3 Medical Plants from A to Z – Herb: Adonis (Adonidis herba). – Important constituents: Flavonoids and steroid cardiac glycosides. – Pharmacological properties: Steroid glycosides have a positive inotropic action. – Heart failure (NYHA classes I–II) – Cardiac arrhythmia – Nervous heart disorders – Daily dose: Mean 0.5 g, maximum 3 g. – Monographs: DAB 1998; Commission E – Scientific publications: see p. 478 – Loew D: Phytotherapie bei Herzinsuffizienz. Z Phytother 18 (1997), 92–96. – Herb: Angelica root (Angelicae radix). – Important constituents: Essential oils (β-phellandrene, α-pinene), furanocoumarins (bergapten, xanthotoxin, imperatorin, isoimperatorin, angelicin, archangelicin), and caffeic acid derivatives (chlorogenic acid). – Pharmacological properties: Angelica root extracts act as calcium antagonists in vitro. – Lack of appetite, anorexia – Dyspeptic complaints – Monographs: Commission E – Scientific publications: see p. 478 – Herb: Aniseed (Anisi fructus). – Important constituents: Essential oil (2–6%) consisting mainly of trans- anethole (ca. 94%) as well as apigenin-7-O-glucoside and luteolin-7-O- glucoside. – Pharmacological properties: Aniseed has expectorant, weakly spasmolytic and antibacterial action. Aniseed oil has antibacterial and antiviral activity. – Fever, colds, and flu – Cough, runny nose, bronchitis – Inflammations of the mouth and throat – Dyspeptic complaints – Lack of appetite – Acute pharyngitis – Internal administration • Daily dose: 3 g dried seeds. • Tea: One cup in the morning and/or evening (expectorant). For gastrointestinal complaints: 1 tablespoon daily (adults), 1 teaspoon in bottle (infants). – When used as a liniment, apply the oil every 30 to 60 minutes (acute) or 1 to 3 times a day (chronic). – Monographs: ESCOP, Commission E – Reichling J, Merkel B: Elicitor-Induced Formation of Coumarin Derivatives of Pimpinella anisum. Planta Med 59 (1993), 187. – Herb: Arnica flower (Arnicae flos). – Important constituents • A. montana: Sesquiterpene lactones of the pseudoguaianolide type (mainly esters of helenalin and 11α, 13-dihydrohelenalin), essential oil (0.2–0.35%), and flavonoids (0.4–0.6%). • A. chamissonis ssp. foliosa: Sesquiterpene lactones of the pseudoguaianolide type (0.2–1.5%), helenalin derivatives, arnifolins, and chamissonolides. – Pharmacological properties: The sesquiterpenes (e. g. helenalin) have antimicrobial action in vitro and antiphlogistic action in animals. Helenalin inhibits the activation of the transcription factor NF-κB, which is a main mediator of the immune response. Topical arnica has antiphlogistic, analgesic, and antiseptic action (due to the sesquiterpene lactones). The essential oil and flavonoid compounds may contribute to these effects. – Thrombophlebitis – Furunculosis and inflammations resulting from insect bites – Inflammation of the skin – Inflammation of the mouth and throat – Rheumatic muscle and joint complaints – Contusions – External use • 1: 10 tincture (DAB): One part arnica flower to 10 parts ethanol 70% (v/v) (dry-weight basis). • Fomentations: Dilute arnica tincture at a ratio of 1 to 3–10 parts water. • Mouth wash: Dilute tincture at a ratio of 1: 10, since the tincture is unstable if diluted at a ratio of 1: 100. • Ointment: Mix (generally 10–20%, but no more than 25%) arnica tincture in a neutral ointment base. The ointment should contain no more than 15% arnica oil. • Oil: One part drug extract to 5 parts slightly warmed, vegetable oil, such as olive oil. – Internal use: Not recommended. Concentrated tincture can cause irritation of the gastrointestinal mucosa accompanied by nausea, vomiting, diarrhea and bleeding, and in high enough doses can lead to respiratory stimulation, paralysis of the heart, and death. – Monographs: DAB 1998, ESCOP, Commission E – Scientific publications: see p. 478; Hörmann HP, Kortin HC: Allergic acute contact dermatitis due to Arnica tincture self-medication. Phytomedicine 4 (1995), 315–317; Lyss G, Schmidt TJ, Merfort I, Pahl HL: Helenalin an anti-inflammatory sesquiterpene lactone from Arnica selectively inhibits transcription factor NF-κB. Biol Chem, 378 (1997), 951–961; Willuhn G, Leven W: Qualität von Arnikazubereitungen. Deutsche Apotheker Ztg 135 (1995), 1939–1942. – Herb: Artichoke leaf (Cynarae folium). – Important constituents: Caffeic acid derivatives, ca. 1% (chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid, cynarin), flavonoids, 0.5% (cynaroside, scolymoside, cynarotrioside, luteolin), and sesquiterpene lactones, 4% (cynaropicrin, 47–83%, dehydrocynaropicrin, grossheimin, and cynaratriol). – Pharmacological properties: Sesquiterpene lactones (bitter principles), hydroxycinnamic acid and flavonoids have choleretic, hepatoprotective, antidyspeptic, and antilipemic effects. The herb was shown to reduce cholesterol levels in rats (luteolin inhibits cholesterol synthesis), as well as to increase choleresis and reduce symptoms of dyspepsia, compared with controls, in randomized double-blind studies with healthy human volunteers. In a small trial (n = 44), artichoke extract reduced total cholesterol in volunteers with baseline values above 220 mg/dL, compared with controls. – Lack of appetite – Meteorism – Liver and gallbladder complaints – Hyperlipoproteinemia (high-dose, standardized extracts) – Daily dose: 6 g drug. – Monographs: BHP 96; Brazil 3; ESCOP. Commission E – Scientific publications: see p. 478; Petrowicz O, Gebhardt R, Donner M, Schwandt P, Kraft K: Effects of artichoke leaf extract on lipoprotein metabolism in vitro and in vivo. Atherosclerosis 129 (1997), 147; Fintelmann V: Antidyspeptische und lipidsenkende Wirkung von Artischockenblätterextrakt. Z Phytother 17 (1996), Beilage ZFA; Gebhardt R: Antioxidative and protective properties of extracts from leaves of the artichoke (Cynara scolymus L.) against hydroperoxide-induced oxidative stress in cultured rat hepatocytes. Toxicol Appl Pharmacol, 144 (1997), 279–286; Wasielewski S: Artischockenblätterextrakt: Prävention der Arteriosklerose. Deutsche Apotheker Ztg 137 (1997), 2065–2067. – Herb: Asian ginseng root (Ginseng radix). The herb consists of the dried primary roots (tap roots), secondary roots, and hair roots of four- to seven-year-old Panax ginseng C. H. M. plants and preparations of the same. – Important constituents: Triterpene saponins (0.8–6%) such as gingenosides; panaxans; panaxynol, essential oil. – Pharmacological properties: Asian ginseng induces an unspecific increase in the endogenous defenses of animals to exogenous noxae and physical, chemical and biological stressors, that is, it has an adaptogenic or antistress effect. Stress models demonstrated that Asian ginseng increased the animals’ ability to cope with psychological and physical pressure. In addition, ginseng increases, shortens the recovery phase, and enhances coordination and memory in humans. – Exhaustion, convalescence – Decreased mental and physical performance and concentration – Fatigue and debility – Tea: Boil 3 g of the finely cut dried roots for at least 30 or 45 minutes and steep for another 15 minutes. Strain and drink or store in refrigerator for use during the day. If only larger root pieces and whole roots are available, the patient should crush or cut the roots into coarse pieces before use; pre-crushed roots may also be available. – Daily dose: Dry extract: 1–2 g. For a usual 5: 1 extract, the dose would be about 1 g, equivalent to 2 “0” caps or usually 2 tablets/day. Standardized extract (5–10% ginsenosides, typically 200 mg per unit); 1–2 capsules or tablets twice daily. Tea: one cup, 3 to 4 times a day. Treatment should be continued for 3 months followed by a break, after which treatment can be re-initiated. – Monographs: DAB 1998; ESCOP, Commission E – Scientific publications: see p. 478; Blasius H: Phytotherapie: Adaptogene Wirkung von Ginseng. Deutsche Apotheker Ztg 135 (1995), 2136–2138; Pfister-Hotz G: Phytotherapie in der Geriatrie. Z Phytother 18 (1997), 165–162. – Drug: Birch leaf (Betulae folium). – Important constituents: Flavonoids, triterpene saponins, essential oil, and phenyl-carboxylic acids. – Pharmacological properties: The chemical substances in birch leaf increase the urinary volume and enhance the flow of urine in the urinary tract, resulting in the increased elimination of water (aquaresis). – Rheumatic diseases (supportive treatment) – Used as a diuretic to flush bacteria out of the lower urinary tract and to flush out renal gravel. – Steep 1–2 tablespoons of the drug in 150 mL of hot water. • Dosage: One cup, between meals, 3 to 4 times a day. An adequate intake of fluids is essential. – Monographs: ESCOP, Commission E – Scientific publications: see p. 478 – Herb: Orange peel (Aurantii pericarpium). The herb consists of the fresh or dried peel of Citrus aurantium (L.) O., without the spongy white layer (albedo layer), and preparations of the same. – Important constituents: Ca. 1.5% essential oil ((+)-limonene, 90%). Expressed orange oil also contains lipophilic flavonoids and furanocoumarins. – Pharmacological properties: Orange peel increases gastric juice production through reflex mechanisms. – Lack of appetite – Dyspeptic complaints – Mean daily dose: 12 g. – Daily dose: 10–15 g of the herb. – Monographs: Commission E, Mar 31 – Scientific publications: see p. 478; Hausen B: Allergiepflanzen, Pflanzenallergene. ecomed Verlagsgesellsch. mbH, Landsberg 1988; Ihrig M: Qualitätskontrolle von süßem Orangenschalenöl. PZ 140 (1995), 2350–2353; Kern W, List PH, Hörhammer L (Ed): Hagers Handbuch der Pharmazeutischen Praxis. 4. Aufl., Bde. 1–8, Springer Verlag Berlin, Heidelberg, New York 1992–1994. – Herb: Bittersweet stems (Dulcamarae stipites). The herb consists of the dried stems of 2- to 3-year-old Solanum dulcamara L. plants, collected in the spring before the start of leafing or in the late fall after the leaves have shed, and preparations of the same. – Important constituents: Steroid alkaloid glycosides (0.07–0.4%) and steroid saponins. – Pharmacological properties: Saponins enhance the absorption of steroid alkaloid glycosides. They stimulate phagocytosis and have hemolytic, cytotoxic, antiviral, anticholinergic, and local anesthetic effects. The constituent solasodine has a cortisone-like effect in individuals with rheumatic poly-arthritis and Bekhterev’s arthritis, and it has a desensitizing effect. – Eczema, boils, acne – Warts – For supportive treatment of chronic eczema – Decoction: Add 1–2 g of the herb to 250 mL of water. – External use only: Apply compresses soaked in bittersweet decoction several times a day. – Monographs: Commission E – Herb: Black cohosh (Cimicifugae rhizoma). The herb consists of the dried rhizomes of Actaea racemosa L. and preparations of the same. Unstandardized liquid and standardized powdered extracts in capsules and tablets are widely available. – Important constituents: Triterpene glycosides (actein, cimifugoside), flavonoids (formononetin), and resins (cimifugin); also other phytoestrogens, which are chemically unidentified. – Pharmacological properties: The extract did not increase the weight of the uterus in ovariectomized animals. The phytoestrogens in the rhizome of Actaea racemosa bind to the estrogen receptors, and have selective estrogen receptor modulator properties. In one double-blind placebo-controlled clinical study, black cohosh extract was shown to improve the symptoms of menopause, especially hot flushes. – Menopausal complaints – Premenstrual syndrome (PMS) – Menstrual cramps – Pregnancy and breast feeding – Hormone-dependent tumors – Daily dose: 3 g herb. – Tincture (1: 10): 10 drops on a cube of sugar, 3 times a day. Allow to dissolve slowly in the mouth. – Standardized extract products (containing 200 mg extract), 1 tablet or capsule twice daily. – Black cohosh root should not be used for more than 6 months without the supervision of a qualified health care practitioner. – Monographs: ESCOP, Commission E – Scientific publications: see p. 478; Einer-Jensen N, Zhao J, Andersen KP, Kristoffersen K: Cimicifuga and Melbrosia lack oestrogenic effects in mice and rats. Maturitas 25 (1995), 149–153; Gruenwald J: Standardized Black Cohosh (Cimicifuga) Extract Clinical Monograph. Quarterly Review of Natural Medicine 4 (1998), 117–125; Jarry H et al: Treatment of Menopausal Symptoms with Extracts of Cimicifuga Racemosa, In vivo and in vitro Evidence for Estrogenic Activity. Loew D et al. (Ed.): Phytopharmaka in Forschung und klinischer Anwendung. Darmstadt, 1995, S 99–112; Liske E: Therapeutic Efficacy and Safety of Cimicifuga racemosa for Gynecologic Disorders. Advances in Therapy 15, 1 (1998), 45–53. – Herb: Buckthorn fruit (Rhamni cathartici fructus). The herb consists of the fresh or dried ripe drupes of Rhamnus cathartica L. and preparations of the same. – Important constituents: Anthracene derivatives (2–7%) (anthranoids), tannins (3–4%), and flavonoids (1–2%). – Pharmacological properties: Anthranoid compounds are antiabsorptive and hydragogue laxatives. Hence, the herb softens the stools and increases the volume of the bowel contents. – Tea: Steep 4 g (ca. 1 teaspoon) of the chopped herb in 1 cup of boiled water for 10 to 15 minutes. Alternatively, place the herb in cold water, boil for 2 to 3 minutes, then strain immediately. • Dosage: One cup in the morning and at night. – Daily dose: 2–5 g. – As a rule, the minimum dose required to soften the stools should be used, and continuous use of the herb should be restricted to only a few days. – Monographs: DAB 1998; Commission E – Scientific publications: see p. 478; Anon: Abwehr von Arzneimittelrisiken, Stufe II. Deutsche Apotheker Ztg 136 (1996), 2353–2354; Anon: Anwendungseinschränkungen für Anthranoid-haltige Abführmittel angeordnet. PUZ 25 (1996), 341–342. – Herb: Butcher’s broom rhizome (Rusci aculeati rhizoma). The herb consists of the dried rhizomes and roots of Ruscus aculeatus L. and preparations of the same. – Important constituents: Steroid saponins (4–6%) (ruscin, ruscoside, aglycon of neoruscogenin, ruscogenin) and benzofuranes. – Pharmacological properties: Butcher’s broom is antiexudative, antiphlogistic, and venotonic. – Hemorrhoids – Varicose veins – External use: Daily dose: 7–11 mg total ruscogenins. – Internal use: Daily dose: 100–200 mg total ruscogenins. – Monographs: ESCOP, Commission E – Scientific publications: see p. 478; Adamek B, Drozdzik M, Samochowiec L, Wojcicki J: Clinical effect of buckwheat herb, Ruscus extract and troxerutin on retinopathy and lipids in diabetic patients. Phytotherapy Res 10 (1996), 659–662; Dunaouau CH et al: Triterpenes and sterols from Ruscus aculeatus. Planta Med 62 (1997), 189–190. – Herb: Calamus rhizome (Calami rhizoma). The herb consists of the dried, coarsely chopped (and usually peeled) rhizome of Acorus calamus (L.). Calamus oil is distilled from the same plant. – Important constituents: Essential oil (1.7–9.3%),α- and γ-asarone, β-gurjunene, α-calacorene, and acorone (the content of cis-isoasarone and, especially, β-asarone depends on the degree of ploidy of the plant). – Pharmacological properties: Calamus inhibits platelet aggregation in vitro and has vermicidal and insecticidal properties. In animal studies, the herb demonstrated spasmolytic and sedative effects, reduced spontaneous stomach activity, and lowered the ulcer index (reduced the production of gastric juices and acids). Calamus also has stomachic action due to the presence of bitter principles and the spasmolytic effect of its essential oil. Calamus induces hyperemia when applied externally. – Internal use: Dyspeptic complaints. – External use: To induce local hyperemia and treat exhaustion. Used as a bath additive, it stimulates the circulation in the arms and legs. – Tea: Steep 1–1.5 g (ca. 2 teaspoons) of the herb in ca. 150 mL of boiled water for 3 to 5 minutes. • Dosage: One cup with each meal. – Bath additive: Use 250–500 g of the herb to prepare an infusion and add to bath water. – Monographs: None available. – Scientific publications: see p. 478; Schneider K, Jurenitsch, J: Kalmus als Arzneidroge: Nutzen oder Risiko. Pharmazie 47 (1992), 79–85; Steinegger E, Hänsel R: Pharmakognosie. 5. Aufl., Springer Verlag, Heidelberg 1992. – Herb: Camphor (Cinnamomi camphorae aetheroleum) • The herb consists of either natural or synthetic camphor. Natural R(+) camphor is obtained by steam distilling the wood of the camphor tree, the product of which is then purified by sublimation. • Camphor is applied locally in liquid (camphor spirit) or semisolid form (liniment or ointment). The liquid form is used for inhalation therapy. – Important constituents: D-(+)-camphor and (1R,4R)-1,7,7-trimethyl-bicyclo[2,2,1]-heptan-2-one. Synthetic camphor is designated DL-camphor. – Pharmacological properties: Used externally, camphor induces hyperemia and bronchosecretolysis. – Cardiac arrhythmias – Coughs and bronchitis – Low blood pressure – Nervous heart disorders – Rheumatic complaints – Semisolid forms (ointments, liniments) generally contain 10–20% camphor (maximum camphor content 25%); preparations for infants and small children should contain no more than 5%. – Camphor spirit containing 9.5–10.5% camphor (DAB 10): Apply to skin several times a day. – Monographs: DAB 1998; Commission E – Scientific publications: see p. 478; Bruchhausen F von, Ebel S, Frahm AW, Hackenthal E (Eds): Hagers Handbuch der Pharmazeutischen Praxis. 5. Aufl., Bde 7–9 (Stoffe), Springer Verlag Berlin, Heidelberg, New York 1993; Roth L, Daunderer M, Kormann K: Giftpflanzen, Pflanzengifte. 4. Aufl., Ecomed Fachverlag Landsberg/Lech 1993. – Herb: Caraway oil (Carvi aetheroleum). The herb consists of the essential oil distilled from the ripe seedlike fruit of Carum carvi L. – Important constituents: D-(+)-carvone (45–65%) and D-(+)-limonene (30–40%). – Pharmacological properties: Carvone demonstrated antimicrobial action against Bacillus subtilis, Pseudomonas aeruginosa, Candida albicans, and Aspergillus niger. It was also reported to have a moderate effect on dermatophytes. Caraway oil has spasmolytic effects in animals. – Dosage: 1 to 2 drops of caraway oil on sugar. – Daily dose: 3 to 6 drops. – Herb: Caraway fruit (Carvi fructus). The herb consists of the ripe, dried, seedlike fruit of Carum carvi L. – Important constituents: Essential oil (3–7%), fatty oil (10–18%) containing petroselinic acid (40–50%), oleic acid (29–30%), and polysaccharides (13%). – Pharmacological properties: See Caraway Oil. – Tea: Steep 1 to 2 teaspoons (ca. 1.5 g) of the herb, crushed immediately prior to use, in 150 mL of hot water for 10 to 15 minutes in a covered vessel. • One dose equals 1–5 g herb. – Daily dose: 1.5–6 g herb. – Monographs: DAB 1998; ESCOP, Commission E – Scientific publications: see p. 478. – Herb: Cayenne fruit (Capsici fructus). The herb consists of the ripe, dried fruit (without calyx) of Capsicum annuum L. or Capsicum fructescens L. – Important constituents: Capsaicinoids (mainly capsaicin, 32–38%), dihydrocapsaicin (18–52%), carotinoids (0.3–0.8%), and flavonoids. – Pharmacological properties: Capsaicinoids are potent inducers of local hyperemia. Topical application of the herb initially induces erythema accompanied by sensations of pain and heat, followed by a phase of insensitivity (reversible or irreversible deactivation of afferent fibers). The antinociceptor and antiphlogistic effects of the herb can persist for several hours to several weeks. – Muscular tension – Rheumatic diseases – Tincture (1: 10): Apply a few drops to the affected area of the skin and rub in thoroughly. Repeat several times daily. – Semisolid preparations should contain no more than 50 mg of capsaicin in 100 g of a neutral base. – Despite official warnings in the monograph of using Cayenne for more than three consecutive days, to prevent the occurrence of side effects, in North America the use of prescription pharmaceutical preparations for shingles and rheumatism for extended periods has caused no problems. – Monographs: DAB 1998; Commission E – Scientific publications: see p. 478; Anon: Behandlung chronischer Schmerzen: Capsaicin—Lichtblick für Schmerzpatienten. Deutsche Apotheker Ztg 137 (1997), 1027–1028; Anon: Phytotherapie: Pflanzliche Antirheumatika—was bringen sie? Deutsche Apotheker Ztg 136 (1996), 4012–4015; Kreymeier J: Rheumatherapie mit Phytopharmaka. Deutsche Apotheker Ztg 137 (1997), 611–613. – Herb: Chamomile flower (Matricariae flos). The herb consists of the fresh or dried flower heads of Matricaria recutita L., which is also called Chamomilla recutita (L.) R., and preparations of the same. – Pharmacological properties: The essential oil has antiphlogistic and spasmolytic effects and promotes wound healing. The compound α-bisabolol inhibits fungal and bacterial growth. – Colds and fever – Inflammation of the skin – Coughs and bronchitis – Decreased resistance to infections – Inflammations of the mouth and throat – Mild nervousness or insomnia (not rated by the Commission E) – Tea: Pour 1 cup of hot water onto 1 tablespoon (3 g) of the herb, cover, and steep for 5 to 10 minutes (1 teaspoon = 1 g herb). • Dosage: One cup, freshly prepared, between meals, 3 to 4 times a day. – Bath additive: Steep 50 g of the herb in 1 liter of hot water, then add to bath water. – Steam bath: Pour hot water onto ca. 6 g of the herb. – Mouthwash and gargle: Rinse the mouth or gargle with the fresh tea infusion several times a day. – Monographs: DAB 1998; ESCOP; Commission E – Scientific publications: see p. 478; Ammon HPT, Sabieraj J, Kaul R: Kamille – Mechanismus der antiphlogistischen Wirkung von Kamillenextrakten und -inhaltsstoffen. Deutsche Apotheker Ztg 136 (1996), 1821–1834; Miller T, Wittstock U, Lindequist U, Teuscher E: Effects of some components of the essential oil of chamomile, Chamomilla recutita, on Histamine release from mast cells. Planta Med 62 (1997), 60–61. – Herb: Chaste tree fruit (Agni casti fructus). The herb consists of the ripe, dried fruit of Vitex agnus-castus L. and preparations of the same. – Important constituents: Iridoids (agnuside, aucubin), flavonoids, and essential oil (0.8–1.6%). – Pharmacological properties: Chaste tree fruit has dopaminergic effects and inhibits lactation. It suppresses the release of prolactin and reduces the symptoms of premenstrual syndrome. In animals, the extract was found to inhibit lactation, normalize stress-induced hyperprolactinemia, and exert dopaminergic effects. Clinical studies demonstrated a positive effect on symptoms associated with hyperprolactinemia such as mastalgia and other symptoms of PMS. – Menopausal complaints – Premenstrual syndrome (PMS) – Daily dose: 30–40 mg of the herb, usually in the form of 1–2 mL of an aqueous-alcohol extract, first thing in the morning. – Monographs: ESCOP, Commission E – Scientific publications: see p. 478; Jarry H et al: In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus, direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 102 (1994), 448–454; Loew D, Gorkow C, Schrödter A et al: Zur dosisabhängigen Verträglichkeit eines Agnus-castus-Spezialextraktes. Z Phytother 17 (1996), 237–243; Winterhoff H: Arzneipflanzen mit endokriner Wirksamkeit. Z Phytother 14 (1993), 83–94. – Herb: Clove (Caryophylli flos). The herb consists of the hand-picked and dried flower buds of Syzygium aromaticum (L.) Merr. et L.M. Perry. – Important constituents: Essential oil (15–21%), consisting of 70–90% eugenol plus eugenyl acetate, eugenol acetate (17%), and β-caryophyllene (5–12%), as well as flavonoids and tannins (10%). – Pharmacological properties: Caryophylli flos is said to have bactericidal, fungicidal, virustatic, antioxidant, hepatoprotective, local anesthetic, and spasmolytic effects, but only a few of these effects have been proven experimentally. The only confirmed data apply to the essential oil. – Inflammations of the mouth and throat – Used in dental medicine as a topical pain reliever – As a mouthwash/gargle: Rinse the mouth or gargle several times a day with an aqueous solution containing 1–5% of the essential oil. – For dental complaints: Apply the undiluted essential oil as a topical pain reliever. – Monographs: DAB 10; Commission E – Scientific publications: see p. 478; Cai L, Wu CHD: Compounds from Syzygium aromaticum possessing growth inhibitory activity against oral pathogenes. J Nat Prod 59 (1996), 987–990: Debelmas AM, Rochat J: Plant Med Phytother 1 (1967), 23; Tanaka T, Orii Y, Nonaka GI et al: Syziginins A and B, two ellegitannins from Syzygium aromaticum. Phytochemistry 43 (1996), 1345–1348. – Herb: Coffee bean (Coffeae semen). The herb consists of the dried, husked beans of Coffea arabica (L.) and other Coffea species. – Coffee charcoal (Coffeae carbo), the ground, blackish-brown to charcoal roasted outer seed parts of the dried green seeds of Coffea arabica L. s.l., Coffea liberica B. et H., Coffea canephore P. et F., and other coffee species. – Important constituents: Purine alkaloids (caffeine, 0.6–2.2%), theobromine, theophylline, caffeic and ferulic acid esters of quinic acid (chlorogenic acid, 5–8%), trigonelline, no–diterpene glycoside esters (atractyloside), and diterpenes (diterpene alcohol fatty acid esters kahweol and cafestol). Roasted coffee beans contain many aroma substances due to the pyrolysis of carbohydrates, proteins, fats, and aromatic acids. – Pharmacological properties: The stimulatory effect of caffeine sets in within a few minutes after administration. Most of the effects specified for coffee are attributable to the action of caffeine. • Effects of caffeine: Caffeine has positive inotropic effects and, when administered in high doses, exerts a positive chronotropic effect on the heart and stimulates the central nervous system. It relaxes the smooth muscles of the blood vessels (except in the brain, where it causes vasoconstriction) and bronchi. Caffeine has short-term diuretic effects, stimulates the secretion of gastric juices, and increases the release of catecholamines. • Cardiovascular effects: Individuals who normally do not drink coffee exhibit an average 10 mmHg increase in systolic blood pressure within 1 hour of administration of 250 mg of caffeine. Habitual coffee drinkers are tolerant to this dose. • An average dose of 5 to 6 cups of coffee per day (made by steeping the herb in boiling water for 10 minutes) for 9 weeks significantly increases the total cholesterol and LDL cholesterol levels in serum. The use of filter paper can reduce this effect by 80%. – Migraine headaches – Decreased performance – Side effects (attributable to coffee’s chlorogenic acid content) include gastric hyperacidity, gastric irritation, diarrhea, and reduced appetite. Vomiting and abdominal cramps are signs of poisoning. Pregnant and nursing mothers should avoid caffeine. The maximum safe daily dose should not exceed 300 mg (equivalent to 3 cups of coffee). – Caffeine can cause mental and physical dependence. Signs of withdrawal include headaches and sleep disorders. – Monographs: Commission E (Coffee carbon) – Scientific publications: see p. 478; Dieudonne S, Forero ME, Llano I: Lipid analysis of Coffea arabica Linn. beans and their possible hypercholesterolemic effects. Int J Food Sci Nutr, 159 (1997), 135–139; Mensink RP, Lebbink WJ, Lobbezoo IE, Weusten-Van der Wouw MP, Zock PL, Katan MB: Diterpene composition of oils from Arabica and Robusta coffee beans and their effects on serum lipids in man. J Intern Med, 237 (1995), 543–550; Ratnayake WM, Pelletier G, Hollywood R, Malcolm S, Stavric B: Investigation of the effect of coffee lipids on serum chloestrol in hamsters. Food Chem Toxicol, 33 (1995), 195–201; Anon: Kaffee erhöht den Cholesterin-spiegel. Aga 19 (1991), 10682; Anon: Coffein-Entzugssyndrom bei Kaffeetrinkern. Deutsche Apotheker Ztg 133 (1993), 441; Bättig K: Kaffee in wissenschaftlicher Sicht. Z Phytother 9 (1988), 95; Butz S: Nurses-Health-Studie: Kaffee–kein Risikofaktor für koronare Herzkrankheit? Deutsche Apotheker Ztg 136 (1996), 1680–1682; Garattini S: Caffeine, Coffee and Health. Garattini S. Monographs of the Mario Negri Institute for Pharmacological Research, Milan. Raven Press, New York 1993; Lewin L: Gifte und Vergiftungen. 6th ed (reprint), Haug Verlag, Heidelberg 1992; Silnermann K et al: Entzugssymptome nach regelmäßigen Kaffeegenuß. New Engl J Med 327 (1992), 1109. – Herb: Condurango bark (Condurango cortex). The herb consists of dried bark from the trunk and branches of Marsdenia condurango R. fil. – Important constituents: Pregnane glycosides, pregn-5-ene glycosides (including condurangin, 2%), and caffeic acid derivatives (0.7–2.1%). – Pharmacological properties: Like other bitters, condurangin increases the flow of saliva and gastric juices through reflex mechanisms. There is a lack of clinical data on the effects of the herb in humans. – Loss of appetite – Dyspeptic complaints – Daily dose: 2–4 g of the herb. – Add the herb to cold water and wait for 3 to 4 hours. Drink the cold extract. – Dosage: One cup of the tea or one liqueur glassful of condurango wine 30 minutes before meals. – Monographs: Commission E – Herb: Coriander (Coriandri fructus). The herb consists of the ripe, dried fruits of Coriandrum sativum L., var. vulgare A. and microcarpum. – Important constituents: 0.4–1.7% essential oil (D-(+)-linalool/coriandrol (60–75%) and 13–21% fatty oil (oleic acid, linolenic acid). – Pharmacological properties: The essential oil stimulates the secretion of gastric juices and has carminative and mild spasmolytic effects. – Lack of appetite – Dyspeptic complaints – Daily dose: 3 g of the crushed herb. – Pour 150 mL of water onto 1 g of the fresh herb, crushed immediately prior to use, then cover and steep for 10 minutes. • Dosage: One cup, between meals, 3 times a day. – Monographs: Commission E – Herb: Dandelion root and herb (Taraxaci radix cum herba). The herb consists of whole-plant material from Taraxacum officinale G. H. Weber ex Wigger s.l., collected at the time of flowering, and preparations of the same. – Important constituents: Sesquiterpene lactones (tannins), triterpenes (taraxasterol, γ-sitosterol, taraxerol, taraxol), flavonoids (luteolin-7-O- glucoside), and inulin (2–40%). – Pharmacological properties: The tannins contained in dandelion root and herb have cholagogic and secretagogic action. In animals, dandelion root was found to have a saluretic effect attributable to its high concentrations of minerals. – Lack of appetite – Dyspeptic complaints – Urinary tract infections – Tea: Add 3–4 g (1 tablespoon) of the finely chopped herb to 150 mL of water, bring to a boil and steep for 15 minutes. • Dosage: One cup of the tea in the morning and at night. – Monographs: ESCOP; Commission E – Scientific publications: see p. 478; Budzianowski J: Coumarins, caffeoyltartaric acids and their artifactual esters from Taraxacum officinale: Planta Med 63 (1997), 288. – Herb: Devil’s claw (Harpagophyti radix). The herb consists of the secondary storage roots of Harpagophytum procumbens (B.) D. C. and preparations of the same. – Important constituents: Iridoids (0.5–3%) and iridoid glycosides such as harpagoside (0.5–0.6%), harpagide, and procumbide. Phenylethanol derivatives such as acteoside, verbascoside, and isoacteoside are also present. – Pharmacological properties: Devil’s claw stimulates the secretion of gastric juices and the production of bile (harpagoside). In animals, it has anti-inflammatory, analgesic, and antiarthritic effects, and harpagoside was found to inhibit the biosynthesis of certain prostaglandins that cause inflammation. – Lack of appetite – Dyspeptic complaints – Supportive treatment of degenerative connective tissue diseases – Daily dose: 1.5 g herb for lack of appetite; otherwise 4.5 g herb. – Tea: Steep 1 teaspoon (4.5 g) of the finely chopped herb in 300 mL of boiled water for 8 hours. Divide into 3 portions to be taken throughout the day. – Tincture for external use: Dilute 1 tablespoon with 250 mL of water and use for gargling or compresses. – Monographs: BHP 83; BHP 96; ESCOP; HAB 1; Commission E, Mar 31 – Scientific publications: see p. 478; Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 7(3), (2000), 177–183; Baghdikian L, et al. An analytical study, anti-inflammatory and analgesic effects of Harpagophytum procumbens and Harpagophytum zeyheri. Planta Med 63 (1997), 171–176. – Herb: White Echinacea root (Echinaceae pallidae radix). The herb consists of the fresh or dried roots of Echinacea pallida (N.) N., collected during the fall, and preparations of the same. – Important constituents: Polysaccharides (immunostimulatory effects, rhamnoarabinogalactans), essential oil (0.2–2%), caffeic acid derivatives (echinacoside, 1%), and alkylamides (0.1%). – Pharmacological properties: Immunostimulatory, antibacterial, virustatic. Alcohol extracts of Paleflowered Echinacea root were found to stimulate phagocytosis in animals, and the rate of in vitro phagocytosis in granulocytes increased by 23% after injection. In mice, the proliferation of splenic cells increased greatly, and the production of cytokines and antibodies increased. Clinical studies demonstrated that bacterial and viral infections of the upper respiratory tract may improve more rapidly when treated with the herb. – Monographs: ESCOP; Commission E – Scientific publications: see p. 478; Beuscher N et al: Immunmodulierende Eigenschaften von Wurzelextrakten verschiedener Echinacea-Arten. Z Phytother 16 (1995), 157–166. – Herb: Purple Echinacea (Echinaceae purpureae herba). The herb consists of the fresh aerial parts of Echinacea purpurea (L.) Moench, collected at the time of flowering. – Important constituents: Polysaccharides (with immunostimulatory effects; 4-O-methylglucuronylarabinoxylans, alkyl amides, acid rhamnoarabinogalactans), cichoric acid, and essential oil (0.08–0.32%). – Pharmacological properties: Purple Echinacea promotes wound healing. Parenteral and oral doses increase the phagocytosic capacity of granulocytes and macrophages; medium doses increase the production of T lymphocytes. Low doses of the expressed juice lead to induction of TNF-α, interleukin-1 and interleukin-6. The herb has shown antiviral properties in animal studies. Human studies show reduction and shortening of symptoms of viral syndromes, in particular the common cold, but other studies show no effect. Still not proven conclusively with human studies. – Colds and fever – Urinary tract infections – Coughs and bronchitis – Decreased resistance to infections – Runny nose – Wounds and burns (external use) – Take as recommended by the manufacturer. – Daily dose: 6–9 mL of the expressed juice; should not be used continuously for more than 2 weeks. – Monographs: ESCOP; Commission E – Scientific publications: see p. 478; Melchert D, Linde K, Worku F et al: Immunomodulation with Echinacea—a systematic review of controlled clinical trials, Phytomedicine 1 (1994), 245–254; Mose J R: Med Welt 34 (1983), 51; Parnham MJ: Benfit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomedicine 3 (1996), 95–102. – Herb: Siberian ginseng root (Eleutherococci radix). The herb consists of the dried roots and/or rhizomes, and sometimes the dried prickly stems of Eleutherococcus senticosus R. e. M. and preparations of the same. – Important constituents: Triterpene saponins (0.12%), steroid glycoside eleutheroside A, hydroxycoumarins (isofraxidin, eleutheroside B1), phenylacrylic acid derivatives (eleutheroside B), lignans (sesamin, 0.23%, eleutheroside D, and the 4,4, ′-di-O-glucoside of syringaresinol, 0.1%), and polysaccharides. – Pharmacological properties: The fluid extract of Eleutherococcus root has immunostimulatory, immunomodulatory, and antiviral effects due to its polysaccharide content. Eleutheroside B and other components were found to increase the stress tolerance of animals in many stress models (immobilization test, swim test, cold stress, etc.). The fluid extract increased the number of lymphocytes, especially T lymphocytes, and killer cells in healthy volunteers. Eleutheroside B has a testosterone-like effect. – Decreased resistance to infections – Decreased performance – Prevention or supportive treatment of jet lag or altitude sickness – Daily dose: 2–3 g herb. – Fluid extract (1: 1): 3 to 5 drops in a glass of water several times a day. – Monographs: DAB 1998 ESCOP – Scientific publications: see p. 478 – Herb: Ivy leaf (Hederae helicis folium). The herb consists of the dried foliage leaves of Hedera helix L. and preparations of the same. – Important constituents: Ca. 5% triterpene saponins (mainly hederacoside C, which is broken down into (-hederin) and alkaloids (emetine). – Pharmacological properties: Saponins have anti-inflammatory, antiviral, antibacterial, antimycotic, and anthelmintic effects in animals. They also have secretolytic/expectorant, antitussive, and spasmolytic action. – Monographs: ESCOP; Commission E – Scientific publications: see p. 478; Gladtke E: Zur Wirksamkeit eines Efeublätterpräparates (Prospan). Intern Praxis 32 (1992), 187; Trute A, Gross J, Mutschler E, Nahrstedt A: In vitro antispasmodic compounds of the dry extract obtained from Hedera helix. Planta Med 63 (1997), 125–129; Trute A, Nahrstedt A: Identification and quantitative analysis of phenolic dry extracts of Hedera helix. Planta Med 63 (1997), 177–179. – Herb: English lavender flower (Lavandulae flos). The herb consists of the dried flowers of Lavandula angustifolia M., collected just before full maturity, and preparations of the same. – Important constituents: Essential oil (1–3%) consisting mainly of (−)-linalool (20–50%) and linalyl acetate (30–40%). – Pharmacological properties: In animal studies, lavender was found to have a neurodepressant effect (reduces the sleep induction phase and prolongs the duration of sleep) and to reduce motor activity. In humans, English lavender taken by inhalation was shown to take action in the limbic cortex (similarly to nitrazepam). – Lack of appetite – Dyspeptic complaints – Circulatory disorders – Nervous complaints and insomnia – Tea: Steep 1 to 2 teaspoons (1–2 g) lavender flower in 1 cup (150 mL) of hot water for 10 minutes. – Daily dose: 3–5 g of the herb, equivalent to 3 cups per day. – Bath additive: Steep 100 g of lavender flower in 2 liters of hot water, or add 100 g of lavender flower to 2 liters of cold water and bring to a boil. Strain, then add the concentrated infusion to the bath water. – Infusion for external use: Add a handful of lavender flower to 1 liter of water and boil for 10 minutes, then add another liter of water. – Lavender oil: Take 1 to 4 drops on a suitable medium, e. g., a cube of sugar. – Monographs: DAB 1998; Commission E – Scientific publications: see p. 478; Buchbauer G, Jirovetz L, Jäger W et al: Aromatherapy: Evidence for Sedative Effects of the Essential Oil of Lavender after Inhalation. Z Naturforsch 46c (1991), 1067–1072; Hausen B; Allgeriepflanzen, Pflanzenallergie. ecomed Verlagsgesellsch. mbH, Lands-berg 1988. – Herb: English plantain leaftherb (Plantaginis lanceolatae folium/herba). The herb consists of the fresh or dried aerial parts of Plantago lanceolata L., collected at the time of flowering, and preparations of the same. – Important constituents: Iridoids (2–3%), including aucubin, rhinanthin, and catalpol, as well as mucilage (2–6%), flavonoids, and tannins (6%). – Pharmacological properties: Fluid extracts and expressed juices from the fresh leaves have bactericidal effects due to their content of aucubigenin (hydrolyzed aucubin) and an antimicrobial saponin. English plantain preparations have a short shelf-life, because aucubigenin is unstable. Aqueous English plantain extracts promote wound healing and accelerate blood coagulation. Aucubin is assumed to protect the liver and soothe the mucous membranes when inflamed. The tannins have astringent effects. – Colds and fever – Skin inflammations – Coughs and bronchitis – Inflammations of the mouth and throat – Runny nose – Tea: Pour boiling water onto 2–4 g of the chopped herb, or place the dose in cold water and bring to a boil. Steep for 10 minutes, then strain. 2 teaspoons = ca. 3 g herb. • Dosage: One cup, several times a day. – Daily dose: 3–6 g herb. – For inflammations of the mouth and throat, gargle with the tea infusion several times a day. – Monographs: DAB 1998, ESCOP; Commission E – Scientific publications: see p. 478; Murai M et al: Phenylethanoids in the herb of Planatago lanceolata and inhibitory effects on arachidonic acid-induced mouse ear edema. Planta Med 61 (1995), 479–480. – Herb: Eucalyptus leaf (Eucalypti folium). The herb consists of the dried mature leaves of older Eucalyptus globulus L. B. trees. – Important constituents: 1–3% essential oil (1,8-cineole, 45–75%, α-pinene, β-pinene, pinocarvone), and flavonoids (rutin, hyperoside, quercetin). – Pharmacological properties: Eucalyptus leaf has secretomotor, expectorant, astringent, and weakly spasmolytic action. The drug has anti-inflammatory and antiproliferative effects in animals. – Tea: Pour 150 mL boiling water onto 1.5–2 g of the finely chopped drug; cover and steep for 5 to 10 minutes. – Daily dose: 4–6 g dried leaves. One dose equals 1.5 g dried leaves. – Monographs: DAB 1998; Commission E – Scientific publications: see p. 478; Fenaroli’s Handbook of Flavor Ingredients, Vol. 1, 2 nd Ed., CRC Press 1975; Osawa K et al: Macrocarpals H, I, and J from the leaves of Eucalyptus globulus. J Nat Prod 59 (1996), 824–827. – Important constituents: 80% (of the rectified essential oil) consists of 1,8-cineole; p-cymene and α-pinene are also present. – Pharmacological properties: Some of the properties listed below refer to isolated cineole. Eucalyptus oils have antibacterial and fungicidal effects in vitro. Eucalyptus oil inhibits prostaglandin synthesis and has weak hyper-emic effects when applied topically. The drug also has expectorant, secretomotor, antitussive, and surface-active surfactant-like effects and improves lung compliance. – Coughs and bronchitis – Rheumatic complaints – Internal use: Eucalyptus oil should not be used by children under 12 years of age or during the first trimester of pregnancy. It also should not be used by patients with inflammations of the gastrointestinal or biliary tract or severe liver diseases. – External use: Eucalyptus oil should not be applied to the face of infants and small children since it can cause laryngospasm, bronchospasm, asthma-like attacks and/or respiratory arrest. – Internal use: Daily dose: 0.3–0.6 g drug (0.2 g = 10 drops). Take 3 to 6 drops in 150 mL warm water several times a day. Inhalation: Add 2 to 3 drops to boiling water and inhale the vapors. – External use: Oily and semisolid forms with 5–20% essential oil content. Aqueous ethanol preparations with 5–10% essential oil content. Liniment: Rub a few drops of 20% eucalyptus liniment onto the affected area of the skin. – Monographs: DAB 10; ESCOP; Commission E – Scientific publications: see p. 478; Juergens UR, Stober M, Vetter H: Inhibition of cytokine production and arachidonic acid metabolism by eucalyptol (1,8-cineole) in human blood monocytes in vitro. Eur J Med Res, 3(11) (1998), 508–510; Riechelmann H, Brommer C, Hinni M, Martin C: Response of human ciliated respiratory cells to a mixture of menthol, eucalyptus oil and pine needle oil. Arzneimittelforschung 47(9) (1997), 1035–1039; Gräfe AK: Besonderheiten der Arzneimitteltherapie im Säuglings- und Kindesalter. PZ 140 (1995), 2659–2667. – Herb • Elder flower (Sambuci flos). The herb consists of the dried and sifted flower heads of Sambucus nigra L. and preparations of the same. – Important constituents: Flavonoids (3%), including rutin, isoquercitrin, quercetin, and hyperoside, essential oil (0.03–0.14%), and caffeic acid derivatives (ca. 3%). – Pharmacological properties: Elder flower was found to increase bronchial secretion in animals. The essential oil and flavonoids play a role in its sudorific (sweat-producing) action, but no scientific investigations are available on this subject. Elder fruit is used for easing the symptoms of colds and flu. Some research in human cell cultures demonstrates antiviral and immunomodulating effects. Two small clinical trials showed shortening of recovery time in patients with influenza. Elder berry is not officially recommended in a German monograph. – Fever and colds, mild cases of flu – Coughs and bronchitis (supportive) – Antiviral and immunomodulating effects as demonstrated in some small clinical trials – Tea: Steep 2 teaspoons (3–4 g) of elder flower in 150 mL of boiled water for 5 minutes. • Dosage: One to two cups of the tea, as hot as possible, several times a day (especially in the second half of the day). – Daily dose: 10–15 g drug. – Fruit and syrups: Infuse 1 teaspoon in 1 cup of freshly boiled water for 30 minutes, and drink 1 cup 2 or 3 times daily. For syrups, 2 to 3 teaspoons daily. – Monographs: Commission E – Scientific publications: see p. 478 – Herb: European golden rod (Solidaginis virgaureae herba). The herb consists of the aerial parts of Solidago virgaurea (L.). – Important constituents: Triterpene saponins (0.2–0.3%), essential oil (0.4–0.5%; less than 0.2% in the stored drug), polysaccharides (6–8%), 1.1–2% flavonoids (rutin, 0.8%), phenol glycosides (0.2–1.0%), and caffeic acid derivatives (0.2–0.4%). – Pharmacological properties: European golden rod has diuretic and analgesic action (due to the content of phenol glycosides). The essential oil and saponins have antimicrobial, weakly spasmolytic, antiexudative, and aquaretic effects. – Used for irrigation therapy, to flush the kidneys of patients with urinary tract infections and to eliminate renal or urinary calculi. – For prevention of urinary calculi and renal gravel. – Tea: Steep 1 to 2 teaspoons (3–5 g) of the dried herb in ca. 150 mL of boiled water for 15 minutes. • Dosage: One cup, between meals, 2 to 4 times a day. – Daily dose: 6–12 g chopped drug for infusions or other internally used galenicals. – Monographs: DAB 1998; ESCOP; Commission E – Scientific publications: see p. 478; Bader G, Wray, V, Hiller, K: The main saponins from the arial parts and the roots of Solidago virgaurea subsp. virgaurea. Planta Med 61 (1995), 158–161; Hiller K, Bader G: GoldrutenKraut–Portrait einer Arzneipflanze. Z Phytother 17 (1996), 123–130. – Herb • Fennel oil (Foeniculi aetheroleum) is the essential oil obtained by steam distilling the dried ripe fruit of common fennel (Foeniculum vulgare) or sweet fennel (Foeniculum dulce). • Fennel seed/fruit (Foeniculi fructus) is the dried ripe fruit of Foeniculum vulgare M. var. vulgare. – Important constituents • Common fennel: trans-Anethole (50–75%), fenchone (12–33%), and estragole (2–5%). • Sweet fennel: trans-Anethole (80–90%), fenchone (1–10%), and estragole (3–10%). • Both varieties contain flavonoids, rutin, and fatty oil (9–21%).
Plant Summaries—A
Adonis (Adonis vernalis L.)
Synonyms: False hellebore; Adonisröschen (Ger.)
General comments: The aerial plant parts of Adonis vernalis L. are used in medicine.
Pharmacology
Indications
Contraindications: Pregnant or nursing mothers, children under 12 years of age, and individuals hypersensitive to digitaloid drugs should not use adonis.
Dosage and duration of use
Adverse effects: Vomiting, diarrhea, headache, loss of appetite, gynecomastia. Signs of overdose range from mild cardiac arrhythmias to life-threatening ventricular tachycardia, atrial tachycardia with AV block, stupor, confusion, hallucinations, impaired vision, depression, and/or psychoses. Adonis poisoning is rare since the oral absorption rate is low.
Herb–drug interactions: Comparable to those of other digitaloid pharmaceutical drugs such as foxglove.
Summary assessment: Owing to its low and irreproducible absorption behavior and the lack of adequate data on the drug, adonis is used only in combination with other digitaloid drugs.
Literature
Angelica (Angelica archangelica L.)
Synonyms: European angelica; Engelwurz (Ger.)
General comments: Angelica has an aromatic odor and a sweetish taste.
Pharmacology
Indications
Contraindications: Pregnancy.
Dosage and duration of use: 2 or 3 weeks, or longer under recommendation by an experienced health-care provider.
Herb–drug interactions: None known.
Literature
Aniseed (Pimpinella anisum L.)
Synonyms: Anise; Anis (Ger.)
General comments: The essential oil extracted from the mature and dried fruit is used in medicine.
Pharmacology
Indications
Contraindications: Hypersensitivity to aniseed or anethole; pregnancy.
Dosage and duration of use
Adverse effects: Occasional allergic reactions of the skin, respiratory tract and gastrointestinal tract. Health hazards in conjunction with proper administration of the designated therapeutic doses of the drug are not known. In very rare cases, sensitization can occur after repeated contact.
Herb–drug interactions: None known.
Common misconceptions: Claims of estrogenic action have never been proven.
Summary assessment: The information presented here is based on empirical experience. No recent studies are available. The carminative action of aniseed is weaker than that of fennel or caraway, but it is a better expectorant than fennel
Literature
Arnica (Arnica montana L.)
General comments: Medicinal arnica oil is extracted from fresh or dried arnica flowers.
Pharmacology
Indications
Contraindications: Known allergy to arnica or other composite plants.
Arnica tincture should not be applied to open wounds or used undiluted.
Dosage and duration of use
Adverse effects: Health hazards in conjunction with external administration of the designated therapeutic doses of arnica are minor. Frequent use of the undiluted tincture can lead to sensitization (allergic skin rashes, itching, blistering, ulcers/superficial gangrene). The external application of very high concentrations of the drug can cause primary toxic blister formation and necrosis.
Herb–drug interactions: None known.
Arnica flower should not be used by persons allergic to the plant. When selecting the remedy, the individual preferences of the patients should be taken into consideration.
Common misconceptions: Not all varieties of arnica trigger contact allergies. Ointments made using the Spanish species of Arnica montana contain very low concentrations of the allergy-causing substance helenalin.
Summary assessment: Arnica is an effective remedy, especially for contusions and strained muscles.
Literature
Artichoke (Cynara scolymus L.)
General comments: The dried whole or chopped basal leaves and the fresh or dried herb of Cynara scolymus L. are used in medicine.
Pharmacology
Indications
Contraindications: Allergy to composite plants; biliary tract obstruction; gallstones.
Dosage and duration of use: The fresh leaves, fresh expressed plant juice, and dry extracts are used in medicinal preparations.
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb.
Herb–drug interactions: None known.
Summary assessment: Clinical studies of the antidyspeptic effect of artichoke have been performed. The antilipemic effect is still being investigated.
Literature
Asian Ginseng (Panax ginseng C.H. Meyer)
Pharmacology
Indications
Contraindications: A contraindication in people with hypertension, especially with concomitant caffeine consumption is frequently given in North America; however, little clinical or research evidence exists to confirm this.
Dosage and duration of use:
Adverse effects: Insomnia, hypertension, and edema have been reported as symptoms of overdose.
Herb–drug interactions: The concurrent use of beverages and substances containing caffeine should be avoided.
Summary assessment: Asian ginseng is an herbal drug with reliable effectiveness in the specified indications. Clinical studies on the efficacy of Asian ginseng are available. Use of teas from whole roots chopped or ground at home are acceptable; other use should be restricted to standardized preparations. As recent studies show, some products are substandard, despite their labeling.
Literature
Plant Summaries—B
Birch (Betula pendula Roth.)
General comments: Two birch species are used in medicine, Betula pendula and Betula pubescens. Various medicinal preparations are made from the leaves of these two species.
Pharmacology
Indications
Contraindications: The drug is not recommended in patients with cardiac or renal edema.
Adverse effects: Health hazards in conjunction with proper administration of the designated therapeutic doses of the drug are not known.
Herb–drug interactions: None known.
Common misconceptions: Birch leaf does not irritate the renal parenchyma.
Summary assessment: Birch leaf is an effective herbal aquaretic. It can be usefully combined with other aquaretics.
Literature
Bitter Orange (Citrus aurantium sinensis [L.] Osbeck)
General comments: Both fresh and dried orange peel as well as the oil distilled from the peel are used in medicine.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use
Herb–drug interactions: None known.
Summary assessment: Orange peel has relatively weak effects, but can be usefully combined with other herbal preparations.
Literature
Bittersweet (Solanum dulcamara L.)
Synonyms: Bitter nightshade; Bittersüß (Ger.)
General comments: The stems, which have especially high concentrations of the active principles, are selected for medicinal use.
Pharmacology
Indications
Contraindications: Pregnancy and breast feeding.
Dosage and duration of use: No dose or duration of use specified for external use.
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. Toxic effects are not to be expected when doses less than approximately 25 g per day are used.
Herb–drug interactions: None known.
Summary assessment: In recent years, bittersweet has become increasingly popular for treatment of chronic eczema, but further study is necessary to validate its efficacy in this indication.
Literature
Black Cohosh (Actaea racemosa L. Nutt.)
Synonym: Cimicifuga racemosa Nutt.
General comments: The herb grows in the United States and Canada, where it was used by the aboriginal population to treat snake bites and to facilitate labor.
Pharmacology
Indications
Contraindications
Dosage and duration of use
Adverse effects: Can occasionally upset the stomach.
Herb–drug interactions: None known.
Summary assessment: Black cohosh is a well-tolerated herbal remedy that is becoming increasingly popular, especially for treatment of menopausal complaints.
Literature
Buckthorn (Rhamnus cathartica L.)
Synonyms: Common buckthorn, European buckthorn; Kreuzdorn (Ger.)
General comments: The buckthorn bush is widely distributed throughout Europe. Its fruit is used as a laxative.
Pharmacology
Indications: Constipation.
Contraindications: Bowel obstruction, acute intestinal inflammations, appendicitis, abdominal pain of unknown origin. Pregnant or nursing mothers should not use buckthorn fruit unless directed by a physician. Use is contra-indicated in children under 12 years of age.
Dosage and duration of use
Adverse effects: The laxative effect of the herb can lead to cramplike gastrointestinal complaints. Long-term use can result in the loss of electrolytes, particularly potassium ions, thereby leading to problems such as hyper-aldosteronism and decreased bowel motility. Arrhythmias, nephropathies, edemas, and accelerated bone degeneration are rare side effects. Consumption of large quantities of buckthorn fruit can lead to diarrhea with vomiting and kidney irritation.
Herb–drug interactions: Owing to its laxative effect, buckthorn fruit can impair the absorption of pharmaceutical drugs or herbal preparations containing potentially toxic or life-sparing constituents such as cardiac glycosides (i. e., Digitalis spp.) if taken concomitantly.
Chronic use or abuse of the herb can increase the potency of cardiac glycosides and diuretics owing to the resulting potassium deficiency.
Summary assessment: Buckthorn fruit and other herbs containing anthranoids should not be used to treat chronic constipation.
Literature
Butcher’s Broom (Ruscus aculeatus L.)
General comments: Butcher’s broom is native to almost all parts of Europe, West Asia and North Africa and has been used in medicine since ancient times.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use
Adverse effects: None known. Rare cases of diarrhea and lymphocellular colitis have been reported.
Herb–drug interactions: None known.
Summary assessment: The indications specified for butcher’s broom have not been substantiated in controlled clinical studies, but are based on many years of empirical experience.
Literature
Plant Summaries—C
Calamus (Acorus calamus L.)
Synonyms: Acorus, sweetflag; Kalmus (Ger.)
General comments: Calamus is a very common plant, the rhizome of which is used in medicine.
Pharmacology
Indications
Contraindications: Should not be used by pregnant or nursing mothers or by children under 6 years of age.
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in humans in conjunction with proper administration of the designated therapeutic doses of calamus of European origin (the essential oil of the European herb contains 15% β-asarone) Alcoholic extracts of calamus will contain considerably more β-asarone and should not be used for more than a few days.
Long-term use of the herb is not recommended since malignancies were found to develop in rats.
Herb–drug interactions: None known.
Summary assessment: Calamus has not been systematically evaluated, and prolonged use of the herb is not recommended. In Germany, no official risk-to-benefit assessment of calamus root has yet been published in any monograph. The use of Indian calamus is not permitted owing to its high β-asarone content.
Literature
Camphor Tree (Cinnamomum camphora L. Sieb.)
General comments: Medicinal camphor is the product of steam distillation of wood chips obtained from the camphor tree.
Pharmacology
Indications
Contraindications: Camphor should not be applied to the face, especially the nose, of infants and small children. It is not recommended for internal use.
Dosage and duration of use
Adverse effects: Skin irritation; poisoning due to excessive drug absorption and/or inhalation (especially in children) can induce states of intoxication, delirium, convulsions, and respiration regulation disorders. Oily camphor liniments can induce contact eczema.
Herb–drug interactions: None known.
Literature
Caraway (Carum carvi L.): Caraway Oil (Carvi aetheroleum)
General comments: Caraway is a well-known culinary herb, the fruits of which are also used in medicine (e. g., as a carminative).
Pharmacology
Indications: Dyspeptic complaints.
Contraindications: None known.
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. Long-term, high-dose administration of caraway oil (e. g., in caraway liqueur) can cause kidney and liver damage.
Herb–drug interactions: None known.
Summary assessment: Caraway oil has a marked carminative effect (see also Caraway Seeds (Carvi fructus). Caraway Fruit (Carvi fructus)
Pharmacology
Indications: Dyspeptic complaints.
Contraindications: None known.
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. Long-term, high-dose administration of caraway oil (e. g., in caraway liqueur) can cause kidney and liver damage.
Herb–drug interactions: None known.
Summary assessment: Caraway is a stronger carminative than either anise or fennel. Caraway seeds should be crushed immediately prior to use to prevent unnecessary loss of the highly volatile essential oil.
Literature
Cayenne (Capsicum annuum L.)
Synonyms: Red pepper, hot pepper; Paprika (Ger.)
General comments: The cayenne plant is native to Central America. Its hot and spicy fruit is best known as a spice, but is also used in medicine.
Indications
Contraindications: Skin diseases or inflammation, broken skin.
Cayenne should not come into contact with the mucous membranes.
Dosage and duration of use
Adverse effects: Cayenne can cause blistering and ulcer formation above and beyond the desired hyperemic effect.
Herb–drug interactions: None known.
Summary assessment: Cayenne can be usefully combined with other anti-inflammatory herbal preparations.
Literature
Chamomile (Matricaria recutita L. Rauschert)
Synonyms: German chamomile; Kamille (Ger.)
General comments: Chamomile is widely distributed throughout Europe and is a favorite of people who like to pick their own herbs. When collecting chamomile, it is important to remember that the receptacle of true (German) chamomile is hollow and conical. The flower heads are used in medicine.
Pharmacology
Indications
Contraindications: Chamomile flower should not be used in compresses applied in the eye region to prevent pollen and other flower particles from getting in the eyes.
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. The herb has a slight potential for sensitization.
Herb–drug interactions: None known.
Summary assessment: Chamomile is a well-known, well-tolerated, thoroughly investigated herb with a relatively wide therapeutic range. Only distillates and alcohol preparations of the herb contain therapeutically effective concentrations of the essential oil.
Literature
Chaste Tree (Vitex agnus-castus L.)
General comments: Chaste tree has been used as an herbal remedy since ancient times. Its natural habitat ranges from the Mediterranean region to Western Asia.
Pharmacology
Indications
Contraindications: Pregnancy and breast feeding
Dosage and duration of use
Adverse effects: Exanthema (skin eruptions) is an occasional side effect.
Herb–drug interactions: None known.
Summary assessment: Chaste tree fruit is an effective remedy for premenstrual syndrome, especially for relieving mastalgia, as has been demonstrated in clinical studies.
Literature
Clove (Syzygium aromaticum L. Merr. et L.M. Perry)
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use
Adverse effects: Allergic reactions to eugenol can occur as a rare side effect. The concentrated essential oil can irritate the mucous membranes.
Herb–drug interactions: None known.
Summary assessment: Clove is an herb with demonstrated effectiveness. The medicinal uses for the herb are a consequence of the therapeutic action of clove oil. No clinical studies are available. Clove is safe enough for unrestricted over-the-counter use.
Literature
Coffee (Coffea arabica L.)
Pharmacology
Contraindications: None known.
Dosage and duration of use: Daily dose: 15 g of the herb.
Adverse effects: Doses of up to 500 mg of caffeine (= 5 cups of coffee) per day are toxicologically safe for healthy adults who are habitual coffee drinkers. Patients with cardiovascular lability, kidney diseases, hyperthyroidism, a predisposition to convulsions, and certain psychiatric disorders (e. g., panic attacks) should use the herb cautiously.
The prolonged administration of more than 1.5 g of caffeine per day is often observed to lead to unspecific symptoms such as restlessness, irritability, insomnia, palpitation, dizziness, vomiting, diarrhea, lack of appetite, and headaches. These effects can even occur with chronic use of as little as 300–500 mg/day in sensitive individuals.
Herb–drug interactions: None known.
Summary assessment: Ubiquitously used herbal preparation, OTC preparation, to increase mental performance. Clinically for headaches etc.
Literature
Condurango (Marsdenia condurango Reichb. F.)
Synonyms: Marsdenia, eagle-vine bark; Kondurango (Ger.)
General comments: The condurango tree grows in forests on the slopes of the Andes mountains. Its bark is used as a bitter.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb.
Herb–drug interactions: None known.
Summary assessment: Condurango is a well-tolerated bitter herb that is becoming more popular in Europe today. It can usefully be combined with other bitter herbs.
Literature
Coriander (Coriandrum sativum L.)
General comments: The fruits of the coriander plant are used as a kitchen herb (bread, baked goods, etc.) and medicinal herb (e. g., for dyspeptic complaints).
Pharmacology
Indications
Contraindications: None known
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. Coriander has a slight potential for sensitization.
Herb–drug interactions: None known.
Summary assessment: Coriander is an old and familiar herbal remedy that should be used in combination with other antidyspeptic preparations. Clinical studies of the herb are not available.
Literature
Cowslip (Primula veris)
See Primula
Plant Summaries—D
Dandelion (Taraxacum officinale Weber)
General comments: Dandelion is a widely distributed plant that has many uses in folk medicine. The whole plant is used in medicine.
Pharmacology
Indications
Contraindications: Biliary tract obstruction, empyema of the gallbladder, and intestinal obstruction. Patients with gallbladder problems should not use dandelion unless instructed by a qualified health care provider owing to the risk of colic.
Dosage and duration of use
Adverse effects: Because dandelion acts as a secretagogue, it can cause complaints related to gastric hyperacidity. The herb has a weak potential for sensitization.
Herb–drug interactions: None known.
Summary assessment: Dandelion is a popular herbal medicament, but further scientific research is required to characterize its effects.
Literature
Devil’s Claw (Harpagophytum procumbens Burch. D. C.)
General comments: Devil’s claw grows in the Kalahari Desert region of southern Africa. The plant has gained significance as an herbal medicament in recent years.
Pharmacology
Indications
Contraindications: Gastric and duodenal ulcers.
Dosage and duration of use
Adverse effects: Allergic reactions can occur in isolated cases.
Herb–drug interactions: None known.
Summary assessment: Preparations made of devil’s claw are suitable for physician-supervised self-treatment. Devil’s claw is an effective herbal remedy that is especially well suited for adjuvant treatment of rheumatic diseases. Used in this capacity, it can reduce the frequency and dose of synthetic antirheumatic drugs. Some recent controlled clinical trials suggest efficacy and safety.
Literature
Dwarf Pine (Pinus mugo spp.)
See Pine.
Plant Summaries—E
Echinacea: Paleflowered Echinacea (Echinacea pallida Nutt.)
Synonyms: Pale coneflower; Blasse Kegelblume (Ger.)
General comments: Paleflowered Echinacea is native to the United States. The root is used in medicine.
Pharmacology
Indications: For supportive treatment of colds or flulike infections.
Contraindications: Hypersensitivity to any of the compounds in Paleflowered Echinacea root in particular, or to composite plants in general. Parenteral administration of echinacea as used in Europe is contraindicated during pregnancy and in general discouraged.
Paleflowered Echinacea root should be used under the advice of a qualified health practitioner by individuals with progressive systemic diseases such as tuberculosis, leukosis, connective tissue diseases, multiple sclerosis, or other autoimmune diseases such as HIV infection.
Dosage and duration of use: Continuous oral use of the tincture (1: 5) or oral preparations for more than 2 weeks is not recommended.
Adverse effects: There are no known health hazards or side effects in conjunction with proper internal or external administration of the designated therapeutic doses of the herb. Skin rashes and itching have been observed in isolated cases. Facial swelling, difficulty in breathing, dizziness and reduction of blood pressure are rare side effects.
Herb–drug interactions: None known.
Summary assessment: Paleflowered Echinacea root is less commonly used than the purple, the experimental and clinical investigation of the herb is not yet complete.
Literature
Purple Echinacea (Echinacea purpurea L. Moench).
Synonyms: Purple coneflower; Purpurfarbene Kegelblume (Ger.)
General comments: Purple Echinacea is native to the United States, where the native Americans utilized its immunity-enhancing properties. The aerial parts of the plant collected at the time of flowering are used in medicine.
Indications
Contraindications: Hypersensitivity to any of the compounds in Purple Echinacea in particular or to composite plants in general.
Purple Echinacea should be used by individuals with progressive systemic diseases such as tuberculosis, leukosis, connective tissue disease, multiple sclerosis or other autoimmune diseases such as HIV infection under the advice of a qualified health practitioner.
Dosage and duration of use
Adverse effects: Skin rashes and itching have been observed in isolated cases. Facial swelling, difficulty in breathing, dizziness, and reduction of blood pressure are rare side effects. Parenteral administration of Purple Echinacea, as used in Europe, is contraindicated during pregnancy and in general discouraged.
Herb–drug interactions: None known.
Summary assessment: Purple Echinacea is a commonly used herb, the effectiveness of which has been demonstrated in a growing number of studies. A preventive effect with respect to flulike infections has not been proven.
Literature
Eleutherococcus (Eleutherococcus senticosus Rupr. Maxim)
Synonyms: Siberian ginseng
General comments: Siberian ginseng is a shrub with effects largely similar to those of ginseng, but is native to Siberia. The root is used in medicine.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use:
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb.
Herb–drug interactions: None known.
Summary assessment: Data on the effects of Eleutherococcus in human volunteers are available for the specified indications. The herb probably has many more potential uses.
Literature
English Ivy (Hedera helix L.)
General comments: The young, tender leaves and shoots are used in medicine.
Pharmacology
Indications: Coughs and bronchitis
Contraindications: None known.
Adverse effects: Health hazards in conjunction with proper administration of the designated therapeutic doses of the drug are not known.
Herb–drug interactions: None known.
Summary assessment: Use should be restricted to commercially manufactured products. Recent clinical studies with positive effects in bronchitis are available.
Literature
English Lavender (Lavandula angustifolia Mill.)
General comments: English lavender flowers are widely used in folk medicine. The oil and the flowers are used in modern herbal medicine.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use.
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. The essential oil has a weak potential for sensitization.
Herb–drug interactions: None known.
Summary assessment: English lavender is a popular herb in empirical folk medicine, but it has not been adequately evaluated in pharmacological or clinical studies. English lavender combines well with other calming and sleep-promoting herbal preparations.
Literature
English Plantain (Plantago lanceolata L.)
Synonyms: Ribwort; Spitzwegerich (Ger.)
General comments: English plantain has been used in many indications since antiquity. It is distributed in cool to moderate zones throughout the world.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use
The enzyme that hydrolyzes aucubin is inactivated upon heating.
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb.
Herb–drug interactions: None known.
Summary assessment: The internal and external uses of plantain are generally regarded as safe and effective. Plantain is also a popular remedy in pediatric medicine (cough syrups).
Literature
Eucalyptus Leaf (Eucalypti folium)
Pharmacology
Indications: Coughs and bronchitis.
Contraindications: See Eucalyptus Oil, internal use.
Dosage and duration of use
Adverse effects: Nausea, vomiting, and diarrhea can occur as rare side effects. No cases of overdose have been reported.
Herb–drug interactions: None known.
Summary assessment: Eucalyptus leaf is weaker than eucalyptus oil and should be combined with equal parts of other expectorants such as thyme and anise seed.
Literature
Eucalyptus Oil (Eucalyptus globulus L. B.)
General comments: Eucalyptus oil is obtained by steam distilling and purifying the essential oil extracted from the fresh leaves or branch tips of Eucalyptus globulus L. B.
Pharmacology
Indications
Contraindications
Dosage and duration of use
Adverse effects: Nausea, vomiting and diarrhea are rare side effects.
Overdose can result in life-threatening poisoning (only a few drops can cause severe poisoning in children, and 4 to 5 mL can cause lethal poisoning in adults). Signs include a drop in blood pressure, circulatory disorders, collapse, and respiratory paralysis.
Herb–drug interactions: Eucalyptus oil accelerates the decomposition of pharmaceutical drugs, thereby weakening or shortening their effectiveness.
Summary assessment: Preliminary studies (see Literature) show that eucalyptus oil might be effective as an inhalant in steams to reduce inflammation and congestion in sinus conditions related to the common cold, asthma, and respiratory allergies.
Literature
European Elder (Sambucus nigra L.)
General comments: Elder flowers and fruit (berries) are used in medicine.
Pharmacology
Indications
Contraindications: None known.
Dosage and duration of use
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb.
Herb–drug interactions: None known.
Summary assessment: Elder flower is a widely used household remedy with long traditional use in the specified indications. Use of elder berry is more common in North America.
Literature
European Golden Rod (Solidago virgaurea L.)
Pharmacology
Indications
Contraindications: Irrigation therapy is not recommended in patients with cardiac or renal edema.
Dosage and duration of use
An ample supply of fluids is essential.
Adverse effects: No known health hazards.
Herb–drug interactions: None known.
Patients with chronic renal disease should not use European golden rod unless instructed by a physician or qualified health care provider.
Summary assessment: The indications for European goldenrod are based on the pharmacological properties of its constituents and therapeutic experience. European goldenrod combines well with other aquaretic and urinary disinfectant drugs.
Literature
Plant Summaries—F
Fennel (Foeniculum vulgare Miller)
General comments: The oil and seedlike fruit of Foeniculum vulgare Miller are used in medicine.
Pharmacology
Adverse effects: Sunbathing or intense exposure to UV light should be avoided when using Angelica root, since the furanocouramins in the drug may induce photodermatosis in susceptible individuals.
Adverse effects: There are no known health hazards or side effects in conjunction with proper administration of the designated therapeutic doses of the herb. The essential oil has a slight potential for sensitization after skin contact.
Pharmacology
Indications
Pharmacology
Dosage and duration of use: Only commercial ivy preparations should be taken according to the manufacturer’s instructions.
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