Veterinary Herbal Medicine

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11830 Westline Industrial Drive St. Louis, Missouri 63146

VETERINARY HERBAL MEDICINE

ISBN-13: 978-0323-02998-8 ISBN-10: 0-323-02998-1

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, PA, USA: phone: (+1) 215 239 3804, fax: (+1) 215 239 3805, e-mail: [email protected]. You may also complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by selecting “Customer Support” and then “Obtaining Permissions”.

Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment, and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. The Publisher Library of Congress Cataloging-in-Publication Data Veterinary herbal medicine / [edited by] Susan G. Wynn, Barbara J. Fougère. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-323-02998-8 ISBN-10: 0-323-02998-1 1. Alternative veterinary medicine. 2. Herbs—Therapeutic use. I. Wynn, Susan G. II. Fougère, Barbara. [DNLM: 1. Phytotherapy—veterinary. 2. Veterinary Medicine–methods. 3. Medicine, Herbal–methods. SF 745.5 V586 2007] SF745.5.V4844 2007 636.089′5321—dc22 2006047201

Publishing Director: Linda Duncan Publisher: Penny Rudolph Developmental Editor: Shelly Stringer Publishing Services Manager: Pat Joiner Senior Project Manager: Karen M. Rehwinkel Senior Designer: Jyotika Shroff

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Contributors

James Martin Affolter, PhD (Botany) Professor University of Georgia Department of Horticulture; Director of Research State Botanical Garden of Georgia University of Georgia Athens, Georgia Chapter 17: Conserving Medicinal Plant Biodiversity Kerry Martin Bone, BSc (Hons); Dip Phyt (Diploma in Phytotherapy) Adjunct Associate Professor School of Health University of New England Armidale, New South Wales, Australia; Director of Research Research & Development MediHerb Pty Ltd Warwick, Queensland, Australia Chapter 7: Evaluating, Designing, and Accessing Herbal Medicine Research

Cindy Engel, PhD, MRSS Lecturer, Open University Clover Forge Farm Suffolk, United Kingdom Chapter 2: Zoopharmacognosy Terrence S. Fox, BS (Hon), MS, PhD Buck Mountain Botanicals Miles City, Montana Chapter 16: Commercial Production of Organic Herbs for Veterinary Medicine Joyce C. Harman, DVM, MRCVS Harmany Equine Clinic, Ltd Washington, Virginia Chapter 21: Herbal Medicine in Equine Practice Hubert J. Karreman, VMD Penn Dutch Cow Care Quarryville, Pennsylvania Chapter 22: Phytotherapy for Dairy Cows

William Bookout, BS, MBA President, Genesis Limited; President, National Animal Supplement Council Valley Center, California Chapter 8: Regulation and Quality Control

Linda B. Khachatoorian, RVT Product Manager Genesis Limited Valley Center, California Chapter 8: Regulation and Quality Control

Marina Martin Curran, BSc (Hons), MSc School of GeoSciences University of Edinburgh United Kingdom Chapter 3: Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems?

Tonya E. Khan, DVM, BSc Veterinarian Mosquito Creek Veterinary Hospital North Vancouver, British Columbia, Canada Chapter 3: Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems?

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CONTRIBUTORS

Robyn Klein, RH (AHG), MS, Medical Botanist Adjunct Professor Department of Plant Sciences Montana State University Bozeman, Montana Chapter 10: Medical Botany Cheryl Lans, MSc, PhD Postdoctoral Scholar Department of Sociology University of Victoria Victoria, British Columbia, Canada Chapter 3: Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? Steven Paul Marsden, DVM, ND, MSOM, LAc, Dipl. Chinese Herbology, RH(AHG) Instructor International Veterinary Acupuncture Society Fort Collins, Colorado; Member, Board of Directors National College of Naturopathic Medicine Portland, Oregon; Co-founder, Edmonton Holistic Veterinary Clinic Edmonton, Alberta, Canada; The Natural Path Clinic Edmonton, Alberta, Canada Chapter 5: Overview of Traditional Chinese Medicine: The Cooking Pot Analogy Chapter 13: Herbal Energetics: A Key to Efficacy in Herbal Medicine Constance M. McCorkle, PhD Senior Research Scientist and President CMC Consulting Falls Church, Virginia; Graduate Faculty Member University of Fairfax Vienna, Virginia Chapter 3: Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? Andrew Pengelly, DBM, ND, BA, FNHAA Program Convener and Lecturer in Herbal Therapies School of Applied Sciences University of Newcastle New South Wales, Australia Chapter 17: Conserving Medicinal Plant Biodiversity

Robert H. Poppenga, DVM, PhD, Diplomate, American Board of Veterinary Toxicology Professor of Clinical and Diagnostic Veterinary Toxicology California Animal Health and Food Safety Laboratory System University of California School of Veterinary Medicine Davis, California Chapter 12: Herbal Medicine: Potential for Intoxication and Interactions With Conventional Drugs David W. Ramey, DVM Ramey Equine Calabasas, California; Adjunct Faculty College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins, Colorado Chapter 9: A Skeptical View of Herbal Medicine Robert J. Silver, DVM, MS Boulder’s Natural Animal: An Integrative Wellness Center Boulder, Colorado Chapter 6: Ayurvedic Veterinary Medicine: Principles and Practices Eric Yarnell, ND, RH(AHG) President, Botanical Medicine Academy Seattle, Washington; Adjunct Faculty Department of Botanical Medicine Bastyr University; Adjunct Faculty Herbal Healing Program Tai Sofia Institute; Visiting Professor Pochon CHA University Seoul, Korea; Chief Financial Officer, Healing Mountain Publishing, Inc.; Vice President, Heron Botanicals, Inc. Seattle, Washington Chapter 11: Plant Chemistry in Veterinary Medicine: Medicinal Constituents and Their Mechanisms of Action Ellen Zimmerman, MA Austin School of Herbal Studies Austin, Texas Chapter 15: Designing the Medicinal Herb Garden

Preface

onsumers of medicine and veterinary medicine have shown that they desire a variety of medical approaches. Herbal medicine just can’t seem to die, and has persisted no thanks to us veterinarians—our clients and nonveterinary herbalists have kept it alive. Skeptics have mourned the loss of medical independence, and have argued that medical research and practice should not be beholden to public opinion. In fact, the last hundred years of medical trajectory is the result of the Flexner report, which aimed to shut down sectarian medicine. Flexner’s sponsor, the Carnegie Foundation, believed that medical education should not be independent and commercialized, but that it in fact should answer to public and charitable interests (Hiatt, 1999). People want herbal medicine. This is our attempt to help veterinarians explore and begin to offer it.

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We recognize that challenges still exist. It may be some time until we clearly understand how herbs and drugs interact. Standardization is a contentious issue, recommended by researchers and resisted by herbalists. In our view, herbal medicine is unique among medical specialties in that we are guided by the past, whereas most of medicine is inspired by new and untested remedies. Still, we support research that clarifies these issues, and our hope is that researchers in this field will recognize the expertise and experience of herbalists already active in clinical investigations of their tools. With this book, we hope that we can contribute to the re-emergence of the art of veterinary herbal medicine.

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Acknowledgments

his book is the result of collaboration between extraordinary experts in a variety of fields. By bringing them together, we hope we have presented a new picture of herbal medicine to the veterinary profession. We could not have done it without our authors, and we have also relied upon reviewers to survey the information for errors. We thank Joni Freshman, Patricia Kyritsi Howell, Beth Lambert, Sherry Sanderson, Roy Upton, David Winston, and Eric Yarnell for previewing some of the chapters for accuracy. Any errors that remain belong to us and should not reflect on their work. Of course, we stand on the shoulders of giants, and the resources of herbalists who come before us have been invaluable. We would like to especially thank Henriette Kress, Michael Moore, Paul Bergner, David Winston, Michael Tierra, James Duke, Daniel Moerman, Kerry Bone, Simon Mills, Berris Burgoyne, and many more who have shared their knowledge in books and on their websites, as well as the authors of the many ethnomedical, scientific herbals, and antiquarian veterinary texts, too many to be named, in our libraries.

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We also acknowledge the tireless efforts of our editors, in particular Shelly Stringer and Karen Rehwinkel. Many thanks to our family and friends, who waited patiently for us to finish so that we could regain our free time. Susan Wynn would particularly like to thank her parents, Jack and Linda Wynn, her students, her coworkers at Bell’s Ferry Veterinary Hospital, and finally, Barbara Fougère, for their heartening reassurances about this project. A special thanks from Barbara Fougère to Lyndy Scott and Karl Walls for your support and encouragement. And to Susan Wynn, its been a real pleasure—a challenging, stimulating, and very exciting journey working with you. Thank you. Together we would also like to especially acknowledge the many animals who have given their lives for the sake of scientific research. If, in the evidence-based medicine scheme, their sacrifices are meaningless to our patients, we are the poorer for it.

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Introduction: Why Use Herbs?

1

Susan G. Wynn and Barbara J. Fougère

CHAPTER “Plants are nature’s alchemists, expert at transforming water, soil, and sunlight into an array of precious substances, many of them beyond the ability of human beings to conceive, much less manufacture. While we were nailing down consciousness and learning to walk on two feet, they were, by the same process of natural selection, inventing photosynthesis (the astonishing trick of converting sunlight into food) and perfecting organic chemistry. As it turns out, many of the plants’ discoveries in chemistry and physics have served us well. From plants come chemical compounds that nourish and heal and poison and delight the senses, others that rouse and put to sleep and intoxicate, and a few with the astounding power to alter consciousness—even to plant dreams in the brains of awake humans.” Botany of Desire, Michael Pollan

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erbal medicine represents a synthesis of many fields—botany, history, ethnomedicine, and pharmacology. Embarking on the study of this field means that veterinarians will be required to reframe the way they think about medicine. Many challenges await us. We are asked to consider plants we learned in toxicology as useful medicines. We are told, in the age of evidence-based medicine, that old authorities (some who lived as long as 2000 years ago) still have something to teach us. Our knowledge about these medicines comes from plant scientists, food scientists, pharmacologists, lay herbalists, and farmers—and we are asked to respect them as equal partners in herbal education and discovery. Even as we become comfortable and familiar with these plants, we are told that we won’t be able to use them unless we become active in conservation efforts. Herbal medicine asks a lot but gives the practitioner more in return. Why use an herb when we have available to us established, effective treatments for so many medical conditions? Most herbalists would answer this way: When conventional treatments are both safe and effective, they should be used. Unfortunately, that isn’t the case for many serious chronic medical conditions—chronicity is virtually defined by the fact that medicine isn’t working. Herbs represent an additional tool for the toolbox. For some, the fact that animals have been thought to treat themselves using herbs is reason enough to try them. For some herbalists, herbs also represent a different approach to the practice of medicine, that is, using the complex formulas “developed” by plants over millennia in relationship with the rest of the beings on the planet. These combinations of chemicals nourish, heal, and kill, but by using rational combinations in the practice of medicine, herbalists believe they attain longer lasting, more profound improvements (Box 1-1).

HERBS ARE NOT SIMPLY “UNREFINED DRUGS” Complex Drugs With Complex Actions Plants may contain many dozens of chemical constituents. Some of these have pharmacologically unique and powerful activity and have been tapped by the drug industry to develop new pharmaceuticals. However, the other ingredients in plants may have important activity as well. Consider, for example, the vitamins, minerals, flavonoids, carotenoids, sugars, and amino acids contained in a plant—do these assist effector cells in mounting the physiologic response initiated by the “drug”? And do constituents with lesser pharmaceutical activity than the one “recognized” active constituent play any role? These complex drugs offer the sick patient a greater range of effects. Because there are many conditions for which the etiopathogenesis is unknown, providing the patient with a choice of biochemical solutions makes sense. Take, for example, Saint John’s Wort for depression, as compared with paroxetine or sertraline. The “active constituents” of Saint John’s Wort and their studied actions include the following (Butterweck, 2003; Simmen, 2001): • Amentoflavone: inhibits binding at serotonin (5HT)(1D), 5-HT(2C), D(3) dopamine, delta opiate, and benzodiazepine receptors • I3, II8-biapigenin: inhibits binding at estrogen–alpha receptor, benzodiazepine receptors • Quercitrin, isoquercitrin, hyperoside, rutin, quercetin, amentoflavone, and kaempferol inhibit dopamine beta-hydroxylase • Hypericin: binds D(3) and D(4) dopamine receptors, beta-adrenergic receptors, human corticotrophinreleasing factor (CRF1) receptor, sigma receptors, and 1

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CHAPTER 1 • Introduction: Why Use Herbs?

NPY Y1 receptors; inhibits activation of N-methyl-Daspartate (NMDA) receptors • Hyperforin: binds D(1) and, to a lesser extent, other dopamine receptors, 5-HT, opiate, benzodiazepine, and beta-adrenergic receptors; inhibits Na-dependent catecholamine uptake at nerve endings; inhibits high-affinity choline uptake; inhibits neuronal uptake of serotonin, norepinephrine, dopamine, gammaaminobutyric acid (GABA), and L-glutamate through mechanisms different from synthetic selective serotonin reuptake inhibitors (SSRIs) (more reminiscent of tricyclic antidepressants [TCAs]); affects cell membrane fluidity; and enhances glutamate, aspartate, and GABA release • Hyperin: decreases malondialdehyde and nitric oxide levels in injury model; decreases Ca influx in brain cells • Pseudohypericin: inhibits activation of NMDA receptors

BOX 1-1 Reasons Whole Herbs Are Preferred to Isolated Active Constituents • The whole herb or whole extract is already understood from history and clinical trials. • The herb’s constituents have complex actions that may benefit the patient through additive, antagonistic, or synergistic effects. • Some constituents may not be stable when isolated. • Most active constituents may be unknown.

Receptor Activity: Saint John’s Wort Constituents 5HT Amentoflavone 12, II8-Biapigenin Hypericin Hyperforin Pseudohypericin

5HT (1D) ✓

5HT (2C) ✓

D(1) Dopamine

✓

✓

D(3) Dopamine ✓

D(4) Dopamine

✓ ✓

✓ ✓

Delta Opiate

Benzodiazepine

✓

✓ ✓

✓

Estrogen Alpha

Betaadrenergic

Sigma

NPY Y1

NMDA

CRF1

✓ ✓

✓

✓

✓

✓

✓

✓

✓

5-HT, serotonin; NMDA, N-methyl-D-aspartate; CRF, corticotrophin-releasing factor.

Uptake Effects: Saint John’s Wort Constituents

Nadependent Catecholamine Uptake

Hyperforin

✓

Inhibit Highaffinity Choline Uptake ✓

Inhibit Lowaffinity Choline Uptake ✗

Serotonin

Norepinephrine

Dopamine

GABA

L-glutamate

✓

✓

✓

✓

✓

GABA, gamma-aminobutyric acid.

Other Effects: Saint John’s Wort Constituents Dopamine Betahydroxylase Quercitrin Isoquercitrin Rutin Quercetin Kaempferol Hyperoside Hyperforin Hyperin

✓ ✓ ✓ ✓ ✓ ✓

GABA, gamma-aminobutyric acid.

Change Membrane Fluidity

GABA Release

Aspartate Release

Glutamate Release

✓

✓

✓

✓

Malondialdehyde Levels

Nitric Oxide Levels

Decrease Neuronal Calcium Influx

✓

✓

✓

Introduction: Why Use Herbs? • CHAPTER 1

Paroxetine is a pure SSRI; sertraline is an SSRI that binds beta-adrenergic receptors. These are much more defined actions, as would be the action of many of the single constituents of Saint John’s Wort. Treatment of patients with depression may require trial and error drug treatment, and the first drug prescribed is often ineffective. Offering a plant drug with multiple actions gives the body a multitude of possible solutions at one time. As a whole, Saint John’s Wort cannot be compared with any known drug. When asked which is the single active ingredient of any herb, the drumbeat of the herbalist will always be: The Plant Is the Active Constituent!

Synergy The chemical compounds in plant medicines may have additive, antagonistic, or synergistic effects. For instance, foxglove is less toxic than its active ingredient digoxin because the digoxin is diluted out by other plant constituents, some of which may antagonize its action. Additive effects are fairly easily quantified when the individual chemicals are well defined. Synergistic effects are more difficult to quantify and are the subject of some investigation into the effects of plants. Synergy between plant components may take pharmacodynamic forms or pharmacokinetic forms. In pharmacokinetic synergy, one component may enhance intestinal absorption or utilization of another component. Pharmacodynamic synergy occurs when two compounds interact with a single target or system. Not all of these interactions fit the strictest physicochemical definition of synergy, and Williamson (2000) has suggested that these should be called polyvalent actions of plant medicines. Barberry (Berberis aquifolium) contains berberine, an alkaloid with documented antigiardial, antiviral, and antifungal properties. It is also an anti-inflammatory and has been shown to modulate prostaglandin levels in renal and cardiovascular disease. Herbalists have long used berberine-containing plants (which also include Goldthread [Coptis spp] and Goldenseal) for treating patients with infection. Use of the single drug berberine may lead to antibacterial resistance, although herbalists appear to use the whole plants repeatedly with no ill effects. One group asked the question, “Why don’t bacteria easily develop resistance to berberine-containing plants?” Stermitz et al screened barberry plants for known multiple drug resistance inhibitors and found one— 5-methoxyhydnocarpin (Stermitz, 2000). A seemingly unimportant constituent contained in barberry may synergistically enhance the effectiveness of the berberine it contains. Other examples of purported synergism may be seen in plant medicines. Wormwood (Artemisia annua) is the source of the antimalarial compound, artemisinin. The flavonoids contained in the plant apparently enhance the antimalarial activity of this compound in vitro (Phillipson, 1999). Similar types of activity have been determined for compounds found in kava, valerian, dragon’s blood (Croton draconoides), and licorice (Williamson, 2000).

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HERBAL PRESCRIPTIONS ARE INDIVIDUALIZED FOR EACH PATIENT Herbal Simples and Specifics In earlier times, a single herb that was appropriate for a particular condition was called a simple. For example, use of cranberry for a urinary tract infection is a simple prescription. Simple prescriptions allow new practitioners to learn about individual herbs thoroughly, one at a time, before taking the next step to formula design. Some American eclectic practitioners (specifically, John M. Scudder, MD) taught that herbs have specific indications for use. According to this system of specific diagnosis and specific treatment, single herbs were recommended for a particular condition or diagnosis with associated symptoms. For example, quite a few herbs are appropriate for diarrhea (as there are drugs for diarrhea). Some herbs are considered astringents; others are demulcents. Some come with the accompanying features of soothing the respiratory tract or the skin as part of their therapeutic spectrum. A specific is chosen with the patient’s overall health or disease picture in mind, when the herbalist possesses this depth of knowledge. Specific prescriptions reflect the growing popularity of homeopathy during the 19th century, and the herb symptom picture descriptions in John Scudder’s specific medication are superficially similar to homeopathic symptom pictures (Table 1-1).

Herbal Formulas In herbal medicine, polypharmacy is de rigueur; herbalists try to anticipate and treat associated problems and possible adverse effects of treatment in a proactive way. An herbal formula may provide the following for any individual patient: 1. One or more herbs that provide multiple mechanisms by which the major sign or complaint can be resolved 2. If these herbs do not fit the specific picture of the patient, the formula may provide herbs to reduce adverse effects or support other signs 3. Herbs that support other signs or systems in need Formula design can be complicated or simple, and more information on this process can be found in Chapter 19, Approaches in Veterinary Herbal Medicine Prescribing.

HERBS OFFER A DIFFERENT APPROACH TO CHRONIC DISEASE The diseases that dominate human medicine are different today from the ones described 100 or 1000 years ago. Animal health and disease have changed in sometimes similar ways; we currently have good treatment options for patients with bacterial and parasitic diseases, for instance, but we face challenges with cancer and allergic and degenerative diseases. For this, if for no other reason, the traditions of herbal medicine deserve another look. Conventional pharmacology currently has no place for considering alteratives, tonics, and adaptogens—these represent just some of the activities that are possibly

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CHAPTER 1 • Introduction: Why Use Herbs?

TABLE 1-1 Specific Medication: Comparison of Cough Remedies Herb Licorice

Action Against Cough Demulcent, antispasmodic, anti-inflammatory

Elecampane Slippery elm Lobelia

Aromatic stimulant and tonic Demulcent Nauseant, emetic, expectorant, relaxant, antispasmodic, diaphoretic, sialagogue, sedative; secondarily, occasionally cathartic, diuretic, and astringent Tonic, carminative, emmenagogue, and antispasmodic

Thyme

Other Indications for the Herb Urinary tract inflammation, intestinal spasm Digestive weakness Chronic digestive disorders Formerly, for spasmodic problems from muscular tetany to seizures

Flatulence, colic, headache

unique to plant medicines. Adaptogens, for instance, increase nonspecific responses to stress, usually without adverse effects and are often taken for long periods. Alteratives were formerly considered (among other things) blood cleansers, but today, we view alteratives as herbs that restore or correct absorptive and excretory functions. The traditions of Traditional Chinese Medicine, Ayurveda, and other ethnomedical systems are even more unfamiliar for modern veterinarians trained in the scientific tradition. This is no excuse, however, for ignoring the possibilities when conventional medicine fails to serve our patients. These traditions offer hundreds to thousands of years of empirical experience, and the alternative perspective may open new avenues for scientific investigation. Veterinary herbalists do not graduate from these traditions—they learn from them.

SUMMARY Herbal medicine is used in ways that differ from the ways conventional pharmacologic drugs are used. Because herbs have nutritional elements, and because pharmaceutical elements interact with one another polyvalently, the clinical effects may have greater depth and breadth than those seen in drug therapy. Patient prescriptions are based on both the pharmacology AND the traditional indications for the herbs. For many of the reasons cited here, and for other reasons, veterinarians are using herbal medicine again. A recent survey of 2675 veterinarians in Austria, Germany, and Switzerland suggested that approximately three quarters of veterinarians in those countries are using herbal

Other Characteristics of the Herb Suppresses cortisol breakdown; do not use in patients with hyperadrenocorticism Very safe herb Very safe herb Very strong herb—effective at low doses

Safe herb in culinary doses

medicine, especially for chronic diseases and as adjunct therapy (Hahn, 2005). Most veterinarians view their animal patients as kin, and veterinary herbalists may expand the family even further. Native Americans who depended on their domesticated animals (such as the Plains tribes and their horses) had greater knowledge of plant medicine than did other tribes (Stowe, 1976). Herbalists await scientific investigation of plant medicines but also learn from the plants themselves, acknowledging the ancient and evolving relationship between plants and mammals. References Butterweck V. Mechanism of action of St John’s wort in depression: what is known? CNS Drugs 2003;17:539-562. Hahn I, Zitterl-Eglseer K, Franz CH. Phytomedizin bei hund und katze: internetumfrage bei Tierärzten und Tierärztinnen in Österreich, Deutschland und der Schweiz. Schweiz Arch Tierheilk 2005;147:135-141. Phillipson JD. New drugs from plants—it could be yew. Phytother Res 1999;13:1-7. Simmen U, Higelin J, Berger-Buter K, et al. Neurochemical studies with St. John’s wort in vitro. Pharmacopsychiatry 2001; 34(suppl 1):S137-S142. Stermitz FR, Lorenz P, Tawara JN, Zenewicz LA, Lewis K. Synergy in a medicinal plant: antimicrobial action of berberine potentiated by 5’-methoxyhydnocarpin, a multidrug pump inhibitor. Proc Natl Acad Sci U S A. 2000 Feb 15;97(4):1433-1437. Stowe CM. History of veterinary pharmacotherapeutics in the United States. JAVMA 1976;169:83-89. Williamson EM. Chapter. In: Ernst E, ed. Herbal Medicine: A Concise Overview for Professionals. Oxford: ButterworthHeinemann; 2000.

Zoopharmacognosy Cindy Engel

2 CHAPTER

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olklore asserts that animals instinctively know how to medicate their ills from the herbs they find growing wild. Traditional herbalist Juliette de Bairacli Levy writes that sick animals partake “only of water and the medicinal herbs which inherited intelligence teaches it instinctively to seek.” Around the world, traditional herbalists use observations of sick wild animals to find new medicines. Benito Reyes of Venezuela, for example, claims to have discovered the antiparasitic benefits of the highly astringent seeds of the Cabalonga tree ( Nectandra pinchurim) by observing emaciated animals scraping and chewing the fallen seeds. As a result of such folklore, there is a common lay assumption that animals unerringly know which herbs to use for which ills. However, this overly romantic view of the wisdom of an all-knowing animal is clearly incorrect. Both wild and domestic animals are known to poison themselves by feeding on toxic substances, repeatedly return to feed on toxic but intoxicating plants, and sometimes quite clearly fail to successfully medicate their ills. Such failures could suggest that animals are in fact incapable of helping themselves when ill and have in the past kept the topic of animal self-medication off the research agenda. However, a growing body of scientific evidence shows that animals—not only mammals but birds and insects— are self-medicating a variety of physical and psychological ills. Such behavioral strategies though, like all strategies, are fallible; however, it is the limits of efficacy that are of great interest to those working in the field of animal health. Because self-medication strategies have the potential to greatly enhance the health of animals in our care, we would be wise to explore them more closely.

SELF-REGULATION Living systems are inherently self-regulatory. Behavior is one means by which animals regulate their physiologic and psychological states. For example, overheated animals move into the shade, where it is cooler; dehydrated, they search for water; anxious, they seek safety.

However, behavioral self-regulation is far more refined than this. Deprived of only one amino acid, rats increase their consumption of novel foods until they find a diet that is rich in that missing amino acid. Furthermore, they learn an aversion to foodstuffs that are deficient in only one amino acid (Rogers, 1996; Fuerte, 2000). Lambs monitor the carbohydrate and protein content of their diet and adjust their feeding accordingly. If deprived of phosphorus, sheep not only identify a phosphorus-rich diet but also learn a preference for the foods that correct deficiency malaise (Villalba, 1999; Provenza, 1995). Reviewers conclude that such nutritional wisdom is achieved via a combination of postingestive hedonic feedback and individual learning. They propose that “behavior is a function of its consequences” (Provenza, 1995, 1998). This is true of health maintenance in general, that is, the individual assesses via hedonic feedback—“Do I feel better or worse after doing that?” The cost to an individual of not maintaining health can be high. Consequently, natural selection has honed a variety of behavioral health maintenance strategies reviewed most recently by Hart (1990, 1994) and Huffman (1997a). As Hart points out, behavior is often the first line of defense against attack by pathogens and parasites. As a result, animals use behavioral strategies for avoiding, preventing, and therapeutically addressing threats to survival.

NATURE’S LARDER—POWERFUL PHARMACOPOEIA Animals must obtain the nutrients and energy they need from a larder that is constantly changing in composition and is often well defended. Moreover, nutrients and energy often come packaged with varying quantities of nonnutrients, many of which are bioactive. This bioactivity is not a fixed phenomenon either. These nonnutrients can be toxic, intoxicating, or medicinal, depending on dose, frequency of consumption, and combination with other foodstuffs, as well as on the changing internal conditions of individual animals. 7

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PART I • Historical Relationship Between Plants and Animals

Priority is given to finding sufficient nutrients and energy without consuming too many toxic defensive compounds. Adaptive taste preferences and biochemical detoxification processes help in this regard. The task requires not only adaptive physiologic characteristics but also continuous self-regulation at the behavioral level. A food that is safe on one occasion may be unsafe on another. The postingestive effects of each feeding bout must be monitored, so that survival is not threatened. Put simply, foods that create unpleasant sensations are avoided, those that create pleasant sensations or remove unpleasant sensations such as deficiency malaise are preferred. As animals use hedonic feedback to find ways of remedying the unpleasant sensations of dietary deficiencies, and of avoiding the worst chemical defenses of plants and insects foods, so they can also find ways of removing the unpleasant sensations of disease and injury. Early research on insects distinguished normal feeding from pharmacophagy (Boppre, 1984). Further refinement included a new term—zoopharmacognosy—that described the discoveries of animals who were apparently using medicinal herbs to treat illness (Rodriguez, 1993). Huffman described a set of conditions that would help primatologists discriminate self-medication from normal feeding in wild primates. First, the animal should show signs of being ill (preferably with some quantifiable test as evidence of sickness). Second, it should seek out and consume a substance that is not part of its normal diet and that preferably should have no nutritional benefit. Its health should then improve (again, established quantifiably by tests) within a reasonable time, commensurate with the known pharmacology of the substance. Laboratory analysis of the plant or substance is then needed to establish that the amount consumed contains enough active ingredients to bring about the changes observed. Although these criteria are helpful for identifying possible instances of self-medication in the field, they do not define self-medication. As we shall see, recent research on various animal species (both wild and domesticated) illustrates the broad spectrum of approaches that animals use to self-medicate.

Wild Medicine—Beneficial Diets Everyday diets include beneficial nonnutritional components. A few of many possible examples are described here. In the rain forests of Costa Rica, mantled howler monkeys are infested with different quantities of internal parasites, depending on where they live. Those living in La Pacifica have high levels of parasites, and those living in Santa Rosa have low levels. None of the heavily infested group has access to fig trees (Ficus spp), but the less infested group has many fig trees available. South Americans traditionally use fresh fig sap to cure themselves of worms because the sap decomposes worm proteins (Stuart, 1990; Strier, 1993; Glander 1994). In the Fazenda Montes Claros Park in southeastern Brazil, endangered muriquis (or woolly spider monkeys)

and brown howler monkeys are completely free of all intestinal parasites—a startling and unexpected discovery. In another location, both species are infested with at least three species of intestinal parasites. The main difference between monkeys in the two locations is that the worm-free monkeys have access to a greater selection of plants used as anthelmintics by local Amazonian people (Stuart, 1993). The everyday diet of great apes contributes much to the sustainable control of parasites. Chimpanzees at Mahale Mountains National Park, for example, eat at least 26 plant species that are prescribed in traditional medicine for the treatment of internal parasites or the gastrointestinal upset that they cause (Huffman, 1998). In Brazil, the gold and red maned wolf roams the forest at night hunting small prey but taking up to 51% of its diet from plants. By far, its favorite is the tomato-like fruit of Lobeira, or Wolf’s fruit (Solanum lycocarpum). Although these fruits are more plentiful at certain times of year, the wolf works hard to eat a constant amount throughout the year, suggesting that this fruit is of some significant value. Researchers at Brazilia Zoo found that they could not help their captive wolves survive infestation with a lethal endemic giant kidney worm unless they fed Lobeira daily to their packs (daSilveira, 1969). Correlations have been noted too in domestic diets and worm loads. When commercially raised deer in New Zealand were grazed on forage containing tannin-rich plants such as chicory, farmers needed to administer less chemical de-wormer (Hoskin, 1999). Furthermore, given a choice, parasitized deer and lambs select the bitter and astringent Puna chicory, thereby reducing their parasite load (Schreurs, 2002; Scales, 1994). Tannin-rich plants such as this are commonly selected in moderate amounts by free-ranging animals. Researchers in Australia and New Zealand have found that certain types of forage such as Hedysarum coronarium, Lotus corniculatus, and L. pedunculatus, which contain more useful condensed tannins, can increase lactation, wool growth, and live weight gain in sheep, apparently by reducing the detrimental effects of internal parasites (Aerts, 1999; Niezen, 1996). Tannin-rich pastures may also provide opportunities for ungulates to regulate bloat (McMahon, 2000). Occasionally, even extra large doses of astringent tannins may be consumed. Janzen described how the Asiatic two-horned rhinoceros occasionally eats so much of the tannin-rich bark of the mangrove Ceriops candolleana that its urine turns dark orange. He postulated that the rhinoceros may be self-medicating against endemic dysentery, pointing out that the common antidysentery medicine—clioquinol (Enterovioform)—consists of about 50% tannin ( Janzen, 1978).

Adaptive Taste Preferences Evidence suggests that animals seek out particular tastes because of the adaptive consequences. Tannins usually deter mammals from eating plants because their astringency puckers and dries the tongue and impairs digestion by binding proteins. However, as we have seen, tannins

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9

are not avoided entirely. Given a choice, deer avoid selecting food with the lowest tannin levels and instead select those containing moderate amounts, suggesting that a certain amount of tannin is attractive to them (VerheydenTixier, 2000). It appears such taste preferences may be adaptive because of the impact of tannins on intestinal parasites. When domesticated goats were fed polyethylene glycol (PEG), which deactivates tannins, numbers of intestinal parasites increased (Kabasa, 2000). Sheep, goats, and cattle increase tannin consumption when fed the deactivating PEG. Alternatively, when fed high-tannin diets, lambs increase PEG intake (Provenza, 2000). These results indicate an attempt to self-regulate tannin consumption to an optimal level. As we shall see in the next section, other so-called feeding deterrents are sought out when their potent bioactive effects outweigh taste aversions.

Bioactive Botanicals—Toxin or Medicine? Chimpanzees have similar taste preferences to humans. They prefer sweet over bitter foods. In the Mahale Mountains of Tanzania is a small shrub, Vernonia amygdalina, known as bitter leaf. Its extreme bitterness successfully keeps most indigenous animals away, although introduced domesticated goats appear unable to identify the risks; consequently, another common name for this plant is “goat killer.” When local chimpanzees are sick, they seek out this bitter, toxic plant, carefully strip off the outer layers of shoots, and chew and suck the juicy bitter pith. The plant is considered a very strong medicine by local people who use it to treat malarial fever, stomachache, schistosomiasis, amoebic dysentery, and other intestinal parasites (Huffman, 1989). Pig farmers in Uganda supply their animals with branches of this plant, in limited quantities, to treat intestinal parasites. Bitter pith chewing is rare, but chimpanzees with diarrhea, malaise, and nematode infection recover within 24 hours (similar to the recovery time of local Tongwe people who use this medicine). The behavior clearly influences nodular worm infestation. In one example, fecal egg count dropped from 130 to 15 nodular worm eggs within 20 hours of chewing bitter pith. Bitter pith chewing is more common at the start of the rainy season, when nodular worms increase (Huffman, 1997b) (Figure 2-1). Furthermore, scientists have noticed that chimpanzees with higher worm loads, or those that appear to be more ill, tend to chew more bitter pith than those with lower infestation levels. Vernonia amygdalina from Mahale contains seven steroid glucosides, as well as four sesquiterpene lactones, capable of killing parasites that cause schistosomiasis, malaria, and leishmaniasis. The sesquiterpene lactones (previously known to chemists as “bitter principles”) are not only anthelmintic but also antiamoebic, antitumor, and antimicrobial. The outer layers of the shoots and leaves of the shrub, which chimpanzees so carefully discard, contain high levels of vernonioside B1 that would be extremely toxic to a chimpanzee. Not only can chimpanzees find a suitable plant to alleviate their symp-

Figure 2-1 Chimpanzee sucks on the bitter pith of Vernonia amygdalina (bitter leaf) in Tanzania. (Courtesy Michael Huffman.)

toms, they can also find the right part of the plant to be effective without harm (Ohigashi, 1991, 1994). It is possible that bitterness in plants may be an effective indicator of medicinal properties: it generally indicates toxicity, but it is this very toxicity that is so effective against parasites. This plant is not just bitter, it is the most bitter plant the chimpanzees can find in the forest. One slurp of its juice will make an adult human wince. Chimpanzees and other animals normally avoid it, but appetitive or tolerance changes may take place during sickness. Sick human patients will apparently tolerate more bitter herbal prescriptions, but as health improves, their tolerance of bitters declines. The mechanism that brings about these changes is not yet known, but experimental evidence supports the idea of an adaptive taste preference for bitters. Laboratory mice were used to explore the link between illness and consumption of bitters. Experimental mice were given a choice between two water bottles—one contained only water, and the other, a bitter-tasting chloroquine solution that would combat malarial infection. Control mice were given only water. Those mice infected with malarial parasites and given access to chloroquine experienced significantly less infection and mortality than did infected mice with no access to chloroquine. Malarial infection was reduced because mice took approximately 20% of their water from the bottle containing the bitter chloroquine solution. However, consumption of chloroquine was not related to malarial infection. Given a choice, both sick and nonsick mice took small doses of the bitter solution, supporting the idea of an adaptive taste preference for moderate consumption of bitters (Vitazkova, 2001). It is not only primates, or even vertebrates, that use herbal medicines to control parasites. Even insects do it.

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PART I • Historical Relationship Between Plants and Animals

It has long been known that certain butterflies harvest and store the toxic cardiac glycosides from milkweed plants, and that this stash protects them against some predatory birds. However, these glycosides also protect butterfly larvae from internal parasites. It is not clear whether these benefits are merely incidental to feeding, yet the dietary choice is distinctly beneficial. Scientists who study insect parasitoids (lethal parasites) have found convincing evidence that insects do self-medicate. Woolly bear caterpillars of the tiger moth can be injected with the eggs of parasitic tachinid flies. Fly larvae develop inside the caterpillars, feeding off their fat reserves and finally bursting out of the abdominal wall. Under laboratory conditions, infected caterpillars usually die from this experience. However, when Richard Karban and his colleagues at University of California Davis started rearing their caterpillars in outdoor enclosures, they noticed that the survival rate of parasitized caterpillars was much higher. Outside, the caterpillars had access to plant species not provided in the laboratory. Given a choice, healthy caterpillars chose to feed on lupine (Lupinus arboreus), and parasitized caterpillars preferred to feed on hemlock (Conium maculatum). Having parasites affected dietary choices, and the change in diet improved chances for survival. Although hemlock, which is known to contain at least eight alkaloids, does not kill the parasites, it helps caterpillars survive infection (Karban, 1997).

Geophagy Geophagy—the consumption of soil, ground-up rock, termite mound earth, clay, and dirt—is extremely common in mammals, birds, reptiles, and invertebrates. The habit is still found among many contemporary indigenous peoples, including the Aboriginal people of Australia and the traditional peoples of East Africa and China (Abrahams, 1996). Geophagy is far more common in animals that rely predominantly on plant food and is more common in the tropics. Historically, the explanation for geophagy was that animals ate earth for the purpose of gaining minerals, such as salt (sodium chloride), lime (calcium carbonate), copper, iron, or zinc. Certainly, wild animals do seek minerals from natural deposits, but a need for minerals is by no means a universal explanation for geophagy. There are many cases in which the soils eaten are not rich in minerals; they sometimes even have lower levels of minerals than the surrounding topsoil. Recent geophagy research indicates that the small particle clay profile of soil is often the prime reason for geophagy. In the body, clays can bind mycotoxins (fungal toxins), endotoxins (internal toxins), manmade toxic chemicals, and bacteria, and they can protect the gut lining from corrosion, acting as an antacid and curbing diarrhea. In short, clay is an extremely useful medicine. The benefits of clay to animal health have been known for some time. Addition of bentonite clay improves food intake, feed conversion efficiency, and absorption patterns in domestic cattle by 10% to 20%. Clay-fed cattle also experience less diarrhea and fewer gastrointestinal

ailments (Kruelen, 1985). In addition, veterinarians find clay an effective antacid. Free-ranging cattle help themselves to clay by digging out and licking at subsoils. High in the Virunga Mountains of Rwanda, mountain gorillas mine yellow volcanic rock from the slopes of Mount Visoke. After loosening small pieces of rock with their teeth, they take small lumps in their powerful leathery hands and grind them to a fine powder before eating (Schaller, 1964). Gorillas are more likely to mine rock in the dry season, when they are forced to change their diet to plants such as bamboo, Lobelia, and Senecio, which contain more toxic plant secondary compounds than are found in their usual diet. Along with this change in diet comes diarrhea (a natural response to rid the body of toxins); this extra loss of fluid during the dry season could be a serious health problem for the gorilla (Fossey, 1983). Halloysite, the type of clay found in the subsoil eaten by mountain gorillas, is similar to kaolinite, the principal ingredient in Kaopectate, the pharmaceutical commonly used to soothe human gastric ailments. Kaolinite helps reduce the symptoms of diarrhea by absorbing fluids within the intestine (Mahaney, 1995). Wild chimpanzees take regular mouthfuls of termite mound soil and scrape subsoils from exposed cliff faces or river banks. When scientists spent 123 hours looking specifically at the health of chimpanzees eating termite mound soil, they found that all were unwell, with obvious diarrhea and other signs of gastrointestinal upset (Mahaney, 1996). Analyses of termite mound soils show them to be low in calcium and sodium but high in clay (up to 30%), more specifically, in the same sort of clay used by mountain gorillas and sold by human chemists to treat gastrointestinal upsets in the West. Termite mound soils are used not only by chimpanzees but also by many other species, such as giraffes, elephants, monkeys, and rhinoceroses. In the rain forests of the Central African Republic, forest elephants and other mammals have created large treeless licks on outcrops of ancient subsoils (Figure 2-2). Most are high in minerals, but almost a third of the licks have lower levels of minerals than surrounding soils. The one thing all the sites have in common is a clay content of over 35%. These elephants feed primarily on leaves all year round, except for 1 month—September—when ripening fruit is so abundant that they change to eating mainly fruits. Leaves generally contain defensive secondary compounds to deter herbivores; ripe fruits do not. A change from eating leaves to fruits would therefore dramatically reduce the consumption of toxic secondary compounds—a natural experiment to see whether toxin consumption equates with clay consumption. The only month in which elephants reduce their visits to the clay licks is during that fruit-eating month—September (Klaus, 1998)! In the tropical forests of South America, too, clay consumption is particularly common in parrots, macaws, monkeys, tapirs, peccaries, deer, guans, curassows, and chachalacas. After studying geophagy in the Amazon forest of Peru for many years, Charles Munn concluded that nearly all vertebrates that feed on fruits, seeds, and leaves also eat clay. On an average day, he has observed

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Scientists who research geophagy agree that, as a strategy, it has many benefits. The Director of the Geophagy Research Unit in Utah, William Mahaney, concludes, “All geophagy is a form of self-medication.” Archaeological nutritionist Timothy Johns proposes that geophagy may be the earliest form of medicine and concludes that, although some soils can be a source of nutrients (minerals and/or trace elements), the primary benefit of clay consumption is its effect of countering dietary toxins and, secondarily, the effects of parasites. This explains why plant eaters need to eat earth, and why this practice is more common in the tropics, where plants are more heavily defended by toxic secondary compounds.

Mechanical Scours Figure 2-2 Elephants dig down to find clay deposits in Central Africa. (Courtesy Martin Gruber.)

up to 900 parrots from 21 species and 100 large macaws gathering to feed on the eroding riverbanks, biting off and swallowing thumb-sized chunks of orange clay (Mayer, 1999). In 1999, the hypothesis that animals eat clay for the purpose of inactivating plant toxins was tested experimentally with macaws by James Gilardi and a team of scientists at the Davis California campus. First, they established that seeds eaten by macaws contain toxic plant alkaloids. Then, they fed one group of macaws a mixture of a harmless plant alkaloid (quinidine) plus clay. A second group of macaws were fed just the quinidine, without any clay. Several hours later, the macaws that ate the quinidine with clay had 60% less alkaloid in their blood than did the control group, demonstrating that clay can indeed prevent the movement of plant alkaloids into the blood. What surprised the scientists though was that the clay remained in the macaws’ gut for longer than 12 hours, meaning that a single bout of geophagy could protect the birds for quite some time. It is suspected that clay not only prevents plant toxins from getting into the blood, but it also lines the gut and protects it from the caustic chemical erosion of seed toxins (Gilardi, 1999). Because macaws do not have a diarrheal response to toxins, the consumption of clay may be an essential part of their diet, allowing them to successfully use foods that other animals are unable to tolerate. It is evident that clay is sought by many animals with gastrointestinal malaise—often caused by plant toxins but also by internal pathogens. In fact, eating clay is used as an indicator of gastrointestinal upset in rats (Takeda, 1993). Rats are unable to vomit, and when they are experimentally poisoned with lithium chloride, they eat clay; this “illness response behavior” is dose dependent, that is, the more sick they feel, the more clay they eat. If they are then given saccharin (a sweet taste) with the poison, they learn to associate the sweet taste with the feeling of nausea. They will then eat clay even when given saccharin alone (Sapolsky, 1998).

Great apes (i.e., chimpanzees, bonobos, and gorillas) do something peculiar with hairy leaves. They assess a potential leaf with their hands, mouth, and tongue while it is still attached to the plant; then, if it is desirable, they pick it, fold it in concertina fashion, and swallow it whole without chewing (Figure 2-3). In each bout, apes swallow from one to one hundred leaves, which are later excreted undigested. Across Africa, they use leaves from at least 34 different species of herbs, trees, vines, and shrubs. Some contain bioactive phytochemicals, others do not; however, all are rough in surface texture with hooklike microstructures called trichomes (Wrangham, 1977; Huffman, 1997, 2003). Leaf swallowing, as it is known, is more common at the beginning of the rainy season, when nodular worm infestation starts to increase; many of the apes seen doing this are clearly suffering from symptoms of nodular worm infestation, including diarrhea, malaise, and abdominal pain (Huffman, 1997). After decades of research, scientists discovered that the rough texture of leaves acts as a mechanical scour, scraping loose intestinal worms out through the gut. Rough leaves also stimulate diarrhea and speed up gut motility, helping the animal to shed worms and their toxins from the body. This is likely to provide rapid relief from feelings of gastrointestinal malaise (Huffman, 2001). It seems that leaf swallowing is particularly effective against nodular worms because they move around freely in the large intestine looking for food and mates. Other worms (such as threadworms and whipworms) burrow into the mucosa of the small intestine and thereby probably escape the scraping effects of rough leaves. However, leaf swallowing has also helped chimpanzees at Kibale National Park, Uganda, to rid themselves of a particularly heavy outbreak of tapeworms (Bertiella studeri) (Wrangham, 1995). It is thought that the unpleasant sensations of abdominal pain, diarrhea, and bowel irritation of nodular worm and tapeworm infestations could be the triggers for leaf swallowing or the chewing of bitter pith (Huffman, 1997). Primates are not the only species to seek out mechanical scours. Biologists have long known that bears somehow rid themselves of internal parasites before hibernation. Alaskan brown bears in Katmai National

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PART I • Historical Relationship Between Plants and Animals

Figure 2-4 European starlings fill nest box with pungent herbs at hatching time. (Courtesy Helga Gwinner.)

nonherbal), there is a delicate balance between a dose toxic enough to harm the parasites yet not the host. These nontoxic physical remedies used by wild animals may be a particularly useful addition to parasite control in modern farming, where parasites are increasingly resistant to drugs (Huffman, 2003).

Topical Applications

Figure 2-3 Chimpanzee selects hairy Aspilia leaf in Tanzania. (Courtesy Michael Huffman.)

Park change their diet before hibernation. Highly fibrous, sharp-edged, coarse sedge (Carex spp [Cyperaceae]) appears in large dung masses almost completely composed of long tapeworms. The coarse plant material scrapes out the worms in a similar way to the rough leaves swallowed by chimpanzees (Huffman, 1997). Physical expulsion also seems to be used by Canadian snow geese. Just before migration, they deposit large boluses of undigested grass and tapeworms in their dung. When they reach their migration destination, they are clear of tapeworms. In both brown bears and snow geese, worms are being shed at a time of critical nutritional stress—a time when carrying these parasites would greatly reduce the animal’s chances of survival. Wolves eat grass, and wolf scats have been found that contain both grass and roundworms (Murie, 1944). Tigers are reported to eat grass “when hungry,” although if heavily infested with worms, they may appear emaciated. Samples of the droppings of wild Indian tigers consist almost entirely of grass blades, and in at least one case, a tapeworm was found inside (Schaller, 1967). Both domestic dogs and cats occasionally chew grass—possibly a residual self-medication strategy of their wild ancestors. Traditional herbalists use physical scours as a method of worm control. With chemical de-wormers (herbal or

Birds and mammals also use nature’s pharmacy externally on their skin and in their immediate environment. In these examples, they are exploiting the volatile components of plant and insect secretions. During nesting time, male European starlings collect a selection of aromatic herbs to bring back to the nest (Figure 2-4). In North America, they preferentially select wild carrot (Daucus carota), yarrow (Achillea millefolium), agrimony (Agrimonia parviflora), elm-leaved and rough goldenrod (Solidago spp), and fleabane (Erigeron spp), even when they are not the most common plants nearby. These herbs are all highly aromatic. Furthermore, they contain more volatile oils, in greater concentrations, than are found in aromatic plants close at hand that are not selected. Back at the nest, the fresh herbs are woven into the nest matrix and topped up all the while the chicks are hatching. The benefits of these herbs to the chicks are evident. Chicks in herb nests have a significantly greater chance of surviving into the next season than do chicks in nests from which the herbs have been removed (Clark, 1988). Chicks do not eat or actively rub against these pungent herbs, yet when herbs are removed from nests, chicks become infested with more mites. More specifically, chicks in nests that contain wild carrot have higher hemoglobin levels than do those without, again suggesting that they are losing less blood to blood-sucking mites. Preferred plants contain monoterpenes and sesquiterpenes (such as myrcene, pinene, and limonene) that are harmful to bacteria, mites, and lice in the laboratory. These herbs are particularly effective against the harmful bacteria Streptococcus aureus, Staphylococcus epidermidis,

Zoopharmacognosy • CHAPTER 2

and Pseudomonas aeruginosa. Lining the nest with pungent herbs is adaptive in that it has a number of different beneficial effects on chicks (Clark, 1985). In Panama, white-nosed coatis, relatives of raccoons, rub their coats with resin from the Trattinickia aspera tree that has a camphor- or menthol-like smell. This resin is used by local Guaymi Indians to repel biting flies. Chemists at Cornell University have identified sesquiterpene lactones in the resin that are repellent to fleas, lice, ticks, and mosquitoes. In the mosquito-ridden llanos of central Venezuela, wedge-capped capuchin monkeys rub the secretions of large millipedes into their skin. The active ingredients are benzoquinones, which are potentially carcinogenic but antimicrobial and repellent to insects such as the bothersome mosquitoes (Valderrama, 2000).

LABORATORY EXPLORATIONS OF SELF-MEDICATION Although biologists were initially surprised by examples of self-medication observed in the field, the ability of animals to self-medicate has been used in laboratory experiments for many years. Self-selection of drugs is commonly used in pain, addiction, and mental health research. Laboratory experiments show that mice actively selfmedicate feelings of anxiety. In one example, one group of mice received electric shocks to the feet (“acute physical stress”), and the other group was forced to witness another mouse getting a foot shock (“acute emotional stress”). Both groups of mice had free access to morphine, but only the mice exposed to emotional stress selfadministered the morphine (Kuzmin, 1996). A similar effect is seen with cocaine self-administration in emotionally stressed rats (Ramsey, 1993). Scientists in the Ukraine found that stressed rats learned to self-administer strobe lighting at certain frequencies that changed electrical activity in the brain, thereby calming heart rhythm and lowering blood pressure. The rats thereby ingeniously calmed themselves down (Shlyahova, 1999). A feeling of anxiety is clearly unpleasant, and it is surely the animal’s desire to feel better that drives this kind of behavioral self-regulation. The welfare of animals in intensive farming is a contentious issue, and any objective measure of their suffering is useful in the debate. A team of veterinary scientists at Bristol University in the United Kingdom have used chickens’ ability to self-medicate as proof that they suffer pain. Broiler chickens have been artificially selected to grow extremely quickly, turning food into meat at the expense of bone growth. Their legs therefore are often not strong enough to support their weight, and they frequently suffer broken leg bones. Lame birds go off their food and remain still, unwilling to walk—even to the water trough. However, 1-month-old birds can rapidly learn to select feed that contains the painkilling analgesic carprofen; in addition, the amount of painkiller the birds eat increases with the severity of lameness. Carprofen tastes slightly peppery and can cause gastrointestinal upset. Sound birds tend to avoid the drugged feed, suggesting that they find it unpleasant (Danbury, 2000).

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Broiler chickens can also self-medicate stress. It has long been known that supplementing chicken feed with vitamin C (ascorbic acid) helps chickens cope better with heat stress, but producers have difficulty knowing when, and by how much, to supplement the feed. Mike Forbes and his colleagues at Leeds University in the United Kingdom solved this problem by allowing individual birds to self-medicate. To do this though, birds need some way of detecting the tasteless, colorless, and odorless vitamin C. Birds have acute color vision and readily learn color associations. By coloring feed that contains vitamin C, researchers revealed that birds could learn the positive effects of colored feed within 3 days and could selfmedicate as and when necessary. Kutlu and Forbes (1993) suggest that vitamin C works by reducing production of the stress hormone corticosterone, thereby reducing other symptoms of chronic stress. They point out that self-medication with vitamin C could be applied to other forms of stress such as parasite infection, high humidity, and high production rates.

MECHANISMS OF ANIMAL SELF-MEDICATION It is clear that the behavioral repertoires of mammals and birds include many remedial strategies other than those involving the consumption of bioactive phytochemicals. The physical scraping actions of fibrous scours, the topical and local use of volatile oils, and the absorptive properties of clays illustrate the wider landscape of self-medication. It seems we need to consider at least three nonexclusive mechanisms of self-medication: 1. Adaptive dietary/behavioral preferences—for example, adult mice have taste preferences for moderate levels of bitters that protect them from disease; deer have taste preferences for tannins that affect parasite levels. Both bitters and tannins are normally considered feeding deterrents. 2. Adaptive illness response behaviors—for example, rats seek clay when nauseous. 3. Exploratory hedonic feedback—for example, chicks rapidly learn the beneficial analgesic effects of distasteful drugged food.

APPLICATIONS OF SELF-MEDICATION Understanding how animals attempt to self-medicate is essential if we are to provide optimal conditions for self-regulation. Much of the self-medication we see can be explained by hedonic feedback. This ensures that animals only rarely attempt to consume highly toxic substances and prefer to consume those that confer rapid positive feedback. When it comes to finding relief from discomfort, hedonic feedback ensures that animals use safer, less potent “medicines” and resort to the stronger, often more toxic medicines only on rare occasions. This means that continuous moderate self-regulation will be more common than dramatic curative strategies using strong medicines. In other words, much self-medication is unseen. The limits of hedonic feedback are also worth considering. Because individuals use substances that provide a

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“feel good factor,” they are vulnerable to intoxication and even addiction. Although not described here, both intoxication and addiction occur in wild and domestic species. Just because an animal readily consumes a certain substance does not mean that the substance is safe for consumption in unlimited quantities. Self-medication via hedonic feedback is a fairly blunt instrument; the animal feels discomfort and tries a range of things until the discomfort is eased. This form of selfmedication is aimed at relieving symptoms—not at the pathogen per se. This means that self-medication may or may not affect the pathogen. In some cases, such as when apes scour intestinal parasites, the action that removes the discomfort also removes the pathogen, but this is not always the case. Although Karban’s caterpillars survived infestation with normally lethal parasitoids by selfmedicating on potent alkaloids, the parasites themselves were unharmed. It is also important to consider the role that learning plays in the refinement of self-medication strategies. Even those strategies that are apparently innate are usually refined through experience. Young male starlings, for example, have a selective preference for collecting a wide range of pungent plants at hatching time; however, the profile of those choices is refined with experience, so that older males show similar localized preferences. Chimpanzees too seem to need experience on the benefits of leaf swallowing to refine their self-medicating skills. It is clear that birds and mammals are able to rapidly find remedies in unfamiliar compounds. Laboratory studies on pain relief and stress reduction demonstrate the readiness of rodents and birds to try novel strategies. This has management implications. In their attempt to remove feelings of unease, disease, and discomfort using what is available locally, inexperienced and poorly provisioned animals may try to self-medicate with unsuitable, even unsafe materials. It is therefore essential that safe choices be provided to them for use as potential medicines. Health maintenance strategies are flexible but are not infallible. The ability to successfully self-medicate requires a complex mix of innate behavioral strategies and refinement attained via learning (experience). It is not appropriate to leave sick animals to fend for themselves —even free-ranging animals—in the hope that they will find some way of self-medicating, especially naïve or domesticated animals. The more opportunities animals have to learn the consequences of their actions, the better. Domestication has not selected individuals for their ability to self-regulate, and the domestic environment often provides little opportunity for trial and error, experience with potentially toxic bioactive materials, or learning from the observations of others. Even so, given the paucity of research in this area, it is apparent from the examples presented here that domestic animals retain a surprising array of self-medicating abilities. Incorporating our embryonic understanding of selfmedication into animal health management requires that we acknowledge the individual’s ability to self-regulate. This means providing individual animals with access to

as many potential natural medicines as possible ad libitum. For example, although clay can provide numerous health benefits for ungulates, it is not necessarily best practice to administer clay in standardized form, say via feed, to the whole herd. This is not allowing for selfregulation. It is far better to provide clay licks for individuals to use as and when required. The essential provision of plant biodiversity for all animals (not only herbivores) cannot be overemphasized. Exposure to diverse flora is especially important during early years when the banes and benefits of certain tastes are being developed by the individual. Another area that veterinarians might consider is self-administration of certain drugs (herbal or nonherbal). Self-selection of appropriate levels of veterinary medication looks promising, especially for analgesia and carminatives, as long as there is no danger that hedonic feedback may lead to overindulgence. Although more research is urgently needed, it is clear that there exists an exciting opportunity for encouraging—even exploiting—an individual’s ability to selfregulate health status.

References Abrahams PW, Parsons JA. Geophagy in the tropics: a literature review. The Geographical Journal 1996;162:63–73. Aerts RJ, Barry TN, McNabb WC. Polyphenols and agriculture: beneficial effects of proanthocyanidins in forages. Agric Ecosyst Environ 1999;75:1–12. Boppré M. Redefining pharmacophagy. J Chem Ecol 1984;10: 1151–1154. Clark L, Mason JR. Effect of biologically active plants used as nest material and the derived benefit to starling nestlings. Oecologia 1988;77:174–180. Clark L, Mason JR. Use of nest material as insecticidal and antipathogenic agents by the European starling. Oecologia (Berlin) 1985;67:169–176. Danbury TC, Weeks CA, Chambers JP, Waterman-Pearson AE, Kestin SC. Self-selection of the analgesic drug carprofen by lame broiler chickens. Veterinary Record, March 11, 2000. daSilveira EKP. O.lobo-guara (Chyrsocyon brachyrus). Possival acao inhibidoria de certas solancas sobre o nematoide renal. Vellozia 1969;1:58–60. Fossey D. Gorillas in the Mist. London: Hodder & Stoughton; 1983. Fuerte S, Nicoladis S, Berridge, KC. Conditioned taste aversion in rats for a threonine-deficient diet: demonstration by the taste reactivity test. Physiol Behav 2000;68:423–429. Gilardi JD, Duffey SS, Munn CA, Tell LA. Biochemical functions of geophagy in parrots: detoxification of dietary toxins and cytoprotective effects. J Chem Ecol 1999;25:897–919. Glander KE. Nonhuman primate self-medication with wild plant foods. In: Etkin N, ed. Eating on the Wild Side: The Pharmacologic, Ecologic, and Social Implications of Using Non-cultigens. Tucson, Ariz: University of Arizona Press; 1994:227–239. Hart BL. Behavioral adaptations to pathogens and parasites: five strategies. Neurosci Biobehav Rev 1990;14:223–294. Hart BL. Behavioural defence against parasites: interaction with parasite invasiveness. Parasitology 1994;109:S139–S151. Hoskin SO, Barry TN, Wilson PR, Charleston WAG, Hodgson J. Effects of reducing anthelmintic input upon growth and faecal egg and larval counts in young farmed deer grazing chicory (Cichorium intybus) and perennial ryegrass (Lolium perenne)

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white clover (Trifolium repens) pasture. J Agric Sci 1999;132: 335–345. Huffman MA. Animal self-medication and ethno-medicine: exploration and exploitation of the medicinal properties of plants. Proc Nutr Soc 2003;62:371–381. Huffman MA. Current evidence for self-medication in primates: a multidisciplinary perspective. Yearbook Phys Anthropol 1997a;40:171–200. Huffman MA, Caton JM. Self-induced gut motility and the control of parasite infections in wild chimpanzees. Int J Primatol 2001;22:329–346. Huffman MA, Gotoh S, Turner LA, Hamai M, Yoshida K. Seasonal trends in intestinal nematode infection and medicinal plant use among chimpanzees in the Mahale Mountains, Tanzania. Primates 1997b;38:111–125. Huffman MA, Ohigashi H, Kawanaka M, et al. African Great Ape self-medication: a new paradigm for treating parasite disease with natural medicines? In: Ageta H, Ami N, Ebizuka Y, Fujita T, Honda G, eds. Towards Natural Medicine Research in the 21st Century. Amsterdam: Elsevier Science; 1998. Huffman MA, Seifu M. Observations on the illness and consumption of a possibly medicinal plant Vernonia amygdalina by a wild chimpanzee in the Mahale Mountains National Park, Tanzania. Primates 1989;30:51–63. Janzen DH. Complications in interpreting the chemical defences of trees against tropical arboreal plant-eating vertebrates. In: Montgomery GG, ed. The Ecology of Arboreal Folivores. Washington: Smithsonian Institute Press; 1978:73–84. Kabasa JD, OpudaAsibo J, terMeulen U. The effect of oral administration of polyethylene glycol on faecal helminth egg counts in pregnant goats grazed on browse containing condensed tannins. Trop Anim Health Prod 2000;32:73–86. Karban R, English-Loeb G. Tachinid parasitoids affect host plant choice by caterpillars to increase caterpillar survival. Ecology 1997;78:603–611. Klaus G, Klaus-Hugi C, Schmid B. Geophagy by large mammals at natural licks in the rain forest of the Dzanga National Park, Central African Republic. J. Trop. Ecol 1998;14:829–839. Kruelen DA. Lick use by large herbivores: a review of benefits and banes of soil consumption. Mam Rev 1985;15:107–123. Kutlu HR, Forbes JM. Self-selection of ascorbic acid in coloured foods by heat-stressed broiler chickens. Physiol Behav 1993;53:103–110. Kuzmin A, Semenova S, Zvartau EE, Van Ree JM. Enhancement of morphine self-administration in drug naïve, inbred strains of mice by acute emotional stress. Eur Neuropsychopharmocol 1996;6:63–68. Mahaney WC, Aufreiter S, Hancock RGV. Mountain gorilla geophagy: a possible seasonal behavior for dealing with the effects of dietary changes. Int J Primatol 1995;16:475–488. Mahaney WC, Hancock RGV, Aufreiter S, Huffman MA. Geochemistry and clay mineralogy of termite mound soils and the role of geophagy in chimpanzees of Mahale Mountains, Tanzania. Primates 1996;37:121–134. Mayer W. Feat of clay. Wildlife Conservation Magazine, June 1999. McMahon LR, McAllister TA, Berg BP, et al. A review of the effects of forage condensed tannins on ruminal fermentation and bloat in grazing cattle. Can J Plant Sci 2000;80: 469–485. Murie A. The Wolves of Mount McKinley. Washington DC, US Department of the Interior. Fauna Series 1944;5:59. Niezen JH, Charleston WAG, Hodgson J, Mackay AD, Leathwick DM. Controlling internal parasites in grazing ruminants without recourse to anthelmintics: approaches, experiences and prospects. Int J Parasitol 1996;26:983–992.

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Ohigashi H, Huffman MA, Izutsu D, et al. Toward the chemical ecology of medicinal plant use in chimpanzees: the case of Vernonia amygdalina Del. A plant used by wild chimpanzees possible for parasite-related diseases. J Chem Ecol 1994;20: 246–252. Provenza FD. Post-ingestive feedback as an elementary determinant of food preference and intake in ruminants. J Range Manage 1995;48:2–17. Provenza FD, Buritt EA. Self-regulation of polyethylene glycol by sheep fed diets of varying tannin concentrations. J Anim Sci 2000;78:1206–1212. Provenza FD, Villalba JJ, Cheney CD, Werner SJ. Selforganisation of foraging behaviour: from simplicity to complexity without goals. Nutr Res Rev 1998;11:199–222. Ramsey NF, Van Ree JM. Emotional but not physical stress enhances intravenous cocaine self-administration in drugnaïve rats. Brain Res 1993;608:216–222. Rodriguez E, Wrangham RW. Zoopharmacognosy: the use of medicinal plants by animals. In: Downum KR, Romeo JT, Stafford H, eds. Recent Advances in Phytochemistry 27: Phytochemical Potential of Tropical Plants. New York: Plenum Press; 1993:89–105. Rogers W, Rozin P. Novel food preferences in thiamine-deficient rats. J Compar Physiol Psychol 1996;61:1–4. Sapolsky RM. Junk food monkeys. London Headline 1998:156. Scales GH, Knight TL, Saville DJ. Effect of herbage species and feeding level on internal parasites and production performance of grazing lambs. N Z J Agric Res 1994;38:237–247. Schaller G. The Deer and the Tiger: A Study of Wildlife in India. Chicago, Ill: University of Chicago Press; 1967. Schaller G. The Year of the Gorilla. Chicago, Ill: University of Chicago Press; 1964. Schreurs NM, Lopez-Villalobos N, Barry TN, Molan AL, McNabb WC. Effects of grazing undrenched weaner deer on chicory or perennial ryegrass/white clover on the viability of gastrointestinal nematodes and lungworms. Vet Rec 2002;151: 348–353. Shlyahova AV, Vorobyova TM. Control of emotional behaviour based on biological feedback. Neurophysiology 1999;31:38–40. Strier KB. Menu for a monkey. Natural History, 1993. Stuart MD, Greenspan LL, Glander KE, Clarke M. A coprological survey of parasites of wild mantled howler monkeys. J Wildlife Dis 1990;26:547–549. Stuart MD, Strier KB, Pierberg SM. A coprological survey of wild muriquis Brachyteles arachnoids and brown howling monkeys Aloutta fusca. J Helminth Soc, 1993. Takeda N, Hasegawa S, Morita M, Matsunaga T. Pica in rats is analogous to emesis: an animal model in emesis research. Pharmacol Biochem Behav 1993;45:817–821. Valderrama X, Robinson JG. Seasonal anointment with millipedes in a wild primate: a chemical defense against insects? J Chem Ecol 2000;26:2781–2790. VerheydenTixier H, Duncan P. Selection for small amounts of hydrolysable tannins by a concentrate selecting mammalian herbivore. J Chem Ecol 2000;26:351–358. Villalba JJ, Provenza FD. Nutrient-specific preferences by lambs conditioned with intraluminal infusions of starch, casein, and water. J Anim Sci 1999;77:378–387. Vitazkova S, Long E, Glendinning J. Mice suppress malaria infection by sampling a “bitter” chemotherapy agent. Anim Behav 2001;61:887–894. Wrangham RW. Feeding behaviour of chimpanzees in Gombe National Park, Tanzania, In: Clutton-Brock TH, ed. Primate Ecology. New York: Academic Press; 1977:504–538. Wrangham RW. Leaf swallowing by chimpanzees, and its relation to a tapeworm infection. Am J Primatol 1994;37:297–303.

Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? Cheryl Lans, Tonya E. Khan, Marina Martin Curran, and Constance M. McCorkle *

WHAT IS EVM? Also sometimes called veterinary anthropology (McCorkle, 1989),† ethnoveterinary medicine or EVM can be broadly defined in this way: The holistic, interdisciplinary study of local knowledge and its associated skills, practices, beliefs, practitioners, and social structures pertaining to the healthcare and healthful husbandry of food, work, and other income-producing animals, always with an eye to practical development applications within livestock production and livelihood systems and with the ultimate goal of increasing human well-being via increased benefits from stockraising (McCorkle, 1998a).

This definition suggests the myriad scientific disciplines that are implicated in the research and development (R&D) and application of EVM. It also signals attention to all aspects of a people’s knowledge and practices in animal healthcare, productivity, and performance, that is, their diagnostic (including ethologic) understandings; preventive, promotive, and therapeutic skills and treatments; and a wide range of health-related management techniques. These aspects in turn embrace local Materia medica, which include minerals and animal products or parts, as

*The authors would like to acknowledge important inputs to this chapter by Dr. Med. Vet. Evelyn Mathias. She contributed data on the history of EVM, of which she was one of the leading pioneers. She also shared recent information on avian influenza, as per a study of this subject that she was preparing in Spring 2006. † Because they are so voluminous yet also often recondite, references to the history of EVM and to specific examples of knowledge and techniques from one or another culture are not cited one-by-one in this introduction. Rather, such references are mentioned only if they cannot be found in one or more of the sources by Martin, Mathias/Mathias-Mundy, McCorkle, and their coauthors that are cited in the text. These all represent formal publications released as books or as articles in peer-reviewed disciplinary outlets spanning agriculture, anthropology, international development, and veterinary medicine. These items are more readily accessible to interested readers.

3 CHAPTER

well as plants and human-made and natural materials; modes of preparation and administration of ethnoveterinary medicaments; basic surgery; various types of immunization; hydro, physical, mechanical, and environmental treatments and controls; herding, feeding, sheltering, and watering strategies; handling techniques; shoeing, shearing, marking, and numerous other husbandry chores such as ethnodentistry; management of genetics and reproduction; medicoreligious acts; slaughter, as one medical option; and all the various socioorganizational structures and professions that discover, devise, transmit, and implement this knowledge and expertise. These human elements span not only traditional healers of animals (Mathias, 2003) but also families, clans, castes, tribes, communities, cooperatives, dairy associations, other kinds of grassroots development organizations, and more. Impelled in large part by livestock development projects around the world, EVM has evolved to embrace other topics, such as zoopharmacognosy (animals’ selfmedication) as a possible source of EVM ideas; participatory epidemiology; gendered knowledge, tasks, and skills in EVM (Davis, 1995; Lans, 2004); safety in handling and processing food and other products from animals; product marketing and associated agri-business skills; conservation of biodiversity in terms of natural resources, including animal genetic resources (Köhler-Rollefson, 2004); health- and husbandry-related interactions between domestic and wild animals; ecosystem health (i.e., how animals, humans, and their environment can interact to protect or improve the health of all three); EVM-related primary education curricula in rural areas and in training programs for veterinary professionals and paraprofessionals; and policy, institutional, and economic analyses in most of the foregoing realms. For fuller discussions of all the previously listed topics and themes in EVM, see related studies in Reference Section (Mathias, 2004; McCorkle, 1995, 1998b; McCorkle, 2001). It is important to mention, however, that by far the most-studied element of EVM is veterinary ethnopharmacopoeia, especially the use of botanicals. 17

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PART I • Historical Relationship Between Plants and Animals

WHERE DID EVM COME FROM? All over the world and down through the ages, people who keep livestock have developed their own ideas and techniques for meeting the health and husbandry needs of their food, farm, and work animals. Their knowledge and skills may be hundreds or even thousands of years old. Classic cases include Ayurveda in India and acupuncture and herbal medicine in China, all of which were (and are) practiced for animals as well as for humans. These and a few other traditions of EVM have long-standing written records, like scrolls of the Talmud and the Bible’s Old Testament, which occasionally advise on Jewish pastoralism; Sri Lankans’ 400-year-old palm leaf manuscripts on cattle and elephant health and husbandry; early military manuals from numerous peoples on the health care, conditioning, and training of warhorses and draught animals; and, probably most ancient of all, hieroglyphic papyri on Egyptians’ care of sacred bulls. In preliterate or still-nonliterate societies, EVM was and is perforce passed down verbally across the generations. With the 14th century Renaissance in Europe, however, literacy and publishing opportunities expanded and nascent scientific disciplines emerged, some of which occasionally mentioned EVM—most notably, agriculture, botany, medicine (both human and veterinary), folklore studies, and anthropology. In the so-called developing world, European colonialism from the 16th to the 20th century stimulated the production of government reports, personal memoirs, enterprise records, and so forth, by civil servants and technical staff, missionaries, large landowners and ranchers, and others who worked or traveled in the colonies. Some of these authors chronicled their observations and impressions of native veterinary knowledge and practices—albeit often in very ethnocentric and unflattering terms. But even today, much of EVM is transmitted orally. To take just one example, this is still the case for local acumen about the care and training of hunting dogs and mules in parts of rural United States (personal communication, from C. M. McCorkle, for her native state of Missouri). However, not until the 1970s did a noticeable number of peer-reviewed scientific articles, book chapters, special journal issues (Ethnozootechnie), and report series (as from the UN’s Food and Agriculture Organization [FAO]) emerge that were devoted to “traditional,” “indigenous,” or later, “local” or “community-based” animal healthcare and husbandry. From the 1970s onward, an ever-growing number of graduate theses and dissertations in anthropology and, especially, veterinary medicine also addressed EVM. These initially spanned a few universities in Africa, India, and West Germany, plus at least four in France. Later they were joined by Dutch and UK (notably Edinburgh) universities, along with several prestigious schools in the United States (e.g., Cornell, Harvard, Stanford, Tufts).

HOW HAS EVM EVOLVED? On the basis of a review of emerging literature along with firsthand research in 1980 among Quechua stockraisers

in the high Andes of South America, EVM was finally codified in 1986 as a legitimate field of scientific R&D (McCorkle, 1986). An annotated bibliography on EVM and related subjects followed soon thereafter (MathiasMundy, 1989). Published by a US agricultural university program of indigenous knowledge studies within a series on technology and social change, this item was available only as “grey literature.” Nevertheless, it was in high demand. Only in 1996 did the first formally published anthology of scientific studies dedicated solely to EVM reach print (McCorkle, 1996). Between 1986 and 1996, however, the field of EVM literally exploded. This explosion was ignited and thereafter fanned by various fuels. One major stimulus was the World Health Organization’s project to incorporate valid human-ethnomedical techniques and—on the model of barefoot doctors in China—local medical practitioners into real-world strategies for achieving WHO’s goal of “basic healthcare for all.” EVM seeks to do likewise for livestock; e.g., via the creation of cadres of community-based veterinary paraprofessionals (ILD Group 2003) that ideally deliver both conventional and ethno-options. EVM embraces a costeffective return to the “one medicine” concept, in which such healthcare services are delivered jointly to both animals and humans—especially in poor and/or remote areas (Green, 1998; McCorkle, 1998b; others in the special section on human and animal medicine in this issue of Agriculture and Human Values), along with the creation of cadres of community-based veterinary paraprofessionals (IDL Group, 2003) that, ideally, deliver both conventional and ethnomedical options. Another stimulus was the developed world’s burgeoning, billions-of-dollars clamor for more healthful and organic food products (including those for livestock), as well as safer, more natural medical options with fewer adverse effects for both humans and (especially companion) animals. Probably most important, however, was the growing realization among international livestock developers and even some early policymakers that conventional, formal sector, “high-tech” (thus also high-cost) healthcare and husbandry interventions transferred from the developed world could not sustainably meet the basic stockraising needs of most rural people in the developing world, where every rural community keeps animals, as do many urban inhabitants as well. This realization grew out of the on-farm experiences of agricultural, animal, and social scientists and veterinarians in governmental and nongovernmental overseas field projects. An early public-sector leader in this regard was the US Small Ruminant Collaborative Research Support Project. Begun in 1979 in Peru, but growing and continuing until 1997, it involved some 15 US agricultural universities and research centers that worked in cooperation with literally hundreds of governmental and nongovernmental organizations (NGOs) in Bolivia, Brazil, Indonesia, Kenya, Morocco, and Peru. Pioneering international NGOs in EVM included: in the US, Heifer Project International (HPI), notably in Cameroon and the Philippines; the Philippines-based

Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? • CHAPTER 3

International Institute for Rural Reconstruction (IIRR); and the UK Intermediate Technology Development Group (ITDG), which worked particularly in East Africa. Later NGO leaders included India’s ANTHRA group, which focuses on livestock development among women in that country; also in India, the Bharatiya Agro Industries Foundation (BAIF); Germany’s League for Pastoral Peoples (LPP), especially with its work on camels; the US Christian Veterinary Mission; and Vétérinaires Sans Frontières (VSF/Switzerland, 1998). A related factor in the EVM explosion appears to have been the growing volume of articles or papers published in well-known and respected journals or presented at established disciplinary conferences in Europe and the United States. Initially most such items were written about the developing world by developed-world scientists and field practitioners. However, these groups’ serious engagement of the topic seems in turn to have empowered and motivated their counterparts in the developing world to document and report on their own emic (i.e., native) knowledge and field-based observations in EVM. Had these counterparts done so previously, they would have risked ridicule by their national peers who would have perceived them as nonscientific, ignorant, backward, or even superstitious. Indeed, this same fate was suffered by many developed-world explorers of EVM in the 1970s and 1980s. It was also helpful that between 1986 and 1996, new outlets and technologies came into being for more rapid, informal, and globally inclusive exchanges of EVM observations and information across a much wider range of national and disciplinary groups. A pioneering outlet in this regard was the Indigenous Knowledge and Development Monitor. Based first in the United States and later in the Netherlands, this development magazine was published from 1993 to 2001 and was distributed gratis to developing world subscribers. In 1999, it was followed by a global electronic mailing list devoted solely to EVM. Recently, this list was expanded topically and renamed the Endogenous Livestock Development List (http://groups.yahoo. com/group/ELDev/). Although initiated and funded in the developed world, all these efforts relied on hands-on management by and content input from a panel of editors who represented nearly all continents of the globe.* In hindsight, perhaps it is not surprising that this period also saw an increase in grants for R&D and conferences on EVM. Funding came from agencies such as Sweden’s Foundation for Science, the Swiss Agency for Development and Cooperation, the World Bank, FAO, and national federations of local grower or dairier groups. Furthermore, most of these funds were earmarked for livestock projects, researchers, or organizations associated with the developing world, albeit often with pro bono input from colleagues in the developed world. This carried forward the sincere spirit of peer-based North/South collaboration established by earlier publicsector (whether bilateral or multilateral) and NGO efforts, as mentioned previously. *See the Resources section at the end of this chapter for additional resources.

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A notable example is the first-ever international conference, Ethnoveterinary Medicine: Alternatives for Livestock Development. Held in India in 1997, it was supported by the World Bank and many other donors, plus pharmaceutical companies. This event was hosted by India’s BAIF based on a proposal written by Indian, German, UK, and US scientists. Together they thereafter produced two volumes of formal abstracts and proceedings (Mathias, 1999). The conference boasted 33 formal papers and nearly as many poster papers on EVM. Disciplines represented ran from A (anthropology) to Z (zoology) and included all the animal and veterinary sciences in between, along with traditional veterinary praxis as represented by local healers from India. At this point, a patent need arose to update, expand, and more tightly focus the 1989 bibliography referenced earlier. This was done, and the bibliography was released through a major publishing house in international development, with financial support provided by the UK Department for International Development. The new bibliography (Martin, 2001) boasted 1240 annotations spanning 118 countries, 160 ethnic groups, and 200 health problems of 25 livestock breeds and species. It covered publications dated through December of 1998. Since 1998, EVM has rocketed ahead. Publications are increasing exponentially, now with a greater number of developed-world authors researching or writing about EVM in their own cultures and native lands. Recent examples of publications and conferences in this vein come from Canada (TAHCC, 2004), Italy (Guarrera, 1999, 2005; Manganelli, 2001; Pieroni, 2004), the Netherlands (van Asseldonk, 2005), and Scandinavia (Waller, 2001). This trend is due in part to the fact that established scientific outlets in numerous disciplines—like the Revue Scientifique de l’Office Internationale des Epizooties (OIE, 1994)—are now more open than ever to papers on EVM. Also, new outlets are coming into being. For instance, the Journal of Evidence-Based Complementary and Alternative Medicine plans to mount a series of articles on EVM beginning in 2006. Even more important is the fact that the literature is beginning to demonstrate a salubrious move up from mere description of EVM knowledge and practices to more critico-analytic and applied studies. The two cases presented in this chapter are indicative. Scientific meetings on EVM have likewise burgeoned— whether in the form of sessions set aside for EVM at long-standing events like the University of Utrecht (Netherlands) Symposium on Tropical Animal Health and Production, or entire conferences devoted only to EVM. The range of topics presented has also broadened such that workshops and conferences have been created to accommodate specialized interests in a particular region, species, or type of EVM. Moreover, such events are increasingly mounted and funded by developing-world organizations and governments. Consider the following history. In 1994, 1996, and 1998, the NGOs IIRR, ITDG, and VSF held workshops on EVM in Southeast Asia, Eastern Africa, and Sudan, respectively. Meanwhile, in 1997, LLP convened a workshop on both EVM and conventional practices for camel health and husbandry (Köhler-

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PART I • Historical Relationship Between Plants and Animals

Rollefson, 2000). In 1999, a conference was held in Italy on “Herbs, Humans and Animals—Ethnobotany & Traditional Ethnoveterinary Practices in Europe” (Pieroni, 2000). In 2000, an international conference on EVM was mounted in Africa and hosted by Nigeria’s Ahmadu Bello University (Gefu, 2000). Later, a participatory workshop on EVM was held in the Canadian province of British Columbia, funded by the Social Sciences and Humanities Research Council of the government of Canada (see http://bcics.uvic.ca/ bcethnovet/rationale.htm). The year 2005 witnessed the first Pan-American conference on EVM in Latin America, which was organized and hosted by a Guatemalan university, with financial support provided by the Guatemalan government. Also in 2005, various Mexican universities, research centers, and government agencies hosted an international conference on animal genetics and the invaluable animal germplasms, including diseaseresistant ones that local peoples have developed and husbanded down through time. Upcoming in 2006 is a key conference on the same issue, which has been organized by LPP and is being funded and hosted by the Rockefeller Foundation at its prestigious Bellagio Centre in Italy. Also in 2006, the British Society of Animal Science is organizing a special conference/workshop on veterinary ethnobotany targeted to both plant and animal researchers and emphasizing, “the role of plants and their derived products as a means of preventing or treating diseases of animals and improving health” in an environmentally sustainable way. Even more impressive is the number of universities and associated research centers that now include curricula on EVM. Besides the Netherlands, Nigerian, and UK universities already mentioned, some others include Ethiopia’s Addis Ababa University, Mexico’s Universidad Autónoma de Chiapas, Rwanda’s University Centre for Research on Traditional Pharmacology and Medicine, and the University of the West Indies. In addition, particularly in Africa, technical units or components of traditional medicine have been incorporated into a number of government livestock, veterinary, or medical agencies.

• Especially if they are imported, the desired commercial drugs may not be available; if they are available, supplies may be expired, insufficient, or even adulterated. • Other problems with commercial medicines are that veterinary professionals to advise on them may be absent. Stockraisers (especially those illiterate in the language on the drugs’ labels and instructions) may be uncertain about their indications, dosages, and even modes of administration. Dangers here include not only the obvious ones for patients but also the problem of escalating chemoresistance. • As a rule, people are more comfortable receiving healthcare services from known, trusted, local, and co-ethnic practitioners, such as traditional healers or respected livestock extensionists who are from the same community, speak the same tongue, and are themselves stockraisers. • In emergencies or fast-spreading epidemics, there simply may not be time for anything other than local practitioners and treatments. To the extent that such help and treatment are cheaper, they make for better returns to stockraising and thus are more sustainable. • Again, particularly among poor and remote rural populations, opportunities are available for cheaper and more sustainable services via the joint extension of human and veterinary traditional and modern medicine to both people and livestock. • People in many cultures are concerned about adverse effects from food or environmental pollution associated with powerful modern drugs and biocides. Ethnomedical alternatives may prove more benign. • Indeed, long-time savvy about the local ecology, livestock and wildlife ethology, natural resources, and so forth may result in management interventions that are even more effective in preventing disease in the first place—thus avoiding the dangers or costs of therapy of any sort, whether conventional or ethno-medical. • Studies of EVM treatments and practices in different cultures and between different biosocial groups within them (e.g., women vs men, high vs low castes) may bring to light useful new Materia medica or techniques for promoting, protecting, or restoring the health and well-being not only of animals but also of people.

WHY THE INTEREST IN EVM?

WHERE IS EVM HEADED NEXT?

The appeal of EVM can be summarized as bulleted below. Most of these considerations apply to both developing and developed nations. • Particularly among poor or remote stockraisers who can neither afford nor may access expensive or distant conventional healthcare options, validated EVM techniques may be the most realistic choice. • This may also be true for wealthier and better-situated stockraisers insofar as the conventional services on offer may not respond to these producers’ particular veterinary needs. • Whether for poor or rich stockraisers, depending on their production systems and market conditions, the value of the animals in question may not warrant the cost of professional veterinary care and inputs.

Along with others, all the benefits outlined previously have been attested to in the larger literature on EVM. Doubtless, readers will think of others. But beyond providing more culturally comfortable, practical, and economical alternatives or complements to conventional medical approaches, R&D in EVM may conceivably help solve problems left in the wake of, or new to, conventional medicine. An example of the former is ailments that have become resistant to overprescribed or misused commercial drugs like antibiotics and commercial parasiticides. Viral diseases exemplify the latter, in that antigenic shifts may render conventional vaccination responses unrealistic (Atawodi, 2002). Such shifts come about when two varieties of a virus concurrently infect the same host, allowing genomes to recombine into a novel subtype.

Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? • CHAPTER 3

Of course, various limitations to EVM have been noted in the literature. Among others are the following claims (after Fielding, 2000). • For ethnoveterinary botanicals, the required type and amount of (especially) plant materials may not be available when needed, particularly if the plants in question are seasonal or nonlocal, or if herds or flocks are very large. • Even when the materials are available, the mode of administration may not be practical for large herds or flocks. • EVM treatments are too site-specific to justify R&D investments designed to modify them for more universal application. • EVM has little or nothing to offer against acute viral disease. The first and second concerns above are certainly valid. But the literature suggests that they apply equally to conventional treatments because of import, supply, or price problems with commercial drugs—whether in the developing or the developed world. A case in point involves experiences in modern-day France regarding the relative availability and efficacy of conventional and EVM treatments for sudden outbreaks of sheep disease, some of which are viral (Brisebarre, 1996). In response to the third bullet above, this omnibus claim has been largely debunked. Time and again, historically and contemporaneously, and across different continents and cultures, the same or similar plant or other materials and management techniques have been reported for the same or similar livestock and human health problems. Indeed, many so-called modern pharmaceuticals for both animals and people derive from plants and other materials (or their molecular models) used in traditional medicine. In 1990, it was estimated that world sales of medicines derived from plants discovered by indigenous peoples amounted to US $43 billion. With increased bioprospecting (Clapp, 2002), this trend has intensified and become even more profitable (Lans, 2003). In the developing and the developed world, companies that process or merely package and then retail or wholesale “natural,” “organic,” or “ancient” alternatives based on ethnomedicine for livestock and humans have expanded, proliferated, and specialized. In the past decade alone, a number of companies have sprung up in Europe and on the East and West coasts of the United States to distribute EVM-based herbal preparations, many of which are imported from India. Some of these enterprises even specialize in preparations for a single animal species such as horses (Stephen Ashdown, DVM, personal communication). More intriguing is the fourth bullet’s claim that EVM has little or nothing to offer against viral diseases. To date, this statement has gone largely uncontested in the EVM literature. Meanwhile, the effectiveness of a wide variety of EVM treatments for parasitic and bacterial ills, wounds and fractures, fertility and obstetric problems, and numerous husbandry needs has been clearly documented. The primary conventional response to viral epidemics is mass vaccination. However, this approach can have

21

drawbacks that go even beyond those implied for conventional veterinary medicine discussed earlier. These concerns are listed here: • Viruses may mutate so rapidly that research, development, production, and administration of an appropriate vaccine cannot keep pace. • Depending on the disease that is diagnosed, it is not always possible to distinguish infected from already vaccinated animals. In the absence of strict immunization records, this makes it difficult to tightly target the populations to be vaccinated. Thus, the costs of vaccine purchase and administration will mount insofar as some animals are treated two or three times over. • As noted earlier, the cost of treatment may outstrip the value of the animals in question. This is particularly true for small stock like poultry. • Even after animals have been immunized with an effective vaccine, they may continue to shed the virus. This risks further mutation or reinfection. • Mass vaccination also risks eliminating the 1% or 2% of a population that has some natural immunity to the virus. Yet such animals could serve as prime breed stock in the future (Köhler-Rollefson, 1998). In light of the foregoing considerations and in response to the question of “Where is EVM headed next?” the following sections offer two literature-based cases that illustrate EVM potentials for prevention and control of viral disease, whether in livestock or people.

EVM AND VIRAL DISEASES: TWO CASES FROM POULTRY PRODUCTION The cases presented here focus on major viral disease in family poultry enterprises in the developing world. There, more than 80% of poultry are raised in such enterprises. These “backyard birds” provide up to 30% of household protein intake in the form of eggs and meat. Trade in these poultry products and (depending on the culture) in fertilized eggs, chicks, and live birds also contributes significantly to household nutrition and income. Often, this income is used to step up the family farming enterprise through the purchase of larger stock, like pigs, sheep, goats, or even cattle and buffalo (Ibrahim, 1996). Family poultry enterprises normally consist of small to medium-sized flocks of free-ranging birds. They are typically owned and cared for by household women and children. Generally, producers endeavor to supply their flocks with local or purchased feed supplements; various types of protection from predators and the elements; assistance in incubation and chick fostering; and more. However, rarely do they employ costly commercial veterinary inputs. Arguably, viruses are responsible for the most massive and pervasive economic losses from disease of poultry worldwide—especially in family enterprises, but also in agro-industrial poultry production. Newcastle’s disease (ND) is perhaps the best known of these banes. However, much in the news of late is avian influenza (AI), which constitutes a new strain of the centuries-old “fowl plague”—today, generally called simply “bird flu.” Developed-world producers can ward against such threats with modern immunizations, albeit with the

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PART I • Historical Relationship Between Plants and Animals

drawbacks already noted. However, many family poultry enterprises in the developing world simply cannot afford commercial vaccines–—even where these are available and reliable (i.e., unexpired, unadulterated, or unfalsified), with trained personnel to administer them (such as community-based paraprofessionals). Although some ethnoveterinary vaccines of variable efficacy do exist for viral diseases of poultry,* poor or remote people in the

*Although this chapter deals only with plant-based treatment, note that native peoples of Africa, Asia, and later Europe also elaborated indirect and direct methods of inoculating against viral ills.—notably, foot-and-mouth disease, rinderpest (cattle plague), and poxes (camel, cow, fowl, and in humans, smallpox). Indirect methods consist mainly of controlled exposure. Direct methods entail administering various preparations derived from tissue, blood, scabs, mucous, or saliva from infected animals to healthy stock. Some of these techniques are still in use today, including for poultry. All were based in (and indeed, gave rise to) what is now considered sound medical science. For historical and efficacy details, consult Schillhorn van Veen 1996 plus items in Martin 2001.

developing world rely primarily on plant-based prophylactic measures to stave off such ills in their birds. The question is: Do any such measures really make any difference? To begin to answer this, Cases 1 and 2 below respectively address: Africans’ phytomedical treatments for ills identified as ND; and Africans’ and other peoples’ botanicals for responding to unspecified respiratory signs in poultry, which are here taken as suggestive of AI. Unless otherwise indicated, for Case 1, production data on ND in Africa are drawn from Guèye 1997, 1999, and 2002. For both cases, technical background on the etiological agents and clinical signs of both ND and AI is based mainly on Alexander 2000 and 2004 plus Tollis 2002. Both OIE and WHO offer a periodically updated technical and other information on AI at their websites (www.oie.int. and http.www/who.org). Finally, it should be noted that for both cases, the references to and discussion of EVM treatments for ND and probable incidences of AI are only illustrative. They derive from a convenience sample of English-language publications available to the first two authors, rather than from an exhaustive review of pertinent EVM or human ethnomedical literature globally.

CASE 1: NEWCASTLE’S DISEASE ND is especially devastating to free-ranging flocks in developing countries, where it kills 70% to 80% of unvaccinated birds every year. ND was first identified in 1926 in Newcastle-upon-Tyne, England, and simultaneously in Java, Indonesia. However, almost certainly, these were not the first outbreaks. ND is caused by an enveloped RNA virus of the Paramyxoviridae family. It can infect at least 241 species of birds. Chickens are particularly susceptible, whereas waterfowl are often asymptomatic. Today, ND is described in terms of multiple pathotypes. The velogenic strain is the most virulent and occurs as two subtypes—viscerotropic and neurotrophic. The former is characterized by diarrhea, facial edema, nasal discharge, and, often, sudden death. The latter manifests as respiratory and subsequently neurologic signs, along with high mortality without gastrointestinal lesions. Although a thermostable vaccine against ND exists, family flocks in Africa are rarely immunized due to the reasons discussed previously. Family-level producers instead rely on their own local/indigenous knowledge and resources. Indeed, Africans’ choice of EVM to treat poultry diseases in general reportedly ranges from 55% of family producers in Mozambique to 79% in Botswana. Across Africa, people use many botanicals to control ND. Usually, the Materia medica are crushed and then mixed into birds’ drinking water. Table 3-1 lists a sampling of the plants involved in such preparations, labeled by the names given in the original scientific paper about them. As discussed in the following paragraphs, a number of these plants have proved promising for combating ND.

Aloe secundiflora Aloe species are used extensively for a variety of poultry diseases across Africa, including Aloe excelsa for fowlpox—another viral disease. In a controlled experiment, an extract of Aloe secundiflora was prepared in much the same way as villagers prepare it. It was composed of the inner gel, containing antiviral polysaccharides such as acemannan, and the outer sap, containing anthraquinone glycosides. The extract was administered to or withheld from treatment or control groups of chickens purposely infected with ND at the same time. Administered at the time of infection, this traditional medicine decreased mortality by 21.6%. Pretreatment with the extract for 2 weeks before infection decreased mortality by 31.6% (Waihenya, 2002). Because most farmers are aware of the seasonality of ND, pretreatment is feasible. The anthraquinone components in Aloe species (aloenin and aloin) are at least partially responsible for the anti–ND virus activity (Waihenya, in press). Indeed, enveloped viruses seem to be particularly sensitive to anthraquinones. These biochemicals have been demonstrated to impair the influenza, pseudorabies, and varicella-zoster viruses, as well as herpes simplex virus (HSV) types 1 and 2 (Andersen, 1991; Sydiskis, 1991). Azadirachta indica This plant acts against both ND (Babbar, 1970; Kumar, 1997) and foot-and-mouth disease viruses (Wachsman, 1998). However, its usefulness against ND is likely better explained by its anti-inflammatory and immunestimulating properties (Boeke, 2004; Sadekar, 1998a).

Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? • CHAPTER 3

23

CASE 1: NEWCASTLE’S DISEASE—cont’d Capsicum spp These are widely used worldwide to treat patients with a variety of diseases, particularly in polyprescriptions with other plant materials. The key constituent is capsaicin, which may improve disease resistance in poultry (Guèye, 1999). For controlling ND, African families use Capsicum (especially Capsicum frutescens) in combination with other species such as Aloe secundiflora, Amaranthus hybridicus, Iboza multiflora, Khaya senegalensis, and Lagenaria breviflora (Guèye, 1999, 2002; ITDG, 1996). Although one clinical trial found that a combination with Citrus limon and Opuntia vulgaris was not effective in controlling ND (Mtambo, 1999), further study of Capsicum seems justified. Cassia tora Similar to aloes, this plant contains significant quantities of anthraquinones (Koyama, 2003), which explains its demonstrated activity against ND (Mathew, 2001). Related species with anti–ND virus activity include Cassia auriculata (Dhar, 1968) and Cassia fistula (Babbar, 1970; Mathew, 2001). Euphorbia ingens In a small clinical trial (Guèye, 2002), branches of this plant were crushed and soaked in chickens’ drinking water overnight. When this water was administered at the same time that the birds were infected with ND, mortality decreased by 38.4% in comparison with controls. With pretreatment, mortality fell by 100%. Many other Euphorbia species or their chemical constituents possess significant antiviral activity. Examples include Euphorbia compositum against respiratory syncytial virus and influenza (Glatthaar-Saalmüller, 2001a),

Euphorbia thymifolia and Euphorbia tirucalli against HSV (respectively, Lin, 2002; Betancur-Galvis, 2002), Euphorbia australis against human cytomegalovirus (HCMV; Semple, 1998), and Euphorbia grantii and Euphorbia hirta against polio and coxsackie viruses (Vlietinck, 1995). Beyond the five species just discussed, also promising are five other EVM plants listed in Table 3-1, because they possess scientifically demonstrated antiviral activity for various human diseases. These plants and the corresponding human diseases and research references are displayed in Table 3-2. Although the antiviral properties of EVM treatments for ND are important, other EVM responses to ND may provide symptomatic relief or immune system support. These effects should not be overlooked. This is especially true for family poultry, which are almost invariably infected with velogenic ND. In this regard and in relation to Table 3-2, it should be noted that Africans use Adansonia digitata (Tal-Dia, 1997), Mangifera indica (Sairam, 2003), Strychnos potatorum (Biswas, 2002), and Ziziphus abyssinica (Adzu, 2003) to assuage diarrhea in livestock and humans. They also employ bronchorelaxants based on Adansonia digitata (Karandikar, 1965) and Cassia didymobotrya (Kasonia, 1997). Finally, all the following plants used in African EVM have been shown to have immune-enhancing properties: Allium sativum (Kyo, 2001), Aloe vera (Tan, 2004), Azadirachta indica (Sadekar, 1998a), Mangifera indica (Garcia, 2003; Makare, 2001), Piper nigrum (Chun, 2002), Tephrosia purpurea (Damre, 2003), and Trigonella foenum-graecum (Bin-Hafeez, 2003).

TABLE 3-1 Plants Used in African Ethnoveterinary Medicine for Newcastle’s Disease Ethnoveterinary Medicine Plants Adansonia digitata Agave americana + pepper fruit and soot Agave sisalana Agave sisalana + Aloe secundiflora, pepper fruit, and “oswawandhe” root Allium sativum Aloe spp

Family Bombacaceae Agavaceae Agavaceae Agavaceae Liliaceae Liliaceae

Part(s) Used Fruit Leaf Leaf, stalk Leaf/leaf/fruit/ root Bulb Leaf

Aloe nuttii

Liliaceae

Unspecified

Aloe nuttii + Kigelia aethiopica, Sesamum angolense, and soil

Liliaceae

Unspecified

Reference(s) Guèye, 1997 ITDG, 1996 Guèye, 2002 ITDG, 1996 Alders, 2000 Guèye, 2002 ITDG, 1996 Kambewa, 1999 Kambewa, 1999 Continued

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PART I • Historical Relationship Between Plants and Animals

TABLE 3-1 Plants Used in African Ethnoveterinary Medicine for Newcastle’s Disease—cont’d Ethnoveterinary Medicine Plants Aloe secundiflora Aloe secundiflora + Agave sisalana, pepper fruit, and “oswawandhe” root Aloe secundiflora + Capsicum spp and Amaranthus hybridus Amaranthus hybridus + Capsicum spp and Aloe secundiflora

Family Liliaceae Liliaceae

Part(s) Used Leaf Leaf/leaf

Reference(s) Minja, 1999 ITDG, 1996

Liliaceae Amaranthaceae

Leaf/fruit/leaf Leaf, flower/ fruit/leaf Unspecified Root Leaf, stalk Bark, leaf Barks

ITDG, 1996 ITDG, 1996

ITDG, 1996 ITDG, 1996 Guèye, 2002 Guèye, 2002 ITDG, 1996 Guèye, 1999 Guèye, 2002 Guèye, 2002 Guèye, 2002 Guèye, 2002 Mtambo, 1999 Guèye, 2002

Anacardium spp Anogeissus leiocarpus Apodytes dimidiata Azadirachta indica Butyrospermum paradise + Combretum micranthum and Ficus gnaphalocarpa Capsicum spp Capsicum annuum Capsicum annuum + Iboza multiflora Capsicum frutescens + Lagenaria breviflora Capsicum spp + Amaranthus hybridus and Aloe secundiflora

Anacardiaceae Combretaceae Icacinaceae Miliaceae Sapotaceae

Capsicum spp + Khaya senegalensis Cassia didymobotrya Cassia sieberiana Cassia tora Cissus quadrangularis Citrus limon + Capsicum frutescens and Opuntia vulgaris Combretum micranthum + Butyrospermum paradoxum and Ficus gnaphalocarpa Diplorhynchus condylocarpon Euphorbia ingens Euphorbia metabelensis Euphorbia tirucalli Ficus spp Ficus gnaaphalocarpa + Combretum micranthum and Butyrospermum paradoxum Guibourtia coleosperma Iboza multiflora + Capsicum annuum or Euphorbia ingens Inula glomerata Khaya senegalensis + Capsicum spp Kigelia aethiopica + Aloe nuttii, Sesamum angolense, and soil Kigelia africana Lagenaria breviflora + Capsicum frutescens Lamnea acida Mangifera indica

Solanaceae Caesalpiniaceae Caesalpiniaceae Caesalpiniaceae Vitaceae Rutaceae Combretaceae

Seed Seed Fruit/leaf Seed/fruit Seed, fruit/leaf, flower/unspecified Seed/bark Leaf Bark Leaf, stalk Leaf, stalk Fruit/fruit/stem Barks

Apocynaceae Euphorbiaceae Euphorbiaceae Euphorbiaceae Moraceae Moraceae

Leaf, stalk Branch Latex Leaf, stalk Leaf, stalk Bark

Guèye, Guèye, Guèye, Guèye, Guèye, Guèye,

Caesalpiniaceae Lamiaceae Asteraceae Meliaceae Bignoniaceae Bignoniaceae Cucurbitaceae Unspecified Anacardiaceae

Leaf, stalk Leaf/fruit/stem Leaf, stalk Bark/unspecified Unspecified Leaf, stalk Fruit Bark Bark, leaf

Fabaceae Ochnaceae Fabaceae Fabaceae Unspecified Pedaliaceae Loganiaceae Caesalpiniaceae Euphorbiaceae Fabaceae Lauraceae Rhamnaceae

Leaf Leaf, stalk Bark Unspecified Fruit Unspecified Leaf, stalk Bark Bark Unspecified Unspecified Leaf, stalk

Guèye, 2002 Guèye, 2002 Guèye, 2002 Guèye, 1999 Kambewa, 1999 Guèye, 2002 Guèye, 2002 Guèye, 2002 Alders, 2000 Guèye, 2002 ITDG, 1996 PRELUDE, nd Guèye, 1997, 2002 Kambewa, 1999 Guèye, 2002 Kambewa, 1999 Guèye, 2002 Guèye, 2002 PRELUDE, nd Kambewa, 1999 Kambewa, 1999 PRELUDE, nd

Mucuna spp Ochna pulchra Parkia filicoidea Physostigma mesoponticum Piper nigrum Sesamum angolense + Aloe nuttii and Kigelia aethiopica Strychnos potatorum Swartzia madagascariensis Synadenium volkensii Tephrosia vogelii Tylostemon spp Ziziphus abyssinica

Solanaceae Solanaceae Solanaceae Solanaceae Solanaceae

Guèye, 2002 PRELUDE, nd Guèye, 2002 Guèye, 2002 Guèye, 2002

2002 2002 2002 2002 2002 2002

Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? • CHAPTER 3

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TABLE 3-2 Plants Used in African Ethnoveterinary Medicine for Newcastle’s Disease That Act Against Viruses in Humans EMV Plants Adansonia digitata Allium sativum Cassia didymobotrya Combretum micranthum Mangifera indica

Active Against HSV1/2, poliovirus, SINV HSV1/2, HRV2, parainfluenza 3, Vaccinia virus, VSV, HCMV, murine CMV, influenza B VSV HSV1/2 HSV1/2

References Ananil, 2000; Hudson, 2000 Guo, 1993; Liu, 2004; Nagai, 1973; Weber, 1992 Cos, 2002 Ferrea, 1993 Yoosook, 2000; Zheng, 1990; Zhu, 1993

CMV, Cytomegalovirus; HCMV, human cytomegalovirus; HRV2, human rhinovirus type 2; HSV1/2, herpes simplex virus type 1 or 2; SINV, Sindbis virus; VSV, vesicular stomatitis virus.

CASE 2: AVIAN INFLUENZA Similar to ND, AI is caused by an enveloped RNA virus, but from the Orthomyxoviridae family. It is a type A influenza that is further categorized according to membrane proteins into 15 hemagglutinin (H1 to H15) and 9 neuraminidase (N1 to N9) subtypes. This virus replicates in the respiratory and gastrointestinal systems, with the corresponding clinical signs and modes of shedding. Wild waterfowl are the natural hosts, but other birds and even mammals can become infected. First documented in 1878, AI is clinically classified as having low or high pathogenicity (LPAI or HPAI). LPAI is usually asymptomatic in wild waterfowl but causes mild or even severe disease in domestic poultry. Untreated HPAI in domestic birds approaches 100% mortality. The last three major antigenic shifts in type A influenza led to the human pandemics of Spanish, Asian, and Hong Kong flu in 1918, 1957, and 1968. Spanish flu was the most devastating of these. It infected 20% to 40% of the world’s population, and it took more than 20 million human lives (Hien, 2004). In 1997, a new strain of HPAI (H5N1) was detected in humans in Hong Kong. Formerly found only in birds in Asia, this strain has lately been reported in wild or domestic fowl in Africa, Eastern and Western Europe, and the Middle East. As of the time of this writing (late February 2006), 91 zoonotic deaths from H5NI have reportedly occurred. Virtually all of these have involved poultry workers who were in direct contact with the nasal, respiratory, or fecal discharges of infected animals. So far, no human-to-human transmission has been definitively confirmed. However, this new, virulent strain has an estimated mortality rate of anywhere between 50% and 72% in directly infected humans. Although this figure is obviously in flux, by comparison, mortality from the Spanish flu was only 2.5%. Given the possible threat to human health from this new strain of AI, and given that respiratory signs

are the more distinctive ones for differential diagnosis of AI, a review of EVM botanicals for preventing or controlling the clinical signs of unspecified respiratory disease in poultry hardly seems amiss. To this end, Table 3-3 documents a wide variety of plants used in EVM in these regards. As with ND, the plant materials are usually administered in the drinking water of flocks. Three species stand out here in terms of their documentation in both EVM and human (see Table 3-4) medical literature for their promise in combating viral disease. Allium sativum (Garlic) Clinically, the constituents of garlic are antiviral to influenza (Yakovlev, 1950) and possibly also beneficial when administered before infection (Nagai, 1973). Fresh garlic is virucidal against herpes simplex virus types 1 and 2 (HSV1 and HSV2), human rhinovirus type 2, parainfluenza 3, Vaccinia virus, and vesicular stomatitis virus (Weber, 1992). Andrographis paniculata Families in India boil this whole plant in 2 L of water until half the water evaporates. Then, they add 2 handfuls of uncooked, milled rice and leave the mixture to stand overnight. The next morning, it is fed with the flocks’ regular food. In vitro and clinical studies indicate that either alone (Thamlikitkul, 1991) or in combination with Eleutherococcus senticosis (Melchior, 2000; Spasov, 2004), A. paniculata reduces the severity of symptoms associated with respiratory infections in humans—including colds, sinusitis, and influenza (Cáceres, 1999; Glatthaar-Saalmüller, 2001b). Moreover, this plant or its constituents possess activity against hepatitis B (Mehrotra, 1990), human immunodeficiency virus, i.e., HIV (Chang, 1991), and respiratory syncytial virus (Ma, 2002). Also, it has potent antiinflammatory (Panossian, 2002) and immunestimulating (Kumar, 2004) properties. These may Continued

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PART I • Historical Relationship Between Plants and Animals

CASE 2: AVIAN INFLUENZA—cont’d account for the amelioration of respiratory signs observed in chickens. It is interesting to note that the plant’s isolated andrographolide constituents are not as immune stimulating as is the crude extract employed in family poultry enterprises in India (Melchior, 2000). Nicotiana glauca Both in vitro and clinical studies show that the aqueous extract of this tobacco plant increased survival of chick embryos infected with influenza virus. Moreover, studies indicate that unlike ostrich and other birds or many mammals, chickens can eat the leaf without experiencing any obvious adverse effects (Watt, 1962). Turning from these three plants to others listed in Table 3-3, Heliotropium indicum has powerful antiinflammatory properties (Srinivas, 2000), as do Eryngium foetidum (Garcia, 1999), Pimenta racemosa (Garcia, 2004), and Zingiber officinale (Penna, 2003). Momordica charantia (Spreafico, 1983), Trigonella foenum-graecum (Bin-Hafeez, 2003), and Zingiber officinale (Tan, 2004) all exhibit immune-enhancing properties. The fourth and last table in this chapter (Table 3-4) lists EVM plants from Tables 1-1 and 1-3 that are used for apparent viral diseases of poultry and that share the same genus, or are even the same species, as plants demonstrated to have anti-influenza or antiviral activity in humans. Among the items in Table 3-4, it should be noted that Citrus species contain relatively large quantities of flavonoids such as hesperitin from Citrus junos, which

significantly inhibits influenza A virus in vitro (Kim, 2001). Hesperidin is also anti-inflammatory (Emim, 1994). Euphorbia compositum and Mahonia aquifolium both show anti-influenza activity. The latter is also immunomodulatory (Kostalova, 2001), although it has demonstrated no activity against AI in vitro (Sauter, 1989). Other EVM plants of interest have known antiviral properties, although their anti-influenza activity may remain unknown. For instance, Curcuma longa is antiinflammatory (Joe, 2004); as a feed additive, it improves broiler performance (Al-Sulton, 2003). Ocimum sanctum wards against inflammation and, specifically for poultry, the immunosuppressive effects of infectious bursal disease (Godhwani, 1987; Sadekar, 1998b). O. sanctum also has other immunomodulatory effects (Mediratta, 2002). Ocimum gratissimum is active against HIV (Ayisi, 2004). Various species of Plantago, a popular Chinese medicine for infectious diseases, are antiviral or immune stimulating for HSV2, adenovirus, and human respiratory syncytial virus (Chiang, 2002, 2003; Gomez-Flores, 2000; Li, 2004). Plantago palmata combats coxsackievirus (Vlietinck, 1995). Finally, plants reported as having anti-influenza effects for humans merit mention. Even though they may not be referenced in the EVM literature, they may be suggestive for future R&D or application in EVM. A few examples are Crataegus crus-galli, Euonymus europaeus, Fragaria vesca, Ribes rubrum, Ribes uva-crispa, Sambucus nigra, Solanum nigrum, and Viburnum opulus (Sauter, 1989).

TABLE 3-3 Plants Used in Ethnoveterinary Medicine Worldwide for Respiratory Signs in Poultry EVM Plants Allium cepa Allium sativum Capsicum annuum Citrus aurantifolia Citrus aurantium Citrus limetta Coffea arabica Coffea robusta Colocasia esculata Curcuma longa Eryngium foetidum Eriobotrya japonica Euphorbia metabelensis Heliotropium indicum Mahonia aquifolium

Part(s) Used Bulb Bulb Fruit Fruit juice, peel Fruit juice, peel Fruit juice, peel Beans Beans Tuber Rhizome Leaf Unspecified Latex Mature leaf Root

Location India India, West Indies Africa West Indies West Indies West Indies West Indies West Indies Africa India West Indies Italy Africa Philippines Canada

Reference(s) IIRR, 1994 IIRR, 1994; Lans, 2001 Guèye, 1999 Lans, 2001 Lans, 2001 Lans, 2001 Lans, 2001 Lans, 2001 ITDG, 1996 IIRR, 1994 Lans, 2001 Viegi, 2003 Guèye, 1999 IIRR, 1994 TAHCC, 2004

Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems? • CHAPTER 3

27

TABLE 3-3 Plants Used in Ethnoveterinary Medicine Worldwide for Respiratory Signs in Poultry—cont’d EVM Plants Momordica charantia Nicotiana tabacum Nicotiana glauca Ocimum micranthum Ocimum sanctum Pimenta racemosa Piper guineense Plantago major Ricinus communis Spondias pinnata Trigonella foenum-graecum Zingiber officinale

Part(s) Used Stem, leaf Leaf Leaf Unspecified Leaf Leaf Fruit Unspecified Leaf Young leaf Seed Rhizome

Location West Indies Africa Africa Honduras India West Indies Africa Italy West Indies Philippines India India

Reference(s) Lans, 2001 Guèye, 1999 Watt, 1962 Ketzis, 2002 IIRR, 1994; Kumar, 1997 Lans, 2001 Guèye, 1999 Viegi, 2003 Lans, 2001 IIRR, 1994 IIRR, 1994 IIRR, 1994

TABLE 3-4 Plants (or Closely Related Ones) Used in Ethnoveterinary Medicine for Viral Diseases or Respiratory Signs in Poultry That Act Against Viruses in Humans Ethnoveterinary Medicine Plants Cassia didymobotrya, Cassia sieberiana, Cassia tora Citrus aurantifolia, Citrus aurantium, Citrus limetta, Citrus limon Combretum micranthum Curcuma longa

Same or Closely Related Plants Cassia mimosoides

Active Against HSV1

Reference(s) Sindambiwe, 1999

Citrus junos

Influenza type A

Kim, 2001

Combretum hartmanni Same

HIV HIV

Euphorbia metabelensis Eriobotrya japonica Ficus spp Ficus gnaphalocarpa Mahonia aquifolium Momordica charantia

Euphorbia compositum Same Ficus ovata Ficus polita Mahonia bealei Same

Influenza Rhinovirus HSV, poliovirus HIV Influenza HIV, HSV1, poliovirus, HSV1, SINV, HSV

Nicotiana glauca, Nicotiana tabacum Plantago major Ricinus communis Tephrosia vogelii

N. glauca Same Same Tephrosia madrensis, Tephrosia viridiflora, Tephrosia crassifolia Same

Influenza HSV2 HSV, SINV Dengue virus

Ali, 2002 Barthelemy, 1998; Mazumder, 1995 Glatthaar-Saalmüller, 2001a DeTommasi, 1992 Ananil, 2000 Ayisi, 2003 Zeng, 2003 OK Bourinbaiar, 1995; Jiratchariyakul, 2001; Lee-Huang, 1990; Schreiber, 1999 Foà-Tomasi, 1982; Beloin, 2005; Bourinbaiar, 1996 Watt, 1962 Chiang, 2002 Mouhajir, 2001 Sánchez, 2000

Rhinovirus

Denyer, 1994

Zingiber officinale

HIV, Human immunodeficiency virus; HSV1/2, herpes simplex virus type 1 or 2; SINV, Sindbis virus.

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POTENTIAL SOLUTIONS FOR LARGE-SCALE PROBLEMS? This chapter began with a brief overview of the evolution of EVM. From roots doubtless dating back to the dawn of human domestication of animals, EVM has today become a globally recognized and multidisciplinary field of study and application. Beyond that, however, this chapter has endeavored to suggest how—whether bench, field, or literature based—R&D in EVM is not just an historical or academic pursuit. Rather, it is a living, breathing field that holds promise for addressing many animal and also human concerns regarding health, safety, and the environment in both the developing and developed worlds, especially as these two worlds become ever more entwined in the process of globalization. Moreover, EVM may hold greater potential than was heretofore suspected for one of the most recalcitrant categories of disease— viral infection. This last point is illustrated by a sampling of the literature on plant-based treatments used in EVM to prevent or control two major viral diseases of livestock (here, poultry) worldwide—Newcastle’s disease and avian influenza (the latter based presumptively on respiratory signs). Both strike wild as well as domesticated birds, and typically cause respiratory (as well as gastrointestinal) distress. However, AI poses a particular danger to humans. Thus EVM botanicals for ND and AI are compared with literature on the use of the same or closely related species with known activity against viral disease in humans. The four tables presented in this chapter reveal 25 overlapping items. Two plants in particular stand out for their frequent occurrence: Cassia didymobotrya and Combretum micranthum. Along with other Cassia species, also noteworthy are species of Citrus, Euphorbia, and Nicotiana. Taken together, these preliminary, literature-based findings suggest that EVM may hold greater promise for preventing, controlling, or at least alleviating the clinical signs of viral disease than was previously thought—especially when conventional treatments are unavailable, unaffordable, or unreliable. Also, EVM could conceivably play a supporting or a multitiered role in the control of viral disease. Illustrating for AI and depending on the immuneenhancing or anti-influenza properties of the plants administered, EVM could possibly increase birds’ resistance to the disease; if LPAI is present, decrease the chances of its mutating into HPAI; during an outbreak of HPAI, help prevent or slow the spread of HPAI to otherwise healthy animals; and generally, reduce environmental contamination with the influenza virus. Also, it may be that pretreatment could be effective with AI as it has been with ND, but this remains to be investigated. More broadly, analyses of the sort presented in this chapter can point out which EVM treatments merit further study and evaluation for their value against one or another disease in one or more species of livestock, or even humans. Again illustrating for AI, to the extent that EVM can help decrease viral contamination of the environment, then to that extent, too, it can decrease humans’ exposure to AI. That would in turn reduce the

chances of an antigenic shift that might provoke a new pandemic of human influenza. None of this is to say, however, that conventional techniques should be replaced across-the-board by semi- or even fully-validated EVM treatments—whether the latter consist of phytomedicines, indigenous inoculations, ethnosurgical or more mechanical or husbandry interventions. Particularly for viral diseases, EVM treatments await further research outside the lab or the literature. Like conventional techniques, EVM treatments must also be verified using the actual livestock species in question under controlled on-station and then on-farm conditions. Nor do EVM treatments obviate the need for sound husbandry and biosecurity measures, whether for viral or other contagious diseases. However, this is to say that the effectiveness of conventional measures can almost certainly be augmented by EVM measures. It is also to say that—faced with pandemic threats such as that posed by AI, and echoing the wisdom of WHO as much as 30 years ago—it would be foolish not to investigate all promising preventive, control, or mitigation options that might derive from EVM savvy for enhancing the health and well-being of animals, humans, or both. References Adzu B, Amos S, Amizan MB, Gamaniel K. Evaluation of the antidiarrhoeal effects of Ziziphus spina-christi stem bark in rats. Acta Trop 2003;87:245-250. Alders RG. Sustainable control of Newcastle disease in rural areas. In: Alders RG, Spradbrow PB, eds. SADC Planning Workshop on Newcastle Disease Control in Village Chickens. Proceedings of an International Workshop. ACIAR Proceedings No. 103; March 6-9, 2000; Maputo, Mozambique. Alexander DJ. A review of AI in different bird species. Vet Microbiol 2000;74:3-13. Alexander DJ, Bell JG, Alders RG. Technology review: Newcastle disease with special emphasis on its effect on village chickens. International Conference of the Food and Agriculture Organization; February 12-13, 2004; Rome, Italy. Ali H, König GM, Khalid SA, Wright AD, Kaminsky R. Evaluation of selected Sudanese medicinal plants for their in vitro activity against hemoflagellates, selected bacteria, HIV-1-RT and tyrosine kinase inhibitory, and for cytotoxicity. J Ethnopharmacol 2002;83:219-228. Al-Sulton SI. The effect of Curcuma longa (turmeric) on overall performance of broiler chickens. Int J Poultry Sci 2003;2:351353. Ananil K, Hudson JB, de Souzal C, et al. Investigation of medicinal plants of Togo for antiviral and antimicrobial activities. Pharm Biol 2000;38:40-45. Andersen DO, Weber ND, Wood SG, Hughes BG, Murray BK, North JA. In vitro virucidal activity of selected anthrquinones and anthraquinone derivatives. Antiviral Res 1991;16:185-196. Atawodi SE, Ameh DA, Ibrahim S, et al. Indigenous knowledge system for treatment of trypanosomiasis in Kaduna state of Nigeria. J Ethnopharmacol 2002;79:279-282. Ayisi NK, Nyadedzor C. Comparative in vitro effects of AZT and extracts of Ocimum gratissimum, Ficus polita, Clausena anisata, Alchornea cordifolia, and Elaeophorbia drupifera against HIV-! And HIV-2 infections. Antiviral Res 2003;58:25-33. Babbar OP, Chowdhury BL, Singh MP, Khan SK, Bajpai S. Nature of antiviral activity detected in some plant extracts screened in cell cultures infected with Vaccinia and Ranikhet disease viruses. Indian J Exp Biol 1970;6:304-312.

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Vlietinck AJ, Van Hoof L, Totte J, et al. Screening of hundred Rwandese medicinal plants for antimicrobial and antiviral properties. J Ethnopharmacol 1995;46:31-47. VSF/Switzerland. Ethnoveterinary Workshop—Malual Kon, Sudan; November 9-12, 1998; Nairobi, Kenya (unpublished paper). Wachsman MB, Castilla V, Coto CE. Inhibition of foot and mouth disease virus (FMDV) uncoating by a plant-derived peptide isolated from Melia azedarach L leaves. Arch Virol 1998;143:581-590. Waihenya RK, Mtamba MMA, Nkwengulila G. Evaluation of the efficacy of the crude extract of Aloe secundiflora in chickens experimentally infected with Newcastle disease virus. J Ethnopharmacol 2002;79:299-304. Waihenya RK, Mtambo MMA, Nkwengulila G, Kayser O, Hafez HM. Antiviral activity of the crude extract and fractions obtained using high performance liquid chromatography of Aloe secundiflora against Newcastle disease virus. Fitoterapia. Journal of Tropical Microbiology and Biotechnology, 2005 (1), 2005, 10-13 Waller PJ, Bernes G, Thamsborg S, et al. Plants as de-worming agents of livestock in the Nordic countries: historical perspective, popular beliefs and prospects for the future. Acta Vet Scand 2001;42:31-44. Watt JM, Breyer-Brandwijk MG. The Medicinal and Poisonous Plants of Southern and Eastern Africa. London: E&S Livingstone Ltd; 1962:987. Weber N, Andersen DO, North A, Murray BK, Lawson LD, Hughes BG. In vitro virucidal effects of Allium sativum (garlic) extract and compounds. Planta Med 1992;58:417-423. Yakovlev AI, Zviagin SG. Influence of phytocides on virus influenza A. I. Action of the volatile components from garlic and onion on influenza A. Bull Biol Med 1950;29:284-387. Yoosook C, Bunyapraphatsara N, Boonyakiat Y, Kantasuk C. Anti–herpes simplex virus activities of crude water extracts of Thai medicinal plants. Phytomedicine 2000;6:411-419.

Zeng X, Lao B, Dong X, et al. Study on anti-influenza effect of alkaloids from roots of Mahonia bealei in vitro [Chinese]. Zhong Yao Cai 2003;26:29-30. Zheng MS. Antiviral effect of mangiferin and isomangiferin on herpes simplex virus. Chin Med J 1990;103:160-165. Zhu XM, Song JX, Huang ZZ, Wu YM, Yu MJ. Antiviral activity of mangiferin against herpes simplex virus type 2 in vitro. Acta Pharmacol Sin 1993;14:452-454.

Resources Other internet resources that readers interested in EVM may consult include those listed in McCorkle 2001 plus later additions such as the following: www. ethnopharmacology.org of the International Society for Ethnopharmacology www.ethnovetweb.com, Dr. Med. Vet. Evelyn Mathias’ Ethnoveterinary Medicine website www.ik-pages.net on indigenous knowledge generally www.metafro.be/preludehttp://www.metafro.be/prelude, for an ethnobotanical database for Africa; for plants used in human or, more rarely, animal ethnomedicine, Phytomedica@ egroups.com www.unesco.org/most/bpikreg.htm and http://www. vetwork.org.uk/pune10.htm for the 1997 India conference mentioned in the text; http://www.asa2000.anthropology.ac. uk/kohler/kohler.html Examples of scientific journals other than purely veterinary ones that occasionally include articles on EVM can be appreciated in the Martin et al. 2001 bibliography.

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4

Susan G. Wynn and Barbara J. Fougère

CHAPTER

oday, veterinarians frequently study the names and properties of herbs, yet they may have little or no personal experience of the nature of the plant, its environment, its taste, and its properties. Theoretical knowledge is sterile compared with traditional herbalists’ approach of tasting each herb, experiencing its unique qualities, and discerning its properties. Herbalists like Shen Nong Dioscorides and many others learned from their direct experience; this is invaluable even today. Observing herbs and tasting them directly or by infusion, decoction, pills, or formulas is of great benefit, as is taking the herbs for a course of therapy to experience the effects. Herbalists who follow this path will know at a deep experiential level what it is they are prescribing. Herbal medicine is one of the oldest forms of treatment known and used by all races and all peoples. The World Health Organization (WHO) estimates that botanical medicines are used by 70% of the world’s population (Eisenberg, 1998), and it is no surprise that people have used the same plant medicines for the animals in their care as long as animals have been associated with human life. Thus, the history of veterinary botanical medicine, the oldest form of veterinary medicine, has followed a parallel route alongside the evolution of human medicine for much of history. Indeed, herbal medicine itself has undergone a number of philosophical shifts over time, but from antiquity until now, it has remained fundamentally unchanged in tone. Herbal medicine is empiricist, holistic, and vitalist in orientation, and some herbalists argue that it should remain so, even as modern medicine tries to incorporate the use of herbs as “drugs” seeking the “active constituent.” This “scientism,” perhaps bordering on reductionism, is simply a new philosophy in the larger picture of herbal medicine. The earliest indications for the use of plants as treatments date back to prehistoric times, with herbs found in graves older than 60,000 years. How did people begin to use plants as medicines? Two main theories are suggested. One is trial and error with final development of a system of thought (such as Traditional Chinese Medicine, one of the best developed systems) and passage of this empiric

T

knowledge from person to person, shaman to shaman, healer to healer. The other is, to our Western mind, a mystical communication between healer and plant, wherein the herbalist directly discovers the plant’s medicinal qualities. In many indigenous cultures, the process whereby the plant informs the healer is indeed a spiritual phenomenon that is treated with reverence. Is biochemical screening for biological activity more or less efficient than communing with a plant? Only time will tell. What we do know is that herbs have been used and recorded throughout antiquity in both human and animal medicine.

ANTIQUITY Evidence suggests that Ayurveda, developed in India, is perhaps the earliest medical system. The Rig veda, the oldest document of human knowledge, written between 4500 and 1600 BCE, mentions the use of medicinal plants in the treatment of humans and animals. The “Nakul Samhita,” written during the same period, was perhaps the first treatise on the treatment of animals with herbs. Chapters dealing with animal husbandry like “Management and Feeding” appear in ancient books like Skandh Puran, Devi Puran, Harit, and others. Palkapya (1000 BC) and Shalihotra (2350 BC) were famous veterinarians who specialized in the treatment of elephants and horses (Unknown, 2004). King Asoka (274-236 BC) engaged people to grow herbs for use in the treatment of sick and aged animals (Haas, 1992). Medicines that are mentioned in early Ayuvedic texts (200 BC-AD 200) of Charaka Samhita include ricinus, pepper, lily, and valerian. Vasant Lad describes the basis for Ayurveda (“life science”) in a way that is reflected in the Tao of Chinese medicine and echoes the humors of Greek medicine: “According to Ayurveda, every human being is a creation of the cosmos, the pure cosmic consciousness, as two energies: male energy, called Purusha and female energy, Prakruti. Purusha is choiceless passive awareness, while Prakruti is choiceful active consciousness. Prakruti is the divine creative will. . . . The structural aspect of the body is made up of five

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PART I • Historical Relationship Between Plants and Animals

elements, but the functional aspect of the body is governed by three biological humors [or doshas]. Ether and air together constitute vata; fire and water, pitta; and water and earth, kapha. Vata, pitta, and kapha are the three biological humors that are the three biological components of the organism. They govern psycho-biological changes in the body and physio-pathological changes too. Vata-pitta-kapha are present in every cell, tissue, and organ. In every person, they differ in permutations and combinations. [The balance in the doshas can be effected by] hereditary, congenital, internal, external trauma, seasonal, natural tendencies or habits, and supernatural factors.” (Lad, 1996)

In China, one of the oldest known and longest preserved Materia Medica was compiled in 3700 BC by a Chinese emperor named Shen Nong. Shen Nong (the Divine Farmer) is the legendary originator of Chinese herbal medicine. He is credited with tasting hundreds of herbs, selecting those that were suitable as remedies, and describing their properties. As a result of his efforts, numerous herbs became routinely used for healthcare, and knowledge was handed down by oral tradition for centuries. His book of medicinal herbs listed herbal Materia Medica for both humans and animals. It is interesting to note that it discussed the antifever properties of Artemesia annua (Chinese wormwood), which has now been shown to be extremely effective against malaria. When these herbs were described in a formal manner, the book was named after Shen Nong, known today as the Shen Nong Ben Cao Jing (Herbal Classic of Shen Nong). The earliest mention of a text called Shen Nong Jing (Classic of Shen Nong) came from authors who lived during the period immediately following the fall of the Han Dynasty (220 AD), suggesting that it might have been compiled during the latter part of the Han Dynasty. It is thought that Shen Nong lived from 2737 BC to 2697 BC— nearly 5000 years ago; this is why it is common to hear that Chinese medicine has a history of 5000 years. However, we are able to access little information about how herbal medicines were used before the compilation of the Shen Nong herbal—about 1800 years ago. The Shen Nong Ben Cao Jing describes for the first time the flavors (sour, salty, sweet, bitter, acrid/pungent), natures (cold, hot, warm, cool), functions, and indications for the herbs. Herbs were classified according to their efficacy and toxicity, and the terms sovereign (or king), minister, assistant, and envoy were described to define the function of an herb within a formula. According to the Ben Cao, “Medicinals should coordinate [with each other] in terms of yin and yang, like mother and child, or brothers. . . . to treat cold, one should use hot medicinals. To treat heat, one should use cold medicinals.” Shen Nong clearly tasted the herbs and fit their characteristics into the Tao, the philosophy that guided people’s understanding of their world. Herbs were tools that interacted with people to shift and balance their bodies back to health. An English language translation of the ancient Shen Nong Ben Cao Jing has been published (Yang, 1997). The earliest Chinese medical practitioners treated both people and animals until the Zhou dynasty (1122-770 BC), when veterinary medicine became a separate branch

Figure 4-1 Administering liquid medicine with a bamboo bottle is an aspect of the old Chinese-Japanese art of horse healing, Ryoyaku-ba-ryn-benkai, as portrayed in Zisanshi (first edition, Kyoto [1759]; second edition, Yedo [1859]). (From Dunlop RH, Williams DJ. Veterinary Medicine: An Illustrated History. St. Louis, Mo: Mosby; 1996.)

of traditional Chinese medicine (Schoen, 1994), and in China, the first mention of diseases and treatments of horses appeared in writings of the Shang Dynasty (17661027 BC). One of the first texts in Chinese veterinary medicine was Bai Le’s Canon of Veterinary Medicine, written by Sun Yang in approximately 650 AD (Figure 4-1). In Mesopotamia, the Sumerians used cuneiform written language from about 3500 BC. The earliest extant clay tablet from Sumeria dates from about 2100 BC; it contains 15 medical prescriptions and mentions 120 mineral drugs and 250 plant-derived medicines. These included asafetida, calamus, crocus, cannabis, castor, galbanum, glycyrrhiza, hellebore, mandragon, menthe, myrrh, opium, turpentine, styrax, and thyme. The largest surviving medical treatise is from about 1600 BC; it is entitled “Treatise of Medical Diagnoses and Prognoses.” Although the names of the medicines used then do not translate well, it is probable that milk, snakeskin, turtleshell, cassia, thyme, willow, fir, myrtle, and dates were also used (Janick, 2002). The Code of Hammurabi (circa 1780 BC), another famous document arising from Babylonian society, discussed treatments of animals, costs of treatments, and penalties for mistreatment and errors (Swabe, 1999). The Edwin Smith Papyrus (found in Egypt and preserved at the New York Academy of Medicine) dates from 1700 BCE. These scrolls include a surprisingly accurate description of the circulatory system, noting the central role of the heart and the existence of blood vessels throughout the body. They describe the use of herbs such as senna, honey, thyme, juniper, pomegranate root, henbane, flax, oakgall, pinetar, bayberry, ammi, alkanet, aloe, cedar, caraway, coriander, cyperus, elderberry, fennel, garlic, wild lettuce, myrrh, nasturtium, onion, peppermint, papyrus, poppy, saffron, watermelon, and wheat. The Ebers Papyrus (now in University Library at

The Roots of Veterinary Botanical Medicine • CHAPTER 4

Leipzig) dates from about 1500 BC and contains more than 800 prescriptions. Some of these are very complicated, containing such ingredients as opium, hellebore, salts of lead and copper, and blood, excreta, and viscera of animals (Haas, 1999). Many more of the ancient scrolls were housed in the Library of Alexandria, which was destroyed by fire in 47 BCE. However, early evidence of veterinary herbal medicine is found in ancient Egyptian parchments such as the Kahun Veterinary Papyrus (dating around 1900 BC) (Karasszon, 1998), on which cattle feature prominently. Ancient Greek and Roman societies began developments in veterinary medicine in similar, yet slightly different directions compared with the Egyptians. The “Hippiatrika” is one of the first documents we see that relates to Roman practitioners and their study of horses (Walker, 1991). “Hippiatros” was a term used in Greece around 500 BC to refer to horse doctors (Swabe, 1999). The horse was central in Greek and Roman society because members of society depended on it for military and trade functions. Earlier on (between 383 BC and 322 BC), Aristotle, sometimes called “the Father of Veterinary Medicine,” became very influential in Greek society. Physiology, comparative anatomy, and pathology were a few of the specialized areas that Aristotle discussed in his writings. He compared animal and human anatomy and physiology and disease in writings such as Historia Animalium, De Partibus Animalium, De Generatione Animalium, and Problematicum (Karasszon, 1998). Another important influence on both veterinary and herbal medicine was Hippocrates (460-377 BC). He wrote Corpus Hippocraticum, in which he described more than 200 plants, and he is credited with the development of the humoral theory (Figure 4-2).

HUMORAL THEORY The idea of the Four Humors became popular in Ancient Greece from about 400 BC. It probably originated in Indian Ayurvedic medicine, where it was picked up by travelers and taken to the Greek empire (which included the present-day countries of Greece, Egypt, Turkey, and Italy). However, it is attributed to Hippocrates. At this time, thinkers were beginning to explain events in the world around them in terms of natural phenomena rather than blaming the gods and spirits. They established that all things were made up of the four elements air, water, fire, and earth. These elements were also linked to the four seasons and to body fluids or “humors”—blood, phlegm, black bile, and yellow bile. Illness was thought to result when these humors lost their natural balance, and health could be restored by rebalancing the humors. This theory was very important because it encouraged doctors to look for natural causes of disease and to provide physical, rather than spiritual treatments. The rise of rationalism meant that doctors were now observing patients and reasoning toward a logical cure, just as the Chinese had done. Hippocrates reasoned that medicine could be applied without ritual because disease was a natural phenomenon and not a supernatural event. He argued that some acute diseases were self-limiting and

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Figure 4-2 An illustration from the 14th century Hippiatrika manuscript showing treatment of distention in a horse. Much of the information on horse care found in the Hippiatrika came from the Greeks, and the use of oil and wine for medicinal purposes is frequently prescribed. Here, a clyster of wine, oil, soda salt, and sap from wild cucumber roots is being administered to relieve the distention. (Cod. G. 2233. Bibliothèque Nationale, Paris) (From Dunlop RH, Williams DJ. Veterinary Medicine: An Illustrated History. St. Louis, Mo: Mosby; 1996.)

should not necessarily be treated, and that diet and exercise were vital in preventing and treating conditions of the human body. The humoral theory remained very influential for more than a thousand years and was not seriously challenged until the 15th century. It is interesting to note that it is related in many ways to the philosophical basis of Traditional Chinese Medicine and of many other traditional medical practices (Table 4-1).

MEANWHILE IN JAPAN Kampo (also written Kanpo) is based on Traditional Chinese Medicine and literally means “the Han Method,” referring to the herbal system of China that developed during the Han Dynasty. Cultural contact between China and Japan has occurred since ancient times. There is a story about a Chinese Emperor (reign: 221-210 BC) who is said to have sent emissaries by ship on the Eastern Sea

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PART I • Historical Relationship Between Plants and Animals

TABLE 4-1 Humor Blood Phlegm Black bile Yellow bile

Associated Element Air Water Earth Fire

Energetic Qualities Hot, moist Cold, moist Cold, dry Hot, dry

to find the herb of immortality; it is suggested that they returned from Japan at the end of their mission with ganoderma (lingzhi; Japanese: reishi). Some Chinese medical works were introduced to Japan as early as the 4th or 5th Century AD, coming first by way of Korea, which had adopted Chinese medicine by that time. Historical records indicate that a Korean physician named Te Lai came to Japan in 459 AD, and that a Chinese Buddhist named Zhi Cong brought medical texts with him to Japan via Korea in 562 AD. It was during this period that the Chinese written language was adopted in Japan, which enabled people to learn from China about Buddhism, Confucianism, governmental organization, and the divination arts and opened the way for study of Chinese medicine. Kampo encompasses acupuncture and other components of Traditional Chinese Medicine but relies primarily on prescription of herb formulas. It differs today from the practice of Chinese herbal medicine in mainland China primarily in its reliance on a different basic collection of important herb formulas and a somewhat different group of primary herbs. Kampo medicine is widely practiced in Japan today (Dharmananda, 2004).

THE RISE OF ROME A first century Roman (Lucius Junius Moderatus Columella) wrote 12 volumes of On Agriculture. Volume VI dealt with cattle, horses, and mules; volume VII with sheep, goats, pigs, and dogs; and volume VIII with poultry and fowl. In volume VI, we find reference to the use of garlic in cattle: “It will be no use to give cattle a satisfying diet, unless every care is taken that they are healthy in body and that they keep up their strength. Both these objects are secured by administering, on three consecutive days, a generous dose of medicine compounded of equal weights of the crushed leaves of lupine and of cypress, which is mixed with water and left out of doors for a night. This should be done four times a yearat the end of spring, of summer, of autumn, and of winter. Lassitude and nausea also can often be dispelled if you force the whole raw hen’s egg down the animal’s throat when it has eaten nothing; then, on the following day, you should crush spikes of ‘Cyprian’ or ordinary garlic in wine and pour it into the nostrils.”

He also recommended for bloat in cattle a drench of wild myrtle and wine mixed with hot water. For ulceration of the lungs, he recommended administration of cabbage leaves baked in oil. He also recommended a seton (a foreign body, more recently of cloth, introduced into tissue to elicit drainage or form an open tract for drainage

of a wound) of white hellebore through the ear and a daily mixture of leek juice, olive oil, and wine to “avert death of cattle” (Smithcors, 1957). The decline of Ancient Greece corresponded with the rise of the Roman Empire, and many Greek scholars moved to Rome. Two Greek scholars working in Rome had an influence on herbal medicine. Dioscorides of Anazarbus (Pedianos Dioskurides) was a careful observer and naturalist, botanist, and skilled physician and is known today for the famous work De Materia Medica, published in the year 65 AD. This book listed more than 500 plants and was translated into many languages, including Persian, Hebrew, and Anglo-Saxon. The organization of Dioscorides’ work followed the pattern of one plant, one chapter. Following the description of the plants, some indications for use were described.

Origins of the Name “Veterinarian” The origins of the term “veterinarian” are not clear, but classical Roman derivation seems likely. Animal caretakers were named souvetaurinarii, and pack animals were called veterina. The veterinarium was the compound in Roman military encampments where pack animals were kept. Columnella wrote a famous text on agriculture that included information on animal husbandry, and he used the term veterinarius for those who cared for livestock other than horses. Men who cared for horses were called mulomedicus. (Dunlop, 1996)

Dioscorides classified plant medicines according to the state of the plants themselves (with seasonal variations) and their effects on people—this was a drug affinity system (Riddle, 1985) that had little to do with mystical powers or cosmic relationships that would later characterize the alchemical herbology of Culpepper. It became the foremost classical source of modern botanical terminology and the leading pharmacologic text for the next 1600 years. An illuminated copy prepared in the year 512 is now housed in the Österreichische Nationalbibliothek. The second Greek physician who had a lasting impact was Claudios Galenos (131-201 AD), who is generally referred to as Galen. He learned much about anatomy through his work treating professional gladiators. He developed an interest in anatomy and skills as a surgeon, and he dissected pigs, goats, and apes and applied what he found to the human body. He was strongly influenced by Hippocrates’ Four Humors and his theory was built on Hippocrates’ idea that the body was made up of four liquids—blood, phlegm, yellow bile, and black bile—and that imbalances in one of these humors might be treated with a substance that opposed that tendency. For instance, psoriasis is considered a hot and dry condition, so Galen would suggest that the patient drink cool liquids, eat cold foods, and use a cool, wet herb such as plantain. He wrote more than 500 books on medicine and

The Roots of Veterinary Botanical Medicine • CHAPTER 4

developed a system of pharmacology and therapeutics. Galen’s humoral theory and Alexandrian Greek medicine shaped Islamic and European medicine for the next 1400 years. His books were used at medical schools until the Renaissance. Other early Roman writers of note on the topic of veterinary medicine include Vegetius, author of Mulomedicina, a comprehensive equine veterinary text compiled from works of the previous authors Pelagonius, Chiron, and Apsyrtus (Mezzabotta, 1998).

THE DARK AGES When Rome fell in 476 AD, Greek medicine was temporarily lost to Europe. Civilization as it was during the reign of Rome ceased to exist, and it took centuries for the level of Roman societal achievements in living standards, culture, architecture, and medical practice to be regained. When Galen’s ideas were rediscovered after Crusaders and Byzantine scholars returned to Europe, his system again became medical dogma for hundreds of years.

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But first, Europe had to endure the Dark Ages, when medicine was characterized in two ways—the storage and adaptation of Greek knowledge by Christian monasteries, and folk medicine. During the Dark Ages, Christian monasteries played a crucial role in preserving the knowledge of the ancients. Monks painstakingly copied classical texts, which were traded or passed on to other eminent individuals or institutions. Monks also cared for the sick and injured because there were very few physicians. So, monks not only preserved but also developed skills in the use of herbs and natural medicine. Each monastery maintained its own herbal garden and kept others up-to-date with advances in medical treatments. The writings of the Dark Ages in Europe are largely lost to us, but some books from those times remain. AngloSaxon herbals were published from the 7th to the 11th centuries (Table 4-2). The medicine of this age incorporated many charms, in addition to the plants; Christian prayers probably replaced older pagan charms over time. The herbs that appeared most commonly included betony, vervain, peony, yarrow, mugwort, and waybroad

TABLE 4-2 Examples of Anglo-Saxon Veterinary Medicine Diagnosis Sick cattle

To prevent sudden death in swine

Elf-shot horse

“If a beast drinks an insect” Drowned bees

Treatment “Take the wort, put it upon gledes and fennel and hassuck and “cotton” and incense. Burn all together on the side on which the wind is. Make it reek upon the cattle. Make five crosses of hassuck grass, et them on four sides of the cattle and one in the middle. Sing about the cattle the Benedicite and some litanies and the Pater Noster. Sprinkle holy water upon them, burn upon them incense and give the tenth penny in the Church for God, after that leave them to amend; do this thrice.” “Sing over them four masses, drive the swine to the fold, hang the worts upon the four sides and upon the door, also burn them, adding incense and make the reek stream over the swine.” or “Take the worts of lupin, bishopwort, hassuck grass, tufty thorn, vipers bugloss, drive the swine to the fold, hang the worts upon the four sides and upon the door.” “If a horse be elf-shot, then take the knife of which the haft is the horn of a fallow ox and on which are three brass nails, then write upon the horse’s forehead Christ’s mark and on each of the limbs which thou mayest feel at; then take the left ear, prick a hole in it in silence, then strike the horse on the back, then it will be healed. And write upon the handle of the knife these words—‘Benedicite omnia opera Domini dominum.’ Be the elf what it may, this is mighty for him to amend.” or “If a horse or other neat be elf-shot take sorrel-seed or Scotch wax, let a man sing twelve Masses over it and put holy water on the horse or on whatsoever neat it be; have the worts always with thee. For the same take the eye of a broken needle, give the horse a prick with it, no harm shall come.” Sing this: “Gonomil, orgomil, marbumil, marbsai, tofeth.” Place them in warm ashes of pennyroyal and then, “they shall recover their lyfe after a little tyme as by ye space dissertation.”

Source Lacnunga

Lacnunga

Leech Book of Bald

Leech Book of Bald The Boke of Secretes of Albartus Magnus of the Virtues of Herbes, Stones, and Certaine Beastes

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PART I • Historical Relationship Between Plants and Animals

(plantain). There are four known texts from the 10th century; these are now held by the British Museum and include Leech Book of Bald, Lacnunga, Herbarium of Apuleius (a translation from the 5th century), and a translation from Petronius’ Practica Petrocelli Salernitani entitled περι´ Διδαξε´ ως (which means “about learning/instruction”). One of the most interesting Middle European monastic personalities was German abbess Hildegard von Bingen (1098-1179). Remnants of Greek medicine were evident in her writings, which retained some of the old herb characteristics but introduced a new spiritualism that reflected her love of God and her Old Testament belief that everything in creation was made to serve man (Hozeski, 2001): “Every herb, however, is either warm or cold. They spring up this way. The warmth of herbs signifies the soul and the cold of herbs signifies the body.”

And: “. . . for the earth has many useful herbs that reach out to people’s spiritual needs, and yet they are distinct from people. In addition, the earth has useless herbs that reflect the useless and diabolical ways of humans.”

Hildegard wrote Causeae et Curae and Physica, in which she described causes of diseases and their cures. She compiled the beginnings of a Germanic herbal knowledge and wrote widely on devotion, mysticism, and healing. She used the four-element and four-humor system, and her approach integrated body, mind, and spirit with specific prescriptions for herbs, diet, and gems. She also wrote Liber Simplicis Medicinae, in which she prescribed different herbs for cattle, goats, horses, pigs, and sheep (Haas, 2000). Currently, the writings of Hildegard are undergoing a revival in the German-speaking world. Outside the monasteries, the wise women and traveling herbalists were using medicinal plants in ritual and magic. It was mainly these wise women who felt the brunt of the Inquisition, and many were burned as witches; because they relied on an oral tradition, their knowledge was widely lost. While Europe’s Dark Ages trundled on under the influence of Christianity, Spain became a center of botanical research. Among other bright lights, Arab culture and society in the Near East advanced medicine to new heights.

Energetics of Herbs—The European Perspective Coles’ Art of Simpling (echoing Paracelsus and others of the time) Temperate Plants and Fruits Maidenhair, Asparagus, Licorice, Pine Nuts, Figs, Raisins, Dates, Woodruff, Bugle, Goat’s Rue, Flaxweed, Cinquefoil. Hot in the First Degree Wormwood, Marshmallows, Borage, Bugloss, Oxeye, Beets, Cabbage, Chamomile, Agrimony, Fumitory, Wildflax, Melilot, Comfrey, Avens, Eyebright, Selfheal, Chervil, Basil, etc. Sweet Almonds, Chestnuts, Cypress Nuts, Green Walnuts, Ripe Grapes, Ripe Mulberries, Seeds of Coriander, Flax, Gromwell, etc. Hot in the Second Degree Brooklime, Green Anise, Angelica, Parsley, Mugwort, Betony, Groundpine, Fenugreek, Saint John’s Wort, Ivy, Hops, Balm, Horehound, Rosemary, Savory, Sage, Maudlin, Ladies Mantle, Dill, Smallage, Marigolds, Carduus benedictus, Scurvygrass, Alehoose, Alexander, Archangel, Devilsbit, Sanicle, Capers, Nutmegs, Dry Figs, Dry Nuts, The Seeds of Dill, Parsley, Rocket, Basil, Nettle, The Roots of Parsley, Fennel, Lovage, Mercury, Butterburr, Hog’s Fennel, etc. Hot in the Third Degree Asarabacca, Agnus, Arum, Dry Anixe, Germander, Bastard, Saffron, Centaury, Celandine, Calamint, Fleabane, Elecampane, Hyssop, Bays, Marjoram, Pennyroyal, Rue, Savine, Bryony, Pilewort, Bankcresses, Clary, Lavender, Feverfew, Mint, Watercresses, Hellebore, etc. Hot in the Fourth Degree Selatica, Cress, Spurge, Pepper, Mustardseed, Garlic, Leeks, Onions, Stonecrop, Dittander or Pepperwort, Garden Cresses, Crowfoot, Ros Solis, and the Root of Pellitory of Spain.

Cold in the First Degree Orage, Mallows, Myrtle, Pellitory of the Wall, Sorrel, Woodsorrel, Burdock, Shepherd’s Purse, Hawkweed, Burnet, Coltsfoot, Quinces, Pears, Roses, Violets. Cold in the Second Degree Blites, Lettuce, Duckmeat, Endive, Hyacinth, Plantain, Fleawort, Nightshade, Cucumbers, Chickweed, Dandelion, Fumitory, Wild tansy, Knotgrass, etc. Oranges, Peaches, Damsons, etc. Cold in the Third Degree Purslane, Houseleek, Everlasting, Orpine, etc. Seeds of Henbane, Hemlock, Poppy. Cold in the Fourth Degree Henbane, Hemlock, Poppies, Mandrake, etc. Moist in the First Degree Bugloss, Borage, Mallows, their flowers and roots; Pellitory, Marigolds, Basil and the roots of Satyrion, etc. Moist in the Second Degree Violets, Waterlily, Orage, Blites, Lettuce, Ducksmeat, Purslane, Peaches, Damsons, Grapes, Chickweed, etc. Dry in the First Degree Agrimony, Chamomile, Eyebright, Selfheal, Fennel, Myrtle, Melilot, Chestnuts, Beans, Barley, etc. Dry in the Second Degree Pimpernel, Shepherd’s Purse, Wormwood, Vervain, Mugwort, Betony, Horsetail, Mint, Scabious, Bugle, Carduus benedictus. Dry in the Third Degree Southernwood, Ferns, Yarrow, Cinquefoil, Angelica, Pilewort, Marjoram, Rue, Savory, Tansy, Thyme, Hellebore. Dry in the Fourth Degree Garden Cresses, Wild Rue, Leeks, Onions, Garlic, Crowfoot.

The Roots of Veterinary Botanical Medicine • CHAPTER 4

ARABIC MEDICINE Rational approaches to medicine were developed to the highest level in the Middle East, where Avicenna lived from 980 to 1037 AD. He is the most famous and influential of the philosopher scientists of Islam and was born in Persia (now Iran). Abdullah Ibn Ahmad Ibn al-Baytar, as he was known in his land, was a botanist (he described more than 1400 medical herbs, comparing them with the descriptions of ancient authors) and pharmacist. He further codified Galen’s theory of using opposites to correct disease processes. His Canon of Medicine is one of the most influential medical books of all time. The Canon described the primary constituents of the human body as the elements—earth, air, fire, and water—that possess two qualities each. Earth is dry and cold, water is wet and cold, air is hot and moist, and fire is hot and dry. The humors are described as the primary body fluids that affect physiologic processes; they are themselves influenced by states of motion and rest. These humors include sanguineous (blood), serous (phlegm), bilious (choler or yellow bile), and atrabilious (melancholy, or black bile), which correspond with air, water, fire, and earth, respectively. Avicenna is credited with introducing astrology into medicine. Each humor possessed certain normal qualities and was associated with certain signs of the zodiac. Avicenna’s Canon was widely read by Europeans after it was translated into Latin in the 12th century. From 1500 to 1674, more than 60 editions were published in Europe. It was the standard text for university medical training until the 18th century. In the 12th century, Ibn al-Wwam wrote “Kitab AlFalaha,” a treatise on agriculture with a section on veterinary medicine. The 33rd chapter discusses diseases of the horse. Redness in the eye was said to be cured with rose water, blepharitis and conjunctivitis with centaury or saffron, mange in the ears or on the nose with saffron and sulphur, stomatitis with powder of pomegranate shells, headache with a linseed cataplasm, leeches in the mouth, nose, or throat with olive oil, and red urine with white pepper (Erk, 1960).

THE RENAISSANCE The Renaissance represented a flourishing of new ideas and discoveries in all areas of human endeavor. Great herbals from all over Europe began to appear in the 16th century, with the advent of the printing press. These included Herbarum Vivae Eicones (1530) by Otto Brunfels; Kreuter Buch (1542) by Jerome Boch; De Historias Stirpium (1542) by Loenhart Fuchs; New Herball (1551) by William Turner; Commentary on Dioscorides (1544) by Pier Andrea Mattioli; Croydeboeck (1554) by Rembert Dodoens, and Herball (1597) by John Gerard. Fuchs’ herbal is particularly distinguished as providing a new standard for plant illustrations. Leaves from copies of the herbal printed in the 16th century are regularly offered for sale on Ebay! One of the greatest challenges to the traditional Galenic humoral practice of medicine came from Phillipus Theophrastus Bombastus von Hohenheim (1493-1541), also known as Paracelsus. He was the son of

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a doctor and became an alchemist who contributed greatly to the discovery of medicinal effects of metals. Paracelsus was from a time when the discovery of the New World by Columbus called into question every construct developed by modern thought of the time. He rejected the theoretical dogma of Hippocrates and Galen for experimental medicine. He was particularly interested in the intrinsic property of a remedy—plant or mineral— and not necessarily the relationships and properties attributed to it by the ancients (Wood, 2000). Paracelsus said that the size of the dose determined whether the substance was a poison or a medicine. He believed that humans functioned chemically and that illness should be treated chemically, and he introduced the use of chemical drugs in place of herbal remedies. He opened the way for exploration of new remedies, including opium and the inestimable calomel—mercury. He was a firm believer in the Doctrine of Signatures, which linked the physical properties and habitat of a plant with its possible actions and indications. It is recorded that Paracelsus used Saint John’s Wort topically for gangrene in horses (Mulder, 1994).

DOCTRINE OF SIGNATURES The Doctrine of Signatures is an ancient theory that reemerged in Europe through the efforts of Paracelsus, and again in the 16th century with Jakob Böhme (15751624), a shoemaker in Görlitz, Germany, who wrote “Signatura Rerum; The Signature of All Things.” This doctrine espoused the philosophy that God stamped his “signature” on a plant to show how it might be used for medicine. As an example, two very different plants that resemble lung tissue are named “lungwort.” Pulmonaria officinalis has broadly lanceolate leaves that are mottled to look like lung parenchyma; the other plant, Sticta pulmonaria, is a lichen in which the structure resembles the pulmonary tree. The doctrine of signatures is not unique to Europe. Ancient medical practices, including Chinese medicine, contain elements of it, and Israeli folk medicine practices reflect some of this thought (Dafni, 2002). Certain of the precepts inherited from Europe were found in the early 1900s in isolated Appalachian communities of the United States. People looked at plant shape, color, and taste for clues as to their medical uses. The form of the leaf, flower, or root might recall a certain organ. Ginseng root, for instance, is shaped like a human, and in Traditional Chinese Medicine, some vines, worms, and snakes are long and thin and are thought to easily enter the jing-luo (or meridians). Orchids often have bulbs or flowers shaped like testicles, hence their common name derived from the Greek word for testicle—“orchis.” In addition, it was thought that some plants were usually found growing in association with others that complemented or remedied their actions. For instance, poison ivy can very often be found growing near jewelweed (Impatiens capensis), which is thought to stop the itching when applied topically. Plant color is important as well. For instance, plants with yellow parts are often associated with the liver (recalling the yellow color of bile). Plants with red parts

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(like the root of bloodroot) might be associated with treatment of blood disorders. Blue plant parts might cool fevers, and purple parts are thought to manage blood infections. The philosophy reflected the belief, “As above, so below.” Taken to a greater extreme, one could fit all plants into the alchemical cosmology that grew in influence in the 16th and 17th centuries. The plant might, because of its taste sensation or color, be associated with one of the Elements (Spirit [Ether], Fire, Air, Earth, and Water) and may therefore be more closely aligned with certain types of diseases. This sympathetic magic was formalized in the great book by Nicholas Culpeper, The English Physitian [sic], which was written in 1652 and is still in print. Here is the description of dandelion found in an undated early 20th century edition of the book: “It is under the dominion of Jupiter. It is of an opening and cleansing quality, and therefore very effectual for the obstructions of the liver, gall, and spleen, and the diseases that arise from them, as the jaundice and hypochondriac [sic]; it opens the passages of the urine both in young and old; powerfully cleanses imposthumes and inward ulcers in the urinary passage, and by its drying and temperate quality, doth afterwards heal them . . . The distilled water is effectual to drink in pestilential fevers, and to wash the sores.”

George Turberville wrote an influential book on the treatment of dogs in 1576, titled The Noble Art of Venerie or Hunting. His treatment recommendations reflected the beliefs of the day. To prevent “madness,” or to obtain mostly male hunting dog offspring, for instance, he recommended that care in husbandry be paid to the phases of the moon and the signs of Gemini and Aquarius (Dunlop, 1996). William Coles, author of The Art of Simpling (1656), knew of Culpeper, and although he apparently thought Culpeper went too far, he still believed in the Doctrine. He lists, for instance, Adder’s tongue as an herb that should be used for curing the bite of an adder because of its shape. On the other hand, viper’s bugloss (Echium vulgare) has speckled stalks (like a snake’s skin), and this also makes it good for snake bites and for “poison” from scorpions and other venomous beasts. In addition, “Walnuts bear the whole Signature of the Head, the outward most green bark answerable to the thick skin wherewith the head is covered, and a Salt made of it is singularly good for wounds in that part, as the kernel is good for the brains which it resembles, being environed with a Shell, which imitates the Skull, and then it is wrapped up again in a silken covering somewhat representing the Pia Mater.”

Coles provided a good example of how extreme this system could become under the cover of official doctrine: “And I know not why Sagittaria, or Arrowhead, should not be good for wounds made with the head of an Arrow, and Kidney beans for diseases of the Kidneys, though I confess I have not read to that purpose in any Author.”

Yet he acknowledges that, although the doctrine is useful, not all plants are marked (Figure 4-3): “But because all Plants have not their Signatures, we are not rashly to conclude that they are therefore unfit for Medicinal

Figure 4-3 Lungwort has anatomic characteristics resembling lung parenchyma—a good example of naming a plant according to the doctrine of signatures. uses, there being no necessity that all should be thus signed, though some be, for then the rarity of it, which is the delight, would be taken away by too much harping upon one thing.

In England, the Renaissance period produced several great botanists and herbalists. The first printed herbal in England was Bancke’s Herbal, author unknown, from 1524. This work is probably a compilation from medieval manuscripts, and it has gone through many editions. The first illustrated herbal in England was Grete Herball, which is a translation of other herbals. Turner’s Herball was an influential text, but the most famous English herbal was John Gerard’s The Herball or Generall Historie of Plantes. This work was probably the result of the labor of another man, a Dr Priest, but Gerard’s Herball is still known as the most beautiful of the English herbals because of the illustrations and its Elizabethan style. His work reflected the theory that herbs treat not only physical diseases but also those of the mind and spirit. Interestingly, Gerard describes methods of aromatherapy that involve the inhalation of volatile oils and the absorption of these through the skin into the circulatory system. The last great English herbalist of this period was John Parkinson, who wrote Paradisus in 1629 and the Theatrum Botanicum in 1640. The Theatrum Botanicum described more than 3800 plants and was the most complete and aesthetically beautiful English treatise on plants of the day. Rohde (1922) claims that the only herbal to devote an entire chapter to animals is Coles’ Art of Simpling (1656) (see the box on p. 38). Throughout the 16th century, the division between university-trained doctors and other practitioners such as midwives, herbalists, and bone crackers grew. The era of “homemade” practitioners had its roots in the tradition of the village healer, along with the increased numbers of

The Roots of Veterinary Botanical Medicine • CHAPTER 4

publications made possible by the spread of the printing press. Written knowledge of medicine and herbs became available to masses. During the reign of Henry VIII, practitioners of contemporary alchemy and practitioners of traditional herbal medicine clashed. Untrained practitioners also referred to as “quacks” were common. To stop this flood of lay practitioners and the associated competition with trained physicians, starting in 1512, the English Parliament passed a series of Acts of Parliament to regulate the practice of medicine in England. However, to the dismay of the surgeons who tried to use one of the new acts to stop local healing women from practicing their home remedies, this resulted in the passing of what is known as “The Quacks’ Charter.” This new act allowed, “it shall be lawful to every person . . . having knowledge and experience of the nature of Herbs, Roots, and Waters . . . to practice, use, and minister . . . without suit, vexation, trouble, penalty, or loss of their goods.” Modern herbalists refer to this Act as “The Herbalists’ Charter.” The practice of folk medicine and the use of herbs were distinguished and protected from the emerging medical paradigm. This may be where herbal medicine diverged and began to develop a separate theory and practice from what would become the practice of medicine. It is under the protection of this Herbalists’ Charter Act that natural therapists in England are still able to practice to this day.

CHEMICAL MEDICINE Chemical medicine embodied in the tradition of alchemy attempted to distill different waters from herbs, minerals, and parts of animals, as opposed to Galenical preparations made from whole plant parts. It was a trend encouraged by Paracelsus, who was one of the first to realize that it was the “active constituents” or chemicals present in plants that interacted with the body and stimulated healing. A schism between herbal medicine and embryonic scientific medicine began. This gap widened when medical science developed the concept of experiment as a way to gain knowledge. Renaissance thinkers like William Harvey (1578-1657) and Francis Bacon (1561-1626) were early authors of scientific medicine, now called “biomedicine,” and the herbalists remained empiricists at heart and in practice for the next few hundred years. Paracelsus’ discovery of chemical medicine, using metals and other new substances, a weakening of the church’s grip on how disease was understood, systematic compilations and distribution of pharmacopeias with the introduction of the printing press, the anatomic research by Vesalius and experimental physiology of Harvey—all of these contributed to changing attitudes, or a “modernization” that left gentle herbal cures behind in the minds of the public. By the end of the 16th century, the followers of Paracelsus were actively promoting their new medicines, many of which (e.g., mercury) were extremely toxic. Paracelsus would have been appalled by the often violent reactions in patients that resulted in great suffering—quite the opposite of what he was attempting to achieve. The 17th century was characterized by a number of developments. First, the discovery of the Americas led to

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the introduction of new and exotic medicines such as Peruvian bark (from South American species of Cinchona). It also saw an increasing number of books on the subject of self-treatment using herbs and simple cures. Nicholas Culpeper (1616-1654) was one of the most fervent critics of the imported exotic medicines. He initially studied to be a doctor and later, as an apothecary, trained at Cambridge. At that time, to restrict access to medical information, the language of choice for physicians was Latin. In Culpeper’s opinion, this was an elitist ploy to keep the knowledge of herbs and healing from the masses. He translated the London pharmacopoeia into vernacular English and simplified the recipes, so that exotic foreign (and very expensive) ingredients were replaced with locally grown plants. In 1652, he published his classic, The English Physician or an Astrologo-physical Discourse of the Vulgar Herbs of this Nation, Being a Compleat Method of Physick Whereby a Man may Preserve his Body in Health, or Cure himself being Sick, for threepence charge, with such Things as onlie Grow in England, they being Most Fit for English Bodies. In it, he tied Galenical herbalism to astrology, as Avicenna had done, claiming that this was a predictable, consistent, and reliable system, but he also relied on a wealth of practical experience. Culpeper’s permanent contribution was to make practical herbal medicine available to everyone. This book has had more than 40 editions, was the first medical book published in America, and still has a healthy spot in the used book trade today. Early in the 18th century, Carl von Linne (Linnaeus) developed binomial nomenclature to denote every species of plant. In the preceding centuries, medicinal plants were identified by a single name, but that name might be given to several plants, or a plant could have multiple names. Plants could now be catalogued based on morphology, without any context in which to judge whether these plants were or had been useful in medicine. Some think that this is the precursor for random chemical screening of plants for the purpose of finding an active chemical—a process that is still used today but that has generally been found inefficient. Drug companies and researchers alike are now back to studying plants on the basis of their traditional uses, but thanks to Linnaeus, we can identify these plants with certainty.

THE FRENCH CONNECTION Tracking forward in time now to the 17th century, the link between Western herbal medicine and veterinary medicine grew stronger as did the importance of animal husbandry and agriculture to support the rising human population in Europe. As domestic animals became increasingly valuable, so did the need to study them in greater depth. Claude Bourgelat in Lyons, France, opened the first veterinary medicine school on February 13, 1762. The school was founded by Louis XV and was designed mainly for the study of the diseases and treatments of livestock. In 1764, the school was transferred to Paris, and in 1766, the Royal Veterinary School of Alfort was opened, as was the Jardin des Plantes. Veterinary students grew medicinal plants, collected, dried, and prepared extracts, and distilled them to produce drugs. Activities

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at the renamed Alfort Imperial Veterinary School of 1803 included the systematic study of plants, toxic plants, and spices and medicinal plants.

THE AMERICAS Little is known of herbal practice by natives in North, Central, or South America because they left no written record. What we do know survives in the practice of remaining indigenous peoples and the pioneers who colonized the United States and in a very few descriptive herbals compiled by explorers. Europeans learned some aspects of Native American healing and exported many of these remedies to Europe. Land grant colleges were started very early, and herbariums and study of plant material were part of university study. One of the early Central American herbals is Codex de la Cruz-Badiano (Badianus manuscript) of 1552, originally known as Libellus de Medicinalibus Indorum Herbis. The book was written in Nahuatl (an Aztec language) by Martin de la Cruz, an Aztec physician of the 25-year-old Spanish colony called New Spain (now Mexico) and translated by Juan Badiano. The illuminated text contains such familiar herbs as thistle, clover, oak, cypress, beans, senna, wormwood, artichoke, cress, tobacco, nettles, and jimson weed. North American native practices have been preserved by word of mouth and revived by modern ethnobotanists in a number of books (Moerman, 1998; Weslager, 1973; Densmore, 1974; Hutchens, 1991). In the United States, herbal practice evolved from colonial times to the early 20th century. Initially, the Puritans brought herbs and herb seeds from Europe, in addition to their copies of Culpeper’s English Physician. William Byrd II (1674-1744) reported that Virginia gardens of his time usually contained the following herbs: angelica, anise, borage, burnet, chives, coriander, dill, fennel, garlic, marjoram, parsley, rosemary, savory, sorrel, and yarrow. The first description of herbs that would grow in North America was New England’s Rarities Discovered, written by “John Josselyn Gentleman” in 1672. Josselyn described native herbs and explains in detail how the Native Americans used them. He also described plants that were brought from England and forever changed the American plant landscape with their invasiveness, such as couch grass, shepherd’s purse, dandelion, stinging nettle, plantain, chickweed, and comfrey. In the 18th and early 19th centuries, the Materia Medica enlarged and changed to include American herbs, primarily those of Eastern forests. Pioneers learned these herbs from natives. At the same time, botanists were hard at work discovering and describing unique American plants and their use by American Indians. One such famous botanist was Constantine Rafinesque (17841841), who spent time with natives to write his masterpiece, New Flora of North America (1836). As European doctors immigrated and the United States opened its own medical schools, the bloodletting, salivation from calomel administration, and other horrific practices soon became “regular medicine.”

HEROIC MEDICINE The 17th and 18th centuries saw the increasing use of chemical medicine, as well as the introduction and practice of heroic medicine. As European doctors immigrated and the United States opened its own medical schools, the heroic practices of the time included materials such as animal feces and burnt animal matter in medicines; the use of debilitating procedures such as bloodletting; and the administration of chemicals such as mercury, arsenic, and antimony, mainly for the purpose of inducing purging, which was considered cleansing to remove possible toxins. Heroic medicine no doubt caused enormous suffering among patients. The public and the medical profession were becoming polarized, and medical reform was imminent. Herbal medicine’s great revival occurred in the early 1800s in rebellion against heroic medical practices, but was also a reflection of the Jacksonian political climate of the times. Nineteenth century capitalism promoted economic self-sufficiency and nationalistic confidence. Applied science was freed from philosophy and became an instrument of the culture. Lay reformers and practitioners promoted new theories that the public found easy to accept. Medical schools were privatized, and licensure was eventually eliminated because it was considered elitist. This situation laid the foundation for medical sects, which developed and flourished in America throughout the 19th century. No wonder healers with a different approach were able to make an extraordinary impact on medical practice. Samuel Thomson (1769-1843) was one of those who changed the course of medicine in the United States. Thomson, a self-taught herbalist, birthed Botanic Medicine and taught about the power of the body to heal itself. He learned some of the arts of herbal medicine from a local woman, the Widow Benton, and went on to develop a system that was to spark a revolution against the dominant “heroic” model of medicine. Thomson’s initial model emphasized “sweating out” the disease influence and restoring “animal warmth” with herbs and a sweat bath; some herbalists believe that this model is borrowed directly from certain Native American practices. His herbal pharmacopoeia consisted of cayenne pepper to produce sweating, and lobelia and buckthorn to produce vomiting and purging, with rests in between, which earned him and his followers the appellation “steam and puke doctors.” Although it was still considered heroic, his treatment was aimed at stimulating self-healing—a rediscovered Hippocratic doctrine. His system became known as the Thomsonian System of Practice, which he patented in 1813 and which was practiced throughout the United States as a franchise known as the “Improved System of Botanic Practice of Medicine.” He licensed agents to be educated and receive his products, and by 1939, more than 3,000,000 members made up his Friendly Botanic Society. Many doctors and herbalists began referring to themselves as Thomsonians to distinguish themselves from the “regular” physicians of 19th century America. The interest in herbal medicine was rekindled, but its success and appeal to the masses would bloom only after

The Roots of Veterinary Botanical Medicine • CHAPTER 4

a group of medical doctors took it on. Soon came the NeoThomsonians, who despite their teacher’s complaints, greatly expanded the Materia Medica, probably on the basis of Native American uses of these herbs, as well as experimentation and empiric observations. The Physiomedical movement was a direct outgrowth of the Thomsonian movement, and its philosophy was to use only healing plants—toxins were not allowed, even if they were toxic plants and even in homeopathic doses. The Physiomedicals were vitalists who believed that the remedy only corrected abnormal tissue states, and that the vital force did the rest of the work of healing the patient. Eclectic medicine arose from these roots as a philosophy that subscribed to no particular dogma; it suggested that scientific and empiric methods would provide evidence for selection of the best methods of practice. Wooster Beach, a student of Thomson’s, opened two Eclectic hospitals in the northeastern United States, where the science of the time was combined with herbal treatments. Beach called this discipline “Eclectic” medicine. Alva Curtis and William Cook were two reformers who led the Physiomedical movement to open multiple schools in the East and Midwest. Later, Eclectics and Physiomedicalists built this combined scientific herbalism into a high medical art, and the publications of John Scudder, John King, Finley Ellingwood, Harvey Wickes Felter, William Cook, and John Uri Lloyd serve as valuable references for today’s practicing herbalists.

Battlefield Medicine of the 19th Century An interesting peek into the pharmacy of the Confederacy during the Civil War is given in Denney’s work (1994). According to Denney, The Confederate States Medical and Surgical Journal, July 1864 issue, detailed a “standard supply table of indigenous remedies for field service and sick in general hospital.” Herbs listed as stimulants were calamus, lavender, partridgeberry, sassafras, Seneca snakeroot, tulip tree, and Virginia snakeroot. Astringents were derived from white oak bark and leaves, bearberry bush, marsh rosemary, and sumac. Tonics recommended were American century, American Colombo, American gentian, blackberry or dewberry, dogwood, Georgia bark, hops, persimmon, sage, white willow, and wild cherry.

No major changes or movements occurred in European herbal medicine until American herbal practitioners came to the continent in the early 1800s with a new message. Albert Coffin, a charismatic medical doctor, modified the Thomsonian system somewhat and took it to England. The “nature cure” system became popular in Germany, where Father Sebastian Kneipp championed his famous “water cure.” Benedict Lust brought this system to the United States, where he opened the first health food store in 1896, calling it the Kneipp Store. He founded the American School of Naturopathy, which granted degrees.

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Some writers claim that, although the populist, selfhelp tone of the Eclectics and the Physiomedicalists brought them to their full power in the United States, their downfall lay in their failure to grant any validity to the germ theory. While regular medicine was building hospital-based academic practices and developing laboratory procedures that would revolutionize diagnostics and treatment, reform movements continued to insist on using part-time faculty and holding to a fully empiric view of the patient. Failure to adopt Council on Education guidelines and unwillingness to embrace new developments caused a wane in their popularity, and some of the schools fell to selling diplomas and graduating unqualified doctors. The last Eclectic college was closed in 1939, and not until the 1960s was significant interest in herbal medicine to rise again. The knowledge of herbal medicine built by the Eclectics and the Physiomedicalists was kept alive in the Naturopathic schools that began to open in the United States. Two Naturopathic books that sparked the renaissance in herbal medicine in the United States were Edward Shook’s Treatises in Herbology, and John Christopher’s School of Natural Healing, both of which were published in the 1960s. Many of those who are interested in alternative modalities are familiar with the Flexner report, which is said to have been the death knell for herbal and homeopathic medicine in the early years of the 20th century. This report, entitled “Medical Education in the United States and Canada,” was published in 1910, was funded by the Carnegie and Rockefeller Foundations, and was backed by the American Medical Association (AMA). Readers have found ample connections between the Rockefellers, pharmaceutical and industrial monopolies, and an ingrained opposition to the public’s use of any medicine not dependent on the drug industry. The report described American medicine as rife with sectarianism, disagreement about best treatments for patients, and, in some cases, frighteningly dirty and substandard facilities among the sectarian schools. Reformers did themselves in by not recognizing or instituting the changes recommended by Flexner—that schools should have up-to-date laboratory facilities, that faculty should be full-time teachers and researchers with hospital affiliations for bedside teaching, and that licensing should be reinstituted to ensure adequately educated doctors. In their place, scientific medicine and chemical drugs with the backing of the increasingly powerful AMA and drug companies began to dominate the health industry. Botanical medicine, it was claimed, was no longer needed because all chemicals could be synthesized by extracting active constituents from plants. Most drugs currently in use originate from plants or are based on plant chemicals. Some of the most important examples include digitoxin from foxglove, aspirin from willow bark, morphine from poppy, vincristine from the Madagascan periwinkle. Not only do these plants provide the basis for synthesized drugs; to this date, they are still the raw material used in the synthesizing process. The reader can peruse the US Pharmacopoeia and, for that matter, the veterinary Materia Medica, to track this history of declining plant use as drug therapy grew in prominence during the 20th century.

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From the 1920s to the 1950s, orthodox medicine in America and worldwide made significant leaps forward. Pharmaceutical companies began to mass produce drugs such as antibiotics, surgical techniques continued to advance, and new vaccines were developed. However, despite these developments, herbal medicine has undergone a resurrection since the 1960s and is increasingly being rediscovered as a source of treatments that can potentially prevent costly adverse effects of standard drug treatments and offer a different approach and opportunity for treatment when other treatments have failed (one of the most striking examples is Chinese Artemisia for malaria) (Abdin, 2002). Presently, herbal medicine is used by herbalists as a complete system of healing, and by medical professionals as complementary therapy. However herbs fit into the practice of medicine, some guiding philosophy for their prescription is usually at work. Modern herbalists tend to claim that there are three main philosophies that undergird herbal use: 1. Scientific herbal medicine, or Phytotherapy—this is usually reductionistic, studying herbs and diseases in isolation to understand them as molecular interactions that are more easily measured than whole systems. Phytotherapists tend to use evidence-based treatments. 2. Heroic—In this philosophy, illness is seen primarily as an accumulation of toxins, worsening as people age. Treatment centers on detoxification and controlling one’s exposure to toxins. Herbs used in this tradition are strong, generally starting with laxatives, diuretics, and diaphoretics. 3. Traditional medicine—This is the most holistic of the traditions. Traditional medicine, such as the Wise Woman tradition, Native American medicine, Chinese medicine, and other cultural medical systems, tends to view the organism as a whole, using simple herbs, physical activity, food, and emotional support to restore health. Modern practitioners of herbal medicine tend to combine evidence-based practice with the knowledge of traditional uses of the herbs.

VETERINARY BOTANICAL MEDICINE If you find yourself with some spare time, visit a veterinary school library and access some of the older veterinary textbooks. Besides fascinating reading that describes techniques and conditions that seem oldfashioned now, the contrast is obvious in one field— therapeutics. Herbs form the very basis of veterinary medicines and, up until the 1960s, are found in most veterinary pharmacopoeias and textbooks.

The use of herbal treatments within veterinary medicine is not new, as we have seen. Herbs have been integral to all folk and cultural traditions, and study of these traditions is making a comeback (see Chapter 3, Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems). Even before academic researchers began to

study traditional uses of herbs, lay authors were reviving the traditions. Juliette de Bairacli Levy was one of the first. She was born in England and apparently attended veterinary school for a short while before dropping out. She continued to learn natural medicine on her own and from gypsies, who became her friends. She is the author of five herbals that make very interesting reading indeed. As the profession of veterinary medicine grew in the 17th and 18th centuries, advances in regular and herbal medicine continued to develop alongside those in human regular and herbal medicine. What is interesting to observe is how recently many herbs were considered orthodox within the veterinary profession (to at least the 1960s). It is also interesting to observe what some would consider alternative terms in the herbal literature, such as alterative and carminative as mainstream descriptors of plant actions in veterinary textbooks. During the 18th and 19th centuries, herbal medicine was entrenched in the veterinary profession. However, orthodox veterinary use of herbs did not follow the true tradition of herbal medicine, and typically, treatments called for combinations of herbs and inorganic substances. Veterinarians became medical professionals following the establishment of veterinary schools. After the first school in Lyon was established, veterinary colleges were founded in Turin, Göttingen, Copenhagen, London, Edinboro, and other European cities. Horse doctors, farriers, and some lay animal experts were now considered quacks. Education centered on horses, but William Youatt, a British veterinarian, elevated the knowledge of canine medicine in his books that are still fairly easily found in the antiquarian trade. In North America, the first established veterinary schools were located in Mexico and Canada. The first veterinary school in the United States was established at Cornell in 1894. Previous to this, veterinarians had formed professional organizations (such as the US Veterinary Medical Association [USVMA] in 1863 and regional associations), but these veterinarians may have had medical or other training. The Eclectics had their share of “veterinary reformers,” two of whom were Nelson N. Titus and G. H. Dadd. Dadd’s book, The American Cattle Doctor (published in 1858), explains the Reformed Practice. His “Creed of the Reformers” details Eclectic veterinary practice as follows: “We believe that a perfect system of medical science is that which never allows disease to exist at all; which prevents disease, instead of curing it, by means of a perfect hygienic system, proper modes of life, attention to diet, ventilation and exercise. “We believe that the next best system is that which, after disease has made its appearance, promptly meets its development by the use of such agencies as are perfectly in harmony with the laws of life and health, and physiological in their action; such, for example, as water, air, heat and cold, friction, food, drink, and medicines that are not usually regarded as poisons, and are known to prove congenial to the animal constitution. “We have no attachment to any remedy which experience shows unsafe; but on the contrary, we rejoice in the success of every attempt to sanative for disease-creating agents, and believe that a number of the articles which are still

The Roots of Veterinary Botanical Medicine • CHAPTER 4

occasionally used in the old school, will in time become obsolete, as medical science progresses. “We hold that our opposition to any course of medical treatment should be in proportion to the mischief it produces, entirely irrespective of medical theories. Hence our hostility to the lancet. “We do not profess to know more about anatomy, physiology, surgery, etc, than our allopathic brethren; but the superiority which our system claims over others is, in the main, to be found in our therapeutic agents, all of which are harmless, safe, and efficient. While they arouse the energies of nature to resist the ravages of disease, they act harmoniously with the vital principle, in the restoration of the system from a pathological to the physiological state.”

It may be instructive to compare the treatments presented in various texts over the course of the 19th century. In the following paragraphs, three common conditions and suggested treatments for each of them are presented. The early authors (Varlo, Youatt, Hinds, and Lambert) were chosen to represent typical practices of the time, and Dadd and Titus are the quintessential Eclectic veterinary practitioners who reintroduced to the American veterinary profession plant medicine in the treatment of animals.

Diarrhea in Cattle Varlo, 1785: “Take half a pint of verjuice [sour juice of crabapples or other unripe fruit], and mix in it an ounce of bole armoniac reduced to powder; or, for want of this, bruise to powder a large handful of kennel coal, and give it in a quart of new milk three mornings together.” Lambert (from Richardson, 1828): Calf scours: “You must take a pint of verjuice and clay that is burnt till it be red, or very well-burnt tobacco pipes, pound them to a powder and sift them very finely; put to it a little powder of charcoal, then blend them together and give it to the calf, and he will mend in a night’s time for certain.” Dadd, 1858: “In the early stages of this disease, it is not always to be checked. It is often a salutary operation of nature to rid the system of morbific materials, and all that we can do with safety, is to sheathe and lubricate the mucous surfaces, in order to protect them from the acrid and stimulation properties of the agents to be removed from the alimentary canal. When the disease, of which diarrhea is only a symptom, proceeds from exposure, apply warmth, moisture, friction, and stimulants to the external surface, aided by the following lubricant—powdered slippery elm 1 ounce; powdered charcoal 1 tablespoon, boiling water 2 quarts. When the fecal charges appear more natural and less frequent, a tea of raspberry leaves or bayberry bark will complete the cure. When the disease assumes a chronic form, and the animal loses flesh, the following tonic, stimulating, astringent drink is recommended: Infusion of chamomile 1 quart, powdered caraway seeds 1 ounce, powdered bayberry 1 /2 ounce. For “scouring rot,” the recipe is powdered charcoal 1 teacup full, common salt 2 ounces; Pyroligeneous acid half a wine glass (vinegar obtained from wood), warm water, 2 quarts. Titus, 1865: Diarrhea: “This disease is better known than the method of cure. It is more difficult to cure this disease in horned cattle than in man, or any other animal. But I have never failed to effect a cure with the following treatment, if given in time: tincture of opium 2 ounces, tincture of kino 3 ounces, tincture of camphor 1 ounce, essence of peppermint

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1 ounce, Paregoric 4 ounces. Mix, and given an ounce in 6 hours, until the disease abates; in bad cases, give injections of: slippery elm flower 2 ounces, morphine 20 grams, warm water 1 quart. The animal should have no water to drink; but should have a liberal allowance of linseed tea or some other mucilaginous drink. A tea made of the Indian arrow-root has been very effectual in curing the disease. The animal should be kept on dry food, and kept in a warm, comfortable place.”

Canine “Itch” or Mange Lambert (from Richardson, 1828): “Get brimstone, beat it into fine powder and sift it, then take an ounce of elecampane root, waterlily roots dried, and beat to a powder, of each one ounce, a little handful of bay salt dried and powdered; make an ointment with half a pint of oil of turpentine, and two ounces of hogs lard, and having rubbed the dog with a wool card (or some such thing) till the blood comes in some places, anoint him with this warm, and it will cure him.” Youatt, 1857: “Bleeding, aperient, and cooling medicines are indicated, and also applications of the subacetate of lead, or spermaceti ointment. A weak infusion of tobacco may be resorted to when other things fail, but it must be used with much caution. The same may be said of all mercurial preparations. The tanner’s pit has little efficacy, except in slight cases. Slight bleedings may be serviceable, and especially in full habits; setons may be resorted to in obstinate cases. A change in the mode of feeding will often be beneficial, and also mercurial alteratives, as Aethiop’s mineral with cream of tartar and nitre. The external applications require considerable caution. If mercury is used, care must be taken that the dog does not lick it. . . . Unguents are useful, but considerable care must be taken . . . Lotions of corrosive sublimate, decoction of bark, infusion of digitalis or tobacco effected some little good; but the persevering use of the iodine of potassium, purgatives, and the abstraction of blood very generally succeeded.” Dadd, 1858: “Powdered charcoal half a tablespoon full, powdered sulphur 1 ounce, soft soap sufficient to form an ointment. Apply externally for 3 successive days, at the end of which time, the animal is to be washed with castile soap and warm water, and afterwards wiped dry. The internal remedies consist of equal parts sulphur and cream of tartar, half a teaspoonful of which may be given daily, in honey. When the disease becomes obstinate and large, scabby eruptions appear on various parts of the body, take pyroligneous acid 2 ounces, water 1 pint, and wash parts daily, and keep animal on a light diet.”

Equine Founder Lambert (in Richardson, 1828): “If the founder is settled in the feet and legs, you may take from the horse one pint of blood, once in 3 days, put him in running water and let him stand 2 hours, morning and night, give him 1 day, four ounces of Glauber’s salts, and the next day, one ounce of saltpeter, and in this manner, repeat these doses until the horse is well. The medicine may be given to the horse in moistened oats or meal, but he must not have much provender, until he gets well. Wash his legs down well with hot pot-liquor, or dishwater. The horse must be bled in the foot between the hair and the hoof.” Hinds, 1830: “. . . take off the shoe . . . Apply a bran poultice warm to the whole foot daily, but do not add to it any greasy or oily substances as is too often practiced . . . a number of contrivances for affording coolness and natural

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PART I • Historical Relationship Between Plants and Animals

pressure to the sole and frog, besides the foregoing, have been resorted to, and among these the admixture of vinegar, alegar, verjuice, or solution of nitre with the clay, with the stopping, etc are well calculated to answer the purposes intended. Rubbing the knees with turpentine is also serviceable. Physic . . . either of the three evacuations being suppressed or imperfectly performed must be restored, and a purgative, a urine-ball, or a diaphoretic powder must be administered as occasion requires, and opportunity presents itself; of course, neither of those will be given while the animal is out of doors.” Youatt, 1857: “Bleeding is indispensable, and that to its fullest extent. If the disease be confined to the forefeet, 4 quarts of blood should be taken as soon as possible from the toe of each . . . poultices of linseed meal, made very soft, should cover the whole of the foot and pastern and be frequently renewed, which will promote evaporation from the neighboring parts, and possibly through the pores of the hoof, and, by softening and suppling the hoof, will relieve the painful pressure on the swelled and tender parts underneath . . . shoe should be removed . . . the sole pared . . . There is doubt as to the propriety of administering physic. The horse may find it difficult or impossible to rise, in which case much inconvenience will ensue from the operation of physic; or there may be danger, from the intense character of the fever in the feet often assumes, of producing a change in inflammation to the bowels or lungs, in which case the irritation of physic would probably be fatal. Sedative and cooling medicines should be diligently administered, consisting of digitalis, nitre, and emetic tartar . . . If no amendment be observed, three quarts of blood should be taken from each foot on the following day, and in extreme cases, a third bleeding of two quarts may be justifiable, and, instead of the poultice, cloths kept wet with water in which nitre has been dissolved immediately before, and in the proportion of an ounce of nitre to a pound of water, and wrapped round the feet. About the third day, a blister may be tried, taking in the whole of the pastern and coronet . . . The horse should be kept on a mash diet, unless green meat can be procured for him; and even that should not be given too liberally . . .” Titus, 1865: The foot, like every other part, is liable to inflammation from various causes and particularly from violence, long continued action, and more especially, letting the horse drink cold water, when very warm from exercise. As soon as the horse is discovered to be foundered, he should be placed in a vat of water about summer temperature; this is better than to place the horse in running water as this chills the horse and obstructs the circulation. When it gets too warm for the heat of the feet, it should be changed; it should be kept 2 or 3 degrees below the temperature of the body, and the horse should be kept constantly in it until all fever and inflammation have abated. If the horse cannot be kept on his feet, they should be kept constantly wet by means of cloths or a sponge. This treatment is an infallible cure, and will be found more effectual than all the medicines in the whole Materia Medica. It requires no medicine, excepting a dose of physic occasionally. [One recipe for physic balls: Powdered aloes, 1 oz; powdered mandrake, 1/4 oz; powdered ginger, 1/4 oz {variations included the addition of blood root and peppermint}—balls are formed by adding honey].”

In 1878, Finlay Dun published the ninth edition of his popular textbook, Veterinary Medicines, Their Actions and Uses. He was a respected lecturer at the Edinburgh Veterinary College and an examiner in chemistry at the Royal College of Veterinary Surgeons. He details the use

of remedies such as gentian as a bitter tonic—“useful in treating atonic digestion”—and dissolved Linseed tea or ale together with nitre and Epsom salts for treating “simple catarrh in the horse.” Juniper is described as a topical irritant, a mild stimulant, a carminative, and a diuretic “of use in treating indigestion and flatulence, diminishing the evil effects of bad fodder and marshy pastures.” Herbs were still prominent in the veterinary literature into the 1900s. In Leeney (1929), Home Doctoring for Animals, fennel, aniseed, gentian, fenugreek, ginger, opium, cassia bark, cinnamon, caraway, peppermint, cumin, aloes, thymol, male fern, digitalis leaves, elm bark, camphor, capsicum, belladonna, Peruvian bark, linseed, quassia, oak bark, licorice, cinchona, and other herbs are featured in standard powders, ball, and drench recipes. In Banham and Young’s Veterinary Posology (1935), aloes, belladonna, buchu, caffeine, camphor, cannabis, capsicum, cinchona, cinnamon, crocus, turmeric, digitalis, eucalyptus, fenugreek, galangal, gentian, ginger jalap, juniper, lavender, lobelia, peppermint, myrrh, olive oil, senna, tamarind, thymol, uva ursi, and ginger took a prominent place beside the increasing numbers of chemical drugs that were proliferating at the time such as strychnine, arsenic, ammonium, apomorphine, atropine, iodine, zinc, lead salts, and many others. Even into the 1960s, in Daykin’s Veterinary Applied Pharmacology and Therpauetics, a textbook used in veterinary schools throughout the United Kingdom, Australia, and the United States, male fern, acacia, podophyllum, camphor, buchu, cascara, senna, peppermint, betel nut, calabar, kamala, licorice, aniseed, belladonna, ginger, and nux vomica, among others, still feature highly as contemporary medicines, along with vaccines, antibiotics, corticosteroids, and hormone treatments now available. As the demise of herbal medicine occurred concomitantly with the rise of scientific medicine, veterinary medicine followed suit. Many of the patented herbal medicines used in veterinary medicine had become associated with the use of inorganic substances like mercury and arsenic. It is therefore not surprising that the use of such remedies came into some disrepute with the advent of “modern” pharmaceuticals. Perhaps paralleling the contemporary story of Western herbal medicine (Griggs, 1981), as pharmaceutical research changed the modern standard of medicine (including veterinary), within a decade, the study of herbs all but disappeared from the curriculum of veterinary schools. Instead, plants as treatments were replaced with the toxicology of weeds and “poisonous plants.” As a result, few herbal remedies survive today in conventional veterinary practice.

VETERINARY BOTANICAL MEDICINE RENAISSANCE Since perhaps the late 1970s, holistic veterinarians have created a renaissance of interest in and study of medicinal plants, plant-derived drugs, and phytotherapy. At the same time, organic agriculture has become more important, and the need to find nondrug treatments for food animals has pushed this rebirth in veterinary herbal

The Roots of Veterinary Botanical Medicine • CHAPTER 4

medicine as well. “Clearly, a new opportunity had surfaced to improve the quality of practicing veterinary medicine by using herbal plants and their extracts to improve health, increase energy, facilitate healing, modify symptoms, help the immune system function, and improve quality and longevity of patients’ lives” (Basko, 2002). The first international veterinary herbal organization, the Veterinary Botanical Medicine Association, was formed in 2000 to develop responsible herbal practice by encouraging research and education, strengthening industry relations, keeping herbal tradition alive as a valid information source, and increasing professional acceptance of herbal medicine for animals. Currently, Ayurvedic medicine, Western medicine, Traditional Chinese herbs as well as Kampo and other systems of herbal medicine are employed by veterinary and animal herbalists throughout the world. Growth in interest is expected to continue as we reflect on the various traditions and scientific applications of herbal medicines and find their place within the context of veterinary medicine. Research must continue into the safety, efficacy, and appropriate applications of herbal medicines, along with their comparative costs and benefits in veterinary medicine. Yet, although reductionism and experimental science have their place in veterinary medicine, they are simply a piece of the whole. Medicine and science are not the same. Although medicine has benefited greatly from the scientific approach, medical history always brings the pendulum back when dogma sets in, and it affirms the value of empiric observation. Evidence-based medicine is becoming part of veterinary practice. Even with perfect knowledge of the genetics, environment, psychology, and chaos potential of an individual patient, science may never allow us to predict his or her interaction with an herb or herbal practitioner—the individual practitioner reigns supreme in this decision making. Western veterinary botanical medicine is still in its infancy, but the value of herbal medicine and of herbal medicine’s approach to chronic disease (in particular) should not be underestimated. As we collectively learn more about herbal medicine and its applications to animals, we are sure to find herbs playing a far more extensive role in the care and health of our animals as a society. It is an exciting time to be on the bridge that spans the past and the future of veterinary herbal medicine. Further Information on Herbal History Griggs B. Green Pharmacy, Healing Arts Press, Rochester, Vt (1981, 1991, 1997) Anderson FJ. An Illustrated History of the Herbals. New York: Columbia University Press; 1977 Berman A, Flannery MA. America’s Botanico-Medical Movements. Vox Populi. New York: Pharmaceutical Products Press; 2001 Hammurabi. “Code of Hammurabi.” April 29, 2004. http://www. yale.edu/lawweb/avalon/hamframe.htm Columella http://www.gmu.edu/departments/fld/CLASSICS/ columella.rr.html Culpeper’s The English Physitian of 1652: http://info.med.yale.edu/ library/historical/culpeper/culpeper.htm

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Grieves M. 1973. A Modern Herbal. This is a classic book originally published in 1931. It compliles information on herbs that is not easily accessible elsewhere. www.botanical.com/ botanical/mgmh/comindx.html Fuchs DeHistoria Stirpium: http://info.med.yale.edu/library/ historical/fuchs/ The Academic Medical Library of Paris has an online version of Galen’s works at: http://www.bium.univ-paris5.fr/histmed/ medica/galien_va.htm History of Maisons-Alfort Veterinary School Botanic Garden http://uiabotanique.free.fr/navigu/ist6eng.htm World Association for the History of Veterinary Medicine. Available at: http://wahvm.vet.uu.nl. Contains bibliographic listings of source manuscripts and books, links to veterinary libraries, and searchable databases.

*** A surviving chapter on herbal medicine to treat animals (1656). William Coles, 1656. The Art of Simpling. Chapter XXXI: Of such Plants as have operation upon the bodies of Bruit Beasts. Though the Bodies of Men be more tender than any other Creatures, fuller of Diseases, and easier to be wrought upon, and so the greatest number of Plants is applicable to them, yet Bruit Beasts also have some share in the Physical use of Plants as well as they. For a Toad being over-charged with the poison of the Spider, as is ordinarily believed, hath recourse to the Plantain leaf which cures him. The Weasel when she is to encounter the Serpents, arms herself with eating of Rue. The Dog when he is sick at the Stomach knows the Grass that will cure him, eats of it, falls to his Vomit and is well. When the Cat is sick, she goes to Nepal or Catmint, of which there is this old Rhyme: If you set it, the Cats will eat it. If you sow it, the Cats won’t know it. If the Ass be oppressed with melancholy, he eats of the herb asplenium, or miltwaste, and so eases himself of the swelling of the Spleen. (Vitruvius saith, that the Swine in Candy, feeding thereon, were found to be without Spleens.) So, the wild Goats being shot with Darts, or Arrows, cure themselves with Dittany, which Herb hath that power to work them out of the Body, and to heal up the wound. The Swallow makes use of Celandine, which is therefore called Chelidonium, the Linnet and Goldfinch of Eyebright, for the repairing of their own, and their young ones’ sight. And here, though I am no Leech, yet I shall set down such Plants as I have seen and read, are used by Leeches, and the manner of applying them to Cattle, and such unusual Accidents as happened to them by their operation. The Leaves of black Bryony bruised with Wine and laid upon the forenecks of Oxen that are galled with the yoke, helpeth them. When a Cow hath newly Calved, they give her unthreshed Rye out of the Barn to make her clean, as they call it. If the Calf be dead in the Cow’s Belly, they give her Savine to make her cast it. When a Cow is troubled with the Tail Evil, they make an Incision toward the lower end of the Tail, where the Evil is, and put therein Rue, Pepper, and Salt, which will cure them. And if Hogs or other Cattle be subject to the Murrain, it is usual with them, and almost with every Husbandman, to cut an hole in the ear or Dewlap, and put therein a piece of the root of Bear’s-foot, which some call Pegging, some Settering, and therefore, the plant is by some called Setterwort. Hay sodden Continued

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in Water till it be tender, and applied hot to the Chaps of Beasts, which are Chapfallen, through too much abstinence, either by long standing in the Pound or Stable without meat, is a present remedy. Ground Ivy stamped and mixed with a little Aloe and Honey, and strained, taketh away the Pin and Web, or any grief out of the eyes of Horses or Cows, or other Beast, being squirted into the same with a Syringe. It is reported that if one cast Lysimachia, or loosestrife between two Oxen when they are fighting, they will part presently, and being tied about their necks, it will keep them from fightling. Cocks having eaten Garlic are most stout to fight, and so are Horses. A Serpent doth so hate the Ash tree, that she will not come nigh the shadow of it, but she delights in Fennel very much, which she rates to clear her eyesight. If you are troubled with Moles in your Gardens or other Grounds, put Garlic, Leeks, or Onions in their passages, and they will leap out of the ground presently. Adder’s tongue wrapped in Virgin’s wax, and put into the left ear of any Horse, will make him fall down as if he were dead, and when it is taken out again, he becomes more lively than he was before. If Asses chance to feed much upon Hemlock, they will fall so fast asleep, that they will seem to be dead, insomuch that some thinking them to be dead indeed, have flayed off their skins, yet after the Hemlock done operating, they have stirred and wakened out of their sleep, to the grief and amazement of the owners, and to the laughter of others. If a Horse cannot piss without pain, take an Elder bough full of Leaves, and strike him gently therewith, and cover his Head, Neck, and Body with the same Leaves, and it will help him much. Wood Nightshade, or Bittersweet, being hung about the neck of Cattle that have the Staggers helpeth them. The roots of Gentian, or the juice of them, or in the decoction of the Herb or Root, being given to Cattle to drink, freeth them from the Botts and Worms, and many other Diseases, as also when they begin to swell being poisoned by venomous Worm or Tick, which often lick up with the Grass; as also when such sorms, or other hurtful vermin, have bitten Kine by the Udders, or other tender places, which presently thereupon swell and put them in so great pain, that it makes them forsake their meat, do but take the Leaves of Gentian and stroke the bitten place with the juice of them, and they by two or three times are helped and cured. He that desires further information in cures of this nature, let him read the works of Gervase Markham, who had one very well upon this subject (1668).

References Abdin MZ. Artemesinin, a novel antimalarial drug: biochemical and molecular approaches for enhanced production. Planta Med 2002;69:289-299. Banham GA, Young WJ. Veterinary Posology: Table of Veterinary Posology. London: Bailliere Tindall & Cox; 1935. Basko I. Introduction to Veterinary Western herbology. Procedings of the 17th Annual Conference of the American Holistic Veterinary Medical Association; September 28-October 1, 2002; Eugene, Ore. Coles W. The Art of Simpling: An Introduction to the Knowledge and Gathering of Plants. St Catharine’s, Ontario: Kessinger Publishing; 1968. Culpeper N. The English Physitian. Reprint, No date. Dadd GH. The American Cattle Doctor, A.O. Moore, Agricultural Book Publisher. New York. 1858. Dafni A, Lev E. The doctrine of signatures in present-day Israel. Economic Botany 2002;56:328-334.

Daykin PW. Veterinary Applied Pharmacology and Therapeutics. London: Bailliere Tindall & Cox Ltd; 1964. Denney RE. Civil War Medicine: Care and Comfort of the Wounded. New York: Sterling Publishing Corp, Inc; 1994:11. Densmore F. How Indians Use Wild Plants for Food, Medicine and Crafts. New York: Dover Publications; 1974. Dharmananda S. Kampo medicine. The practice of Chinese herbal medicine in Japan. Portland, Ore: Institute for Traditional Medicine. Available at: http://www.itmonline.org/ arts/kampo.htm 25 March 2004. Dun F. Veterinary Medicines: Their Actions and Uses. 5th ed. David Douglas, Edinburgh 1878:580. Dunlop RH, Williams DJ. Veterinary Medicine: An Illustrated History. St. Louis: Mosby; 1996. Eisenberg D, Davis R, Ettner S, et al. Trends in alternative medicine use in the United States 1990-1997; results of a follow up survey. JAMA 1998;280:1569-1575. Erk N. A study of the veterinary section of Ibn Al-Awwam’s Kitab Al Falala. MSU Vet 1960;21:42-44. Focus on: Farmers’ reliance on ethnoveterinary practices to cope with common cattle ailments. Richardson Josiah, compiler. The New-England Farrier and Family Physician, 1828. Gresswell G; Gresswell C, Gresswell A. 1887. The Veterinary; pharmacopoeia, materia medica, and therapeutics . . . 1886. London: Bailliere, Tindall. Griggs B. Green Pharmacy: A History of Herbal Medicine. New York: Viking Press; 1981. Haas KB. Animal therapy over the ages. Early Botanical Medicine Veterinary Heritage 2000;23:6-8. Haas KB. The father of wildlife rehabilitation. Wildlife Rehabil Today (Spring) 1992;3:52. Haas LF. Papyrus of Ebers and Smith. J Neurol Neurosurg Psychiatry 1999;67:578. Hinds J, Smith TM. The Veterinary Surgeon, 1830. Hozeski BW. (Transl) Hildegard’s Healing Plants: from her medieval classic Physica Boston, MA: Beacon Press 2001. Hutchens AR. Indian Herbalogy of North America. Boston, Mass: Shambala Publications; 1991. Janick J. 2002. Herbals: the connection between horticulture and medicine. History of Horticulture Lecture Series, Purdue University. Available at: http://www.hort.purdue.edu/newcrop/ history/lecture23/lec23l.html. Accessed September 22, 2004. Karasszon D. A Concise History of Veterinary Medicine. Budapest: Akademiai Kiado; 1998. Lad V. An introduction to Ayurvedic medicine. Health World Online. Available at: http://www.healthy.net/asp/templates/ article.asp?PageType=Article&ID=373. Accessed September 22, 2004. Leeney H. MRCVS Home Doctoring for Animals. London: Macdonald & Martin; 1929. Markham G. Markham’s Farewell to Husbandry, 9th edition, 1668. Mezzabotta MR. 1998. Aspects of multiculturalism In: The Mulomedicina of Vegetius. Available at: http://academic.sun.ac.za/ as/journals/akro/Akro45/mezzabot.pdf. Accessed September 20, 2004. Moerman DE. Native American Ethnobotany. Timber Press, Portland OR. 1998. Mulder JB. A historical review of wound treatments in animals. Vet Heritage 1994;17:17-27. Riddle JM. Dioscorides on pharmacy and medicine. Austin, Texas: University of Texas Press, 1985. Rohde ES. The Old English Herbals. London: Constable and Company; 1922. (reprinted in 1971 by. Dover Publications, Inc.) Schoen A. Veterinary Acupuncture: Ancient Art to Modern Medicine. Sydney, Australia: Mosby; 1994. Smithcors JF. Evolution of Veterinary Art. Kansas City, Mo: Veterinary Medical Publishing Company; 1957.

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Swabe J. Animals, Disease, and Human Society: Human-Animal Relations and the Rise of Veterinary Medicine. New York: Routledge; 1999. Titus NN. The American Eclectic Practice of Medicine, As Applied to the Diseases of Domestic Animals, 1865. Unknown. History of herbal traditions. Available at: http://www. indianherbsltd.com. Accessed January 15, 2004. Varlo C. A New System of Husbandry, vol I and II, 1785. Walker RE. Ars Veterinaria: The Veterinary Art From Antiquity to the End of the XIXth Century: Historical Essay. Kenilworth, NJ: Schering-Plough Animal Health; 1991:17.

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Weslager CA. Magic Medicines of the Indians. Somerset, NJ: The Middle Atlantic Press; 1973. Wood M. Vitalism: The History of Herbalism, Homeopathy, and Flower Essences. Berkeley, Calif: North Atlantic Books; 2000. Yang S (translator). The Divine Farmer’s Materia Medica. Boulder, Colo: Blue Poppy Press; 1997. Youatt W. The Dog, 1857.

Overview of Traditional Chinese Medicine: The Cooking Pot Analogy Steven Paul Marsden

I

n Nei Jing Su Wen, the 2000-year-old seminal classic that gave rise to all of Chinese medicine, it is stated that to be a master physician, one must master the use of metaphors as they apply to medicine and the body. Perhaps the best metaphor for the inner workings of the body as understood by Chinese medicine is that of a cooking pot suspended over a fire (Figure 5-1).

THE BODY AS A COOKING POT Mastering the simple implications of this analogy eliminates much of the confusion surrounding Chinese medical physiology and pathophysiology, and provides a solid foundation for understanding the use of herbs in Chinese medicine.

The Kidneys and Essence The best place to begin a discussion of the cooking pot analogy is with the fire underneath the pot. In Chinese medicine, this fire and the fuel that supplies it are the contributions of the Kidneys. Just as the fire is located underneath the pot, the Kidneys are located in the lower third, or jiao, of the body. In animals, this is equivalent to the caudal abdomen. The “fuel” component of the Kidneys is Essence, or Jing. Essence is a sticky glutinous substance, tantamount to a sort of primordial ooze, which harbors the basic life force of the body. Tangible manifestations of this lifegiving fluid stored in the Kidneys include semen, breast milk, and blood. It is not surprising then that Kidney failure was recognized early on in Chinese medicine as an important cause of anemia. Essence is of two types—prenatal and postnatal—and is classified according to origin. Postnatal Essence is continually produced by the body through digestion. Foods that contain the raw materials that can be converted into Essence often are rich in animal protein. Cases of Kidney Essence deficiency, such as chronic renal failure in cats, are sometimes treated with the use of diets that are high

5 CHAPTER

in animal protein, calling into question the standard recommendation of most veterinary practitioners for lowphosphorus diets. Prenatal Essence, which cannot be generated by the body, includes all hormones crucial to normal physical and sexual development, such as growth hormone, estrogen, testosterone, erythropoietin, and progesterone. Until the advent of synthetic versions by modern medicine, these hormones were irreplaceable once they were no longer produced by the body. Animals that lack prenatal Essence are thus prone to developmental abnormalities. Although Essence has functions in the body in its own right, it can also be converted into just about anything else the body requires. In a sense, Essence was considered to function similarly to a stem cell in the bone marrow, with an inherent pleuripotentiality. Indeed, Chinese medicine recognized that the soft gelatinous material inside the cavities of bones was a major component of the body’s Essence pool. Chinese medicine extended the definition of marrow to also include the soft gelatinous tissues of the central nervous system housed within the cavities of the cranium and the spinal column. The relationship of these tissues to Essence seemed obvious in that their function routinely declined as organisms slowly ran out of life-giving Essence and approached death. Declines in hearing, cognitive function, and memory are examples of symptoms of Kidney Essence deficiency. Because marrow is a key component of both bone and Essence, bone integrity likewise came to be associated with Kidney Essence. Loss of bone strength that manifests as osteoporosis in humans and as lower limb and back weakness in many companion animals is an additional key symptom of Kidney Essence deficiency. The ability of Essence to be converted into a number of different substances in the body makes it similar in concept to cash in a savings account. Similar to cash, Essence can be spent in a number of ways, but all expenditures can roughly be classified as having a Yin or a Yang nature. Yang is roughly equivalent to energy, and Essence may be mobilized to create Yang energy that can then 51

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PART I • Historical Relationship Between Plants and Animals

BOX 5-1 Common Signs of Kidney Deficiency in Small Animals • • • • • • •

Figure 5-1 The body as a cooking pot.

warm or generally animate the body. Yin, or substance, may be produced from Essence to combat certain wasting conditions, or to keep the body moist during extremes of heat. Although it allows the organism to meet the temporarily high demands for Yin and Yang produced by disease or climate extremes, the penalty associated with Essence consumption is a potential shortening of the life span of the organism. A third class of material produced by Essence is known as Qi (pronounced “chee”). Essence mobilization into Yin and Yang is the first step in this process, after which Yin and Yang interact to “ignite” each other. This process was envisioned to be somewhat similar to the powering of an oil lamp, wherein Yang energy is the spark, Yin is the oil, and the interaction of the two produces a flame known as Qi. Qi is the specific type of power consumed and stored by most of the internal organs. When an organ is lacking in power and is functioning poorly, it is thus often said to be Qi deficient. In the cooking pot metaphor for Chinese medical physiology, Qi is the flame that allows the cooking pot to function; the logs are the ultimate fuel source and represent Essence.

The Bladder The Kidney’s main function in Chinese medicine is as a storage depot of Essence; in conventional medicine, a main function is the management of body water stores through alterations in urine concentration. In Chinese medicine, urine concentration is believed to be performed by the Bladder, which is thereby considered an absorptive organ. Specifically, the Bladder is believed to accumulate water absorbed from the digestive tract by the Small Intestine; it then sorts the water into pure and turbid components. Only pure substances and fluids are considered appropriate for storage within the internal organs of the body. Turbid materials are duly excreted. The Bladder’s function in storage and absorption is powered directly by the Kidney. Even in Chinese medicine, then, Kidney failure is considered the ultimate cause of a failure

Profuse clear urine Urinary incontinence Anemia Lower limb and back weakness Deafness Vaginal discharge Cognitive dysfunction

to concentrate urine, together with the common sequela of urinary incontinence. Box 5-1 summarizes common symptoms of Kidney deficiency in small animals, as discussed earlier. Almost all symptoms are derived from a decline in body Essence, or Jing, over the life of the animal. It is not surprising, then, that these symptoms are also the most common signs of advancing age in both humans and animals.

The Spleen and the Stomach The cooking pot hung over the fire of the Kidneys represents the digestive organs of Chinese medicine, particularly, the Spleen and the Stomach. The Spleen and the Stomach nourish the body by transforming raw materials in food into pure, useful substances such as Yang, Yin, Qi, Blood, and Essence. Apart from prenatal Essence, if a substance exists in the body, the Spleen and the Stomach are considered to have manufactured it. Their central location in the middle of the body matches this central role in manufacturing every one of its tissues. The Stomach is the vessel in which the mechanical processes of digestion take place, including the secretion of digestive juices and peristalsis. When Stomach Qi does not promote peristaltic movement “downward” in an aboral direction but instead “rebels upward,” the result is emesis. Food may also simply linger in the Stomach, producing halitosis through the direct connection between the Stomach and the mouth. The Spleen is considered to facilitate assimilation following digestion through the microvilli and the pancreas. Absorption of amino acids, glucose, and fats by mediated cell transporters within both the gastrointestinal lumen and even the body as a whole results from the presence of sufficient Spleen power, or Qi. If Spleen function is inadequate, the products of the Stomach’s efforts simply descend to be voided as watery, painless diarrhea, resulting in tissue atrophy and loss of weight. In Chinese medical parlance, then, the Spleen “raises the clear,” such that only the turbid, or impure, descends to the Small and Large Intestines. Given its complete lack of any digestive function in conventional medical physiology, the labeling of the Spleen as a digestive organ is a source of discomfiture for

Overview of Traditional Chinese Medicine: The Cooking Pot Analogy • CHAPTER 5

many veterinarians who attempt to study Chinese medicine. The initial conjecture that the Spleen was a digestive organ was reasonable, however, given its obvious prominence in the human body in the exact location where digestion was quite literally felt to take place. The Spleen’s function was later determined as being filled by the pancreas; however, in humans, the pancreas is largely retroperitoneal and is almost indistinguishable from the adipose of the omentum, making it forgivable that the early Chinese did not identify it. Once the error was made, it was difficult to undo. Because texts written even 1500 years ago are in daily use by Chinese medical practitioners, editing of all relevant Chinese medical literature would have been an onerous task, and it would have been unnecessary because Chinese medicine was not engaged in surgery or any physical manipulation of the organ itself. In the final analysis, it seemed less confusing and more harmless to simply acknowledge that, in light of present knowledge, a splenectomy could never cause digestive weakness, and that the practice of arbitrarily labeling the Spleen the organ of digestion can be continued for the purposes of discussion. The products of digestion are numerous and include Blood, postnatal Essence, Yang, Yin, all fluids, and Qi. The stronger the function of the Spleen and the Stomach, the less often the organism must dip into its reservoir of Kidney Essence to meet the demands for these substances imposed by daily living. In the cooking pot diagram, we can see Essence dripping as a liquid fuel down to the woodpile and clouds of Qi wafting up to where these gather inside the lid of the cooking pot, or the Lung. Likewise, all other substances produced by the Spleen and the Stomach are stored only briefly before they are sent to the internal organ, where they are stored, or out into the circulation. The Liver is considered the main storage organ for Blood, and Ying Qi and Blood are the substances sent into the circulation. Ying Qi, which equates roughly to plasma, was correctly considered to carry the heavier or corpuscular elements of Blood. In keeping with the Spleen’s general role of uptake and assimilation, when the Spleen’s production of Ying Qi was deficient, Blood was not able to be held in the vessels, and it passively oozed out in a process known today as diapedesis. The Spleen is the source of not only healthful fluids but pathologic ones as well. When the Spleen and the Stomach lack the power to adequately transform food and water into useful substances, the material that is produced instead is known as Dampness or Phlegm. Dampness and Phlegm behave as normal fluids do to some extent, going where normal fluids go, such as into the joints, the mouth, and the bloodstream; then, they simply accumulate as a useless detritus that provides the foundation for some of the most serious and common small animal disorders. Sometimes, the pathologic fluid accretes into masses; at other times, it simply serves as a source of friction with circulating energy, which it releases uselessly as heat. In the mouth, Dampness and Phlegm can be directly visualized as tenacious saliva or, especially in humans, as a thick, greasy coating on the tongue surface. Manufacture of Dampness and Phlegm is prevented when the fire under the cooking pot is ade-

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BOX 5-2 Common Signs of Spleen and Stomach Pathology COMMON SIGNS OF SPLEEN DEFICIENCY

COMMON SIGNS OF STOMACH PATHOLOGY/DISEASE

Muscle wasting and weakness

Vomiting and regurgitation

Watery painless diarrhea

Halitosis

Anemia

Excessive appetite

Hemorrhage

Thirst

Inappetance Lassitude

Epigastric pain or distention

Dyspnea

Dyspepsia

Pallor

BOX 5-3 Common Signs of Dampness and Phlegm • Masses • Joint swelling • Heat symptoms—increased appetite or thirst, restlessness, hyperexcitability, panting, insomnia, heat and exercise intolerance • Polyuria • Weight gains • Exudates and discharges from the ears, skin, and eyes • Slimy fluid and mucous in the stool and vomit • Productive cough • Tenesmus (organ wall swelling)

quate, and when the pot itself is not overfilled (Boxes 52 and 5-3).

The Lungs and the Large Intestine The major action of the Lungs and the Large Intestine is to gather, carry downward, and distribute Qi. In a sense, the Lungs are the quartermaster of the body, and early Chinese medical writings depicted them as the Minister placed in charge of guarding the Imperial granaries. Essentially, the Lungs gather Qi the way the lid of a cooking pot gathers steam. The Qi is then carefully distributed to certain centers of the body. The steam metaphor is appropriate, given that Qi is essentially considered to be a vapor. The cooking pot diagram depicts Qi as wafting up from the cooking pot and thus being solely produced by the Spleen. Qi is also inhaled, however, and it is a mix of Qi from air and from food that is distributed around the body.

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One form of Qi produced by the Spleen and gathered by the Lungs is Wei Qi. Like Ying Qi, Wei Qi circulates within the bloodstream. From the blood, Wei Qi is envisioned to move out to the periphery, where it acts as a defensive barrier to pathogenic Qi, or Xie Qi. This early concept of the front line of the body’s defenses being carried to the periphery via the circulation, where they confront pathogens, is a succinct summary of some of the intricacies that would be discovered almost 2 millennia later by immunologists and microbiologists. Besides the circulation, Qi is also distributed by the Lungs to the fire in the woodpile beneath the cooking pot. Qi from the Lungs stored by the Kidneys helps ensure that the body’s Essence stores are not mobilized to generate Qi but can instead be conserved to lengthen life. The storage of Lung Qi by the Kidneys is not a passive act, however. The Kidneys must have enough strength to reach up and actively grasp the descending Lung Qi. Dyspnea, asthma, and coughing result from the inability of Lung Qi to descend, whether because of Kidney weakness or because of physical obstructions such as mucus and Phlegm (Table 5-1).

TABLE 5-1 Types of Qi in the Body Types of Qi Zhong Qi Gu Qi

Translation Central Qi Food Qi

Da Qi; Tian Qi

Great or Heavenly Qi

Zong Qi

Ancestral Qi

Xie Qi

Pathogen

Wei Qi

Defensive Qi

Ying Qi

Plasma

Zheng Qi

Righteous Qi

Jing-Luo Qi

Channel and Vessel Qi

Yuan Qi

Source Qi

Zang-Fu Qi

Organ Qi

Function Energy of digestion Energy derived from food Inhaled air (for this reason the Lungs are said to open to the nose and connect with the throat) The aggregate of all Qi that has accumulated in the chest before departing to serve various functions; includes Gu Qi and Da Qi Exogenous cause of disease Resists pathogen invasion Circulates with Blood and source perspiration Sum complement of healthy Qi Circulating Qi; both Ying and Wei Qi circulate Power supplied by the Kidney Power possessed by each organ

The Large Intestine is considered loosely related to the Lungs in that it too functions to carry its contents downward. As in conventional medicine, the Large Intestine in Chinese medicine is believed to absorb a small amount of water, with most water being absorbed upstream in the Small Intestine. Another similarity between the Lung and the Large Intestine is their dependence on a carefully controlled temperature. Qi, similar to all vapors, is extremely vulnerable to temperature fluctuations. If the Lungs become too cold, the moist Qi vapor may congeal into water; if the Lungs become too hot, the vapor evaporates and disappears. Within the Large Intestine, too much heat dries up the small amount of moisture that is present, creating stool dryness and constipation; too much moisture leads to diarrhea (Box 5-4).

The Heart and the Small Intestine (upper Jiao) The Heart houses consciousness, or Shen. The immediate survival of an organism hinges, above all else, upon its ability to engage in an appropriate manner with its environment. The fact that the Heart is responsible for this power of discernment has earned it the title in Chinese medicine of Emperor of the body. As the Emperor, the Heart speaks for the rest of the body, accounting in part for the association in Chinese medicine of the tongue with the Heart. The Heart is nestled within the clear air, or Qi, of the Lungs, giving it the clarity of vision it needs to wisely rule the rest of the body. Consciousness is disturbed and even lost when this clarity is lost. In such a case, the Orifices of the Heart are said to be obstructed. A common condition in which this occurs is a grand mal seizure. Because of the tendency for heat to rise, the Heart, in its lofty position under the lid of the cooking pot, has a tendency to accumulate fiery Yang energy. As such, it is an important source of Yang energy (or spark) for use by the Kidneys in the ignition of Yin to create Qi, or power. In turn, some of the Kidney Yin is steamed up by the resultant fire in the woodpile to cool the innately Yang Heart, serving to establish a mutually reciprocating and controlling relationship between the two organs. Without the connection between the Heart and the Kidney, the lower body would become too cold and the

BOX 5-4 Common Signs of Lung and Large Intestine Disease

SIGNS OF LUNG PATHOLOGY/DISEASE

SIGNS OF LARGE INTESTINE PATHOLOGY/DISEASE

Dyspnea

Constipation

Cough

Diarrhea

Frequent colds in humans Neck and back pain

Overview of Traditional Chinese Medicine: The Cooking Pot Analogy • CHAPTER 5

upper body would become too hot. A common clinical syndrome in which this occurs is chronic renal failure in cats, wherein the heat in the upper burner, or Heart, creates uncontrollable thirst; coldness and weakness of the lower burner or Kidneys, on the other hand, result in poor urine concentration. The Heart governs consciousness and receives extensive support from the Pericardium. The Pericardium is necessary to ensure that the Heart has an adequate blood supply; it serves as the interface between the Emperor and the rest of the kingdom. This caretaker role is emphasized in the Nei Jing, which details the pathways of the Heart channel but recommends only Pericardium points for the treatment of Heart disorders. Additionally, the Nei Jing describes pathogenic attacks on the Heart or Emperor as always ending in death, in that its Pericardium protector must have already been vanquished. The function of the Small Intestine is considered loosely allied with that of the Heart; both organs are involved in prudent engagement with the environment. Although the Heart exhibits this prudence by governing the external interactions of the organism, the Small Intestine exhibits it by discerning the “clear” from the “turbid” in the chyme received from the Stomach. The pure water it extracts from the lumen is sent directly to the Bladder for final processing, and the turbid water is sent on for a final brief filtering by the Large Intestine (Box 5-5).

The Liver The major action of the Liver is to facilitate movement, particularly of the circulation. Once the Heart has initiated the movement of Blood, the Liver becomes responsible for ensuring smooth laminar flow. The main requirement for smooth laminar flow is, in turn, an adequate blood supply. When the smooth flow of blood is disrupted, pain that is improved by movement results. If blood is particularly stagnant, bruising, hemorrhage, vascular engorgement, and tumors may result. A by-product of adequate Qi and Blood circulation to the farthest reaches of the body by the Liver is the maintenance of healthy skin, hair, and nails. When circulation of Qi and Blood to the periphery is adequate, pathogenic Qi can invade with little resistance from the Wei Qi, producing skin rashes. In addition, inadequate Blood circulation can lead to desiccation of the Tendons, resulting in

BOX 5-5 Signs of Heart Disease in Chinese Medicine • • • • •

Incontinence Seizures Agitation, confusion Cystitis Circulatory failure, or blood stasis

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cramping pain and thinning and falling out of hair, which does not regrow; menstrual bleeding is painful, scanty, or erratic, resulting in dysmenorrhea, metrorrhagia, or amenorrhea; the fetus may fail to receive adequate nourishment, resulting in miscarriage; the cornea dries and desiccates, manifesting as keratoconjunctivitis sicca; a sense of inadequacy sets in that results in an enhanced sense of covetousness and fear; and vivid dreams disturb sleep. The Spleen is the source of all fluids, including Blood; adequate Blood production by the Spleen ensures that the Liver has sufficient Blood with which to nourish the extremities. Unfortunately, when the Liver has an inadequate supply of Blood, a disharmony is created between the Liver, the Spleen, and the Stomach. The pressure brought to bear on the Spleen and the Stomach by the Liver overwhelms the two neighboring organs, further compromising Blood supply. Common clinical syndromes arising from the vicious cycle that ensues include hyperlipidemia, chronic active hepatitis, pancreatitis, ascites, gastric ulceration, and liver failure. All are amenable to treatments that restore harmony between the Liver and the Spleen. The Gallbladder as a bile storage organ is considered relatively unimportant in Chinese veterinary medicine, as it is in conventional medicine. There is far more interest, however, in the Gallbladder acupuncture channel because it traverses the joints, most commonly causing lameness in the dog. The Gallbladder channel is discussed more fully in the next section (Table 5-2).

The Triple Burner and the Gallbladder The major action of the Triple Burner and its cousin, the Gallbladder, is to facilitate the activity of all other organs. The Triple Burner has no Western organ equivalent but is

TABLE 5-2 Symptoms of Blood Deficiency and Its Sequelae* Liver Blood Deficiency Pale tongue Alopecia, hair dryness Thin pulses Cramping pain Recurrent skin rashes Fearfulness, territoriality Vivid dreams

Liver Qi Stagnation Lavender tongue

Blood Stasis Purple tongue

Wiry pulses Distention; shooting pain

Erratic pulses Stabbing localized pain

Irritability

Colic

Masses Hemorrhage (dark clotted blood)

*Often all three syndromes may be present in the same animal, usually dogs.

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perceived to be a sort of internal axis that provides a conduit for the movement of Qi and fluids up and down the body. In the cooking pot diagram, it is essentially the space between the fire and the pot, and the lid and the pot. Within the Triple Burner, Lung Qi descends to the Kidneys, taking with it water and fluids obtained from the Spleen and the digestive tract. Meanwhile, the Source Qi, depicted by Fire, moves up from the Kidneys to supply the various organs of the body. The Triple Burner is thus the intermediary between the rest of the body and the Source Qi of the Kidneys. It thus plays a similar role to the Pericardium, which acts as an intermediary with the Heart. Without the Triple Burner, no organs could access the fires of the Kidney. Because both the Pericardium and the Triple Burner are gatekeepers, they are considered related in Chinese medicine. Similar to the Pericardium, the Gallbladder is closely related in function to the Triple Burner. Whereas the

Triple Burner conducts energy internally, the Gallbladder channel is believed to deliver energy from the interior of the body to its surface. Once on the surface, the energy of the Gallbladder channel galvanizes the structures it passes through, such as the knee and hip joints. Congenital hip dysplasia, hind limb paralysis, and crucial ligament tears are just a few of the small animal conditions commonly treated via the Gallbladder and its channel (Table 5-3).

CONCLUSIONS Chinese medicine is often dismissed by conventional medical practitioners as arcane and as having little relevance to modern medicine. It is clear, however, that the poetic and circular logic of Chinese medicine allowed it to speculate on the existence of dozens of physiologic processes and phenomena that would not be described by

TABLE 5-3 External Pathogens and Their Treatment Pathogen Wind-Cold

Definition Outer body layers and appendages most often affected. As the pathogen invades from the outside, the patient commonly experiences chills (even though body temperature may be high); aching of the neck, back, and head; and a superficially palpable pulse

Wind-Heat

Superficial (epithelial) body layers are involved, but symptoms are more overtly inflammatory. Symptoms may range from pharyngitis to skin wheals and pustules. Even some cases of acute diarrhea were classified in Chinese medicine as a special (Damp) form of Wind-Heat invasion, known as “summerheat”

Treatment Goal Disperse Wind

Disperse Wind, clear Heat. In the case of summerheat, the orderly movement of Qi internally is obstructed by the invading pathogen, resulting in vomiting, diarrhea, and coughing

Indicated Flavor Warm, pungent herbs are required. The expansive power of the pungent flavor helps push the cold pathogen out of the body. The warmth of the herb counters the coldness of the pathogen. In essence, spicy warm herbs (e.g., garlic) are called for, which often induce perspiration and have strong antimicrobial properties; this association between antimicrobial power and diaphoresis led most cultures to believe that resolution of colds and flu required the induction of perspiration Pungent, cool herbs are needed to provide an effective outward push to pathogens of the skin and throat. Bitter and pungent herbs are used internally for summerheat invasion. The bitter taste has a vigorous descending effect, harnessing the explosive power of the pungent flavor and driving it downward. The net effect is an opening, dilating effect on smooth muscle, which relieves cramps and dilates bronchioles

Examples Cinnamon twigs, garlic, ephedra

Pungent, cool, superficially acting herbs consist of Mint leaves and many flowers, including Dandelion and Honeysuckle. Bitter, pungent herbs that carry Qi downward include Citrus peel, Apricot kernel, Coltsfoot herb, and Chamomile flowers

Overview of Traditional Chinese Medicine: The Cooking Pot Analogy • CHAPTER 5

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TABLE 5-3 External Pathogens and Their Treatment—cont’d Pathogen Wind-Damp

Cold

Heat

Damp

Phlegm

Definition Appendages and the back are particularly affected. Symptoms are worse from exposure to Damp weather and most often include aching joints. Fluid accumulations, such as edema and joint swelling, may be noted, along with moist, tacky skin eruptions. Wind-Damp invasion requires an internal predisposition to dampness. Damp is elaborated internally because of digestive weakness Cold invasion creates a sense of chilliness. Cold internally slows circulation and movement, resulting in stiffness and sometimes severe abdominal pain. Limb pain may also be observed—the application of warmth may bring pain relief Heat invasion produces heat intolerance, perspiration, plethora, increased heart rate, thirst, dehydration, yellow exudation, and severe inflammation. Unrelenting or deeply entrenched heat leads to fluid loss, desiccation of the Blood, and circulatory failure

Treatment Goal Disperse Wind, drain Damp

Indicated Flavor Bland-tasting herbs “leech” out dampness, while also supporting the digestive power of the patient. This dual draining and supporting function is much like the sand of a beach on which a person’s weight is supported but water is drained rapidly away. Windexpelling herbs are pungent

Examples Bland herbs include Coix seed, various fungi such as Poria, and the stigmata and silk of Corn. Pungent herbs that expel Wind-Damp include Angelica pubescens (Du Huo) and Ledebouriella (Fang Feng)

Warm Yang, expel Cold pathogens

Hot, pungent, spicy herbs warm Aconite, corydalis, the Yang. Pairing these with a fennel, and bitter cathartic (e.g., Rhubarb cinnamon bark are root and rhizome) was believed common examples to expel the pathogen. Bitter, warm, pungent herbs are notorious for their analgesic properties

Clear Heat, Nourish Yin and move Blood in later stages

Heat-clearing herbs are always Bitter herbs include bitter. Herbs that replenish natural sources of (i.e., rehydrate) Yin usually antimicrobials such taste sweet and may have a as Peruvian bark, glutinous texture. Blood-moving Oregon grape, and herbs may be bitter or bitter Goldenseal. and pungent Glutinous sweetish herbs include Panax ginseng and Slippery elm. Bitter or bitter, pungent Blood movers include Angelica sinensis (Dang Gui) and Peach kernel Bland herbs, as discussed earlier, Other examples include are the mainstay of treatment Polyporus fungus and Alisma

Damp internally manifests as Drain Damp weight gain, oily discharge, abundant bland exudates, and tenesmus Phlegm manifests as tangible Transform tissue accumulations or Phlegm, tenacious catarrhal soften discharges nodules

Very hard lumps may require (mineral-laden) salty herbs, which are believed to be taken up by the lesions, which then imbibe moisture. Sweet, pungent herbs may also be used, with the sweet taste emolliating the lesion and the pungent taste breaking it up

Examples of mineralladen herbs that are useful for breaking up indurations include Horsetail for bladder scar tissue and various seaweeds for thyroid goiter. Sweet, pungent herbs used in treating mass lesions and mucus include Poke root and Echinacea, respectively

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conventional medical physiology for more than a thousand years. These processes include a notion of humoral immunity; a basic understanding of body water management, and the roles of the kidney, small intestine, and colon in that process; and the dependence of normal development on liquid substances (later called hormones), which, if lacking at birth, could not be replaced. Given their predictive value millennia ago, many conventional

medical practitioners are revisiting the Chinese medical classics. Their goal is to determine whether these classics have new insights to offer, as veterinary medicine evolves out of its outdated belief in single “magic bullet” cures for chronic diseases and begins instead to recognize them as arising from complex interrelationships between organs and organ systems, much as Chinese medicine postulated centuries ago.

Ayurvedic Veterinary Medicine: Principles and Practices

6

Robert J. Silver

CHAPTER

INTRODUCTION TO AYURVEDIC VETERINARY MEDICINE In recent years, there has been increased interest by the pharmaceutical industry in discovering medicines derived from other cultures. The hope is that these unique medical remedies can address disease conditions that do not respond well enough with conventional medicines. This upsurge of interest in medicines from other cultures, or ethnomedicine, is shared by the general populace as well. More people than ever are studying and practicing Traditional Chinese Medicine, the ethnomedical system of China. The ethnomedical system of the subcontinent of India—Ayurveda—has attracted the interest of many people and practitioners in recent years. Today, in India, Ayurveda is still practiced side by side with conventional Western medicine. To become an Ayurvedic physician in India now, one must complete a Western medical degree followed by 8 years of training in Ayurvedic medicine. Ayurveda has had a profound influence on the way medicine is practiced in every culture throughout the world. Ayurveda provides the historical foundation for the practice of the following: • Traditional Chinese Medicine • Western “Galenic” medicine • Middle Eastern “Unani” ethnomedicine Ayurvedic medical texts dating thousands of years BC document the treatment of livestock, horses, camels, and elephants with surgery and with herbal therapies. One such text is the Mahabharata, which dates back to circa 3000 BC (Mahabarat, 1958). The practice of ethnoveterinary medicine is as old as the domestication of livestock. According to the World Health Organization (WHO), ethnomedical, or “traditional” medical practices are still used by 85% of people in developing countries as their first line of medical “defense” (WHO, 1988). The Food and Agricultural Organization (FAO) advocates the use of traditional medical practices for animal treatment in developing countries (Anjaria, 1984).

To use Ayurvedic therapies effectively, one does not need to have an understanding of the philosophy that underlies Ayurveda. Modern veterinarians can use Ayurvedic herbal therapies on the basis of the scientifically determined pharmacologic actions of the botanical compounds contained in these formulas. A large volume of basic and clinical research has been undertaken on the herbs of Ayurveda. Thus, in the World scientific literature, documentation is available that enables the veterinary practitioner to evaluate herb safety, efficacy, and dosing. Ayurveda means, literally, “the Science of Life.” Ayurveda is an ancient healing system that has its roots in India. Ayurveda is more than simply a compendium of procedures and therapies: Ayurveda is a way of life that relates an individual’s existence to universal principles. As a holistic healing system, Ayurveda encompasses not just the treatment of disease, but also the creation and maintenance of individual health and optimal wellness. It is a detailed and complete system that puts its emphasis on living in harmony with the laws of Nature and the Universe. Health in Ayurveda results from this harmonious integration of individual constitution with Nature and Universe. The actual practice of Ayurvedic medicine involves the combined use of herbs, diet, massage, exercise, detoxification, and meditation. These therapies are prescribed to the patient as a result of the patient’s Ayurvedic diagnosis. Ayurvedic diagnosis is made after three sources of patient information are considered: 1. The practitioner’s observations of the patient during the examination 2. A thorough medical, familial, and environmental history 3. A description of the medical problem in depth with details It is important to stress again that a veterinarian need not adopt any or all of the principles and practices of Ayurvedic medicine to benefit from its use. Many Ayurvedic herbs are unique, coming from the very diverse panoply of ecosystems found in India. Many herbs from 59

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the Indian subcontinent contain phytochemicals that are not found in the herbs of the Western tradition. This is due, in part, to the more tropical climate and richly volcanic soil specific to the Himalayans and other mountain ranges in India. One such herb that is indigenous to India is the tree named Boswellia serrata, from which the oleo-resin boswellia is extracted. Another unique herbal from India is shilajeet, which is an organic exudate derived from a specific geologic formation that incorporates layers of organic sediment. Ayurvedic herbs have a long and ancient history of use; thus, their effects and adverse effects have been evaluated empirically in great detail. This allows the practitioner a large degree of confidence in using these herbs safely and effectively in veterinary medical prescriptions. This chapter provides some background information to assist the veterinary practitioner in understanding the basics of Ayurvedic thought; also provided are examples of which Ayurvedic medicines are prescribed in a modern veterinary practice and how this is done. A guide to some of the more commonly used Ayurvedic herbs and their clinical applications can be found at the end of this chapter.

HISTORY OF AYURVEDA India possesses one of the oldest organized systems of medicine. Its roots can be traced back to the remote and distant past of human prehistory. Elements of Ayurvedic medicine can be found at the roots of nearly all traditional and modern systems of medicine in the world. Early written accounts describing the medicinal use of plants are found in the ancient Vedic texts. These writings originated in the period circa 3147 BC (Anjaria, 2002). The Indian mythologic epic poem, “The Ramayana” (Ramayana, 1958), described Vaid Sushena from Sri Lanka treating the unconsciousness of Laxmanji with the use of a specific herb (not mentioned). Herbal treatments for animals are also emphasized in this text, dating back to circa 4000 BC (Anjaria, 2002). The Mahabharata (~3000 BC), another Indian classic (Mahabarat, 1958), includes a story of an animal trainer and a caretaker. Elsewhere in this ancient text are descriptions of “noted animal physicians.” This book contains one of the earliest written records documenting the practice of veterinary medicine in ancient history. Somavanshi has reviewed the ethnoveterinary resources of ancient India. This review reports the availability and sources of ancient Indian literature from different libraries and documentation centers in India (Somavanshi, 1998). Chapters that discuss animal husbandry practices appear in Skanda Purana, Devi Purana, and other lesser known texts. The horse played an important role in the lives of ancient people; because of this, equine ethnoveterinary medicine attained a glorified status in ancient India. Famous veterinarians were described: Palkapya, around 1000 BC, and Shalihotra, around 2350 BC, specialized in the treatment of horses and elephants. Elephants were also very important because of their role in ancient Indian culture as beasts of burden. The science of

elephant medicine is detailed in many early Indian texts (Anjaria, 2002). Shalihotra was the first to describe in writing detailed accounts of surgical and medical therapies (Shalihotra, no date). Shalihotra compiled an Indian Materia Medica, which provided step-by-step descriptions of methods of administration of herbs, including instructions on preparing medicines for injection. Shalihotra is reported to have written the first book on veterinary treatments in Sanskrit. This text was called The Shalihotra and is considered to be the first book ever written to describe specific techniques in veterinary medicine, including the use of indigenous herbs in the treatment of working animals. Another text attributed to Shalihotra is Ashva-Ayurveda, which discussed treatment of the horse. Shalihotra is considered to be historically the first true veterinarian because of his contributions to the science of veterinary medicine (Anjaria, 2002). A number of other ancient Indian texts not as well known as the texts previously discussed also contain chapters on veterinary medicine. Prescriptions for the treatment of animals have been detailed in these texts as well (Anjaria, 2002). Charak and Sushruta, 1220 BC and 1356 BC, respectively, compiled their observations on indigenous and herbal therapy as the Charak Samhita (medicine) and the Sushruta Samhita (surgery) (Charak Samhita, 1941). Mrig Ayurveda is another ancient text that describes the medical treatment of animals; it is sometimes loosely translated as Animal Ayurveda. A synonym of Mrig is Pashu, which often follows Mrig in parentheses. Mrig (Pashu) Ayurveda is considered to be a special branch of Ayurveda. This ancient text is stored in the Library of Gujarat Ayurveda University in Jamnagar, India. Hasti Ayurveda is a comprehensive text that contains material devoted to medicine for elephants (Anand, 1894). The first veterinary hospital was built by King Ashoka (300 BC). He also developed operational protocols for veterinary hospitals regarding the use of botanical medicinals (Anjaria, 2002). Historically, Ayurvedic medicine expanded its influence into Asia, contributing to the development of Traditional Chinese Medicine. Buddhist monks practiced Ayurveda and planted Ayurvedic herb gardens along their peripatetic routes while spreading Buddhist thought and political influence throughout all the far corners of Asia. In this way, Ayurveda spread to Sri Lanka, Nepal, Tibet, Mongolia, Russia, China, Korea, Japan, and other parts of Southeast Asia. The influences of Ayurvedic medicine reached as far as the empires of Egypt, Greece, and Rome. During the reign of Alexander the Great, Hindu physicians were used to treat snakebites and other ailments among the soldiers of the Grecian camp. Some authorities believe that many Greek and postclassical philosophers like Paracelsus, Hippocrates, and Pythagoras may have actually visited India and the East and learned from Ayurvedic and other Eastern teachings; they then brought the medicines they found there back to Greece. The great Hellenic physician Dioscorides mentions many Indian plants in his work, including the use of datura for asthma, and nux vomica for paralysis and dys-

Ayurvedic Veterinary Medicine: Principles and Practices • CHAPTER 6

pepsia. The Roman Empire also relied heavily upon Indian medicines. Imports of ginger and other spices from India were so large that the famous Roman herbalist, Pliny, complained about the heavy drain of Roman gold for the purchase of Indian herbal medicines and spices and the effects of this on the Roman economy (Kapoor, 1990). Ayurvedic medicine, with its ancient roots, also has a broad base of followers in our modern era. Ayurveda is actively practiced in India, and Ayurvedic practitioners can be found in increasing numbers in many countries of the modern world. In the United States, Deepak Chopra, MD, and the Transcendental Meditation movement of the Maharishi Mahesh Yogi, along with many others, have been instrumental in the establishment and promulgation of the concept and practice of Ayurvedic healing modalities.

PHILOSOPHIES UNDERLYING AYURVEDA Considering that Ayurvedic thought historically preceded Traditional Chinese Medicine (TCM) and served as a basis (in part) for the development of TCM, it should be no surprise that many similarities can be noted between TCM and the basic structure and philosophy of Ayurvedic medicine. Contemporary veterinarians interested in systems of ethnomedicine have been studying the principles and practices of TCM by learning to practice veterinary acupuncture. These TCM-trained veterinarians will be able to more readily understand Ayurvedic medical principles and practices. As an example, the concept that Yin and Yang are the fundamental underlying substances of the Universe in TCM finds a parallel in Ayurveda. Purusha, which is male in energy, is considered to be the Great Spirit. Prakruti, or Great Nature, is the representation of matter. The union of these two primal forces produces all things. Similar to Yin and Yang, Purusha and Prakruti are opposite yet complementary concepts. Purusha and Prakruti as two complementary forces constitute together a single cohesive dynamic, called Mahat. They are continuously being created and destroyed in the same way that Yin becomes Yang and Yang becomes Yin.

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The joining of these two forces creates Mahat, or Cosmic Consciousness. In a similar fashion, in Taoist philosophy (which underlies the principles of TCM), the Tao contains the two forces of Yin and Yang. The word Prakruti has two meanings according to the context in which it is used. In the context just described, Prakruti refers to Universal Nature. Most commonly though, Prakruti refers to Individual Nature, or individual constitution. Ayurveda is directed toward creating Life in harmony with Mahat. Disease is not natural—it is artificial and results from lack of balance with Mahat. Ayurveda considers the Universe, as well as the physical bodies of humans, animals, and plants, to consist of five basic elements: Earth, Air, Fire, Water, and Ether. Ayurvedic thought also attributes five states that matter can embody: Solid, Liquid, Radiant, Gaseous, and Ethereal. The five elements in Ayurvedic thought are responsible for the physical nature of all visible and invisible matter in the universe. Ayurveda teaches that a subtle energy called Prana is the “Life Force,” or the Qi (of TCM) of the body. It binds body, mind, and spirit and orchestrates their smooth interaction. Similar to Qi, Prana is not air. Oxygen, however, is considered to be one of the agents of Prana. Seven types of vital tissues (Dhatus) in the bodies of humans and animals are derived from food. These tissues include Plasma, Blood, Muscle, Fat, Bone, Bone Marrow and Nervous Tissue, and Reproductive Tissue. Plants have tissue types that correspond to these animal tissues. Each plant tissue nourishes its corresponding animal tissue. It is thought that each tissue nourishes the next tissue on the list (Table 6-1). Thus, the juice of the leaf nourishes the flowers and fruit; the flowers and fruit nourish the softwood, and so forth. Plant parts also relate to the five elements. These relationships are also outlined in Table 6-1.

THE TRIDOSHA Critical to an understanding of Ayurvedic principles is the concept of the three Doshas (the group is known as the Tridosha) (Table 6-2), which describe the three basic characteristics found in all livings things from both Animal

TABLE 6-1 Ayurvedic Elements Associated With Mammalian and Plant Tissues Plant Tissue or Part Juice of leaf Flowers/Fruit Softwood Gum, hard sap Bark Leaf Resin, sap Root Stem and branches Seed

Correspondence to Mammalian Tissue Plasma Blood Muscle Fat Bone Bone marrow and nervous tissue Reproductive tissues None None None

Element Correspondence None Fire/Ether None None None Air None Earth Water All five elements

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TABLE 6-2 Comparison of the Tridosha Dosha Vata

Qualities Dry, light, cold, subtle, unstable, rough, clear and transparent; strongest of the Doshas; powerful and mobile in nature

Anatomy and Physiology Sensory organs, nervous system, respiratory system, digestion— separating the nutrients from the waste

Pitta

Heat, sharpness, liquidity, slight oiliness; blue and yellow colors; fleshy and unpleasant smell; pungent and sour tastes; fluidity

Kapha

Heavy, cool, soft, viscous, sweet, stable, slimy; sturdiness, plumpness, enthusiasm, wisdom, virility

Eyes get red in the summer and after bathing; provides color shine and heat to the body; bodies tend to be hot and sweaty; enzymes and digestive function, hormones, acid, bile, stomach, small intestines Maintains oiliness of the body and organs; maintains general stability of the body; provides strength, patience, and virility; promotes smooth working of the joints; primary agent of all cellular development and reproductive activity

and Plant Kingdoms. In Sanskrit, Dosha means, literally, “fault or error, a thing which can go wrong” (Svoboda, 1995). The three Doshas are described by the elements and energies inherent in each tendency. These qualities include factors like temperature, moisture, weight, and texture. The Tridosha represents three primal metabolic tendencies in the living organism. Each individual, whether human, plant, or animal, embodies one or a combination of two of the Doshas. This embodiment is considered to be an organism’s individual constitution. Balance among the members of the Tridosha results in health and homeostasis. Disease results from an imbalance among the three Doshas. Individual constitution also represents the type of disease to which an individual is most prone. Disease conditions that differ in nature from the individual are usually easy to treat. When the disease is the same Dosha as the individual, it is more difficult to treat because the constitution of the individual reinforces the disease pattern (Frawley, 1988). The first Dosha is named Vata, which means “wind.” Vata is dry and cold. It is the principle of kinetic energy and corresponds most closely to the TCM concept of Qi (Svoboda, 1995). Vata is associated with the mental phenomena of enthusiasm and concentration. It is concerned with processes that are activating and dynamic in nature. It is derived from the elements Ether and Air. Vata is the most powerful of the Doshas and is considered to be the “Life Force.”

Characteristics Restless mind, weak memory; avoid confrontation; active and sensitive nature; express themselves through sport and creative pursuits, sometimes by overindulgence in pleasures, often sexual in nature. Intelligent, aware; vision, hunger, thirst, taste; precise, irritable, articulate, learned, proud; have an aggressive nature; are sharp and knifelike in anger

Courageous, tolerant, and generous; slow talkers; can be lethargic; phlegmatic, even lazy if not motivated by others; stable patient personality; honorable; not easily provoked, but difficult to calm down if provoked

Vata governs all movement in the body, such as respiration, circulation, excretion, and voluntary action. It is located in the body below the navel in the bladder, large intestines, nervous system, pelvic region, thighs, bone marrow, and legs. Its principal organ is the large intestine. When Vata is out of balance, the primary symptoms are gas, colic, low back pain, arthritis, pruritus, and paralysis. Individuals with a Vata constitution are more susceptible to these symptoms. Vata symptoms include cold extremities, cold aversion, and aversion to cold food. Clinical manifestations of Vata pathology can also include hypertension and cardiac arrhythmias. Muscle spasms, back aches, dry eyes, dry skin, and a dull and rough hair coat are all symptoms of Vata pathology. In a veterinary context, breeds that have a Vata constitution are the ectomorphic ones, such as the Borzoi, the Greyhound, and the Afghan. The second Dosha, Pitta, or bile, is derived from Fire and an aspect of Water. It is the principle of biotransformation and balance and is the cause of all metabolic processes in the body. It rules all of the enzymes and hormones in the body. It is most closely associated with the TCM concept of Yang. Pitta is associated with the mental processes of intellect and clear and focused concentration. Pitta governs the activities of the endocrine organs. It governs body heat, temperature (thermogenesis, thermal homeostasis), and all chemical reactions (Svoboda, 1995). Pitta maintains digestive and glandular secretions, including digestive enzymes and bile. It is responsible

Ayurvedic Veterinary Medicine: Principles and Practices • CHAPTER 6

for digestion, metabolism, pigmentation, hunger, thirst, sight, courage, and mental activity. Its location in the body is between the navel and the chest in the stomach, small intestines, liver, spleen, skin, and blood. Its primary location in the body though is the small intestines and, to a lesser extent, the stomach. When Pitta is out of balance, its primary manifestation is acid and bile, leading to inflammation. Humans with Pitta pathology complain of a burning sensation in the stomach or liver. Animals with a Pitta constitution have a mesomorphic constitution and a tendency toward “hot” behavior, such as might be found in a Rottweiler, Chow Chow, or Pit Bull terrier (Sodhi, 2003). The third Dosha, Kapha, is derived from Water and Earth. It is the principle of cohesion and stability. It regulates Vata and Pitta. Kapha functions by way of the bodily fluids and is most closely associated with the TCM concept of Yin. When there is Kapha pathology, it corresponds to the TCM pathogenic factors of Damp and Phlegm. Kapha promotes properties that are conserving and stabilizing in nature, along with anabolic functions. It is responsible for keeping the body lubricated and is essential for maintenance of its solid nature, its tissues, its strength, and its sexuality. Kapha maintains substance, weight, structure, solidity, and body build and is associated with the mental properties of courage and patience. Kapha integrates the structural elements of the body into stable form. It forms connective and musculoskeletal tissue. Its normal locations in the body are the upper part of the body and the thorax, head, neck, upper portion of the stomach, pleural cavity, fat tissues, and areas between joints. Kapha’s principal organ is the lungs. When out of balance, it manifests disease symptoms associated with being heavy and slow, leading to obesity. Humans with Kapha pathology complain of feeling heavy after eating, and they report a feeling of depression. Kapha people have slow speech and slow movements. Discharges may or may not be present in a Kapha imbalance. Veterinary patients with a Kapha constitution include the English bulldog, the Newfoundland, and the Great Pyrenees breeds, as well as the obese, sluggish Golden retriever. For a living being to exist, it must employ characteristics of all three of the Doshas. This means it must have the following: 1. Tissue structure or anabolism in its Kapha quality. 2. Chemical processes or metabolism in its Pitta quality. and 3. Movement and elimination or catabolism in its Vata qualities. Without any one of these qualities, life cannot exist. Seven combinations of the three Doshas in turn become the seven possible constitutions (Boxes 6-1 and 6-2). The origins and pathogenesis of disease in Ayurvedic medical theory are considered to be the following: • The buildup of waste products or toxins such as Mala and Ama • The blockage of the Srotas (or nourishing vessels), most commonly by a buildup of waste products or toxins (Mala and Ama) • The lack of appropriate nourishment to the vital tissues, often secondary to the blocked Srotas

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BOX 6-1 The Seven Constitutions From the Tridosha Vata

Anxious, fearful, light and “airy”; ectomorphic; prone to Vata diseases

Pitta

Aggressive and impatient, “fiery” and hot headed; mesomorphic; prone to Pitta diseases

Kapha

Stable and entrenched, heavy, wet and “earthy;” endomorphic; prone to Kapha diseases

Vata-Pitta

Blend of Vata/Pitta traits

Pitta-Kapha

Blend of Pitta/Kapha traits

Vata-Kapha

Blend of Vata/Kapha traits

Sama

Balanced Vata/Kapha/Pitta (rare)

Malas are the waste products of digested food and drink. The four categories of malas, or waste products, are as follows: • Urine, feces, and sweat • Fatty secretions from the skin and intestines, along with earwax • Mucus of the nose, saliva, and tears • Hair and nails In Ayurvedic thought, digestion is the most important function of the body. Problems with digestion are considered to be the principal cause of disease. Ayurveda defines 13 different types of Agnis, or enzymes. Agnis are enzymes that assist in the digestion and assimilation of food. Agnis (enzymes) are found in the mouth, stomach, and gastrointestinal tract (jatharagnis), the liver (bhutagnis), and in the tissues (dhatvagnis). Ama is considered to be the chief cause of disease. It is formed when there is a decrease in enzyme activity, or when food and drink are digested improperly. Ama takes the form of a liquid sludge and travels through the blood channels, as does the nourishing “chyle” from digestion. Because of its heavy nature, Ama lodges in different parts of the body, obstructing the channels and causing disease. Internal disease begins with Ama, and external diseases create Ama. In TCM, Ama corresponds to the pathogenic factor called Phlegm. The diagnosis of Ama is made on the basis of the following signs: • Thick, greasy coating on the tongue • Feces and turbid urine with a foul odor • Feces that contain undigested food • Feces accompanied by abundant bad-smelling flatulence Just as there are channels, meridians, or vessels in TCM, Ayurveda has the Srotas. These are the subtle body channels through which certain types of energy move through the organism. Srotas are the energetic equivalents of physical structures such as nerves and blood vessels. This makes them responsible for the transportation of

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PART I • Historical Relationship Between Plants and Animals

BOX 6-2 Seasons and Times According to Tridosha Vata Season: Fall (September—November) Avoid Vatapromoting foods during Vata months Time: 2 PM until sunset (6 PM); 2 AM until sunrise (6 AM) Life cycle: Old age Digestive cycle: After Key word: Dry Promoting foods: Dried fruit, apples, melon, potato, tomato, eggplant, ice cream, beef, peas and green salad, high-protein foods Inhibiting foods: Sweet fruits, coconut, brown rice, red cabbage, bananas, grapes, cherries, oranges Pitta Season: Summer (June-August) Avoid Pitta-promoting foods during Pitta months Time: 10 AM-2 PM; 10 PM-2 AM Life cycle: Adulthood Digestive cycle: During Key word: Hot Promoting foods: Spicy and pungent food, peanut butter, sour fruit, banana, papaya, tomato, garlic (Allium sativum) Inhibiting foods: Mangoes, oranges, pears, plums, sprouts, green salad, sunflower seeds, asparagus, mushrooms Kapha Season: Winter (December-February) Avoid Kaphapromoting foods during Kapha months Time: 6 AM (sunrise) until 10 AM; 6 PM (sunset) to 10 PM Life cycle: Childhood Digestive cycle: Before Key word: Heavy Promotional foods: Bananas, melons, coconuts, dates, papayas, pineapples, dairy products Inhibiting foods: Pomegranate (Punica granatum), cranberry, basmati rice, sprouts, chicken Note: Early spring months (March–April) produce Kapha aggravation; thus, Kapha-promoting foods need to be avoided then. The later spring months (April–May) create Pitta aggravation.

energies through the entire body; thus, they serve an important nourishing function. Large Srotas are considered to correspond to the physical form of the large and small intestines, uterus, arteries, and veins. Small Srotas correspond to the capillaries. Healthy bodies have open and free-flowing channels. Disease commonly occurs when overly abundant waste materials, such as the Ama and the Mala (discussed previously), clog up the Srotas, which are the conducting tubules or channels through which the body’s energy

comes and goes, thus contributing to a regional deficiency in nourishment that leads to symptoms and disease. In addition to the physical structures associated with the Srotas, Ayurveda recognizes that underlying the physical body are nonphysical “subtle bodies” that are derived from higher planes of consciousness. These subtle bodies provide the energetic warp and woof that allows matter to be organized on the physical plane. The Srotas provide channels for the movement of energy and fluid through the Physical Body. In the Vital Body, Prana moves through subtle channels and nodes called Nadis and Chakras, respectively. The Pranic body affects the physical body by influencing the Srotas, which flow synchronously with the Nadis. The Chakras are located along the most important Nadis—the Sushumna, or Central Conduit. The Central Conduit is located in the same physical location as the central sulcus of the spinal cord. Because the spinal cord and the Sushumna exist on different planes, they can occupy the same physical space simultaneously. According to Ayurvedic thought, the three categories of disease include the following (Zysk, 1996): • Diseases that originate within the body (hereditary, congenital, and Dosha-related or constitutional) • Diseases that originate outside the body (trauma and external pathogens such as bacteria and viruses) • Diseases that originate from “supernatural” sources (seasons, planetary influences, curses, and acts of God)

AYURVEDIC DIAGNOSTIC PRACTICES Ayurveda has a well-established system of diagnosis, similar in some respects to TCM. An initial examination is made using visual observation, palpation, and questioning. The detailed examination determines the patient’s physical constitution type and mental status. The diagnostician tries to discover any indications of imbalances or abnormalities in the patient. Susruta (cited in Frawley, 1988) writes as follows: “. . . the physician should interrogate the patient about his complaints in detail. He should use the five senses of sight, touch, hearing, smell, and taste, in addition to his verbal inquiry.”

Some Ayurvedic physical diagnostic tests are not common to Western medical practice. Tongue diagnosis and pulse diagnosis are two unique diagnostic tools that a Western practitioner can readily learn and use clinically to add new perspectives that can enhance the patient’s understanding of his or her condition. Ayurvedic tongue diagnosis is based on observation of the geographic location on the tongue of superficial color and surface coatings. The different locations, colors, and surface coatings have specific diagnostic interpretations. The tongue that shows Vata aggravation is dry, rough, and cracked. Pitta aggravation shows up as red and hot and is associated with a burning sensation in the mouth. Kapha aggravation tongues are wet, slimy, and coated. Pulses are considered to provide important information to assist the clinician in his or her quest to under-

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Ayurvedic Veterinary Medicine: Principles and Practices • CHAPTER 6

stand the patient and gain control over disease. Pulse taking makes use of the physical interaction of physician and patient. For the veterinarian, whose patient does not speak of the condition, pulse taking can provide another dimension for gaining insight into the animal and its condition. Pulse diagnosis is used by most Ayurvedic practitioners. It was introduced as an Ayurvedic diagnostic around the 9th century AD. For the Ayurvedic pulse, the hands are positioned similarly to TCM positioning. In dogs and cats, the femoral artery is palpated. The radial artery of the right hand is palpated for human males, and the left hand is palpated for females. In Ayurvedic tradition, palpation of a pulse wave at the index finger that feels like a snake indicates Vata. If the pulse feels like a frog at the middle finger, this indicates Pitta. If the pulse wave at the ring finger feels like the movement of a swan or a peacock, then the predominant dosha is Kapha. In other words, pulse quality variation can help the clinician to determine constitution. In a similar way, femoral pulse variation in animals can be useful to a skilled Ayurvedic practitioner for determining constitutional pathology (Table 6-3). Additional diagnostic parameters are gathered by the practitioner through detailed observations of the patient and examination of the urine. Observations of the patient’s demeanor in the examination room helps with the practitioner’s diagnosis. Consideration is given to patient body type, ambulation—both in and out of the examination room—and the appearance of patient skin, haircoat, pads, nails, and hooves. Also of importance to a thorough diagnosis is the nature, quantity, and quality of vocalizations. Urine examination involves the freecatch collection of the first urine mid stream in a clear glass jar. After sunrise, the urine is examined for color and degree of transparency (Box 6-3). After visual inspection, a few drops of sesame oil are placed in the urine and examined in the sunlight. Shape, movement, and diffusion of the oil in the urine are prognosticators. The drops will form different shapes, giving an indication of which Doshas are involved. Visual examination of various parts of the body aid the Ayurvedic veterinarian in diagnosis. Tongue, skin, nails, and other physical features point out which Doshas are most involved in the patient’s diagnosis. The physical condition of the body can be related to the Tridosha (Box 6-4). Three types of prognoses are recognized in Ayurvedic medicine:

1. Easily curable 2. Palliative 3. Incurable/Difficult to cure If the disease-type and patient constitution are different, it is easy to cure the disease, but if the disease type and patient constitution are the same, the disease is difficult to cure. The ability to cure a patient is also dependent on the season in which he or she is being treated. Thus, if the disease, constitution, and season correspond to the same Dosha, then the disease is nearly impossible to cure (Zysk, 1996). Treatment in Ayurveda is dependent on the Tridosha of the patient. The patient’s constitution is taken into account, and therapy is directed toward balancing the excesses (reducing excess first, then supporting deficiency). This balance is achieved through a combination of dietary therapy, lifestyle alterations, detoxification, and herbal therapies.

BOX 6-3 Urine Diagnosis According to the Tridosha DOSHAS

COLOR

TRANSPARENCY

SHAPES

Vata

Pale-yellow

Oily

Snakelike

Pitta

Intense yellow, reddish, or blue

Kapha

White

Umbrella

Foamy and muddy

Pearl shaped

BOX 6-4 Tridosha Diagnosis Based on Physical Characteristics TRIDOSHA

PHYSICAL CONDITION OF THE BODY

Vata

Coldness, dryness, roughness, and cracking

Pitta

Hotness and redness

Kapha

Wetness, whiteness, and coldness

TABLE 6-3 Guide To Ayurvedic Pulses Dosha Vata Pitta

Pulse Description @ index finger, feels like a snake @ middle finger, feels like a frog

Pulse Sensation Motion is irregular or zigzagging Has a jumping motion

Kapha

@ ring finger, feels like a swan or peacock

Movement is slow

Tongue Dry, rough, and cracked Red and hot, associated with a burning sensation in the mouth Wet, slimy, and coated

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PRINCIPLES OF AYURVEDIC HERBAL THERAPY Ayurveda is a “holographic” and “holistic” system (Svoboda, 1995). It is stated in the Charaka Samhita that “Everything that exists in the vast external universe also appears in the internal cosmos of the body, the microcosm, in altered form.”

One example of this correspondence of macrocosm to microcosm is the relationship between the Five Elements of Ayurveda and the five parts of a plant. The root is equal to the element, Earth; the stem and branches correspond to the element, Water; the plant’s flowers are considered to contain the Fire element; the leaves correspond to the element of Air; the fruit is the element of Ether; and the seed contains all five elements. This macrocosm/microcosm relationship can also be seen in the way that plants are categorized in Ayurveda according to the seven bodily tissues (Dhatus). A correspondence is noted between the tissues of the Plant Kingdom and the tissues of the Animal Kingdom. In Box 6-5, the plant tissue is listed to the right of the animal tissue it is associated with. The tissues of plants have activity on the tissues of the mammalian body to which they correspond. Of all plants, the tree is considered to be the ultimate expression of the Plant Kingdom, in the same way that the human being is considered to be the ultimate expression of the Animal Kingdom (Frawley, 1988). Each part of the plant is chosen for its medicinal appropriateness, taking into account its characteristics with respect to the following four qualities: 1. Five Elements 2. Taste 3. Temperature 4. Tridosha

Ayurvedic Plant Properties Plant properties are defined by Ayurveda according to their energetics. These energetics are determined by the herb’s taste, heating or cooling nature, postdigestion effects, and special potency effect on target organs. From these selection criteria, the individualized herbal remedy is chosen to match or balance the Ayurvedic diagnosis

that reflects the characteristics specific to the Ayurvedic patient (Sodhi, 2003).

Taste (rasa) Six primary tastes have been described: Sweet, Sour, Salty, Pungent (AKA Acrid), Bitter, and Astringent. The taste of an herb directly affects the nervous system; this begins the first process of digestion performed by the salivary glands.

Energy (virya) Energy defines the heating or cooling nature of an herb. Hot herbs create thirst, fatigue, sweating, a burning sensation, and dizziness. Cool herbs refresh, calm, and promote tissue balance.

Postdigestion effect (vipaka) Following digestion, the six herbal tastes are transformed into three postdigestion tastes: Sweet, Sour, and Pungent. Sweet remains sweet. Salty becomes sour. Sour remains sour. Pungent, bitter, and astringent become pungent following digestion. The Sweet taste is associated with the mouth and stomach. The Stomach is also associated with the taste sour, as is the small intestine. The large intestine is associated with the taste, pungent.

Special potency (prabhava) Herbs have unique, subtle, and more specific qualities.

Ayurvedic Herbs Grouped by Therapeutic Category The herbs of Ayurveda are organized in a number of ways. Categorizing the herbs according to their taste, temperature, and other energetic qualities, including the herb’s relationship to the Tridosha, has been discussed previously. Perhaps the most useful way to categorize herbs is to do so according to their therapeutic impact on the patient. Grouping herbs in this fashion allows the practitioner to choose herbs that are most pertinent when he or she is addressing a patient’s medical condition. The following therapeutic categories are common to all ethnomedical systems of herbal medicine. Examples of Ayurvedic herbs are provided in each category (Sodhi, 2003).

Alterative

BOX 6-5 Animal–Plant Tissue Correspondence ANIMAL TISSUE

PLANT TISSUE

Plasma

Juice of leaf

Blood

Resin, sap

Muscle

Softwood

Fat

Gum, hard sap

Bone

Bark

Marrow and nerve tissue

Leaf

Reproductive tissue

Flowers and fruit

Herbal detoxifiers and blood “cleansers,” with anti-infective properties. Antipyretic in nature, these herbs cool the blood and reduce Pitta. Diseases addressed by this group of herbs include fever, sore throat, otitis, acne, dermatitis, and, in some cases, cancer. Aloe vera (Aloe barbadensis), neem (Azadirachta indica), and sandalwood (Santalum album) are examples.

Anthelmintic Pungent or bitter-tasting herbs help to eliminate parasites, bacteria, fungus, virus, and yeast. Ajwain (Trachyspermum ammi), cloves (Syzygium caryophyllata), garlic (Allium sativum), pomegranate (Punica granatum), pumpkin seeds are examples.

Ayurvedic Veterinary Medicine: Principles and Practices • CHAPTER 6

Astringent Tissue-firming, condensing, compacting action on the body. Arrests excessive discharge and secretions. Uses include alleviating diarrhea and bleeding. Nutmeg (Myristica fragrans), saffron, turmeric (Curcuma longa), ginger (Zingiber officinale), haritaki (Terminalia chebula), amla (Phyllanthus emblica) and Bibhitaki (AKA Bahera, Terminalia belerica) are examples.

Bitter tonic and antipyretic Prescribed in moderation, the bitter nature of these herbs can suppress digestion and reduce the assimilation of digesta. Bitter herbs are used in purification, sedation, and heat-dispelling and heat-reducing therapies. Chirata (Swertia chirata), kutki (Picrorrhiza kurroa), neem (Azadirachta indica), Aloe vera (Aloe barbadensis), and gentian (Gentiana kuroo) are examples.

Carminative Dispel flatulence, pain, and bloating, promoting normal gastrointestinal peristaltic function. Aromatic herbs such as spices belong to this category. Ajwain (Trachyspermum ammi), asafetida (Ferula foetida), basil (Ocimum sanctum), bay leaves, cardamom (Elettaria cardamomum), cinnamon (Cinnamomum zeylanicum), cloves (Syzygium caryophyllata), garlic (Allium sativum), nutmeg (Myristica fragrans), turmeric (Curcuma longa), coriander (Coriandrum sativum), cumin (Cuminum cyminum), and fennel (Foeniculum vulgare) are examples.

Diaphoretic Stimulate perspiration, improve circulation, and dispel fevers and chills as part of their function in removing toxins. Cool herbs include coriander (Coriandrum sativum), spearmint, peppermint, and chamomile Hot herbs include basil (Ocimum sanctum), camphor, cardamom (Elettaria cardamomum), cinnamon (Cinnamomum zeylanicum), cloves (Syzygium caryophyllata), ginger (Zingiber officinalis), and eucalyptus (Eucalyptus globulus).

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mum), cinnamon (Cinnamomum zeylanicum), cloves (Syzygium caryophyllata), pipali (Piper longum), and eucalyptus (Eucalyptus globulus) are examples.

Laxative and purgative Relieve constipation and promote bowel movements, thus eliminating Mala or waste products and promoting health. Castor seed oil (Ricinus communis), bran, senna (Cassia italica), Aloe vera (Aloe barbadensis), flaxseed (Linum usitatissimum), ghee (clarified butter), licorice (Glycyrrhiza glabra), prunes, psyllium seed (Plantago ovata), warm milk, Trifal, Haritaki (Terminalia chebula), Bahera (AKA Bibhitaki; Terminalia bellerica), and Ambla (Emblica officinalis; AKA amla [Phyllanthus emblica]) are examples.

Nervine and antispasmodic Promote improved nervous system function by sedation or by stimulation. Ashwagandha (Withania somnifera), licorice (Glycyrrhiza glabra), Gotu Kola (Centella asiatica), Guggul (Commiphora mukul), valerian (Valeriana officinale), and sandalwood (Santalum album) are examples.

Stimulent and digestive Promote energy, activity, and digestive process. Hot in energy, pungent in taste. Spices, ginger (Zingiber officinale), garlic (Allium sativum), Ajwain (Trachyspermum ammi), asafetida (Ferula foetida), black pepper (Piper nigrum), cloves (Syzygium caryophyllata), and onion (Allium cepa) are examples.

Nutritive tonics Nourish the tissues of the body and increase weight and bone density. Almonds, Amla (Emblica officinalis; AKA Phyllanthus emblica), coconut, dates, honey, licorice (Glycyrrhiza glabra), milk, sesame seeds (Sesamum indicum), and Shatavari (Asparagus racemosus) are examples.

Rejuvenating tonics (single herbs) Diuretic Increase urine production through direct effects on the kidney and urinary bladder. Barley, buchu, coriander (Coriandrum sativum), fennel (Foeniculum vulgare), Gokshura (Tribulus terrestris), punarva (Boerhaavia diffusa), uva ursi, and Ajwain (Trachyspermum ammi) are examples.

Emmenagogue Promote and regulate menstruation in women. Aloe vera (Aloe barbadensis), cotton root and seed (Gossypium herbaceum), licorice (Glycyrrhiza glabra), Shatavari (Asparagus racemosus), and saffron are examples.

Rejuvenate mind and body and reverse aging process (Box 6-6).

BOX 6-6 Tonic Herbs for the Tridosha Vata tonic:

Ashwagandha (Withania somnifera), garlic (Allium sativum), Guggul (Commiphora mukul), and Haritaki (Terminalia chebula)

Pitta tonic:

Amla (Emblica officinalis), Gotu Kola (Centella asiatica), saffron, and Shatavari (Asparagus racemosus)

Kapha tonic:

Bibhitaki, AKA Bahera (Terminalia bellerica), Guggul (Commiphora mukul), and Pipali (Piper longum)

Expectorant and demulcent Promote the elimination of phlegm and mucus from the body. Indirectly, clear lungs and nasal passages and soothe the gastrointestinal tract. Ginger (Zingiber officinale), licorice (Glycyrrhiza glabra), calamus (Acorus calamus), cardamom (Elettaria cardamo-

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Rejuvenating rasayanic tonics (special combination formulas) Special combinations of herbs that have been used for hundreds of years for the purposes of rejuvenation and improved vitality. Ayurvedic practitioners recommend that after 40 years of age in humans, and the corresponding age of entry into the years of “middle age” for animals, that some or all of these formulas be taken on a regular basis to improve overall health and well-being. Rasayana tonics, for best results, must be ingested over long periods. Rasayana herbal therapy is considered to be very safe, both at elevated dosages and for very long periods of time. Ashwagandha (Withania somnifera), although a single herb, is considered a powerful Rasayana therapy. Most Rasayana herbal therapies consist of special combinations of herbs. Trifala is considered to be a Rasayanic tonic herb combination for Rasayanic therapy. Trifala is made up of three herbs: Emblica officinalis (AKA Phyllanthus emblica [Amla]), Terminalia ballerica (Bahera; AKA Bibhitaki), and Terminalia chebula (Haritaki). Shilajeet, another Rasayana herbal therapy, is derived from organic, bituminous exudates found under rock formations that are located in the northwestern Himalayas. It is specifically applied to genitourinary infections, diabetes, bronchial asthma, and stomach problems. Chavanprash is a complex herbal paste that consists of clarified butter (ghee), honey, and approximately 40 different herbs, including Amla; it is processed specially to produce this paste, which is used as a condiment or spread on bread or other foods.

Aphrodisiac These herbs rejuvenate both male and female reproductive organs, in terms of sexual or reproductive function.

PRINCIPLES UNDERLYING AYURVEDIC HERBAL MEDICINALS It is uncommon for a practitioner of Ayurvedic medicine to use a single, individual herb as the herbal therapy for a patient. These are called “singulars” or singles. More commonly, the practitioner will formulate a complex medicinal that will include a variety of herbs, minerals, and trace metals, in specific proportions and processed in specific ways so as to create a “whole” that is greater than its parts—more potent, more biologically active, and less likely to produce adverse effects than any of the individual herbs involved. Each formulation has a unique character, whose activity may be quite different than the activity of its ingredients. A few formulations have been in use for thousands of years that serve as examples of this. For instance, Triphala (AKA Trifala, Trifal) is one of these ancient combination formulas that has taken on a life of its own. It consists of three fruits that in combination have properties far different than each of its constituents. These fruits include Terminalia chebula (Haritaki), Terminalia bellerica (Bahera), and Phyllanthus emblica (AKA Emblica officinalis [Amla]). This formula is an alterative, adaptogenic rejuvenating compound. It has digestive

benefits and provides some laxative and diuretic activity. This herb also has found uses as a topical solution for wound care and burns. Trifala can be used to treat patients with clinical conditions such as indigestion, carbohydrate intolerance, anemia, diabetes, chronic lung conditions, hypertension, hypercholesterolemia, skin disorders, conditions of the eye, and yeast infections. The three herbs have effects on each other, thus increasing each of their individual potencies by virtue of their unique interaction. Herb-to-herb interactions make up the foundation of Ayurvedic herbal prescriptions. Synergism is one such interaction. Opposition occurs when ingredients in the formulation have opposite effects on each other. Often, this principle is used to create increased balance in a formula or to reduce potential adverse effects. Laxative or diuretic herbs can be added in small amounts to a formula so as to reduce the possibility of toxin buildup. This is called protection. Circulatory-stimulating herbs, added in small amounts to a formulation, can improve that formulation’s absorption and bioavailability. Ginger, for instance, in addition to improving a formula’s absorption, speeds up the circulation so as to distribute that formula’s ingredients to the body that much more quickly. Ginger also serves as a digestive aid, protecting the stomach from irritation. In this capacity, ginger provides the formulation with enhancement (Sodhi, 2003).

AYURVEDIC HERBS COMMON TO WESTERN CULTURES Ayurveda, as a 5000-year-old system of healing, has influenced the development of many other systems of healing. As was discussed earlier in this chapter, the Egyptians, Greeks, and Romans all traveled to India to bring back indigenous medicinal and herbal therapies. Over thousands of years, many of these herbs have inserted themselves into common usage in both our Western culture and the Traditional Medicine of China and East Asia. Many of these herbs can now be found in the kitchen and on the spice rack, as well as in our herbal pharmacies (Table 6-4).

THE PRACTICE OF AYURVEDIC VETERINARY MEDICINE Adapting the principles of Ayurveda to a conventional veterinary practice begins with understanding the following four Ayurvedic axioms: 1. The natural state of the individual is to be healthy. 2. Disease can be prevented at its premanifestation stage by maintaining and modifying the balance of the Tridosha in a seemingly healthy individual. 3. The root cause of disease is a lowering of the internal fire (Agni) of digestion, which is considered to be a deficiency of the enzyme systems that drive a healthy digestive process. 4. The body possesses an innate ability to heal itself (Barnett, 1996). Thus, the Ayurvedic veterinary practitioner regards the diet and digestive system as central to the healing

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TABLE 6-4 Some Effective Ayurvedic Herbs That Are Commonly Found in Our Kitchens (Williamson, 2002) Common Name Garlic

Botanical Name Allium sativum

Ayurvedic Name Lasan

Turmeric

Curcuma longa

Haldi

Sweet Basil

Ocimimum sanctum

Tulsi

Black Pepper

Piper nigrum

Golmirch, kalmirch

Pomegranate

Punica granatum

Anar, Dadim

Fenugreek

Trigonella foenumgraecum

Methi

Ginger Root

Zingiber officinale

Adrak (fresh), Sonth (dried)

process for patients with disease, and as essential for those patients in whom the establishment of “Wellness” is a priority. The Ayurvedic veterinary practitioner establishes an Ayurvedic diagnosis, generally through observation and history, and thus defines the nature of the disease problem. Then, the practitioner recommends specific dietary therapies, perhaps with the addition of digestive enzymes or raw foods, along with the inclusion of active, beneficial, probiotic bacterial cultures in the patient’s diet. Herbal therapies are used that address the biomedical definition of the patient’s disease(s) and that help to balance the animal’s Tridosha. Ayurvedic veterinary medicine is not as complex as Ayurvedic human medicine because of of our more limited understanding of domestic animal disease, compared to human medical conditions. Thus, some elements of Ayurvedic medicine that address spirituality, higher thought, and meditation, as well as some of the Panchakarma therapies of purgation, are not as readily applied or used in the practice of Ayurvedic medicine with veterinary patients. It is not uncommon for Ayurvedic herbal therapies to be used in a simple fashion with domestic animals. Use of an

Common Clinical Applications General tonic, addresses conditions of the digestive, respiratory, nervous, reproductive, and circulatory systems. General tonic and blood purifier, anti-inflammatory agent, analgesia in arthritis and rheumatism and for the common cold. It finds a particular use in diseases of the liver such as jaundice, and as a cholegogue; it has also been used as an anodyne, antimalarial, antiepileptic, aperitif, carminative, diuretic, and vermifuge. Topical use for insect bites and wounds as an antiseptic. Demulcent, diaphoretic, expectorant for bronchitis, insecticide, anthelmintic, laxative, stimulant, anti-inflammatory cardiotonic, and blood purifier Stomach and digestive complaints, colds, bronchitis. Other uses include for neuralgia, and scabies. Topical use as an anodyne for pain due to cold and neuralgia, for hemorrhoids and dermatologic disorders. Bark, root, and fruit are put to ethnoveterinary use for intestinal worms in poultry and ruminants. Fruit and leaves are used to treat eye diseases in swine and ruminants. Leaves and stem are used for diarrhea in swine. Topically, as a poultice, relieves swelling, treats burns, and on hair follicles, prevents premature graying of the hair. Internally, the seeds increase lactation, the leaves are good for indigestion and disorders of the gallbladder. A decoction of the herb is used for leukorrhea and addresses hyperglycemia; thus finds its way into formulas for diabetes. Rheumatism, inflammation; diuretic, carminative, aphrodisiac.

herb for its historically or scientifically derived application in a specific, biomedically defined medical condition is common to the practice of Ayurvedic veterinary medicine. In this sense then, the non-Ayurvedic practitioner of veterinary medicine can use these herbs as therapeutic modalities without being specifically cognizant of the principles and practices of Ayurvedic medicine or the specific Ayurvedic techniques of diagnosis and therapy.

AYURVEDIC THERAPEUTIC PROTOCOLS FOR VETERINARY PRACTICE* *Protocols and Dosages, courtesy Dr T. Sodhi (a founder of Ayush Herbs, Redmond, WA), are for dried, powdered herbs. See Chapter 24, under individual herb monographs, for alternative dosing recommendations.

Anemia (Sodhi, 2003) Causes: Chronic renal failure, feline leukemia, myelofibrosis. Therapy: Withania somnifera (Ashwagandha). 100 mg/kg BID (can administer up to 4-6 times the recommended dosage for greater effectiveness without toxicity).

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Immune-mediated hemolytic anemia (IMHA) Therapy: Trifala* and Ashwagandha (can administer up to 46 times the recommended dosage [100 mg/kg BID] of each or combined 50:50). *Traditional herbal digestive combination consisting of Terminalia chebula, Terminalia bellerica, and Emblica officinalis.

Allergic Bronchitis and Feline Asthma (Sodhi, 2003) Therapy: Tylophora (Tylophora indica), Trifala, and Ashwagandha (Withania somnifera). Dosage: 100 mg/kg BID of a 33:33:33.combination formula.

tions or dermatophytosis, use Ashwagandha and Trifala, in addition to neem, internally, combined with supportive herbs in a proprietary formula.† These supportive herbs are Phyllanthus emblica, Terminalia bellerica, Terminalia chebula, Tinospora cordifolia, and Rubia cordifolia. Neem can also be used topically, and traditionally, this use was more common than internal use. Dietary changes, including the addition of omega-3 and omega-6 fatty acids to meals, home-made hypoallergenic diets, and oatmeal baths, are used for resistant atopic individuals. *Boswellia Plus™, Ayush Herbs. † Neem Plus™, Ayush Herbs.

Herbs for Skin and Hair Autoimmune Conditions (Sodhi, 2003) Therapy: Ashwagandha (Withania somnifera), Trifala, a proprietary liver formula:* (Andrographis paniculata, Berberis aristata, Boerhaavia diffusa, Calotropis gigantea, Eclipta alba, Picrorrhiza kurroa, Solanum nigrum, Swertia chirata, Tephrosia purpurea, Raphanus sativa, Terminalia arjuna, Belleric myrobalan, Terminalia chebula, Emblicus officinalis), cease vaccinations; home-cooked diet, digestive enzymes, and stress reduction. Immunocompromised animals may need to receive Ashwagandha, liver support, and digestive enzymes for their entire lives. *Livit-2™, Ayush Herbs.

Herbs for Healthy Immune Function (Anjaria, 2002) Allium sativum Curcuma longa Ocimum sanctum Phyllanthus emblica Solanum nigrum Terminalia chebula Tinospora cordifolia Tribulus terrestris Withania somnifera

(Anjaria, 2002) Allium sativum Azadirachta indica Boerhaavia diffusa Cedrus deodara Commiphora mukul Curcuma longa Ferula foetida Phyllanthus emblica Piper nigrum Withania somnifera

Epilepsy (Sodhi, 2003) Therapy: Support liver with Livit-2™ (described under Autoimmune Conditions) and administer Ashwagandha (Withania somnifera) in a proprietary formula that also contains Mucuna pruriens, Ashwagandha, Gotu Kola, and Valeriana officinalis*. Monitor phenobarbital and bromide levels if patient is on anticonvulsant therapy, as dosages may need to be adjusted. The dose of Livit-2™ may be adjusted as much as 2 times higher than maintenance dose, if liver enzymes are elevated. *Mucuna Plus™, Ayush Herbs.

Giardiasis Cognitive Dysfunction and Geriatrics (Sodhi, 2003) Therapy: Ashwagandha (Withania somnifera) and Bacopa monniera.

Dermatologic Conditions (Sodhi, 2003) Therapy: Neem (Azadirachta indica) leaf tea topical soaks, neem oil topically to ears, neem orally. For inflammatory skin lesions, I use a proprietary Boswellia formulation* (Boswellia, ginger, Ashwagandha, turmeric, glucosamine sulfate, chrondroitin sulfate); for chronic mite infesta-

(Sodhi, 2003) Therapy: A proprietary digestive tonic* that contains the following herbs: Azardirachita indica (neem), Embelia ribes (vidanga), Piper longum (pipali), Aegel marmelos (bilwa), Momordica charantia (Karela), Ocimum basilicum (tulsi), Holarrhena antidysenterica (kutaja), and Berberis aristata (daruharidra); add additional Aegle marmelos (bilwa powder) and kutki, also known as Picrorrhiza kurora, to increase the formula potency against this protozoal parasite. Therapy may need to be long term, occasionally up to 6 months, depending on the condition of the animal and reexposure to pathogens. *AP-Mag™, Ayush Herbs.

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Hepatic Conditions

Lower Urinary Tract Problems

(Sodhi, 2003) Therapy: Phyllanthus amarus and Livit-2™ (described previously). If ascites is present, a proprietary diuretic formula*, containing standardized extracts of Didymocarpus pedicellata (patharphori), Saxifraga ligulata (pashanbhed), Rubia cordifolia (manjistha), Achyranthes aspera (apa marga), Tribulus terrestris (gokhru), Ocimum basilicum (Tulsi), Crataeva religiosa (Varun), Mimosa pudica (lajwanti), Dolichos biflorus (kulthi), Cyperus rotundus (nagarmotha), and Shilajeet, can assist the kidneys in promoting diuresis.

(Sodhi, 2003) Therapy: Diet modification, avoidance of stress, Ashwagandha (Withania somnifera) for its adaptogenic properties, and herbs such as shilajeet and Tribulus and others* for their direct benefit to the organs of the urinary system. Concurrent use of cranberry extract and vitamin C may improve patient response to therapy.

*Rentone™, Ayush Herbs.

Osteoarthritis

Herbs for the Liver

(Sodhi, 2003) Therapy: Ashwagandha (Withania somnifera) combined with Boswellia serrata has enhanced anti-inflammatory properties to improve patient comfort. Ashwagandha also contains an anabolic plant steroid, lactone, which may help to build muscle mass secondary to disuse atrophy. Ashwagandha possesses calming properties as well, which also improve patient comfort levels. Arthritic animals sleep better, giving them a chance to reduce their stiffness and soreness. Boswellia has been studied, and in a variety of clinical trials, it has proved to be a potent antiinflammatory agent.

(Anjaria, 2002) Allium sativum Andrographis paniculata Boerhaavia diffusa Curcuma longa Eclipta alba Phyllanthus amarus Solanum nigrum Terminalia chebula Tinospora cordifolia

*Rentone™, Ayush Herbs.

Inflammatory Bowel Disease and Colitis (Sodhi, 2003) Therapy: Restricted diet: avoid wheat, corn, soy, and potentially allergenic proteins. Livit-2*, Boswellia Plus (both described previously) for inflammation.† Herbs for regulating digestive function are also used. Feeding omega-3 and omega-6 fatty acids, and adding digestive enzymes of plant origin. Trifala‡ and deglycyrrhized licorice root (Glycyrrhiza glabra, AKA DGL) are used in patients with more severe symptoms. Rotating the diet every 3 to 4 months can also be helpful. *Livit-2™, Ayush Herbs. † Boswellia Plus™, Ayush Herbs. ‡ Traditional digestive tonic consisting of Terminalia chebula, Terminalia bellerica, and Emblica officinalis.

Herbs for Musculoskeletal Conditions (Anjaria, 2002) Allium sativum Asparagus racemosus Azadirachta indica Boswellia serrata Commiphora mukul Curcuma longa Piper nigrum Plantago ovata Trigonella foenum-graecum Withania somnifera Zingiber officinale

Herbs for Gastrointestinal Conditions (Anjaria, 2002) Acacia catechu Aegle marmelos Andrographis paniculata Asparagus racemosus Holarrhena antidysenterica Plantago ovata Trigonella foenum-graecum Azadirachta indica Commiphora mukul Ferula foetida Ocimum sanctum Piper nigrum Punica granatum Tribulus terrestris

Hypothyroid Conditions in Dogs (Sodhi, 2003) Therapy: Guggul, liver support* and Phyllanthus amarus may help patients with frankly reduced serum T4 values. Home cooking and elimination of vaccinations are also recommended by this author. Dogs will respond over 3 to 6 months with improved haircoat and weight loss. Patients who have borderline values can benefit from this program alone. Patients with abnormal values will have an improved response when this program is used concurrently with exogenous thyroid hormone supplementation. *Livit-2™, Ayush Herbs.

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Herbs to Improve Milk Production (Anjaria, 2002) Leptadenia reticulata Asparagus racemosus Trigonella foenum-graecum

Renal Tonic Herbs (Anjaria, 2002) Boerhaavia diffusa Crataeva nurvala Tribulus terrestris

CURRENT STATUS OF AYURVEDIC VETERINARY MEDICINE The subcontinent of India has one of the most ancient cultures in the world. In contrast, modern-day India has achieved a very high level of advanced scientific progress. As a result of the scientific technological transformation of Indian culture, the ancient healing art of Ayurveda has undergone its own transformation, guided by scientific studies and technology. In India today, there is a new type of Ayurvedic physician or veterinarian who still uses the ancient wisdom inherent in Ayurveda but integrates that wisdom into contemporary scientific understanding of the human body, and of the actions of drugs and herbal formulations. Modern pharmaceutical companies in India now produce Ayurvedic herbal formulations that are not “Dosha specific” but that apply to all body types. The roots of these broad-spectrum formulations can be found described in the ancient classic texts of Ayurveda. Indian pharmaceutical research has focused on gaining an understanding the action of the herbs of Ayurveda. This research ranges from the basic pharmacognosy of the Ayurvedic herbs to publication of hospital-based, standardized clinical trials to establish scientifically the effects and effectiveness of a number of herbs and combination herbal formulations.

VETERINARY CLINICAL TRIALS AND CONTROLLED STUDIES “Research on traditional medicinal plants is an important facet of biomedical research. A considerable amount of literature on veterinary herbal drug research, clinical trials, pharmacology, and basic research has been generated with a view to scientifically systematize the ethnoveterinary medicinal practices and folklore claims on herbal treatments. Research efforts by the National Laboratories and Veterinary, Medical, Pharmacy, and Science Colleges in India have established detailed data regarding herbs—their effects and effectiveness and safety.” (Anjaria, 2002)

Two works of the Indian Council of Medical Research have been published. One text, Medicinal Plants of India, volume 1, presents work on more than 310 plants; volume 2 provides data collected on another 550 species of plants. The other text, Iyengar’s Bibliography of Investigated Medicinal Plants, covers more than 2500 medicinal

plants investigated over a period of 25 years (1950-1975) and cites nearly 400 references (Anjaria, 2002). Unfortunately, of the studies analyzed in the Iyengar text, it was found that only 1.36% ended in actual clinical trials. However, 1.95% of the research reviewed did involve animal model experimental studies (Anjaria, 2002). One such study on the effects of nutmeg (Myristica fragrans), also a common culinary spice, evaluated its effects on blood pressure, diarrhea, and pain (Grover, 2002). Nutmeg extracts were able to correct diarrhea in guinea pigs without any adverse impact on blood pressure. Another study that was a cooperative project between the University of Sydney and the Department of Pharmaceutical Studies at Andhra University, India, evaluated the impact on blood pressure of an Ayurvedic herb known for centuries for its benefit for patients with cardiac disease and hypertension. Terminalia arjuna is the main herb in a number of formulas directed toward improving cardiovascular function (Nammi, 2003). In this study, an alcohol extract of Terminalia arjuna was administered to anesthetized dogs, and hemodynamic parameters were collected. It was concluded that a peripheral mechanism of vasodilation likely aids in the reduction of blood pressure, thus confirming the traditional application for this herb in patients with cardiac disease and hypertension. Quite a few studies have been performed to investigate the impact that a variety of Ayurvedic herbs have on patients with type 2 diabetes mellitus. One study in experimentally induced diabetic rats determined that Embelia ribes possesses statistically significant antihyperglycemic effects on the rats in this study when compared with nontreated controls. The authors conclude, “The results of test drug were comparable [with] glipazide (25 mg/kg, orally), a standard oral antihyperglycemic agent.” This is the first pilot study to provide biochemical evidence of the potential of E. ribes in the treatment of patients with diabetic dyslipidemia (Bhandari, 2002). Momordica charantia, or bitter melon—an edible vegetable—has a long history of use in the treatment of humans with diabetes in India. In this placebo-controlled study, the fresh juice of M. charantia was administered orally to streptozotocin (STZ)-induced diabetic rats. It was found that the juice partially reversed all diabetesinduced effects measured in this study. Treatment of STZinduced diabetic rats with M. charantia juice normalized the structural abnormalities of peripheral nerves. The results of this study indicate that M. charantia can exert marked beneficial effects in diabetic rats; moreover, it can regulate glucose uptake into jejunal brush border vesicles and stimulate glucose uptake into skeletal muscle cells similar to the response obtained with insulin (Ahmed, 2004). Many of the culinary spices commonly found in our kitchens have been the subject of intense investigation into their biomedically defined actions. Many spices came into usage not just for their taste, but also for their activity as antioxidants and antimicrobial agents. These spices served to preserve foods long before the advent of

Ayurvedic Veterinary Medicine: Principles and Practices • CHAPTER 6

refrigeration. Turmeric and ginger, common spices of Asia, have been found to possess potent anti-inflammatory and antioxidant properties (Chainani-Wu, 2003). Ayurvedic herbs are being studied for their ability to augment immune function. Asparagus (Asparagus racemosus), Ashwagandha (Withania somnifera), and Guduchi (Tinospora cordifolia) were evaluated for their ability to improve immune function in mice subjected to cyclophosphamide chemotherapy for sarcoma-producing

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ascites. Investigators found that treatment of ascitic sarcoma-bearing mice with a formulation of total extracts of Withania somnifera and Tinospora cordifolia (80:20) and an alkaloid-free polar fraction of Withania somnifera resulted in protection toward cyclophosphamide-induced bone marrow effects, and immunoprotection, as indicated by a significant increase in white cell counts and specific antibody titers (Tables 6-5 and 6-6) (Diwanay, 2004).

TABLE 6-5 Twenty-six of the Most Investigated Ayurvedic Herbs Botanical Name and Part Used Abrus precatorius; seeds and roots Acorus calamus; rhizomes Allium sativum; bulbs

Selected Constituents Steroidal fraction (oil)

Principle Actions and Uses Antifertility

A and B-arasone Allin essential oil

Tranquilizing, antitubercular Cholesterol lowering; antibacterial; antidiabetic; anti-inflammatory Antibacterial; antitubercular; antiviral; antifungal; antihelmintic; insecticidal; diuretic Anti-inflammatory Anti-inflammatory; spares gastrointestinal system; synergistic with glucosamine; indicated for inflammatory bowel disease and colitis, as well as pruritic skin disease and asthma Tranquilizing; anabolic; promotes wound healing

Azadirachta indica: stem, bark, leaves Boerhaavia diffusa; roots Boswellia serrata; gum, resin

Sodium nimbidinate; nimbidin; nimbidol; azadirachtin Punarnavine Boswellic acids, beta sitosterol

Centella asiatica; whole plant

Brahmosides, glycosides (asiaticoside), alkaloids (hydrocotyline), valerine, beta-sitosterol, ascorbic acid Forskolin (diterpenoid compound)

Plectranthus barbatus, formerly Coleus forskohlii

Addresses cardiac output; reduces intraocular pressure; asthma, antihistaminic properties; increases thyroid hormone production; atopic dermatitis; K9 dose = 100 mg BID Anti-inflammatory; antirheumatic

Commiphora mukul; gum resin Curcuma longa; rhizome Emblica officinalis; Phyllanthus emblica; seeds Glycyrrhiza glabra; peeled root Gymnema sylvestris Holarrhena antidysenterica; seeds, bark Momordica charantia; fruits Nardostachys jatamansi; roots Picrorrhiza kurroa; roots

An unidentified crystalline steroidal compound Curcumin sodium; curcuminate Phyllembin; ascorbic acid

Psoralea carylifolia; seeds Pterocarpus marsupium; heartwood Syzygium cumini; Eugenia jambolana; seeds Tribulus terrestris; fruits Tylophora asthmatica; Tylphora indica; stem

Psoralen; isopsoralen Pterostilbene

Choleretic; antihepatotoxic; antibacterial; cure for jaundice Useful in leukoderma; antibacterial; antihelmintic Antidiabetic

Jamboline

Antidiabetic

Tribuloside potassium Tylophorine; tylophorinine

Diuretic Antiasthma; anticancer

Anti-inflammatory; antiarthritic Anabolic; antibacterial; resistance building

Glycyrrhizin; glycyrrhetic acid

Anti-inflammatory; antiarthritic; antipyretic

Gymnemic acid Alkaloids: conamine, conkurchine; conessimine, conessine, etc. Charantin Valeranone (jatamansone)

Antidiabetic Antidiarrheal; antidysenteric; antiamebic; antibacterial

Picrorrhizin; kutkin

Antidiabetic Tranquilizing; antihypertensive; antiarrhythmic

Continued

74

PART I • Historical Relationship Between Plants and Animals

TABLE 6-5 Twenty-six of the Most Investigated Ayurvedic Herbs—cont’d Botanical Name and Part Used Vinca rosa; whole plant Withania ashwagandha; Withania somnifera; roots Zingiber officinale

Selected Constituents Vinblastine; reserpine Withaferin-A, etc. Gingerols, shogaols zingerone, zingiberone, etc.

Principle Actions and Uses Anticancer; antihypertensive; antibacterial; antidiabetic Tranquilizing; cardiotonic; antibacterial; antifungal; anticancer; antiarthritic Antiemetic; anti-inflammatory; hepatoprotective; inhibits platelet-activating factor (PAF); antipyretic; antioxidant; immunomodulatory; thermogenic; antiviral; nematodicidal; insect repellent; molluscicidal activity

(Anjaria, 2002)

TABLE 6-6 Quick Guide to the Most Commonly Used Ayurvedic Herbs in Veterinary Practice Botanical and Common Names Achyranthes aspera Chaff-flower Aegle marmelos Bael or Bael fruit Allium sativum Garlic

Ayurvedic Name Apamarg

Aloe barbadensis Aloe vera

Kumari

Andrographis paniculata Green chiretta; Creat

Kalmegh

Asparagus racemosus Asparagus (wild); Sparrow-grass

Shatavari

Azadirachta indica Chinaberry; Neem tree; Margosa

Neem or Nimba

Bilva Lahsan

Actions and Applications Young leaves steamed and eaten like spinach. Potassium rich. Traditional uses include diuretic, lithotriptic Clinically proven to address amebic dysentery and chronic diarrhea, and to improve digestive activity and appetite One of the most studied herbs in the world, garlic has many benefits: It improves digestive, respiratory, nervous, cardiovascular, and reproduction function. Indications include colds, coughs, asthma, heart disease and hypertension, arrhythmias, dermatitis, and rheumatism Gel and thickened leaves are used. Tonic to renew female nature Indicated for fever, constipation, obesity, inflammatory skin conditions, swollen glands, conjunctivitis, bursitis, jaundice, hepatitis, splenomegaly, hepatomegaly, and intestinal helminthiasis Liver tonic, heart tonic. Positive cardiac ionotrope, alterative, anthelmintic, febrifuge, anti-inflammatory. Antineoplastic benefits have been documented Roots promote lactation and are used for their demulcent, diuretic, aphrodisiac, tonic, alterative, antiseptic, and antidiarrheal properties. Used to treat debility, infertility, impotence, and reduced libido in women, menopause, stomach ulcers, hyperacidity, dehydration, lung abscesses, hematemesis, cough, herpes, leucorrhea, and chronic fevers An evergreen tree, Neem is considered to be one of the most important herbal detoxicants in Ayurvedic medicine. Most of the tree is used: leaf, root, seed, root bark, gum, fruits, flowers, stems, and oil. Ethnoveterinary uses vary, depending on which part of the tree is used. Bark: Vomiting, burning sensation near the heart, fatigue, fever, thirst, bad taste in the mouth, cough, ulcers, inflammations, leprosy, blood disorders, urinary discharges; can also cause loss of appetite. In poultry, the bark is used to address wounds, diarrhea, ticks, and lice, and as an insect repellent. Leaf: Eye disorders, biliousness, skin diseases, inflammation, earache, rheumatism, boils, blood impurities. Also used to treat abscesses and commonly applied after castration. Leaves have also been found to be useful for bleeding, udder infections, fever, foot rot, and lice in ruminants. Also serve as an insect repellent. Neem leaves are commonly placed in bags of grain to ward off insect infestations. Decoction of leaf: As a gargle in stomatitis and for gingival and periodontal disease

Ayurvedic Veterinary Medicine: Principles and Practices • CHAPTER 6

75

TABLE 6-6 Quick Guide to the Most Commonly Used Ayurvedic Herbs in Veterinary Practice—cont’d Botanical and Common Names Azadirachta indica, Continued

Ayurvedic Name Neem, Continued

Actions and Applications Tender young leaves: Eye and skin diseases, leprosy Old leaves: Help cure ulcers rapidly Young branches: Cough, asthma, hemorrhoids, tumors, urinary discharges Ripe and unripe fruits: Urinary discharges, skin diseases, tumors, hemorrhoids, toothache Seeds: In ruminants, used for ticks and as an insect repellent in all species Oil of the seed: Used to treat skin disorders topically All of the plant parts share the following applications: Helminthiasis, oral wounds, glossitis, Escherichia coli bacillosis, hepatomegaly, jaundice, hemorrhagic dysentery, and intestinal wounds; constipation, indigestion, respiratory and throat disorders; asthma, pleuropneumonia, and swelling of the mucous membranes in the lungs and respiratory tract. Common skin disorders such as dermatophytosis, alopecia, eczema, urticaria, and scabies are also addressed by all the parts of the tree. Miscellaneous indications for Neem include metritis, tetanus, stranguria, swelling of the kidney, mastitis, otitis, ear abscesses, rinderpest, and rheumatism. Therapeutic Actions of Neem Medicinal and Pharmacologic Activities, General Attributes • Antifungal • Antibacterial • Antiviral • Antidiabetic • Antimalarial • Antipyretic • Antiulcer • Anxiolytic • Hepatoprotective • Hypoglycemic activity • Anti-inflammatory • Immunomodulatory • Antitumor • Antiifertility • Insecticidal activity: This is the main attribute for which Neem is known. Seed extracts have been found to disrupt the growth and development of tobacco caterpillar larvae and of Spodoptera litura. The leaf was measured to have the second highest activity after seed extracts. Other insecticidal effects include alteration of insect ovarian function and blockage of insect ecdysis and maturation. Specific Attributes of Plant Parts Bark: Tonic; Refrigerant, Anthelmintic Leaf: Carminative, Expectorant, Anthelmintic, Insecticidal Young branches: Anthelmintic Flowers: Stimulant, Stomachic, Bitter, Anthelmintic Ripe and Unripe Fruits: Oily, Bitter, Hot, Purgative, Anthelmintic Seeds: Oil, bitter, anthelmintic. Neem is considered to be quite safe; it possesses a wide margin of safety. Moderate use is not associated with any signs of toxicity. The dose that kills 50% of the population (LD50) of a 50% ethanolic extract of the stem bark was >1 g/kg body weight when given intraperitoneally in rats. Excessive dosages are associated with liver and kidney changes of laboratory animals. There are no cases on record of adverse reactions or toxicity to this herb in humans. Dosage Infusion (tea) 1-10 mL TID Powder 0.5-1 g TID Oil (most common use is topical, this dosage is for internal use): 0.05 mL0.5 mL TID Continued

76

PART I • Historical Relationship Between Plants and Animals

TABLE 6-6 Quick Guide to the Most Commonly Used Ayurvedic Herbs in Veterinary Practice—cont’d Botanical and Common Names Bacopa monniera Thyme-leaved gratiola

Ayurvedic Name Brahmi

Berberis aristata or English barberry

Daruhaldi or Daruharidra

Boerhaavia diffusa Pigweed, spreading pigweed Boswellia serrata Indian olibanum tree

Punavarna

Calotropis gigantea Swallow wart Centella asiatica Gotu kola; Indian pennywort

Akanda

Cinnamomum cassia or zeylanicum; Cinnamon Plectranthus barbatus, formerly Coleus forskohli

Dalchini

Salai

Kula kudi or Mandukparni brahmi

Actions and Applications Small, creeping herb; grows easily in damp areas. Considered a brain tonic; improves intellect, asthma, hoarseness, insanity, and, of most frequent use, epilepsy in dogs and cats. Anticonvulsant, antiviral, immunostimulant, antipyretic, antineoplastic, cardiotonic, hypotensive. Used for febrile conditions, hepatomegaly, splenomegaly, conjunctivitis, chronic dysentery, jaundice, hepatitis, and diabetes. Hepatitis, cholecystitis, giardiasis, amebiasis, gastric ulcers. Beneficial effect on kidney and liver function, diuretic. Commonly used to address ascites secondary to liver disease. Extract of resin collected from the sap of this tree has been used for centuries to address pain and inflammation. Traditional uses include rheumatism, dysentery and diarrhea, and inflammatory skin disease. Has anti-inflammatory, expectorant, and diuretic properties. Very safe; studies indicate that Boswellia produces none of the adverse effects commonly associated with anti-inflammatory pharmaceuticals, such as ulcers, gastritis, and adverse cardiovascular effects. Recent studies confirm its value for rheumatoid arthritis and osteoarthritis, musculoskeletal pain in general, and ulcerative colitis and Crohn’s disease. Also effective for inflammatory skin diseases such as psoriasis and for bronchial asthma. Inhibits both cyclooxygenase and lipoxygenase enzyme systems, thus reducing inflammation by reducing production of proinflammatory mediators of pain. Dosage of Powdered Herb: Dogs: 10-20 mg/kg BID Cats: 5-10 mg/kg BID (liquid forms are available) Analgesic, anti-inflammatory, antiviral. Traditional uses include asthma, rheumatoid arthritis, leprosy, and viral hepatitis. Improves circulation, especially in nervous tissue. Traditional uses include topically for wound healing and internally as a nervine and brain tonic; improves memory. Benefits the heart, possesses anti-inflammatory and diuretic properties as well. Other plants have also been called Brahmi (Bacopa monnieri). Bark of the plant improves circulation, digestive function, and respiratory function. Traditionally used for colds, sinus congestion, bronchitis, and dyspepsia. A member of the mint family, this plant is found commonly at altitudes >1000 ft and C40

10+

Nonvolatile

Modified with permission from Yarnell E. Phytochemistry and Pharmacy for Practitioners of Botanical Medicine. Wenatchee, Wash: Healing Mountain Publishing; 2004.

BOX 11-7 Select Low-Molecular-Weight Terpenoid-Rich Herbs Monoterpenoids and Sesquiterpenoids • Hyssopus vulgaris (hyssop) • Juniperus communis (juniper) • Lavandula officinalis (lavender) • Melissa officinalis (lemon balm) • Mentha x piperita (peppermint) • Mentha crispa (curly mint) • Mentha pulegium (pennyroyal) • Mentha spicata (spearmint) • Origanum spp (marjoram, basil) • Orthosiphon stamineus (Java tea) • Pinus spp (pine) • Piper nigrum (black pepper) • Rosmarinus officinalis (rosemary) • Salvia apiana (white sage) • Salvia officinalis (sage) • Santalum albium (sandalwood)* • Stachys betonica (betony) • Thymus serpyllum (wild thyme) • Thymus vulgaris (thyme) • Zingiber officinale (ginger)

Sesquiterpene Lactones • Achillea millefolium (yarrow) • Arnica spp (arnica) • Artemisia annua (sweet Annie) • Artemisia absinthium (wormwood) • Cichorium intybus (chicory) • Ginkgo biloba (ginkgo) • Inula helenium (elecampane) • Lactuca serriola (wild lettuce) • Marrubium vulgare (horehound) • Tanacetum parthenium (feverfew) Iridoid Glycosides • Erythraea centaurium (common centaury) • Gentiana lutea (yellow gentian) • Harpagophytum procumbens (devil’s claw) • Menyanthes trifoliata (bogbean) • Morinda citrifolia (noni) • Picrorhiza kurroa (picrorhiza) • Plantago lanceolata (English plantain) • Swertia chirayita (chiretta) • Verbena spp (vervain)

*Threatened in the wild. Use only ethically cultivated sources.

about LMWT terpenoids apply equally to phenylpropanoids. However, phenylpropanoids are much less common than LMWT (Box 11-8). LMWT represent the most diverse category of plant constituents, with more than 25,000 individual compounds identified so far. This structural diversity gives rise to chemical and therapeutic variety. Generalizations about their actions are not as useful as with some other categories of constituents.

The vast majority of LMWT and phenylpropanoids share many chemical properties. They are lipophilic with marginal water solubility. They generally have strong odors and flavors and, in fact, form the basis of the flavor and perfume industries. The family best known for its LMWT is the Lamiaceae or mints, with its strong aromas and tastes. LMWT are flammable. Many are optically active, and different isomers can have completely different properties. They are almost always colorless.

170

PART III • The Plants

BOX 11-8

O

Select Phenylpropanoid-Rich Herbs • • • • • • • • • • • •

Acorus calamus (sweet flag) Alpinia galanga (galangal) Cinnamomum spp (cinnamon, cassia) Eleutherococcus senticosis (eleuthero) Foeniculum vulgare (fennel) Melissa officinalis (lemon balm) Nigella sativa (black seed) Ocimum basilicum (basil) Pimpinella anisum (anise) Rhodiola rosea (rhodiola) Sassafras albidum (sassafras) Syzygium aromaticum (clove)

OH

HO O

O Figure 11-14 Lactucin, a sesquiterpene lactone.

H3CO

HO Figure 11-15 Eugenol, a phenylpropanoid.

OH

H Figure 11-12 (−)-Menthol, a monoterpenoid.

O

O

Glucose

O

O Figure 11-16 Gentiopicroside, an iridoid glycoside.

Figure 11-13 Limonene, a monoterpenoid.

The medicinal properties of LMWT are nearly as diverse as the molecules themselves. A small sampling will suffice to highlight this variability. D-Limonene solubilizes cholesterol from bile stones (Igimi, 1976) and has recently gained great acclaim as an antineoplastic and apoptosis stimulator, which it accomplishes through mechanisms that are not yet fully understood (Lu, 2004). Menthol is a calcium channel–blocking smooth muscle relaxant (Hawthorn, 1988). Linalool, cineole, geraniol,

menthol, and citral were found to be antibacterial and antifungal to varying degrees (Pattnaik, 1997). Iridoids are cyclic monoterpenoids that are almost uniformally bitter in taste. They often occur as glycosides. Their bitter flavor makes them general gastrointestinal stimulants. A quintessential example of a bitter iridoid glycoside–containing plant is Gentiana lutea (gentian) root. This can help remedy any number of conditions related to gastrointestinal atony, such as gastric ulcer, dyspepsia, and hypochlorhydria, but it may exacerbate conditions associated with gastrointestinal hyperactivity, such as duodenal ulcer, gastroesophageal reflux, and hyperchlorhydria. Iridoids can have other properties besides bitterness. Sesquiterpene lactones are cyclic sesquiterpenoids that have a bitter flavor and activity, as iridoids do. A quin-

Plant Chemistry in Veterinary Medicine: Medicinal Constituents and Their Mechanisms of Action • CHAPTER 11

OH

H OH

H

H

O

O

O

O Figure 11-17 Absinthin, a sesquiterpene lactone.

O

O

O O

O Figure 11-18 Artemisinin, a sesquiterpene lactone.

tessential example here is the compound absinthin found in Artemisia absinthium (wormwood). Sesquiterpene lactones can also have many other properties, and these have been widely investigated. Most important among these is the antineoplastic and antimalarial activity of artemisinin from Artemisia annua (sweet Annie) leaf (Beekman, 1998; Krungkrai, 1987). Sesquiterpene lactones in general can act as haptens and are responsible for the phenomenon in some animals of cross-sensitivity within the Apiaceae or Asteraceae family, as opposed to true allergies to multiple plants within these families. The phenylpropanoids are as diverse in their effects as are LMWT. Eugenol has recently been shown to be a potent inhibitor of metastasis of melanoma cells and to strongly induce apoptosis in them, apparently through inhibition of a transcription factor dubbed E2F1 (Ghosh, 2005). It also inhibits adenosine triphosphate (ATP) production and may alter membrane permeability in many different pathogenic microbes, which helps to explain the antimicrobial activity of eugenol-rich herbs (Gill, 2004).

171

Vanillin is a singlet oxygen-quenching antioxidant (Kamat, 2000). LMWT and phenylpropanoids are well absorbed orally and transdermally. Evidence also suggests that they are absorbed via the olfactory nerve and transit directly to the brain after inhalation. After oral administration, the half-lives of those LMWT that have been studied, such as menthol, can be as long as 14 hours (Kaffenberger, 1990). This is not surprising, given their lipophilicity. LMWT and phenylpropanoids are excreted by the kidneys, as well as the lungs, making them particularly useful for conditions that affect those organs. LMWT and phenylpropanoids occur in very small quantities in herbs (often 50 g/day) of the drug for extended periods (>6 wk) may increase water accumulation. Sodium excretion is reduced and potassium excretion is increased. Blood pressure may rise. Prolonged use can lead to pseudoaldosteronism (Bradley, 1992; Stewart, 1987). In rare cases, myoglobinuria and myopathy may occur (Caradonna, 1992). It is believed that licorice derivatives may cause retinal or occipital vasospasm, giving rise to transient monocular or binocular visual loss/aberrations. Of five patients who reported recent ingestion of a licorice candy (1/4-2 lb), two had documented visual loss (Dobbins, 2000). In the United States, licorice candy is most often flavored with anise—not licorice. Notes of Interest: Dioscorides left one of the earliest records of the ancient Greek name for this plant, Glykrrhiza (Greek glukos, sweet, and riza, a root). The plant is often found under the name Liquiritia officinalis. The Latin name Liquiritia, whence is derived the English name Liquorice (Lycorys in the 13th century), is a corruption of Glycyrrhiza, as is shown in the transitional form, Gliquiricia. The Italian Regolizia, the German Lacrisse or Lakriz, the Welsh Lacris, and the French Reglisse have the same origin (Grieve, 1975). Dosage: Human: Licorice should not be used for longer than 4-6 weeks without medical advice, and should not be used at doses that provide more than 100 mg glycyrrhizin per day for longer than 2 weeks without regular blood pressure monitoring Dried herb: 5-15 g total daily, corresponding to not more than 250 mg daily of glycyrrhizin. Doses of other preparations should be calculated accordingly DGL powder or tablets: 800-1600 mg chewed 15 min before meals (must be chewed, as capsules are ineffective) Tincture (usually 30%-35% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID DGL (deglycyrrhizinated licorice): 1.2-4.8 mL per day Small Animal: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually in 30%-35% ethanol) 1 : 2-1 : 3: 0.5-1.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. Historical Veterinary Doses: Dried herb: Horse: 15-45 g (RCVS, 1920); 30-60 g (Hungerford, 1970) Pig: 2-6 g (RCVS, 1920); 4-12 g (Hungerford, 1970) Cattle: 30-60 g (Hungerford, 1970) Dog: 1-4 g (RCVS, 1920); 1.3-4 g (Hungerford, 1970)

References Arzi A, Hemmati AA, Amin M. Stimulation of wound healing by licorice in rabbits. Saudi Pharmaceut J 2003;11:57-60. Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth: British Herbal Medicine Association; 1992:145-148. Caradonna P, Gentiloni N, Servidei S, Perrone GA, Greco AV, Russo MA. Acute myopathy associated with chronic licorice ingestion: reversible loss of myoadenylate deaminase activity. Ultrastruct Pathol 1992;16:529-535. Chin WY, Keng H. An Illustrated Dictionary of Chinese Medicinal Herbs. Singapore: CRCS Publications; 1992. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. Dehpour AR, Zolfaghari ME, Samadian T, et al. Antiulcer activities of licorice and its derivatives in experimental gastric lesion induced by ibuprofen in rats. Int J Pharmaceut 1995;119:133138. Dobbins KR, Saul RF. Transient visual loss after licorice ingestion. J Neuro-ophthalmol 2000;20:38-41. Farnsworth NR, ed. NAPRALERT database. Chicago, Ill: University of Illinois at Chicago; March 15, 1995 production (an online database of subjects). BMJ 1977;1:488-490. German Commission E. Monograph: Liquiritiae radix. Bundesanzeiger 1985;90:15. Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint, 1975). Hikino H. Recent research on Oriental medicinal plants. In: Wagner H, Hikino H, Farnsworth NR, eds. Economic and Medicinal Plant Research, vol 1. London: Academic Press; 1985:53. Hungerford T. Veterinary Physicians Index. 5th ed. Sydney: Angus & Robertson; 1970. Jarrett RH, Norman EJ, Squires RA. Liquorice and canine Addison’s disease. N Z Vet J 2005;53:214. Kamei J, Nakamura R, Ichiki H, Kubo M. Antitussive principles of Glycyrrhizae radix, a main component of the Kampo preparations Bakumondo-to (Mai-men-dong-tang). Eur J Pharmacol 2003;469:159-163. Kassir ZA. Endoscopic controlled trial of four drug regimens in the treatment of chronic duodenal ulceration. Irish Med J 1985;78:153-156. Okada K, Tanaka J, Miyashita A, et al. High-speed liquid chromatographic analysis of constituents in licorice root. I. Determination of glycyrrhizin. Yakugaku Zasshi 1981;101:822-828. RCVS (Royal College of Veterinary Surgeons). Veterinary Counter Practice. London: Ballantyne Press; 1920. Saeedi M, Morteza-Semnani K, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. J Dermatol Treat 2003; 14:153-157. Sagara K. Determination of glycyrrhizin in pharmaceutical preparations by ion pair high-performance liquid chromatography. Shoyakugaku Zasshi 1986;40:77-83. Shibata S. A drug over the millennia: pharmacognosy, chemistry, and pharmacology of licorice [Review]. Yakugaku Zasshi 2000; 120:849-862. Sigurjonsdottir HA, Manhem K, Axelson M, et al. Subjects with essential hypertension are more sensitive to the inhibition of 11 beta-HSD by licorice. J Hum Hypertens 2003;17:125-131. Stewart PM, et al. Mineralocorticoid activity of licorice: 11-β hydroxysteroid dehydrogenase deficiency comes of age. Lancet 1987;ii:821-824. Williamson E, ed. Major Herbs of Ayurveda. Sydney: Churchill Livingstone; 2002. Winslow K. Veterinary Materia Medica and Therapeutics. New York: William R. Jenkins; 1908.

Materia Medica • CHAPTER 24

Yamamoto K, Kakegawa H, Ueda H, et al. Gastric cytoprotective anti-ulcerogenic actions of hydroxychalcones in rats. Planta Med 1992;58:389-393.

Lobelia Lobelia inflata L. • low-BEE-lee-uh in-FLAT-uh or in-FLAYtuh Distribution: Eastern North America Other Names: Indian tobacco, puke weed, asthma weed, indianascher tabak, tabac indien Family: Campanulaceae Parts Used: Aerial parts Collection: Collect in late summer/fall when the seed capsule is inflated. Selected Constituents: Piperidine alkaloids (lobeline, isolobinine, etc), resin, volatile oil

O

OH N Lobeline

N

CH3 N

Nicotine

CH3 H3C

N

O CH2

CH2

O

C

CH3

CH3 Acetylcholine

Clinical Action: Respiratory stimulant, antispasmodic, sedative expectorant, emetic, central nervous system depressant Energetics: Pungent, bitter, neutral; moves Qi History and Traditional Usage: Native Americans used the root and herb topically for sores and ulcers, and to relieve body pain. It was chewed or taken internally as an emetic, for cough and asthma, for headache, and to “break the smoking habit.” The Eclectics used lobelia for spasmodic bronchitis, asthma, and spasms in other systems as well— colic and epilepsy are two examples. It has also been used topically for insect bites, bruises, sprains, and muscle spasms. Lobelia has been used as an aid to stop smoking because lobeline is somewhat chemically similar to nicotine, but adverse effects are unpleasant. Milks (1949) suggested that lobelia may be useful for heaves in horses; it was combined with belladonna for those cases. It is not mentioned in the Eclectic veterinary text by Titus (1865).

595

Published Research: Lobeline is a nicotinic receptor antagonist; it has been found to inhibit dopamine uptake and promote dopamine release (Dwoskin, 2002). It crosses the blood–brain and placental barriers and enhances gastrointestinal tone and mobility. Lobelia stimulates the respiratory center (Bradley, 1992). Indications: Chronic obstructive pulmonary disease (COPD), asthma, and as an aid to stop smoking Potential Veterinary Indications: Chronic bronchitis, asthma, pneumonia Contraindications: Pregnancy, lactation, nausea, dyspnea, hypotension Toxicology and Adverse Effects: AHPA class 2b, 2d. Causes immediate vomiting at doses slightly higher than a therapeutic dose (which may naturally limit toxicity). This is a strong herb that should not be used by untrained pet owners; however, the toxicity of the herb has been greatly exaggerated. Bergner (2001) claims that part of the reason for this is that lobelia was a symbol of the conflict between regular medicine and the new sects that sprang up in the early 19th century that opposed regular medicine. The medical literature has repeatedly cited “many cases” of fatal poisoning by lobelia, but primary references cannot be found. The only cases that can be confirmed are one involving Samuel Thomson, who was acquitted by the jury in the case, and one in London, in which the practitioner was convicted of practicing without a license. Other cases (all in London) were probably due to the natural course of the epidemic cholera, and the practitioners were acquitted. No human cases of fatality due to lobelia have been reported in the subsequent two centuries. Bergner quotes William Cook, who described Yale professor William Tully’s experiments on cats, dogs, and rabbits. Despite administration of large doses by enema, none of the experimental animals was killed. Adverse effects described in the medical literature include nausea, vomiting, tachycardia, bradycardia, dizziness, dyspnea, hypotension, diaphoresis, respiratory depression, and seizures, although according to Bergner (2004), toxicology references generally fail to include Lobelia; because high doses lead to vomiting, adverse effects are rare. Drug Interactions: None reported. Dosage: Human: (see Chapter 12 in which Poppenga notes that toxicity has been associated with a dose of 50 mg dried herbs, or 1 mL of tincture.) Dried herb: 12.5-200 mg up to TID Infusions and decoctions: 0.05-0.6 g in water TID or 1 1 /4- /2 tsp dried herb in 1 cup water; administer 1/4-1 cup up to TID Tincture (usually 40%-60% ethanol; some pharmacies include vinegar to better extract alkaloids) 1 : 2 or 1 : 3: 0.25-1 mL TID Small Animal: Dried herb: 1-5 mg/kg up to TID (do NOT increase an individual dose above 5 mg/kg unless one’s individual experience with a particular lobelia product suggests that this is safe) Tincture (usually 40%-60% ethanol; some pharmacies include vinegar to better extract alkaloids) 1 : 2-1 : 3: 0.1-1.0 mL

596

PART IV • Veterinary Clinical Uses of Medicinal Plants

divided daily (optimally, TID) and diluted or combined with other herbs Large Animal (Karreman, 2004): Tincture: horse, 30-60 mL Tincture: cattle, 30-60 mL Tincture: sheep and goats, 4-15 mL Historical Veterinary Doses: Small Animals: Dogs Fluid extract: 0.03-1.3 mL Tincture: 0.2-2 mL (Milks, 1949) Horses Fluid extract: 4-30 mL Tincture: 30-60 mL (Milks, 1949) Notes of Interest: This is the first herb championed by Samuel Thomson that led to extensive investigation of herbal medicine in the United States; he and the movements he inspired rebelled against “regular medicine of the early 1800s.”

Selected References Bergner P. Lobelia: is lobelia toxic? Medical Herbalirm 2001; 10:15-17,20-25. Available online at: http://medherb.com/ Materia_Medica/Lobelia_-_Is_lobelia_toxic_.htm. Accessed April 30, 2006. Bradley PR, ed. British Herbal Compendium. Bournemouth: British Herbal Medicine Association, Scientific Committee; 1992:158159. Dwoskin LP, Crooks PA. A novel mechanism of action and potential use for lobeline as a treatment for psychostimulant abuse. Biochem Pharmacol 2002;63:89-98. Karreman H. Treating Dairy Cows Naturally: Thoughts and Strategies. Paradise, Pa: Paradise Publications; 2004. Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics. Chicago, Ill: Alex Eger, Inc.; 1949. Yarnell E. Clinical Botanical Medicine. Larchmont, NY: Mary Ann Liebert, Inc.; 2003.

Maitake Grifola frondosa (Dicks ex. Fr.) S.F. Gray; formerly, Polyporus frondosus • Grif-O-luh fron-DO-suh Similar Species: None found. Other Names: Hen of the woods, dancing mushroom, mushikusa, king of mushrooms, cloud mushrooms Family: Polyporaceae Parts Used: Fruiting bodies Selected Constituents: B-glucans, lipids, sterols

H OH H H OH H H OH ␤1 4 HO H OHO H H O HO HO O O O O HO 4 HO H OH ␤1 3 H OH ␤1 4 OH ␤1 H H OH H H OH H H H H

Beta-glucan with ␤1

4 and ␤1

3 linkages

Clinical Action: Immunomodulant, antibacterial, antitumor Energetics: Sweet History and Traditional Usage: English (and subsequently, American) culinary culture has been described as “mycophobic,” which contrasts with virtually the rest of the world. This fungus has no traditional use in Western Herbal Medicine, but it has been the subject of recent scientific investigation. In Japan, the mushroom was used as a tonic. Published Research: A well-publicized but uncontrolled case series in human patients with cancer reported percentages of people who had tumor regression or symptom improvement when taking the MD fraction, which contains β-1,6 glucan with β-1,3 branched chains. Those patients with liver cancer, breast cancer, and lung cancer had better outcomes than those with leukemia, stomach cancer, and brain cancer. Because the latter group of cancers are generally more aggressive under most circumstances anyway, these results are not easily interpretable. In vitro trials have shown enhanced bone marrow colony formation and decreased doxorubicin toxicity, which lead to cell death and growth inhibition in canine cancer cell lines (Konno, 2004). Maitake may enhance immune function by activating macrophages and T cells. Laboratory animal and human studies show that maitake D-fraction enhances natural killer (NK) cell activity; it also enhances Th-1 dominant immune responses in tumor-bearing mice (Adachi 1987; Kodama, 2005; Kodama, 2003; Harada, 2003; Kodama, 2002a; Lin, 2001). Animal studies have indicated that maitake extract has hypoglycemic activity (Talpur, 2002; Horio, 2001) and may lower blood lipids (Kubo, 1997). Indications: Cancer, immune suppression, hypertension, hyperlipidemia, diabetes Potential Veterinary Indications: Immune suppression related to chronic disease, cancer, hyperlipidemia, diabetes Notes of Interest: Maitake mushroom is used for food. Contraindications: None reported. Toxicology and Adverse Effects: AHPA class 1. None reported. Drug Interactions: Animal studies showed that maitake increased insulin levels and decreased blood glucose levels, suggesting that the herb may have an additive effect in diabetic patients who are administered hypoglycemic agents. Dosage: Human: Dried herb: 5-30 g TID D-Fraction: Doses vary widely, from 5.5-70 mg TID Tincture (usually 30% ethanol) 1 : 2 or 1 : 3: 5-15 mL TID Small Animal: Dried herb: 200-500 mg/kg to 1 g/kg, divided daily Tincture (usually 30% ethanol) 1 : 2-1 : 3: 2.0-5.0 mL per 10 kg (20 lb), divided daily, and diluted or combined with other herbs

Materia Medica • CHAPTER 24

Selected References Adachi K, Nanba H, Kuroda H. Potentiation of host-mediated antitumor activity in mice by beta glucan obtained from Grifola frondosa (maitake). Chem Pharm Bull 1987;35:262270. Harada N, Kodama N, Nanba H. Relationship between dendritic cells and the D-fraction–induced Th-1 dominant response in BALB/c tumor-bearing mice. Cancer Lett 2003;192:181187. Horio H, Ohtsuru M. Maitake (Grifola frondosa) improve glucose tolerance of experimental diabetic rats. J Nutr Sci Vitaminol 2001;47:57-63. Kodama N, Asakawa A, Inui A, Masuda Y, Nanba H. Enhancement of cytotoxicity of NK cells by D-fraction, a polysaccharide from Grifola frondosa. Oncol Rep 2005;13:497-502. Kodama N, Harada N, Nanba H. A polysaccharide, extract from Grifola frondosa, induces Th-1 dominant responses in carcinoma-bearing BALB/c mice. Jpn J Pharmacol 2002a;90:357360. Kodama N, Komuta K, Nanba H. Effect of maitake (Grifola frondosa) D-fraction on the activation of NK cells in cancer patients. J Med Food 2003;6:371-377. Kodama N, Komuta K, Sakai N, Nanba H. Effects of D-fraction, a polysaccharide from Grifola frondosa, on tumor growth involve activation of NK cells. Biol Pharm Bull 2002b;25:16471650. Konno S. Potential growth inhibitory effect of maitake Dfraction on canine cancer cells. Vet Ther 2004;5:263-271. Konno S, Tortorelis DG, Fullerton SA, Samadi AA, Hettiarachchi J, Tazaki H. A possible hypoglycaemic effect of maitake mushroom on type 2 diabetic patients. Diabet Med 2001; 18:1010. Kubo K, Nanba H. Anti-hyperliposis effect of maitake fruit body (Grifola frondosa). Biol Pharm Bull 1997;20:781-785. Lin H, She YH, Cassileth BR, Sirotnak F, Cunningham Rundles S. Maitake beta-glucan MD-fraction enhances bone marrow colony formation and reduces doxorubicin toxicity in vitro. Int Immunopharmacol 2004;4:91-99. Matsui K, Kodama N, Nanba H. Effects of maitake (Grifola frondosa) D-fraction on the carcinoma angiogenesis. Cancer Lett 2001;172:193-198. Talpur N, Echard B, Dadgar A, Aggarwal S, Zhuang C, Bagchi D, Preuss HG. Effects of Maitake mushroom fractions on blood pressure of Zucker fatty rats. Res Commun Mol Pathol Pharmacol 2002;112:68-82.

Marshmallow Althaea officinalis L. • AL-thay-uh or AL-thee-uh ohfiss-ih-NAH-liss Other Names: Schloss tea, guimauve tea, malve, guimauve, malvavisco, malvavisce, gul-khairu, k’uei, Althaeae radix Family: Malvaceae Distribution: Native to Europe and Asia Similar Species: Althaea taurinensis, Althaea rosea, Malva sylvestris, Malva rotundifolia, and Malva vulgaris are stated by King’s as equivalent in action. Parts Used: Root from 2-year plants, in early spring or autumn. The fleshy part is used and woody parts discarded. The leaf is sometimes used.

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Selected Constituents: Root: 5%-35% mucilage; asparagines, tannins Leaf: mucilage, flavonoids, phenolic acids Clinical Action: Nutritive, demulcent, vulnerary, diuretic Energetics: Sweet, bitter, cool Traditional Usage: King’s states that the decoction is advantageous for nearly every kidney and bladder problem; it lists “diseases of the mucous tissues” that affect most systems, which include hoarseness, respiratory problems, cystitis, urethritis, and diarrhea. It has also been used as a poultice for local inflammatory disorders such as wounds, cellulitis, tumors, and burns. The German Commission E recommends marshmallow root for irritation of the oral and pharyngeal mucosa and associated dry cough, and for mild inflammation of the gastric mucosa. Published Research: Nosal’ova (1992) compared the antitussive capacity of marshmallow extract and its isolated polysaccharide with the nonnarcotic drugs prenoxdiazine and dropropizine. Unanesthetized cats were stimulated to cough through mechanical irritation of laryngopharyngeal and tracheobronchial mucus achieved with the use of a nylon fiber (diameter, 0.35 mm). The number of cough efforts was measured on the basis of changes in tracheal pressure. The polysaccharide dosed at 50 mg/kg body weight PO inhibited the cough as well as it was inhibited by 1000 mg/kg body weight po of Althaea syrup. The complex extract was less effective than the polysaccharide. Indications: Digestive complaints, especially gastroenteritis, gastric ulcer, colitis, diarrhea, urinary tract inflammation (cystitis, nephritis, urethritis), stomatitis, laryngitis, and bronchitis. Topically for ruptured abscesses, ulcers, and open wounds Potential Veterinary Indications: Digestive complaints, especially gastroenteritis, gastric ulcer, colitis, diarrhea, urinary tract inflammation (cystitis, nephritis, urethritis), stomatitis, laryngitis, bronchitis, and other chronic coughs. Topically for ruptured abscesses, ulcers, and open wounds Contraindications: None reported. Toxicity and Adverse Effects: AHPA class 1. None reported. Drug Interactions: The mucilage may theoretically reduce absorption of drugs, glucose, and other soluble molecules from the gut, although the same could be said of many foodstuffs. Preparations: Decocting destroys mucilage. Cold infusion is best for mucilages. Dosage: Human: Dried root or leaf: 5-10 g TID (usually supplied as the cold infusion), up to 6 times daily for acute conditions Syrup: 1/4-1 tsp as needed for cough Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 25%-30% ethanol, but this is not the optimal form for supplying this herb) 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions

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Small Animal: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually in 25%-30% ethanol or glycetract) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

Selected Reference Nosal’ova G, Strapkova A, Kardosova A, Capek P, Zathurecky L, Bukovska E. [Antitussive action of extracts and polysaccharides of marsh mallow (Althaea officinalis L., var. robusta).] Pharmazie 1992;47:224-226.

Meadowsweet

Filipendula ulmaria (L.) Maxim • fil-ih-PEN-dyoo-luh ulMAR-ee-uh Other Names: Queen of the meadow, lady of the meadow, Spiraea ulmaria, Spiraea herba, Philipendula ulmaria Family: Rosaceae Parts Used: The flowers and flowering tops are primarily used in herbal preparations, although historical references are made to use of the root. Distribution: Meadowsweet is found in Northern and Southern Europe, North America, and Northern Asia. Selected Constituents: Flavonoids: spiraeoside (quercetin 4′-glucoside), quercetin, hyperoside, rutin, avicularin, and kaempferol derivatives. Tannins. Phenolic glycosides: spiraein, monotropitin (gaultherin), spireine, 6-xylosylglucosides of salicylaldehyde, and methyl salicylate. Essential oil: salicylaldehyde (75%), phenylethyl alcohol,

benzyl alcohol, anisaldehyde, methyl salicylate, ethylsalicylate, and methoxybenzaldehyde. Polyphenolics: mainly hydrolysable tannides (10%-15%) and rugosin-D Other: chalcones, phenylcarboxylic acids, coumarin (trace), ascorbic acid (trace). Although meadowsweet flowers are high in flavonoids, the primary constituents are salicylates, including salicin, salicylaldehyde, and methyl salicylate (Newall, 1996). In the digestive tract, these compounds are oxidized into salicylic acid. Clinical Actions: Antacid, antiulcerogenic, anti-inflammatory, astringent, mild urinary antiseptic Energetics: Dry, cool History and Traditional Usage: Meadowsweet has a history of use in conditions associated with the gastrointestinal tract, particularly for diarrhea, and especially in disorders of children. It was also used to treat patients with rheumatic complaints of the joints and muscles (Bruneton, 1995). Meadowsweet is well indicated for diarrhea and provides soothing and astringent effects. It is considered a corrector and alterative to the stomach. The salicyin content probably provides some diaphoretic action and may give a mild anti-inflammatory effect. Nicholas Culpeper, a 17th century English pharmacist, mentioned the use of meadowsweet to help break fever and to promote sweating during a cold or flu. Herbal references indicate its uses as a diuretic and as an antacid to treat stomach complaints, including heartburn. De Bairacli Levy (1963) mentions its use by gypsies as a spring tonic for animals and explains that it is eaten by goats and sheep and is used to treat people with fever, blood disorders, diarrhea, and dropsy. She recommends a strong infusion of meadowsweet to control hemorrhage from deep wounds, with leaves and flowers administered externally and internally. In addition, she recommends that meadowsweet be used internally for eczema, and internally and externally for heat rash, scurf, and heat spots (de Bairacli Levy, 1985). Published Research: The antiulcerogenic properties of Filipendula ulmaria have been investigated. An infusion of dried leaves, stems, and flowers (1 : 10) was tested on mice with carrageenan-induced inflammation. Although a 60% rate of ulcer occurrence was noted in the control group, no ulcers were identified for all concentrations of Meadowsweet tested (0.35, 1.25, 5.0, 10.0 mL/kg) (Gorbacheva, 2002). A decoction (1 : 10, 1 : 20) from flowers of Filipendula ulmaria was found to reduce the ulcerogenic action of ligation of the pylorus and to reduce the formation of lesions of the glandular part of the stomach after injection of reserpine to rats and mice or phenylbutazone to rats. The decoction prevented acetylsalicylic acid–induced lesions of the stomach in rats. It promoted healing of chronic ulcers of the rat stomach induced by injection of 70% ethanol. The decoction did not protect rats from the ulcerogenic action of cinchophen, but it increased the bronchosphastic and ulcerogenic properties of histamine in guinea pigs (Barnaulov, 1980). Alcohol and water extracts of meadowsweet flowers showed preventive action against the evolution of experimental erosion and stomach ulcers in mice.

Materia Medica • CHAPTER 24

A clinical trial of 500 middle-aged men found that Filipendula ulmaria reduced the risk of angina (Filipendula alone) and myocardial infarction (Filipendula with Cratageus) (Kielczynski, 1998). A total of 48 women with cervical dysplasia were treated with topical application of Filipendula ulmaria flowers (ointment) to the cervix. Positive responses were recorded in 32 patients (67%), including complete regression in 25 cases (52%). No recurrence was observed in 10 completely cured patients after 12 months (Peresun’ko, 1993). The anticoagulant activities of flower and seed extracts of Filipendula ulmaria were assessed on the basis of recalcification time in plasma from healthy rats after addition of thrombin. It was concluded that both flower and seed extracts of Filipendula ulmaria have significant anticoagulant effects (Lyapina, 1993). Extracts of roots, herb, and flowers of Filipendula ulmaria were investigated for in vitro immunomodulatory properties. The ethyl acetate extracts of roots and flowers, all methanol extracts, and the aqueous root extract exhibited strong inhibition toward the classical pathway of complement (Halkes, 1997). Indications: Acid reflux, gastric ulcer, indigestion, diarrhea, rheumatic conditions, urinary disorders, cervical dysplasia, and repair of the vagina and cervix topically Potential Veterinary Indications: Gastric ulceration and prevention of ulceration in horses, gastrointestinal inflammation, gastritis, colitis Contraindications: Salicylate sensitivity. The salicylate content has been estimated to be approximately 388 μg/ mL of a 1 : 2 fluid extract. The normal human diet provides a daily intake of 10 to 200 mg salicylates; recommendations for a low salicylate diet require approximately 1.5 to 2 mg daily. A daily dose of 3 mL of meadowsweet is equivalent to approximately 1.16 mg salicylates (Burgoyne, 1995). Published aspirin doses to be administered to cats range up to 25 mg/kg daily of acetylsalicylic acid, but the toxic dose of salicylic acid in cats is not well known. See Chapter 12 for more information on salicylate toxicity. Toxicology and Adverse Effects: AHPA class 1. In a Bearded Collie with acute weakness, hematemesis, melena, painful abdomen, and pale mucous membranes, a hematocrit of 13% and panhypoproteinemia were found that had been caused by severe gastrointestinal bleeding. Despite intensive investigations, no systemic or local cause could be identified. After repeated client interrogation, it was found that the dog had been receiving a food supplement formulated for horses. This supplement contained a shell extract plus willow (Salicaceae) and meadowsweet. The ingestion of this supplement was considered a possible cause of gastrointestinal bleeding (Rohner, 2004). Potential Drug Interactions: Meadowsweet flowers may potentiate anticoagulant drugs, although this has not been reported. Notes of Interest: Aspirin is named after the plant used by Bayer as the source of salicylic acid. “A” stood for acetyl chloride, and “spir” was from Spirea ulmaria. This is the former botanical name for meadowsweet.

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Dosage: Human: Dried herb: 1-10 g TID, or more often as needed Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely (Bradley, 1992; Yarnell, 2003) Tincture (commonly 25% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2 or 1 : 3: 15 mL TID, up to 6 times daily for acute conditions Small Animal: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (commonly 25% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2-1 : 3: 0.51.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. References Barnaulov OD, Denisenko PP. Anti-ulcer action of a decoction of the flowers of the dropwort, Filipendula ulmaria (L.) Maxim. Farmakol Toksikol 1980;43:700-705. Bradley PR, ed. British Herbal Compendium. Bournemouth: British Herbal Medicine Association, Scientific Committee; 1992:158159. Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier; 1995. Burgoyne B. Salicylates in herbs. Mod Phytother 1995;1:3-6. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. Halkes SB, Beukelman CJ, Kroes BH. In vitro immunomodulatory activity of Filipendula ulmaria. Phytother Res 1998;11:518-520. Kielczynski W. Clinical outcome of herbal prevention of vascular disease in 500 middle aged males. Proceedings of NHAA International Conference; 1998; Sydney, Australia. Lyapina LA, Koval’chuk GA. A comparative study of the effects of Fillipendula ulmaria flower and seed extracts on hemostasis. Biol Bull Russian Acad Sci 1993;20:505-507. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press; 1996:191-192. Peresun’ko AP, Bespalov VG, Limarenko AI, et al. Clinicoexperimental study of using plant preparations from the flowers of Filipendula ulmaria (L.): maxim for the treatment of precancerous changes and prevention of uterine cervical cancer. Vopr Onkol 1993;39:291-295. Rohner MM, Glaus TM, Reusch CE. Life threatening intestinal bleeding in a Bearded Collie associated with a food supplement for horses [German]. Schweiz Arch Tierheilkd 2004;146:479482. Yarnell E. Clinical Botanical Medicine. Larchmont, NY: Mary Ann Liebert, Inc.; 2003.

Milk Thistle Silybum marianum L. Gaertn. • SIGH-lee-bum mar-eeAH-num Distribution: Southern and Western Europe; naturalized to South America and North America

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Similar Species: Silybum eburneum is an inferior species with which S. marianum can cross-pollinate. Many thistle species may have similar uses. Common Names: Holy thistle, marian thistle, our lady’s thistle, Mary thistle, St. Mary’s thistle, wild artichoke, mariendistel (Germany), Chardon-Marie (French). Milk thistle should not be confused with blessed thistle, Cnicus benedictus. Former botanical name was Carduus marianus. Legalon (Madaus, Cologne, Germany) and Thisilyn (Nature’s Way, Springville, Utah, United States) are the two most studied products. In Chinese medicine, milk thistle is known as shui fei ji. Family: Asteraceae Parts Used: Seed collected in late summer. (In Europe, the leaves were historically used similarly to spinach; once the spines had been removed, the fruit was eaten like an artichoke.) Selected Constituents: Silymarin is a flavonoid complex made up of three parts: silibinin, silidianin, and silichristine. Silibinin is thought most active and is probably responsible for the benefits attributed to silymarin. Also contains sterols, fixed oil, flavonoids (apigenin, quercetin, kaempferol), lignans, biogenic amines (tyramine, betaine), and mucilage O O

HO

O OH

OH

CH2OH OCH3 OH

O Silibinin

Clinical Action: Hepatoprotective, demulcent, cholagogue, galactagogue, antioxidant Energetics: Bitter, warm; has been described in contradicting ways. Holmes (1997) states that it is drying, and Kenner (2001) claims that it is a yin tonic. History and Traditional Usage: This plant has been used since ancient times, and it was mentioned in many of the great Herbals of the 16th and 17th centuries. Gerard recommended it for liver disease (melancholy). No record can be found of its use in North America by native people, although the plant was brought to the West by European settlers. It was not introduced into Eclectic practice until 1898. Specific indications in Eclectic use were as follows: “splenic, hepatic and renal congestion, face sallow, appetite, capricious; nervous irritability; despondency; physical debility; pain in either hypochondriac; pelvic tension and weight; congestion of the parts supplied by the coeliac axis; and non-malarial splenic hypertrophy.” Published Research: Silymarin is thought to have the following effects (Flora, 1998): • Acts as an antioxidant • Inhibits lipid peroxidation in hepatocyte plasma membranes, thereby protecting against many toxins

• Protects against genomic injury through suppression of lipoxygenase, hydrogen peroxide, and superoxide • Increases hepatocyte protein synthesis via stimulation of RNA polymerase • Suppresses nuclear factor (NF)-kappaB • Chelates iron and decreases glutathione destruction in iron overload conditions • Stabilizes mast cells • Slows calcium metabolism • Decreases activity of tumor promoters A total of 20% to 40% of an oral dose is found in bile, and 3% to 8% is excreted in the urine. Silybin levels peak in bile at between 2 and 9 hours post ingestion, and excretion in the bile continues for 24 hours. Extensive enterohepatic circulation is suspected. Absorption is said to be enhanced if silymarin is administered with phosphatidylcholine (Flora, 1998). Liver disorders Controlled clinical trials in various hepatic disorders, including toxin- and drug-induced hepatitis, alcoholic liver disease, viral hepatitis, and cirrhosis, suggest that milk thistle decreases aminotransferase activity and improves various clinical parameters on a less consistent basis. In an evidence report/technology assessment paper prepared by the US Department of Health and Human Services, a literature review revealed the following: Of 16 prospective placebo-controlled trials, study design was found to be of variable quality, and interpretation overall was difficult. However, results revealed that four of six studies on alcoholic liver disease showed significant improvement in at least one measure of liver function. Three of three studies on viral hepatitis showed improvement in clinical disease, and two of three showed improvement in histology. In two of two studies on cirrhosis (alcoholic and nonalcoholic), administration of milk thistle was associated with improvement. Of three trials that evaluated milk thistle in the treatment or prevention of damage due to hepatotoxic drugs, results were mixed (Agency for Healthcare Research and Quality, 2000). Milk thistle and silymarin have been submitted to later critical reviews in the treatment of patients with hepatitis B and C. These compounds do not appear to influence viral infection; however, they may attenuate damage caused by infection (Mayer, 2005; Rambaldi, 2005). Kidney diseases Silybin reduces oxidative damage to kidney cells in vitro (Sanhueza, 1992). In rats, silibinin prevented cisplatininduced nephrotoxicity (Gaedeke, 1996; Bokemeyer, 1996), but it did not prevent cyclosporine-induced glomerular damage, except for lipid peroxidation (Zima, 1998). Blood lipids Animal studies have suggested that silymarin can help control blood lipid levels (Skottova, 2004; Skottova, 2003), possibly by modulating absorption of cholesterol (Sobolova, 2005). Humans given silymarin in an open

Materia Medica • CHAPTER 24

clinical trial did not display significant changes in blood lipid profiles (Somogyi, 1989). Fifteen patients who underwent cholecystectomy received placebo or silymarin (420 mg daily for 1 month). Silymarin administration led to a significant decrease in biliary cholesterol concentration. The authors suggest that silymarin decreases hepatic cholesterol synthesis (Nassuato, 1991). Pancreatic disorders Experimental damage of the pancreas in rats can be ameliorated with the use of silymarin (Soto, 1998). Silibyn protects the pancreas from cyclosporine toxicity. In rats given cyclosporin A, or cyclosprin A plus silymarin, silibinin mitigated changes in amylase secretion, but the combination of cyclosporine and silibinin had an additive effect on inhibiting insulin secretion (von Schonfeld, 1997). In a human clinical trial, 60 alcoholics with hepatic cirrhosis and insulin-dependent diabetes were treated with silymarin (200 mg TID) or placebo. Silymarin administration resulted in significant decreases in fasting glucose, glycosuria, and insulin needs over 6 months (Velussi, 1997; Velussi, 1993). Cancer Silibinin and silymarin have been investigated in animal studies as cancer preventive agents. In prostate cancer cells, for example, these compounds alter cell cycle progression, inhibit cell survival signaling and mitogenic signaling, synergize the effects of doxorubicin, inhibit secretion of proangiogenic factors, inhibit growth, and enhance apoptosis. Silibinin also inhibits growth of implanted prostate tumor cells in nude mice (Singh, 2004). Silibinin may improve repair of mouse skin DNA damaged by UV radiation (Singh, 2005); silymarin, applied topically, inhibits chemical carcinogenesis in mice (Katiyar, 2005). Veterinary trials In two trials of dogs given hepatotoxic chemicals, silymarin or silibinin improved biochemical and histologic measures of hepatotoxicity, and survival was improved. In the first trial, beagles were given 85 mg/kg Amanita phalloides lyophilizate orally. In addition to a control group, 4 groups of 6 to 10 dogs were given the following: • Prednisolone, 30 mg/kg IV at 5 and 24 hours • Cytochrome C, 50 mg/kg IV at 5 and 24 hours • Penicillin G, 1000 mg/kg IV at 5 hours • Silymarin, 50 mg/kg IV at 5 hours and 30 mg/kg IV at 24 hours Blood was sampled at 5, 24, 48, 96, and 192 hours. Results of this study showed that all liver enzymes of dogs that received milk thistle remained nearly normal throughout the testing period, whereas those of control dogs increased precipitously (Floersheim, 1978). Vogel (1984) administed 85 mg/kg of amanita lysate to beagles, then treated half of them with silibinin (78 mg/kg IV at 5 and 24 hours). In the control group, 4 of 12 dogs died, and histopathology showed severe liver necrosis. None died in the silibinin-treated group, and liver histopathology was nearly normal.

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In one trial of postparturient cattle given milk thistle seeds, milk production was increased and ketonuria reduced, as compared with controls. Tedesco (2004a, 2004b) found that 10 g of silymarin (the extract) daily protected postparturient cows from a loss in body condition and improved lactation performance. No silymarin residues were found in milk or colostrum. The same group examined liver histology and biochemistry of periparturient cows and found that silymarin had no observable effect on fat accumulation or biochemical parameters of liver disease. Tedesco (2004c) also examined the effect of a silymarin–phospholipid/phytocome complex administered to 14-day-old broiler chicks to determine whether it provided protection against aflatoxin B1. A total of three groups of chicks were administered diet alone, diet plus 0.8 mg/kg of feed of the aflatoxin B1, or diet plus aflatoxin plus 600 mg/kg of the silymarin phytosome. The silymarin complex resulted in lower alanine aminotransferase (ALT) levels and better weight gain than were noted in birds given aflatoxin but no silymarin. Birds receiving aflatoxin and silymarin had body weight gain and ALT levels equivalent to those of birds given no aflatoxin. Giardia and interactions with metronidazole Chon (2005) investigated the efficacy of silymarin for the treatment of giardiasis, measured with use of the giardia antigen test. Dogs that tested positive for giardia were treated orally for 2 weeks with silymarin (3.5 mg/kg QD), metronidazole (50 mg/kg QD), metronidazole and silymarin at the same doses, or nothing. Seven days into the trial, no significant difference in infection levels was observed between the silymarin and metronidazole and metronidazole alone groups, but by the 10th day, the combination group showed significantly less infection than did the group given metronidazole alone. By the end of 2 weeks, the metronidazole and the metronidazole + silymarin groups tested negative for giardia; the silymarin and placebo groups remained positive. It is interesting to note that dogs treated with silymarin in addition to metronidazole did not experience weight loss, and liver measurements were similar to those seen in the metronidazole alone group. Indications: Used for a variety of liver diseases, but especially as protection against toxic ingestion such as occurs in alcoholism; for hypercholesterolemia and varicose veins. It is used by some herbalists to increase lactation. Potential Veterinary Indications: Hepatitis, cholangiohepatitis, toxic injury to liver (especially aflatoxicosis), hepatic lipidosis; adjunct for giardia treatment or during metronidazole administration to decrease adverse effects; for protection of the pancreas during pancreatitis or protection from drug damage; hyperlipidemia; to increase lactation and protect dairy cows from ketonemia Contraindications: No known contraindications have been reported. Milk Thistle has been recommended for problems associated with the gallbladder during pregnancy, and so it is likely to be safe even for pregnant and lactating animals. Patients allergic to members of the daisy family may be sensitive to milk thistle.

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Toxicology and Adverse Effects: AHPA class 1. Milk thistle is relatively nontoxic, and the seeds, plant, and root have been used as food. In one study, mice tolerated a dose of 20 g/kg. The most common adverse reactions were allergy, urticaria, and gastrointestinal distress. The European Agency for Evaluation of Medicinal Products, Committee for Veterinary Medicinal Products, has determined that milk thistle is safe in food-producing animals when used as the homeopathic mother tincture (an alcohol tincture of 1 part dried seed and 2 parts alcohol) and in all homeopathic dilutions. This author (SW) has noted at least 2 cases in which milk thistle administration (prescribed for elevated liver enzymes) led to increased ALT in dogs; when the herb was discontinued, ALT returned to the former level. This occurs in only a small minority of treated cases in this practice, however, and has thus far been attributed to a hypersensitivity reaction. Potential Drug Interactions: Milk thistle reduces the activity of CYP3A4 and other liver enzymes in vitro, but clinical trials did not demonstrate any effect on anti–human immunodeficiency virus (HIV) drugs (Brinker, 1998). A clinical trial in healthy volunteers suggests that the effect is minimal and perhaps not clinically significant (Gurley, 2004). Silymarin has been reported to stimulate activity of the p-glycoprotein drug transporter (Zhou, 2004). Milk thistle may reduce insulin requirements in some patients with diabetes. Silymarin has been shown to protect against organ toxicity induced by cisplatin, acetaminophen, butyrophenones, halothane, phenothiazines, tacrine, and vincristine. Preparation Notes: Flavonolignans are not very water soluble, so dried seeds or liquid extracts must be alcohol based. Even so, Brinker notes that water extracts have been used traditionally; this suggests that other components in the herb may be beneficial as well. Notes of Interest: The characteristic spiked leaves display white veins, which were said to carry the breast milk of the Virgin Mary. Dioscorides made mention of the leaf, and Gerard (1596) had this to say of it: “My opinion is that this is the best remedy that grows against all melancholy (bile-liver) diseases.” Culpeper also made use of Milk Thistle. Dosage: Milk thistle is usually supplied as a solid extract, standardized to 70% to 80% silymarin. Milk thistle should be used for at least 8 weeks before results such as improvement in biochemistry are expected. Human: Dried herb: 1-10 g TID Standardized extract (standardized to 70% silymarin): 140200 mg TID; reduce to 90 mg TID after 6 weeks Infusions and decoctions: Not recommended Fluid extract (1 : 1) (usually 60%-80% ethanol): 10-15 mL per day Glycetract (1 : 1): 5-9 mL per day, divided Small Animal: Dried herb: 50-100 mg/kg, divided daily (optimally, TID) if extracted and dried; triple or quadruple dose for unprocessed herb

Dry standardized extract (70% silymarin): 10-15 mg/kg, divided daily Fluid extract (1 : 1) (usually 60%-80% ethanol): 1.0-2.0 mL per 10 kg (20 lb), divided daily and diluted or combined with other herbs Glycetract (1 : 1): 1.0-2.0 mL per 10 kg (20 lb), divided daily and diluted or combined with other herbs Cattle: Dried herb: 10 g daily References Agency for Healthcare Research and Quality. Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Available at: http://www.ahrq.gov/clinic/ epcsums/milktsum. Accessed May 2, 2006. Bokemeyer C, Fels LM, Dunn T, et al. Silibinin protects against cisplatin-induced nephrotoxicity without compromising cisplatin or ifosfamide antitumour activity. Br J Cancer 1996;74:2036-2041. Brinker F, ed. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, Ore: Eclectic Medical Publications; 1998:74-75. Chon SK, Kim NS. Evaluation of silymarin in the treatment on asymptomatic Giardia infections in dogs. Parasitol Res 2005;97:445-451. Floersheim GL, Eberhard M, Tschumi P, Duckert F. Effects of penicillin and silymarin on liver enzymes and blood clotting factors in dogs given a boiled preparation of Amanita phalloides. Toxicol Appl Pharmacol 1978;46:455-462. Flora K, Hahn M, Rosen H, Benner K. Milk thistle (Silybum marianum) for the therapy of liver disease. Am J Gastroenterol 1998;93:139-143. Gaedeke J, Fels LM, Bokemeyer C, Mengs U, Stolte H, Lentzen H. Cisplatin nephrotoxicity and protection by silibinin. Nephrol Dial Transplant 1996;11:55-62. Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Carrier J, Khan IA, Edwards DJ, Shah A. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-440. Holmes P. The Energetics of Western Herbs. Boulder, Colo: Snow Lotus Press; 1997. Katiyar SK. Silymarin and skin cancer prevention: antiinflammatory, antioxidant and immunomodulatory effects. Int J Oncol 2005;26:169-176. Kenner D, Requena Y. Botanical Medicine. Brookline, Mass: Paradigm Publications; 2001. Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hep 2005;12:559-567. Nassuato G, Iemmolo RM, Strazzabosco M, Lirussi F, Deana R, Francesconi MA, Muraca M, Passera D, Fragasso A, Orlando R, Comos G, Okolicsanyi L. Effect of Silibinin on biliary lipid composition experimental and clinical study. J Hepatol 1991; 12:290-295. Paulova J, Dvorak M, Kolouch F, Vanova L, Janeckova L. [Verification of the hepatoprotective and therapeutic effect of silymarin in experimental liver injury with tetrachloromethane in dogs.] Vet Med (Praha) 1990;35:629-635. Rambaldi A, Jacobs BP, Iaquinto G, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C liver diseases—a systematic cochrane hepato-biliary group review with meta-analyses of randomized clinical trials. Am J Gastroenterol 2005;100:25832591. Sanhueza J, Valdes J, Campos R, Garrido A, Valenzuela A. Changes in the xanthine dehydrogenase/xanthine oxidase

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ratio in the rat kidney subjected to ischemia-reperfusion stress: preventive effect of some flavonoids. Res Commun Chem Pathol Pharmacol 1992;78:211-218. Singh RP, Agarwal R. Prostate cancer prevention by silibinin. Curr Cancer Drug Targets 2004;4:1-11. Singh RP, Agarwal R. Mechanisms and preclinical efficacy of silibinin in preventing skin cancer. Eur J Cancer 2005;41:19691979. Skottova N, Kazdova L, Oliyarnyk O, Vecera R, Sobolova L, Ulrichova J. Phenolics-rich extracts from Silybum marianum and Prunella vulgaris reduce a high-sucrose diet induced oxidative stress in hereditary hypertriglyceridemic rats. Pharmacol Res 2004;50:123-130. Skottova N, Vecera R, Urbanek K, Vana P, Walterova D, Cvak L. Effects of polyphenolic fraction of silymarin on lipoprotein profile in rats fed cholesterol-rich diets. Pharmacol Res 2003;47:17-26. Sobolova L, Skottova N, Vecera R, Urbanek K. Effect of silymarin and its polyphenolic fraction on cholesterol absorption in rats. Pharmacol Res 2006;53:104-112. Epub 2005 Nov 4. Somogyi A, Ecsedi GG, Blazovics A, Miskolczi K, Gergely P, Feher J. Short term treatment of type II hyperlipoproteinaemia with silymarin. Acta Med Hung 1989;46:289-295. Soto CP, Perez BL, Favari LP, Reyes JL. Prevention of alloxaninduced diabetes mellitus in the rat by silymarin. Compar Pharmacol Toxicol 1998;119:125-129. Tedesco D, Tava A, Galletti S, et al. Effects of silymarin, a natural hepatoprotector, in periparturient dairy cows. J Dairy Sci 2004a;87:2239-2247. Tedesco D, Domeneghini C, Sciannimanico D, Tameni M, Steidler S, Galletti S. Silymarin, a possible hepatoprotector in dairy cows: biochemical and histological observations. J Vet Med 2004b;A51:85-89. Tedesco D, Steidler S, Galletti S, Tameni M, Sonzogni O, Ravarotto L. Efficacy of silymarin-phospholipid complex in reducing the toxicity of aflatoxin B1 in broiler chicks. Poult Sci 2004c;83:1839-1843. Velussi M, Cernigoi AM, De Monte A, Dapas F, Caffau C, Zilli M. Long-term (12 months) treatment with an anti-oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatol 1997;26:871-879. Velussi M, Cernigoi AM, Viezzoli L, Dapas F, Caffau C, Zilli M. Silymarin reduces hyperinsulinemia, malondialdehyde levels, and daily insulin needs in cirrhotic diabetic patients. Curr Ther Res 1993;53:533-545. Vogel G, Tuchweber B, Trost W, Mengs U. Protection by silibinin against Amanita phalloides intoxication in beagles. Toxicol Appl Pharmacol 1984;73:355-362. Vojtisek B, Hronova B, Hamrik J, Jankova B. [Milk thistle (Silybum marianum, L., Gaertn.) in the feed of ketotic cows.] [Article in Czech] Vet Med (Praha) 1991;36:321-330. von Schonfeld J, Weisbrod B, Muller MK. Silibinin, a plant extract with antioxidant and membrane stabilizing properties, protects exocrine pancreas from cyclosporin A toxicity. Cell Mol Life Sci 1997;53:917-920. Zhou S, Lim LY, Chowbay B. Herbal modulation of Pglycoprotein. Drug Metab Rev 2004;36:57-104. Zima T, Kamenikova L, Janebova M, Buchar E, Crkovska T, Tesar V. The effect of silibinin on experimental cyclosporine nephrotoxicity. Renal Failure 1998;20:471-479.

603

Mullein

Verbascum thapsus L. • ver-BASK-um THAP-sus Other Names: Aaron’s rod, Verbascum schraderi Family: Scrophulariaceae Parts Used: Leaves, flowers, and tops Distribution: Mullein is indigenous to Europe, India, Asia, Egypt, North Africa, and Ethiopia. It is a weed that is now widely established across temperate North America. Selected Constituents: Polysaccharides, including verbascose, heptaose, and octaose. Flavonoids, including 3′methylquercitin, hesperidin, and verbascoside. Saponins, including verbasterol. Volatile oil. Clinical Actions: Demulcent, emollient, expectorant, mild sedative, mild diuretic Energetics: Cool, slightly astringent and bitter History and Traditional Usage: The demulcent, expectorant, and astringent properties of the leaves and flowers have been used for thousands of years. Mullein tea is given to treat patients with influenza, catarrh, bronchitis, and tracheitis and is thought to be effective because of the mucilage content, which coats and soothes irritated mucous membranes, and the mild expectorant action of saponins. In folk medicine, mullein tea was used as a diuretic and antirheumatic and for treating those with wounds, gout, piles, cramps, convulsions, skin conditions, and ear problems. Mullein was given to patients with tuberculosis in Europe, the United Kingdom, and the United States in the 19th century. According to Blumenthal and others (2000), naturopathic physicians and medical herbalists prescribe mullein for chronic otitis media and eczema of the ear. The German Commission E recognizes mullein flowers for treating catarrh, and clinical studies have shown antiviral action against fowl plague virus, influenza A and B, and herpes simplex virus (Blumenthal, 2000). The soft, padded leaves can also be used as natural bandages or insoles for sore-footed hitchhikers. According to Grieve (1975), the origins of the name mullein include Moleyn in Anglo-Saxon and Malen in Old French, derived from the Latin malandrium (i.e., the malanders, or leprosy). The term “malandre” also applied to diseases of cattle and to lung disease among the rest, and the plant was

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used as a remedy; thus, it acquired its names of “mullein” and “Bullock’s lungwort.” It is mentioned in Coles, in 1657, in Adam in Eden, that “Husbandmen of Kent do give it their cattle against the cough of the lungs. Mullein is “famed for its powers in pulmonary ailments, being much used in lung ailments in cattle, one of its names being cow lungwort. The powdered roots are used to fatten poultry” (de Bairacli Levy, 1963). It is used for treatment of cough, pneumonia, pleurisy, bronchitis, tuberculosis, asthma, diarrhea, and internal bleedings of the lungs and bowels, and externally for neuralgia, pains, and cramps. Published Research: Antibacterial activity (especially the water extract) was observed in vitro with Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli (Turker, 2002). Mullein was shown in vitro to inhibit viral infectivity against pseudorabies virus strain RC/79 (herpes suis virus) (Zanon, 1999) and herpes virus type 1 (McCutheon, 1995). Indications: Bronchitis with hard cough, respiratory catarrh, tracheitis, gastrointestinal conditions requiring demulcency—ulcers, diarrhea Potential Veterinary Indications: Contagious bronchitis; bronchitis; diarrhea; topically for inflamed mucosa Contraindications: None known. Toxicology and Adverse Effects: AHPA class 1. Flowers are approved in the United States as a flavoring for alcoholic beverages. No adverse effects have been reported; however, the leaf hairs (trichomes) of Mullein species can cause skin irritation in susceptible persons. The leaves contain rotenone and coumarins (Foster, 1990). Notes of Interest: The down on the leaves and stem makes excellent tinder when dry, readily igniting on the slightest spark; it was, before the introduction of cotton, used for lamp wicks, hence its older names Candlewick Plant, Hag’s, Our Lady’s Candle, and Torches (Grieve, 1975). Dosage: Human: Dried herb: 1-10 g TID, up to 6 times daily for acute conditions Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 25%-35% ethanol) 1 : 2 or 1 : 3: 1.5-5 mL TID, up to 6 times daily for acute conditions Small Animal: Dried herb: 50-300 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually in 25%-35% ethanol) 1 : 2-1 : 3: 1.0-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

References Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, Mass: American Botanical Council, Integrative Medicine Communications; 2000:270-272.

Coles W. The Art of Simpling: An Introduction to the Knowledge and Gathering of Plants. St Catharine’s, Ontario: Kessinger Publishing; 1968. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. Foster S, Duke JA. Eastern/Central Medicinal Plants (Peterson Field Guide). New York: Houghton Mifflin; 1990. Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint, 1975). McCutcheon AR, Roberts TE, Gibbons E, et al. Antiviral screening of British Columbian medicinal plants. J Ethnopharmacol 1995;49:101-110. Turker AU, Camper ND. Biological activity of common mullein, a medicinal plant. J Ethnopharmacol 2002;82:117-125. Zanon SM, Ceriatti FS, Rovera M, Sabini LJ, Ramos BA. Search for antiviral activity of certain medicinal plants from Cordoba, Argentina. Rev Latinoam Microbiol 1999;41:59-62.

Myrrh Commiphora myrrha (Nees) Engl., formerly, Commiphora molmol Engl. • kom-MEE-for-uh MIR-uh Distribution: Somalia, Ethiopia, Kenya, Iran, India, Arabia Similar Species: Commiphora guidotti, Commiphora abyssinica, Commiphora gileadensis, Commiphora Africana, Commiphora erythraea, Commiphora madagascariense, Commiphora schimperi Other Names: Myrrhe, mirra, mur, mulmul, mukula, heerabole, mo yao shu, mo yao Family: Burseraceae Parts Used: Resin that exudes from the bark Collection: Natural exudation product. Lower-quality product is said to result if the bark of a shrub is intentionally damaged. Selected Constituents: Triterpenoids, sesquiterpenes, essential oil (limonene, dipentene, elemene, lindestrene, boubonene), resins (commiphoric acids, heerabomyrrols, burseracin), gum (contains proteoglycans) History and Traditional Usage: Long used in Chinese, Tibetan, and Unani traditions. Expectorant, emmenagogue, vermifuge, stimulant, antimicrobial, vulnerary. Used for gonorrhea, laryngitis, bronchitis, asthma, stomatitis, gum disease, aphthous ulcers, chronic gastritis, and muscle pain. Powder used topically for wounds and chronic ulcers. Milks (1949) reported that myrrh is an emmenagogue, a stimulant to mucous membranes, and a stimulating expectorant. It was combined with iron or aloes as an emmenagogue (an unusual recommendation in an old veterinary textbook, presumably referring to human uses or to stimulation of estrus cycles in general). As a stimulant to mucous membranes, the tincture was diluted and used as a wash for stomatitis. Energetics: Aromatic, bitter, warm Published Research: A proprietary brand of myrrh known as Mirazid (Pharco Pharmaceuticals, Alexandria, Egypt) has been investigated extensively for its parasite control activity. Clinical trials in humans suggest that it may be effective for controlling schistosomiasis (Abo-Madyan, 2004a), but a trial from another laboratory found that it had no effect (Barakat, 2005). In a field study, the product

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was found effective in the treatment of human liver flukes (Abo-Madyan, 2004b). In sheep, a dose of 3600 mg daily (on an empty stomach) for 4 days yielded 100% cure for Moniezia expansa infection (Haridy, 2004). A dose of 900 to 1200 mg of the same preparation resulted in 100% clearance of Fasciola hepatica (Haridy, 2003). Sheep infected with Dicrocoelium dendriticum were completely cleared of the parasite after they were given 600 mg daily (on an empty stomach) for 4 days (Al-Mathal, 2004). Indications: Gum disease, mouth ulcers, liver flukes, schistosomiasis; topically for skin lesions Potential Veterinary Indications: Stomatitis, gingivitis, topically for skin lesions, possibly rheumatism. In large animals especially, may be considered for fascioliasis and gastrointestinal parasites Notes of Interest: One of the oldest known remedies, it is believed to be one of the precious gifts offered by the Magi to the infant Jesus. Contraindications: Pregnancy, uterine bleeding Toxicology and Adverse Effects: AHPA class 2b, 2d. Contact dermatitis has been reported, and The Botanical Safety Handbook suggests that kidney irritation and diarrhea can occur at human doses greater than 2 to 4 g (McGuffin, 1997). It is considered GRAS (generally recognized as safe) by the US Food and Drug Administration (FDA) as a food and beverage flavoring. Drug Interactions: None reported. Dosage: External Use: Tinctures can be diluted in water for a mouthwash Internal Use: Human Dried herb: 1-10 g TID Infusions and decoctions not used in infusion form because they are not water soluble, although the finely powdered gum can be suspended if necessary Tincture (usually 80%-90% ethanol) 1 : 5: 1-5 mL TID Small Animal Dried herb: 10-20 mg/kg, divided daily (optimally, TID) Tincture (usually 80%-90% ethanol) 1 : 5: 0.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. Large Animal Tincture (Karreman, 2004): Cows and horses, 8-15 mL; sheep and goats, 4-8 mL Historical Veterinary Doses: Dog: dried herb, 5-30 grains (0.3-2 g); tincture, 0.5-2 dr (2-4 mL) (Winslow, 1909) Horse and cow: dried herb, 2-4 dr (3.5-7 g); tincture, 1-2 oz (Winslow, 1909) Sheep and swine: dried herb, 3-6 dr (5-10 g); tincture, 3-6 dr (12-24 mL) (Winslow, 1909) Selected References Abo-Madyan AA, Morsy TA, Motawea SM. Efficacy of Myrrh in the treatment of schistosomiasis (haematobium and mansoni) in Ezbet El-Bakly, Tamyia Center, El-Fayoum Governorate, Egypt. J Egypt Soc Parasitol 2004a;34:423-446. Abo-Madyan AA, Morsy TA, Motawea SM, Morsy AT. Clinical trial of Mirazid in treatment of human fascioliasis, Ezbet El-Bakly

(Tamyia Center) Al-Fayoum Governorate. J Egypt Soc Parasitol 2004b;34:807-818. Al-Mathal EM, Fouad MA. Myrrh (Commiphora molmol) in treatment of human and sheep Dicrocoeliasis dendriticum in Saudi Arabia. J Egypt Soc Parasitol 2004;34:713-720. Barakat R, Elmorshedy H, Fenwick A. Efficacy of myrrh in the treatment of human Schistosomiasis mansoni. Am J Trop Med Hyg 2005;73:365-367. Haridy FM, Dawoud HA, Morsy TA. Efficacy of Commiphora molmol (Mirazid) against sheep naturally infected with Monieziasis expansa in Al-Santa Center, Gharbia Governorate, Egypt. J Egypt Soc Parasitol 2004;34:775-782. Haridy FM, El Garhy MF, Morsy TA. Efficacy of Mirazid (Commiphora molmol) against fascioliasis in Egyptian sheep. J Egypt Soc Parasitol 2003;33:917-924. Karreman H. Treating Dairy Cows Naturally: Thoughts and Strategies. Paradise, Pa: Paradise Publications; 2004. McGuffin M, Hobbs C, Upton R, Goldberg A. Botanical Safety Handbook. Boca Raton, Fla: CRC Press; 1997. Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics. Chicago, Ill: Alex Eger, Inc.; 1949. Winslow K. Veterinary Materia Medica and Therapeutics. New York: William R. Jenkins; 1908.

Neem Azadirachta indica A. Juss. (also, Melia azadirachta L.) • ay-zad-ih-RAK-tuh IN-dih-kuh or in-DEE-kuh Distribution: Native to India, Sri Lanka, and Burma, but now grown in many tropical areas Similar Species: Azadirachta siamensis (or A. azadirachta var. siamensis) and Azadirachta excelsa Common Names: Sanskrit: nimba, Sarva Roga Nirvani (curer of all ailments), margosa, margousier, nimbaum, neembaum, nem, bead tree, pride of China, nim, holy tree, indiar, lilac tree Family: Meliaceae Parts Used: Root bark, bark, and seed (or nut) are most commonly used, but also fruit, leaves, juice, nut oil, and flowers. Selected Constituents: Limonoid triterpenes (including azadirachtin, salannin, nimbin, gedunin), flavonoids, tannins, fixed oil

CH3 CH3

H3C

O

O CH 3 O O H3C

H

O

H

O H3C

O O CH3 OH O HO OH

O H

O Azadirachtin

O

H

O

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Clinical Action: Antibacterial, antifungal, bitter tonic, insecticidal (antifeedant), anthelmintic, antimalarial, astringent, antifertility, vulnerary Energetics: Bitter, astringent, pungent, cold. In Ayurvedic medicine, it balances kapha and pitta. History and Traditional Usage: Neem twigs have traditionally been used in India for cleaning teeth and are used for treatment of patients with infection and chronic disease of all types. Neem was and is especially valued for external conditions like wounds, ulcers, eczema, ringworm, vulvovaginitis, and leprosy, for which leaf preparations are applied topically. It is taken orally for the treatment of those with malaria, fever, and intestinal worms. It is also used for external parasites in people (lice) and animals. Neem seed oil is most commonly used externally as a stimulant (for rheumatism and some skin problems), and the leaf and bark are usually taken internally. The bark, leaves, and seeds are used for a large number of conditions in farm animals. A full listing given by Williamson (2002) is found in Box 24-1. Published Research: Constituents of neem leaf have been shown to have antimalarial, antifungal, antibacterial, antiviral, antioxidant, anticarcinogenic, immunemodulatory, anti-inflammatory, antihyperglycemic, and antiulcer activities (Subapriya, 2005). Ectoparasite infestations Neem has antifeedant, antifecundity, sterilization, and growth effects on insects (Mulla, 1999). It has proved effective against a number of insect parasites of crops. Various parts of neem tree and its constituents have demonstrated repellent or larvicidal activity against biting midges (Blackwell, 2004), and mosquitoes (Wandscheer, 2004; Batra, 1998; Mishra, 1995; Su, 1999). It has variable benefit with parasites of cattle, showing efficacy against ixodid ticks but not against myaisis. In sheep treated for Bovicola ovis, neem spray was apparently as effective as cypermethrin (Heath, 1995). Psoroptic mites in sheep appeared susceptible to neem (O’Brien, 1999). A single trial examined the benefits of neem, alone and in combination with other insecticides, in controlling fleas in dogs and cats. A total of 36 racing Greyhounds were naturally infested with Ctenocephalides felis and 9 caged cats were inoculated twice with fleas. Animals were treated with a combination of neem and N,N-diethyl-mtoluamide (DEET). All concentrations of neem used on these dogs reduced flea numbers by 94% to 100% for the first 12 hours, but as time went on, only neem extract adjusted to 2400 ppm (the highest concentration) inhibited flea populations (by manual count) by 53% to 96% for 19 days. Lower concentrations had some inhibiting effect but were not 100% effective. In cats administered the combination of DEET and neem, flea populations fell progressively until 100% reduction was achieved at days 2 to 6. DEET alone did not significantly reduce flea numbers. Investigators noted that even though higher concentrations of neem were effective, they were not as cost effective as were combinations with DEET and Dlimonene. They also noted that azadirachtin is light and oxidation sensitive and is probably better protected when applied with an oil base (Guerrini, 1998).

BOX 24-1 Ethnoveterinary Uses of Neem in India Poultry Diarrhea Wounds Ticks Lice Ruminants Abscesses Castration sites Bleeding Udder infections Fever Footrot Lice ticks Insect repellent Stomatitis Glossitis Escherichia coli bacillosis Hepatic swelling Jaundice Bloody dysentery Intestinal wounds Constipation Indigestion Respiratory disorders Throat disorders Asthma Pleuropneumonia Mucous membrane irritation anywhere in the respiratory tract Ringworm Alopecia Eczema Urticaria Scabies Ticks Lice Metritis Orchitis Tetanus Anuria Nephritis Mastitis Otitis Rinderpest Rheumatism

Animal feed The seed has been investigated as feed for poultry, with good results noted in chickens but toxicity reported in quail. White Leghorns fed 100 g/kg of neem kernel meal showed no adverse effects, but at higher concentrations, weight gain, shell quality, fertility, and some blood parameters were adversely effected (Gowda, 1998). Broiler chicks fed 135 or 300 g/kg of alkali-treated neem kernel

Materia Medica • CHAPTER 24

cake exhibited similar growth and feed efficiency as chicks fed standard diets (Nagalakshmi, 1996). Investigators concluded that neem may have a sparing effect on other protein sources used by humans in developing countries. On the other hand, when Japanese quail were fed neem seed at 0, 50, 75, or 100 g/kg, long-term effects included lower feed efficiency, fatty infiltration of the liver, and degeneration of the kidneys (Elangovan, 2000). Immune effects Sadekar (1998) administered powdered neem leaves to a flock of broiler chickens that had survived an outbreak of infectious bursal disease (IBD). A dose of 2 g/kg appeared to enhance antibody titers against Newcastle’s disease antigen. Gastrointestinal parasites Dawo (2001) examined more than 50 goats divided into seven treatment groups. Subjects were divided into a control (no treatment) group, a group that received albendazole, and five groups that were given dried neem leaf— one each at 0.5, 1, 2, 5, and 10 g/kg. Neem leaves reduced fecal egg counts by only 16.99%, but albendazole reduced counts by 94.82%. Further, at 21 days, goats administered neem leaves had lower packed cell volume (PCV) values. Dried neem leaves were mixed with feed and were fed to sheep for 3 months while fecal egg counts, worm burden, hematocrit, and weight gain were monitored (Costa, 2006). Sheep were divided into 4 groups that received 100 mg neem/kg of food, 200 mg/kg, closantel, or nothing. At these doses, neem had no anthelmintic effect in sheep. Ulcer healing In rats and dogs, nimbidin alone enhanced healing of ulcers induced with acetic acid (Pillai, 1984). A case series in humans with gastroduodenal and esophageal ulcers found that a dried, aqueous extract of neem bark reduced gastric acid secretion and may have enhanced healing of ulcers (Bandyopadhyay, 2004). The dose administered was 30 to 60 mg BID. Dental care Pai (2004) compared the antiplaque effects of a dental gel that contained 25 mg/g of neem leaf extract with those of a chlorhexidine dentrifice and a control. Semiquantitative methods were used to determine that neem use was associated with a significant (P < .05) reduction in plaque index and bacterial count. Contraception An extract of neem appears effective as a spermicidal contraceptive in humans, primates, and rabbits (Garg, 1998; Khillare, 2003; Talwar, 1997). Diabetes Laboratory animal studies suggest that neem may improve glucose control. In stressed and normoglycemic dogs, a 50% w/v aqueous leaf extract given at 0.15 mg/kg

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intravenously led to a significant decrease in blood glucose levels (Shukla, 1973). Indications: Some external parasites and skin infections as a topical treatment, possibly as a dentrifice Potential Veterinary Indications: External parasiticide, wound healing, skin and dental infections, possibly diabetes Contraindications: Pregnancy, lactation, and possibly hypoglycemia Toxicology and Adverse Effects: Not rated in The Botanical Safety Handbook. High doses can lead to nausea, vomiting, and diarrhea. The LD50 (dose that kills 50% of a sample) of a 50% ethanolic extract of stem bark was >1000 mg/kg. Experimental studies have shown lung, liver, and kidney toxicity when animals are fed high doses of neem products. Long-term oral use has been reported to result in anemia, weakness, loss of appetite, and weight loss. High-dose toxic effects (probably of the oil) have been listed as convulsions, respiratory distress, stupor, coma, death, metabolic acidosis, and seizures (Herr, 2002). Neem oil has produced vomiting, diarrhea, drowsiness, acidosis, and encephalopathy in humans. In calves, administration of the oil led to reduced hemoglobin content and growth suppression (Biswas, 2000). Drug Interactions: May have additive effects with insulin and oral glycemics. Less than 15 mg/kg of a 50% aqueous extract resulted in reduced blood glucose levels in dogs. Dosage: External Use: Neem oil: add 25 mL of oil to 400 mL of shampoo for topical use Dried neem leaf: add 1 cup leaf to 1 L of water, and bring to low simmer for 5 min; cool and use as topical spray Internal Use: Human Dried leaf: 0.25-2 g TID Infusion: 2.5-20 mL Oil: 0.05-1 mL total daily dose (Williamson, 2002) Tincture (usually 50%-80% ethanol; higher alcohol preparations are more potent): 1.5-3.5 mL divided daily Small Animal Dried leaf: 25-50 mg/kg, divided daily Infusion: 5 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 50%-80% ethanol; higher alcohol preparations are more potent) 1 : 2: 0.25-0.5 mL per 10 kg (20 lb), divided daily and diluted or combined with other herbs Selected References Bandyopadhyay U, Biswas K, Sengupta A, et al. Clinical studies on the effect of Neem (Azadirachta indica) bark extract on gastric secretion and gastroduodenal ulcer. Life Sci 2004;75: 2867-2878. Batra CP, Mittal PK, Adak T, Sharma VP. Efficacy of neem oil-water emulsion against mosquito immatures. Indian J Malariol 1998;35:15-21. Biswas K, Chattopadhyay I, Banerjee RK, Bandyopadhyay U. Biological activities and medicinal properties of neem (Azadirachta indica). Curr Sci 2000;82:1336-1345. Available on the Web at: http://www.ias.ac.in/currsci/jun102002/1336.pdf. Accessed May 4, 2006.

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Blackwell A, Evans KA, Strang RH, Cole M. Toward development of neem-based repellents against the Scottish Highland biting midge Culicoides impunctatus. Med Vet Entomol 2004;18:449452. Costa CT, Bevilaqua CM, Maciel MV, Camurca-Vasconcelos AL, Morais SM, Monteiro MV, Farias VM, da Silva MV, Souza MM. Anthelmintic activity of Azadirachta indica A. Juss against sheep gastrointestinal nematodes. Vet Parasitol 2006;137:306310. Dawo F, Asseye Z, Tibbo M. Comparative evaluation of crude preparation of Azadirachta indica leaf and albendazole in naturally infected goats with internal parasites. Bull Anim Health Prod Afr 2001;49:140-144. Elangovan AV, Verma SV, Sastry VR, Singh SD. Laying performance of Japanese quail fed graded levels of neem (Azadirachta indica) kernel meal incorporated diets. J Sci Food Agric 2000; 88:113-120. Garg S, Talwar GP, Upadhyay SN. Immunocontraceptive activity guided fractionation and characterization of active constituents of neem (Azadirachta indica) seed extracts. J Ethnopharmacol 1998;60:235-246. Gowda SK, Verma SV, Elangovan AV, Singh SD. Neem (Azadirachta indica) kernel meal in the diet of White Leghorn layers. Br Poult Sci 1998;39:648-652. Guerrini VH, Kriticos CM. Effects of azadirachtin on Ctenocephalides felis in the dog and the cat. Vet Parasitol 1998; 74:289-297. Heath AC, Lampkin N, Jowett JH. Evaluation of nonconventional treatments for control of the biting louse (Bovicola ovis) on sheep. Med Vet Entomol 1995;9:407-412. Herr SM. In: Ernst E, Young VSL, eds. Herb–Drug Interaction Handbook. 2nd ed. Nassau, NY: Church Street Books; 2002. Khillare B, Shrivastav TG. Spermicidal activity of Azadirachta indica (neem) leaf extract. Contraception 2003;68:225-229. Mishra AK, Singh N, Sharma VP. Use of neem oil as a mosquito repellent in tribal villages of Mandla district, Madhya Pradesh. Indian J Malariol 1995;32:99-103. Mulla MS, Su T. Activity and biological effects of neem products against arthropods of medical and veterinary importance. J Am Mosq Control Assoc 1999;15:133-152. Nagalakshmi D, Sastry VR, Agrawal DK, Katiyar RC, Verma SV. Performance of broiler chicks fed on alkali-treated neem (Azadirachta indica) kernel cake as a protein supplement. Br Poult Sci 1996;37:809-818. O’Brien DJ. Treatment of psoroptic mange with reference to epidemiology and history. Vet Parasitol 1999;83:177-185. Pai MR, Acharya LD, Udupa N. Evaluation of antiplaque activity of Azadirachta indica leaf extract gel—a 6-week clinical study. J Ethnopharmacol 2004;90:99-103. Pillai NR, Santhakumari G. Effects of nimbidin on acute and chronic gastroduodenal ulcer models in experimental animals. Planta Med 1984;50:143. Sadekar RD, Kolte AY, Barmase BS, Desai VF. Immunopotentiating effects of Azadirachta indica (Neem) dry leaves powder in broilers, naturally infected with IBD virus. Indian J Exp Biol 1998;36:1151-1153. Shukla R, Singh S, Bhandari CR. Preliminary clinical trials on antidiabetic actions of Azadirachta indica. Med Surg 1973; 13:11. Su T, Mulla MS. Effects of neem products containing azadirachtin on blood feeding, fecundity, and survivorship of Culex tarsalis and Culex quinquefasciatus (Diptera: Culicidae). J Vector Ecol 1999;24:202-215. Subapriya R, Nagini S. Medicinal properties of neem leaves: a review. Curr Med Chem Anticancer Agents 2005;5:149-146. Talwar GP, Raghuvanshi P, Misra R, Mukherjee S, Shah S. Plant immunomodulators for termination of unwanted pregnancy

and for contraception and reproductive health. Immunol Cell Biol 1997;75:190-192. Wandscheer CB, Duque JE, da Silva MA, Fukuyama Y, Wohlke JL, Adelmann J, Fontana JD. Larvicidal action of ethanolic extracts from fruit endocarps of Melia azedarach and Azadirachta indica against the dengue mosquito Aedes aegypti. Toxicon 2004;44:829-835. Williamson E, ed. Major Herbs of Ayurveda. London: Churchill Livingstone; 2002. Winslow K. Veterinary Materia Medica and Therapeutics. New York: William R. Jenkins; 1908.

Nettle

Urtica dioica L. sp. Dioica • UR-ti-kuh dy-oh-EE-kuh Similar Species: Urtica urens, others Common Names: Nettles, stinging nettle, dwarf nettle, urtica Family: Urticaceae Parts Used: Leaf: For inflammatory disease Root: For prostatic disease Seed: For renal disease Selected Constituents: Flavonoids, acetylcholine, phenolic acids, coumarin, sterols. As a nutritive tonic, this herb is particularly high in calcium, chromium, magnesium, zinc, cobalt, manganese, phosphorus, potassium, protein, riboflavin, selenium, silicon, thiamine, vitamin A, and vitamin C. The seed contains glycerol, linoleic acid, linolenic acid, oleic acid, and palmitic acid. Clinical Action: Anti-inflammatory, diuretic, nutritive, hemostatic, antidiarrheal. Root is used for prostatic disease, particularly for benign prostatic hypertrophy (BPH) in men. The seed may be a kidney trophorestorative. Energetics: Sweet, cool Published Research: Nettle contains a lectin that binds N-acetylglucosamine on cell surfaces and is known to be a major histocompatibility complex (MHC) I and MHC II superantigen. A phenolic extract inhibits proinflamma-

Materia Medica • CHAPTER 24

tory cytokine production via cyclooxygenase, including LTB4; a whole plant extract, IDS23, partially inhibits lipoxygenase-derived inflammatory products and inhibits NF-kappaB activation. Allergies In a double-blind, randomized trial comparing freezedried nettle (600 mg) with placebo given at onset of symptoms to 69 human patients with allergic rhinitis, nettle was rated higher than placebo on symptom assessments (Mittman, 1990). Prostatic hypertrophy Wilt (2000) conducted a systematic review of phytotherapy for BPH in 18 trials involving 2939 men. Saw palmetto (Serenoa repens) was more effective than other plant therapies, including nettle root. Studies that involved nettle were, however, inadequate for investigators to fully judge its efficacy. A subsequent randomized, doubleblind, placebo-controlled trial found that ingestion of a dry extract of the root led to significant improvement in international prostate symptom scores, but no differences in maximum urinary flow rate or residual urine volume were observed. Fewer adverse events were reported in the treatment group as well (Schneider, 2004). Renal disease Nettle seed was first suggested for the treatment of patients with renal disease by herbalist David Winston. A paper reported two cases of humans with persistently elevated serum creatinine that required them to undergo long-term dialysis (Treasure, 2003). A hydroethanolic (1 : 5) tincture of Nettle seed (5 mL TID) led to reductions in serum creatinine in both patients. In one patient, discontinuation of Nettle seed was associated with a subsequent rise in creatinine; when the herb was started again, creatinine fell once more. Osteoarthritis Randall (1999) surveyed 18 patients with arthritis to determine whether nettle had been helpful in the treatment of their arthritis. Almost all associated nettle with improvement or cure, and the only reported adverse effect was a transient urticarial rash. The same group (Randall, 2000) then conducted a randomized, controlled, double-blind, crossover study in 27 patients with thumb or index finger base arthritis. Nettle leaf was applied topically to sting the area, once daily for 1 week. After 5 weeks of washout, placebo (white nettle, Lamium album) was applied similarly. Active nettle provided significantly better pain control than was produced by placebo, according to visual analogue scale and disability questionnaires. Indications: Leaf: chronic diarrhea, kidney disease, cystitis, eczema, warts, suppression of bleeding, osteoarthritis, allergic rhinitis. Root: prostatitis, benign prostatic hypertrophy. Seed: chronic renal disease Potential Veterinary Indications: Leaf: chronic diarrhea, cystitis, osteoarthritis allergic rhinitis. Topically as a hemostatic for hot spots.

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Root: prostate cancer, prostatitis, benign prostatic hypertrophy. Seed: chronic renal disease Contraindications: Cautious authors have suggested that diabetes, congestive heart failure, kidney disease, edema, pregnancy, and lactation are contraindications for this herb (Herr, 2002). The authors do not agree and believe this to be a very safe herb in practice. Adverse Effects: AHPA class 1. The European Medicines Agency saw fit to establish no maximum intake on nettle herb for animals. Overindulgence in the herb can result in transient urticaria. The most obvious adverse effect is contact dermatitis that is caused by touching the fresh plant. Massive exposure has been reported to cause trembling, salivation, dyspnea, vomiting, pain, and weakness in hunting dogs (atropine and rapid-acting corticosteroids are said to provide effective treatment). More recent reports claim that these effects were due to misidentification of the culprit plant, which was believed by these latter authors to be Urtica chamaedryoides, or possibly, a “nettle” of another genus, such as Cnidoscolus, Jatropha, or Solanum. Another possibility is that these effects were caused by inhalation of pollen or another factor elaborated by the plant (Edom, 2002). Dosage: External Use: Fresh plant juice Internal Use: Human Dried leaf, root, or seed: 1-10 g TID, up to 6 times daily for acute conditions Concentrated root extract (5 : 1 to 10 : 1): 300-400 mg TID Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 30%-35% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions Small Animal Dried herb: 50-600 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually in 30%-35% ethanol) 1 : 2-1 : 3: 1.0-3.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. Notes of Interest: Handled with gloves, nettle leaf can be sauteed in butter and is tastier than spinach. The exact agent responsible for the sting of nettle is unknown; however, nettle hairs and whole plant extract have been found to contain high levels of leukotrienes and histamine, and so resemble insect venoms and cutaneous mast cells with regard to their mediators (Bone, 2003). When the “sting” is initiated, acetylcholine, histamine, and serotonin are released, in addition to a fourth, unidentified substance thought to be an enzyme. Selected References Bone K. A Clinical Guide to Blending Liquid Herbs. Sydney: Churchill Livingstone; 2003. Edom G. The uncertainty of the toxic effect of stings from the Urtica nettle on hunting dogs. Vet Hum Toxicol 2002;44:4244.

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Herr SM. In: Ernst E, Young VSL, eds. Herb–Drug Interaction Handbook. 2nd ed. Nassau, NY: Church Street Books; 2002. Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990;56:44-47. Randall C, Meethan K, Randall H, Dobbs F. Nettle sting of Urtica dioica for joint pain—an exploratory study of this complementary therapy. Complement Ther Med 1999;7:126-131. Randall C, Randall H, Dobbs F, Hutton C, Sanders H. Randomized controlled trial of nettle sting for treatment of base-ofthumb pain. J R Soc Med 2000;93:305-309. Schneider T, Rubben H. Stinging nettle root extract (Bazotonuno) in long term treatment of benign prostatic syndrome (BPS). Results of a randomized, double-blind, placebo controlled multicenter study after 12 months. Urologe A 2004; 43:302-306. Treasure J. Urtica semen reduces serum creatinine levels. J Am Herb Guild 2003;4:22-25. Wilt TJ, Ishani A, Rutks I, MacDonald R. Phytotherapy for benign prostatic hyperplasia. Public Health Nutr 2000;3:459-472.

Noni Morinda citrifolia L. • Moh-RIN-duh sit-tru-FOH-lee-uh Distribution: Southeast Asia, Polynesian Islands; found in open coastal regions, often along lava flows Similar Species: Morinda officinalis (Ba Ji Tian), Morinda lucida Common Names: Indian mulberry, nono or nonu, cheese fruit, nhau, hog apple Family: Rubiaceae Parts Used: Roots, stems, bark, leaves, flowers, fruit Selected Constituents: Terpenoids, alkaloids, anthraquinones (damnacanthal, morindone, rubiadin, rubiadin-1-methyl ether, anthraquinone glycoside), β-sitosterol, flavone glycosides, linoleic acid, caprylic acid, proxeronine. Proxeronine is the most touted constituent in noni. It is converted to the patented alkaloid, xeronine. One investigator claims that a unique enzyme called proxeroninase is responsible for this conversion, and that xeronine is capable of altering the structure of a wide variety of proteins in the body, making it a normal metabolic coregulator. Xeronine has proved very difficult to isolate, and attention has recently been focused on the anthraquinone, damnacanthal. O

OMe CHO

OH O Damnacanthal

History and Traditional Usage: Said to have been in use by Polynesian Islanders for 2000 years, the noni plant has multiple traditional uses, and all parts of the plant can be used. The root was used to produce yellow or red dyes. The fruit was eaten for food in Polynesia, Southeast Asia, India, and Australia (likely only in times of starvation— it is disgusting and when ripened, ferments immediately).

Medicinally, it is used as an emmenagogue and for broken bones (likely with the leaves externally as a poultice), lacerations, bruises, sores, wounds (also probably externally), infectious disease, breast cancer, and eye problems. By the 1930s, Hawaiians used the plant mixed with ginger, coconut milk, and sugar cane juice for tuberculosis, intestinal worms, and sexually transmitted diseases, and as a blood purifier. Only the fruit extract and a juice made with the fruit are sold commercially at this time. Published Research: In vitro studies suggest that noni suppresses growth or replication of numerous bacterial species, human immunodeficiency virus (HIV), and, to a lesser extent, Mycobacterium tuberculosis; it paralyzes the human roundworm. Noni juice appears to have cyclooxygenase (COX)-1 and COX-2 inhibitory activity in vitro. Two animal studies show that noni root has central analgesic properties. Noni root showed hypotensive activity in anesthetized dogs. The fruit juice may have immunomudulatory activity; it increased thymus weight in mice and may enhance TH1–type immunologic responses. Researchers have speculated that enhancement of immune function may account for some of the antitumor activity noted in other studies. Noni juice suppressed carcinogen-induced DNA damage in two laboratory animal studies. In a randomized, double-blind, placebo-controlled trial, human cigarette smokers were found to produce lower plasma superoxide anion and lipid peroxidation activity when given noni juice as compared with placebo (Wang, 2002). Most in vitro and laboratory animal studies center on activity against tumor promotion and growth (Furusawa, 2003; Hornick, 2003). In a small clinical trial in humans, noni juice improved mental functioning and highfrequency hearing (Lanford, 2004). In summary, noni has clear antioxidant activity and contains anthraquinones with antitumor capacity; quality clinical trials undertaken to investigate its use in the treatment of patients with osteoarthritis, pain, and cancer are lacking. Indications: Primarily an antioxidant; may have immune modulating activity. Arthritis and cancer are currently the primary indications. Although the fruit is most often used, the root may be more effective for pain control and hypertension. Suggested Veterinary Indications: Conditions that benefit from antioxidant activity such as cancer and arthritis. Pain control (the root); immune support. The high sugar content of the commercially available sweetened fruit juice should be taken into account for overweight patients, and as understanding is enhanced about the possible promotional role of carbohydrates in the growth and metastasis of cancer. Contraindications: Hyperkalemia and conditions that may predispose to it—a single case report of a man in chronic renal failure suggested that noni juice had high levels of potassium (56.3 mEq/L, similar to that in orange juice and tomato juice) that led to the development of hyperkalemia in those on a low-potassium diet (Mueller, 2000). Toxicology and Adverse Effects: Laboratory studies showed that up to 8 mL/kg of the juice and the concentrated equivalent of 80 mL/kg of the juice were nontoxic

Materia Medica • CHAPTER 24

in laboratory animals. Constipation is said to be a common adverse effect of ingestion of the fruit juice. Hepatotoxicity following noni juice ingestion has been reported (Stadlbauer, 2005). One case was described of a man who had evidence 10 months previously of paracetamol toxicity and had taken a Chinese herbal formula for 9 days before admission, along with 1.5 L of noni juice during the previous 3 weeks. The other was of a woman who had taken noni juice (2 L, apparently a cumulative dose) alone and had milder clinical symptoms. If reported doses are indeed cumulative, this is a low dose of the juice, and in one of these cases, the assignment of cause to noni juice is suspect. A final case involved a man who was taking no other medication, and whose liver enzymes normalized when noni ingestion was discontinued (Millonig, 2005). Drug Interactions: None known, but some have suggested that laboratory animal studies showing hypoglycemic activity warrant caution in patients with diabetes who use hypoglycemic drugs. Dosage: Human: Noni juice: 1/4-2 oz of the sweetened fruit juice BID on an empty stomach for prevention and long-term use. Pharmacokinetic studies suggest that acute dosing should occur at least every 4 hours Small Animal: Noni juice: 2-6 mL per kg, divided doses Large Animal: Noni juice: 100 mL per 100 kg, divided doses Notes of Interest: Almost all supportive research has been done by companies that produce the product; others have pointed to claims about the broad activity of xeronine as flawed. References Furusawa E, Hirazumi A, Story S, Jensen J. Antitumour potential of a polysaccharide-rich substance from the fruit juice of Morinda citrifolia (noni) on sarcoma: 180 ascites tumours in mice. Phytother Res 2003;17:1158-1164. Hornick CA, Myers A, Sadowski-Krowicka H, Anthony CT, Woltering EA. Inhibition of angiogenic initiation and disruption of newly established human vascular networks by juice from Morinda citrifolia (noni). Angiogenesis 2003;6:143-149. Langford J, Doughty A, Wang M, Clayton L, Babich M. Effects of Morinda citrifolia on quality of life and auditory function in postmenopausal women. J Altern Complement Med 2004; 10:737-739. Li RW, Myers SP, Leach DN, Lin GD, Leach G. A cross cultural study: anti-inflammatory activity of Australian and Chinese plants. J Ethnopharmacol 2003;85:25-32. Millonig G, Stadlmann S, Vogel W. Herbal hepatotoxicity: acute hepatitis caused by a Noni preparation (Morinda citrifolia). Eur J Gastroenterol Hepatol 2005;17:445-447. Mueller BA, Scott MK, Sowinski KM, Prag KA. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? Am J Kidney Dis 2000;35:310-312. Stadlbauer V, Fickert P, Lackner C, Schmerlaib J, Krisper P, Trauner M, Stauber RE. Hepatotoxicity of Noni juice: report of two cases. World J Gastroenterol 2005;11:4758-4760. Wang MY, West BJ, Jensen CJ, et al. Morinda citrifolia (Noni): a literature review and recent advances in Noni research. Acta Pharmacol Sin 2002;23:1127-1141.

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Oats Avena sativa L. • av-VEE-nuh sa-TEE-vuh Other Names: Oats, groats Family: Poaceae Parts Used: The above-ground parts (fresh or dried), the seeds (grain), and the dried, threshed leaf and stem. Immature Oat seeds are known as “milky oats.” Some herbalists believe that only the milky oats are effective clinically. Distribution: The cultivated oat, Avena sativa, is a major human and animal food that is grown in many countries. Wild Oats are considered weeds. Selected Constituents: Oat grass greens contain the following: aconitic acid, apigenin, avenarin, caffeic acid, calcium, carbohydrates, carotene, β-carotene, chlorine, chlorophyll A and B, chromium, cobalt, copper, rhamnosides, glucosides, fat, fiber, fructose, glutamic acid, glutaric acid, guanine, hypoxanthine, iodine, iron, isoleucine, leucine, lignin, luteolin, lysine, magnesium, malic acid, manganese, methionine, niacin, oxalic acid, pantothenic acid, pentosans, phosphorus, potassium, proline, protein, pyridoxine, riboflavin, selenium, silicon, silicon oxide, β-sitosterol, sodium, spermidine, spermine, sugars, sulfur, tartaric acid, thiamine, threonine, the antioxidant tricin, tryptophan, uronic acids, valine, vanillin, and zinc Clinical Actions: General tonic, nervine tonic, stimulant, antidepressant Energetics: Warm, sweet History and Traditional Usage: Oats have been used as food and medicine since antiquity. Paleobotanists suggest that this ancient cereal grass was cultivated as early as 2000 BC. Traditionally, tinctures and extracts of oat straw and immature seed are used in Europe as a nervous system restorative, to assist convalescence, and to strengthen a weakened constitution; recently, European herbal practitioners have recommended oat straw extract for treating patients with multiple sclerosis. It is also used to treat shingles, herpes zoster, herpes simplex, and neurasthenia. The Commission E has approved oat straw for external use in treating those with inflammatory and seborrheic skin disease, especially conditions involving itching, similar to the use of colloidal oatmeal preparations (Blumenthal, 2000). Oats are made into gruel and are used for nervine, stimulant, and antispasmodic properties. Grieve (1975) describes the preparation as “boiling 1 oz Oatmeal or groats in 3 pints water until reduced to 1 quart, then straining it; sugar, lemons, wine, or raisins may be added as flavoring”. Gruel is a mild, nutritious remedy that can be used in inflammatory cases and fever; after parturition, and employed in poisoning from acid substances. It has also been used as a demulcent enema and an emollient poultice. Grieve (1975) says that in horses, it was said to cause excitement. Modern herbalists believe that only milky oats (preferably fresh or extracted fresh) are active as a nervine, and oat straw is used only as a nutritive mineral source.

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In dogs, oats have been used for convalescence, teeth problems, thinness, and growth abnormalities like hip dysplasia (de Bairacli Levy, 1985). In A Practical Treatise on the Veterinary Art, Briddon (1846) formulated a poultice for general purposes, but especially for wounds of the stifle joint in horses. This comprised the dregs of ale and sufficient oatmeal to form a stiff paste; it could be mollified with hog’s lard. Published Research: One study compared the efficacy of two products—one containing liquid paraffin with 5% colloidal Oatmeal, and the other liquid paraffin alone— for the treatment of patients with pruritus caused by postburn injuries. A total of 35 patients with acute burns were monitored in an assessor-blinded clinical trial. Patients were asked to rate their discomfort from itch and pain twice daily and to monitor their antihistamine use. Results showed that the group who used the product with colloidal oatmeal reported significantly less itch and requested significantly less antihistamine than did those who used the oil that contained liquid paraffin alone (Matheson, 2001). β-Glucan, extracted from oats, has immune modulatory effects and was studied in immune suppressed mice infected with Eimeria vermiformis. Fecal oocyst shedding was reduced in the β-glucan–treated groups compared with control groups. Control groups showed more severe clinical signs of disease and 50% mortality; minimal clinical signs and no mortality were recorded in the β-glucan–treated groups. Total immunoglobulins of β-glucan–treated groups were higher than those in nontreated groups, and interferon-γ– and interleukin4–secreting cells were noted in the spleen and mesenteric lymph nodes of β-glucan–treated groups only (Yun, 1997). Indications: Malnutrition, immune support, depression, insomnia, exhaustion, convalescence Potential Veterinary Indications: Convalescence; topically for pruritus Contraindications: None known. Toxicology and Adverse Effects: AHPA class 1. None known. Potential Drug Interactions: None described. Dosage: External Use: For external use against skin irritation and itching: 100 g of milky oats (seed heads) for 1 full bath, or equivalent preparations Internal Use: Human Oat is a common food that is used, for example, in porridge, granola, and oatcakes Dried herb: 1-10 g TID, up to 6 times daily for acute conditions Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 25%-40% ethanol, or 75%-80% glycerin) 1 : 2 or 1 : 3: 1-8 mL TID, up to 6 times daily for acute conditions Small Animal Oats can be fed to large and small animals as a gruel

Infusion: 5-30 g per cup of water, administered at a rate of 1 /2-4 cups, divided daily (optimally, TID) Tincture (usually 25%-40% ethanol, or 75%-80% glycerin) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

References Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newtown, Mass: American Botanical Council, Integrative Medicine Communications; 2000:281-282. Briddon J. A Practical Treatise on the Veterinary Art. London: Simpkin, Marshall and Co; 1846:105. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint, 1975). Matheson JD, Clayton J, Muller MJ. The reduction of itch during burn wound healing. J Burn Care Rehabil 2001;22:76-81; discussion 75. Yun CH, Estrada A, Van Kessel A, Gajadhar AA, Redmond MJ, Laarveld B. Beta-(1- > 3, 1- > 4) oat glucan enhances resistance to Eimeria vermiformis infection in immunosuppressed mice. Int J Parasitol 1997;27:329-337.

Oregon Grape

Mahonia aquifolium (Pursh) Nutt., also known as Berberis aquifolium Pursh • Ma-HO-nee-uh a-kwee-FOH-lee-um Other Names: Mountain grape, holy grape, creeping barberry Similar Species: Indian barberry (Berberis aristala) Family: Berberidaceae Parts Used: Root Distribution: Grows wild throughout Europe and North and South America Selected Constituents: Alkaloids berbamine, berberine, canadine, corypalmine, mahonine, oxyacanthine. Quaternary alkaloids palmatine and jatrorrhizine. Aporphine alkaloids, corytuberine, magnoflorine, isothebaine, and isocorydine. Bisbenzylisoquinoline alkaloids, armo-

Materia Medica • CHAPTER 24

line, baluchistine, obamegine, aquifoline. Resin and tannin Clinical Actions: Cholagogue, mild laxative, liver tonic, bitter tonic, alterative, antiemetic, anticatarrhal Energetics: Bitter and cooling History and Traditional Usage: Native Americans used Berberis aquifolium root tea to treat patients with recurrent fever and dysentery, to tone, and to stop rectal hemorrhage. It is believed to stimulate bile and kidney secretions and to improve digestion. The root’s antibacterial properties explain its successful use in treating those with skin and internal infection. Extracts were used as a blood cleanser to treat acne, nausea, eczema, psoriasis, and cold sores. The decoction acts as a digestive and liver tonic to improve appetite and relieve rheumatic inflammation. The alkaloids make it an effective antiseptic and treatment for diarrhea. Berberine has been shown to possess fungicidal and antibacterial activities, as well as activity against protozoa. Currently, predominant clinical uses of berberine include bacterial diarrhea, intestinal parasite infection, and ocular trachoma infection (Anonymous, 2000). Published Research: Berberine has antimutagenic activity (Cernakova, 2002b) and antitumor effects (Bone, 2000). Antimicrobial activity Berberine, from Berberis aquifolium, has demonstrated antibacterial (Cernakova, 2002a) and antifungal activity (Vollekova, 2001, 2003) against a variety of organisms, including resistant strains of Pseudomonas aeruginosa and Escherichia coli. Antitussive activity A glucuronoxylan isolated from stems of Berberis aquifolium was tested for antitussive activity on mechanically induced coughing in cats. It exhibited a much greater effect in comparison with drugs used in clinical practice to treat those with cough (Kardosova, 2002). Dermatologic activity Berberis aquifolium has been used to treat patients with psoriasis (Wiesenauer, 1996; Gieler, 1995). Products of lipoxygenase metabolism are known to play a role in the pathogenesis of psoriasis, and alkaloids in Berberis inhibit lipid peroxide substrate accumulation by direct reaction with peroxide or by scavenging of lipid-derived radicals (Bezakova, 1996). Indications: Externally for acne, psoriasis, vulvovaginitis. Internally as a digestive bitter; for hepatitis, enteritis, inflammatory skin disorders, and possibly infections such as urinary tract infection Potential Veterinary Indications: Chronic skin disease; giardia, enteritis; possibly other types of infection such as urinary tract infection and topically for skin and ear infections Contraindications: Berberine and other alkaloids can stimulate the uterus and should not be used during pregnancy. Toxicology and Adverse Effects: AHPA class 2b. At recommended dosages, berberine is considered to be non-

613

toxic. If taken in large quantities, it has been reported to cause acute and even fatal poisoning. Injections may produce hyperpigmentation. Dosage: External Use: Topically as a cream (containing 10% tincture) or decoction of stem bark or root: 1.5-3 g per day, divided Internal Use: Human Dried herb: 1-10 g TID Infusions and decoctions: 5 g per cup of water, with 1/2-1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 25%-50% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID Small Animal Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Infusion: 5 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually in 25%-50% ethanol) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. References Anonymous. Berberine. Altern Med Rev 2000;5:175-177. Bezakova L, Misik V, Malekova L, Svajdlenka E, Kostalova D. Lipoxygenase inhibition and antioxidant properties of bisbenzylisoqunoline alkaloids isolated from Mahonia aquifolium. Pharmazie 1996;51:758-761. Bone K, Mills S. Principles and Practice of Phytotherapy. Sydney: Churchill Livingstone; 2000. Cernakova M, Kost’alova D. Antimicrobial activity of berberine— a constituent of Mahonia aquifolium. Folia Microbiol 2002a; 47:375-378. Cernakova M, Kost’alova D, Kettmann V, Plodova M, Toth J, Drimal J. Potential antimutagenic activity of berberine, a constituent of Mahonia aquifolium. BMC Complement Altern Med 2002b;2:2. Gieler U, Weth A, von der Heger M. Mahonia aquifolium—a new type of topical treatment for psoriasis. J Dermatol Treat 1995; 6:31-34. Kardosova A, Malovkova A, Patoprsty V, Nosal’ova G, Matakova T. Structural characterization and antitussive activity of a glucuronoxylan from Mahonia aquifolium (Pursh) Nutt. Carbohydrate Polymers 2002;47:27-33. Vollekova A, Kost’alova D, Kettmann V, Toth J. Antifungal activity of Mahonia aquifolium extract and its major protoberberine alkaloids. Phytother Res 2003;17:834-837. Vollekova A, Kost’alova D, Sochorova R. Isoquinoline alkaloids from Mahonia aquifolium stem bark are active against Malassezia spp. Folia Microbiol 2001;46:107-111. Wiesenauer M, Ludtke R. Mahonia aquifolium in patients with psoriasis vulgaris—an intraindividual study. Phytomedicine 1996;3:231-235.

Panax Ginseng Panax ginseng C.A. Mey. • PAN-aks JIN-sing Other Common Names: Radix ginseng, Korean ginseng, red ginseng, Chinese ginseng, ren shen Family: Araliaceae Parts Used: Main root

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Distribution: Mountain regions of China, Korea, Japan, and Eastern Siberia Selected Constituents: The major chemical constituents are the triterpene saponins dammarane and ginsenosides (derived from oleanolic acid) (Shibata, 1985; Bruneton, 1989; Cui, 1995). The dammarane saponins are derivatives of protopanaxadiol or protopanaxatriol. Clinical Actions: Adaptogenic, stimulant, tonic, thymolepic, hypoglycemic, immune stimulant, hepatoprotective, cardioprotective, antiarrhythmic; increases adrenocorticotrophic hormone (ACTH) Energetics: Sweet, slightly bitter, slightly warming History and Traditional Usage: Used traditionally as a tonic, particularly for geriatrics, as a prophylactic and restorative agent for enhancement of mental and physical capacities; in cases of weakness, exhaustion, tiredness, and loss of concentration; during convalescence (Hallstrom, 1982; D’Angelo, 1986; Pieralisi, 1991; Forgo, 1985). Ginseng has been used in the treatment of patients with diabetes and impotence and in the prevention of hepatotoxicity and gastrointestinal disorders such as gastritis and ulcers (Bruneton, 1989). Other uses include treatment of those with liver disease, cough, fever, tuberculosis, rheumatism, vomiting during pregnancy, hypothermia, dyspnea, and nervous disorders (Bruneton, 1989). Published Research Physical performance Ginseng has an adaptogenic effect that produces a nonspecific increase in defenses against exogenous stress factors and noxious chemicals; it promotes overall improvement in physical and mental performance (Wagner, 1994; Phillipson, 1984). A randomized, doubleblind, crossover study of the effects of ginseng on circulatory, respiratory, and metabolic functions during maximal exercise in 50 men showed that ginseng increased the work capacity of participants by improving oxygen utilization (Pieralisi, 1991). A placebo-controlled, crossover study determined the effects of ginseng on the physical fitness of 43 male triathletes. Participants received 200 mg ginseng twice daily for 2 consecutive 10-week training periods. No significant changes were observed during the first 10 weeks, but ginseng prevented the loss of physical fitness during the second 10-week period (Van Schepdael, 1993). Placebo-controlled, double-blind trials have demonstrated significant athletic improvement in the ginseng group as compared with the placebo group (Forgo, 1983). Similar results were reported in athletes in whom the differences lasted for 3 weeks after the last ginseng dose (Forgo, 1985). Ginseng (1200 mg) effects were assessed in a placebocontrolled, double-blind crossover study of fatigued night nurses and were compared with those of placebo and with effects on nurses engaged in daytime work. Ginseng restored ratings on tests of mood, competence, and general performance; study investigators concluded that Ginseng had antifatigue activity (Hallstrom, 1982). Seven healthy men were subjected to treadmill tests before and after administration of a ginseng extract (2 g TID) for 8 weeks. In addition, blood was analyzed for

serum malondialdehyde, catalase, and superoxide dismutase levels as a measure of oxidant stress. At the end of the trial, subjects exhibited significantly increased exercise capacity, and ginseng extract attenuated markers of oxidant stress (Kim, 2005). Respiratory function Pulmonary function tests were monitored in 92 humans with moderate to severe chronic obstructive pulmonary disease (COPD). Patients took a placebo or 100 mg BID of a ginseng extract in this randomized, placebo-controlled trial. Function tests were studied every 2 weeks for 3 months, and all parameters were found to be improved above baseline compared with placebo (Gross, 2002). No adverse effects were observed. Immune function In a placebo-controlled, double-blind study of immune modulatory actions of ginseng, a total of 60 healthy volunteers were divided into three groups of 20 each; volunteers were given placebo or 100 mg of aqueous ginseng extract, or 100 mg of a standardized ginseng extract, every 12 hours for 8 weeks. Blood samples compared with those of the placebo group revealed an increase in chemotaxis of polymorphonuclear leukocytes, phagocytic index, and total numbers of T3 and T4 lymphocytes after 4 and 8 weeks of ginseng therapy. The group given the standardized extract also showed increased T4 : T8 ratio of natural killer cells activity. It was concluded that ginseng extract stimulated the immune system in humans, and that the standardized extract was more effective than the aqueous extract (Scaglione, 1990). Administration of 5.4 g daily of Panax ginseng to HIV1–infected patients slowed progression of the disease; this did not occur in patients who took no ginseng. Patients were not being treated with antiretroviral drugs. Ginseng slowed the loss of CD4 lymphocytes associated with progression of the disease, and it slowed the increase in CD8associated markers. It was determined that HLA subtype (which is associated with prognosis) was not involved in this change in progression (Sung, 2005). Cognitive function Rat studies have shown that administration of ginseng improved specific learning and memory tasks (Nishijo, 2004). A double-blind, placebo-controlled clinical study assessed the effects of standardized ginseng (100 mg twice daily for 12 weeks) on psychomotor performance in 16 healthy humans and showed a positive effect on attention, processing, integrated sensory motor function, and auditory reaction time. Ginseng was superior to placebo in improving certain psychomotor functions in healthy subjects (D’Angelo, 1986). In a double-blind, counterbalanced, placebo-controlled study, 200 mg of Panax ginseng extract was given to 28 young adult humans, and cognitive and mood effects were assessed. Ingestion of this herb led to improved task performance and enhanced speed of memory task performance (Kennedy, 2004). Reay (2005) examined whether the cognitive enhancement activity of ginseng extract (200 mg and 400 mg) in healthy people was related to its hypoglycemic effects.

Materia Medica • CHAPTER 24

In a placebo-controlled, double-blind, crossover trial, 30 humans completed cognition tests before and after administration of ginseng or placebo. Blood glucose was also measured before and after treatment. Both doses of ginseng led to significant reductions in blood glucose, and the 200-mg dose significantly improved some mental function test results. The authors suggest that ginseng can improve “mental performance and subjective feeling of mental fatigue during sustained mental activity,” and that this may be associated with the blood glucose changes related to ginseng ingestion. Diabetes Oral ginseng (200 mg daily for 8 weeks) given to 36 non–insulin-dependent patients elevated mood, improved physical performance, reduced fasting blood glucose and serum procollagen concentrations, and lowered glycated hemoglobin levels (Sontaneimi, 1995). A randomized, single-blind, placebo-controlled trial of healthy people in whom hyperglycemia was induced showed variable effects of Panax ginseng on blood glucose. The authors note that different concentrations of ginsenosides or simply differences in batch may have been responsible for the inconsistent results (Sievenpiper, 2003). Hypolipidemic effects Kim (2003) investigated the effects on lipid metabolism of people when 6 g ginseng extract was ingested daily. Results suggested that after 8 weeks of administration, ginseng may decrease cholesterol, triglycerides, lowdensity lipoprotein, and plasma malondialdehyde. Ginseng also increased superoxide dismutase and catalase activities, and the authors suggest that an antioxidant mechanism may be involved. Erectile dysfunction A double-blind, placebo-controlled, crossover trial in 45 men with erectile dysfunction suggested that administration of ginseng (900 mg TID) improved function scores (Hong, 2002). Veterinary Trials Immune function: pigs and cows Cows with subclinical mastitis caused by Staphylococcus aureus were injected subcutaneously with ginseng extract at 8 mg/kg per day for 6 days, or with saline as a control. The numbers of S. aureus–infected quarters and milk SCCs (somatic cell counts) decreased in ginseng-treated cows. Phagocytosis and oxidative burst activity were significantly increased 1 week after initiation of ginseng treatment. The number of monocytes in ginseng cows was significantly higher 1 week post treatment, and the number of lymphocytes was significantly higher at 2 and 3 weeks than was the preinfusion number. These findings indicated that ginseng can activate innate immunity and accelerate recovery from mastitis (Hu, 2001). Adjuvant effects of a crude ginseng extract and purified ginsenoside R(b1) were evaluated in dairy cattle that had been immunized with ovalbumin (OVA) or an S. aureus bacterin (used for prevention of bovine mastitis). In all, 36 lactating cows were randomly divided into six groups.

615

Cows were inoculated twice intramuscularly at 2-week intervals with saline solution, OVA in saline, or OVA in combination with 4, 16, or 64 mg ginseng, or aluminium hydroxide adjuvant. The antibody response in serum was significantly higher in animals immunized with OVA and ginseng than in those immunized with OVA alone. A significant increase in milk antibody titers was noted 2 weeks after the second immunization with OVA and 4 mg ginseng. Addition of R(b1) resulted in significantly higher antibody production and lymphocyte proliferation than occurred in the control group. Ginseng induced significantly higher lymphocyte proliferation. It was concluded that both ginseng and R(b1) were safe adjuvants, and that R(b1) had the strongest adjuvant effects (Hu, 2003). In pigs, the adjuvant effect of ginseng was demonstrated by vaccinating them against porcine parvovirus (PPV) and Erysipelothrix rhusiopathiae infections with the use of commercially available vaccines. It was found that the addition of 2 mg ginseng per vaccine dose significantly potentiated the antibody titer response to both vaccines without altering their safety. Aluminium hydroxide–adjuvanted vaccines favored the production of IgG1 antibodies. Vaccines supplemented with ginseng favored IgG2. The study concluded that ginseng used as an adjuvant provides a safe and inexpensive alternative for improving the potency of aluminium hydroxide– adjuvanted vaccines (Rivera, 2003). Miscellaneous trials In White Leghorn poultry, females were fed for 4 weeks a corn-based diet (control) or an experimental diet with 0.25% ginseng or petroleum ether (PESF), methyl alcohol (MESF), or water (WASF) extract. Each ginseng treatment lowered serum total cholesterol level (67%-83% of control) and serum low-density lipoprotein cholesterol level (53%-81% of control). PESF treatment was the most effective suppressor of each, and WASF had significant impact. PESF effected a change in the ratio of low- to high-density lipoprotein cholesterol from 1.46 (control) to 0.88. In companion studies, broiler females were fed 0.28% ginseng root powder or fractions. Results confirmed those recorded earlier. Ginsenosides are considered to be the active agents for suppression of cholesterogenesis and lipogenesis (Qureshi, 1983). In dogs, a study investigated the effects of ginseng on liver morphologic change and function. Fifteen adult dogs were divided into three groups: control (40% hepatectomy, untreated), a 250 group (40% hepatectomy, 250 mg/kg of ginseng PO), and a 500 group (40% hepatectomy, 500 mg/kg of ginseng PO). Liver regeneration rates were higher in treated groups than in controls. Blood values returned to normal ranges except for leukocyte counts for 3 days postoperatively. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in treated groups were significantly decreased compared with control values. Degenerative cells and connective tissue were significantly decreased with ginseng. It was concluded that ginseng accelerates liver regeneration and ameliorates liver injury in dogs (Kwon, 2003). Indications: To aid with short-term stress, recovery from disease or surgery; to minimize adverse effects of

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chemotherapy, cardiac arrhythmia; to improve resistance to infection, low sperm count, erectile dysfunction, chronic inflammation; for long-term use in geriatric patients and those with diabetes, asthma, cancer, depression, and cognitive disorders Potential Veterinary Indications: Improving immune function; adjuvant for vaccination; mastitis treatment in cattle; diabetes mellitus; liver disease in dogs; tonic for convalescing animals or those with chronic debilitating disease; performance animals; fertility improvement in male animals Contraindications: Ginseng should be avoided in hypertension, although a trial using a related species—Panax quinquefolius (American ginseng)—in hypertensive people for 12 weeks found no adverse effect on blood pressure after administration of the herb (Stavro, 2006). Toxicology and Adverse Effects: AHPA class 2d. See contraindication provided earlier. One case of ginsengassociated cerebral arteritis was reported in a patient who consumed a high dose of an ethanol extract of ginseng root (6 g) (Ryu, 1995). Two cases of mydriasis and disturbance in accommodation and dizziness have been reported after large doses (3-9 g) (Lou, 1989). Estrogeniclike adverse effects have been reported in women. Seven cases of mastalgia (Palmer, 1978; Koriech, 1978) and one of vaginal bleeding in a postmenopausal woman were reported. Increased libido in premenopausal women has been reported (Punnonen, 1980). However, clinical studies have demonstrated that standardized ginseng extract does not cause a change in male or female hormonal status (Buchi, 1984; Reinhold, 1990). Potential Drug Interactions: Ginseng intake may slightly reduce blood glucose levels (Kwan, 1994; Sotaneimi, 1995). Two instances of interaction have been reported between ginseng and phenelzine, a monoamine oxidase inhibitor (Jones, 1987; Shader, 1985). The clinical significance of this has not been evaluated. Preparation Notes: Red ginseng is Panax ginseng that has been steamed before drying. Dosage: Human: Dried herb: 1-10 g TID 5 : 1 dried extract: 200 mg daily Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID Tincture (usually 60%-70% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Decoction: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 60%-70% ethanol) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. References Bradley PR, ed. British Herbal Compendium, vol 1. Guildford, UK: British Herbal Medicine Association; 1992:115-118. Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier; 1995.

Buchi K, Jenny E. On the interference of the standardized ginseng extract G115 and pure ginsenosides with agonists of the progesterone receptor of the human myometrium. Phytopharmacy 1984:1-6. Cui JF. Identification and quantification of ginsenosides in various commercial ginseng preparations. Eur J Pharmaceut Sci 1995;3:77-85. D’Angelo L, Grimaldi R, Caravaggie M, et al. Double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers. J Ethnopharmacol 1986;16:15-22. Forgo I. Effect of drugs on physical performance and hormone system of sportsmen. Münchener Medizinische Wochenschrift 1983;125:822-824. Forgo I, Schimert G. The duration of effect of the standardized ginseng extract in healthy competitive athletes. Notabene Med 1985;15:636-640. Gross D, Shenkman Z, Bleiberg B, Dayan M, Gittelson M, Efrat R. Ginseng improves pulmonary functions and exercise capacity in patients with COPD. Monaldi Arch Chest Dis 2002; 57:242-246. Hallstrom C, Fulder S, Carruthers M. Effect of ginseng on the performance of nurses on night duty. Compar Med East West 1982;6:277-282. Hong B, Ji YH, Hong JH, Nam KY, Ahn TY. A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002;168:2070-2073. Hu S, Concha C, Johanisson A, Meglia G, Walker KP. Effect of subcutaneous injection of ginseng on cows with subclinical Staphylococcus aureus mastitis. J Vet Med B Infect Dis Vet Public Health 2001;48:519-528. Hu S, Concha C, Lin F, Persson Waller K. Adjuvant effect of ginseng extracts on the immune responses to immunisation against Staphylococcus aureus in dairy cattle. Vet Immunol Immunopathol 2003;91:29-37. Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-202. Kennedy DO, Haskell CF, Wesnes KA, Scholey AB. Improved cognitive performance in human volunteers following administration of guarana (Paullinia cupana) extract: comparison and interaction with Panax ginseng. Pharmacol Biochem Behav 2004;79:401-411. Kim SH, Park KS. Effects of Panax ginseng extract on lipid metabolism in humans. Pharmacol Res 2003;48:511-513. Kim SH, Park KS, Chang MJ, Sung JH. Effects of Panax ginseng extract on exercise-induced oxidative stress. J Sports Med Phys Fitness 2005;45:178-182. Koriech OM. Ginseng and mastalgia. BMJ 1978;297:1556. Kwan HJ, Wan JK. Clinical study of treatment of diabetes with powder of the steamed insam (ginseng) produced in Kaesong, Korea. Tech Info 1994;6:33-35. Kwon YS, Jang KH, Jang IH. The effects of Korean red ginseng (Ginseng radix rubra) on liver regeneration after partial hepatectomy in dogs. J Vet Sci 2003;4:83-92. Lou BY, Li CF, Li PY, Ruan JP. Eye symptoms due to ginseng poisoning. Yan Ke Xue Bao 1989;5:96-97. Morris AC, Jacobs I, Kligerman TM. No ergogenic effect of ginseng extract after ingestion. Med Sci Sports Exerc 1994;26:S6. Nishijo H, Uwano T, Zhong YM, Ono T. Proof of the mysterious efficacy of ginseng: basic and clinical trials: effects of red ginseng on learning and memory deficits in an animal model of amnesia. J Pharmacol Sci 2004;95:145-152. Owen RT. Ginseng: a pharmacological profile. Drugs Today 1981;17:343-351. Palmer BV, Montgomery AC, Monteiro JC. Ginseng and mastalgia. BMJ 1978;279:1284.

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Phillipson JD, Anderson LA. Ginseng-quality, safety and efficacy? Pharmaceut J 1984;232:161-165. Pieralisi G, Ripari P, Vecchiet L. Effects of a standardized ginseng extract combined with dimethylaminoethanol bitartrate, vitamins, minerals, and trace elements on physical performance during exercise. Clin Ther 1991;13:373-382. Punnonen R, Lukola A. Oestrogen-like effect of ginseng. BMJ 1980;281:1110. Qureshi AA, Abuirmelah N, Din ZZ, Ahmad Y, Burger WC, Elson CE. Suppression of cholesterogenesis and reduction of LDL cholesterol by dietary ginseng and its fractions in chicken liver. Atherosclerosis 1983;48:81-94. Reay JL, Kennedy DO, Scholey AB. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol 2005;19:357-365. Reinhold E. Der Einsatz von Ginseng in der Gynäkologie. Natur Ganzheits Medizin 1990;4:131-134. Rivera E, Daggfeldt A, Hu S. Ginseng extract in aluminium hydroxide adjuvanted vaccines improves the antibody response of pigs to porcine parvovirus and Erysipelothrix rhusiopathiae. Vet Immunol Immunopathol 2003;91:19-27. Ryu SJ, Chien YY. Ginseng-associated cerebral arteritis. Neurology 1995;45:829-830. Scaglione F, Ferrara F, Dugnani S, Falchi M, Santoro G, Fraschini F. Immunomodulatory effects of two extracts of Panax ginseng. Drugs Exp Clin Res 1990;26:537-542. Shader RI, Greenblatt DJ. Phenelzine and the dream machine— ramblings and reflections. J Clin Psychopharmacol 1985;5:67. Shibata S, Tanaka O, Shoji J, et al. Chemistry and pharmacology of Panax. In: Wagner H, Farnsworth NR, Hikino H, eds. Economic and Medicinal Plants Research, vol 1. London: Academic Press; 1985. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Null and opposing effects of Asian ginseng (Panax ginseng C.A. Meyer) on acute glycemia: results of two acute dose escalation studies. J Am Coll Nutr 2003;22:524-532. Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non–insulin-dependent diabetic patients. Diabetes Care 1995; 18:1373-1375. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47:791-796. Epub 2006 Mar 6. Sung H, Kang SM, Lee MS, Kim TG, Cho YK. Korean red ginseng slows depletion of CD4 T cells in human immunodeficiency virus type 1–infected patients. Clin Diagn Lab Immunol 2005;12:497-501. Van Schepdael P. Les effets du ginseng G115 sur la capacité physique de sportifs d’endurance. Acta Ther 1993;19:337-347. Wagner H, Norr H, Winterhoff H. Plant adaptogens. Phytomedicine 1994;1:63-76.

Parsley Petroselinum crispum (Mill.) Nyman ex. A.W. Hill • petroh-sel-EE-num KRISP-um Family: Apiaceae Distribution: A native of Mediterranean countries, it is now naturalized around the world. Parts Used: The herb, root, and fruit (which looks like a seed), but mainly the root for therapeutic purposes Selected Constituents: Apiol, essential oil (Parsley camphor), myristicin mainly in the seed and root.

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Bergapten, a furanocoumarin, flavonoids (apiin, luteolin, apigenin glycosides), fatty oil (in seeds), vitamin C, provitamin A, iron, calcium, phosphorus, manganese. Tannins, sterols, triterpenes, cumarines, imperatorin O O

H3CO

OCH3

Apiol

CH3 O

O

O

O

Bergapten

Clinical Actions: Antispasmodic, diuretic, expectorant, antirheumatic, antimicrobial, carminative Energetics: Sweet, bland, warm History and Traditional Usage: Parsley is used traditionally as a carminative (similar to fennel and dill, which also contain apiol) for reducing flatulence and colic. In Germany, it has been used for the treatment of patients with anorexia to stimulate appetite. Parsley also has a tradition of use in constipation and is used as a traditional remedy to decrease blood sugar in diabetes and dropsy (edema). Galen said, “It provoketh the urine mightily.” In France, it was used to treat those with kidney stones. Parsley has a long tradition of use in anemia and iron deficiency disorders; it is high in vitamin C and iron, and the vitamin C component improves the bioavailability of iron. Parsley has also been used as a remedy for rheumatism and gout. Grieves (1975) writes, “Hares and rabbits will come from a great distance to seek for it, so that it is scarcely possible to preserve it in gardens to which they have access. Sheep are also fond of it, and it is said to be a sovereign remedy that preserves them from footrot, provided it is given to them in sufficient quantities.” “The foliage is well liked by sheep and goats. It improves their milk yield and keeps them free from foot ills. It is used for the treatment of all disorders of the kidneys and bladder, gravel, stone, congestion, cystitis, jaundice, obesity, dropsy, worms, rheumatism, sciatica, neuritis, arthritis, and swellings of the joints” (De Bairacli-Levy, 1963). The root is used for constipation, obstruction of the intestine, and fever, the seed for colic and fever (de Bairacli Levy, 1963). de Bairacli (1985) states that parsley alone has cured even severe cases of rheumatism and arthritis, and it can be used to improve eye health. Steamed parsley roots can be fed following gastroenteritis and can be used for anemia and bad breath.

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Published Research: Parsley leaf (ethanolic extract) was tested for its ability to inhibit gastric secretion and to protect the gastric mucosa against induced physical and chemical injury in vivo. In doses of 1 and 2 g/kg body weight, it had significant antiulcerogenic activity. Acute toxicity tests showed a large margin of safety for the extract (Al-Howiriny, 2003). A mechanism of action for laxative effects has been investigated. In the rat colon, an aqueous extract of parsley seeds significantly reduced net water absorption from the colon, as compared with controls. Results suggest that parsley acts by inhibiting sodium and consequently water absorption through inhibition of the Na+/K+ pump, stimulating the Na-K-Cl transporter, and increasing electrolyte and water secretion (Kreydiyyeh, 2001). The same mechanism of action leads to a reduction in Na+ and K+ reabsorption and a diuretic action. This was demonstrated in a study in which rats were offered an aqueous parsley seed extract to drink. Rats eliminated a significantly larger volume of urine daily compared with when they drank water alone. This effect was apparent in the presence of amiloride and furosemide and in the absence of sodium—but not in the absence of potassium. Reduced reabsorption led to an osmotic water flow into the lumen and diuresis (Kreydiyyeh, 2002). In one study, parsley extract was given to male rats with diabetes. The numbers of secretory granules and cells in islets and other morphologic changes were not different from those of the control diabetic group; however, blood glucose levels were reduced compared with the diabetic group. It was suggested that parsley can provide blood glucose homeostasis but cannot regenerate B cells of the endocrine pancreas (Yanardag, 2003). Parsley leaves (methanolic extract) showed potent estrogenic activity, similar to that of isoflavone glycosides from soybeans. The methanolic extracts of parsley, apiin, and apigenin restored uterine weight in ovariectomized mice when orally administered for 7 consecutive days. These compounds were shown to have proliferative activity in an estrogen-sensitive breast cancer cell line (Yoshikawa, 2000). Antioxidant activity has been demonstrated in vitro (Fejes, 1998) and in rats (Hempel, 1999). The antioxidative properties of parsley have also been demonstrated in a randomized crossover trial in 14 human subjects. The urinary excretion of flavones and biomarkers for oxidative stress were measured. Erythrocyte glutathione reductase and superoxide dismutase activities increased during intervention with parsley (P < .005) as compared with levels in the basic diet (Nielsen, 1999). Indications: Colic, flatulence, dysuria, cystitis, dysmenorrhea, myalgia Potential Veterinary Uses: Mild colic and flatulence; cystitis, dysuria, and urinary calculi; incontinence in females; diabetes Contraindications: Inflammatory kidney disease, pregnancy Toxicology and Adverse Effects: AHPA class 2b, 2d, because of the contraindications listed earlier. In isolation, apiol (a chemical extracted from the seed) is toxic in large doses, causing irritation to mucous membranes,

liver damage, cardiac arrhythmia, and central paralysis; it is an abortifacient. Parsley, however, has no reputation at all for toxicity in humans. Phytophotodermatitis has been described in pigs exposed to parsley (Griffiths, 2000). Drug Interactions: The effect of parsley on mice (pretreated with parsley juice) was investigated in terms of the hypnotic action of pentobarbital and the analgesic action of paracetamol and aminopyrine—drugs that rely on the cytochrome P450 superfamily for their metabolism. In mice pretreated with parsley juice, the action of pentobarbital was prolonged compared with its effects in controls. Parsley increased and prolonged the analgesic action of aminopyrine and paracetamol. Parsley juice caused a significant decrease in cytochrome P450 in the liver compared with control values (Jakovljevic, 2002). Dosage: Human: Fresh leaves: A handful a day Dried herb: 1-10 g TID, up to 6 times daily for acute conditions Infusions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 45% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions Small Animal: Fresh Parsley leaves (minced): 1 teaspoon per 5 kg of body weight in food Dried herb: 25-500 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 45% ethanol) 1 : 2-1 : 3: 0.5-2.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula References Al-Howiriny T, Al-Sohaibani M, El-Tahir K, Rafatullah S. Prevention of experimentally-induced gastric ulcers in rats by an ethanolic extract of “Parsley” Petroselinum crispum. Am J Chin Med 2003;31:699-711. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. Fejes S, Kery A, Blazovics A, et al. [Investigation of the in vitro antioxidant effect of Petroselinum crispum.] Acta Pharm Hung 1998;68:150-156. Griffiths IB, Douglas RG. Phytophotodermatitis in pigs exposed to parsley (Petroselinum crispum). Vet Rec 2000;146:73-74. Hempel J, Pforte H, Raab B, Engst W, Bohm H, Jacobasch G. Flavonols and flavones of parsley cell suspension culture change the antioxidative capacity of plasma in rats. Nahrung 1999;43:201-204. Jakovljevic V, Raskovic A, Popovic M, Sabo J. The effect of celery and parsley juices on pharmacodynamic activity of drugs involving cytochrome P450 in their metabolism. Eur J Drug Metab Pharmacokinet 2002;27:153-156. Kreydiyyeh SI, Usta J. Diuretic effect and mechanism of action of parsley. J Ethnopharmacol 2002;79:353-357.

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Kreydiyyeh SI, Usta J, Kaouk I, Al-Sadi R. The mechanism underlying the laxative properties of parsley extract. Phytomedicine 2001;8:382-388. Nielsen SE, Young JF, Daneshvar B, et al. Effect of parsley (Petroselinum crispum) intake on urinary apigenin excretion, blood antioxidant enzymes and biomarkers for oxidative stress in human subjects. Br J Nutr 1999;81:447-455. Yanardag R, Bolkent S, Tabakoglu-Oguz A, Ozsoy-Sacan O. Effects of Petroselinum crispum extract on pancreatic B cells and blood glucose of streptozotocin-induced diabetic rats. Biol Pharm Bull 2003;26:1206-1210. Yoshikawa M, Uemura T, Shimoda H, Kishi A, Kawahara Y, Matsuda H. Medicinal foodstuffs. XVIII. Phytoestrogens from the aerial part of Petroselinum crispum Mill. (Parsley) and structures of 6″-acetylapiin and a new monoterpene glycoside, petroside. Chem Pharm Bull (Tokyo) 2000;48:1039-1044.

Passionflower Passiflora incarnata L., other species also used; Passiflora edulis, Passiflora caerulea • pass-iff-FLOR-uh in-kar-NAHtuh Other Names: Passionvine, maypop, apricot vine, wild passionflower, passiflore, fleur de la passion, fleischfarben passionsblume, pasiflora Family: Passifloraceae Parts Used: Aerial parts. The yellow pulp from the berry is edible. Distribution: Passionflower is indigenous from Southeast United States to Argentina and Brazil. It is cultivated in other parts of the world as a garden plant. Selected Constituents: Flavonoids (up to 2.5%): in particular, C-glycosyl-flavones, including, among others, isovitexin-2″-o-glucoside, schaftoside, isoschaftoside, isoorientin, isoorientin-2″-o-flucoside, vicenin-2, and lucenin-2; cyanogenic glycosides: gynocardine (21 g/kg (Schisandra extract, standardized to 2% schisandrins) in rats (Burgos, 1999). No toxicity was observed in pigs after oral intake of schisandra extract (2% schisandrins) for 90 days at daily doses of 0.07 to 0.72 g/kg. No embryotoxic effects were observed in rats or mice after oral dosages of 0.1 to 0.5 g/kg (Hanke, 1999). Potential Drug Interactions: Although no interactions have been documented, the potential for drug–herb interactions with corticosteroid medications, reserpine, and drugs metabolized by the cytochrome P450 pathway has been suggested. Because schisandra enhances phase I/II metabolism, it might promote the clearance of several drugs, and caution should be exercised with those drugs that have a narrow therapeutic window, such as digoxin, coumarin, and anticonvulsants. Use of Schisandra should be discontinued about 1 week before surgery is performed. Dosage: Human: Dried herb: 1-10 g TID Infusions: 5-30 g per cup of water, with 1 cup of the tea given TID Tincture (usually 45%-60% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried herb: 50-400 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 45%-60% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2-1 : 3: 1.02.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

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References Ahumada F, Hermosilla J, Hola R, et al. Studies on the effect of Schizandra chinensis extract on horses submitted to exercise and maximum effort. Phytother Res 1989;3:175-179. Azizov AP, Seifulla RD. [The effect of elton, leveton, fitoton and adapton on the work capacity of experimental animals.] Eksperimentalnaia I Klinicheskaia Farmakologiia 1998;61:6163. Bensky D, Gamble A. Chinese Herbal Medicine Materia Medica. Seattle: Eastland Press; 1986:541-543. Burgos RA, Hancke JL. Toxicological studies on S. chinensis. Fitoterapia 1999;70:451-471. Hancke J, Burgos R, Caceres D, et al. Reduction of serum hepatic transaminases and CPK in sport horses with poor performance treated with a standardized Schizandra chinensis fruit extract. Phytomedicine 1996;3:237-240. Hancke J, Burgos R, Wikman G, et al. Schisandra chinensis, a potential phytodrug for recovery of sport horses. Fitoterapia 1994;65:113-118. Hikino H, Kiso Y, Taguchi H, et al. Antihepatotoxic actions of lignoids from Schizandra chinensis fruits. Planta Med 1984;50:213218. Kubo S, Ohkura Y, Mizoguchi Y, et al. Effect of gomisin A (TJN101) on liver regeneration. Planta Med 1992;58:489-492. Ma DY, Shan AS, Li QD, et al. Effects of Chinese medicinal herb on growth and immunization of laying chicks. J Northeast Agric Univ (English ed) 2003;10:121-125. Maeda S, Takeda S, Miyamoto Y, Aburada M, Harada M. Effects of gomisin A on liver functions in hepatotoxic chemical– treated rats. Jpn J Pharmacol 1985;38:347-353. Ohtaki Y, Hida T, Hiramatsu K, et al. Deoxycholic acid as an endogenous risk factor for hepatocarcinogenesis and effects of gomisin A, a lignan component of Schizandra fruits. Anticancer Res 1996;16:751-755. Panossian AG, Oganessian AS, Ambartsumian M, et al. Effects of heavy physical exercise and adaptogens on nitric oxide content in human saliva. Phytomedicine 1999;6:17-26. Peng GR, Xu ZQ, Zeng XG, et al. Effects of Schisandra chinensis on the contents of DNA, glycogen and enzymes in kidneys and gonads of rabbits. Shanghai J Tradit Chin Med 1989;2:43-45. Cited in Abstracts of Chinese Medicine 1989;3:157. Shiota G, Yamada S, Kawasaki H. Rapid induction of hepatocyte growth factor mRNA after administration of gomisin A, a lignan component of Shizandra fruits. Res Commun Mol Pathol Pharmacol 1996;94:141-146.

Sheep Sorrel Rumex acetosella L. • ROO-meks a-see-TOE-sell-uh or akee-TOE-sell-uh Other Names: Sour weed, field sorrel, sorrel, red weed, sour dock, sour grass, dog-eared sorrel Family: Polygonaceae Parts Used: Leaves, fresh and dried Distribution: Sheep sorrel grows in pastures and dry gravelly places in most parts of the world, except the tropics; it has also been found in Arctic and Alpine regions. Selected Constituents: Aerial parts contain rutin 0.53%, flavone glycosides (hyperoside or quercitin-3dgalactoside) 0.05%, and hyperin (12 mg/100 g), as well as vitamins C, A, B complex, D, E, K, P, and U. Also included are calcium, phosphorus, magnesium, potassium, silicon,

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iron, sulphur, copper, iodine, manganese, and zinc. Carotenoids, chlorophyll, organic acids (malic, oxalic, tannic, tartaric, and citric) and phytoestrogens, anthraquinones, emodin, aloe emodin, chrysophanol, rhein, and physcion are other ingredients. Clinical Actions: Anti-inflammatory, antioxidant, laxative, diuretic Energetics: Drying, cooling History and Traditional Usage: Indigenous peoples of Canada and the United States have used this plant as food and medicine. The tea was also used traditionally as a diuretic and to treat patients with fever, inflammation, and scurvy (Turner, 1991). Sheep sorrel contains phytoestrogens similar to the isoflavone phytoestrogens common to red clover, licorice, and soy—all legumes known for their health restorative properties. The herb also contains several anthraquinones that are antioxidants and radical scavengers (Duke, 1985). The seeds were used occasionally for diarrhea. Southeastern folk herbalist Tommy Bass claimed that the plant was used for sore throat and topically for cancer (Crellin, 1997). Sheep sorrel is related to the tangy salad green, French sorrel, and it can be used similarly. The plant is much enjoyed by grazing animals and is used for blood ailments, fever, and kidney ailments and externally for skin irritations (de Bairacli Levy, 1963). Published Research: No published trials have evaluated the efficacy of sheep sorrel for any proposed claims. It is one of four components of Essiac, a proprietary tea that has been reported to demonstrate anticancer activity in vitro, although its effects in vivo remain a matter of debate. A recent study indicated that Essiac tea possesses antioxidant and DNA-protective activity—properties that are common to natural anticancer agents (Leonard, 2006). Indications: Scurvy, vascular disorders; possibly as an alterative because of its diuretic and aperient qualities Potential Veterinary Indications: Possibly antioxidant and alterative for chronic disorders Contraindications: Sheep Sorrel and other plants of the Polygonaceae family contain oxalates in their fresh and cooked leaves and are contraindicated in cases of oxalate urolithiasis. Toxicology and Adverse Effects: Sorrel leaves contain enough oxalates and anthraquinone to cause poisoning and possibly death if eaten in excessive amounts. Ruminants have been reported to be poisoned by consuming sheep sorrel (Rumex acetosella) in addition to other plants that are recognized poisons; these include autumn crocus (Colchicum autumnale), cowbane (Cicuta virosa), Bracken fern (Pteridium aquilinum), and St. John’s wort (Hypericum perforatum). Animals died after they consumed this combination of plant intoxications (Schrader, 2001). Sheep sorrel is also a common allergen for which canines with atopic dermatitis are tested. Drug Interactions: In large dosages, the anthraquinonetype laxative compounds may enhance the action of other laxatives and should not be taken. Notes of Interest: Acetosella means vinegar salts. Sheep sorrel was considered the most active herb in Essiac for stimulating cellular regeneration, detoxification, and

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cleansing, according to reports by Rene Caisse, the nurse behind the famous Essiac formula that has been promoted for cancer treatment. No scientific evidence has been published to suggest that the Essiac formula has clinical efficacy; however, anecdotal evidence exists, and popularity among clients is considerable. Dosage: This herb can be used as an occasional fresh food addition to the diet, unless high-oxalate foods are contraindicated. Human: Dried herb: 1-10 g TID Infusions: 5-30 g per cup of water, with 1 cup of the tea given TID Tincture 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried herb: 25-500 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture 1 : 2-1 : 3: 0.5-2.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. References Crellin J, Philpott J. Reference Guide to Medicinal Plants: Herbal Medicine Past and Present. Durham, NC: Duke University Press; 1997. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. Duke JA. Rumex crispus L. In: Handbook of Medicinal Herbs. Boca Raton, Fla: CRC Press; 1985:414-415. Leonard SS, Keil D, Mehlman T, et al. Essiac tea: scavenging of reactive oxygen species and effects on DNA damage. J Ethnopharmacol 2006;103:288-296. Epub 2005 Oct 13. Schrader A, Schulz O, Volker H, Puls H. [Recent plant poisoning in ruminants of northern and eastern Germany. Communication from the practice for the practice.] Berl Munch Tierarztl Wochenschr 2001;114:218-221. Turner N, Kuhnlein H. Traditional plant foods of Canadian indigenous peoples. Nutrition, botany and use. In: Food and Nutrition in History and Anthropology, vol 8. Philadelphia, Pa: Gordon & Breach Science Publishers; 1991:222.

Shiitake Lentinula edodes (Berk.) Singer • Len-TIN-ew-luh ee-DOEdeez Other Names: Shitake, black mushroom, hua gu, fragrant mushroom Family: Tricholomataceae Parts Used: Fruiting body Distribution: China, Japan, and throughout Asia. Commercially grown worldwide Selected Constituents: Polysaccharide (lentinan), purine alkaloid (eritadenin), proteins, fatty acids, and vitamins D, B2, and B12. The proteins contain all essential amino acids, commonly occurring nonessential amino acids, and amides. The fatty acids are largely unsaturated, and shiitakes are rich in vitamins and minerals. Commercial preparations employ the powdered mycelium of the mushroom before the cap and stem grow; this is called

lentinan edodes mycelium extract (LEM). LEM is also rich in polysaccharides and lignans. The most thoroughly investigated bioactive molecule isolated from shiitake is the pure β(1-3)-D-glucan lentinan. Crude mushrooms are also used in the manufacture of extracts. Clinical Actions: Immune modulating, nutritive Energetics: Neutral, sweet History and Traditional Usage: Shiitake has had a long reputation as an elixir of life because of its high nutritional content (Crisan, 1978). The therapeutic importance of L. edodes has been known since the Ming dynasty (1368-1644). Wu Ri, a famous physician from the Chinese Ming Dynasty (AD 1368-1644), wrote extensively about this mushroom, noting its ability to increase energy, cure colds, and eliminate worms (Ito, 1978). The Chinese have always regarded the mushroom as having special properties. Mushrooms are regarded as “spirit medicine” because they are believed to nourish the shen, or spirit. Shiitake is particularly thought to replenish Qi and support the spleen and stomach channels. In Japan, lentinan is used as a popular anticancer drug and has been studied in numerous clinical trials, although none of these studies was placebo controlled or double blind (Ooi, 2000). Published Research: In vitro and in vivo studies show that shiitake has an inhibitory effect on dental plaque. A significantly improved score was observed in rats infected with Streptococcus mutans and fed a cariogenic diet containing 0.25% shiitake extract compared with controls fed the cariogenic diet without shiitake extract (Shouji, 2000). Perhaps one of the most interesting aspects of shiitake is that it is used as an alternative to antibiotics for use in animals that are used for food. Preparations of Lentinus edodes and a polysaccharide extract were investigated in vitro with the use of microflora from chicken ceca. The mushroom showed potential for improving microbial activity and composition in chicken ceca (Guo, 2003). This was also confirmed in vivo. One trial compared the effects of polysaccharide extracts of Lentinula edodes, Tremella fuciformis (a different mushroom), and Astragalus membranaceus on growth performance and gastrointestinal tract organ weight in broiler chickens with an antibiotic treatment group (20 mg/kg, virginiamycin) and in nonsupplemented birds. No significant differences were discerned between the extract-supplemented groups and the antibiotic groups. Birds fed with shiitake showed greater body weight gain and lower feed conversion ratios than did those fed Tremella and Astragalus extracts. The optimal concentration for enhancing growth efficiency was 2 g/kg (Guo, 2004a). Researchers also investigated the effects of polysaccharide extracts from Lentinula edodes on the cellular and humoral immune responses of Eimeria tenella–infected chickens. A total of 150 broiler chicks were infected with E. tenella and were fed the extract from 8 to 14 days of age at a dose of 1 g/kg of the diet. A significantly higher production of specific immunoglobulin (Ig)A, IgM (at days 14 and 21 post infection), and IgG (at day 21 post infection) was detected in the Eimeria-infected groups fed

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the extract than in the control group. Cecal antibody production showed a similar trend to that seen with serum antibodies (Guo, 2004b). Another experiment was conducted to study the potential prebiotic effects of mushroom and herb polysaccharide extracts, Lentinus edodes extract (LenE), Tremella fuciformis extract, and Astragalus membranaceus root extract on chicken growth and the cecal microbial ecosystem, as compared with the antibiotic apramycin (APR). Extracts significantly stimulated growth of chickens infected with avian Mycoplasma gallisepticum and increased the number of potentially beneficial bacteria (bifidobacteria and lactobacilli), but they reduced the number of potentially harmful bacteria (Bacteroides spp and Escherichia coli). LenE was associated with the greatest quantity of cecal bifidobacteria and lactobacilli. With each increase in LenE dose, birds tended to have greater body weight gain and higher total aerobe and anaerobe counts. The numbers of predominant cecal bacteria—in particular, E. coli, bifidobacteria, and lactobacilli—were significantly increased with increases in the LenE dose. It was suggested that these specific mushroom and herb polysaccharide extracts are potential modifiers of intestinal microbial populations in diseased chickens (Guo, 2004c). Alternatives to growth-promoting antibiotics in pig nutrition include nondigestible oligosaccharides or polysaccharides. Lentinan or dried L. edodes mycelium was added to the diet of piglets. Four groups of five newly weaned piglets received one of four diets: a control diet, a diet supplemented with 50 mg/kg of avilamycin, a diet supplemented with 0.1% of lentinan, or a diet supplemented with 5% of dried L. edodes mycelium powder. The diet that contained 5% dried L. edodes produced lower viable counts of total bacteria, E. coli, streptococci, and lactic acid bacteria. Luminal and mucosal effects corresponded with this finding. Acetate and butyrate concentrations in the distal jejunum were doubled— an obvious advantage when their trophic effects on enterocytes and colonocytes are considered (van Nevel, 2003). Lentinan from L. edodes has also shown anticancer activity. Mice treated with a carcinogen, N-butylN′butanolnitrosoamine, received 5% dried, powdered Shiitake in the diet, or a control diet. One hundred percent of the control group developed urinary bladder carcinoma (10/10); the incidence was reduced to 52.9% in the experimental group (9/17) (Kurashige, 1997). Lentinan is in clinical use (i.e., 0.5-1.0 mg lentinan/ day, iv), especially in Japan and China, for adjuvant tumor therapy; clinical studies have been conducted in Asia (Lindequist, 2005). In a study of patients with advanced colorectal cancer, median survival times were 200 days in the lentinan-treated group (2 mg/week, 23 patients) and 94 days in the control group (Taguchi, 1982). In patients with stomach cancer, colon cancer, and other carcinomas, application of parenteral lentinan with chemotherapy led to prolongation of survival time, restoration of immunologic parameters, and improvements in quality of life compared with patients who were given chemotherapy alone (Hazama, 1995). In a randomized multicentric study

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of 89 patients with stomach cancer, median survival time in the group treated with chemotherapy and lentinan (2 mg/week, IV) was 189 days, compared with the control group (with only chemotherapy) time of 109 days (Ochiai, 1992). Supplementation of a shiitake polysaccharide extract was investigated in 62 men with prostate cancer. The open-label study monitored PSA (prostate-specific antigen) over 6 months. Results suggested that Shiitake extract was not effective in the treatment of patients with prostate cancer (deVere, 2002). Lentinan has been tested in the treatment of patients with human immunodeficiency virus. Gordon (1998) enrolled people with HIV to be treated with lentinan (2, 5, or 10 mg of lentinan) or placebo IV. Investigators noted trends toward improvement in the CD4 count or in neutrophil activity, although these did not reach statistical significance. Adverse effects, including anaphylactoid reaction, were notable when lentinan was administered rapidly, but when it was administered intravenously over 30 minutes, it was better tolerated. Indications: Chemotherapy support, hepatitis, human immunodeficiency virus (HIV) support Potential Veterinary Indications: To enhance growth efficiency in food animals; immune support; adjunct to chemotherapy Contraindications: None found. Toxicology and Adverse Effects: AHPA class 1. Shiitake has an excellent record of safety but has been known to induce diarrhea and abdominal bloating when used in high dosages. One patient was found to have occupational allergic contact dermatitis to shiitake mushroom (Curnow, 2003). Rash, abdominal discomfort, and eosinophilia led to withdrawal of 17 of 49 patients involved in a trial to examine the possibility that shiitake may lower blood cholesterol. Subjects ingested 4 g of dried powdered herb daily (Levy, 1998). Chronic hypersensitivity pneumonitis (HP) caused by shiitake mushroom spores was diagnosed (Suzuki, 2001; Moore, 2005). Dosage: Human: Dried herb: 5-30 g TID LEM (lentinan edodes mycelium extract): intake is 1-3 g 2 to 3 times per day until the condition improves Infusions: 5-30 g per cup of water, with 1 cup of the tea given TID Tincture (usually 30% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried (and soaked) or fresh mushroom: 2-4 chopped mushrooms per 10 kg (20 lb) in food daily Dried herb: 50-400 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 30% ethanol) 1 : 2-1 : 3: 1.0-2.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

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References Crisan EV, Sands A. Nutritional value. In: Chang ST; Hayes WA, eds. The Biology and Cultivation of Edible Mushrooms. London: Academic Press; 1978:137-165. Curnow P, Tam M. Contact dermatitis to Shiitake mushroom. Austral J Dermatol 2003;44:155-157. deVere White RW, Hackman RM, Soares SE, Beckett LA, Sun B. Effects of a mushroom mycelium extract on the treatment of prostate cancer. Urology 2002;60:640-644. Gordon M, Bihari B, Goosby E, Gorter R, Greco M, Guralnik M, Mimura T, Rudinicki V, Wong R, Kaneko Y. A placebocontrolled trial of the immune modulator, lentinan, in HIV-positive patients: a phase I/II trial. J Med 1998;29:305330. Guo FC, Kwakkel RP, Williams BA, et al. Effects of mushroom and herb polysaccharides, as alternatives for an antibiotic, on growth performance of broilers. Br Poult Sci 2004a;45:684694. Guo FC, Kwakkel RP, Williams BA, Parmentier HK, Li WK, Yang ZQ, Verstegen MW Effects of mushroom and herb polysaccharides on cellular and humoral immune responses of Eimeria tenella–infected chickens. Poult Sci 2004b;83:11241132. Guo FC, Williams BA, Kwakkel RP, Li HS, Li XP, Luo JY, Li WK, Verstegen MW. Effects of mushroom and herb polysaccharides, as alternatives for an antibiotic, on the cecal microbial ecosystem in broiler chickens. Poult Sci 2004c;83:175-182. Guo FC, Williams BA, Kwakkel RP, Verstegen MW. In vitro fermentation characteristics of two mushroom species, an herb, and their polysaccharide fractions, using chicken cecal contents as inoculum. Poult Sci 2003;82:1608-1615. Hazama S, Oka M, Yoshino S, Iizuka N, Wadamori K, et al. Clinical effects and immunological analysis of intraabdominal and intrapleural injection of lentinan for malignant ascites and pleural effusion of gastric carcinoma. Cancer Chemother 1995;22:1595-1597. Ito T. Cultivation of Lentinus edodes. In: Chang ST; Hayes WA, eds. The Biology and Cultivation of Edible Mushrooms. London: Academic Press; 1978:461-473. Kurashige S, Akuzawa Y, Endo F. Effects of Lentinus edodes, Grifola frondosa and Pleurotus ostreatus administration on cancer outbreak and activities of macrophages and lymphocytes in mice treated with carcinogen, N-butyl-N′butanolnitrosoamine. Immunopharmacol Immunotoxicol 1997;19: 175-183. Levy AM, Kita H, Phillips SF, Schkade PA, Dyer PD, Gleich GJ, Dubravec VA. Eosinophilia and gastrointestinal symptoms after ingestion of shiitake mushrooms. J Allergy Clin Immunol 1998;101:613-620. Lindequist U, Niedermeyer THJ, Jülich WD. The pharmacological potential of mushrooms. eCAM 2005;2:285-299. Available at: http://ecam.oxfordjournals.org/cgi/content/full/2/3/285. Accessed November 2005. Moore JE, Convery RP, Millar BC, Rao JR, Elborn JS. Hypersensitivity pneumonitis associated with mushroom worker’s lung: an update on the clinical significance of the importation of exotic mushroom varieties. Int Arch Allergy Immunol 2005; 136:98-102. Ochiai T, Isono K, Suzuki T, Koide Y, Gunji Y, Nagata M, et al. Effect of immunotherapy with lentinan on patients’ survival and immunological parameters in patients with cancer. Int J Immunother 1992;8:161-169. Ooi VEC, Liu F. Immunomodulation and anti-cancer activity of polysaccharide-protein complexes. Curr Med Chem 2000;7: 715-729.

Shouji N, Takada K, Fukushima K, Hirasawa M. Anticaries effect of a component from shiitake (an edible mushroom). Caries Res 2000;34:94-98. Suzuki K, Tanaka H, Sugawara H, et al. Chronic hypersensitivity pneumonitis induced by Shiitake mushroom spores associated with lung cancer. Intern Med 2001;40:1132-1135. Taguchi T, Furue H, Kimura T, Kondoh T, Hattori T, Itoh I, et al. Life-span prolongation effect of lentinan on patients with advanced or recurrent colorectal cancer. Int J Immunopharmacol 1982;4:271. van Nevel CJ, Decuypere JA, Dierick N, Molly K. The influence of Lentinus edodes (Shiitake mushroom) preparations on bacteriological and morphological aspects of the small intestine in piglets. Arch Tierernahr 2003;57:399-412.

Skullcap

Scutellaria lateriflora L. • skew-teh-LARE-ee-uh la-ter-uhFLOR-uh Other Names: Hoodwort, helmut flower, scullcap, blue skullcap Family: Lamiaceae Parts Used: Aerial parts Distribution: Skullcap is a perennial herb that is native to North America and is also found in Asia and Europe. Selected Constituents: Skullcap contains flavonoids (apigenin, hispidulin, luteolin), scutellarein, scutellarin (bitter glycoside), iridoids (catalpol) and volatile oils (limonene, terpineol [monoterpenes], δ-cadinene, caryophyllene, trans-β-farnesene, and β-humulene [sesquiterpenes]); other constituents include lignin, resin, and tannin.

Materia Medica • CHAPTER 24

OH HO

O

HO OH

O

Scutellarein

Clinical Actions: Anticonvulsant, sedative, nervine, antiinflammatory, antispasmodic, astringent, febrifuge, tonic Energetics: Bitter, cool History and Traditional Usage: Traditionally, skullcap has been used as a mild sedative (BHMA, 1996) and in the management of headache (Grieve, 1971). In folk medicine, it has been used to treat patients with epilepsy, chorea, hysteria, nervousness, and grand mal seizures. Skullcap has been used by Native Americans for generations, generally to treat female problems and nervous disorders. de Bairacli Levy (1963, 1985) suggested that skullcap should be used for treatment of all patients with nervous complaints, including meningitis, fits, nervous spasm, distemper, gastroenteritis, lack of appetite, sterility, and rabies. (Note: The authors do not recommend treating any animal with rabies!) Published Research: A double-blind, placebo-controlled study of healthy subjects demonstrated the anxiolytic effects of skullcap. Nineteen healthy people 20 to 70 years of age were supplied with separate and coded packets of four different herbal preparations (2 placebo capsules; 350-mg capsule organically grown, freeze-dried skullcap; 100-mg capsule organic, freeze-dried skullcap extract; and 2 capsules with each containing 100 mg organic, freezedried skullcap extract). Of the three variables (energy, cognition, and anxiety), the effect on anxiety was the most pronounced, and results were superior to those of placebo and to baseline measurements (Wolfson, 2003). Male rats were given a single systemic injection of lithium (3 mEq/kg) and pilocarpine (30 g/kg) to induce status epilepticus. One week later, they were administered one of three herbal treatments through the water supply for 30 days; a fourth group was administered colloidal minerals and diluted food grade hydrogen peroxide in water; a fifth group of rats received only tap water as a control. Spontaneous seizures were recorded for each rat during the treatment period and during an additional 30 days, when only tap water was given. Rats given Scutellaria lateriflora experienced no seizures during treatment, compared with controls, which exhibited seizure activity. However, when herbal treatment was discontinued, the rats in this group and controls displayed comparable numbers of spontaneous seizures (Peredery, 2004). The anxiolytic effects of oral S. laterifolia were investigated in rats through observation of behavior. Significant

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increases in the number of entries into the center of an “open-field arena,” the number of unprotected head dips, the number of entries, and the length of time spent on the open arms of a maze test were seen, indicating reduced anxiety. Baicalin and baicalein are known to bind to the benzodiazepine site of GABA-A (gamma-aminobutyric acid) (Awad, 2003). Indications: Epilepsy, nervous tension, insomnia, chorea Potential Veterinary Indications: Anxiety, epilepsy, nervousness Contraindications: None found. Toxicology and Adverse Effects: AHPA class 1. Excessive use or overdose may cause giddiness, stupor, confusion, and seizures. Hepatotoxic reactions have been reported after ingestion of some preparations that reportedly contain skullcap. Adulteration of skullcap herb by germander has been documented in cases of hepatitis (Larrey, 1992). Germander is a known hepatotoxin. Potential Drug Interactions: May theoretically interact with other central nervous system depressants. Preparation Notes: Some herbalists have stated that this herb loses potency when dried; tinctures of fresh plant may be preferred. Dosage: Human: Last dose may be taken 30 min before bedtime and may be doubled for insomnia Dried herb: 1-10 g TID Infusions and decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID Tincture (usually 40% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions Glycerite (80% glycerin) 1 : 5: 4-5 mL TID Small Animal: Dried herb: 25-400 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 40% ethanol) 1 : 2-1 : 3: 0.5-2.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

References Awad R, Arnason JT, Trudeau V, et al. Phytochemical and biological analysis of skullcap (Scutellaria lateriflora L.): a medicinal plant with anxiolytic properties. Phytomedicine 2003;10:640-649. British Herbal Medicine Association (BHMA). British Herbal Pharmacopoeia (BHP). Exeter (UK): BHMA; 1996. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. Grieve M. A Modern Herbal, vol 1, 2. New York, NY: Dover Publications; 1971. Larrey D, Vial T, Pauwels A, et al. Hepatitis after germander (Teucrium chamaedrys) administration: another instance of herbal medicine toxicity. Am Call Phys 1992;117:129-213.

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Peredery O, Persinger MA. Herbal treatment following postseizure induction in rat by lithium pilocarpine: Scutellaria lateriflora (Skullcap), Gelsemium sempervirens (Gelsemium) and Datura stramonium (Jimson Weed) may prevent development of spontaneous seizures. Phytother Res 2004;18:700-705. Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Altern Ther Health Med 2003;9:74-78.

Slippery Elm Ulmus rubra Muhl. = Ulmus fulva Michx. • UL-mus REWbruh Distribution: Eastern Canada and the United States Similar Species: Other species (Ulmus glabra, Ulmus laevis, Ulmus carpinifolius) have been used for similar purposes. Dioscorides described a species in the 1st century AD. Other Names: Red elm, Indian elm, sweet elm, ulme, orme, olmo, rotulme Family: Ulmaceae Parts Used: Inner bark, which should be collected in the spring or fall Selected Constituents: Mucilage (a mixture of polyuronides that consists of sugar and uronic acid units that form a hydrocolloid in the gut), tannins, phytosterols Clinical Action: Demulcent, emollient, antitussive, astringent, nutritive, laxative Energetics: Sweet, neutral History and Traditional Usage: The inner bark and, rarely, the leaves were used by Native Americans for food, in the treatment of gastrointestinal troubles, topically for wounds and skin problems, and for sore throat and eye problems. The powder has been cooked and used for convalescing patients and weak babies. It has been used for upper respiratory tract irritation—sore throat, tracheitis, bronchitis, and dry cough; and inflammation of the gastrointestinal tract, including gastritis, gastric ulcer, colitis, and irritable bowel. It has been used topically (as a poultice) for skin inflammation, burns, and wounds; as an eyewash for styes; and as a mouthwash for patients with stomatitis. Also used for cystitis, urethritis, and other inflammatory disorders of the urinary tract. Published Research: No relevant trials found. Indications: Inflammatory bowel disease, diarrhea, irritable bowel syndrome, and gastrointestinal disease that is fiber responsive; dry ticklish cough; and topically for slow-healing wounds and anal fissures Potential Veterinary Indications: Fiber-responsive gastrointestinal problems such as inflammatory bowel disease, diarrhea, constipation, and colitis; for dry cough, perianal fistulas, and anal gland abscesses; feline lower urinary tract disease; topically for burns; and as a sweetener and demulcent Notes of Interest: Although slippery elm is not an endangered plant, United Plant Savers considers it at risk because it is not in cultivation, because it has been affected by Dutch Elm disease, and because sales of the bark have increased in recent years. Possible substitutes include psyllium, marshmallow, and fenugreek. Contraindications: Known allergy.

Toxicology and Adverse Effects: AHPA class 1. Allergic reactions (including contact dermatitis and urticaria) possible. Drug Interactions: As with any soluble fiber, absorption of drugs from the gut may be altered if they are administered simultaneously. Preparation Notes: The fiber is best extracted in cold water. Dosage: Dried: 5-10 g TID (usually supplied as the cold infusion), up to 6 times daily for acute conditions Infusion of powder: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 25%-30% ethanol 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions Small Animal: Dried herb: 50-400 mg/kg, divided daily (optimally, TID) added to moist food Infusion of powder: 5 g per cup of cold water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (in 25%-30% ethanol) 1 : 2-1 : 3: 1.0-2.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula.

St. John’s Wort

Hypericum perforatum L. • hy PER ee kum per for Ay tum Other Names: Herba hyperici, millepertuis perforé, echtes Johanniskraut, tüpfel-Johanniskraut, iperico, erba di San Giovanni Family: Clusiaceae Parts Used: Dried flowering tops or aerial parts Distribution: Indigenous to Northern Africa, South Africa, South America, Asia, Australia, Europe, and New Zealand. Naturalized in the United States (Bisset, 1994). Selected Constituents: Major characteristic constituents include 0.05% to 0.30% naphthodianthrones (hypericin, pseudohypericin, hyperforin, adhyperforin—the latter two compounds are classified as phloroglucinols); 2% to 4% flavonoids (hyperoside, quercitrin, isoquercitrin, rutin); and 7% to 15% catechin tannins (Bisset, 1994; Nahrstedt, 1997).

Materia Medica • CHAPTER 24

OH OH HO

O

OH OH

O Quercetin

O O O

HO

Hyperforin

OH

O

OH

OH

HO HO

CH3

OH

O

OH

Pseudohypericin

Clinical Actions: Nervine tonic, antidepressant, vulnerary, anti-inflammatory, antiviral Energetics: Bitter, cool History and Traditional Usage: Uses reported in pharmacopoeias and in traditional systems of medicine: externally for the treatment of minor cuts, burns, and skin ulcers (Bombardelli, 1995; Blumenthal, 1998). Topical use for viral infection (Ivan, 1979). Aromatic, astringent, expectorant, and nervine. Used in pulmonary and bladder inflammation; hemoptysis; for worms, diarrhea, hysteria, nervous depression, neuralgia, migraine headaches, sciatica, ulcers, hemorrhage; for jaundice, biliary disorders, diabetes, hemorrhoids; as a diuretic, emmenagogue, and antimalarial agent (Farnsworth, 1998; Bombardelli, 1995; Grieves, 1975). For bedwetting children and externally for hard tumors, caked breasts, and ecchymosis (Grieves, 1975). de Bairacli Levy (1985, 1963) suggests St. John’s wort for jaundice, tail injuries (applied as a salve), and sickness in farm animals; for coughs, inflammation of the chest and lungs, rheumatism, jaundice, lymphoma,

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dropsy, earache, worms, and inflammation; externally for wounds, eruptions, ulcers, swellings, and skin inflammation. Published Research: A meta-analysis published in 2005 that included 37 randomized, double-blind, controlled trials found significant positive response to St. John’s wort for mild to moderate depression (Linde, 2005). Trials involved various proprietary extracts of Hypericum perforatum; 26 comparisons were made with placebo and 14 with synthetic standard antidepressants. St. John’s wort extracts were more effective than placebo in patients with mild to moderate depression, and less so in those with major depression. No difference was noted between the clinical effects of St. John’s wort and those of conventional antidepressants. Adverse effects were less commonly observed with St. John’s wort than with conventional antidepressants. The authors suggest that inconsistency observed in these results may be attributed to pharmaceutical differences in the various extracts tested. Schulz (2006) reviewed 38 trials, which comprised a total of 34,804 patients, for the safety of St. John’s wort. Adverse events were mild and transient in almost all cases; the major consideration for use of St. John’s wort involves potential interaction with other drugs. The adverse event rate and dropout rate for St. John’s wort are at least 10-fold lower than those reported for synthetic antidepressants. Current thinking suggests that hyperforin is one of the more active constituents of St. John’s wort. In vitro, hyperforin leads to nonselective inhibition of uptake of many neurotransmitters, as well as interaction with dopamine and opioid receptors. However, hyperforin levels in the brain do not mirror the concentrations that cause these changes. Hypericum extract is theorized to indirectly activate sigma receptors (Mennini, 2004). Other constituents that may be at work (Butterweck, 2003; Simmen, 2001) include amentoflavone (inhibits binding at 5-HT[1D], 5-HT [2C], D3 dopamine receptors, delta opiate receptors, and benzodiazepine receptors in vitro); I3,II8-biapigenin (inhibits in vitro binding at the estrogen-alpha receptor and the benzodiazepine receptor); other flavonoids that inhibit dopamine hydroxylase activity in vitro; hyperin (decreases malondialdehyde and nitric oxide in animal models); and pseudohypericin (inhibits activation of NMDA receptors in vitro). St. John’s wort caused significant increases in salivary cortisol and plasma growth hormone in human volunteers and rats; however, it decreased plasma prolactin versus placebo. In animal studies, acute treatment with St. John’s wort, hyperforin, and hypericin caused significant increases in plasma corticosterone (Franklin, 2001). The efficacy of St. John’s wort for obsessive-compulsive disorder was investigated. Twelve humans with a diagnosis of obsessive-compulsive disorder for at least 12 months were evaluated. Treatment involved 450 mg of 0.3% hypericin given twice daily for 12 weeks, and participants were monitored weekly and monthly. A significant change from baseline to endpoint occurred at 1 week and continued to increase throughout the trial. By the end of the trial, 5 of 12 patients were rated much or very much improved, 6 were minimally improved, and 1

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exhibited no change. The most common adverse effects reported were diarrhea and restless sleep (Taylor, 2000). Hyperforin may inhibit the growth of some tumor cells according to in vitro studies. The antiproliferative effects of serotonin-reuptake inhibitors and serotonin antagonists have been demonstrated in prostate tumors. One paper reported a significant reduction in tumor growth and numbers of metastases, suggesting that St. John’s wort may be useful in the treatment of patients with prostate cancer (Martarelli, 2004). Indications: Seasonal affective disorder, mild to moderate depression, menopausal depression, fibrositis, obsessivecompulsive disorder, anxiety and irritability, nervous fatigue, neuralgia; topically for wounds Potential Veterinary Indications: Peripheral neuropathy, mild depression (e.g., associated with pain), anxiety, obsessive-compulsive disorder Contraindications: None found. Toxicology and Adverse Effects: AHPA class 2d (see “Potential Drug Interactions” later). Ultraviolet or prolonged exposure to sunlight should be avoided because photosensitization may occur in light-sensitive individuals (Blumenthal, 1998). St. John’s wort has low toxicity; mice given 2 g/kg/day for up to 1 year showed no signs of toxic change (Okpanyi, 1990). Two case histories and a review of existing literature showed that it may cause serotonin syndrome in sensitive patients and may be associated with hair loss (Parker, 2001). Awasi sheep given chopped St. John’s wort at 0, 4, 8, 12, and 16 mg/kg in feed for 14 days were monitored for signs of poisoning. Blood samples were collected at 0, 7, and 14 days after the start of dosing. Clinical signs included restlessness, photophobia, tachycardia, polypnea, congested mucous membranes, diarrhea, and hyperthermia. Skin lesions involved redness of exposed parts of the tail and legs, edema of the eyelids, and swelling and secretions from the ears. After 1 week, signs worsened and included salivation, alopecia of the face and head, keratoconjunctivitis, severe congestion of the mucous membranes, loss of eyelashes, corneal opacity, and blindness. Hemoglobin, red cell count, packed cell volume, total protein, glucose, triglycerides, and serum alkaline phosphatase activity were all decreased. Blood urea nitrogen, sodium, potassium, and total and direct bilirubin values, as well as aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and γ-glutamyltransferase activities, were all increased (Kako, 1993). The roles of shade, fleece length, and wool type in the protection of sheep from Hypericum perforatum poisoning (3 mg hypericin/kg body weight) were investigated. After treatment, hypericin poisoning was evident in 26.5% of woolled sheep that were exposed to sunlight, but in none of those that were fully shaded. Among recently shorn sheep, 94% showed hypericin poisoning when exposed to sunlight. It was concluded that Merinos with at least 14 weeks’ wool growth are not poisoned by a single oral dose of 3 mg hypericin/kg. Because hypericin persists in the circulation for several days, this safe dose is reduced in the face of continuous daily ingestion. Sheep with access to substantial areas of shade may ingest much

greater amounts of hypericin safely. Wool removal clearly increases the risk of poisoning. The ability of ruminant livestock to graze St. John’s wort safely is probably better predicted by the level of skin protection against incident sunlight than by differences in hypericin metabolism and excretion capacity (Bourke, 2003). Potential Drug Interactions: Several herb–drug interactions have been well documented for St. John’s wort. A systematic review of potential St. John’s wort–drug interactions was undertaken to examine trial quality and the results of these trials (Mills, 2004). Twenty-two trials of pharmacokinetics were located, 5 of which involved clinical patients, and 12 of which involved healthy volunteers. Three of 19 trials found no important drug–herb interactions; 17 noted a decrease in the systemic availability of conventional drugs. Pharmacokinetic interactions may be the result of drug-metabolizing enzymes (P450) or drug-transporting proteins (P-glycoprotein). Clinical risk is determined by the therapeutic range of the conventional drug. Schulz (2006) has suggested that clinical interactions are relatively rare, and that they might be expected with “antidepressants, with coumarin-type anticoagulants, the immunosuppressants cyclosporine and tacrolimus, protease and reverse transcriptase inhibitors used in anti-HIV treatment, or with specific antineoplastic agents.” St. John’s wort may potentiate the effects of monoamine oxidase (MAO) inhibitors. Coadministration of theophylline and St. John’s wort lowered the serum level of theophylline in a patient who had been previously stabilized, requiring an increase in theophylline dose (Nebel, 1999). St. John’s wort and digoxin taken together reduced serum digoxin concentrations after 10 days of treatment (Johne, 1999). Decreases in serum cyclosporine, warfarin, and phenprocoumon concentrations were seen in patients after they had additionally taken St. John’s wort (Ernst, 1999). Concomitant use of St. John’s wort in five patients who had been stabilized on serotonin reuptake inhibitors resulted in symptoms of central serotonin excess (Lantz, 1999). Significant drug interaction has been noted between St. John’s wort and indinavir (Piscitelli, 2000). Notes of Interest: Many ancient superstitions arose regarding this herb. Its name Hypericum is derived from the Greek and means “over an apparition,”—a reference to the belief that the herb was so obnoxious to evil spirits that a whiff of it would cause them to fly. Dosage: External Use: Oil or ointment is used for burns and minor wounds. The tincture is also used topically by some herbalists to treat human herpes lesions. Internal Use: Human Dried herb: 1-10 g TID Standardized tinctures or fluid extracts up to a daily dose of 900 mg extract (equivalent to 0.2-2.7 mg total hypericin) (Woelk, 1994). A move is growing to standardize to 2%-3% hyperforin and hypericins (0.3%) Infusion: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely

Materia Medica • CHAPTER 24

Tincture (usually 45%-60% ethanol) 1 : 2 or 1 : 3: 0.5-5 mL TID Small Animal Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 45%-60% ethanol) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs

References Bisset NG. Herbal Drugs and Phytopharmaceuticals. Boca Raton, Fla: CRC Press; 1994. Blumenthal M, et al, eds. The Complete German Commission E Monographs. Austin, Tex: American Botanical Council; 1998. Bombardelli E, Morazzoni P. Hypericum perforatum. Fitoterapia 1995;66:43-68. Bourke CA. The effect of shade, shearing and wool type in the protection of Merino sheep from Hypericum perforatum (St John’s wort) poisoning. Aust Vet J 2003;81:494-498. Butterweck V. Mechanism of action of St John’s wort in depression: what is known? CNS Drugs 2003;17:539-562. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. Ernst E. Second thoughts about safety of St John’s wort. Lancet 1999;354:2014-2016. Farnsworth NR, ed. NAPRALERT database. Chicago, Ill: University of Illinois at Chicago; February 9, 1998 production. Franklin M, Cowen PJ. Researching the antidepressant actions of Hypericum perforatum (St. John’s wort) in animals and man. Pharmacopsychiatry 2001;34(suppl 1):S29-S37. Grieve M. A Modern Herbal (1931). London: Jonathan Cape; Reprint 1975. Ivan H. Preliminary investigations on the application of Hypericum perforatum in herpes therapy. Gyogyszereszet 1979; 23:217-218. Johne A, Brockmöller J, Bauer S, Maurer A, et al. Interaction of St John’s wort extract with digoxin. Eur J Clin Pharmacol 1999;6:80. Kako MDN, Al-Sultan II, Saleem AN. Studies of sheep experimentally poisoned with Hypericum perforatum. Vet Human Toxicol 1993;35:298-300. Lantz MS, Buchalter E, Giambanco V. St John’s wort and antidepressant drug interactions in the elderly. J Geriatr Psychiatry Neurol 1999;12:7-10. Linde K, Mulrow CD, Berner M, Egger M. St John’s wort for depression. Cochrane Database Syst Rev 2005;2:CD000448. Martarelli D, Martarelli B, Pediconi D, Nabissi MI, Perfumi M, Pompei P. Hypericum perforatum methanolic extract inhibits growth of human prostatic carcinoma cell line orthotopically implanted in nude mice. Cancer Lett 2004;210:27-33. Mennini T, Gobbi M. The antidepressant mechanism of Hypericum perforatum. Life Sci 2004;75:1021-1027. Mills E, Montori VM, Wu P, Gallicano K, Clarke M, Guyatt G. Interaction of St John’s wort with conventional drugs: systematic review of clinical trials. BMJ 2004;329:27-30. Nahrstedt A, Butterweck V. Biologically active and other chemical constituents of the herb of Hypericum perforatum L. Pharmacopsychiatry 1997;30:129-134.

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Nebel A, Schneider BJ, Baker RK, Kroll DJ. Potential metabolic interaction between St John’s wort and theophylline. Ann Pharmacother 1999;33:502. Okpanyi SN, et al. Genotoxizität eines standardisierten Hypericum Extrakts. Arzneimittelforschung 1990;40:851-855. Parker V. Adverse reactions to St John’s Wort. Can J Psychiatry 2001;46:77-79. Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John’s wort. Lancet 2000; 355:547-548. Schulz V. Safety of St. John’s Wort extract compared to synthetic antidepressants. Phytomedicine 2006;13:199-204. Simmen U, Higelin J, Berger-Buter K, et al. Neurochemical studies with St. John’s wort in vitro. Pharmacopsychiatry 2001; 34(suppl 1):S137-S142. Taylor LH, Kobak KA. An open-label trial of St. John’s Wort (Hypericum perforatum) in obsessive-compulsive disorder. J Clin Psychiatry 2000;61:575-578. Woelk H, Burkard G, Grunwald J. Benefits and risks of the Hypericum extract LI 160: drug monitoring study with 3250 patients. J Geriatr Psychiatry Neurol 1994;7(suppl 1):S34-S38.

Sweet Wormwood Artemisia annua L. • art-em-MIZ-ee-uh ANN-yew-uh Distribution: China, Korea, Japan, Vietnam, and Russia; widely naturalized in the United States Similar Species: Many species of Artemisia are used as medicine worldwide. Common Names: Sweet Annie, qing hao, annual wormwood Family: Asteraceae Parts Used: Aerial parts Collection: Leaves collected in summer before blooming. Constituents: Sesquiterpene lactones (such as artemisinin, arteannuin B), volatile oil (with abrotamine, β-bourbonene), flavonoids, vitamin A H O O H

O O O

Artemisinin

Clinical Action: Antimalarial, antipyretic, possibly antineoplastic Energetics: Bitter and cold; enters the kidney, liver, and gallbladder meridians History and Traditional Usage: This herb was first mentioned by name in 168 bc. In Traditional Chinese Medicine, qing hao clears summer heat, clears fevers from deficiency, cools the blood, and stops bleeding. Used for summer heat with low fever, headache, dizziness, and stifling sensation in the chest. Especially used for fevers that are unremitting or that occur at night. For morning coolness caused by heat in the blood. Used for malaria to relieve the alternating fever and chills.

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Published Research: Early Chinese research indicated that qing hao is effective against some fungal skin disease and leptospirosis. It is plasmodicidal, even against multiresistant strains of the malarial agent, Plasmodium falciparum (Young, 2004; Sriram, 2004) Researchers believe that artemisinin reacts with free intracellular iron through the endoperoxide bridge in the molecule. Cancer cells and malarial parasites both contain high levels of iron. When the artemisinin reacts, free radicals result; these induce cell death (Zhang, 1992). Artemisinin and artemether are as effective as conventional antimalarial drugs, with variable efficacy and adverse effect profiles (WHO, 1998). Numerous in vitro studies have indicated that artemisinin has antineoplastic activity. In a canine study, dihydroartemisinin was applied to the oral mucosa of dogs that had been challenged with the canine oral papillomavirus. Dihydroartemisinin inhibited virusinduced tumor formation but did not prevent papillomavirus replication. These findings suggest that some artemisinin derivatives may be useful for the topical treatment of epithelial papillomavirus lesions (Disbrow, 2005). Artemisinin, when applied to cultured cells infected with Neospora caninum, inhibited intracellular tachyzoite multiplication. Extracts of the whole plant have been examined in the treatment of chicks with coccidian infection. Artemisinin reduces oocyst output when fed at levels of 8.5 and 17 ppm in the diet. Investigators suggested that artemisinin works by inducing oxidative stress (Allen, 1997, 1998). Artemisinin and, less consistently, the whole plant suppress lesions caused by Eimeria tenella (Kim, 2002). Most published research focuses on the single extract, artemisinin. Different plant harvests contain variable levels of artemisinin—even none at all. Indications: Possibly certain cancers. Malara: “Artemisinin derivatives presently show no cross-resistance with known antimalarials and as such are important for treating severe malaria in areas of multidrug resistance; however, they require long treatment courses and, when used alone, recrudescence may occur” (WHO, 1998). Potential Veterinary Indications: Certain cancers (as an adjunct to effective conventional care); some blood and gastrointestinal parasites, oral and genital papillomas Contraindications: None known. Toxicology and Adverse Effects: AHPA class 2b. Central nervous system depression and seizures were observed in dogs given 40 to 80 mg/kg of artemether (a synthetic derivative of artemisinin) intramuscularly. Dogs given up to 600 mg/kg orally demonstrated no adverse effects (Classen, 1995). Potential Drug Interactions: Artemisinin induces CYP3A4 within 7 to 10 days (Giao, 2001). This difficulty has been approached clinically by administration of each dose with 4 to 8 oz grapefruit juice and by the use of pulsed therapy (10 days on, 5 days off). Artemisinin may also induce CYP2C19 (Svennson, 1998). No drug interactions have been described at the time of this writing, however.

Dosage: Human: The traditional human dose for the whole herb used in Chinese medicine is 20 to 40 g taken daily, in decoction Dried herb: 1-10 g TID Artemisinin: 400-500 mg TID Infusion: 5-15 g per cup of water, with 1 cup of the tea given TID Tincture 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried herb: 25-500 mg/kg, divided daily (optimally, TID) Artemisinin: 2-4 mg/kg daily, divided dose Infusion: 5-15 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture 1 : 2-1 : 3: 0.5-2.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs References Allen PC, Danforth HD, Augustine PC. Dietary modulation of avian coccidiosis. Int J Parasitol 1998;28:1131-1140. Allen PC, Lydon J, Danforth HD. Effects of components of Artemisia annua on coccidian infections in chickens. Poult Sci 1997;76:1156-1163. Bone K. Artemisia annua: herbal use vs isolated active. Townsend Letter for Doctors and Patients, April 2005. Available at: http://www.tldp.com/. Accessed July 2005. Classen W, Altmann B, Gretener P, Souppart C, Skelton-Stroud P, Krinke G. Differential effects of orally versus parenterally administered qinghaosu derivative artemether in dogs. Exp Toxicol Pathol 1999;51:507-516. Disbrow G, Baege AC, Kierpiec KA, et al. Dihydroartemisinin is cytotoxic to papillomavirus-expressing epithelial cells in vitro and in vivo. Cancer Res 2005;65:10854-10861. Giao PT, de Vries PJ. Pharmacokinetic interactions of antimalarial agents. Clin Pharmacokinet 2001;40:343-373. Jung M, Lee K, Kim H, Park M. Recent advances in artemisinin and its derivatives as antimalarial and antitumor agents. Curr Med Chem 2004;11:1265-1284. Kim JT, Park JY, Seo HS, et al. In vitro antiprotozoal effects of artemisinin on Neospora caninum. Vet Parasitol 2002;103:5363. Sriram D, Rao VS, Chandrasekhara KV, Yogeeswari P. Progress in the research of artemisinin and its analogues as antimalarials: an update. Nat Prod Res 2004;18:503-527. Svensson US, Ashton M, Trinh NH, Bertilsson L, Dinh XH, Nguyen VH, Nguyen TN, Nguyen DS, Lykkesfeldt J, Le DC. Artemisinin induces omeprazole metabolism in human beings? Clin Pharmacol Ther 1998;64:160-167. World Health Organization Malaria Fact Sheet, 1998. Available at: http://www.who.int/malaria/docs/artrep.htm. Accessed May 12, 2006. Zhang F, Gosser DK. Hemin-catalyzed decomposition of artemisinin (qinghaosu). Biochem Pharmacol 1992;43:18051809.

Tea Tree Oil Melaleuca alternifolia (Maiden and Betche) Cheel. • meluh-LOO-kuh al-tern-ee-FOH-lee-uh Other Names: “Tea tree” may refer to many different species within the Melaleuca and Leptospermum genera.

Materia Medica • CHAPTER 24

Family: Myrtaceae Parts Used: Volatile oil extract of the leaves of Melaleuca alternifolia Distribution: Native to Australia and parts of New Zealand Selected Constituents: Major compounds include terpenes γ-terpinene, p-cymene, 1,8-cineol, and 1-terpinen4-ol.

gamma-Terpinene

CH3 H3C

CH3 P-cymene

O 1,8-cineole

Clinical Actions: Antimicrobial Energetics: Pungent, cooling (leaf) History and Traditional Usage: The leaves of many Melaeuca species were used traditionally by Australian indigenous people. Leaves were crushed or made into tea and used to treat patients with cough, colds, and skin infection. The herb came to be known as tea tree in the late 1700s, when James Cook gave the tea to his men to prevent scurvy. Tea tree oil has been used topically to treat those with skin, joint, and muscle conditions, including acne, athlete’s foot, boils and burns, insect bites, lice, scabies, body and foot odor, vaginal infection, sinus congestion, hemorrhoids, ringworm, mouth and throat infections, herpes, warts, sprains, rheumatism, and sore muscles. Published Research: Studies that began in the 1920s revealed the oil’s antibacterial and antiseptic properties; it has proved effective as an antifungal and germicide. Tea tree has been investigated for its effects on oral microorganisms and pathogens. In one trial that compared 5-week treatments with oral rinses containing 0.2%

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tea tree oil, garlic, or chlorhexidine in 30 people, tea tree showed intermediate tolerability, but efficacy was not as great as with chlorhexidine or garlic (Groppo, 2002). Two prospective, single-center, open-label studies evaluated the capacity for tea tree oil to affect fluconazoleresistant oral candidiasis (thrush) in patients with HIV (Vazquez, 2002; Jandourek, 1998). Treatments were reasonably effective. Because animals cannot be instructed to avoid swallowing the oil, toxicity limits its usefulness for oral infection in small animals. The efficacy of tea tree cream (10%) was investigated in patients with methicillin-resistant Staphylococcus aureus (MRSA). In all, 224 patients were treated with tea tree 10% cream and 5% body wash, or mupirocin 2% nasal ointment; clinical results were approximately equivalent (46% clearance with tea tree regimen vs. 56% clearance with mupirocin treatment). Tea tree treatment was more effective than chlorhexidine or silver sulfadiazine in clearing superficial skin lesions and sites, but less effective at clearing nasal carriage, than mupirocin. Tea tree preparations were safe and well tolerated (Dryden, 2004). Antifungal activity has also been demonstrated in a randomized, controlled, double-blind study of 158 patients with a dermatophyte infection (Tinea Pedis). Patients received placebo or 25% or 50% tea tree oil solution applied twice daily to affected areas, for 4 weeks; they were examined after 2 and 4 weeks. Mycologic cure was assessed by culture of skin scrapings taken at baseline and after 4 weeks. The cure rate was 64% in the 50% tea tree oil group, compared with the placebo group (31%) (Satchell, 2002). An earlier study that used a 10% tea tree cream or placebo in the treatment of tinea pedis found this concentration ineffective (Tong, 1992). Investigators have studied the anti-inflammatory effects of tea tree oil in vitro (Finlay-Jones, 2001). In a human clinical trial, 27 volunteers and subjects were injected intradermally (study and control) with histamine diphosphate. Topical liquid paraffin had no significant effect on histamine-induced wheal, and mean wheal volume significantly decreased with tea tree oil (Koh, 2002). Bassett (1990) compared a 5% tea tree oil gel with 5% benzoyl peroxide for the treatment of 124 patients with mild to moderate acne. These treatments were both effective, and although tea tree was slower to act, those receiving this treatment had fewer adverse effects than did those treated with benzoyl peroxide. The yeast Malassezia pachydermatis is frequently involved in skin diseases such as seborrhoeic dermatitis, especially in dogs and cats. The in vitro activity of tea tree oil was confirmed against several strains of Malassezia pachydermatis. All tested strains showed remarkably high susceptibility to tea tree oil (Weseler, 2002). A commercial preparation, Bogaskin (Bogar, AG Zurich), a 10% emulsion of the oil in a water-based cream, was administered twice daily to 53 canine dermatology patients for 4 weeks in an open, multicenter trial. Dogs treated during the previous 2 weeks with antibiotics, antiinflammatory agents, or other herbal therapy were excluded from the trial. Significant improvements were

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noted in pruritus, erythema, pustules, oozing, crusts, erosions, alopecia, hyperkeratosis, and scaling (Fitzi, 2002). The same group tested a 10% tea tree cream in dogs with focal dermatitis, manifested as pruritic skin lesions, skin fold pyoderma, and other conditions that were associated with positive fungal or bacterial testing. A total of 57 dogs seen by 7 different practitioners were randomly assigned to practitioner-blinded treatment with a commercial skin cream or with tea tree cream twice daily for 10 days. Application of tea tree cream led to significantly better clinical improvement. A single adverse event was reported in the tea tree group; investigators suspected that this was unrelated to treatment (Reichling, 2004). Indications: Bacterial infection; fungal infection; inflammatory skin lesions Potential Veterinary Indications: Fungal, yeast, and bacterial skin infection; inflammatory skin lesions Contraindications: Known allergy. Toxicology and Adverse Effects: Tea tree oil should not be ingested and should not be used over long periods. The LD50 value of tea tree oil in rats is 1 to 2 g/kg—a dose that is considered mildly toxic (Tisserand, 1995). The essential oil of Melaleuca alternifolia was investigated for skin irritation by means of an occlusive patch test given to 28 human subjects for 21 days. In all, 3 of 28 subjects were withdrawn because of severe allergic (not irritant) response to tea tree oil (Southwell, 1997). About 30 mL tea tree oil was applied to a raw eczematous skin lesion on a 10-year-old dog. The dog became unconscious 20 minutes later and was later treated by a veterinarian. Two days after this occurred, the dog was seizing, semicomatose, and dehydrated and had putrid diarrhea. After other possible causes were ruled out and further unsuccessful treatment was administered, the dog was euthanized (Thornton, 1990). Two cats were treated with tea tree oil spray (strength unknown) for flea prevention. One cat with unbroken skin was normal; the other had several small, moist areas of dermatitis. The latter cat presented to a veterinarian in a collapsed state 2 hours after receiving treatment. Intensive treatment was provided, and the cat initially improved, but its condition deteriorated and the cat died after 12 hours (Norris, 1990). Three purebred cats were poisoned with tea tree oil (Bischoff, 1998). A rescued baby spectacled flying fox was treated all over with tea tree oil to kill flies on its body. The flying fox was presented to a veterinarian with dehydration, severe depression, and bloody diarrhea. It was assumed that the tea tree oil had been absorbed through the delicate wing membrane and was ingested during fastidious cleaning. The oral mucosa was ulcerated, and clinical signs revealed ulceration throughout the entire gastrointestinal tract. The flying fox recovered after undergoing intensive therapy (Olsson, 1993). Preparation Notes: For a 1% solution, suspend 5 mL tea tree oil with 500 mL or just over 2 cups distilled water. This solution may be used as a disinfecting wash and room spray, after it is well shaken. For an antiseptic wash, 30 to 40 drops essential oil should be added to 1 cup distilled, sterile, or filtered water, or to an infusion of tea tree leaves.

Dosage: Ointments and creams: 1%-10% tea tree oil in animals; human studies on fungal onychomycosis suggest that 50% creams are effective and safe in that species; many use 100% tea tree oil on toenails or on very thick skin on the feet. References Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust 1990;153:455-458. Bischoff K, Guale F. Australian tea tree (Melaleuca alternifolia) oil poisoning in three purebred cats. J Vet Diagn Invest 1998;10:208-210. Dryden MS, Dailly S, Crouch M. A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization. J Hosp Infect 2004;56:283-286. Finlay-Jones J, Hart P, Riley T, Carson C. Anti-inflammatory activity of tea tree oil. RIRDC Publication No. 01/10, 2001. Available at: http://www.rirdc.gov.au/reports/TTO/01-10.pdf Fitzi J, Furst-Jucker J, Wegener T, Saller R, Reichling J. Phytotherapy of chronic dermatitis and pruritis of dogs with a topical preparation containing tea tree oil (Bogaskin®). Schweiz Arch Tierheilk 2002;144:223-231. Groppo FC, Ramacciato JC, Simoes RP, Florio FM, Sartoratto A. Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. Int Dent J 2002;52:433-437. Jandourek A, Vaishampayan JK, Vazquez JA. Efficacy of melaleuca oral solution for the treatment of fluconazole refractory oral candidiasis in AIDS patients. AIDS 1998;12:10331037. Koh KJ, Pearce AL, Marshman G, Finlay-Jones JJ, Hart PH. Tea tree oil reduces histamine-induced skin inflammation. Br J Dermatol 2002;147:1212-1217. Norris J. Tea tree oil poisoning in a cat. Control and Therapy Series, Postgraduate Foundation in Veterinary Science of the University of Sydney, December 1990. Olsson A. Tea tree oil poisoning: flying foxes. Control and Therapy Series, Postgraduate Foundation in Veterinary Science of the University of Sydney, December 1993. Satchell AC, Saurajen A, Bell C, Bametson RS. Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomized, placebo-controlled, blinded study. Australas J Dermatol 2002;43:175-178. Southwell IA, Freeman S, Rubel D. Skin irritancy of tea tree oil. J Essential Oil Res 1997;9:47-52. Thornton M. Tea tree oil poisoning: possible case. Control and Therapy Series, Postgraduate Foundation in Veterinary Science of the University of Sydney, April 1990. Tisserand R, Balacs T. Essential Oil Safety: A Guide for Health Care Professionals. Edinburgh: Churchill Livingstone; 1995. Tong MM, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Australas J Dermatol 1992;33: 145-149. Vazquez JA, Zawawi AA. Efficacy of alcohol-based and alcoholfree melaleuca oral solution for the treatment of fluconazolerefractory oropharyngeal candidiasis in patients with AIDS. HIV Clin Trials 2002;3:379-385. Weseler A, Geiss HK, Saller R, Reichling J. Antifungal effect of Australian tea tree oil on Malassezia pachydermatis isolated from canines suffering from cutaneous skin disease. Schweiz Arch Tierheilkd 2002;144:215-221.

Materia Medica • CHAPTER 24

Thuja

Thuja occidentalis L. • THOO-yuh ock-sih-den-TAY-liss Other Names: Eastern white cedar, Northern white cedar, Eastern arborvitae, arborvitae, arbor vitae, American arborvitae, swamp-cedar, hackmatack, abendländischer lebensbaum, amerikanischer lebensbaum, heckenthuja, lebensbaum, livsträ, thuya d’occident, tuja, livsträd, zerav zapadni Family: Cupressaceae (Cypress) Parts Used: Leaves and twigs Distribution: Eastern white cedar is native to Northeastern North America from Nova Scotia and Quebec to Manitoba, Minnesota, Ohio, New York, and Northern New England. It is most often associated with cool, moist, nutrient-rich sites, particularly on organic soils near streams or other drainageways, or on calcareous mineral soils. Selected Constituents: Volatile oil, flavonoids, mucilage, astringent. Bitter principle: pinipicrin, tannic acids, and thujin, thujigenin, and thujetin. The essential oil consists of 65% thujone. High-molecular-weight glycoproteins and polysaccharides are the focus of recent research (Chang, 2000).

O

Thujone

Clinical Actions: Expectorant, immune enhancing, antiviral, astringent, diuretic, depurative, antifungal Energetics: Cool, dry History and Traditional Usage: The name Arborvitae, or “tree of life,” dates from the 16th century when the French explorer Jacques Cartier learned from Native Americans how to use the tree’s foliage to treat scurvy and a variety of ailments. The branches were used in steam baths for colds and fever, as poultices for swelling and skin problems, and as decoctions for pneumonia, colic in babies, cystitis, and rheumatism; for periparturient con-

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ditions; and for a variety of other diseases. Eastern white cedar is valued for its soft, rot-resistant, easily worked wood, which can be made into canoe ribs, toboggans, shingles, and fence posts. The decoction has been used with intermittent fever, rheumatism, dropsy, cough, and scurvy, and as an emmenagogue. An ointment of the leaves was used in rheumatism. Injection of the tincture was thought to cure venereal warts (Grieve, 1975). Milks treated thuja oil as unproven and listed its reported uses as removing excrescences from skin and mucous membranes, retarding growth of malignant cells, removing warts and papillomas, and healing mucocutaneous fissures. The oil, when given internally, was said to act as an antiseptic expectorant (Milks, 1949). Published Research: Although many preclinical investigations are documented in the literature, no data on clinical trials in which thuja was used as a single herbal substance were available at this writing. Water-soluble polysaccharides from thuja increase Tlymphocyte counts. When mice were injected with a thuja extract, activity of tumor necrosis factor-α, interleukin-6, and interleukin-1 was increased. Antibody responses in mice are stimulated in Peyer’s patches after oral administration of the extract (Naser, 2005). One study in mice was designed to investigate the theory that thuja may be effective in the treatment of patients with male pattern baldness (androgenetic alopecia). Thuja seed extract inhibited 5α-reductase activity (although not as well as finasteride). When it was applied topically to rats, sebum secretion and sebaceous gland size decreased. Alopecia was less pronounced in a rat alopecia model when treatment consisted of topical thuja, compared with vehicle alone (Park, 2003). Indications: Bronchitis with cardiac weakness, warts (oral and topical use), cystitis, rheumatism, psoriasis, sinusitis Potential Veterinary Indications: Topically for warts and possibly other skin conditions; potentially for chronic otitis externa; orally for sinusitis and upper respiratory tract infection Contraindications: Thuja has abortifacient and emmenagogue properties—not for use during pregnancy or lactation. Toxicology and Adverse Effects: AHPA class 2b, 2d. Not for long-term use or at doses exceeding manufacturer recommendations. Symptoms, in people, of intoxication from the fresh thuja plant include gastroenteritis followed by absorption disorders, headache, nervous agitation, and chronic convulsions, as well as symptoms of liver and renal toxicity that may extend to arrhythmia and myocardial bleeding (Frohne, 1997). Excessive oral intake of thuja extracts induced severe metabolic disturbances. Intoxication was accompanied by irritant effects on the gastrointestinal tract, uterus, liver and kidney. Infants who ingested leaves and twigs of fresh plant showed mild gastrointestinal disorders and vomiting (EMEA, 1999). These reactions can be explained by the high contents of thujone in the fresh plant. As with any plant that is high in essential oils, caution should be observed at any dose considered for use in the cat.

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Notes of Interest: The name thuja is a Latinized form of a Greek word, meaning “to fumigate,” or thuo (“to sacrifice”), for the fragrant wood was burned by the ancients during sacrifice rituals. The tree was described as “arbor vita” by Clusius, who saw it in the royal garden of Fontainebleau after it had been imported from Canada. It was introduced into Britain in about 1566 (Grieve, 1975). Dosage: Human: Tincture (usually 60%-80% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2 or 1 : 3: 0.51 mL TID, up to 6 times daily for acute conditions Small Animal: Tincture (usually 60%-80% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2-1 : 3: 0.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs Historical Veterinary Dose: Topical (Milks, 1949): 10% ointment or oil, or applied undiluted

References Chang LC, Song LL, Park EJ, et al. Bioactive constituents of Thuja occidentalis. J Nat Prod 2000;63:1235-1238. EMEA Committee for Veterinary Medicinal Products—Thuja occidentalis. EMEA—The European Agency for the Evaluation of Medicinal Products Summary Report 1999. Frohne D. Giftpflanzen: Cupressaceae. Stuttgart: Wissenschaftliche Verlagsgesellschaft mbH; 1997:153-156. Grieve M. A Modern Herbal (1931). London: Jonathan Cape; Reprint 1975. Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics. Chicago, Ill: Alex Eger, Inc.; 1949. Naser B, Bodinet C, Tegtmeier M, Lindequist U. Thuja occidentalis (Arbor vitae): a review of its pharmaceutical, pharmacological and clinical properties. Evid Based Complement Alternat Med 2005;2:69-78. Epub 2005 Feb 9. Park WS, Lee CH, Lee BG, Chang IS. The extract of Thujae occidentalis semen inhibited 5alpha-reductase and androchronogenetic alopecia of B6CBAF1/j hybrid mouse. J Dermatol Sci 2003;31:91-98.

Tribulus Tribulus terrestris L. • TRY-bew-lus ter-RES-triss Other Names: Gokshura, chota gokhru, small caltrops, puncture vine, “cow-scratcher” Family: Zygophyllaceae Parts Used: Fruit, root, leaf Distribution: Throughout India, China, and Vietnam and in parts of Europe and South Africa on wasteland Selected Constituents: Steroidal saponins (Xu, 2001), including protodioscin and protogracilin, and phytosterols such as β-sitosterol. Tribulus leaf standardized extract (TLSE) is a product obtained from the aerial parts of Tribulus terrestris, which contains mainly saponins of the furostanol type (not less than 45%, calculated as protodioscin) and was developed in Bulgaria from Mediter-

ranean varieties of tribulus. Tribestan is a standardized tribulus leaf extract that contains not less than 45% steroidal saponins. It is about 30 to 40 times more concentrated than tribulus leaf. The methanol extract of the Tribulus cistoides leaf was found to contain nine steroid saponins, among them the cardioactive cistocardin (Achenbach, 1994).

OH O O

␤DGluc

R ⫽ Glucose: Rhamnose (1:2) RO Protodioscin

Clinical Actions: Antispasmodic, fertility enhancer, antihypertensive, diuretic, antilithic Energetics: Sweet, cold History and Traditional Usage: The fruit of tribulus is used in Traditional Chinese Medicine for pruritus, insufficient milk production, and sore eyes. In Ayurveda, the fruit is used for urinary tract problems and for male and female reproductive tract disorders. In Bulgaria, the leaves have gained a reputation among body builders and athletes as an herbal equivalent to anabolic steroids, despite the lack of scientific support. However, Bulgarian research has focused on the potential of tribulus as a reproductive tonic for impotence, infertility in both sexes, and menopausal symptoms. tribulus has been commonly used in folk medicine as a diuretic, and in Turkey, it has been used to treat patients with colic pain, hypertension, and hypercholesterolemia (Arcasoy, 1998). Ethnoveterinary usage includes bloody dysentery, urinary disorders in ruminants, and rheumatism (Williamson, 2002). Published Research: To validate the claim of T. terrestris as an aphrodisiac, the sexual behavior of rats and intracavernous pressure measurements were investigated. Weight gain, increased intracavernous pressure, and improvement in sexual behavior were observed, and authors believed that these were possibly due to the androgen-enhancement property of protodioscin (PTN). The dose used was 2.5 to 10 mg/kg/day (Gauthaman, 2003). In male rats, tribulus showed considerable stimulation of sperm production. Also, sperm cells were more viable, which suggests improved fertility (Zarkova, 1984). In another study, it was observed that PTN produced a moderate increase in testosterone, dihydrotestosterone, and dehydroepiandrosterone sulfate levels in primates given intravenous tribulus extract at doses of 7.5, 15, and 30 mg/kg body weight. It also improved libido, sexual activity, and intracavernous pressure in rats after oral administration for 8 weeks (at doses of 2.5, 5, and 10 mg/kg body weight) and had a proerectile effect on the corpus cavernosum smooth muscle of rabbits (orally for 8 weeks at doses of 2.5, 5, and 10 mg/kg body weight) (Adaiken, 2001).

Materia Medica • CHAPTER 24

Neychev (2005) treated 21 healthy young men with 2 different doses of tribulus extract (10 mg/kg or 20 mg/kg, divided TID) or placebo for 4 weeks. Serum testosterone, androstenedione, and luteinizing hormone levels were tested before treatment and at intervals up to 24 days after starting supplementation. No changes in hormone levels were detected in any group treated, and all results remained within the normal range. The stimulating effect of a proprietary tribulus extract (Tribestan) on rams that were intended for breeding, as well as on rams that exhibited sexual impotence and deteriorating semen qualities, was studied. Treatment led to extension of the duration of sexual activity and improved semen production over the service period. Results of therapy with rams with reduced libido showed that the animals could recover by the seventh or eighth day with no essential morphologic changes in the structure of testes and epididymides. Treatment was associated with increased testosterone levels, and the sexual activity of rams affected with coital impotence was normalized (Dimitrov, 1987). Tribestan (250 mg/day) increased testosterone levels and accelerated sexual development in rams and male lambs, respectively (Georgiev, 1988). Libido and sexual reflexes were restored in 71% of boars with long-term sexual impotence (70 mg/kg/day) (Zarkova, 1981). The effects of tribulus on body composition and exercise performance in resistance-trained human males were also investigated. Fifteen men were randomly assigned to placebo or tribulus (3.21 mg/kg body weight daily). Body weight, body composition, maximal strength, dietary intake, and mood states were monitored before and after 8 weeks of periodized resistance training and supplementation. No changes were noted in body weight, percentage fat, total body water, dietary intake, or mood state in either group. Supplementation with tribulus did not enhance body composition or exercise performance in resistance-trained men in this study (Antonio, 2000). It has been suggested that T. terrestris L. or its saponin mixture may be useful in the treatment of some patients with smooth muscle spasms or colic pain. A saponin extract of dried and powdered T. terrestris caused a significant decrease in peristaltic movement of isolated sheep ureter and rabbit jejunum preparations in a dosedependent manner (Arcasoy, 1998). T. terrestris has hypotensive effects in rats. In hypertensive rats treated with a single daily dose of 10 mg/kg of lyophilized aqueous extract of tribulus fruit orally for 4 weeks, systolic blood pressure (SBP) was significantly decreased compared with that of hypertensive rats that were not so treated. Angiotensin-converting enzyme (ACE) activity in all tissues of tribulus-fed hypertensive rats was significantly lower than that in control hypertensive rats; this was more pronounced in the kidney. Results suggested a negative correlation between consumption of tribulus and ACE activity in serum and various tissues of rats (Sharifi, 2003). In a human clinical trial, treatment with the saponin fraction of T. terrestris in 406 patients with coronary heart disease resulted in remission in 82.3% of cases.

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The saponin fraction was claimed to dilate the coronary artery and improve coronary circulation. The authors suggest that tribulus was safe and would be effective in the treatment of patients with angina pectoris (Wang, 1990). The decoction of tribulus may inhibit gluconeogenesis and influence glycometabolism in normal mice. This decoction may also reduce plasma triglyceride and cholesterol levels (Li, 2001). An ethanolic extract of the fruits of T. terrestris demonstrated significant dose-dependent protection against (glass bead implantation–induced) uroliths in rats by preventing deposition of calculogenic material around a glass bead; it also protected against leukocytosis and elevation in serum urea levels (Anand, 1994). In rats, an oral dose (5 g/kg) of aqueous extract of T. terrestris elicited positive diuresis, which was slightly greater than that of furo-semide. Urinary Na(+), K(+), and Cl(+) concentrations also increased. In addition to this diuretic activity, T. terrestris evoked contractile activity in guinea pig ileum. The diuretic and contractile effects of T. terrestris may indicate that it has the potential to propel urinary stones (Al-Ali, 2003). T. terrestris was found to be a rich source of calcium and iron (Duhan, 1992). Indications: Infertility, decreased libido Potential Veterinary Indications: Improving reproductive performance Contraindications: None found. Toxicology and Adverse Effects: Tribulus is a ground weed with sharp spines. It causes photosensitization and liver damage in sheep that consume too much. Tribulus toxicity has been reported in Australia (Bourke, 1992), the United States (McDonough, 1994), South Africa (Wilkins, 1996), and Argentina (Tapia, 1994). However, no toxicity in humans has been reported when tribulus is used as an herbal medicine. The LD50 of a saponin extract was 813 mg/kg (mice, intraperitoneal) (Arcasoy, 1998). Photosensitization and cholangiohepatopathy have been noted in sheep grazing T. terrestris (Tapia, 1994). Two β-carboline indolamines (harmane and norharmane) isolated from plant material of T. terrestris have been implicated as causing central nervous system effects in sheep that have grazed on Tribulus over a period of months. Researchers proposed that harmane and norharmane accumulate in tryptamineassociated neurones of the central nervous system and gradually interact irreversibly with a specific neuronal gene DNA sequence (Bourke, 1992). Large amounts of tribulus are required for toxicity to occur. Dosage: Human: Dried herb: 0.25-5 g TID Standardized extract (standardized to 100 mg of furostanol saponins (calculated as protodioscin per tablet): 1 tablet TID-QID. Higher doses may be necessary in some cases, especially for male impotence Infusions and decoctions: 5-10 g per cup of water, with 1/4-1 cup of the tea given TID

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Tincture (usually 45%-60% ethanol; higher alcohol preparations may require lower dose rates; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2 or 1 : 3: 12.5 mL TID Small Animal: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Infusion and decoction: 5-10 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture 2 : 1 (not 1 : 2): 1.5-2.5 mL per 10 kg (20 lb), divided daily and diluted or combined with other herbs Large Animal: Suggested from literature with Tribestan or Tribulus leaf standardized extract (TLSE): sheep, rams, and lambs: 250 mg/day Boars: 70 mg/kg/day

References Achenbach H, Hubner H, Brandt W, Reiter M. Cardioactive steroid saponins and other constituents from the aerial parts of Tribulus cistoides. Phytochemistry 1994;35:1527-1543. Adaikan PG, Gauthaman K, Prasad RNV. History of herbal medicines with an insight on the pharmacological properties of Tribulus terrestris. The Aging Male 2001;4:163-169. Al-Ali M, Wahbi S, Twaij H, Al-Badr A. Tribulus terrestris: preliminary study of its diuretic and contractile effects and comparison with Zea mays. J Ethnopharmacol 2003;85:257-260. Anand R, Patnaik G, Kulshreshtha D. Activity of certain fractions of Tribulus terrestris fruits against experimentally induced urolithiasis in rats. Indian J Exp Biol 1994;32:548-552. Antonio J, Uelmen J, Rodriguez R, Earnest C. The effects of Tribulus terrestris on body composition and exercise performance in resistance-trained males. Int J Sport Nutr Exerc Metab 2000;10:208-215. Arcasoy HB, Erenmemisoglu A, Tekol Y, Kurucu S, Kartal M. Effect of Tribulus terrestris L. saponin mixture on some smooth muscle preparations: a preliminary study. Boll Chim Farm 1998;137:473-475. Bourke CA, Stevens GR, Carrigan MJ. Locomotor effects in sheep of alkaloids identified in Australian Tribulus terrestris. Aust Vet J 1992;69:163-165. Dimitrov M, Georgiev P, Vitanov S. [Use of Tribestan on rams with sexual disorders.] Vet Med Nauki 1987;24:102-110. Duhan A, Chauhan BM, Punia D. Nutritional value of some nonconventional plant foods of India. Plant Foods Hum Nutr 1992;42:193-200. Gauthaman K, Ganesan AP, Prasad RN. Sexual effects of puncturevine (Tribulus terrestris) extract (protodioscin): an evaluation using a rat model. J Altern Complement Med 2003; 9:257-265. Georgiev P, Dimitrov M, Vitanov S. The effect of the preparation Tribestan on the plasma concentration of testosterone and spermatogenesis of lambs and rams. Vet Sib 1988;3:20-22. Li M, Qu W, Chu S, Wang H, Tian C, Tu M. [Effect of the decoction of Tribulus terrestris on mice gluconeogenesis.] Zhong Yao Cai 2001;24:586-588. McDonough SP, Woodbury AH, Galey FD, Wilson DW, East N, Bracken E. Hepatogenous photosensitization of sheep in California associated with ingestion of Tribulus terrestris (puncture vine). J Vet Diagn Invest 1994;6:392-395. Neychev VK, Mitev VI. The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young men. J Ethnopharmacol 2005;101:319-323.

Sharifi AM, Darabi R, Akbarloo N. Study of antihypertensive mechanism of Tribulus terrestris in 2K1C hypertensive rats: role of tissue ACE activity. Life Sci 2003;73:2963-2971. Tapia MO, Giordano MA, Gueper HG. An outbreak of hepatogenous photosensitization in sheep grazing Tribulus terrestris in Argentina. Vet Hum Toxicol 1994;36:311-313. Wang B, Ma L, Liu T. 406 cases of angina pectoris in coronary heart disease treated with saponin of Tribulus terrestris. Chung Hsi I Chieh Ho Tsa Chih 1990;10:85-87. Wilkins AL, Miles CO, De Kock WT, Erasmus GL, Basson AT, Kellerman TS. Photosensitivity in South Africa. IX. Structure elucidation of a beta-glucosidase-treated saponin from Tribulus terrestris, and the identification of saponin chemotypes of South African T. terrestris. Onderstepoort J Vet Res 1996;63:327334. Williamson E, ed. Major Herbs of Ayurveda. Sydney: Churchill Livingstone; 2002. Xu YJ, Xie SX, Zhao HF, Han D, Xu TH, Xu DM. [Studies on the chemical constituents from Tribulus terrestris.] Yao Xue Xue Bao 2001;36:750-753. Zarkova S. Steroid saponins of Tribulus terrestis L. having a stimulant effect on the sexual functions. Rev Port Ciencias Vet 1984;79:117-126. Zarkova S. Tribestan: Experimental and Clinical Investigations. Sofia Bulgaria: Chemical Pharmaceutical Research Institute; 1981.

Turmeric

Curcuma longa L. syn. Curcuma domestica Valeton (dried rhizomes of Curcuma wenyujin, Curcuma kwangsiensis, and Curcuma phaeocaulis are also official sources of turmeric in China) (Pharmacopoeia of the People’s Republic of China, 1992). • KER-koo-muh LONG-uh Other Names: Haridra, haldi, Indian saffron, yellow ginger, jiang huang (rhizome), yu jin (root tuber) Family: Zingiberaceae Parts Used: Dried rhizome, tuber Distribution: Cambodia, China, India, Indonesia, Lao People’s Democratic Republic, Madagascar, Malaysia, the Philippines, and Vietnam. It is extensively cultivated in China, India, Indonesia, Africa, and Thailand, and throughout the tropics. Selected Constituents: Volatile oil (6%) composed of monoterpenes and sesquiterpenes, including zingiberene, curcumene, and α- and β-turmerone. The coloring prin-

Materia Medica • CHAPTER 24

ciples (5%) are curcuminoids, 50% to 60% of which are a mixture of curcumin, monodesmethoxycurcumin, and bisdesmethoxycurcumin (Bruneton, 1995). CH3

O

O

O

CH3 O OH

HO Curcumin

Clinical Actions: Anti-inflammatory, antioxidant, antiplatelet, cholagogue, hepatoprotective, anticancer, cholesterol reducing Energetics: Warm, pungent, drying History and Traditional Usage: Turmeric has been used to treat patients with peptic ulcer and pain and inflammation due to rheumatoid arthritis (Medicinal Plants in Viet Nam, 1990), as well as those with amenorrhea, dysmenorrhea, diarrhea, epilepsy, pain, and skin disease (Chang, 1986). Other uses include asthma, boils, bruises, cough, dizziness, epilepsy, hemorrhage, insect bites, jaundice, ringworm, urinary calculi, and slow lactation (Chang, 1986; Medicinal Plants in Viet Nam, 1990) and as a general tonic, blood purifier, and anti-inflammatory. Ethnoveterinary uses include external application for abscesses, ulcers, ticks, castration wounds, bleeding, eye disorders, and fungal disease. It is also used to treat animal patients with diarrhea and rheumatism; for worms in poultry; for constipation, udder infection, swollen teats, and sprains; for cough and colds in ruminants and poultry; and for jaundice and swinepox. The rhizome is used for gastrointestinal tract disorders, glossitis, Escherichia coli bacillosis, threadworm, irregular growth of teeth, loss of appetite, and colic. Respiratory disease, asthma, pneumonia, swelling of the throat, tonsillitis, leeches in the nostrils, and renal disease are other uses. Other indications include lumbar and compound fractures, hemorrhagic septicemia, rinderpest, hematuria, anthrax, and baldness (Williamson, 2002). Published Research: Turmeric may benefit patients with arthritis. A short-term, double-blind, crossover study of 18 patients with rheumatoid arthritis showed that patients who were given curcumin (1200 mg/day) or phenylbutazone (30 mg/day) had significant improvement in morning stiffness, walking time, and joint swelling (Deodhar, 1980). In another study, the effectiveness of curcumin and phenylbutazone for postoperative inflammation was investigated in a double-blind study. Both resulted in a better anti-inflammatory response than was produced by placebo (Satoskar, 1986), but the degree of inflammation varied greatly among patients. A randomized, double-blind, placebo-controlled, parallel-group clinical trial of P54FP (an extract of Indian and Javanese turmeric, Curcuma domestica, and Curcuma xanthorrhiza, respectively) as a treatment for patients with osteoarthritis of the canine elbow or hip was conducted to assess its efficacy and safety. A total of 61 dogs with

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osteoarthritis were recruited through general practices and then were randomly allocated to receive P54FP or a placebo (orally twice daily for 8 weeks). They were reexamined after 4, 6, and 8 weeks of treatment. No differences were noted between 25 P54FP-treated dogs and 29 placebo-treated dogs when the affected limb was evaluated. Investigators’ assessment showed a statistically significant treatment effect of P54FP, but owners’ assessment failed to show statistical significance. No adverse effects were recorded, but 2 dogs given P54FP and 4 dogs given placebo were withdrawn because their condition deteriorated (Innes, 2003). In atherosclerosis and related cardiovascular disease, free radical–induced blood lipid peroxidation and peroxidized low-density lipoprotein cholesterol (LDL) play a central role in the pathogenesis of disease. One study showed that daily oral administration of turmeric significantly decreased LDL and apo B and increased highdensity lipoprotein cholesterol (HDL) and apo A of healthy subjects; this herb may be useful as a complement to standard treatments for patients with atherosclerosis (Ramirez-Bosca, 2000). In 32 patients with chronic anterior uveitis (CAU), curcumin was administered orally at a dose of 375 mg 3 times a day for 12 weeks. A total of 18 patients received curcumin alone, and 14 patients were given curcumin with antitubercular treatment (tuberculosis is the most common cause of anterior uveitis in India). Patients in both groups showed improvement after 2 weeks. All patients who received curcumin alone improved, whereas the group given antitubercular therapy along with curcumin had a response rate of 86%. Follow-up for the next 3 years indicated recurrence rates of 55% in the group receiving curcumin alone and 36% in the group given combination therapy. Comparable numbers of patients in each group lost their vision during the follow-up period because of complications, but no other adverse effects were reported. The efficacy of curcumin and incidences of recurrence after treatment are comparable with those associated with corticosteroid therapy (Lal, 1999). In broiler chickens, the effect of turmeric as a feed additive on performance was investigated. Turmeric was included in the diet at 0.25%, 0.5%, and 1.0%. Birds fed turmeric had greater body weight gain at 0.5% followed by 0.25% and 1% compared with controls. Similarly, feed conversion of birds receiving 0.5% turmeric was best as compared with controls. Protein percentages of breast and thigh muscles of birds in different groups were nearly the same. The lowest fat percentage was recorded in carcasses at 1.0% turmeric, followed by 0.5%, control, and 0.25%. Higher levels of turmeric inclusion (0.5% and 1.0%) increased erythrocytic and total leukocytic counts. Turmeric did not induce any abnormal flavor, color, or smell. Results indicate that turmeric as a feed additive at the level of 0.5% can enhance the overall performance of broiler chickens (Al-Sultan, 2003). Dogs envenomated with nonlethal doses of Bothrops alternatus snake venom received standard antivenom therapy, intramuscular injections of flunixin meglumine, or topical treatment with aqueous Turmeric extract for a comparison of efficacy. No significant difference was

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noted in the efficacy of antivenom and turmeric in terms of local effects, but flunixin treatment had lower efficacy. Serum levels of antivenom reached their maximum 2 to 4 hours after administration and were not detected after day 5 (Jacome, 2002). Turmeric extracts have a hepatoprotective effect in laboratory animal studies; they protect the liver against inflammation caused by galactosamine, lipopolysaccharide, diethylnitrosamine, and carbon tetrachloride, and they improve the clearing function of the liver when it has been damaged (Chuang, 2000; Lukita-Atmadja, 2002; Deshpande, 2003). Doses administered to mice by gavage ranged from 40 mg/kg of curcuminoids to 600 mg/kg curcumin to 5% turmeric extract in the diet. Curcumin has shown antiangiogenic effects and proapoptotic activities against Ehrlich ascites tumor cells. It has also been found to be cytotoxic in vitro to melanoma cells resistant to doxorubicin, and in vivo studies show that curcumin may serve as a tool against melanoma (Odot, 2004). Curcumin is known to inhibit the growth of ovarian cancer cells (Zheng, 2004). Curcumin has been found to induce apoptosis in lung cancer cell lines (Radhakrishna, 2004). Studies suggest that the chemopreventive action of curcumin may be due to its ability to induce apoptosis and arrest the cell cycle. Indications: Turmeric is used principally for the treatment of patients with acid, flatulent, or atonic dyspepsia (German Commission E, 1985). It is also used to prevent cardiovascular disease and cancer; arthritis, asthma, and eczema, and to improve the function of the gastrointestinal tract and liver; anterior uveitis is associated with tuberculosis. Potential Veterinary Indications: Adjunct cancer treatment; arthritis, hepatitis. Improvement in broiler chicken performance; topically for viper envenomation Contraindications: Obstruction of the biliary tract. Hypersensitivity to turmeric Herb–Drug Interactions: Turmeric should not be used for patients with gastrointestinal ulceration or hyperacidity, according to The Botanical Safety Handbook; however, it may protect against the development of ulcers. Supporting studies show that gastrointestinal ulceration occurred only when mice were administered 50,000 ppm (50 g/kg of diet) of turmeric oil, which was estimated to deliver 7700 to 9300 mg/kg body weight after 2 years (National Toxicology Program, 1993). Clinical trials in animals (Rafatullah, 1990) and a case series in people (Prucksunand, 2001) suggest that turmeric may enhance gastric ulcer healing; at the very least, it may not inhibit healing. Toxicology and Adverse Effects: AHPA class 2b, 2d. One study evaluated the oral acute and 28-day feeding toxicity of turmeric powder in rats. The acute oral LD50 of turmeric powder was greater than 5000 mg/kg. No toxic effects were found through evaluation of clinical signs, body weight, feed consumption and efficiency, hematology, and autopsy in the turmeric- and curcumin-treated groups. No acute oral toxicity was observed, and the higher daily intake (1000 mg/kg) of turmeric for 28 days resulted in no significant toxic effects in rats (Liao, 2003).

Allergic dermatitis from turmeric has been reported. Reactions to patch testing occurred in persons regularly exposed to the substance and in those in whom dermatitis of the fingertips had already been diagnosed. Persons who were not previously exposed to the drug had few allergic reactions (Seetharam, 1987). Potential Drug Interactions: Caution is advised with antiplatelet or anticoagulation medication. Dosage: Human: Dried herb: 1-10 g TID, up to 6 times daily for acute conditions; 1.5-3.0 g daily (European Pharmacopoeia, 1997) Curcumin: 400-600 mg TID, up to 6 times per day acutely Decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 45%-60% ethanol) 1 : 2 or 1 : 3: 2-5 mL TID, up to 6 times daily for acute conditions Small Animal: Curcumin: canine, 50-250 mg TID; feline, 50-100 mg QD (Silver, 1997) Dried herb: 50-600 mg/kg, divided daily (optimally, TID) (to maximum palatability tolerance) Decoction: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually in 45%-60% ethanol) 1 : 2-1 : 3: 1.0-3.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula Horses: Curcumin: 1200-2400 mg daily References Al-Sultan SI. The effect of Curcuma longa (turmeric) on overall performance of broiler chickens. Int J Poult Sci 2003;2:351-353. Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier; 1995. Chang HM, But PPH, eds. Pharmacology and Applications of Chinese Materia Medica, vol 1. Singapore: World Scientific Publishing; 1986. Chuang SE, Cheng AL, Lin JK, Kuo ML. Inhibition by curcumin of diethylnitrosamine-induced hepatic hyperplasia, inflammation, cellular gene products and cell-cycle–related proteins in rats. Food Chem Toxicol 2000;38:991-995. Deodhar SD, Sethi R, Srimal RC. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J Med Res 1980;71:632-634. Deshpande UR, Joseph LJ, Samuel AM. Hepatobiliary clearance of labelled mebrofenin in normal and D-galactosamine HCl–induced hepatitis rats and the protective effect of turmeric extract. Indian J Physiol Pharmacol 2003;47:332-336. European Pharmacopoeia. 3rd ed. Strasbourg: Council of Europe; 1997. German Commission E. Monograph: Curcumae longae rhizoma. Bundesanzeiger 1985;223:30. Innes JF, Fuller CJ, Grover ER, Kelly AL, Burn JF. Randomised, double-blind, placebo-controlled parallel group study of P54FP for the treatment of dogs with osteoarthritis. Vet Rec 2003;152:457-460. Jacome D, Melo MM, Santos MM, Heneine LG. Kinetics of venom and antivenom serum and clinical parameters and treatment efficacy in Bothrops alternatus envenomed dogs. Vet Hum Toxicol 2002;44:334-338.

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Lal B, Kapoor AK, Asthana OP, et al. Efficacy of curcumin in the management of chronic anterior uveitis. Phytother Res 1999;13:318-322. Liao JW, Tsai SJ, Wang SC, et al. Safety evaluation of turmeric (Curcuma longa L.) powder via oral gavage for 28 days in rats [Chinese]. Plant Protect Bull 2003;45:237-255. Lukita-Atmadja W, Ito Y, Baker GL, McCuskey RS. Effect of curcuminoids as anti-inflammatory agents on the hepatic microvascular response to endotoxin. Shock 2002;17:399-403. National Toxicology Program. NTP Toxicology and Carcinogenesis Studies of Turmeric Oleoresin (CAS No. 8024-37-1) (Major Component 79%-85% Curcumin, CAS No. 458-37-7) in F344/N Rats and B6C3F1 Mice (Feed Studies). Research Triangle Park, NC: National Toxicology Program; 1993:1-275. Odot J, Albert P, Carlier A, Tarpin M, Devy J, Madoulet C. In vitro and in vivo anti-tumoral effect of curcumin against melanoma cells. Int J Cancer 2004;111:381-387. Pharmacopoeia of the People’s Republic of China (English ed). Guangzhou: Guangdong Science and Technology Press; 1992. Prucksunand C, Indrasukhsri B, Leethochawalit M, Hungspreugs K. Phase II clinical trial on effect of the long turmeric (Curcuma longa Linn) on healing of peptic ulcer. Southeast Asian J Trop Med Public Health 2001;32:208-215. Radhakrishna Pillai G, Srivastava AS, Hassanein TI, Chauhan DP, Carrier E. Induction of apoptosis in human lung cancer cells by curcumin. Cancer Lett 2004;208:163-170. Rafatullah S, Tariq M, Al-Yahya MA, Mossa JS, Ageel AM. Evaluation of turmeric (Curcuma longa) for gastric and duodenal antiulcer activity in rats. J Ethnopharmacol 1990;29:25-34. Ramirez-Bosca A, Soler A, Carrión MA, et al. An hydroalcoholic extract of Curcuma longa lowers the apo B/apo A ratio: implications for atherogenesis prevention. Mechanisms Ageing Development 2000;119:41-47. Satoskar RR, Shah Shenoy SG. Evaluation of antiinflammatory property of curcumin (diferuloyl methane) in patient with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24:651-654. Seetharam KA, Pasricha JS. Condiments and contact dermatitis of the finger-tips. Indian J Dermatol Venereol Leprol 1987;53: 325-328. Silver RJ. Ayurvedic veterinary medicine. In: Schoen AM, Wynn SG, eds. Complementary and Alternative Veterinary Medicine. St Louis, Mo: Mosby, Inc.; 1997:463-464. Williamson E, ed. Major Herbs of Ayurveda. Sydney: Churchill Livingstone; 2002. World Health Organization. Medicinal Plants in Viet Nam. Manila: WHO Regional Publications, Western Pacific Series, No. 3; 1990. Zheng L, Tong Q, Wu C. Growth-inhibitory effects of curcumin on ovary cancer cells and its mechanisms. J Huazhong Univ Sci Technolog Med Sci 2004;24:55-58.

Uva Ursi Arctostaphylos uva ursi (L.) Spreng. • ark-toh-STAF-ih-los OO-va UR-see Common Names: Bearberry, kinnickinick, mountain cranberry, uva ursi, uvae ursi folium Family: Ericaceae Parts Used: Leaves Distribution: Indigenous to Europe, the United Kingdom, Asia, Northern America, and Canada Selected Constituents: The glycoside arbutin, the main active constituent in uva ursi, accounts for up to 10% of

655

the plant by weight. Hydroquinone derived from arbutin and methylarbutin is a powerful antibacterial agent that is thought to be responsible for the ability of uva ursi to treat urinary tract infection (Matsuda, 1992a). Polyphenols consist of tannins (6%-40%), including gallotannins, ellagic acid, catechin, and anthocyanidins (with astringent and antioxidant properties); phenolic gallic, p-coumaric, and syringic acids; flavanoids—mainly glycosides of quercetin, hyperoside, and myricetin; and the triterpenes ursolic acid, amyrin, montropein, and allantoin. HO

OH O O

OH HO

OH

Arbutin

Clinical Actions: Urinary antiseptic, astringent Energetics: Cold History and Traditional Usage: Uva ursi use was recorded as early as the 13th century by the Welsh Physicians of Myddfai. It was listed in the London Pharmacopoeia for the first time in 1788 (Grieve, 1975). It is a traditional herb of American Indians, who used the leaves for ceremonial smoking. Uses by Eclectic physicians included chronic irritation of the bladder, enuresis, excessive mucus and bloody discharges in the urine, chronic diarrhea, dysentery, menorrhagia, leukorrhea, diabetes, and strangury. Howard Milks (1949) described the herb as a urinary antiseptic recommended for the same uses as buchu, but he considered it inferior to buchu. He noted that it renders the urine dark green. Published Research: The antibacterial effects of uva ursi are due to hydroquinone esters such as arbutin, as well as to free hydroquinone; the activity of arbutin was directly correlated with the β-glucosidase activity of bacteria (this enzyme converts arbutin to hydroquinone) (Jahodar, 1985). Arbutin metabolites are excreted in human urine variably, ranging from approximately 5% of the administered dose for one metabolite to 75% over 24 hours (Schindler, 2002; Quintus, 2005). Uva ursi extracts have shown a broad spectrum of antimicrobial activity in vitro against Escherichia coli, Proteus vulgaris, Enterobacter aerogenes, Streptococcus faecalis, Staphylococcus aureus, Salmonella typhi, and Candida albicans (Holopainen, 1988). One study on the use of uva ursi extract in the course of acute bacterial pyelonephritis in rats showed that at a dose of 25 mg/kg, uva ursi extract had marked antibacterial and nephroprotective effects (Nikolaev, 1996). One of the probable and potentially important mechanisms of action for bearberry is its ability to influence the surface characteristics of microbial cells, thereby

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affecting their ability to adhere to host cells. This is thought to be important in the development of gramnegative infections. One of the characteristics that uva ursi influences is the surface hydrophobicity of microbial cells. In one study, the hydrophobicity of 155 E. coli strains was determined. Among the strains isolated from fecal samples of calves and pigs with diarrhea, some 40.0% to 60.0% of E. coli strains were aggregative. Decoctions of uva ursi leaves significantly increased the hydrophobicity of both microbial species; however, bactericidal action was relatively low (Turi, 1997). A methanolic extract of uva ursi enhanced the inhibitory effects of dexamethasone on allergic and inflammatory models (Matsuda, 1992b). It is suggested that the suppressive effects of uva ursi against immunemediated inflammation are due to arbutin. Arbutin enhanced the inhibitory action of prednisolone on induced contact dermatitis, allergic hypersensitivity, and adjuvant-induced arthritis, and it synergized prednisolone or dexamethasone anti-inflammatory activity (Matsuda, 1990). Topical application of uva ursi might increase the anti-inflammatory effects of other steroid-like compounds such as plant-derived saponins (Matsuda, 1992b). Uva ursi may have use as an adjunct treatment for patients with diabetes. Arbutin reduced postprandial blood glucose elevation following glucose ingestion by mice; blood glucose reductions of between 40% and 52% were observed (Takii, 1997). Bearberry reduced hyperphagia, weight loss, and polydipsia in an induced model of diabetes in mice. However, no effect on insulin or glucose concentration was observed (Swanston-Flatt, 1989). Bearberry extract may assist in the treatment of patients with hyperpigmentary disorders, in that arbutin inhibits melanin synthesis in vitro by inhibiting tyronase activity (Matsuda, 1992a). Melanogenesis in brownhaired guinea pigs was reduced by 80% through topical application of arbutin (Nishimura, 1995). Indications: Urinary tract infection and bacterial prostatitis (as a general urinary antiseptic); potentially for diabetes; perhaps as adjuvant treatment for those with inflammatory conditions Potential Veterinary Uses: Urinary tract infection, perhaps diabetes Contraindications: Pregnancy, kidney disease, inflammatory digestive conditions. Not for use in urinary tract infection when urine is acidic. Toxicology and Adverse Effects: AHPA class 2b, 2d. Not for use longer than 2 weeks at a time. Hydroquinone is toxic in high doses—oral LD50 in rats is 320 mg/kg, and it is 400 mg/kg in mice, 550 mg/kg in guinea pigs, 70 mg/kg in cats, and 200 mg/kg in dogs (ESCOP, 1997). Maculopathy due to long-term ingestion for 3 years has been reported (Wang, 2004). Potential Drug Interactions: Urinary acidifiers inhibit the conversion of arbutin to active hydroquinone, making uva ursi less effective. No other clinical interactions have been described. One constituent (coraligin) restored beta lactam activity against methicillin-resistant Staphylococcus aureus in vitro. May potentiate anti-inflammatory actions of steroids.

Notes of Interest: The generic name, derived from the Greek, and the Latin specific name, uva ursi, mean the same thing: the bear’s grape. The name may have been given to the plant because of the notion that bears eat the fruit with relish, or it may derive from its very rough, unpleasant flavor, which may have been considered fit only for bears (pithy but not unpleasant). The tannin in the leaves is so abundant that they have been used in Sweden and Russia for tanning leather. Dosage: Herb should be used for no longer than 1 month. Human: Dried herb: 1-10 g TID, up to 6 times daily for acute conditions Infusions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 45% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2 or 1 : 3: 1.5-5 mL TID, up to 6 times daily for acute conditions Small Animal: Dried herb: 50-400 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 45% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2-1 : 3: 1.02.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. Historic Veterinary Doses: Dogs: fluid extract (1 : 1): 2-8 mL per dose (Milks, 1949) Horses: fluid extract (1 : 1): 15-60 mL per dose (Milks, 1949) References ESCOP Monographs on the Medical Uses of Plants. European Scientific Cooperative on Phytotherapy, Exeter UK 1997 Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint 1975). Jahodar L, Jilek P, Paktova M, Dvorakova V. [Antimicrobial effect of arbutin and an extract of the leaves of Arctostaphylos uvaursi in vitro.] Cesk Farm 1985;34:174-178. Matsuda H, Nakamura S, Shiomoto H, Tanaka T, Kubo M. [Pharmacological studies on leaf of Arctostaphylos uva-ursi (L.) Spreng. IV. Effect of 50% methanolic extract from Arctostaphylos uva-ursi (L.) Spreng. (bearberry leaf) on melanin synthesis.] Yakugaku Zasshi 1992a;112:276-282. Matsuda H, Nakamura S, Tanaka T, Kubo M. [Pharmacological studies on leaf of Arctostaphylos uva-ursi (L.) Spreng. V. Effect of water extract from Arctostaphylos uva-ursi (L.) Spreng. (bearberry leaf) on the antiallergic and antiinflammatory activities of dexamethasone ointment.] Yakugaku Zasshi 1992b;112:673-677. Matsuda H, Nakata H, Tanaka T, Kubo M. [Pharmacological study on Arctostaphylos uva-ursi (L.) Spreng. II. Combined effects of arbutin and prednisolone or dexamethazone on immunoinflammation.] Yakugaku Zasshi 1990;110:68-76. Matsuda H, Tanaka T, Kubo M. [Pharmacological studies on leaf of Arctostaphylos uva-ursi (L.) Spreng. III. Combined effect of arbutin and indomethacin on immuno-inflammation.] Yakugaku Zasshi 1991;111:253-258. Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics. Chicago, Ill: Alex Eger, Inc.; 1949. Nikolaev SM, Shantanova LN, Mondodoev A, et al. Pharmacological activity of the dry extract from the leaves of Arc-

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tostaphylos uva-ursi L. in experimental nephropyelitis. Rastitel’nye Resursy 1996;32:118-123. Nishimura T, Kometani T, Okada S, Ueno N, Yamamoto T. [Inhibitory effects of hydroquinone-alpha-glucoside on melanin synthesis.] Yakugaku Zasshi 1995;115:626-632. Quintus J, Kovar KA, Link P, Hamacher H. Urinary excretion of arbutin metabolites after oral administration of bearberry leaf extracts. Planta Med 2005;71:147-152. Schindler G, Patzak U, Brinkhaus B, et al. Urinary excretion and metabolism of arbutin after oral administration of Arctostaphylos uvae ursi extract as film-coated tablets and aqueous solution in healthy humans. J Clin Pharmacol 2002;42:920927. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Evaluation of traditional plant treatments for diabetes: studies in streptozotocin diabetic mice. Acta Diabetol Lat 1989;26:51-55. Takii H, Matsumoto K, Kometani T, Okada S, Fushiki T. Lowering effect of phenolic glycosides on the rise in postprandial glucose in mice. Biosci Biotechnol Biochem 1997;61:15311535. Turi M, Turi E, Koljalg S, Mikelsaar M. Influence of aqueous extracts of medicinal plants on surface hydrophobicity of Escherichia coli strains of different origin. APMIS 1997;105:956962. Wang L, Del Priore LV. Bull’s-eye maculopathy secondary to herbal toxicity from uva ursi. Am J Ophthalmol 2004;137: 1135-1137.

be a very potent species. Valeriana edulis and Valeriana wallichi (Indian Valerian) from China and India are used in Mexico, and Valeriana chinensis var. Batalin has been used for longer than 1000 years in China; Valeriana fauriei is used in China and Japan today. Valeriana capensis is used in Africa for epilepsy and nervous disorders. Common Names: Setwall, setewale, great wild valerian, all-heal, amantilla, capon’s tail, phu (galen or dioscorides), baldrianwurzel (German) Family: Valerianaceae Parts Used: Root. The odor makes valerian root easy to distinguish from pretenders. Selected Constituents: Volatile oil (contains α- and βpinene, borneol, etc.); sesquiterpenes (valerenic acid, valeranone, etc.); baldrinols and phenolic acids. The dried root contains γ-aminobutyric acid (GABA), but the alcoholic extract does not.

CH3 H3C

CH3

O O O

O H

O

O CH3

Valerian

CH3 Valepotriate

Valeriana officinalis L. • va-ler-ee-AH-nuh oh-fiss-ihNAH-liss Distribution: Europe, Northern Asia Similar Species: Valeriana dioica (Linn.) (Marsh Valerian) may be a common inferior substitute. Valeriana milkanii (Syme) and Valeriana sambucifolia (Mikan) are two common English species used in the 20th century in trade. Valeriana celtica (Saliunca) was used in the East in ancient times for aromatic baths. Valeriana sitchensis is an American species considered in older Russian research to

Clinical Action: Sedative, hypnotic, antispasmodic, anticonvulsant, stimulant tonic Energetics: Warm, pungent; some consider valerian to be a Qi mover with particular influence on the cardiovascular system. History and Traditional Usage: Used since the Middle Ages for promoting sleep, relieving anxiety, suppressing maniacal and aggressive behavior, and controlling seizures. The Blackfoot tribe of North America administered decoctions of the root of V. dioica to horses for colic and distemper; both V. dioica and V. sitchensis were used externally for sores and wounds in horses (note anecdote relayed in Chapter 21 about a horse that colicked when given valerian, however). Various Valeriana species were used by Native Americans for diarrhea and stomach troubles, for seizures in babies, as a mild sedative, topically for wounds, and as flavor for smoking mixtures and incense. The Eclectics used valerian for nervous irritability and weakness, nervous headache, and epilepsy. The specific indication was as follows: “A cerebral stimulant. [Indicated for] hysteria, chorea, hemicrania; all with mental depression and despondency; cerebral anemia; mild spasmodic movements.” The apparently paradoxical effects (e.g., cerebral stimulant, hypnotic) are resolved in this description of indications for this herb from King’s: “The cases requiring it are those evidencing enfeebled cerebral circulation; there is despondency and marked mental depression, often amounting to hypochondria. In

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properly selected cases, it relieves irritability and pain, and favors rest and sleep.” Milks (1949) stated that valerian is carminative and slightly stimulates the heart and vasomotor and respiratory centers. He explained that the antispasmodic and antihysteric actions in humans were probably not applicable to veterinary patients, in that the herb acted by stimulating the “highest centers which exert psychic control.” He noted that although valerian had been recommended for chorea in dogs, it was not very effective. Published Research: Valepotriates, valeric acid, and volatile oils interact with GABA. Valepotriates dissipate in days to weeks and are not contained in most commercial preparations. Aqueous extracts of valerian root contain significant amounts of GABA, although the oral bioavailability of this neurotransmitter in the context of valerian root is not known. Valerenic acid acts directly on the amygdaloid body in the brain and inhibits the breakdown of GABA, which leads to sedation (Houghton, 1999). Valerian extract and valerenic acid appear to modulate GABA receptor function as well (Yuan, 2004). Valepotriate activities are not as well understood, but they seem to act as prodrugs that are converted to homobaldrinol, a chemical that has been shown to reduce spontaneous motility in mice. The lignan, hydroxypinoresinol, binds benzodiazepine receptors (Houghton, 1999). Recent studies have shown that dichloromethane and petroleum ether extracts of valerian bind the 5-HT(5a) receptor, which is notably found in the suprachiasmatic nucleus of the brain, the area implicated in the sleep–wake cycle (Dietz, 2005). Insomnia In an Internet-based, randomized, double-blind, placebocontrolled trial, 391 participants with both anxiety and insomnia were asked whether taking kava, valerian, or the combination of both improved their sleep. Neither herb performed better than placebo in this trial (Jacobs, 2005). In a different trial, a series of 42 n-of-1 placebocontrolled trials showed that valerian was no better than placebo at improving sleep (Coxeter, 2003). Older trials were generally more positive. A double-blind, placebo-controlled trial compared valerian (a 400-mg aqueous extract) with placebo. A total of 128 volunteers were studied for changes in sleep latency, sleep quality, sleepiness on awakening, night awakening, and dream recall. Valerian was significantly more effective than placebo in improving sleep latency and sleep quality (Leathwood, 1982). The same group conducted a double-blind trial, in which 8 people were given 450 mg or 900 mg of a valerian extract, or placebo. Again, ingestion of valerian was associated with better sleep (Leathwood, 1985). Other studies have had positive results (Donath, 2000; Balderer,1985); doses ranged from 450 to 900 mg. Valerian increased the number of alpha waves as measured by electroencephalogram and reduced anxiety, which appeared to be a main contributor to its benefit for insomnia (Poyares, 2002). In a trial in which oxazepam and valerian (600 mg/day of a proprietary extract) were compared for the treatment of patients with

insomnia, valerian showed efficacy equal to that of oxazepam (Dorn, 2000). Despite these promising results, a comprehensive review of valerian for insomnia concluded that results were inconsistent, and that valerian should be studied further for its use in insomnia (Stevinson, 2000). If valerian is used for the treatment of those with insomnia, the onset of action occurs generally 2 to 3 weeks after supplementation is begun (Wheatley, 2005). Stress In laboratory stress tests, humans given valerian showed decreased heart rate and blood pressure (Cropley, 2002). In all, 70 hospitalized patients with various psychosomatic diagnoses were given Valmane (a valepotriate extract) at 150 to 300 mg daily. Tachycardia, hypertension, sweating, restless legs, and other conditions were positively affected by treatment (Boeters, 1969). In a different study, adults underwent laboratory social stress tests in a double-blind trial. Valerian was effective in reducing symptoms of anxiety in these subjects (Kohnen, 1988). In a randomized, double-blind study of 80 people with various anxiety syndromes, 270 mg daily of a standardized valerian extract was as effective and well tolerated as clobazam, according to standardized anxiety questionnaires (Sousa, 1992). Cats given 10 mg/kg valerian extract by gastric lavage showed significant decreases in restless, fearful, and aggressive behaviors (von Eickstedt, 1969). Cardiovascular disorders Valerian has shown coronary vasodilating and antiarrhythmic activity in laboratory rabbits and mice (Petkov, 1979). In cats, intravenous valerian extract significantly increased coronary blood flow while temporarily reducing heart rate and blood pressure (Zhang, 1982). Indications: Anxiety, nervous tension, insomnia, uterine cramps Potential Veterinary Indications: Anxiety, insomnia, and possibly as an adjunct for the treatment of patients with epilepsy. May be useful in cats with hypertrophic cardiomyopathy Contraindications: Some theoretical concern has been expressed that valerian may worsen the symptoms of schizophrenia or bipolar disorder in humans. Toxicology and Adverse Effects: AHPA class 1. Some authors report paradoxical excitement or overstimulation after valerian is used. Tachycardia is also a common adverse effect in some people, as is a hung-over feeling the day after use. Overdose may cause nausea and stupor; in humans, headache and blurred vision have been reported. Rare allergic contact dermatitis has been documented. Valerian is considered a very safe herb and is generally recognized as safe (GRAS) by the U.S. Food and Drug Administration (FDA); it has been approved for use in food. Safety for long-term use has not been established. Drug Interactions: Valerian may interact with barbiturates and other central nervous system depressants. It may also enhance the effects of benzodiazepines. Anec-

Materia Medica • CHAPTER 24

dotal reports have described valerian use that resulted in positive drug tests for reserpine in horses. Notes of Interest: Mrs. Grieve (1975) has this to say about valerian and animals: “Valerian has an effect on the nervous system of many animals, especially cats, which seem to be thrown into a kind of intoxication by its scent. It is scarcely possible to keep a plant of valerian in a garden after the leaves or root has been bruised or disturbed in any way, for cats are at once attracted and roll on the unfortunate plant. It is equally attractive to rats and is often used by rat-catchers to bait their traps. It has been suggested that the famous Pied Piper of Hamelin owed his irresistible power over rats to the fact that he secreted Valerian roots about his person.”

Dosage: Human: For insomnia, take the last dose 30 min before you go to bed, doubling the amount. Valerian does not usually work immediately; consistent use over 3 to 4 weeks is required. Dried herb: 1-10 g TID Decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 45%-55%) 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried herb: 25-300 mg/kg, divided daily Decoction: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily Tincture (usually 45%-55% ethanol) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula Large Animal (Karreman, 2004): Horses: fluid extract, 30-60 mL; oil, 2-4 mL Farm animals: fluid extract: cow, 30-60 mL; sheep and goat, 4-8 mL ; oil cow, 2-4 mL; sheep and goat, 0.6-1.3 mL Historical Veterinary Doses: Horse and Cow Dried herb: 1-2 oz (Milks, 1949) Dog Dried herb: 1-7.5 g Tincture: 7-15 mL (Milks, 1949) References Balderer G, Borbely AA. Effect of valerian on human sleep. Psychopharmacology [Berl] 1985;87:406-409. Boeters U. Treatment of control disorders of the autonomic nervous system with valepotriate (Valmane). Munch Med Wochenschr 1969;111:1873-1876. Cropley M, Cave Z, Ellis J, Middleton RW. Effect of kava and valerian on human physiological and psychological responses to mental stress assessed under laboratory conditions. Phytother Res 2002;16:23-27. Dietz BM, Mahady GB, Pauli GF, Farnsworth NR. Valerian extract and valerenic acid are partial agonists of the 5-HT5a receptor in vitro. Brain Res Mol Brain Res 2005;138:191-197. Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry 2000;33:4753.

659

Dorn M. [Efficacy and tolerability of Baldrian versus oxazepam in non-organic and non-psychiatric insomniacs: a randomised, double-blind, clinical, comparative study.] [Article in German] Forsch Komplementarmed Klass Naturheilkd 2000;7:79-84. Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint, 1975). Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol 1999;51:505-512. Jacobs BP, Bent S, Tice JA, Blackwell T, Cummings SR. An Internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore) 2005;84:197-207. Karreman H. Treating Dairy Cows Naturally: Thoughts and Strategies. Paradise, Pa: Paradise Publications; 2004. Kohnen R, Oswald WD. The effects of valerian, propranolol, and their combination on activation, performance, and mood of healthy volunteers under social stress conditions. Pharmacopsychiatry 1988;21:447-448. Leathwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav 1982;17:65-71. Leathwood PD, Chauffard F. Aqueous extract of valerian reduces latency to fall asleep in man. Planta Med 1985;2:144-148. Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics. Chicago, Ill: Alex Eger, Inc.; 1949. Petkov V. Plants and hypotensive, antiatheromatous and coronarodilatating action. Am J Chin Med 1979;7:197-236. Poyares DR, Guilleminault C, Ohayon MM, Tufik S. Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal? Prog Neuropsychopharmacol Biol Psychiatry 2002;26:539-545. Sousa MPD, Pacheco P, Roldao V. Double-blind comparative study of the efficacy and safety of Valdispert vs clobazapam. KaliChemie Medical Research and Information, 1992. In Blumenthal M, Hall T, Goldberg A, Kunz T, Dinda K, Brinkman J, et al, eds. The ABC Clinical Guide to Herbs. Austin, TX, The American Botanical Counal, 2003. Stevinson C, Ernst E. Valerian for insomnia: a systematic review of randomized clinical trials. Sleep Med 2000;1:91-99. von Eickstedt KW. Modification of the alcohol effect by valepotriate. Arzneimittelforschung 1969;19:995-997. Wheatley D. Kava and valerian in the treatment of stress-induced insomnia. Phytother Res 2001;15:549-551. Wheatley D. Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability. J Psychopharmacol 2005;19:414-421. Yuan CS, Mehendale S, Xiao Y, Aung HH, Xie JT, Ang-Lee MK. The gamma-aminobutyric acidergic effects of valerian and valerenic acid on rat brainstem neuronal activity. Anesth Analg 2004;98:353-358, table of contents. Zhang BH, Meng HP, Wang T, et al. Effects of Valeriana officinalis L. extract on cardiovascular system. Yao Hsueh Hsueh Pao 1982;17:382-384.

Varuna Crataeva nurvala Buch.-Ham. syn. Crateva nurvala Buch.Ham. • kray TA vuh ner VAH luh Common Names: Varuna, Three-Leaved Caper Family: Capparidaceae Parts Used: Stem and root bark and leaves Distribution: Throughout India and cultivated worldwide.

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Selected Constituents: Varuna contains lupeol (a triterpene), the most active principle, which has antiurolithic properties and reverses biochemical and histopathologic changes caused by calculosis (Anand, 1990); it also contains glucosinolates, triterpenoid saponins, sterols (including β-sitosterol), and flavonoids (e.g., catechin).

H HO H

Clinical Actions: Anti-inflammatory, antilithic, bladder tonic, urinary antiseptic Energetics: Cooling History and Traditional Usage: Crataevus was a Greek botanist from whom the name of crataeva is derived. The plant was known to ancient physicians, who used it as a blood purifier and for maintenance of homeostasis. Ayurvedic medicine texts dating back to 1100 AD record the use of varuna in urinary tract disorders; Varuna is the name of the God of Water in the Hindu religion. It is used in the treatment of patients with urinary tract infection, calculi, and crystalluria and is valued as a bitter, astringent, demulcent, laxative, rubifacient, tonic, liver stimulant, and vesicant; it is also used for malaria and tumors. Ethnoveterinary usage includes the treatment of animals with renal lithiasis, swelling of the liver, and diarrhea (Williamson, 2002). Published Research: In human studies, 50 mL of decoction given twice daily for 3 months significantly improved incontinence, pain, and retention in patients with prostatic hypertrophy with hypotonic bladder (Deshpande, 1982). After 4 weeks of treatment, 68% of patients had achieved symptomatic relief from chronic urinary tract infection; 17% were devoid of microorganisms and white cells (Deshpande, 1982). Water extract of the stem bark increased tone in guinea pig, dog, and human skeletal and smooth muscle (intestine and ureter) in vitro (Das, 1974); after oral treatment with varuna was provided for 40 days, a significant increase in bladder tone was observed in dogs (Deshpande, 1982). The role of lupeol in calcium oxalate experimental rat urolithiasis was studied. Lupeol administration (25 mg/kg body weight/day) significantly reduced oxalate excretion by kidneys. It also decreased levels of damage marker enzymes in urine, which may indicate a reduction in tubular damage. Such effects may be beneficial in minimizing the deposition of stone-forming constituents in the kidney (Malini, 1995). Administration of lupeol and its structural analogue betulin to hyperoxaluric rats min-

imized tubular damage and reduced markers of crystal deposition in the kidneys, and lupeol was found to be more effective than betulin (Vidya, 2000). In rats, lupeol produced a dose-dependent (1050 mg/kg po) (up to 95%) reduction in weight of the formed urolith (protective effect). In preformed stones after 16 weeks of lupeol at 10 to 50 mg/kg po, a weight reduction of 15% to 55% was observed in stones, but no size reduction was detected. Very small stones had disappeared, suggesting their dissolution or subsequent flushing. Biochemical and urinary abnormalities were markedly normalized (Anand, 1994). Stem bark decoction was used in patients with calcium oxalate stones. After 12 weeks, pain and dysuria were significantly reduced, as was the size of stones (Singh, 1991). In an experimental model in rats, Crataeva significantly inhibited bladder stone formation. Bladders of treated animals showed less edema, ulceration, and cellular infiltration when compared with controls (Deshpande, 1982). Among 46 patients with calcium oxalate stone who used 50 mL decoction twice daily for between 1 and 47 weeks, 28 passed the stone and 18 experienced symptomatic relief. These outcomes were thought to be due to the tonic contractile action of the drug on smooth muscle (Deshpande, 1982). In rats, crude extract given at 100 mg/kg PO significantly reduced stone formation (81%) (Prabhakar, 1997). In an earlier study, crataeva decoction prevented the expected elevation of the oxalate-synthesizing liver enzyme, glycolate oxidase, produced by feeding of glycollic acid; it was thought that crataeva had a regulatory action on endogenous oxalate synthesis. On the other hand, protein-bound carbohydrates were increased in the renal tissues during calculosis, but these changes were not reversed with crataeva. Increased deposition of stoneforming constituents in the kidneys of calculogenic rats was lowered with decoction administration. Increased urinary excretion of the crystalline constituents, along with lowered magnesium excretion found in stoneforming rats, was partially reversed by decoction treatment (Varalakshmi, 1990). A pharmacologic study showed that crataeva influenced small intestinal sodium and potassium adenosine triphosphatase (ATPase), which may in turn influence transport of minerals (Varalakshmi, 1991). Lupeol is an effective antioxidant (Baskar, 1996). The effects of lupeol and lupeol linoleate on the development of complement in adjuvant arthritis in rats were studied and compared with those of indomethacin as a model for rheumatoid arthritis in people. Results suggest that the anti-inflammatory activity of the triterpenes may be due to their anticomplementary activity (Geetha, 1999a). Lupeol and lupeol linoleate were administered orally (50 mg/kg) for 8 days to arthritic rats, after the 11th day of adjuvant injection. Lupeol linoleate was more effective than lupeol, possibly because it caused stabilization of the lysosomal membrane of cells (Geetha, 1999b). Indications: Chronic urinary tract infection; prevention of kidney and bladder stones; benign prostatic hyperplasia; hypotonic and atonic bladder; incontinence; adjunct treatment for urinary calculi (calcium oxalate)

Materia Medica • CHAPTER 24

Potential Veterinary Uses: Calcium oxalate and possibly other uroliths; urinary tract infection; atonic and hypotonic bladder; incontinence Contraindications: None found. Toxicology and Adverse Effects: The LD50 of a 50% ethanolic extract of stem bark was found to be greater than 1000 mg/kg administered intraperitoneally to adult rats. Dosage: Human: Dried herb: 4.5-8 g TID Traditional decoction: 1 part powdered stem bark boiled in 16 parts water and evaporated until 1/4 remains Tincture (generally 25% ethanol) 1 : 2: 6-14 mL, divided daily Small Animal: Dried herb: 50-400 mg/kg, divided daily (optimally, TID) Tincture (generally 25% ethanol) 1 : 2: 1.0-3.0 mL per 10 kg (20 lb), divided daily and diluted or combined with other herbs

661

Wild Cherry

References Anand R, Patnaik G, Jain P, et al. Antiurolithic activity of Crataeva nurvala in Albino rats. Indian J Pharmacol 1990; 222:23-24. Anand R, Patnaik G, Kulshreshtha D, et al. Antiurolithiatic activity of lupeol, the active constituent isolated from Crataeva nurvala. Phytother Res 1994;8:417-421. Baskar R. Effect of lupeol isolated from Crataeva nurvala stem bark against free radical induced toxicity in experimental urolithiasis. Fitoterapia 1996;67:121-125. Das P. Antiinflammatory and antiarthritic activity of Varuna. J Res Indian Med 1974;9:49. Deshpande P, Sahu M, Kumar P. Crataeva nurvala Hook and Forst (Varun): the Ayurvedic drug of choice in urinary disorders. Indian J Med Res 1982;76(suppl):46-53. Geetha T, Varalakshmi P. Anticomplement activity of triterpenes from Crataeva nurvala stem bark in adjuvant arthritis in rats. Gen Pharmacol 1999a;32:495-497. Geetha T, Varalakshmi P. Effect of lupeol and lupeol linoleate on lysosomal enzymes and collagen in adjuvant-induced arthritis in rats. Mol Cell Biochem 1999b;201:83-87. Malini MM, Baskar R, Varalakshmi P. Effect of lupeol, a pentacyclic triterpene, on urinary enzymes in hyperoxaluric rats. Jpn J Med Sci Biol 1995;48:211-220. Prabhakar Y, Kumar S. Crataeva nurvala: an Ayurvedic remedy for urological disorders. Br J Phytother 1997;4:103-109. Singh R. Evaluation of antilithic properties of varun (Crataeva nurvala): an indigenous drug. J Res Indian Med 1991;10:35-39. Varalakshmi P, Latha E, Shamila Y, Jayanthi S. Effect of Crataeva nurvala on the biochemistry of the small intestinal tract of normal and stone-forming rats. J Ethnopharmacol 1991;31:6773. Varalakshmi P, Shamila Y, Latha E. Effect of Crataeva nurvala in experimental urolithiasis. J Ethnopharmacol 1990;28:313-321. Vidya L, Varalakshmi P. Control of urinary risk factors of stones by betulin and lupeol in experimental hyperoxaluria. Fitoterapia 2000;71:535-543. Williamson E, ed. Major Herbs of Ayurveda. Sydney: Churchill Livingstone; 2002.

Prunus serotina Ehrh., formerly Prunus virginiana • PROOnus se-roh-TEE-nuh Distribution: Native to North America Other Names: Black cherry, wild black cherry, Virginia prune, sauerkirsch, griottier, cerezo, ciliegio, ying tao Family: Rosaceae Parts Used: Inner bark Collection: Bark harvested in the spring contains more tannins, and bark collected in the autumn is higher in starch and prussic acid. Fall-harvested bark is viewed as more desirable. Selected Constituents: Cyanogenic glycosides (prunasin), tannins, flavonoids, sugars, coumarins (scopoletin)

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HO HO HO

Reference O

Bunn, JF. veterinary school lectures, undated (approximately 1920, Concord, NC).

O OH H N Prunasin

Clinical Action: Antitussive, antispasmodic, mildly astringent Energetics: Astringent, bitter, aromatic History and Traditional Usage: Native Americans used the bark and roots for diarrhea, fever, “female problems,” and pain; topically for skin problems and cough. The berries were used for food. Used as a cough suppressant for bronchitis, whooping cough, pneumonia, and asthma to relieve the cough—usually as part of a formula to address other aspects of these conditions. Also used topically as an eyewash for keratitis. King’s claimed that it is best for chronic problems. It can also be used for fever and inflammatory problems, sore throat, gastrointestinal problems, and diarrhea. Published Research: Clinical research on this herb appears to be lacking. Indications: Persistent, irritating cough Potential Veterinary Indications: Chronic bronchitis, asthma (should be combined with an expectorant herb) Contraindications: Pregnancy and lactation Toxicology and Adverse Effects: AHPA class 2d. Not for long-term use. Enzymatic hydrolysis of prunasin yields prussic acid (hydrogen cyanide) and benzaldehyde. The agent has been classified as GRAS (generally recognized as safe) and is used as a flavoring for syrups; however, it is dangerous in large doses or when taken for a long period. Cases of livestock poisoning after animals have eaten from low or fallen branches have been well recognized. Drug Interactions: May affect the metabolism of drugs processed through the CYP3A4 P450 isozymes, although clinical interactions have not been reported. Dosage: Some authors state that cold infusion is the preferred form; it best extracts the cyanogenic glycosides Human: Dried herb: 0.25-10 g TID, up to 6 times daily for acute conditions Decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID, up to 6 times daily acutely Tincture (usually 40%-50% ethanol) 1 : 2 or 1 : 3: 0.25-5 mL TID, up to 6 times daily for acute conditions Small Animal: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Decoction: 5-30 g per cup of water, administered at a rate of 1/2-4 cups, divided daily (optimally, TID) Tincture (usually 40%-50% ethanol) 1 : 2-1 : 3: 0.5-2.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs Historic Veterinary Doses: Fluid extract (1 : 1): horse, 1/2-1 oz; dog, 1-7 mL (Bunn, circa 1920) Syrup: dog, 2-7 mL (Bunn, circa 1920)

Wild Yam Dioscorea villosa L. • di-oh-SKOR-ee-uh vil-OH-suh Distribution: North and Central America Similar Species: Dioscorea batatas or Dioscorea opposita is Shan Yao used in Chinese medicine. Other Names: Colic root, China root, North American wild yam, rheumatism root, igname sauvage, racines de colique, zottige yamswurzel, dioscorea, Atlantic yam Family: Dioscoreaceae Parts Used: Rhizome Selected Constituents: Steroidal saponins (diosgenin glycosides, including dioscin), polysaccharides, alkaloid (dioscorin), tannins O

H3C

CH3

CH3 CH3

O

HO Diosgenin

History and Traditional Usage: Native North Americans used the root as food and for pain relief during childbirth. Antispasmodic, anti-inflammatory, cholagogue. Used to relieve pain from spasm in the gastrointestinal tract, gallbladder, and uterus; also used for rheumatism. For nausea, colic (gallbladder, hepatic, gastric, or intestinal), ovarian and uterine spasm. Commonly used today by women for a supposed progesterone-like effect (for menopausal symptoms and birth control) because marketers claim that it contains dehydroepiandrosterone (DHEA) or progesterone; this is inaccurate. (Anecdotes that support a progesterone-like effect may be associated with products that are spiked with synthetic progesterone.) Energetics: Bitter, mildly pungent, and sour; moves Qi Published Research: Evidence from in vitro trials from the 1920s supports the presence of antirheumatic, antispasmodic properties (Brinker 1996). Wild yam (80 mg/kg) reduced intestinal inflammation and normalized bile secretion in an experimental model (Yamada, 1997). Diosgenin can be converted in vitro to a number of hormonal agents (e.g., progesterone, dihydroepiandrosterone). Although it has been suggested that this conversion may occur in vivo, existing objective evidence does not support this claim (Arahiniknam, 1996; Dollbaum, 1996). A trial in menopausal women that compared a wild yam cream with placebo showed that the cream was ineffective in relieving symptoms of menopause (Komesaroff, 2001). By contrast, postmenopausal women

Materia Medica • CHAPTER 24

were instructed to replace their staple food (which was usually rice) with white yam (Dioscorea alata, 390 g daily for 30 days) or sweet potato (240 g daily). Significant increases in serum concentrations of estrone and sex hormone binding globulin, as well as near significant increases in estradiol, were noted in the group that ate yams. Urinary estrogen metabolites decreased and serum androgen increased. Plasma cholesterol decreased slightly, but significantly. Only serum estrone, estradiol, and sex hormone binding globulin were measured in the control group; these levels did not change (Wu, 2005). Many laboratory animal studies suggest that wild yam beneficially modulates blood lipids. Diosgenin alone was effective in some studies in increasing biliary cholesterol output (Ulloa, 1985; Nervi, 1984). Diosgenin may block intestinal reuptake of intraluminal cholesterol (Zagoya, 1971). Hypercholesterolemic animal models showed decreasing cholesterol absorption, increasing hepatic cholesterol synthensis, and increasing biliary cholesterol secretion when diosgenin was added to the diet (Nervi, 1988; Cayen, 1979; Uchida, 1984). Dioscorea treatment was associated with a decrease in serum triglycerides, but no change in serum cholesterol was seen in humans with ischemic heart disease (Zakharov, 1977). Seven elderly volunteers were given doses of wild yam pills; no increases in serum DHEA were noted. However, lower serum triglycerides and higher HDL were seen (Araghiniknam, 1996). Other species of Dioscorea have shown hypoglycemic, hypocholesterolemic, and antirheumatic activity in animal and human trials. Indications: Irritable bowel, biliary colic, intestinal colic, flatulent colic, dysmenorrheal symptoms, menstrual pain, hyperlipidemia Potential Veterinary Indications: Tenesmus and painful colitis, inflammatory bowel disease, flatulent colic, abdominal spasms, hyperlipidemia Notes of Interest: Mexican wild yam has been and is still used commercially as a source for partial synthesis of pharmaceutical steroids and contraceptives, although total synthesis (via cell culture systems) is increasingly used. No evidence suggests that steroidal saponins contained in the herb are converted to steroids in vivo. Relatives of this plant provide the edible yam, but they are members of the sweet potato family (Convolvulaceae). Contraindications: Use with caution in pregnancy and lactation. The most conservative sources list gallbladder and hepatic disease as contraindications, in direct contrast to some traditional uses. Toxicology and Adverse Effects: AHPA class 1. Overdose of the tincture may lead to nausea, vomiting, diarrhea, and headache. Drug Interactions: Animal studies have suggested that wild yam, in combination with clofibrate, synergistically lowers low-density lipoprotein (beyond the effects of clofibrate alone) (Cayen, 1978). Dosage: Human: Dried herb: 0.5-10 g TID Decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID

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Tincture (usually 40%-60% ethanol) 1 : 2 or 1 : 3: 1-5 mL TID, up to 6 times daily for acute conditions Small Animals: Dried herb: 25-300 mg/kg, divided daily (optimally, TID) Decoction: 5-30 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 40%-60% ethanol) 1 : 2-1 : 3: 0.5-1.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. Horses: Fluid extract (1 : 1): 8-24 mL ((Karreman, 2004) Farm Animals: Fluid extract (1 : 1): horses and cows, 8-24 mL; sheep and goats, 2-4 mL (Karreman, 2004) Combinations: Should be used with carminatives such as ginger and fennel for gastrointestinal spasm and gas. References Araghiniknam M, Chung S, Nelson-White T et al. Antioxidant activity of disocorea and dehydroepiandrosterone (DHEA) in older humans. Life Sci 1996;59:147-157. Boon H, Smith M. Botanical Pharmacy. Kingston: Quarry Press; 1999. Brinker FA. A comparative view of eclectic female regulators. J Naturopathic Med 1996;7:11-26. Cayen MN, Dvornik D. Combined effects of clofibrate and diosgenin on cholesterol metabolism in rats. Atherosclerosis 1978; 29:317-328. Cayen MN, Dvornik D. Effects of diosgenin on lipid metabolism in rats. J Lipid Res 1979;20:162-174. Dollbaum C. Lab analyses of salivary DHEA and progesterone following ingestion of yam-containing products. Townsend Letter for Doctors and Patients 1996;Aug/Sept:101. Karreman H. Treating Dairy Cows Naturally: Thoughts and Strategies. Paradise, Pa: Paradise Publications; 2004. Komesaroff PA, Black CV, Cable V, Sudhir K. Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women. Climacteric 2001;4: 144-150. Nervi F, Bronfman M, Allalon W, Depiereux E, Pozo RD. Regulation of biliary cholesterol secretion in the rat: role of hepatic cholesterol esterification. J Clin Invest 1984;74:2226-2237. Nervi F, Marinovic I, Rigotti A, Ulloa N. Regulation of biliary cholesterol secretion: functional relationship between the canalicular and sinusoidal cholesterol secretory pathways in the rat. J Clin Invest 1988;82:1818-1825. Uchida K, Takase H, Nomura Y, Takeda Ki, Takeuchi N, Ishikawa Y. Effects of diosgenin and B-sitosterol on bile acids. J Lipid Res 1984;25:236-245. Ulloa N, Nervi F. Mechanism and kinetic characteristics of the uncoupling by plant steroids of biliary cholesterol from bile salt output. Botanika et Biophysica Acta 1985;837:181-189. Wu WH, Liu LY, Chung CJ, Jou HJ, Wang TA. Estrogenic effect of yam ingestion in healthy postmenopausal women. J Am Coll Nutr 2005;24:235-243. Yamada T, Hoshino M, Hawakawa T, et al. Dietary diosgenin attenuates subacute intestinal inflammation associated with indomethacin in rats. Am J Physiol 1997;273(2 Pt 1):G355G364. Zagoya JCD, Laguna J, Guzman-Garcia J. Studies on the regulation of cholesterol metabolism by the use of the structural analogue, diosgenin. Biochem Pharmacol 1971;20:3471-3480.

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Zakharov VN. Hypolipemic effect of diosponine in ischemic heart disease depending on the type of hyperlipoproteinemia. Kardiologiia 1977;17:136-137.

Willow Bark Salix alba L. • SAL-iks or SAY-liks AL-buh Common Names: White willow bark, willow, salix cortex, bail liu, bai liu gen (root), bai liu ye (leaf) Similar Species: The name white willow caught on among herbalists, even though it was not a preferred source of the bark. Several other species are preferred. Many Salix species (e.g., crack willow [S. fragilis], purple willow [S. purpurea], and S. daphnoides) are used interchangeably with white willow. Salix acrophylla is used in India for fever. Salix alba is among the poorest sources of salicin among Salix species. Family: Salicaceae Parts Used: Bark (inner bark); outer bark can be very corky. Originally, bark of branches—not trunk bark—was used. The bark is stripped from branches of 2- to 5-yearold trees in the spring. Distribution: Salix alba is native to much of Europe. It is also found in North Africa and Asia, and it thrives in damp areas such as river banks. Selected Constituents: Salix contains phenolic glycosides, including salicin, salicortin, salireposide, picein, and triandrin. Salicylates calculated as salicin vary between species (e.g., 0.5% in S. alba, 1%-10% in S. fragilis, 3%-9% in S. purpurea). Up to 20% of Salix bark consists of tannins; Salix also contains catechins and flavonoids.

HO

OH

OAc

O O

CO2H OH

OH OH Salicin

Acetylsalicylic acid

Clinical Actions: Anti-inflammatory, antirheumatic, antipyretic, antiseptic, analgesic, astringent Energetics: Cold, dry History and Traditional Usage: Salicylate-containing plants have been used since antiquity. The Assyrians and the Egyptians were aware of the analgesic effects of a decoction of willow leaves for joint pain. Hippocrates recommended chewing willow leaves for analgesia in childbirth. In 1827, salicin was extracted from meadowsweet (Filipendula ulmaria, formerly Spiraea ulmaria), and French chemists discovered how to convert salicin into salicylic acid. Salicylic acid, however, was too irritating on the stomach to be taken orally. Charles Gerhardt was the first to synthesize acetylsalicylic acid, or aspirin, but Felix Hoffman from Bayer in Germany reportedly tested the rediscovered agent on himself and on his father

(Levesque, 2000). Bayer began marketing acetylsalicylic acid in 1899 under the trade name aspirin. Bayer named the drug after the German word (spirsäure) for salicylic acid, which had first been isolated from meadowsweet (spirea). Spirea (meadowsweet) was never a commercial source for the drug; acetylsalicylic acid was synthesized because Hoffman developed that process for Bayer. Willow bark has a long history of folk use for relief of headache. It has been used to treat patients with many different kinds of pain, including rheumatic pain, back pain, toothache, headache, and menstrual cramps. It is also used to relieve sore throat, fever, and headache associated with upper respiratory tract infection and influenza (Friend, 1974). It has been approved by the U.S. Food and Drug Administration (FDA) as a topical treatment for warts and calluses, bunions, corns, and acne. Salicylic acid is a strong antiseptic because of its carboxylated phenol base. The European Scientific Cooperative on Phytotherapy (ESCOP) has approved willow bark extract to treat patients with fever, pain, and mild rheumatic complaints (Anon, 1997) Cattle and horses eat the young shoots and foliage, and the bark has been used for fever, debility, enteritis, colic, pleurisy, rheumatism, rickets, and cramps (de Bairacli Levy, 1963). The herb does not have prominence in the authors’ historic books, but salicin and salicylic acid, once synthesized in the 19th century, began to appear in 20th century veterinary Materia Medica texts. Published Research: Willow bark extract has anti-inflammatory activities that are comparable with those of acetylsalicylic acid (ASA), and it shows antinociceptive and antipyretic action. A daily dose of 1572 mg willow bark extract of a proprietary preparation (Assalix; standardized to 15.2% salicin, i.e., 240 mg salicin per day) produced no adverse effects, in contrast to ASA, on the stomach mucosa. In two open studies, with active treatments as controls, Willow Bark extract exhibited advantages against routinely prescribed nonsteroidal antirheumatic drugs; it also displayed similar efficacy to the cyclooxygenase (COX)-2 inhibitor refecoxib (Marz, 2002). The proprietary willow bark extract (Assalix; Bionorica, Neumarkt, Germany) is a selective inhibitor of COX-2–mediated prostaglandin E2 release. It inhibits the release of cytokines to a greater or lesser degree—possibly enough to have a preventive effect on cartilage destruction (Chrubasik, 2001; Goldring, 1999). A very early study showed that an extract (1 : 1) of fresh willow bark (1 tsp diluted in half a glass of water three times daily after meals) for the treatment of patients with chronic rheumatic disease was a strong antirheumatic, antineuralgic, and antipyretic, with no undesirable adverse effects. The dose was increased to 2 to 3 teaspoons three times daily in cases of acute illness or fever (Mayer, 1949). In patients with osteoarthritis, a double-blind, placebo-controlled study on the efficacy of a standardized willow bark extract showed that a daily dose of 1572 mg of the aforementioned Assalix was significantly superior to placebo. Patients had osteoarthritis of the hip and knee or chronic low back pain. The study concluded that the willow bark extract showed a moderate analgesic

Materia Medica • CHAPTER 24

effect in osteoarthritis and was well tolerated (Schmid, 2001b). In another randomized, placebo-controlled, blinded trial, the effectiveness of willow bark extract for the treatment of low back pain was investigated. Patients were randomly assigned to receive an oral willow bark extract with 120 mg (low dose) or 240 mg (high dose) of salicin, or placebo, with tramadol as the sole rescue medication, in a 4-week blinded trial. In the last week of treatment, the numbers of pain-free patients were highest in the group receiving high-dose extract, next highest in the group receiving low-dose extract, and significantly lower in the placebo group. Response in the high-dose group was evident after only 1 week of treatment. Willow Bark extract may be a useful and safe treatment for those with low back pain (Chrubasik, 2000). The analgesic effects of a standardized willow bark extract (240 mg salicin/day) in patients with osteoarthritis of the knee or hip were investigated in a randomized, double-blind, placebo-controlled clinical trial. The analgesic effect was reportedly comparable with the effect of tenoxicam (20 mg/day) and approximately 40% lower than the effect of diclofenac (150 mg/day) (Schmid, 1998). The effects of salicin, saligenin (an aglycone of salicin), and salicylic acid (an active metabolite of salicin) were compared in pharmacokinetic and pharmacologic studies in rats. Salicylic acid appeared rapidly in the plasma after sodium salicylate and saligenin were administered, but not after salicin was given. Salicin did not induce gastric lesions at a dose of 5 mmol/kg, but sodium salicylate and saligenin induced severe gastric lesions dose dependently. This study suggests that salicin is a prodrug that is gradually transported to the lower part of the intestine, is hydrolyzed to saligenin by intestinal bacteria, is converted to salicylic acid after absorption, and provides antipyretic effects without causing gastric ulceration (Akao, 2002). Willow bark extract also shows antithrombocyte activity, but the activity is clearly weak (Marz, 2002). In a placebo-controlled study, acetylsalicylate (100 mg) had a significant inhibitory effect on platelet aggregation compared with willow extract and placebo. Daily consumption of willow extract with 240 mg salicin per day affects platelet aggregation to a far lesser extent than does intake of acetylsalicylate (Krivoy, 2001); therefore willow should not be used as a substitute for aspirin in a preventive thrombolytic protocol against stroke and heart attack. On the other hand, salicin preparations from crude willow bark do not present a hemorrhagic risk and may be clinically advantageous for the treatment of pain some patients. Indications: Rheumatoid arthritis, ankylosing spondylitis, respiratory catarrh Potential Veterinary Indications: Anti-inflammatory; antipyretic; osteoarthritis, ankylosing spondylitis, myositis Contraindications: Salicylate sensitivity Toxicology and Adverse Events: AHPA class 1. Safety has been described in cats: Assuming that willow bark (Salix alba) contains 0.5% to 1% salicins and that a 1 : 2 extract

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contains 500 mg willow in 1 mL, 1% is 5000 μg or 5 mg. A 1-mL dose would provide 5 mg salicin or 10% of the normal dose of aspirin (50 mg) in cats; thus, the risk of reaching toxic levels with normal doses in cats is very low (Fougere, 2003). In brushtail possums, salicin was administered orally by incorporation in food for 6 days at three dose levels (0.05%, 0.5%, and 1.5% wet weight). Salicyl alcohol glucuronide accounted for 56% to 64% of urinary metabolites, salicyluric acid 15% to 26%, and salicin 10% to 18%; smaller amounts of free (2%-4%) and conjugated (0%-6%) salicylic acid were included. Hydrolysis of dietary salicin enabled reconjugation of its aglycone, salicyl alcohol, with a more polar sugar, glucuronic acid, thus enhancing its renal excretion and resulting in little net loss of substrates for conjugation and a low measurable metabolic cost of excretion (McLean, 2001). In humans and rats, willow is considered to be a safe herb. It is possible that signs of toxicity associated with salicylates may occur with willow consumption. However, given the large amount of willow bark that must be consumed to equal the salicylate content of one aspirin, this is an unlikely possibility. Salicin has been documented to cause skin rash. Safety during pregnancy, lactation, or childhood has not been established. Nephropathy has been associated with Salix ingestion in six okapis (Okapia johnstoni) (relatives of the giraffe). Although the cause and pathogenesis are unclear, primary damage of the renal tubular epithelium appears to be the most likely cause, and toxicity from ingested plant material, possibly willow, is possible (Haenichen, 2001). Potential Drug Interactions: Nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have the potential to interact with herbal supplements that are known to possess antiplatelet activity (Abebe, 2002). Note that the activity of salicin is very low. Notes of Interest: Of importance when the use of willow bark preparations is considered is the decision of whether to use anti-inflammatory agents at all in patients with fever. Inflammation is a homeostatic response to pathogens and tissue injury. Inhibiting such processes may do more harm than good and may be associated with some degree of cellular and organ system toxicity. The use of anti-inflammatory agents should therefore be carefully considered, restricted to a limited time, and followed by more appropriate therapies to address the underlying cause of inflammation. Dosage: Improvement from willow bark treatment is usually observable within 1 to 4 weeks and is sometimes preceded by a transient worsening of symptoms that is followed by a significant decrease in discomfort, swelling, and inflammation. In some cases, improvement is seen within the first few days of initiation of therapy (Schmid, 1998). Human: Dried herb: 1-10 g TID Dry standardized extract: tablets 500 mg TID (with 240 mg salicin) Decoctions: 5-30 g per cup of water, with 1 cup of the tea given TID

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Tincture (usually 35% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2-1 : 3: 1-5 mL TID Small Animal: Dry standardized (to salicins) extract: 10 mg per day (cats) Dried herb: 25-500 mg/kg, divided daily (optimally, TID) Tincture (usually in 35% ethanol) 1 : 2-1 : 3: 0.5-2.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. References Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther 2002;27:391-401. Akao T, Yoshino T, Kobashi K, Hattori M. Evaluation of salicin as an antipyretic prodrug that does not cause gastric injury. Planta Med 2002;68:714-718. Anonymous. Monographs on the Medicinal Uses of Plants. Exeter: European Scientific Cooperative on Phytotherapy; 1997. Chrubasik S, Eisenberg E, Balan E, Weinberger T, Luzzati R, Conradt C. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med 2000;109:9-14. Chrubasik S, Künzel O, Model A, Conradt C , Black A. Treatment of low back pain with an herbal or synthetic anti-rheumatic: a randomized controlled study: Willow bark extract for low back pain. Rheumatology 2001;40:1388-1393. de Bairacli Levy J. Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. Fougere B. Salicylate safety and cats. In: Proceedings of the Veterinary Business Management Association Symposium; September 19-20, 2003; Durham, North Carolina. Friend D. Aspirin: the unique drug. Arch Surg 1974;108:765-769. Goldring MB. The role of cytokines as inflammatory mediators in osteoarthritis: lessons from animal models. Connect Tissue Res 1999;40:1-11. Haenichen T, Wisser J, Wanke R. Chronic tubulointerstitial nephropathy in six okapis (Okapia johnstoni). J Zoo Wildlife Med 2001;32:459-464. Krivoy N, Pavlotzky E, Chrubasik S, Eisenberg E, Brook G. Effect of Salicis cortex extract on human platelet aggregation. Planta Med 2001;67:209-212. Levesque H, Lafont O. [Aspirin throughout the ages: a historical review.] Rev Med Interne 2000;21(suppl 1):8s-17s. Marz RW, Kemper F. Willow bark extract—effects and effectiveness: status of current knowledge regarding pharmacology, toxicology and clinical aspects. Wien Med Wochenschr 2002; 152:354-359. Mayer R, Mayer M. Mayer R, Mayer M. Biological salicyl therapy with cortex salicus [Weidenrinde]. Pharmazie 1949;4:77-81. McLean S, Pass GJ, Foley WJ, Brandon S, Davies NW. Does excretion of secondary metabolites always involve a measurable metabolic cost? Fate of plant antifeedant salicin in common brushtail possum, Trichosurus vulpecula. J Chem Ecol 2001;27: 1077-1089. Schmid B, Kotter I, Heide L. Pharmacokinetics of salicin after oral administration of a standardised willow bark extract. Eur J Clin Pharmacol 2001a;57:387-391. Schmid B, Ludtke R, Selbmann HK, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial. Phytother Res 2001b;15:344-350. Schmid BM. Handling of Cox and gonarthroses with a dry extract of Salix purpurea x daphnoides [dissertation]. Tubingen, 1998.

Witch Hazel Hamamelis virginiana L. • ham-uh-MEE-lis or ham-uhMAY-lis vir-jin-ee-AN-uh Other Names: Spotted alder, winterbloom, snapping hazelnut Family: Hamamelidaceae Parts Used: Dried or fresh leaves or dried bark Distribution: Indigenous to the Atlantic coast of North America (Bisset, 1994) Selected Constituents: Major constituents of the dried leaf and bark are tannins (up to 10%) (Bisset, 1994; Bruneton, 1995). Leaf tannins are a mixture of gallic acid (10%), hydrolyzable hamamelitannin (1.5%), and condensed proanthocyanidins. Bark tannins are similar qualitatively but have a much higher hamamelitannin level—up to 65% of a hydroalcoholic extract (Bruneton, 1995). Essential oil and flavonoids are also present (Bisset, 1994). Clinical Actions: Astringent, hemostatic, venotonic, antiinflammatory Energetics: Cold History and Traditional Usage: It is used topically as a hemostat (Reynolds, 1996). For the treatment of colitis, diarrhea, dysentery, dysmenorrhea, eye inflammation, hematuria, kidney pain, and neuralgia; as a poultice for swellings, nosebleeds, and excessive menstruation. Also as a tonic (Farnsworth, 1998; Newall, 1996). It has been used for controlling internal and external hemorrhage; for hemorrhoids, bruises, and inflammatory swellings; also for diarrhea, dysentery, and mucous discharges. North American Indians used it as a poultice for painful swellings and tumors. It has been used for ophthalmia, menorrhagia, stomach and bowel complaints, and hemoptysis (Grieve, 1975). In animals, it has been recommended for use in uterine, vaginal, and udder inflammation, as well as for torn udders that result in milk leakage, sore eyes, inflamed ears, wounds, sores, bruises, and ulcers in farm animals; internally, it was used for ulcerated and burned tissues from poisonings (de Bairacli Levy, 1963). It can be used for umbilical cords of the newborn and anal glands, for cleaning ears, and for treating patients with metritis and tail injuries (de Bairacli Levy, 1985). Veterinary Materia Medica texts make it clear that witch hazel has little systemic effect, but it is valued for its local effects, whether applied to skin lesions or directly onto the mucosa of the gastrointestinal or urinary tract. Winslow (1908) recommended it as an astringent and styptic for oozing wounds and to reduce the swelling and pain of bruises and sores. It was also recommended for anal irritation. Published Research: In a randomized clinical trial involving 266 patients undergoing episiotomy, the efficacy of three analgesic treatments, including a cream containing witch hazel, a reference cream containing 1% hydrocortisone, and a local anesthetic and ice packs, was investigated to determine their effects on pain, bruising, and edematous swelling. The efficacy of all three analgesic treatments was found to be equal (Moore, 1989).

Materia Medica • CHAPTER 24

One study evaluated the antibacterial activity of six plants, including witch hazel leaves. The methanol extract of witch hazel showed inhibiting activity against many of the species tested. Results suggested that alcohol extracts of witch hazel could be used for topical periodontal prophylaxis (Iauk, 2003). Another study evaluated the antimicrobial activity of a distillate of witch hazel and urea formulated as a topical dermatologic preparation in 15 healthy volunteers. Significant antimicrobial activity for a product containing witch hazel distillate (90%) and urea (5%) was demonstrated (Gloor, 2002). Another ointment prepared with witch hazel bark was assessed for efficacy and safety in a randomized, double-blind, placebo-controlled study for the treatment of patients with Herpes labialis infection. Thirty-four patients were treated within 48 hours of symptom recurrence; treatment lasted for 8 days. By the time therapy had ceased, the size of the inflamed area was significantly reduced in patients treated with witch hazel ointment as compared with placebo (Baumgaertner, 1998). The phenolic constituents of witch hazel are responsible for its astringent activity (Vennat, 1992). Application of witch hazel preparations to the skin and mucosa in low concentrations sealed cell membranes and reduced capillary permeability (Steinegger, 1992). Higher concentrations precipitated proteins and thickened colloidal tissue, forming a thin membrane in the wound region (Laux, 1993). Alcohol extracts of witch hazel had strong astringent action, with the bark extract being slightly superior to the leaf extract (Grascza, 1987). A randomized, double-blind, placebo-controlled trial compared the efficacy of three creams that contained witch hazel distillate, 0.5% hydrocortisone, or a drug-free vehicle for the symptomatic treatment of 72 patients with moderately severe atopic eczema. All treatments reduced the incidences of itching, scaling, and erythema after 1 week of treatment. The cream that contained witch hazel was no more effective than that containing placebo (Korting, 1995). A randomized, double-blind comparison study assessed the efficacy of ointments that contain a standardized extract of witch hazel or bufexamac in the treatment of 22 patients with bilateral, moderately severe endogenous eczema (neurodermatitis). Patients were treated three times daily for an average of 17 days. Both treatments reduced the severity of symptoms such as desquamation of the skin, redness, itching, and lichenification, with desquamation showing the highest reduction; their efficacy was found to be the same (Swoboda, 1991). Later, in a pilot study of 37 patients with endogenous eczema (neurodermatitis), a cream witch hazel leaf extract was applied twice daily for 2 weeks. Following treatment, considerable improvement in symptoms such as inflammation and itching was noted in 24 patients (Wokalek, 1993). A randomized, double-blind trial compared the efficacy of rectal ointments containing witch hazel, bismuth subgallate, or a local anesthetic in the treatment of 90 patients with acute, stage 1 hemorrhoidal symptoms. The local anesthetic was present in two control ointments,

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which also contained policresulen or fluocinolone acetonide. After 21 days, all four ointments were deemed equally effective in improving pruritus, bleeding, burning sensation, and pain (Knoch, 1992). Indications: Topical application for minor skin lesions, bruises, sprains, local inflammation of the skin and mucous membranes, hemorrhoids, and varicose veins (Blumenthal, 1998; ESCOP Monographs, 1997). Diarrhea, colitis Potential Veterinary Indications: Colitis, anal furunculosis, local inflammation of the skin and mucous membranes, ear cleaning, episiotomy, stomatitis Contraindications: None found. Toxicology and Adverse Effects: AHPA class 1. The Botanical Safety Handbook notes that the tannins in witch hazel may cause gastritis in susceptible individuals. Allergic contact dermatitis may occur in sensitive individuals (Bruynzeel, 1992; Granlund, 1994). Preparation: The fluid extract of witch hazel leaves and bark was made by maceration and percolation with alcohol, glycerin, and water. It should be noted that “witch hazel water” is made of the bark that is macerated in water and distilled, with alcohol added to the distillate. Witch hazel water does not contain tannins, which are thought to be essential for the astringent and possibly anti-inflammatory effects. Dosage: External Use: Steam distillates are commonly available but are not thought to contain tannins. Herbalists do not recommend this form. Decoction: 5-10 g to 250 mL water for poultices and wound irrigation Rectal suppositories: 1-3 times daily, with the quantity of a preparation corresponding to 0.1-1.0 g crude drug Infusion: undiluted or diluted 1 : 3 with water Other preparations: several times daily, corresponding to 0.1-1.0 g drug in preparations (Blumenthal, 1998) Internal Use: Rarely used internally Human Tincture 1 : 2-1 : 3: 1-2 mL TID, up to 6 times daily for acute conditions Small Animal Not used internally Historical Veterinary Doses: Horses: Hamamelis liquid extract, 30-60 mL per dose (RCVS, 1920) Cows: 30-60 mL per dose (Winslow, 1908) Pigs: Hamamelis liquid extract, 3.5-7 mL per dose (RCVS, 1920) Dogs: Hamamelis liquid extract, 1.7-3.5 mL daily (RCVS, 1920); dogs, 2-8 mL (Winslow, 1908) References Baumgärtner M. A Hamamelis-Spezialextrakt zur lokalen Behandlung des Herpes labialis. Zs Allg Med 1998;74:158161. Bisset NG. Herbal Drugs and Phytopharmaceuticals. Boca Raton, Fla: CRC Press; 1994. Blumenthal M, Goldberg A, Brinckman J, eds. The Complete German Commission E Monographs. Austin, Tex: American Botanical Council; 1998.

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Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier; 1995. Bruynzeel DP, van Ketel WG, Young E, van Joost T, Smeenk G. Contact sensitization by alternative topical medicaments containing plant extracts. Contact Dermatitis 1992;27:278-279. De Bairacli Levy J. The Complete Herbal Handbook for Farm and Stable. London: Faber and Faber; 1963. De Bairacli Levy J. The Complete Herbal Handbook for the Dog and Cat. London: Faber and Faber; 1985. ESCOP Monographs on the Medicinal Uses of Plant Drugs. Fascicule 5. Devon: European Scientific Cooperative on Phytotherapy; 1997. Farnsworth NR, ed. NAPRALERT database. Chicago, Ill: University of Illinois at Chicago; February 9, 1998 production. Gloor M, Reichling J, Wasik B, Holzgang HE. Antiseptic effect of a topical dermatological formulation that contains Hamamelis distillate and urea. Forschende Komplementarmedizin und Klassische Naturheilkunde 2002;9:153-159. Granlund H. Contact allergy to witch hazel. Contact Dermatitis 1994;31:195. Grascza L. Adstringierende Wirkung von Phytopharmaka. Deutsche Apotheker Zeitung 1987;44:2256-2258. Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint 1975). Iauk L, Lo Bue AM, Milazzo I, Rapisarda A, Blandino G. Antibacterial activity of medicinal plant extracts against periodontopathic bacteria. Phytother Res 2003;17:599-604. Knoch HG, Klug W, Hubner WD et al. Ointment treatment of 1st degree hemorrhoids: comparison of the effectiveness of a phytogenic preparation with two new ointments containing synthetic drugs. Fortschr Med 1992;110:135-138. [German] Korting HC, Schafer-Korting M, Hart H, et al. Comparative efficacy of Hamamelis distillate and hydrocortisone cream in atopic eczema. Eur J Clin Pharmacol 1995;48:461-465. Laux P, Oschmann R. Die Zaubernuss—Hamamelis virginiana L. Zeitschrift für Phytotherapie. 1993;14:155-166. Moore W, James DK. A random trial of three topical analgesic agents in the treatment of episiotomy pain following instrumental vaginal delivery. J Obstet Gynaecol 1989;10:35-39. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Healthcare Professionals. London: The Pharmaceutical Press; 1996. RCVS (Royal College of Veterinary Surgeons). Veterinary Counter Practice. London: Ballantyne Press; 1920. Reynolds JEF, Prasad AB. Martindale, The Extra Pharmacopoeia. 30th ed. London: The Pharmaceutical Press; 1996. Steinegger E, Hansel R. Pharmakognosie. Berlin: Springer; 1992. Swoboda M, Meurer J. Therapie von Neurodermitis mit Hamamelis virginiana Extrakt in Salbenform. Zeitschrift für Phytotherapie 1991;12:114-117. Vennat B, Gross D, Pourrat A, et al. Hamamelis virginiana: identification and assay of proanthocyanidins, phenolic acids and flavonoids in leaf extracts. Pharmaceut Acta Helvet 1992;67:11-14. Winslow K. Veterinary Materia Medica and Therapeutics. New York: William R. Jenkins; 1908. Wokalek H. Zur Bedeutung epidermaler Lipide und des Arachidonsäurestoffwechsels bei feuilles d’hamamelis. Journal de Pharmacie de Belgique 1993;27:498-506.

Yellow Dock

Rumex crispus L. • ROO-meks KRISP-us Other Names: Curled dock, curly dock, narrow-leafed dock Family: Polygonaceae Parts Used: Root Distribution: Native to Europe originally. Now a very common free-growing plant in many parts of the world. Selected Constituents: Anthraquinone glycosides, including rhein and chrysophanol. Tannins, resin, volatile oil, oxalic acid, calcium oxalate, and vitamins A, B1, B2, B3, and C Clinical Actions: Alterative, cholagogue, purgative Energetics: Cold, dry History and Traditional Usage: Yellow dock has been used traditionally as an alterative for debility caused by cancer and necrosis. The root has laxative, alterative, and mildly tonic action and is used in “bilious complaints, rheumatism, and diphtheria”; it is used in the treatment of patients with blood diseases from jaundice to scurvy and with chronic skin disease. The anthraquinones have a gentle cathartic action on the bowel (Grieve, 1975). The Eclectics considered the root an alterative and an astringent. Cook’s Physiomedical Dispensatory (1869) describes its indications and actions most succinctly as follows:

“The greater portion of its power is expended upon the skin; but the gall-ducts, small intestines, and kidneys feel its impressions to a fair extent. Though not cathartic, it is fairly laxative; and exerts a desirable tonic and diluent influence upon the entire hepatic and alvine structures. It moderately resembles rhubarb, in the same botanical family. The chief use made of it is in scrofulous affections of the skin, scrofulous ulcers, and scrofulous forms of diarrhea; for all which it is of superior efficacy. . . . In nearly all forms of dry, scaly, and pustular skin disease, it has a deserved reputation,

Materia Medica • CHAPTER 24

both as an inward and an outward remedy; in itch and eczema . . .”

Published Research: Little published research exists despite the fact that it is a popular herbal medicine. The antioxidant activities, radical-scavenging activities, and antimicrobial activities of various extracts of the leaves and seeds of yellow dock were studied. The antioxidant activities increased with increasing amount of extracts (50-150 μg). Water extracts of both leaves and seeds showed antioxidant activity. The ether extracts of both leaves and seeds and the ethanol extract of leaves showed antimicrobial activities. None of the water extracts showed antimicrobial activity (Yildirim, 2001). It should be noted that these studies did not explore the root, which is the part that has been and is used medicinally. Indications: Skin disease, chronic skin disease, jaundice, constipation Potential Veterinary Indications: Chronic skin disease; constipation Contraindications: Should not be used in high doses for prolonged periods. One should start at a low dose and increase to the point of normal motion. Griping may be due to free anthraquinones. Habituation may occur, and long-term use can lead to potassium loss. Calcium oxalate urolithiasis Toxicology and Adverse Effects: AHPA class 2d because of oxalate content (see Contraindications, earlier) and anthraquinone content Ten of 100 mature ewes exhibited acute oxalate poisoning within 40 hours after being penned on a small plot that contained patches of yellow dock, in which they ate aerial portions of the plant—which are not the subject of this monograph. Clinical signs included excess salivation, tremor, ataxia, and recumbency. Affected ewes were hypocalcemic and azotemic. Gross post mortem lesions in two ewes revealed perirenal edema and renal tubular degeneration. Oxalate poisoning was confirmed by histologic findings. Samples of yellow dock contained 6.6% to 11.1% oxalic acid, dry weight basis (Panciera, 1990). A case of fatal poisoning due to ingestion of yellow dock (aerial parts) has been described. The patient, a 53year-old man, presented with gastrointestinal symptoms, severe hypocalcemia, metabolic acidosis, and acute hepatic insufficiency (Reig, 1990). Dosage: Human: Dried herb: 1-10 g TID (this is a bitter herb and the higher doses are not usually required) Decoctions: 5-10 g per cup of water, with 1/2-1 cup of the tea given TID Tincture (usually 25%-40% ethanol; some pharmacies include glycerin to prevent precipitation by tannins) 1 : 2-1 : 3: 0.53 mL TID Small Animal: Dried herb: 25-200 mg/kg, divided daily (optimally, TID) Decoction: 5-10 g per cup of water, administered at a rate of 1/4-1/2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture (usually 25%-40% ethanol) 1 : 2-1 : 3: 0.5-1.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and

669

diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. References Grieve M. A Modern Herbal. London: Jonathan Cape; 1931 (Reprint, 1975). Panciera RJ, Martin T, Burrows GE, Taylor DS, Rice LE. Acute oxalate poisoning attributable to ingestion of curly dock (Rumex crispus) in sheep. J Am Vet Med Assoc 1990;196:19811984. Reig R, Sanz P, Blanche C, Fontarnau R, Dominguez A, Corbella J. Fatal poisoning by Rumex crispus (curled dock): pathological findings and application of scanning electron microscopy. Vet Hum Toxicol 1990;32:468-470. Yildirim A, Mavi A, Kara AA. Determination of antioxidant and antimicrobial activities of Rumex crispus L. extracts. J Agric Food Chem 2001;49:4083-4089.

Yerba Santa Eriodictyon californicum (Hook. Et Arn), Torr. = Eriodictyon glutinosum Benth. • Eh-err-o-DIK-tee-on kal-ih-FOR-nikum Other Names: California yerba santa, woolly yerba santa Family: Hydrophyllaceae Parts Used: Leaf Selected Constituents: Flavonoids, volatile oil, tannins, catechins (eriodictyol), organic acids, resin OH OH O

HO

OH

O Eriodictyol

Clinical Action: Anti-inflammatory, antimicrobial, expectorant, carminative, diuretic Energetics: Sweet, warm, pungent; transforms phlegm History and Traditional Usage: Colds, cough, asthma, and other pulmonary disorders; stomachache; as a steam or bath for rheumatism; as an analgesic poultice for headache; a “blood purifier”; eyewash. Used by Coahuilla people as a poultice for sores on animals. King’s American Dispensatory describes its use in “chronic mucous affections of the respiratory tract,” chronic bladder catarrh, and catarrhal gastritis, but it is not very enthusiastic about its efficacy. The specific indication is as follows: “Chronic asthma with cough, profuse expectoration, thickening of the bronchial mucous membrane, loss of a petite, impaired digestion, emaciation” . . . “Cough, with abundant and easy expectoration.”

Milks (1949) claimed that the leaves destroy bitter tastes but theorized that they would render alkaloids insoluble because of the tannic acid content. He also

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PART IV • Veterinary Clinical Uses of Medicinal Plants

warned that in many cases, the bitter taste had to be tasted for the herb to be effective. Published Research: No relevant clinical trials found Indications: Suppresses bitter taste and is used to mask the taste of bitter herbs in formulas. Used for bronchitis, asthma, cystitis, and rheumatism. Potential Veterinary Indications: Upper and lower respiratory disorders requiring expectoration. As a flavor enhancer for herbal formulas Contraindications: None reported. Toxicology and Adverse Effects: AHPA class 1. None reported. Dosage: Human: Dried herb: 1-10 g TID Infusions: 5-30 g per cup of water, with 1 cup of the tea given TID Tincture (usually high in ethanol) 1 : 2-1 : 3: 1-5 mL TID Small Animal: Dried herb: 25-500 mg/kg, divided daily (optimally, TID) Infusion: 5-30 g per cup of water, administered at a rate of 1 1 /4- /2 cup per 10 kg (20 lb), divided daily (optimally, TID) Tincture 1 : 2-1 : 3: 0.5-2.5 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs. Higher doses may be appropriate if the herb is used singly and is not combined in a formula. Historic Veterinary Doses (Karreman, 2004): Fluid extract (1 : 1): horses and cows, 15-60 mL; sheep and goat, 2-8 mL References Karreman H. Treating Dairy Cows Naturally: Thoughts and Strategies. Paradise, Pa: Paradise Publications; 2004. Milks HJ. Practical Veterinary Pharmacology, Materia Medica and Therapeutics. Chicago, Ill: Alex Eger, Inc.; 1949.

Yucca

Yucca schidigera Roezl ex Ortgies • YUK-uh shi-di-GER-uh

Distribution: Southwestern United States to Northern Mexico; has spread to Eastern United States Similar Species: Yucca filamentosa, Yucca aloifolia L., Yucca filamentosa L., Yucca glauca Nutt Common Names: Mojave yucca, Spanish dagger, amole, Spanish bayonet, soapweed, soapwell, Adam’s needle Family: Liliaceae Parts Used: Stalk, root, leaves Selected Constituents: Steroidal saponins (including tigenin, smilagenin) Clinical Action: Anti-inflammatory, antirheumatic, alterative, laxative Energetics: Sweet, bland, cool History and Traditional Usage: Poultices or baths for skin sores and other diseases. For inflammation of all sorts, including joint inflammation and bleeding. Other uses include arthritis, rheumatism, gout, urethritis, and prostatitis. Native Americans washed their hair with yucca to fight dandruff and hair loss. The plant was used more often as food and a source of string, or to make baskets or other usefulness, than for medicine. Root poultices were used for sprains, wounds, and ulcers; they were also applied to saddle sores on horses. The Lakota burned the root and believed the fumes allowed horses to be caught and haltered easily. Currently popular as a veterinary treatment for arthritis. Published Research: In a preliminary trial, yucca has shown some benefit in the treatment of people with arthritis. The dose used was 1 g TID (Bingham, 1975). In heifers given up to 6 g daily of Yucca schidigera, rumen propionate levels increased (Hristov, 1999). The authors concluded that this change was probably due to a selective inhibitory effect of yucca on rumen microbial species. Wilson (1998) found that in multiparous Holstein cows given 9 g of yucca daily, no effect on ruminal pH or ammonia was noted, and that milk yields were not benefited by supplementation. Two different groups have studied the effects of yucca supplementation to canine and feline diets in reducing the odor of flatus (Giffard, 2001; Lowe, 1997a; Lowe, 1997b). Yucca appears to change the volatile components in the colon and specifically reduces hydrogen sulfide production. Lowe (1997b) also found that in cats, administration of yucca was correlated with a significant rise in serum urea nitrogen. Colina (2001) found that the addition of Yucca schidigera extract to the diet of nursery pigs reduced ammonia concentrations in the nursery room. In contrast to the study in cats, blood urea nitrogen levels were not increased. Yucca was investigated in lambs for antigiardial activity and was found ineffective at controlling infection at doses of 10 g per lamb daily (McAllister, 2001). Indications: Rheumatism, urethritis, prostatitis; as a poultice for wounds or sores Potential Veterinary Indications: To reduce fecal odor. Some use it for osteoarthritis. Contraindications: None reported. Toxicology and Adverse Effects: AHPA class 1. Saponins may have a laxative effect when Yucca is taken in high doses. Some concern has been raised regarding the potential for saponins to be absorbed and cause intravascular

671

Materia Medica • CHAPTER 24

hemolysis, but this is a theoretical concern. Yucca is approved for use in foods as a foaming agent (particularly in root beer). Some people experience nausea, probably because of the saponin content, and should take the herb with food. Drug Interactions: None reported. Notes of Interest: The leaf fibers were used by Native Americans for cord, cloth, baskets, and sandals. Raw flowers were eaten in salads or were boiled as vegetables. The immature pods were roasted and peeled before eating. Dried seed pods are ground into flour and are used in the cooking of South and Central America. The roots have been used for soap. Dosage: Human: Dried herb: 1 g TID Tincture 1 : 2-1 : 3: 2-3 mL TID Small Animal: Dried herb: 25-200 mg/kg, divided daily (optimally, TID); cats: 1/4 tsp daily (Tilford, 1999) Tincture 1 : 2-1 : 3: 0.5-1.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs References Bingham R, Bellew BA, Bellew JG. Yucca plant saponin in the management of arthritis. J Appl Nutr 1975;27:45-50. Colina JJ, Lewis AJ, Miller PS, Fischer RL. Dietary manipulation to reduce aerial ammonia concentrations in nursery pig facilities. J Anim Sci 2001;79:3096-3103. Giffard CJ, Collins SB, Stoodley NC, Butterwick RF, Batt RM. Administration of charcoal, Yucca schidigera, and zinc acetate to reduce malodorous flatulence in dogs. J Am Vet Med Assoc 2001;218:892-896. Hristov AN, McAllister TA, Van Herk FH, Cheng KJ, Newbold CJ, Cheeke PR. Effect of Yucca schidigera on ruminal fermentation and nutrient digestion in heifers. J Anim Sci 1999;77:25542563. Lowe JA, Kershaw SJ. The ameliorating effect of Yucca schidigera extract on canine and feline faecal aroma. Res Vet Sci 1997a;63:61-66. Lowe JA, Kershaw SJ, Taylor AJ, Linforth RS. The effect of Yucca schidigera extract on canine and feline faecal volatiles occurring concurrently with faecal aroma amelioration. Res Vet Sci 1997b;63:67-71. McAllister TA, Annett CB, Cockwill CL, Olson ME, Wang Y, Cheeke PR. Studies on the use of Yucca schidigera to control giardiosis. Vet Parasitol 2001;97:85-99. Tilford MW, Tilford G. All You Ever Wanted to Know about Herbs for Pets. Irvine, Calif: Bow Tie Press; 1999. Wilson RC, Overton TR, Clark JH. Effects of Yucca shidigera extract and soluble protein on performance of cows and concentrations of urea nitrogen in plasma and milk. J Dairy Sci 1998;81:1022-1027.

Zizyphus, Chinese Date Ziziphus jujuba Mill • ZIZ-ih-fuss JOO-joo-buh Other Names: Ziziphus jujuba Mill is jujube = da zao (the fruit), Chinese date, Chinese jujube, jujube date. Ziziphus jujube Mill var. spinosa (Bunge) Hu ex H.E. Chow is a different herb—it is the seed of this plant, known as

sour Chinese date, wild Chinese jujube, mountain jujube, suan dzao ren, suan zao or suan zao ren Family: Rhamnaceae Parts Used: Seed Distribution: Zizyphus is indigenous to China and commonly grows on the mountains on the outskirts of Beijing. It also grows in India, Malaysia, Afghanistan, and Japan. Selected Constituents: Saponins, including jujubosides (Tang, 1992), which are considered to be the active constituents. Also, fixed oil and volatile oil. Nutrients include vitamins A, B2, and C and the minerals calcium, phosphorus, and iron. The triterpenoid glycoside ziziphin suppresses the sweet taste sensation. OH

O

O glu.

ara.

xyl.

rha.

O

Jujuboside

Clinical Actions: Sedative, hypnotic, hypotensive, anticonvulsant, antihydrotic, digestive tonic, nutritive, relaxant, stomachic Energetics: Sour, neutral, sweet, mild History and Traditional Usage: Zizyphus use is recorded as far back as the fifth century AD, for insomnia, palpitations, neurasthenia, forgetfulness, and nightmares (Leung, 1996). Zizyphus is also noted for abnormal sweating, including nightsweats, especially when accompanied by feelings of anxiety and irritability (Trickey, 1998). In Traditional Chinese Medicine, it acts on the liver and heart channels; it nourishes the heart and calms the nerves and is therefore used in insomnia and restless sleep. Zizyphus tonifies the spleen and benefits the stomach and is therefore used for weakness and shortness of breath. It nourishes the nutritive Qi and calms the spirit and is thus indicated for irritability, emotional debility, and convulsions. Zizyphus also moderates and harmonizes the characteristics of harsh herbs in a formulation (Bensky, 1986). Published Research: In all, 50 Korean traditional plants were screened for effects on choline acetyltransferase and attenuation of scopolamine-induced amnesia. The methanolic extracts of Zizyphus, and especially oleamide, showed the highest activatory effect on choline acetyltransferase in vitro (Heo, 2003). Jujuboside A is a main constituent extracted from the seed of Ziziphus jujuba, which is widely used in traditional medicine for the treatment of patients with insomnia and anxiety. A study examined the effects of jujuboside A on the glutamate-mediated excitatory signal pathway in the hippocampus. Results suggested that Jujuboside A has

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PART IV • Veterinary Clinical Uses of Medicinal Plants

inhibitory effects on glutamate-mediated excitatory signal pathways in the hippocampus and probably acts through its anticalmodulin action (Zhang, 2003). Antisteroidogenic activity has been shown in adult female mice treated with the ethyl acetate extract of Ziziphus jujuba bark. Changes in estrus cycle, body weight, weight of ovaries, steroidogenic enzymes, and substrates were assessed. It arrested the normal estrus cycle in the mice at diestrus stage and significantly reduced the weight of ovaries. Significant inhibition of δ(5)-3betahydroxysteroid dehydrogenase and glucose-6-phosphate dehydrogenase—two key enzymes in ovarian steroidogenesis—was also observed. Hematologic profiles and biochemical estimations were unaltered. Normal estrus cycle and ovarian steroidogenesis were restored after withdrawal of treatment, and antifertility activities were found to be reversible (Gupta, 2004). Indications: For nervous depletion, anxiety, insomnia, excess sweating and palpitations, exhaustion, irritability, hypertension Potential Veterinary Indications: Anxiety and restlessness, insomnia; cognitive dysfunction; reducing fertility in mice; hyperthyroidism (as an adjunct) Contraindications: Zizyphus is contraindicated in conditions of excess dampness such as symptoms of epigastric distention and bloating. Caution should be used in cases of diarrhea. Zizyphus may have synergistic effects with a range of sedatives and hypnotics (Chang, 1987). Toxicology and Adverse Effects: AHPA class 1. Very low toxicity if used orally. At 50 g/kg by decoction, it did not produce any toxicity in mice (Chang, 1987).

Dosage: Human: Dried herb: 1-10 g TID Tincture 1 : 2 or 1 : 3: 1-5 mL TID Small Animal: Dried herb: 50-500 mg/kg, divided daily (optimally, TID) Tincture 1 : 2-1 : 3: 1.0-3.0 mL per 10 kg (20 lb), divided daily (optimally, TID) and diluted or combined with other herbs References Bensky D, Gamble A. Chinese Herbal Medicine Materia Medica. Seattle, Wash: Eastland Press; 1986:580-581. Chang HM, But PP. Pharmacology and Applications of Chinese Materia Medica, vol 2. Singapore: World Scientific; 1987. Gupta M, Mazumder UK, Vamsi ML, Sivakumar T, Kindar CC. Anti-steroidogenic activity of the two Indian medicinal plants in mice. J Ethnopharmacol 2004;90:21-25. Heo HJ, Park YJ, Suh YM, et al. Effects of oleamide on choline acetyltransferase and cognitive activities. Biosci Biotechnol Biochem 2003;67:1284-1291. Leung A, Foster S. Encyclopaedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. New York: John Wiley; 1996:475-476. Tang W, Eisenbrand G. Chinese Drugs of Plant Origin. Berlin: Springer Verlag; 1992. Trickey R. Women, Hormones & the Menstrual Cycle: Herbal and Medical Solutions from Adolescence to Menopause. St. Leonards, NSW, Australia: Allen & Unwin; 1998:364. Zhang M, Ning G, Shou C, Lu Y, Hong D, Zheng X. Inhibitory effect of jujuboside A on glutamate-mediated excitatory signal pathway in hippocampus. Planta Med 2003;69:692-695.

Weights and Measures Conversions*

A APPENDIX

Dry Weights

Measure Pound

Symbol lb, lb avdp, or #

Ounce oz or oz avdp

Dram dr or dr avdp

Avoirdupois (this system is still common in the United States) 16 ounces 7000 grains 0.454 kilogram

16 drams 437.5 grains 0.0625 pound 28.350 grams

Troy 1 lb t 12 ounces 240 pennyweight 5760 grains 0.373 kilogram

Apothecary 1 lb ap 12 ounces 5760 grains 0.373 kilogram

1 oz t 20 pennyweight 480 grains 0.083 pound 31.103 grams

1 oz ap 8 drams 480 grains 0.083 pound 31.103 grams

27.344 grains 0.0625 ounce 1.772 grams

1 dr ap 3 scruples 60 grains 3.888 grams

Scruple

1 s ap 20 grains 0.333 dram 1.296 grams

Grain

gr

Pennyweight

dwt, pwt

Kilogram Gram Milligram Microgram

kg g mg μg

0.037 dram 0.002286 ounce 0.0648 gram

0.042 pennyweight 0.002083 ounce 0.0648 gram

1 gr 0.05 scruple 0.002083 ounce 0.0166 dram 0.0648 gram

24 grains 0.05 ounce 1.555 grams 2.2046 pounds 0.035 ounce 0.015 grain 0.000015 grain

* Merriam Webster online. An excellent online converter can be found at: http://www.people.virginia.edu/~rmf8a/convert.html. (accessed February 15, 2005).

673

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PART V • Appendices

Liquid Measures Measure Gallon

Symbol gal

US Liquid 4 quarts (231 cubic inches) 3.785 liters

US Dry

British Imperial Liquid and Dry 4 quarts (277.420 cubic inches) 4.546 liters

Quart

qt

2 pints (57.75 cubic inches) 0.946 liter

2 pints (67.201 cubic inches) 1.101 liters

2 pints (69.355 cubic inches) 1.136 liters

Pint

pt

4 gills (28.875 cubic inches) 473.176 milliliters

1

/2 quart (33.600 cubic inches) 0.551 liter

4 gills (34.678 cubic inches) 568.26 milliliters

Bushel

bu

4 pecks (2150.42 cubic inches) 35.239 liters

4 pecks (2219.36 cubic inches) 36.369 liters

Peck

pk

8 quarts (537.605 cubic inches) 8.810 liters

2 gallons (554.84 cubic inches) 9.092 liters

Gill

gi

4 fluid ounces (7.219 cubic inches) 118.294 milliliters

5 fluid ounces (8.669 cubic inches) 142.066 milliliters

Fluid ounce

fl oz

8 fluid drams (1.805) cubic inches) 29.573 milliliters

8 fluid drams (1.7339 cubic inches) 28.412 milliliters

Fluid dram

fl dr

60 minims (0.226 cubic inch) 3.697 milliliters

60 minims (0.216734 cubic inch) 3.5516 milliliters

Minim

1 60

1 min 1 60

/ fluid dram (0.003760

cubic inch) 0.061610 milliliter Liter

L

61.02 cubic inches 1.057 quarts

0.908 quart

Milliliter

mL

0.061 cubic inch

0.27 fluid dram

Microliter

μL

0.000061 cubic inch

0.00027 fluid dram

OTHER CONVERSIONS ppm = mg/kg 1000 μg = 1 mg 1000 mg = 1 g

OTHER OLD WEIGHTS (Christopher, 1976) 1 teaspoon—1/2 dessertspoon, 1 dram, 60 grains, 4–5 mL, 3 scruples 1 dessertspoon—2 drams, 1/4 fluid oz, 120 grains, 8 mL, 6 scruples, 1/2 tablespoon, 1/8–1/10 teacup 1 tablespoon—4 drams 1 wineglass—2 oz 1 cup—8 oz

/ fluid dram (0.003612 cubic inch) 0.059194 milliliter

Capsules* 2 “0” sized capsules hold 3/4 teaspoon of dried herb, or about 1000 mg of dried herb. 2 “00” sized capsules will hold 1 teaspoon or 1300 mg of dried herb. They will also hold 60 drops or 1 teaspoonful of tincture. 2 “000” sized capsules hold approximately 11/3 teaspoon or 1600 mg of dried herb. 1 oz. of dried herb will make approx. 60 “0” sized capsules and 30 “00” sized capsules. *The weights held by any specific capsule size will vary depending on the density of the herb

Suppliers

B APPENDIX

U.S. SUPPLIERS Veterinary Products Only Jing Tang Herbal Company 9791 NW 160th Street Reddick, FL 32686 Phone: 352-591-3165 Fax: 352-591-0988 Hilton Herbs, Ltd. US Distributor Chamisa Ridge 3212a Richard’s Lane Santa Fe, NM 87505 Phone: 1-800-743-3188 Fax: 1-505-438-4811 www.chamisaridge.com Equilite, Inc. 437 Kulp Road Pottstown, PA 19465 Toll Free: 1-800-942-LITE (5483) Direct: 610-326-6480 Fax: 610-326-6481 http://www.equilite.com/ Animals’ Apawthecary P.O. Box 212 Conner, MT 59827 Phone: 406-821-4090 Buck Mountain Botanicals HC 30 Miles City, Montana 59301 Phone: 406-232-1185 Fax: 406-232-4491 www.buckmountainbotanicals.com Healing Herbs for Pets 4292-99 Fourth Avenue Ottawa, Ontario Canada K1S 5B3 Phone: 613-230-9966 Fax: 613-230-0750 [email protected]

Suppliers of Combination Nutraceutical/ Herb Formulas Vetri-Science Laboratories 20 New England Drive-C 1504 Essex Junction, VT 05453-1504 Phone: 800-882-9993 Rx Vitamins for Pets 200 Myrtle Boulevard Larchmont, NY 10538 Phone: 800-792-2222 Fax: 914-834-1804 www.rxvitamins.com Genesis/Resources Ltd. 4093 Oceanside Boulevard, Suite B Oceanside, CA 92056 Phone: 1-760-631-6225 Fax: 1-760-631-6227 Toll-Free: 1-877-P-E-T-S-4-L-I-F-E Thorne Research, Inc. 25820 Highway 2 West P.O. Box 25 Dover, ID 83825 Phone: 800-228-1966 www.thorne.com Natural Animal Feeds Telephone: 813-920-7613 Fax: 813-920-1642 http://www.naf-usa.com

Suppliers of Human Herbal Products Chinese herbs Health Concerns 8001 Capwell Drive Oakland, CA 94621 Phone: 800-233-9355 Lotus Herbs 1124 N. Hacienda Boulevard La Puente, CA 91744 675

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PART V • Appendices

Phone: 626-916-1070 Fax: 626-917-7763 Brion Corporation 9200 Jeronimo Road Irvine, CA 92718 Phone: 800-333-4372 Institute of Traditional Medicine 2017 S.E. Hawthorne Portland, OR 97214 Phone: 503-233-4907 MayWay Trading Company 1338 Cypress Street Oakland, CA 94607 Phone: 510-208-3113 Nuherbs Co. 3820 Penniman Avenue Oakland, CA 94519 Phone: 800-233-4307 Chinese herb combos Golden Flower Chinese Herbs P.O. Box 781 Placitas, NM 87043 Phone: 800-729-8509

Ayurvedic Medicine Ayush Herbs, Inc. 2115 112th N.E. Bellevue, WA 98006 Phone: 206-637-1400 Fax: 206-451-2670 [email protected]

Western Herbal Medicine Herbalist and Alchemist P.O. Box 553 Broadway, NJ 08808-0553 Phone: 908-689-9020 Toll-Free: 800-611-8235 Fax: 908-689-9071 www.herbalist-alchemist.com Herb Pharm P.O. Box 116 Williams, OR 97544 Phone: 800-348-4372 Fax: 541-846-6112 Wise Woman Herbals P.O. Box 279 Creswell, OR 97426 Phone: 541-895-5172 Fax: 541-895-5174 http://www.wisewomanherbals.com/ Gaia Herbs 108 Island Ford Road Brevard, NC 28712 Phone: 800-831-7780

Murdock Pharmaceuticals, Inc. 1400 Mountain Springs Park Springville, UT 84663 Phone: 800-962-8873 Eclectic Institute, Inc. 14385 S.E. Lusted Road Sandy, OR 97055 Phone: 800-332-4372 Essential Wholesale 8850 S.E. Herbert Court Clackamas, OR 97015 Phone: 503-722-7557 Fax: 503-296-5631 http://www.essentialwholesale.com/ Unscented creams, shampoos, and cosmetic ingredients for use in formulating topical formulas

AUSTRALIAN SUPPLIERS Veterinary Herbs The Natural Vet Company Drummoyne, Sydney, N.S.W. Australia Phone: 02-97198462 www.naturalvetcompany.com

Western Herbs Mediherb MediHerb Pty Ltd. P.O. Box 713 Warwick QLD 4370 Australia Toll-Free: 1-800-639-122 www.mediherb.com.au Medical grade herbal medicines, excellent technical support

Phytomedicine P.O. Box 1995 Dee Why N.S.W. 2099 Phone: 02-9939-1380 Toll-free: 1-800-822-922 www.phytomedicine.com.au Medical grade herbal medicines

Chinese Herbs Sun Ten P.O. Box 830 Hamilton, Queensland 4007 Phone: 07-3260-3300 Phone (country and interstate): 1-800-777-648 Chinese herbs—singles and formulas Acuneeds Australia 622 Camberwell Road Camberwell, VIC 3124

Suppliers • APPENDIX B

Australia www.acuneeds.com.au Toll-Free: 1-800-678-789 Phone: 03-9889-4100 Variety of Chinese herbal products Helio Supply Company Chippendale Sydney N.S.W. Australia Phone: 02 9698-5555 Variety of Chinese herbal products

Other Supplies Plasdene 6 Sheridan Close Milperra N.S.W. 2214 Phone: 02-9773-8666 Toll-Free: 1-800-252-709 Glass dispensing bottles

UNITED KINGDOM SUPPLIERS Natural Animal Feeds (NAF) and Nutrilabs Wonastow Road Industrial Estate West Monmouth NP25 5JA United Kingdom Tel : 0800 373106 (Freephone) Fax: 01600 710701 http://www.naf-uk.com/ Dorwest Herbs Ltd. Shipton Gorge Bridport Dorset United Kingdom DT6 4LP Phone: +44-0-870-733-7272 Fax: +44-0-870-733-7929 [email protected]

North Perrott Crewkerne Somerset England TA18 7SH Phone: +44-1460-270700 Fax: +44-1460-270702 http://www.hiltonherbs.com Global Herbs Ltd. Tamarisk House 12 Kingsham Ave. Chichester W. Sussex PO19 2AN United Kingdom Tel: 01243 773363 Fax 01243 788775 http://www.globalherbs.co.uk/

CANADIAN SUPPLIERS The Natural Path Herb Company 8215-102 Street Edmonton AB Canada T6E4A5 fax: 780-438-0465 ph: 780-436-3040 email:[email protected] www.nphc.ca Seroyal International Inc. 44 East Beaver Creek Road, Suite 17 Richmond Hill ON l4B 1G8 Phone: 905-764-6355 Fax: 905-764-6357 Supplements T.C. Unicorn Toronto Phone: 1-800-567-1668 Herbs

Wendals Herbs Phone: +44-01945-780880 Fax: +44-01945-780044 United States & Canada Toll-Free: 1-800-981-0320 Republic of Ireland 0503 75006 http://www.wendals.com/

Eastern Current Distributing Ltd. #200A 3540 West 41st Avenue Vancouver, BC V6N 3E6 Toll-Free: 1-800-667-6866 Phone: 604-263-5042 Fax: 604-263-8781 www.acupuncturetcm.com Herbs, AP needles, and other supplies

Dodson and Horrell Dodson & Horrell Ltd. Ringstead Northamptonshire NN14 4BX United Kingdom Phone: +44-0-1832-737300 Fax: +44-0-1832-737303 http://www.dodsonandhorrell.com

Nutra Med 3168 Drinkwater Road Duncan, BC Phone: 250-746-9397 Fax: 250-746-3966 Supplements

Hilton Herbs Downclose Farm

Lucid Distributors, Inc. Animal Health Products Unit B 9444 190th Street Surrey, BC V4N 3S2

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Phone: 604-882-9918 Fax: 604-882-9443 Supplements NutriScience 51 Beverly Hills Drive

Toronto, Ontario M3L 1A2 Phone: 416-240-1234 Toll-Free: 1-800-661-2434 Fax: 419-249-0341 Supplements

Training in Herbal Medicine

C APPENDIX

VETERINARY HERBAL MEDICINE U.S. Courses in Veterinary Herbal Medicine Integrative Veterinary Herbalism Tufts University School of Veterinary Medicine 200 Westboro Road North Grafton, MA 01536 Phone: 508-839-5302 http://www.tufts.edu/vet/continedu/[email protected] Offered episodically through the Continuing Education Program International College of Veterinary Herbal Medicine http://www.vetherbalmedicine.com Basic to advanced online education Chi Institute 9708 West Highway 318 Reddick, FL 32686 Phone: 1-800-891-1986, 352-591-5385 Fax: 352-591-2854 www.tcvm.com [email protected] In-depth course on Chinese veterinary herbal medicine Healing Oasis Wellness Center 2555 Wisconsin Street Sturtevant, WI 53177 Phone: 262-884-9549 Fax: 262-886-6460 www.thehealingoasis.com In-depth course on Chinese and Western veterinary herbal medicine International Veterinary Acupuncture Society P.O. Box 271395 Fort Collins, CO 80527-1395 Phone: 970-266-0666 Fax: 970-266-0777 Ivasoffi[email protected] www.ivas.org In-depth course on Chinese veterinary herbal medicine New Mexico Chinese Herbal Veterinary Medicine Course 1925 Juan Tabo N.E., Suite E

Albuquerque, NM 87112 Phone: 505-450-4325 Fax: 505-332-4775 In-depth course on Chinese veterinary herbal medicine Veterinary Botanical Medicine Association Jasmine C. Lyon, Executive Director 1785 Poplar Dr. Kennesaw, GA 30144 http://www.vbma.org Various online courses, annual Veterinary Herbal Medicine Symposium Veterinary Information Network www.vin.com Offers introductory and intermediate courses online from time to time

UK Courses in Veterinary Herbal Medicine Introduction to Veterinary Herbal Medicine Course coordinator: Jimmy Symmonds, MRCVS Phone: +44-0-1869-349955 [email protected] www.healthybeast.com

Canadian Courses in Veterinary Herbal Medicine Academy of Veterinary Acupuncturists of Canada C.P. 73 Beaconsfield Québec, Canada H9W 5T6 Phone: 514-697-0295 offi[email protected]

Australian Courses in Veterinary Herbal Medicine Introduction and Intermediate Veterinary Herbal Medicine (Western) Course coordinator: Barbara Fougere www.naturalvet.com.au [email protected] 679

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Courses in Traditional Chinese Herbal Veterinary Medicine

[email protected] www.herbalmedicine.org.uk

Course coordinator: Barbara Fougere Contact: [email protected]

Middlesex University Queens Way Enfield EN3 4SA Phone: 0208-411-5161 [email protected] www.mdx.ac.uk

HUMAN HERBAL MEDICINE Selection of U.S. Courses Herbal Therapeutics Principle Instructor: David Winston, AHG School of Botanical Medicine P.O. Box 553 Broadway, NJ 08808 [email protected] Botanologos Principal Instructor: Patricia Kyritsi Howell P.O. Box W Mountain City, GA 30562 Phone: 706-746-5485 [email protected] http://www.botanologos.com/ Planet Herbs Home Study Course Principal Instructors: Michael and Lesley Tierra East West School of Herbology P.O. Box 275 Ben Lomond, CA 95005 Phone: 800-717-5010 [email protected] Tai Sophia Institute for the Healing Arts Principal Instructor: Simon Mills 7750 Montpelier Road Laurel, MD 20723 Phone: 410-888-9048 Fax: 301-725-1674 Toll-Free: 800-735-2968 http://www.tai.edu/ Southwest School of Botanical Medicine Principal Instructor: Michael Moore P.O. Box 4565 Bisbee, AZ 85603 Phone: 520-432-5855 http://www.swsbm.com/homepage/ Foundations in Herbal Medicine Principal Instructor: Tierona Low Dog, MD, AHG P.O. Box 4544 Albuquerque, NM 87196 Phone: 888-857-1976 Fax: 505-266-2160 [email protected] http://www.fihm.com

University of Westminster 115 New Cavendish Street London W1M 6UW Phone: 0207-911-5000 http://www.wmin.ac.uk/sih/page-45 The University of Central Lancashire Preston PR2 2HE Phone: 44/0-1772-201-201 www.uclan.ac.uk/parttime/section1/19.htm Napier University Faculty of Health and Life Sciences School of Community Health Canaan Lane Campus 74 Canaan Lane Edinburgh EH9 2TB Phone: 0131-455-5653 or 5315 (course tutors) www.napier.ac.uk University of Lincoln Brayford Pool Lincoln LN6 7TS Phone: +44-0-1522-882000 www.lincoln.ac.uk

Selection of Australian Courses The National Herbalists Association of Australia (NHAA) is the peak herbal medicine body in Australia. It does not accredit training institutions—only individual courses. Its professional process ensures that full membership in the NHAA is granted only when a person has successfully completed the required course content. See www.nhaa. org.au to ensure that any course undertaken is accredited. Australasian College of Natural Therapies P.O. Box K1356 Haymarket N.S.W. 1240 Australia Phone: 02-9218-8888 Toll-Free: 1-800-46-2268

For postgraduate courses Selection of European Courses The Scottish School of Herbal Medicine Unit 20, Alexander Stephen House 91 Holmfauld Road Glasgow G51 3BA Phone: 0141-445-2500

The Australian College of Phytotherapy Pty, Ltd. P.O. Box 661 Warwick Queensland 4370 Australia Phone: +61-7-4661-9653 www.herbaleducation.com.au

Herbal Terminology

D APPENDIX

These traditional categorizations of herbs are based on their clinical actions. Adaptogen A plant adaptogen is a “smooth” pro-stressor that reduces reactivity of host defense systems and decreases damaging effects of various stressors caused by increased basal levels of mediators involved in the stressresponse (Panossian, 1999). Adaptogens allow easy adaptation of the entire body to the environment or illness; they achieve this by enhancing homeostatic mechanisms. Adaptogens act on nervous, endocrine, or immune function via the hypothalamic-pituitary-adrenal axis. Some think the term is synonymous with “tonic”; however, tonics may act simply as nutritional supplements, or they may have direct immune-modulating effects. The term was originally coined by Soviet researchers, who defined an adaptogen as a substance that (1) increases nonspecific responses to stress, (2) is mild, without strong adverse effects, and (3) can be taken for extended periods, similar to a food. Alterative A traditional term for an herb that “cleanses and purifies” the blood by gradually modulating tissue metabolism; it restores absorptive and excretory functions and most have mild diuretic or laxative properties. An alterative herb may change the course of a chronic condition by improving overall physiological functioning of the patient. Some equate “alterative” with “depurative.” Amphoteric A substance that normalizes organ or system dysfunction. If deficient, the herb stimulates activity; if excessive, the herb may normalize or even blunt activity. It has opposite physiologic action (e.g., it lowers and elevates blood pressure). This bidirectional modulation of physiology occurs because of the multitude of constituents in the herb; the body takes what it needs and “knows what to do.” Analgesic Relieves pain when administered orally Anodyne Relieves pain via topical application Anitcatarrhal Diminishes secretions, inflammation, and congestion of all mucous membranes Antiphlogistic Relieves and counters inflammation Antispasmodic Relieves muscle spasms

Aperient Mild laxative; gentle and nonirritating purgative causing slight increase in peristalsis Aromatic Herbs with strong odor that stimulate the digestive system Asthenia Lack or loss of strength; debility; any weakness, but especially one originating in muscular or cerebellar disease Asthenic Weak; pertaining to asthenia; body constitution characterized by a narrow, shallow thorax, a long thoracic cavity, and a short abdominal cavity Astringent Contracts and firms tissues and organs; decreases secretions and discharges. Binds proteins, glycoproteins, and carbohydrates (mucin) in the body and on microorganisms Balsam A soothing and healing agent Bitter An agent that increases tone and activity of gastric mucosa, improves the appetite, and stimulates gastric juices. The term covers a number of different types of phytochemicals. Bitters that are prescribed for gastrointestinal problems are meant to be tasted to stimulate secretion of saliva and stomach acids; this may limit their traditional use in animals. Calmative Nourishes the entire body and nervous system Carminative Promotes proper intestinal function, relieves indigestion, abdominal distention, and flatulence Cathartic Strong laxative that causes rapid evacuation of the colon Cholagogue Cholagogues stimulate release and flow of bile formed in the liver; generally a property of bitters, but produced by other plant constituents as well. Choleretic Choleretics stimulate bile production by hepatocytes and most have effective cholagogue properties as well. Counterirritant External application to relieve more deep-seated pain through hyperemia or local irritation Decoction Herb extracted by boiling (used for hard parts of plants like seeds, roots, and bark) Demulcent Soothes, protects, and restores mucous membranes; relieves irritation of inflamed or abraded surfaces, usually through mucilage content 681

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Depurative “Blood purifying”; aids in the removal of metabolites, mineral, drugs, and so forth from the body via the gastrointestinal tract, urine, skin, or lungs Diaphoretic Promotes perspiration via dilation of vessels in the skin Diathesis Constitutional predisposition to certain disease conditions Diuretic Increases the flow of urine Emmenagogue Promotes and normalizes menstrual flow Emollient Softening, soothing, and/or protecting Escharotic An herbal paste (sometimes caustic or corrosive) that is capable of producing an eschar (or scab) that is most often used for the removal of warts and tumors Expectorant Promotes and dispels mucus from lungs and bronchi Febrifuge Assists the body to reduce fever Fluid extract Plant extract 1 : 1 (i.e., 1 mL of liquid equals 1 gram of herb) Galactagogue Promotes lactation Galenical Standard medicinal preparation (as an extract or tincture) that contains usually one or more active constituents of a plant; made by a process that leaves the inert and other undesirable constituents of the plant undissolved Glycetract Herb extracted in glycerine or alternatively extracted in alcohol, then the alcohol is removed and replaced with glycerine as a preservative. Hemostatic Stops the flow of blood Hypnotic Powerful relaxant and sedative that promotes drowsiness Infusion Herbal extract prepared with warm or cold water as a tea (without boiling); used for soft parts of the plant like leaves, flower, or green parts Liniment Soothing, liquid preparation for rubbing on the skin Mucilaginous Contains mucins (complex carbohydrates) that are demulcent, emollient, and soothing Narcotic Central nervous system depressant; relieves pain and promotes sleep Nervine Herbs that tone, nourish, and strengthen the central nervous system; some stimulate, and some are relaxing or sedative Neurocirculatory asthenia Psychosomatic disorder characterized by mental and physical fatigue, dyspnea, giddiness, precordial pain, and palpitation, especially on exertion Nutritive Nourishes the body or affects metabolic processes; increases weight by providing supplies for

tissue building; supplies vitamins, minerals, trace elements, amino acids, and/or fats Oxymel Medicinal vinegar with added honey Oxytocic Accelerates or facilitates childbirth Parturient Stimulates uterine contractions that induce and assist labor Pectoral Having an effect on diseases of the chest Phytotherapy Using plants as medicine; a term used mainly in Europe, the UK, and Australia; a term that refers to both scientific and traditional herbal medicine Protective Lessens damage from environmental influences, including what is taken into the body Purgative Watery evacuation of the colon Relaxant Eases tension and pain in the body and organs; nonsedating Restorative Restores normal function of the body, organ, or system Rubefacient Externally applied; reddens the skin by causing capillary dilation Scrofula An obsolete term frequently seen in historical texts; refers to a variety of tuberculous adenitis. This is thought to consist of secondary involvement of cervical lymph nodes as a result of localized hematogenous spread from a pulmonary lesion. Most common in childhood. Sedative Calms or tranquilizes by lowering functional activity Sialagogue Promotes the flow of saliva Stomachic Promotes normal physiologic function of the stomach Styptic External application stops blood flow by constricting blood vessels Succus Plant juice Sudorific Promotes perspiration; stronger effect than diaphoretic Tonic Slowly restores and strengthens the tone of the body, organ, or system; it stimulates nutrition and enhances or normalizes physiologic function Troche Lozenge for slow dissolution in the mouth; commonly used for demulcent herbs Trophorestorative Herb that restores function and morphology of a specific organ or tissue Vermicide Kills intestinal worms Vermifuge Dispels intestinal worms Vesicant Causes blistering Vital Force Energy that makes body, tissue, or cells grow, develop and restore enthalpy Vulnerary Aids in wound and skin healing; usually applied externally

Client Handout: Hints on Administering Herbs to Animals*

E

Compiled by members of the Veterinary Botanical Medicine Association

APPENDIX

Herbs can be beneficial to animals when medications are not working or are resulting in adverse effects, or when the practitioner or owner would prefer to try the natural medicine approach first. Administration of these herbs can be challenging at times. Here are a few suggestions on how to make their administration easier for both you and your animal companion. Sometimes, the effect of the herb varies according to the patient’s actual ability to taste it, but in most cases, we have the option of trying to trick pets into taking herbs by disguising the taste in an “herb delivery system.” (Please consult your veterinary herbalist for information on the best quality herbs, the correct doses, and the best ways of giving them to your animals. Giving the wrong herbs or giving the correct herbs at incorrect doses can seriously damage your animal’s health. This is especially important if your animal is taking other medication as well. Drug–herb interactions are real. Talk to your veterinary herbalist about this.)

MEDICATING DOGS AND CATS Dogs and cats can be given powdered herbs, powder herb extracts, and liquid herb extracts in their meals. If your pet’s appetite is poor because of illness or learned preferences, you may need to disguise the taste further by using especially strong-smelling foods, like tuna, sardines, or braunschweiger. For some pets, baby food or canned cat food is such a novelty that they will take the herbs mixed into these foods. Some pharmacies and veterinary manufacturers make flavored “tab wraps” for dogs and cats; these are especially designed to hide small tablets. Other tasty treats to hide the herbs include cream cheese, jelly, peanut or other nut butters, ground meat or liver, and fruit. Applesauce is particularly recommended by some herbalists. Flavored gravies for pets can also be used to dilute the herbs and mask the taste. If your pet’s appetite

*Copyright 2003, Veterinary Botanical Medicine Association, Kennesaw, Georgia.

is suppressed because of illness, do not mix medicines in regular meals—administer the herbs separately in a different food treat. Powdered herbs may be mixed into small “pills” of butter, then frozen to increase firmness. You can blend them with anchovy paste, organic peanut butter, jelly, jam, sandwich pastes, or other thick tasty foods. It may be easier in some cases to administer the powdered or liquid herbs by mixing them into a liquid that is to be gently and slowly administered by syringe. Vehicles that have been recommended include meat or poultry broth, clam juice, flavored syrups (one veterinary product is VAL SyrupTM, (Fort Dodge Animal Health, Overland, KS), and fruit juice. You can take advantage of your cat’s fastidiousness by mixing the herb in a hairball gel (such as VetBasis [petroleum free] (Pet Living, Inc, Bloomington, MN) or LaxatoneTM (Evsco Pharmaceuticals, Buena, NJ) vegemite or anchovy paste, and smearing it on his or her paws— only very sick cats will let that insult go unchallenged! Some herbalists make traditional teas using meat broth instead of plain water, then frozen in ice cube trays to preserve until the day of use. Liquid herbal extracts are often not accepted in any form by some animals. In this case, you can use a dropper to put the extract into a capsule, close it, and administer it to the animal in that form quickly. Always dilute liquid extracts (preferably with something sweet-tasting) if giving directly into the mouth. If herb capsules must be administered, they often “go down” more easily if one end is covered in butter. Be sure to administer water or broth afterward to ensure that the capsule passes quickly from the esophagus to the stomach.

RABBITS AND BIRDS Rabbits can be medicated by grinding herbs into their pellets with a coffee grinder. Mix dried herbs with good quality honey. Strawberry jam is effective in disguising the taste before administration to exotic species. Birds, 683

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especially parrots, seem to accept liquid extracts when dropped onto a cracker. Your veterinary herbalist may also recommend other routes of administration, such as by enema. This is especially appropriate for vomiting animals. If your pet has food allergies or any other illness, check the herb delivery system with your veterinarian before using it.

MEDICATING HORSES AND FARM ANIMALS Horses and ruminant farm animals are herbivores— natural grazers, used to eating many different plant mate-

rials. They usually accept herbs mixed in their grain and pellet rations. If that doesn’t work, applesauce, molasses, or frozen concentrated fruit juices can be effective vehicles.

FINAL CAUTIONS Some animals will not tolerate herbs in any form, and we must accept that in some cases, insisting on the continued administration of these medications may affect their quality of life. If your pet won’t accept herbs, discuss this with your veterinary herbalist.

Index

A AAFCO. See American Association of Feed Control Officials Abortion, 364-365 Abrus precatorius, 73t Absinthe, 185 Absinthin, 171f Absinthism, 185 Acacia, 196t Acacia senegal, 196t Acceptance criteria, 107 Aceitilla, 196t Acemannan, 304, 466-468 Acetazolamide, 195t Acetylcholine, 595f Acetyl-CoA, 152t, 172 Acetylsalicylic acid, 151, 188, 664f Achillea millefolium, 243, 346 Achyranthes aspera, 74t Ackee apple seed, 196t Aconine, 185 Aconite, 185 Aconitine, 185 Aconitum spp., 185 Acorus calamus, 73t, 189t Actaea racemosa description of, 486-487 dosage of, 487 menopausal symptoms treated with, 362 nervine uses of, 348, 364 spasmolytic uses of, 345 substitutes for, 269t uterine effects of, 364 Adansonia digitata, 23t, 25t Adaptive taste preferences, 8-9

Page numbers followed by f indicate figures; t, tables; b, boxes

Adaptogens cancer uses of, 297, 307 definition of, 283, 285, 353 dermatologic uses of, 315 description of, 4, 151 for hematologic disorders, 291292 hypothalamic-pituitary-axis and, 353 immune system effects, 295-296 indications for, 285 list of, 286b stress treated with, 151, 315 Additive effects, 91 Adenine triphosphate, 143 Adequate, 107 Adonis vernalis, 203t Adulteration, 127-128, 192-193, 259, 266t Adverse drug reactions, 184 Adverse effects, 289 Adverse event report, 107 Adverse event reporting system, 111-114, 112f-113f Aegle marmelos, 70, 74t Aesculus hippocastanum, 189t, 201t Aflatoxins, 154 Africa, 100 Agalactia, 365 Agar, 196t Agathosma betulina description of, 496-497 diuretic effects of, 376 dosage of, 496-497 drug interactions with, 191t urinary tract asepsis using, 380 Agave spp. A. americana, 23t A. sisalana, 23t Aglycones, 162 Agnis, 63

Agrimony (Agrimonia spp.) A. eupatoria, 327 astringent activity of, 327 description of, 463 drug interactions with, 196t Agropyron repens, 376-377, 379-380 Albendazole, 442 Albizia (Albizia spp.) A. kalkora, 316 A. lebbeck, 316 description of, 316, 463-464 Alcohol extracts, 224 Alcohol-based tinctures, 224 Alder birch, 447 Aletris farinosa, 197t Alfalfa, 196t, 464 Algae, blue-green, 185-186 Alkalinizing agents, 380 Alkaloids description of, 174-176, 175b176b, 184 herbs with high levels of, 226b solubility of, 224t tannin combinations, 226 Alkylamides, 92-94 Allergic bronchitis, 70, 374 Allergic rhinitis, 370 Allergies food, 314 skin, 319 Allicin, 140t, 145, 186, 556 Allied and Complementary Medicine Database, 95 Alliin, 109, 145 Allinase, 145 Allium spp. A. cepa, 202t A. nuttii, 23t A. sativum adverse effects of, 557-558 alliin composition, 109 685

686

INDEX

Allium spp.—cont’d A. sativum—cont’d anticoagulant effects of, 312 anthelminthic uses of, 328 antihyperlipidemic effects of, 293 antimicrobial uses of, 557 antiprotozoal uses of, 329, 556557 avian influenza treated with, 25 Ayurvedic use of, 69t, 73t-74t cardiovascular effects of, 311 constituents of, 73t contraindications, 557 description of, 555-559 dosage of, 558 drug interactions with, 199t harvesting of, 109 hypolipidemic effects of, 332, 556 kidney cancer treated with, 302 National Animal Supplement Council adverse event reporting system report for, 111, 112f-113f Newcastle’s disease treated with, 23t, 25t oral tumors treated with, 303 pulmonary vascular responses to, 556 quality control for, 108-109 reproductive cancer treated with, 301 safety of, 186-187 toxicology of, 557-558 Aloe (Aloe spp.) A. barbadensis, 74t, 333 A. secundiflora, 22, 24t A. vera antihyperglycemic effects of, 322-323 description of, 74t neurologic cancers treated with, 302 pancreatic effects of, 334 thyroid gland effects of, 323 acemannan, 304, 466-468 antihyperglycemic effects of, 322323 antithyroid activity, 466 burns treated with, 466 description of, 464-469 dosage of, 468 drug interactions, 196t fibrosarcoma treated with, 303 gel, 196t indications for, 465-468 laxative effects of, 465 mastitis treated with, 367 purgative effects of, 333 safety of, 185

Aloe (Aloe spp.)—cont’d wound healing benefits of, 387388, 465-466 Aloe-emodin, 185 Alteratives cancer uses of, 299, 307 definition of, 286 dermatologic uses of, 315-316 description of, 345 list of, 288b Althaea officinalis, 326-327, 372, 379, 597-598 Alum root, 383 Ama, 63 Amanita muscaria var. muscaria, 151152 Amaranthus hybridus, 24t Amentoflavone, 1 American Association of Feed Control Officials, 101, 103, 105 American Cattle Doctor, The, 44 American ginseng description of, 353 drug interactions with, 200t nervine uses of, 358 uses of, 262, 267-268, 292 American Herbal Pharmacopoeia, 109 American Herbal Products Association, 222 American mistletoe, 187 American School of Naturopathy, 43 Ammi visnaga, 197t Ammoniac, 385 Amyema scandens, 266 Amyloplasts, 143 Anabaena flos-aquae, 185 Anacardium spp. A. occidentale, 385 Newcastle’s disease treated with, 24t Anal fistula, 387 Analgesics cancer uses of, 300 description of, 344-345, 354-355 herb interactions with, 193t Ananas comosus, 197t Anandamide, 152 Anatoxin-a, 185 Androecium, 156 Androgenic herbs, 321 Andrographis (Andrographis paniculata) anti-inflammatory properties of, 25 avian influenza treated with, 25-26 Ayurvedic uses of, 74t bile flow affected by, 331 drug interactions with, 196t hepatic effects of, 332

Anemia Ayurvedic treatment of, 69-70 treatment of, 294 Anesthetics, 352-353 Aneubin, 547f Angelica (Angelica spp.) A. archangelica, 325 A. dahurica, 196t A. sinensis description of, 534-535 dosage of, 535 drug interactions, 198t hematologic and immunologic disorders treated with, 292 melanin synthesis affected by, 318 stimulatory effects of, 357 uterine effects of, 364 antacid and antiulcer effects of, 325 drug interactions, 196t Angiogenesis inhibitors, 298b Angiosperms description of, 154-155 polysaccharide-rich, 162b Angiotensin-converting enzyme inhibitors, 312 Animal Medicinal Drug Use Clarification Act, 104b Anise, 196t Aniseed oil adrenal effects of, 321 antispasmodic uses of, 330 hepatic effects of, 333 Annatto, 196t Anodyne, 382b, 386-387 Anogeissus leiocarpus, 24t Antagonism, 91 Anthocyanins, 150, 485f Anthraquinone glycosides, 164, 164b Antiallergy herbs, 316-317 Antiarrhythmics herb interactions with, 194t herbal, 312 Antibacterial herbs, 383-384 Anticatarrhal herbs, 373 Anticoagulants herbs, 292, 312 interactions with, 194t Anticonvulsants drug interactions with, 193t herbs used as, 355-356 Antidepressants, 193t, 354 Antidiabetic herbs description of, 321-322 drug interactions with, 195t Antiemetic herbs administration of, 328 description of, 328-329

INDEX

Antiemetic herbs—cont’d in dogs, 560 drug interactions with, 193t Antifungals, 195t Antigonadotrophic herbs, 321 Antihelmintics Ayurvedic, 66 description of, 8 herbs used as, 327-328 Antihyperglycemic herbs, 322-323 Antihyperlipidemics, 194t Antihypertensives, 194t Antiinflammatory herbs dermatologic uses of, 317 gastrointestinal uses of, 326-327 hematologic and immunologic disorders treated with, 292 respiratory uses of, 369-370 urinary tract uses of, 377 Antilithic herbs, 377-378 Antimicrobial herbs description of, 329 urinary tract, 379-380 Antioxidants cancer uses of, 299-300, 307-308 dermatologic uses of, 317 plant sources of, 150 Antiparkinsonism drugs, 194t Antiprotozoal herbs, 329, 556-557 Antipruritics, 317-318, 386 Antipsychotics, 194t Antipyretics, 67 Antirheumatics, 342-343 Antiseptics, 379-380 Antispasmodics Ayurvedic, 67 herbs used as, 330-331, 353 Antitussive herbs, 369, 501 Antivertigo drugs, 193t Antiviral herbs, 329 Antoxin aS, 185 Anxiety, 286, 358-359 Anxiolytics description of, 350-352 drug interactions with, 194t Aperients, 333 Aphrodisiacs, 357 Apigenin, 166f Apiol, 617f Apium graveolens diuretic effects of, 346, 376 drug interactions with, 197t Aplastic anemia, 127 Aplotaxis lappa, 268 Apocynum cannabinum, 198t Apodytes dimidiata, 24t Apoptosis, 298b Aporphine alkaloids, 175b Appalachian Ginseng Foundation, 270 Arbutin, 655f

Arctium spp. A. lappa antitussive uses of, 369 cancer uses of, 299 description of, 345, 500-501 dosage of, 501 drug interactions, 197t drug interactions with, 197t Arctostaphylos uva ursi antidiabetic effects of, 321-322 description of, 655-657 diuretic effects of, 377 dosage of, 656 drug interactions with, 205t melanin synthesis affected by, 318 urinary tract uses of, 380 Areca catechu, 197t Argemone mexicana, 385 Aristolochia spp. A. fangchi, 363 safety of, 185 Aristolochic acid, 185 Arjun. See Tephrosia spp. Armoise, 191t Armoracia rusticana, 201t Arnica (Arnica spp.) A. latifolia, 189t A. montana anti-inflammatory uses of, 344 description of, 189t drug interactions with, 196t anti-inflammatory uses of, 344 drug interactions, 196t growing of, 251b substitutes for, 269t wound healing benefits of, 388 Art of Simpling, The, 40, 47-48 Arteannuin, 140t Artemisia spp. A. absinthium, 171, 185, 205t A. annua, 171, 258, 645-646 A. dracunculus antidiabetic effects of, 321-322 description of, 191t drug interactions with, 204t Artemisinin, 171f, 645f Articum lappa dermatologic uses of, 315-316 description of, 299 Asafetida. See Ferula foetida Asclepias spp. A. fruticosa, 196t A. tuberosa anticatarrhal uses of, 373 description of, 188, 625-626 dosage of, 626 drug interactions with, 203t Ascophyllum nodosum, 368 Ashva-Ayurveda, 60

687

Ashwagandha adrenal effects of, 320 cancer uses of, 297 cardiopulmonary effects, 476-477 central nervous system effects, 476 chemoprotective activity of, 476 description of, 68, 315, 354, 475478 dosage of, 477 drug interactions, 196t hematologic and immunologic disorders treated with, 292 immune-mediated hemolytic anemia treated with, 70 immunomodulatory effects of, 476 lymphoma/lymphosarcoma treated with, 305 nervine uses of, 348 thyroid gland effects of, 323 Asian ginseng adrenal effects of, 320 antidiabetic effects of, 321 anxiolytic uses of, 351-352 cancer uses of, 298 description of, 353 drug interactions with, 200t gastrointestinal tract cancers treated with, 303 hair growth promoted using, 318 hematologic and immunologic disorders treated with, 291292 hepatic effects of, 332-333 stimulatory effects of, 357 Asiaticoside, 568f Asparagus racemosus, 74t Aspergillus flavus, 154 Aspirin, 124 Asthma, 495 Astragalin, 478 Astragalus (Astragalus spp.) A. membranaceus cancer uses of, 297 cardiovascular effects of, 310 dermatologic uses of, 318 description of, 478-479 dosage of, 479 drug interactions, 196t hematologic and immunologic disorders treated with, 293 kidney cancer treated with, 302 kidney function effects of, 378 oral tumors treated with, 304 A. mongholicus, 379 anticancer uses of, 297, 299, 308 cardiovascular effects of, 310 dermatologic uses of, 318 description of, 478-479 dosage of, 479

688

INDEX

Astragalus (Astragalus spp.)—cont’d drug interactions, 196t hematologic and immunologic disorders treated with, 293 immune system affected by, 296 kidney cancer treated with, 302 kidney function effects of, 379 oral tumors treated with, 304 renal protection uses of, 378 Astringents Ayurvedic, 67 definition of, 67 gastrointestinal uses of, 327 topical, 383 urinary tract, 380 uterine, 363 Atopic dermatitis, 319 Atopy, 319 Atractylodes spp., 196t, 479-480 Atropa belladonna, 189t, 196t, 201t, 387 Atropine, 174 Aucklandia lappa, 268 Aucubin, 624f Australia, 100, 265-266 Autoimmune diseases and conditions Ayurveda for, 70 immune-enhancing herbs for, 320b skin disease, 319 treatment of, 70, 294-295 Autumn crocus, 196t Avena sativa, 202t, 611-612 Avian influenza description of, 21 H5N1, 25 human risks associated with, 28 viral causes of, 25 Avicenna, 39 Ayurveda Agnis, 63 allergic bronchitis treatment, 70 Ama, 63 anemia treatment, 69-70 in Asia, 60 definition of, 59 diagnostic practices of, 64-65, 69 disease processes in, 63-64 Doshas, 61-64, 62t ethnoveterinary medicine, 18 herbal therapy in herbs, 59-60, 69t, 73t-81t plant properties, 66 principles of, 68 safety of, 82 singulars, 68 therapeutic categorization of herbs, 66-67 history of, 33, 60-61 influences of, 59-60, 68

Ayurveda—cont’d information needed for, 59 international bias against, 82 lead poisoning concerns, 82 Mala, 63 philosophies and principles of, 33-34, 59, 61, 68 prescribing methods, 278 pulse diagnosis in, 64-65, 65t resources, 82 Srotas, 63-64 tongue diagnosis, 64 traditional Chinese Medicine influenced by, 61 in United States, 61 Universe as viewed by, 61 urine examination, 65, 65t veterinary medicine clinical trials of, 72-73 overview of, 68-69 status of, 72 therapeutic protocols, 69-72 vital tissues, 61, 61t Azadirachta indica animal feed uses of, 606-607 Ayurvedic uses of, 73t-75t constituents of, 73t contraceptive uses of, 607 dental care treated with, 607 description of, 74t-75t, 605-608 diabetes treated with, 607 dosage of, 75t, 607 drug interactions, 202t ectoparasiticidal uses of, 383, 606607 ethnoveterinary uses of, 606b immune effects of, 607 Newcastle’s disease treated with, 22, 24t oral tumors treated with, 304 pesticide uses of, 252 therapeutic uses of, 75t ulcer healing of, 607 Azadirachtin, 605f Azedarach, 383 B Bacon, Francis, 41 Bacopa (Bacopa monniera) antacid and antiulcer effects of, 326 anticonvulsant uses of, 356 antidepressant uses of, 354 anxiolytic uses of, 351 cognitive enhancement uses of, 356 description of, 76t, 292, 480-482 dosage of, 481 drug interactions with, 197t thyroid gland effects of, 323 Bacoside, 480f

Bael. See Aegle marmelos Bai zhi, 196t Bai zhu, 196t Baical skullcap root antiallergy uses of, 316 anticonvulsant uses of, 355 antispasmodic uses of, 353 description of, 482-483 dosage of, 482 drug interactions with, 196t nervine uses of, 357 Baicalein, 355, 482f Balloon cotton, 196t Balloon flower, 196t Ballota nigra, 329 Balms, 228 Balsam of Peru, 172 Banana, 196t Bancke’s Herbal, 40 Banyan stem, 196t Baptisia (Baptisia tinctoria), 386, 483 Barberry antiarrhythmic effects of, 312 description of, 483-484 dosage of, 484 drug interactions with, 196t synergistic properties of, 3 Barleria plant, 196t Basil, 191t, 384 Bat guano, 242t Batch, 107 Batch production, 108 Bay laurel, 388 Bay leaf, 191t, 196t Bayberry, 196t Bayes, Thomas, 96 Beach, Wooster, 43 Bearberry, 377 Bears, 11-12 Beeswax, 228 Behavioral self-regulation, 7 Belladonna, 196t, 387 Belleric myrobalan. See Terminalia (Terminalia spp.) Benign prostatic hyperplasia, 363, 365, 367, 609 Berbamine, 176 Berberine, 3, 140t, 176, 177f, 483f Berberis spp. B. aquifolium anti-inflammatory uses of, 317 description of, 299 drug interactions with, 202t B. aristata, 76t B. vulgaris antiarrhythmic effects of, 312 dosage of, 484 drug interactions with, 196t synergistic properties of, 3 Bergapten, 617f

INDEX

Best manufacturing practices description of, 106 National Animal Supplement Council standards, 107 Beta sitosterol, 148 Beta sitosterol-6-glucoside, 219 Beta vulgaris, 198t Beta-galactosidase, 162 Beta-glucan, 596f Beta-glucosidase, 162 Betel nuts, 128, 197t Betula alnoides, 447 Bibliography of Investigated Medicinal Plants, 72 Bidens pilosa, 196t Bilberry antacid and antiulcer effects of, 325 antihyperglycemic effects of, 322 cancer uses of, 300 description of, 485-486 dosage of, 486 drug interactions, 197t Bile, 62-63 Bingen, Hildegard von, 38 Bioactive botanicals, 9-10 Bioavailability, 91 Biodiversity loss causes of, 257-258 problems associated with, 258-259 socioeconomic effects, 259, 265 Biomedicine, 41 Bioprospecting, 21 Birch, 191t Birdfoot trefoil, 442 Bishop’s weed, 197t Bitter almond, 191t Bitter herbs, 295 Bitter melon drug interactions with, 197t lymphoma/lymphosarcoma treated with, 305 Bitter orange, 197t Bitter pith, 9 Bitter taste, 215b, 215-216, 218 Bitter tonics, 67 Bitters adaptive taste preference for, 9 characteristics of, 329-330 definition of, 329 description of, 447 list of, 330 mice studies involving, 9, 13 sickness and, 9 Bixa orellana, 196t Black ash tree bark, 383 Black cohosh description of, 486-487 dosage of, 487 menopausal symptoms treated with, 362

Black cohosh—cont’d nervine uses of, 348, 364 spasmolytic uses of, 345 substitutes for, 269t uterine effects of, 364 Black cumin, 301 Black cumin seed, 449 Black currant, 197t Black haw, 353, 364, 385, 488 Black hellebore, 122, 197t Black horehound, 329 Black nightshade. See Solanum spp. Black pepper, 197t Black radish seed. See Raphanus sativa Black raspberry, 303 Black seed, 197t Black tea anticancer uses of, 301 antipruritic uses of, 386 oral tumors treated with, 303 Black walnut anthelminthic uses of, 328 description of, 488-490 dosage of, 489 drug interactions, 197t heartworms treated with, 313 Black willow, 387 Blackberry astringenic activity of, 327 description of, 490-491 dosage of, 491 drug interactions with, 197t Bladder, in traditional Chinese Medicine, 52 Bladder cancer, 302 Bladder stones, 381 Bladder tonics, 378 Bladderwrack antacid and antiulcer effects of, 327 description of, 491-492 dosage of, 492 thyroid gland effects of, 323 Blazing star, 197t Bleeding, 295 Blessed thistle, 197t Blighia sapida, 196t β-Blockers, 194t Blood, 55 Blood meal, 242t Blood tonics, 292 Bloodroot auricular uses of, 386 cardiovascular effects of, 311 description of, 251b, 492-493 dosage of, 493 escharotic uses of, 384-385 expectorant uses of, 371 substitutes for, 269t

689

Blue cohosh drug interactions, 197t substitutes for, 269t uterine effects of, 364 Blue flag, 316, 345 Blue-green algae, 185-186 Body energy, 279-280 Boerhaavia diffusa, 73t, 76t Bogbean, 197t, 344 Böhme, Jakob, 39 Boldine, 176f Boldo leaf, 191t, 197t Boneset, 346, 493-494 Borage, 197t Borago officinalis, 197t Boswellia (Boswellia serrata) anti-inflammatory uses of, 71, 326, 344 arthritis treated with, 495 asthma treated with, 370, 495 Ayurvedic uses of, 73t, 76t brain tumors treated with, 495 constituents of, 73t description of, 494-496 dosage of, 496 neurologic cancers treated with, 302 oleo-resin boswellia from, 60 ulcerative colitis treated with, 495 Boswellic acid, 494f Botanic Medicine, 42 Botanical medicine description of, 126 Flexner report’s effect on, 43 labeling of, 131 skepticism regarding, 121-133 Botanical Safety Handbook, The, 206 Bourgelat, Claude, 41 Brahmi drug interactions with, 197t thyroid gland effects of, 323 Brassica spp., 198t Brassinosteroid, 150 Bromelain, 197t Bronchodilating herbs, 372-373 Broom, 310 Buchu description of, 496-497 diuretic effects of, 376 dosage of, 496-497 drug interactions with, 191t urinary tract asepsis using, 380 Buckthorn, 197t Bufadienolides, 163 Buffering, 125, 183 Bugleweed cardiovascular effects of, 310-311 description of, 497-498 dosage of, 498 drug interactions with, 197t thyroid gland effects of, 323

690

INDEX

Bulk laxatives, 333 Bupleurum (Bupleurum falcatum) anti-inflammatory uses of, 317 description of, 315, 499-500 dosage of, 499 Burdock antitussive uses of, 369 cancer uses of, 299 dermatologic uses of, 315-316 description of, 345, 500-501 dosage of, 501 drug interactions, 197t Butcher’s broom, 197t Butterbur, 326, 370 Butyrosperumum paradise, 24t Byrd, William II, 42 C Cabalonga tree, 7 Cactus, 310 Caffeic acid derivatives, 92 Caffeine, 177f, 187 Calamus, 191t Calamus root, 269t Calcium channel blockers, 195t Calendula (Calendula officinalis) antacid and antiulcer effects of, 325 description of, 501-503 dosage of, 502-503 drug interactions with, 197t mastitis treated with, 368 reproductive cancer treated with, 301 wound healing benefits of, 388 California poppy analgesic uses of, 345, 355 anxiolytic uses of, 350 description of, 504 dosage of, 504 drug interactions with, 197t sedative uses of, 352 Calotropis gigantea, 76t Caltrops. See Tribulus Calvin cycle, 146f, 146-147 Calyx, 156 Camellia sinensis anticancer uses of, 300-301 antiparasitic effects of, 576 antipruritic uses of, 318, 386 description of, 575-577 dosage of, 576 drug interactions, 204t-205t mastitis treated with, 367 oral tumors treated with, 303 topical uses of, 383 Campesterol, 148 Camphor, 190 Camptothecine, 140t Canada, 100

Cancer adaptogens, 297, 307 alteratives, 299, 307 analgesics, 301 antioxidants, 300, 307-308 bladder, 302 colon, 304 essiac, 306-307 fibrosarcoma, 303 gastric, 304 gastrointestinal tract, 303-304 hematopoietic, 304-305 herbal remedies for, 305-306 Hoxsey formula for, 306 immune modulators, 297-299 kidney, 301-302 leukemia, 304 liver, 304 lymphoma, 304-305 mechanisms, 297 myeloma, 304 neurologic, 302 oral, 303-304 osteosarcoma, 302-303 overview of, 296-297 prostate, 302 renal, 301-302 reproductive, 302 reproductive system, 301 respiratory, 301 rhabdomyosarcoma, 303 small cell lung carcinoma, 301 urogenital, 301-302 Canine “itch,” 45 Cannabinoid receptors cytokine mediation of, 93 discovery of, 93 Echinacea and, 93 Cannabinoids, 152 Cannabis (Cannabis sativa) description of, 141 neurologic cancers treated with, 302 Canon of Medicine, 39 Cap fungi, 154, 154b Capsicum (Capsicum spp.) C. annum cardiovascular effects of, 311, 345 Newcastle’s disease treated with, 24t C. frutescens, 24t drug interactions with, 197t Newcastle’s disease treated with, 23, 24t Capsules, 227 Carbohydrates, 146, 160f Carbon dioxide, 147 Carbon-linked reactions, 145-146 Cardamom oil, 331 Cardenolides, 163, 625f

Cardiac glycosides description of, 163, 164b in digitalis, 186 herb interactions with, 194t parasite control using, 10 Cardioactive herbs, 310-311 Cardiomyopathy dilated cardiomyopathy, 312-313 hypertrophic, 313-314 Cardioprotective herbs, 309-310 Cardiotonic herbs, 309-310 Cardiovascular system antiarrhythmics, 312 circulatory stimulants, 311, 345346 congestive heart failure, 309 description of, 309 Carica papaya, 202t Carminatives Ayurvedic, 67 gastrointestinal uses of, 330-331 Carob gum, 160f Carotenes, 150 Carotenoids description of, 146-147 function of, 150 Carprofen, 13 Carrageenan gum, 197t Carthamus tintorius, 203t Carum copticum. See Trachyspermum ammi Caryophyllene, 515f Caryophyllus aromaticus, 80t Cascara, 197t, 215, 269t, 504-505 Cashew nut rind juice, 385 Cassia spp. C. angustifolia, 334 C. didymobotrya, 24t, 25t C. sieberiana, 24t C. tora, 23, 24t Castor oil, 197t Castor-aralia tree, 197t Cat(s) antitussive activity in, 501 diarrhea in, 337 megacolon in, 336 salicylates and, 190b Cataplasm, 382b Catarrh, 373 Catarrhal gingivitis, 339 Catha edulis, 187, 201t Catharanthus roseus antihyperglycemic effects of, 322 description of, 145 drug interactions with, 202t Cathartics, 220 Catnip, 197t, 349 Cat’s claw description of, 505-507 dosage of, 506 drug interactions with, 197t

INDEX

Cat’s claw—cont’d lymphoma/lymphosarcoma treated with, 305 Cattle. See also Dairy cows constipation in, 336 diarrhea in, 45 Caulophyllum thalictroides drug interactions with, 197t uterine effects of, 364 Causeae et Curae, 38 Cayenne antipruritic uses of, 386 drug interactions with, 197t Ceanothus americanus, 373 Cedrus deodara, 444 Celery diuretic effects of, 346, 376 drug interactions with, 197t Centella asiatica antacid and antiulcer effects of, 326 anti-inflammatory uses of, 317 description of, 73t, 76t, 315, 567570 drug interactions with, 200t lymphoma/lymphosarcoma treated with, 305 nervine uses of, 350 periodontal disease treated with, 339 wound healing benefits of, 388 Center for Veterinary Medicine, 101 Central America, 42 Centrosome, 144f Cerebrovascular accident, 362 Cereus, 198t Certificate of analysis, 107, 110f Cetraria islandica drug interactions with, 201t respiratory uses of, 372 Chaff-flower. See Achyranthes aspera Chakras, 64 Chamaelirium luteum, 364 Chamaemelum nobile, 203t Chamomile antacid and antiulcer effects of, 325 anti-inflammatory uses of, 326 antimicrobial uses of, 329 antipruritic properties of, 317-318 antispasmodic uses of, 330-331 anxiolytic uses of, 351, 508 bile flow affected by, 331 description of, 507-510 diarrhea treated with, 336-337 dosage of, 509 drug interactions with, 198t goats’ milk and, 508 hepatic effects of, 333 kidney function effects of, 378

Chamomile—cont’d mouth lesions treated with, 507508 nervine uses of, 349 sedative effects of, 349, 352 skin inflammation treated with, 508 throat lesions treated with, 507508 wound healing benefits of, 388 Chamomilla recutita, 198t Chan su, 198t Chaparral, 186, 198t, 329 Charak Samhita, 60 Chard, 198t Chaste tree anticancer uses of, 301 description of, 510-512 dosage of, 511 drug interactions, 198t ectoparasiticidal uses of, 383 hyperadrenocorticism in horses treated with, 511 milk production affected by, 363 premenstrual syndrome treated with, 362, 510-511 Chaulmoogra, 383 Chavanprash, 68 Chelidonium (Chelidonium majus), 325, 384, 388 Chelone (Chelone glabra), 387 Chemical medicine, 41 Chemotherapeutic agents, 308 Chichorium intybus, 198t Chickens, 467 Chickweed, 512-513 Chicory, 198t Chimpanzees, 8-9 China description of, 100 Shen Nong Ben Cao Jing, 34 Sho-saiko-to, 121 veterinary botanical medicine in, 34 Chinaberry. See Azadirachta indica Chinese cinnamon, 198t Chinese date, 671-672 Chinese herbal medicine. See also Traditional Chinese medicine adulteration concerns, 127-128 Four Examinations listening, 212 looking, 212-213 questioning, 211-212 touch, 213-214 history of, 122-123 inorganic contaminants in, 184 lifestyle factors, 210-211 metaphoric approach to, 210-211 principles of, 210-211 production techniques, 106b

691

Chinese herbal medicine—cont’d tastes in, 215-218 tongue examination, 212-213, 213b Chinese patent medicines, 192 Chinese salvia, 311 Chinese skullcap, 482-483 Chionanthus virginicus, 334, 554-555 Chiretta. See Swertia chirata Chitosan, 198t Chlorophyll, 146-147, 147f Chloroplasts compounds produced by, 146 description of, 143, 144f Cholagogues, 287b, 331, 338 Cholecystitis, 338 Choleretics, 287b, 331, 338 Choleric humor, 278, 279t Cholesterol-lowering herbs, 332 Chondroitin sulfate, 198t Chondrus spp. C. crispus, 372 C. ocellatus, 161 Christian monasteries, 37 Christopher, John, 43 Chromatin, 144f Chromoplasts, 143 Chronic demodectic mange, 319 Chronic obstructive pulmonary disease, 374 Chronic skin disease, 314-315 Chrysanthemum cinerariifolium, 382383 Chuan Xiong, 373, 379 Cichoric acid, 89 Cicuta maculata, 387 Cimicifuga racemosa menopausal symptoms treated with, 362 nervine uses of, 348 spasmolytic uses of, 345 substitutes for, 269t Cinchona bark, 198t Cinchona spp., 198t 1,8-Cineole, 647f Cinnamomum spp. C. aromaticum, 198t C. camphora, 190 C. cassia, 76t, 198t C. zeylanicum, 76t description of, 513-514 Cinnamon, 513-514 Circulatory stimulants, 311, 345-346 Cissus quadrangularis, 24t Citral, 591f Citrus oil, 190 Citrus spp. C. aurantium, 197t C. junos, 26 C. limon, 24t

692

INDEX

Clarke’s rule, 233 Claviceps purpurea, 154 Clay antacid uses of, 10 elephant consumption of, 10 gastrointestinal disorders treated with, 11 health benefits of, 10 plant toxin inactivation using, 11 Cleavers, 316, 514-515 Client education, 456 Clove anesthetic uses of, 352 description of, 357, 515-516, 515517 drug interactions, 198t Clove leaf, 191t Clove oil, 352 Cnicus benedictus, 197t Cnidium, 302 Coagulopathy, 295 Cochane Reviews, The, 95 Cocoa, 198t Code of Hammurabi, 34 Codeine, 140t Codex Alimentarius Commission, 99 Codex de la Cruz-Badiano, 42 Coenzyme Q10, 198t Coffin, Albert, 43 Cognitive dysfunction, 70, 359 Cola (Cola nitida), 198t, 357 Colchicum autumnale, 196t Cold, 57t, 212b, 281t Coles, William, 40, 47-48 Coleus spp. C. barbatus, 553-554 C. forskohlii, 553-554 Colic, 334-335 Colitis Ayurvedic treatments for, 71 herbal treatments for, 335-336 Colleagues, 456 Collinsonia (Collinsonia canadensis) cardiovascular effects of, 310 kidney stones treated with, 377 Colon cancer, 304 Coltsfoot, 198t, 372 Combretum micranthum, 24t, 25t Comfrey antacid and antiulcer effects of, 325, 327 description of, 186, 517-519 mastitis treated with, 367, 518-519 respiratory uses of, 372 Commiphora spp. C. molmol, 172, 202t, 443 C. mukul anti-inflammatory uses of, 344 description of, 73t, 77t, 294, 577-578

Commiphora spp.—cont’d C. mukul—cont’d dosage of, 578 drug interactions with, 200t C. myrrha, 604-605 Companion animals, 101 Complaints definition of, 107 handling of, 106 Complex carbohydrates description of, 159 gel-forming, 161 Compliance Plus, 105, 111 Component, 107 Compost, 240, 242t, 252 Compound Q, 198t Compress, 382b Compresses, 229 Condensed tannins, 165, 167t, 167168 Congestive heart failure, 163, 309, 309t Conium, 387 Conium maculatum, 189t Constipation, 218-219, 336 Consultations, 454 Control number, 107 Convallaria majalis cardiovascular effects of, 310 description of, 189t drug interactions with, 201t Convention on International Trade in Endangered Species description of, 262 endangered medicinal plants, 265269 Conventional medicine, 275-276 Cook, William, 43 Coptis (Coptis spp.) antiarrhythmic effects of, 312 C. chinensis, 312 description of, 300-301, 519-520 dosage of, 520 drug interactions with, 200t Cordyceps (Cordyceps sinensis) adrenal effects of, 320 antidiabetic effects of, 322 cancer uses of, 298 description of, 155, 520-524 dosage of, 522 hematologic and immunologic disorders treated with, 292 kidney function effects of, 378 lymphoma/lymphosarcoma treated with, 305 Coriander (Coriandrum sativum), 77t, 198t Coriolus versicolor, 305 Corn silk, 376-377, 379, 524-525 Cornmint, 191t Corns, 385

Corolla, 156 Corpus hippocraticum, 35 Corticosteroids, 195t Corticotropin releasing hormone, 152 Corydalis (Corydalis spp.) analgesic uses of, 344-345, 354 antacid and antiulcer effects of, 326 anticonvulsant uses of, 356 C. ambigua, 326 C. incisa, 344-345 C. tecumbens, 344-345 C. turtschaninovii, 344-345 C. yanhusuo, 344-345, 354, 356 description of, 525-526 dosage of, 525-526 Costus, 268 Cottage garden design, 239 Couch grass, 376-377, 379-380, 526527 Coughing, 369, 622 Coumestans, 166b Counterirritants, 382b, 385 Cover crops, 252 Cow manure, 242t, 252 Cowhage. See Mucuna spp. Cowitch. See Mucuna spp. Cramp bark antispasmodic uses of, 353, 379 description of, 527-528 dosage of, 527-528 spasmolytic uses of, 345 uterine effects of, 364 Cranberry, 198t, 377, 379-380, 528529 Cranesbill, 327 Cranial cruciate ligament rupture, 346 Crataegus spp. C. laevigata, 579-581 C. oxyacantha cancer uses of, 300 cardiovascular effects of, 309, 311 drug interactions, 201t Crataeva nurvala, 377-378, 659-661 Creams, 227-228 Creatine, 198t Cropping, 250 Crucifer, 198t Cruciferous vegetables, 301 Cucurbita pepo, 363, 379 Culpeper, Nicholas, 40-41 Cultivation, 222, 260, 260t-261t Cumin, 198t Curcuma longa adverse effects of, 654 antacid and antiulcer effects of, 325 antidiabetic effects of, 321

INDEX

Curcuma longa—cont’d anti-inflammatory uses of, 26, 317, 344 Ayurvedic uses of, 69t, 73t, 77t cancer uses of, 300 constituents of, 73t description of, 652-655 dosage of, 654 drug interactions, 205t ethnoveterinary uses of, 653 liver cancer treated with, 304 lymphoma/lymphosarcoma treated with, 305 mastitis treated with, 444 ocular uses of, 653 oral tumors treated with, 303 toxicology of, 654 Curcumin antiangiogenic effects of, 654 chemical structure of, 653f liver cancer treated with, 304 lymphoma/lymphosarcoma treated with, 305 Curly dock, 345 Current good manufacturing practice standards, 107 Curtis, Alva, 43 Cushing’s disease, 324 Cyamopsis tetragonolobus, 200t Cyanogenic glycosides, 164-165 Cydonia vulgaris, 384 Cymbopogon citratus, 201t Cynara scolymus bile flow affected by, 331 description of, 294 hepatic effects of, 332 hypolipidemic effects of, 332 Cynoglossum (Cynoglossum officinale), 387 CYP450 enzymes, 308-309 Cyperus rotundus, 77t Cystitis, 380 Cytisus scoparius, 189t, 204t, 310 Cytokines, 93 D Da Qi, 54t Dadd, G. H., 44-45 Daidzein, 167, 167f Daidzin, 91 Dairy cows description of, 441 digestive problems in, 447 estrus in, 446 fever in, 447, 449-450 inflammation in, 447, 449-450 mastitis in, 367-368, 443-445, 518-519 parasitism in, 441-442

Dairy cows—cont’d phytotherapeutic dosages in, 448t-449t reproduction in, 445-446 Damiana, 198t, 529-530 Damnacanthal, 610 Damp, 57t Dampness, 53, 53b Dan shen angiotensin-converting enzyme inhibitor effects of, 312 antacid and antiulcer effects of, 326 anticoagulant effects of, 312 cancer uses of, 300 cardiovascular effects of, 311 description of, 530-532 dosage of, 531 drug interactions, 198t hematologic and immunologic disorders treated with, 292 hepatic effects of, 332 reproductive uses of, 363 Dandelion antihyperglycemic effects of, 323 bile flow affected by, 331 cancer uses of, 299 description of, 532-534 diuretic effects of, 312, 376 dosage of, 533 drug interactions, 198t pancreatic effects of, 334 Dang Qui, 292, 534-535 Dark Ages, 37-38 Datura stramonium, 189t, 201t, 387 Daucus carota, 205t De Materia Medica, 36 Decoctions, 226-227, 227t Decongestants, 373 Defense compounds, 145, 150-153 Deficiency, 212b Degenerative myelopathy, 359 Delphinium staphisagria linn, 383 Demodectic mange, 319 Demulcents Ayurvedic, 67 definition of, 382b description of, 161 gastrointestinal uses of, 326-327 respiratory uses of, 372 urinary tract, 379 Department of Agriculture, 243 Depolarizing muscle relaxants, 195t Depression, 286, 359 Depuratives, 315-316 Dermatitis, 314, 319 Dermatologic conditions. See also Skin adaptogens, 315 alteratives, 315-316 antiallergy herbs, 316-317

693

Dermatologic conditions—cont’d antipruritics, 317-318 atopy, 319 autoimmune skin disease, 319 Ayurvedic treatments for, 70 chronic demodectic mange, 319 depuratives, 315-316 dermatitis, 319 dry skin or coat, 318-319 eczema, 319 leaky gut syndrome, 314-315, 342 mechanisms of, 314-315 overview of, 314 pyoderma, 320 skin allergies, 319 Detoxification, 153 Devil’s claw anti-inflammatory uses of, 343 description of, 268-269, 535-537 dosage of, 536 drug interactions with, 198t Diabetes mellitus, 324 Diagnosis accuracy of, 456-457 of intoxication, 205 traditional, 276 Diallyl disulphide, 555f Diapedesis, 53 Diaphoretics Ayurvedic, 67 respiratory uses of, 373 Diarrhea, 45, 336-337, 447 Didymocarpus pedicellata, 77t Diet, 8 Dietary fiber, 161 Dietary Supplement Health and Education Act, 101-102, 104, 128, 140 Dietary supplements, 127, 140 Digestive herbs, 283b Digestive system, 238t Digestive weakness, 337 Digitalis cardiac glycosides in, 186 description of, 124 safety of, 186 Digitalis spp., 199t Digitoxigenin, 163f Digoxin, 3, 140t Dihydrotestosterone, 634 Dilated cardiomyopathy, 312-313 Dioscorea villosa analgesic uses of, 355 anti-inflammatory uses of, 344 description of, 269t, 302, 662-664 dosage of, 663 Dioscorides, 36, 60 Diosgenin chemical structure of, 662f description of, 173f osteosarcoma treated with, 302

694

INDEX

Dioxin, 125 Diplorhynchus condylocarpon, 24t Dipteryx spp., 189t, 205t Dispensary, 231 Dispensing description of, 456 equipment for, 455-456 of extracts, 226 of fluid extracts, 226 requirements for, 231 of tinctures, 226 Diterpenoids, 171-172, 172f Diuretics Ayurvedic, 67 description of, 287b, 312, 346 herb interactions with, 194t indications for, 376-377 Doctrine of Signatures, 39-41, 214215 Dog(s) description of, 245 diarrhea in, 337 gastric dilation-volvulus syndrome in, 338-339 health signs in, 282b upper respiratory infection in, 540 Dogbane, 198t Dolichos B, 77t Dong quai description of, 292, 534-535 drug interactions with, 198t kidney function effects of, 379 melanin synthesis affected by, 318 stimulatory effects of, 357 uterine effects of, 364 Dorema ammoniacum, 385 Dose comparing of, 232 formats for, 236 proportionate, 234-235 Doshas characteristics of, 62t combinations of, 63t description of, 61-62 Kapha, 62t, 63, 64b, 278 Pitta, 62t, 62-63, 64b, 278 Vata, 62, 62t, 64b, 278 Dosing description of, 232 drop, 233 guidelines for, 232, 235-236 recommendations for, 232-235 tips for, 236 Dried extracts, 223 Dried herbs, 253, 255 Drop dosing, 233 Drosera (Drosera rotundifolia), 385 Drug(s) adverse reactions to, 184 plants as, 124, 140t Drug approval, 104-105

Drug discovery modern, 88 phytopharmacologic, 88-89 Drug–herb interactions definition of, 193 description of, 184 list of, 193t-205t Dry, 281t Dry coat, 318-319 Dry skin, 318-319 DSHEA. See Dietary Supplement Health and Education Act Dun, Finlay, 46 Durham-Humphrey Act, 105 Dusty miller, 385 Dyers madder. See Rubia cordifolia Dysbiosis, 315 E Ears, 385-386 Ebers Papyrus, 34-35 Echinacea (Echinacea spp.) alkylamides, 93-94 antibacterial uses of, 383-384 cancer uses of, 298-299, 539 cannabinoid receptors and, 93 chemical structure of, 537f dermatologic uses of, 316 description of, 537-542 dosage of, 234, 541 drug interactions with, 199t, 540541 E. angustifolia, 92, 250, 539 E. purpurea, 145, 234, 304, 316, 538 fungal infections treated with, 538 growing of, 239b, 251b harvesting of, 244b hematologic and immunologic disorders treated with, 293 historical context of, 92 immune response enhanced by, 93-94, 295-296, 539-540 lipophilic extract, 92-93 liver metabolism of, 94 maintaining of, 242b preparing of, 244b recent insights regarding, 92-94 standardization of, 222 storing of, 244b substitutes for, 269t upper respiratory infections treated with, 538-540 wound healing uses of, 539 Eclectics, 43-45 Eclipta alba, 77t Ectomycorrhizae, 154 Ectoparasiticidal herbs, 382-383 Eczema, 319 Edwin Smith Papyrus, 34

Elder anticatarrhal uses of, 373 description of, 542-543 dosage of, 543 drug interactions with, 199t Elecampane anthelminthic uses of, 328 cough uses of, 4t description of, 543-544 Elettaria cardamomum, 77t Eleuthero (Eleutherococcus senticosis) description of, 315, 353, 544-546 dosage of, 546 drug interactions, 204t hematologic and immunologic disorders treated with, 292 nervine tonic uses of, 357 stress treated with, 354 Eliminatives cholagogues, 287b, 331, 338 choleretics, 287b, 331, 338 definition of, 286 diuretics, 287b expectorants, 287b laxatives, 287b list of, 287b Elymus repens, 376-377, 379-380, 526-527 Emaciation, 337 Embelia ribes, 72 Emblica officinalis, 73t, 77t Embrocation, 382b Emetic swallow worry. See Tylophora spp. Emmenagogues, 67, 362 Emollients, 161 Encephalitis, 360-361 Endangered medicinal plants in Australia, 265-266 description of, 265 finding of, 271 in United States, 266 Endocrine herbs adrenal activity, 320-321 androgenic activity, 321 antidiabetic activity, 321-322 antigonadotropic activity, 321 antihyperglycemic activity, 322323 description of, 320 thyroid stimulating activity, 323 Endocrinologic disorders hyperadrenocorticism, 324 hyperthyroidism, 324 hypoadrenocorticism, 323-324 hypothyroidism, 324-325 Endomycorrhizae, 154 Endophytes, 155, 156 Endoplasmic reticulum, 144f 2-Ene alkylamides, 94 Enema, 228-229

INDEX

English barberry. See Berberis spp. English Physician, The, 40, 42 English plantain, 372 Enterohepatic recycling, 167 Ephedra description of, 128-129 drug interactions with, 199t E. sinensis, 140 E. sinica, 199t, 373 respiratory uses of, 373 safety of, 186 Ephedrine, 177f, 186 Epicatechin, 575f Epigallocatechin, 575f Epilepsy, 70, 355-356 Equine chronic obstructive pulmonary disease, 374 Equine founder, 45-46 Equisetum arvense, 78t, 201t, 582584 Ergieron canadense, 383 Ergotamine, 154 Eriodictyon californicum, 373, 669670 Escharotics, 382b, 384-385 Eschscholzia californica analgesic uses of, 345, 355 anxiolytic uses of, 350 description of, 504 dosage of, 504 drug interactions with, 197t sedative uses of, 352 Essence, 51-53 Essential oils camphor, 190 citrus oil, 190 definition of, 190 melaleuca oil, 190, 192 sassafras oil, 191t, 192 solubility of, 224 toxic, 190, 191t wintergreen, 191t, 192 Essiac, 306-307 Estragole, 548f Estrogen receptor-α, 150 Estrogen receptor-β agonists of, 167 description of, 150 Estrogens, 195t Estrus, 446 Ethics, 131 Ethnomedicine definition of, 59 World Health Organization statistics about, 59 Ethnoveterinary botanicals administration of, 21 availability concerns, 21 Ethnoveterinary medicine bibliography of, 18-19 case studies of, 21-27

Ethnoveterinary medicine—cont’d codification of, 18 conferences on, 19-20 definition of, 17 educational curricula on, 20 in Europe, 18 evolution of, 18-20 future of, 20-21 goals of, 18 history of, 18, 59 international conferences on, 19 limitations of, 21 literature regarding, 19 nongovernmental organizations involved in, 18-20 poultry-related case studies, 21-27 scientific meetings on, 19 stimuli for development of, 18 veterinary ethnopharmacopoeia, 17 zoopharmacognosy and, 17 Ethylene, 149 Eucalyptus (Eucalyptus globulus), 199t, 444 Eucalyptus oil, 184 Eucommia, 311 Eucommia ulmoides, 311 Eugenia caryophyllata, 80t Eugenol, 170f Eukaryote, 156 Euonymus spp., 189t Eupatorium spp. E. perfoliatum, 346, 377, 493-494 E. purpureum, 200t, 574 Euphorbia spp. E. compositum, 26 E. hirta, 329 E. ingens, 23, 24t E. metabelensis, 24t E. tirucalli, 24t Euphrasia spp. anticatarrhal uses of, 373 description of, 142, 155 E. officinalis, 266-267, 385 E. rostkoviana, 546-547 ocular uses of, 385 Eurixor, 305 EUROPAM, 108 European Agency for the Evaluation of Medicinal Products, 99 European mistletoe, 187 European Scientific Cooperative on Phytotherapy, 95 European Societies’ Cooperation on Phytotherapy, 99-100 European starlings, 12 Evening primrose oil anti-inflammatory uses of, 317 drug interactions with, 199t kidney function effects of, 378

695

Evidence clinical, lack of, 130 levels of, 96 Evidence-based medicine decision making in, 95 history of, 95 phytotherapy and, 95-96 Exaptation, 149t Excess, 213b Expectorants, 67, 287b, 370-372 Extracts alcohol, 224 decoctions, 226-227, 227t dispensing of, 226 dried, 223 fresh plant, 225-226 glycerin, 225 infusions, 226-227, 227t supercritical CO2, 225 vinegar, 225 Eyebright anticatarrhal uses of, 373 description of, 155, 266-267, 546547 Eyes, 385 F Facial paralysis, 360 False daisy. See Eclipta alba False pregnancy, 368 False unicorn root, 364 Fatty acids, 152t Federal Food and Drug Cosmetic Act, 101 Feline asthma, 70 Feline hyperesthesia syndrome, 360 Feline immunodeficiency virus, 467 Feline leukemia, 466-467 Feline lower urinary tract disease, 381 Feline viral upper respiratory disease, 375 Fennel anti-inflammatory effects of, 449 description of, 547-549 dosage of, 549 drug interactions with, 199t estrogenic effects of, 548-549 gastrointestinal effects of, 548 milk production affected by, 363 reproductive uses of, 362 respiratory effects of, 548 Fennel seed oil, 331 Fenugreek antacid and antiulcer effects of, 326-327 antihyperglycemic effects of, 322 colon cancer treated with, 304 description of, 549-552 dosage of, 551 drug interactions with, 199t

696

INDEX

Fenugreek—cont’d hypocholesterolemic effects of, 332 indications for, 384 kidney stones treated with, 377 osteosarcomas treated with, 302 respiratory uses of, 372 Fertilizers, 242, 242t Ferula foetida, 78t Fever, 447, 449-450 Feverfew anti-inflammatory uses of, 343 description of, 552-553 dosage of, 553 drug interactions with, 199t FFDCA. See Federal Food and Drug Cosmetic Act Fiber, 161 Fibrosarcoma, 303 Ficus spp. F. bengalensis, 196t F. carica, 388 F. gnaaphalocarpa, 24t Figwort, 199t, 388 Filipendula ulmaria, 325, 343, 598599 Finished product quality of, 107 testing of, 109, 111 Fisetin, 166 Fish, anesthesia of, 516 Fish emulsion, 242, 242t Fistula anal, 387 perianal, 337 Fixed oils, 184 Flagellum, 144f Flasks, 231 Flatulence, 337 Flavonoids antioxidant properties of, 166 condensed tannins vs., 167t description of, 150 glycosides and, 162 herbs with high levels of, 166b nontoxic nature of, 167 pharmacokinetics of, 167 proanthocyanidins vs., 167t properties of, 167t structure of, 165-166 vitamin C and, 166 Flavonoligans, 166b Flax, 176 Flaxseed anticancer uses of, 301 drug interactions, 199t reproductive cancer treated with, 301 Flaxseed oil, 176-177 Fleabane, 383 Fleas, 382 Flexner report, 43

Flies, 382 Floral diagram, 142, 143f Floras, 142-143 Fluid extracts definition of, 223b dispensing of, 226 preparing of, 224-225 Fly Agaric mushroom, 151-152 Foeniculum vulgare description of, 78t, 547-549 dosage of, 549 drug interactions with, 199t estrogenic effects of, 548-549 gastrointestinal effects of, 548 milk production affected by, 363 respiratory effects of, 548 Fomentation, 382b Food allergies, 314 Food and Drug Administration description of, 101, 104 ephedra ban by, 128 website of, 206 Food intolerance, 314 Food supplements, 126 Forskohlii, 311, 553-554 Forskolin, 172f Fossil diatom, 252 Fowlpox, 22 Foxglove drug interactions with, 199t historical uses of, 124 toxicity of, 3 Fractures, 347 Frangipani, 199t Frangula purshiana, 197t, 215, 269t, 504-505 Fraxinus spp., 383 Fresh plant extracts, 225-226 Fresh plant tinctures, 226 Fringe tree, 334, 554-555 Fuchs, Loenhart, 39 Fucus spp. drug interactions, 199t F. vesiculosis antacid and antiulcer effects of, 327 description of, 491-492 dosage of, 492 thyroid gland effects of, 323 Fumaria parviflora, 328, 443 Fumitory, 328 Functional medicine, 155 Fungi cap, 154, 154b endophytes, 155 life cycle of, 155 medicinal, 154-155 pharmacologic products made from, 154 polysaccharide-rich, 162b Fusarium head blight, 153

G Galactagogues, 363 Galega officinalis drug interactions with, 200t milk production affected by, 363 Galen, 36-37 Galenical extract, 223b Galium aparine, 514-515 Gallbladder description of, 55-56 disorders of, 337-338 Gallium aparine, 316 Gamma-aminobutyric acid, 152 Ganoderma lucidum, 203t Garden. See Herb garden Garden bed, 240-241 Garden nightshade. See Solanum spp. Garlic adverse effects of, 557-558 alliin composition, 109 anticoagulant effects of, 312 anthelminthic uses of, 328 antihyperlipidemic effects of, 293 antimicrobial uses of, 557 antiprotozoal uses of, 329, 556557 avian influenza treated with, 25 Ayurvedic use of, 69t, 73t-74t cardiovascular effects of, 311 constituents of, 73t contraindications, 557 description of, 555-559 dosage of, 558 drug interactions with, 199t harvesting of, 109 hypolipidemic effects of, 332, 556 kidney cancer treated with, 302 National Animal Supplement Council adverse event reporting system report for, 111, 112f-113f Newcastle’s disease treated with, 23t, 25t oral tumors treated with, 303 pulmonary vascular responses to, 556 quality control for, 108-109 reproductive cancer treated with, 301 safety of, 186-187 toxicology of, 557-558 Gas retention, 447 Gastric cancer, 304 Gastric ulcers, 343 Gastritis, 338 Gastrodia (Gastrodia elata), 356 Gastroenteritis, 338 Gastrointestinal disorders Ayurvedic treatments for, 71 cholecystitis, 338

INDEX

Gastrointestinal disorders—cont’d clay ingestion for, 11 colic, 334-335 colitis, 335-336 constipation, 336 diarrhea, 336-337 digestive weakness, 337 emaciation, 337 flatulence, 337 gallbladder disorders, 337-338 gastric dilation-volvulus syndrome, 338-339 gastric ulcers, 343 gastritis, 338 gastroenteritis, 338 giardia, 339 gingivitis, 339 halitosis, 339 hepatitis, 341 inflammatory bowel disease, 339340 intestinal ulcers, 343 irritable bowel syndrome, 340 liver hypofunction, 341 mechanisms of, 325-334 overview of, 325, 334 parvovirus, 341 perianal fistula, 337 periodontal disease, 339 stomatitis, 342 ulcers, 343 vomiting and nausea, 343 Gastrointestinal tract cancers, 303304 Gaultheria procumbens, 205t Gel-forming complex carbohydrates, 161 Gelidium spp., 196t Gelsemium (Gelsemium sempervirens) analgesic uses of, 355 anticonvulsant uses of, 355 antipruritic uses of, 386 General anesthetics, 195t Generally recognized as safe, 101, 103, 114-118 Genetically modified crops, 155-156 Genipa americana, 199t Genipap, 199t Genistein, 167, 167f Genkwanin, 631f Gentian (Gentiana lutea), 170, 330 Gentiopicroside, 170f Geophagy, 10-11 Geranium maculatum, 327, 383 Geriatrics, 70 Germander, 187 Germany, 126 Giardia, 70, 339, 601 Gigartina mamillosa, 197t

Ginger androgenic effects of, 321 antidiabetic effects of, 322 antiemetic uses of, 328-329, 560 antifilarial activity of, 560 anti-inflammatory uses of, 344 anxiolytic uses of, 351 cancer uses of, 300 description of, 559-562 dosage of, 561 drug interactions, 199t heartworms treated with, 313 oral tumors treated with, 304 Gingerol, 559f Gingivitis, 339 Ginkgo (Ginkgo biloba) adrenal effects of, 321 anxiolytic uses of, 351 cancer uses of, 300 cognitive enhancement uses of, 356, 563 contraindications, 185 description of, 88, 562-564 dosage of, 563-564 drug interactions, 200t nervine uses of, 358 oral tumors treated with, 303 platelet-activating factor affected by, 300 respiratory uses of, 370 Ginkgolides, 309-310, 562f Ginseng American, 200t, 262, 267-268, 292 antiemetic uses of, 328 antihyperglycemic effects of, 322 Asian adrenal effects of, 320 antidiabetic effects of, 321 anxiolytic uses of, 351-352 cancer uses of, 298 description of, 353 drug interactions with, 200t gastrointestinal tract cancers treated with, 303 hair growth promoted using, 318 hematologic and immunologic disorders treated with, 291292 hepatic effects of, 332-333 stimulatory effects of, 357 colon cancer treated with, 304 description of, 125, 127 Korean, 267-268 polysaccharides, 293 red, 267-268 Siberian description of, 353, 544-546 dosage of, 546 drug interactions, 204t stress treated with, 354

697

Globe artichoke bile flow affected by, 331 description of, 294 hepatic effects of, 332 hypolipidemic effects of, 332 Globularia, 200t Globularia alypum, 200t Glucans, 151 Glucobrassicins, 165 Glucosamine, 200t Glucosinolates, 165 Glucuronic acid, 160f Glutamine, 152t Glutathione, 153 Glutathione-S-transferase, 165 Glycerin extracts, 225 Glycerin tinctures, 230 Glycerites, 225 Glycerol, 333 Glycetracts, 225 Glycine max, 204t Glycoproteins, 92 Glycosides anthraquinone, 164, 164b cardiac description of, 163, 164b in digitalis, 186 herb interactions with, 194t parasite control using, 10 cyanogenic, 164-165 definition of, 184 description of, 162 diversity of, 162 flavonoids and, 162 hydrolysis of, 163 in Panax ginseng, 163 pharmacokinetics of, 163 saponin, 173, 174b solubility of, 224 Glycowithanolides, 348 Glycyrrhetinic acid, 173f, 593 Glycyrrhiza spp. G. glabra adrenal effects of, 320-321 antacid and antiulcer effects of, 325-327 antiallergy uses of, 316 anti-inflammatory uses of, 317 antispasmodic uses of, 331 antitussive uses of, 369 description of, 73t, 78t, 163, 315, 592-595 dosage of, 594 drug interactions with, 201t expectorant uses of, 371 kidney function effects of, 378379 mastitis treated with, 444 respiratory uses of, 370 G. uralensis, 161 Glycyrrhizic acid, 127

698

INDEX

Glycyrrhizin, 592f Gnaphalium (Gnaphalium polycephalum), 383 Goat’s rue drug interactions with, 200t milk production affected by, 363 Goldenrod, 200t, 380, 564-565 Goldenseal antiarrhythmic effects of, 312 anticatarrhal uses of, 373 antidiabetic effects of, 321-322 anthelminthic uses of, 328 bile flow affected by, 331 description of, 3, 262, 565-567 diarrhea treated with, 336 dosage of, 567 drug interactions, 200t growing of, 251b ocular uses of, 385 otitis media treated with, 385-386 stomatitis treated with, 386 wound healing benefits of, 388 Goldthread, 3, 200t, 269t Golgi apparatus, 144f Gomisin A, 635f Gomisin G, 635f Gonadorelin, 445 Good agricultural and collection practices, 100 Good manufacturing practices, 100, 106, 221-222 Gossypium spp., 200t Gossypol, 200t Gotu kola antacid and antiulcer effects of, 326 anti-inflammatory uses of, 317 description of, 73t, 76t, 315, 567570 dosage of, 569 drug interactions with, 200t lymphoma/lymphosarcoma treated with, 305 nervine uses of, 350 wound healing benefits of, 388 Gracilaria spp., 196t Graduated cylinder, 455-456 Grapes, 200t, 570-574 Grapeseed, 301, 570-574 Grass, 12 Gravel root, 200t, 574 Gravelroot, 377 Greater celandine, 325 Green chiretta Creat. See Andrographis Green tea anticancer uses of, 299, 301 antiparasitic effects of, 576 antipruritic uses of, 318, 386 description of, 299, 575-577 dosage of, 576

Green tea—cont’d drug interactions, 204t-205t mastitis treated with, 367 oral tumors treated with, 303 topical uses of, 383 Grete Herball, 40 Grifola frondosa, 596-597 Grindelia (Grindelia squarrosa), 371, 373 Gu Qi, 54t Guaiacum (Guaiacum officinale), 344 Guan Mu Tong, 363 Guar gum, 200t Guarana, 129, 187, 200t Guava, 200t Guggul anti-inflammatory uses of, 344 description of, 73t, 77t, 294, 577578 dosage of, 578 drug interactions with, 200t Guggulsterone-Z, 577f Gugulipid, 294 Guibourtia coleosperma, 24t Guidelines for Good Agricultural Practice of Medicinal and Aromatic Plants, 108 Gulancha tinospora, 80t Gum, 161, 172 Gut inflammation, 314 Gymnema (Gymnema sylvestre), 73t, 78t, 322, 578-579 Gynocardia (Gynocardia odorata), 383 Gynoecium, 156 H Hair growth, 70, 318 Halitosis, 339 Halloysite, 10 Hallucinogens, 151, 152f Hamamelis virginiana, 205t, 383, 386, 666-668 Han Dynasty, 35 Harpagophytum procumbens anti-inflammatory uses of, 343 description of, 268-269, 535-537 dosage of, 536 drug interactions with, 198t Harpagoside, 535f Harvesting of herbs, 243-244 of medicinal plants, 253, 262 Harvey, William, 41 Hawkweed, 385 Hawthorn cancer uses of, 300 cardiovascular effects of, 309, 311 description of, 579-581 drug interactions, 201t Health risks, 128

Heart, in traditional Chinese Medicine, 54-55 Heartsease, 316 Heartworm disease, 313 Heat, 57t, 212b, 281t Hedeoma pulegiodes, 192 Hedera helix drug interactions with, 201t ectoparasiticidal uses of, 383 expectorant uses of, 371 Hedonic feedback, 7-8, 13-14 Hedysarum coronarium, 442 Heinz body anemia, 184 Heliotropium spp. H. europaeum, 189t H. indicum, 26 Helixor, 305 Hellebore, 201t Helleborus niger, 197t Helonias, 269t Hematologic disorders adaptogens, 291-292 anticoagulant herbs, 292 antihyperlipidemics for, 294 antiinflammatory herbs, 292 blood tonics, 292 description of, 291 hemostatics, 294 herbs for, 291-293 immune modulators, 292 medicinal fungi, 293 Hemidesmus (Hemidesmus indicus), 293, 318 Hemlock, 10, 184 Hemostatics, 294, 382b, 384 Henbane, 201t, 387 Hepatic conditions, 71 Hepatitis, 341 Hepialus americanus, 155 Herb(s) actions of, 283, 284t-285t active constituents of, 183-185 Ayurvedic, 59-60, 69t, 73t-81t combinations of, 125 commonly used, 184-185 complexity of, 1-3, 88-89 constituents of, 183-185 definition of, 183 dried, 223, 253, 255 energetics of, 38t harvesting of, 243-244 high-quality, 250 historical uses of, 125 indirect risks, 130 marketing of, 126-127, 140 mixing with food, 283 philosophies regarding use of, 44 pregnancy contraindications, 365b-366b prescribing of. See Herbal medicine prescribing

INDEX

Herb(s)—cont’d quality control for, 126-127 reactions to, 129-130 reasons for using, 1 solubility of, 224t sources of, 222 stability of, 230 standardization issues for, 127, 255 storing of, 243-244 synergistic effects of, 3 toxicity of, 126, 184 treatment approach offered by, 34 US Pharmacopoeia, 223b variability of, 221 Herb farm cropping, 250 high-quality herbs, 250 issues for growers, 250 sustainable, 249-250 Herb garden air circulation, 240 animal-friendly, 244-245 community resources for, 243 compost, 240, 242t, 252 cottage design, 239 fertilizers, 242, 242t harvesting, 243-244 organic, 242-243 planting of, 240-241 resources for, 243, 246-247 seeding, 241 soil, 239-240, 242t sunlight, 240, 241t water, 240 Herb pills, 227 Herba spp., 205t Herbal baths, 228 “Herbal Ectasy,” 129 Herbal formulas, 3 Herbal medicine barriers to, 453 case selection, 454-455, 455b client education about, 456 clinical evidence regarding, 130 consultations, 454 conventional pharmacology vs., 183 current practice of, 132 definition of, 121, 183 description of, 1, 33, 209 in 18th century, 42 equipment necessary for, 455-456 Flexner report’s effect on, 43 forms of, 223-226 fungi use in, 154-155 in Germany, 126 historical uses of, 121-124 international use of, 4 knowledge necessary for, 141

Herbal medicine—cont’d labeling of, 131, 456 learning about, 454 mechanism of action, 126 origins of, 33 patent protections, 130 philosophies of use, 44 popularity of, 132 pricing for, 454 “Quack’s Charter, The,” 41 reasons for using, 453 recordkeeping, 456-457 regulation of, 41 skepticism regarding, 121-133 summary of, 4 support for, 454 systematic reviews of, 130 in 20th century, 44 for veterinarian, 255 World Health Organization guidelines, 262 Herbal medicine prescribing case study of, 290 description of, 125-126 diagnostic benefits of, 282 humoral theory, 278-279 orthodox medicine vs., 275-276 practices for, 218-219 traditional approaches to, 276-280 traditional Chinese Medicine, 277-278 Herbal practitioners, 126 Herbal prescriptions, 125-126, 126t Herbal products adulteration of, 127-128, 192-193, 266t quality of, 108-109, 114 safety issues, 128-130 selection of, 114 standardization issues, 127 testing of, 109 Herbal simples, 3 Herbal specifics, 3, 4t Herbal teas, 226, 245t Herbal vapor, 229 Herbalism, 125-126, 246 Herball or Generall Historie of Plantes, The, 40 Herbicidal resistance, 153 HerbMed, 206 Heroic medicine, 42-44 Herxheimer reaction, 280b Hesperidin, 166-167 Hesperitin, 26 Heuchera (Heuchera americana), 383 Hibiscus esculentus, 384 Hieracium venosum, 385 “Hippiatrika,” 35 Hippocrates, 35, 124 H5N1, 25

699

Hohenheim, Phillipus Theophrastus Bombastus von. See Paracelsus Holarrhena antidysenterica, 73t Holistic veterinary framework herbal actions, 283, 284t-285t overview of, 280-281 patient, 281-282 prescription, 282-283 Holotrichia koraiensis, 155 Holy basil. See Ocimum spp. Home Doctoring for Animals, 46 Homology, 148-149, 156 Honeybees, 516 Hops drug interactions with, 201t nervine uses of, 348 sedative uses of, 352 Horehound, 201t, 581-582 Horse(s) chronic obstructive pulmonary disease in, 374 grass sickness in, 466 hyperadrenocorticism in, 324 stress in, 361-362 Horse chestnut, 201t Horseradish, 191t, 201t Horsetail, 201t, 582-584 Houttuynia cordata, 368 Hoxsey formula, 306 Huang Di Nei Jing, 215 Humoral theory, 278-279 Humors, 35, 39 Humulus lupulus drug interactions with, 201t nervine uses of, 348 sedative uses of, 352 Huperzine A, 140t Hydrangea (Hydrangea arborescens), 377 Hydrastine, 176, 565f Hydrastis canadensis antiarrhythmic effects of, 312 anticatarrhal uses of, 373 antidiabetic effects of, 321-322 anthelminthic uses of, 328 bile flow affected by, 331 characteristics of, 267 description of, 3, 262, 565-567 diarrhea treated with, 336 dosage of, 567 drug interactions, 200t growing of, 251b ocular uses of, 385 otitis media treated with, 385-386 stomatitis treated with, 386 wound healing benefits of, 388 Hydrocolloid gel, 161 Hydrolyzable tannins, 167-168 Hydrophilic compounds, 145b Hydrophobic compounds, 145b

700

INDEX

11β-Hydrosteroid dehydrogenase, 321 Hygrophilia auriculata, 196t Hyoscyamine, 175f Hyoscyamus niger, 189t, 387 Hyperactivity, 360 Hyperadrenocorticism, 324, 511 Hyperforin, 2, 188, 643f Hypericin description of, 1-2, 91 drug interactions with, 129 Hypericum perforatum active constituents of, 1-3, 2t, 188 analgesic uses of, 345, 355 anticonvulsant uses of, 355 antidepressant uses of, 354 anxiolytic uses of, 350 cognitive enhancement uses of, 356 contraindications, 185 description of, 642-644 drug interactions, 204t epilepsy treated with, 355 kidney cancer treated with, 302 safety of, 188 stress treated with, 354 wound healing benefits of, 388 Hyperin, 2 Hyperlipidemia, 295 Hypertension, 313 Hyperthyroidism description of, 324 drugs for, 195t Hypertrophic cardiomyopathy, 313314 Hypnotics, 194t, 352 Hypoadrenocorticism, 323-324 Hypocholesterolemia, 332 Hypocotyl, 156 Hypocotyle, 145 Hypolipidemia, 332 Hypotensives, 311-312 Hypothalamic-pituitary-axis, 353 Hypothyroidism, 71, 195t, 324-325 Hyssop drug interactions with, 191t respiratory uses of, 373 I I3, 1 Iboga, 201t Iboza multiflora, 24t Iceland moss drug interactions with, 201t respiratory uses of, 372 II8-biapigenin, 1 Ilex paraguariensis, 202t “Illness response behavior,” 11 Immune deficiency, 295-296 Immune function, 70, 73 Immune response, 93-94

Immune system description of, 238t herbs that affect, 295, 307 Immune-mediated hemolytic anemia, 70 Immune-modulating herbs autoimmune diseases treated with, 320b cancer treated with, 297-299 dermatologic uses of, 318 hematologic disorders treated with, 292-293 Immunostimulants, 195t Immunosuppressives, 195t, 295-296 Impatiens balsamifera, 387 Incontinence, 381 Indian bedellium Guggul. See Commiphora spp. Indian coral powder, 78t Indian gooseberry. See Emblica officinalis Indian long pepper, 305 Indian madder. See Rubia cordifolia Indian olibanum tree. See Boswellia Indian pennywort. See Centella asiatica Indian pipe, 345 Indian snakeroot, 201t Indigenous Knowledge and Development Monitor, 19 Indirect risks, 130 Indole alkaloids, 175b Indole-3-carbinol, 165, 165f Infection, 296 Infertility, 367 Inflammation, 447, 449-450 Inflammatory bowel disease aloe for, 466 Ayurvedic treatments for, 71 causes of, 340 herbal treatments for, 339-340 Inflorescences, 143 Infused oils, 227 Infusions, 226-227, 227t Insects parasite control in, 9-10 plants and, relationship between, 150 Insomnia, 360 Institute for Nutraceutical Advancement, 109 Institute of Medicine, 129 Interleukin-2, 148 Intermediate filaments, 144f International Code of Botanical Nomenclature, 141 Internet databases, 94b herbal information resources, 206 research on, 94-95 Interstitial cystitis, 381

Intervertebral disk disease, 360 Intestinal ulcers, 343 Intoxication description of, 184 diagnosis of, 205 information sources regarding, 206 treatment of, 206 Inula (Inula spp.) antihyperglycemic effects of, 322 I. glomerata, 24t I. helenium, 328, 543-544 I. racemosa, 322 Ipomoea purga, 189t Iridoid glycosides, 169t, 170 Iris versicolor dermatologic uses of, 316 description of, 345 Irish moss, 372 Irritable bowel syndrome, 340 Iscador, 305 Isoflavones description of, 167 herbs with high levels of, 166b Isoprene, 168 Isoquinoline alkaloids, 175b Isothiocyanate aglycones, 165 Ispaghula, 334 Ivy drug interactions with, 201t ectoparasiticidal uses of, 383 expectorant uses of, 371 J Jamaican dogwood analgesic uses of, 345, 355 sedative effects of, 349, 352 spasmolytic uses of, 353 Japan, 35-36, 100 Jarisch-Herxheimer reaction, 280b Java tea, 201t Jewelweed, 239, 387 Jimsonweed, 201t, 387 Jing-Luo Qi, 54t Joe pye weed, 574 Josselyn, John, 42 Journal of Ethnopharmacology, 94 Juglans nigra anthelminthic uses of, 328 description of, 488-490 dosage of, 489 drug interactions, 197t drug interactions with, 197t heartworms treated with, 313 Jujuboside, 671f Juniper (Juniperus spp.) description of, 215, 584-586 diuretic effects of, 376-377 dosage of, 585 drug interactions with, 201t

INDEX

K Kalopanax pictus, 197t Kapha, 62t, 63, 64b, 67b, 278 Karoo Garden, 258 Kava adverse effects of, 587 anesthetic uses of, 352 anticonvulsant uses of, 355 anti-inflammatory uses of, 377 antispasmodic uses of, 353 anxiolytic uses of, 351 characteristics of, 267 description of, 187, 586-588 dosage of, 587-588 drug interactions, 201t kidney cancer treated with, 302 nervine uses of, 357-358 sedative uses of, 352 Kava lactones, 91 Kavain, 586f Kawaism, 187 Kelp, 201t, 368 Khat, 187, 201t Khaya senegalensis, 24t Kidney(s) cancer of, 301-302 diseases of, 381 herbs that affect, 332-333 in traditional Chinese Medicine, 51-52 Kidney tonics, 378-379 Kigelia spp., 24t King Ashoka, 33, 60 Kneipp, Sebastian, 43 Korean ginseng cognitive enhancement uses of, 356 description of, 267-268 Krameria (Krameria triandra), 384 Kudzu, 201t Kuth, 268 L Labeling, 131, 456 Labrador tea, 383 Lactuca spp. L. sativa, 449 L. virosa, 352 Lactucin, 170f Lady’s slipper, 269t Lagenaria breviflora, 24t Lagerstroemia, 201t Lagerstroemia speciosa, 201t Lamnea acida, 24t Lanatosides, 186 Lanyana, 191t Lapachol, 620f Large intestine, in traditional Chinese Medicine, 53-54, 54t

Larrea spp. L. mexicana, 329 L. tridentate, 186, 198t Laurus nobilis, 196t, 388 Lavender (Lavendula angustifolia) analgesic uses of, 355 anesthetic uses of, 352 antidepressant uses of, 354 antispasmodic uses of, 331 anxiolytic uses of, 350 description of, 588-590 diuretic effects of, 376 dosage of, 589-590 drug interactions, 201t drug interactions with, 201t Laxatives aperients, 333 Ayurvedic, 67 bulk, 333 constipation treated with, 333334, 336 description of, 287b purgatives, 333-334 vegetable oils as, 333 Leaf swallowing, 11 Leaky gut syndrome, 314-315, 342 Ledum spp. L. glandulosum, 383 L. latifolium, 383 Lemon balm antacid and antiulcer effects of, 325 antispasmodic uses of, 331 cognitive enhancement uses of, 356 description of, 590-592 dosage of, 591 drug interactions with, 201t nervine uses of, 349 sedative effects of, 349 thyroid gland effects of, 323 Lemongrass, 201t Lentinula edodes, 204t, 638-640 Leonurus cardiaca cardiovascular effects of, 310, 312 drug interactions with, 202t Leopards bane, 388 Lettuce seeds, 449 Leukemia, 304 Leukotrienes, 151 Levisticum officinale, 202t Levodopa, 140t Levy, Juliette de Bairacli, 44 Libellus de Medicinalibus Indorum Herbis, 42 Liber Simplicis Medicinae, 38 Lichen, 162b Licorice adrenal effects of, 320-321 antacid and antiulcer effects of, 325-327

701

Licorice—cont’d antiallergy uses of, 316-317 anti-inflammatory uses of, 317 antispasmodic uses of, 331 antitussive uses of, 369 cough uses of, 4t description of, 315, 592-595 dosage of, 594 drug interactions with, 201t expectorant uses of, 371 kidney function effects of, 378379 urinary tract demulcent uses of, 379 Licorice root glycyrrhizic acid, 127 respiratory uses of, 370 Life expectancy, 123 Lignans, 176-177 Lignins, 177 Ligusticum spp. L. lucidum, 302 L. vulgare, 386 L. wallichii, 362-363, 373, 379 Lily of the valley antiarrhythmic effects of, 312 cardiovascular effects of, 310 drug interactions with, 201t Limonene, 170f D-Limonene, 190 Linalool, 588f Linden cardiovascular effects of, 312 nervine uses of, 350 Liniments, 228 Linnaeus, 41 τ-Linolenic acid, 199t Linum usitatissimum anticancer uses of, 301 description of, 176 drug interactions, 199t reproductive cancer treated with, 301 Lipid-lowering herbs, 332 Lipids, 177-178 α-Lipoic acid, 196t Lipophilic extract definition of, 92 of Echinacea angustifolia, 92-93 Liquid seaweed, 242, 242t Liquidambar styrachifolium, 387 Listening examination, in Chinese herbal medicine, 212 LIV 100, 201t Liver Ayurvedic herbs for, 71 Echinacea metabolism by, 94 hypofunctioning of, 341 in Traditional Chinese Medicine, 55 Liver cancer, 304

702

INDEX

Lobelia (Lobelia inflata) cough uses of, 4t description of, 187, 269t, 595-596 dosage of, 595-596 expectorant uses of, 370-371 poison ivy and poison oak treated with, 387 respiratory uses of, 373 safety of, 187 wound healing benefits of, 388 Lobeline, 187, 595f Lomatium, 269t Long pepper, 201t Longpepper. See Piper spp. Looking examination, in Chinese herbal medicine, 212-213 Loosestrife, 385 Lot, 107 Lotions, 227-228 Lotus corniculatus, 442 Lousewort, 383 Lovage, 202t Lower urinary tract disorders, 71 Low-molecular-weight terpenoids, 168-171, 169t Lungs, in traditional Chinese Medicine, 53-54, 54t, 56 Lust, Benedict, 43 Lycium barbarum, 202t Lycopersicon esculentum, 304 Lycopus spp. L. europaeus antigonadotropic activity of, 321 cardiovascular effects of, 310311 description of, 497-498 dosage of, 498 drug interactions with, 197t L. virginicus drug interactions with, 197t thyroid gland effects of, 323 Lymphoma, 304-305 Lymphosarcoma, 304-305 Lythrum (Lythrum salicaria), 385 M Ma Huang, 186 Mace, 188 Maceration, 224-225 Madagascar periwinkle, 202t, 322 Mahabharata, 59-60 Mahat, 61 Mahonia aquifolium antiarrhythmic effects of, 312 anti-inflammatory uses of, 317 avian influenza treated with, 26 bile flow affected by, 331 cancer uses of, 299 dermatologic uses of, 316

Mahonia aquifolium—cont’d description of, 269t, 345, 612-613 drug interactions, 202t Maitake, 596-597 Mala, 63 Malva moschata, 326 Mandragora officinarum, 189t Mange, 45, 319 Mangifera indica, 24t, 25t Manure, 242t, 252 Margosa. See Azadirachta indica Marrubium vulgare, 201t, 581-582 Marsh rosemary, 383 Marshmallow, 326-327, 372, 379, 597-598 Mass vaccinations, 21 Master production, 108 Mastitis, 367-368, 443-445, 518-519 Maté, 202t Materia medica, 459-672 in China, 34, 122 definition of, 139 description of, 17 in 18th and 19th centuries, 42 Indian, 60 Matica, 384 Matricaria recutita antacid and antiulcer effects of, 325 antimicrobial uses of, 329 antipruritic properties of, 317318 antispasmodic uses of, 330-331 anxiolytic uses of, 351, 508 bile flow affected by, 331 description of, 171, 507-510 diarrhea treated with, 336-337 dosage of, 509 drug interactions with, 198t goats’ milk and, 508 hepatic effects of, 333 kidney function effects of, 378 mouth lesions treated with, 507508 nervine uses of, 349 sedative effects of, 349, 352 skin inflammation treated with, 508 throat lesions treated with, 507508 wound healing benefits of, 388 Mayapple, 385 Meadowsweet, 325, 343, 598-599 Mechanical scours, 11-12 Medicago sativa, 196t, 464 Medical botany description of, 139-141 elements of, 139 genetically modified crops, 155156 problems associated with, 139-140

Medical botany—cont’d summary of, 156 taxonomy, 141-142 Medical Botany, 139 Medicinal fungi description of, 154-155 hematologic and immunologic disorders treated with, 293 Medicinal plants biodiversity loss, 257-258 conservation status of, 262-263 endangered, 265-269 harvesting of, 253, 262 organic farming of. See Organic farming overexploitation of, 258-259 species of, 257 wildcrafting of, 253 Medicine metaphoric approach to, 210-211 plants as, 121-124 traditional, 139-140 Meeh’s formula, 233-234 Megacolon, 336 Melaleuca alternifolia, 190, 384, 646648 Melaleuca oil description of, 190, 192 toxicosis caused by, 129 Melancholic humor, 278, 279t Melanin, 318 Melatonin drug interactions with, 202t neurologic cancers treated with, 302 Melia azedarach, 383 Melilotus officinalis, 204t Melissa officinalis antacid and antiulcer effects of, 325 antispasmodic uses of, 331 cognitive enhancement uses of, 356 description of, 590-592 dosage of, 591 drug interactions with, 201t nervine uses of, 349 sedative effects of, 349 thyroid gland effects of, 323 Meningitis, 360-361 Mentha pulegium, 192, 202t Mentha X piperita antacid and antiulcer effects of, 325 antispasmodic uses of, 331 cough treated with, 622 description of, 621-624 dosage of, 623 drug interactions with, 203t nausea treated with, 622 Menthol, 621f

INDEX

(−)-Menthol, 170f Menyanthes trifoliata, 197t Mesopotamia, 34 Metabolomics, 155-156 Metastatic inhibitors, 298b Methotrexate, 195t 5-Methoxyhydnocarpin, 3 Methylsulfonyl methane, 104 Methysticin, 355, 586f Metritis, 368, 446 Metronidazole, 601-602 Mexican yam, 344 Mice bitters ingestion by, 9, 13 stress control in, 13 Microcystis aeruginosa, 185 Microfilaments, 144f Microtubules, 144f Milk production, 72, 363 Milk thistle adverse effects of, 602 antacid and antiulcer effects of, 325 anticancer uses of, 300-301, 601 bladder cancer treated with, 302 description of, 599-603 dosage of, 602 drug interactions, 202t hepatic effects of, 332, 600 kidney diseases treated with, 600 lipids affected by, 600-601 metronidazole and, 601-602 pancreatic disorders treated with, 601 toxicology of, 602 Mimosa pudica, 78t Mimulus, 387 Mint, 78t Mistletoe antidiabetic effects of, 321-322 description of, 187 drug interactions with, 202t kidney cancer treated with, 301302 lymphoma/lymphosarcoma treated with, 304-305 nervine uses of, 350 neurologic cancers treated with, 302 Mitchella repens description of, 259 uterine effects of, 364 Mitochondrion, 144f Moist, 281t Momordica charantia description of, 72, 73t, 78t drug interactions with, 197t lymphoma/lymphosarcoma treated with, 305 Monascus purpureus, 293-294 Monkey flower, 387

Monoterpenoids, 168, 169t, 170f Monotropa uniflora, 345 Morinda spp., 202t, 610-611 Mosquitoes, 13 Mossy stonecrop, 385 Mother tinctures, 235 Motherwort cardiovascular effects of, 310, 312 drug interactions with, 202t nervine uses of, 348-349 Mountain ash fruit, 383 Mrig Ayurveda, 60 Mu Xiang, 268 Mucilages description of, 172, 224t gastrointestinal uses of, 326 Mucolytic expectorants, 372 Mucuna spp. M. pruriens, 78t Newcastle’s disease treated with, 24t Mullein auricular uses of, 386 description of, 239, 603-604 dosage of, 604 expectorant uses of, 371 hemorrhoids treated with, 384 respiratory uses of, 372 Mumie, 154 Musa sapientum, 196t Muscle relaxants, 195t Muscular rheumatism, 347 Musculoskeletal disorders antirheumatics for, 342-343 Ayurvedic treatments for, 71 cranial cruciate ligament rupture, 346 fractures, 347 muscular rheumatism, 347 myopathy, 346 osteoarthritis, 346-347 osteochondritis, 347 overview of, 342 pain, 346 panosteitis, 347 patella luxation, 346 rheumatoid arthritis, 347 spondylosis deformans, 347 trauma, 347 Musculoskeletal pain, 346 Mustard, 191t, 385 Mycology, 155 Myeloma, 304 Myelopathy, 359 Myopathy, 346 Myrica cerifera, 196t Myristica fragrans, 72, 78t, 188, 202t Myristicin, 151 Myrobalan. See Terminalia (Terminalia spp.) Myroxylon pereirae, 383

703

Myrrh anti-inflammatory uses of, 344 description of, 73t, 77t, 294, 604605 dosage of, 605 drug interactions with, 200t stomatitis treated with, 386 N N-acylethanolamines, 152 Na+/K+-ATPase pumps, 163 “Nakul Samhita,” 33 Napelline, 185 Nardostachys jatamansi, 73t Naringin, 162f NASC. See National Animal Supplement Council Nasturtium officinale, 205t National Animal Supplement Council adverse event reporting system, 111-114, 112f-113f best manufacturing practice standards, 107 Compliance Plus quality program of, 111 description of, 101, 111 industry participants, 108 members of, 111 mission of, 111 website for, 114 National Center for Complementary and Alternative Medicine, 206 National Institutes of Health, 95 National Organic Standards, 252 National Research Council of the National Academies, 129 “Natural,” 124-125 Natural pesticides, 251 Nausea and vomiting, 343, 622 Nectandra pinchurim. See Cabalonga tree Neem animal feed uses of, 606-607 contraceptive uses of, 607 dental care treated with, 607 description of, 74t-75t, 605-608 diabetes treated with, 607 dosage of, 607 drug interactions, 202t ectoparasiticidal uses of, 383, 606607 ethnoveterinary uses of, 606b immune effects of, 607 oral tumors treated with, 304 pesticide uses of, 252 ulcer healing of, 607 Nei Jing Su Wen, 51, 55, 217 Nematodes, 442 Neo-Thomsonians, 43 Nepalese neem. See Swertia chirata

704

INDEX

Nepeta cataria, 197t, 349 Nerium oleander, 188 Nervines Ayurvedic, 67 classification of, 347-348 definition of, 286-288, 347 dermatologic uses of, 318 description of, 346 list of, 289b relaxants, 347-350 stimulants, 348, 356 tonics, 348, 357-358 Nervous system, 238t Nettle anodyne uses of, 386 anti-inflammatory uses of, 317, 343-344 benign prostatic hypertrophy treated with, 363 corns treated with, 385 description of, 608-610 diuretic uses of, 376 dosage of, 609 hemostatic uses of, 384 stinging, 202t, 383 topical uses of, 383 warts treated with, 385 Nettle leaf allergic rhinitis treated with, 370 antiallergy uses of, 316 Neurologic cancers, 302 Neurologic system, 347-362 Neuromuscular purgatives, 333-334 New animal drug approval, 104-105 New England’s Rarities Discovered, 42 New Zealand, 100 Newcastle’s disease description of, 21-22 ethnoveterinary medicine approaches to, 22-25 seasonality of, 22 viral causes of, 22 NHFC. See Nonhuman food chain Nicotiana glauca, 26 Nicotine, 595f Nicotine adenine dinucleotide phosphate, 145-146 Nigella sativa, 197t, 301, 449 Nitrates, 195t Nitrogen, 151 Nocturnal restlessness, 360 NodG, 150 Nodular worms, 11 Nonconformity, 107 Nongovernmental organizations, 1820 Nonhuman food chain description of, 101, 103 supplements, 104-106 Noni, 202t, 610-611

Nonsteroidal anti-inflammatory drugs, 194t Nor-dihydroguaiaretic acid, 186 Norlupinane alkaloids, 175b Northern fowl mites, 557 Novel ingredient, 101 N-oxide, 174 Nuclear envelope, 144f Nucleolus, 144f Nucleus, 144f Nutmeg Ayurvedic uses of, 78t clinical studies of, 72 drug interactions, 202t safety of, 188 sources of, 188 Nutrigenomics, 155-156 Nutritive tonics, in Ayurveda, 67 Nux vomica seed description of, 235, 447 stimulatory effects of, 357 O Oats, 202t, 611-612 Obsessive-compulsive disorder, 361, 643-644 Ochna pulchra, 24t Ocimum spp. O. bacillicum, 78t O. basilicum, 204t O. gratissimum, 26, 384, 443 O. sanctum, 26, 69t, 203t Octacosanol, 129 Oenothera biennis anti-inflammatory uses of, 317 description of, 177 drug interactions with, 199t kidney function effects of, 378 Oil of wintergreen, 191t, 192 Ointment, 382b Ointments, 228 Okra, 384 Olea europaea, 202t Oleander, 188 Oleoresins, 172 Oligofructose, 202t Olive, 202t Omega-3 fatty acids, 148, 177 Onion, 202t Opioid receptors, 152 Opium poppy, 202t Opportunists, 108 Opuntia spp., 203t Oral contraceptives, 195t Oral tumors, 303-304 Oregano, 191t Oregon grape antiarrhythmic effects of, 312 anti-inflammatory uses of, 317 bile flow affected by, 331 cancer uses of, 299

Oregon grape—cont’d dermatologic uses of, 316 description of, 269t, 345, 612-613 drug interactions, 202t Organ function, 288 Organic farming cover crops, 251 definition of, 251 garden for, 242-243 harvesting, 253 importance of, 251 natural pesticides, 251 organic certification, 252-253 pests, 251 resources for, 254b-255b sustainable, 253 techniques for, 251-252 weed control, 251 Orthosiphon spp., 201t Osha, 269t Osteoarthritis, 71, 346-347 Osteochondritis, 347 Ovary, 142f Oxalate urolithiasis, 377 Oxidation, 150 P Paclitaxel, 172 Paeonia lactiflora, 304 Pain herbal treatments for, 347-362 musculoskeletal, 346 taste(s) and, 215 Palkapya, 33, 60 Panax spp. P. ginseng adrenal effects of, 320 anticancer uses of, 308 antidiabetic effects of, 321 antiemetic uses of, 328 antihyperglycemic effects of, 322 anxiolytic uses of, 351-352 characteristics of, 267-268 cognitive enhancement uses of, 356, 614-615 description of, 163, 353, 613617 diabetes treated with, 615 dosage of, 616 drug interactions, 200t erectile dysfunction, 615 hematologic and immunologic disorders treated with, 291292 hepatic effects of, 332-333 hypolipidemic effects of, 615 immune function affected by, 614 mastitis treated with, 367-368, 444

INDEX

Panax spp.—cont’d P. ginseng—cont’d physical performance effects of, 614 respiratory effects of, 614 stimulatory effects of, 357 veterinary trials of, 615-616 P. quinquefolius antihyperglycemic effects of, 322 characteristics of, 267-268 description of, 262, 353 drug interactions, 200t hematologic and immunologic disorders treated with, 292 history of, 265 nervine uses of, 358 Pancreas, 334 Panosteitis, 347 Pao Zhi, 229-230 Papain, 202t Papaver somniferum, 202t Papaya extract, 202t Paracelsus, 39, 41 Paradisus, 40 Parasites in bears, 11-12 bitter pith for, 9 ectoparasiticidal herbs, 382-383 in insects, 9-10 natural control of, 8 in primates, 8 Parasitism, 441-442 Parkia filicoidea, 24t Parkinson, John, 40 Paroxetine, 3 Parsley description of, 617-619 diuretic effects of, 312, 376 dosage of, 618 ectoparasiticidal uses of, 383 laxative effects of, 334 Partridgeberry description of, 259, 269t uterine effects of, 364 Parvovirus, 341 Passionflower (Passiflora incarnata) anxiolytic uses of, 351, 619 aphrodisiac effects of, 357 central nervous system effects of, 349 description of, 619-620 dosage of, 620 drug interactions with, 202t sedative uses of, 352 Patella luxation, 346 Patents, 130 Pau d’Arco, 202t, 620-621 Paullinia spp. P. cupana, 187, 200t P. sorbilis, 187 P. yoko, 205t

Pausinystalia yohimbe, 189, 205t PC-SPES, 128 P-cymene, 647f Pectorals, 373-374 Pedicularis, 142 Peduncle, 142f Pelargonium zonale, 384 Pennyroyal oil, 184, 191t, 192, 202t Peppermint antacid and antiulcer effects of, 325 antispasmodic uses of, 331 cough treated with, 622 description of, 621-624 dosage of, 623 drug interactions with, 203t nausea treated with, 622 Peramine, 153 Percolation, 224-225 Perianal fistula, 337 Pericardium, 55 Perilla seed (Perilla frutescens), 148, 369-370, 379 Periodontal disease, 339 Peripheral neuropathy, 361 Peripheral resistance, 311-312 Peripheral vasodilators, 311-312 Periploca of the wood. See Gymnema Periwinkle, 203t Peroxisome, 144f Persicaria senegalense, 368 Peru balsam tree, 383 Pessaries, 228 Pesticides, 251 Pests, 251 Petal, 142f Petasites hybridus gastrointestinal uses of, 326 respiratory uses of, 370 Petroselinum crispum description of, 617-619 diuretic effects of, 312, 376 dosage of, 618 ectoparasiticidal uses of, 383 laxative effects of, 334 Peumus boldus, 197t Pharmacodynamic synergy, 3 Pharmacogenomics, 155, 157 Pharmacokinetic synergy, 3 Pharmacy, 231 Pheasant’s eye, 203t Phenethyl isothiocyanate, 165 Phenobarbital, 194t Phenolic resins, 172 Phenylethylisothiocyanate, 165f Phenylpropanoids absorption of, 171 description of, 168-169 herbs with high content of, 170b Phlegm, 53, 53b, 57t, 63, 209 Phlegmatic humor, 278, 279t

705

Phoradendron serotinum, 187 Photosynthesis chloroplasts, 146 phases of, 145-146 Phyllanthus, 203t Phyllanthus spp. drug interactions, 203t P. amarus, 79t P. emblica, 73t, 77t P. niruri, 79t Physica, 38 Physiomedical colleges, 122 Physiomedicalism description of, 279 prescribing practices, 279-280 Physiomedicals, 43 Physostigma mesoponticum, 24t Phytoecdysteroids, 151 Phytoestrogens, 167 Phytol, 146 Phytolacca spp. description of, 188 P. americana, 302-304, 345, 626627 P. decandra, 316 precautions regarding, 306 Phytomedicines, 99 Phytophagous insects, 151 Phytopharmacology description of, 88-89 knowledge gaps in, 91-92 Phytosterols, 148, 173 Phytotherapist, 96 Phytotherapy definition of, 87 description of, 44 evidence-based medicine and, 9596 Picraconitine, 185 Picrorrhiza kurroa, 73t, 79t, 268 Pigs feed efficiency of, 539 immune function in, 539-540 preweaning diarrhea in, 337 Pigweed. See Boerhaavia diffusa Pimpinella anisum adrenal effects of, 321 drug interactions with, 196t hepatic effects of, 333 α-Pinene, 631f Piper spp. P. angustifolium, 384 P. longum description of, 79t drug interactions with, 201t lymphoma/lymphosarcoma treated with, 305 P. methysticum adverse effects of, 587 anesthetic uses of, 352 anticonvulsant uses of, 355

706

INDEX

Piper spp.—cont’d P. methysticum—cont’d antispasmodic uses of, 353 anxiolytic uses of, 351 characteristics of, 267 description of, 187 dosage of, 587-588 drug interactions, 201t nervine uses of, 357-358 sedative uses of, 352 P. nigrum Ayurvedic uses of, 69t, 79t drug interactions, 197t Newcastle’s disease treated with, 24t Pipsissewa, 269t Piscidea erythrina analgesic uses of, 345, 355 sedative effects of, 349, 352 Pitta, 62, 62t, 64b, 67b, 278 Pitta-Kapha, 63b Plant(s) anatomy of, 142-145 biodiversity loss, 257-258 compartments in, 145f constituents of, 222 cultivation of, 222, 260, 260t-261t detoxification, 153 as drugs, 124, 140t energy compounds of, 146 environmental interactions by, 156 exaptation, 149b floras for, 142-143 genetically modified, 155-156 hallucinogens from, 151, 152f herbicidal resistance by, 153 hormone synthesis by, 144-145 hydrophilic and hydrophobic compounds, 145b identification of, 142-143 medicinal products from, 145 as medicine, 121-124 name of, 141 parasite control using, 8-12 pharmaceutical names of, 141 poisonous, 245b stress resistance by, 151 substances synthesized by, 154t taxonomy of, 141-142 topical applications of, 12-13 toxins from, clay ingestion to inactivate, 11 vascular system of, 144 viral diseases in poultry treated with, 27t volatile oils in, 145 whole, 125 wild harvesting of, 259-260, 260t261 Plant blindness, 140

Plant cells animal cells vs., 143b, 144f description of, 143 plasma membrane of, 143 signal transduction in, 143-144 wall of, 143 Plant compounds alkaloids, 174-176, 175b defense, 145, 150-153 diterpenoids, 171-172, 172f endophytic communication, 150 flavonoids. See Flavonoids glucosinolates, 165 glycosides. See Glycosides lignans, 176-177 lignins, 177 lipids, 177-178 microbial associations with, 150 multiple uses of, 149 omega-3 fatty acids, 148 pathogenesis-related proteins, 148 phytosterols, 148 polysaccharides. See Polysaccharides primary, 148, 159 resins, 172, 173b secondary, 148, 159 steroidal saponins, 172-173 synthesis of, 148 triterpenoids, 172-173, 174b waxes, 178 Plant metabolism, 139 Plantago spp. drug interactions, 203t P. lanceolata, 326, 388 P. major, 372, 384, 388, 624-625 P. ovata colitis treated with, 336 description of, 79t laxative effects of, 334 Plantain, 203t, 388, 624-625 Plasmodesmata, 143 Plaster, 382b Plastids, 143 Platelet-activating factor inhibitors, 300 Platycodon grandiflorum, 196t Plectranthus barbatus, 73t, 76t, 311, 553-554 Pleurisy root anticatarrhal uses of, 373 description of, 188, 269t, 625-625 dosage of, 626 drug interactions with, 203t Pliny, 61, 122 Plumeria rubra, 199t Pneumonia, 375 Podophyllotoxin, 176, 178f Podophyllum peltatum, 176, 189t, 385 Poison hemlock, 387 Poison ivy, 387

Poison oak, 387 Poisoning by digitalis, 186 mechanisms of, 184 Poke root, 316, 626-627 Pokeweed description of, 188, 345 oral tumors treated with, 303-304 osteosarcoma treated with, 302303 Pokeweed mitogen, 188 Polygala senega, 371 Polysaccharides administration of, 161 complex, 159, 161 definition of, 159 description of, 92, 159, 161 drug absorption affected by, 161 gastrointestinal uses of, 326-327 gel-forming, 159, 161, 162b herbs with high amounts of, 162b mechanism of action, 161 safety of, 161 solubility of, 224t structure of, 160f Polyterpenoids, 169t Polyuronides, 159 Pomegranate. See Punica granatum Porphyrin, 146 Posology, 232 Postnatal Essence, 51 Potentiation, 235 Potentilla spp. P. erecta, 329 P. reptans, 627-628 P. tormentilla, 327 Poultices, 229, 382b Poultry Astragalus spp. applications, 479 growth of, 522 respiratory signs in, 26, 27t Poultry manure, 242t, 252 Powdered extract, 223b Prakruti, 61 Prana, 61 Pregnancy in dairy cows, 445-446 false, 368 herbs contraindicated during, 365b-366b Prenatal Essence, 51 Prescribing for cancer, 307-309 case study of, 290 description of, 125-126 humoral theory, 278-279 orthodox medicine vs., 275-276 physiomedicalism, 279-280 practices for, 218-219 traditional approaches to, 276-280

INDEX

Prescribing—cont’d traditional Chinese Medicine, 277-278 Prickly ash, 311, 346, 628-629 Prickly pear, 203t Prickly poppy, 385 Primates, 8-9 Primula root (Primula spp.), 371 Privet leaves, 386 Proanthocyanidins, 165, 167, 572 Probenecid, 195t Procyanidin B1, 571f Procyanidin B2, 571f Procyanidin B3, 571f Procyanidin B4, 571f Production batch, 108 Chinese herbal production techniques, 106b master, 108 testing after, 109 Prokaryote, 157 Proportionate dose, 234-235 Prostaglandin F2α, 445 Prostaglandins, 151 Prostate cancer, 302 Protoalkaloids, 174, 175b Protodioscin, 650f Protozoal parasites, 329, 443 Prunasin, 662f Prunus serotina, 369, 661-662 Pseudoalkaloids, 175b Pseudocyesis, 368 Pseudoephedrine, 186 Pseudohypericin, 2-3, 91, 643f Pseudomelanosis coli, 164 Psidium spp., 200t Psoralea carylifolia, 73t Psyllium antibacterial uses of, 384 drug interactions with, 203t laxative effects of, 334 Psyllium blond psyllium. See Plantago spp. Pterocarpus spp. P. marsupium, 73t P. santalinus, 203t Pueraria lobata, 91, 201t Pulegone, 184, 205 Pulsatilla (Pulsatilla vulgaris), 349 Pulse, 213-214, 214b Pulse depth, 214 Pulses, in Ayurveda, 64-65, 65t Pumpkin seed, 363, 379 Puncturevine, 312 Pungent taste, 215b, 216, 218 Punica granatum, 69t, 79t, 339 Purgatives, 67, 333-334 Purine alkaloids, 175b Purusha, 61 Pussy willow, 387

Pygeum (Pygeum africanus), 363 Pyoderma, 320 Pyrethrum, 382-383 Pyridine alkaloids, 175b Pyrrolizidine alkaloids chemical structure of, 517f description of, 174-175, 176b toxicity of, 184 Pyrrolizidine toxins, 128 Pyrus aucuparia, 383 Q Qi, 52-53, 54t, 61 Qimin yaoshu, 122 “Quack’s Charter, The,” 41 Quality assurance, 107, 127 Quality audit, 107 Quality control best manufacturing practices, 106 definitions, 107-108 example of, 108-109 finished product quality, 107 good manufacturing practices, 106 importance of, 105 issues associated with, 105-106 lack of, 126-127 raw materials, 105-106 Quality control procedures, 107 Quality systems requirements, 107 Quantitative analysis, 106 Quercetin, 166, 203t, 564f, 643f Questioning, 211-212 Questioning examination, in Chinese herbal medicine, 211-212 Quillaja saponaria, 371 Quince seed, 384 Quinidine, 11 Quinine chemical structure of, 178f historical uses of, 124 Quinine sulfate, 447 Quinoline alkaloids, 175b R Rafinesque, Constantine, 42 Raphanus sativa, 79t Rasayana herbal therapy, 68 Raspberry drug interactions with, 203t uterine effects of, 364 Rationalism, 35 Rauwolfia serpentina, 79t, 201t Raw materials definition of, 107 laboratory characterization of, 106 quality of, 105-106, 221 sources of, 142, 221 substitution of, 221 toxicity of, 126

707

Reactive oxygen species, 150, 308 Receptacle, 142f Red algae, 162b Red clover dermatologic uses of, 316 drug interactions with, 203t osteosarcoma treated with, 302 prostate cancer treated with, 302 Red ginseng, 267-268 Red root, 373 Red rose, 385 Red sandalwood, 203t Red yeast rice, 293-294 Redgrape, 299-300 5α-Reductase, 150 Regulations definitions, 101 Dietary Supplement Health and Education Act, 101-102, 104, 128, 140 global, 99-101 industry efforts, 104-105 solutions regarding, 105 timeline of, 102b Rehmannia (Rehmannia glutinosa) antiallergy uses of, 317 antihyperglycemic effects of, 323 description of, 161, 292, 315, 629630 hematologic and immunologic disorders treated with, 292 Reishi, 203t Renaissance, 39 Renal cancer, 301-302 Reproductive disorders abortion, 364-365 agalactia, 365 in dairy cows, 445-446 endocrine modulators, 362-363 false pregnancy, 368 infertility, 367 mastitis, 367-368 metritis, 368, 446 overview of, 362 pseudocyesis, 368 vaginitis, 368-369 Reproductive system, 238t Research efficacy and, 89-91 emphasis in, 90b information about, 94-95 overview of, 87-88 quality, 89-91 synergy considerations, 89-91 Reserpine, 140t, 177f Resins description of, 172, 173b, 184 solubility of, 224t Respiratory cancer, 301

708

INDEX

Respiratory disorders allergic bronchitis, 374 antitussives, 369 equine chronic obstructive pulmonary disease, 374 expectorants, 370-372 feline viral upper respiratory disease, 375 overview of, 369 pneumonia, 375 rhinitis, 375 Respiratory system, 238t Retinoic X receptors, 148 Rhabdomyosarcoma, 303 Rhamnus spp. R. frangula, 197t R. purshiana, 197t Rhaponticum carthamoides, 151 Rhatany, 384 Rheum spp. R. officinale, 203t, 334 R. palmatum, 164 Rheumatoid arthritis, 347 Rhinitis, 370, 375 Rhizoma coptidis, 301 Rhodiola (Rhodiola rosea) description of, 292 for hematologic and immunologic disorders, 292 Rhubarb drug interactions with, 203t laxative effects of, 334 Ribes nigrum, 197t Ribosomes, 144f Ribwort, 326 Ricinus communis, 178, 197t Riddelliine, 176f Rig veda, 33 Roast figs, 388 Roman chamomile, 203t Rosa spp. R. damascene, 79t R. gallica, 385 Rosemary (Rosmarinus officinalis) cancer uses of, 300 drug interactions, 203t stimulatory effects of, 357 Rubefacient, 382b Rubia cordifolia, 80t Rubisco, 147 Rubus spp. R. fruticosus astringenic activity of, 327 description of, 490-491 dosage of, 491 drug interactions with, 197t R. idaeus drug interactions with, 203t uterine effects of, 364 R. occidentalis, 303 Rue, 203t

“Rule of three,” 129 Rumex spp. R. acetosella, 299, 637-638 R. crispus, 316, 345, 668-669 Ruminants classification of, 441 dairy cows. See Dairy cows diarrhea in, 447 Ruscus aculeatus, 197t Ruta graveolens, 203t S Sabal serrulata, 204t Saccardo Clavicipitaceae, 155 Sacred basil, 203t S-Adenosylmethionine, 203t Safety adverse reactions and interactions, 129-130 health risks, 128 historical aspects of, 128 indirect risks, 130 legal barriers, 128-129 Safflower, 203t Sage, 203t, 630-632 Saiboku-to, 203t Saint John’s Wort active constituents of, 1-3, 2t, 188 adverse effects of, 644 analgesic uses of, 345, 355 anticonvulsant uses of, 355 antidepressant uses of, 354 anxiolytic uses of, 350 cognitive enhancement uses of, 356 contraindications, 185 description of, 642-645 dosage of, 644 drug interactions, 204t, 644 epilepsy treated with, 355 kidney cancer treated with, 302 monoamine oxidase inhibitors and, 644 obsessive-compulsive disorder treated with, 643-644 safety of, 188 stress treated with, 354 toxicology of, 644 wound healing benefits of, 388 Sairei-To TJ-114, 203t Salicin, 124, 664f Salicylates cats and, 190b pharmacokinetics of, 190b Salicylic acid description of, 124, 149 systemic acquired resistance use of, 151 Salix spp. description of, 188-189 drug interactions with, 205t

Salix spp.—cont’d S. alba, 343, 664-666 S. nigra, 387 S-allylcysteine, 556 Salty taste, 215b, 216 Salve, 382b Salvia spp. S. miltiorrhiza angiotensin-converting enzyme inhibitors, 312 antacid and antiulcer effects of, 326 anticoagulant effects of, 312 cancer uses of, 300 cardiovascular effects of, 311 description of, 530-532 dosage of, 531 drug interactions, 198t hematologic and immunologic disorders treated with, 292 hepatic effects of, 332 reproductive uses of, 363 S. officinalis, 203t, 630-632 Sama, 63b Sambucus spp. S. canadensis, 199t S. nigra anticatarrhal uses of, 373 description of, 542-543 dosage of, 543 drug interactions with, 199t Sambunigrin, 542f Sandalwood. See Santalum album Sanguinaria canadensis auricular uses of, 386 cardiovascular effects of, 311 description of, 251b, 492-493 dosage of, 493 escharotic uses of, 384-385 expectorant uses of, 371 stomatitis treated with, 386 substitutes for, 269t Sanguinarine, 176, 493 Sanguine humor, 278, 279t Santalum album, 80t Saponins description of, 173, 174b solubility of, 224t Sarcoma fibrosarcoma, 303 lymphosarcoma, 304-305 osteosarcoma, 302-303 rhabdomyosarcoma, 303 Sarcopoterium spinosum, 205t Sarothamnus scoparius, 310 Sarsaparilla dermatologic uses of, 316 description of, 345, 632-633 dosage of, 633 drug interactions with, 203t Sarsapogenin, 632f

INDEX

Sassafra, 203t Sassafras albidum, 203t Sassafras oil, 191t, 192 Saussurea spp. S. costus, 268 S. lappa, 262, 268 Savin, 191t Savory, 191t Saw palmetto benign prostatic hypertrophy treated with, 363, 380, 633634 description of, 633-635 dosage of, 634 drug interactions with, 204t prescribing of, 219 wildlife use of, 258-259 Saxifraga ligulata, 80t Schisandra (Schisandra chinensis), 300, 332, 354, 635-637 Science, 87 Scientism, 33, 87 Scopolamine, 140t, 174 Scopolia, 204t Scopolia carniolica, 204t Scotch broom, 204t Scours, mechanical, 11-12 Scrofula, 382b Scrophularia nodosa, 199t, 388 Scutellarein, 641f Scutellaria spp. S. baicalensis antiallergy uses of, 316 anticonvulsant uses of, 355 antispasmodic uses of, 353 anxiolytic uses of, 351 description of, 482-483 dosage of, 482 drug interactions with, 196t nervine uses of, 357 S. lateriflora anticonvulsant uses of, 355 anxiolytic uses of, 351 description of, 640-642 dosage of, 641 drug interactions with, 204t epilepsy treated with, 355 indications for, 350 Scutellarin, 140t Sedum spp., 385 Seizures, 361 Selenicereus grandiflorus cardiovascular effects of, 310 drug interactions with, 198t Self-administration of drugs, 14 Self-medication applications of, 13-14 description of, 7-8 geophagy, 10-11

Self-medication—cont’d hedonic feedback and, 7-8, 13-14 laboratory explorations of, 13 learning and, 14 mechanical scours, 11-12 mechanisms of, 13 parasite control, 8-12 for stress, 13 Self-regulation, 7 Senecio maritima, 385 Senega snakeroot, 204t, 371 Senna, 188, 204t Senna alexandrina, 162 Senna pod, 334 Sennoside A, 91 Sennoside C, 91 Sepal, 142f Serenoa repens benign prostatic hypertrophy treated with, 363, 380, 633634 description of, 633-635 dosage of, 634 drug interactions with, 204t prescribing of, 219 wildlife use of, 258-259 Serpentine root. See Rauwolfia serpentina Sertraline, 3 Sesamum spp. S. angolense, 24t S. indicum, 80t Sesquiterpenoids, 169t, 170-171 Sex hormones, 195t Shalihotra, 33, 60 Shang Han Lun, 215 Shang Non Ben Cao Jing, 215 Shankhapushpi, 204t Shatter stone. See Phyllanthus spp. Sheelajeet, 80t Sheep sorrel, 299, 637-638 Shen, 54 Shen Nong, 34, 215-216 Shen Nong Ben Cao Jing, 34 Sheng xue ling, 296 Shiitake, 204t, 638-640 Shilajeet, 68 Shilajit, 80t, 154 Shook, Edward, 43 Sho-saiko-to, 121 Sho-saiko-To TJ-9, 204t Si Jun Zi Tang, 277 Sialogogues, 329-330 Siberian ginseng description of, 353, 544-546 dosage of, 546 drug interactions, 204t stress treated with, 354 Signal transduction, 143-144 Silibinin, 600f Silver ragwort, 385

709

Silybum marianum adverse effects of, 602 antacid and antiulcer effects of, 325 anticancer uses of, 300-301, 601 bladder cancer treated with, 302 cancer uses of, 300 description of, 599-603 dosage of, 602 drug interactions, 202t hepatic effects of, 332, 600 kidney diseases treated with, 600 lipids affected by, 600-601 metronidazole and, 601-602 pancreatic disorders treated with, 601 toxicology of, 602 Silymarin, 140t Simmondsia chinensis, 178 Simple prescription, 3 Sinapisa spp., 385 Sitosterol, 148, 632 Skin. See also Dermatologic conditions Ayurvedic treatments for, 70 chronic disease of, 314-315 dry, 318-319 Skin allergies, 319 Skullcap anticonvulsant uses of, 355 anxiolytic uses of, 351 description of, 640-642 dosage of, 641 drug interactions with, 204t epilepsy treated with, 355 indications for, 350 Slippery elm antacid and antiulcer effects of, 327 characteristics of, 267 cough uses of, 4t description of, 269t, 642 drug interactions, 204t respiratory uses of, 372 Small cell lung carcinoma, 301 Small intestine, in traditional Chinese Medicine, 54-55 Smilax spp. dermatologic uses of, 316 description of, 345, 632-633 dosage of, 633 drug interactions with, 203t Snakebite, 387 Soap bark, 371 Soft extract, 223b Soil, 239-240, 242t Solanum spp. S. dulcamara, 189t S. lycocarpum, 8 S. nigrum, 80t Solid extract, 223b

710

INDEX

Solidago virguarea, 200t, 380, 564565 Somatic cell count, 443 SOP. See Standard operating procedures Sorbus aucuparia, 383 Sorbus fruit, 383 Sour taste, 215, 215b Southernwood, 191t Soybeans, 204t Sparteine, 177f Spasmolytic herbs, 345 Spasmolytics, 330-331 Specific prescription, 3, 4t Spikenard, 269t Spleen, in traditional Chinese Medicine, 52-53, 53b Splitters, 141 Spondylosis deformans, 347 Sponghel. See Plantago spp. Square root formula, 233 Squill drug interactions with, 204t expectorant uses of, 371 Srotas, 63-64 St. John’s Wort. See Saint John’s Wort Standard operating procedures, 107108 Standardization, 127, 255 Standardized extract, 223b Stasis, 212b Statice caroliniana, 383 Stellaria media, 512-513 Stephania tetrandra, 204t Steroidal saponins, 172-173 Stigma, 142f Stigmasterol, 148 Stimulants Ayurvedic, 67 circulatory, 311, 345-346 drug interactions with, 194t herbs used as, 57 nervine, 348, 356 Stimulating expectorants, 370-371 Stinging nettle, 202t Stomach, in traditional Chinese Medicine, 52-53, 53b Stomachics, 329-330 Stomatitis, 342, 386 Stone breaker. See Phyllanthus spp. Stoneroot, 269t, 377 “Stop sale” orders, 103 Stress adaptogens effect on, 151, 315 description of, 286 herbs for, 354, 361-362 mammal resistance to, 151 plant resistance to, 151 self-medication of, 13 Stroke, 362 Strophanthus, 204t

Strophanthus spp., 204t Strychnos spp. S. nux-vomica, 235, 357 S. potatorum, 24t Style, 142f Styptic, 382b Succi, 227-229 Sulla, 442 Sumerians, 34 Sundew, 269t Supercritical CO2 extracts, 225 Supplements background of, 101-103 consumer questions about, 109 nonhuman food chain, 104-106 quality of, 108-109 regulation of, 101 Suppositories, 228 Sushumna, 64 Swallow wart. See Calotropis gigantea Swartzia madagascariensis, 24t Sweet basil, 204t Sweet bay, 388 Sweet birch, 191t Sweet clover, 204t Sweet gum, 387 Sweet taste, 215b, 216, 218 Sweet wormwood, 645-646 Swertia chirata, 80t Sympathomimetics, 195t Symphytum spp. description of, 186 S. officinalis antacid and antiulcer effects of, 325, 327 description of, 175, 517-519 mastitis treated with, 367, 518519 respiratory uses of, 372 Synadenium volkensii, 24t Synephrine, 140t Synergy bioavailability enhanced by, 91 description of, 3, 91 Syrups, 227 Systemic acquired resistance, 151 Syzgium spp. S. aromaticum anesthetic uses of, 352 description of, 357, 515-516 drug interactions with, 198t S. caryophyllata, 80t S. cumini, 73t Szechuan lovage root, 362-363 T Tabebuia spp., 202t, 620-621 Tabernanthe iboga, 201t Tanacetum spp. T. cinerariifolium, 382-383 T. parthenium

Tanacetum spp.—cont’d T. parthenium—cont’d anti-inflammatory uses of, 343 description of, 552-553 dosage of, 553 drug interactions with, 199t Tannins adaptive taste preferences to, 8-9 alkaloid combinations, 226 condensed, 165, 167t, 167-168 enzymes inhibited by, 168 herbs with high levels of, 168b, 226b hydrolyzable, 167-168 in khat, 187 medicinal uses of, 8 nausea caused by, 168 properties of, 168 solubility of, 224t Tanshinone, 530f Tansy, 191t Tapeworms, 11 Taraxacum officinale antihyperglycemic effects of, 323 bile flow affected by, 331 cancer uses of, 299 description of, 532-534 diuretic effects of, 312, 376 dosage of, 533 drug interactions, 198t pancreatic effects of, 334 Taraxasterol, 532f Tarragon antidiabetic effects of, 321-322 description of, 191t drug interactions with, 204t Taste(s) bitter, 215b, 215-216, 218 combining of, 217-218 importance of, 215-216 pain relief and, 215 pungent, 215b, 216, 218 salty, 215b, 216 sour, 215, 215b sweet, 215b, 216, 218 Taxol, 140t Taxonomy, 141-142 Taxus brevifolia, 172 Tea antipruritic properties of, 318 black. See Black tea drug interactions with, 204t-205t green. See Green tea mastitis treated with, 367 topical uses of, 383 Tea tree, 191t, 384 Tea tree oil, 129, 646-648 Temperament, 278-279 Tephrosia spp. T. purpura, 80t T. vogelii, 24t

INDEX

Terminalia (Terminalia spp.) T. arjuna, 72, 311 T. belerica, 80t T. chebula, 80t Terpenoids low-molecular-weight, 168-171, 169t monoterpenoids, 168, 169t, 170f polyterpenoids, 169t sesquiterpenoids, 169t synthesis of, 168, 169f tetraterpenoids, 169t Terpinene, 647f delta-9-tetrahydrocannabinol, 152 Tetraterpenoids, 169t Teucrium chamaedrys, 187 Textbook of Pharmaceutical Botany, 139 Theatrum Botanicum, 40 Theobroma cacao, 198t Therapeutic efficacy, 89-91 Thevetia peruviana, 205t Thomson, Samuel, 42 Thomsonian movement, 122 Thomsonian System of Practice, 42 Thorny burnet, 205t Thrombocytopenia, 296 Thuja (Thuja occidentalis), 191t, 385, 649-650 Thujone, 649f Thunder god vine, 293 Thylakoids, 146 Thyme (Thymus vulgaris) antimicrobial uses of, 329 antispasmodic uses of, 331 cough uses of, 4t respiratory uses of, 373 Thyme-leaved gratiola. See Bacopa Thyroid-stimulating herbs, 323 Tian Qi, 54t Tilia cordata, 326 Tiluia platyphyllos cardiovascular effects of, 312 nervine uses of, 350 Tinctures advantages of, 224 alcohol-based, 224 dispensing of, 226 fresh plant, 226 glycerin, 230 maceration of, 224-225 mother, 235 percolation of, 224-225 preparation of, 224 strength of, 224 Tinospora spp. T. cordifolia, 80t T. rumphii, 442 Tissue function, 288 Titus, Nelson N., 44 Tomato, 304

Tongue, 212-213, 213b Tonic herbs actions of, 286t Ayurvedic, 67-68 immune system effects, 295 indications for, 285-286 nervine, 357-358 nutritive, 67 rejuvenating, 67-68 renal, 378-379 uterine, 363-364 Tonka, 205t Topical herbs ectoparasiticidal herbs, 382-383 overview of, 381-382 Tormentil antiviral uses of, 329 astringenic activity of, 327 Touch examination, in Chinese herbal medicine, 213-214 Toxemia, 314 Toxicity description of, 184 of guarana, 187 historical aspects of, 128 information sources regarding, 206 of kava kava, 187 species differences in susceptibility to, 184 Trachyspermum ammi, 81t Traditional Chinese Medicine. See also Chinese herbal medicine Ayurveda influences on, 61 bladder in, 52 description of, 33 Ephedra sinensis in, 140 gallbladder in, 55-56 heart in, 54-55 history of, 209-210 kidneys in, 51-52 large intestine in, 53-54, 54t liver in, 55 lungs in, 53-54, 54t, 56 prescribing in, 277-278 principles of, 210-211 small intestine in, 54-55 spleen in, 52-53, 53b stomach in, 52-53, 53b summary of, 56-58 Triple Burner, 55-56 Traditional diagnosis, 276 Traditional medicine, 139-140 TRAFFIC, 265 Trailing eclipta. See Eclipta alba Trans-Tasman Therapeutic Products Agency, 100 Trattinickia aspera, 13 Treatment goals, 282-283 Tribulus (Tribulus terrestris) angiotensin-converting enzyme inhibitor effects of, 312

711

Tribulus (Tribulus terrestris)—cont’d aphrodisiac effects of, 357 cardiovascular effects of, 311 description of, 73t, 81t, 650-652 diuretic effects of, 377 dosage of, 651-652 hypotensive effects of, 651 kidney stones treated with, 378 reproductive uses of, 363 Trichomes, 11, 146f Trichostrongylus spp., 443 Tridosha constitutions from, 63b description of, 61-62 Trifala description of, 68 immune-mediated hemolytic anemia treated with, 70 Trifolium pratense dermatologic uses of, 316 drug interactions with, 203t osteosarcoma treated with, 302 Trigonella foenum-graecum antacid and antiulcer effects of, 326-327 antihyperglycemic effects of, 322 Ayurvedic uses of, 69t, 81t colon cancer treated with, 304 description of, 549-552 dosage of, 551 drug interactions with, 199t hypocholesterolemic effects of, 332 indications for, 384 respiratory uses of, 372 Trikatu, 205t Trillium, 269t, 302 Triphala, 68, 81t Triple Burner, 55-56 Tripterygium wilfordii, 293, 379 Triterpenes, 151 Triterpenoids, 172-173, 174b Triticum aestivum, 336 Troches, 227 Tropane alkaloids, 175b Trophorestorative, 288 Tryptamines, 151, 153f Tryptophan, 151, 152f, 153t Tuberville, George, 40 Tumor necrosis factor-α, 93 Turkey tail mushroom, 305 Turmeric adverse effects of, 654 antacid and antiulcer effects of, 325 antidiabetic effects of, 321 anti-inflammatory uses of, 26, 317, 344 Ayurvedic uses of, 69t, 73t, 77t cancer uses of, 300 constituents of, 73t

712

INDEX

Turmeric—cont’d description of, 652-655 dosage of, 654 drug interactions, 205t ethnoveterinary uses of, 653 ocular uses of, 653 oral tumors treated with, 303 toxicology of, 654 Turnera diffusa, 198t, 529-530 Tussilago farfara, 189t, 198t, 372 Tylophora spp. T. asthmatica, 73t, 370 T. indica, 73t, 81t, 293, 370 Tylostemon spp., 24t Tyrosine, 151, 152f, 152t U Ulcerative colitis, 336, 495 Ulcers, 343 Ulmus spp., 204t U. fulva antacid and antiulcer effects of, 327 characteristics of, 267 cough uses of, 4t description of, 269t drug interactions, 204t respiratory uses of, 372 U. rubra antacid and antiulcer effects of, 327 characteristics of, 267 cough uses of, 4t description of, 269t, 642 drug interactions, 204t respiratory uses of, 372 Uncaria U. rhynchophylla anticonvulsant uses of, 356 cardiovascular effects of, 311312 U. tomentosa description of, 505-507 dosage of, 506 drug interactions with, 197t lymphoma/lymphosarcoma treated with, 305 United States of America, 100-101 Upper respiratory infections, 538540 Urginea maritima drug interactions with, 204t expectorant uses of, 371 Urinary system, 238t Urinary tract antimicrobials, 379-380 antiseptics, 379-380 astringents, 380 Urinary tract disorders bladder stones, 381 cystitis, 380

Urinary tract disorders—cont’d incontinence, 381 interstitial cystitis, 381 overview of, 375-376 urolithiasis, 381 Urogenital cancers, 301-302 Urolithiasis, 381 Uronic acid, 162 Urtica dioica antiallergy uses of, 316 anti-inflammatory uses of, 317, 343-344 benign prostatic hypertrophy uses of, 363, 609 corns treated with, 385 description of, 608-610 diuretic uses of, 376 dosage of, 609 drug interactions with, 202t hemostatic uses of, 384 kidney function effects of, 379 warts treated with, 385 US Pharmacopoeia, 109 US Small Ruminant Collaborative Research Support Project, 18 Uterine astringents, 363 Uterine tonics, 363-364 Uva ursi antidiabetic effects of, 321-322 description of, 655-657 diuretic effects of, 377 dosage of, 656 drug interactions with, 205t melanin synthesis affected by, 205t, 318 urinary tract uses of, 380 V Vaccinations, 21, 467 Vaccinium spp. drug interactions with, 198t V. macrocarpon, 377, 379-380, 528529 V. myrtillus antacid and antiulcer effects of, 325 antihyperglycemic effects of, 322 cancer uses of, 300 description of, 485-486 dosage of, 486 drug interactions, 197t Vacuoles, 143 Vaginitis, 368-369 Valepotriate, 657f Valerian root, 205t Valerian (Valeriana officinalis) antispasmodic uses of, 353 cardiovascular effects of, 311-312, 658-659 description of, 81t, 90, 657-659

Valerian (Valeriana officinalis)—cont’d dosage of, 658, 659 drug interactions with, 205t insomnia treated with, 658 sedative uses of, 350, 352 spasmolytic uses of, 345 stress treated with, 658 Varuna, 659-661 Vasant Lad, 33 Vasodilators, 311-312 Vata, 62, 62t, 64b, 67b, 278 Vata-Kapha, 63b Vata-Pitta, 63b Vegetable oils, 333 Vegetius, 37 Venus fly trap, 269t Veratrum spp. V. album, 383 V. verde, 201t Verbascum spp. V. densiflorum, 371 V. thapsus auricular uses of, 386 description of, 239, 603-604 dosage of, 604 expectorant uses of, 371 hemorrhoids treated with, 384 respiratory uses of, 372 Verbena officinalis, 205t Vernonia spp. V. amygdalina, 9 V. cinerea, 447 Vernonioside B1, 9 Vervain, 205t Vesicant, 382b Vestibular disease, 362 Veterinarian herbal medicine for, 255 word origin of, 36 Veterinary Applied Pharmacology and Therapeutics, 46 Veterinary botanical medicine in Americas, 42 Anglo-Saxon, 37t in antiquity, 33-35 in Central America, 42 in China, 34 controlled trials, 130-131 in Dark Ages, 37-38 in Egypt, 35 in France, 41-42 history of, 33, 44-46, 122 in Japan, 35-36 in Middle East, 39 recommendations for, 131 in Renaissance, 39 renewed interest in, 46-48 in Rome, 36-37 skepticism regarding, 121-133 Veterinary Botanical Medicine Association, 47, 269-270

INDEX

Veterinary ethnopharmacopoeia, 17 Veterinary herbalists, 105 Veterinary International Cooperation on Harmonization, 106 Veterinary Medicines, Their Actions and Uses, 46 Veterinary Posology, 46 Veterinary schools, 44 Viburnum opulus antispasmodic uses of, 353, 379 description of, 527-528 dosage of, 527-528 spasmolytic uses of, 345 uterine effects of, 364 Viburnum prunifolium, 353, 364, 385, 488 Vinblastine, 140t Vinca spp. V. major, 189t V. minor, 189t, 203t V. rosa, 74t Vinegar extracts, 225 Viola tricolor, 316 Virginia snakeroot, 269t Viscum album antidiabetic effects of, 321-322 description of, 187 drug interactions with, 202t eurixor, 305 helixor, 305 iscador, 305 kidney cancer treated with, 301302 lymphoma/lymphosarcoma treated with, 304-305 nervine uses of, 350 neurologic cancers treated with, 302 Vital force, 140, 276-277 Vitalism, 276 Vitex agnus-castus anticancer uses of, 301 description of, 510-512 dosage of, 511 drug interactions, 198t ectoparasiticidal uses of, 383 hyperadrenocorticism in horses treated with, 511 milk production affected by, 363 premenstrual syndrome treated with, 362, 510-511 Vitis vinifera, 200t, 299-300, 301, 570-574 Volatile oils definition of, 183 description of, 145 plants that contain, 183-184 properties of, 171 Vomiting and nausea, 343

Vulnerary, 382b Vulnerary herbs, 387-388 W Warts, 385 Watercress, 205t Waxes, 178 Wei Qi, 54 Wen-She decoction, 294 Western red cedar, 191t Wheat grass, 336 White ash tree bark, 383 White balsam, 383 White hellebore, 122, 383 White peony, 304 White sage, 269t White willow, 188-189 Wild carrot, 205t Wild celery. See Trachyspermum ammi Wild cherry, 661-662 Wild cherry bark, 369 Wild harvesting, 259-260, 260t-261 Wild indigo, 269t Wild lettuce, 352 Wild plants overharvesting of, 259-260 wildlife use of, 258-259 Wild yam analgesic uses of, 355 anti-inflammatory uses of, 344 description of, 269t, 302, 662-664 dosage of, 663 Wildcrafting, 222, 253 Willow bark, 205t, 343, 664-666 Wind-Cold, 56t Wind-Damp, 57t Wind-Heat, 56t Winter cherry. See Withania spp. Wintergreen, 205t Wintergreen oil, 191t, 192 Witch hazel, 205t, 383, 386, 666668 Withania spp. W. ashwagandha, 74t W. somnifera adrenal effects of, 320 anxiolytic uses of, 350-351 cancer uses of, 297-299, 299 cardiopulmonary effects, 476477 central nervous system effects, 476 chemoprotective activity of, 476 description of, 68, 71, 74t, 81t, 315, 354, 475-478 dosage of, 477 drug interactions, 196t hematologic and immunologic disorders treated with, 292, 476

713

Withania spp.—cont’d W. somnifera—cont’d immune-mediated hemolytic anemia treated with, 70 immunomodulatory effects of, 476 lymphoma/lymphosarcoma treated with, 305 nervine uses of, 348, 358 thyroid gland effects of, 323 Wogonin, 482f Wolfberry, 215 Wolf’s fruit, 8 World Health Organization, 18, 262 Wormseed, 191t Wormwood anthelminthic uses of, 328 drug interactions, 205t fibrosarcoma treated with, 303 safety of, 185 Shen Nong’s writings about, 34 synergistic properties of, 3 toxicity of, 191t Wound healing, 387-388 Wushier bingfang, 122 X Xie Qi, 54, 54t Xylem, 144 Y Yang, 51-52, 61 Yangonin, 586f Yarrow description of, 243, 252 diuretic effects of, 346 Yellow dock, 316, 345, 668-669 Yellow gentiana. See Picrorrhiza kurroa Yellow oleander, 205t Yerba mansa, 269t Yerba santa, 269t, 373, 669-670 Yi mu cao, 205t Yin, 52, 61 Yin yang huo, 205t Ying Qi, 54t Yohimbe, 189, 205t Yoko, 205t Yuan Qi, 54t Yucca (Yucca schidigera), 344, 670671 Yunnan Pai Yao, 294, 384 Z Zang-Fu Qi, 54t Zanthoxylum americanum, 311, 346, 628-629 Zea mays, 376-377, 379, 524-525 Zheng Qi, 54t Zhong Qi, 54t

714

INDEX

Zingiber officinale androgenic effects of, 321 antidiabetic effects of, 322 antiemetic uses of, 328-329, 560 antifilarial activity of, 560 anti-inflammatory uses of, 344 anxiolytic uses of, 351 Ayurvedic uses of, 69t, 74t, 81t

Zingiber officinale—cont’d cancer uses of, 301 constituents of, 74t description of, 559-562 dosage of, 561 drug interactions, 199t heartworms treated with, 313 oral tumors treated with, 304

Zizyphus, 24t, 348, 671-672 Zonal geranium, 384 Zong Qi, 54t Zoopharmacognosy definition of, 17 geophagy, 10-11 nature’s larder, 7-13 self-regulation, 7 Zootherapy, 269-270