to account for the multiple medicinal applications of Ash agandha. Withanolides are steroidal ] bear a resemblance, both in their action ] appearance, to the active constituents of Asian ginseng 0Panax ginsengB #no n as ginsenosides.22CE 5itoindosides protect against stress&induced stomach ulcers, have anti&depressant action, and help to improve learning ] memory in rodents.22CF 5teroidal saponins in the root have been sho n to stimulate the immune system, reduce inflammation, improve memory, ] prevent the development of cancer. ,n general, steroidal saponins have antibacterial, anti&tumor, anti&hepatoto$ic ] antiinflammatory activities.22CH +igh doses of tropane al#aloids have demonstrated prolonged hypotensive, bradycardic, respiratory stimulant ] cerebral depressant effects by binding to ] stimulating *ABA&A receptors, similar to 7alerian ] +ypericum. 22CB 5ystemically, tropane al#aloids are spasmolytic to smooth muscles, e$erting an overall sedative action. 22CC Withania is adaptogenic ] tonic. 6he hole root of +1 somnifera fed to rats caused eight gain ] increase in the eight of their offspring hen compared to controls. 2300 6he hole root has been found to increase hite blood cell counts, specifically, neutrophil counts.230A A pharmacological comparison of Withania ] Panax ginseng demonstrated that Withania has similar potency to 1ana$ in terms of adaptogenic, tonic ] anabolic effects.2302 Withania is more effective than standard anti&inflammatory drugs at decreasing alpha&2&macroglobulin =a liver&synthesi(ed protein hich increases dramatically during inflammation>. 2303 Withania has been demonstrated to prevent bony degenerative changes hich normally occur during inflammatory arthritis. 230< Withania has anti&tumor activity. When a hole plant e$tract of Withania as given orally to mice at 200 mg3#g, their mortality from urethane&induced lung cancers decreased significantly. Also, a decrease in body eight d3t tumor gro th as countered. )inally, the incidence, number ] si(e of tumors decreased. 230E ,ntraperitoneal administration of Withania has been sho n to reduce sarcoma in mice ] appears to sensiti(e tumor cells to the effects of radiation. 230F !urrently, ithaferin A, hich is higher in the leaves, is used to treat cancer. Medicinal actions: +ypotensive. Bradycardic. 5pasmolytic. Anti&tumor. ,mmunomodulating. Anti&inflammatory. Adaptogenic. 4e"uvenating 6onic. Aphrodisiac. 5edative :ervine. Astringent. Current > )raditional Medicinal Use: Ayurvedic medicine & as a re"uvenative, to induce dreamless sleep, ] as a tonic for male reproduction. ,t increases #apha, o"as, ] ama =in e$cess>, as ell as improve memory, strength, ] sattva. Withania is indicated in the follo ing conditions9 general debility, se$ual debility, nervous e$haustion, convalescence, problems of old age, emaciation of children, loss of memory, insomnia, paralysis, /ultiple 5clerosis, ea# eyes, rheumatism, s#in affliction, cough, difficult breathing, anemia, fatigue, infertility, ] glandular s elling. 230H 9eneral 6estern usage & W. somnifera is a tonic herb. ,t is best suited to individuals ho are debilitated ] ho suffer from nervous e$haustion, emaciation ] anemia. Withania is helpful in convalescence after acute illness or stress, impotence, chronic disease 3

inflammation ] bony degeneration, ] as a general tonic ] adaptogen in persons 3 hypertension ] high cholesterol or in persons 3 cancer ] consequent eight loss. Withania acts as a sedative, helping to restore the health of the nervous system ] person overall. Current +esearch +eview: • @,DDM and Hypercholesterolemia: 1o der W. somnifera root administered for 30 days as found to be a potential source of hypoglycemic, diuretic, and hypocholesterolemic agents. 5i$ mild :,%%/ sub"ects and si$ mild hypercholesterolemic sub"ects ere treated ithout noted adverse effects. 5ignificant increase in urine sodium, urine volume, significant decrease in serum cholesterol, triglycerides, .%. and 7.%. cholesterol ere observed. %ecrease in blood glucose level as comparable to that of an oral hypoglycemic drug.230B • 3steoarthritis: +erbomineral formulation containing roots of Withania somnifera, the stem of Bos ellia serrata, rhi(omes of !urcuma longa, and a (inc comple$ =Articulin&)> produced a significant drop in severy of pain and disability score in the patients ith osteoarthritis. )orty&t o patients ere studied over a period of B months. 6he study as placebo controlled. 4adiological assessment did not sho any significant changes.230C • Anemia and 9rowth9 Withania in the dose of 2 g qd $ F0 days as found to be a gro th promoter ith antianaemic activity in children. )ifty eight children B&A2 years old ere involved in a double&blind placebo&controlled clinical trial. 6here as a significant increase in mean corpuscular hemoglobin and serum. Body eight, grip strength ] serum iron also increased, although statistically insignificantly.23A0 • Ageing: Withania in the dose of 3 g qd $ A year as tested on the process of aging in A0A healthy male adults E0&EC years of age in placebo&controlled double&blind study. 5ignificant improvements in +gb, 4B! values, hair melanin ] seated stature ere observed. 5erum cholesterol decreased ] nail calcium as preserved. '54 decreased significantly, and THAG of those ho received the herb reported improvement in se$ual performance. 23AA • )raining Aid9 Withania, A g qd $ 2C days, administered to trainee mountaineers in an uncontrolled trial, improved sleep, responsiveness, alertness, ] physical capabilities.23A2 A&F g3day of dried root.23A3 23A< A92 tincture9 F&A2 ml3day.23AE Drug ,nteractions: Withania may potentiate the effects of barbiturates. 23AF Contraindications.)o*icity: 1otential abortifacient effectK contraindicated during pregnancy. 23AH #harmacy:
2293 2294

)ra ley, %avidK .ad, 7asant. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29AF0 /ills 5, Bone ?. Principles J Practice of Phytotherapy. !hurchhill .ivingstone, :e ;or#, :;,20009ECF. 2295 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 2296 *hosal 5, et al, Phytotherapy Res, 3, ACBC920A. 2297 5ingh :, et al, Huart 7 Drug Res, AF, ACHB9B. 2298 /alhotra !., et al, >nd 7 Med Res, <C, ACF29<<B. 2299 /alhotra !., et al, >nd 7 Physiol Pharmacol, C, ACFE9C. 2300 ?ur]i#ar, et al, >nd Drugs, 23, ACBF9A33. 2301 6hatte, U/, et al, 7 Postgrad Med, 33, ACBH9ABE. 2302 *randhi A, et al, 7 Ethnopharmacol, <<, ACC<9A3A. 2303 Anbalagan ? ] 5adique -, >nt 7 2rude Drug Res, 23, ACBE9AHH. 2304 +a(eena 7 ] 5adique -, >nd 7 Exp Bio, 2F, ACBB9BHH. 2305 5ingh :, et al, >nt 7 2rude Drug Res, 2<, ACBF9C0. 2306 %evi 1U, et al, >nd 7 Exp Biol, 30, ACC29AFC 2307 )ra ley, AF0. 2308 Andallu B, 4adhi#a B. +ypoglycemic, diuretic and hypocholesterolemic effect of inter cherry =Withania somnifera, %unal> root. >ndian 7 Exp Biol 2000K3B=F>9F0H&C. 2309 ?ul#arni 44, 1at#i 15, -og 71, et al. 6reatment of osteoarthritis ith a herbomineral formulation9 a double&blind, placebo&controlled, cross&over study. 7 Ethnopharmacol ACCAK33=A&2>9CA&E 2310 7entaraghavan 5, 5eshadri !, 5undaresan 61 et al1 7 Res )yu ,id ACB0K A93H0&BE. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 'dinburgh, 20009F00. 2311 ?uppura"an ?, 4a"agopalan 55, 5itarman 4, et al, 7 Res )yu ,id ACB0KA92<H&EB. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine. !hurchill .ivingstone, 'dinburgh, 20009F00. 2312 4oy A5, Acharia 5B, %e A?, et al. ,nternational seminar W traditional medicine, !alcutta, :ovember H&C, ACC29AFA. !ited in /ills 5, Bone ?. Principles J Practice of Phytotherapy9 Modern Herbal Medicine1 !hurchhill .ivingstone, .ivingstone, 'dinburgh, 20009F00. 2313 5tudies from the current research revie section. 2314 /ills, ECE 2315 /ills, ECE. 2316 Brin#er ). Herb 2ontraindications J Drug >nteractions1 'clectic /edical 1ublications, 04, ACCB932 2317 Brin#er ), 32.

Eantho*ylum americanum
Common name: 1ric#ly ash Ha!itat: 6he tree gro s in fields and pastures in :. America.

+utaceae

Botanical description9 A small tree ith gray bar# hich is covered ith small pric#les. 6he leaves are pinnately compound in clusters a$illary to the alternate branches. 6he leaflets are acute, do ny hen young and occur in <&E pairs ith one odd one. 6he flo ers are diocious, small, green&yello ith <&E petals. 6he fruit is thic# ith A&2 seed pods containing a small blac# seed. #arts used9 4oot bar# and berries Constituents9 Al#aloids, ben(ophenantridine al#aloids, coumarins Medicinal actions: !irculatory stimulant, diaphoretic, anti&rheumatic, carminative, sialogogue, local counter&irritant )raditional Medicinal Use: 5pecific ,ndications and Uses9 hypersecretion from debility and rela$ation of mucous tissuesK atonicity of the nervous system =larger doses>K in capillary engorgement in the e$anthemata, sluggish circulation, tympanites in bo el complaints, intestinal and gastric torpor = ith deficient secretion>, dryness of the mucous membrane of mouth and fauces = ith gla(ed, glossy surfaces>, flatulent colic, Asiatic cholera, uterine cramps, and neuralgia. )or the painful bo el disorders, the preparations of the berries are to be preferred. 23AB !oo# described 8antho$ylum as having a moderate quantity of rela$ing and stimulating po er, hich acts promptly and diffusivelyK and leaves behind a arm impression. +e considered it as much more pungent and heating than 8ingiber, and much less so than !apsicum, being suited only to languid conditions. ?ing noted that 8antho$ylum acts upon the secretory tissues particularly hen che ed, and the nervous and circulator systems, having both local and systemic action. 6he bar#, hen che ed, imparts an aromatic, s eetish taste, follo ed by bitterness and persistent acridity. +e considered it best adapted to debilitated patients as ell. !oo# also described the berries as quite fragrant, of qualities similar to the bar#, but much more diffusive and transient in action and also stronger and more e$citing than the bar#, less rela$ant, and more li#ely to irritate the stomach and leave the s#in a little hot and dry. 6hey are used for the same general purposes as the bar#, but for proportionately Ilo erJ conditions as a pungent and prompt stimulant to combine ith rela$ant alterants. 1rof. ?ing cautioned that there is a material difference in their influence on the system bet een the tincture of the bar#, or that of the berries. 6he properties of the bar#, as given by him, are stimulant, tonic, alterative, and sialagogueK of the berries, stimulant, carminative, and antispasmodic, acting especially on mucous tissues. =);,9 As an e$ample of some of the contention bet een competing theories of medicine at the time, !oo# stated I%r. -. ?ing tells of a patient having nearly lost his life, in cholera, by using a tincture of the bar# instead of the berries, and connects ith the bar# an idea of unsafenessK but this is a nonsensical story, and is a childish tale to be told by a man directing the use of Aconite, 7eratrum, prussic acid, and strychnine.J> • !ardiovascular !onditions9 !oo# observed an increase of cappilary and smaller arterial circulation. 6he s#in, salivary glands, and lymphatic system ere considered the focus of most of its influence follo ed by the serous and mucous tissues, and the #idneys. A arm infusion as employed to favor full out ard circulation, particularly of service in all cases of capillary stagnation ith blunted sensibilities. Under its effect cardiac function as observed to increase ith the pulse becoming slightly accelerated. • %ermatologic !onditions9 0 ing to its action on blood stasis, overcoming capillary engorgement, it as found useful in determining the rash to the surface in the eruptive diseases, and is especially serviceable in cases of retrocession of the eruption. • *astrointestinal !onditions9 8antho$ylum as observed to increase the flo of saliva, and as considered an e$cellent therapy in dryness of the mouth and throat. )or similar purpose it as used as an associate of +ydrastis and !apsicum as a gargle in scarlatina and diphtheria. 5ome 1hysiomedicalists valued it for mild cases of paralysis of the tongue, and as a ash to the mouth and over the glottis in loss of voice. ?ing observed that ,n the stomach it creates a sense of armth, the flo of both gastric and intestinal "uices is augmented and there is increased biliary and pancreatic activity. ,n general, he utili(ed 8antho$ylum ith lac# of secretion in any part of the intestinal tract. +e also noted 8antho$ylum as an admirable gastro&intestinal tonic and used it in the treatment of atonic dyspepsia and gastric catarrh, many chronic affections of the mucous tissues ith enfeeblement, rela$ation, and hypersecretion. +o ever, ,n regard to constipation, 8antho$ylum as indicated hen due to deficient intestinal secretion and hen accompanied by a flatulent distension of the abdomen. • *enitourinary !onditions9 ?ing notes that the #idneys become more active under the influence of 8antho$ylum and increased urinary product results.

• *ynecological !onditions9 8antho$ylum as used for obstructed menstruation from e$posure secondary to capillary stagnation, functional dysmenorrhea and neuralgic dysmenorrhea ith mar#ed pain and hypersensitiveness. • ,nflammatory !onditions9 ,n sub&acute and chronic rheumatism, it is an agent of the most e$cellent qualitiesK and may be used in arm infusion for acute cases, especially in company ith !imicifuga, particularly lumbago, torticollis, myalgia, and muscular rheumatism. As a cold preparations ith such articles as !imicifuga and the berries of 1hytolacca for chronic casesK in chronic rheumatism, its value as considered to be due to its eliminative po er. • :eurological !onditions9 8antho$ylum as considered a valuable nerve stimulant, ,t is valuable in all cases of prostration, and has been recommended in Mhemiplegia, locomotor ata$ia, and all depressed conditions of the vital forces.M ,t has been employed in neuralgia, and paralytic conditions of the vocal apparatus and organs of deglutition. • 1ain !onditions9 ,ts use in odontalgia as confined to those cases here there is dull, grumbling pain due to peridental inflammation, the parts being dry and shining, and the buccal secretions scanty. • 1ulmonary !onditions9 6he 1hysiomedicalists utili(ed effect of stimulating out ard circulation in cases of capillary stagnation including recent colds and as an associate to Asclepias in typhoid fever cases here the e$tremities are cold and the patient is listless. 6he 'clectics considered it as a remedy of value in pharyngitis, especially the chronic variety, the mucous surfaces presenting a gla(ed, shining, dry condition, ith thin, adherent scales of dried mucus. ,n both pharyngitis and post&nasal catarrh a decoction locally, and specific 8antho$ylum =bar#> internally, as found to aid a cure in those cases having dryness of mucous membranes as a distinctive feature. • 6opical Applications9 '$ternally, the po der is a valuable application for ulcerative conditions, indolent chancres and buboes, and similar lo conditionsK and the tincture is of use in mildly stimulating liniments. Current Medicinal use: • !ardiovascular !onditions9 8antho$ylum is used primarily as a circulatory stimulant. ,t is a strong peripheral vasodilator. ,t is ell indicated in people ith insufficient circulation through their e$tremities, i.e. 4aynaudNs phenomenon, thromboangiitis obliterans =BuergerNs disease>. ,n these conditions, combining 8antho$ylum ith anti&spasmodics such as 7iburnum opulus and Achillea millefolium ill increase circulation to the e$tremities over a several month period of time. 8antho$ylum is also an e$cellent herb for elders ho have deficient circulation and combines ell ith *in#go biloba and 4osmarinus officinalis for this indication. 1ric#ly ash e$erts its influence slo ly and is best suited to chronic conditions. • *astrointestinal !onditions9 8antho$ylum e$erts a counter&irritant effect internally on the gastrointestinal tract and is a sialogogue. • :eurological !onditions9 8antho$ylum stimulates nerve activity. ,t is indicated hen the nervous system lac#s tone and metabolism is sluggish. ,t is also indicated hen mucous membranes are not functioning properly. • 6opical Applications9 8antho$ylum is a local counter&irritant and analgesic. )or this reason, it is applied e$ternally over painful "oints and arthritic "oints to stimulate circulation through the area. 8antho$ylum can be applied over sore gums or gargled for painful inflammation of those tissues. A good combination for an analgesic gargle is !apsicum9 +ydrastis9 8antho$ylum. #harmacy9 6he dosing of 8antho$ylum changes its effects. ,n smaller doses, it addresses hypersecretion resulting from debility and rela$ation of mucous membrane tissues. ,n larger doses, it addresses atonicity of the nervous system. %ecoction9 A&2 tsp.3cupK sig A cup 6,% QA tsp. O A.E gR 6incture9 A9E <EG 't0+K sig A&3 ml 6,% )luid e$tract9 A9A <EG 't0+K sig 0.E&2 ml 6,% Drug ,nteractions: :o information is currently available from the selected resources. Contraindications: !oo# stated that 8antho$ylum should not be employed hen the stomach is irritable. 5uch observation is prudent since 8antho$ylum e$erts a counter&irritant effect on the gastrointestinal tract. ,ts use should, therefore, be avoided in hypersecretory and3or ulcerated gastrointestinal tissues. .arge doses give a feeling of nausea, and may cause an unpleasant burning in the stomach of a person at all sensitive Because of its strong peripheral vasodilating effect 8antho$ylum is contraindicated in ea#, fatigue hearts or in people ith lo vital force. 8antho$ylum is contraindicated in pregnancy and nursing. )o*icity9 :o information is currently available from the selected resources.
2318

)elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB

Eea mays
Common name: !orn sil# Ha!itat: Botanical Description: #arts Used9 )lo er pistils

#oaceae

$nergetics: 23AC • 8ea is mildly s eet and astringent, cool, drying and moistening, nourishing, restoring, stimulating, dissolving, and softening. ,t enters the Urinary Bladder, ?idney and *all Bladder meridians. • !lears heat, dries damp, reduces infection and inflammation, and stops dischargeK promotes bile flo and reduces liver congestion9 ,ndicated in damp heat in the ?idney, Urinary Bladder and *all Bladder. • 1romotes urination, resolves to$icosis and drains fluid congestionK dissolves deposits and stones, and relieves irritation . ,ndicated in ?idney qi stagnation ith to$in accumulation • !ompare ith -in qian cao =.ysimachia> and *uang dong "in gian cao =%esmodium> Constituents: 2320 • 5aponins, allantoin, sterols, al#aloid, vit. !, vit. ?, potassium, sugars including mucilage, crypto$anthin, anthocyanins, plant acids, fi$ed oil =2G>, essential oil =0.AG>9 carvacrol, terpenes, bitter compounds, polyphenols =A2G>, potassium salts #harmacology: • !rude ethanolic e$tract of corn sil# effectively inhibited tumor necrosis factor&alpha =6:)> and '.coli lipopolysaccharide =.15> activity in human endothelial cells. 6:) and .15 cause upregulation of several adhesion molecules and enhance leu#ocyte adhesion to human endothelial cells. By interfering ith these processes, 8ea mays is valuable for the treatment of bacterial sepsis and various inflammatory diseases.232A • :o other pharmacology could be found at this time. 2322 Medicinal actions: %emulcent, %iuretic, !holagogue )raditional Medicinal uses: • *enitourinary !ondtions9 8ea has been used in southern )rance for calculi, gravel and strangury =painful and interrupted urination in drops produced by spasmodic muscular contraction of the urethra and bladder>. 8ea is beneficial in acute and chronic inflammations of the bladder and edema =dropsy> secondary to renal or cardiac origin. 8ea@s diuretic action is largely due to its tonic effect on the heart and vasculature. ,t is particularly valuable in the treatment of pediatric bladder disorders, gonorrhea and conditions here the decomposition of the urine ta#es place ithin the bladder. &C&C Current Medical Uses: • *enitourinary !ondtions9 8ea is best used fresh =organic onlyb> because of the high sugar content, hich gives this plant its diuretic effect. 8ea mays contains mucilage and allantoin, hich e$ert demulcent and vulnerary action. 6he longer the sil# is dried, the less diuretic it is. 6hese sugars are very soluble in ater, as is the allantoin, therefore a cold infusion soa#ed overnight provides a mucilagenous, soothing, diuretic s eet drin#. !orn sil# is rich in potassium salts and therefore is considered to be a potassium&sparing diuretic. ,f added to a urinary formula, it should be a generous part, and it combines ell ith antiseptics. 8ea mays also has mild choleretic activity. 8ea mays is indicated in the treatment of urinary inflammation and irritation, cystitis, pyelitis, gonorrhea, increased phosphates and urates, and edema. • +epatobiliary !onditions9 8ea is indicated in sub&acute gallstone attac# manifesting as sharp right flan# pain. ,n !hina, its cholagogue action is utili(ed in the treatment of simple "aundice. 8ea is considered hepatobiliary sedative =see the comparative !hinese herbs above>. 232< Current +esearch +eview: • Urology: o Diuretic effects: 232E  %esign9 1lacebo controlled double&blind crossover clinical trial  1atients9 :ot stated in the abstract  6herapy9 8ea mays, ,mperata cylindrica, 1lantago ma"or, and 0rthosiphon stamineus

•

4esults9 :o influence as recorded for the A2& and 2<&h urine output or on the sodium e$cretion for any of the drugs Dentistry: o #la?ue and gingivitis: 070&  %esign9 %ouble&blind placebo&controlled clinical trial  1atients9 )orty three sub"ects  6herapy9 /outh ash based on triclosan or mouth ash based on nonsaponifiable mai(e germ =8ea mays .>.  4esults9 6he mouth ash based on 8ea mays . had no beneficial action on the 1laque ,nde$, hich increased slightly, but it led to an improvement in the *ingival ,nde$. 

#harmacy: • Acute9 2&< g3dayK A&2 2t3day or A cup every hour QAtsp. O 0.EgR • A9E tincture9 3&AB ml 3day Contraindications: • 8ea has a hypoglycemic effect and may antagoni(e the effects of prothrombopenic anticoagulants such as dicoumarol and coumadin due to its vitamin ? content.232H )o*icity: none
2319 2320

+olmes, 1eter. 'nergetics of Western +erbs, 7ol. 2, 2nd ed. Artemis 1ress. ACC<. p. FA<&FAF Wren, 4.!., 1otter@s :e !yclopedia of Botanical %rugs and 1reperations, 1otter@s limited, 'ngland. ACBB. 2321 '$tract of corn sil# =stigma of 8ea mays> inhibits the tumour necrosis factor&alpha& and bacterial lipopolysaccharide&induced cell adhesion and ,!A/&A e$pression 1 Planta Med. ACCB /ayKF<=<>93A<&B. 2322 1ersonal comment9 5teve 1arcell, 2002 2323 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB. 20C2&3 2324 +olmes, 1eter. 'nergetics of Western +erbs, 7ol. 2, 2nd ed. Artemis 1ress. ACC<. p.FA<&FAF 2325 %oan %%, :guyen :+, %oan +?, et al. 5tudies on the individual and combined diuretic effects of four 7ietnamese traditional herbal remedies =8ea mays, ,mperata cylindrica, 1lantago ma"or and 0rthosiphon stamineus>. 7 Ethnopharmacol1 ACC2K3F=3>922E&3A. 2326 /achuca *, 7alencia 5, .acalle -4, et al. A clinical assessment of the effectiveness of a mouth ash based on triclosan and on 8ea mays . used as supplements to brushing. Huintessence >nt ACCHK2B=E>932C&3E. 2327 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB. pp. FE, FB

Eingi!er officinalis
Dpdated all &--&

Eingi!eraceae (9inger =amily

Common name: *inger. !hinese9 *an "iang =dry>, 5hen "iang =fresh>. 5ans#rit9 5unthi or :agara =dry>K Ardra#a =fresh>. -apanese9 ?an#yo =dry>K 5ho#yo =fresh>. 8er(ero =,talian>. ,ngefaer =*erman>. *ingembre =)rench>. Ha!itat: ,ndiginous to 5' Asia, !ultivated in U5, ,ndia, !hina, West ,ndies, /e$ico, Africa, )i"i, Australia ] various tropical regions. Botanical description: A creeping perennial on a thic# tuberous rhi(ome, hich spreads underground. ,n the first year, a green, erect, reed&li#e stem about F0 cm high gro s from this rhi(ome. 6he plant has narro , lanceolate to linear&lanceolate leaves AE&30 cm long, hich die off each year. 6he flo er gro s directly from the rhi(ome ] terminates in a long, curved spi#e 3 hite or yello flo ers from each spi#e. #art used: 4hi(ome. $nergetics:070/ 1ungent, 5 eet. +ot, Bitter. =&>7ata ] ?apha. =X> 1itta. Wor#s on all tissues, esp. digestive ] respiratory systems. Constituents: • 'ssential 0il =A&3G>9 5esquiterpenes & 8ingiberene, beta&5esquiphellandrene ] beta&Bisabolene. • 1ungent =+ot> 1rinciples9 *ingerols =A&2.EG> ] 5hogaols. 232C • 0ther9 5tarch, 1roteins, 1roteases, 7itamins, 4esins. 2330 #harmacology: 6he sesquiterpenes =gingerols> beta&sesquiphellandrene ] related (ingiberene are found in the highest concentration in fresh ginger. *ingerols decompose into shogaols upon drying ] storage. 6his may be hy fresh ginger is preferred in 6raditional !hinese /edicine for the treating the common cold.233A '$tracts of alcohol, he$ane or acetone yields both oily ] resinous materials called oleoresin.2332 6he primary effects of ginger are9 • Antio$idant. • ,nhibition of prostaglandin =!0P&2>, leu#otriene =E&.0P> ] thrombo$ane synthesis. *inger also inhibits ,.&A ] 6:). ,nhibition of thrombo$ane synthesis ] lipid pero$ide formation, causes a reduction in platelet aggregation. • *inger impairs cholesterol absorption to reduce serum ] hepatic cholesterol levels. *inger is also thought to stimulate H& alpha&hydro$ylase W the rate limiting en(yme in bile acid synthesis. • 5hogaol has been sho n to act as an analgesic. • 5hogaol ] (ingiberene have been sho n to have antibiotic effects against9 5almonella typhi, 7ibrio cholera ] 6ricophyton violaceum. Aqueous e$tracts as dilute as 2.EG have demonstrated effectiveness against 6richomonas vaginalis. 2333 Medical actions: !holeretic. 1ositive ,notropic ] !hronotropic. *, 5timulant. 6hermogenic. Antibiotic. Anti&inflammatory. %iaphoretic. *eneral 5timulant. 4ubefacient. !arminative. '$pectorant. Analgesic. Current > )raditional Medical uses: ,n general, ginger9 reduces nausea, stimulates circulatory activity, ] inhibits arachidonic acid metabolism. *inger is particularly indicated in cases characteri(ed by a9 loss of appetite, flatulence, borborygmus =rumbling noise d3t propulsion of gas through the intestines>, spasmodic gastric ] intestinal contractions, painful menstruation, amenorrhea d3t cold, acute colds, cool e$tremities, ] cold surface in children@s diseases. 233< • Ayurvedic Medicine W Besides the above uses, ginger as also used topically for +A, toothache ] to improve circulation to the limbs. • Chinese Medicine W )resh ginger as used to promote s eating ] to disperse e$terior cold that is caused by e$ternal influences upon the body. )resh ginger is pungent ] hot, ] is used to treat vomiting, cough ] debilitating s eating, ] to reduce the poisionous effects of other herbs. ,t as commonly used for colds caused by pathogenic ind cold, hich is characteri(ed by9 severe intolerance to cold, slight fever, +A, general ache, nasal congestion ] a runny nose. %ried ginger is also pungent ] hot, but is thought to be more effective at e$pelling interior cold conditions as they relate to the constitution of the client. %ried giner is used for cold conditions characteri(ed by9 pallor, poor appetite ] digestion, cold limbs, vomiting, diarrhea, pale tongue, or thin, atery or hite sputum.233E • 9astrointestinal Conditions9 8ingiber as employed as a stimulating tonic, stomachic, ] carminativeK increasing the secretion of gastric "uices ] the e$citability of the alimentary muscular system. *inger also helps to dispel gas that has accumulated in the stomach ] bo els. ,t has been used in combination 3 astringents in the treatment of9 diarrhea, dysentery, chronic flatulence ]

• • •

• •

atonic dyspepsia. 6he main use of 8ingiber is to9 relieve nausea, pains ] cramps of the stomach ] bo els, ] tenesmus. *inger is particulary indicated in conditions d3t colds or d3t ingestion of poor quality or difficult to digest foods. Atony of the *,, particularly the stomach, appears to be a principle indication. As a sialagogue, ginger is effective in treating paralysis of the tongue, toothache ] a rela$ed uvula. When prepared 3 4heum, ginger as used in the treatment of cholera infantum, characteri(ed by coldness of the surface ] e$tremities, 3 assoc. nausea ] vomiting. 8ingiber is indicated for gastric sub acidity. 233F 8ingiber simultaneously improves gastrointestinal motility hile e$erting antispasmodic effects. 8ingiber has also been sho n to inhibit serotonin&induced diarrhea. 233H 8ingiber also prevents ulcer formation caused by ethanol, indomethacin, aspirin ] other common ulcerogenic compounds. 6his effect appears to be greater in the fresh rhi(ome. 0ther *, complaints calling for 8ingiber include motion sic#ness, hyperemesis gravidum, post&operative nausea ] vomiting. 9ynecologic Conditions: 8ingiber helps to relieve the pain of dysmenorrhea. ,nfectious Conditions: 8ingiber as utili(ed in acute colds in con"unction 3 a hot mustard bath ] rapping in arm blan#ets after ards. ,nflammatory Conditions: *inger as indicated in fevers ith scanty salivary secretions ] painful, gassy intestines. *inger is thought to assist by sedating ] re&establishing secretions. Benefit has been sho n in the treatment of rheumatoid ] osteoarthritis. Along ith the effects on eicosanoids, 8ingiber is a diaphoretic. /igraine headaches also respond to 8ingiber. !ompared to other antiinflammatory botanicals, such as !urcuma, smaller amounts of 8ingiber are necessary for E.0P inhibition. +igher doses are required for !0P&2 inhibition. )opical Applications: !ombined 3 the bar# of 5ali$ nigra, 8ingiber as used as a poultice for indolent ulcers. Cardiovascular Conditions9 *inger has hypertensive effects in humans hich may be due to a short term refle$ response from the pungent effect.233B

Current +esearch +eview: • +heumatism and musculoskeletal disorders: )ifty&si$ patients =2B ith 4A, AB ith 0A, and A0 ith muscular discomfort> used po dered ginger to relieve their symptoms for a period ranging from 3 months to 2.E years. All patients ith muscular discomfort e$perienced relief in pain, and more than k patients ith arthritis e$perienced relief in pain and s elling. :o adverse effects ere reported. Authors suggest that the mechanism of action may involve the inhibition of prostaglandin and leu#otrine biosynthesis =dual inhibition of eicosanoid biosynthesis>. 233C o 3steorthritis:  A highly purified and standardi(ed ginger e$tract =8ingiber officinale and Alpinia galangal, '7.'P6 HH> had a statistically significant, moderate effect on reducing symptoms of 0A on the #nee, hen administered for si$ ee#s in a randomi(ed double&blind, placebo&controlled, multi&center, parallel&group study. 6 o hundred si$ty one patients ith moderate&to& severe pain ere enrolled. 5ome mild adverse *, effects ere e$perienced. 23<0  *inger e$tract as compared to placebo and ,buprofen in patients ith osteoarthritis of the hip or #nee in a controlled, double blind, cross&over study ith a ash&out period of one ee# follo ed by three treatment periods in a randomi(ed sequence, each of three ee#s duration. ,n the cross&over study, no significant difference bet een placebo and ginger e$tract could be demonstrated, hile e$plorative tests of differences in the first treatment period sho ed a better effect of both ,buprofen and ginger e$tract than placebo. 6here ere no serious adverse events reported during the periods ith active medications.23<A • @ausea and vomiting o 5i$ studies ere revie ed to assess the efficacy of ginger for nausea and vomiting. *inger as found to be superior to placebo and equally effective as metoclopramide for post&operative nausea and vomiting in t o of three studies. +o ever, A g of ginger ta#en before operation did not reduce the ris# of post&operative nausea compared to placebo. 0ther studies found ginger effective for sea&sic#ness, morning sic#ness, and chemotherapy&induced nausea. 23<2 o Motion 4ickness:  *inger and other medications ere compared ith scopolamine and d&amphetamine for effectiveness in prevention of motion sic#ness. *inger in the doses used as found to be at the placebo level of efficacy. 6he study concluded that scopolamine 0.F mg ith d&amphetamine A0 mg as the best combination ith acceptable side effects. 23<3 !ontrolled, double&blind study found that neither the vestibular nor the oculomotor system, both of hich are of decisive importance in the occurrence of motion sic#ness, are influenced by ginger. 6hey suggested that any reduction of motion&sic#ness symptoms derives from the influence of the ginger root agents on the gastric system. 23<< o Morning 4ickness: *inger as found to be effective in relieving the severity of nausea and vomiting of pregnancy in the dose of A g qd $ < days in a randomi(ed double&blind study, involving H0 omen at or before AH ee#s@ gestation. :ausea and vomiting episodes decreased ithout any adverse effect on pregnancy outcome. 23<E o #ostoperative nausea and vomiting:

• • •

•

•

*inger po der in the dose of 2 g, droperidol A.E mg, or both ere found ineffective in reducing the incidence of postoperative nausea and vomiting after day case of gynecological laparoscopy in A20 patients in a placebo& controlled trial.23<F  *inger B1 in the doses of 0.E g or A.0 g, given one hour prior to gynecological laparoscopic surgery under general anaesthesia, as found to be ineffective in reducing postoperative nausea and vomiting in A0B patients in a double& blind, randomi(ed, controlled trial. All patients received oral dia(epam premedication. 6he incidence of nausea and vomiting increased slightly but nonsignificantly ith increasing dose of ginger. 23<H =i!rinolysis: Administration of E gm of ginger po der ith fatty meals to 30 healthy adult volunteers increased fibrinolytic activity significantly.23<B 9astroduodenal motility: 0ral ginger as found to improve gastroduodenal motility in the fasting state and after a standard test meal in the dose of A00 mg in A2 healthy human volunteers. 23<C Coronary artery disease.@,DDM: 1o dered ginger, <g qd $ 3 months, did not affect A%1& and epinephrine&induced platelet aggregation in patients ith !A%. 6here ere no changes in the fibrinolytic activity and fibrinogen level. A single dose of A0 g po dered ginger given to !A% patients produced a significant reduction in platelet aggregation induced by the t o agonists. *inger did not affect the blood lipids and blood sugar. ,ncluded in this study ere healthy individuals, patients ith !A%, and patients ith :,%%/, ho either had !A% or ere ithout !A%.23E0 #latelet aggregation9 6 enty healthy male volunteers ere supplemented ith A00 g butter for H days, hich enhanced platelet aggregation to a significant e$tent. )ive grams of dry ginger, administered in t o divided doses ith fatty meal to A0 volunteers significantly inhibited the platelet aggregation induced by A%1 and epinephrine, compared to the placebo group =A0 individual>. 5erum lipids remained unchanged in both the groups. 23EA Breech presentation: )resh ginger paste applied to 8hihying acupoint in A33 pregnant omen 2B to 3B ee#s@ gestation ith breech position, as effective in correcting the fetal position ith HH.<G correction rate =AA3 omen>. !ontrol group of 23B omen had spontaneous correction ith EA.FG correction rate. 23E2 

#harmacy:07%7 • )resh root equivalent9 E00&A000 mg 6,% • %ried root equivalent9 E00 mg B,%&2,% • *inger tablets =E00 mg>9 A tab B,%&2,% • .iquid e$tract9 =A92  0.H&2 ml 2%K A9E  A.H&E ml 2%> Drug ,nteractions:07%: • A.0 g po dered 8ingiber administered 20 min. prior to surgery reduced anesthetic induced nausea. • %ecreases nausea induced by chemotherapeutic agents. • ,ncreases the absorption of some oral drugs =empirical>. • ,nhibition of ulcer formation due to ethanal, indomethacin ] aspirin. • /ay enhance the action of anticoagulant medication such as arfarin due to inhibition of platelet !0P products ] platelet aggregation, although variable effect based on dose as 2 g appears to not have an effect here A0 g is significantK < g qd for 3 months did not elicit these effects. Drug ,nteractions: • Anticoagulant medications9 A0g at one dose can e$tend bleeding time ] decrease platelet aggregation. F g doses may be of concern. < g doses or less do not interfere. Another study ith A g dose immediately prior to surgery to prevent post&op nausea has not affected bleeding indices. =.o %og> • !yclophosphamide9 8ingiber can decrease vomiting caused by cyclophosphamide 23EE • 8ingiber can increase the absorption of oral drugs. 23EF Contraindications.)o*icity: 1eople ith sensitive stomachs do not al ays tolerate 8ingiber. !ontraindicated in gallstones = 3o physician supervision in the case of larger stones, acute 5$> ] pregnancy =large doses, Y 2 g doses >. 23EH ,n pregnancy, large doses may inhibit thrombo$ane synthetase, impairing development of the male fetal brain. 23EB !aution in those 3 inflammatory s#in diseases, high fever, bleeding or ulcers.23EC 6here do not appear to be any to$ic actions associated ith 8ingiber. .arge doses may cause *, upset ith dyspepsia, retrosternal burning in some patients.

2328 2329

)ra ley %, .ad 7. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29A2A. /ills 5, Bone ?. Principles J Practice of Phytotherapy. !hurchhill .ivingstone, :e ;or#, :;K 200093CE. 2330 /urray /, 1i((orno -. Textboo3 of ;atural Medicine, 2nd ed. !hurchill .ivingstone, ACCC92C3

2331 2332

/ills, 3CE. /urray, 2C3 2333 /urray, 2C3 2334 /ills, 3C< 2335 /ills, 3C< 2336 Weiss 2337 +uang 2, /atsuda +, 5a#ai ?, et al. 6he 'ffect of *inger on 5erotonin ,nduced +ypothermia ] %iarrhea. Aa3uga3u ?asshi, ACBBKAA09 C3F&<2 2338 /ills 2339 5rivastava ?!, /ustafa 6. *inger =8ingiber officinale> in rheumatism and musculos#eletal disorders. Med Hypotheses ACC2K3C=<>93<2&B. 2340 Altman 4%, /arcussen ?!. 'ffects of a ginger e$tract on #nee pain in patients ith osteoarthritis. )rthritis Rheum 200AK<<=AA>92E3A&B. 2341 . +, 4oset(s#y A, 5chlichting 1, et al. A randomi(ed, placebo&controlled, cross&over study of ginger e$tracts and ibuprofen in osteoarthritis. "steoarthritis 2artilage 2000KB=A>9C&A2. 2342 'rnst ', 1ittler /+. 'fficacy of ginger for nausea and vomiting9 a systematic revie of randomi(ed clinical trials. Br 7 )naesth 2000KB<=3>93FH&HA. 2343 Wood !%, /anno -', Wood /-, et al. !omparison of efficacy of ginger ith various antimotion sic#ness drugs. 2lin Res Pr Drug Regul )ff ACBBKF=2>9A2C&3F. 2344 +oltmann 5, !lar#e A+, 5cherer +, et al. 6he anti&motion sic#ness mechanism of ginger. A comparative study ith placebo and dimenhydrinate. )cta "tolaryngol ACBCKA0B=3&<>9AFB&H<. 2345 7utyavanich 6, ?raisarin 6, 4uangsri 4. *inger for nausea and vomiting in pregnancy9 randomi(ed, double&mas#ed, placebo&controlled trial. "bstet 5ynecol 200AKCH=<>9EHH&B2. 2346 7isalyaputra 5, 1etchpaisit :, 5omcharoen ?, et al. 6he efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. )naesthesia ACCBKE3=E>9E0F&A0. 2347 Arfeen 8, 0 en +, 1lummer -., et al. A double&blind randomi(ed controlled trial of ginger for the prevention of postoperative nausea and vomiting. )naesth >ntensi!e 2are ACCEK23=<>9<<C&E2. 2348 7erma 5?, Bordia A. *inger, fat and fibrinolysis. >ndian 7 Med ,ci 200AKEE=2>9B3&F. 2349 /ic#lefield *+, 4ede#er ;, /eister 7, -ung 0, *reving ,, /ay B. 'ffects of ginger on gastroduodenal motility. >nt 7 2lin Pharmacol Ther ACCCK3H=H>93<A&F 2350 Bordia A, 7erma 5?, 5rivastava ?!. 'ffect of ginger =8ingiber officinale 4osc.> and fenugree# =6rigonella foenumgraecum ..> on blood lipids, blood sugar and platelet aggregation in patients ith coronary artery disease. Prostaglandins 8eu3ot Essent atty )cids ACCHKEF=E>93HC&B<. 2351 7erma 5?, 5ingh -, ?hamesra 4, Bordia A. 'ffect of ginger on platelet aggregation in man. >ndian 7 Med Res ACC3KCB92<0&2. 2352 !ai 4, 8hou A, *ao +. 5tudy on correction of abnormal fetal position by applying ginger paste at (hihying acupoint A. 4eport of A33 cases. ?hen 2i Aan 7iu ACC0KAE=2>9BC&CA. 2353 /ills, 3CE 2354 Brin#er ). Herb 2ontraindications J Drug >nteractions, 3rd ed. 'clectic /edical 1ublications, 04 200A9HF. 2355 Brin#er, HF 2356 Brin#er, HF 2357 Brin#er, HF 2358 .o %og 2359 )ra ley, A2A

1 2

PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p.B3< ,bid, pp.B33&< 3 5imon /ills, ?erry Bone, Principles and Practice of Phytotherapy: Modern Herbal Medicine, !hurchill .ivingstone, 'dinburgh, 2000, p. BE 4 1eter +olmes, Energetics of +estern Herbs, 2nd ed., Artemis 1ress, ACC<, 7ol. 2, p.H0H 5 PDR, p.B3< 6 .ininger et al, Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A. 7 /ar# Blumenthal et al =eds>, Herbal Medicine: Expanded 2ommission E Monographs, American Botanical !ouncil, Austin, 6e$as, 2000, pp.<20&A 8 ;. 6o(yo et al, I:ovel Antitumor 5esquiterpenoids in Achillea millefolium,J >nt 7 2lin Pharmacol Ther, 7ol 3E, :um H, -ul ACCH, pp. 2CF&30A 9 4udolf )rit( Weiss, Herbal Medicine, 6hieme, 5tuttgart, 200A, pp. C2&3. 10 /rs /. *reive, ) Modern Herbal: The Medicinal, 2ulinary, 2osmetic and Economic Properties, 2ulti!ation and ol3lore of Herbs, 5rasses, ungi, ,hrubs, J Trees :ith Their Modern ,cientific Dses, %over 1ublications, ,nc, :e ;or#, ACHA, 7ol. ,,, pp. BF3&<. 11 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3, 7ol. ,, pp. AC&20. 12 )inley 'lling ood, )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago, ACAC, pp. 3EE&F 13 W/., +., !oo#, Physiomedical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy , 'clectic /edical 1ublications, 1ortland, ACBE, pp. 2AE&H 14 !oo#, pp. 2AE&H 15 'lling ood, pp. 3EE&F 16 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed, 'clectic /edical 1ublications, 5andy, 04, AC03, p. E<. 17 !oo#, pp. 2AE&H. 18 5cudder, p. E<. 19 )elter, 7ol. ,, pp. AC&20. 20 !oo#, pp. 2AE&H. 21 'lling ood, pp. 3EE&F 22 !oo#, p. A< 23 'lling ood, pp. 3EE&F 24 ,bid 25 +olmes, p.H0H 26 4eference not found 27 /ills, pp. 20<, 202 28 4eference not found 29 Blumenthal, p.<2A 30 /ills, pp.AHH, AC3 31 +olmes, p. H0F 32 Weiss, p. 3AE. 33 /ills, p. 2<3 34 Blumenthal, <2A 35 /ills, pp. 2AF, 2AB 36 /ar# Blumenthal et al. =eds.>, The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines, American Botanical !ouncil, Austin, 6e$as, ACCB, p.<2A 37 ,bid 38 ,bid 39 ,bid 40 *rieve, 7ol. ,,, p.BF<. 41 Blumenthal, The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines, p. <2A 42 W. /itchell, ;aturopathic )pplications of the Botanical Remedies, 2nd ed., ACB3, p.22 43 Blumenthal, The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines, p. <2A 44 Blumenthal, Herbal Medicine: Expanded 2ommission E Monographs , p.<2A 45 +olmes, p.H0F 46 )rancis Brin#er, Herb 2ontraindications and Drug >nteractions, 2nd ed., 'clectic /edical 1ublications, 5andy, 0regon, ACCB, p. A3B 47 Blumenthal, Herbal Medicine: '$panded 2ommission E Monographs , p.<2A 48 /ills, p. 30
55 56

PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. ABB&ABC 57 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 58 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. ABB&ABC 59 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 60 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 61 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. ABB&BC 62 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. <<B&<EE

63 64

,bid Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. ABB&BC 65 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. <<B&<EE 66 ,bid 67 ?och 4, !omparative study of 7enostasin and 1ycnogenol in chronic venous insufficiency. Phytother Res 2002KAF 5uppl A95A&E 68 %iehm !, 6ramphisch +-, .ange 5, et al. !omparison of leg compression stoc#ing and oral horse&chestnut seed e$tract therapy in patients ith chronic venous insufficiency. 8ancet ACCFK 3<H=BCCH>92C2&<. 69 %ustman +0, *odolias *, 5eibel ?. Therapie:oche ACB<K3<9E0HH&BB. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 70 'nghofer ', 5eibel ?, +ammersen ). Therapie:oche ACB<K3<=2C>9<3F0&H2. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 71 Alter +. ? )llge Med ACH3K<C=2H>9A30A&<. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 72 %iehm %, 7ollbrecht %, Amendt ? et al. Gasa ACC2K2A=2>9ABB&CA. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 73 Bisler +, 1feifer 4, ?lu#en :, et al. Dtsch Med +ochnscr ACBFKAAA=3E>9A32A&C. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 74 4udofs#y *, :eiss A, 0tto ?, et al. Phlebol Pro3tol ACBFKAE9<H&E2. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 75 .ohr ', *aranin *, -easau 1, et al. Munch Med +ochnschr ACBFKA2B9EHC&BA. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 76 5teiner /, +illemanns +*. Munch Med +ochenschr ACBFKA2B=3A>9EEA&2. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 77 'rdlen ), Med +etl ACBCK<09 CC<&F. !ited in /ills 5, Bone ?. Principles and Practice of Phytotherapy: Modern Herbal Medicine1 !hurchhill .ivingstone, 'dinburgh, 20009<E2. 78 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. <E0 79 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.A20 80 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.A20 81 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. ABB&BC 82 +olmes, 1. 6he 'nergetics of Western +erbs. Ast 'dition. Artemis press, !olorade, ACBC. p A<B 83 Wren, 4.!., 1otter@s :e !yclopedia of Botanical %rugs and 1reperations, 1otter@s limited, 'ngland. ACBB 84 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2EE 85 /ills, 5., Bone, ?. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p 22A 86 +offman, %. 6he Wholistic +erbal, 2nd ed. %otesios 1rinters, .td. ACBF. p.ABH 87 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. <30 88 ,bid, p.<30 89 +offman, %. 6he Wholistic +erbal, 2nd ed. %otesios 1rinters, .td. ACBF. p.ABH 90 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2EE 91 +offman, %. 6he Wholistic +erbal, 2nd ed. %otesios 1rinters, .td. ACBF. p.ABH 92 ,bid, p.ABH 93 ,bid, p.ABH 94 ,bid, p.ABH 95 Weiss, 4.). +erbal /edicine. 7erlag *mb+, 5tuttgart, ACCF. p. 2EE 96 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AH0, 2<E 97 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. 3A<&E 98 /ills and Bone p. AHA 99 /ills and Bone p. AHA 100 5cudder -. 5pecifica /edications and 5pecific /edicines. 101 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. A<2 102 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 3C 103 Brin#er p. AE2 104 Brin#er p. AH0 105 Weiss, 4. +erbal /edicine. ACCF. p AHA 106 /urray, /., 1i((orno, -. 6he 6e$tboo# of :atural /edicine, 2nd ed. !hurchill .ivingstone. ACCC p. 107 !oo#, W. +. 1hysiomedical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ulbications. ABFC. 108 !oo#, 109 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 110 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 111 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 112 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A

113 114

.ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 115 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC 116 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, 1EBE 117 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. EBA 118 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. EB<. 119 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p.EBF 120 1ulse 6., Uhlig '. A significant improvement in a clinical pilot study utili(ing nutritional supplements, essential fatty acids and stabili(ed Aloe vera "uice in 2C +,7 seropositive A4! and A,%5 patients. - Adv /ed ACC0K 3=<>9 20C&230 121 1i((orno, -., et al9 The Textboo3 of ;atural Medicine, 2nd ed., !hurchill .ivingstone, :e ;or#, :;. ACCC, p. EBF 122 .isssoni 1, *iani ., 8erbinie 5, et al. Biotherapy ith the pineal immunomodulating hormone melatonin versus melatonin plus aloe vera in untreatable advanced solid neoplasms. ;at >mmun ACCBKAF=A>92H&33. 123 Williams /5, Bur# /, .oprinin(e !., et al. 1hase ,,, double&blind evaluation of an aloe vera gel as a prophylactic agent for radiation&induced s#in to$icity. >nt 7 Ratiat "ncol Biol Phys ACCFK3F=2>93<E&C. 124 0lsen %., 4aub W -r, Bradley !, et al. 6he effect of aloe vera gel3mild soap versus mild soap alone in preventing s#in reactions in patients undergoing radiation therapy. "ncol ;urs orum 200AK2B=3>9E<3&H. 125 Andriani ', Bugli 6, Aalders /, et al. 6he effectiveness and acceptance of a medical device for the treatment of aphthous stomatitis. !linical observation in pediatric age. Miner!a Pediatr 2000KE2=A&2>9AE&20. 126 +ayes 5/. .ichen planus W report of successful treatment ith aloe vera. 5en Dent ACCCK<H=3>92FB&H2 127 6homas %4, *oode 15, .a/aster ?, et al. Acemannan hydrogel dressing versus saline dressing for pressure ulcers. A randomi(ed, controlled trial. )d! +ound 2are ACCBKAA=F>92H3&F. 128 5yed 6A, Ahmad 5A, +olt A+, et al. /anagement of psoriasis ith ale vera e$tract in a hydrophilic cream9 a placebo&controlled, double&blind study. Trop Med >nt Health ACCFKA=<>9E0E&C. 129 7isuthi#osol 7, !ho chuen B, 5u# anarat ;, et al. 'ffect of aloe vera gel to healing burn ound a clinical and histologic study. 7 Med )ssoc Thai ACCEKHB=B>9<03&C. 130 )ulton -' -r. 6he stimulation of postdermabrasion ound healing ith stabili(ed aloe vera gel&polyethylene o$ide dressing. 7 Dermatol ,urg "ncol ACC0KAF=E>9<F0&H 131 )an ;-, .i /, ;ang W., et al. 1rotective effect of e$tracts from Ale vera .. var. chinensis =+a .> Berg. on e$perimental hepatic lesions and a primary clinical study on the in"ection of in patients ith hepatitis. ?hongguo ?hong Aao ?a ?hi ACBCKA<=A2>9H<F&B. 132 0des +5, /adar 8. A double&blind trial of celandin, aloevera, and psyllium la$ative preparation in adult patients ith constipation. Digestion ACCAK<C=2>9FE&HA. 133 :ersesian 0:, Bogatyreva '7. 'ffect of chemotherapy combined ith the use of tissue preparations on non&specific immunity in patients ith pulmonary tuberculosis. Probl Tuber3 ACC0K=A>92B&3A. 134 *rannam :, ?ingston /, Al&/eshaal ,A, et al. 6he antidiabetic activity of aloes9 preliminary clinical and e$perimental observations. Horm Res ACBFK2<=<>92BB&C<. 135 Agar al 01. 1revention of atheromatous heart disease. )ngiology ACBEK3F=B>9<BE&C2. 136 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p.2C 137 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p2C 138 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A, p. F3F 139 ,bid, pp. F3E&F3F 140 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A, p.F3F 141 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 142 Blumenthal, /., The 2omplete 5erman 2ommission E Monographs: Therapeutic 5uide to Herbal Medicines , )irst 'dition, American Botanical !ouncil. ACCB, p. AFH 143 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. AFC 144 /ills, 5. 1rinciples and 1ractice of 1hytotherapy, /odern +erbal /edicine. !hurchill .ivingstone. 2000 145 /ills, 5. 1rinciples and 1ractice of 1hytotherapy, /odern +erbal /edicine. !hurchill .ivingstone. 2000 146 /ills, 5. 1rinciples and 1ractice of 1hytotherapy, /odern +erbal /edicine. !hurchill .ivingstone. 2000 147 /ills, 5. 1rinciples and 1ractice of 1hytotherapy, /odern +erbal /edicine. !hurchill .ivingstone. 2000 148 Blumenthal,/. 6he !omplete *erman !ommission ' /onographs9 6herapeutic *uide to +erbal /edicines, )irst 'dition, American Botanical !ouncil . ACCB 149 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AFC 150 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. CC 156 8oti#ov, ;./., et al., 4astit. 4esur., ACHB, A<=<>9EHC 157 0pdy#e, %...-., )ood !osmet. 6o$icol., ACHE, A3=supple.>9HA3 158 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. BE, A33, A3C, AHA, AHB, 2AA 159 /urray /, 1i((orno -. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p. EC2 160 Weiss 4). +erbal /edicine, Fth ed. +ippo#rates 7erlag *mb+ ACCF. p. <F 161 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3, p. 2FF&H 162 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacyD 'clectic /edical 1ublications, 5andy, 04 ACBE p. 2<H 163 !oo#, p 2<H 164 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. 30 165 /urray an 1i((orno - p. EC2 and Brin#er p 30 166 /urray /, 1i((orno '. 6e$tboo# of :atural /edicine, 2nd ed.. !hurchill .ivingstone ACCC p. ECA 167 5un4;, ;an ;8, 8hange +, .i !!. 4ole of Beta&4eceptor in the 4adi( Angelicae 5inensis Attenuated +ypo$ic 1ulmonary +ypertension in 4ats. !hinese /edical -ournal ACBCK A02=A>9A&F

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!hang, +/, But 11. 1harmacology and Applications of !hinese /ateria /edica, 7ol A. World 5cientific, 5ingapore. ACBH, pp. <BC&E0E 5un4;, ;an ;8, 8hange +, .i !!. 4ole of Beta&4eceptor in the 4adi( Angelicae 5inensis Attenuated +ypo$ic 1ulmonary +ypertension in 4ats. !hinese /edical -ournal ACBCK A02=A>9A&F 170 !hang, +/, But 11. 1harmacology and Applications of !hinese /ateria /edica, 7ol A. World 5cientific, 5ingapore. ACBH, pp. <BC&E0E 171 .i W, 8hou !+, .u 2.. 'ffects of !hinese /ateria /edica in Activating Blood and 5timulating /enstrual )lo on the 'ndocrine )unction of 0vary&Uterus and its /echanisms. !hun# ?uo !hung +is , !hieh +o 6sa !hih ACC2K A2 =3>9 AFE&AFB, A3< 172 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. 3E0&3 173 .i ., Wang +, 8hu s. +epatic Albumin@s m4:A in :ephrotic 5yndrome 4ats 6reated ith !hinese +erbs. !hung +ua , +sueh 6sa !hih ACCEK HE=E>92HF&2HC 174 /ills and Bone, see also p. 2<A&E 175 .iu/, 2i !, ;ang U. Be"ing - 6rad !hin /ed ACBB. E930&3A 176 +uang, ?!. 6he 1harmacology of !hinese +erbs. !4! 1ress, Boca 4aton. ACC3, pp 2<H&B 177 .ahans 6. ,ntroduction to !hinese +erbs. !lass notes, Winter 2000. 178 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AHH 179 +olmes, 1. 6he 'nergetics of Western +erbs. 2nd 'dition. 5no .otus, ,nc., Boulder. ACC<. p. FB< 180 Wren, 4.!., 1otter@s :e !yclopedia of Botanical %rugs and 1reperations, 1otter@s limited, 'ngland. ACBB. 181 ?elloff *-, Boone !W, !ro ell -A, et al. :e agents for cancer chemoprevention. - !ellular Biochem ACCFK2F59A&2B. 182 Belanger -6, 1erillyl alcohol9 applications in oncology1 )ltern Med Re!. ACCB %ecK3=F>9<<B&EH. 4evie . 183 Belanger -6, 1erillyl alcohol9 applications in oncology. )ltern Med Re!1 ACCB %ecK3=F>9<<B&EH. 4evie . 184 +epatoprotective activity of t o plants belonging to the Apiaceae and the 'uphorbiaceae family1 7 Ethnopharmacol . 2002 /arKHC=3>93A3&F. 185 'ffects of aqueous celery =Apium graveolens> e$tract on lipid parameters of rats fed a high fat diet. Planta Med. ACCE )ebKFA=A>9AB&2A. 186 7asodilatory action mechanisms of apigenin isolated from Apium graveolens in rat thoracic aorta. Biochim Biophys )cta. ACCA :ov A<KAAAE=A>9FC&H<. 187 /ills, 5., Bone, ?. 1rinciple and 1ractice of 1hytotherapy p A<B 188 ,bid 189 ibid 190 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. E2&3, A<F&H 191 ,vie, *Wl 6he !hemistry of 1lant )uranocoumarins and 6heir /edical, 6o$icological, 'nvironmental and !oevolutionary 5ignificance. 4evista .atinoamericana %e 2uimic ACBHK AB =A>9 A&E 281 5cudder, -. ,pecific Meciations J ,pecific Medicines1 'clectic /edical 1ulbications, 5andy, 04. 282 Brin#er ). Herb 2ontraindications J Drug >nteractions1 'clectic /edical 1ublications, 04, ACCB9AA2&3 283 PDR for Herbal Medicines, Ast ed. /edical 'conomics !ompany, /ontvale, :-, ACCB9FH3. 339 1%4 for +erbal /edicines, Ast 'dition. /edical 'conomics company, ACCB. p.FBF 340 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 3AA 341 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 3A0 342 +olmes, 1eter. 'nergetics of Western +erbs, 7ol. A. Artemis 1ress. ACBC. p. 2CF&H 343 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB. 3HA&3 344 )elter, , 6he 'clectic)elter, W, The Eclectic Materia Medica, Pharmacology and Therapeutics , 'clectic /ed. 1ubl, 5andy, 04, 3rd reprint ACC<, originally published AC22. 345 !oo#, W. +. 1hysiomedical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ulbications. ABFC. p. 2C0&A 346 'lling ood, ). American /ateria /edica, 6herapeutic and 1harmacognosy. 'lling ood@s 6herapeutist, !hicago. ACAC p. <2C 347 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. <2 348 /ills, p. 3A0 349 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 3A0 350 1%4. 1 FBF 351 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 3A0 352 +offman, %. 6he +olistic +erbal, 2nd 'dition. )indhorn 1ress, ACBF, p AHC 353 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 3A0 354 +offman, %. 6he +olistic +erbal, 2nd 'dition. )indhorn 1ress, ACBF, p AHC 355 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. <2 356 /ills and Bone, 3AA 357 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 2nd ed. 'clectic /edical 1ublications, 5andy 0regon ACCB p. <2 358 +olmes, 1eter. 'nergetics of Western +erbs, 7ol. A. Artemis 1ress. ACBC. p. 2CF&H 379 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 380 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 381 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 382 )elter

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*roff -., *ropper 55, +unt 5/, )d!anced ;utrition and Human Metabolism, 2nd ed., ACCE, 5t. 1aul, /:9 West 1ubl. !o., <CF. 4obertson %, Wade %, Wor#man 4, et al, 7 2lin >n!est, ACBAKFH9AAAA. 656 !hristensen ., Burro s 4, Beha! Ther, ACC0K2A9AB3. 657 6arnopols#y /A, ,ports Medicine, ACC<KAB=2>9A0C. 658 PDR for Herbal Medicines, 2nd ed., /edical 'conomics !ompany, /ontvale, :e -ersey, 2000, p.H33 659 ,bid. 660 1eter +olmes, Energetics of +estern Herbs, 2nd ed., Artemis 1ress, ACC<, 7ol. 2, pp. FCC&H0A 661 -ames A. %u#e, I!hemicals and 6heir Biological Activities in9 !ollinsonia canadensis,J Dr1 Du3eFs Phytochemical and Ethnobotanical Databases , chttp933 .ars& grin.gov3du#e3inde$.htmlY. 662 +arvey Wic#es )elter and -ohn Uri .loyd, .ing/s )merican Dispensatory, ABth ed., 3rd revision, 'clectic /edical 1ublications, 1ortland, ACB3 663 W/., +., !oo#, Physiomedical Dispensatory: a Treatise on Therapeutics, Materia Medica and Pharmacy , 'clectic /edical 1ublications, 1ortland, ACBE, pp. 3H0&A 664 , ,bid 665 -ohn /. 5cudder, ,pecific Medication and ,pecific Medicines, AEth ed, 'clectic /edical 1ublications, 5andy, 04, AC03, p. AAF 666 )elter, pp. EB0&2 667 )inley 'lling ood, )merican Materia Medica, Therapeutic and Pharmacognosy . 'lling ood@s 6herapeutist, !hicago, ACAC, pp. 2F<&E 668 )elter, pp. EB0&2 669 'lling ood, pp. 2F<&E 670 ,bid. 671 !oo#, pp. 3H0&A 672 5cudder, p. AAF 673 )elter, pp. EB0&2 674 5cudder, p. AAF 675 'lling ood, pp. 2F<&E 676 )elter, pp. EB0&2 677 !oo#, pp. 3H0&A 678 'lling ood, pp. 2F<&E 679 )elter, pp. EB0&2 680 'lling ood, pp. 2F<&E 681 5cudder, p. AAF 682 )elter, pp. EB0&2 683 !oo#, pp. 3H0&A 684 )elter, pp. EB0&2 685 W. /itchell, ;aturopathic )pplications of the Botanical Remedies, 2nd ed., ACB3, pp. <, 3C, H< 686 ,bid. 687 ,bid. 688 ,bid., p. < 689 4eference not found. 690 /itchell, p. < 691 ,bid., p. 3C. 692 ,bid., p H< 693 C.8. ?e5all et al, Herbal Medicine: A Guide for Healthcare Professionals, 3'e P'a&!aceutical P&e , 1ondon, >K, 1996 cited in I/onograph9 5toneroot,J :atural /edicine %atabase, April AC, 2002, chttp933 .naturaldatabase.com3monograph.aspamonodidOA02]hiliteOAY, April 2A, 2002. 694 'lling ood, pp. 2F<&E 695 !oo#, p. 3H2 696 ?e5all 697 !oo#, p. 3H2 698 ?e5all 699 )elter, pp. EB0&2 700 ?e5all 701 )elter, pp. EB0&2 702 PDR for Herbal Medicines, /edical 'conomics !ompany, /ontvale, :-, ACCB cited in I/onograph9 5toneroot,J :atural /edicine %atabase, April AC, 2002, chttp933 .naturaldatabase.com3monograph.aspamonodidOA02]hiliteOAY, April 2A, 2002.

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)ra ley, %avidK .ad, 7asant. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29220 PDR for Herbal Medicines1 /edical 'conomics !ompany, ,nc., /ontvale, :-, ACCC9B32. 898 5tansbury -ill, :%. Pharmacognosy for the Herbal Practitioner1 .ecture notes, p.A2. 899 +utchens A4. >ndian Herbalogy of ;orth )merica1 5hambhala, Boston, /assachusetts, ACCA93AB. 900 +utchens, 3AB1 901 5ource un#no n 902 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. 230 903 /ills, 5imon and Bone, ?erry. 1rinicples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill&.ivingstone ACCC p. EB 964 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 965 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 966 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 967 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 968 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 997 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 998 1rat(el, +*, Q1harmaco#inetic study of percutaneous absorption of salicylic acid from baths ith salicylate methyl ester and salicylic acidR. 999 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 1000 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1001 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AE<, AB3 1002 )elter 1085 /ills 5, Bone ?. Principles J Practice of Phytotherapy . !hurchhill .ivingstone, 20009<FE 1086 )ra ley %avid, .ad 7asant. Aoga of Herbs, The. .otus 1ress, 6 in .a#es, Wisconsin, ACC29A2H. 1087 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-, ACCB9BHF. 1088 /ills, <FE 1089 /ills, <FF. 1090 +attori ,, ,#ematsu 5, ?oito A, et al. 1reliminary evidence for inhibitory effect of glycyrrhi(in on +,7 replication in patients ith A,%5. )nti!ir Res ACBCKAA92EEWF2. 1091 Beil W, Bir#hol( !, 5e ing ?). 'ffects of flavonoids on parietal cell acid secretion, gastric mucosal prostagl]in production ] Helicobacter pylori gro th. )rIneim orsch ACCEK<E9FCHWH00. 1092 /ills, <H0. 1093 1%4 for +erbal /edicines. BHF 1094 *reive /A. Modern Herbal. %over publications, :;, :;, ACHA 1095 )ra ley, A2H 1096 /ills, <H3 1097 /ills, <H2 1098 )uhrman B, 7ol#ova :, ?aplan /. Antiatherosclerotic effects of licorice e$tract supplementation on hypercholesterolemic patients9 increased resistance of .%. to atherogenic modifications, reduced plasma lipid levels, and decreased systolic blood pressure. ;utritition 2002KAB=3>92FB&H3. 1099 van 4ossum 6-*, 7ulto A*, +op W!-, et al. *lycyrrhi(in&induced reduction of alt in 'uropean patients ith chronic hepatitis !. The )merican 7ournal of 5astroenterology 200AKCF=B>92<32&H. 1100 7an 4ossum 6*, 7ulto A*, +op W!, et al. ,ntravenous glycyrrhi(in for the treatment of chronic hepatitis !9 a double&blind, randomi(ed, placebo&controlled phase ,3,, trial. 7 5astroenterol Hepatol ACCCKA<=AA>9A0C3&C. 1101 .u W. ,nt !onf A,%5 ACC< Aug H&A2KA0=2>92A< =abstract no.1B0BFB> cited in /ills, <H3. 1102 5teinberg, %. 6he anticariogenic activity of glycyrrhi(in9 preliminary clinical trials1 >sr 7 Dent ,ci ACBC 0ctK2=3>9AE3&H 1103 %as 5?. %eglycyrrhi(inated liquorice in aphthous ulcers. 7 )ssoc Physicians >ndia ACBC 0ctK3H=A0>9F<H 1104 'vans )2. 6he rational use of glycyrrhetinic acid in dermatology. Br 7 2lin Pract ACEBKA292FCWH<. 1105 )elter, +W. .ing/s )merican Dispensary1 1106 1%4 for +erbal /edicines, ACCB. 1107 1%4 for +erbal /edicines 1108 PDR for Herbal Medicines, (4$ 1109 Brin#er, ). Herb 2ontraindications J Drug >nteractions1 'clectic /edical 1ublications, 04 , ACCB9CA&2 1110 1%4 for +erbal /edicines 1111 5igur"onsdottir +A, )rna(son ., /anhem ?, et al. .iquorice&induced rise in blood pressure9 a linear dose&response relationship. 7 Hum Hypertens 200AKAE=B>9E<C&E2. 1112 5trandberg 6', -arvenpaa A., 7anhanen +, et al. Birth outcome in relation to licorice consumption during pregnancy. )m 7 Epidemiol 200AKAE3=AA>9A0BE&B.
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/ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. ECA&EC3 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1131 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000. p. ECA&EC3 1132 ,bid 1133 ,bid 1134 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. 20A

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/ills and Bone, p AH0 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p 20A 1674 *otteland /, 'spino(a -, !assels B, et al. 'ffect of a dry boldo e$tract on oro&secal intestinal transit in healthy volunteers. Re! Med 2hil ACCEKA23=B>9CEE&F0. 1675 ;eh, et al Antiviral 4es , 20, ABE9ACC3 1676 /ei$a W, +ao ei !, ;an"in ., et al. +erbs of the genus Phyllanthus in the treatment of chronic hepatitis B9 observation ith three preparations from different geographic sites. 7 8ab 2lin Med ACCEKA2F93E0W2. 1677 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000 1678 /ills, 5. and Bone, ?. Principles and Practice of Phytotherapy . !hurchhill .ivingstone, :e ;or#, :;. 2000, p. 220. 1679 6hyagara"an, et al, .ancet, 2, HF<9ACBB 1680 Pin&+ua W, !hang&2ing ., Ping&Bo *, et al. A comparative study of 1hyllanthus amarus compound and interferon in the treatment of chronic viral hepatitis B. ,outheast )sian 7 Trop Med Public Health 200AK32=A>9A<0&2. 1681 :arendranathan /, 4emla A, /ini 1!, et al. A trial of 1hyllanthus amarus in acute viral hepatitis. Trop 5astroenterol ACCCK20=<>9AF<&F. 1682 Wang /, !heng +, .i ;, et al. +erbs of the genus 1hyllanthus in the treatment of chronic hepatitis B9 observations ith three preparations from different geographic sites. 7 8ab 2lin Med ACCEKA2F=<>93E0&2. 1683 %oshi -!, 7aidya AB, Antar#ar %5, et al. A t o&stage clinical trial of 1hyllanthus amarus in hepatitis B carriers9 failure to eradicate the surface antigen. >ndian 7 5astroenterol ACC<KA3=A>9H&B. 1684 6hamli#it#ul 7, Wasu at 5, ?anchanapee 1. 'fficacy of 1hyllanthus amarus for eradication of hepatitis B virus in chronic carriers. 7 Med )ssoc Thai ACCAKH<=C>93BA& E. 1685 Blumberg B5, /illman ,, 7en#ates aran 15, et al. +epatitis B virus and primary hepatocellular carcinoma9 treatment of +B7 carriers ith 1hyllanthus amarus. Gaccine ACC0KB 5upple95BF&C2. 1686 6hyagara"an 51, 5ubramanian 5, 6hirunalasundari 6, et al. 'ffect of 1hyllanthus amarus on chronic carriers of hepatitis B virus. 8ancet ACBBK2=BFA<>9HF<&F 1687 5rividya :, 1eri al 5. %iuretic, hypotensive and hypoglycaemic effect of 1hyllanthus amarus. >ndian 7 Exp Biol ACCEK33=AA>9BFA&<. 1688 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. AFF 1822 6urner :-2 !ontemporary use of bar# for medicine by t o 5alishan native elders of southeast 7ancouver ,sland, !anada. - 'thnopharmacol. ACC0 AprK2C=A>9EC&H2. 1823 /ills 5, Bone ?. 1rinciples and 1ractice of 1hytotherapy9 /odern +erbal /edicine. !hurchill .ivingstone, 2000. p. AH0&A 1824 )elter +W, .loyd -U. ?ing@s American %ispensatory, ABth ed. 'clectic /edical 1ulbications, 5andy, 04 ACB3 p. 1825 5cudder -. 5pecific /edications and 5pecific /edicines. 1826 /ills and Bone p. AHA 1827 /ills and Bone, p AH0 1828 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. A0H 1903 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-. 200A 1904 /aiti, /,et al., )ebs .ett, A<2, 2B0 1905 .ininger et al9 Healthnotes9 2linical Essentials, +erb /onographs. 1rima 1ublishing, 4oc#lin, !A. 200A 1906 - !lin %ent A9 CA&A0A, ACBC 1907 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE p. 1908 ?uftinec //, /ueller&-oseph .-, and ?opc(y# 4A, - !anadian %ental Assoc., ACC0, EF=H>93A 1909 !oo#, W/. 6he 1hysio&/edical %ispensatory9 a 6reatise on 6herapeutics, /ateria /edica and 1harmacy. 'clectic /edical 1ublications, 5andy, 04 ACBE 1910 Brin#er, ). +erb !ontraindications and %rug ,nteractions. 'clectic /edical 1ublications, 5andy, 04 ACCB. p. <0 1969 Brin#er, ). +erb !ontraindications and %rug ,nteractions, 3rd ed. 'clectic /edical 1ublications, 5andy, 04 200A. p. AE3 1970 )elter, +. W., .loyd, -.U. ?ing@s American %ispensatory, ABth ed.. 'clectic /edical 1ublications. 5andy, 04. ABCB 1971 /oore, /. /edicinal 1lants of the %esert and !anyon West, p B0 2016 PDR for Herbal Medicines. /edical 'conomics !ompany ,nc., /ontvale, :-, 200A 2017 7oiten#o *:. Use of stachyrene in combined treatment of patients ith obstructive "aundice. .lin .hir1 ACC0K=AA>92F&H.