Fabaceae

Common Trade Names

Jamaican Dogwood Rootbark, Willow-Meadowsweet Compound

Common Forms

Available as dried preparations of root or bark, fluidextracts (30% to 60% alcohol), tinctures (45% alcohol), and unprocessed bark strips.

Source

Piscidia erythrina grows naturally in the West Indies and northern parts of South America; it has been transplanted to Mexico, Texas, and Florida.

Chemical Components

Jamaica dogwood contains isoflavones (erythbigenin, piscidone, piscerythrone, ichthynone, listetin), rotenoids (rotenone, millettone, isomillettone, dehydromillettone, sumatro]), tartaric acid derivatives (piscidic fukiic, 3′O-methylfukiic acids), organic acids, beta-sitosterol, and tannins.

Actions

Isoflavone components, derived as fluidextracts from P. erythrina and other plant sources, showed spasmolytic activity in mice and anxiolytic to sedative responses, depending on the dose of extract used . Anti-inflammatory, antipyretic, and antitussive activities have also been seen in animals.

Reported Uses of Jamaica Dogwood Trees

Jamaica dogwood trees has been claimed to be a calming agent. It has been claimed to be an analgesic for toothache, an antispasmodic for asthma, and a hypnotic for insomnia and to treat migraines, neuralgias, renal or intestinal colic, and whooping cough. The herb also has been used in dysmenorrhea and to help with labor pains. No human trials attesting to the therapeutic benefits of Jamaica dogwood can be found.

Dosage

Doses vary among researchers.

Dried product: 2 to 4 g P.O. daily in divided doses, or 1 tsp in 1 cup of water, simmered for 10 minutes and then taken as a tonic.

Extract: 1 or 2 drams P.O. as a daily dose, starting with 5 to 20 gtt and increased cautiously.

Tincture: 5 to 15 ml P.O. as a daily dose, usually taken 2 to 3 ml at a time.

Doses for analgesic or antispasmodic effect are given three to five times daily; hypnotic doses are given at bedtime.

Adverse Reactions

CNS: sedation.

GI: indigestion, nausea.

Interactions

CNS depressants (alcohol, benzodiazepines, narcotic analgesics): Jamaica dogwood may potentiate the effects of these drugs. Avoid concomitant use.

Contraindications And Precautions

Jamaica dogwood is contraindicated in pregnant or breast-feeding patients. Avoid use in patients with CV disease because hypotension and mild myocardial depression may occur.

Special Considerations

Caution the patient who is at risk for hypotension or who has CV disease to avoid using Jamaica dogwood.

Inform the patient that few, if any, studies have been conducted in humans and that no evidence exists to confirm a therapeutic benefit.

Symptoms of overdose include increased salivation, sweating, and tremor. I.V. administration has resulted in toxicity in animals; oral administration appears to have a lower potential for toxicity.

Caution the patient to avoid hazardous activity until CNS effects of the herb are known.

Inform the patient that some constituents of the plant have shown carcinogenic activity.

Points of Interest

Central and South American fisherman use rotene and ichthynone to stun fish, but these components do not seem to have this effect in mammals.

Jamaica dogwood is unrelated to the eastern U.S. plant, the common dogwood, Cornus florida.

The European Council has found Jamaica dogwood unsuitable for use as a natural food flavoring.

Commentary

Information on Jamaica dogwood is scarce. Consumption of this plant should be avoided until data regarding its safety are available.

Taxonomic Class

Lamiaceae

Common Trade Names

None known.

Common Forms

Available as an infusion or tincture of leaves and flowers (aerial parts).

Source

Glechoma hederacea, with its kidney-shaped leaves and purple-blue flowers in whorls, is one of the most common plants growing wild in Great Britain.

Chemical Components

Ground ivy contains sesquiterpenes, flavonoids, a volatile oil, a bitter principle (glechomine), saponin, resin, and tannins.

Actions

Ground ivy has not been well studied, and thus little is known about its action . It appears to have astringent properties and is claimed to dry secretions and decrease inflammation. It has been used as a decongestant and a diuretic, but data to support these effects are unavailable.

Reported Uses

Ground ivy has traditionally and anecdotally been recommended by herbalists to treat disorders of the ear, nose, throat, and digestive system. Its astringent properties have been used to reduce phlegm in allergic rhinitis, bronchitis, hay fever, and sinusitis. Its binding nature has led to its use to treat diarrhea and to dry up watery and mucoid secretions. All the evidence of ground ivy’s effectiveness comes from folklore and anecdotal reports; no animal or human trials have been reported.

Dosage

14 to 28 grains prepared as a fluidextract P.O. t.i.d.

Adverse Reactions

None reported.

Interactions

None reported.

Contraindications And Precautions

No known contraindications.

Special Considerations

Inform the patient that little information exists to support a therapeutic use of ground ivy.

Suggest other, contemporary forms of therapy before starting therapy with this herb.

Poisoning has occurred in horses that have ingested the plant. Symptoms include cyanosis, lung congestion, pupil dilation, salivation, and sweating.

Although no known chemical interactions have been reported in clinical studies, consideration must be given to the pharmacologic properties of the herbal product and the potential for exacerbation of the intended therapeutic effect of conventional drugs.

Points of Interest

Ground ivy is known in parts of England as alehoof because it was used in medieval times to flavor and clarify ale.

Commentary

Ground ivy appears to be a well-tolerated herb often given to children to treat congestive conditions such as sinusitis.lt may be safe at low doses, but animal toxicities have been reported at higher doses; thus, caution must be exercised. Because of the lack of controlled animal or human data, this product cannot be recommended.

ALTERNATIVE NAMES: AGATHOSMA, BAROSMA BETULIN A, BETULINE, BOCCO, DIOSMA BETULINA

Taxonomic Class

Rutaceae

Common Trade Names

Multi-ingredient preparations: Alvita Teas Buchu, Buchu Essential Oil, Cranberry/Buchu Concentrate, Gaia Herbs Buchu Leaves, Gaia Herbs Plantain/Buchu

Common Forms

Available as dried leaves (for infusion) and a tincture.

Source

Active components of buchu are derived from a volatile oil in the leaves of Barosma betulina (Agathosma betulina) and the related species Barosma serratifolia and Barosma crenulata, low-lying shrubs that grow in South Africa. The leaves are harvested while the plants are flowering or bearing fruit.

Chemical Components

The volatile oil of B. betulina leaves contains more than 100 chemicals. Those that may be responsible for the pharmacologic properties attributed to the herb include diosphenol (buchu camphor), pulegone, terpene-4-ol, and a number of flavonoids. Mucilage, resin, and coumarins have been reported in other Barosma species.

Actions

Little information is available on the action of buchu. In studies with rats, diosmin, a buchu flavonoid, acted as an anti-inflammatory .

Reported Benefits

Buchu is claimed to be beneficial as an antirheumatic and a diuretic and in the treatment of colds, coughs, stomachaches, and urogenital tract infections. The use of buchu leaves and the volatile oil has been popular among the inhabitants of South Africa for hundreds of years.

Dosage

Infusion: 1 small glass of the infusion (1 oz of dried leaves added to 1 pt of boiling water).

Tincture: I to 2 ml P.O. t.i.d. or q.i.d.

Adverse Reactions

GI: diarrhea, nausea, vomiting (volatile oil).

GU: increased menstrual flow (pulegone), nephritis (volatile oil).

Hepatic: hepatotoxicity from volatile oil constituent (pulegone).

Other: spontaneous abortion (pulegone).

Interactions

Anticoagulants: May potentiate effects of anticoagulants. Avoid administration with buchu.

Contraindications And Precautions

Buchu is contraindicated in pregnant or breast-feeding patients; pulegone has abortifacient activity and increases menstrual flow. It is also contraindicated in patients who are prone to kidney infections or those with urinary tract infections, mild to moderate renal disease, or hepatic dysfunction because the herb may exacerbate these conditions.

Special Considerations

Monitor liver function test results in patients using buchu because of its potential for causing hepatic dysfunction.

Instruct the patient to avoid ingesting this plant; little is known about buchu, and some components could be toxic.

Advise women to avoid using buchu during pregnancy or when breast – feeding.

Points of Interest

Buchu was once included in the U.S. National Formulary as an antiseptic and a diuretic. In 1821, it was listed in the British Pharmacopoeia as a medicine for catarrh of the bladder, cystitis, nephritis, and urethritis.

In Germany, buchu is used as a treatment for kidney and urinary tract infections and as a diuretic. German health authorities, however, do not endorse its use because its purported actions for those conditions have not been substantiated.

Buchu is used as a “cooling diuretic” in Ayurvedic medicine .

Commentary

Buchu’s efficacy has not been demonstrated in clinical trials or animal studies. Because of its potential for causing hepatic dysfunction, this herb cannot be recommended.

Taxonomic Class

Lamiaceae

Common Trade Names

None known.

Common Forms

Available in ointment, tea, and tincture forms and prepared as a poultice.

Source

Active components are derived from the leaves and stems of Stachys palustris (marsh woundwort) and S. sylvatica (hedge woundwort), members of the mint family.

Chemical Components

Woundwort contains various flavonoids (including palustrin), stachydrine, and iridoids.

Actions

Mechanisms of action are not well described for this herb. Investigations have focused on other S. species. S. sieboldii may contain a promising agent (acteoside) for preventing glomerulonephritis . Flavonoids isolated from S. candida and S. chrysantha have been reported to inhibit prostaglandin E2 and leukotriene C4 in murine macrophages and thromboxane B2 production in human platelets . The essential oils of these two species have also been evaluated for antibacterial activity .

Reported Uses

Both varieties of woundwort have been used externally to stop bleeding and promote healing of wounds. The herb has also been used as an antiseptic, an astringent, and a disinfectant. Internally, woundwort is claimed to be useful as an antispasmodic, to ease abdominal cramps and joint pain, and to treat diarrhea, dysentery, fever, menstrual disorders, and vertigo.

Dosage

For abdominal cramps or diarrhea, 1 to 2 ml of tincture P.O. t.i.d.

Tea: 1 tsp of dried herb steeped in 1 cup of boiling water for 10 to 15 minutes; drink tea t.i.d.

Poultice: apply bruised leaves to wound.

Ointment: incorporate dried leaves into an ointment base and apply topically.

Adverse Reactions

None reported.

Interactions

None reported.

Contraindications and Precautions

Avoid using woundwort in pregnant or breast-feeding patients; effects are unknown.

Special Considerations

• Inform the patient that no clinical data support the use of woundwort for any medical condition.
• Advise women to avoid using woundwort during pregnancy or when breast- feeding.
• Inform the patient that several plant species are referred to by the common name woundwort, including Achillea millefolium, Anthyllis vulneraria, Prunella vulgaris, Solidago canadensis, Solidago virga urea, and Stachys officinalis.

Commentary

Although woundwort has traditionally been used to promote wound healing and been taken internally for other complaints, there is no scientific evidence to support these uses. This herb cannot be recommended for use until safety and efficacy data become available.

Taxonomic Class

Ulmaceae

Common Trade Names

Slippery Elm Bark, Vegetarian Caps

Common Forms

Available as powdered or shredded bark, capsules (375 mg, 400 mg), liquid extract (1:1 in 60% alcohol), and lozenges.

Source

The inner bark of Ulmus rubra Muhl. (Ulmus fulva Mich.) is used for medicinal purposes. Slippery elm can be found throughout North America. The pieces of slippery elm bark are flat (2 to 4 mm thick) and oblong. The bark’s outer surface is light yellow to reddish brown; the inner surface is much paler.

Chemical Components

The major therapeutic component in slippery elm bark is a mucilaginous material that consists of hexoses, pentoses, methylpentoses, at least two polyuronides, glucose, galacturonic acid, l-rhamnose, d-galactose, and fructose (trace). Other components include tannins, phytosterols (phytositosterol, citrostadienol, dolichol), sesquiterpenes, calcium oxalate, and cholesterol.

Actions

Slippery elm has largely been used as a soothing agent. It has demulcent and emollient activity . The tannin components may impart some astringent activity.

Reported Uses

Although this plant was once listed in the USP, no clinical study data are available to support its use. Its soothing effects have long been described and been accepted by many herbalists. Slippery elm has, therefore, been used as an antitussive and a skin emollient and to soothe GI discomfort. Some pharmacognosy textbooks have added that a poultice of powdered slippery elm bark has been used for inflammation of the skin and tract.

Dosage

For GI discomfort, powdered bark as a 1:8 decoction of 4 to 16 ml P.O. t.i.d., or 4 gin 500 ml of boiling water P.O. t.i.d.; or 5 ml of liquid extract P.O. t.i.d.

For topical use as a skin emollient, poultice made of coarse powdered bark in boiling water.

Adverse Reactions

GU: spontaneous abortion (with whole bark preparations).

Interactions

None reported.

Contraindications and Precautions

Avoid using slippery elm in pregnant or breast-feeding patients and in those who are hypersensitive to slippery elm or its components.

Special Considerations

• Inform the patient that insufficient data exist to describe the risks and benefits of slippery elm.
• Advise women to avoid using slippery elm during pregnancy or when breast-feeding.
• Caution the patient to avoid whole-bark preparations of slippery elm because little evidence exists to support the herb’s use.
• Although no known chemical interactions have been reported in clinical studies, consideration must be given to the pharmacologic properties of the herbal product and the potential for exacerbation of the intended therapeutic effect of conventional drugs.

Points of Interest

• Small quantities of powdered slippery elm bark have been included in the multiherbal decoction known as Essiac. Anecdotal reports supported the notion that this formulation had anticancer activity, but a clinical trial could not show any benefit.

Commentary

Insufficient published data are available to recommend internal use of this agent. Proven contemporary therapies should be used instead.

Taxonomic class

Asteraceae

Common Trade Names

None known.

Common Forms

Available as dried, powdered santonin and oral tablets.

Source

The flowers and seeds of Artemisia cina (a distinct variety of Artemisia maritima) are found in most parts of Asia.

Chemical Components

Santonin, the active ingredient, is a lactone glycoside extracted from unopened flowers. It is bitter-tasting and odorless and occurs as a colorless to white crystalline powder. Other ingredients include artemisin and a volatile oil.

Actions

Some references claim that this herb has anthelmintic properties and is effective against roundworms and threadworms but not tapeworms.

Reported Uses

Santonica has been used anecdotally throughout history as an anthelmintic for adults and, especially, children. Russia exported the crude powder to the United States during World War II, until the United States was able to produce a domestic supply itself. Santonica was used for pertussis in the 1700s .

Dosage

Oral lozenges, powder, tablets: 2 to 5 grains P.O. in varying dosages.

Adverse Reactions

CNS: epileptiform seizures, headache.

EENT: visual disturbances (including aberrations of color vision).

GI: nausea, vomiting.

Interactions

Anticonvulsants: May lower seizure threshold. Avoid administration with santonica.

Contraindications and Precautions

Avoid using santonica in pregnant or breast-feeding patients; effects are unknown. Use cautiously in patients who are prone to seizures.

Special Considerations

• Advise the patient not to take santonica without medical supervision.
• Caution the patient to avoid performing hazardous activities until CNS effects of santonica are known.
• Advise women to report planned or suspected pregnancy.

Alert Deaths have resulted from poisonings.

• Caution the patient to keep santonica out of the reach of children and pets.

Commentary

Historically, santonica has been widely used as an anthelmintic. It was an official product in the National Formulary and British Pharmacopeia into the 1950s. Its value cannot be discounted, but more contemporary anthelmintics are probably less toxic and more effective against a wider range of worm infestations.