Updated Bastyr Materia Medica

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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



• • • •

!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



,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





• •



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





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 









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.
320 321

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.



• • • • •



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



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

• •

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



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
361 362

)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>
373 374

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.



/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>.



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.



!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







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> 



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.



Current Medicinal uses:



+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:





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.





• •



• •

':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





(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 ".







 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.

• • •

,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.
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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.
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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

• • •

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.





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
1113 1114

)elter +W, .oyd -U. .ings )merican Dispensatory, ABth ed. 'clectic /ecial 1ublications, 5andy, 04, ACB3. )elter.

1115 1116

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.
1118 1119

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.



• •





• • •

!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.





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.
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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.

1211 1212

'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.
1219 1220

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
1224 1225

)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
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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